ACCESSIBILITY AND QUALITY OF HEALTH CARE SERVICES

PROVIDED AMONG RESIDENTS IN BARANGAY

TEJEROS, ROSARIO, CAVITE

Undergraduate Thesis
Submitted to the Faculty of the
College of Nursing
Cavite State University
Indang, Cavite

In partial fulfilment
of the requirements for the degree
Bachelor of Science in Nursing

MARK NEIL MESA

MARIA ANGELICA SALVACION D. NACOR
ROXETTE M. OCAMPO
March 2021
 TABLE OF CONTENTS

Page

BIOGRAPHICAL DATA…………………………………………………………

ACKNOWLEDGEMENT………………………………………………………..

ABSTRACT……………………………………………………………………….

LIST OF TABLES………………………………………………………………...

LIST OF FIGURES……………………………………………………………….

LIST OF APPENDICES………………………………………………………….

LIST OF APPENDIX TABLES………………………………………………….

INTRODUCTION…………………………………………………………… ….. 1

Statement of the Problem………………………………………………….. 5

Objectives of the Study……………………………………………………. 6

Hypothesis…………………………………………………………………. 7

Significance of the Study…………………………………………………... 7

Time and Place of the Study……………………………………………….. 9

Scope and Limitation of the Study………………………………………… 9

Definition of Terms………………………………………………………... 10
 Theoretical and/or Conceptual Framework of the Study………………….. 10

REVIEW OF RELATED LITERATURE……………………………………… 14

METHODOLOGY……………………………………………………………….. 25

Research Design…………………………………………………………… 25

Participants of the Study…………………………………………………… 26

Sampling Technique………………………………………………………… 26

Research Instrument……………………………………………………….. 26

Validation of Research Instrument………………………………………… 27

Ethical Considerations……………………………………………………… 27

Data Gathering Procedure………………………………………………….. 27

Statistical Treatment………………………………………………………... 28

REFERENCES……………………………………………………………………

APPENDICES……………………………………………………………………
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ACCESSIBILITY AND QUALITY OF HEALTH CARE SERVICES
PROVIDED AMONG RESIDENTS IN BARANGAY
TEJEROS, ROSARIO, CAVITE

Mark Neil Mesa

Maria Angelica Salvacion D. Nacor
Roxette M. Ocampo

An undergraduate thesis submitted to the faculty of the College of Nursing, Cavite State
University, Indang, Cavite in partial fulfillment of the requirements for the degree of
Bachelor of Science in Nursing with Contribution No. SP CON. Prepared under the
supervision of Mr. Rolando P. Antonio, RN., MAN.

INTRODUCTION

Health status and the need for health-care services to improve or maintain health

are major determinants of health-care utilization. The World Health Organization states

that health is determined by a person’s individual characteristics and behaviors, physical

environment, and socioeconomic environment (WHO, 2017).

A health care delivery system is an organization of people, institutions, and

resources to deliver health care services to meet the health needs of a target population

(Cohen, et al., 2015). The healthcare delivery system in the Philippines is dominated by

the public sector (regional, provincial, municipal, and barangay level) while being
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supported by private healthcare service providers. The implementation of Universal

Health Care (UHC) is already driving the demand across all sectors of healthcare (Frost

& Sullivan, 2017).

Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan (KP),

is the “provision to every Filipino of the highest possible quality of health care that is

accessible, efficient, equitably distributed, adequately funded, fairly financed, and

appropriately used by an informed and empowered public”. It is a government mandate

aiming to ensure that every Filipino shall receive affordable and quality health benefits.

This involves providing adequate resources – health human resources, health facilities,

and health financing. To attain UHC, three strategic thrusts are to be pursued, namely: 1)

Financial risk protection through expansion in enrollment and benefit delivery of the

National Health Insurance Program (NHIP); 2) Improved access to quality hospitals and

health care facilities; and 3) Attainment of health-related Millennium Development Goals

(MDGs) (DOH, 2018).

The absence of a facilitated referral system robs the patient of the opportunity to

navigate the health system effectively. The referral system can cut short waiting times,

lead to timely care, prevent duplication of diagnostic tests and procedures, and even

improve the course of treatment. But patients often bypass the first (primary care) level to

seek care in hospitals, as there is no effective referral system or gatekeeping at the

primary care level, which also contributes to inefficiencies and increasing cost of care

(Dayrit, 2018).

With the population of 105 million in the Philippines, Cavite has a population

density of 2,754 individuals per square kilometer. Rosario is the densest city/municipality
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in Cavite with 20,929 individuals per square kilometer. The 2017 projected population in

Cavite is 3, 937,445 and 118,666 is from Rosario (Cavite Ecological Profile, 2017,

chapter 3, p. 21). To meet WHO standards, it should have 525,000 hospital beds. With

the minimum standard of at least 100 beds for a provincial or general hospital, it should

have a total of 5,250 hospitals. Sadly, based on data from the 2018 National Health

Facility Registry of the Department of Health, the Philippines only has 1,456 hospitals.

Only 32 percent of these are government hospitals, and 58 percent of these government

hospitals are in Luzon, 17 percent are in the Visayas and 19 percent are in Mindanao

(Palafox, 2020). The province of Cavite has 55 licensed hospitals providing health

services of which 43 hospitals (78.18%) are private owned and 12 hospitals (21.82%) are

government owned operated hospitals. In 2017, Operating RHUs in the province increase

from 38 to 46. The municipal of Rosario has no Government Hospital and has only 1

Rural Health Unit (RHU) and 21 barangay health stations with a projected population of

118, 666 (Cavite Ecological Profile, 2017, chapter 3, p. 21).

In terms of human resources for health, the top four cadres of institution-based

health workers are nurses (90 308), doctors (40 775), midwives (43 044) and medical

technologists (13 413). The public sector engages a higher proportion of nurses (61%),

midwives (91%) and medical technologists (53%) (Dayrit, 2018). Regional and

socioeconomic disparities in the availability and accessibility of resources are prominent.

There is maldistribution of infrastructure and human resources across and within regions.

Philippines is a major exporter of health-care professionals but finds it challenging to

ensure adequate availability within the country (Kenworthy, 2017). In Cavite, there are

63 doctors, 45dentists, 202 nurses and 343 midwives employed in the city/municipal
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health offices. These resulted in the municipal of Rosario to the doctor-population ratio of

1:59,333, nurse-population ratio of 1: 9,889, midwives-population of 1: 1680 and dentist

population ratio of 1:39,555. (Cavite Ecological Profile, 2017, chapter 3, p. 21).

The introduction of social health insurance administered by the Philippine Health

Insurance Corporation (PhilHealth) since 1995 aimed to provide financial risk protection

for the Filipino people. The rapid expansion of its membership in the past 5 years is

considered a positive development as the Government pursues universal health coverage.

The country has a mixed health system with an expanding private sector. However, there

is no effective mechanism to regulate private for-profit health-care providers. More than

50% of the total health spending is out of pocket. Coverage by the Philippine Health

Insurance Corporation (PhilHealth) has increased over the years, but not all the eligible

members are aware of the benefits of the program. There is no effective mechanism in

place to monitor the accreditation of facilities, and regulate the cost and quality of

services (Dayrit, 2018).

Background of the study

Health is a basic human right guaranteed by the Philippine Constitution of 1987.

This is provided in the Philippines through a dual health delivery system composed of the

public sector and the private sector. The public sector is largely financed through a tax-

based budgeting system, where health services are delivered by government facilities

under the national and local governments. The Department of Health (DOH) supervises

the government corporate hospitals, specialty, and regional hospitals, while the

Department of National Defense runs the military hospitals. At the local level, the

provincial governments manage and operate district and provincial hospitals, while
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municipal governments provide primary care, including preventive and promotive health

services and other public health programs through the rural health units, health centers

and barangay health stations. Highly urbanized and independent cities provide both

hospital services and primary care services. The private sector, consisting of for-profit

and non-profit health-care providers, is largely market oriented, where health care is

generally paid for through user fees at the point of service. The introduction of social

health insurance administered by the Philippine Health Insurance Corporation

(PhilHealth) since 1995 aimed to provide financial risk protection for the Filipino people.

The rapid expansion of its membership in the past 5 years is considered a positive

development as the Government pursues universal health coverage (Dayrit, 2018).

Health outcomes are generally improving, but the stagnant maternal mortality

ratio and neonatal mortality rate, and the sluggish rate of improvement in health

outcomes compared to neighboring countries, are worrisome. Many Filipinos suffer from

diseases that are preventable and treatable with cost-effective interventions.

Addressing health system inefficiencies and health inequities due to disorganized

governance, fragmented health financing, and devolved and pluralistic service delivery

remain critical challenges to the Philippine health system. For instance, PhilHealth, DOH

and LGU health facilities are spending on the same maternal and child health services

while the growing cases of non – communicable diseases, including the emergency care

these conditions often require, are inadequately funded and poorly prioritized. Parallel

funding by three sources (DOH, PhilHealth and LGU) and lack of demarcation and

harmonization in premium-funded benefits versus tax funded services are the primary

reasons for confusion and inefficiencies in Philippine health-care financing. Additionally,

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engaging the private sector in delivering health care in the UHC context requires strong

regulatory capacity, not only by using command and control mechanisms but also by

leveraging financing incentives. The impact of these strategies has, however, yet to be

developed and harnessed (Dayrit, 2018).

Given the problem in accessing health care delivery system and the health status,

the researchers will conduct this study among residents in barangay Tejeros, Rosario,

Cavite.

Statement of the Problem

Generally, this study aims to determine the factors in accessing health services

and health status among residents in barangay Tejeros, Rosario, Cavite.

Specifically, this study answers the following:

1. What is the socio demographic profile of the respondents in terms of:

a. Age;

b. Sex;

c. Civil Status;

d. Educational attainment;

e. Religion;

f. Occupation; and

g. Monthly Family Income

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2. What are the respondents perceived factors that affect the health care delivery

in terms of:

a. Availability;

b. Affordability;

c. Accessibility;

d. Accommodation; and

e. Acceptability

3. What are the health care services being provided among residents in barangay

rural health unit at Tejeros, Rosario, Cavite in terms of:

a. Counselling and support services;

b. Health promotion services;

c. Medical and nursing services; and

d. Dental health

4. What is the quality of health care services being rendered in terms of:

a. Effectiveness;

b. Safety;

c. People-centered;

d. Timeliness;

e. Equitability;

f. Integrated; and

g. Efficiency

h. Communication;

i. Health Teaching;
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j. Time Management;

k. Equitability

5. Is there a significant relationship between the respondents perceived factors in

the delivery of healthcare services when group according to their demographic

profile?

Objectives of the Study

Generally, this study aims to determine the factors in accessing health

services and health status among residents in barangay Tejeros, Rosario, Cavite.

Specifically, this study aims the following:

1. Describe the socio demographic profile of the respondents in terms of:

a. Age;

b. Sex;

c. Civil Status;

d. Educational attainment;

e. Religion;

f. Occupation; and

g. Monthly Income

2. Identify the respondents perceived factors that affect the health care delivery

in terms of:
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a. Availability;

b. Affordability;

c. Accessibility;

d. Accommodation; and

e. Acceptability

3. Determine the health services being provided among residents in barangay

rural health unit at Tejeros, Rosario, Cavite in terms of:

a. Counselling and support services;

b. Health promotion activities;

c. Medical and nursing services;

d. Dental health;

4. Describe the quality of health care services being rendered in terms of:

a. Effectiveness;

b. Safety;

c. People-centered;

d. Timeliness;

e. Equitability;

f. Integrated; and

g. Efficiency

h. Communication;

i. Health Teaching;

j. Time Management;

k. Equitability
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5. Determine if there is a significant relationship between the respondents

perceived factors in the delivery of healthcare services when group according

to their demographic profile.

Hypothesis

The researchers came up with hypothesis such as:

Ho1 – There is no significant relationship between the respondents perceived

factors in the delivery of healthcare services when group according to their demographic

profile.

Significance of the Study

This study will be beneficial to the following individuals, groups and institutions:

Respondents. Result of this study will help residents who are experiencing lack

of health services to motivate involvement in ensuring their safety and access right to

receive optimum care from health care provider. To give information about the

accessibility, efficiency, effectiveness and acceptability of the health services in the

certain area.
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Family of respondents. The result of this study will involve the family in

decision making on how they will access health care services efficiently and effectively.

This will improve their health status by accessing the health services being provided by

the Rural Health Unit and other health care providers without considering the factors

affecting health care access.

Health Care Providers. This includes the physician, nurses, medical

technologists, midwives and others. The study will aim at providing information that can

be beneficial in developing ways to characterize the problems and identifies the potential

for avoidable mortality and morbidity as well as to determine the health problems and

risk factors exist in a given population and patterns of care.

Nurses. The study will help nurses in able to provide quality care to individuals,

families and groups within the geographic area. This will provide information on how to

educate and treat a community by considering the facilitating factors that serves as a

hindrance to the residence.

Rural Health Unit and the Staffs. Result of this study will help to reduce gaps

by differences in race and ethnicity, location, social status, income and other factors that

can affect health. This will also help to mitigate disparities, increase access to care,

improve quality of care, and lower healthcare costs.

Government Officials. The study findings will enhance the government officials’

plan on delivering health service to the community more accessible, efficient and

effective by putting great emphasis on the barriers and facilitating factors as well as the
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acceptance of the community to the given health care service to provide optimal care,

comfort and promote wellness.

Health Educator. The study will help in providing wellness information to the

public about health and safety concerns that may be specific to the community. It will add

to their information to really identify and address trends within a population.

College of Nursing and Nursing Students. The result of the study will help the

College of Nursing in terms of health education and health promotion. It will serve as a

way to help students overcome the factors in accessing health services when they are

expose to community area.

Clinical Instructor. Results of this study will help in teaching and building the

students’ knowledge, skills, and positive attitudes about health that they will use in the

future.

Community. The study will help the community to improve their quality of life,

preventing and managing disease, and health promotion by addressing the gaps present

within the area.

Future Researchers. It may add literature which discusses perceived factors in

accessing health service to government officials, health care providers, community and

students who have interest to have a further study.

Time and Place of the Study

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The study will be conducted from March to June 2021 in barangay Tejeros, Rosario

Cavite. 

Figure 1. Map of Rosario, Cavite

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Figure 2. Map of Tejeros

Scope and Limitations of the study

This study will focus on factors in accessing health services and health status

among residents in barangay Tejeros, Rosario, Cavite.

All the information will include the response of the respondents through

questionnaires. The set of questions will cover the profile of the respondent, data about

the perceived factors, and the status of the health service in chosen barangay. On the

other hand, the researchers will gather the data through an online survey where a set of

survey questions will be sent to a target sample. The members of this sample can respond

to the questions over the internet. Respondents receive online surveys via various

mediums such as messenger or google forms. 

Definition of Terms

For better understanding, the following terms will be defined operationally.

Affordability. Determined by how the provider's charges relate to the respondent’s

ability and willingness to pay for services.

Availability. Measures the extent to which the provider has the requisite resources, such

as personnel and technology, to meet the needs of the respondents.

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Accessibility. Determined by how easily the respondent can physically reach the health

care provider's location.

Accommodation. Reflects the extent to which the provider's operation is organized in

ways that meet the constraints and preferences of the respondents.

Acceptability. Captures the extent to which the respondent is comfortable with the more

immutable characteristics of the provider, and vice versa.

Barriers to health services. It refers to anything that restricts the use of health services

by making it more difficult for some individuals to access, use or benefit from care.

Facilitating Factors in Accessing Health Services. It refers to something that actively

contributes to the production of a result of accessible health services.

Health Services. It refers to service that provides medical treatment and care to the

public or to a particular group. the cost-effective delivery of health services to remote

areas.

Health Status. A respondent’s relative level of wellness and illness, taking into account

the presence of biological or physiological dysfunction, symptoms, and functional

impairment.

Rural Health Unit. Provides the basic health services for the population and serves as

the main source of free basic healthcare for rural communities.

Add the additional variables

Theoretical Framework
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This study will be based on System Model Theory by Betty Neuman (1924-

present) and Health Belief Model by Irwin M. Rosenstock, Godfrey M. Hochbaum, S.

Stephen Kegeles, and Howard Leventhal.

The Health Belief Model by Irwin M. Rosenstock, Godfrey M. Hochbaum, S.

Stephen Kegeles, and Howard Leventhal is a theoretical model that will be used to guide

health promotion and disease prevention programs. It will be used to explain and predict

individual changes in health behaviors.

The Neuman Systems Model is a system-based conceptual paradigm that offers a

detailed overview. Originally intended for use by nurses, it can also be used by other

health care practitioners. The Neuman Framework Model is universal and adaptable to a

wide range of conditions. It can also be interpreted in a number of ways.

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Figure 3. Betty Neuman’s System Model

In figure 3, the Betty Neumann’s system model portrays the client from a holistic

and multi-dimensional viewpoint within the structure. It portrays the components of live

interacting client variables such as physiological, psychological, developmental,

sociocultural, and spiritual effects on the client as a system with basic structure, lines of

resistance, and lines of protection in relation to environmental influences.

Figure 4. The Health Belief Model by Rosenstock et., al

In figure 4, the key elements of the Health Belief Model focus on individual

beliefs about health conditions, which predict individual health-related behaviors. The

model defines the key factors that influence health behaviors as an individual's perceived
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threat to sickness or disease (perceived susceptibility), belief of consequence (perceived

severity), potential positive benefits of action (perceived benefits), perceived barriers to

action, exposure to factors that prompt action (cues to action), and confidence in ability to

succeed (self-efficacy).

In this study, action are the health services being provided by the barangay that

also affects the health status of the respondents. The subjective assessment perceived by

an individual are the perceived factors that affects the health care delivery which include

the availability, affordability, accessibility, accommodation, and acceptability. These

factors may affect the decision making and presents different results that will have an

impact on the health status of the residents in terms of past illness and present illnesses.

It will identify key decision-making points that influence health behaviors and

status such as gathering information by conducting a health needs assessments and other

efforts to determine who is at risk and the population(s) that will be targeted. Conveying

the consequences of the health issues associated with risk behaviors in a clear and

unambiguous fashion to understand perceived severity. Communicating to the target

population the steps that are involved in taking the recommended action and highlighting

the benefits to action and providing assistance in identifying and reducing barriers to

action. Lastly, demonstrating actions through skill development activities and providing

support that enhances self-efficacy and the likelihood of successful behavior changes and

improving health status.

Conceptual Framework

Input Process Output

ographic Profile
e

il status
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rceived Factors
Online Survey using  Quality Services
Availability
Affordability Regarding Health
Google forms
Accessibility
Accommodation
Acceptability

Care Service Quality

ctiveness
y
le-Centered
liness
table
munication
th Teaching
Management
table

Figure 5. The Conceptual Framework of The Study

Figure 5 presents the three major research variables. It conceptualized the selected

barangay in Cavite and its relationship with health care assessment in terms of

availability, affordability, accessibility, accommodation and acceptability. It also

indicates that the demographic profile of the residents would havse a significant effect on

the healthcare assessment regarding the age, sex, civil status, occupation, and monthly

income.
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Furthermore, health care service quality roles as an informative variable which

will determine how respondents view the quality of care provided within the community.

In which, an individual’s capacity may vary according to their convenience, as well as the

accessibility of health services. Thus, this factors and barriers may have an impact on the

outcome of decision making among the residents.

 REVIEW OF RELATED LITERATURE

Ayusin hahhahaha

HEALTH CARE SERVICES PHILIPPINE

This chapter contains information gathered from books, journals, websites, and

other theses either foreign and local which provided sufficient background and

knowledge related the perceived factors in accessing health care delivery among residents

in barangay Tejeros, Rosario, Cavite.

Rural residents have a lot of problems accessing health services. These

disadvantages result in higher morbidity and mortality compared to those of their urban

counterparts (Hernandez,2020).

Rural residents receive lower quality health care and have worse results on several

scores compared to urban and suburban dwellers. Physician shortages, poverty, a greater

number of uninsured and long-distance travel are compounded by major disparities in

health equality between urban and rural areas (Hernandez, 2020).

The complex circumstances in which people are born and live that have an effect on

their wellbeing are considered Social Determinants for Health. These include intangible

factors such as cultural construction, environmental, socio-economic and on-site

conditions, including accessible health and education services, availability of nutritious

food and a safe environment (Esparagoza, 2020).

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The government of the country has committed $3.2 billion to the health sector.

This is an improvement of 12% from the budget for 2019. According to Healthcare Asia,

some $1.3 billion (PHP67.4 billion) went to the Philippine Health Insurance Agency,

$1.1 billion (PHP59.6 billion) went to medical facilities, and the remaining $670 million

(PHP34.2 billion) went to public health services (Folger, 2020).

The standard of state-subsidized public health care in the Philippines, while nice,

varies widely between rural and urban areas. Private healthcare in the Philippines has

even more reliable services and hospitals tend to be well prepared than the public

(Allianz Care, 2020). The standard of public health coverage differs directly from the

average income in these areas; urban areas tend to have a higher average income than in

rural areas (Prasad, 2020).

WHO reports State of the World Nursing 2020 predicts that, without intervention,

there will be a shortage of 4.6 million nurses worldwide by 2030. In the Philippines, the

estimated shortage of nurses is predicted to be 249,843 by 2030, unless further

commitment is made to keep them in the Philippine health sector (Tanggol, 2020).

The current universal health care system, PhilHealth, pays for the sick, subsidizes

those who are unable to pay for medical treatment and provides similar assistance to

those who are also financially stable. Unfortunately, with the abundance of citizens in the

country and limited government funding, PhilHealth is struggling to provide medical

financial assistance to every citizen (Prasad, 2020). The agency’s mandate is “to provide

health insurance coverage and ensure affordable, acceptable, available, and accessible

healthcare services for all citizens of the Philippines”, (Folger, 2020).

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The Philippines (as of April 2020) has a population of about 100 million and

PhilHealth also covers all of the expenses of seven million of these people. PhilHealth

provides a wide range of services, including non-emergency operations and inpatient

care, but does not include routine hospital costs. This leaves a health deficit for low-

income earners in the Philippines (Prasad, 2020).

Any organization services, or products that desire growth and sustainability in the

hypercompetitive environment of the 21st century, must be able to provide services and

products that can meet the ever-changing needs of client. To be able to gain competitive

advantage, an organization must provide quality services that can engender customers’

satisfaction and loyalty (Fuxman, et al., 2019).

Access barriers to health care are an international phenomenon. Poverty in low-

income countries has been identified as a crucial component of low access, emphasizing

the importance of the financial barrier (Santalahati et., al., 2020).

Compared to those with health insurance coverage, people without health

insurance are more likely to miss medical attention and say that they do not have a

regular provider of health care. Adults that are uninsured are more than three times more

likely than covered adults to report their own health to a physician or other health care

provider or facility in the last 12 months. And while insured and uninsured individuals

who are hospitalized or newly diagnosed with a chronic illness have comparable

arrangements for follow-up treatment from their providers, people with no insurance

benefits are less likely to receive all the recommended treatments than those with

coverage (Damico, et al., 2019).

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Inadequate health insurance coverage is one of the greatest barriers to access to

health care and the uneven distribution of coverage contributes to health inequalities.

Out-of-pocket medical care costs may lead individuals to delay or forgo the care they

need (such as doctor visits, dental care, and medications), and medical debt is common to

both insured and uninsured individuals. Vulnerable populations are particularly at risk of

inadequate health insurance coverage; low-income people are often uninsured, and

minorities account for more than half of the uninsured population (Damico, et al., 2019).

The lack of health insurance coverage may have a negative impact on health.

Uninsured adults are less likely to receive preventive treatment for chronic conditions

such as diabetes, cancer, and cardiovascular disease. Similarly, children without health

insurance coverage are less likely to receive appropriate treatment for conditions such as

asthma or critical preventive services such as dental care, immunization, and well-child

visits that track developmental milestones (Damico, et al., 2019).

Geographically isolated regions are often connected to inadequate basic services

and facilities such as schools, sanitation, electricity and clinics or health centers. Many of

these conditions have led to the deaths or ill health conditions of poor children.

Moreover, in comparison to the population of higher economic groups, constructive

health-seeking activity among the vulnerable is not detected (Collado, 2019).

Systematic inequalities in access to and utilization of healthcare facilities and/or

insurance funding equity lead to health inequities. Although equality is inherent in

universal health care (UHC), there is also a possibility that weaker, less-favored

communities will be left behind unless health services are adequately concentrated on

assessing equity. It is important to consider whether UHC strategies close rather than
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expanding gaps in the utilization of health facilities and health outcomes, and whether

planning and evaluation procedures are carried out in a pro-equity way (McCollum et.,

al., 2019).

Differences of access to healthcare among diverse communities are the key reason

for the current gaps in healthcare provision. These include main factors such as lack of

health insurance, lack of financial resources, structural/geographic barriers, lack of health

care providers and age (Mandal, 2019).

Health insurance seems to be the difference between when and where people have

the required medical treatment, where they get their services, and, eventually, how safe

they are. Uninsured individuals are much more likely than those with benefits to delay or

ignore health coverage entirely. Consequences can be severe, particularly if preventable

illnesses or chronic diseases are not detected (Damico, et al., 2019).

One major cause of inequity in access to health services is the cost associated with

obtaining healthcare and the inability of disadvantaged populations to pay, also referred

to in the literature as financial barriers to health care. Lack of available finance is a

barrier to healthcare for many residents but access to healthcare is reduced most among

minority populations (Mandal, 2019).

Transportation barriers lead to rescheduled or postponed meetings, delayed treatment

and missed or delayed use of medications. These effects can contribute to poorer

treatment of chronic disease and thus poorer health outcomes (Romero, 2019).

A research carried out by the Philippine Nurses Association in 2017, indicates that

the majority of registered nurses are either overseas (about 150,000) or employed in other
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sectors, such as call centers (roughly 30,000). Overall, the country's health care worker-

to-population ratio is less than half the World Health Organization (WHO) standard, with

45 healthcare workers per 10,000. Our ratio is only 19 per 10,000 (Chanco, 2019).

Older patients often live on a limited income and cannot afford to pay for their health

care. Older people are often more likely to face travel issues or to suffer from a lack of

mobility, which can have an effect on their access to healthcare (Mandal, 2019).

Fairness and justice are central issues of health equity and basic health coverage.

Low population density and populations spread over large geographical distances

contribute to costly transportation. Higher costs for the transport of patients and

healthcare professionals and for the supply of medical services and facilities are expected

to serve these wide regions. Increased use of air travel has been found to be widespread

and expensive, especially within North America. Private service providers in the northern

areas of British Columbia, Canada, were found to have started to withdraw from areas

deemed too costly, leading to service closures in some communities. Increasing costs will

jeopardize the sustainability of healthcare (S. Huot et., al., 2019).

Globally health is regarded as a human capital and thus healthcare delivery is

treated as of crucial importance to all communities. Both non-price and price factors play

a significant role in determining the patient’s choice for healthcare delivery providers.

Recently public hospitals have shown to face fairly growing community expectations,

though they still perceived to have low quality healthcare. It has been observed in

public hospitals that health service provision is constrained by a number of factors

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including poor infrastructure, unavailability of medicine s and medical equipment

and limited human resources (Mwaseba, 2018).

Patients often complain of long waiting time, majorly due to a significant

disparity between patient and medical staff ratio (too many patients for too few medical

staff). Communication between patients and medical staff is often poor, and sometimes

the experiences between patients and medical staff are so poor that a switch from one

hospital to another or from one physician to another becomes necessary with a few

choices available for the patients (Adepoju, 2018).

Patient access to healthcare is the basis for all interactions between patients and

the health care system. When the patient is unable to access the healthcare provider, it is

impossible to obtain medical attention, to establish a partnership with the health care

provider and to achieve optimal patient well-being. In spite of this significance, access to

patient care is not a reality for many patients around the world. There are also obstacles

of obtaining health services between the problems of scarcity of appointments and the

difficulty of seeking transportation to the hospital (Sara Heath, 2018).

Low incomes pose a number of problems for families and children, with access to

health care being the most complex and prevalent. And there are many barriers for low-

income families to have access to quality health care, health insurance issues and the

scepticism of health care providers. Each dilemma is triggered by a multitude of factors

affecting disadvantaged subgroups of low-income families (Davenport & Lazar, 2018).

It is crucial for clinicians to consider how high out-of-pocket costs can have an effect on

patient use, how inadequate access can have an impact on public health, and what role
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healthcare organizations can play in partnering with consumers to minimize cost

pressures and help them take advantage of the benefits that are required (Sara Heat,

2018).

Extensive attempts have been made to enhance the delivery of health care in the

country, but there remain substantial geographical and socio-economic inequalities in the

affordability and accessibility of facilities. Infrastructure and human capital are under-

distributed throughout and within areas that are clustered in Manila Metro and other

major cities (WHO, 2018).

Coverage by the Philippine Health Insurance Corporation (PhilHealth) has

increased over the years, but not all the eligible members are aware of the benefits of the

programmed. There is no effective mechanism in place to monitor the accreditation

facilities and regulate the cost and quality of services (WHO, 2018).

Inequity in health status and access to services are considered the most important

health problems in the Philippines – arising from structural defects in the basic building

blocks of the Philippine health system. These are governance-associated challenges that

serve as an impetus for the recent health reform efforts in the country. (Dayrit, et al.,

2018).

The issue of inequity continues to persist as health care coverage remains out of

control for many residents in rural and remote areas. The lack of an integrated health

network has had a negative effect on economic and geographic access, as well as on the

quality and efficiency of health care (De Guzman, 2018).

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As conceived by Penchansky and Thomas, access reflects the fit between

characteristics and expectations of the providers and the clients. They grouped these

characteristics into five A’s of access to care: affordability, availability, accessibility,

adequacy, and appropriateness (McLaughlin, 2018).

Lack of access to affordable medical care ensures that families are left without the

information, services and treatment they need in order to have a healthier life. Lack of

access to health care has negative long-term impacts on individuals and communities.

Low income and uninsured people are most likely to encounter unfavorable health effects

and are more likely to die early (CCI Health and Wellness Services, 2020). Barriers to

health services may be insurmountable for low-income families, even those with

insurance coverage. Patients who do not seek care at a family medicine facility do not

typically undergo treatment elsewhere (Angier et al., 2017).

The mandate for providing health services is shared by the National and local

governments. The DOH sets policies, standards and guidelines at the national level for

public health programs. These vertical programs8, including for immunization, TB

control, family planning and many Others, are implemented at the local government level

by provinces and municipalities that comprise the devolved health system (Dayrit, et al.,

2018).

Public and private health-care facilities exist for all levels of care, primary to tertiary.

Citizen access to these facilities is determined by individual preferences, geographical

location and ability to pay (Dayrit, et al., 2018).

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Public health services are availed of more by the poor than by the rich; thus,

inefficiencies in delivering public services have a greater negative impact on the poor

who rely on them. The rich more frequently seek health services in private facilities to get

better quality but more expensive services. Private hospitals and clinics can be found in

highly urbanized areas as well as in rural settings; remote areas are largely dependent on

government services (Dayrit, et al., 2018).

Department of Health (2017), including the Philippine Health Insurance

Corporation (PhilHealth), obtained funding of P167.9 billion, up 12.3 per cent from 2016.

However, access to secure and affordable healthcare, along with a lack of healthcare

providers and insufficient technology, remains a daily barrier for most of our people.

Variations in perceived responsiveness across socio-economic groups and

geographic areas can be due to disparities between the level of health care that the lower

socio-economic classes can afford and the quality of health care that the public health

care provider (HCP) or health care facility (HCF) can provide (Jimeno & Onagan, 2017).

World Health Organization (2017), despite progress towards health in the

Americas, tends to exclude and lack of access to quality care for significant parts of the

population. It is projected that 30% of the population may not have financial access to

healthcare; 21% are removed from the search for regional barriers. In 2010, the

approximate out-of-pocket payments made by 103 million people accounted for more

than 10% of total household consumption or income (11.1% of the population of the

area) and by 17.5 million accounted for 25% of total household consumption or income

(1.9 percent of the population).

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The WHO refers to the Filipino Healthcare System as “fragmented”. There is a

history of unfair and unequal access to health services that significantly affects the poor.

Out of the 90 million people living in the Philippines, many do not get access to basic

care (Kenworthy, 2017).

Access to medical care also depends on race, ethnicity, socio-economic status,

age, sex, disability status, sexual orientation, gender identity and residence status. Ideally,

people should be able to easily and confidently access services such as primary care,

dental care, mental health, emergency care and public health services (Muller, 2016).

There have been widespread efforts to improve health service delivery in the

country, but regional and socioeconomic disparities in the availability and accessibility of

resources are prominent. There is maldistribution of infrastructure and human resources

across and within regions, which are concentrated in Metro Manila and other major cities.

Philippines is a major exporter of health-care professionals but finds it challenging to

ensure adequate availability within the country (Kenworthy, 2017).

Residents in rural areas need to travel longer distances to access different points

of the health care delivery system. Health care facilities in these areas are small and often

offer limited services. Often due to geographical distance, extreme weather conditions,

environmental and climatic barriers, lack of public transport and difficult roads, rural

residents may be restricted or prohibited from accessing health care services (Muller,

2016).

Studies have found that the Internet is the most common source of human health

information. The Internet is found to be a widely used source of information to resolve

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communication issues (inadequacy to clarify symptoms) and to mistrust health care

professionals in receiving health facilities. The global value of the Internet for wellbeing

remains questionable. However, there is no mechanism to monitor the credibility of web

providers of health information. (Gonah 2016).

Poverty is one of the barriers that can affect the health of patients. It is an

insidious, self-perpetuating problem that affects generations of families. Beginning

throughout the uterus and moving forward throughout one's life, poverty affects health

through complex mechanisms. Poverty is affected by life expectancy, literacy skills,

health habits and risks to disease growth, as are opportunities for education, employment

and lifestyle (Czapp & Kovach, 2015).

External resources (e.g. social care, developed environments, government

institutions, economic systems, technology) support wellbeing. Prosperity creates ways

for people to avoid or suppress vulnerability to health threats (e.g., knowledge, power,

prestige). In the other hand, poverty impacts health by restricting access to sufficient

nutrition; shelter; healthy neighborhoods for schooling, living and working; clean air and

water; utilities; and other factors that decide the quality of life of the person. Individuals

living in poorer neighborhoods are likely to suffer poor health due to a number of causes

that raise obstacles to health (Czapp & Kovach, 2015).

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METHODOLOGY

This chapter presents the research design, sampling technique, research

instrument, data gathering procedure, validation of instrument, and method of analysis,

statistical treatment that the researchers employed to describe the perceived factors in

accessing health care delivery among residents in barangay Tejeros, Rosario, Cavite.

Research Design

A descriptive correlation design will be employed in this study to describe the

factors in accessing health care services and health status among the residents, and also to

examine the relationship between those variables. Descriptive research has its main

objective, the accurate portrayal of the characteristics of person, situations, or groups,

and/or the frequency with which certain phenomena occur. Correlational research

explores the interrelationships among variables of interest without researcher

intervention. (Polit & Beck,2008)

According to Polit & Beck (2008), the focus or perspective for quantitative

research is usually concise and reductionistic which means whole cannot be studied but it

will be broken down into parts so that the parts can be examined. Furthermore,

quantitative research requires control to identify and limit the problem and attend to limit
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the effect of extraneous or outside variables that are not the focus of the studies (Burns &

Grove, 2006, p. 132).

Participants of the Study

The participants of the study will be 392 residents living at barangay Tejeros,

Rosario, Cavite. The participants will be selected residents in chosen barangay who will

pass on the inclusion criteria. The criterion includes the following: the respondents must

be a resident from barangay Tejeros and their age must be ranging from 20 to 50 years

old.

To determine the sample size and number of participants, Slovin’s formula will be

use.

Sampling Technique

The study will use a non-probability, purposive sampling technique. It is a

technique in which researchers will select and study a specific number of a special group

that represents the target population with regards to their demographic profile. This

sampling technique will utilize in the study to get valid and accurate results from the

chosen participants. The target population was chosen with the use of Slovin’s formula

and based on the computed target population, 392 residents will be included in the study.

Research Instrument

The researchers will formulate a questionnaire from the report of Access to

Healthcare produced by European Patients Forum (EPF). The questionnaire will consist

of three parts.
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Part I describes the demographic profile of the respondents of the study such as age,

sex, civil status, educational attainment, religion, occupation and monthly family income.

While Part II is the checklist for the inclusion area: (1) secured a letter of consent to

the barangay and for the respondents; (2) must be willing to participate in the study; (3)

must be a resident of barangay Tejeros, Rosario, Cavite; and (4) ages must be ranging

from 20 to 50.

Part III is twenty-five (25) item questions divided into two parts. Part III- A is

composed of 16 items questions composed of two (2) questions for the Availability of

health care, six (6) questions for Affordability of health care, four (4) questions for

Accessibility of healthcare, two (2) questions for Accommodation and Acceptability of

health care.

Part III- B composed of nine (9) question for the health status of the respondents.

Validation of Research Instrument

The validation of instrument will be done through the presentation of the study to the

experts in the field of nursing in Cavite State University - Main, Indang Campus. The

questionnaire will be check and validated by five professionals: one clinical instructor

from the College of Nursing, one registered nurse from Divine Grace Medical Center,

one barangay health official, one statistician and one Filipino teacher from Cavite State

University.
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The instrument will be review and revise based on their recommendations. The

questionnaire will be translated into Tagalog for the participants to fully understand the

contents of the questionnaire.

Ethical Considerations

The data privacy act states that the collection of personal data “must be a declared,

specified, and legitimate purpose” and further provides that consent is required prior to

the collection of all personal data.

To ensure the confidentiality of the participants in the study, the researcher will make

an informed consent as a form of disclosure or the purpose, objectives and benefits of the

respondents in involving in the study. Identity will be kept confidential. The researchers

will assure that no one would know this information. The consent form also indicates the

respondent’s willingness to participate in the study. However, respondents would have

the freedom to withdraw from the study and would be free to ask questions for

clarification.

Data Gathering Procedure

The researchers demonstrate research tool to the thesis adviser and technical critic

prior to the actual collection of the data and requested permission to conduct the study.

Due to curent pandemic, the initial plan is collection of data through online. Participants

will be reach through either Facebook messenger or email. Survey forms will be

answered within participant’s preferably way of participating, it may be through image,

google forms, and other. If the initial plan will not work, we will request some assistance
 PAGE \*
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from barangay officials and their Barangay Health Workers (BHW) in collection of data

from their residence, in order to minimize or avoid direct contact and lessen the risk of

acquiring virus . Upon approval of the dean of College of Nursing, the researchers will

coordinate to the officials and administrator of the barangay Tejeros, Rosario, Cavite.

Overall, the household from the barangay were involved in the data gathering procedure.

Throughout the data collection, confidentiality of information and human rights

requirements will be followed.

Statistical Treatment of Data

To ensure reliable outcome based on problems presented on the previous chapter,

different statistical analyses will be applied.

1. Weighted Mean – will be used to represent the average of data that will be

gathered to consider from each perceived factor that will be collected from the

participants.

Where:

W = weighted average
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n = number of terms to be averaged

wi = weights applied to x values

Xi = data values to be averaged

2. Frequency Distribution and Percentage – will be used to describe the

demographic profile of the participants in terms of age, sex, civil status,

educational attainment, religion, occupation and monthly income. These will be

also used in determining the perceived factors as viewed by the selected

participants of the study in terms of accessing health service.

%= _f_
N x 100

Where: % = Percent

f = Frequency

N = Number of cases

3. Pearson – product moment correlation coefficient will be used to determine the

relationship between demographic profile and accessing health services and to

find out the relationship between barriers and access to health services.

The following formula will be used in computing for the Pearson r correlation:

r=
n(∑xy)-(∑x)(∑y)
[ ][
n∑x2-(∑x2 n∑y2-
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Where:

r = Pearson r correlation coefficient ∑x = sum of x scores

N = number of value in each data set ∑y = sum of the y scores

∑xy = sum of the products of paired ∑x2 = sum of squared scores

∑y2 = sum of squared y scores

REFERENCES
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APPENDICES
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Informed Consent

Good day!
We, the researchers, are inviting you to participate in our research study entitled
“FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH
STATUS AMONG RESIDENTS IN BARANGAY TEJEROS, ROSARIO,
CAVITE” that will be conducted by Mark Neil Mesa, Maria Angelica Salvacion D.
Nacor and Roxette M. Ocampo from Cavite State University Main Campus, Indang,
Cavite. We hope to learn the perceived factors in accessing health care delivery system
among residents. You were selected as a possible participant in this study because you
have the criteria that our study needed.

If you decide to participate, there will be questionnaire provided for you and there will be
some questions that will be asked to you for some clarifications. However, your
participation in this study will consume some of your time in answering the questions. In
order for this some inconvenience to lessen, we will provide you the questionnaire on
your free time only.

Any information that is obtained in relation with this research and that can be identified
with you will remain confidential and will be disclosed only with your permission.
Subject identities will be kept confidential by keeping all the data gathered and will not
be shared to anyone.

Your participation is voluntary. Your decision will not affect your relationship with the
researchers and the school. If you decide to participate, you are free to withdraw your
consent and discontinue participation at any time without penalty.

If you have any questions about the study, please feel free to communicate and contact as
09957993002. Your signature indicates that you have read and understand the
information provided above, that you willingly agree to participate, that you may
withdraw your consent at any time and discontinue participation without penalty.

______________ _____________
Signature Date
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Researchers:
MARK NEIL MESA
MARIA ANGELICA SALVACION D. NACOR
ROXETTE M. OCAMPO
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Republic of the Philippines

CAVITE STATE UNIVERSITY
(CvSU)
Don Severino De Las Alas Campus
Indang, Cavite
415-0010 Loc 270/200  862-0806
www.cvsu.edu.ph

Oct 25, 2020

Rolando P. Antonio, RN., MAN

Clinical Instructor
Cavite State University

Dear Mr. Antonio,

We are BS Nursing Students 3rd Year Section 3 of Cavite State University - Main
Campus and currently enrolled in Research 1 this First Semester AY 2020 – 2021. We
would like to ask your kind assistance to be our adviser in the research proposal.

In relation to this, the following are the list of our proposed research title:

1. Learning Behavior of Underweight School Children as Perceived by the Mother:

Implications to Health Management in Selected Barangay in Cavite
2. The Psychological Effect of COVID-19 Pandemic Among CVSU students
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3. Physiological Effect of Pandemic COVID-19 Among Postpartum Women in
Selected Barangay in Cavite
4. Comparative Study Between Modular and Online Learning Among Nursing
Students in Cavite State University
5. Implications of Sleeping Pattern to Academic Performance of Nursing Students in
Cavite State University
6. Level of Awareness of COVID-19 Pandemic Among Older Adults in Selected
Barangay in Cavite
7. Barriers and Facilitating Factors in Accesing Health Service Among Residents in
Selected Barangay in Cavite

We would highly appreciate any suggestions and comments regarding our research
proposal. We are hoping for your consideration and support on this matter.

Respectfully yours,

Caridad Lintao, RN., MAN

Clinical Instructor

Mark Neil Mesa

Maria Angelica Salvacion Nacor

Roxette Ocampo
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Republic of the Philippines
CAVITE STATE UNIVERSITY
(CvSU)
Don Severino De Las Alas Campus
Indang, Cavite
415-0010 Loc 270/200  862-0806
www.cvsu.edu.ph

Feb 23, 2021

EVELYN M. DEL MUNDO, RN., PhD

Dean, College of Nursing
Cavite State University

Dear Dr. Del Mundo,

We are BS Nursing Students 3rd Year Section 3 of Cavite State University - Main
Campus and currently enrolled in Research II this Second Semester AY 2020 – 2021. We
would like to ask your kind assistance to be our Technical Critic in our research entitled,
“Factors in Accessing Health Care Services and Health Status Among Residents in
Barangay Tejeros, Rosario, Cavite”.

We would highly appreciate any suggestions and comments regarding our research study.
We are hoping for your consideration and support on this matter.
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Respectfully yours,

Caridad Lintao, RN., MAN

Clinical Instructor

Mark Neil Mesa

Maria Angelica Salvacion Nacor

Roxette Ocampo
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CON RDE Form No. 1

Republic of the Philippines

CAVITE STATE UNIVERSITY
Don Severino de las Alas Campus
Indang, Cavite

COLLEGE OF NURSING 
Department of Nursing

March 1, 2021

                                            TITLE APPROVAL 

      
      We wish to apply for the approval of this title for our undergraduate research study
as partial requirement in the subject NURS 12 – Research 1 for the Bachelor of Nursing
course:

Proposed Title: FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH

STATUS AMONG RESIDENTS IN BARANGAY TEJEROS, ROSARIO, CAVITE

Thank you.

Respectfully yours,

Mark Neil Mesa

Maria Angelica Salvacion D. Nacor

Roxette M. Ocampo
Recommending Approval:

Rolando P. Antonio, RN., MAN   ___   Evelyn M. Del Mundo, RN, PhD.   _____
    Adviser               Date       Technical Critic   Date
________________________ _____ ROLANDO P. ANTONIO, RN., MAN _____
     Department Chairman      Date     College Research Coordinator      Date  
   
Approved by: 

  EVELYN M. DEL MUNDO, RN, PhD.             _________

                            College Dean      Date
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CON RDE Form No. 2

Republic of the Philippines

CAVITE STATE UNIVERSITY
Don Severino de las Alas Campus
Indang, Cavite

COLLEGE OF NURSING 
Department of Nursing

March 1, 2021

EVELYN M. DEL MUNDO, RN., PhD

Dean, CON
This University

Thru:  ROLANDO ANTONIO, RN, MAN

CON Research Coordinator

Dear Dr. Del Mundo,

We wish to ask for approval of the thesis adviser and technical critic for our study
entitled: FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH
STATUS AMONG RESIDENTS IN BARANGAY TEJEROS, ROSARIO, CAVITE
CONFORME: 

Rolando P. Antonio, RN., MAN ____ Evelyn M. Del Mundo, RN, PhD.   ____
    Adviser               Date       Technical Critic       Date
 
Thank you.
Respectfully yours,

Mark Neil Mesa

Maria Angelica
Salvacion D. Nacor

Roxette M. Ocampo
Recommending Approval:
______________________ _____   ROLANDO P. ANTONIO, RN,MAN  _____
     Department Chairman        Date     College Research Coordinator    Date  
   
Approved by: 

  EVELYN M. DEL MUNDO, RN, PhD.              _________

                            College Dean      Date
 PAGE \*
MERGEFORMAT 40

CON RDE Form No. 3

Republic of the Philippines

CAVITE STATE UNIVERSITY
Don Severino de las Alas Campus
Indang, Cavite

COLLEGE OF NURSING 
Department of Nursing

March 1,  2021

                              OUTLINE PROPOSAL DEFENSE

We wish to request for the presentation of the proposal for our undergraduate research
study entitled: FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH
STATUS AMONG RESIDENTS IN BARANGAY TEJEROS, ROSARIO, CAVITE
at   March 1, 2021, 10:00-11:00 am.

Thank you.

Respectfully yours,

Mark Neil Mesa

Maria Angelica Salvacion D. Nacor

Roxette M. Ocampo
Recommending Approval:

Rolando P. Antonio, RN., MAN   ___   Evelyn M. Del Mundo, RN, PhD.   ______
    Adviser               Date      Technical Critic             Date

________________________ ____   ROLANDO P. ANTONIO, RN, MAN   ____

      Department Chairman Date     College Research Coordinator  Date  
   
Approved by: 

  EVELYN M. DEL MUNDO,RN ,PhD.              _________

                            College Dean      Date
 PAGE \*
MERGEFORMAT 40
CON RDE Form No. 4

Republic of the Philippines

CAVITE STATE UNIVERSITY
Don Severino de las Alas Campus
Indang, Cavite

COLLEGE OF NURSING 
Department of Nursing

March
1, 2021

PROPOSAL MANUSCRIPT ROUTING FORM: 

         We, the undersigned, certify that this proposal was read, evaluated and all
recommendations were satisfactorily complied by the student researchers and,
therefore, is recommended for its conduct / implementation.

Study Title: FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH

STATUS AMONG RESIDENTS IN BARANGAY TEJEROS, ROSARIO, CAVITE
Researchers: Mark Neil Mesa

Maria Angelica Salvacion D. Nacor

Roxette M. Ocampo

Rolando P. Antonio, RN., MAN   ______   Evelyn M. Del Mundo, RN, PhD.  
______
    Adviser               Date       Technical Critic        
Date

Recommending Approval:

_________________________ ____ ROLANDO P. ANTONIO, RN, MAN ____

     Department Chairman Date        College Research Coordinator    Date  
   
Approved:

EVELYN M. DEL MUNDO, RN, PhD.         _______

 PAGE \*
MERGEFORMAT 40
College Dean Date
Title of Study: Perceived Factors in Accessing Health Care Delivery Systems Among
Residents in Barangay Tejeros, Rosario, Cavite
Researchers: Mark Neil Mesa
Maria Angelica Salvacion D. Nacor
Roxette M. Ocampo

SURVEY QUESTIONNAIRE

PART I. A DEMOGRAPHIC PROFILE

Name: (Optional) Age: _____Sex: ______

Religion: _____________
Educational Attainment: ________________
Occupation: __________________

Civil Status: (Check what is applicable)

Single Separated
Married Others: (Please specify) __________
Widowed
Monthly Family Income:
P 30,001 above P 10,001 – 15,000
P 20,001 – 30,000 P 5,001 – 10,000
P 15,001 – 20,000 P 5,000 below
PART II

Inclusion Criteria

The respondents for this study must be:

1. Secured a letter of consent;

2. Willing to participate in the study;
3. A resident in barangay Tejeros, Rosario, Cavite; and
4. Ages ranging from 20-50 years old.

PART III

Directions: Below are the statements about factors in accessing health care delivery
system. Check the box that corresponds your answer.

AVAILABILITY OF HEALTH CARE

Direction: Below are statements about the factors in
accessing health services and health status among 5 4 3 2 1
residents in barangay Tejeros, Rosario, Cavite.
Check the number that corresponds to your answer
based on the following scale:
Legend: 5= Very Good 4 = Good 3= Average
2= Poor 1= Very Poor
1. Thinking of access overall, how difficult or easy
was it to actually obtain the healthcare services
you needed within the past 12 months?
2. How would you rate access to information on
available healthcare services from the following
sources or channels:
a. School
b. Work
c. The doctor’s practice
d. Hospitals
e. Pharmacies
f. Internet websites
g. Social media
h. TV
i. Patient Organizations
j. Relative and peers
 k. Public Health Authorities
l. Rural Health Unit
m. Health Center

AFFORDABILITY OF HEALTH CARE

Direction: Below are statements about the factors in
accessing health services and health status among
residents in barangay Tejeros, Rosario, Cavite.
Check the number that corresponds to your answer 5 4 3 2 1
based on the following scale:
Legend: 5 = Always 4= Very Often
3=Sometimes 2=Rarely 1=Never
1. When you need it, can you afford (financially) to
access:
Primary Care Doctor
Specialist Doctor
Specialized Health Care Provider
Hospital
Medicine
Medical Equipment or device
Dental Health Care
Cosmetic Intervention
2. Do you experience financial difficulties as a
result of spending on healthcare?
3. In the past 12 months, have you ever reduced
your spending on essential needs, such as food or
clothing, to be able to cover healthcare costs?
4. In the past 12 months, did you forgo (do without)
or postpone healthcare visits because of cost?
5. In the past 12 months, did you forgo (do without)
or postpone treatment because of cost?
6. Do you need to have recourse to a private or
complementary health insurance in order to cover
your healthcare cost?

ACCESSIBILITY OF HEALTH CARE

Directions: Below are statements about the factors in
accessing health services and health status among 4 3 2 1
residents in barangay Tejeros, Rosario, Cavite.
Check the number that corresponds to your answer
based on the following scale:
4= Strongly agree 3= Moderately Agree
2=Agree 1=Disagree
1. Over the past 12 months, have you experienced a
significant delay in accessing:
a. A treatment intervention, such as surgery
or other procedure.
b. A medical device or medical equipment

c. A diagnostic test
d. An appointment with a nurse
e. appointment with a primary care doctor
(e.g. a general practitioner)
f. An appointment with a specialist
g. Help/support from social services
h. Your medicines
2. Would you say the following services are located
near enough from your home?
a. Hospital
b. Rural Health Unit
c. Health Center
d. Pharmacy
e. Lying-in
f. Hospital
g. Specialist
h. Clinic
3. Do you face any of the following issues when
seeking care for your condition(s)?
a. I need to go to another city to get the
service I need.
b. I need to go to another region to get the
service I need.
c. I need to go to another country to get the
service I need
4. To overcome this geographical barrier, do you
have access to:
a. A mobile or eHealth service to help you
access healthcare remotely
b. Financial support for travel
c. Transportation
d. Others:
ACCOMMODATION OF HEALTH CARE
Direction: Below are statements about the factors in
accessing health services and health status among 5 4 3 2 1
residents in barangay Tejeros, Rosario, Cavite.
Check the number that corresponds to your answer
based on the following scale:
Legend: 5= Always 4 = Very Often 3=
Sometimes 2= Rarely 1= Never
1. Please rate the statements below that relate to the
communication with your healthcare providers.
a. I am easily informed by healthcare providers
about my treatment options.
b. I am involved in decisions regarding my
care by my healthcare providers.
c. My healthcare providers give me the
information I need about the safety of my
treatment
d. My healthcare provider adapts my care
according to my changing needs.
e. My healthcare providers are capturing my
feedback on quality of care provided.
2. Would you agree with the following statement
on the quality and safety of your care?
a. I receive good quality care according to the
standard/ guidelines or best practices
available for my condition.
b. I am satisfied with the safety of care
provided to me.
c. I am satisfied with continuity in my care
over time.
d. I receive good quality care according to the
standard/ guidelines or best practices
available for my condition.
e. I am satisfied with the safety of care
provided to me
f. I am satisfied with continuity in my care
over time.
g. I receive good quality care according to the
standard/ guidelines or best practices
available for my condition.
h. I am satisfied with the safety of care
 provided to me.
i. It is easy to me to reach my doctor or health
care providers when in need of medical
advice.

ACCEPTABILITY OF HEALTH CARE

Direction: Below are statements about the factors in
accessing health services and health status among
residents in barangay Tejeros, Rosario, Cavite. 4 3 2 1
Check the number that corresponds to your answer
based on the following scale:
4= Strongly agree 3= Moderately Agree
2=Agree 1=Disagree
1. Please rate the statements below that relate to your
responses with your healthcare providers.
a. I feel better when treated in private hospitals.
b. I feel better when treated in public hospitals.
c. I feel better when treated by a doctor.
d. I feel better when treated by faith healers.
e. I always participate in health-related programs
in our barangay.
f. I consider and apply the medical based
practice compared to superstitions/beliefs.
g. I prefer over the counter drugs and medicines
in treating and managing my health condition.
h. I prefer herbal plants in treating and managing
my health condition.
i. Going to health facilities to know my health
status is a waste of time for me.
j. I understand the importance of intervention
given by the healthcare providers.
k. I understand the importance of health
education given by the healthcare providers.

Add the quality of health care services

 Researchers: Mesa, Mark Neil
Nacor, Marica Angelica Salvacion D.
Ocampo, Roxette M.
Research Entitled: “FACTORS IN ACCESSING HEALTH CARE SERVICES AND HEALTH STATUS AMONG
RESIDENTS IN BARANGAY TEJEROS, ROSARIO, CAVITE”

GANNT CHART
AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN JUL
Activities 2020 2020 2020 2020 2020 2021 2021 2020 2020 2020 2020 2020
Problem Identified                        
Chapter 1                        
Chapter 2                        
Chapter 3                        
Initial Online Defense                        
Validation of Instruments                        
Data Gathering                        
Statistician                        
Chapter 4                        
Chapter 5                        
Final Defense