Increasing incentives and its perceived satisfaction and intensifying training sessions may result in improvements in contraceptive prevalence rate.

Neophyte senator and health advocate Risa Hontiveros pushed for six bills during her first 15 days in office. One of these bills is called “Bibong Barangay Health Workers Bill,” which seeks to increase the minimum allowance to Php 6,000 monthly, institutionalize a six-month training program, and introduce social security benefits (SSS, Pag-Ibig, PhilHealth) for community (barangay) health workers.

These provisions are supported by a 2014 study that I have done together with six others (full text) where we explored internal and external factors that may affect a community health worker’s delivery of reproductive health services in all barangay health centers in District 2, Quezon City, Philippines. Quezon City is known to have the most number of households living in informal settlements, mostly in District 2. As majority of these informal settlers belong to the lowest income classes, they are expected to utilize health centers more often than other health care facilities.

The outcome measure we used is contraceptive prevalence rate (CPR), which is the standard for measuring family planning service delivery, a significant component of reproductive health. The World Health Organization (WHO) defines CPR as the “proportion of women or reproductive age [15 – 44 years old] who are using (or partner is using) a contraceptive method at a given point in time.” The number is expressed as a percentage.

Using multiple regression, we found that three variables had a positive, moderate relationship with CPR – the amount of incentives received, level of satisfaction with these incentives, and the number of training hours received. Based on our analysis, we found that:

• Every hour of increase in family planning training may increase CPR by 2.8 percentage points.
• Every peso increase in allowance may increase CPR by 0.1 percentage point.
• Every unit increase in satisfaction with incentives (on an ordinal scale of 5 points) may increase CPR by 2.3 percentage points.

Our analysis is limited to community health workers of District 2, Quezon City in 2012-2013, and the expected impact may not reflect the state of the whole country. Nonetheless, our initial evidence may help in the advocacy of this bill.

But beyond statistics, improving the welfare of community health workers is essential for the success of the primary health care system, which is now the focus of the Department of Health through the leadership of Secretary Paulyn Ubial. Such efforts help our country inch towards universal health coverage.