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.
Context of Community Health
Programs
A.
Health Care System Infrastructure
B.
Individual Health Care Context
C.
Social institutions and Community
Health Programs
II.
Use of field research methods
A.
Program development cycle
B.
Qualitative methods
C.
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
ECONOMIC SUPPORT
1. Public Health Activities
2. Medical Care Services
3. HHR Production
4. Research
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
Juan or Maria and Health Care Financing
Govern ment
Appropriations
Public Health
Programs
Health Care Services
Taxes
Subsidies
Contributions
Premiums
Juan
or
Premiums
Maria
Community
Organizations
User Fees
Health Care Services
Insurance Companies
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
Objective
Setting
Strategy Formulation
Programming
Monitoring and
Evaluation
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