In 2007, the Sentrong Sigla Program of the Department of Health finally concluded when decisions to transfer it to Philhealth had materialized. Concerned about the status of the primary health care facilities (PHCS) after this major episode, the present study was conducted to assess the factors associated with compliance of the Sentrong Sigla standard 2-3 years after its last implementation. A random sample of 92 health facilities in Eastern Visayas were selected with representation from 54 certified facilities and 38 from non-certified facilities among the different provinces and cities in the region. These PHCs were visited and 19 quality standards were assessed for compliance using Facility Certification Form for SS Phase II Level I and an Interview Schedule to obtain information on technical assistance provision of the DOH, the LGU support for health services and community participation. Sustainability of SS standards was assessed in the 54 certified facilities. Results for compliance with the 8 facility and system standards was generally low except on human resource development where 94% of certified and 90% of non-certified PHCs complied and on signages standard with 94% and 90% compliance in certified and non-certified facilities respectively. Compliance with 11 program standards was also low except on standards fro TB management (98%), community-level advocacy for infectious disease (83%), postnatal care (90%), management of pregnancy complications (88%) and basic curative services (88%). Sustainability of quality standards was also at a record low except on human resource development (94%), signages (98%), postnatal care and management of pregnancy complications both with 82% sustainability. The most difficult standards to maintain were on equipment and supplies with only 17% sustainability and logistics system with only 26%. Essential factors such as good technical assistance and community support will significantly increase the PHCs' capacity to comply and sustain certain quality standards while good LGU support has only limited effect. For instance, PHCs with good technical assistance will have 1.56 times more likely to comply with the signages standard at p value of 0.0008434 and 1.14 times more likely to sustain the same standard and the TB management standard at p value of 0.0155021. Attaining the signages standard will increase the client's awareness of the services being offered in the health facility while complying with the TB standard will increase the number of cured patients and reduce multi-drug resistance. With good TA, health facilities will have 2.11 times more capacity to meet the requirements for the personnel standard at p value of 0.0159521 thereby maintaining the workforce in the health organization, very high probability of 4 times to comply with the health information system standard at p value of 0.0161157 resulting in increased reliability of reports reaching the DOH and 1.58 times for basic curative standard at p value of 0.0035093. Good participation from the community on health services will provide PHCs with 1.97 times more capability to meet the standard for BHWs at p value of 0.0432502 resulting in large number of active community health volunteers, 2.58 times more likely to comply with the standard at p value of 0.014577 and 1.67 times more capability to comply with the standard on management of pregnancy complications at p value of 0.0196546. The outcome of these efforts will reduce the Maternal mortality ratio of which Eastern Visayas has one of the highest reports. On sustaining some standards, PHCs with strong community support will have 1.85 times more capability to sustain the prenatal care standard at p value of 0.0428076 with the same protective effect and significantly higher probability for family planning standard at p value of 0.0504659. While good TA was significantly associated with compliance for personnel standard, good LGU support had only limited effect since facilities provided with strong support from their local governments will have 1.79 times more capacity to comply with the personnel standard in certain periods only (95% Conf. Level of 4.22) but not in other instances (95% C.L. of 0.76). In the logistics systems standard, a better relationship between good LGU support and sustainability was noted as the relationship showed p value of 0.0922790, that is, nearing statistical significance of
GENERAL OBJECTIVE: To determine the factors associated with compliance of Sentrong Sigla standards among selected primary health care facilities in Region 8.
SPECIFIC OBJECTIVES: 1. To determine the compliance with Sentrong Sigla standards among selected primary health care based on quality standard for: a. Facility and systems b. Public health programs 2. To determine the association of the following factors vis-a-vis compliance with Sentrong Sigla standards among selected primary health care facilities. a. Technical assistance (TA) b. LGU support c. Community participation 3. To assess the sustainability of Sentrong Sigla standards among certified primary health care facilities. 4. To determine the association of the three (3) essential factors vis-a-vis sustainability of Sentrong Sigla standards among primary health care facilities.