CHAPTER II

REVIEW OF RELATED LITERATURE

This part of the study discusses the relevant literature connected with

BHERTs profile, capabilities, and level of performance. Studies regarding level of

satisfaction as perceived by clients or the constituents. It also accounts for the works

which were published on the topic by accredited scholar and researchers. Moreover,

this justifies the reason for the conduct of this study. Concurrently, it allowed the

researcher to establish the conceptual framework and the hypothesis of this study.

Philippine BHERTS: Its Establishment and Roles

The Local Government Code, which established the structure and authority of

local government units (LGUs) across the nation, was enacted into law in the

Philippines in 1991. These LGUs include the provinces, cities, municipalities, and

barangays. Health services regulations were disseminated from the national level

through the Department of Health to the governors and mayors as part of the

decentralization process in the early 1990s. This empowered the LGUs to manage

the government's disease prevention and control programs as well as the

administration of health personnel at the local level.

The Barangay Health Emergency Response Teams (BHERTs) were

established in response to the multi-country SARS pandemic in 2003 and in

accordance with Memorandum Circular No. 2003-95 from the Philippine Department

of Interior and Local Government (DILG). In the said memorandum, it is mandated

that one BHERT should be organized for every 5000 population in the barangay.

Each BHERT had been established in accordance with the barangay captain's

instructions. The team is made up of an appointed Executive Officer, a Barangay

Tanod (village enforcer), and two health professionals, one of which is ideally a nurse
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or midwife. Initial functions of BHERT are aligned with the national health issue on

SARS pandemic. This includes home visitation, providing lists, taking daily

temperatures, and monitoring the people arriving in the barangay coming from foreign

countries.

From 2003 to present, BHERT was one of the organized key players in

combating epidemics and pandemics in the country. Epidemiological statistics

demonstrated that after the implementation of BHERT and its systematized plan,

malaria morbidity and death drastically decreased across the Palawan province

(Matsumoto-Takahashi and Kano, 2016).

As part of their roles, BHERTs are involved in various programs that are

geared towards strengthening the capacity of communities to respond to health

emergencies and disasters. Some of the programs implemented by BHERT include

(1) Basic Life Support and First Aid Training where every BHERT member is trained

in basic life support and first aid to respond to medical emergencies such as heart

attack, stroke, and other health-related emergencies; (2) Disaster Risk Reduction and

Management, where they should be trained in disaster risk reduction and

management to respond to natural disasters such as typhoons, floods, and

earthquakes. They are also involved in pre-disaster activities such as community

preparedness planning and risk assessments; (3) Disease Surveillance and Contact

Tracing, where BHERT members should be involved in disease surveillance and

contact tracing activities to identify and isolate cases of infectious diseases within

their barangay; (4) Health Promotion and Education where they are involved in health

promotion and education activities such as community health campaigns and health

screenings. They also provide information on proper hygiene, sanitation, and disease

prevention; and (5) Emergency Response Planning where BHERTs are involved in
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emergency response planning activities to ensure a coordinated and effective

response to health emergencies and disasters within their barangay.

The Role and Importance of Barangay Health Emergency Response Teams

(BHERTs)

Barangay Health Emergency Response Teams (BHERTs) are vital

components of the public health system in the Philippines. They play a crucial role in

managing health emergencies at the grassroots level, providing essential services

during crises such as disease outbreaks, natural disasters, and other emergencies.

This literature review examines the role and importance of BHERTs, their structure

and functions, factors influencing their effectiveness, and the challenges they face.

BHERTs are designed to provide immediate health services and manage

emergencies within barangays. Their responsibilities include disease surveillance,

health education, emergency medical response, and coordination with higher health

authorities.

One of the primary roles of BHERTs is to monitor and report communicable

diseases within their communities. This includes conducting house-to-house visits,

identifying symptomatic individuals, and ensuring they receive appropriate medical

attention (Robielos, et al., 2020). BHERTs also engage in vaccination campaigns and

health education to prevent disease outbreaks (Amit, et al., 2022).

BHERTs are often the first responders in medical emergencies, providing

initial assessment and basic life support before transferring patients to higher-level

healthcare facilities. Their presence is particularly critical in rural and remote areas

where access to healthcare is limited (Juanzon and Oreta, 2018).

Educating the community about health risks and preventive measures is a key

function of BHERTs. They conduct information campaigns on hygiene practices,

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disease prevention, and proper nutrition, thereby promoting overall community health

(Dodd, et al., 2021).

BHERTs work closely with local government units, healthcare providers, and

non-governmental organizations to ensure a coordinated response to health

emergencies. This collaboration is essential for mobilizing resources and providing

comprehensive care (Bautista, 2006).

Factors Affecting BHERTs Performance

Varying conditions such as socio-demographic profile and capabilities of

members of BHERTs are needed to be studied so as to ensure an improved health

and emergency response-related services in the community. A training needs

analysis among barangay health workers in Davao City revealed that the level of

competence and training needs of the respondents were highly needed in all areas

identified in the study (Dagangon et al 2014). However, a study conducted by

Quiteves (2011) implied that the level of performance of BHERT was not significantly

influenced by their socio-demographic profile.

BHERT is composed of volunteer members who are not paid a fixed wage or

salary. BHERT members are expected to render their services without any monetary

compensation as part of their commitment to public service and community

volunteerism. However, the study of Mallari Et. Al. (2020) claimed that as the roles of

the Barangay Health Workers are largely voluntary, most BHWs in the urban areas of

the country seek for financial and non-financial incentives, increased technical

knowledge and skills, 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.

Regular training and capacity-building activities are essential for ensuring that

BHERT members are well-equipped to handle health emergencies. Studies have

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shown that teams with ongoing training programs are more effective in their roles (del

Valle, 2022).

Adequate resources, including medical supplies, protective equipment, and

transportation, are crucial for the operational success of BHERTs. Resource

constraints can significantly hinder their ability to perform effectively (Mann, 2005).

Strong community support and engagement are vital for the success of

BHERTs. Community trust and cooperation can facilitate better health outcomes and

more efficient emergency responses (Tiangco, et al., 2023).

Effective governance and supportive policies are critical for the functionality of

BHERTs. Policymaking that ensures regular funding, clear operational guidelines,

and accountability mechanisms contributes to their overall effectiveness (Gonzalez &

David, 2018).

Clients’ Satisfaction of BHERTs

Client satisfaction is a critical indicator of the effectiveness of health services

provided by Barangay Health Emergency Response Teams (BHERTs).

Understanding the factors that influence client satisfaction can help improve the

quality of these services and enhance public health outcomes

Client satisfaction with BHERTs is influenced by various factors, including the

timeliness of response, the quality of interaction with BHERT members, perceived

competence, and the overall outcome of the services provided.

One of the most significant factors affecting client satisfaction is the timeliness

of the response provided by BHERTs. Quick and efficient service delivery during

emergencies is crucial in meeting client expectations (Zeithaml et al., 1990). Studies

have shown that clients highly value the prompt arrival of BHERTs during health

emergencies, as delays can lead to exacerbation of health conditions and increased

anxiety among patients and their families (Gebru et al., 2019).

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The manner in which BHERT members interact with clients significantly

impacts satisfaction levels. Empathy, communication skills, and professionalism are

critical components of high-quality interactions. Research by Negroni et al. (2020)

indicates that clients appreciate BHERT members who demonstrate genuine

concern, provide clear explanations, and maintain a respectful attitude. Positive

interpersonal interactions foster trust and satisfaction.

Clients' perceptions of the competence of BHERT members play a vital role in

their satisfaction. This includes the ability of BHERT members to accurately assess

and address health issues, provide appropriate medical interventions, and offer

reliable health advice (Asuncion, et. al., 2020). Clients feel more satisfied when they

believe they are receiving care from knowledgeable and skilled professionals.

The overall health outcomes resulting from BHERT interventions also

influence client satisfaction. Successful treatment, effective disease containment, and

improvement in health conditions are key factors that contribute to higher satisfaction

levels. Clients who experience positive health outcomes are more likely to express

satisfaction with the services received.

Conceptual Framework of the Study

In this study, profile, capabilities and level of performance of BHERTs will be

identified. Furthermore, this study will determine the level of satisfaction of the

BHERTs as perceived by the barangay constituents. The relationships between 1)

profile and capabilities of the members of the BHERTs, 2) level of performance of the

BHERTs, and 3) level of satisfaction as perceived by barangay constituents. These

indicators will be the basis of the development of the Intervention Program and/or

Policy Enhancement to improve the implementation of BHERT programs. The

relationship between the dependent variable and the independent variable is shown

in Figure 1 which will be determined through quantitative design.

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Independent Variable Dependent Variable

Output

Level of
Profile of BHERTS Performance and
in terms of: Level of
Socio-economic Satisfaction of the
profile and BHERT Services
Training needs

Figure 1- Paradigm of Study

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Hypothesis of the Study

This study tested the following null hypothesis at α=0.05 level.

1. There is no significant relationship between BHERTs profile, and their clients’

level of satisfaction.