JMIR Publications

ABSTRACT

Background:

The Philippines' primary care is delivered via local health centers called barangay health centers (BHCs). Barangays are the most local government units in the Philippines. Designed to promote and prevent disease via basic healthcare, these BHCs are staffed mainly by barangay health workers (BHWs). However, there has been limited research on the social and environmental factors affecting underserved communities access to healthcare in underserved areas of the Philippines. Given the importance of BHCs in disease prevention and health promotion, it is necessary to identify obstacles to providing their services and initiatives.

Objective:

This study aimed to explore multilevel barriers to accessing and providing basic healthcare in barangay health centers (BHCs).

Methods:

We used a qualitative approach and the socio-ecological model as a framework to investigate the multilevel barriers affecting basic healthcare provision. Four public health nurses and eighteen barangay healthcare workers from six BHCs across the country participated in focus group discussions and individual semi-structured interviews. In addition, traditional thematic content analysis was used to examine the data.

Results:

Findings revealed various barriers to the individual (lack of staff motivation, misperceptions of healthcare needs), interpersonal (lack of training, unprofessional behaviors, lack of communication), institutional (lack of human resources for health, lack of accountability of staff, unrealistic expectations, lack of physical space/supplies), community (lack of community support, lack of availability of appropriate resources, belief in traditional healers), and policy (lack of uniformity in policies and resources, lack of a functional infrastructure) levels.

Conclusions:

Examining individual, interpersonal, institutional, community, and policy level determinants that affect BHCs can inform community-based health promotion interventions for the country's underserved communities. Given the multidimensional barriers identified, a comprehensive program must be developed and implemented in collaboration with healthcare providers, community leaders, local and regional healthcare department representatives, and policymakers.