The project documented the processes of primary health care (PHC) implementation in transferring role expectation of the municipal offices (MHO) in the three selected study sites of Munos, Nueva Ecija; Barugo, Leyte; and Samar, Davao.Perceptions on the role transformation of the MHOs under PHC implementation were different as perceived by the different paticipants/beneficiaries in the community. Residents viewed the MHOs as health service providers; the RHU staff looked at the MHOs as a health administrator while the GOs and NGOs viewed them from the perspective of their own sectoral concerns.The MHOs perceived themselves as performing their three-pronged multi-dimensional role as health service provider, health administrator and community leader/organizer. The role of MHO in Nueva Ecija is strongest in the health service provider aspect. Performance of other roles were not sustained in the community. On the other hand, in Leyte, there is more reliance on the midwives (RHM) as health service provider than the MHO. The MHOs roles as health administrator and community organizer were strengthened more at the barangay level. In Davao, the MHO's activities has been confined to that as health service provider and health administrator.Role transformation of the municipal health officers has been set in motion by PHC but this was not sustained in the three study sites due to various reasons such as: (a) concentration of PHC operations at the barangay level without a corresponding effort to extend said operations at the municipal level (b) political factors affecting MHO community relations (c) rapid changes in the health manpower level (d) perceived needs of the community in areas other than health (which employment are on lack of job opportunities, poverty, peace and order, roads and transformation) (e) the community's health seeking behavior still doctor-dependent and crisis-oriented (f) no clear/specific health care strategy adopted by the government.The performance of the multi-dimensional role of the MHO under the PHC strategy was different. Factors accounting for such variations were identified such as: (a) length of stay and service of the MHO in the municipality (b) outside intervention/early initiation of PHC (c) training program received by the MHO (d) availability and accessibility of health resources.Policy implications/recommendations identified were: In public health there is a need for the DOH to reexamine and redefine its health care strategy. An MHO must be technically competent, be a good administrator and a leader with sensitivity to community problems and practices. The DOH must train MHOs to develop a health plan for the municipality that will take into account traditional health indicators, epidemiological trends, and disease patterns. The public health education currriculum and medical education in general should include community development and organization.In public administration, there is a need to clarify the organizational structure of the DOH at the field level. Area program managers of field offices must be trained to be competent in administering every available source and in relating to both government and non-government agencies and the general public. There is a need to strengthen social awareness and the commitment of government personnel to public service.
This study aims to (1) determine whether the introduction of primary health care has transformed the role and role perception of the main health professional in the community, i.e., the physicians or municipal health officer (MHO), from a traditional health service provider to one who is also both a health program administrator and a community leader and organizer (2) identify factors which affect the role transformation of MHOs and (3) identify policy programs and options for a more effective health care strategy.
2.To provide policy lawmakers alternative options to make for a more effective implementation of the PHC approach.
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