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Advances in Social Sciences Research Journal – Vol. 11, No. 2
Publication Date: February 25, 2024
DOI:10.14738/assrj.112.15333.
Tulaytay, D. M. E., Fonte, A. D., & Basallo, M. L. B. (2024). The Level of Satisfaction of the Residents on the Public Healthcare Services
in the Isolated Mountain Barangays of Cebu City: A Research as Basis for Crafting an Action Plan. Advances in Social Sciences
Research Journal, 11(2). 395-424.
Services for Science and Education – United Kingdom
The Level of Satisfaction of the Residents on the Public
Healthcare Services in the Isolated Mountain Barangays of
Cebu City: A Research as Basis for Crafting an Action Plan
Donna Mae E. Tulaytay
Cebu Technological University,
Moalboal Campus in Cebu, Philippines
Allain D. Fonte
Western Covenant University in Los Angeles, California
Ma. Leslie B. Basallo
Cebu Technological University in Barili Campus, Cebu, Philippines
ABSTRACT
This research study aims to investigate the level of satisfaction among residents of
isolated mountain barangays in Cebu City regarding healthcare services. The
identified barangays for this study are Bonbon, Sudlon 1, Sudlon 2, and Sinsin. By
distributing survey questionnaires to randomly selected participants from each
barangay, the study sought to assess residents' satisfaction levels with respect to
healthcare services provided within their respective communities. The study
employed a mixed-methods approach, incorporating both quantitative and
qualitative data collection techniques. The questionnaires were designed to
measure various aspects of healthcare services, including accessibility, quality of
care, healthcare personnel, facilities, and overall satisfaction. Data analysis
involved descriptive statistics to examine the quantitative data. Qualitative data
were analyzed using thematic analysis to identify recurring themes and patterns in
participants' responses. The preliminary findings of the study indicated that
residents' satisfaction levels with healthcare services in these isolated mountain
barangays varied across different aspects. While some residents expressed overall
satisfaction, others identified specific areas that required improvement.
Accessibility, availability of healthcare personnel, quality of care, and the adequacy
of healthcare facilities emerged as critical factors influencing residents'
satisfaction. The research findings have important implications for policymakers,
healthcare providers, and local government units in improving healthcare services
in isolated mountain barangays. The study provides valuable insights into
residents' perceptions, allowing for targeted interventions and the development of
strategies to address the identified areas of concern.
Keywords: healthcare, policies, services, satisfaction, remote communities
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Advances in Social Sciences Research Journal (ASSRJ) Vol. 11, Issue 2, February-2024
Services for Science and Education – United Kingdom
THE PROBLEM AND ITS SCOPE
INTRODUCTION
Rationale of the Study
The mountain barangays in the Philippines are remote, isolated, and difficult to reach, making
it challenging to provide basic public health services (Collado, 2019; Cabello, 2018). The issues
on the Philippines’ public health services have been raised since the 1950’s. From the lack of
medical centers and facilities to the insufficient supply of healthcare products and services,
these issues hindered the survival rate of Filipino suffering from medical conditions or health
problems. From the 1950’s to early 1990’s, average life span of Filipinos is between 60-65 years
old (O’Neill, 2022). However, significant improvements are visible from the mid-1990’s to the
present, as the survival rates have improved and there is a 0.180% growth rate on the life
expectancy of most Filipinos, from 60-65 years old before to 73-75 years old at present (O’Neill,
2022). Yet, even with significant and continuous improvements, many Filipinos still find the
public health services unsatisfactory (Collado, 2019; Mallari et. al., 2020).
One of the major factors that cause the inefficient and less effective delivery of public health
services is funding. The average national budget allocation in most Southeast Asian countries
is 4.5% with its gross domestic product; with Singapore ranking first by allocating 7.3% for
public health, while the Philippines only allocates 4.1% (Dayrit et. al., 2018). World Health
Organization (2014) even proposed that the ideal allocation of a state to health services should
not be less than 5% of its gross domestic product. This explains that even if the Philippines has
an excessive population of healthcare professionals and continuous improvements on medical
centers, facilities, and services, there are still more developments needed to achieve efficient
and effective public health services. If the major metropolitans in the Philippines have issues
with the public health services, this research aims to study on the condition of the public health
services in the isolated areas of the country like the mountain barangays or island barangays.
This research also aims to identify the major issues raised by the people in the area so
appropriate action plans can be developed, and solutions to repeating problems will be
proposed. The mountain barangays in Cebu City, even though they are considered under the
jurisdiction of the city, the accessibility of these mountain barangays is challenging because of
narrow roads, harsh weather and environmental conditions, and limited transportation
systems. Because of the challenges in accessibility in these areas, public services, including
healthcare services, are limited and there is always a delay in the delivery of services (Collado,
2019; Estoque et. al., 2020). Using Dayrit et. al.’s (2018) report, this research identified four
factor to measure the people’s satisfaction rating on their barangay’s health services: (a)
Knowledgeability and Quality of Service of Local Health Workers, (b) Availability and
Accessibility of Medicines and Health Supplements, (c) Availability and Quality of Healthcare
Equipment, and (d) Programs for Healthcare Awareness and Education. By conducting a
survey, and computing the weighted average means, this research paper shall identify which
factor scores the highest and which one scores the least. Basin, from the scores, this research
paper shall draft suggestions, recommendations, and proposals for the main actors (barangay
officials, city
Theoretical Background
This research paper is anchored from theories of Dayrit et. al. (2018), Collado (2019), and
Arroyo (1998). Their research papers identified the issues on the efficiency and effectiveness
of the public health services as delivered by the local communities, locally known as barangays.
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Tulaytay, D. M. E., Fonte, A. D., & Basallo, M. L. B. (2024). The Level of Satisfaction of the Residents on the Public Healthcare Services in the Isolated
Mountain Barangays of Cebu City: A Research as Basis for Crafting an Action Plan. Advances in Social Sciences Research Journal, 11(2). 395-424.
URL: http://dx.doi.org/10.14738/assrj.112.15333
Arroyo (1998) discusses that the initial plan of establishing barangay health workers is to
extend social services instead of health services. Their main duties are to brief the local
households of family planning and one of their main concerns is to assist the women in the
barangays in handling domestic issues. However, because of the absence of a community
doctor/nurse/other healthcare professional, the people in the barangays seek the assistance of
barangay health workers (Arroyo, 1998). This has elevated the duties and function of barangay
health workers to bridge the needs of the people to the city health offices. Plus, due to the lack
of manpower in the city health offices, and the lack of volunteers to live in the remote areas, the
city health offices endorsed their health services to the barangay health workers (1998). By this
research paper, Arroyo theorized that health services in the mountain barangays or island
barangays will never improve, regardless of an increase in funding or an improvement of
facilities and supplies, because the people providing the healthcare services are not
professionally trained healthcare workers. Hence, this research paper will anchor from this
theory of Arroyo (1998).
Another theory that this research paper uses is the theory of Collado (2019) on Geographically
Isolated and Disadvantaged Areas (GIDA). By conducting a case study on the GIDA areas in the
province of Quezon, Collado (2019) concluded that the deficiency of health services is neither
caused by the inefficiency of the local government nor the lack of accountability but by the
challenging means of transportation systems and harsh weather conditions that limit the
delivery of services in the area; plus, the lack of access to clean water and electricity that makes
it more difficult to carry out healthcare services. This means that setting up better medical
centers and providing medical facilities are useless because there is no electricity to run the
technologies and no easy access to clean water, which is highly necessary to improve a person’s
health. This theory is considered by the researcher because the identified mountain barangays
in this research also share similar issues as transportation, access to clean water, and stability
of electricity.
Lastly, the theory Dayrit et. al. (2018) is considered because the researcher uses the identified
factors of Dayrit et. al.’s theory in developing the research questions and in drafting the survey
questionnaire. Dayrit et. al. (2018) submitted “The Philippines Health System Review” report
to the Asia Pacific Observatory on Health Systems and Policies – World Health Organization,
where they discuss (2018, p. xix),
Philippines adopted decentralized health governance in 1991, introduced a social
health insurance programme – PhilHealth – in 1995, and has actively pursued
universal health coverage since 2010. As a consequence of its focus on the health
sector and general socioeconomic development, Philippines has achieved
significant improvements in life expectancy and immunization coverage, as well as
a twofold reduction in infant and under- 5 mortality.
Although much has been achieved to date, there are still many concerns in the
health sector that need to be tackled. These include a reduction in the prevalence of
tuberculosis and childhood pneumonia, as well as managing the rising tide of
noncommunicable diseases and further strengthening the preparation and
response capacity to natural and human- induced disasters.
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Advances in Social Sciences Research Journal (ASSRJ) Vol. 11, Issue 2, February-2024
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The decentralization of health services established city health offices, and the delegation of
their tasks and services with the barangay health workers because of the lack of manpower,
and the lack of volunteers to go to the geographically isolated and disadvantaged areas. Because
of the arising problems even if the health services are already being localized, Dayrit et. al.
(2018) assessed the local health services using the four factors: (a) Knowledgeability and
Quality of Service of Local Health Workers, (b) Availability and Accessibility of Medicines and
Health Supplements, (c) Availability and Quality of Healthcare Equipment, and (d) Programs
for Healthcare Awareness and Education. Their report is based on these four criteria. Hence,
the researcher shall use the same criteria to assess the satisfaction level of the people in their
respective barangay health services.
Theoretical Framework
The theoretical framework for this research study on exploring the level of satisfaction among
residents of isolated mountain barangays in Cebu City revolves around three key theoretical
perspectives: the Service Quality Model, the Access to Healthcare Model, and the Socioeconomic
Factors Model.
Service Quality Model
The Service Quality Model, proposed by Parasuraman, Zeithaml, and Berry (1988), serves as
the foundation for assessing residents' satisfaction with healthcare services. This model
identifies five dimensions of service quality: tangibles, reliability, responsiveness, assurance,
and empathy. These dimensions provide a comprehensive framework for evaluating the quality
of healthcare services and understanding residents' satisfaction levels.
Access to Healthcare Model
The Access to Healthcare Model, discussed by Andersen and Newman (1973), is relevant for
examining residents' satisfaction levels in relation to the accessibility of healthcare services.
This model highlights three dimensions of healthcare access: availability, affordability, and
acceptability. It acknowledges that residents' satisfaction is influenced by their ability to obtain
healthcare services in a timely, affordable, and culturally appropriate manner.
Socioeconomic Factors Model
The Socioeconomic Factors Model recognizes that residents' satisfaction levels can be
influenced by various socioeconomic factors. This model encompasses variables such as
income, education level, employment status, and social support networks. These factors can
shape residents' perceptions and experiences of healthcare services, affecting their satisfaction
levels.
By integrating these theoretical perspectives, the research study aims to gain a holistic
understanding of the factors contributing to residents' satisfaction with healthcare services in
isolated mountain barangays. The Service Quality Model helps assess the quality of healthcare
services provided, the Access to Healthcare Model provides insights into the accessibility of
these services, and the Socioeconomic Factors Model allows for the examination of socio- demographic variables that may impact satisfaction levels.
The study's survey questionnaires will be designed based on the dimensions of the Service
Quality Model, incorporating items related to tangibles, reliability, responsiveness, assurance,
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Tulaytay, D. M. E., Fonte, A. D., & Basallo, M. L. B. (2024). The Level of Satisfaction of the Residents on the Public Healthcare Services in the Isolated
Mountain Barangays of Cebu City: A Research as Basis for Crafting an Action Plan. Advances in Social Sciences Research Journal, 11(2). 395-424.
URL: http://dx.doi.org/10.14738/assrj.112.15333
and empathy. Additionally, questions related to the Access to Healthcare Model will be included
to explore residents' perceptions of availability, affordability, and acceptability of healthcare
services. Finally, socio-demographic information will be collected to analyze the influence of
socioeconomic factors on satisfaction levels. By utilizing this theoretical framework, the study
aims to provide a comprehensive understanding of the factors influencing residents'
satisfaction with healthcare services in isolated mountain barangays, thereby contributing to
the development of targeted interventions and strategies for improving healthcare delivery in
these communities.
Theoretical Framework
Figure 1: Theoretical Framework
Statement of the Problem
This study's goal is to find out how satisfied are the residents with the healthcare services
provided by their respective barangays on the identified areas of Cebu City namely barangay
Bonbon, Sudlon 1, Sudlon2, and Sinsin as basis for the crafting of an appropriate action plan.
Specifically, this will answer the following questions:
1. What is the profile of the respondents in terms of:
1.1 geographic location
1.1.1 Distance from the office of public services;
1.1.2 Distance from the nearest hospital;
1.1.3 Road infrastructures in the area;
1.1.4 Quality of the roads; and
1.1.5 Means of transport.
1.2 manpower resources
1.2.1 Number of nurses working in the area;
Residents' level of satisfaction with their barangay's
healthcare services
Service Quality Model Access to Healthcare
Model
Data Interpretation, Conclusion,
Recommendation Action Plan to
Improve the barangay health care
services
Action Plan to
Improve the
barangay health care
services
Socioeconomic Factor
Model