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Utilization of Primary Health Care Services in the Province of Capiz
Dissertation Abstract:
The major purpose of the study was to describe the nature, condition, and use of Primary Health Care (PHC) services of the Department of Health (DOH) in Capiz, Philippines before and during the implementation of RA 7160 (known as the Local Government Code of 1991). Specifically, it sought to: 1) describe the demographic, cultural, and economic characteristics of the PHC user-households in terms of age, family size, education, religion, occupation, and income; 2) determine the mode of health service use; 3) describe the changes in the institutional and leadership structure, support mechanism, and extent of participation existing in PHC; 4) determine the convergence in the perception of and attitude toward the PHC programs/services among health users, workers, and implementors; 5) determine the PHC users' awareness and degree of satisfaction in the services; and 6) analyze the factors related to the use of the health services among the PHC users.
The study was undertaken in 12 barangays (villages) of the six municipalities in the first and second districts of Capiz. It involved 357 PHC user-households and 57 key informants composed of local government officials. Data were gathered using a structured interview schedule and analyzed using mean, range. frequency count, percentage, standard deviation, and T-test for paired observations. Pearson's R correlation method was used to determine correlations among variables.
Results were interpreted at five percent level of significance. Findings revealed that PHC was a strategy in adopting the recommended health practices ofhouseholds. The predictors of adoption before the devolution were accessibility, frequency of use, information dissemination, and awareness, perception, and degree of satisfaction in the PHC programs and services. During the devolution, the predictors were sources, accessibility, awareness, and perception of health programs and services.
Health services prior to the devolution were being undertaken by DOH through the Rural Health Unit (RHU) and managed by the national government. However, in the new setup pursuant to RA 7160, the health services have been devolved to the local government unit (LGU) with the Municipal Mayor as Chief Executive. Key informants gave only moderate priority to PHC services. Support in terms of budget, logistics, and infrastructure/facilities was insufficient but the human resources were sufficient.
The devolution of the health services to the LGU led to positive and negative changes in the mode of PHC use and extent of participation and socio-psychological conditions of the PHC user households. These were: mode of PHC use (less availability of health services, more sources of health services, and more accessible health services/facilities); extent of participation (less use and less information dissemination of health services ); and socio-psychological changes (positive perception, increased awareness, and less satisfaction in the PHC programs services). The devolution resulted in significant improvements in the adoption of the recommended health practices but only minor improvements were noted in the reduction of morbidity and mortality rates in Capiz. Generally, the PHC programs/services before and during the devolution had strengths as well as weaknesses. However, PHC proved its role as a strategy in improving the health practices and lives of the people in the six municipalities of Capiz.