Subject: Community Medicine
Topic: Activity: Barangay Health Workers Forum
Date: Feb 2, 2016
OUTLINE
I. BHW generalities
II. Tuberculosis
III. Expanded Program on Immunization
IV. Hypertension
V. Diarrhea
VI. Malnutrition
I. BHW generalities
 Barangay Health Workers (BHW) from Brgy San Perfecto, San Juan came
to class today for open forum in preparation for health-teaching
demonstration activity
o Health teaching activity: teach new Barangay Health Workers in City
UERM
 BHWs are trained in primary health care (3-day training). BHWs are
involved in everything that’s done in the health center.
o Proper nutrition of the child/proper feeding
o Re-weighing
o Clean surroundings
o First aid- for wounds
 BHWs should come from the community/barangay, recommended by the
captain to be a BHW
 9 BHWs in Brgy San perfecto. 50 families assigned per BHW. They follow
them up everyday.
1. Do you use IMCI? Is it effective? Helpful? Is there a better way of
assessment that can help you manage the child besides IMCI?
o IMCI (Under-5) is very much used by the BHWs. The charts states if the
child is severe, moderate, mild in severity.
2. Since there has been an ordinance passed that women are not allowed to
give birth at home, are there still mothers who give birth at home? How do
you find out and what do you do about it?
o There are no more home births (daw) because we advise them, if they
cannot go to the hospital due to the cost, there are lying in clinics
which are much cheaper. The mothers, when they go for prenatal
care, are aware that they are not allowed to give birth at home.
o If there are home-birth cases, they go to the health center for
vaccination (BCG and HepB). There, the midwife finds out why they
gave birth at home.
3. Acquirement of essential medicines: when do you get your supply, and
what are the usual medicines that get finished easily?
o For vaccines and medicines, they are supplied by DOH and are
dropped at CHO1 (at the city hall). The BHWs go there to get the
medicines.
o So far, there is NO supply of measles and polio
o Medicines for Hypertension and Diabetes Mellitus are free from the
barangay, but limited. Specifically, only those who are enlisted are
given free meds.
4. Are you (BHWs) the one conducting the 4Ps program?
o Yes, we are the one who identify them. So whenever there are
researches in the community, we get those enrolled in the 4Ps
program.
o What are the requirements for enrollment?
 Any person who cannot send their children to school can be
enrolled (Even if you’re old).
o How do you follow-up?
 We go from house to house and assess if the family enrolled in
the 4Ps program adhere to the rules of the program (and not use
the money for other stuff like for gambling).
o The money is sent to their bank account
Trans Group: yoj, hazel, mj, lyndon
Edited By: 3rd
5. In your community, what are the top health problems that you have
identified?
o Most common: cough and colds, fever
o Those taking maintenance medications (Htn, DM) supplied by the DO
are the ones we really follow-up
o How did you identify this problem?
 When the patient comes to us with Htn, we refer them right away
to the doctor, then the patient comes back to us for meds
o The programs that you implement in your community, are they based
on DOH programs or did you make these programs?
 We don’t really plan, we follow DOH orders
 They are implemented naman
o Are you (BHWs) the one that implement the program?
 We ask what the activity for the day is then implement it
o If there is a health seminar, who gathers the people, etc?
 We gather the people through house to house to come to the
lecture. But compliance is not really that good without incentives.
 There are people (not us) who facilitate these lectures
 Flyers for the activity of the day comes from the DOH
o Are the target groups (for the seminar) targeted?
 Yes, there are diligent people who really go to these seminars
o We sometimes require those enrolled in 4Ps (for family planning for
example) because they are the ones who have many children
 Seminar is conducted 2x a year at Family Dev office in city hall
 We give them options to choose what family planning to use
o What do you do with patients who are lost to follow up?
 We go to their houses and ask why they did not go back to the
Family development office and explain to them that they are
responsible for their children. Sometimes, we don’t leave their
house until they go to the family planning seminar.
5. Verbatim cause it’s more fun. “Ano po yung ligayang natatamasa niyo
bilang Barangay Health worker?” (what gives you a sense of joy and
fulfillment in being a BHW?)
o Pakain ni kagawad, okay na kami.
o Pay check – allowance only. We are not allowed to ask for more pay
etc.
6. Do you have support groups in the community?
o None, because they are quite few with DM or Htn or the like.
7. Does your health center have the capacity to take blood sugar?
o Yes we have a blood sugar kit
8. Do you have herbal medicines in your community?
o We used to have asitaba, oregano, okra etc before they got
flooded.
o Currently we have: lettuce, eggplant etc
II. Tuberculosis
1. Is there a program in your barangay for TB?
o We have the MTB program
o They have to be enrolled, with requirements of X-ray and DSSM. If
they are positive, we enroll them at DOH so they have a weekly supply
of free TB meds (4in1)
 Enrolment is confidential
 Enrolment also requires HIV testing
 DSSM and HIV testing is free.
 CXR is not free (no facility in the barangay)
o Follow up is also done by BHWs. If the patients do not go to the
barangay for follow-up, we go to their house and force them to drink
meds.
o One reason for non-compliance is they are ashamed of having TB.
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2. How do you monitor for TB? Are there lectures on TB?
o Some patients come to the center wanting TB treatment but are
negative for sputum test and CXR
o If there’s a memo asking us to conduct a lecture, we do it
III. Expanded Program on Immunization
1. How do you address wrong beliefs about vaccination?
o None encountered in the barangay
o Wednesday is vaccination day. They look at baby book. At hospital or
st
lying in, once they are born, they are given HCG and 1 dose of HepB
IV. Hypertension
1. is there BP monitoring in the health center?
o Yes we have BP apparatuses and we have to use them
o If we find out that they have high BP, we refer them to the doctor
o Then they go back and enroll for free meds (they are not allowed to
sell meds)
 Meds available: Metformin, Amlodipine, Metropolol, Simvastatin,
Aspirin, Catapres
o Are there activities in your barangay that address exercise or lifestyle?
 Every morning at the city hall 6-7am there’s walking and cumba
 Do you monitor if they exercise?
 Some, the others you can’t really force them because they
are aged
 So there’s no exercise program in your barangay?
 Currently stopped due to flooding (materials and tools were
destroyed)
2. Are there programs for Htn in your barangay?
o We have BP monitoring, then we ask if they have medications, and if
they have, do they drink them. If they don’t drink them, we ask them
why (sometimes they just forget).
o How do you enroll for free meds?
 We ask first what is the source/reason of Htn
 We enroll them
 Supply of meds comes from DOH (refer to free meds above)
3. How waste management controlled in the community especially in the
slum areas?
o We have provided free 1 month de-sludging of all houses in the
barangay. (after 1 month, may bayad na)
o For stray dogs that poop, they report to the city hall to get the stray
dogs and cats.
o For garbage disposal, we go to the garbage corners and make sure the
garbage is picked up by the truck (usually in the morning)
V. Malnutrition
1. What are your on-going programs for malnutrition and are they effective?
o We have a feeding program
 Then after 6 months, we re-weigh the children.
 If child is still malnourished, we continue feeding program, give
vitamins and re-weigh again
 If the child’s weight is back to normal, we just follow up
 Feeding happens everyday for 6 months
 Food comes from the nutrition office of city hall
o Is it successful?
 Yes it’s closely monitored by the nutrition office
 We BHWs go door to door with the nutritionist to identify
malnourished children
o Do you do health teaching among the parents about malnutrition?
 Yes, we have a mother’s class and we teach them about nutrition,
proper cooking and proper food to give their children
 If they don’t take care of their children well, then it’s not the
barangay’s problem anymore
 There are cases wherein after the feeding program, the weight of
the child goes back to normal then when the feeding program
stops, the child becomes malnourished again.
 There are some mothers that just depend on the feeding and they
don’t cook at home. We advise them to cook at home.
~ END ~

V. Diarrhea
1. As BHWs, what do you do to address the problem of diarrhea? How do
you start addressing sanitation problem?
o First thing when a diarrhea case comes in: refer to doctor
 If there’s no doctor around, we give ORS (from the health center
supply)
o Sanitation
 We go first to the patient’s home and ask why the patient has
diarrhea
 Assess environment especially in a depressed area – if there’s a
proper bathroom/comfort room
 “Flying saucer style” (She did not really elaborate. This is likely
a type of latrine)
 Advice to dig a hole in the ground and put a toilet bowl
o Advice the parents to:
 Bathe their children everyday
 Wash hand before eating
 As much as possible their belongings are not infested by
cockroaches, lizards or rats

2. What is the incidence of diarrhea in your area? And what’s the most
common cause?
o Almost none in a month
o Their previous case of diarrhea (1 y/o, malnourished), the parents
bought “lutong-ulam” (food from an outside and likely contaminated
source)
 They advised parents to cook themselves because outside food
has a lot of betchin and decreased nutrition
 Their house is also not ventilated with 3 families

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