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
Outline of Presentation
I. A. B. C.
II. A. B. C.
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
Philippine Health System Infrastructure ( Sanchez et.al, 1993,Adopted from WHO,1987) MANAGEMENT
1 Health Planning 2. Administration 3. Regulation
RESOURCE PRODUCTION 1. HHR 2. Health Care Facilities 3. Commodities 4. Science and Technology
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
ECONOMIC SUPPORT 1. Public Health Activities 2. Medical Care Services 3. HHR Production 4. Research
Juan or Maria and Health Care Financing
Govern ment
Taxes
Appropriations
Health Care Services
Public Health Programs
Subsidies Contributions
Community Organizations
User Fees
Juan or Premiums Maria
Health Care Services
Insurance Companies
Premiums
Personal Health Care Providers
Premiums
3rd party payer
User Fees
Ekonomiya Pulitika Populasyon Kalikasan
Isip Gawa Kilos Damdam
Intervening organizations
Social Institutions
Individual
Community, intervening organizations/
programs and social institutions
Community
Intervening Organizations/ programs
Social Institutions
The Program Development Cycle
Situational Assessment and Analysis
Monitoring and Evaluation
Objective Setting Strategy Formulation Programming
Implementation
Sample study on the use of field research methods for community health programs
Context A development agency (Catholic Relief Service) preparing to support the implementation of a community-based social health insurance project in rural villages II. Objectives Determine viability and acceptability of CB-SHI schemes Identify most appropriate CB-SHI scheme
I.
Sample study…
III. Specific objectives 1.
2. 3.
4.
5.
Community health problems Health services and resources Social/solidarity support schemes Other community resources Appropriate CB-SHI scheme
Sample study….
IV. Methodology a. Review of records - reports, forms, minutes of meetings b. Key informant interviews - LGU leaders, health program leaders, health providers c. Community survey
- Sampling design
Sample study…
IV. Results a. Health problems - distance, cost,
b.
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
Sample study…
IV. d.
e.
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
Sample Study
IV. Results
f. Other community solidarity mechanisms/resources – Bayanihan, Pintakasi, Damayan, Death Aid collection, Ambagan sa maysakit, paluwagan, cooperative, BHW/CHW, CBHP, Water Management project
Sample Study…
V. a. b.
c.
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