ArticleBMC health services research2021
Governance of community health worker programs in a decentralized health system: a qualitative study in the Philippines.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- The Locus-of-Hope Enhancement Program for Filipino Community Health Workers' Hope and Well-Being: A Parallel Randomized Alternative-Treatments Study.Journal of community psychology · 2026Trial
- Assessment of community health workforce governance in federal Nepal.Health policy and planning · 2026Article
- Impact of home-visit counselling on maternal and child health and nutrition by Barangay health workers: a quasi-experimental study from Eastern Visayas, Philippines.Journal of global health · 2025Article
- Sociodemographic factors associated with concurrent stunting and wasting among children experiencing extreme poverty in the Philippines: A cross-sectional study.Nutrition and health · 2025Article
- Pragmatic Application of Implementation Science in Filipino Healthcare Environments.International forum for nursing and healthcare · 2025Article
- Amplifying Community Health Worker Voices to Examine the Implementation and Scaling of a Community Health Program: A Qualitative Study in the Philippines.Health services insights · 2025Article
- Smoking knowledge and decision in an era of widespread awareness: Persistent disparities and policy implications.PloS one · 2025Article
- Important but Neglected: A Qualitative Study on the Lived Experiences of Barangay Health Workers in the Philippines.Acta medica Philippina · 2025Article
- Resilience, ingenuity, and identity: A multi-level analysis of the Filipino community health worker experience in rural and remote municipalities in the Philippines.PLOS global public health · 2025Article
- Expanded roles of community health workers beyond malaria in the Asia-Pacific: A systematic review.PLOS global public health · 2024Article
- Using the Socioecological Model to Explore Barriers to Health Care Provision in Underserved Communities in the Philippines: Qualitative Study.Asian/Pacific Island nursing journal · 2023Article
- The policy environment of self-care: a case study of the Philippines.Health policy and planning · 2023Article
- Extending health systems resilience into communities: a qualitative study with community-based actors providing health services during the COVID-19 pandemic in the Philippines.BMC health services research · 2022Article
- Navigating fear and care: The lived experiences of community-based health actors in the Philippines during the COVID-19 pandemic.Social science & medicine (1982) · 2022Article
- Dramatic increases in knowledge, attitudes and practices of COVID-19 observed among low-income households in the Philippines: A repeated cross-sectional study in 2020.Journal of global health · 2022Article
- Exploring the Role of Social Networks in Facilitating Health Service Access Among Low-Income Women in the Philippines: A Qualitative Study.Health services insights · 2022Article
- Codevelopment of COVID-19 infection prevention and control guidelines in lower-middle-income countries: the 'SPRINT' principles.BMJ global health · 2021Article
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7 authors.
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Abstract
backgroundCommunity health worker (CHW) programs are an important resource in the implementation of universal health coverage (UHC) in many low- and middle-income countries (LMICs). However, in countries with decentralized health systems like the Philippines, the quality and effectiveness of CHW programs may differ across settings due to variations in resource allocation and local politics. In the context of health system decentralization and the push toward UHC in the Philippines, the objective of this study was to explore how the experiences of CHWs across different settings were shaped by the governance and administration of CHW programs.
methodsWe conducted 85 semi-structured interviews with CHWs (n = 74) and CHW administrators (n = 11) in six cities across two provinces (Negros Occidental and Negros Oriental) in the Philippines. Thematic analysis was used to analyze the qualitative data with specific attention to how the experiences of participants differed within and across geographic settings.
resultsHealth system decentralization contributed to a number of variations across settings including differences in the quality of human resources and the amount of financial resources allocated to CHW programs. In addition, the quality and provider of CHW training differed across settings, with implications for the capacity of CHWs to address specific health needs in their community. Local politics influenced the governance of CHW programs, with CHWs often feeling pressure to align themselves politically with local leaders in order to maintain their employment.
conclusionsThe functioning of CHW programs can be challenged by health system decentralization through the uneven operationalization of national health priorities at the local level. Building capacity within local governments to adequately resource CHWs and CHW programs will enhance the potential of these programs to act as a bridge between the local health needs of communities and the public health system.
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