UNDER THE MICROSCOPE
Almost everyone was all praise for the decision to put up specialty centers for health in different parts of the country. They cite the difficulty of accessing advanced health care by folks from the provinces, who have to trek all the way to Imperial Manila for the expertise required for highly specialized heart, lung, kidney, and pediatric care. Yet, the budget for the DOH has been slashed by ₱10 billion for 2024. So, how can we put up the necessary infrastructure, equipment, and personnel for these new centers?
But we may be missing the point of health care after all, equating it with sophisticated (therefore expensive) equipment and highly trained doctors, nurses, medtechs, and other hospital personnel. It seems we are not being mindful of the adage that “An ounce of prevention is worth a pound of cure.”
Preventive (primary) health care is actually the best way to a nation’s health. Preventing diseases before they occur is the key to staying healthy so that you will not need many of the health care services that are required for treating advanced diseases.
These preventive care services are usually at the primary care level. In our setting, it is at the barangay health center where people should be able to access checkups, vaccinations, health screenings for autism and HPV (Human Papilloma Virus) for children; and for adults, vaccinations for flu, Covid-19, hepatitis B, laboratory tests, and screening for early detection of various diseases like heart disease, hypertension, diabetes, and cancer.
Preventive care is much more affordable than treating advanced disease conditions, which it can prevent or mitigate the effects of. Just imagine the savings for hospitalizations of unvaccinated children who contract infectious diseases such as measles, diphtheria, tetanus, dengue, mumps, rubella, pertussis, polio, Hemophilus influenza, chickenpox, and more.
Now, translate that into adult medicine, where lifestyle diseases and cancer are top killers. If we will screen for diabetes, hypertension, heart disease, and kidney disease; and launch effective smoking prevention and cessation programs, there will be a definite drop in the numbers of patients being confined for these conditions.
Screening for breast, cervical, colon, lung, and prostate cancer will likewise decrease the need for more cancer treatment services, since early detection can stop the progress of tumors before radical surgery, chemotherapy, and more advanced and very expensive targeted and immune therapies are needed.
Similarly, mass exercise and counselling programs on a community basis can lead to great benefits in controlling the obesity epidemic we are currently experiencing, as well as having beneficial effects on patients suffering from the metabolic syndrome (obesity, hypertension, high bad cholesterol, and diabetes) which leads to heart attacks and strokes (brain attacks).
Unfortunately, with the devolution of primary health care to the local government level, our health services seem to have suffered a setback in terms of effectiveness in basic minimum services. In 1978, a joint WHO-UNICEF conference held in Alma Ata, USSR (present-day Russia), called for “Health for All” by 2000. It is now 2023 and sadly, that vision is a long way from being realized.
The barangay health workers (BHW) are actually volunteers who are trained in basic health care delivery services. Most are women, undergraduates, and unemployed or self-employed. One study shows that BHW are moderately competent and have satisfactory ratings in attitude; nevertheless, continuous attendance in trainings and seminars would lead to more knowledge and skills.
My personal experience with BHW was during our Covid-19 vaccination activities in our village. I found out that they were not allowed to administer vaccinations, and we needed to get doctors and nurses to administer the injections. Chatting with them confirmed the above study observations, and I wish they were better trained and equipped to deliver more services that they currently do, considering the mass exodus of health personnel to greener pastures abroad.
My observations and the studies show that if we are to make headway in primary health care service delivery, our BHW should be better trained and equipped for the above preventive care services. They should also be better compensated, as they are only given allowances that do not even cover their personal expenses when on duty.
It is high time we professionalize the BHW, since they are the first line of defense against diseases on the community level. This will alleviate the nursing shortage, as well as provide more and better preventive care services to the majority of Filipinos who are living hand-to-mouth and can’t afford to pay for basic health services, let alone advanced medical care in specialty centers.
Then, perhaps, we will not need so many specialty hospitals, which our measly health care budget can hardly cover, whether on the national or local level.