CHAPTER I

INTRODUCTION

Background of the study

Covid-19 had rapidly spread all over the world and developed into a pandemic

and it became a sudden public crisis. The virus had mutated giving birth to other variants

that are deadly and highly infectious such as the delta and omicron variants. People

continuously lose their life due to this unseen enemy. To deal with the surge in

community incidents, the government has set up a new community health organization to

support the emergencies caused by the virus. The BHERT is the long-arm of the DOH-

IATF in reaching and responding to the health needs of the community. They are the first

contact and manpower that are readily available 24 hours in the different barangays of the

country. They play a significant role as a first responder to Covid-19 and other health

emergencies in the community. The BHERT is the backbone alongside with the people in

the most challenging time of availing health services especially when there are no

available hospitals and no available quarantine facilities, they stood still to manage

Covid-19 patients and their families in the barangay.

Healthcare is one of the main concerns of the government. The general well-being

and development of the community also depends on the types of services offered

specifically for the health aspect. As a country that wants to improve the welfare of

residents, a concrete health service system from the national government to local

governments is necessary. Therefore, the need for quality and efficient services by the

Government is very important to increase satisfaction in responding to the effectiveness

of the services that people can receive.

 According to the Municipality Health Office (MHO) of Bayombong, Nueva

Vizcaya as of Feb 28, 2022, there have been 3, 767 confirmed cases of Covid-19 with

188 deaths. Which is the highest number of Covid-19 cases in Nueva Vizcaya. Which is

very alarming to the residents in the Municipality. Therefore, it is important for us to

know if BHERTs from different barangays in Bayombong, Nueva Vizcaya are doing

their job properly and fulfilling their responsibilities to prevent, mitigate and contain the

covid-19 within the community for the safety of the residents and students from all levels

especially when face to face classes starts to resume. The purpose of this study is to

identify the level of satisfaction of the residents of Bayombong, Nueva Vizcaya to

determine the effectiveness of services provided by BHERTs by surveying the people of

said Municipality. The questionnaire will assess and determines the level of satisfaction

of the people.

Statement of the problem

This study attempts to assess the level of satisfaction of the residents of

Bayombong, Nueva Vizcaya on the services of Barangay Health Emergency Response

Team.

This study is intended to answer the following questions:

1. How do profile of respondents be described in terms of:

1.1 Age

1.2 Sex

1.3 Civil status

 1.4 Occupation

2. What is the level of satisfaction of residents of Bayombong on the services of

Barangay Health Emergency Response Team.

3. Is there a significant relationship in terms of the respondents and Level of

Satisfaction of residents on the services of Barangay Health Emergency Response

Team on the Covid-19 Pandemic?

Hypothesis

In this study it is assumed that the residents of the barangay Sto. Domingo Proper

are satisfied with the emergency response services on covid-19 pandemic by the BHERT.

There is no significant relationship in terms of the respondents and the level of

satisfaction of residents on the services of Barangay Health Emergency Response Team

on the Covid-19 Pandemic?

Theoretical framework

Figure 1 shows a basic model of Expectation Confirmation Theory.

The most commonly recognized conceptualization of the customer satisfaction

concept is the expectation confirmation theory developed in a series of two papers

authored by Richard L. Oliver in 1997 and 1980. A model has been proposed that
expresses consumer satisfaction as a function of expectations and unconfirmed

expectations. Satisfaction is said to influence changes in attitude and willingness to buy

(Oliver, 1980).

The four main components of the model are expectation, performance,

disconfirmation, and satisfaction (fig 1). Expectations act as comparison anchors for ECT

— what consumers use to evaluate performance and form negative decisions. (Halstead,

1999). Satisfaction started with expectations. Customers are experiencing the

performance and quality of the services they provide, so whether they are satisfied or not,

there is a counter-argument to their beliefs.

Performance is a post-event evaluation by people, Awareness of product quality.

If the product meets or exceeds expectations (confirmation), post-sales satisfaction will

increase. Consumers are probably dissatisfied if the product is below expectations

(disconfirmation) (Spreng, et al., 1996).

In relation to this study, Expectation confirmation theory is more likely to be

relevant to in terms of measuring the level of satisfaction of the residents of Bayombong,

Nueva Vizcaya on the services of BHERTs.

Conceptual Framework

shows the independent variable has reflected on the first box which is the profile of the

respondents and the dependent variable on the second box which is the level of satisfaction on the

emergency response.

Scope and Delimitation

 This study is only limited to measure the level of satisfaction of residents of the

Municipality of Bayombong, Nueva Vizcaya in the services of BHERT. Only the aspects

that were considered relevant in this research will be given emphasis because of the

limited time and resources available to us to complete this study. With that said, the

researchers do not claim to be able to make broad conclusions and generalizations.

Significance of the study

This study will be beneficial to the following:

Residents – This study will benefit the residents through the increase of

knowledge on the different services that the BHERT offers.

- This study will boost their confidence in fighting Covid-19 disease since the BHERT

exist in their barangay to help them.

BHERT – This study will be beneficial for the BHERT to have an idea if the

residents are satisfied with their services and will give them insight if their services must

need to improve in order to satisfy the residents.

School administration - This study will be beneficial to the school

administration to access whether the BHERTs’ are doing their job in preventing the

spread of Covid-19 in Bayombong, Nueva Vizcaya especially when the school is

planning to resume the face-to-face classes. The school administration will have an idea

or knowledge whether to take actions or not in the safetiness of a student or staff in their

home if the data gathered in this study says that BHERT are not doing their job properly

in case any of the students and staffs will be infected by Covid-19.

 Future researchers – This study may serve as a guide in locating reputable and

accurate reference data for them to do a fresh study or have a better understanding of the

topic. In fact, they will undoubtedly use this research as a main source of knowledge in

future investigations.

7 Definition of Terms

For the reader to better understand our study. The researcher defines words

operationally or theoretically.

Level of satisfaction – It is described in this study as whether the person is

contented or not on the performance of the BHERT (operational)

Barangay Health Emergency Response Team (BHERT) - Group composed of

staff assigned by the barangay to directly prevent the spread of Covid-19 in the

community (according to DILG MC No. 2020-023)

Emergency response – In this study it is used to described for the prevention,

mitigation, preparedness for, and containment of the Covid-19 virus by the BHERT.

(operational)

Expectation confirmation theory - Is a cognitive theory which seeks to explain

post-purchase or post-adoption satisfaction as a function of expectations, perceived

performance, and disconfirmation of beliefs (theoretical).

Service quality - In its contemporary conceptualization, is a comparison of

perceived expectations of a service with perceived performance This conceptualization of

service quality has its origins in the expectancy disconfirmation paradigm (theoretical)
 Healthcare - Efforts made to maintain or restore physical, mental, or emotional

well-being especially by trained and licensed professionals (theoretical)

Expectation - Your expectations are your strong hopes or beliefs that something

will happen or that you will get something that you want (theoretical)

Performance - The action or process of carrying out or accomplishing an action,

task, or function (theoretical)

Disconfirmation - Introduction of evidence which conclusively establishes that a

belief or hypothesis is not true or which diminishes the acceptability of a belief or

hypothesis (theoretical)

Satisfaction - An act of satisfying; fulfillment; gratification. the state of being

satisfied; contentment. the cause or means of being satisfied (theoretical).

CHAPTER II

REVIEW OF RELATED LITERATURE

Customer satisfaction

Customer satisfaction is the satisfaction that a customer experiences by using the

service. Therefore, this reflects the gap between the expected service and the service

experience from the customer's perspective. Measuring customer or patient satisfaction

has become an integral part of hospital / clinic management strategies around the world.
In addition, quality assurance and certification processes in most countries require regular

measurement of customer satisfaction (Matthew and Beth, 2001). Asking patients what

they think about the care and treatment they receive is an important step in improving the

quality of care and ensuring that community health services meet their needs. Satisfaction

is a fact that has proven to affect a person's ability to seek medical advice, receive

treatment, and maintain a lasting relationship with a doctor (Westaway et al, 2008)

Customer satisfaction is considered one of the organization's internal measures, its

focus is on meeting customer needs and pointing in the direction of promoting the quality

of products and services. According to Shi et al (2016), customer satisfaction is the state

in which a customer feels that a product’s functionality meets expectations.

Dissatisfaction is also a condition in which a product’s weakness create consumer

dissatisfaction, complaints, and refusals. In other words, customer satisfaction is

customer/consumer product or service consumption or purchase (Maleki and Darabi,

2008). Donabadian (1988) A leading theorist in the field of quality assurance emphasized

that customer satisfaction as a measure of quality of care is fundamental. Customers are

the highest authority.

Based on a study by Dong and Zhang (2017), assessing population satisfaction

with primary care is a complex process. In the mid-20th century, many precedents were

set for assessing medical services based on patient opinions and comments. Satisfaction

is commonly used to assess the medical services a patient receives in the medical setting,

and many factors such as personal health, demographic characteristics, social

psychological factors, and characteristics of the healthcare system. Is affected by. By

improving patient satisfaction, you can promote compliance and improve your health.
Measuring patient satisfaction also includes a variety of indicators from multiple

dimensions, including: Satisfaction with the daily care received, satisfaction with the

information given, and satisfaction with the medical environment. However, there is still

no gold standard method or indicator for measuring patient satisfaction.

Satisfaction is a measure of the similarity between a patient's belief in ideal care

and an observation of the care actually received. Patient satisfaction is the degree to

which the patient is satisfied with his or her medical care, both inside and outside the

medical setting. This gives providers insights into various characteristics of healthcare,

including Level of effectiveness and understanding of care. Understanding the patients,

caregivers, and families from their own perspective is an opportunity to think about the

behavior of healthcare providers (politeness and respect), improving medical services,

and patient outcomes (Deriba et al. 2020).

Service quality
Some authors define service quality based on various theoretical hypotheses. For

example, with Bates and Hubbert (1994) defines quality of service as the customer's

general perception of relative inferiority or superiority complex of organizations and their

services. According to Parasuraman et al (1985), Quality of service as a "global judgment

or attitude towards the superiority of the services provided". The success of all

organizations and institutions, including manufacturing and services, commercial and

non-profit organizations, government and non-governmental organizations, is influenced

by several factors. One of the most important factors to consider for business success is

customer satisfaction. There are five dimensions of service quality: reliability,

responsiveness, assurance, empathy, and tangibility.

 Reliability is the ability to perform promised services accurately and reliably.

failure. Reliable service is the expectation of our customers Services run on time, just like

without every time error. For example, they receive emails at about the same time Tags

are important to a particular person. Reliability extends to the back-office when the

accuracy of billing and record keeping is expected.

Responsiveness is the willingness to assist a customer through prompt delivery.

service. Keeping customers waiting for no apparent reason is Unnecessary negative

perception of quality of service. For services Failure or interruption, service provider

quick recovery capability Professionalism can evoke a very positive perception of quality

service.

Assurance dimensions Refers to customer service knowledge and courtesy Ability

to express confidence and trust with employees. Warranty aspect Includes ability,

courtesy and respect to provide the services provided Effective communication with

customers for their customers, and generally the attitude that the server is in the best

interests of the customer.

Empathy, on the other hand, is the provision of compassion shown through

customer service. Personal and personal customer care. Including empathy Efforts to

understand accessibility, security, and customers' needs.

Tangibility includes physical facilities, equipment, personnel, And

communication materials. Overall state of the physical environment It is a concrete proof

of attention and attention to the details shown by Service provider. The evaluation of this

dimension is other customers served by loud guest Adjacent room to the hotel.
 Achieving customer satisfaction today is one of the basic requirements of quality

management systems and excellence models. Due to the different features, it is difficult

to evaluate and improve quality of service. This requires the use of appropriate tools to

assess the quality of intangible products. In addition, services, not supplies It cannot be

saved or duplicated, and defects cannot be eliminated. Customers are often present at the

time-of-service Provision existing defects and observe them directly. This shows the

sensitivity of the service department to quality improvement. It should be noted that

service activities require a large number of human resources, and it seems impossible to

standardize service quality (Noorolsana et al., 2008).

Broadly speaking, residents and staff share the same environment and many

potentially dangerous factors in that environment, from infectious diseases to the risk of

interpersonal stress and assault. Therefore, it is plausible to assume that workplace

stressors and risks can adversely affect an employee's ability to provide quality care.

However, only a very limited amount of literature examines the link between the

environment of nursing home workers and the processes or consequences of residents.

According to participants in 27 focus groups, nursing assistants who feel stressed, rushed,

unsupported, and underestimated by management find a stressful work environment to be

a non-optimal care for residents (Holmberg et al, 2013).

Barangay Health Emergency Response Team (BHERT)

When SARS occurred in several countries in 2003, the Barangay Health Emergency

Response Team (BHERT) was born out of an urgent need. The Philippine public health system

has been rigorously tested during the SARS outbreak, the Department of Health, especially

Infectious Disease Office of the National Center for Disease Prevention, announced on March
17th. By declaring, we responded early to the unprecedented global health emergency declared by

the World Health Organization. In 2003, we established our own SARS Operations Center

(Baquilod et al. n.d).

Villages across the country (barangays) need to form a barangay health

emergency response team (BHERT) to help governments respond to the crisis caused by

the new coronavirus in 2019 in their communities. The Department of Internal Affairs

and Local Government (DILG) is partnering with the Ministry of Health (DOH) to

strengthen the role of the Barangay Health Emergency Response Team (BHERT), which

helps Filipinos navigate the public health system (DOH, 2020).

According to news on the DILG website, villages across the country (barangays)

have a barangay health emergency response team (barangay) to help governments

address the crisis posed by the new coronavirus in 2019 in their communities. BHERT

needs to be formed. Secretary of Interior and Local Government Eduardo Año said on

Sunday, stressing that “all barangays must be properly informed about the disease and

ready to adopt a protocol to contain it”. Año said that “each barangay chair, or Punong

Barangay (PB), BHERT member consisting of a senior officer, a barangay tanod, and two

barangay health workers, one of whom is a nurse or midwife. He said he had to appoint.

BHERT members must be equipped with protective equipment such as surgical gowns,

goggles, masks and gloves”.

Health emergencies caused by the Covid19 virus are treated by BHERT as an immediate

on-site health frontline for Covid19. BHERT composed of an executive officer who

monitors the work of BHERT. Establish contact with Punong Barangay and other local

governments. Make sure that BHERT has sufficient capacity, equipment, and PPE to
carry out its mission, a barangay tanod that supports the organization of BHERT

activities in the community and maintain peace at all times, two barangay health workers,

if possible, a nurse or midwife helping BHW and other BHERT volunteers with medical

issues, and volunteers - BHW can monitor or perform its role, especially in surge

capacity, and take care of other people in need of primary health care, such as pregnant

women and infants.

Related studies

“Healthcare workers satisfaction and patient satisfaction - where is the linkage?”

Authored by Janicijevic I, Seke K, Djokovic A, Filipovic T. (2013)

This study used a method which data was collected via questionnaire-based surveys, from

18,642 healthcare workers and 9,283 patients across 50 secondary healthcare institutions

in Serbia. Data analysis was based on descriptive statistics, correlations and the I2-

distance method.

Results: Despite the general belief that healthcare worker satisfaction has a significant

impact on patient satisfaction, the research results show that the correlation factor

between these two is relatively low. Despite this, the obtained value of correlation cannot

be neglected, therefore it can only corroborate the fact that healthcare worker satisfaction

does impact patient satisfaction. The results of the study show that the satisfaction of

healthcare workers with the time they have to accomplish their assigned tasks has the

greatest effect upon patient satisfaction.

Conclusion: By understanding the importance of certain elements of healthcare worker

satisfaction and its effects on patient satisfaction, it is possible to make decisions about

factors that need to be improved in order to raise patient satisfaction to the highest

possible level. These research results are significant for the management of health care

institutions and responsible state institutions which create policy and strategy for

improving the quality of health care services.

CHAPTER III

RESEARCH METHODOLOGY

This chapter explain the specific procedures or techniques used to identify, select,

process, and analyze information about the topic. And it covers the discussion of the

research design, locale of the study, the respondents, the instrument used, the data

gathering procedures and the statistical tool and treatment of data.

Research Design

Since the aim of this study is to identify the level of satisfaction of the residents,

descriptive research design will be used. This method includes giving questionnaires.

Descriptive since it involves describing, recognizing, analyzing, and interpreting the data.

With the use of this method, the researchers were able to assess and analyze the Level of

Satisfaction on Emergency Response of Barangay Health Emergency Response Team on

the Covid-19 pandemic.

According to Gay (1992), descriptive studies include collecting data to test

hypotheses or to answer questions about the current condition of the subject under
investigation. Descriptive studies find and report on what things are like. Descriptive

research is scientific research that describes an event, phenomenon, or fact that

systematically deals with a particular area or group.

Locale of the Study

The locale of this study is the Municipality of Bayombong as it has the highest

confirmed covid cases in Nueva Vizcaya. It is where the researchers desire to find out the

level of satisfaction of residents on the services of the BHERT.

Bayombong is a municipality and capital of the province of Nueva Vizcaya. The

land area of the municipality is 163.36 square kilometers or 63.07 square miles, which is

3.39% of the total area of Nueva Vizcaya. At the time of the 2020 census, the population
was 67,714. This represents 13.61% of the total population of Nueva Vizcaya, or 1.84%

of the total population of the Cagayan Valley region. Based on these figures, the

population density is calculated to be 415 per square kilometer or 1,074 per square mile

(PhilAtlas).

Respondents and Sample

The respondents of this study are the residents of Bayombong, Nueva Vizcaya

who are recipients of the health services against Covid-19 by the BHERT.

This study is being conducted with a random sampling which is a basic sampling

method for selecting a group (sample) to be studied from a larger group (population).

Each individual is selected purely random and each member of the population is equally

likely to be included in the sample. All possible samples of a particular size are equally

likely to be selected (Easton and McColl, 1997).

Slovin's formula is used to calculate the sample size required to achieve the

specified confidence interval when sampling the population. Written as: n= N / (1+Ne2)

where “n” is the sample size, “N” is the population size and “e” is the margin of error of

5%, we get a sample size of

Research Instrument

To gather the necessary data for this study, the researcher will use questionnaires.

The questionnaire is adapted from the Department of Interior and Local

Government Memorandum Circular no. 2020-172 dated 22nd December 2020 and from

the COVID-19 Pocket Guide for BHERTs published in May 2021.

 .

The questionnaire is composed of two parts. The first part explained the profile of

the respondents wherein they were asked to check their appropriate options applicable to

them. The second part is a questionnaire about the Level of Satisfaction.

Data gathering Procedures

Questionnaire as the main tool of this study will be used to gather data hence the

researchers will distribute the questionnaires to respondents via online to prevent the

spread of Covid-19 virus.

Statistical Tool and Treatment of Data

This study aims to find the Level of Satisfaction of the residents on Emergency Response

of Barangay Health Emergency Response Team on the Covid-19 pandemic thus the data

from this study will be processed through the use of statistical package for social

sciences. Descriptive and Inferential statistics are used in this study.

1. Frequency count. It was used as statistical tool to describe and analyze the

profile of the participants.

2. T-test - A t-test is a type of inferential statistic used to determine if there is a

significant difference between the means of two groups, which may be related in

certain features.

3. F-test - An F-test is any statistical test in which the test statistic has an F-

distribution under the null hypothesis. It is most often used when comparing
 statistical models that have been fitted to a data set, in order to identify the model

that best fits the population from which the data were sampled.

4. Mean. It was used to analyze and describe Level of Satisfaction on Emergency

Response of Barangay Health Emergency Response Team on the Covid-19 pandemic.

The mean ranges were qualitatively described in the following scales:

Mean
Scale Qualitative Description Description
Ranges

4.51- 5.00 5 Strongly Satisfied Greatly above the expectations

3.26 - 4.50 4 Satisfied Above expectations

2.51 - 3.25 3 Neutral Meets expectations

1.76 - 2.50 2 Dissatisfied Below expectations

1.00 - 1.75 1 Strongly Dissatisfied Greatly below expectations