Factors Affecting Family Planning Service Delivery by Community Health Workers in District 2, Quezon City, Philippines: A Cross-Sectional Study
Keywords:community health workers, family planning
AbstractBackground: In the Philippines, family planning (FP) service delivery is an integral part of the roles expected of community health workers who are at the forefront of primary health care delivery, especially among the underprivileged. District 2, Quezon City has the highest concentration of informal settlers in the country. Objective: To determine the factors that significantly affect FP service delivery by community health workers in District 2, Quezon City, Philippines Design: Cross-sectional study Setting: All community health workers in the 11 health centers in the District during the periods of April to September 2013 Measurements: The authors conducted primary quantitative and qualitative data collection on selected factors found in previous studies to be significantly correlated with contraceptive prevalence rate (CPR), the performance target measure for FP service delivery. Bivariate analysis and multiple regression were used to establish associations between the variables and CPR. Thematic clustering was used to extract themes and generate hypotheses for possible reasons on the strength of associations. Because the whole population of community health workers was sampled, confidence intervals and p-values were not reported and all associations were assumed to be significant. Results: Four factors reported moderate level of association with CPR: FP training received (r = 0.40), allowances received (r = 0.55), satisfaction with incentives (rs = 0.46), and age (r = -0.44). Multiple regression showed that these four variables account for 26% of the variation in CPR. For every unit increase in FP training (hours), allowance received (pesos), and rating higher in satisfaction with incentives, there is an increase of 2.85, 0.11, and 2.31 CPR percentage points, respectively. For every decrease in one year of age, there is an increase of 1.07 CPR percentage points. Limitations: Although the questionnaire was pretested and based on previous studies, data collection was prone to recall bias. There was no other available source of secondary data during the conduct of the study. The researchers informally confirmed some of the qualitative data from focus group discussions through interviews with supervisors and local leaders, and observation by the researchers themselves. Conclusions: The factors that have moderate impact on FP service delivery are FP training, allowances, satisfaction with incentives, and age. The authors recommend that the local health department increase training sessions, increase allowances and other benefits, and encourage younger people to be community health workers.
Republic Act 7160: An Act Providing for a Local Government Code of 1991, 8th Congress of the Philippines (1991).
National Statistics Office [Philippines], ICF Macro, Philippines. National Demographic and Health Survey 2008: Key Findings. Claverton, Maryland, USA: NSO and ICF Macro; 2009.
David F, Chin F. Factors the Contribute to the Varying Performance of BSPOs and BHWs in the Delivery of Family Planning Services in Iloilo City. Philippines: Central Philippine University: Social Science Research Institute; 1994.
Anrudh J, RamaRao S, Costello M, Lacuesta M, Amoyen N. Learning About Clients’ Needs: Family Planning Field Workers in the Philippines, 2002. In: Responding to Cairo: Case Studies of Changing Practice in Reproductive Health and Family Planning; 2011. vol. 4, p. 99-113.
De Guzman EM, Canda RG, Hisanan TM. Motivating Couples to Practice Family Planning through Chat Group Sessions in a Neighborhood Setting. Technical Notes. Philippines: The Social Acceptance Project: Family Planning (TSAP-FP), United States Agency for International Development Philippines; 2006.
Crigler L, Hill K. Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving CHW Programs and Services. United States Agency for International Development; 2011.
Lacuesta MC, Sarangani ST, Amoyen ND. A Diagnostic Study of the DOH Health Volunteer Workers Program. Phil Pop J. 2002;9(1-4):26-36.
World Health Organization [Internet]. Geneva: Contraceptive Prevalence Rate [updated 2006; cited 2014 Mar 3]. Available from: http://www.who.int/whosis/whostat2006ContraceptivePrevalenceRate.pdf.
Arias EA. Interview at Quezon City Health Department [2013 Feb 6].
National Statistics Office [Philippines] [Internet]. Manila: Population and Annual Growth Rates for the Philippines and Its Regions, Provinces, and Highly Urbanized Cities Based on 1990, 2000, and 2010 Censuses [updated 2012; cited 2014 Mar 1]. Available from:
Department of Health [Philippines], United States Agency for International Development. Family Planning Desk Flip Chart. Health Promotion and Communication Project; 2010.
Malwenna L, Jayawardana PL, Balasuriya A. Effectiveness of a Community-Based Health Educational Intervention in Reducing Unmet Need for Modern Methods of Family Planning among Ever-Married Reproductive Age Women in the Kalutara District, Sri Lanka. Int J of Coll Res On Int Med And Pub Heal. 2012;4(6);1097-14.
Razee H, Whittaker M, Jayasuriya R, Yap L, Brentnall L. Listening to the Rural Health Workers in Papua New Guinea – The Social Factors that Influence Their Motivation to Work. Soc Sci and Med. 2012;75:828-35.
Costello M, Lacuesta M, RamaRao S, Jain A. A Client-Centered Approach to Family Planning: The Davao Project. Stud In Fam Plan. 2001;32(4):302-14.
Palma J [Internet]. Manila: Statement on Reproductive Health Bill, Catholic Bishops Conference of the Philippines [updated 2012 July; cited 2014 Feb 15]. Available at: http://www.cbcpnews.com/cbcpnews/?p=919