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Assessment on the functionality and effectiveness of

Community Health Team Program in Eastern Visayas,


Philippines
- Accomplishment and Lesson Learned -

DOH-JICA Project for Strengthening Maternal and Child Health Services in Eastern Visayas

IC NET LIMITED/HANDS
May 2016

Abbreviations
Abbreviation

Term in Full

AHA
BEmONC
BHS
BHW
BNS
BSPO
CHO
CHT
C/P
DHC
DOH
DOH RO8
DSWD
EVRMC
EPI

Aquino Health Agenda


Basic Emergency Obstetric and Newborn Care
Barangay Health Station
Barangay Health Worker
Barangay Nutrition Scholar
Barangay Service Point Officer
City Health Office
Community Health Team
Counterpart
District Health Center
Department of Health
Department of Health, Regional Office VIII
Department of Social Welfare Department
Eastern Visayas Regional Medical Center
Expanded Program on Immunization

FBD

Facility Based Delivery

FHSIS

Field Health Service Information System

Hi-5
ILHZ
IMC
IMR
IRA
KP
LGU
MCAP
MC Book
MCH
MDG
MMR
MNCHN
NDP
NHTS-PR
OECD-DAC

Universal Care High Impact Five


Inter-Local Health Zone
International Medical Corps
Infant Mortality Rate
Internal Revenue Allotment
Kalusugan Pangkalahatan Execution Plan and Implementation Arrangement
Local Government Unit
Maternal Care Assistant Program
Mother and Child Book
Maternal and Child Health
Millenium Development Goals
Maternal Mortality Ratio
Maternal, Newborn, Child Health and Nutrition (Policy)
Nurse Deployment Program
National Household Targeting System for Poverty Reduction
Organisation for Economic Co-operation and Development-Development
Assistance Committee
On-the-Job Training
Philippine Health Insurance Corporation
Provincial Health Office
Prenatal Care Visit 4
Postpartum Care Visit
Rural Health Unit
Technical Working Group

OJT
PhilHealth
PHO
PNV4
PPC
RHU
TWG

USAID
WHT
4Ps

United States Agency for International Development


Womens Health Team
Pantawid Pamilyang Pilipino Program

Photos

CHT TWG meeting to discuss the plan of CHT


assessment

Orientation and training of the surveyors

Interview with CHT volunteers

Interview with the client (mother)

CHT monthly Report at RHU

Review meeting to discuss the results of CHT


assessment

Table of Contents
CHAPTER 1

BACKGROUND ........................................................................................................... 1

1.1

BACKGROUND OF JICA SMACHS-EV PROJECT ............................................................................. 1

1.2

BACKGROUND OF A COMMUNITY HEALTH TEAM ............................................................................ 1

1.3

CHT PROGRAM IN THE JICA PROJECT AND HARMONIZATION WITH THE KP PROGRAM .................. 2

1.4

ASSESSMENT OBJECTIVES ............................................................................................................... 4

CHAPTER 2

METHODOLOGY OF THE CHT ASSESSMENT ............................................................ 5

2.1

METHODOLOGY ............................................................................................................................... 5

2.2

SURVEY TEAM ................................................................................................................................. 5

2.3

TARGET OF THE ASSESSMENT AND SAMPLING METHODS ................................................................ 6

2.4

ASSESSMENT TOOLS ........................................................................................................................ 7

2.5

SCHEDULE OF THE CHT ASSESSMENT ............................................................................................. 8

2.6

LIMITATIONS .................................................................................................................................... 8

2.7

BACKGROUND OF THE RESPONDENTS.............................................................................................. 9

CHAPTER 3

RESULTS .......................................................................................................................... 13

3.1

RELEVANCE.................................................................................................................................... 13

3.2

EFFECTIVENESS ............................................................................................................................. 14

3.2.1 Effectiveness of the intervention in MNCHN service delivery................................................... 14


3.2.2 Effectiveness of the CHT program in strengthening the function of health volunteers ............. 16
3.3

EFFICIENCY .................................................................................................................................... 22

3.3.1 Appropriateness of the tools and resources provided to the CHT program .............................. 23
3.3.2 Efficiency of the required tasks in the CHT program ................................................................ 25
3.3.3 Support environment of the CHT program ................................................................................ 26
3.3.4 Other factors affecting efficiency .............................................................................................. 29
3.4

IMPACT ........................................................................................................................................... 29

3.5

SUSTAINABILITY ............................................................................................................................ 30

3.5.1 Ownership of the program......................................................................................................... 30


3.5.2 Capacity and Resource Mobilization to Sustain the Program................................................... 31
3.6

OTHERS .......................................................................................................................................... 33

CHAPTER 4

CONCLUSION AND LESSONS LEARNED .................................................................. 34

CHAPTER 5

RECOMMENDATIONS ................................................................................................... 37

List of Tables
Table 1: Areas of CHT Program supported/promoted by JICA and DOH .............................................. 3
Table 2: Basic components of JICA-supported activities and tools in CHT program ............................. 3
Table 3: Evaluation Criteria .................................................................................................................... 5
Table 4: Sample size and sampling methods employed for interviews ................................................... 7
Table 5: Background data of health workers who participated in the interviews .................................. 10
Table 6: Socio-demographic data of the mothers who participated in the interviews ........................... 10
Table 7: Socio-demographic data of the CHT volunteers in assessment ............................................... 12
Table 8: Accomplishment of CHT volunteers on FBD and PNV4 ........................................................ 14
Table 9: Comparison of the accomplishments between JICA target and non-JICA target areas ........... 15
Table 10: Pregnancy tracking accomplished by CHT volunteers (January to September 2015) ........... 17
Table 11: Accomplishment of home visits (4 times) during the prenatal period by CHT volunteers .... 18
Table 12:Types of services provided by CHT volunteers (multiple answers) ....................................... 19
Table 13: Tools developed by the Project .............................................................................................. 23
Table 14: Use of MC book by CHT volunteers during home visits ...................................................... 24
Table 15: Views on availability of adequate resources .......................................................................... 25
Table 16: Assistance in any form received by CHT volunteers (by source) .......................................... 28
Table 17: Breakdown of the content of the assistance........................................................................... 28
Table 18: Status of MCIP ordinance and implementation in Leyte and Ormoc .................................... 30
Table 19: Results of interviews with CHT volunteers ........................................................................... 32
Table 20: Transition of the number of active CHT volunteers from 2011 to 2015................................ 32

List of Figures
Figure 1: Schedule of the CHT Assessment ............................................................................................ 8
Figure 2: Results of the interviews on the importance of CHT activities (5 key areas) ........................ 13
Figure 3: Opinions on the CHT program in improving three key MCH services ................................. 16
Figure 4: Person who provides MCH services in community ............................................................... 16
Figure 5: Trends of CHT accomplishment in JICA priority barangays ................................................. 18
Figure 6: Number of home visits by CHT volunteers during prenatal and postnatal periods ............... 20
Figure 7: Clients satisfaction with CHT volunteers service ................................................................ 20
Figure 8: Sources of information on MCH care .................................................................................... 21
Figure 9: Personnel influencing mothers decision on using MCH services ......................................... 22
Figure 10: Evaluation on the tools developed by the Project ................................................................ 24
Figure 11: Status of recording on clients MC book.............................................................................. 25
Figure 12: CHTs opinions on their workload ....................................................................................... 25
Figure 13: Health workers opinions on their workload........................................................................ 26
Figure 14: Satisfaction with the support to CHT volunteers ................................................................. 27
Figure 15: Perceived recognition of the importance of CHTs work by others ..................................... 27

Appendixes
Appendix 1

Matrix of Differences in CHT Strategy

Appendix 2

Questionnaires for CHT assessment

Appendix 3

Results of CHT assessment

Chapter 1
1.1

BACKGROUND

Background of JICA SMACHS-EV Project

In the Philippines, the Maternal Mortality Ratio (MMR) in 2006 of 162 per 100,000 live births had
increased to 221 in 2012. It was still far from the National Millennium Development Goals (MDGs) of
MMR to 52 per 100,000 live births by 2015. Therefore, the Government of the Republic of the
Philippines (GRP) needed to reduce the MMR at a faster rate to achieve the national MDGs. The DOH
gave priority to the maternal and child health program and issued the Maternal, Neonatal and Child
Health and Nutrition (MNCHN) policy, which focuses on improving the quality of services and delivery
care. The GRP promoted enhancement of Maternal and Child Health (MCH) activities based on the
MNCHN policy and its manual of operations (MOP).
From 2006 to 2010, the Japan International Cooperation Agency (JICA) conducted the Maternal and
Child Health (MCH) Project in the provinces of Ifugao in the Cordillera Administrative Region and
Biliran in the Eastern Visayas Region. The project aimed to introduce the Emergency Obstetric and
Neonatal Care (EmONC) system and improve the quality of MCH services in accordance with the
MNCHN policy. With the success of the project, the DOH requested Japan to provide technical
assistance to scale up project achievements in other provinces in the Eastern Visayas region. In response,
JICA started a technical assistance project named the Project for Strengthening Maternal and Child
Health Services in Eastern Visayas (SMACHS-EV; hereinafter the Project) in Leyte Province
(excluding Tacloban City) and Ormoc City for the four-year period from July 15, 2010, to June 14, 2014.
The Project was extended for two years when the Super Typhoon Yolanda hit the region in November
2013.

The Project has its target areas in 18 municipalities in the Province of Leyte and five districts
in Ormoc City. The purpose of the Project is to increase the number of pregnant women and
newborns receiving safe pregnancy, safe delivery, and postpartum care services in the target
areas in the region wherein five output indicators were set to achieve this purpose.
Institutionalization and operation of the Community Health Teams (CHTs) is one of the five
outputs of the Project, which aims to strengthen the link between health facilities and the
community through the work of health volunteers.
1.2

Background of a Community Health Team

The Community Health Team (CHT) was formerly known as a Womens Health Team (WHT). In 2006,
it was first introduced by the Department of Health (DOH) as an essential component of the Second
Womens Health and Safe Motherhood Project. The creation of the WHT aimed to establish an effective
community-based support system to ensure that all women were adequately served for potential obstetric
complications and to lead the efforts in convincing mothers to pursue facility-based delivery (FBD)1.
Following this national strategy, JICA promoted the WHT activity in the previous MCH project and
continued its support in accelerating the attainment of Millennium Development Goals 4 and 5 in the
1

Dale Huntington and others A system approach to improving maternal health in the Philippines. Bulleting of the World
Health Organization; 2011. Available from http://www.who.int/bulletin/volumes/90/2/11-092825/en/#

Eastern Visayas Region through the SMACHS-EV Project.


Meanwhile, in December 2010, the first year of Benigno Aquino IIIs presidency, the DOH central office
issued an administrative order to announce the Aquino Health Agenda (AHA)2 for implementation
of Universal Health Care (UHC). The creation of the CHT was introduced in this administrative order
with the following definition.
CHT is a group of health volunteers assigned in each barangay/priority population area led by a
midwife that tracks eligible population for public health services, assists families in assessing and acting
on health needs, provides information on available services in the locality, and facilitates the
organization of transportation and communication systems, outreach services and linkages with other
providers in the service delivery network.
Subsequently, the DOH issued the Department Order Kalusugan Pangkalahatan (KP) (or UHC)
Execution Plan and Implementation Arrangement 3 in August of 2011. The order provides specific
guidelines to implement the UHC. The new guidelines expanded the task of the CHT (the former WHT)
to address other health-related concerns such as chronic cough, child health, family planning, and
PhilHealth enrollment in addition to maternal and child health. In addition, the strategy narrows the
target from all women in the community in the original WHT program to National Household Targeting
System for Poverty Reduction (NHTS-PR)4 families. The DOH Central Office allocated a large amount
of operational funds for the implementation of the KP program from 2011 to 2015.
1.3

CHT Program in the JICA Project and Harmonization with the KP Program

The Project started implementing the activity during the transition period between the existing and new
policy after the presidential election in June 2010. The first set of training materials was developed by
the Project and the counterpart (C/P) before the announcement of the AHA. The content was based on
the WHT manual developed by the DOH Central Office at that time. The training of CHT volunteers by
the Project started in early May 2011. By September 2011, the Project had trained 237 regional and
provincial trainers and 3,169 CHT volunteers in the Project areas of Leyte and Ormoc. However, it was
at this very moment that the DOH Central Office introduced new instructions and a guideline for CHT
volunteers related to the KP program.
The new guideline for CHT volunteers had many differences in the tasks and responsibilities from the
previous CHT program, which the JICA has been promoting in the region (see the appendix 1 Matrix
of Differences in CHT Strategy). The wider scope of health issues and the specific target population
with which CHT volunteers have to follow up did not completely fit in with the strategy to meet the
expected outcome or purpose of the Project (See Table 1). Therefore, a number of consultations and
discussions were held in the DOH Central Office for the Department of Health Regional Office VIII
(DOH RO8) and JICA to come up with a solution. In 2012, the DOH RO8 and the Project agreed on
2

Administrative order No. 2010-0036 The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos
Department of Health 2010
3 DO No. 2011-0188 Kalusugan Pangkalahatan Execution Plan and Implementation Arrangement (August 2011)
4 National Household Targeting System for Poverty Reduction (NHTS-PR) is a data bank and an information management
system that identifies who and where the poor are in the Philippines

harmonizing and integrating the activities as one, and all required tasks by both the Project and the KP
program became essential work of CHT volunteers. Region-wide orientation on the harmonized CHT
program was conducted by the DOH RO8 from 2013 to 2014.
Table 1: Areas of CHT Program supported/promoted by JICA and DOH

Maternal and Child Health: Pregnancy & PostCHT program supported by the Project
partum

Newborn Health

Infant Health

Maternal Health: Pregnancy & Post-partum


CHT program promoted by DOH

Family Planning

Chronic Cough Management

PhilHealth Enrollment

Based on the background above, the Project continued to support the following key areas of the CHT
program in JICA target sites, as shown in Table 2.
Table 2: Basic components of JICA-supported activities and tools in CHT program
CHT Organization
CHT volunteers

Barangay Health Workers, Barangay Nutrition Scholars and any volunteers who completed an
orientation on a CHT course and is willing to serve the community. Each volunteer has assigned
catchment area for work.

Midwife/NDP

Supervisor of the CHT volunteer in her assigned catchment. Nurse in Nurse Deployment Program
serves as the assistant of the midwife for CHT program.

Public Health Nurse (PHN)/Municipal


Health Officer(MHO)/Medical
The suprvisors of the midwife.
Officer (MO)
Task of each party
Serves as a link between the community and health facilities through the following task:

CHT volunteers

1. Identifying and tracking of pregnant/postpartum women and newborns


2. Conducting home visits to monitor and provide counseling to the client from prenatal to postnatal
period
3. Refering/encouraging the pregnant women, mothers and babies to a health facility
4. Reporting to the midwife such as submission of tracking reports every month
5. Attending a monthly CHT meeting
6. Assisting the midwife in outreach activity
7. Coordinating with local officials such as barangay

Midwife

1. Suprvising and monitoring CHT volunteers for their routine work


2. Conducting a monthly CHT meeting
3. Consolidating CHT's tracking report and make a CHT monthly report at BHS level

PHN/MHO/MO

1. Providing overall supervision and assistance in CHT program at their RHU/DHC


2. Consolidate CHT monthly reports from BHS, and develop a CHT monthly report at RHU/DHC
level

Tools developed by the Project to assist CHT program


1.
2.
3.
4.
5.
6.
7.

Pregnancy tracking form


Postpartum and newborn tracking form
CHT monthly report form
CHT database
Reference guide of Mother and Childbook and calender for home visits
CHT handbook
Mother and Child Book in local dialect (revised and updated with the DOH approval)

In addition, the Project at the beginning selected priority barangays from 18 Rural Health Units (RHUs)
and five District Health Centers (DHCs) in the JICA target areas as a pilot group. These barangays
represent 50% of the population in the respective RHUs and DHCs. The Project prioritized support and
monitoring of the activity in these priority barangays throughout the implementation of the Project while
3

the same activity was also implemented in non-priority barangays as an initiative of the Provincial
Health Office (PHO) and City Health Office (CHO) to harmonize all activities.
1.4

Assessment Objectives

Since the first deployment of CHT volunteers in 2011, the Project has implemented a number of
activities to strengthen CHT operation in the JICA target areas. As the end of the Project approaches, it
is necessary to determine the effect of the CHT program supported by the Project on the project goal of
improvement in MNCHN service delivery. The findings of the assessment and recommendation shall
be used to inform stakeholders such as the DOH and PHO/CHO on ideas to enhance the intervention
and to advocate for policy support from the national and local governments. In addition, the report shall
be used to improve the design for the future strategy of the CHT program or any community-based
intervention in the health sector.
In general terms, this study focused on assessing the CHT programs current and potential contribution
to the improvement of MNCHN service delivery. The Project believes that the general findings of the
current assessment can be a good reference for the evaluation of a national CHT program even though
the current assessment only highlights the components of the CHT program supported by JICA
intervention.

Chapter 2
2.1

METHODOLOGY OF THE CHT ASSESSMENT

Methodology

The Project employed a mix of office-based research; review of reports, documents and secondary data,
and face-to-face semi-structured interviews. Reviewing the document includes the review of statistical
data and the record of CHT monthly reports to analyze the performance of CHT volunteers and health
facilities on MNCHN service delivery. A semi-structured interview tool was used for key informants
such as mothers, CHT volunteers, and health workers at RHUs and DHCs. The sampling methods will
be discussed in Section 2.3.
The assessment analyzes the effectiveness of the CHT program in terms of its impact on MNCHN
indicators. To evaluate the effectiveness, the Project employed OECD DAC evaluation criteria5 for
analysis. Table 3 bellows summarizes those criteria.
Table 3: Evaluation Criteria
Criterion
Relevance

Effectiveness

Areas for evaluation

To what extent did the CHT program contribute to the improvement of the health
of mothers and babies and MNCHN service delivery?

How effective is the intervention in improving the status of MNCHN service


delivery?
To what extent has the CHT program contributed to strengthening the function
of health volunteers as a link between health facilities and community?
Are the tools and resources provided to the CHT program adequate to meet the
needs of CHT volunteers and supervisors in performing their tasks?
Is the required task of the CHT program efficient in relation to the existing
workload of health workers and volunteers?

Efficiency

Impact

What other changes were produced by the CHT program?

What are the bottlenecks and gaps in the CHT program that keep CHT volunteers
from functioning as a link between health facilities and community to improve
MNCHN service delivery?
To what extent do the DOH RO8 and/or the local government demonstrate
ownership and capacity or resource mobilization to continue the program?

Sustainability

2.2

Survey Team

The survey team (hereinafter the Team) consists of the members of the CHT Technical Working Group
(TWG), including the PHO of Leyte, the CHO of Ormoc, the DOH RO8, and the Project. In addition,
one local consultant was hired during the preparation period, and seven surveyors were recruited to
conduct the interviews. The Team held a number of meetings to design the survey strategy and
questionnaires and review the results of CHT assessment. All surveyors were hired by the Project and
were fluent in local dialects such as Waray and Visayan. The Project trained the surveyors on interview
and survey skills, technical terminologies, and use of the questionnaires and protocols for this
assessment.
5

The DAC Criteria for evaluating development assistance


http://www.oecd.org/dac/evaluation/daccriteriaforevaluatingdevelopmentassistance.htm

2.3

Target of the Assessment and Sampling Methods

The CHT assessment targets mothers, health workers at RHUs/DHCs, and CHT volunteers in the JICA
target areas (18 RHUs of Leyte and 5 DHCs of Ormoc). As mentioned in Chapter 1, the Project had
focused its intervention in priority barangays of JICA target areas. This assessment, therefore, only
reviewed the performance of the CHT program in JICA priority barangays, and the Team selected CHT
volunteers assigned in these barangays for interviews.
Table 4 shows the sample size and the methods employed for the interviews in this assessment. Because
of the time and the budget constraints, the Team had to limit the sample size in this assessment. In
addition, the Team had to allocate a different proportion of the sample size to Leyte and Ormoc because
of their difference in the population and size of the coverage area. In fact, the projected population of
the JICA project area in Leyte is about four times the one in Ormoc. The Team subjectively set the
proportion as 6065% of the total sample size to Leyte and 3540% of those to Ormoc in this assessment.
For assessment of the accomplishment of CHT volunteers, the data of a CHT monthly report (from 1 st
to 3rd quarters of 2015) were collected from all JICA priority barangays of RHUs and DHCs.
For selection of health workers, the Team first developed a list of health workers in RHUs/DHCs of the
JICA project areas. This list only includes midwives, nurses, and doctors who are full-time and have
been working at the same health facility for more than a year. Nurses in the Nurse Deployment Program
(NDP) are not included in this list. It is because they are also a contractual health worker and most of
them work less than one year. In addition, the current assessment aims to ask the impact and opinion of
the CHT program at health facility (RHU and BHS), and the Project considered it is more appropriate
to ask health workers, rather than NDP nurses, who are responsible for overall performance of health
facility. The Team randomly selected the names of health workers to reach the intended number of
samples.
For selection of the mother, the Team employed a combination of different sampling methods. The Team
set the criteria as a mother who delivered the baby in September 2015. The number of mothers who met
these criteria was identified through the CHT monthly report submitted from health facilities in the
Project area. In Leyte, because of a wide geographical area, only one RHU per Inter Local Health Zone
(ILHZ) was selected randomly. Subsequently, the Team used the varying probabilities sampling methods
to take into account the possible importance of the size of each health facility with the mother. The
number of mothers who met the criteria in a health facility was used as a size measure, and RHUs/DHCs
were taken as sampling units. The allocation of the mother for interview in each RHU/DHC was
determined by these methods. Because the Team only knew the number of deliveries at the Barangay
Health Station (BHS) in each RHU/DHC, the random selection of BHSs was conducted until the number
of mothers for interview reached the allocated number at RHUs/DHCs. During the survey, the surveyor
occasionally had to use a convenient sampling method to select mothers because of unavailability of
health workers at the intended BHS; therefore, some mothers outside of the originally selected BHSs
were invited for the interviews.

Target

Table 4: Sample size and sampling methods employed for interviews


No. of
Para
Area
Sample
Sampling Methods
Criteria/Remark
meter
(Actual)
Leyte

45 (48)

146

Ormoc

25 (26)

33

Health
Workers

Leyte

60 (55)

381

Mothers
Ormoc

40 (44)

223

Leyte

60 (60)

385

Ormoc

40 (40)

106

CHT
volunteer

The inventory only includes


Random sampling methods full-time employees at health
based on the inventory of facility. Newly hired
health workers
employees (less than one
year) were excluded.
Combination of multistage
sampling methods and
varying probabilities
sampling; 1) Stratified
random selection of the
RHU (one RHU per
ILHZ); 2) Varying
probabilities sampling to
determine the allocation of
mothers for interview per
RHU/DHC, then BHSs
were randomly selected
based on the allocated
number of mothers, 3)
Convenient sampling of
the mother was partially
done during the interviews

The criteria of mothers is


those who delivered a baby in
September 2015 based on the
record of the submitted CHT
monthly report.

1) High and low


performing RHUs/DHCs
were selected based on the
record of CHT monthly
report
2) The equal number of
CHT members were
randomly selected from
the inventory from
identified health facilities

In Leyte, 2 high performing


and 2 low performing
facilities were selected. 15
CHTs per facility were invited
for the interviews. In Ormoc,
1 high performing and 1 low
performing were selected. 20
CHTs were interviewed per
facility.

The Team aimed to examine the factors contributing to the good performance of CHT volunteers in this
assessment. With the intention of comparing CHT volunteers in high-and low-performing health
facilities, the Project first selected health facilities based on the performance of the CHT program and
then randomly selected CHT volunteers from these health facilities. In Leyte, a total of four facilities
(two high-performing and two low-performing) were selected, and 15 CHT volunteers were randomly
withdrawn from the inventory of each health facility. In Ormoc, one health facility was identified per
high and low performance, and 20 CHT volunteers were randomly selected from each.
2.4

Assessment Tools

The Team developed a set of tools for the assessment. Three sets of questionnaires were developed for
the interviews with mothers, health workers, and CHT volunteers. The first draft of the questionnaires
was developed in English, and then the questionnaires for mothers and CHT volunteers were translated
into Waray and Visayan dialects to ensure understanding of the questions by the respondents. The
translated questionnaires were pre-tested by the Project and the surveyor and then revised for
7

improvement accordingly. The final version of the questionnaires was finalized by the Team at a CHTTWG meeting. There were cases in which Waray-speaking respondents better understood some words
in English as there are no equivalent words in Waray. The surveyors therefore used Waray and English
interchangeably. The questionnaires developed for this assessment are attached in Appendix 2
Questionnaires for CHT assessment.
2.5

Schedule of the CHT Assessment

The Team started the preparation of the CHT assessment in September 2015. Figure 1 shows the
schedule of the CHT assessment. While conceptualizing the design, the team started the collection of
the necessary data such as statistical data, inventory of CHT volunteers, and CHT monthly reports since
March 2015. The draft of the design was discussed with the members during the TWG and CHT core
team meetings from September to October 2015. During this period, the preliminary study was also
conducted at RHUs/DHCs in the JICA target areas to see the availability of the intended data at health
facilities. As the assessment was implemented in conjunction with other CHT assessment necessary for
the terminal evaluation of the Project, most of the work was focused on data collection and data encoding,
which were necessary for the terminal evaluation at the beginning. The assessment was in full swing
from mid-November to mid-December 2015. The data encoding of the results of interviews and data
validation started in January 2016, but, because of the data inconsistencies, the validation of the data ran
until mid-April 2016. The results of the data were then reviewed and analyzed by the Team from April
to May 2016.
Figure 1: Schedule of the CHT Assessment
Stage

Activity

Sept.

2015
Oct. Nov.

Dec.

Jan.

Feb.

2016
Mar.

April

May

- Drafting the Assessment Design


Assessment Design
- Discussion and Review of the Design
- Initial collection of Basic Data
- Development of Questionnaires
Preparation
- Recruiting of Survey Assistant
- Pre-Testing and finalization of tools
- Data collection through interviews
Data Collection & Encoding - Follow-up data collection
- Data Encoding
- Data Validation
Data Analysis & Report
- Data Analysis
Writing
- Report Writing & Finalization

2.6

Limitations

The time and financial constraints limited the sample size in this assessment. This is especially the case
in Leyte as the Province has a land area of 6,313.33 km2, and health facilities in the JICA target areas
are geographically spread out throughout the province. Thus, the survey results could present the
dominant trends in the JICA project areas, and it is noted that simple generalization of the findings
should be avoided. In addition, there is a concern on the quality of data, especially the CHT monthly
report, submitted from RHUs/DHCs. The Project only validated the data on the submitted CHT monthly
reports from RHUs/DHCs that were already consolidated at RHU/DHC levels. The data of the CHT
monthly report at the BHS level were not validated by the Project; therefore, the Team is not 100%
confident about the accuracy of the data on the CHT monthly report, which is related to the
accomplishment of the CHT program on key MNCHN indicators.
8

Furthermore, in the assessment of the impact of the CHT program on MNCHN service delivery, the
results also should be viewed with a clear understanding of the methodological limitations such as
controlling other factors contributing to MNCHN service delivery. For example, the Team looked at the
impact of the CHT program on the accomplishment of four prenatal care visits (PNV4) and FBD in 2015
through the comparison of statistical and collected data from the PHO and CHO. The Team
acknowledged that accomplishment of these indicators is the result of multiple factors including
availability and accessibility of services at health facilities or other related programs implemented by
other international donors and the DOH. For example, two health facilities, Alang-Alang (Leyte) and
San Pablo (Ormoc), had a temporary closure of the birthing facility due to the re-construction of the
facility after super-typhoon Yolanda. Many international organizations such as, but not limited to,
UNICEF, Save the Children, International Medical Corps (IMC), and USAID, conducted activities
related to maternal and child health particularly after the supertyphoon. Meanwhile, the DOH Central
Office has been also implementing since April 2015 the Universal Health Care High Impact Five (UHC
HI-5) Plan in the JICA target areas to intensify operations and coverage in priority programs of the DOH
including maternal and child care.
2.7

Background of the Respondents

(1) Health Workers


The Team interviewed 74 health workers at RHUs and DHCs (48 in Leyte and 26 in Ormoc,
respectively). In JICA project areas, there were 183 health workers, either full-time or casual, working
at health facilities as of November 2015. This means that 40% of the health workers in JICA target areas
participated in this survey. Referring to the population in 2015, 23 health facilities in JICA project areas
cater to an average population of 34,700, but the proportion differs significantly among them. For
example, the Tanauan RHU has the highest population with 61,152 while Tabon-Tabon has the lowest
with 11,396 in the area. In contrast, the number of health workers assigned at each health facility does
not always match the volume of the population. In Leyte, some health facilities have a greater number
of health workers than others with larger populations. It depends on the policy and priority of local
government in the respective municipalities.
Table 5 shows the background data of health workers who took part in this study. As mentioned in the
previous section 2.3, the Team intentionally excluded NDP nurses, casual or contractual health workers
and health workers with less than one year in service as interviewees.
The majority of the respondents were female and worked as rural health midwives. The average age of
the respondents was 45 years old (45.89 11.30). The respondents had been working at the current
health facilities for an average of 17 years but ranged from 1 to 41 years. During the interviews, it was
also confirmed that, at RHUs/DHCs, Municipal Health Officers (MHO)/Medical Officers (MO) do not
usually provide prenatal care and postpartum care to the client when the client is in normal condition.

Table 5: Background data of health workers who participated in the interviews


No. of
Respondents

74

Age
(mean )
(range)

Gender

No. of working years*


(mean )
(range)

Position

45.8911.30

Female

69

Rural Health Midwife

(22------64)

Male

PHN
MHO/MO

57

17.2111.02

8
9

(1------41)

*1 respondent has no answer.

(2) Mothers
The socio-demographic data of the mothers who participated in the interviews are listed in Table 6.
Table 6: Socio-demographic data of the mothers who participated in the interviews
(n=99)
Socio-demographic data
Age
(mean ) (range)
Marital Status
Single
Common Law Spouse
Married
Separated
Widow
Educational Attainment
(mean ) (range)
Number of Children
(mean ) (range)
Occupation
Housewife
Food vendors
Farmers
Sari-Sari Store
Others
Monthly Household Income
Less than Php 1,000
Php 1,000 to 3,999
Php 4,000 to 6,999
Php 7,000 to 9,999
Php 10,000 to 14,999
Php 15,000 and above
Philhealth Membership
Yes with ID
Yes without ID
No, but beneficiary
No
4P's Membership
Yes
No

(N)

(%)
Characteristics of Residence
Within town proper/commercial area
Near downtown/town proper
Mountain area
Coastal area
Interior barangay
Length of living in the current barangay
Less than 6 month
6 month to less than year
1 to less than 3 years
3 to less than 6 years
6 years or more
Travel time to health facility
0-15 minutes
16-30 minutes
31-45 minutes
46-60 minutes
61-90 minutes
120 minutes
Means of Transportation to health facility
By walking
Motorcycle/Habal-habal
Pedicab
Tricycle

27.23 6.17 (18------46)


4
63
28
3
1

4
63.6
28.3
3.0
1.0

8.75 2.7 (1------14)


2.94 1.85 (1------10)
87
3
2
1
6

87.9
3.0
2.0
1.0
6.1

10
45
30
7
4
3

10.1
45.5
30.3
7.1
4.0
3.0

29
23
16
31

29.3
23.2
16.2
31.3

28
71

28.3
71.7

By Walking and Motorcycle/Tricycle/Pedicab

Motorcycle and Jeepney/Pedicab


Tricycle and Pedicab
Multicab
Own vehicle
Place of the delivery of the last baby
RHU/DHC
District Hospital
EVRMC
Private Clinic/Hospital
Schistosomiasis Hospital
Unknown

(N)

(%)

13
51
16
5
14

13.1
51.5
16.2
5.1
14.1

0
3
10
17
69

0.0
3.0
10.1
17.2
69.7

78
13
3
2
0
1

80.4
13.4
3.1
2.1
0.0
1.0

31
23
17
15
7
2
2
1
1

31.3
23.2
17.2
15.2
7.1
2.0
2.0
1.0
1.0

48
41
1
6
2
1

48.5
41.4
1.0
6.1
2.0
1.0

As noted in the previous chapter, the Team interviewed 99 mothers (55 in Leyte and 44 in Ormoc) who
met the criteria during the assessment period. Most of the mothers who took part in the interviews were
relatively young (mean age of 27.2 years old); average educational attainment was eight years (high
school incomplete); and they had an average of three children (mean = 2.94), although it ranged from 1
to 10 children. The majority of the mothers were either common law spouses (63.3%) or married
(28.3%), and the remaining 8% were either single, separated, or widowed.
10

The majority of the mothers were housewives (87.9%), and only few reported having a job such as sales
people, food/sari-sari store vendors, farmers, or labors. The data showed a great range of monthly
household income among the mothers; however, the first 55% had an income level below PHP 3,999
per month. Only 28% were enrolled in the Pantawid Pamilyang Pilipino Program (4Ps)6, and 52.5% had
membership in PhilHealth with or without a proper ID. It is important to note that 30% of the mothers
were not enrolled in Philhealth.
Regarding the residence of the mothers, 64.6% lived either within the town proper or nearby, and the
remaining mothers lived in the mountain or coastal areas and interior barangays. No transient mothers
were identified; the majority of mothers had lived in their current residence for six years or more, and
the shortest length of living in the area was more than six months.
In terms of the travel time to health facilities, the majority of the mothers (80.4%) answered that they
could reach the health facility within 15 minutes; 18.6% could access it within one hour, and only one
mother mentioned two hours as her travel time to the health facility. As for the means of transportation,
the majority of them walked or used motorcycles, pedicabs, or tricycles to access the health facilities.
Of all mothers, 48 had delivered their last babies at RHUs/DHCs followed by 41 at district hospitals and
6 at private clinics. The remaining had delivered either at the Eastern Visayas Regional Medical Center
or Schistosomiasis hospital, and one did not specify the place.
(3) CHT volunteers
The Team interviewed a total of 100 CHT volunteers (60 in Leyte and 40 in Ormoc). Table 7 summarizes
key socio-demographic data of the CHT volunteers. The age of CHT volunteers ranged from 22 to 66
years old with an average age of 47 years old in both Leyte and Ormoc. The majority of them were
women, and men accounted for only 3%. Average educational attainment was nine years or incomplete
high school. The data show that approximately 70% of CHT volunteers belonged to families with less
than PHP 3,999 income per month; however, the majority (55.9% in Leyte, 75% in Ormoc) did not have
4Ps memberships.
The average number of years worked by respondents in the CHT program was approximately three (3.7
years; 3.4 years). The number of households each CHT covered ranged significantly with an average of
66 households in Leyte and 100 households in Ormoc. CHT volunteers in Ormoc seemed to have more
households to cover than those in Leyte.
The majority of the CHT volunteers held Barangay Health Worker (BHW) positions (71.7%; 72.5%);
however, the composition of the remaining CHT volunteers differed in Leyte and Ormoc. In Leyte, CHT
volunteers without any position (13.3%) were the second most frequent followed by Barangay Nutrition
Scholars (BNS) (8.5%) and the rest such as a barangay officers, day care workers, and parent leaders.
On the other hand, in Ormoc, CHT volunteers with BNS positions ranked second (22.5%), and the
remaining were either volunteers or parent leaders. As for the reason for becoming a CHT volunteer,
6

The Pantawid Pamilyang Pilipino Program (4Ps) is a human development measure of the national government that
provides conditional cash grants to the poorest of the poor, to improve the health, nutrition, and education of children aged 018.

11

90% of the respondents in Leyte were either recommended or recruited while 56% in Ormoc selfvolunteered.
Table 7: Socio-demographic data of the CHT volunteers in assessment
Leyte (N=60)
(N)
(%)

Background data
Age
(mean ) (range)
Gender
Female
Male
Educational Attainment
(mean ) (range)
Monthly Household Income
Less than Php 1,000
Php 1,000 to 3,999
Php 4,000 to 6,999
Php 7,000 to 9,999
Php 10,000 to 14,999
Php 15,000 and above
4P's Membership*
Yes
No
Number of years working as a CHT volunteer**
(mean ) (range)
Number of households in charge
(mean ) (range)
Position (aside from CHT volunteers)
None/Volunteers
BHW
BHW and other positions (BNS/Kagawad/parent leader)
BNS
BSPO
Barangay Officers/Kagawad
Parent Leader
Daycare Worker
Reason for becoming a CHT volunteer**
Through recommendation
Recruitment
Self-volunteerd
Automatically assigned

47 9.32 (26------66)
59
1

98.30
1.70

9.33 2.45 (3------14)

47.23 13.48 (22------65)


38
2

95.0
5.0

9.08 3.12 (2------14)

3
40
11
2
2
2

5.0
66.7
18.3
3.3
3.3
3.3

3
25
11
1
0
0

7.5
62.5
27.5
2.5
0.0
0.0

26
33

44.1
55.9

10
30

25.0
75.0

3.7 1.3 (0.2-----6)

3.4 1.4 (0.1------5)

65.27 44.94 (21-----200)

99.62 58.79 (32------250)

8
34
9
5
1
1
1
1

13.3
56.7
15.0
8.3
1.7
1.7
1.7
1.7

1
29
0
9
0
0
1
0

2.5
72.5
0.0
22.5
0.0
0.0
2.5
0.0

28
26
6
0

46.7
43.3
10.0
0.0

8
5
22
4

20.5
12.8
56.4
10.3

*One respondent in Leyte had no answer; **One respondent in Ormoc had no answer.

12

Ormoc (N=40)
(N)
(%)

Chapter 3

RESULTS

Findings presented in this chapter are structured to provide answers to key areas for evaluation outlined
for the given criteria in the previous chapter. In this chapter, special emphasis was given to the
effectiveness of the program in terms of MNCHN service delivery. For the detail of the interview results,
please refer to the Appendix 3 Results of CHT assessment.
3.1

Relevance

This section examines relevance of the CHT program in terms of facilitating a national MNCHN strategy
and addressing the needs in the target area based on the review of the document and the results of the
interviews.
The CHT program backed by the Project was meant to mitigate the following problems in the region.

High maternal and neonatal mortality rates: The region is ranked as the seventh highest region
for MMR and the fifth highest region for NMR in the country.

Low status in key MNCHN service indicators: In Leyte and Ormoc, the low status of MNCHN
service indicators was a serious concern. According to the baseline data of 2010, the FBD rates
were 56% in Leyte and 65% in Ormoc; the PNV4 rates were 22% and 29%; and the postnatal care
visit (two times) rates were 53% and 61% in Leyte and Ormoc, respectively. In the CHT
assessment, 43 (66.2%) of the health workers in the JICA project area perceived a difficulty in
attaining PNV4 coverage in their target area.

The relevance of the CHT program with regard to government policy is also high. The Project started
implementation of the CHT program in line with the national policy and strategies such as the MNCHN
policy, AHA, and KP. The approach of CHT institutionalization as a bridge between the client and
health service is also supported by the national KP strategy.
Furthermore, in the interviews with 74 health workers, more than 90% agreed on the importance of
five key activities of the CHT program in the improvement of MNCHN service delivery (Figure 2).
This means that the activities promoted by the Project match the needs of health workers in the
intervention through health volunteers.

Figure 2: Results of the interviews on the importance of CHT activities (5 key areas)
13

3.2

Effectiveness

This section examines the effectiveness of the CHT program by looking at the following areas.

Effectiveness of the intervention in improving the status of MNCHN service delivery

Effectiveness of the CHT program to strengthen the function of health volunteers as a link between
the community and health facilities

The findings were summarized based on the results of a CHT monthly report and the interviews
conducted with health workers, mothers, and CHT volunteers.
3.2.1

Effectiveness of the intervention in MNCHN service delivery

Table 8 shows the accomplishment of FBD and PNV4 among the mothers who were tracked by CHT
volunteers based on the results of CHT monthly reports from January to September 2015 in the JICA
priority barangays. The accomplishment was compared with the Field Health Service Information
System (FHSIS) reports of 2015 and 2010 and the target accomplishments set by the JICA project. The
Project uses the FHSIS report of 2010 as the baseline data for the project. The data of the CHT monthly
report exceeds the target accomplishment of the Project and shows higher accomplishment than those
of the baseline and the province and city in 2015. One exception is the FBD coverage in the FHSIS
report from 2015 in Ormoc. The accomplishment in the FHSIS report from 2015 in Ormoc shows
slightly better performance of FBD coverage than in the CHT monthly report.
Table 8: Accomplishment of CHT volunteers on FBD and PNV4
(From January to September 2015)
1. LEYTE PROVINCE
Data Source

No. of women who


delivered

Facility-Based
Delivery (FBD)
coverage

Prenatal Visit 4
(PNV4) coverage

CHT Monthly Report


5,996
95.5% (5,728)
52.8% (3,164)
(JICA priority barangays in Leyte)
FHSIS Report 2015
28, 652
92.9% (26,606)
46.14% (17,920)*
Project Target
80.0%
45.0%
FHSIS Report 2010 (Baseline data)
56.0%
22.0%
*The percentage is calculated based on the eligible population (38,837) , which was computed based on the
FHSIS definition (population x 2.7%), in Leyte. As for CHT monthly report, the parameter uses the actual
number of the pregnant who delivered the baby.

2. ORMOC CITY
Data Source

No. of women who


delivered

Facility-Based
Delivery (FBD)
coverage

Prenatal Visit 4
(PNV4) coverage

CHT Monthly Report


1,560
93.6% (1,460)
69.4% (1,083)
(JICA priority barangays in Ormoc)
FHSIS Report 2015
7,030
96.9% (6,810)
63% (3,609)*
Project Target
80.0%
45.0%
FHSIS Report 2010 (Baseline data)
65.0%
29.0%
*The percentage is calculated based on the eligible population (5,764) , which was computed based on the
FHSIS definition (population x 2.7%), in Ormoc. As for CHT monthly report, the parameter uses the actual
number of the pregnant who delivered the baby.

To analyze the impact of the CHT program, the accomplishment of MNCHN indicators was compared
between JICA project areas (18 RHUs and 5 DHCs) and non-JICA project areas (23 RHUs and 1 DHC)
14

in both Leyte and Ormoc, as shown in Table 9. Although the CHT program has been expanded to nonJICA target areas since 2012, the Project continued to prioritize the JICA target areas in conducting all
follow-up activities such as capacity enhancement, monitoring activities, and distribution of CHTrelated logistics. The Team expects higher achievement in JICA target areas than non-JICA target areas
as a result of such extensive intervention by the Project.
Table 9: Comparison of the accomplishments between JICA target and non-JICA target areas
1. LEYTE PROVINCE
Category
Eligible Population
Maternal Care Program
PNV (4 or more)
PP (at least 2 times)
Deliveries
Total number of deliveries
FBD
Home Deliveries
Others

JICA Areas
(18 RHUs)

Non-JICA Areas
(23 RHUs)

Leyte Province

15,097

23,740

38,837

7,622
11,055

50.5%
73.2%

10,298
16,575

43.4%
69.8%

11,116
10,734
308
74

96.6%
2.8%
0.7%

17,536
15,872
90.5%
1,583
9.0%
81
0.5%

17,920
27,630

46.1%
71.1%

28,652
26,606
92.9%
1,891
6.6%
155
0.5%

2. ORMOC CITY
Category

Non-JICA Areas
(1 DHC & nonresident)
1,250

JICA Areas
(5 DHCs)

Eligible Population
Maternal Care Program
PNV (4 or more)
PPC (at least 2 times)

4,496
2,857
3,417

Deliveries
Total number of deliveries
FBD
Home Deliveries
Others

3,436
3,233
195
8

Ormoc City
5,746

63.5%
76.0%

752
881

60.2%
70.5%

3,609
4,298

62.8%
74.8%

94.1%
5.7%
0.2%

3,594
3,577
17
0

99.5%
0.5%
0.0%

7,030
6,810
212
8

96.9%
3.0%
0.1%

The JICA target areas showed higher accomplishment than non-JICA target areas in most of the coverage
areas except one. Again, the coverage of FBD in Ormoc in non-JICA target areas was higher than in the
JICA target areas. The Team believes that this is because the non-JICA target areas are located in the
city proper with better access to hospitals and private birthing facilities. In addition, there is the effect
of non-Ormoc residents, who were accounted for in non-JICA target areas. In Ormoc, many clients from
outside the city were referred to or voluntarily came to the hospital for delivery, which contributes to
higher accomplishment of FBD in the area than JICA target areas. Nonetheless, the abovementioned
results show the positive impact of the CHT program on selected indicators. While the Team
acknowledges that other factors, such as other relevant activities or programs by the Project or other
organizations, contributed to the accomplishment of MNCHN indicators, much of the accomplishment
in the above indicators is believed to be attributed to the work and effort by the CHT program.
A total of 74 health workers in the JICA target areas were also interviewed regarding the improvement
15

of MNCHN service delivery in relation to the CHT program. All health workers (100%) answered that
there was improvement in performance of MNCHN service delivery after the introduction of the CHT
program. The health workers were further asked for their opinions on the CHT program contributing to
the improvement of three key MCH service delivery areas: antenatal care service, FBD service, and
postnatal care service. As seen in figure 3, the large majority of health workers answered that the CHT
program is very helpful in improving these services.

Figure 3: Opinions on the CHT program in improving three key MCH services

3.2.2

Effectiveness of the CHT program in strengthening the function of health volunteers

The effectiveness of the CHT program was also evaluated with regard to strengthening health volunteers
as a link between community and health facilities to ensure client access to necessary maternal and child
care services. The following findings were also based on the analysis of CHT monthly reports and the
results of the interviews.
(1) Visibility of the Community Health Team
The CHT is composed of different types of volunteers and supervisors. The KP strategy strongly
emphasized the establishment of a CHT as a mechanism of linking communities with health services.
Therefore, the Project supported the promotion of the awareness of the CHT program and CHT
volunteers from municipal to barangay
levels. To measure the impact of the
activity

and

the

program,

the

familiarity of the name Community


Health Team was assessed among the
mothers during the interviews. It was
found that more than half of the clients
(63.6%) were familiar with the name of
the CHT, and the remaining 36.4%
were not.
Figure 4: Person who provides MCH services in community
16

Among the interviewed mothers, the most popularly known figure in providing MCH services in the
community was the BHW, as shown in Figure 4. It is noted, however, that, aside from BHWs, other
people such as BNSs, Day Care Workers, Parents Leaders, and Barangay Service Point Officers were
also recognized people who provided MCH services. This shows that many people with different
positions were now involved in MCH service at the community level, and their function as CHT
volunteers was recognized by the clients despite the slightly low visibility of the name Community
Health Team.
(2) Performance of CHT task
The Team reviewed the performance of CHT volunteers on pregnancy tracking and four home visits
(HV4) during the prenatal period. These were key activities promoted and monitored by the Project.
Identification of the possible pregnant women is the first task of CHT volunteers in the community. CHT
volunteers need to track these women at the early stage of pregnancy to ensure their clients avail
themselves of all necessary prenatal care services, which leads to the accomplishment of PNV4. The
accomplishment of pregnancy tracking by CHT volunteers is assessed based on comparison with the
expected number of pregnant women calculated as projected population 2.7%. Table 10 below shows
the result of the accomplishment from January to September 2015 based on CHT monthly reports. CHT
volunteers showed a high accomplishment rate (98% in Leyte and 100% in Ormoc) in tracking the
possible pregnant women.
Table 10: Pregnancy tracking accomplished by CHT volunteers (January to September 2015)
Area

Population in JICA
priority barangays
(2015)

Expected number of
pregnant women
(for a 9-month period)

No. of the pregnant


women tracked by
CHT volunteers
(actual)

Accomplishment
rate

Leyte

421,887

8,543

8,355

98%

Ormoc

105,433

2,135

2,136

100%

Note: The expected number of the pregnant women per year was computed based on FHSIS definition (population x 2.7%),
and then the expected number of a nine-month period was calculated for this study.

CHT volunteers were expected to conduct at least four home visits synchronized with the schedule of
clients prenatal care visits in each trimester. This is because part of their task aims to remind the clients
of their scheduled prenatal check-ups at the health facility. The accomplishment rates of the completed
four home visits by CHT volunteers were 67.7% in Leyte and 74.4% in Ormoc (Table 11). The Team
further analyzed the success rate of CHT home visits in convincing the clients based on the
accomplishment of PNV4 among the women tracked by CHT volunteers. As a result, a relatively high
success rate was observed in Ormoc (93.3%) while Leyte still has a little more room for improvement
(78% in Leyte).
The percentage of non-attainment of HV4 was approximately 30% in JICA priority areas. This
percentage coincides with the results of CHT interview in terms of the difficulty in identifying the
pregnant women in the early stage of pregnancy. Of the 100 CHT volunteers, 29 acknowledged such
difficulty, and the majority mentioned denial of the pregnancy by the client as a reason.
17

Table 11: Accomplishment of home visits (4 times) during the prenatal period by CHT volunteers
(January to September 2015)
Area

No. of women
who delivered
(A)

No. of women who


delivered with
completed 4 home
visits by CHT (B)

No. of women who


delivered with completed
PNV4 (C)

Leyte

5,996

4,059 (67.7%)

3,164 (52.8%)

Success rate of
convincing the client to
avail PNV4 through 4
home visits
(D: CB)
78%

Ormoc

1,560

1,161 (74.4%)

1,083 (69.4%)

93.3%

(3) Trends of CHT Performance


Figure 5 presents the trends of CHT performance from 2013 to the third quarter of 2015. The data are
only available from 2013, when the Project officially established the monitoring system of CHT
performance through the CHT monthly report. The data show significant decreases and increases of the
performance in pregnancy tracking from the fourth quarter of 2013, which coincides with the time when
the super-typhoon Yolanda (Haiyan) hit the region. The PHO reported the increased number of pregnant
women after the typhoon, and such baby boom was confirmed by the sharp increase of pregnancy
tracking rate by the CHT volunteers from first to second quarter of 2014. The remaining performance
of CHT activities such as HV4 and PNV4 among the tracked pregnant women has been slowly but
steadily improving over the last three years. Figure 5 further shows the synchronized accomplishment
between HV4 and PNV4. In light of the previous finding on the high success rate of PNV4 by the CHTs
four home visits, home visits by the CHT volunteers certainly contributed to improving PNV4
accomplishment among their clients.

Figure 5: Trends of CHT accomplishment in JICA priority barangays


From 2013 to 3rd quarter of 2015
(4) Availability of the Service by the CHT volunteers
Service Provided by the CHT Volunteers
To evaluate the functionality of CHT volunteers, the mothers were interviewed on the kind of service
they received from CHT volunteers during their prenatal to postnatal periods. The selection of the
18

answers was not given to the respondent unless the respondent had difficulty in understanding how to
answer. In addition, multiple answers were encouraged. Four activities by CHT volunteers were
identified by the majority of the participants: 1) home visits during the prenatal period, 2) home visits
during the postnatal period, 3) health education, and 4) reminding of or encouraging to visit the health
center (see Table 12). These are the key activities of CHT volunteers according to the Project, as
mentioned in Chapter 1. By contrast, health education scored relatively low considering the number of
respondents who mentioned home visit. Another area of concern is the smaller number of the clients
(n = 30) who mentioned confirmation of a birth and emergency plan by CHT volunteers. Confirmation
of clients birth and emergency plan was important for the Project to ensure the client had an emergency
plan for delivery, and availability of the plan among the clients was one of the project indicators to
evaluate success. The team arrived at two possible reasons. First, some CHT volunteers may not focus
on confirmation of a birth and emergency plan because, in the case of Ormoc, a birth plan is mostly
followed by the midwife. Second, many of the clients in the interviews may have considered the
confirmation of a birth and emergency plan as part of health education or health advice, which has
resulted in a lower number of responses on this service. This analysis was supported by the confirmation
of clients Mother and Child book (MC book) during the analysis of efficiency. Eighty-three mothers
had a completed birth and emergency plan, which resulted in the high accomplishment of the follow-up
on clients birth and emergency plan by the CHT volunteer.
Table 12: Types of services provided by CHT volunteers (multiple answers)
Home Visits (during prenatal period)
Home Visits (during postnatal)
Health Education/Advice
Reminding/Encouraging the visit to health center
Confirmation of a birth & emergency plan
Referral/accompany to the health center
Distribution of vitamins, medicines and de-worming
Follow-up on Immunization
Family Planning
Processing PhilHealth
Weighing children
Giving information regarding health center
Total

(N)
97
80
74
67
30
27
12
7
2
1
1
1

(%)
24.3%
20.1%
18.5%
16.8%
7.5%
6.8%
3.0%
1.8%
0.5%
0.3%
0.3%
0.3%

399

100.0%

Home visits
The interview further questioned those mothers who had received home visits by CHT volunteers
regarding the number of such visits and the average length of time the CHT volunteer spent on each
home visit. For the home visits during the prenatal period, the average was seven times. As shown in
Figure 6, the majority of the mothers (61%) reported three to four visits by the CHT volunteers. For the
postnatal period until 42 days after delivery, the average was four visits, and the most common answer
was one to two visits (36.8%) followed by three to four visits (31.6%). One client mentioned that a CHT
volunteer visited the client every day during the prenatal and post-partum periods. Because the minimum
requirement of home visits promoted by the Project was four times per prenatal and postnatal period,
these results met the expectations of the CHT program.

19

Figure 6: Number of home visits by CHT volunteers during prenatal and postnatal periods

In response to the length of time CHT volunteers usually spent on each of their home visits, the clients
gave a wide range of answers from 2 to 240 minutes. The median, the middle value of all the answers,
was 30 minutes, which accounts for 32.3% of the responses. Sixty minutes (22.6%) was the second most
common answer. Twelve mothers (12.9%) mentioned that CHT volunteers stayed less than five minutes
during each home visit.
(5) Satisfaction with the Service by CHT Volunteers
To measure the quality of the service by the CHT volunteers, the mothers were asked about their
satisfaction with the four types of key services mentioned in the previous section; 1) home visits during
the prenatal period, 2) home visits during the postnatal period, 3) health education, and 4) reminding or
encouraging to visit the health center. As seen in Figure 7, the majority of the respondents reported their
satisfaction with each of the services provided by the CHT volunteers, and only 12% of mothers
mentioned their dissatisfaction with the service by the CHT volunteer.

Figure 7: Clients satisfaction with CHT volunteers service

20

(6) Effectiveness of the CHT activity to encourage change in clients health-seeking behavior
The CHT program aimed at demand creation for quality maternal and child care and health-seeking
behavior through information and education of mothers by CHT volunteers. Therefore, the Team
assessed effectiveness of the program based on the following results of the interviews with mothers:
clients source of information about maternal and child care, personnel who influenced the client to use
MCH-related service, and importance of CHT volunteers in their maternal experience. These questions
were asked to the mothers during the interviews, and the respondents were allowed to give more than
one answer.
Source of information on maternal and child health care
Figure 8 shows that CHT volunteers were
the top source of information received by
the mothers (n = 81). Family (n = 79) was
second, and followed by health personnel
(n = 69). The MC book was also mentioned
by 58 mothers as another important source
of information. These are additional
positive results as the Project has been
promoting the use of the MC book as part
of the CHT program. Mass media or
magazines did not play a big role as
information sources for the clients on
MCH care.

Figure 8: Sources of information on MCH care

Personnel influencing the decision to use MCH services


During the interview, the mothers were asked about their use of the following MCH services at health
facilities from their last pregnancy to the current period: 1) prenatal check-up during the first trimester,
2) prenatal check-ups during the second and third trimesters, 3) facility-based delivery of the baby, 4)
postpartum check-ups, 5) immunization services, and 6) family planning. Subsequently, those mothers
who used the services were asked whose opinions they took into account when deciding to use each
service. As seen in Figure 9, CHT volunteers seem to have had the strongest impact on clients decision
making on using the MCH services in question. Health workers, mainly midwives, at RHUs/DHCs also
had good influence, especially concerning the delivery and postpartum care service. Family and clients
own decision were also recognized as another important factor associated with mothers decisions to
seek care at health facilities. Overall, it is clear that CHT volunteers were able to play a significant role
in encouraging mothers to avail themselves of health services

21

Figure 9: Personnel influencing mothers decision on using MCH services

Importance of CHT volunteers in mothers maternal experiences


Of the mothers interviewed, 94% evaluated CHT volunteers as very important or important in their
maternal experience. Many of them mentioned that a reason for such good evaluation was the CHT
volunteers guidance and advice on maternal and child health care, their follow-up on the schedule of
mothers health check-ups, their monitoring of mother and babys health status through home visits, or
their encouragement. The results showed that CHT volunteers not only linked with the clients to provide
necessary health information on maternal and child health and refer them for the services but also to
give emotional support throughout the course of clients pregnancy and delivery. On the other hand,
some ineffectiveness of the CHT program was also identified. Two mothers considered the work of CHT
volunteers to be unimportant in their maternal experience because those CHT volunteers assigned to
them were not active and failed to conduct follow-ups or give them health advice.
3.3

Efficiency

Evaluation of efficiency in general involves the analysis of resource use; however, the current
assessment cannot analyze the efficiency of the CHT program in this area. The assessment of the
efficiency of resource use was constrained by two main factors. Detailed information on the total cost
used for the CHT program in JICA priority areas was unavailable. This is because the majority of CHT
activities in JICA project areas were funded by the DOH RO8 and different sections of the DOH RO8
such as the Family Health Unit and Health Systems Development Unit, allocating budgets under
different expense items. Based on the data provided by the DOH RO8, the DOH RO8 spent
approximately PHP 223 million on the CHT program in the region from 2011 to 2015, and
approximately PHP 70 million of the amount was spent in Leyte and Ormoc; however, it is difficult to
obtain a breakdown of the cost with which the Team can identify the amount of resources used for
specific activities or only in JICA priority barangays. Furthermore, although a possibility exists to work
out costs of intervention for further analysis, it is difficult to identify relevant activities supported by the
DOH or other donors for fair comparison of analysis. For these reasons, this assessment will focus on
the analysis of the efficiency in the following operational aspect of the CHT program:
22

Appropriateness of the tools and resources provided to the CHT program

Efficiency of the required task in terms of existing workload or capacity of CHT volunteers and
health workers

Support environment of the CHT program

Other factors affecting efficiency

3.3.1

Appropriateness of the tools and resources provided to the CHT program

(1) Tools developed by the Project


The Project has developed a number of tools to assist CHT volunteers and supervisors in performing
their tasks. Table 13 summarizes the description and intended users of each tool.
Table 13: Tools developed by the Project
Tools

Description

Primary User

CHT handbook

The material to guide CHT volunteers and supervisors


regarding their roles and responsibilities, and instructions
on how to complete the report

CHT volunteers
Health Workers

Pregnancy tracking form

The record of pregnant women tracked by CHT


volunteers, the record of prenatal care visits, and the
home visits by CHT volunteers

CHT volunteers

Post-partum & newborn


tracking form

The record of post-partum women and newborns tracked


by CHT volunteers, the record of postnatal care visits, and
the home visits by CHT volunteers

CHT volunteers

Reference guide of MC
book and home visit

Reference for CHT volunteers of the important pages to


review during each home visit of the client and a calendar

CHT volunteers

CHT monthly report form

A consolidated record of CHT volunteers activities based


on the pregnancy/postpartum tracking reports. It is used
by the supervisor to monitor CHT performance

CHT volunteers/
Health Workers

CHT database

A tool (Excel) for collecting and managing the CHT


monthly report for the purpose of easy consolidation of
the data and monitoring of CHT activities

Health Workers

The interviews asked health workers and CHT volunteers about the usefulness or importance of these
tools in the CHT program. Figure 10 shows the results of answers by each group. All tools received high
evaluationeither very useful/important or useful/importantby both health workers and CHT
volunteers. There are two tools for which a relatively large number of respondents failed to give any
answer or considered as not applicable. These are a CHT database for health workers (n = 12) and a
reference guide for the MC book for CHT volunteers (n = 21). As for the CHT database, the Team
believes that the CHT database is usually used to consolidate CHT monthly reports at the RHU/DHC
level, and some health workers who were not in charge of such consolidation at the RHU/DHC level
may not be familiar with the tool. As for the reference guide for the MC book, because the distribution
of the reference guide was only done once during the first orientation of the CHT program, a few CHT
volunteers, especially those who did not give any answer on this question, may have already stopped

23

using the tool.

Figure 10: Evaluation on the tools developed by the Project

(2) Mother and Child Book


The Project translated the MC book into local dialects (Waray, Bisaya, and Tagalog) in 2011 and
incorporated it into part of the essential tool for the CHT program in educating and monitoring mothers.
This strategy aimed to maximize the use of the existing resource among mothers and health workers by
introducing a check-and-balance system through CHT volunteers.
All CHT volunteers, except two who did not give any answer, mentioned that the MC book is either
very important or important as a tool in promotion and use of health service by the client (81.4%;
18.6%). Health workers and mothers also supported the usefulness of the MC book. The majority of
both groups answered that the MC book was very useful (85.1% among health workers; 82.7% among
mothers) or useful (13.5%; 13.3%). Only one health worker referred to the MC book as slightly
useful because of repetitive information and time-consuming recording. Four mothers answered that
the MC book was somewhat useful, and two of them explained their reasons as the importance of
the MC book not being explained by anyone.
Of 98 mothers who had received an MC Table 14: Use of MC book by CHT volunteers during
home visits
book during their last pregnancy, 77
mentioned that CHT volunteers discussed

Mothers

(N)

(%)

Discussion of the content of MC book by CHT volunteers during home visits (N=98)

the content of the MC book during home

Yes

77

78.6

visits (Table 14). The majority of those

No

21

21.4

Satisfaction of CHT volunteers discussing the content of MC book (N=77)

mothers showed their satisfaction with this

Very good

43

55.8

service provided by CHT volunteers.

Good

29

37.7

Fair

3.9

Poor

1.3

No answer

1.3

The status of proper completion of the


important pages of the MC book was

checked with 90 mothers who had brought their MC books during the interview. The following pages
of the MC book were checked by the surveyors: 1) birth and emergency plan (P14), 2) schedule of home
visits (by CHT volunteers) (P63), 3) present pregnancy (P3), 4) post-partum care within 42 days (P18),
and 5) postnatal care (P21). Midwives or health workers at RHUs/DHCs are responsible for filling out
24

the abovementioned pages of the MC book except the page of home visits, which is done by CHT
volunteers. As shown in Figure 11, a big
gap was identified in the recording status
between pages concerning prenatal and
postnatal periods.
The results showed that maximization of
MC book use is still limited by health
workers and CHT volunteers; however,
the usefulness of the MC book as a tool or
resource

for

health

education

was

supported by all concerned people.

Figure 11: Status of recording on clients MC book

(3) Availability of adequate resources in supporting the clients


Table 15 summarizes CHT volunteers
responses on their views on the resources.

Table 15: Views on availability of adequate resources

The majority answered that they had

Answer by CHT volunteers

(N)

adequate tools or resources to support the

Strongly agree

20

client. Among the CHT volunteers who

Agree

67

disagreed, the most commonly mentioned

Disagree

12

resources in need were financial assistance

Strongly disagree

1
100

and logistics such as forms and stationery.


3.3.2

Efficiency of the required tasks in the CHT program

Appropriateness of the task and workload related to the CHT program were assessed based on the results
of the interview with health workers and CHT volunteers. As for CHT volunteers, the results of their
opinions on their workload differed between Leyte and Ormoc (Figure 12). In Leyte, the majority of
CHT volunteers (53.3%) mentioned that their workload was just enough while CHT volunteers in
Ormoc had evenly spread-out answers with a slightly high frequency of too much. The backgrounds
of the interviewed CHT volunteers
gave some insights into such difference
in their opinion. CHT volunteers in
Ormoc seem to have heavier workload
than those in Leyte. For example, the
average numbers of households in a
CHT volunteers catchment area were
65 in Leyte and 100 in Ormoc. In
addition, the average working hours of
CHT volunteers per week were slightly
longer among the CHT volunteers in
Ormoc than in Leyte (seven hours in

Figure 12: CHTs opinions on their workload


25

Leyte; nine hours in Ormoc). In addition, according to the CHO, all CHT volunteers in Ormoc are
required to have duty at DHC and BHS during the daytime and sometimes even at night.
As for the ratio of households per health volunteer, the DOH sets the ideal ratio of the number of
households as one CHT volunteer per 20 households; however, in reality, CHT volunteers cover more
than three times the expected number of households in both Leyte and Ormoc.
Health workers were asked about the appropriateness of the required task of CHT volunteers by the
program in relation to their capacity; the majority (50.7%) consider the task appropriate. Slightly
difficult and difficult were also mentioned by 24.7% and 9.6% of the respondents, respectively. The
remaining respondents (15.1%) answered that the task of CHT volunteers was easy. Those who
answered difficult or slightly difficult said these were due to low educational level or old age of
CHT volunteers followed by lack of incentives. Health workers were further asked for their suggestions
on any CHT task to be removed from or added to the Program. The majority answered that no task
should be either removed (90%) or added (77%). Four health workers suggested adding commitment
on work as the task of CHT volunteers.
The

majority

of

health

workers

mentioned increased (39%) or slightly


increased (20%) workload after the
introduction of the CHT program. On
the other hand, 18% of health workers
mentioned their workload decreased or
slightly

decreased.

The

remainder

mentioned that their workload stayed


the same as before (figure 13). As
gleaned
interview,

from the

results

the

efficiency

of

the
and

appropriateness of the CHT program in

Figure 13: Health workers opinions on their workload

terms of staff workload and the required


task is acceptable.
3.3.3

Support environment of the CHT program

(1) Satisfaction with the support from others


To assess the support environment of the CHT program, CHT volunteers were interviewed regarding
their satisfaction with the support from different types of personnel involved in the program. Figure 14
shows the results of the answers by CHT volunteers. The support from the midwife, an immediate
supervisor of CHT volunteers, was the most common response followed by Public Health Nurse. A few
CHT volunteers mentioned their dissatisfaction with the support from Local Government Units (LGUs)
and a barangay captain. The main reason for the dissatisfaction was unavailability of financial support
for the CHT volunteers.

26

Figure 14: Satisfaction with the support to CHT volunteers

In a similar manner, CHT volunteers were asked about their perceived recognition by others of the
importance of their work. The results showed similar trends as their answers to the previous question
except that MHOs/MOs received higher evaluation by CHT volunteers this time (Figure 15). Many CHT
volunteers felt they were being appreciated by health workers when health workers treated and
cooperated with them as part of their team at the health facility, coaching and mentoring them on skills
and knowledge. CHT volunteers also felt their importance being acknowledged by health workers when
their referred clients were accommodated well by health workers. It is noted that about 1020% of CHT
volunteers felt the importance of their work not being recognized by the LGU and barangay officials.

Figure 15: Perceived recognition of the importance of CHTs work by others

(2) Availability of assistance


Table 16 shows the answers by CHT volunteers regarding the available assistance in the form of
incentives, honorariums, or collaterals from different sources. CHT volunteers were allowed to mention
27

all sources of assistance they had received. The results presented limited assistance provided to the CHT
volunteers in general. Only barangay and the DOH were mentioned for assistance by about half of the
respondents.
Table 16: Assistance in any form received by CHT volunteers (by source)
CHT volunteers (n=100)

Area
Leyte
Ormoc

60
40

Total

100

DOH
30
(50%)
31
(77.5%)

PhilHealth
9
(15%)
28
(46.6%)

LGU
5
(8.3%)
18
(30%)

Barangay
46
(76.7%)
29
(48.3%)

61

37

23

75

(61%)

(37%)

(23%)

(75%)

As seen in Table 17, the majority mentioned the cash incentive from the DOH as the content of the
assistance. The DOH started providing cash incentive (PHP 3,000 per year) for CHT volunteers in 2012
as part of the national CHT program; however, this cash incentive ended in June 2015. In Ormoc, many
CHT volunteers mentioned the monetary assistance by PhilHealth. This is a sharing of Maternity Care
Package reimbursement which CHT volunteers are entitled to receive per their service. The amount of
such sharing depends on DHC. In addition, each barangay has an annual budget, which comes from the
Internal Revenue Allotment (IRA). Some barangays provide CHT volunteers with a monthly
honorarium or financial assistance (e.g., transportation) through the use of the IRA in the barangay.
In Ormoc, the LGU provides a relatively high monthly honorarium to BHWs and BNSs; however, some
CHT volunteers or BHWs/BNSs are not yet included in the payroll because of the limitation of the
number of slots available for such a benefit at the LGU.
Table 17: Breakdown of the content of the assistance

28

3.3.4

Other factors affecting efficiency

One area that became a hindrance to the efficiency in the CHT program was the timing of the
implementation of the CHT program. As mentioned in Chapter 1, the DOH central office introduced
their plan for KP-CHT implementation in August 2011 with a set of new guidelines and training
materials. The Project had just completed CHT orientation with more than 3,500 people using a set of
tools developed by the Project. Because of this, the Project and the C/P spent a considerable amount of
time developing a strategy to harmonize the activities such as revising the training materials and
guidebook and re-training CHT supervisors and CHT volunteers. Based on the training cost spent on the
first CHT orientation in Leyte, approximately PHP 2 million was additionally spent by the DOH RO8
on the harmonization of the CHT program in 2012.
3.4

Impact

The impact of the CHT program was examined to identify other areas where the CHT program was able
to have a positive influence. As a result, the following positive impacts were observed.

Contribution to other areas of health service delivery: A total of 82.4% of health workers
mentioned that the CHT program has contributed to delivery of health services aside from MCH
care. Other areas of such health services include the following: 1) MNCHN-related service (e.g.,
Expanded Program for Immunization, family planning, and nutrition); 2) communicable disease;
3) environment and sanitation; and 4) barangay-related activities.

Strengthened policy support for MCH service delivery: With the effort of PHOs, CHO and
RHUs, 35 LGUs in Leyte (both JICA and non-JICA target areas) and Ormoc city have passed the
ordinance on implementation of the maternal care incentive program (MCIP) by PhilHealth (Table
18). The program aims to provide cash incentives to the mother and the CHT volunteer in charge
of the client based on the clients use of expected MCH service at a health facility. CHT volunteers
are entitled to financial incentives based on the client and their performance. This scheme was
originally discussed among the C/Ps at the beginning of implementation as an alternative method
to increase PNV4 and help promote the activity by CHT volunteers. As a result, it created another
opportunity to strengthen political support for MNCHN service delivery. Of 36 LGUs with the
ordinance, 12 LGUs (11 LGUs from JICA target areas) in Leyte and Ormoc City have already
started actual implementation of the program.

Establishment of a regional initiative in promotion of MNCHN service: The DOH RO8 has
rolled out CHT orientation throughout the region to harmonize all CHT activities. The component
of CHT activities related to the Project was introduced to the rest of the region as a regional
initiative in the promotion of MNCHN service. As of now, all provinces and cities in the region
have adapted the component of the CHT program supported by the Project. Other donors, such as
USAID and IMC, have also supported training and meetings related to the CHT program.

29

Table 18: Status of MCIP ordinance and implementation in Leyte and Ormoc
ILHZ

Municipality
(with ordinance and
implementation)

Leyte Gulf

Golden Harvest
Maharlika

Calesan
Leyte West Coast
Mainbay
Mabahinhil

Alangalang, Pastrana

Sta. Fe, Babatngon

Javier

MacArthur, Abuyog, Mayorga

Jaro, San Miguel


Leyte
Isabel
Mahaplag, Inopacan,
Baybay
Bato, Hindang

Kammao
Ormoc

3.5

Municipality
(without ordinance)

Tanauan, Dulag, Tolosa, Palo

Leyte Plain
Goodwill

Municipality
(with Ordinance)

Burauen, Dagami, LaPaz,


Julita, Tabon-Tabon
Barugo, Carigara, Capoocan,
Tunga
Palompon, Tabango, Vilaba
Hilongos, Matalom

Ormoc

Calubian, San Ishidro


Kananga, Albuera,
Merida, Matag-ob
-

Sustainability

The Team examined the sustainability of the CHT program with regard to the ownership and the capacity
and resource mobilization to sustain the program.
3.5.1

Ownership of the program

(1) National and regional policy-making level


Currently, ownership of the CHT program at the national level is uncertain even though improvement
of MNCHN service delivery will remain a national goal. The advent of a new administration in the
country is likely to bring another policy or strategy to strengthen MNCHN service delivery in the future,
and it may counteract with the content of the CHT program in the region.
At the regional level, the DOH RO8 ownership is present. In March 2016, the DOH RO8 issued the
regional special order7 to show their commitment on the sustainability of the CHT program. In this
special order, the DOH RO8 took initiative to equip all BHWs in the region with the CHT functions to
enhance the sustainability of the program. The capacity enhancement training of BHWs on CHT
function has been held region-wide since April 2016. By contrast, with the end of the national budget
for the CHT program, the DOH RO8 will not be able to provide any financial incentives to the CHT
volunteers. Unfortunately, financial incentives by the DOH created a level of expectation over the
required work among the CHT volunteers. This has contributed to the challenge of sustainability in the
CHT program at the local level.
Furthermore, the sustainability also depends on how the DOH RO8 can coordinate the CHT program
with a possible new strategy or program at the national level in the future. As in the course of the CHT

DOH-RO VIII Special Order No. 069s, 2016 Clarification on the Operation of Community Health Team (CHT) in the
Region
7

30

program in the region with the introduction of the national CHT program, it required the effort of the
program manager to localize and harmonize the national program to fit into the existing system for
sustainability of the current CHT program. In addition, the effort must be made before the roll-out of
the program to avoid any possible confusion regarding the program at the local level. This mostly relies
on the capacities of the program manager in charge and his or her individual effort.
(2) Local government level
The level of ownership at PHOs and CHOs is high; however, one constraint noticed especially in PHOs
is the limited leverage to mobilize resources in support of the CHT program. In most cases, LGUs
depend on the funds by the DOH RO8 or other international donors for implementation of training
sessions and meetings or sometimes even provision of most logistics because of the limitation of their
budget or the cumbersome approval process at LGU. Nevertheless, they continue to take every
opportunity to monitor and sustain the program. It is also fair to say that the ownership of and
commitment to continuing the CHT program is high at the municipal and district levels. The results of
interview with health workers revealed that 97% think the CHT program should be continued at health
facilities. Some of them even mentioned in the interview that the program is already an established
system in their facility.
3.5.2

Capacity and Resource Mobilization to Sustain the Program

Quality of service and human resources are other important areas of consideration for sustainability of
the CHT program. In the interview with health workers, training needs for CHT volunteers were
confirmed with 82% of health workers, especially in the areas of report making (n = 45), client tracking
(n = 45), and knowledge on maternal and newborn care (n = 44). Mothers also attested to the importance
of maintaining good service by the CHT during the interview, and a few (n = 5) voiced that CHT
volunteers need more training to provide the service.
Table 19 shows the results of the interview with CHT volunteers on the different questions concerning
their performance and experiences. The top five responses by the CHT volunteers are arranged in
descending order. Training needs were mentioned in all areas as negative or positive factors affecting
performance, challenges, and suggestions for improving the program.
For the CHT program to continue to deliver expected services and outcomes, continuous training of
CHT volunteers is essential. This is relevant because of their low educational attainment and old age.
The constraint is that such training requires a large amount of money if the DOH RO8 or PHOs/CHOs
must be the ones to fund. For sustainability, it is ideal for training to take place on a much lower scale
and mainly at health centers. Some good practices shared by health workers during the interview were
conduct of a refresher training or on-the-job training activity for CHT volunteers and a monthly peer
review among CHT volunteers at health facilities. Some health workers use their monthly meeting as an
opportunity to conduct these activities. These practices can be strengthened throughout RHUs/DHCs.

31

Table 19: Results of interviews with CHT volunteers

Factors affecting the


performance
Attitude of the
community or the client
(44)

Challenges or difficulties
experienced

(N=100; multiple answers)


Suggested
Motivational factors
improvement

Lack of cooperation by the


community/client (33)

Own commitment to
serve (81)

Training (74)

Availability of monetary
incentives (38)

Prioritizing CHT task due


to financial difficulty and
other reasons (29)

Knowledge
enhancement (57)

Provision of
monetary incentives
(40)

Lack of training (34)

Inadequacy of skills &


knowledge (20)

Recognition by the
community (22)

Provision of logistics
(29)

Availability of IEC
material (25)

Weather condition (19)

Means of income (13)

Supervision by health
workers (29)

Availability of logistics
(23)

Transportation (18)

Benefits related to
work (12)

Provision of IEC
materials (28)

As for human resources, the decreasing number of CHT volunteers has been a major concern in Leyte.
As seen in Table 20, the number of CHT volunteers in Leyte has decreased by more than 1,000 since
2011 when the first CHT orientation was conducted by the Project. An average 15.2% attrition rate per
year was recorded in Leyte. Unfortunately, the current assessment did not conduct an interview with
health workers and CHT volunteers to find out reasons of resignation by other CHT volunteers. However,
based on the experiences of the Project, CHT volunteers usually became inactive when they found a job
or other financial opportunities, or they decided to go back to school, or had health problems. The
attrition rate is likely to increase more in 2016 due to the termination of cash incentives by the DOH. In
contrast, a low attrition rate was observed in Ormoc. This is because the majority of CHT volunteers in
Ormoc are BHWs or BNSs who receive relatively high monthly honorarium by the LGU.
Table 20: Transition of the number of active CHT volunteers from 2011 to 2015
JICA priority
areas

2011

2013

2014

2015

Average per
year

Leyte

3,005

2,095

1,898

1,786

-406.3

-15.2

Ormoc

164

206

210

220

18.7

10.8

Total

3,169

2,301

2,108

2,006

-387.7

-13.5

Note: No data were available in 2012 because of the training of CHT orientation.

The decreased number of CHT volunteers will lead to increase of workload among the remaining CHT
volunteers, which will further jeopardize the service provided by CHT volunteers. Availability of
financial incentives for CHT volunteers is certainly one solution to keep CHT volunteers active in their
service. In Table 19, financial factors were also mentioned by CHT volunteers in all categories. For the
time being, CHT volunteers are highly motivated, as seen in the majority answering that their
motivational factor was their own commitment to serve the community. These are mainly sustained by
the enthusiasm of applying their new skills and knowledge and better relations with the clients and health
workers that show gratitude for the service. Contrary to the training needs mentioned by CHT volunteers,
100% of CHT volunteers also answered that they were very confident (52%) or confident (48%)
with their knowledge and skills to give health education to clients. Such high self-confidence is likely
32

to be boosted by both the expansion of their knowledge and competency due to the application of skills
into practice. In doing so, they have gained the trust of the client or even the community, who appreciate
the benefits coming from their service. In the long run, such motivation may deteriorate if basic
necessary changes like provision of financial assistance do not take place. As mentioned in section 3.4,
many RHUs have now started implementation of the MCIP in Leyte. The success of implementation of
the MCIP is crucial, as it will certainly contribute to the sustainability of the CHT program if no other
alternative solution is identified. Meanwhile, it is important to note that 30% of the mothers who
participated in the assessment was not enrolled in the PhilHealth. The source of MCIP funds comes from
the reimbursement of the PhilHealth through the utilization of the service by the client with PhilHealth.
It is equally important for RHUs to strengthen enrollment of the PhilHealth among the client to secure
the financial source of MCIP.
One cannot overlook the political influence at the local level. In the interview with health workers, a
few health workers mentioned the problem of barangay politics over CHT volunteers. In some cases,
CHT volunteers were replaced or recruited by barangay officials, and the level of support given to the
CHT volunteers is sometimes limited owing to the difference in their political affiliation with the
barangay. This tendency was also observed over the course of the Project. In the Philippines, as local
elections take place every three years, it is part of the sustainability risk of the CHT program over human
resources.
3.6

Others

The assessment originally aimed to analyze factors contributing to the functionality of the CHT program
through the comparison of health facilities with high and low accomplishment on the CHT program.
The assessment identified six facilities (four in Leyte; two in Ormoc) based on the review of the CHT
monthly report. These facilities were examined with regard to 1) policy support, 2) health financing, 3)
service quality based on the skills of Basic Emergency Obstetric and Newborn Care (BEmONC) service
delivery, and 4) geographic characteristics. CHT volunteers were also selected from these facilities for
the interview to examine any difference in their attitudes and characteristics. The Team identified health
facilities with low accomplishment of the CHT program in Leyte as being located in a geographically
challenged area, but this was not applicable in Ormoc. No other clear factors contributing to the
functionality of the CHT program were identified in this part of the assessment.

33

Chapter 4

CONCLUSION AND LESSONS LEARNED

The findings of the assessment reveal a positive impact of the CHT program on MNCHN service
delivery. More than 90% of the interviewed health workers appraised the concept of the CHT program
by the Project as suitable to the regional needs and the national strategy, and deemed as important the
programs key activities such as tracking of pregnant and post-partum women and newborns, home visits
during prenatal and postnatal periods, and health education.
The statistical data and the interview outcome also confirmed the effectiveness of the CHT program.
The data show a tangible achievement of the CHT program in improving the status of MNCHN service
in the JICA target area. CHT volunteers in the area served successfully as an important link between
mothers and health facilities. The interview results also showed that CHT volunteers are considered as
a mothers source of information on MCH care and a contributing factor in a mothers decision making
on seeking MCH services at a health facility.
The efficiency of the CHT program seems acceptable. Health workers and CHT volunteers evaluated
highly all the tools developed by the Project for the program. The strategy of institutionalizing the MC
book as a tool for the CHT program helped CHT volunteers provide standardized health information to
their clients and increased the use of the MC book by health workers and mothers. However, it is still
necessary to increase the use of the MC book among health workers and CHT volunteers. An
environment supportive of the CHT program was established firmly within health facilities while limited
support at the community level was identified among a few CHT volunteers. A major obstacle to the
efficiency of the CHT program was the initial overlapping in the CHT program activities between the
Project and the DOH central office. It took much time and money to harmonize the activities and retrain the facilitators and CHT volunteers during the second year of the Project.
The CHT program produced a few positive impacts on strengthening other areas of health service
delivery by CHT volunteers, strengthened LGUs policy support for MCH service delivery, and helped
the DOH RO8s establishment of the regional initiative in promoting MNCHN service delivery. The
latter two impacts also helped enhance the sustainability of the CHT program. PhilHealth initiated the
Maternal Care Incentive Program (MCIP) to create an incentive provision system for women. With the
growing recognition of the importance of CHT volunteers, the volunteers also became beneficiaries of
the MCIP. They are entitled to a financial incentive based on the performance of both their clients and
their tasks. Thirty-five LGUs of Leyte and Ormoc City have passed the required ordinance for the MCIP,
and a few have started implementing the MCIP (refer to Table 18). The MCIP will enhance the
sustainability of CHT volunteers greatly because the lack of financial assistance is a major reason for
the high attrition rate of CHT volunteers. Meanwhile, policy makers must meet the challenge of
protecting active CHT volunteers from the influence of local politics because lack of recognition on this
matter by barangay officials caused a few volunteers to resign or be replaced.
The CHT program in the region gave the DOH RO8 an opportunity to implement an additional strategy
to strengthen MNCHN services. The DOH RO8 has adopted the activities introduced by the Project
34

component in national CHT program as its regional initiative. The ownership of the DOH RO8 became
another backbone of the sustainability of the program in the region. By contrast, the advent of a new
administration in the country may require the DOH RO8 to cope with a new national strategy in
MNCHN services. The DOH RO8 must come up with a strategy to localize any future national program
and make it fit into the existing system of the CHT program in the region for the CHT programs
sustainability.
The Team identified the following lessons learned through the intervention of the CHT program. These
lessons should be taken into account to improve the CHT program and implement effectively any
relevant future programs involving communities.
1. Selection of CHT volunteers: To meet the national target ratio of one health volunteer per 20
households, the Project and the C/Ps tried to recruit many CHT volunteers in the JICA target areas in
such a way that the number of CHT volunteers in each JICA target area would be appropriate for the
areas population. Because of the emphasis on reaching the expected number of CHT volunteers, the
qualifications of the volunteers were not given the priority that they deserved in the recruitment process.
As attested by the results of the current assessment, there are CHT volunteers with low educational
attainment and of old age. Many health workers stated that these factors affected the performance of
CHT volunteers and the implementation of the program. Meanwhile, the feasibility of recruiting the
expected number of qualified people as CHT volunteers was questionable because the incentive to the
volunteers was meager. It is necessary to provide a suitable incentive to recruit qualified and dedicated
people for any work.
2. Legalization of CHT volunteers: The CHT program deployed many CHT volunteers who were
willing to serve a community regardless of their positions in the community. challenge in the
program is how to ensure the status of these volunteers. Unlike BHW whose status was backed by law
as a community health volunteer8, CHT volunteers have no legal evidence or backup to secure their
status. This affects some CHT volunteers with regard to receiving support such as financial assistance
or incentives from barangays or LGUs.
3. Involvement of barangay and community: The Project conducted the CHT program only up to the
RHU/DHC level because of the large size of the JICA project area; therefore, not many activities were
either supported or implemented in mobilizing CHT volunteers at the community level. To obtain proper
understanding of the program and solicit more support to CHT volunteers at the barangay level, more
active intervention is necessary to enhance the performance of the program. This is evidenced by a
barangay captain allocating some IRA funds to support CHT volunteers for logistics and travel costs
because of her familiarity with and engagement in the CHT program.
4. Establishment of a system for the benefit of CHT volunteers: With the confirmed needs of support
to CHT volunteers, especially in the logistical and financial spheres, it is necessary to provide each CHT
volunteer with tangible benefits for his or her service. The volunteers serve a highly useful purpose by

R.A. 7883 Barangay Health Workers Benefits and Incentives Act of 1995.

35

being part of the system to promote good health in the communities. Those CHT volunteers who serve
but are not commensurately rewarded for their work may be demoralized and resign. Thus, a supportive
environment with a sustainable financial and non-financial benefit scheme must be established for the
CHT program at the beginning.
5. Efficient use of tools and maximizing local resources: Given the limited budget available at health
facilities, the strategy of minimizing the number of tools and maximizing resources is important for the
sustainability of the CHT program. Reporting formats used for CHT volunteers in the Project were
mainly the pregnancy tracking form and the post-partum tracking form. A sheet of each of the two forms,
which is printed on both sides of a piece of paper, can accommodate 16 clients and be used for the entire
duration of the prenatal and post-natal periods. Tanauan and Linao have the largest population sizes in
the JICA priority barangays of Leyte and Ormoc: Tanauan has 48,356 people; and Linao, 29,831. Based
on the number of available CHT volunteers and the expected number of pregnant women per year, each
CHT volunteer tracks average one to three women per month. Two sheets of each reporting format used
in the CHT program are good for one year if they are used appropriately. The cost of those sheets
(approximately PHP 8.00 per set) is a worthwhile investment for the program considering the benefit of
the tracking using them in MCH service. Another format introduced by the Project is a CHT monthly
report, which is used once a month at BHS and RHU/DHC. The Project also introduced the CHT
database to RHUs/DHCs, PHO/CHO and the DOH RO8 for possible computerization of the CHT
monthly report to reduce the logistical cost. The use of the MC book as an education tool has brought a
few advantages such as the standardization of health information, the maximization of the use of national
resources, and the reduction in the cost of producing another educational material that would require
sustainable funds for reproduction.

36

Chapter 5

RECOMMENDATIONS

Based on all the findings and lessons learned, the Team submits the following recommendations for
improving the CHT program in the region and its sustainability.
Recommendation 1: Sharing the results of CHT assessment:
The results of the current assessment showed the effectiveness of the CHT program and the importance
of CHT volunteers at the community level. The challenges regarding the CHT program were also
addressed well. These results should be shared with the DOH central office, donors and respective LGUs
for improving the CHT program and any future interventions.
Recommendation 2: Coordination with the DOH central office and other donors:
The DOH RO8 should take necessary actions to harmonize and localize similar national programs or
projects by other donors in the future to ensure the sustainability of CHT program. This does not prevent
the implementation of other important programs but enables the DOH RO 8 to give consistent policies
and instructions to health officers and workers at the local level. Technical working group meetings with
relevant program managers should be held for any new intervention which may affect the CHT program
in region.
Furthermore, it would be useful if the DOH Central Office developed a national policy to encourage all
the regional offices to harmonize a new program with their existing system to maximize the benefits of
all programs.
Recommendation 3: Strengthening policy support to the CHT volunteers:
To provide sustainable assistance to the CHT volunteers, PHO and CHO, in cooperation with the DOH
RO8, should continue to advocate policy support to the CHT volunteers through the MCIP. The
implementation of the MCIP will not only help CHT volunteers receive financial assistance but also
help convince their clients of the merit of the use of MCH services in health facilities. At the same time,
PHO and CHO must expand the enrollment and ensure the continued enrollment of PhilHealth among
the client to secure the financial resource to implement the MCIP.
PHO and CHO should also strive to establish a system to protect active CHT volunteers from local
politics. The Team suggests that a barangay or municipal resolution be formulated to prevent barangay
officials from replacing registered or accredited health volunteers without consulting RHUs or DHCs.
Furthermore, the DOH RO8 should train existing active CHT volunteers with no position on BHW
functions to be registered and accredited as BHWs. Simultaneously; the DOH should develop criteria
such as qualification and the ratio of health volunteers for appropariate recruitment of health volunteers.
It is strongly recommended that the criteria be feasible enough for LGUs to implement by considering
the characteristics of the area (e.g., urban and rural) and availability of financial resource to support
health volunteers.

37

Recommendation 4: Strengthening capacity enhancement and activities at the local level:


As seen in the results of the CHT assessment, continuous training of CHT volunteers is essential. The
Team suggests that PHO and CHO conduct regularly refresher training or on-the-job training of CHT
volunteers at a lower tier such as at a health facility in the Province and the City. Using existing venues
such as the monthly CHT meeting is highly recommended for this activity. In addition, it is necessary
to emphasize repeatedly to health workers and CHT volunteers the importance of using the MC book
because there is still some area for improvement in recording of the MC book.
Recommendation 5: Strengthening harmonization and sustainability of the activities in the region:
The DOH RO8 and PHO should harmonize the activities in non-JICA project areas or the rest of the
region by sharing the practices and strategies implemented in the JICA project area. These include, but
are not limited to, the following: the use of the CHT database; promotion of the MCIP; and establishing
resolutions to protect CHT volunteers from local politics. Such activities as monitoring of CHT activities
through CHT monthly reports, implementation of regular monitoring and consultative meetings, and
awarding of CHT volunteers at different levels should be continued to ensure the high quality and
sustainability of the CHT program.

38

Appendix 1: Matrix of the differences in CHTstrategy


No
A
1

Area of Concerns
Organizational Structure and Management
Composition of Community Health Team

2.1.1 Management Structure (1)

2.1.2 Roles and Responsibilities

DOH/JICA SMACHS-EV

CHT Leader and Members

National KP Program

CHT Management Group, its Members and CHT partners/ volunteers/health


navigators

CHT Leaders - RHMs at Brgy Level

CHT Management Group at the Brgy level


(1) Chairperson - Barangay Captain
(2) Co-chair - RHM
(3) Members:
- Brgy Kagawad committee on Health
- BNS
- BHW representative
- TBA representive
- others (Purok leaders etc)
1. Conducting regular monitoring and supervision of CHT members and their 1. Assess the capability of the community health teams and provide technical
activities
assistance/guidance or build their capabilities relative to their functions;
- disseminating information and giving regular feedback of the activity to the CHT
members
2. Issuing Mother and Child book (MC Book)
2. Assess and identify gaps in service delivery provision using the facility
- assisting the pregnant woman/ mother in filling up necessary information and inventory and mapping tools and guide;
developing her birth plan
3. Consultation at health centers and during home visits

3. Supervise, monitor and evaluate the performance of the different teams on a


quarterly basis;

4. Consolidating reports from CHT members

4. Lobby to the local health board for the establishment of a public-private service
delivery network that includes public and private providers;

5. Holding a monthly CHT meeting at BHS

5. Submit a quarterly status report to the local health board.

6. Attending a regular meeting and a Maternal /Neonatal Death Review Meeting

6. Coordinate with the MHO/ CHO to secure validated list of NHTS-PR families
in coordination with the PHO and CHD.
7. Ensure that community volunteers selected are comprehensively trained,
evaluated, and are able to perform expected tasks
8. Continuously assess performance and capabilities of the community health team
members and provide technical assistance/guidance as needed and make the
necessary adjustments (to CHT matching / allocation of NHTS families) based on
the results of assessment.
9. Lobby to the LCE (BC, Mayor) and local health board for: 1) Securing
resources and policy support for CHT-related activities, 2) Establishing a
functional public-private service delivery network
10. Review HUP compliance forms and support preparation of the HUP
compliance consolidation forms

No

Area of Concerns

DOH/JICA SMACHS-EV

National KP Program

2.2.1 Management Structure (2)

CHT Supervisors - MHOs and PHNs at the RHU/DHC level

Managers - MHO/MO at the RHU/DHC level

2.2.2 Roles and Responsibilities

1. Holding monthly/quarterly CHT meetings at RHU/DHC

1. Oversees CHT operations in each barangay through the RHM

2. Conducting a Maternal/Neonatal Death Review Meeting at municipal/city Level 2. Provides technical guidance to RHMs in the management of CHT
3. Conducting monitoring and follow-up on CHT activities

3. Links CHTs to resources and other forms of support at various levels (LGU,
PHO, CHD, development partners)

4. Consolidating the data of the reports from each BHS, and updating the
monitoring tools
5. Organizing and providing training and orientation to CHTs in their
municipality/district
3.1 CHT volunteers

3.2 Roles and Responsibilities

Called "CHT Member " consisting of;


(1) BHWs
(2) BNS
(3) TBAs
(4) Others (including Barangay Kagawad and other volunteers)

Called "CHT partners /Health Navigator/Community Volunteer " consiting of;


(1) BHW
(2) BNS
(3) WHT current members*
(4) 4P's parent leader*
(5) Others community volunteers * Could be possible members/volunteers to be
recruited
1.Tracking & Monitoring of Pregnant/Postpartum women
1. Orient household to family health guide (e.g., making of family profiling and
health use plans)
2. Conduct of Home Visit (from Pregnancy to Postpartum period ) and 2. Complete Family Profile & determines family members with health conditions.
implement;
(1) Counseling/Health Education on danger signs
(2) Birth & Emergency Plan (confirmation)
(3) Importance of checkups and prepartion
(4)Referrals/accompanying
Feeding/Immunization (if necessary)
3.
3. Delivering Core Health Messages and PhilHealth information.
4. Assisting Midwife (outreach)

4. Assists family to accomplish Health Plan Implementation Form by:


(1)Undertaking health risk assessment
(2) assist the family to set goals
(3) makes referral to health provider,
(4)In case of emergencies, make referrals to transport and communication provider

5. Reporting (Tracking forms, verbal report of MDR/NDR)

5. Monitors health plan implementation of the family

6. Attendance to the meeting

6. Reports accomplishments, problems and issues to RHM

CHT as a Team

At least one team in a barangay

At least one CHT in each barangay and can have sub-teams

Point Person of CHT Volunteers

Called "Focal Person "

Called "Team Leader " for the sub-teams

No

Area of Concerns

DOH/JICA SMACHS-EV

National KP Program

B
1

Process and Tools


Program Focus and Core Messages

Meeting

Monthly Meeting at BHS: CHT members and midwife


Monthly Meeting at RHU/DHC: Midwife & MHO
Barangay Session: CHT members, midwife and community

(CHT Navigator) Monthly reporting with Midwife and Barangay Captain


(CHT Management Group) Regular Meeting (to be agreed by the group - could be
monthly)
*MHO/MO shall be invited as a resource person/technical consultant

Home Visits

Clearly stipulated, 4ANC and 4PNC

Not Clearly stated as to how many visits, depending on the families needs based
on the health risks identified (or monthly)

CHT tools/forms

1. CHT Guidebook (Kept by CHT member, not given for the family) * It was 1. CHT Guidebook (developed by National KP-CHT program)
renamed as "Handbook for Community Health Team" in 2014 by the Project.

Focusing on "Pregnant/Postpartum Women and newborns " and "MCH related Focusing on Maternal Health (Pregnant/Postpartum Women), Newborn, Infant,
services" based on "MC book "
Child and Adolescent Health, Children, Family Planning, TB and PhilHealth.

2. MC Book (Kept by Mother & CHT members): MC book is issued to the mother 2. Family Health Guide and Family Guide on PhiliHealth (kept by family,
by the Midwife and kept at house, and CHT will refer the book during their issued/distributed by the CHT member)
Homevisits
3. Tracking Forms (Pregnancy, Postpartum and Newborn) for the use of CHT

3. Forms on:
(1) Family Profile
(2)Health Plan Implementation for Newborn Health
(3)Heallth Plan Implementation for Infant Health
(4) Health Plan Implementation for Child Health
(5) Health Plan Implementation for Maternal Health : Pregnancy
(6)Health Plan Implementation for Maternal Health : Post-partum
(7) Health Plan Implementation for Maternal Health: Family Planning
(8)Health Plan Implementation for Chornic Cough Management
4. CHT monthly report: tools to consolidate the data of pregnancy/postpartum 4. Logbook and Summary report of Health Visits* likely to be changed
tracking forms for use of CHT leader during the meeting

CHT Target

5. Other: reference guide for MC book & IEC materials

5. List of NHTS families

All household

6. List of available health providers


7. CHT Flashcards and other IEC materials
NHTS-PR families

Appendix 2 Questionnaires for CHT assessment

Adult Informed Consent


DOH/JICA SMACHS-EV Project

Information for the Respondents of the Survey


The following information is being presented to help you decide whether or not you want to be a part of a minimal risk
research study. Please read carefully. If you do not understand anything, ask the Person in Charge of Survey
Title of Survey: Assessment on the functionality of CHT program in Maternal and Child Health Services
Principal Investigator: Chisaki Sato- DOH/JICA SMACHS-EV Project
Study Location (s): Province of Leyte and Ormoc City, Philippines
You are being asked to participate in a survey study that aims to investigate the impact of DOH/JICA's CHT program in
Maternal and Child Health Service Delivery. We are interested in your personal experiences and opinions related to the
program for the improvement of Maternal and Child Health Service Delivery.
Background of the Survey
JICA, Japan International Cooperation Agency, has been conducting the project for Strengthening Maternal and Child
Health Services in Eastern Visayas (SMACHS-EV Project) in cooperation with the Department of Health, Province of Leyte
and City of Ormoc. As the end of the Project approaches, this survey is being implemented to assess and evaluate the impact
of our activity related to Community Health Volunteers, and to learn experiences and lessons from the people involved in
this program for the furthur improvement of the program.
Plan of Study
You will be expected to answer the questions about your personal experiences in CHT program or maternal and newborn
care. Interview will take about 30 minutes to one hour. We may also wish to talk to you in order to find out more
information on your personal experience at a later day.
Benefits of Being a Part of this Survey
By taking part in this survey, you will assist health services to help mothers and children in Eastern Visayas Region, and
the rest of the country. The information that you give us will be used to improve health care program in the region.
Risks of Being a Part of this Survey
There is no risk of being a part of this survey. No information you give us in any way will influence your future interests.
Confidentiality of Your Records
Your privacy and survey records will be kept confidential to the extend of the law. Authorized research personnel at DOH8,
JICA-SMACHS EV Project and Regional CHT Technical Working Group may inspect the records from this survey, stored
at JICA Office.
The information will only be used to inform health workers of the Province and City, JICA and Department of Health.
The results of this survey may be published. However, the data obtained from you will be combined with data from other
people in the publication. The published results will not include your name or any other information that would in any way
personally identify you. Code names will be used to ensure the confidentiality of the participants.
Volunteering to Be Part of this Survey
Your decision to participate in this survey is completely voluntary. You are free to participate in this survey or to withdraw
at any time. If you choose not to participate, or if you withdraw, there will be no penalty or loss of benefits that you are
entitled to receive.

Adult Informed Consent


DOH/JICA SMACHS-EV Project

Appendix 2 Questionnaires for CHT assessment

Questions and Contacts


If you have any questions about this survey, contact Ms. Chisaki Sato, 053-323-6114, JICA SMACHS-EV Project Office,
DOH8.
Your Consent by signing this form I agree that:
1 I have fully read or have had read and explained to me information in this consent form describing a survey.
2 I have had the opportunity to question one of the persons in charge of this research and have received satisfactory
answers.
3 I understand that I am being asked to participate in this survey. I understand the risks and benefits, and I freely give my
consent to participate in the survey outlined in this form, under the conditions indicated in it.
4 I have been given a signed copy of this informed consent form, which is mine to keep.

Date

Signature of Participant over printed name

Surveyor Statement
I have carefully explained to the subject the nature of the above protocol. I hereby certify that to the best of my knowledge
the subject signing this consent form understands the nature, demands, risk and benefits involved in participating in this
survey.

Date

Signature of Surveyor over printed name

OFFICIAL USE ONLY


Survey Category
Client
Health Workers
CHT

Location

Code Number

Survey Questionnaire on impact of CHT Activities on MCH Service Delivery


For Health Worker
Name of Health Worker

Contact # (Mobile)

Name of assigned BHS

Official Use Only


Area No

ID No

Starting Time

Ending Time

RHU

Questions
A1 Gender

1) Female

2) Male

A2 How old are you?

years old
A3 What is your educational attainment?

1) College degree

3) Post graduate (Doctorate)

(Pls specify: Grad, 1, 2, 3, 4, 5)

2) Post graduate (Master's)

4) Other: specify________________________

A4 What is your position in the health center? How many years have you been working in this facility?

1) Rural Health Midwife (___________ years)


2) PHN (___________ years)

3) MHO/MO (_________years)

A5 As a health worker, do you provide prenatal service?

1) Yes
2) No

Proceed to Question A7

A6 In providing prenatal care, do you find it difficult to achieve the coverage of 4 prenatal check-up to all your target

clients?
1) Yes Why? What are the issues and problems?

2) No How do you achieve your target coverage?

A7 In your opinion, was there any improvement in the performance of MNCHN service delivery in your facility after

the introduction of the CHT program?


1) Yes
2) No
Proceed to Question A9

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

A8 In your opinion, how helpful was the CHT program in improving MNCHN service delivery in your facility?

1) Slightly helpful

3) Mostly helpful

2) Helpful

4) Very helpful

A9 How helpful was the CHT program in improving the following services related to MNCHN? You have six selections

from: Not at all; Slightly helpful; Helpful; Mostly helpful; Very helpful; or I don't know.
(1) Antenatal Care service (ANC)
1) Not at all
3) Helpful
5) Very helpful
2) Slightly helpful
4) Mostly helpful
6) I dont know
(2) Facility Based Delivery Service
1) Not at all
2) Slightly helpful

3) Helpful
4) Mostly helpful

5) Very helpful
6) I dont know

(3) Post-natal Care Service (PNC)


1) Not at all
2) Slightly helpful

3) Helpful
4) Mostly helpful

5) Very helpful
6) I dont know

A10 Are there any other health services in your facility in which CHT program helps to improve? If yes, what are those?

1) Yes
2) No

Specify:

A11 In your opinion, how much do you agree on the importance of the following activities by CHT members to help

improve MNCHN service delivery at your facility? Please select your answer from the following: Strongly Agree;
Agree; Disagree; Strongly Disagree; Not Sure for each activity.
[SURVEYOR] Please start by asking "How much do you agree on the importance of "******"?, per item. If the
answer is "Strongly Agree" or "Strongly Disagree" , please follow-up on the reason. If the Participant mentioned
the reason, please take notes in the column also. Please check "Not Sure" if the participant is not familiar with the
activity.
Strongly
agree
(4)

Agree
(3)

Not sure

(2)

Strongly
disagree
(1)

Reason
4 Home Visits during client's postpartum period

Reason
5 Health Education

Reason
6 Health Profiling of the client

ITEM
1 Pregnancy Tracking of the Client
Reason
2 Home visits during client's pregnancy period
Reason
3 Post-partum and Newborn Tracking of the
client

Disagree

(0)

Reason

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

A12 How do you evaluate the usefulness of the following tools provided by DOH or JICA for CHT program? Please

select your answer from: Very Useful; Useful; Slightly Usefult; Not Useful; or N/A for each item.
[SURVEYOR] Start by asking, "Do you know ******? How do you evaluate its usefulness?" If the interviewee is
not familiar with the item, please mark as "N/A". IF THE ANSWER IS EITHER:" Very Useful" or " Not Useful" ,
PLEASE ASK FOR THE REASON. At the end, please ask "Anything else?" for the answer in (10) Others.
Very
useful
(4)

Useful

Not
Useful
(1)

N/A

(3)

Slightly
useful
(2)

Reason
2 CHT Handbook (SMACHS-EV)

Reason
3 Health Use Plan

Reason
4 Pregnancy Tracking Form

Reason
5 Postpartum and Newbon Tracking Form

Reason
6 CHT monthly report

Reason
7 CHT database (SMACHS-EV)

Reason
8 MC Book

Reason
9 CHT reference guide (laminated)

ITEM
1

KP-CHT Guidebook

(0)

Reason
10 Others: Specify_______________________
Reason
A13 In general, how do you assess the required task of the CHT member in relation to their capacity?

1) Difficult

=> Move to A14

2) Slightly difficult => Move to A14

3) Appropriate => Move to A15


4) Easy

=> Move to A15

A14 In your opinion, what is the reason for the difficulty?

1) Educational level of CHT


2) Lack of trainging
3) Age of the CHT member
4) Other: Please Specify

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

A15 Do you think your CHT member needs training?

1) Yes

Move to A16

2) No

Move to A17

A16 If you answered "Yes", in what areas do CHT members need to have training?

* Multiple answers
1) Knowledge on Maternal and Newborn Care (Please specify:

2) Skills on making required reports (e. g., Tracking Report/Health Use Plan)
3) Tracking of pregnant women
4) Tracking of post-partum women and newborn
5) Others: Specify:
A17 Among the tasks given to CHT members, is there any task which should be removed from them?

1) Yes What are those?


2) No
A18 Aside from the tasks given to CHT members, are there other necessary tasks which should be conducted by

CHT members to improve your services?


1) Yes

What are those?

2) No
A19 How is your workload after the implementation of the CHT program?

1) Increased

3) Same as before

2) Slightly increased

4) Slightly decreased

5) Decreased

A20 Do you think the CHT program should be continued in your facility?

1) Yes

Why?

2) No

Why?

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

A21 What is the most challenging activity in the implementation of the CHT program in your facility, if any?

* Only ONE Answer


1) Conducting CHT monthly meeting
2) Consolidating and submitting CHT monthly report
3) Supervising CHT members
4) Training CHT members
5) Providing logistics to CHT members
6) Motivating CHT members to continue their work
7) Other

Specify:

A22 What are the reasons for your difficulty?

A23 What are the necessary activities to sustain the implementation of the CHT program, if any?

* Multiple answers
1) Regular training of CHT volunteers
2) Regular meetings conducted by PHO/CHO/DOH8
3) Deployment of adequate number of CHT volunteers/members
4) Deployment of additional health workers (either contractual or permanent, e. g. DTTB, NDP, RHMPP, etc.)
5) Provision of financial incentives to CHT volunteers
6) Provision of financial incentives to health workers
7) Ordinance

Specify:

8) Other

Specify:

A24 What advantages did the CHT program bring to you or your facility, if any?

A25 What disadvantages did the CHT program bring to you or your facility, if any?

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

A26 What areas in the implementation of the CHT program need improvement?

A27 Based on your experience, can you give any suggestions to the DOH to improve the implementation of the CHT

program?

A28 Could you share any innovative activity done by you, or by your facility to improve performance of CHT program, if

any?

INTERVIEW & CHECKING


Date of interview:
/
Name of interviewer:
Signature:

Office Use Only


Data entry ID#:
2015 (D/M) Date of data entry:
Name:
Signature:

DOH/JICA SMACHS-EV Project-Questionnaire for Health Worker

2015/6 (D/M)

Waray

Survey Questionnaire on Impact of CHT Activities on MCH Service Delivery


For Mother
Name of Respondent

Contact # (Mobile)

Name of Barangay

Name of BHS

Name of RHU

Name of CHT in charge

Official Use Only


Area No

ID No

Starting Time

Ending Time

A. Background Information
A1 Pira it imo edad?
(How old are you?)
years old
A2 May asawa ka na ba?
(What is your marital status?)
1) Single
2) Common Law Spouse

3) Married (Legal)
4) Separated

5) Widow

A3 Pira it imo anak?


*Only those children who are still alive!
(How many children do you have?)
Remark: if any
children
A4 Nanganak ka ba dida han nakalabay nga 6 ka bulan?
(Did you deliver in the last 6 months?)
1) Yes
2) No
A5 Kakan-o ngan diin ka urhi nanganak?
(When and Where did you deliver your last child?)
Month & Year
A6 Ano an imo nahuman nga edukasyon?
(What is your educational attainment?)
1) Never attended school

Place of delivery/Name of
facility

4) College

6) Post graduate

(Pls specify: Grad, 1, 2, 3, 4)

2) Elementary School

5) Vocational School

7) Other: Please specify

(Pls specify: Grad, 1, 2, 3, 4, 5, 6)

3) High School
(Pls specify: Grad, 1, 2, 3, 4)

A7 May ada ka ba pakabuhi ha gawas hit balay? Gin babayaran ka ba para hiton nga trabaho?
(Do you have work outside home? Are you paid for work?)
1) Yes, I have paid work (Specify the kind of work:
2) Yes, I have unpaid work (Specify the kind of work:
3) No, I don't have any work
DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

)
)

Waray

A8 Pira it kasagaran nga kita hit imo pamilya kada bulan?


(How much is your average family monthly income?)
1) Less than Php 1,000.00
3) 4,000.00 to 6,999.00
2) 1,000.00 to 3,999.00
4) 7,000.00 to 9,999.00

5) 10,000 to 14,999.00
6) 15,000.00 and above

A9 Miyembro ka ba hit PhilHealth?


(Are you a PhilHealth member?)
* Please ask the respondent the membership ID if she is a member
1) Yes with a PhilHealth ID
3) No, but a Philhealth beneficiary
2) Yes without a PhilHealth ID
4) No
A10 Miyembro ka ba hit 4P's?
(Are you a 4P's member?)
1) Yes
2) No
A11 Pira na ka-tuig an imo pagukoy dida ha iyo barangay?
(How long have you lived in the current barangay? )
1) Less than 6 month
3) 1 to less than 3 years
2) 6 month to less than 1 year 4) 3 to less than 6 years
A12 Diin matatad-an an lugar nga imo gin uukyan?
(How do you describe the area where you live?)
1) Within downtown (or commercial area)
2) Near downtown (or commercial area)

5) 6 years or more

3) Mountain area
4) Island

5) Others: specify

A13 Ano it imo kasagaran nga sinasakyan tikang ha iyo balay tikadto ha ______________________(ngaran han iya health
center)?
(What is your usual means of transportation from your house to ________________________(name of her health
center)?)
*Multiple answers. Please use the name of RHU/BHS where she used the service when asking the respondent.
Travel
Means of transportation time (in
minutes)

Is there a regular
trip?

How regular/frequent is the trip per


Cost for
day? (e.g., every 10 minutes, every transportation
hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes

No

3. Tricycle

Yes

No

4. Jeepney

Yes

No

5. Multicab

Yes

No

Yes

No

6. Other: (specify)

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Waray
A14 Ano ka dako it imo problema, kun may ada man, hiunong hit imo pagsakay tikadto ha health center?
(How much problem do you have with your transportation in going to the health center?)
1) Not a problem

3) Big problem

2) Somewhat problem

A15 Nagkukuri ka ba pagkadto ha health center para hit imo regular nga prenatal check-up o check-up kahuman panganak?
(Do you have a difficulty in going to health center for regular prenatal or postpartum check-ups?)
1) Yes
2) No
Proceed to B1
A16 Ano an mga nangunguna nga rason hit imo kakurian?
(What are the main reasons of your difficulty?)
1) Cost of Transportation
4) Travel Distance
2) Cost of health service

5) Household work

3) Family's disagreement

6) Outside work/job

7) Doesnt see the importance

8) Poor quality of service at


HC

9) Other: specify below


B. Question regarding CHT work
B1 Nakabati ka na ba hiunong han "Community Health Team" or "CHT"?
(Have you heard of "Community Health Team" or "CHT"?)
1) Yes

Proceed to B3

2) No
B2 Nakilala ka ba han tawo nga naghahatag hin serbisyo panlawas para han mga nanay ngan mga bag-o nga gin anak ha
iyo komunidad?
(Do you know the person who is providing maternal and newborn services in your community?)
1) Yes
2) No

End of survey, please thank the respondent

B3 Hin-o nga tawo o mga tawo nga naghahatag hini nga mga serbisyo?
(Who are the person/people who provide such services?)
*Multiple answers. Please read the following to the respondent.
1) Barangay Health Worker (BHW)
4) Barangay Nutrition Scholars (BNS)
2) BSPO

5) Parent's leader

3) Day Care Worker

6) Others: specify

B4 Maaram ka ba hit ngaran hit CHT/BHW/BNS/BSPO nga nakapot hit iyo komunidad?
(Do you know the name of the CHT/BHW/BNS/BSPO who is assigned in your community?)
* Please confirm the name of CHT at the office after interviews, and mark "confirmed". The respondent may
give a nickname instead of the actual name. If so, please record as it is.
1) Yes : please tell me the name of CHT
2) No

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Confirmed (at office)

Waray
B5 Ano nga mga klase hin serbisyo an gin hahatag ni ___________________________(ngaran han CHT nga baton ha
igbaw) ha imo? Alayon pag grado tikang ha 1 ngada ha 4 han imo kakuntento han kada serbisyo nga gin hatag. An 4
komo kuntento hin duro.
(What kind of services does _______________(name of CHT answered the above) provide you?)
What is your satisfaction of each service you mentioned?
* Multiple answers. Please do not give any answer key to the respondent, but "Probe" (E.g. "What else?") .
Very
Somewhat
Not
Dissatisfied
satisfied satisfied satisfied
(1)
(4)
(3)
(2)

Services

1. Home Visit (during prenatal)


2. Home Visit (during postnatal)
3. Health Education/Advise
4. Confirm with your birth and emergency plan
5. Reminding/Encouraging your visit to HC
6. Referral/ accompany to the HC
7. Other: Please specify
(
)
8. Other: Please specify
(
)

N/A
(0)

B6 (Only for those who answered "Home Visit" in the above question in B5.)
Pira ka beses nagbisita an CHT ha imo?
(How many times did CHT visit you?)
Time Period

How many times?

1 Prenatal period until delivery


2 Kahuman panganak
(After delivery of the baby)
B7 Ha kasagaran, pira ka minutos hi ______________________(ngaran han CHT) naukoy ha iyo ha kada pagbisita niya?
(How long does ___________________(name of CHT) usually spend time with you per visit? (Average time))
minutes

B8 (Only for those who answered "Health Education/Advice" in Question B5)


Han pagbisita ni ______________________(ngaran han CHT) ha imo, ano nga klase hin impormasyon an gin hatag
niya ha imo?
(When _________________________(name of CHT) visited you, what kind of information did CHT give you?
Multiple Answers

1) Importance of Prenatal Visit


2) Importance of Facility based delivery
3) Importance of Post-partum visit
4) Immunization
5) Baby Care Routine

6) Warning Sings during pregnancy


7) Birth and Emergency Plan
8) Family Planning
9) Other: specify

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Waray
B9 Gintagan ka ba hin Mother and Child Book dida han imo urhi nga pagburod? Kun waray, ano an rason?
(Were you given a Mother and Child Book for your last pregnancy? If no, what was the reason?)
*(Interviewer) Please show the MC book to the Client.
1) Yes
Proceed to next question
2) No
Specify reason and proceed to B16
Reason:
B10 Aada pa ba ha imo an Mother and Child Book han imo urhi nga pagburod? Kun waray, ano an rason?
(Do you still have a Mother and Child book for your last pregnancy? If no, why?)
1) Yes
2) No
Specify reason and proceed to B12
Reason:
B11 (Ask the respondent to show you her MC book & check the status of the following pages)
Pages
Properly filled-out?
1

Birth and Emrgency Plan (P14)

Yes

No

Schedule of Home Visit (P63)

Yes

No

Present Pregnancy (P3)

Yes

No

Postpartum Care Within 42 days


(P18)

Yes

No

Postnatal Care (P21)

Yes

No

Remark

*Blood donor info is not necessary

B12 Ano kadako an naibulig han MC Book ha imo han imo urhi nga panganak?
(Was the MC Book useful for your latest delivery?)
Very useful (4)
Useful (3)
Somewhat useful (2) Not useful at all (1)
B13 Ano an rason han imo gin baton ha igbaw?
(What is the reason of your answer above?)

B14 Gin tutdo ba ni ____________________ (ngaran han CHT) an sulod han MC Book?
(Did _________________(name of CHT) discuss the content of MC book?)
1) Yes
2) No
Go to B16
B15 Ha grado tikang ha 1 ngada 4, 4 komo maupay hin duro, ano kaupay an pagtutdo ni _____________________(ngaran
han CHT) han sulod han MC Book dida han iya pagbisita
(On the scale of 1 to 4, 4 being very good how well did _______________________(name of CHT) discuss the
content of MC book during her/his visit?)
Very good (4)

Good (3)

Fair (2)

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Poor (1)

Waray
B16 Ano ka importante an CHT han imo eksperyansya ha pagburod ngan han panganak?
(How do you evaluate the importance of CHT in your maternal experience?)
Very important (4)

Important (3)

Somewhat important (2)

Not important (1)

B17 Ano an rason han imo baton?


(What is the reason of your previous answer (B16)?)

B18 Hin-o o ano an imo kinukuhaan hin impormasyon hiunong han pagataman han panlawas han nanay ngan bata?
(Who or what are your sources of information about maternal and child health care?)
1) Family/relatives

5) RHU/BHS/DHC staff

2) Friends

6) MC book

3) CHT members

7) Others

4) Mass media/magazine

*Multiple Answers

Specify:
8) No information/ Did not know

Specify:

B19 Ha imo opinyon, ano kaimpluwensiya han mga masunod han imo desisyon pangita hin serbisyo panlawas para nanay
ngan bata ha pasilidad nga panlawas? Alayon pag grado tikang ha 1 ngada ha 4, 4 komo makusog hin duro it
impluwensiya.
(In your opinion, how influential are the following in your decision of seeking Maternal Child Care Services at health
facility? Please answer on the scale of 1 to 4, 4 being the most influential.)
Item

Very
influential
(4)

Influential

Not
influential
(1)

N/A

(3)

Slightly
influential
(2)

(0)

Husband

Parents

Community's opinion

CHT:(Name:

Midwife

Nurse

Doctor

Ordinance

Other: Specify

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Waray
B20 Nakatagamtam ka ba han mga masunod nga mga serbisyo dida han imo urhi nga pagburod? Kun oo, hin-o an nag
impluwensya ha imo para makakuha hini nga mga serbisyo? Kun waray, ano an imo rason o mga rason?
(Have you availed of the following services for your last pregnancy? If yes, who influenced you to avail of these
services? If no, what is/are your reason/s?)
Services

Yes, I
availed

Who influenced?

No, I didn't
avail

1. Prenatal Care during


1st Trimester

2.Prenatal Care: 2nd and


3rd trimester

3. Facility based
Delivery (FBD)

4. Post-partum Care

5. Immunization

6. Family Planning

What is the reason?

C. Suggestions and Comments for improvement


C1 Alayon pagsumat hin bisan ano nga maupay o diri maupay nga imo eksperyensya hiunong han CHT.
(Please share any good or bad experiences you had with your CHT.)

C2 Alayon pagsumat hit imo mga ideya kun uunan-un hit CHT it pagpauruupay hit ira serbisyo para ha mga nanay ngan
(Please share your ideas on how CHT can improve their service for mothers and babies?)

INTERVIEW & CHECKING


Date of interview:
/
Name of interviewer:
Signature:

Office Use Only


Data entry ID#:
2015 (D/M)
Date of data entry:
Name:
Signature:

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Waray Waray

Visaya

Survey Questionnaire on Impact of CHT Activities on MCH Service Delivery


For Mother
Name of Respondent

Contact # (Mobile)

Name of Barangay

Name of BHS

Name of RHU

Name of CHT in charge

Official Use Only


Area No

ID No

Starting Time

Ending Time

A. Background Information
A1 Pila ang imong edad?
(How old are you?)
years old
A2 Minyo na ka?
(What is your marital status?)
1) Single
2) Common Law Spouse

3) Married (Legal)
4) Separated

5) Widow

A3 Pila ang imong bata?


(How many children do you have?)
children
A4 Did you deliver in the last 6 months?
(Nanganak ba ka sa milabay nga 6 ka buwan?)
1) Yes
2) No
A5 Kanus-a ug asa ka ulahi nga nanganak?
(When and Where did you deliver your last child?)
Month & Year

Place of delivery/Name of
facility

A6 Unsa ang imong natapos nga edukasyon?


(What is your educational attainment?)
1) Never attended school
4) College

6) Post graduate

(Pls specify: Grad, 1, 2, 3, 4)

2) Elementary School

5) Vocational School

7) Other: Please specify

(Pls specify: Grad, 1, 2, 3, 4, 5, 6)

3) High School
(Pls specify: Grad, 1, 2, 3, 4)

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


1

Visaya
A7 Aduna ba kay trabaho gawas sa imong balay? Gibayaran ba ka sa imong trabaho?
(Do you have work outside home? Are you paid for work?)
1) Yes, I have paid work (Specify the kind of work:
2) Yes, I have unpaid work (Specify the kind of work:
3) No, I don't have any work
A8 Pila ang tibuok nga kita sa imong pamilya sa usa ka buwan?
(How much is your average family monthly income?)
3) 4,000.00 to 6,999.00
1) Less than Php 1,000.00
2) 1,000.00 to 3,999.00
4) 7,000.00 to 9,999.00

)
)

5) 10,000 to 14,999.00
6) 15,000.00 and above

A9 Miyembro ba ka sa PhilHealth?
(Are you a PhilHealth member?)
* Please ask the respondent the membership ID if she is a member
1) Yes with a PhilHealth ID
3) No, but a Philhealth beneficiary
2) Yes without a PhilHealth ID
4) No
A10 Miyembro ba ka sa 4P's?
(Are you a 4P's member?)
1) Yes
2) No
A11 Unsa ka dugay na ka nagapuyo sa imong barangay?
(How long have you lived in the current barangay? )
1) Less than 6 month
3) 1 to less than 3 years
2) 6 month to less than 1 year 4) 3 to less than 6 years
A12 Asa dapit ang imong lugar nga ginapuy-an?
(How do you describe the area where you live?)
1) Within downtown (or commercial area)
2) Near downtown (or commercial area)

5) 6 years or more

3) Mountain area
4) Island

5) Others: specify

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


2

Visaya
A13 Unsa kasagaran ang imong masakyan gikan sa imong balay padulong sa __________________(ngalan sa iyahang
health center)?
What is your usual means of transportation from your house to ________________________(name of her health
center)?
*Multiple answers. Please use the name of RHU/BHS where she used the service when asking the respondent.
Travel
Means of transportation time (in
minutes)

Is there a regular
trip?

How regular/frequent is the trip per


Cost for
day? (e.g., every 10 minutes, every transportation
hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes

No

3. Tricycle

Yes

No

4. Jeepney

Yes

No

5. Multicab

Yes

No

Yes

No

6. Other: (specify)

A14 Unsa ka dako ang imong problema alang sa masakyan padulong sa health center?
(How much problem do you have with your transportation in going to the health center?)
1) Not a problem
3) Big problem
2) Somewhat problem
A15 Naglisod ba ka sa pag-adto sa health center alang sa imong regular nga prenatal check-up o check-up human sa pangan
(Do you have a difficulty in going to health center for regular prenatal or postpartum check-up?)
1) Yes
2) No
Proceed to B1
A16 Unsay mga nangunguna nga rason sa imong pagkalisod?
(What are the main reasons of your difficulty?)
1) Cost of Transportation
4) Travel Distance
2) Cost of health service
5) Household work
3) Family's disagreement
6) Outside work/job

7) Doesnt see the importance


8) Poor quality of service at

HC
9) Other: specify below

B. Question regarding CHT work


B1 Nakadungog na ba ka kabahin sa "Community Health Team" o "CHT"?
(Have you heard of "Community Health Team" or "CHT"?)
1) Yes
2) No

Proceed to B3

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


3

Visaya

B2 Kaila ba ka sa mga tawo nga nagahatag og serbisyo sa panglawas alang sa mga inahan ug sa mga bag-ong natawo sa
imong komunidad?
(Do you know the person who is providing maternal and newborn services in your community?)
1) Yes
2) No
End of survey, please thank the respondent
B3 Kinsa ni nga tawo o mga tawo nga nagahatag niini nga mga serbisyo?
(Who are the person/people who provide such services?)
*Multiple answers. Please read the following to the respondent.
1) Barangay Health Worker (BHW)
4) Barangay Nutrition Scholars (BNS)
2) BSPO
5) Parent's leader
6) Others: specify
3) Day Care Worker
B4 Kabalo ba ka sa ngalan sa CHT/BHW/BNS/BSPO nga nadestino sa inyong komunidad?
(Do you know the name of your CHT/BHW/BNS/BSPO who is assigned in your community?)
* Please confirm the name of CHT at the office after interviews, and mark "confirmed". The respondent may
give a nickname instead of the actual name. If so, please record as it is.
1) Yes : please tell me the name of CHT
2) No

Confirmed (at office)

B5 Unsa nga mga klase og serbisyo ang ginahatag ni ________________(ngalan sa CHT nga gitubag sa taas) sa imo?
Palihug sa pag grado gikan sa 4 hangtod sa 1 alang sa katagbawan sa serbisyo nga gihatag kanimo. 4 isip pinaka
katagbawan.
(What kind of services does _______________(name of CHT answered the above) provide you?)
What is your satisfaction of each service you mentioned?
* Multiple answers. Please do not give any answer key to the respondent, but "Probe" (E.g. "What else?") .
Services

Very
Somewhat
Not
Dissatisfied
satisfied satisfied satisfied
(1)
(4)
(3)
(2)

1. Home Visit (during prenatal)

2. Home Visit (during postnatal)

3. Health Education/Advise

4. Confirm with your birth and emergency plan

5. Reminding/Encouraging your visit to HC

6. Referral/ accompany to the HC


7. Other: Please specify

(
)
8. Other: Please specify

(
)
B6 (Only for those who answered "Home Visit" in the above question in B5.)
Pila ka higayon nga ang CHT nagbisita kanimo?
(How many times did CHT visit you?)

Time Period

N/A
(0)

How many times?

1 Prenatal period until delivery


2 After delivery of the baby

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


4

Visaya
B7 Unsa kadugay kasagaran si _______________________(ngalan sa CHT) mogahin og panahon uban kanimo matag
bisita?
(How long does ___________________(name of CHT) usually spend time with you per visit? (Average time))
minutes

B8 (Only for those who answered "Health Education/advise" in the question B5.)
Katong miduaw si ______________________(ngalan sa CHT), unsa nga mga impormasyon ang gihatag sa CHT kanim
(When _________________________(name of CHT) visited you, what kind of information did CHT give you?
Multiple Answers)

1) Importance of Prenatal Visit


2) Importance of Facility based delivery
3) Importance of Post-partum visit
4) Immunization
5) Baby Care Routine

6) Warning Sings during pregnancy


7) Birth and Emergency Plan
8) Family Planning
9) Other: specify

B9 Gitagaan ba ka og Mother and Child Book alang sa imong ulahi nga pagmabdos? Kon wala, unsa ang rason?
(Were you given a Mother and Child Book for your last pregnancy? If no, what was the reason?)
*(Interviewer) Please show the MC book to the Client.
1) Yes
Proceed to next question
2) No
Specify reason and proceed to B16
Reason:
B10 Anaa lang ba gihapon ang Mother and Child Book gikan sa imong ulahi nga pagmabdos? Kon wala, ngano?
(Do you still have a Mother and Child book for your last pregnancy? If no, why?)
1) Yes
2) No
Specify reason and proceed to B12
Reason:

B11 (Ask the respondent to show you her MC book & check the status of the following pages)
Pages
Properly filled-out?
1

Birth and Emergency Plan (P14)

Yes

No

Schedule of Home Visit (P63)

Yes

No

Present Pregnancy (P3)

Yes

No

Postpartum Care Within 42 days


(P18)

Yes

No

Postnatal Care (P21)

Yes

No

Remark

*Blood donor info is not necessary

B12 Mapuslanon ba ang basahon alang sa imong pinaka-ulahi nga panganganak?


(Was the MC Book useful for your latest delivery?)
Very useful (4)
Useful (3)
Somewhat useful (2) Not useful at all (1)

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


5

Visaya
B13 Unsa ang rason sa imong gitubag sa taas?
What is the reason of your answer above?

B14 Gihisgot ba ni ___________________(ngalan sa CHT) ang sulod sa MC Book?


(Did _________________(name of CHT) discuss the content of MC book?)
1) Yes
2) No
Go to B16
B15 Sa grado nga 1 hangtod 4, 4 mao ang pinakamaayo, unsa kaayo ang paghisgot ni ____________________(ngalan sa
CHT) sa sulod sa MC Book sa iyang pagbisita kanimo?
(On the scale of 1 to 4, 4 being the very good, how well did _______________________(name of CHT) discuss the
content of MC book during her/his visit?)
Very good (4)

Good (3)

Fair (2)

Poor (1)

B16 Unsa ka importante ang CHT sa imong kasinatian sa pagmabdos ug sa panganganak?


(How do you evaluate the importance of CHT in your maternal experience?)
Very important (4)
Important (3)
Somewhat important (2)

Not important (1)

B17 Unsa ang rason sa imong gitubag?


(What is the reason of your previous answer (B16)?)

B18 Kinsa og unsa ang imong mga tinubdan sa impormasyon bahin sa pag-atiman sa panglawas sa inahan ug bata?
Who or what are your sources of information about maternal and child health care? *Multiple answers.
1) Family/relatives

5) RHU/BHS/DHC staff

2) Friends

6) MC book

3) CHT members

7) Others

4) Mass media/magazine
Specify:

Specify:
8) No information/ Did not know

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


6

Visaya
B19 Sa imong opinyon, unsa ka impluwensiya ang mga mosunod sa imong desisyon sa pagpangita og serbisyo sa
panglawas alang sa inahan ug bata sa usa ka pasilidad? Palihug sa pag grado gikan sa 1 hangtod 4, 4 mao ang pinaka
kusog ang impluwensya
(In your opinion, how influential are the following in your decision of seeking Maternal Child Care Services at health
facility? Please answer on the scale of 1 to 4, 4 being the most influential.)
Item

Very
influential
(4)

Influential

Not
influential
(1)

N/A

(3)

Slightly
influential
(2)

(0)

Husband

Parents

Community's opinion

CHT:(Name:

Midwife

Nurse

Doctor

Ordinance

Other: Specify

B20 Nakapahimulos ba ka sa mosunod nga mga serbisyo alang sa inyong ulahi nga pagmabdos? Kon oo, kinsa ang
nagimpluwensiya kanimo sa pagpahimulos niini nga mga serbisyo? Kon walay, unsa ang mga rason?
(Have you availed of the following services for your last pregnancy? If yes, who influenced you to avail of these
services? If no, what is/are your reason/s?)
Services

Yes, I
availed

Who influenced?

No, I didn't
avail

1. Prenatal Care during


1st Trimester

2. Prenatal Care: 2nd and


3rd trimester

3. Facility based
Delivery (FBD)

4. Post-partum Care
(PNC)

5. Immunization

6. Family Planning

What is the reason?

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


7

Visaya
C. Suggestions and Comments for improvement
C1 Palihug sa paghatag bisan unsa nga maayo og dili maayo nga kasinatian nga imong nasinati sa CHT.
(Please share any good or bad experiences you had with your CHT.)

C2 Palihug sa paghatag sa imong mga ideya sa kung unsang paagi mapalambo ang serbisyo sa CHT alang sa mga inahan
ug sa mga bata?
(Please share your ideas on how CHT can improve their service for mothers and babies?)

INTERVIEW & CHECKING


Date of interview:
/
Name of interviewer:
Signature:

Office Use Only


Data entry ID#:
2015 (D/M)
Date of data entry:
Name:
Signature:

DOH/JICA SMACHS-EV Project-Questionnaire for Mother-Bisaya


8

Waray

Survey Questionnaire on Impact of CHT Activities on MCH Service Delivery


For CHT
Name of CHT Respondent

Contact # (Mobile)

Name of Barangay & BHS

Official Use Only


Area No

ID No

Starting Time

Ending Time

RHU

A. Background Information
A1 (Gender)

1) Female

2) Male

A2 Pira it imo edad?

(How old are you?)


years old
A3 May asawa ka na ba?

(What is your marital status?)


1) Single
2) Common Law Spouse

3) Married (Legal)
4) Separated

5) Widow

A4 Ano an imo nahuman nga edukasyon?

(What is your educational attainment?)


1) Never attended school

4) College

6) Post graduate

(Pls specify: Grad, 1, 2, 3, 4)

2) Elementary School

5) Vocational School

7) Other: Please specify

(Pls specify: Grad, 1, 2, 3, 4, 5, 6)

3) High School
(Pls specify: Grad, 1, 2, 3, 4)
A5 May ada ka ba gin kakaputan nga posisyon? Ano ka na kaiha dida hiton nga posisyon?

(Do you hold any position? For how long?)


1) None
4) BNS (_________years)
2) BHW (___________ years)
5) Parent Leader (___________years)
3) BSPO(___________ years)
6) Barangay Kagawad (___________years)
7) Other (please specify: _________________, __________years)
A6 Pira na ka bulan an imo pagtrinabaho komo usa ka miyembro han CHT?

(How long have you been working as CHT member?) *If CHT answered in years, convert it to number of months
months

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
A7 Paano ka naging usa nga miyembro han CHT?

(How did you become a CHT member?)


1) Through Recommendation (By whom?
2) Recruitment (By whom?

)
)

3) Self-volunteered
4) Other :Please specify
A8 Pira ka oras ha usa ka semana ka nagtratrabaho komo CHT?

(How many hours a week do you work as CHT?)


hours
A9 May ada ka ba iba nga trabaho labot la hit CHT? Gin babaydan ka ba para hini nga trabaho?

(Do you have work aside CHT? Are you paid for work?)
1) Yes, I have paid work (Specify the kind of work:

2) Yes, I have unpaid work (Specify the kind of work:

3) No, I don't have any work


A10 Ano an imo nangunguna nga pinagkukuhaan hin kita?

(What is your main source of income?)

A11 Pira it kasagaran nga kita hit imo pamilya kada bulan?

(How much is your average family monthly income?)


1) Less than Php 1,000.00
3) 4,000.00 to 6,999.00
2) 1,000.00 to 3,999.00
4) 7,000.00 to 9,999.00

5) 10,000 to 14,999.00
6) 15,000.00 and above

A12 Miyembro ka ba hit PhilHealth?

(Are you a PhilHealth member?)


* Please ask the respondent for the membership ID if he/she is a member
1) Yes with a PhilHealth ID
3) No, but a Philhealth beneficiary
2) Yes without a PhilHealth ID
4) No

A13 Miyembro ka ba hit 4P's?

(Are you a 4P's member?)


1) Yes
2) No

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
A14 Puydi mo ba maisumat ha akon an mga ngaran han mga cluster/purok/sitio nga imo gin kakaptan?

(Could you please tell me about your assigned clusters/puroks/sitios?)


* Please write all names of the assigned areas by the CHT (including those which are not in JICA area). If it is
not possible to specify the exact number of households, ask for the rough estimate.
Name of clusters/purok/sitios

No

No. of HH

Remark if any

Total
A15 Ano it imo sinasakyan tikang ha iyo balay ngadto ha pinakaharayo nga panimalay/pamilya nga imo gin kakaptan?

(What is your means of transportation from your house to your furthest household/family?)
*Multiple answers
Means of transportation

Travel
time (in
minutes)

Is there a regular
trip?

Cost for
How regular/frequent is the trip per
transportation
day?
(e.g., every 10 minutes, every hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes No

3. Tricycle

Yes No

4. Jeepney

Yes No

5. Multicab

Yes No

6. Other: (specify)

Yes No

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
A16 Ano it imo sinasakyan tikang ha imo balay tikadto ha iyo barangay health center?

(What is your means of transportation from your house to your assigned barangay health center?)
*Multiple answers
Travel
Means of transportation time (in
minutes)

Is there a regular
trip?

Cost for
How regular/frequent is the trip per
transportation
day?
(e.g., every 10 minutes, every hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes No

3. Tricycle

Yes No

4. Jeepney

Yes No

5. Multicab

Yes No

6. Other: (specify)

Yes No

A17 May ada ka ba travel allowance nga gin hatag han LGU o Barangay?

(Do you have travel allowance given by LGU or Barangay?)


1) Yes: Please specify the source_________________________
2) No
B. Information regarding CHT work
B1 Nagkamay-ada ka ba hin orientasyon kabahin han trabaho han CHT tikang han RHU/DHC/CHO/PHO/DOH?
(Have you had orientation on CHT work by RHU/DHC/CHO/PHO/DOH?)
1) Yes
When? by month and year:
2) No
B2 Ano nga mga aktibidades an imo ginbubuhat komo usa nga miyembro hit CHT?

(What activities do you conduct as a CHT member?) *Multiple answers


* Please do not give any answer key to the respondent, but "Probe" (E.g. "What else?") .
1) Tracking of Pregnant Women
6) Tracking of Postpartum & Newborns
2) Health Education
7) Home Visit
3) Submission of Report
8) Reporting to Health Center
4) Supporting outreach activities
9) Attending a regular meeting
5) Referral
10) Other: Please specify

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
B3 Ha imo opinyon, ano ka importante it paggamit hini nga masunod nga mga butang para mabuligan it imo cliyente

nga makatagamtam hit iya kinahanglanon nga serbisyo panlawas? Alayon pag grado tikang ha 1 ngada ha 4. 4
komo pinaka importante.
(In your opinion, how important is it to use following items to help your client to avail necessary health service?
Please answer on the scale of 1 to 4. 4 being the most important.)
* Please mark only one answer and ask the respondent for reason of her/his answer. "Not Applicable or N/A"
for non-use of the item. If the answer is either: " Very Important "or " Not Important" , please ask for the
reason.
ITEM
1 Pregnancy Tracking Form

Very
Important Somewhat
Not
Important
Important Important
(4)
(3)
(2)
(1)

N/A
(0)

2 Post-partum & Newborn Tracking Form

Reason
3 CHT Monthly Report

4 MC Book

Reason
5 Reference Guide for MC book

Reason
6 Health Use Plan

Reason

Reason

Reason
B4 Na atender ka ba hit CHT meeting ha Barangay Health Center/station?

(Do you attend CHT meeting at Barangay Health Center/station?)


per
1) Yes : How often?
2) No
B5 Makuri ba para ha imo ini nga masunod nga aktibidades? Kun oo, ano it rason?

(Do you have difficulty in the following activities? If yes, what is the reason?)
Yes (1)

No (0)

Activity
1) Pagkilala hin temprano kun burod it usa nga babaye. (Identifying women in the
early stage of pregnancy.)
Reason:

2) Pagkumbinsir han burod nga magpa-prenatal check up. (Convincing pregnant


women for prenatal check-ups)
Reason:

3) Pagkumbinsir han burod nga manganak ha usa nga health facility. (Convincing
pregnant women for facility-based delivery)
Reason:

4) Pagkumbinsir han bag-o na nanganak nga magpacheck-up. (Convincing


postpartum women for postnatal check-ups
Reason:

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
B6 Ano ka kusog it imo pagtapod ha imo kalugaringon hibaro ngan kapasidad ha paghatag hin edukasyon

panlawas ngadto han kliyente?


(How confident are you with your knowledge and skills to give health education to the client?)
Very confident (3)
Confident (2)
Not confident (1)
B7 Ha imo opinyon, ano kabug-at it imo trabaho komo miyembro han CHT?

(In your opinion, how do you consider your workload as a CHT member? )
Too much (4)

Just enough (2)

A little too much (3)

Not enough (1)

C. Support System
C1 Paano mo gragraduhan an suporta nga tikang han masunod nga mga tawo ngadto han imo trabaho? Ano an mga
rason? Alayon paghatag hin grado tikang 1 ngada 4. 4 amo it kuntento hin duro.
(How do you rate the support from the following people to your work? And, what are the reasons? Please answer
on the scale of 1 to 4. 4 being the most satisfied.)
* Please mark only one answer and ask the respondent for reason of her/his answer.
IF THE ANSWER IS EITHER: " Very Satisfied" or " Very Dissatisfied" , PLEASE ASK FOR THE
REASON.
Very
satisfied
(4)

Satisfied
(3)

Not
satisfied
(2)

Very
dissatisfied (1)

1 LGUs/Mayor

Reason
2 MHO/MO

Reason
3 PHN

Reason
4 Midwife

Reason
5 NDP

Reason
6 Barangay Captains

Reason
7 Community members in catchment area

Reason
8 Other: Specify

ITEM

Reason
C2 Nakakakarawat ka ba hin bisan ano nga insentibo o honorarium?

(Do you receive any incentive or honorarium?)


1. Yes
2. No
Move to Question D1

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
C3 Kun oo, ano nga klase hin mga insentibo/honorarium it imo nakakarawat tikang ha mga masunod?

(If yes, what type of incentives/honorarium do you receive from the following?)
Source of Incentive/
Honorarium

*Multiple Answers
Type of Incentive/Honorarium Received
(Check relevant box and specify amount/material, if applicable)
PhilHealth

Monetary (per freq) Enrollment

Transportation
Allowance

In-Kind

1. DOH

Php______/___

Php______/___

2. PhilHealth

Php______/___

Php______/___

3. Barangay
LGU

Php______/___

Php______/___

4. Municipal
LGU/RHU

Php______/___

Php______/___

5. Provincial
LGU

Php______/___

Php______/___

Php______/___

Php______/___

6. Others:
Specify

Others

D. Opinion on CHT activities


D1 Ha imo pagbati gin tatagan ba hin importansya an imo pagboluntaryo han mga masunod nga mga tawo? Alayon pag
grado tikang ha 1 ngada ha 4. 4 komo makusog nga imo pag-uyon.
(Do you feel that your voluntarism is valued by the following people? Please answer on the scale of 1 to 4. 4 being
the strongly agree.)
* Please mark only one answer and ask the respondent for reason of her/his answer by asking, "Any specific
reason?"
IF THE ANSWER IS EITHER: " Strongly Agree" or "Strongly Disagree" , SURVEYORS MUST ASK FOR
THE REASON.
Strongly
Agree
(4)

Agree
(3)

Disagree
(2)

Strongly
disagree
(1)

N/A

1 Doctor

Reason
2 Nurse

Reason
3 Midwife

Reason
4 Client/Mothers

Reason
5 Community

Reason
6 Barangay Officials

Reason
7 Municipal/City Officials

ITEM

Reason

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
D2 Ha imo pagbati mayda ka ba sadang nga "resources" para suportahan it imo kliyente. Alayon pag grado tikang ha 1

ngada 4. 4 komo makusog nga pag-uyon.


(Do you feel that you have adequate resources to support your client? Please answer on the scale of 1 to 4. 4 being
the strongly agree.)
Strongly Agree (4) => Go to D4
Disagree (2)
Agree (3)

=> Go to D4

Strongly Disagree (1)

D3 (Only for those who answered "Disagree" o "Strongly Disagree".)

Ano nga "resources" it imo kinahanglan para hit imo kliyente?


(What resources do you need for the client?)

D4 Ano nga mga impluwensiya an nakakaapekto hit imo trabaho komo usa ka miyembro hit CHT?

(What are the factors affecting your performance as a CHT member?) *Multiple answers
1) Lack of Training
5) Availability of Logistics
2) Availability of Monetary Incentives
6) Supervision by health workers
3) Attitude of community/client
7) Other: please specify
4) Availability of IEC materials
D5 *For those who answered (2), (4), (5), or (7):

May panahon ba nga nakagasto ka hit imo kalugaringon nga kuwarta para ha trabaho kabahin ha CHT?
Have you ever shouldered any of the following expenses related to CHT work with your own money? *Multiple
answers)
1) Transportation cost to attend or report to health center
2) Transportation cost for home visits
3) Transportation cost for accompanying client going to health center
4) Transportation cost (Other: specify_____________)
5) Communication cost (texts or phone calls)
6) Purchase of Logistics (photocopy of reporting forms, stationary)
7) Other: Please specify
8. ) No
D6 Ano it sadang pa buhaton para makahatag ka hin mas mauruupay nga serbisyo ha imo kliyente?

(What improvement, if any, could be made to enable you to provide better services to your client?)
*Multiple answers
1) Training
4) Provision of other Logistics
2) Monetary Incentives
5) Supervision by health workers
3) Provision of IEC materials
6) Other: please specify
D7 Ano it nagpapadasig ha imo pagtrabaho komo usa nga miyembro hit CHT?

(What factors motivate you to perform as a CHT member?) *Multiple answers


1) Commitment to serve
5) Awards
2)
Knowledge
enhancement

6) Recognition by community
3) Means of income => Go to D8
7) Other: please specify
4) Benefits availment

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

Waray
D8 *For those who answered "(3) Means of Income" in D7

Magpapadayon ka ba ha imo trabaho bisan kun waray na insentibo tikang ha DOH?


(Will you continue your work even after the termination of incentives by DOH?)
1) Yes
2) No
D9 Ha imo paghunahuna, makakahatag ba hin maupay nga kabag-uhan an imo trabaho para ha panlawas hit mga

nanay ngan mga bata?


(Do you think your work can make a difference in the health of mothers and babies?)
1) Yes
2) No
D10 Mayda ka ba bisan ano nga maupay nga mga pamaagi han imo trabaho nga puydi mo maibahin ha iba nga

miyembro hit CHT?


(Do you have any good methods to promote your work that you can share with other CHT members?)

D11 Ha imo opinyon, ano an tulo nga mga kaulangan o kakurian komo usa ka miyembro hit CHT?

(In your opinion, what are the three challenges or difficulties as a CHT member?)

D12 Ha imo opinyon, ano an pinaka importante nga butang para maging malinampuson an imo trabaho komo CHT?

(In your opinion, what is the most important thing that would make your work as CHT successful?)

INTERVIEW & CHECKING


Date of interview:
/
Name of interviewer:
Signature:

Office Use Only


Data entry ID#:
2015 (D/M) Date of data entry:
Name:
Signature:

DOH/JICA SMACHS-EV Project-Questionnaire for CHT-Waray Waray

2015/6 (D/M)

Cebuano

Survey Questionnaire on Impact of CHT Activities on MCH Service Delivery


For CHT
Name of CHT Respondent

Contact # (Mobile)

Name of Barangay & BHS

Official Use Only


Area No

ID No

Starting Time

Ending Time

RHU

A. Background Information
A1 (Gender)

1) Female

2) Male

A2 Pila ang imong edad?

(How old are you?)


years old

A3 Minyo na ka?

(What is your marital status?)


1) Single
2) Common Law Spouse

3) Married (Legal)
4) Separated

5) Widow

A4 Unsa ang imong natapos nga edukasyon?

(What is your educational attainment?)


1) Never attended school

4) College

6) Post graduate

(Pls specify: Grad, 1, 2, 3, 4)

2) Elementary School

5) Vocational School

7) Other: Please specify

(Pls specify: Grad, 1, 2, 3, 4, 5, 6)

3) High School
(Pls specify: Grad, 1, 2, 3, 4)
A5 Naa kay katungdanan nga gihuptan sa barangay? Unsa ka dugay na ka sa inani nga posisyon?

(Do you hold any position? For how long?)


1) None
4) BNS (_________years)
2)
BHW
(___________
years)

5) Parent Leader (___________years)


3) BSPO(___________ years)
6) Barangay Kagawad (___________years)
7) Other (please specify: _________________, __________years)
A6 Pila na ka ka-buwan nga nagatrabaho isip usa ka miyembro sa CHT?

(How long have you been working as CHT member?) *If CHT answered in years, convert it to number of months
months

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
A7 Sa unsa nga paagi ka nahimong miyembro sa CHT?

(How did you become a CHT member?)


1) Through Recommendation (By whom?
2) Recruitment (By whom?

)
)

3) Self-volunteered
4) Other :Please specify
A8 Diha sa imong hunahuna, pila ka kaha ka oras sa usa ka semana nagatrabaho isip usa ka miyembro sa CHT?

(How many hours a week do you work as CHT?)


hours
A9 Aduna ka trabaho gawas sa CHT? Gibayaran ba ka sa imong trabaho?

(Do you have work aside CHT? Are you paid for work?)
1) Yes, I have paid work (Specify the kind of work:

2) Yes, I have unpaid work (Specify the kind of work:

3) No, I don't have any work


A10 Unsa ang imong panginabuhi?

(What is your main source of income?)

A11 Pila ang tibuok nga halin sa imong pamilya sa usa ka buwan?

(How much is your average family monthly income?)


3) 4,000.00 to 6,999.00
1) Less than Php 1,000.00
2) 1,000.00 to 3,999.00
4) 7,000.00 to 9,999.00

5) 10,000 to 14,999.00
6) 15,000.00 and above

A12 Miyembro ba ka sa PhilHealth?

(Are you a PhilHealth member?)


* Please ask the respondent for the membership ID if he/she is a member
1) Yes with a PhilHealth ID
3) No, but a Philhealth beneficiary
2) Yes without a PhilHealth ID
4) No
A13 Miyembro ba ka sa 4P's?

(Are you a 4P's member?)


1) Yes
2) No
A14 Puwede ko ba mahibaluan kung unsa ang imong mga sakop nga cluster/purok/sitio?

(Could you please tell me about your assigned clusters/puroks/sitios?)


* Please write all names of the assigned areas by the CHT (including those which are not in JICA area). If it is
not possible to specify the exact number of households, ask for the rough estimate.
No

Name of clusters/purok/sitios

No. of HH

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Remark if any

Cebuano

Total
A15 Unsa ang imong ginasakyan gikan sa imong balay padulong sa imong pinakalayo nga sakop nga

panimalay/pamilya?
(What is your means of transportation from your house to your furthest household/family?)
*Multiple answers
Travel
Means of transportation time (in
minutes)

Is there a regular
trip?

Cost for
How regular/frequent is the trip per
transportation
day?
(e.g., every 10 minutes, every hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes No

3. Tricycle

Yes No

4. Jeepney

Yes No

5. Multicab

Yes No

6. Other: (specify)

Yes No

A16 Unsa ang imong ginasakyan gikan sa imong balay padulong sa imong sakop nga health center?

(What is your means of transportation from your house to your assigned barangay health center?)
*Multiple answers
Means of transportation

Travel
time (in
minutes)

Is there a regular
trip?

Cost for
How regular/frequent is the trip per
transportation
day?
(e.g., every 10 minutes, every hour etc.)
(one way)

1. By walking

2. Motorcycle
(Habal-habal)

Yes No

3. Tricycle

Yes No

4. Jeepney

Yes No

5. Multicab

Yes No

6. Other: (specify)

Yes No

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
A17 Naa ba gihatag kanimo nga kwarta gikan sa LGU o Barangay aron gamiton sa pagpliti og sakyanan?

(Do you have travel allowance given by LGU or Barangay?)


1) Yes: Please specify the source_________________________
2) No
B. Information regarding CHT work
B1 Gitudluan ba ka sa RHU/DHC/CHO/PHO/DOH kung unsa ang mga buluhaton sa CHT?
(Have you had orientation on CHT work by RHU/DHC/CHO/PHO/DOH?)
1) Yes
When? by month and year:
2) No
B2 Unsa nga mga kalihokan ang imong ginabuhat isip usa ka miyembro sa CHT?

(What activities do you conduct as a CHT member?) *Multiple answers


* Please do not give any answer key to the respondent, but "Probe" (E.g. "What else?") .
6) Tracking of Postpartum & Newborns
1) Tracking of Pregnant Women
2) Health Education
7) Home Visit
3) Submission of Report
8) Reporting to Health Center
4) Supporting outreach activities
9) Attending a regular meeting
5) Referral
10) Other: Please specify
B3 Sa imong opinyon, unsa ka importante ang paggamit sa mosunod nga mga butang aron matabangan ang imong

kliyente ug makakuha sa gikinahanglan nga pag-alagad sa panglawas? Palihug sa paghatag og grado gikan sa 1
hangtod sa 4. 4 mao ang importante kaayo.
(In your opinion, how important is it to use following items to help your client to avail necessary health service?
Please answer on the scale of 1 to 4. 4 being the most important.)
* Please mark only one answer and ask the respondent for reason of her/his answer. "Not Applicable or N/A"
for non-use of the item. If the answer is either: " Very Important "or " Not Important" , please ask for the
reason.

ITEM

Very
Important Somewhat
Not
Important
Important Important
(4)
(3)
(2)
(1)

N/A
(0)

2 Post-partum & Newborn Tracking Form

Reason
3 CHT Monthly Report

4 MC Book

Reason
5 Reference Guide for MC book

Reason
6 Health Use Plan

1 Pregnancy Tracking Form


Reason

Reason

Reason

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
B4 Motambong ba ka ug mga miting sa CHT diha sa sentro?

(Do you attend CHT meetings at the Barangay Health Center/station?)


per
1) Yes : How often?
2) No
B5 Naglisod ba ka sa mga mosunod nga mga buluhaton? Kon oo, unsa ang rason?

(Do you have difficulty in the following activities? If yes, what is the reason?)
Yes (1)

No (0)

Activity
1) Pag-ila og sayo sa mga babaye nga mabdos. (Identifying women in the early
stage of pregnancy.)
Reason:

2) Makapakombinsir sa mabdos nga magpaprenatal. (Convincing pregnant women


for prenatal check-ups)
Reason:

3) Makapakombinsir sa mabdos nga manganak sa sentro o ospital. (Convincing


pregnant women for facility-based delivery)
Reason:

4) Makapakombinsir sa bag-o nga nanganak nga magpacheck-up. (Convincing


postpartum women for postnatal check-ups
Reason:

B6 Unsa ka dako ang imong pagsalig sa imong hibalo ug kahanas sa paghatag og edukasyon sa panglawas

sa imong kliyente?
(How confident are you with your knowledge and skills to give health education to the client?)
Very confident (3)
Confident (2)
Not confident (1)
B7 Sa imong opinyon, unsa ka daghan ang imong trabaho isip usa ka miyembro sa CHT?

(In your opinion, how do you consider your workload as a CHT member? )
Too much (4)

Just enough (2)

A little too much (3)

Not enough (1)

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
C. Support System
C1 Unsaon man nimo ang pag grado sa suporta nga gikan sa mga tawo diha sa imong trabaho? Ug, unsa ang mga
rason? Palihug sa paghatag og grado gikan 1 hangtod 4. 4 mao ang labi nga kontento.
(How do you rate the support from the following people to your work? And, what are the reasons? Please answer
on the scale of 1 to 4. 4 being the most satisfied.)
* Please mark only one answer and ask the respondent for reason of her/his answer.
IF THE ANSWER IS EITHER: " Very Satisfied" or " Very Dissatisfied" , PLEASE ASK FOR THE REASON.
Very
satisfied
(4)

Satisfied
(3)

Reason
4 Midwife

Reason
5 NDP

Reason
6 Barangay Captains

Reason
7 Community members in catchment area

Reason
8 Other: Specify

ITEM
1 LGUs/Mayor
Reason
2 MHO/MO
Reason
3 PHN

Not
Very dissatisfied
satisfied
(1)
(2)

Reason
C2 Nakadawat ba ka og insentibo o honorarium?

(Do you receive any incentive or honorarium?)


1. Yes
2. No
Move to Question D1

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
C3 Kon oo, unsa nga mga insentibo o honorarium ang imong nadawat gikan sa mosunod?

(If yes, what type of incentives/honorarium do you receive from the following?)

*Multiple Answers
Type of Incentive/Honorarium Received
(Check relevant box and specify amount/material, if applicable)

Source of Incentive/
Honorarium

Transportation
Allowance

Monetary

PhilHealth
Enrollment

1. DOH

Php______/___

Php______/___

2. PhilHealth

Php______/___

Php______/___

In-Kind

3. Barangay
LGU

Php______/___

Php______/___

4. Municipal
LGU/RHU

Php______/___

Php______/___

5. Provincial
LGU

Php______/___

Php______/___

Php______/___

Php______/___

6. Others:
Specify

Others

D. Opinion on CHT activities


D1 Imo bang gibati ang paghatag og importansiya sa imong pagboluntaryo gikan sa mga mosunod nga tawo? Palihug
sa paghatag og grado gikan sa 1 hangtod sa 4. 4 mao ang hugot nga pag-uyon.
(Do you feel that your voluntarism is valued by the following people? Please answer on the scale of 1 to 4. 4 being
the strongly agree.)
* Please mark only one answer and ask the respondent for the reason of her/his answer, by asking "Any
specific reason?"
IF THE ANSWER IS EITHER: " Strongly Agree" or " Strongly Disagree" , SURVEYORS MUST ASK FOR
THE REASON.
Strongly
Agree
(4)

Agree
(3)

Disagree
(2)

Strongly
disagree
(1)

N/A

1 Doctor

Reason
2 Nurse

Reason
3 Midwife

Reason
4 Client/Mothers

Reason
5 Community

Reason
6 Barangay Officials

Reason
7 Municipal/City Officials

ITEM

Reason

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
D2 Imo bang gibati nga ikaw adunay igo nga hinabang sa pagsuporta sa imong kliyente? Palihug sa paghatag og grado

gikan sa 1 hangtod sa 4. 4 mao ang hugot nga pag-uyon.


(Do you feel that you have adequate resources to support your client? Please answer on the scale of 1 to 4. 4 being
the strongly agree.)
Strongly Agree (4)
Move to D4
Disagree (2)
Agree (3)

Move to D4

Strongly Disagree (1)

D3 Kon ang imong tubag sa taas "Disagree" o "Strongly Disagree", unsa pa nga mga klase og hinabang ang imong

gikinahanglan alang sa imong kliyente?


(If your answer above is "2"or "1", what resources do you need for the client?)

D4 Unsa ang mga impluwensiya nga makaapekto sa imong trabaho isip usa ka miyembro sa CHT?

(What are the factors affecting your performance as a CHT member?) *Multiple answers
1) Lack of Training
5) Availability of Logistics
2) Availability of Monetary Incentives
6) Supervision by health workers
3) Attitude of community/client
7) Other: please specify
4) Availability of IEC materials
D5 *Please ask for those who answered (2),( 4), (5), or (7):

Adunay panahon ba nga gigamit nimo ang imong kaugalingon kwarta sa imong trabaho sa CHT?
(Have you ever shouldered any of the following expenses related to CHT work with your own money?) *Multiple
answers
1) Transportation cost to attend or report to health center
2) Transportation cost for home visits
3) Transportation cost for accompanying client going to health center
4) Transportation cost (Other: specify_____________)
5) Communication cost (texts or phone calls)
6) Purchase of Logistics (photocopy of reporting forms, stationary)
7) Other: Please specify
8. ) No
D6 Unsang kalamboan ang puwede mahimo aron makahatag ka og oras og mas maayo nga serbisyo sa imong kliyente?

(What improvement, if any, could be made to enable you to provide better services to your client?)
*Multiple answers
1) Training
4) Provision of other Logistics
2) Monetary Incentives
5) Supervision by health workers
3) Provision of IEC materials
6) Other: please specify
D7 Unsa nga mga butang ang modasig kanimo sa imong trabaho isip usa ka CHT?

(What factors motivate you to perform as a CHT member?) *Multiple answers


5) Awards
1) Commitment to serve
6) Recognition by community
2) Knowledge enhancement
3) Means of income Move to D8 7) Other: please specify
4) Benefits availment
DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

Cebuano
D8 *Only for those who answered "(3) Means of Income" in D7:

Mopadayon ba ka sa imong trabaho isip usa ka CHT bisag wala na ka madawat nga insentibo sa DOH?
(Will you continue your work even after the termination of incentives by DOH?)
1) Yes
2) No
D9 Sa imong hunahuna, makahimo ba og kaibahan ang imong trabaho sa kaayuhan sa panglawas sa mga inahan ug

ilahang mga bata?


(Do you think your work can make a difference in the health of mothers and babies?)
1) Yes
2) No
D10 Adunay ba kamo bisag unsa nga mga pamaagi sa pagpalambo sa imong mga buhat nga imong maipaambit sa uban

nga miyembro sa CHT?


(Do you have any good methods to promote your work that you can share with other CHT members?)

D11 Sa imong opinyon, unsa ang tulo nga mga kalisdanan isip usa ka miyembro sa CHT?

(In your opinion, what are the three challenges or difficulties as a CHT member?)

D12 Sa imong opinyon, unsa nga butang ang labing importante aron ang imong trabaho malampuson?

(In your opinion, what is the most important thing that would make your work as CHT successful?)

INTERVIEW & CHECKING


Date of interview:
/
Name of interviewer:
Signature:

Office Use Only


Data entry ID#:
2015 (D/M) Date of data entry:
Name:
Signature:

DOH/JICA SMACHS-EV Project Questionaire for CHT-Bisaya

2015/6 (D/M)

Appendix 3: Results of CHT Assessment

Results of the interviews with Health Workers in Leyte & Ormoc


Total number of respondents: 74 people (48 people in Leyte, 26 people in Ormoc)

1. Background of the Respondents


(1) Gender
Female
Male
Total
(2) Age
(mean )
(range)

69
5
74

93.2%
6.8%
100.0%

45.8911.30
(22------64)

(3) Position
Rural Health Midwife
PHN
MHO/MO
Total

57
8
9
74

77.0%
10.8%
12.2%
100.0%

(4) Number of working years at Health Center


(mean )
17.2111.02
(range)
(1------41)
*1 respondent did not answer

(5) Number of personnel providing prenatal care to the client


Yes
65
No
9
Total
74

87.8%
12.2%
100.0%

*MHO/MO does not usually provide prenatal care to the client

(6) Perceived difficulty in attaining the coverage of PNV4 in the target client (N=65)
Yes
43
66.2%
No
21
32.3%
No answer
1
1.5%
Total
65
100%
(7) Reasons for difficulties (Multiple answers) (N=43)
Hesitation or Denial of the Pregnant Woman (due to unwanted/teenage
pregnancy/multigravida)
Negative attitude of the Pregnant Woman (Not cooperative or Hard headed)
Large population in the area
Transient Clients
Geographical problem in accessing to health facility
Delayed report submission by CHT volunteers

23

Total

*2 respondents did not provide any answer

9
4
4
3
1
44

(8) Reasons for having no difficulties (Multiple answers) (N=21)


Assistance from CHT volunteers/BHW

11

Conducting regular monitoring, and counseling and health teaching to the client

Setting a target and a having masterlist to achieve PNV4


Coordination with the barangay
Never had any problems as part of the routine

3
1
1
22

Total

Interview with Health Workers

2. Impact of the CHT program on MNCHN service delivery


(1) Improvement in the performance of MNCHN service after the introduction of the CHT program
Yes
74
100.0%
No
0
0.0%
Total
74
100%
(2) Opinion on the CHT program: Improvement of overall MNCHN service
Very helpful
54
73.0%
Mostly helpful
11
14.9%
Helpful
7
9.5%
Slightly helpful
2
2.7%
Total
74
100.0%
(3) Opinion on the CHT program: Improvement of Antenatal Care Service
Very helpful
47
63.5%
Mostly helpful
13
17.6%
Helpful
11
14.9%
Slightly helpful
1
1.4%
Not at all
1
1.4%
Dont know
1
1.4%
Total
74
100.0%
(4) Opinion on the CHT program: Improvement of Facility-based Delivery Service
Very helpful
56
75.7%
Mostly helpful
9
12.2%
Helpful
7
9.5%
Slightly helpful
1
1.4%
Not at all
1
1.4%
Dont know
0
0.0%
Total
74
100.0%
(5) Opinion on the CHT program: Improvement of Postnatal Care Service
Very helpful
49
66.2%
Mostly helpful
11
14.9%
Helpful
13
17.6%
Slightly helpful
1
1.4%
Not at all
0
0.0%
Dont know
0
0.0%
Total
74
100.0%
(6) Are there other areas/health services in which the CHT program contributed to improve?
Yes
61
82.4%
No
13
17.6%
Total
74
100%

Interview with Health Workers

(7) Areas/health services in which CHT program contributed in improving (Multiple answers)
MNCHN related service delivery
EPI Program
Nutrition Program
Family Planning Program
Operation Timbang (weighning)
Communicable Disease
TB-DOTs program
Communicable Disease Program (General)
Other Health Program or related activity
Health education
Patient's tracking and follow-ups
Home visits to the client
Environmental and Sanitation Program
All DOH programs
Outpatient service
Facility maintenance
KP program
Barangay
Barangay Survey For Women
Family development session/orientation at barangay
Identification of Hilots
4P's program
Medical mission
Blood-letting activity
Others
Opportunity to have logistics (e.g., MC book/forms)
Opportunity to provide incentives to the volunteer

(N=61)
28
12
10
5
1
13
9
4
27
9
8
3
2
2
1
1
1
7
2
1
1
1
1
1
3
2
1

(8) Importance of the specified activity in contributing to the improvement of MNCHN service
1) Pregnancy Tracking of the Client
Strongly agree
Agree
Disagree
Strongly disagree
Not sure
Total

51
22
1
0
0
74

68.9%
29.7%
1.4%
0.0%
0.0%
100.0%

44
26
3
1
74

59.5%
35.1%
4.1%
1.4%
100.0%

*Disagree: the respondent did not specify the reason

2) Home visits during the prenatal period


Strongly agree
Agree
Disagree
Strongly disagree
Total

Reasons for disagree/strongly disagree (N=4)


CHT fails to conduct home visits/ follow-up the pregnant women
The clients doesn't have to seek care from the staff. It is the CHT who will find them.
No answer
Total

2
1
1
4

Interview with Health Workers

3) Post-partum and newborn tracking


Strongly agree
Agree
Disagree
Strongly disagree
Total

45
26
3
0
74

60.8%
35.1%
4.1%
0.0%
100.0%

Reasons for disagree/strongly disagree (N=3)


Some CHT volunteers do not update the report
CHT volunteers do not conduct home visits unless reminded
No answer
Total
4) Home visits during the postpartum period
Strongly agree
Agree
Disagree
Strongly disagree
Total

45
28
1
0
74

60.8%
37.8%
1.4%
0.0%
100.0%

51
18
4
0
1
74

68.9%
24.3%
5.4%
0.0%
1.4%
100.0%

1
1
1
3

*Disagree: the respondent did not specify the reason

5) Health Education
Strongly agree
Agree
Disagree
Strongly disagree
Not sure
Total

Reasons for disagree/strongly disagree (N=4)


CHT volunteers cannot convince the client
CHT volunteers do not conduct home visits to give health education
No answer
Total
6) Health Profiling of the client
Strongly agree
Agree
Disagree
Strongly disagree
Total

42
29
2
0
73

1
1
2
4

57.5%
39.7%
2.7%
0.0%
100.0%

*Of the 74, 1 respondent has no answer

Reasons for disagree/strongly disagree (N=2)


Not usually done by the CHT volunteers because of other functions in the brgy and a
replacement of CHT volunteers due to political administration change.
No answer
Total

1
1
2

Interview with Health Workers

3. Evaluation on the operational arrangement/management of the CHT program


(1) Usefulness of the tools provided for the CHT program:
1) KP-CHT guidebook
Very useful
Useful
Slightly useful
Not useful
Not applicable
Total

49
22
2
0
1
74

66.2%
29.7%
2.7%
0.0%
1.4%
100.0%

Reasons for slightly useful (N=2)


Some copies have been lost
No answer
Total
2) CHT Handbook (SMACHS-EV Project)
Very useful
Useful
Slightly useful
Not useful
Not applicable
Total

50
18
2
1
3
74

67.6%
24.3%
2.7%
1.4%
4.1%
100.0%

Reasons for slightly useful/not useful (N=3)


Slightly useful as it serves as a guide to the patient
CHT volunteers do not read the handbook
No answer
Total
3) Health Use Plan
Very useful
Useful
Slightly useful
Not useful
Not applicable
Total

1
1
2

35
26
3
0
8
72

1
1
1
3

48.6%
36.1%
4.2%
0.0%
11.1%
100.0%

*Of the 74, 2 respondents have no answer

Reasons for slightly useful/not useful (N=3)


CHT volunteers do not usually use this tool
No answer
Total

1
2
3

4) Pregnancy Tracking Form


Very useful
Useful
Slightly useful
Not useful
Total

58
15
0
0
73

79.5%
20.5%
0.0%
0.0%
100.0%

*Of the 74, 1 respondent has no answer

Interview with Health Workers

5) Postpartum and Newborn Tracking Form


Very useful
Useful
Slightly useful
Not useful
Total

52
21
0
0
73

71.2%
28.8%
0.0%
0.0%
100.0%

48
22
1
0
71

67.6%
31.0%
1.4%
0.0%
100.0%

34
28
0
0
10
72

47.2%
39.4%
0.0%
0.0%
14.1%
100.7%

63
10
1
0
74

85.1%
13.5%
1.4%
0.0%
100.0%

*Of the 74, 1 respondent has no answer

6) CHT monthly report


Very useful
Useful
Slightly useful
Not useful
Total
*Of the 74, 3 respondents have no answer
*Slightly useful: the respondent did not specify the reason

7) CHT Database (SMACHS-EV Project)


Very useful
Useful
Slightly useful
Not useful
Not applicable
Total
*Of the 74, 2 respondents have no answer

8) MC Book
Very useful
Useful
Slightly useful
Not useful
Total
Reasons for slightly useful/not useful (N=1)
Time-consuming and repetitive questions

Total
9) CHT reference guide (SMACHS-EV Project)
Very useful
Useful
Slightly useful
Not useful
Not applicable
Total

42
25
0
1
3
71

56.8%
33.8%
0.0%
1.4%
4.1%
95.9%

Total

1
1
1
1
4

1
1

*Of the 74, 3 respondents have no answer


*Not useful: the respondent did not specify the reason

(2) Other useful tools for the CHT program


Bulletin Board
Ordinance
Revised reporting forms
Immunization related items

Interview with Health Workers

(3) Opinion on the required task of CHT volunteers in relation to their capacity
11
15.1%
Easy
Appropriate
37
50.7%
Slightly difficult
18
24.7%
Difficult
7
9.6%
Total
73
100.0%
*Of the 74, 1 respondent has no answer

Reasons for the difficulty (Multiple answers) (N=25)


Educational level of CHT volunteers
Age of CHT volunteers
Lack of incentives
Negative attitude of CHT volunnteers
Workload
Lack of travel allowance
Lack of training
Health problem of CHT volunteers
Geographic distance to reach the client
Conflict of CHT's schedule with family
Negative attitude of the client
Weather
Politics (e.g., recruitment of CHT volunteers)
Training methods (e.g., adult learning)
Total

19
15
9
4
3
3
2
2
2
2
2
1
1
1
66

28.8%
22.7%
13.6%
6.1%
4.5%
4.5%
3.0%
3.0%
3.0%
3.0%
3.0%
1.5%
1.5%
1.5%
100.0%

(4) Training needs for CHT volunteers


Yes
No
Total

61
12
73

83.6%
16.4%
100.0%

*Of the 74, 1 respondent has no answer

(5) Areas on which CHT volunteers need to be re-trained


Knowledge on Maternal & Newborn Care

44

25.0%

Skills on making required reports


Tracking of pregnant women

45
45

25.6%
25.6%

Tracking of post-partum women & newborn

39

22.2%

Content of MC book
Interpersonal/communication skills
Total

2
1
176

1.1%
0.6%
100.0%

(6) Tasks need to be removed from CHT volunteers


Yes
7
No
62
Total
69

10.1%
89.9%
100.0%

*Of the 74, 5 respondents have no answer

(7) Suggested tasks to be removed for CHT volunteers


CHT forms (DOH-KP)
Conduct of barangay activity/barangay survey requested by barangay
Total

2
2
4

Interview with Health Workers

(8) Other comments related to the removal of CHT task


CHT volunteers cannot improve PNV4
Total
(9) Tasks need to be added to CHT volunteers
Yes
No
Total

1
1

17
57
74

23.0%
77.0%
100.0%

Total

4
2
1
1
1
1
10

(10) Suggseted task to be added for CHT volunteers


Commitment on work
Survey (e.g., LMP survey)
Health education
Duty at health facility
Interpersonal communication
Training on value formation/transformation

(11) Health worker's workload after the introduction of CHT program


Increased
29
Slightly increased
15
Same as before
16
Slightly decreased
8
Decreased
6
Total
74

39.2%
20.3%
21.6%
10.8%
8.1%
100.0%

(12) Should CHT program be continued at health facility?


Yes
72
No
2
Total
74

97.3%
2.7%
100.0%

Reasons for continuing CHT program (N=72)


Very helpful in improving MNCHN services

42

Important counterparts/manpower of RHU/Barangay to monitor the clients at community level

26

It is already an established system


N/A

2
2
72

Total
Reasons for not continuing CHT program (N=2)
Pregnant women visits health facility without efforts from CHT volunteers
The CHT volunteers are not helpful in providing better health services especially in tracking
the client
Total

1
1
2

Interview with Health Workers

(13) The most challenging activity in the implementation of the CHT program at health facility

Motivating CHT volunteers to continue their work

19

29.2%

Providing logistics to CHT volunteers

10

15.4%

Consolidating and submitting CHT monthly report

13.8%

Supervising CHT volunteers

9.2%

Conducting CHT monthly meeting

7.7%

Motivating the client to access necessary health service (PNV4, FBD,


PNC)

7.7%

Training CHT volunteers

6.2%

Recruiting CHT members (with good qualification)

4.6%

CHT's staus (other affiliation/not BHW etc)

3.1%

Motivating the pregnant for the support of the CHT volunteers

1.5%

Reducing maternal & neonatal death

1.5%

65

100.0%

Total
(14) Reasons for difficulties
1) Motivating CHT volunteers to continue their work
Lack of logistics or incentives
Political influence on CHT volunteers
Lack of cooperation
Dicrepancy of benefits among CHT volunteers
Conflict with other schedules (e.g., seminar and report submission/meeting)
Distance to health center

10
4
4
1
1
1
Total

21

Total

3
2
1
1
1
8

Total

3
2
2
1
1
9

Total

3
1
1
1
6

2) Providing logistics to CHT volunteers


Unavailability of materials at health facility
Lack of incentives
Politics
CHT looks for better needs than logistics provided by health facility
Low educational attainment of CHT volunteers

3) Consolidating and submitting CHT monthly reports


Lack of cooperation/commitment
Financial problem
Inconsistent/mistaken entry by CHT volunteers
CHT's other priority
Difficulty in transportation to submit the report

4) Supervising CHT volunteers


The client's attitude making CHT volunteers' work difficult
CHT volunteers are too busy
Lack of cooperation/commitment
Old age of CHT volunteers

Interview with Health Workers

(15) Necessary activities to sustain CHT program (Multiple answers)


Provision of financial incentives to CHT
Regular training of CHT volunteers
Provision of financial incentives to health workers
Deployment of adequate number of CHT
Regular meetings conducted by PHO/CHO/DOH8
Deployment of additional health workers
Ordinance
CHT monthly meeting
Provision of logistics (tools/handouts/forms)
Recognition/Awarding of CHT volunteers
Continuing the activity
Symposium/Health Education to the client
Training of Health Workers
Timely release of CHT incentives
Advocacy for LGU support
Good communication with the coworkers
Total

61
33
26
21
20
15
11
9
4
3
3
2
2
2
1
1
214

(16) Suggested ordinances to support CHT program


Facility-based delivery
Incentive/additional incentives to CHT volunteers
PNV4
Supporting CHT program
Protecting the right of CHT volunteers
PhilHealth Manual of Operational Plan (MOP) implementation
Total

3
3
2
2
1
1
12

28.5%
15.4%
12.1%
9.8%
9.3%
7.0%
5.1%
4.2%
1.9%
1.4%
1.4%
0.9%
0.9%
0.9%
0.5%
0.5%
100.0%

4. Advantages/disadvantages of the CHT program at health facility


Advantages
Increase of MNCHN indicators/accomplishment at health facility
Helps midwives to track and monitor the pregnant/post-partum mothers
Helps to carry out all health programs
Additional workforce to provide health services at health facility
Identification of the client in need
Dissemination of health information (e.g., schedule of health center/health education) to the
client
Opportunity to provide incentives to health volunteers
Availability of forms to monitor the client
Strict implementation of ordinance
Opportunity to have a monthly meeting to share the information among the staff
None

(N)
39
32
8
7
6

Disadvantages
None
CHT volunteers are not active
Delayed or lack of incentives to CHT volunteers
Additional workload for health personnel/health volunteers
Problmens with politics (e.g., selection of health volunteers)
Clients dont favor their work (e.g., being tracked/going to health center)
Lack of forms
No answer

(N)
50
8
7
5
3
2
1
1

10

6
1
1
1
1
1

Interview with Health Workers

5. Areas where CHT program needs improvement (Multiple answers)


Provision of adequate incentive or honorarium to CHT volunteers
Knowledge & skill enhancement (e.g., communication, reporting) of CHT volunteers through
training
None
Provision of logistics to CHT volunteers
Proper tracking of the client
Prenatal visits by the client
Conduct of home visit
A solution or strategy to cater the far flung barangays
Health education (including the availability of helpful tools) by CHT volunteers
Validation of reporting formats and the content
Referral of the client by CHT volunteers
All areas of CHT programs need to be improved
Conduct of regular meetings
Policy or law to protect CHT volunteers
6. Suggestions to DOH for the improvement of the CHT program (Multiple answer)
Provision of incentives/travel allowance to CHT volunteers
Provision of logistics (forms/IEC materials/stationaries) to CHT volunteers
Conduct of training/refresher trainings for CHT volunteers
Continuation of CHT program
More deployment of CHT volunteers/proper selection of CHT volunteers
Establish the government policy to protect the right of CHT volunteers from the politics
Improvement on CHT forms
Lessesn the required paper work to CHT volunteers
Sharing of resources from the regional office to the municipality
Strategy to the far flung barangay
Continuation of CHT awards
Extension of the building
Centralized health service at the DOH
Deployment of more midwife

20
15
13
12
11
6
3
3
2
2
1
1
1
1
52
23
14
8
7
5
2
1
1
1
1
1
1
1

*None: 7 respondents

7. Innovative activities being implemented for strengthen performance of the CHT program at health facility
(Multiple answers)
Conduct of recognition or awarding of CHT volunteers for accomplishment (including
17
certificate)
Conduct of monthly meetings with CHT volunteers
8
Conduct of activity to establish team work (including recreation program)
7
Provision of incentives to CHT volunteers based on their accomplishment (through PhilHealth6
MCIP or other sources)
Conduct of refresher training/knowledge enhancement/OJT activity for CHT volunteers
5
Provision of travel fare/logistics/food to CHT volunteers
3
Conduct of monthly peer-reviews among CHT volunteers
2
Conduct seminars or health education activity by RHU/DHC personnels to the client
2
Provision of breast feeding kits for mothers
2
Ordinance on FBD
2
Revision of forms
2
Enlistment of Women on reproductive age
2
Attend training of BEmONC
1
Coordination with barangays to allocate funds for CHT volunteers
1
Utilization of CHT database
1
Banco de Nueve: Introduction of good practices from CAR region
1
Positive attitude towards the client
1
Flexible schedule for prenatal check-ups (e.g., night time opening for prenatal)
1
Sharing words of wisdom
1
Not applicable
1
*None: 20 respondents

11

Interview with Health Workers

Results of the interviews with Mothers in Leyte & Ormoc


Total number of respondents: 99 people (55 people in Leyte, 44 people in Ormoc)
*Leyte originally had 59 people interviewed, but 4 were dropped-out during the interview.
1. Socio-demographic Data of the Respondents
(1) Age
(mean )
(range)

27.236.17
(18------46)

(2) Marital Status


Single
Common Law Spouse
Married
Separated
Widow
Total

4
63
28
3
1
99

4.0%
63.6%
28.3%
3.0%
1.0%
100%

(3) Educational Attainment


(mean )
(range)

8.752.7
(1------14)

(4) Number of Children


(mean )
(range)

2.941.85
(1------10)

(5) Occupation
Housewife (full-time)
Food Vendor
Farmer
Sugercane Laborer
Sari-Sari Store Owner
Sales Lady
Contractual Worker
Unknown (paid)
Unknown (unpaid)
Total

87
3
2
1
1
1
1
2
1
99

87.9%
3.0%
2.0%
1.0%
1.0%
1.0%
1.0%
2.0%
1.0%
100%

(6) Monthly Household Income


Less than Php 1,000
1,000 to 3,999
4,000 to 6,999
7,000 to 9,999
10,000 to 14,999
15,000 and above
Total

10
45
30
7
4
3
99

10.1%
45.5%
30.3%
7.1%
4.0%
3.0%
100%

(7) PhilHealth Membership


Yes with ID
Yes without ID
No, but beneficiary
No
Total

29
23
16
31
99

29.3%
23.2%
16.2%
31.3%
100.0%

Interview with Mothers

(8) 4P's Membership


Yes
No
Total

28
71
99

28.3%
71.7%
100.0%

(9) Place of delivery of the last baby


RHU
District Hospital
EVRMC
Private Clinic/Hospital
Schistosomiasis Hospital
Unknown
Total

48
41
1
6
2
1
99

48.5%
41.4%
1.0%
6.1%
2.0%
1.0%
100.0%

(10) Characteristic of residence


Within town proper/commercial area
Near downtown/town proper
Mountain area
Coastal area
Interior barangay
Total

13
51
16
5
14
99

13.1%
51.5%
16.2%
5.1%
14.1%
100.0%

(11) Length of residency in the current barangay


Less than 6 months
6 months to less than 1 year
1 to less than 3 years
3 to less than 6 years
6 years or more
Total

0
3
10
17
69
99

0.0%
3.0%
10.1%
17.2%
69.7%
100.0%

(12) How big is the problem with transportation to health center?


Not a problem
84
Somewhat problem
12
Big problem
3
Total
99

84.8%
12.1%
3.0%
100.0%

(13) Difficulty in going to the health center for regular prenatal/postpartum check-up
Yes
11
11.1%
No
88
88.9%
Total
99
100.0%
*All "Yes" come from the respondents from Leyte

(14) Reasons for the difficulty in going to health center for prenatal/postnatal check-ups
(Multiple answers) (N=11)
Cost of Transportation
3
Household Work
2
Family's disagreement
1
Due to her job/work
1
Bad Weather
2
No answer
2
Total
11

Interview with Mothers

(15) Means of Transportation


By walking
Motorcycle/Habal-habal
Pedicab
Tricycle
By Walking and Tricycle/Pedicab
Motorcycle and Jeepney/Pedicab
Tricycle and Pedicab
Multicab
Own vehicle
Total

31
23
17
15
7
2
2
1
1
99

(16) Travel time from house to health center (1)


(mean )
13.81 15.99
(range)
(2------120)

31.3%
23.2%
17.2%
15.2%
7.1%
2.0%
2.0%
1.0%
1.0%
100.0%

minutes

*2 respondents did not specify the time

(17) Breakdown of Travel Time from house to health center (2)


0-15 minutes
78
16-30 minutes
13
31-45 minutes
3
46-60 minutes
2
61-90 minutes
0
More than 90 minutes
1
Total
97

80.4%
13.4%
3.1%
2.1%
0.0%
1.0%
100.0%

(18) Cost of Transportation (one way) among those who use public/pvt transportation
(mean )
11.128.16
pesos
(range)
(5------50)

2. Knowledge and satisfaction related to CHT activities


(1) Familiarity with the name "Community Health Team"
Yes
63
No
36
Total
99

63.6%
36.4%
100.0%

(2) Knowledge on the person with the position who provides maternal & child health service in the
community (Multiple answers)
BHW
95
48.5%
Midwife/Nurse/Doctor
25
12.8%
BNS
21
10.7%
Day Care Worker
19
9.7%
Parent Leaders
16
8.2%
Barangay Service Point Officer
12
6.1%
Barangay Kagawad
3
1.5%
CHT volunteers
2
1.0%
Medical mission
1
0.5%
NPS*
1
0.5%
Dont' know the specific position
1
0.5%
Total
196
100.0%
*Possibly "Nurse Deployment Program (NDP)"

Interview with Mothers

(3) Type of service provided by CHT volunteers (Multiple answers)


Home Visits (during prenatal period)
97
Home Visits (during postnatal)
80
Health Education/Advice
74
Reminding/Encouraging the visit to HC
67
Confirmation of a birth & emergency plan
30
Referral/accompany to the HC
27
Distribution of vitamins, medicines and
12
deworming
Follow-up on Immunization
7
Family Planning
2
Processing of Philhealth
1
Weighing children
1
Giving information regarding health center
1
Total
399

1.8%
0.5%
0.3%
0.3%
0.3%
100.0%

(4) Satisfaction of Home Visits (during prenatal) (N=97)


Very Satisfied
67
Somewhat Satisfied
23
Not Satisfied
1
Dissatisfied
0
No Asnwer
6
Total
97

69.1%
23.7%
1.0%
0.0%
6.2%
100.0%

(5) Satisfaction of Home Visits (during postnatal) (N=80)


Very Satisfied
51
Somewhat Satisfied
22
Not Satisfied
2
Dissatisfied
0
No Asnwer
5
Total
80

63.8%
27.5%
2.5%
0.0%
6.3%
100.0%

(6) Satisfaction of Health Education/Advice (N=74)


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
No Asnwer
Total

64.9%
23.0%
1.4%
0.0%
10.8%
100.0%

48
17
1
0
8
74

24.3%
20.1%
18.5%
16.8%
7.5%
6.8%
3.0%

(7) Satisfaction of reminding/encouraging the visit to health center (N=67)


Very Satisfied
49
73.1%
Somewhat Satisfied
14
20.9%
Not Satisfied
1
1.5%
Dissatisfied
0
0.0%
No Asnwer
3
4.5%
Total
67
100.0%
(8) Confirmation of birth & emergency plan (N= 30)
Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
No Asnwer
Total

18
10
1
0
1
30

60.0%
33.3%
3.3%
0.0%
3.3%
100.0%

Interview with Mothers

(9) Referral/accompanying the client to health center (N=27)


Very Satisfied
21
Somewhat Satisfied
4
Not Satisfied
1
Dissatisfied
0
No Asnwer
1
Total
27

77.8%
14.8%
3.7%
0.0%
3.7%
100.0%

(10) Number of home visits by CHT volunteers from prenatal period until delivery (N=95) (1)
(mean )
7.47 28.39
times
(range)
(1------280)
(median)
4
*Of the 97, 2 respondents did not answer

(11) Breakdown of number of home visits by CHT volunteers from prenatal period until delivery (2)
1-2 times
10
10.5%
3 times
23
24.2%
4 times
35
36.8%
5-10 times
24
25.3%
11-20 times
2
2.1%
More than 21 times*
1
1.1%
Total
95
100.0%
* 280 times

(12) Number of home visits by CHT volunteers after delivery until 42 days (N=78) (1)
(mean )
3.85 5.23
times
(range)
(1------42)
(median)
3
*Of the 80, 2 respondents did not answer
(13) Breakdown of the number of home visits by CHT volunteers after delivery until 42 days (2)
1-2 times
35
44.9%
3-4 times
30
38.5%
5-10 times
11
14.1%
11-25 times
1
1.3%
More than 26 times*
1
1.3%
Total
78
100.0%
*42 times

(14) Average time CHT volunteers spend every home visit (N=93) (1)
(mean )
42.44 44.42
minutes
(range)
(2------240)
(median)
30
*Of the 97, 3 respondents did not answer, and 1 respondent was not applicable

(15) Breakdown of the average time CHT volunteers spend every home visit (2)
5 minutes or less
12
12.9%
10-15 minutes
13
14.0%
20-25 minutes
6
6.5%
30 minutes
30
32.3%
40-50 minutes
2
2.2%
60 minutes
21
22.6%
80 minutes or more
9
9.7%
Total
93
100.0%
5

Interview with Mothers

(16) Type of information given by CHT volunteers during health education (Multiple answers)
Importance of prenatal visit
55
Immunizaion
52
Baby care routine
50
Warning signs during pregnancy
45
Importance of facility-based delivery
41
Importance of post-partum visit
35
Birth & emergency plan
35
Family planning
30
Nutrition
4
Exclusive Breastfeeding
2
Referral to HC for a baby
1
Total
350
3. MC Book and CHT work
(1) Mother and Child Book was given during last pregnancy
Yes
98
No
1
Total
99

99.0%
1.0%
100.0%

Reason for "No": The client was transferred in (from Manila), and had a home based mother's record instead of
MC book (Leyte).
(2) Availability of Mother and Child Book after delivery (as of now) (N=98)
Yes
97
99.0%
No
0
0.0%
No answer
1
1.0%
Total
98
100.0%
(3) Status of Recording on MC book (if properly filled-out on the important records) (N=90)
*Of the 97 respondents, 7 did not bring their MC book during the assessment

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No

Birth & Emergency Plan


Schedule of Home Visits
Present Pregnancy
Postpartum Care Within 42 days
Postnatal Care

83
7
70
20
85
5
40
50
46
44

92.2%
7.8%
77.8%
22.2%
94.4%
5.6%
44.4%
55.6%
51.1%
48.9%

(4) Usefulness of MCB during the last delivery (N=98)


Very useful
Useful
Somewhat useful
Not useful at all

81
13
4
0
98

Total

82.7%
13.3%
4.1%
0.0%
100.0%

Interview with Mothers

(5) Reasons for Usefulness of MCB (Multiple answers) (N=94)


MC book serves as a guide or source of information related to maternal and child care
MC book helps in monitoring the health status and the schedules of health visit/immunization
It is useful to keep the record of the mother and child
It is a big help
Total
(6) Reasons for MC book being somewhat useful (N=4)
The importance of MC book was not being explained by anyone
Not being able to read all
It serves as a guide
Total

81
13
17
1
112
2
1
1
4

(7) Whether CHT volunteers discussed the content of MC book during home visits (N=98)
Yes
77
78.6%
No
21
21.4%
Total
98
100.0%
(8) Client's Satisfaction of CHT volunteers discussing the content of MC Book during home visits (N=77)
Very good
Good
Fair
Poor
No answer

43
29
3
1
1
77

Total

(9) Importance of CHT volunteers in mother's maternal experience


Very important
65
Important
28
Somewhat important
3
Not important
2
No Answer
1
Total
99

55.8%
37.7%
3.9%
1.3%
1.3%
100.0%

65.7%
28.3%
3.0%
2.0%
1.0%
100.0%

(10) Reasons for importance of CHT volunteers (Multiple answers)


Providing guidance and advice about maternal and child health care
Following-up the schedule of health visits/immunization of the client
Providing health education and information to the client
Conducting monitoring/home visits to the clientto check their health status
Giving the client encouragement and good services
Providing necessary assistance in going to health center
Total

30
26
20
16
12
2
106

Total

2
3
1
6

(11) Negative comments on the importance of CHT volunteers


No follow-up conducted by CHT volunteers
Lapses in her duties/advices/ health education
Not active

Interview with Mothers

4. Source of information and decision making on maternal and child health care
(1) Source of information about MCH care (Multiple answers)
CHT members
81
23.5%
Family/relatives
79
22.9%
Health Personnel (RHU/DHC/BHS)
69
20.0%
MC book
58
16.8%
Friends
30
8.7%
Mass media/Magazine
18
5.2%
Health Personnel at Private Clinic
5
1.4%
Neighbors/Other mothers
3
0.9%
Personal experience
2
0.6%
Total
345
100.0%
(2) People who influenced the decision to seek maternal and child care services at health center
Score: 1 (not influential)------4 (very influential)
Category
(mean )
(range)
Midwife
3.74 0.50
1---------4
Parents
3.64 0.74
1---------4
Doctor
3.64 0.66
1---------4
Husband
3.62 0.73
1---------4
Nurse
3.55 0.65
1---------4
CHT volunteer
3.48 0.82
1---------4
Ordinance
3.46 0.89
1---------4
Community's opinion
2.88 0.92
1---------4
Others: Religion (1), NDP (1)
(3) Availment of health services: Prenatal Care during 1st Trimester
Yes
82
No
17
Total
99

N
98
95
97
94
96
97
87
98

82.8%
17.2%
100.0%

(4) Personnel who influenced for availing the service (Multiple answers) (N=82)
CHT volunteers
52
54.2%
Midwife/RHU staff
16
16.7%
Own decision
12
12.5%
Mother/Parent
8
8.3%
Husband
5
5.2%
Friend
1
1.0%
Health Worker (aside from DHC/RHU)
1
1.0%
Neighbor
1
1.0%
Total
96
100.0%
(5) Reasons for not availing the service (Multiple answers) (N=4)
Not aware of being pregnant/irregular
7
menstration
Out of town
4
Unnecessary
2
Delay in accessing the service
2
Schooling/Working (unplanned pregnancy)
2
Total
17

41.2%
23.5%
11.8%
11.8%
11.8%
100.0%

Interview with Mothers

(6) Availment of health services: Prenatal Care during 2nd and 3rd Trimester
Yes
97
98.0%
No
2
2.0%
Total
99
100.0%
(7) Personnel who influenced for availing the service (Multiple answers) (N=97)
CHT volunteers
70
57.4%
Midwife/RHU/DHC staff
25
20.5%
Own decision
11
9.0%
Mother/Parent/Family Members (aside from
11
9.0%
husband)
Husband
3
2.5%
Friend
2
1.6%
Total
122
100.0%
(8) Reason for not availing the service (N=2)
Out of town
Total

2
2

(9) Availment of health services: Facility-based Delivery


Yes
97
No
2
Total
99

98.0%
2.0%
100.0%

(10) Personnel who influenced for availing the service (Multiple answers) (N=97)
Midwife/RHU/DHC staff
46
38.7%
CHT volunteers
43
36.1%
Mother/Parent/Family Members (aside from
13
10.9%
husband)
Own decision
12
10.1%
4
3.4%
Husband
Community
1
0.8%
Friend
0
0.0%
Total
119
100.0%
(11) Reason for not availing the service (N=2)
Delivery room was not available due to
repair

Unknown

1
2

Total
(12) Availment of health services: Post-partum Care
Yes
No
No answer
Total

89
9
1
99

89.9%
9.1%
1.0%
100.0%

Interview with Mothers

(13) Personnel who influenced for availing the service (Multiple answers) (N=89)
Midwife/RHU/DHC staff
43
46.2%
CHT volunteers
29
31.2%
Health Worker (aside from DHC/RHU)
7
7.5%
Own decision
5
5.4%
Mother/Parent/Family Members (aside from
4
4.3%
husband)
Husband
3
3.2%
Friend
1
1.1%
Unknown
1
1.1%
Total
93
100.0%
(14) Reasons for not availing the service (N=9)
Unnecessary

33.3%

Did not know about post-partum care visit

33.3%

No time to visit

22.2%

Looking for other health facilities l to attend

11.1%

Total

100.0%

97
2
99

98.0%
2.0%
100.0%

(15) Availment of health services: Immunization


Yes
No
Total

(16) Personnel who influenced for availing the service (Multiple answers) (N=97)
CHT volunteers
61
52.6%
Midwife/RHU/DHC staff
41
35.3%
Own decision
6
5.2%
Mother/Parent/Family Members (aside from
4
3.4%
husband)
Neighbor
1
0.9%
Unknown
1
0.9%
Health Worker (aside from DHC/RHU)
1
0.9%
Husband
1
0.9%
Total
116
100.0%
(17) Reason for not availing the service (N=2)
Dont have any schedule
Total

2
2

(18) Availment of health services: Family Planning


Yes
No
Total

64
35
99

10

64.6%
35.4%
100.0%

Interview with Mothers

(19) Personnel who influenced for availing the service (Multiple answers) (N=64)
CHT volunteers
33
45.2%
Midwife/RHU/DHC staff
28
38.4%
Own decision
5
6.8%
Husband
3
4.1%
Unknown
2
2.7%
Mother/Parent/Family Members (aside from
1
1.4%
husband)
Health Worker (aside from DHC/RHU)
1
1.4%
Total
73
100.0%
(20) Reasons for not availing the service (Multiple answers) (N=35)
17
Not allowed
13
Not right timing (berastfeeding/no6
No schedule
3
Unnecessary
3
Unknown
2
Fear (e.g. side effect)
2
No information on importance or necessity
2
Undecided/confused
1
Busy doing house work
Total
49

34.7%
26.5%
12.2%
6.1%
6.1%
4.1%
4.1%
4.1%
2.0%
100.0%

5. Experience with CHT volunteers


Types of Experiences being shared (N=79)
Positive
Negative
Total

91.1%
8.9%
100.0%

72
7
79

Positive comments:
Accomodating & giving special assistance to the mothers
Reminding the client about shedules of check-ups & immunization
Providing advices/health educations to the mothers
No bad experiences, compliment

(N)
30
20
20
4

Negative comments:
CHT not being active (no home visits/follow-up)
CHT being forgetful (e.g., information on schedule of prenatal service)
CHT not having enough knowledge/information to give health advice
CHT having negative attitude (e.g., favoritism over the client)

(N)
3
2
2
1

6. Suggestions for improvement of CHT service/program (N=69)


CHT to maintain their good service/satisfied
CHT to be more active/more home visits
CHT to treat the client nicely/patiently
CHT to be trained more
The program to focus on remote area/the client more in need
CHT to cooperate more with co-CHT volunteers
CHT to remove priority system/ to be fair
More CHT to be deployed
CHT to be equipped properly (e.g., umbrella/raincoat)
Gathering of mothers to give more information/
Give more information about health center

11

(N)
27
14
9
5
4
3
2
2
1
1
1

Interview with Mothers

Results of the interviews with CHT volunteers in Ormoc (ALL)


Total number of respondents: 40 people (20 people in high performing DHC; 20 people in low performing DHC)
1. Socio-demographic Data of the Respondent
(1) Gender
Female
Male

38
2
40

Total
(2) Age
(mean )
(range)

95.0%
5.0%
100.0%

47.2313.48
(22------65)

(3) Breakdown of the age


30 years old or below
31-40 years old
41-50 years old
51-60 years old
61 years old or more

(4) Marital Status


Single
Common Law Spouse
Married
Separated
Widow
Total
(5) Educational Attainment
(mean )
(range)

7
5
10
9
9
40

17.5%
12.5%
25.0%
22.5%
22.5%
100.0%

2
2
28
0
8
40

5.0%
5.0%
70.0%
0.0%
20.0%
100.0%

9.08 3.12
(2------14)

(6) Breakdown of the Educational Attainment


0-3 years (Grade 3)
4-6 years (Grade 6)
7-10 years (High school)
11 years or more (College)
Total

1
8
20
11
40

2.5%
20.0%
50.0%
27.5%
100.0%

Total

1
29
0
9
1
40

2.5%
72.5%
0.0%
22.5%
2.5%
100.0%

(8) Work aside from CHT volunteer


Yes with paid work
Yes without paid work
No
Total

12
4
24
40

30.0%
10.0%
60.0%
100.0%

(7) Position
None
BHW
BSPO
BNS
Parent Leader

Interview with CHT Volunteers (Ormoc)

(9) Details of paid work


BNS/BHW/Kagawad
Carpenter
Private Business
Total

6
1
5
12

50.0%
8.3%
41.7%
100.0%

(10) Main Source of Income


Family's income (e.g., husband/children)
Sari-Sari Store
Farming/gardening/shell gathering
Labor/house keeper/driver
CHT with a part-time job or the family
Own business
Pension/SSS
BHW/BNS
Total

7
2
15
3
1
6
1
4
39

17.9%
5.1%
38.5%
7.7%
2.6%
15.4%
2.6%
10.3%
100.0%

Total

3
25
11
1
0
0
40

7.5%
62.5%
27.5%
2.5%
0.0%
0.0%
1

Total

17
1
11
11
40

42.5%
2.5%
27.5%
27.5%
100.0%

Total

10
30
40

25.0%
75.0%
100.0%

*1 respondent (Group B) has no answer

(11) Monthly Household Income


Less than Php 1,000
1,000 to 3,999
4,000 to 6,999
7,000 to 9,999
10,000 to 14,999
15,000 and above

(12) PhilHealth Membership


Yes with ID
Yes without ID
No, but beneficiary
No

(13) 4P's Membership


Yes
No

(14) Length of service as a CHT volunteer


(mean )
(range)

3.4 1.4
(0.1------5)

years

*1 respondent (Group A) has no answer

(15) Breakdown of the length of working years as a CHT volunteer


Less than 1 year
1-2 years (less than 2 years)
2-3 years (less than 3 years)
3-4 years (less than 4 years)
4-5 years (less than 5 years)
5 years or more
Total

2
3
7
5
16
6
39

5.1%
7.7%
17.9%
12.8%
41.0%
15.4%
100.0%

Interview with CHT Volunteers (Ormoc)

(16) Reason for becoming a CHT volunteer


Through recommendation
Recruitment
Self-volunteered
Automatically assigned
Total

8
5
22
4
39

20.5%
12.8%
56.4%
10.3%
89.7%

6
3
1
1
2
13

46.2%
23.1%
7.7%
7.7%
15.4%
100.0%

*1 respondent (Group B) has no answer

(17) Person who recommended/recruited CHT volunteers (N=13)


Midwife
BHW/CHT
Barangay Kagawad
BHW coordinator
Unknown

(18) Working hours as a CHT volunteer per week


(mean )
(range)

9.42 7.91
(0.5------30)

(19) Number of households in catchment area (1)


(mean )
(range)

99.62 58.79
(32------250)

hours/week

HHs

*3 respondents (Group B) have no answer

(20) Breakdown of HHs in catchment area (2)


1-20 households
21-50 households
51-100 households
101-150 households
151-250 households
Total

0
8
14
9
6
37

0.0%
21.6%
37.8%
24.3%
16.2%
100.0%

(21) Means of transportation in going to the furthest catchment area


By walking
Motorcycle (habal-habal)
Multicab
By walking and motor
By walking and tricycle
Boat
Private motor
Total

29
6
1
1
1
1
1
40

72.5%
15.0%
2.5%
2.5%
2.5%
2.5%
2.5%
100.0%

(22) Travel time from house to the furthest catchment (1)


(mean )
(range)

32.50 34.83
(5------180)

minutes

*2 respondents (Group B) have no answer

(23) Breakdown of travel time from house to the furthest catchment (2)
0-15 minutes
16-30 minutes
31-45 minutes
46-60 minutes
61-90 minutes
More than 90 minutes
Total

17
11
3
4
1
2
38

44.7%
28.9%
7.9%
10.5%
2.6%
5.3%
100.0%

Interview with CHT Volunteers (Ormoc)

(24) Cost of transportation (one way) among those who use public/private transportation (N=11)
(mean )
15 10.54
pesos
(range)
(0------30)
*1 respondent (Group A) has no answer

(25) Means of transportation in going to the assigned barangay health center


By walking
Motorcycle (habal-habal)
Tricycle
Jeepney
Multicab
By walking and motor
Boat
Hitchhike
Private motor
Total

(26) Travel time from house to the assigned barangay health center (1)
(mean )
(range)

26
9
1
0
0
1
1
1
1
40

65.0%
22.5%
2.5%
0.0%
0.0%
2.5%
2.5%
2.5%
2.5%
100.0%

13.34 12.63
(1------60)

minutes

*2 respondents (Group B) have no answer

(27) Breakdown of travel time from house to the assigned barangay health center (2)
0-15 minutes
30
16-30 minutes
5
31-45 minutes
2
46-60 minutes
1
61-90 minutes
0
More than 90 minutes
0
Total
38

78.9%
13.2%
5.3%
2.6%
0.0%
0.0%
100.0%

(28) Cost of transportation (one way) among those who use public/private transportation (N=13)
(mean )
12.507.82
pesos
(range)
(5------30)

2. Information regarding CHT activities


(1) Have you received training on CHT program?
Yes
No
Total
(2) Activities conducted by CHT volunteers (Multiple answers)
Tracking of the pregnant women
Health education
Submission of report
Supporting outreach activities
Referral
Tracking of the postpartum & newborns
Home Visit
Reporting to health center
Attending a regular meeting
Assisting duty at health center
Provision of vitamines
Attending an emergency meeting
Total

39
1
40

97.5%
2.5%
100.0%

38
32
21
10
14
33
39
28
25
5
3
2
250

15.2%
12.8%
8.4%
4.0%
5.6%
13.2%
15.6%
11.2%
10.0%
2.0%
1.2%
0.8%
100.0%

Interview with CHT Volunteers (Ormoc)

(3) Perceived importance of the tools to promote utilization of health service by the client
1) Pregnancy Tracking Form
Very important
35
Important
4
Somewhat important
0
Not important
0
0
Not applicable
Total
39

89.7%
10.3%
0.0%
0.0%
0.0%
100.0%

*1 respondent (Group B) has no answer

The most common reasons for very important (Multiple answers)


To record tracked pregnant and update/follow-up their prenatal visits and
CHT's home visits
To gather informations of the pregnant women in the area
To confirm the LMP of the pregnant women being tracked
2) Postpartum & Newborn Tracking Form
Very important
Important
Somewhat important
Not important
Not applicable
Total

20
6
1

34
4
0
0
1
39

87.2%
10.3%
0.0%
0.0%
2.6%
100.0%

*1 respondent (Group B) has no answer

The most common reasons for very important (Multiple answers)


To monitor the status of the postprtum mother and baby after delivery
To know the schedule of postpartum home visits and the mother's
postpartum check-ups
To gather informations of the newborn
3) CHT Monthly Report
Very important
Important
Somewhat important
Not important
Not applicable

28
6
2

30
7
0
0
1
38

Total

78.9%
18.4%
0.0%
0.0%
2.6%
100.0%

*2 respondents (from Group A and B) have no answer

The most common reasons for very important (Multiple answers)


To monitor the accomplishment of CHT work (tracking and performance)

20

To ensure a better flow of report submission

4) MC book
Very important
Important
Somewhat important
Not important
Not applicable

32
6
0
0
0
38

Total

84.2%
15.8%
0.0%
0.0%
0.0%
100.0%

*2 respondents (Group B) have no answer

Interview with CHT Volunteers (Ormoc)

The most common reasons for very important (Multiple answers)


Record of client's status such as birth plan and emergency contact
A guide for the mother during pregnancy till delivery
Important tools to monitor the status of prenatal check-ups/immunization
and home visits.
A guide for CHT to care the client
5) Reference Guide for MC book
Very important
Important
Somewhat important
Not important
Not applicable

9
14
9
3

25
9
0
0
4
38

Total

65.8%
23.7%
0.0%
0.0%
10.5%
100.0%

*2 respondents (from Group A and B) have no answer

The most common reasons for very important (Multiple answers)


A guide for client's health status
A guide for CHTs on what to advise during hyome visits
To locate important pages in MC book easily and faster
6) Health Use Plan
Very important
Important
Somewhat important
Not important
Not applicable

6
6
2

26
12
0
0
1
39

Total

66.7%
30.8%
0.0%
0.0%
2.6%
100.0%

*1 respondent (Group B) has no answer

The most common reasons for very important (Multiple answers)


Tools for profiling and monitoring the health status of clients
For emergency preparation
Tools to let the mothers know the benefits of having a good health and to
know the health plan of the clients
(4) Attendance to the CHT meeting at barangay health station
Yes
No
Total

8
7
9

39
0
39

100.0%
0.0%
100.0%

1
26
7
2
2
1
39

2.6%
66.7%
17.9%
5.1%
5.1%
2.6%
100.0%

*1 respondent (Group B) has no answer

(5) Frequency of attendance to the CHT meeting


Once a week
Once a month
Once every 2 month
Once every 3 month
Once every 4 month
Once every 8 month
Total

(6) Difficulty in conducting the activity: Identifying the pregnant women in the early stage of pregnancy
Yes
14
35.0%
No
26
65.0%
Total
40
100.0%

Interview with CHT Volunteers (Ormoc)

Reasons for difficulty


The pregnant women hide or deny her pregnancy
Some clients can not be identified by appearance
The client doesnt go to prenatal check-up
N/A
Total

10
1
1
2
14

Reasons for having no difficulty


Physical appearance/Symptoms
Information from community or neighbors
Total

1
0
1

(7) Difficulty in conducting the activity: Convincing the client for prenatal check-ups
Yes
9
No
31
Total
40
Reasons for difficulty (Multiple answers)
The client is not cooperative
Health condition of the client
Weather
Shyness/denial of the client
Lack of money
N/A
Total

22.5%
77.5%
100.0%

3
1
1
2
1
2
10

*No reason was provided for non difficulty of convincing the client for prenatal check-ups

(8) Difficulty in conducting the activity: Convincing the pregnant women for Facility-Based Delivery
Yes
6
15.0%
No

34
40

Total
Reasons for difficulty
Depending on the decision of the client
Hard headed clients regarding the importance
The client prefer private clinic for delivery
N/A
Total

1
3
1
1
6

Reasons for non-difficulty

Depends on the client's choice (e.g., convenience)

Total

85.0%
100.0%

(9) Difficulty in conducting the activity: Convincing the postpartum women for postnatal check-ups
Yes
6
15.0%
No
34
85.0%
Total
40
100.0%
Reasons for difficulty
Hard headed clients regarding the importance
Financial problem of the client (e.g., transportation)
Total

2
1
3

*3 respondents (Group B) did not specify the reason or not applicable answer.

Interview with CHT Volunteers (Ormoc)

(10) Confidence with the knowledge and skills to give health education to the client
Very confident
24
Confident
16
Not confident
0
Total
40
(11) Workload
Too much
A little too much
Just enough
Not enough

60.0%
40.0%
0.0%
100.0%

15
12
13
0
40

37.5%
30.0%
32.5%
0.0%
100.0%

(1) Satisfaction of the Support given to CHT volunteers: LGUs/Mayor


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

13
20
3
4
40

32.5%
50.0%
7.5%
10.0%
100.0%

Reasons for dissatisfaction


No financial support received from the city
Not adequate support from the city
No participation in CHT meeting by the LGU/City
No answer
Total

4
1
1
1
7

Reasons for very satisfied


Contended of the support by the mayor
Increased the monetary budget or provide incentives
Provision of support through medicines and items/transportation
No answer
Total

8
3
2
0
13

(2) Satisfaction of the Support given to CHT volunteers: MHO/MO


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

21
16
1
1
39

Total

3. Support System to CHT activities

53.8%
41.0%
2.6%
2.6%
100.0%

*1 respondent (Group B) has no answer

Reasons for dissatisfaction


Support is not adequate
No answer
Total

1
1
2

Reasons for very satisfied


Supportive
Provide updates and advice on the work
Active on the work
Provide medicines to the Client
Total

9
8
3
1
21

Interview with CHT Volunteers (Ormoc)

(3) Satisfaction of the Support given to CHT volunteers: PHN


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

27
11
1
0
39

69.2%
28.2%
2.6%
0.0%
100.0%

*1 respondent (Group B) has no answer

Reasons for dissatisfaction


PHN is not satisfied with the work by CHT volunteers
Total

1
1

(4) Satisfaction of the Support given to CHT volunteers: Midwife


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

31
8
0
0
39

79.5%
20.5%
0.0%
0.0%
100.0%

24
14
1
0
39

61.5%
35.9%
2.6%
0.0%
100.0%

(6) Satisfaction of the Support given to CHT volunteers: Barangay Captains


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

20
13
5
2
40

50.0%
32.5%
12.5%
5.0%
100.0%

Reasons for dissatisfaction


No support/financial incentive given to CHT volunteers
Barangay Captain does not respond to CHT's request of assistance
No answer
Total

4
1
2
7

(7) Satisfaction of the Support given to CHT volunteers: Community members


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

21
17
1
0
39

*1 respondent (Group B) has no answer

(5) Satisfaction of the Support given to CHT volunteers: NDP


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total
*1 respondent (Group B) has no answer
* No reason was provided for "Not satisfied" (Group B)

53.8%
43.6%
2.6%
0.0%
100.0%

*1 respondent (Group B) has no answer


* The reason for "Not satisfied" (Group B) is not applicable

(8) Others who support CHT volunteers


JICA incentive
Total

1
1

*Client mentioned "dissatisfied" on JICA incentive while JICA does not provide any incentives (aside logistics) to CHT volunteers

Interview with CHT Volunteers (Ormoc)

(9) Availability of honorarium/incentives/collateral or any form of incentives


Yes
No
Total

39
1
40

97.5%
2.5%
100.0%

(10) Honorarium/Incentives received from DOH


Yes
No
Total

31
9
40

77.5%
22.5%
100.0%

(11) Types of honorarium/incentives received from DOH (Multiple answers)


Monetary
PhilHealth enrollment
Transportation allowance
In-kind (T-shirts, medical kits)
Total

30
1
0
2
33

90.9%
3.0%
0.0%
6.1%
100.0%

(12) Honorarium/Incentives received from PhilHealth


Yes
No
Total

28
12
40

70.0%
30.0%
100.0%

(13) Types of honorarium/incentives received from PhilHealth (Multiple answers)


Monetary
26
PhilHealth enrollment
1
Transportation
1
In-kind
0
Total
28

92.9%
3.6%
3.6%
0.0%
100.0%

(14) Honorarium/Incentives received from Barangay LGU


Yes
No
Total

72.5%
27.5%
100.0%

29
11
40

(15) Types of honorarium/incentives received from Barangay LGU (Multiple answers)


Monetary
20
Transportation
15
Total
35
(16) Details of monetary incentives from Barangay (N=20)
(mean)
(range)

415.8
(50----900)

(17) Details of transportation allowance from Barangay (N=15)


P50
P150
P300
P366
P700
Unknown
Total

1
2
2
1
1
8
15

(18) Source of transportation allowance provided by barangay


Barangay IRA
Total

15
15

10

57.1%
42.9%
1

per time

Interview with CHT Volunteers (Ormoc)

(19) Honorarium/Incentives received from City LGU


Yes
No
Total

18
22
40

45.0%
55.0%
100.0%

(20) Types of honorarium/incentives received from Municipal/City LGU (Multiple answers)


Monetary
18
PhilHealth enrollment
0
Transportation
0
In-kind
0
Other
1
Total
19

94.7%
0.0%
0.0%
0.0%
5.3%
100.0%

*Other: BNS position

4. Satisfaction with CHT work and management


(1) Perceived recognition of the importance of their work by others: Doctor
Strongly agree
Agree
Disagree
Strongly disagree
Not applicable
Total

28
12
0
0
0
40

Reasons for strongly agree/agree (Multiple answers)


Acknowledge the work of CHT volunteers
Give assistance to or accomodated request by CHT volunteers
Accomodates referrals by CHT volunteers (even night time)
Coaching and mentoring CHT volunteers on knowledge/skills
Assist CHT volunteers to receive incentives
Not applicable
No answer
Total

4
6
3
12
1
1
12
39

(2) Perceived recognition of the importance of their work by others: Nurse


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable
Total

29
11
0
0
0
40

Reasons for strongly agree/agree (Multiple answers)


Give assistance or support to CHT volunteers (e.g., regular visit to
barangay)
Cooperative with CHT volunteers
Accomodates referrals by CHT volunteers
Coaching and mentoring CHT volunteers on knowledge/skills
No answer
Total

1
5
18
11
43

(3) Perceived recognition of the importance of their work by others: Midwife


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable
Total

31
9
0
0
0
40

11

70.0%
30.0%
0.0%
0.0%
0.0%
100.0%

72.5%
27.5%
0.0%
0.0%
0.0%
100.0%

77.5%
22.5%
0.0%
0.0%
0.0%
100.0%

Interview with CHT Volunteers (Ormoc)

Reasons for strongly agree/agree (Multiple answers)


Guideing, coaching and mentoring CHT volunteers on knowledge/skills
Give assistance or support to CHT volunteers (e.g., regular visit to
barangay)
Aknowldge the work of CHT volunteers
Accomodates referrals by CHT volunteers
Dedicated/patient
Counterpart of CHT volunteers (respectful to each other)
Treat CHT volunteers well
No answer
Total

18
7
1
2
1
4
1
9
43

(4) Perceived recognition of the importance of their work by others: Clients/mothers


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable

22
15
3
0
0
40

Total
Reasons for strongly agree/agree (Multiple answers)
Supportive and cooperative with CHT volunteers
Learn and follow advices of CHT volunteers
Seek advice and support from CHT volunteers
Sometime not cooperative
They need to be reminded by CHT volunteers
Appreciate CHT volunteer's work
No answer
Total

14
9
2
2
0
2
13
42

Reasons for strongly disagree/disagree


The clients/mothers are hard headed
No answer
Total

1
2
3

(5) Perceived recognition of the importance of their work by others: Community


Strongly agree
20
Agree
18
Disagree
2
Strongly disagree
0
Not applicable
0
Total
40
Reasons for strongly agree/agree (Multiple answers)
Supportive and cooperative with CHT volunteers
Learn and follow advices of CHT volunteers
Seek advice and support from CHT volunteers
Appreciate/acknowledge CHT volunteer's work
No answer
Total

14
3
1
2
17
37

Reasons for disagree/strongly disagree


Community members are sarcastic
No answer
Total

1
1
2

12

55.0%
37.5%
7.5%
0.0%
0.0%
100.0%

50.0%
45.0%
5.0%
0.0%
0.0%
100.0%

Interview with CHT Volunteers (Ormoc)

(6) Perceived recognition of the importance of their work by others: Barangay officials
Strongly agree
22
Agree
13
Disagree
3
Strongly disagree
1
Not applicable
0
Total
39

56.4%
33.3%
7.7%
2.6%
0.0%
100.0%

*1 respondent (Group A) has no answer

Reasons for strongly agree/agree (Multiple answers)


Supportive and cooperative with CHT volunteers
Encourage CHT volunteers to attend trainings/seminars (provision of
transportation allowance)
Accomodating with CHT volunteers' request
Acknowledge the work of CHT volunteers
Assist logistic needs (e.g., allowance, office supply)
Some are not that supportive or cooperative
No answer
Total
Reasons for disagree/strongly disagree
Not supportive at all
Does not show any respect to CHT work
No answer
Total

15
1
3
2
1
2
13
37

1
1
2
4

(7) Perceived recognition of the importance of their work by others: Municipal/City officials
Strongly agree
9
Agree
24
Disagree
3
Strongly disagree
2
Not applicable
2
Total
40
Reasons for strongly agree/agree (Multiple answers)
Supportive and cooperative on the needs of CHT volunteers
Supportive financially
Acknowledge the work of CHT volunteers
Monitor CHT volunteers' work
Not always supportive
No answer
Total

6
2
2
1
1
21
33

Reasons for disagree/strongly disagree


No financial support provided for CHT work
No answer
Total

2
3
5

(8) Availability of adequate resources in supporting the client


Strongly agree
Agree
Disagree
Strongly disagree
Total

16
22
2
0
40

Necessary resources (N=2)


(among who answered Disagree/Strongly disagree)
Permanent supplies (e.g., medicine, logistics and forms)
No answer
Total

1
1
2

13

22.5%
60.0%
7.5%
5.0%
5.0%
100.0%

40.0%
55.0%
5.0%
0.0%
100.0%

Interview with CHT Volunteers (Ormoc)

(9) Factors affecting the performance as a CHT volunteer (Multiple answers)


Lack of training
Availability of monetary incentives
Attitude of community/client
Availability of IEC materials
Availability of logistics
Supervision by health workers
Weather
Conflict of schedule with other priorities or family
Distance
Health condition
Health education
Client's demand
CHT's attitude towards work/the client
Total

13
13
11
12
7
5
1
9
0
6
1
1
1
80

16.3%
16.3%
13.8%
15.0%
8.8%
6.3%
1.3%
11.3%
0.0%
7.5%
1.3%
1.3%
1.3%
100.0%

(10) Experiences spending out of pocket money on work related to CHT activities (N=35)
Yes
33
No
1
Total
34

97.1%
2.9%
1

*1 respondent (Group A) has no answer

(11) Expenses for out-of-pocket money spending (Multiple answers) (N=33)


Transportation cost to attend/report to health center
Transportation cost for home visits
Transportation cost to accompany/refer the client
Transportation (other: training/unknown)
Communication costs (texts/calls)
Purchase of logistics (forms/umbrella etc)
Purchase of medicines/food for the patient
Contribution for lunch/snack/Christmas party
Unknown
Total

29
12
22
4
9
13
3
4
1
97

29.9%
12.4%
22.7%
4.1%
9.3%
13.4%
3.1%
4.1%
1.0%
100.0%

(12) Suggested improvement for better performance by CHT volunteers (Multiple answers)
30
Training
15
Provision of monetary incentives
9
Provision of IEC materials
6
Provision of other logistics
13
Supervision by health workers
5
Health education
Availability of medicines
1
Exact time to the client
2
Good health condition
1
Increased number of CHT volunteers
1
Total
82

36.6%
18.3%
11.0%
7.3%
15.9%
6.1%
1.2%
2.4%
1.2%
1.2%
100.0%

(13) Factors motivating the performance of CHT volunteers (Multiple answers)


Commitment to serve
Knowledge enhancement
Means of income
Benefits availment
Awards
Recognition by community
Enjoyment of work
Reporting
Total

37.2%
28.7%
6.4%
7.4%
2.1%
13.8%
2.1%
2.1%
100.0%

14

35
27
6
7
2
13
2
2
94

Interview with CHT Volunteers (Ormoc)

(14) Willingness to continue CHT work after the termination of incentives by the DOH
3
Yes
1
No
2
Unknown
Total
6

50.0%
16.7%
33.3%
100.0%

(15) Opinion on whether CHT work can make a difference in the health of mothers and baby
40
Yes
0
No
Total
40

100.0%
0.0%
100.0%

15

Interview with CHT Volunteers (Ormoc)

5. Good practices/innovative methods used to promote work of CHT volunteers (Multiple answers) (N=40)
Maintaining positive/approachable attitude to the work and the client
Unity among the CHT volunteers to work as a team
Sharing ideas and cooperative with others
Consulting mothers (especially after they gave a birth)
Patience
Convincing power to the client
Consulting client's husband
Be punctual on time/Good time management skills
Providing quality service
Provide additional service to the client (e.g., massage or BP check-up)
Willingness to learn more
None
Not applicable
TOTAL
6. Challenges or difficultes experienced by CHT volunteers (Multiple answers) (N=40)
Prioritizing CHT tasks due to financial difficulty or other responsibility to engage in work
Lack of tools or logistics (e.g., forms, stationery)
Weather condition (e.g., rain)
Lack of incentives
Lack of cooperation by the client/community
Inadequacy of the skill or knowledge to perform required CHT task
Lack of transportation or allowance for transportation/distance to the catchment/health center
Health condition
Lack of assistance/supervision by the midwife/NDP
Workload
Changes in rules or policy every year
Safety in the catchment area (e.g., dog)
None
TOTAL

8
8
8
5
3
2
1
1
1
1
1
1
5
45

6
1
10
2
15
8
10
5
1
1
1
1
3
64

Interview with CHT Volunteers (Ormoc)

7. The most important matters to make CHT work successful (Multiple answers) (N=40)
Giving full support to the client and family/commitment on serving for the community
Performing required task such as tracking, home visiting and report submission
Team work/cooperation with others
Financial support
Patience
Equipped with necessary materials/logistics
Good health condition
Proper training
Supervision on CHT's task
Man power to serve the community
TOTAL

17
13
3
1
9
3
4
2
1
1
54

Interview with CHT Volunteers (Ormoc)

Results of the interviews with CHT volunteers in Leyte (ALL)


Total number of respondents: 60 people (30 people in high performing RHUs; 30 people in low performing RHUs)
1. Socio-demographic Data of the Respondent
(1) Gender
Female
Male
Total

59
1
60

(2) Age
(mean )
(range)

98.3%
1.7%
100.0%

479.32
(26------66)

(3) Breakdown of the age


30 years old or below
31-40 years old
41-50 years old
51-60 years old
61 years old or more
Total

3
16
21
16
4
60

5.0%
26.7%
35.0%
26.7%
6.7%
100.0%

Total

3
3
49
1
4
60

5.0%
5.0%
81.7%
1.7%
6.7%
100.0%

(4) Marital Status


Single
Common Law Spouse
Married
Separated
Widow

(5) Educational Attainment


(mean )
(range)

9.33 2.45
(3------14)

(6) Breakdown of the Educational Attainment


0-3 years (Grade 3)
4-6 years (Grade 6)
7-10 years (High school)
11 years or more (College)
Total

1
8
38
13
60

1.7%
13.3%
63.3%
21.7%
100.0%

Total

8
34
1
5
1
1
3
1
1
1
2
1
1
60

13.3%
56.7%
1.7%
8.3%
1.7%
1.7%
5.0%
1.7%
1.7%
1.7%
3.3%
1.7%
1.7%
91.7%

(8) Work aside from CHT volunteer


Yes with paid work
Yes without paid work
No
Total

25
6
29
60

41.7%
10.0%
48.3%
100.0%

(7) Position
None
BHW
BSPO
BNS
Parent Leader
Barangay Kagawad
BHW/BNS
BHW/BNS/Kagawad
BHW/BNS/Day Care Worker
BHW/BSPO
BHW/Kagawad
BHW/Parent Leader
Daycare Worker

Interview with CHT Volunteers (Leyte)

(9) Details of paid work


BNS/BHW/Kagawad
Day Care Worker
Private Business
Vendor
Street Sweeper
Maintenance
Piggery
Unknown

14
2
2
2
1
1
2
1
25

56.0%
8.0%
8.0%
8.0%
4.0%
4.0%
8.0%
4.0%
100.0%

18
9
18
2
5
3
1
1
57

31.6%
15.8%
31.6%
3.5%
8.8%
5.3%
1.8%
1.8%
100.0%

3
40
11
2
2
2
60

5.0%
66.7%
18.3%
3.3%
3.3%
3.3%
1

Total

20
9
17
14
60

33.3%
15.0%
28.3%
23.3%
100.0%

Total

26
33
59

44.1%
55.9%
100.0%

Total
(10) Main Source of Income
Family's income (e.g., husband/children)
Sari-Sari Store
Farming/gardening/shell gathering
Labor/house keeper
Food vendors/dress making
Own business
Botika ng barangay
BHW
Total
*2 respondents in Group A and 1 respondent in Group B have no answer.

(11) Monthly Household Income


Less than Php 1,000
1,000 to 3,999
4,000 to 6,999
7,000 to 9,999
10,000 to 14,999
15,000 and above
Total
(12) PhilHealth Membership
Yes with ID
Yes without ID
No, but beneficiary
No

(13) 4P's Membership


Yes
No
*1 respondent in Group A has no answer

(14) Length of service as a CHT volunteer


(mean )
(range)

3.7 1.3
(0.2------6)

(15) Breakdown of the length of working years as a CHT volunteer


Less than 1 year
1-2 years (less than 2 years)
2-3 years (less than 3 years)
3-4 years (less than 4 years)
4-5 years (less than 5 years)
5 years or more
Total

5
0
6
7
29
13
60

years

8.3%
0.0%
10.0%
11.7%
48.3%
21.7%
100.0%

Interview with CHT Volunteers (Leyte)

(16) Reason for becoming a CHT volunteer


Through recommendation
Recruitment
Self-volunteered
Total

28
26
6
60

46.7%
43.3%
10.0%
100.0%

(17) Person who recommended/recruited CHT volunteers (N=26; N=28)


Barangay Captain
Midwife
MHO/MO
NDP
Other CHT/BHW
Unknown
Total

20
23
4
1
3
3
54

37.0%
42.6%
7.4%
1.9%
5.6%
5.6%
100.0%

(18) Working hours as a CHT volunteer per week


(mean )
(range)

7.215.09
(1------30)

(19) Number of households in catchment area (1)


(mean )
(range)

65.27 44.94
(21------200)

hours/week

HHs

(20) Breakdown of HHs in catchment area (2)


1-20 households
21-50 households
51-100 households
101-150 households
151-200 households
Total

0
33
17
6
4
60

0.0%
55.0%
28.3%
10.0%
6.7%
100.0%

(21) Means of Transportation going to the furthest catchment area


By walking
Motorcycle (habal-habal)
Tricycle
Jeepney
Multicab
Pedicab
By walking and motor
By walking and boat
Total

49
1
2
0
0
2
5
1
60

81.7%
1.7%
3.3%
0.0%
0.0%
3.3%
8.3%
1.7%
100.0%

(22) Travel time from house to the furthest catchment (1)


(mean )
(range)

19.3815.42
(1------65)

minutes

*3 respondents (Group B) have no answer and 1 respondent's answer (Group B) not applicable

(23) Breakdown of travel time from house to the furthest catchment (2)
0-15 minutes
16-30 minutes
31-45 minutes
46-60 minutes
61-90 minutes
Total

30
20
3
2
1
56

(24) Cost of Transportation (one way) among those who use public/private transportation
(mean )
17.7322.29
(range)
(0------70)

53.6%
35.7%
5.4%
3.6%
1.8%
100.0%

pesos

Interview with CHT Volunteers (Leyte)

(25) Means of Transportation going to the assigned barangay health center


By walking
Motorcycle (habal-habal)
Tricycle
Jeepney
Multicab
Pedicab
By walking and motorcycle
By walking and pedicab
Motorcycle and pedicab
Total
(26) Travel time from house to the assigned barangay health center (1)
(mean )
(range)

34
15
2
0
0
3
4
1
1
60

17.6317.68
(1------90)

56.7%
25.0%
3.3%
0.0%
0.0%
5.0%
6.7%
1.7%
1.7%
100.0%

minutes

*3 respondents (Group B) have no answer

(27) Breakdown of travel time from house to the assigned barangay health center (2)
0-15 minutes
36
16-30 minutes
14
31-45 minutes
2
46-60 minutes
4
61-90 minutes
1
Total
57

63.2%
24.6%
3.5%
7.0%
1.8%
100.0%

(28) Cost of Transportation (one way) among those who use public/private transportation (N=25)
(mean )
20.7238.35
pesos
(range)
(5------200)

2. Information regarding CHT activities


(1) Have you received training on CHT program?
Yes
No
Total
(2) Activities conducted by CHT volunteers (Multiple answers)
Tracking of pregnant women
Health education
Submission of report
Supporting outreach activiteis
Referral of the client
Tracking of postpartum women and newborns
Home visits
Reporting to health center
Attending a regular meeting
Assisting health workers at health center
Attending barangay activities
Assisting to make a birth plan
Not specified
Total

59
1
60

98.3%
1.7%
100.0%

56
46
23
16
23
43
51
18
23
7
5
1
1
313

17.9%
14.7%
7.3%
5.1%
7.3%
13.7%
16.3%
5.8%
7.3%
2.2%
1.6%
0.3%
0.3%
100.0%

(3) Perceived importance of the tools to promote utilization of health service by the client
1) Pregnancy Tracking Form
Very important
49
Important
10
Somewhat important
1
Not important
0
0
Not applicable
Total
60

81.7%
16.7%
1.7%
0.0%
0.0%
100.0%

*The most common reason for importance is that it is the tool for CHT volunteers to monitor the client throughout the course of her
pregnancy.

Interview with CHT Volunteers (Leyte)

2) Postpartum & Newborn Tracking Form


Very important
Important
Somewhat important
Not important
Not applicable
Total
3) CHT Monthly Report
Very important
Important
Somewhat important
Not important
Not applicable
Total

41
19
0
0
0
60

68.3%
31.7%
0.0%
0.0%
0.0%
100.0%

31
27
1
0
0
59

52.5%
45.8%
1.7%
0.0%
0.0%
100.0%

*1 respondent (Group A) has no answer


*The most common reason for importance is that it is a tool for midwife and NDP to monitor the activity done by CHT volunteers.

4) MC book
Very important
Important
Somewhat important
Not important
Not applicable

47
12
0
0
0
59

Total

79.7%
20.3%
0.0%
0.0%
0.0%
100.0%

*1 respondent (Group A) has no answer


*The most common reasons for importance includes record of immunization for the baby, monitoring tools for the client and baby, birth
and emergency plan and record of home visits.

5) Reference Guide for MC book


Very important
Important
Somewhat important
Not important
Not applicable
Total

25
19
1
0
13
58

43.1%
32.8%
1.7%
0.0%
22.4%
100.0%

*2 respondents (Group A) have no answer


*The most common reasons for importance include easy tools to calculate LMP/EDD and to identify necessary information on MC book
to be given during home visits

6) Health Use Plan


Very important
Important
Somewhat important
Not important
Not applicable
Total

15
19
4
0
21
59

25.4%
32.2%
6.8%
0.0%
35.6%
100.0%

58
1
59

98.3%
1.7%
100.0%

51
7
58

87.9%
12.1%
100.0%

*1 respondent (Group A) has no answer

(4) Attendance to the CHT meeting at barangay health station


Yes
No
Total
*1 respondent (Group B) has no answer

(5) Frequency of attendance to the CHT meeting


Once a month
Once every 2 month
Total

Interview with CHT Volunteers (Leyte)

(6) Difficulty in conducting the activity: Identifying the pregnant women in the early stage of pregnancy
Yes
15
25.0%
No
45
75.0%
Total
60
100.0%
Reasons for difficulty
The pregnant women hide or deny her pregnancy
Some clients can not be identified by appearance
Lack of technical skills to identify the pregnant woman
No answer
Total

11
1
2
1
15

Reasons for having no difficulty


Physical appearance/Symptoms
Information from community or neighbors
Total

6
3
9

(7) Difficulty in conducting the activity: Convincing the client for prenatal-checkup
Yes
6
No
54
Total
60
Reasons for difficulty
The client is not cooperative
The client is just being lazy
Lack of money for transportation
Total

4
1
1
6

Reasons for having no difficulty


Skills of giving health education/encouragement
The client's trust on CHT and their cooperation
Total

3
3
6

10.0%
90.0%
100.0%

(8) Difficulty in conducting the activity: Convincing the pregnant women for Facility-Based Delivery
Yes
8
No
Total

13.3%

52

86.7%

60

100.0%

Reasons for difficulty


Financial problem of the client (e.g., transportation)
Hard headed clients regarding the importance
Total

5
3
8

Reasons for having no difficulty


Emphasis during the prenatal visits
Requirement by 4P's beneficiary
Ordinance
Good relationship with the client
Total

3
1
1
1
6

(9) Difficulty in conducting the activity: Convincing the postpartum women for postnatal check-ups
Yes
3
No
56
Total
59

5.1%
94.9%
100.0%

*1 respondent (Group B) has no answer

Reasons for difficulty


Financial problem of the client (e.g., transportation)
Total

3
3

Interview with CHT Volunteers (Leyte)

Reasons for having no difficulty


Client's attend the check-up on her own/cooperative
CHT accompnys the client for check-up
CHT follows-up on her schedule
Total

4
1
1
6

(10) Confidence with the knowledge and skills to give health education to the client
Very confident
28
Confident
32
Not confident
0
Total
60
(11) Workload
Too much
A little too much
Just enough
Not enough

46.7%
53.3%
0.0%
100.0%

5
21
32
2
60

8.3%
35.0%
53.3%
3.3%
100.0%

(1) Satisfaction of the Support given to CHT volunteers: LGUs/Mayor


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

15
34
9
2
60

25.0%
56.7%
15.0%
3.3%
100.0%

Reasons for dissatisfaction


Late implementation of provision of incentives
No incentives/travel allowance for the meeting
No or inconsistent support
No answer
Total

1
2
3
5
11

(2) Satisfaction of the Support given to CHT volunteers: MHO/MO


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

19
37
4
0
60

Reasons for dissatisfaction


There are times that CHT volunteers dont feel MHO's presence
No answer
Total

1
3
4

(3) Satisfaction of the Support given to CHT volunteers: PHN


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

17
39
1
1
58

Total

3. Support System to CHT activities

31.7%
61.7%
6.7%
0.0%
100.0%

29.3%
67.2%
1.7%
1.7%
100.0%

*2 respondents (Goup A) have no answer


*No reasons were provided for not satisfied/dissatisfied.

Interview with CHT Volunteers (Leyte)

(4) Satisfaction of the Support given to CHT volunteers: Midwife


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

26
31
0
0
57

45.6%
54.4%
0.0%
0.0%
100.0%

16
39
3
0
58

27.6%
67.2%
5.2%
0.0%
100.0%

14
36
4
1
55

25.5%
65.5%
7.3%
1.8%
100.0%

*1 respondent (Group A) and 2 respondents (Group B) have no answer

(5) Satisfaction of the Support given to CHT volunteers: NDP


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total
*2 respondents (Group A and Group B) have no answer
*No reasons were provided for not satisfied/dissatisfied.

(6) Satisfaction of the Support given to CHT volunteers: Barangay Captains


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total
*4 respondents (Group A) and 1 respondent (Group B) have no answer

Reasons for dissatisfaction


No support given to CHT volunteers
No answer
Total

2
3
5

(7) Satisfaction of the Support given to CHT volunteers: Community members


Very Satisfied
Somewhat Satisfied
Not Satisfied
Dissatisfied
Total

8
48
2
0
58

13.8%
82.8%
3.4%
0.0%
100.0%

*2 respondents (Group A and Group B) have no answer


*No reasons were provided for not satisfied/dissatisfied.

(8) Others who support CHT volunteers


Barangay Kagawad
Co-CHT/BHW/BNS
Family
Teacher
Total

2
2
2
0
6

(9) Availability of honorarium/incentives/collateral or any form of incentives


Yes
No
Total

53
7
60

88.3%
11.7%
100.0%

(10) Honorarium/Incentives received from DOH


Yes
No
Total

30
30
60

50.0%
50.0%
100.0%

Interview with CHT Volunteers (Leyte)

(11) Types of honorarium/incentives received from DOH (Multiple answers)


Monetary
PhilHealth enrollment*
Transportation allowance*
In-kind
Other
Total

29
2
1
3
0
35

82.9%
5.7%
2.9%
8.6%
0.0%
100.0%

*According to the DOH RO8, no PhilHealth enrollement or transportation allowance were given to the CHT volunteer

(12) Details of monetary incentives from the DOH


(mean)
(range)

1,643.3
(1,000----3,000)

pesos per time

*According to the DOH RO8, only Php 250/month has been released to CHT volunteers

(13) Breakdown of In-Kind/Others (N=3)


T-shirts, CHT bag, umbrella, CHT handbook

(14) Honorarium/Incentives received from PhilHealth


Yes
No
Total

9
51
60

15.0%
85.0%
100.0%

(15) Types of honorarium/incentives received from PhilHealth (Multiple Answers)


Monetary
7
PhilHealth enrollment
5
Transportation
0
In-kind
2
Other
1
Total
15

46.7%
33.3%
0.0%
13.3%
6.7%
100.0%

(16) Details of monetary incentives from PhilHealth (N=7)


Php 239.00
Php 300.00
Php 500.00
Php 3,000.00
Php 6,400.00
Total

1
3
1
1
1
7

(17) Breakdown of In-Kind/Other (N=3)


T-shirts, umbrella

Sponsoring food and accomodation during seminar/christmas party

(18) Honorarium/Incentives received from Barangay LGU


Yes
No
Total

46
14
60

(19) Types of honorarium/incentives received from Barangay LGU (Multiple answers)


Monetary
39
PhilHealth enrollment
1
Transportation
21
In-kind
2
Other
0
Total
63
(20) Details of monetary incentives from Barangay
(mean)
(range)

596.2
(200----1,500)

76.7%
23.3%
100.0%

61.9%
1.6%
33.3%
3.2%
0.0%
1

pesos per month

Interview with CHT Volunteers (Leyte)

(21) Details of transportation allowance from Barangay


(mean)
(range)
Unknown amount

169.4
(50----300)
9

(22) Source of transportation allowance provided by barangay


Barangay IRA
Unknown
Total

16
5
21

(23) Breakdown of In-Kind/Other (N=2)


Stationary (e.g., paper, pen)
Unkown

1
1

(24) Honorarium/Incentives received from Municipal/City LGU


Yes
No
Total

5
55
60

(25) Types of honorarium/incentives received from Municipal/City LGU (Multiple answers)


Monetary
4
PhilHealth enrollment
1
Transportation
0
In-kind
1
Other
1
Total
7
(26) Details of monetary incentives from Municipal LGU
Php 214.00
Php 500.00
Total

2
2
4

(27) Breakdown of In-Kind/Other (N=2)


Token during Christmas party
Relief goods

1
1

(28) Honorarium/Incentives received from Provincial LGU


Yes
No
Total

3
57
60

(29) Types of honorarium/incentives received from Provincial LGU (Multiple answers)


Monetary
2
PhilHealth enrollment
0
Transportation
1
In-kind
1
Other
0
Total
4

per time
respondents

8.3%
91.7%
100.0%

57.1%
14.3%
0.0%
14.3%
14.3%
1

5.0%
95.0%
100.0%

50.0%
0.0%
25.0%
25.0%
0.0%
1

*According to PHO, no monetary or transportation allowance were given to CHT volunteers; they are likely done by Municipal LGUs

(30) Details of monetary incentives from Provincial LGU


Php 180.00/ month
Php 525.00/month
Total

1
1
2

(31) Details of transportation allowance from Provincial LGU


Php 500.00 during the convention

(32) Breakdown of In-Kind/Other (N=1)


T-shirt

10

Interview with CHT Volunteers (Leyte)

(33) Honorarium/Incentives received from Other


Yes
No
Total

0
60
60

0.0%
100.0%
100.0%

(1) Perceived recognition of the importance of their work by others: Doctor


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable
Total

29
28
3
0
0
60

48.3%
46.7%
5.0%
0.0%
0.0%
100.0%

Reasons for strongly agree/agree


Treat CHTs as part of their team at health facility
Acknowledge the work of CHT volunteers
Give assistance to or accomodated request by CHT volunteers
Accomodates referrals by CHT volunteers (even night time)
Coaching and mentoring CHT volunteers on knowledge/skills
Provide travel allowance
Not applicable
No answer
Total

9
6
12
4
4
1
1
22
59

Reasons for disagree/strongly disagree


Not supportive
No formal education
No answer
Total

1
1
1
3

(2) Perceived recognition of the importance of their work by others: Nurse


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable
Total

17
37
3
0
3
60

4. Satisfaction with CHT work and management

Reasons for strongly agree/agree


Acknowledge the work of CHT volunteers
Give assistance or support to CHT volunteers (e.g., regular visit to
barangay)
Cooperative with CHT volunteers
Accomodates referrals by CHT volunteers
Coaching and mentoring CHT volunteers on knowledge/skills
Trust between PHN and CHT volunteers
No answer
Total

2
1
3
2
34
54

Reasons for disagree/strongly disagree


Sometime no attention to CHT volunteers
Does not recognize the task of BHW
No answer
Total

1
1
1
3

11

28.3%
61.7%
5.0%
0.0%
5.0%
100.0%

3
9

Interview with CHT Volunteers (Leyte)

(3) Perceived recognition of the importance of their work by others: Midwife


Strongly agree
Agree
Disagree
Strongly disagree
Not applicable

29
31
0
0
0
60

Total
Reasons for strongly agree/agree
Guideing, coaching and mentoring CHT volunteers on
knowledge/skills
Give assistance or support to CHT volunteers (e.g., regular visit to
barangay)
Aknowldge the work of CHT volunteers
Provide necessity (e.g., materials, advice)
Dedicated/patient
Counterpart of CHT volunteers
Coordinate the work with CHT volunteers
Treat CHT volunteers well
Follow-up on CHT volunteers if any problem
Never had a problem
No answer
Total

48.3%
51.7%
0.0%
0.0%
0.0%
100.0%

15
8
3
3
3
1
1
1
1
1
26
63

(4) Perceived recognition of the importance of their work by others: Clients/mothers


Strongly agree
20
Agree
33
Disagree
6
Strongly disagree
0
Not applicable
0
Total
59

33.9%
55.9%
10.2%
0.0%
0.0%
100.0%

*1 respondent (Group A) has no answer

Reasons for strongly agree/agree


Supportive and cooperative with CHT volunteers
Learn and follow advices of CHT volunteers
Seek advice and support from CHT volunteers
Sometime not cooperative
They need to be reminded by CHT volunteers
Appreciate CHT volunteer's work
No answer
Total

13
5
2
1
1
4
28
54

Reasons for disagree/strongly disagree


The client feels envy towards CHT volunteers
No answer
Total

1
5
6

(5) Perceived recognition of the importance of their work by others: Community


Strongly agree
11
Agree
44
Disagree
3
Strongly disagree
0
Not applicable
0
Total
58

19.0%
75.9%
5.2%
0.0%
0.0%
100.0%

*2 respondents (Group A and Group B) have no answer

12

Interview with CHT Volunteers (Leyte)

Reasons for strongly agree/agree


Supportive and cooperative with CHT volunteers
Learn and follow advices of CHT volunteers
Seek advice and support from CHT volunteers
Sometime not cooperative
They need to be reminded by CHT volunteers
Appreciate/acknowledge CHT volunteer's work
Additional workforce to link with health facility/ assist the pregnant
woman aside from BHWs
No answer
Total
Reasons for disagree/strongly disagree
Many people in the community want to become CHT volunteers and
feel envy towards CHT volunteers
No answer
Total

7
2
2
2
1
2
2
37
55

1
2
3

(6) Perceived recognition of the importance of their work by others: Barangay officials
Strongly agree
13
Agree
39
Disagree
3
Strongly disagree
4
Not applicable
0
Total
59

22.0%
66.1%
5.1%
6.8%
0.0%
100.0%

*1 respondent (Group A) has no answer

Reasons for strongly agree/agree


Supportive and cooperative with CHT volunteers
Encourage CHT volunteers to attend trainings/seminars (provision of
transportation allowance)
Accomodating with CHT volunteers' request
Acknowledge the work of CHT volunteers
Guide CHT volunteers
Some are not that supportive or cooperative
No answer
Total

1
2
1
2
36
52

Reasons for disagree/strongly disagree


Not supportive at all
Remove CHT volunteer's incentives at barangay level
Envy with CHT volunteers
Only limited support given (by the committee on health)
No answer
Total

1
1
1
1
3
7

7
3

(7) Perceived recognition of the importance of their work by others: Municipal/City officials
Strongly agree
4

6.8%

Agree

39

66.1%

Disagree

15

25.4%

Strongly disagree

0.0%

Not applicable
Total

1.7%

59

100.0%

*1 respondent (Group A) has no answer

13

Interview with CHT Volunteers (Leyte)

Reasons for strongly agree/agree


Supportive and cooperative on the needs of CHT volunteers
Provide bonues or gift to CHT volunteers
Acknowledge the work of CHT volunteers
Encourage the work of CHT volunteers
Provide moral support
Not always supportive
No answer
Total

2
1
2
1
1
1
35
43

Reasons for disagree/strongly disagree


Not supportive at all or only limited support
Not familiar with or see the importance of CHT work
No answer
Total

3
3
9
15

(8) Availability of adequate resources in supporting the client


Strongly agree
Agree
Disagree
Strongly disagree
Total

4
45
10
1
60

Necessary resources (N=11)


(among who answered Disagree/strongly disagree)
Financial assistance
Forms/logistics (e.g., stationary)
Medicine
MCB
IEC material
ID/uniform
No answer
Total

5
6
2
1
1
1
2
18

6.7%
75.0%
16.7%
1.7%
100.0%

(9) Factors affecting the performance as a CHT volunteer (Multiple answers)


21
Lack of training
25
Availability of monetary incentives
33
Attitude of community/client
13
Availability of IEC materials
Availability of logistics
16
Supervision by health workers
6
Weather
3
Conflict of schedule with other priorities or family
4
Distance
1
Health condition
3
Politics
1
Support from barangay
1
Support from family
1
Total
128

16.4%
19.5%
25.8%
10.2%
12.5%
4.7%
2.3%
3.1%
0.8%
2.3%
0.8%
0.8%
0.8%
100.0%

(10) Experiences spending out of pocket money on work related to CHT activities (N=37)
Yes
35
No
1
Total
36

97.2%
2.8%
1

*3 respondents (Group A) have no answer

14

Interview with CHT Volunteers (Leyte)

(11) Types of out of pocket money being spent (Multiple answers) (N=35)
Transportation cost to attend/report to health center
Transportation cost for home visits
Transportation cost to accompany/refer the client
Communication costs (texts/calls)
Purchase of logistics (forms/umbrella etc)
Purchase of medicines for the patient
Contribution for lunch/snack/Christmas party
Total

28
5
24
6
23
1
3
90

(12) Suggested improvement for better performance by CHT volunteers (Multiple answers)
44
Training
25
Provision of monetary incentives
19
Provision of IEC materials
23
Provision of other logistics*
16
Supervision by health workers
1
Support from the client
1
More counseling to the client
2
Regular employees and increased number of CHT volunteers
1
Good relationship with co-CHT volunteers and the client
1
Attitude of CHT volunteers (focus/attention to the task)
Total
133

31.1%
5.6%
26.7%
6.7%
25.6%
1.1%
3.3%
100.0%

33.1%
18.8%
14.3%
17.3%
12.0%
0.8%
0.8%
1.5%
0.8%
0.8%
100.0%

*Other logistics: medical equipment at barangay level, logistics for rainy season

(13) Factors motivating the performance of CHT volunteers (Multiple answers)


46
Commitment to serve
30
Knowledge enhancement
7
Means of income
5
Benefits availment
2
Awards
9
Recognition by community
5
Support and relationship with the client/co-workers/family
3
Career advancement
1
Provision of logistics (e.g., umbrella, bag)
1
Health condition
Total
109

42.2%
27.5%
6.4%
4.6%
1.8%
8.3%
4.6%
2.8%
0.9%
0.9%
100.0%

(14) Willingness to continue CHT work after the termination of incentives by the DOH (N=7)
7
Yes
0
No
Total
7

100.0%
0.0%
100.0%

(15) Opinion on whether CHT work can make a difference in the health of mothers and baby
58
Yes
2
No
Total
60

96.7%
3.3%
100.0%

15

Interview with CHT Volunteers (Leyte)

5. Good practices/innovative methods used to promote work of CHT volunteers (Multiple answers) (N=60)
Maintaining positive/approachable attitude to the work and the client
Unity among the CHT volunteers to work as a team
Sharing ideas and cooperative with others
Convincing power to the client
Consulting mothers (especially after they gave a birth)
Be punctual on time/Good time management skills
Establish the network of friends to identify the client
Providing quality service
Provide additional service to the client (e.g., massage or BP check-up)
Duty at health centers
None
Not applicable
TOTAL

6. Challenges or difficultes experienced by CHT volunteers (Multiple answers) (N=58)


Prioritizing CHT task due to financial difficulty or other responsibility to engage in work
Lack of tools or logistics (e.g., forms, stationary)
Weather condition (e.g., rain)
Lack of incentives
Lack of cooperation by the client/community
Inadequacy of the skill or knowledge to perform required CHT task
Lack of transportation or allowance for transportation/distance to the catchment/health center
Health condition
Lack of assistance/supervision by the midwife
Lack of support from family members
Workload
None
TOTAL

15
9
5
5
3
3
2
1
1
1
11
6
62

23
16
9
9
18
12
8
4
1
2
3
4
109

Interview with CHT Volunteers (Leyte)

7. The most important matters to make CHT work successful (Multiple answers) (N=60)
Giving full support to the client and family/commitment on serving for the community
Performing required task such as tracking, home visiting and report submission
Team work/cooperation with others
Financial support
Patience
Equipped with necessary materials/logistics
Good health condition
Proper training
None
TOTAL

25
15
8
5
2
3
2
2
1
63

Interview with CHT Volunteers (Leyte)