IPC-DSA SA 227 “ Using Field Research Methods for Community Health Programs”

1. IPC-DSA SA 227 “Using Field Research Methods for Community Health Programs” Dennis B. Batangan, M.D., M.Sc.(CHDC) Institute of Philippine Culture Ateneo de Manila University

2. Outline of Presentation • Context of Community Health Programs • Health Care System Infrastructure • Individual Health Care Context • Social institutions and Community Health Programs • Use of field research methods • Program development cycle • Qualitative methods • Quantitative methods

3. Philippine Health System Infrastructure ( Sanchez et.al, 1993,Adopted from WHO,1987) MANAGEMENT 1 Health Planning 2. Administration 3. Regulation ORGANIZATIONL STRUCTURE 1. Hierarchy of Health Services 2. Integration of Public Health and Medical Care 3. Roles of Different Sectors 4. Indigenous Medicine DELIVERY OF SERVICES 1. Health in the Hands of the People 2. Community Health Workers 3. Professional and Paraprofessional Health Personnel 4. People Oriented Programs RESOURCE PRODUCTION 1. HHR 2. Health Care Facilities 3. Commodities 4. Science and Technology ECONOMIC SUPPORT 1. Public Health Activities 2. Medical Care Services 3. HHR Production 4. Research

5. Ekonomiya Pulitika Populasyon Kalikasan Isip Gawa Kilos Damdam Intervening organizations Individual Social Institutions

6. Intervening Organizations/ programs Community, intervening organizations/ programs and social institutions Community Social Institutions

7. The Program Development Cycle Situational Assessment and Analysis Monitoring and Evaluation Objective Setting Strategy Formulation Programming Implementation

8. Sample study on the use of field research methods for community health programs • Context A development agency (Catholic Relief Service) preparing to support the implemen- tation of a community-based social health insurance project in rural villages • Objectives • Determine viability and acceptability of CB-SHI schemes • Identify most appropriate CB-SHI scheme

9. Sample study… • Specific objectives • Community health problems • Health services and resources • Social/solidarity support schemes • Other community resources • Appropriate CB-SHI scheme

10. Sample study…. • Methodology • Review of records - reports, forms, minutes of meetings • Key informant interviews - LGU leaders, health program leaders, health providers • Community survey - Sampling design

11. Sample study… • Results • Health problems - distance, cost, availability of health services; poverty related health problems – food, water, education, low-income • Health providers – MHO, pvt M.D.,self medication, Albularyo/Hilot, BHW, Midwife

12. Sample study… • Results • Health expenditures – 1/3 of respondents with no regular budget for health; range 50-800 pesos; mode 200 pesos • Acceptability of a SHI Scheme – 72/77 willing to join; 2/77 willing but…; 3/77 not willing. Acceptable contribution for a scheme – 5-15 pesos per month

13. Sample Study • Results f. Other community solidarity mechanisms/resources – Bayanihan, Pintakasi, Damayan, Death Aid collection, Ambagan sa maysakit, paluwagan, cooperative, BHW/CHW, CBHP, Water Management project

14. Sample Study… • Analysis and recommendations • Partnership program for CB-SHI • Strengthen CBHP and community systems • Program planning to include: Long term and operational plans; clear policy decisions; programmed organizational adjustments; provision of technical inputs and advocacy