Revised Manuscript

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ST. ANTHONY COLLEGE OF ROXAS CITY, INC.

COLLEGE OF NURSING 2023
Chapter 1
Introduction to the Study
Chapter 1 is made up of five parts, namely: (1) Background and
Rationale of the Study, (2) Statement of the Problem and the Hypotheses,
(3) Significance of the Study, (4) Definition of Terms, and (5) Delimitation
of the Study.
Part One, Background and Rationale of the study, presents the
introduction, discusses the rationale for conducting the investigation and
presents the theoretical framework, which serves as the study’s frame of
reference.
Part Two, statement of the Problem and the Hypotheses, gives the
main problem and the specific questions the study seeks to for an
answer. It also presents the hypotheses to be tested.
Part Three, Significance of the Study, provides explanations on
what benefit each stakeholder will have on the research results.
Part Four, Definition of Terms, gives the meaning of the important
terms used in the study conceptually and operationally for the purpose
of clarity and understanding.
Part Five, Delimitation of the Study, sets the scope of the research
in terms of research design, participants, sample size and sampling
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procedures, locale, data-gathering instruments, and statistical tools
employed in the analysis of data.
Background and Rationale of the Study
A Barangay Health Worker is a type of health care provider in the
Philippines. Before providing primary care in the community, they must
complete a basic training and development program approved by the
government or a non-governmental organization. They provide services in
the barangays such as maternal, newborn, and child welfare. The local
health board authorizes Barangay Health Workers to carry out their roles
and responsibilities in accordance with the Department of Health's
standards, as specified in Section 3 of Republic Act No. 7883. (Poe,
2014). The BHWs were considered the guardians of the nation’s health at
the grassroots level. Through the years, they continued to serve selflessly
and sacrificially to their communities. Until today, they step up on the
frontlines in their own barangays to hold the ropes for the healthcare
system.
The Philippines has a long history of PHC having adopted the
approach in 1981 as a national strategy. This strategy relies heavily on
the community through barangay health stations (BHS) that serve a
population of 5,000 and rural health units (RHUs)/city health offices
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(CHOs) that serve a population of 20,000. The devolution of health
services in 1991 mandated the management of primary care facilities at
the barangay, city, or municipal levels to local governments units (LGU).
The DOH, on the other hand, sets the standards for primary care
facilities, including their staffing. In addition to formal cadres of health
workers under the primary care facility (e.g., physicians, nurses, and
midwives), Barangay Health Worker (BHW) complement health services
at the community level, acting as the first point of contact between the
healthcare system and the rest of the community.
Health center programs are guaranteed programs of the
Department of Health (DOH) which are disseminated to the health
centers of different barangays. They have the same objectives which are
to promote health, prevent diseases and educate people in the
community, also to ensure quality health care service to depressed
marginalized and underserved areas through the deployment of
competent and community-oriented healthcare workers.
BHWs are considered to be nurturers and providers of health care
services to their constituents even in the far-flung barangays. The
Department of Health (2016) emphasized the importance of the BHWs as
part of Community Health Teams since they are a link between
communities or families to health care providers. As a link, they increase
family awareness and recognition of health risks and the promotion of
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positive health behaviors. The BHW maintain regular communication
and linking the community with the local leaders and the health
professionals. Also assisting the community from the identification of the
health problems, the development of health plans and in taking action to
promote their health and well-being.
Motivation to perform tasks well can be affected by work
environment, particularly the availability of resources and policies.
Facilities and policies have significant effects in the work performance of
BHWs. Health workers can perform their duties effectively when they are
provided with adequate resources and well-defined policies. The presence
of a permanent BHS can give health workers a favorable working
environment. They can easily access equipment and medical supplies
needed to perform their jobs. BHWs constantly make required reports. A
designated workplace will help them do their paperwork easily, resulting
to better work output. Moreover, BHWs should have adequate personal
paraphernalia to perform health services to the community efficiently.
Inadequate resources can limit the capabilities of the BHWs in rendering
services. Well-defined policies can guide and guard the BHWs in the
performance of their duties in the community, especially that the BHWs
are exposed to different types of people in the community. As a result,
problems in connection with the performance of their duties may be
encountered. When equipped with the knowledge of the policies, they will
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know how to react and face any situation accordingly. With policies in
place, the BHWs will know the scope and limitations of their role in the
community, therefore, allowing them to fully utilize their capacity to
practice self-care.
According to (WHO, 2019), 6.4 million Filipinos are paying more
than 10% of their income on health care, a level that WHO considers
potentially catastrophic. To solve this problem, WHO highlight the need
to strengthen primary health care as the foundation for the Universal
Health Care (UHC) Act. For the Department of Health to achieve the
Universal Health Care (UHC), the three strategic thrusts should be
effectively implemented with the help from the Community Health Teams
(CHTs). A CHT is composed of midwives, barangay health workers
(BHWs), barangay nutrition scholars (BNSs), and parent leaders. As
mentioned, the BHWs are part of the CHT thus their role and
contribution in the attainment of the DOH thrusts cannot be overlooked.
The roles and functions of BHWs have been evolving to accommodate the
changing needs and demands of their catchment area and thrusts of the
healthy system. There is a total of 224, 886 Barangay health workers
nationwide as of March 28, 2022 according to the freedom of information
Philippines. And there are currently 1,467 active BHWs in Roxas City.
However, as observed in the community today, BHWs frequently
provided follow-up services but frequently failed to refer clients to health
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centers in the first place. General consultation services are available in
all Barangays, and health professionals are sometimes "forced" to issue
prescriptions due to a lack of doctors in some areas. Some health
workers (health professionals and BHWs) believe that BHW training is
inadequate and that additional training is required. The cost of
transportation to the main health center is one factor that sometimes
discourages BHWs from attending training. In some places, BHWs are
incompetent on some opportunities such as whenever there are free
seminars regarding health care delivery most of them would only send a
representative thus not only, they are missing out on valuable knowledge
but also presenting incompetence in this matter.
Competency-based theory is a framework that focuses on
assessing the knowledge, skills, and abilities of individuals in relation to
specific roles or professions. When applied to community health workers
(CHWs), the competency-based theory helps determine their level of
practice by evaluating their demonstrated capabilities in performing their
duties effectively. This theory emphasizes assessing the knowledge,
skills, and abilities of CHWs in their specific roles. It involves defining the
core competencies required for effective CHW practice and developing
assessment tools to measure their proficiency in these competencies. The
theory helps determine the extent of practice by evaluating CHWs'
demonstrated capabilities in performing their duties. To determine the
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level of practice of CHWs using the competency-based theory, a
systematic assessment process is typically employed. This process
involves evaluating CHWs against established competency frameworks or
standards. Assessment methods may include written exams, direct
observation of CHWs' practice, interviews, performance evaluations, or
simulations. The assessment focuses on measuring the extent to which
CHWs possess the necessary competencies and can effectively apply
them in their day-to-day work. It examines their knowledge of relevant
health topics, their ability to communicate and engage with community
members, their proficiency in delivering health education, their capacity
to coordinate care and refer patients when needed, and their cultural
competence in working with diverse populations.
Based on the assessment outcomes, CHWs' extent of practice can
be determined. Those who demonstrate a high level of proficiency in the
identified competencies are considered to have a higher extent of
practice. Conversely, CHWs who exhibit gaps or deficiencies in certain
competencies may require additional training or support to enhance their
practice and reach a higher level of proficiency.
The roles and functions of BHWs have been evolving to
accommodate the changing needs and demands of their catchment area
and health system. For these BHWs to do their jobs effectively proper
health practice, are vital to work well in a variety of settings, which
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reflects on the health status of the people they serve. Both constant and
periodic evaluation is crucial to ensure competency and commitment to
performing duties and responsibilities as they are at the forefront of the
healthcare delivery system at the grassroots level. To validate these facts,
this research study will pave the way in determining the BHW’s health
practice providing quality healthcare services to the community.
Conceptual Framework
Independent variable Dependent variable
Respondents Extent of Health

Demographic Profile: Practices on Selected
Government Health
• Age Programs Among BHWs
• Educational of Barangay Lawaan,
Attainment Roxas City
• Length of Service
• Number of • Pre-Natal
Trainings Attended • Dengue Prevention
• Immunization
Figure 1. The schematic diagram shows the possible variation of
variables covered in this study. The diagram shows the dependent
variables which is the extent of health practices on selected government
health programs is influenced by the independent variables which are
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the demographic profile of the respondents in terms of: Age, Educational
Attainment, Length of Service, and Number of Trainings Attended
Statement of the Problem and Hypotheses
The main objective of this study is to determine the extent of
health practices on the selected government health programs, among the
barangay health workers of Barangay Lawaan, Roxas City.
More specifically, it sought to provide answers to the following
questions:
1. What is the extent of health practices on the selected
government health programs of the barangay health workers of
Barangay Lawaan, Roxas City?
2. Is there a significant difference in the extent of health practices
of the respondents on the selected government health programs
when grouped according to:
a. Age,
b. Educational Attainment,
c. Length of service, and
d. Number of trainings attended?
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In the view of preceding problems, the following hypotheses were
advanced;
1. There is no significant difference in the extent of health practices of
the respondents on the selected government health programs when
grouped according to:
a. Age,
b. Educational Attainment,
c. Length of service, and
d. Number of Trainings Attended.
Significance of the Study
This study was aimed to provide valuable information on the
Barangay Health Workers (BHWs) about their extent of health practices
on the selected government health programs, and how this can affect the
field and its performance in Primary Health Care (PHC).
Researchers. The information and data from this study helped
them develop interventions and a holistic approach to the study. This
helped them know and understand the level of extent, competence,
practices, and experience of the Barangay Health Workers (BHWs).
Local Government Unit (LGU). To be notified of the level of
extent, competence, practices, and experience of the Barangay Health
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Workers (BHWs) and develop a meeting and formulate an idea that would
solve the problem in the barangay.
Department of Health (DOH). Based on the information and
data gathered by the researchers this would help them monitor and
supervise the health care providers and help them formulate programs or
innovate old programs that would strengthen the level of extent,
competence, practices, and experience of the Barangay Health Workers
(BHWs).
Barangay Officials. The information and data gathered by the
researchers would help them know the experience and skills of their
Barangay Health Workers (BHWs), and would further give interventions
and programs or seminars that would further enhance their practices
and experience in the field.
Barangay Health Workers (BHWs). This would help them know
their level of practices and skill in the field based on the information and
data that the researchers have gathered. Thus, this would help them
identify what is lacking and the skills that they need to improve their
practices and experience in the field.
And, for future researchers. The result of this research would
be the basis of further studies and can be used in related literature.
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Definition of Terms
To facilitate understanding of the contents of this study, the
researcher deemed it necessary to define the following terms
conceptually and operationally:
Health Practices is defined as a set of actions and behavior people
take to understand their health state, maintain optimal state of health,
prevent illness, and injury, and reach their maximum physical and
mental potentials (Kozier et al., 2008).
In this study, “health practices” was referred to the actions and
behavior of the Barangay Health Workers in terms of maintaining their
optimal state of health, and prevent and treat illness and injury. This
was also referred to the mean score in 21-item researcher-modified
questionnaire which presented the extent of health practices of an
individual answered by the following responses: 5 – always, 4 – often, 3 –
moderate, 2 – sometimes, and 1 – not at all. The mean score that had
been obtained from the health practices questionnaire had carefully
categorized as highly observed (4.21-5.00), observed (3.41-4.20),
moderately observed (2.61-3.40), less observed (1.81-2.60), and least
observed (1.00-1.80).
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Scope and Delimitation of the Study
This study was conducted in sixty (60) Barangay Health Workers of
Barangay Lawaan, Roxas City. Primarily, this study aimed to determine
the extent of health practices on the selected government health
programs among Barangay Health Workers.
This study utilized a survey-correlation research design. Simple
random sampling was employed to obtain the representative sample.
Sixty Barangay Health Workers were randomly selected from Barangay
Lawaan, Roxas City.
The data of this study was gathered using the researcher modified
questionnaire for the extent of health practices. The dependent variable
of the study is the extent of health practices on the selected government
health programs such as Pre-Natal, Dengue Prevention and
Immunization Program, while the independent variables are respondents
demographic profile in terms of; age, educational attainment, length of
service, and number of trainings attended.
To analyze the data, descriptive analysis researchers were
employed such as frequency count, percentage, rank, mean, and
standard deviation for the descriptive statistics and One-Way ANOVA for
inferential statistics. All inferential statistics were set at a 0.05 alpha
level of significance.
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Chapter 2
Review of Related Literature
This Chapter is divided into five (3) parts namely: (1) DOH Health
Programs, (2) Barangay Health Workers, and, (3) Synthesis.
Part One, Health Programs of the Department of Education,
focuses on the legal mandates of the health programs implemented by
the DOH as well as how it is being delivered and made available to the
community.
Part Two, Barangay Health Workers act as the healthcare provider
in the community and implements the DOH Health Programs in their
Barangay.
Part Three, Synthesis, summarizes the literatures used in this
study.
DOH Health Programs
The Department of Health (DOH) is currently implementing various
public health programs that would provide interventions on addressing
the triple burden of diseases in the country – morbidity caused by
infectious diseases; mortality by non-communicable diseases (NCDs);
and emerging incidence of injuries, mental health, and alcohol and drug
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abuse. These programs are: a) National Immunization Program, b)
Women, Men, and Children’s Health Development Programs, c)
HIV/AIDS and STI Prevention, Emerging and Re-emerging Infectious
Disease, Integrated Helminth Control, Food and Waterborne Diseases
Prevention and Control, and National Dengue Prevention and Control
Programs, d) Tuberculosis Control Program, e) Malaria Control,
Schistosomiasis Control, Leprosy Control, and Filariasis Elimination
Programs, f) Rabies Control Program, g) Lifestyle Related Diseases
Prevention and Control, and Essential NCDs Programs (SDS, 2019).
One of the duties of Barangay Health Workers (BHW) is to assist
community from identification of the Health problems, the development
of health plans and in taking action to promote their health and well-
being. According to (Poe, 2014), author of Senate Bill No. 2219, Under
the current government structure, a Barangay Health Worker is a type of
health care provider in the Philippines. Before providing primary care in
the community, they must complete a basic training and development
program approved by the government or a non-governmental
organization. They offer services in the barangays such as maternal,
newborn, and child welfare. The local health board authorizes Barangay
Health Workers to carry out their roles and responsibilities in accordance
with the Department of Health's standards, as specified in Section 3 of
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Republic Act No. 7883. Each volunteer receives five weeks of training.
Barangay Health Workers remain in the areas they represent and serve
as development agents. They provide primary health care concerns to
their community. They get immunizations and weigh children on a
constant schedule. They also assist midwives with infant delivery. Each
Volunteer was expected to work with an average of 20 families in their
community. However, a lack of trained volunteers has reduced the
number of volunteers, particularly in remote areas, where one or two
volunteers nowadays serve an entire barangay.
Maternal Health and Family Planning which says that Community
Health Workers (CHW) or locally known as Barangay Health Workers
(BHW), are people who have undergone training programs under any
accredited government and non-government organization; as stated in
the study of (Robil, 2020), that they voluntarily render primary health
care services in the community after having been accredited to function
as such by the local health board in accordance with the guidelines
promulgated by the health department. Currently, there are 229,830
registered BHWs in the Philippines. The study investigated the
knowledge, attitude, and practices (KAP) of BHWs in terms of the use of
the Primary Health Care Services. The study utilized the statistical
percentages to indicate the extent of the knowledge, attitude, and
practices whereas the spearman method was used to test for
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relationships. Results showed that BHWs have a better knowledge
(86.7%) and attitude (87.5%) but has poor practice (37.8%). Further,
knowledge (r = 0.174, p = 0.105), and attitude (r = -0.089, p = 0.412)
were not significantly related to practice. The result of the study was a
basis of a Primary Health Care program to enhance the knowledge,
attitude, and skills of the BHWs.
n A variety of community health workers (CHWs) provide maternal
and newborn health (MNH) services in low-income and middle-income
settings. However, there is a need for a better understanding of the
diversity in type of CHW in each setting and responsibility, role, training
duration and type of remuneration. (Olaniran, et.al., 2019) identified
CHWs providing MNH services in Bangladesh, India, Kenya, Malawi and
Nigeria by reviewing 23 policy documents and conducting 36 focus group
discussions and 131 key informant interviews. We analysed the data
using thematic analysis. Irrespective of training duration (8 days to 3
years), all CHWs identify pregnant women, provide health education and
screen for health conditions that require a referral to a higher level of
care. Therapeutic care, antenatal care and skilled birth attendance, and
provision of long-acting reversible contraceptives are within the exclusive
remit of CHWs with training greater than 3 months. In contrast,
community mobilisation and patient tracking are often done by CHWs
with training shorter than 3 months. Challenges CHWs face include
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pressure to provide MNH services beyond their scope of practice during
emergencies, and a tendency in some settings to focus CHWs on facility-
based roles at the expense of their traditional community-based roles.
CHWs are well positioned geographically and socially to deliver some
aspects of MNH care. However, there is a need to review and revise their
scope of practice to reflect the varied duration of training and in-country
legislation.
A study entitled “Knowledge and practice regarding dengue and
chikungunya: a cross-sectional study among Healthcare workers and
community in Northern Tanzania” investigate knowledge and prevention
practices regarding dengue and chikungunya amongst community
members, as well as knowledge, treatment and diagnostic practices
among healthcare workers. A knowledge score was generated based on
participant responses to a structured questionnaire, with a score of 40 or
higher (of 80 and 50 total scores for community members and healthcare
workers, respectively) indicating good knowledge. We conducted
qualitative survey (n = 40) to further assess knowledge and practice
regarding dengue and chikungunya fever. 20.3% (n = 16) of participants
from lowland areas and 6.5% (n = 3) from highland areas had good
knowledge of dengue (χ2 = 4.25, P = 0.03). Only 2.4% (n = 3) of all
participants had a good knowledge score for chikungunya. Some
healthcare workers thought that they were new diseases. There is
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insufficient knowledge regarding dengue and chikungunya fever among
community members and healthcare workers. Health promotion
activities on these diseases based on Ecological Health Mode components
to increase knowledge and improve preventive practices should be
developed (Kajeguka, et.al., 2017).
Dengue fever is a rapidly emerging infection throughout the tropics
and subtropics with extensive public health burden. Adequate training of
healthcare providers is crucial to reducing infection incidence through
patient education and collaboration with public health authorities. We
examined how public sector healthcare providers in a dengue-endemic
region of Ecuador view and manage dengue infections, with a focus on
the 2009 World Health Organization (WHO) Dengue Guidelines. A 37-
item questionnaire of dengue knowledge, attitudes, and practices was
developed and administered to dengue healthcare providers in Machala,
Ecuador. A total of 76 healthcare providers participated in this study, of
which 82 % were medical doctors and 14 % were nurses. Fifty-eight
percent of healthcare professionals practiced in ambulatory clinics and
34 % worked in a hospital. Eighty-nine percent of respondents were
familiar with the 2009 WHO Dengue Guidelines, and, within that group,
97 % reported that the WHO Dengue Guide was helpful in dengue
diagnosis and clinical management. Knowledge gaps identified included
Aedes aegypti mosquito feeding habits and dengue epidemiology.
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Individuals with greater dengue-related knowledge were more likely to
consider dengue a major health problem. Only 22 % of respondents
correctly reported that patients with comorbidities and dengue without
warning signs require hospital admission, and 25 % of providers reported
never admitting patients with dengue to the hospital. Twenty percent of
providers reported rarely (≤25 % of cases) obtaining laboratory
confirmation of dengue infection. Providers reported patient presumptive
self-medication as an ongoing problem. Thirty-one percent of healthcare
providers reported inadequate access to resources needed to diagnose
and treat dengue. Participants demonstrated a high level of knowledge of
dengue symptoms and treatment, but additional training regarding
prevention, diagnosis, and admission criteria is needed. Interventions
should not only focus on increasing knowledge, but also encourage
review of the WHO Dengue Guidelines, avoidance of presumptive self-
medication, and recognition of dengue as a major health problem. This
study provided an assessment tool that effectively captured healthcare
providers’ knowledge and identified critical gaps in practice (Handel,
et.al., 2016).
Dengue fever (DF) is increasingly recognized as one of the world’s
major mosquito borne diseases and causes significant morbidity and
mortality in tropical and subtropical countries. Dengue fever is endemic
in most part of Pakistan and continues to be a public health concern.
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Knowledge, attitude and practices can play an important role in
management of the disease. Current study was aimed to determine the
level of knowledge, attitude and practices regarding dengue fever among
health practitioners, to study the level of knowledge and attitude with
preventive practices for dengue fever. A cross sectional study was carried
out in medical practitioners of the four districts of Malakand region
during October to November 2019. A pre-structured questionnaire was
used to collect data from medical practitioners. Data was analyzed using
Graph Pad version 5. Significant value was considered when less than
0.05 (at 95% confidence of interval). Nearly 81.2% participants were
aware from transmission of dengue fever is by mosquito bite. Practices
based upon preventive measures were found to be predominantly
focused towards prevention of mosquito bites rather than elimination of
breeding places. Although the knowledge regarding DF and mosquito
control measure was quite high among the medical practitioners but this
knowledge was not put into practice. Further studies are required to
aware the people about dengue and its vector in order to get prevention
and control (Khan, et.al., 2023).
Vaccination represents one of the most effective means of
preventing infections for the population and for the public health in
general. Recently there has been a decline in vaccinations, also among
healthcare workers (HCWs). The aim of the study is to detect the
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knowledge, skills, attitudes and barriers of HCWs regarding vaccinations
in a tertiary children’s hospital in order to support clinical management
in immunization practices. An observational study was conducted on 255
subjects over a period of 8 months. The 31-item questionnaire considered
profession, level of instruction and different ages. A 4-point Likert scale
and closed-ended questions were used. A confidence interval of 95%, p
value ≤ 0.05, Chi-square, ANOVA and the Kruskal-Wallis test were
considered. In relation to the injection site, in all the age ranges there
was a high level of knowledge except for those aged over 61 who
responded incorrectly. Generally, scientific sources were used
infrequently. The higher the education level, the more frequent the
utilization of trustworthy scientific resources and literature. (p = 0.0002).
In line with the attitude observed in recent years, nurses are not inclined
to get vaccinated themselves although they agree to having their children
vaccinated. HCWs have a good level of knowledge about vaccines and
immunization practices. With the nurses we found that the higher the
education level, the greater the knowledge about vaccines which leads to
the conclusion that low levels of adherence are not due to a lack of
knowledge, but rather, to a low perception of risks. Hence the need to
strengthen the vaccination strategies inside the companies (Tomboloni
et.al., 2019).
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Immunization is one of the most effective government-led health
campaigns to prevent the spread of communicable diseases and its
complications that may eventually lead to death. Its goal to protect the
community has been apparent ever since its inception despite several
issues that arise to defeat its purpose. The study of (Castro, et,al., 2020)
was conducted to determine the extent of knowledge, attitudes, and
treatment beliefs in immunization. A purposive sampling method was
used to 323 participants for the study. Descriptive statistics, mean,
standard deviation, Pearson product-moment coefficient, t-test, and
ANOVA were used for statistical analysis. Results showed that primary
caregivers have a high knowledge (M = 1.78; SD = 0.16), generally had a
positive attitude (M = 3.90; SD = .56), and very good treatment beliefs in
healthcare professionals while having a poor belief in faithhealing or
spiritual healing (M = 3.23; SD = .55). Generally, respondents have a very
high practice regarding the use of the single-dose vaccine (M = 4.02; SD
= 1.06) but have poor immunization practices on multiple-dose vaccines
(M = 3.09; SD = .95). A significant negative correlation was found
between treatment beliefs and immunization practices (p = .002, r = -
.174) which means that as the beliefs increase, immunization practices
decrease. On the other hand, there was no significant correlation
between immunization practices and knowledge and attitude. It is
recommended that health promotion regarding the benefits of
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immunization should be a priority given the high incidence of
preventable diseases.
Barangay Health Workers
As defined in Section 3, are people in the healthcare group who
volunteers and have undertaken multiple training programs provided by
the authorized government or non-government organizations and who
work in the community on a volunteer basis providing healthcare
services to their constituents. Republic Act 7883 is enacted as a token of
appreciation for the Barangay Health Worker's services. This Act aims to
create a platform that allows volunteers to obtain access to a wide range
of resources and opportunities that will benefit them in their personal
and professional development. Accredited BHWs who interactively and
regularly perform their obligations under this law are entitled to
incentives and benefits. In addition, accordance to the provisions under
Section 2 of Republic Act No. 7883 which states that The
Primary Health Care Approach is often regarded as the most important
strategy for achieving health empowerment, recognizing the need of
delivering efficient and appropriate health services through interactive
approaches. (RA 7883, 1995).
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Barangay Health Workers (BHW) is a person who has undergone
training programs under any accredited government and non-
government organization and who voluntarily renders primary health
care services in the community after having been accredited to function
as such by the local health board in accordance with the guidelines
promulgated by the DOH (Bureau of Local Health Systems Development,
(2022.). They serve as the frontliners in the barangay in providing basic
health services. They play a vital role in accomplishing the primary
health care approach towards health empowerment by providing
accessible and acceptable health services in the barangay level (Go,
2019)
Under the current government structure, a Barangay Health
Worker is a type of health care provider in the Philippines. Before
providing primary care in the community, they must complete a basic
training and development program approved by the government or a non-
governmental organization. They offer services in the barangays such as
maternal, newborn, and child welfare. The local health board authorizes
Barangay Health Workers to carry out their roles and responsibilities in
accordance with the Department of Health's standards, as specified in
Section 3 of Republic Act No. 7883. Each volunteer receives five weeks of
training. Barangay Health Workers remain in the areas they represent
and serve as development agents. They provide primary health care
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concerns to their community. They get immunizations and weigh
children on constant schedule. They also assist midwives with infant
delivery. Each Volunteer was expected to work with an average of 20
families in their community. However, a lack of trained volunteers has
reduced the number of volunteers, particularly in remote areas, where
one or two volunteers nowadays served an entire barangay. (Poe, 2014).
Barangay Health Workers (BHW) consist of different roles in the
community. According to (Annesaya, 2017), they are an advocate of
current health programs, projects and activities to improve access and
use of health services. An educator who will advise and counsel the
community. A disseminator to maintain regular communication between
local professional health workers and their catchment household. A
linker to facilitate access to or association of the community with
relevant network of health and non-health service providers within or
outside their catchment areas. A record keeper to maintain updated
lists/records of health data, health activities/events in the community.
BHWs may have different tasks depending on the agreement reached
between community leaders. Notwithstanding the said agreement, the
BHW shall continue discharging his/her duties and responsibilities as a
community organizer, educator, and a primary health care service
provider. As a community organizer, he/she shall participate in
organizing and mobilizing the community towards self-reliance. This
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includes maintaining regular communication and linking the community
with the local leaders and the health professionals.
Health is an indispensable element of living in the community.
Barangay health workers (BHWs) provide healthcare services that meet
the health needs of their constituents in their barangay. They motivate
people to live a clean and healthy life. Core skills, applied knowledge and
a good attitude are vital for these BHWs to complete their jobs effectively
and efficiently. The goal of this study is to evaluate their competence. The
descriptive-correlational method was used with a self-made
questionnaire as the main data gathering tool. Purposive sampling
through total enumeration was used to determine the participants. Data
was analyzed through the percentage technique, weighted mean, and
chi-square test for independence. Results revealed that BHWs are
moderately competent, with a satisfactory rating on attitude; personal
and environmental factors affect have an impact on their competence.
The length of service as a BHW was to be found significant in the
competence of BHWs. To be well-equipped with knowledge and skills,
BHWs are encouraged to continuously attend training and seminars and
use the self-learning kit (Taburnal, 2020).
Healthy living in the community is affected by many factors. Vital
among these factors, is the presence of the barangay health (BHW)
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worker who inspires and motivates people to live a healthy lifestyle. With
competence, commitment and having relevant tools as BHW can provide
quality health care services to their constituents. As such, the study
determined the level of competence of BHWs. The descriptive
correlational method was used with questionnaire as the primary data
gathering tool. Quota sampling method was used in determining the
respondents. Data analysis included percentage technique, weighted
mean, Spearman rank method, Kendallâ Coefficient of Concordance and
Kruskal-Wallis test. Findings revealed that BHWs are competent. The
personal, political and environmental factors affect the level of
competence of the BHWs. Continuous attendance to seminars and
trainings and the use of the BHW intervention bundle is highly
encouraged to enhance their performance (Taburnal, 2017.).
Community health workers (CHWs) are an important cadre of the
primary health care (PHC) workforce in many low- and middle-income
countries (LMICs). The Philippines was an early adopter of the CHW
model for the delivery of PHC, launching the Barangay (village) Health
Worker (BHW) programme in the early 1980s, yet little is known about
the factors that motivate and sustain BHWs’ largely voluntary
involvement. This study aims to address this gap by examining the lived
experiences and roles of BHWs in urban and rural sites in the
Philippines. This cross-sectional qualitative study draws on 23 semi-
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structured interviews held with BHWs from barangays in Valenzuela City
(urban) and Quezon province (rural). A mixed inductive/ deductive
approach was taken to generate themes, which were interpreted
according to a theoretical framework of community mobilisation to
understand how characteristics of the social context in which the BHW
programme operates act as facilitators or barriers for community
members to volunteer as BHWs. Interviewees identified a range of
motivating factors to seek and sustain their BHW roles, including a
variety of financial and non-financial incentives, gaining technical
knowledge and skill, improving the health and wellbeing of community
members, and increasing one’s social position. Furthermore, ensuring
BHWs have adequate support and resources (e.g. allowances, medicine
stocks) to execute their duties, and can contribute to decisions on their
role in delivering community health services could increase both
community participation and the overall impact of the BHW programme.
These findings underscore the importance of the symbolic, material and
relational factors that influence community members to participate in
CHW programmes. The lessons drawn could help to improve the impact
and sustainability of similar programmes in other parts of the Philippines
and that are currently being developed or strengthened in other LMICs
(Mallari, et.al., 2020).
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The barangay health workers (BHWs) play a significant role in the
Philippine health care delivery system. They act as frontliners under the
primary health care approach. They render primary care services such as
first aid, maternal, neonatal, and child- and community-based
interventions in the community. Individual work performance can be
affected by individual motivation, work environment, and existing
regulatory requirements. This study of (Ibo, 2019) generally aimed to
determine the working environment of BHWs in the province of Albay.
Specifically, it identified the motivations of the BHWs, conducted
inventory of barangay health stations, and determined the existing
policies relative to BHWs. Questionnaires were used as the primary tool.
Total enumeration was attempted among the midwives, whereas
systematic random sampling was done for BHWs resulting to 88
midwives and 324 BHW respondents. The findings of the study showed
that BHWs serve more than 20 households. The motivator factor is the
primary motivation of BHWs in their work performance rather than the
hygienic factor. It is evident that majority of the barangay health stations
have necessary equipment, instruments, and supplies to provide health
care services. However, water, sanitation, and hygiene facilities need to
be enhanced. The BHWs are not fully equipped personally with
paraphernalia needed for delivering services. The schedule of health
services is dependent on the midwife. Local policies relative to BHWs are
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limited. The work environment can be more favourable if BHWs are
equipped personally with resources necessary to provide quality services
and if inadequacy in water, sanitation, and hygiene facilities will be
addressed. More so, functionality of the barangay health station should
be maintained. The BHWs’ Benefit and Incentive Act (RA 7883) should be
properly implemented to sustain BHWs’ motivation to better work
performance.
The study primarily assessed the health service delivery trainings
that determined the competence of Barangay Health Workers (BHWs) in
Kiblawan, Davao del Sur. It also determined the effect of trainings and
the motivating factors and perceived benefits of attending such trainings.
The descriptive correlational technique was applied with a questionnaire
representing as the primary method of data collection. Total
Enumeration has been used to select participants in conducting the
study. Statistical tools such as, Percentage, Mean, and Analysis of
Variance (ANOVA) were employed. Results showed that majority of the
respondents were 45 years old and above, high school graduates,
married, with 1-3 number of trainings attended, and capable of serving
the community for over ten years. Findings revealed that BHWs were
competent in dealing and handling the health concerns of the community
and showed that the trainings they have attended were effective.
However, Barangay officials' allotment of financial resources for BHW's
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trainings and seminars was recommended so that they could properly
deliver the healthcare services to their constituents. The relationship
between the demographic profile and the competence of barangay health
workers, as well as the effect of trainings, was discovered to be
significant. Therefore, the hypothesis formulated was rejected. On the
other hand, for the second hypothesis, the findings revealed that the
relationship between the Competence of Barangay Health Workers and
the Effect of Trainings is significant and the hypothesis formulated is
also rejected (Ninal & Apas, 2021).
Synthesis
Health is the most precious commodity of humanity. Healthy
individuals, families, and communities are vital in creating a healthier
world; and one of the most important health instruments in creating a
healthier community are the BHW. The review was performed to know
the level of competence, and training needs of BHW. This is to determine
the capacity and extent of the BHW in which to define the level of their
competency and practice-based learning in order to know the limit of
their actions and learning experience on their field.
As summary, according to (Robil, 2020) and (Khan, et.al., 2023),
BHW has poor practice when it comes to maternal care and dengue
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prevention while in contrary, according to (Taburnal, 2020) and
(Kajeguka, et.al., 2017), are only moderately competent, and to be well
equipped with skills, they are encouraged to continuously attend
trainings and seminars, and use self-learning kit together with health
promotion activities to increase knowledge. The same with (Handel, et.al.,
2016), (Tomboloni, et.al., 2019), and (Olaniran, et.al., 2019), that there is
a need for improvement when it comes to the practices of BHW through
guidelines, new strategies, and seminars. However, according to
(Taburnal, 2017), (Ninal & Apas, 2021), and (Castro, 2020), that BHW
are high in practice and competent. Lastly, (Mallari, et.al., 2020), and
(Ibo, 2019) talked about the importance of materials and equipment in
providing primary health care in the community. Lack of resources could
influence the delivering of primary healthcare programs in the
community.
In conclusion, the researchers must understand the capacity and
extent of the BHWs on their field wherein further study is needed. And
also if there are ways to enhance and improve the BHWs skills and
practices. And the researchers must know what other capabilities that
the BHWs can do other than taking care of the community, the
researchers must understand the level of competency and practices so
that they will determine what is lacking on the study and what further
research is needed.
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CHAPTER 3
Research Design and Methodology
Chapter 3 is consists of three parts namely: (1) Purpose of the
Study and Research Design, (2) Method, and (3) Data Analysis
Procedure.
Part One, Purpose of the Study and Research Design, restates the
main problem, discusses the approach that the researcher used in the
study of variables, and enumerates variables and statistical tools
utilized.
Part Two, Method, describes the participants, the research
instrument, and the procedure employed in the conduct of the study.
Part Three, Data Analysis Procedure, presents the date, the scoring
procedures, and discusses the descriptive and inferential statistics used
in the analysis of data.
Purpose of the Study and Research Design
This study employed the quantitative method of research in order
to determine the extent of health practices on the selected government
health programs, among barangay health workers of Barangay Lawaan,
Roxas City.
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The survey-correlation method of research was used in the study.
According to Fraenkel and Wallen (2005) survey is used as a descriptive
method to further analyze the quality and accuracy of the study
objectives. Surveys can be useful when a researcher wants to collect data
on phenomena that cannot be directly observe. On the other hand,
correlation research investigates the relationships between factors or
variables (David, 2005).
The dependent variables of this study were the extent of health
practices of Barangay Health Workers while the independent variable
was the demographic profile in terms of; age, educational attainment,
length of service, and number of trainings attended.
The statistical tool that was used to analyze and interpret the data
gathered were the frequency count, percentage, rank, mean, and the
standard deviation for the descriptive statistics and One-Way ANOVA for
inferential statistics. All inferential statistics were set at 0.05 alpha level
of significance.
Methods
Participants
The participants of this study were the sixty (60) Barangay Health
Workers of Barangay Lawaan, Roxas City. Primarily, this study aims to
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determine the extent of health practices on the selected government
health programs among Barangay Health Workers of Barangay Lawaan,
Roxas City. Simple random sampling was employed to obtain the
representative sample. Among seventy-one (71) population of the BHW in
Barangay Lawaan, sixty (60) were randomly selected from the said
barangay. Number of respondents was identified using Slovin’s Formula
since the sample were only small and finite. The sample size of the
respondents in each school is shown in Table 1.
Table 1
Distribution of BHW by designated area
Areas N N
Carmelite 11 8
Km. 2 & Tres Arcangeles 9 8
Km. 3 7 6
Proper 11 9
Servant 7 7
Jail 15 12
Patag 8 7
Homesite 3 3
Total 71 60
Profile of the Respondents
Table 2 presents the demographic profile of the respondents. It was
classified according to the age, educational attainment, length of service,
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and number of trainings attended by the BHWs of Barangay Lawaan,
Roxas City.
Data show that out of 60 BHW, in terms of age, majority are those
who were 31 to 45 years old with 33 or 55% of the respondents, and 27
or 45% are above 46 years old.
While, majority of the respondents in terms of educational
attainment are high school graduate (40 or 66.7%), followed by college
level (12 or 20%). Third are the high school level (4 or 6.7%) then, those
who were college graduate (3 or 5%), and lastly are those who were
elementary graduate (1 or 1.7%).
Data also reveals that in terms of the length of service of the BHW
of Barangay Lawaan, Roxas City, 9 or 15% of the respondents are in
service for 5 years and below, while 14 or 23.3% are 11 years above in
the service, and majority of them are 6-10 years in service with a number
of 37 or 61.7%.
Lastly in terms of the number of trainings attended, 29 or 48.3% of
the respondents had attended 0-5 trainings or seminars, as well as those
who attended 6-10 trainings has also 29 or 48.3% respondents, and
lastly the remaining 2 or 3.3% of the respondents attended more than 10
trainings.
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Table 2
Profile of the Respondents
Category f %
Entire Group 60 100.0

Age 60 100
31-45 years old 33 55.0
46 years old and above 27 45.0
Educational Attainment 60 100
Elementary Graduate 1 1.7
High School Level 4 6.7
High School Graduate 40 66.7
College Level 12 20.0
College Graduate 3 5.0
Length of Service 60 100
5 years below 9 15.0
6-10 years below 37 61.7
11 years above 14 23.3
Number of Training 60 100
0-5 29 48.3
6-10 29 48.3
Above 10 2 3.3
Data Gathering Instrument
The researcher used a researcher-modified questionnaire in
collecting the needed data. The questionnaire was divided into two
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sections. Section one determined the socio-demographic profile of the
respondents, and section two determined the health practices of
respondents on the selected government health programs.
Health Practices Questionnaire. A 21-item researcher-modified
questionnaire which presented the different commonly observed health
related practices of an individual aligned in the works of Pender (1996),
was answered in following responses: 5 – always, 4 – often, 3 – moderate,
2 – sometimes, and 1 – not at all. Moreover, questionnaire was also
determined the level of observance of the different health practice of the
respondents. Basically, items number 2, 5, 6, 8, 13, 18, 20 of the
questionnaires pertained to Pre-Natal; items number 1, 4, 9, 15, 16, 19,
21 are for Dengue; and items number 3, 7, 10, 11, 12, 14, 17 are for
immunization.
The health practices questionnaire underwent to content and faced
validation by the panel committee and experts from the field of public
and community health. Their suggestions and recommendations for the
improvement of the instruments was incorporated in the modification of
it. The instrument was pilot tested.
The result of the pilot testing was used in determining the
computer-processed factor analysis, construct validation, and reliability
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testing of the research instrument by the use of the Statistical Package
for Social Science (SPSS) software.
McDaniel (1992) contends that an instrument with a reliability
index .70 and above is consider reliable. The result of Cronbach’s alpha
revealed a reliability index of .882. The results of statistical tests
indicated that the instrument was reliable and valid.
To describe the extent of health practices on the different
government health programs the scale below was used:
Scale Verbal Interpretation
4.21 – 5.00 Highly Observed
3.41 – 4.20 Observed
2.61 – 3.40 Moderately Observed
1.81 – 2.60 Less Observed
` 1.00 – 1.80 Least Observed
Data Gathering Procedure
The data were been gathered during the period of February to April
2023. The researcher determined the participants and secured a
permission to conduct the study, from the Barangay Hall of Barangay
Lawaan, Roxas City.
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Prior to the conduct of the study, a courtesy call was done to the
Barangay Captain and President of the Barangay Health Workers of
Barangay Lawaan, Roxas City, and asked for permission to conduct the
study.
The Barangay Health Workers was given an explanation of the
nature, purpose, and objectives of the study. They were fully assured
that any information that they provided would be kept confidential and
would be used only for the purpose of this study and not be used for any
other purposes without their consent. Moreover, the respondents
informed that their participation in the study was voluntary and that
they have freedom to refuse if they do not want to participate.
Data has been collected through the use of the researcher modified
questionnaires via survey in a given date and place of the study. The
instruments have been reviewed carefully to ensure the validity of the
data. After which, the data has been encoded into the computer for
processing and analysis.
Statistical Data Analysis Procedure
The data had been processed and analyzed was used the Statistical
Package for Social Sciences (SPSS) PC software. The following were the
appropriate statistical tools used in this study:
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Frequency count and Percentage. Frequency count and Percentage
was used to find out the number of respondents that was belonged to a
particular category.
Mean. Mean was employed to find out the extent of health
practices on the selected government health programs.
Standard Deviation. Standard Deviation was utilized to determine
the homogeneity and heterogeneity of the responses.
Ranking. Ranking was employed to determine the emerging health
practices of respondents among government health programs.
One-way Analysis of Variance (ANOVA). One-way Analysis of
Variance (ANOVA) was used to determine if there were significant
differences on the extent of health practices on the selected government
health programs of the respondents when group according to age, sex,
educational attainment, and length of service. The alpha level was set at
.05.
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Chapter 4
Results and Discussions
This chapter contains two parts (1) Descriptive Data Analysis, and
(2) Inferential Data Analysis.
Part One, Descriptive Data Analysis, presents the descriptive
analysis of the extent of health practices of the BHW on the different
Government Health Programs and its level of observance.
Part Two, Inferential Data Analysis, presents the significance of the
differences in the extent of health practices of BHW on the selected
Government Health Programs.
Extent of Health Practices of
the Respondents
Table 3 presents the health practices of the respondents and its
overall level of observance.
Results shows that the extent of health practices of BHW is “Highly
Observed” as shown by the computed mean (M= 4.35). Among the extent
of health practices, Dengue Prevention Program is ranked first with a
mean of 4.57. It was followed by Pre-Natal Program (M= 4.42).
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Furthermore, the Immunization Program ranked last among the three
with a mean score of 4.06.
Table 3A. Extent of Health Practices on Pre-Natal
Items Extent of Health Practice Mean Description

2 Examine pregnant women 3.28 Moderately
Observed
5 Provide iron with folic acid 3.75 Observed
tablets to prevent anemia and
strengthen their blood
6 Inform on the danger signs of 4.82 Highly Observed
pregnancy
8 Provide a birth and emergency 4.77 Highly Observed
plan to the pregnant women
13 Advice on home care for the 4.78 Highly Observed
pregnant woman and ensure
healthy growth of the baby
18 Immunize to prevent tetanus 4.75 Highly Observed
20 Counsel pregnant women 4.82 Highly Observed
about the importance of
prenatal
Overall 4.42 Highly Observed
4.21 - 5.00 Highly Observed
3.41 - 4.20 Observed
2.61 - 3.40 Moderately Observed
1.81 - 2.60 Less Observed
1.00 - 1.80 Least Observed
Table 3A presents the extent of health practice on pre-natal
program of the BHW of Barangay Lawaan, Roxas City. Result shows that
the grand mean on the extent of health practice on prenatal is “highly
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observed” with a weighted mean of 4.42. The results would mean that
BHW are practicing the most basic healthcare activities that could
promote optimum level of health wellness in the community. This is be
because BHW are usually trained to provide basic health care service
and education to their community including prenatal care. The findings
implied that BHW practice about the prenatal program in their barangay.
It shows that they do health teaching to pregnant mothers about the
importance of prenatal, and the things that they should remember to
keep the baby safe, and immunize to prevent tetanus.
Moreover, as far as the extent of health practices is concerned, it
could be inferred that the respondents do the necessary actions for them
to perform their duty and responsibilities knowing that it is very essential
factor in their job efficiency and productivity.
The results basically conform of what is legally mandated in Senate
Bill No. 316 of (Poe, 2019) wherein BHWs provide information, education
and motivation services for maternal and child health.
In this study, most of the areas of prenatal show a very high result.
The highest practice of the BHW is informing about the danger sign of
pregnancy and counsel the pregnant women about the importance of
prenatal. This is be because health education is their most common role
as BHW wherein they provide information about the warning signs that
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pregnant women should be aware of. BHW as a member of CHT, they
also play a vital role in the health of mothers. As stated in the BHW
manual of Western Visayas (HHRDB, 2018), it was stated that one of
their responsibilities is to counsel pregnant women. The DOH provides
them the mother and Child Book, a comprehensive tool that consist of
the mother’s record, the child’s record and key health information that
will serve as their guide in health educating pregnant mothers.
However, when it comes to pregnancy examination, results show
as “moderately observed” with a mean of 3.28. This might be due to the
fact that this is out of their responsibility as BHW and they have
midwives in their barangay that are be the one who performs it. As stated
by the (DOH, 2015) that midwives shall assist the mother in monitoring
pregnancy. Also, it was stated in the BHWs reference manual (HHRDB,
2018), that BHW only remind the pregnant woman of the next scheduled
for check-up during their home visits and not directly examine them.
Whereas the roles and responsibilities of the BHW only limits to health
promotion and health education among mothers.
The result contradicts to the claim of (Robil, 2020) wherein his
study shows that BHWs has poor practice on maternal health. This
study sought to identify the suitable program intervention training
among the BHWs which will increase their primary health care services
of maternal health and family planning.
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Table 3B. Extent of Health Practices on Dengue Prevention

1 Turn containers upside down to 4.88 Highly
avoid water collection Observed
4 Health educates the community 4.87 Highly
about dengue prevention Observed
9 Clean the surroundings and 4.95 Highly
breeding site of mosquito causing Observed
dengue
15 Use insecticide sprays to reduce 3.83 Observed
mosquitos
16 Get rid of Aedes mosquito larvae if 3.83 Observed
there is in the water tank
19 Eliminates standing water around 4.85 Highly
the community to reduce Observed
mosquitos
21 Check mosquito larvae in the 4.78 Highly
water pot Observed
Overall 4.57 Highly
Observed
As far as the extent of observance of the health practice on dengue
prevention is concerned, BHWs of Barangay Lawaan, Roxas City have a
level of “highly observed” with a weighted mean if 4.57 as shown in table
3B. This means that BHW are practicing the most basic healthcare
activities that could promote optimum level of health wellness in the
community. BHW plays a crucial role in dengue prevention through
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community education and outreach programs, as well as by actively
engaging in efforts to eliminate potential breeding sites for mosquito. The
findings implied that BHW practice about the dengue-prevention
program in their barangay. It shows that they do health teaching to the
people in the community about dengue prevention, clean their
surroundings and get rid of the mosquitos or the possible breeding site of
mosquitos.
Whereas, as stated in the BHWs manual (HHRDB, 2018), that
BHW plays an important role in dengue prevention and monitoring. They
are responsible for community monitoring of the possible dengue infected
person in their community, health education, and do the protocols that
will prevent dengue.
In this study, most of the areas of dengue prevention shows a very
high result. Cleaning the surroundings and breeding site of mosquito
that could cause dengue is the most observe practice of the BHW which
has a score of 4.95. This is because the barangay usually conducted
clean-up drives in the community that could eliminate breeding sites for
mosquitos. As stated also in their manual, the 4th roles of BHW in
dengue prevention is to “regularly conduct community clean-up drives to
eliminate breeding sites of mosquito”. This result also supports the study
of (Solidum, 2013) that among the roles of the BHW “cleans the
environment together with the community residents” is the most
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performed roles of BHW. Furthermore, the result is supported by an
ordinance authored by (Legacion, et.al., 2012) stating that BHW render
essential healthcare services in the community, including promotion of
basic environmental sanitation.
However, the use of insecticides to get rid of the mosquito is only
labeled as “observed” with a weighted mean of 3.83 which is due to the
fact that insecticides is harmful to our health when inhaled and could
cause water contamination. According to (Zhang, et.al., 2023) that
mosquitocides or the frequently used to control the spread of dengue, it
can affect the environmental pollution, and can cause continuous
pollutant for rain runoff.
The same with getting rid of the mosquito larvae in the tank
wherein it has a weighted mean of 3.83 which is because they may not
have time to regularly check and remove mosquito larvae from the tank
and they can be difficult to recognize because they are small and often
hard to see with the naked eye.
The result contradicts to the claim of (Khan, 2023) wherein his
study shows that although the knowledge was quite high, this knowledge
was not put into practice. Practices based upon preventive measures
were found to be predominantly focused towards prevention of mosquito
bites rather than elimination of breeding places.
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Table 3C. Extent of Health Practices on Immunization

3 Provide immunization to children 2.82 Moderately
Observed
7 Home visit and follow-up of 4.83 Highly Observed
immunized children
10 Collaborate with mothers and 4.97 Highly Observed
encourage them to immunize their
children causing dengue
11 Monitor the expiration date of every 4.12 Observed
vaccine
12 Follow cold chain system in 4.17 Observed
administering vaccination
14 Use safe injection practice 2.75 Moderately
Observed
17 Monitor immunization status of the 4.75 Highly Observed
children
Overall 4.06 Observed
Table 3C presents the extent of health practice on immunization
program of the BHW of Barangay Lawaan, Roxas City. Result shows that
the grand mean on the extent of health practice on prenatal is “observed”
with a weighted mean of 4.06. The results would mean that BHW are
practicing the immunization to promote health and well-being of
children.
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The findings implied that BHW practice about the immunization
program in their barangay. It shows that they collaborate with mothers
and encourage them to immunize their children, monitor their
immunization status. According to (RA No. 10152, 2011), immunization
for all infants and children are mandatory where BHW plays an
important role as part of the CHT.
Collaboration with mothers and encouraging them to immunize
their children shows as the most observe health practice with a mean of
4.97. This is because health education is the most common
responsibility of the BHW and it is their role to have an immunization
campaign in their community to ensure that immunization programs are
successful and reduce the spread of vaccine-preventable diseases.
According to the BHW manual (HRRDB, 2018), that BHW function as
health educator and encourage mothers to do immunizations and
maintain the health of their infants and children.
However, in this study, it shows that safe injection practice ranked
as the lowest with a mean of 2.75. This is due to the fact that they do not
handle injection since administration of vaccines is a major role of their
midwives. As stated in (RA No. 10152, 2011) that administration of
vaccines should only done by the licensed physician, nurse, or midwives.
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The result contradicts to the claim of (Nestory, et.al., 2022) where
he concludes that practices in immunization were poor for some health
facilities and the gaps observed, inform the health managers and
policymakers toward establishing interventions to improve health
workers knowledge and practice, to guarantee that child in all
communities reaps the benefits of immunization program.
Difference in the Extent of Practice on the
Different Government Health Programs
The data of the difference of the extent of health practices of the
BHW are reflected in Table 4. Generally, there is a significant difference
in terms of age (F= 3.076, Sig.= .001), educational attainment (F= 3.430,
Sig.= .000), and number of training (F= 8.256, Sig.= .000). While there is
no significant difference in terms of length of service (F= 1.047, Sig.=
.438).
Table 4A. Analysis of Variance among the Extent of Health Practices in
Terms of Age
Source of Variation Df F Sig.

Age Between Groups 21 3.076 .001
Within Groups 38
Total 59
*p<0.05, significant @ 5% level of significance
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The data reflect that the extent of observance of health practices of
Barangay Health Workers varies in terms of age. This means they
observed health practices differently according to their age. The result
implies that there is a significant difference in the health practice when
grouped according to age. Findings indicate that mature BHW are
therapeutic and can handle situation with utmost care and confidence as
stated by (Hora, 2017) in an article on the traits of mature women.
Likewise, females are more pathetic and compassionate in handling
patients. Much more, majority of the BHWs have their own families
which can be considered as an edge over others having acquired the
experience in handling learning situations in life.
The result contradicts to the study of (Robil, 2020), wherein he
states that there is no significant difference on health practice and the
age distribution of the BHW. He stated concludes that age do not matter
when it comes the extent of practice of the BHWs.
Consequently, the null hypothesis that declares that there is no
significant difference in the extent of health practice of the BHWs on the
different government health programs when grouped according to age is
rejected.
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Table 4B. Analysis of Variance among the Extent of Health Practices in
Terms of Educational Attainment

Educational Attainment Between Groups 21 3.430 .000
Within Groups 38
Total 59
The data reflects that the extent of observance of health practices
of Barangay Health Workers varies in terms of educational attainment.
This means they observe health practices differently in terms of
educational attainment. The result implies that there is a significant
difference in the extent of health practices when grouped according to
educational attainment. BHWs with higher levels of education have
better understanding of healthcare practices and are able to provide
more effective healthcare services to their communities. Higher levels of
education may also lead to better healthcare skills, including better
communication skills and the ability to use healthcare technologies and
tools effectively. BHWs with higher levels of education are more adept at
providing health education, counseling, and other forms of healthcare
services.
The result supports the claim of (Taburnal, 2020) that educational
attainment may vary in terms of the extent of health practice. A person’s
educational level has a significant influence on work quality and
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performance. It is expected that the higher level of education a worker
has, the more efficient his or her performance. Thus, educational
background for a prospective job is always considered as one of the
criteria requirements which is supported by a study by (Santos, 2011),
according to which the competence of a BHW depends on background
knowledge about their functions and responsibilities as healthcare
service providers. These main functions require a BHW to posses’
adequate information and skills to perform the job effectively and
efficiently. This is further supported by (Kok, 2012), according to whom
the selection of CHWs with specific characteristics, such as higher
education level would lead to better competencies and less drop-outs
amongst community health workers.
However, it contradicts to the claim of (Robil, 2020), that there is
no significant difference in terms of health practice and educational
attainment.
different government health programs when grouped according to
educational attainment is rejected.
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Table 4C. Analysis of Variance among the Extent of Health Practices in
Terms of Length of Service

Length of Service Between Groups 21 1.047 .438
Within Groups 38
Total 59
of Barangay Health Workers do not varies in terms of length of service.
This means they do not observe health practices differently in terms of
length of service. The result implies that there is no significant difference
in the level of health practices when grouped according to length of
service which is because the implementation of government health
programs is regularly updated and reinforced through continuous
training and education programs regardless of the length of service. All
BHWs are required to undergo a basic training program before they can
start practicing, regardless of their length of service. The training
program aims to provide BHWs with the necessary skills to perform their
duties effectively. Therefore, the extent of health practice among BHWs
may not differ significantly based on their length of service, as they have
all undergone the same training.
The result support to the claim of (Robil, 2020), that there is no
significant difference in terms of health practice and the years of service
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of the respondents. Whereas according to (Taburnal, 2020), that length of
service may not guarantee competence since training, seminars, and the
right attitude towards work can boost such ability.
In contrary, according to (Santos, 2011), to whom length of time
should provide workers with the opportunity to adapt to the system, be
more organized, and become comfortable with the job. Having lived and
worked in the same locality for several years may give workers the
chance to become familiar with clients and residents of the community in
identifying their needs as well as barangay officials, families and the
community to develop a harmonious working relationship.
different government health programs when grouped according to length
of service is accepted.
Table 4D. Analysis of Variance among the Extent of Health Practices in
Terms of Number of Trainings

Number of Training Between Groups 21 8.256 .000
Within Groups 38
Total 59
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of Barangay Health Workers varies in terms of the number of trainings
attended. This means they observe health practices differently in terms of
the number of trainings attended. The result implies that there is
significant difference in the level of health practices when grouped
according to number of trainings attended. Attending more training
sessions could lead to a better understanding of health-related issues, as
well as new skills that can be applied in their work. Health practices and
guidelines are constantly evolving, and attending training sessions can
help BHWs stay up-to-date with the latest information and best
practices. This can lead to better decision-making and improved health
outcomes for the community they serve.
According to (Dagangon, et.al., 2014), the main duties of BHWs
that was promulgated by the DOH was to provide information, education,
and motivation on primary health care services such as maternal and
child health, family planning and nutrition in the communities where
they live. They also stated that the lack of skills-based training is a
barrier to effective BHWs performance. The (DOH, 2017), specified in the
RA 7883, the government endeavors to provide training and continuing
education programs to provide professional development to BHWs. It also
stipulated that DOH is the one who directed and provides the guidelines
for the effective implementation of RA 7883.
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The result supports the claim of (Ninal & Apas, 2021) wherein they
claim that there is a significant difference in the level of health practice of
the BHW when grouped according the number of trainings attended.
Whereas they recommended to the Barangay Officials to have financial
allotment for the trainings and seminars so that BHW could properly
deliver the healthcare services to their constituents. The same with
(Taburnal, 2020) which stated that, to be well-equipped with skills,
BHWs are encouraged to continuously attend training and seminars.
significant difference in the level of health practice of the BHWs on the
different government health programs when grouped according to
number of trainings attended is rejected.
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Chapter 5
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
Chapter 5 consists of three parts, namely: (1) summary of the
problems, methods, and finding; (2) conclusions; and (3)
recommendations.
Part one, summary of the problem, methods and findings; present
the summary, methods used, and findings obtained from the results of
the study.
Part two, conclusions, states the generalizations that have been
formulated after the results and the findings have been analyzed and
interpreted.
Part three, recommendations, offers some suggestions on the
application of findings of the study. It also presents possible areas for
future research that may be undertaken by interested individuals.
Summary
The study investigated the extent of health practices on the
selected government health programs, of Barangay health workers of
Barangay Lawaan, Roxas City.
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The study utilized a method of research employing quantitative
approaches in gathering the data. The study was conducted using a
random sample of 60 barangay health workers in Barangay Lawaan,
Roxas City. A researcher-modified instrument was used to gather needed
data and is made up of two parts namely: the socio-demographic profile,
and extent of health practice. The instrument’s validity and reliability
were established and administered by the researcher themselves through
SPSS. The data were then collated, scored, and given corresponding
verbal interpretation using descriptive and inferential statistics of the
SPSS. Statistical tool used to analyze and interpret data were frequency
count, percentage, mean, and ANOVA. For the results the following were
obtained.
1. The extent of health practices on the selected health programs of
barangay health workers of barangay Lawaan, Roxas City was highly
observed.
2. There were significant differences in the extent of health practice
of the respondents on the different government health programs when
grouped according to age, educational attainment, and number of
trainings attended. However, there was no significant difference in terms
of the length of service.
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Conclusions
Based on the results, the major findings of the study were:
1. The barangay health workers who are good on health practices
are also well-positioned to identify and respond to health issues in their
communities. They can observe health practices and identify areas where
improvement is needed, provide health education and counseling, and
monitor individuals for signs of illness or disease.
2. Younger BHWs may have received more recent and updated
training in health practices compared to older BHWs. While mature BHW
are therapeutic and can handle situation with utmost care and
confidence.
BHWs with higher levels of education may have better
understanding of healthcare practices and may be able to provide more
effective healthcare services to their communities
Attending more training sessions could lead to a better
understanding of health-related issues, as well as new skills that can be
applied in their work
Implementation of government health programs is regularly
updated and reinforced through continuous training and education
programs regardless of the length of service.
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Recommendations
Based on the conclusions made, the following recommendations
were presented:
1. Encouragement of participation of barangay health workers in
various health-related activities such as health fairs, outreach programs,
and community health campaigns. These activities can provide a
platform for them to apply their skills and practices in promoting and
implementing government health programs, while also gaining practical
experience and exposure to different health issues.
2. Continuous education and training: Barangay health workers
should be given regular training and education on the latest information
and guidelines related to pre-natal care, immunization, and dengue
prevention. This can help them stay up-to-date with the best practices
and approaches for these health programs.
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Challenges for Dengue Prevention and Control in the Dominican
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Gebbie, K., & Merrill, J. (2002). public health & practices. Public Health
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Go, C.L. (2019, July). An Act Mandating the Appointment of Barangay

Health Workers in Barangays, Providing for their Duties and
Responsibilities, Compensation and Benefits, and for Other
Purposes (Explanatory Note). Retrieved from
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Good Neighbors, (2022). Barangay Health Workers in this Time of

COVID-19. Retrieved from https://goodneighbors.ph/good-stories-
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Hartzler, A., Tuzzio L., Hsu C., & Wagner E. (2018). Roles and Functions
of Community Health Workers in Primary Care. National Library of
Medicine, 16(3), 240-245. https://doi.org/10.1370/afm.2208
Health Improve Organization. (2019). Health practices definition. Your

Health Improve. Retrieved from https://www.health-
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Kavishe, R., Mosha, F., & Kulkarni, M. (2017, March 13).
Knowledge and practice regarding dengue and chikungunya: a
cross-sectional study among Healthcare workers and community
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https://doi.org/10.1111/tmi.12863
Ku, G.M., & Kegels, G (2014). Global Health Action. Integrating chronic
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people with diabetes through the First Line Diabetes Care Project
in the Philippines. Global Health Action, 7(1).
https://doi.org/10.3402/gha.v7.25286
Mallari, E., Lasco, G., Sayman, D.J., Amit, A.M., Balabanova, D., Mckee,
M., Mendoza, J., Villanueva, P., Renedo, A., Seguin, M., & Palafox,
B. (2020, September 11). Connecting Communities to Primary
Care: A Qualitative Study on the Roles, Motivations and Lived
Experience of Community Health Workers in the Philippines. BMC
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https://doi.org/10.1186/s12913-020-05699-0
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Monsale, D.M., Monsanto, C.J., Pescante, K.K., Rico, J.M., Rosello, C.A.,
& Dela Torre, J.K., (2019). Effect of a Basic Life Support Seminar
on the Level of Knowledge on Basic Life Support Among Barangay
Health Workers in Selected Barangay of Mandaue City. Retrieved
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https://sdg.neda.gov.ph/public-health-programs/
Poe, G. (2014, May 14). An Act to Improve and to Promote Quality

Delivery of Health Services in Barangay, Enacting the “Barangay
Health Workers and Services Reform Act of 2014” (Explanatory Note).
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Robertson. (2018). What is attitude? Definition, components, types, and

its formation. Retrieved from https://tyonote.com/attitude/
Robil, J.L. (2020, July). Knowledge, Attitude and Practices on Primary

Health Care Services on Maternal Health and Family Planning
Among Barangay Health Workers of San Andreas, Quezon: Basis
for an Enhancement Program. Journal of Health Sciences, 3(1), 55-
64. Retrieved from https://web1.aup.edu.ph/urc/wp-
content/uploads/2021/02/JHS-July-2020-Online.pdf#page=56
Siongco, K.L., Nakamura, K., Seino, K., Moncatar, T.R., Tejero, L.M., De
La Vega, S.A., Bonito, S., Javier, R., Tsutsui, T., Tashiro, Y., Al-
Sobaihi, S., Lorenzo, F.M., & Canila, C. (2021, September 9).
Improving Community Health Workers’ Attitudes Toward
Collaborative Practice in the Care of Older Adults: An In-Service
Training Intervention Trial in the Philippines. MDPI, 18(19).
https://doi.org/10.3390/ijerph18199986
Taburnal, M. M. (2020). Knowledge and Competence of Barangay Health

Workers (BHWS). International Journal of Innovation, Creativity
and Change, 14(1), 1310. Retrieved from
https://www.ijicc.net/images/Vol_14/Iss_1/14160_Taburnal_202
0_E_R.pdf
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Taburnal, M.V., (2017). Barangay Health Workers Level of Competence.

Asia Pacific Higher Education Research Journal, 4(1). Retrieved
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cle/view/437
Villanueva, G. V., Villantes, Y. L., Pusod, M. L., & Lasutaz, M. E. (2018).

Basic oral health care knowledge of primary workers appraisal for
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Appendices
A. Communication Letters
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B. Research Instruments
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C. Statistical Analysis
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D. Study Information and Consent Form
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E. Curriculum Vitae
Name: Ma. Angeline B. Bornales
Sex: Female
Civil Status: Single
Date of Birth: November 6, 2001
Place of Birth: Dr. Jose Fabella Hospital, Sta. Cruz, Manila
Father's Name: Mario T. Bornales
Occupation: Businessman
Mother's Name: Arlene B. Bornales
Occupation: Teacher
Address: Carataya, Maayon, Capiz
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Name: Maryluna R. Gonzales
Sex: Female
Date of Birth: October 25, 2001
Place of Birth: Brgy. Taslan Dumarao Capiz
Father’s Name: Norberto B. Gonzales Sr.
Occupation: Farmer
Mother’s Name: Sanita G. Gonzales
Occupation: Housewife
Address: Brgy. Taslan Dumarao Capiz
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Name: Tristan Jay P. Hiponia
Sex: Male
Date of Birth: April 27, 2002
Place of Birth: Emmanuel Hospital, Roxas City
Father’s Name: Richard Hiponia
Occupation: Businessman
Mother’s Name: Herlene Hiponia
Address: Pob. Ilawod, Panitan Capiz
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Name: Sylen A. Miranda
Sex: Male
Place of Birth: Emmanuel Hospital, Roxas City
Father’s Name: Anthony A. Miranda
Occupation: Mechanical Engineering
Mother’s Name: Liezl A. Miranda
Occupation: Accountant
Address: New Road Banica Mendoza Subd. Roxas City
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Name: Van Venice L. Ocate
Sex: Female
Place of Birth: Mambusao District Hospital, Mambusao, Capiz
Father's Name: Boyet S. Ocate
Occupation: Technician
Mother's Name: Evangelyn L. Ocate
Address: Navarra Avenue Poblacion Proper, Mambusao,Capiz
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Name: Khrizlynne L. Soberano
Sex: Female
Date of Birth: March 23, 2002
Place of Birth: St. Anthony Hospital, Roxas City
Father's Name: Ramonito A. Soberano
Occupation: Farmer
Mother's Name: Mechelle L. Soberano
Occupation: Teacher
Address: Old Guia, Maayon Capiz
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ST. ANTHONY COLLEGE OF ROXAS CITY, INC.

Introduction to the Study

Chapter 1 is made up of five parts, namely: (1) Background and

Part One, Background and Rationale of the study, presents the

introduction, discusses the rationale for conducting the investigation and

presents the theoretical framework, which serves as the study’s frame of

answer. It also presents the hypotheses to be tested.

Part Three, Significance of the Study, provides explanations on

what benefit each stakeholder will have on the research results.

Part Four, Definition of Terms, gives the meaning of the important

of clarity and understanding.

in terms of research design, participants, sample size and sampling

procedures, locale, data-gathering instruments, and statistical tools

employed in the analysis of data.

Background and Rationale of the Study

A Barangay Health Worker is a type of health care provider in the

Philippines. Before providing primary care in the community, they must

complete a basic training and development program approved by the

government or a non-governmental organization. They provide services in

and responsibilities in accordance with the Department of Health's

standards, as specified in Section 3 of Republic Act No. 7883. (Poe,

and sacrificially to their communities. Until today, they step up on the

The Philippines has a long history of PHC having adopted the

approach in 1981 as a national strategy. This strategy relies heavily on

the community through barangay health stations (BHS) that serve a

population of 5,000 and rural health units (RHUs)/city health offices

(CHOs) that serve a population of 20,000. The devolution of health

services in 1991 mandated the management of primary care facilities at

the barangay, city, or municipal levels to local governments units (LGU).

facilities, including their staffing. In addition to formal cadres of health

midwives), Barangay Health Worker (BHW) complement health services

healthcare system and the rest of the community.

Health center programs are guaranteed programs of the

Department of Health (DOH) which are disseminated to the health

to promote health, prevent diseases and educate people in the

community, also to ensure quality health care service to depressed

marginalized and underserved areas through the deployment of

competent and community-oriented healthcare workers.

BHWs are considered to be nurturers and providers of health care

services to their constituents even in the far-flung barangays. The

Department of Health (2016) emphasized the importance of the BHWs as

part of Community Health Teams since they are a link between

communities or families to health care providers. As a link, they increase

family awareness and recognition of health risks and the promotion of

positive health behaviors. The BHW maintain regular communication

professionals. Also assisting the community from the identification of the

health problems, the development of health plans and in taking action to

promote their health and well-being.

Motivation to perform tasks well can be affected by work

environment, particularly the availability of resources and policies.

Facilities and policies have significant effects in the work performance of

provided with adequate resources and well-defined policies. The presence

of a permanent BHS can give health workers a favorable working

environment. They can easily access equipment and medical supplies

needed to perform their jobs. BHWs constantly make required reports. A

designated workplace will help them do their paperwork easily, resulting

to better work output. Moreover, BHWs should have adequate personal

paraphernalia to perform health services to the community efficiently.

Inadequate resources can limit the capabilities of the BHWs in rendering

performance of their duties in the community, especially that the BHWs

are exposed to different types of people in the community. As a result,

problems in connection with the performance of their duties may be