International Journal of Research Studies in Psychology

2024 Volume 10 Number 1, 143-160

Challenges of barangay health workers in advent of health

care emergencies

Mirano, Jan Miguel M.

Graduate School, Lyceum of the Philippines University - Batangas, Philippines ([email protected])

ISSN: 2243-7681
Received: 25 May 2024 Revised: 25 June 2024 Accepted: 10 July 2024 Online ISSN: 2243-769X
Available Online: 15 July 2024 DOI: 10.5861/ijrsp.2024.011
OPEN ACCESS

Abstract

The government, response and recovery team, the community and the individuals can carry
out preparedness action in building the capacities needed to come through types of
emergencies and achieve sustained recovery. Based on the data revealed, one of the most
challenging aspects of coping health care emergency cases is the lack of hospital facility that
can accommodate the number of patients. 11 respondents were contacted and interviewed to
gain insight on their accounts using Colaizzi’s method, a Descriptive-Phenomenological
research design that actively seek the patient’s experiences and makes some significant
interpretation to come up with a theme that generates a strong concept of what their
experiences are. The Phenomenological inquiry yielded some significant themes which were
in line with the actual experiences of the respondents during health care emergencies. Results
showed that majority of them experienced the fear and felt worried during the emergency
cases; however, the respondents still have positive feelings towards their experiences. More so,
the effects of health care emergencies in daily life and routine of the respondents in which the
respondents stated that, their personal hygiene or health was considered the number one
affected by the different heath care emergencies. In conclusion, the respondents became aware
of their health. In terms of their perspectives in the government policies and health measure,
the respondents said that, through the implementation of the different health protocols, the
people was enforced to follow especially the vaccination policy.

Keywords: challenges, barangay health workers, healthcare emergencies

© The Author(s) / Attribution-NonCommercial-NoDerivs CC BY-NC-ND

Mirano, J. M. M.

Challenges of barangay health workers in advent of health care emergencies

1. Introduction

According to Baliolaa et al (2024), barangay health workers (or BHWs) are the community health workers
(CHW), who were trained to serve as the first point of contact for patients from a larger health system. The
program of BHW is the main approach of the Philippine government to get rid of disparities in the delivery and
accessibility of health services between urban and rural areas in the country. The Global adoption of the Primary
Health Care (PHC) framework from the 1978 aims to strengthen local health systems at the community level.

This further champions health empowerment by increase access to preventive health information and
training BHWs to build communities' self-reliance. BHWs' voluntary provision of primary care services is
repeatedly emphasized in legislation and relevant policies. For instance, the Implementing Rules and Regulations
of the BHW Benefits and Incentives Act (RA 7883) state that, volunteerism must be consistently promoted and
observed by all parties. While, the care and concern for the community are motivating factors, the appreciation
of volunteerism, especially in formal laws and policies, poses the risk of legitimizing the BHWs' role as a form
of free labor. More recently, during the COVID-19 lock downs, BHWs actively delivered PHC services despite
mobility of restrictions and additional pandemic mitigation tasks. Health workers continued the delivery of
prescription medicines, schedule immunizations, perform prenatal checkups, and refer clients for consultations to
the local health centers. Through this, it was found that some municipalities has an increase in the BHWs'
caseload as more patients preferred visiting smaller RHUs for PHC to seeking outpatient services in tertiary
facilities. This made the value of the BHWs' contribution to delivering community care as a critical role in
bridging the community to the larger health system. Moreover, BHWs support communities' well-being by
ensuring health programs reach the underserved population.

More significantly, they possess intimate knowledge of the communities' health needs and issues, rendering
them essential voices of inclusion. Furthermore, in response to the COVID-19 crisis, the BHW role had evolved
to assist the Barangay Health Emergency Response Team (BHERT) in covering essential pandemic responses
such as active contact tracing and monitoring of community members under quarantine. However, despite the
enacted policies to support their role and work, perennial challenges to policy implementation remain. These
hinder BHWs from effectively fulfilling their tasks and serve as barriers to full and adequate recognition of their
role in community health. BHW encountered various difficulties amid a health crisis, even as they are among the
first-line responders for community health safety. They had limited access to personal protective equipment
(PPE), alcohols, and other necessary supplies that prevent them from effectively doing their tasks; there was an
increase in demands for health services at the height of the pandemic that escalated the burden of BHW as they
had to do more of the workload such as contact tracing, monitoring quarantine protocols, and giving health
education, that some BHW felt underappreciated and undervalued over their contribution.

Objectives of the Study - This study explores the challenges and experiences of Barangay Health Workers
during times of health care emergencies.

Theoretical Framework - In this study, the researcher used the Adaptation Model by Callista Roy. This
model shows the individual as a set of interconnected systems that maintain a balance between various stimuli.
Additionally, as living systems, individuals are in constant interaction with their environments. The integration
of human and environmental meanings results in the adaptation. The following are Callista Roy’s Adaptation
Model’s major concepts ; according to Roy Callista , Person are holistic beings that are in constant interaction
with their environment. Humans use a system of adaptation, both innate and acquired, to respond to the
environmental stimuli they experience. Human systems can be individuals or groups, such as families,
organizations, and the whole global community. While, Environment is defined as conditions, circumstances,

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 Challenges of barangay health workers in advent of health care emergencies
and influences that affect humans’ development and behavior as an adaptive system. The environment is a
stimulus or input that requires a person to adapt. These stimuli can be positive or negative. Next is Health which
is defined as the state where humans can continually adapt to stimuli. Because illness is a part of life, health
results from a process where health and illness can coexist. If a human can continue to adapt holistically, they
will maintain health to reach completeness and unity within themselves. If they cannot adapt accordingly, the
integrity of the person can be affected negatively. Nursing or nurses based on Roy Calista’s Model are
facilitators of adaptation. They are responsible in assessing the patient’s behaviors for adaptation, promote
positive adaptation by enhancing environment interactions and helping patients react positively to stimuli.
Nurses eliminate ineffective coping mechanisms and eventually lead to better outcomes. Last one is the
Adaptation which refers to a process and outcome whereby thinking and feeling persons as individuals or in
groups use conscious awareness and choice to create human and environmental integration.

Figure 1: Roy Adaptation Model

In relation with the study as shown in the graphic, the human system represents the Barangay Health Worker.
Triggered by Public Health Emergencies as the Stimuli, things have change. The use of PPE for their safety
reflects the Physical/Physiologic. While Self-Concept/Group Identity can be related to the adapting to their
responsibilities and tasks in their barangay. Interdependence symbolizes the exchange of information between
medical professionals, including doctors, nurses, and midwives. Etc. lastly, changes in the Roles/Function
because in each of their local barangays, BHW are regarded as the frontliner.

2. Methods

Research Design - This study used a Descriptive-Phenomenological Research design. Descriptive –

phenomenological is a qualitative research approach that seeks to understand and describe the universal
essence of a phenomenon such as the challenges experienced by barangay health workers in healthcare
emergencies. According to Holloway and Galvin (2017), descriptive – phenomenological study is a type of
qualitative research study design that describes the lived experiences of individuals or how human beings are
able to experience a specific situation or phenomenon.

Setting - This study was conducted in San Luis Batangas, it is a 4th Class Municipality in the province of
Batangas. It is politically subdivide into 26 barangays. Each barangay consist of puroks and some have sitios.
The researcher gathered data from the Barangay Health worker comes from different barangay, who were
actively performing their duties in public health emergency. Depending on the size of the actual population. The

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Mirano, J. M. M.
sample size was based on the data saturation from the responses gathered or until additional data can no longer
be acquired from the research informants when close similarities between older and newer data gathered can be
noticed.

Participants of the Study - The respondents of the study were contacted and interviewed to gain their insight.
A letter of informed consent will be given first to barangay chairman where the respondents live. Each of the
respondents for the study were also given a letter of informed consent that explains to them fully, the scope on
which the grounds of the study is limited to, and that all of the data will be gathered was for research purposes
only. The research informants were all situated within the area of San Luis, Batangas, across different Barangays.
Each was Barangay Health Worker who was active in duty during public health emergencies.

Respondent A. A 69 year old from Mahabang Parang San Luis Batangas who serve for 23 years as
barangay health worker. For her, the most challenging aspect of coping health emergencies is the risk of being
infected.

Respondent B. The interviewee was a 53 year old female health worker of barangay San Jose San Luis
Batangas is serving as a health worker for 18 years. She believed that, the people faced challenges during
emergency cases through community adaptation and response.

Respondent C. She is a 56 year old health worker in barangay Bonliw who is serving the community for
already 20 years. For her, difficulty in socialization especially in finding the patients is one of the challenging
aspects they’ve experienced.

Respondent D. The interviewee is a 45 year old female health worker who serves the community for 14
years. According to her, the most challenging aspect of facing health emergency cases is the lack of emergency
facilities that will accommodate the number of patients.

Respondent E. A 39 year old female respondent who is from Banoyo San Luis Batangas. She is serving as
barangay health worker for 6 years. She said that, the lack of hospital facilities is the number challenge
experienced by the front liners during health emergency circumstances.

Respondent F. The interviewee is a 66 year old health worker from Muzon San Luis Batangas who serves
the community for 41 years. She is one of the front liners who encourages people in the community to avail the
vaccines.

Respondent G. She is a 45 year old female respondent who is already 14 years in service as a health worker
in barangay Bagong Tubig San Luis Batangas. According to her, the most challenging aspect of facing the health
emergencies is the fact that, people thought that we are also infected.

Respondent H. A 53 year old female health worker who is serving the barangay and the community for 20
years. She is from Calumpang San Luis Batangas who said that, personal health is the number one challenging
aspect of coping to emergency health cases.

Respondent I. The interviewee is a 53 year old female respondent from Tunggal San Luis Batangas. She
became aware of their health to avoid any illness.

Respondent J. The interviewee is a 52 year old health worker from barangay Durungao San Luis Batangas.
She experienced the fear and worries during emergency cases but through the courage of her family they were to
cope the circumstances.

Respondent K. The last respondent is a 57 year old health worker of barangay Balagtasin San Luis
Batangas who said that, the most challenging aspect of coping health emergency cases is the restriction of
movement and travel.

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 Challenges of barangay health workers in advent of health care emergencies
Data Gathering Instrument - A self-report questionnaire and an interview guide questions was applied in
this study. The researcher utilized a survey interview to gather qualitative information on the respondents, the
survey interview will utilize the following as its guide questions. This will be validated by qualitative experts.

Data Gathering Procedures - In data gathering, the researcher devised a process to collect information that
contribute to the study by initially identifying a specified time frame which certain number of BHW will be
recorded. The researcher conducted the study from the month of January to February, 2024 as the time frame
from which data from the informants of the study was gathered. The study was conducted primarily in San Luis
Batangas covering the selected barangay. The interview with each of the BHW would last from around thirty (30)
to an average of sixty (60) minutes at a time depending on how the respondents answered the questions. With the
knowledge gained from the included literature review, the researcher(s) then formulated their own survey
questionnaire as the research instrument and then the researcher(s) presented to their adviser for opinions,
recommendations and approval. After the approval and validation of the research instrument, the researchers
administers the research instrument to the Barangay Health workers who were active in duty in public health
emergencies. The researchers prepared a structured interview with the respondents to get insights and
information that will be used for the study. The researchers prepared a structured interview with the respondents
to get insights and information that will be used for the study. This includes the introduction, the purpose and
explanation for the visit, and the supposed interview together with a written document containing the purpose of
the interview and a written consent paper to be signed by the respondent, stating their full knowledge and
consent over the course of the interview. While the data gathering was designed to be an oral interview, most of
the respondents opted for a written response about the topic and just provided with additional details that further
gives an insight on their experiences during COVID-19 public health emergency.

Data Analysis - The study was utilize Colaizzi’s Phenomenological Method. According to Colaizzi’s
descriptive - phenomenological method used to uncover the genuine experience of the phenomenon under
investigation, Colaizzi's method consists of seven steps. First informants' descriptions of the experiences are read
in order to acquire a sense of the whole. After that significant statements are extracted. Meanings are formulated
from the significant statements. Formulated meanings are organized into themes. Themes are integrated into an
exhaustive description. The essential structure of the phenomenon is formulated. And, finally for validation the
informants will evaluate the result of the analysis, if it means the same as their original experiences were.

Figure 2. Colaizzi’s Phenomenological Method

Nurses’ roles during a pandemic crisis includes preparation even before the disease has the opportunity to
spread devastation. Nurses’ roles during a pandemic crisis includes preparation even before the disease has the
opportunity to spread devastation. Nurses during this pandemic have been a vital point of reference for
communities in terms of information dissemination and prevention strategies on how to cope in the health crisis;
this, in turn, makes them responsible for managing the situation and often inhibits their capability to understand

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Mirano, J. M. M.
and recognize their individual feelings, concerns, and worries.

Ethical Considerations - Getting approval from the research instrument proponent, the nursing school, the
nursing administration, and the research ethics committee is the first step in starting the study. The researcher in
this study made sure that the data samples were fully informed about the nature of the research, that the
appropriate ethical clearance had been obtained from individual and institutional stakeholders, and that all
respondents had been subjected to prior notice, waivers, or agreements regarding the nature of the research. In
addition, research participants have been adequately briefed about the nature of the study, its objectives, and how
their personal information, will be utilized to further understand the phenomenon. The participants were made
aware of their freedom to refuse to participate in the study and to stop at any time. In addition, formal consent
was given to study participants, and their identity and the confidentiality of the information they supplied were
guaranteed. The researchers also gathered the LPU ethics approval upon conducting the study.

3. Results and discussion

The researchers, using Colaizzi's methodology, analyzed the transcripts of interviews from the 11 informants.
The challenges and application of the ego-ideal concept of Psychoanalytic theory were explored leading to the
formulation of themes with associated meanings derived from the findings of this study. Since this study adopted
the Roy Model by Callista Roy in which this model sees the individual as a set of interrelated systems that
maintain a balance between various stimuli. Person, environment and health are some of the major concepts in
this model which was adopted to get the major themes of the study. The narrative statements of the 11 informants
were reviewed and clustered based on their affinity. Analysis was done in the form of major themes supported by
sub themes which were symbolically presented along with the supporting literature that closely resembles the
results as a part of the entire concept theory in general.

Theme 1: Coping the tides. These theme discusses the general sense of the participants challenging aspects
of coping the tides or what we called the the health care emergencies like COVID pandemic which is based from
what they’ve experienced and the effects that it have caused them. In general, this may vary between boats to
boats or health workers to health workers based on their experiences.

Sub-theme 1: Insufficient harbor. Most of the sailors of the study stated that, one of the most challenging
aspects they’ve experienced in coping the tides like COVID pandemic is the lack of harbor or the lack of
available hospital facilities that could accommodate hundreds of boat passengers. A respondent from Barangay
Banoyo, San Luis Batangas, who is a 39 years old with six years in service as a Barangay health worker stated
that, “For me, one of the most challenging aspects I ever experienced during health care emergency is the
difficulty in looking for the available hospital or emergency facilities that could help our patients.” In other
terms, the sailor is experiencing difficulty in looking for a harbor to bring all the passengers sailing in the sea of
health care emergencies. Another participant responded and stated that, “One of the greatest challenging aspects
of coping emergency cases or tides is the lacking of hospital facility that will help the patients in their situation
as well as, the lack of medicine and the lack of medical experts.” The data was given by a respondent from
Durungao San Luis Batangas who is a 52 years old with 3 years’ service as a Barangay Health Worker. The
general experience coincide that, it is really the lacking of harbor were the greatest challenging aspects
experienced by the boats of each barangay in San Luis Batangas.

According to Koontalay (2021), Healthcare providers are the frontline soldiers fighting against the
coronavirus disease 2019 or (COVID-19) pandemic. Their responsibility is to directly provide and manage
COVID-19 care processes, which is considered overwhelming number of cases which cause them to develop
mental health issues and fail to perceive their own psychological distress symptoms such as anxiety or
depression. The people’s view of healthcare providers who were experiencing struggles during the current
pandemic should thus be obtained to gain a better understanding of how they are handling such situation and to
help them resolve their issues. The study of Koontalay (2021), systematically reviewed the qualitative researches

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that have been conducted on healthcare providers’ experiences during the current pandemic.

Sub-Theme 2: Sailing in distance. Most of the respondents of the study stated that, they experienced
difficulties in communicating with other boats or to socialize with other boat driver because in some case, there
is a risk or other boat were afraid to get infected or damaged by the sea of health care emergencies. A 56 years
old respondent from Bonliw San Luis Batangas with 20 years’ in service as a Barangay Health Worker stated that,
“For me, sailing in distance is the most challenging aspects I experienced especially during COVID-19
pandemic way back 2020. It became challenging for me as a boat driver or health worker of our barangay since,
we are on the community quarantine or high tide. Though, I am a health worker or the one who manipulates the
boat I also have limited time to help my neighbors since I am also afraid to get infected or damaged.” Moreover,
a resident from Barangay Luya, San Luis Batangas who is a 45 years old with 14 years in service as a health
worker, added that, “As a health worker, it is really hard to face sea of emergency cases or situations during
tides since, I am not sure if the passengers I talked to are infected with corona virus or not.” While, a respondent
from Barangay Balagtasin San Luis Batangas said that, “I only have limited time communicating with other boat
driver, especially in addressing their concerns.” This implies that, apart from the lack of harbors, the most
common challenges experienced by the boat drivers or BHWs in San Luis Batangas is the limited social
interaction or sailing in distance due to tides of emergency cases. Almost all of the areas around the country were
in high tide. Only those who were serving the people and the community are allowed to go outside. Only boat
drivers who were fighting in the waves of emergency cases are allowed to sail on the sea. The statements from
most respondents can be closely associated with the study by Osaka (2021), who stated that, there were trouble
that stemmed from infection control measures and visiting restrictions and these include limited communication
with patients, their families, and other healthcare professionals, which made it difficult to make patient-centered
decisions and provide appropriate support.

Sub-Theme 3: Warning out ship paint. Among the selected boat drivers of the different Barangays of San
Luis Batangas, almost six (6) who stated that, personal health risk or warning out ship paint is the most
challenging aspect of sailing in the sea of emergency cases especially due to the tides and waves. A 53 years old
respondents from Calumpang East San Luis Batangas stated that, “In my own opinion, one of the hardest aspects
in dealing with the emergency cases like covid 19 is the personal health.” The data implies that the boat divers
were also afraid to get affected of any disease from their passengers. This made their experiences challenging
especially during the sailing in the sea with tides and waves. This data was added by a boat driver or respondent
from Tunggal San Luis Batangas who said that, “maintaining personal health habits to avoid being infected is a
challenge.” Another respondent said that, “I am afraid because I might be infected.” Moreover, a respondent
from barangay Bagong Tubig who is a 45 years old with 1 year length of service said that, “most of the
passenegers we encountered during tides hates us because of their perceptions about abot drivers or BHWs.”

While, a respondent from San Jose San Luis Batangas who is a 53 years old with 13 years in service as a
health worker in the barangay and a respondent from Muzon San Luis Batangas stated that, “one of the most
challenging part of being a health worker in our barangay is the fact that, we are hated by our neighborhoods
since, we are asked to bring the patients in different health facilities, people get used to hate us because they
think that we are also infected.”

The data shows that, it is important for the boat drivers to maintain their personal safety sailing since they
are battling for their passengers recovery while sailing. They should be aware of the possible consequences or
sea barriers of being a captain during the sea waves and high tides.

Theme 2: Sailing the rough seas. This theme discusses the different responses of the boat drivers about the
specific examples of how the community came together or faced challenges during waves and tides. The
responses of the respondents vary since they have different experiences in facing challenges during the
pandemic.

Sub-theme 1: Mapping and utilizing radar. Only three (3) sailors answered that, mapping and utilization

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of radars or dissemination of health protocols and health related announcements is the number one specific
example of how boat drivers help together in facing the waves and tides. Respondent B stated that, “We,
barangay health workers helped each other in giving the right information to the residents of our barangay.”
This was added by Respondent D who said that, “Giving of quarantine pass and implementing health
protocols.” Respondent J also stated that, “The community simply followed the protocols provided by the
government health officials.” This implies that, one of the specific examples on how the boat drivers faced
challenges amidst of big waves is the use of maps and utilization of radars the safety of every passengers.

According to Marston et. al.,(2020), community involvement is necessary in the collective response
especially to COVID-19, from compliance with lockdown, to the steps that need to be taken as countries ease
restrictions, to community support through volunteering. In the study of Marston, et al., (2020), metioned that
Global health guidelines already emphasized the value of community involvement. Incorporating insights and
ideas from diverse communities is central for the co-production of health, whereby health professionals work
together with communities to plan, research, deliver, and evaluate the best possible health promotion and
health-care services.

Sub-Theme 2: Service beyond gain. Helping is caring as shown in the statements given by the three
respondents of the study. Respondent E stated that, “Most of the community members extend their voluntary
participation in giving relief goods for those who were affected by the pandemic.” While, Respondent G added
that, “Health official extend their help in giving health aid for the patients.” Also, Respondent H who is a 53
years old barangay health worker, stated that, “People in our community extend their generous heart in giving
foods and supplies needed by the patients affected by Covid 19.” The data given by the respondent I shows that,
the sailors were eager to help those passengers who are in need. Research has shown that those who have a
strong sense of togetherness are more likely to help in a crisis. In many instances, people expressed feeling a
sense of identity with those who were troubled. As the government restrict public gatherings to slow the outbreak,
businesses are getting shut down and people are losing their jobs around the world.

Sub-Theme 3: Carrying to Safety. The data from the respondents show how the the sailors help together in
facing the big waves behind the sea. As stated by Respondent A, the LGU of San Luis and the sailors/BHWs of
the barangay had their duties to monitor those who enter the area. Also, Respondent C stated that, community
quarantine were strictly implemented While, Respondent F added that, whenever they had passengers or with
symptoms of Covid 19, they immediately isolate them in the barangay health stations or other harbors.
Respondent K also added that, they also provided security checkpoints for the safety of every passengers. This
implies that, carrying the safety truly helped the sailors in facing the challenges due to big waves of pandemic.

Despite a significant focus on healthcare sector preparedness and response to this emergency, the serious
health needs of many people have put healthcare services and providers under great pressure. This scenario has
prompted medical associations, international organizations, and governments to offer clinical ethics guidelines
for the pandemic (Joebges et. al., 2020)

Theme 3: Navigating through rough waves. This theme discusses how the rough waves affects the daily
life and routine of the sailors. The responses of the respondent may vary since, the respondents came from
different barangay in San Luis Batangas. The selected respondents who were a sailor shared their experiences
during the sail in the rough waves.

Sub-theme 1: Vigilance to the Path. Respondent E stated that, “the personal hygiene of the family was
affected by the different health care emergencies.” In other terms, the path of the boats were affected by the
rough waves during the sail in the sea. Moreover, Respondent K also mentioned that, they become more aware
of the path they should take. Exercising is one of the practices mentioned by the respondent which helped them
in maintaining good health status. Also, Respondent J said that, they become aware of their health since, they
don’t want to be infected. This shows that, due to the emergency cases one of being affected is the health matters
of the people. They were afraid that, their families might be infected.

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Personal hygiene involves a few tasks, but its main goal is to keep you clean and minimize risk for
contracting an illness. Practicing a good hygiene determining factor of a person’s body image. Being well-kept
and neat also helps us with psychological issues. Looking clean and presentable is vital to every little success in
life. Whether it is in relationships or at work, hygiene is a crucial element that plays a big part in forming
relationships.

Sub-theme 2: Splash the waves. Almost 4 sailors agreed that, the splash of the waves affect their sailing in
the sea of health emergency cases or waves. As stated by respondent A, their everyday sailing have been affected
by the waves, tides, and reefs. Low tides became the number one reasons of the changes in their routine since,
they were not allowed sail due to reef barriers in the sea. Also, not being able to visit their relatives who were a
victim of covid made their life affected since, lock downs were implemented in different part of the community.
Moreover, Respondent H stated that, they almost had no time for their family and other extra jobs because of the
calling of their responsibility in barangay. But, Respondent H added that, “yet, I am happy to serve the
community.” While, Respondent F and G stated that, they were included in those health workers who is in need
to duty in checkpoints.

The data shows that, every individual were affected by waves of health emergency cases like covid. Their
responsibility being a barangay health worker or boat drivers was added by their responsibility in the community
as they gave most of their time in ensuring the safety of the passengers. Good health literacy helps students cope
with public health emergencies. Overall, the health literacy of young students is relatively low. Health education
can promote health literacy, but the health education related to public health emergencies for Chinese junior
middle school students needs to be improved. To design and implement health education courses related to
public health emergencies for junior middle school students and examine the impact on their health literacy,
emotions, and coping styles.

Sub-Theme 3: Barriers of the reef. Almost 4 of the sailors agreed that, they have limited time outside
since, there were barriers in the sea like the reefs or represented as implemented health protocols. As Respondent
B stated that, they need to be careful in every duties they have every day since they only have limited time
outside. While, Respondent C added that, due to low tides, they only had limited time in doing what they need to
do. Respondent D also added the same answer that, they only had limited time to go outside. Furthermore, the
last respondent who is Respondent I state that, “I worry whenever I go outside and do my responsibility being a
health worker or boat drivers, but, I make sure that I maintain cleanliness within myself so that, I won’t get
sick.” Lock downs and other related actions to avoid the spread of the said virus really affects the life of the
people. They only have limited time to buy the things they need and even to go other places or harbors. This
implies that the barriers of reefs or the movement and travel restrictions have been crucial in stopping the boats
in sailing in the sea of low tides. Governments and public health officials worldwide have implemented drastic
measures to curb the transmission of the virus. These restrictions vary depending on the specific region and its
current quarantine classification

Theme 4: Ships waddling on the emotional ocean. These themes show what are the emotions or feelings
experienced by the sailors as a result of the experienced waves, tides and barriers. Their responses may vary
since, they all have their own experiences and observations in sailing in different barangay in San Luis Batangas.

Sub-Theme 1: Unnecessary Fear and Worries. The World Health Organization has raised concerns about
the consequences of the tides or health emergency cases, negatively affecting the health across societies, cultures
and age-groups. Based on the interview, most of the respondents felt the unnecessary fear and worries during
pandemic or high tides. Like, Respondent B who said that, she is afraid since according to the news, many
people died due to the symptoms of covid. Respondent D also felt the fear but, as time passed by, it was resolved
through the giving of vaccines. Respondent F mentioned that, fear, difficulty, and tiredness are what they felt.
Also, Respondent G said that, “I was afraid because my family might be infected, so I became strong for them.”
Same as what Respondent I said that, “I felt worried because they may be infected of the virus.” Moreover,

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another respondent shared that, she also felt the fear for her family. This indicates that, fear really inevitable in
times of emergency situations like covid pandemic.

Healthcare professionals often face the stress of making rapid decisions, witnessing human suffering, and
dealing with life-and-death situations. The pressure to perform optimally while ensuring patient safety can lead
to heightened anxiety and stress

Sub-Theme 2: Seeing the horizon. Despite of the big waves, sea barriers, lows and high tides, the boat
keeps on sailing in the ocean of hopes. Satisfaction arises when the objectives are met, and appropriate responses
address passenger’s needs. These positive feelings upon seeing the horizon contribute to personal and
professional growth, fostering person-centered care or the care for the passengers. The remaining six sailors
shared what they felt during sail in the middle of big waves or covid-19. Respondent A stated that, “I felt fear at
the beginning but overtime, it was replaced by hope and unity as an answer to the challenge of the waves”.
Respondent C added that, “Life is difficult during tides, I always wonder when everything will end”. Also,
Respondent E mentioned that. “At first there was uncertainty and fear but overtime resilience emerged for the
community and family to overcome the challenge”. While, Respondent H added that, “it was a mixed emotion of
fear and worries but an eagerness to fulfill my responsibility of being the driver of hope for my passengers”. The
last respondent who is Respondent K said that, “I felt really a mixed emotions like, anxiety, loneliness and
tiredness but it was resolved through her powerful prayers every day”.

The responses of the respondents showed that boredom, anxiety, fear, and worry were common emotional
reactions as they sail in the sea as it emerged. Amazingly, participants' emotional experience did not mirror
infection and death rates: Instead of negative emotions growing as the virus spread, emotions soon reverted back
to normality. This held regardless of whether the viral spread was contained. Accordingly, people's hindering
behaviors were predicted by fear, anxiety, and worry only at the onset of the viral outbreak.

Theme 5: Influenced of Tides in Passengers’ perspective of Government Response to Pandemic. The

data under this theme shows influenced of pandemic in the different perspectives of the sailor about the
Government policies and Health measures. The responses of the respondents vary since, they have their own
perspectives about how the Government implemented their policies and health measures. The following are the
sub-themes which was based on the answers shared by the respondents who were the selected barangay health
workers of San Luis Batangas.

Sub-Theme 1: Essential Role of Paddle. The respondents of the study shared their experiences and
observation with regards to the influenced of tides in their perspectives with the captains policies and health
measures. According to Respondent A, the government provided an aid to avoid the spread of the virus. The
worries and fear of the people was replaced by the protection of having vaccines. This means that, the fear of the
sailors and the passengers were influenced by the use of a paddle to keep them going. The respondents find it
effective since, some of the news showed that, the number of people who got vaccinated increased day by day.
This means that, through the effective use of a paddle the number of passengers sent to the harbors increases.
Moreover, Respondent B added that, through the spread of the virus, the people were strained to get their
vaccines since they don’t want to be infected. Respondent E also stated that, the pandemic influences her
perspective in the government policies since, she thought that the vaccines provided by the Government were
effective as it deduced the number of emergency case patients. Furthermore, Respondent F mentioned that, the
Government had their best to provide the needs of the nation like vaccines, Personal Protective Equipment (PPE)
for the health workers, and medicines. This influenced people to avail the vaccines. The last respondent under
this category stated that, the Government had an immediate actions to help the people and avoid the spread of the
virus. Though, millions are asking for it, the Government were able to provide everything to fight the battle of
called pandemic.

COVID-19 pandemic represents the most serious seen in a respiratory virus since the 1918 H1N1 influenza
pandemic. In the absence of a vaccine, the rapid spread of this disease elicited a wide range of responses from

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different governments across the globe to contain the spread of the pandemic. These policies were aimed at: (a)
mitigation, which focuses on slowing but not necessarily stopping epidemic spread—reducing peak healthcare
demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to
reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.
Suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that
situation indefinitely.

Sub-Theme 2: Implementation of Sailing Protocols. As movement is restricted to contain the disease,

passengers are forced to stay indoors for months as there is still no cure or help against the tides and waves.
However, many still refuse quarantine protocols for various reasons. This prompted the government to ask local
government units (LGUs), particularly barangays, to intensify the implementation of restrictions especially in the
movement of people and repeatedly sought their cooperation to minimize, if not totally wipe out the number of
infections.

Through this, Respondent A mentioned that the implementation of different health protocols or boat
protocols helped passengers and sailors to be aware of their health. The people also learned to follow the policies
provided by the Local Government Unit (LGU) for the safety of every individual as stated by Respondent D.
While, Respondent G added that, people became aware of the news about health measures provided by the
Government. Same as what Respondent I shared about her awareness of the news and advertisement about the
prevention of the virus. Respondent H also mentioned that, the provided health measures boost their confidence
and deduced the fear of fulfilling their responsibility as a health workers. The last respondent who is Respondent
K shared that, she became eager in the people in the community. Respondent K also added on her statement that,
people should be ready and focus all the time, in case of another pandemic will come.

The vitality of the frontliners in crisis is not in doubt. However, they experienced considerable physical
distress and psychological stressors, even leading to psychological illness and infection in this environment.
There is an urgent need to accurately, comprehensively and objectively understand their experiences, perceptions
and current situation of burnout, post-traumatic stress disorder (PTSD), anxiety, depression, insomnia and
coronavirus infection. Therefore, this protocol is to conduct a mixed-methods systematic review to summarize
the evidence on the experiences of healthcare providers and impacts of the coronavirus on their psychological
status and infection during the pandemics.

Focus Group Results and Discussion. The researchers analyzed the transcripts of interviews from the 10
informants of Unit 1 and 11 informants of Unit 2. The challenges and application of the ego-ideal concept of
Psychoanalytic theory were explored leading to the formulation of themes with associated meanings derived
from the findings of this study. Since this study adopted the Roy Model by Callista Roy in which this model
shows the individual as a set of interrelated systems that maintain a balance between various stimuli.

Theme 1: Background of the role and experience of a Sailors.

Sub-Theme 1: First Aid. The researcher asked all the informants under unit 1 of sailors or barangay heath
workers about their background in their role and experience as a sailor. Most of them said that, being a first aide
became one of the backgrounds they can give since, whenever there is a passenger who feels unconscious or not
feeling well the first to respond are those who served as a barangay health workers especially when the patient
has the symptoms of high blood pressure.

Volunteer BHWs play important roles as community health workers. The eligibility criteria to become
BHWs is the people who has voluntarily rendered at least five years of continuous active and satisfactory service
in the community. Their function as a link between the community and the local health centers, especially in
health promotion and surveillance activities, and provide support to health professionals in health service
delivery.

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Sub-Theme 2: Monitoring. The respondents from unit 2 of sailors of pandemic mentioned that, one of their
background experience being a health worker is the monitoring of vaccination for children, distribution of
vitamins, deworming, monthly monitoring of children’s weight to identify who are the malnourished who needs
to be feed, and encouraging pregnant women to have their regular check up in the rural health unit of the
municipality. The aforementioned experiences and roles of sailors are some of the top answers of each
informants.

Barangay Health Worker (BHW) are vital in Barangay Health Centers as they cater assistance and support to
other health workers. Their roles and functions have been evolving to accommodate the changing needs and
demands of their catchment area and thrusts of the healthy system as evidenced by the approved policies.

Theme 2: Inspiration of the Sailors

Sub-theme 1: To provide health care service to the community. Most of the participants of the focus
group study under unit 1 or group 1 mentioned that, their inspiration as a Barangay Health Workers is to help the
people in the community and spread their love and concerns. Moreover, respondents from group 1 or unit 1 also
mentioned that, providing health care services is their inspiration as a sailor without asking for something in
return. BHWs or sailors support the communities' well-being by ensuring health programs for the undeserved
population or passengers. More importantly, as members of the same communities they serve, they possess
intimate knowledge of the communities' health needs and issues. Moreover, in response to the COVID-19 crisis,
the sailor’s role had evolved to assist the Barangay Health Emergency Response Team (BHERT) in covering
essential pandemic responses such as active contact tracing and monitoring of community members under
quarantine. However, despite the enacted policies to support their role and work, perennial challenges to policy
implementation remain. These hinder the sailors from effectively fulfilling their tasks and serve as barriers to full
and adequate recognition of their role in community health as cited by Baliola, et al., (2024).

Theme 3: Typical duties and responsibilities of Sailors in the Community.

Sub-theme 1: Provides sail services any time. Among the 21 respondents of the focus group, 10 of them
under unit 1 mentioned that, one of the best duty and responsibility of being a sailor in the community is the
heart of giving service at any time. According to Baliola, et al., (2024), BHWs are front liners delivering certain
primary care services to barangays. They usually belong to several barangays. They undergo training from any
authorized government and non-government agencies. As advocates, educators, and disseminators of information
on health programs, BHWs are expected to be knowledgeable in basic concepts of family planning and
reproductive health, maternal and child health, communicable and non-communicable diseases, and a healthy
lifestyle, among others. Previous studies have shown their role's impact on community health, for instance,
through their contributions in improving children's nutrition outcome and in supporting primary postpartum
maternal education health care.

Sub-theme 2: Monitoring and evaluation Based on the conducted focus group, the researcher analyzed the
responses who come up saying that, monitoring patients with recurring disease in lung is one their duties as a
barangay health worker. The respondents also mentioned that, distribution of medicines to the ill patients is one
of their common duties. As mentioned by Baliola et al. (2024), BHWs also continued to deliver prescription
medicines, schedule immunizations, perform prenatal checkups, and refer clients for consultations to the local
health centers. As a result, some municipalities saw an increase in the BHWs' caseload as more patients preferred
visiting smaller RHUs for PHC to seeking outpatient services in tertiary facilities. The value of the BHWs'
contribution to delivering community care is thus evident as they play a critical role in bridging the community
to the larger health system.

Theme 4: Most common type of health care emergencies in the barangay or community.

Sub-theme 1: Pregnancy cases. Based on the analysis of the researcher it was found out that, unit 1 and

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unit 2 of barangay heath workers mentioned that, pregnancy cases is the number 1 type of health care
emergencies they usually encounter in the community.

Sub-theme 2: Dengue. The researcher also found that, dengue is one of the types of health care
emergencies they deal with in different barangays of unit 1 and unit 2. Majority of the respondents agreed that
dengue brings health problems in some of the barangay in the municipality of San Luis including Taliba,
Calumpang West, Sta. Monica, Dulangan, Durungao, Poblacion, San Martin, and Abiacao.

Sub-theme 3: Animal Bite. The last common type of health care emergency as experienced by the barangay
health workers of San Luis Batangas is the animal bite cases. Many patients are seeking for animal bite vaccines
or anti rabies to prevent the spread of rabies in the body of the victim. Due to this cases, the rural health unit of
San Luis Batangas implemented the schedule of regular animal bite vaccination for the animal bite patients.

Theme 5: Ways to respond in health care emergencies.

Sub-theme 1: Engaged themselves. The respondents from Unit 1 or group 1 stated that, the barangay
health workers of different barangays in the municipality engaged themselves in the emergency situations by
directing into the Rural Health Unit. Unit 2 or group 2 of the focus group study also mentioned that, the
barangay health workers must have coordination with the rural health unit to provide the needs of the patients.

Theme 6: Biggest Challenges faced when responding to health care emergencies in the community.

Sub-theme 1: Afraid to get infected. Both pf the groups mentioned that, they were afraid to get infected
since they serve to provide their best health care responses to the community. Most of them are afraid that, they
might get the same ill or disease from the patients.

Sub-theme 2: Attitude of People in the Community. Also, both of the groups mentioned that, the biggest
challenges they were facing in response to health care emergencies is the attitude of the people in the community.
It seems that, they were also afraid to get infected.

Theme 7: Resources and Support system available in the community in response to the health care
emergencies. Both of the Unit mentioned that, coordination with the Rural health Unit helped the BHWs better
in responding to the different health care emergencies in the community.

Theme 8: Gaps and deficiencies in resources that make it difficult for sailors to effectively handle tides
and big waves of emergency cases.

Sub-theme 1: Lack of Knowledge. Based on the analysis of FGD, the researcher found that unit 1,
mentioned that the lack of knowledge of the sailors in responding to the unexpected waves is one of the gaps and
deficiencies of BHWs in the community. It made them difficult to manage health care emergencies since, it is not
their expertise. According to Baliola, et al. (2024), BHWs are supposed to be knowledgeable in basic thought of
family planning and reproductive health, maternal and child health, communicable and non-communicable
diseases, and a healthy lifestyle, among others

Sub-theme 2: Lack of health equipment, medicines and budget. Based on the responses of the
respondents from unit 1 and unit 2, it was found that majority of them mentioned that it is a gap for them
knowing that there is a lack of equipment, medicines and budget in their response to the different health care
emergencies.

Theme 9: Ways to navigate resources constraints when faced a health care emergency.

Sub-theme 1: Coordination with RHU. The researcher’s conduct of focus group discussion about how the
barangay health workers navigate resources constraints when faced a health care emergencies found that,
coordination is the majority answer of group 1 or unit 1. The respondents from this unit mentioned that, “We

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coordinate with RHU to provide the needs of the patients.” The majority of the respondents were at the 40 and
above. Out of 10 informants the two of them were from barangay San Martin San Luis Batangas.

Sub-theme 2: Utilization of Personal Wealth. The respondents of the study under Unit 2 composed of 11
informants said that, “We utilize our own wealth and things to sustain the needs of the patients.” The respondents
also added that, they are the one who find ways on how they are going to fulfill their duties.

Theme 10: Communication of Barangay Health Workers and with higher-level healthcare facilities
during emergencies.

Sub-Theme 1: Group Discussion. Based on the responses of the respondents from group 1 and group 2,
majority of them stated that for them to be able to communicate with other members of barangay health workers,
they are conducting group discussion so that, the leader will be the one to discuss the things they need to do or to
clarify. The respondents verbatim in this theme is “There are group discussions for barangay health workers to
address the health situations of the community, and inform the RHU of San Luis about it.” based on them, the
group discussion involves barangay personnel such as the barangay Captain. The barangay Captain will be the
one to inform the rural health of the municipality to provide solutions to the health problems.

Theme 11: Challenges encounter in terms of communication and coordination when responding to
emergencies.

Sub-Theme 1: Lost of Coordination. According to the respondents of Unit 1, the challenges they
encounter in terms of communication and coordination when responding to emergencies is the loss of
coordination. The respondents said that, “If they lost communication and coordination with the higher level
health care workers and facilities, it became a challenge for us.”

Sub-theme 2: Attitude of People. Most of the respondents of Unit 2 or group 2 of barangay health workers
said that, “the attitude of the people in the community is a big challenge for them when dealing with the
emergency cases if they are reminded or informed by the health workers. This is the common problem as shared
by the health workers of different barangays in San Luis Batangas under Unit 2.

Theme 12: Example of a situation where communication breakdowns or coordination challenges

hindered the ability to respond to a healthcare emergency.

Sub-theme 1: Miss Communication. Based on the conducted FGD of barangay health workers, both of the
group said that miss communication is a hindrance for them to respond in a healthcare emergency. Group 2
stated that, “When there is no available driver in a rescue vehicle, it hinder us to respond in a health care
emergency cases in the community.”

Theme 13: How do Barangay Health Workers engage with the community to promote emergency
preparedness and response.

Sub-theme 1: Through Group Chat. Most of the respondents under unit 1 and unit 2 stated that, “through
group chat or gc and home to home visit, they can promote emergency preparedness and response to the
community.” Based on them, using group chat is a great help for them to disseminate information and updates
about emergency cases. They can also shared different thoughts as they use their group chat or messenger. They
also added that, barangay health workers do monitoring and home visit to spread awareness for the people in the
community.

Theme 14: Strategies to educate community members about recognizing and responding to healthcare
emergencies.

Sub-Theme 1: Home to home visit. In connection to the response of the respondents in the engagement
of BHW’s to promote emergency preparedness, the respondents from both unit also shared strategies to educate

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the community members about recognizing and responding to healthcare emergencies. Group 1 or unit 1 stated
that, “they have home to home visit to check the situation of the patients. While unit 2 or group 2, said that,
“they conduct home to home visit to keep reminding and to spread awareness about new disease.

Theme 15: Encountered resistance or barriers from the community when trying to promote
emergency preparedness and response.

Sub-theme 1: Rejection. Promoting emergency preparedness and response within a community can indeed
be challenging, but it’s crucial for building resilience. Based from the responses of the respondents from unit 1
and 2, it was found that people are afraid of getting vaccinated. The respondents from unit 1 stated that, “People
said that, they were afraid of vaccines because of the ill it may bring to them.” while, respondents from unit 2
added that, “people don’t want to be reminded about the vaccines.” These are the common barriers in the
community that hindrance the BHWs to promote emergency preparedness and response.

Theme 16: How do you cope with the stress and emotional toll of your work as a sailor or Barangay
Health Worker? Being a Barangay Health Worker or sailor in the middle of emergency cases can indeed be
emotionally challenging, but there are strategies you can use to manage stress and maintain your well-being.
They must prioritize self-care. Make sure they get enough rest, eat nutritious meals, and engage in physical
activity. Regular exercise can help reduce stress and improve mood. In connection, respondents from unit 1
stated that, “a broader understanding and patients is a virtue.” Patients in different kind of emergency cases help
them cope the stress and longing in their work. Respondents from unit 2 also added that, “we just need to be
strong because we love our duty.”

Theme 17: Can you describe a particularly challenging or emotionally demanding experience you've
had while responding to a healthcare emergency? The respondents from both unit of barangay health workers
shared their thoughts about a particular challenging experience while responding to healthcare emergency. The
respondents from unit 1 or group 1 which composed of 10 participants said that, “we wanted to help but it is
difficult since we don’t have enough budget.” This is one of the most challenging experiences shared by the
informants. While, respondents from unit 2 said that, “We are afraid for ourselves and for our family.” This
example experience made them feel the challenge of being a barangay health worker who served as the hero of
the community during healthcare emergency cases.

Theme 18: What support systems or mechanisms are in place to help Barangay Health Workers deal
with the personal and emotional impact of their work? Barangay Health Workers (BHWs) in the Philippines
play a crucial role in health care delivery, acting as the bridge between the community and the health system.
However, their well-being is often neglected. BHWs’ commitment to serve should not excuse inadequate support.
Prioritizing their well-being benefits both them and the communities they serve. Based on the FGD among the
respondents from two different units. The researcher found that, respondents from unit 1 conducts discussion
about the things they need to do which help them promote preparedness in healthcare emergencies. While, the
respondents from unit 2 stated that, “we are given foods, and conducts orientation about isolation.” The
mentioned responses of the respondents showed that there is a similarity between their answers.

Theme 19: What training or capacity-building opportunities are available to Barangay Health
Workers to enhance their skills in responding to healthcare emergencies?

Sub-theme 1: MDRRMO training. Almost all of the respondents under unit 1 and 2 of barangay health
workers stated that, “We have conducted trainings from MDRRMO on how to handle the patients during an
accident.” It can be gleaned that, MDRRMO of San Luis Batangas had its partnership with the barangay health
workers of different barangays of the municipality. Based on the researcher’s collected information, there are
TESDA trainings that can be given to the BHW’s to improve their skills.

Theme 20: Are there any specific areas of training or skill development that you feel are particularly

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Mirano, J. M. M.
important for Barangay Health Workers in relation to emergency response? Based on the responses of the
respondents in both unit, the researcher found that trainings for the barangay health workers is important in
enhancing their skills in dealing with different kinds of healthcare emergency cases in the community. It is useful
for them to save more life as they served as a hero in the community due to some consequences they might bring
like the risk of their personal health.

Theme 21: How do you think training and capacity-building efforts could be improved to better
prepare Barangay Health Workers for handling healthcare emergencies? Based on the responses of unit 1
and 2, the researcher found that trainings and refreshers of their skills help them boost their confidence.
Improving training and capacity-building for Barangay Health Workers (BHWs) is crucial for enhancing their
preparedness in handling healthcare emergencies. Conduct periodic refresher courses to reinforce knowledge and
skills. BHWs should participate in ongoing learning opportunities to stay updated on best practices and new
developments. Empowering BHWs involves a holistic approach, including not only technical knowledge but
also empathy, communication skills, and community engagement. By investing in their development, we
strengthen the frontline response to healthcare emergencies.

Theme 22: Looking ahead, what do you see as the most pressing challenges or areas for improvement
in terms of Barangay Health Workers' response to healthcare emergencies? Majority of the respondents
under unit 2 stated that, “to have enough supplies of medicine, medical equipment, and knowledge in response to
emergency cases should be improve in the community.” Unit 1 added that, those supplies will improve or
enhance their skills as a community health workers. BHWs need sufficient remuneration and training
opportunities to enhance their competence and confidence in performing their extensive tasks. Formal and
structured training can improve service quality.

Theme 23: Based on your experiences, what recommendations would you make to policymakers or
healthcare authorities to better support Barangay Health Workers in responding to healthcare
emergencies? Based on the collected data, both of the group said that, the healthcare authorities must give an
enough budget, enough supplies of medicines like vitamins, and enough supply of medical equipment to sustain
the needs of the community in terms of health issues. The policy makers must implement an effective policy that
every barangay health workers will follow.

Theme 24: Is there anything else you would like to share about your experiences as a Barangay Health
Worker in relation to healthcare emergencies? The respondents from both unit shared that, their knowledge,
and skills learned from the trainings given by the mdrrmo and the emergency cases made them be a better life
saver. Though, there are some cases that leads them to feel the stress and being challenged, it doesn't stop them
to serve the community.

Sailor’s model shows the representation of how the barangay health workers handle the waves of health
emergency cases. This was used to further analyze the role of the barangay health workers in the middle of
health emergencies. The researcher chose to use the following symbols such as the waves, harbor, sailors, sand
and reefs. The big waves in the model were represented as the different health emergency cases that affects the
lives of the barangay health workers. The researcher chose waves as the representation of health emergency
cases since it hinder the sailors in sailing. Harbors were represented as the health care facilities which was found
that there were lacking facilities according to the informants or respondents. Sailor’s symbol was used as a
representation of the healthcare workers who were battling in the middle of the big waves. Moreover, the sand
and the reefs were used as the representation of barriers in the sea during low tides. The low tides were used as
the representations of lock downs in different barangays. While, high tide was represented as high number of
emergency cases in the community. It can be seen in the model that, the waves hinder the boat to keep going
through the situations.

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 Challenges of barangay health workers in advent of health care emergencies

Figure 3: Sailors Model

4. Conclusion and recommendation

The researcher asked all the respondents about what are the most challenging aspect of coping pandemic
with health care emergencies like covid pandemic. Most of the respondents shared that the most challenging
aspects of coping pandemic is getting risk of personal health. Healthcare providers are the frontline soldiers
fighting against COVID-19 pandemic. Their responsibility as health workers is to directly provide and manage
COVID-19 care processes, which, considering the overwhelming number of cases, may cause them to risk their
personal health. Moreover, the respondents were also asked how the community faced the challenges during
emergency cases. The responses of the respondents vary since they have different experience in facing
challenges during pandemic. However, most of the respondents mentioned that, the LGU of San Luis and the
health workers of the barangay had their duties to monitor those who enter the area as community quarantine
were strictly implemented. They also provided security checkpoints for the safety of every individual. This
implies that, the monitoring and security team truly helped in facing the challenges due to pandemic. More so,
the effects of health care emergencies in daily life and routine of the respondents were also asked by the
researcher in which the respondents stated that, their personal hygiene or health was considered the number one
affected by the different heath care emergencies. So, the respondents became aware of their health. While, in
connection to the effects, the respondents were also asked about their emotions or feelings during pandemic.
Most of them mentioned that, they felt the fear and worries amidst of covid-19 pandemic. In terms of their
perspectives in the government policies and health measure, the respondents said that, through the
implementation of the different health protocols, the people was forced to follow especially the vaccination
policy. And, this case leads a better result, since the number of cases affected by the virus decreased day by day
though the risk is still there. The hope and prayers of the people says that, the pandemic has an ending.

Based on the findings and conclusion drawn from the study, the following

Recommendations were made: Hospitals may provide certain measures to improve the quality of health care
system with the proper implementation and acceptable admitting areas for each patients in accordance to the
minimum health standards and the isolation of each patients. Since, Frontline health care workers are faced with
imminent risks of getting infected, the researcher recommend to decrease the rate of patient encounter per
frontline health care worker and decrease the interaction time between the frontline health care worker and the
patients. The researcher recommends the Local Government Unit of San Luis Batangas to have an organized
schedule for each of the front liner or health worker. It will better help them to have time management so, their
daily routine will not be affected. Based on the data, it was revealed that most of the respondents felt the fear and

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worries which are inevitable, but the researcher recommends the barangay health workers to undergo training
and seminars about emergency preparedness. Future researchers may further discuss the topic related from this
study with the use of selective quantitative research design that quantifies the possible action to be taken in
deducing the challenges encountered by the Health Workers amidst of emergency cases.

5. References

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Systematic Review. J Multidiscip Healthc. 2021; 14: 3015–3025.Published online 2021 Oct 27. doi:
10.2147/JMDH.S330041
Baliola M, Golpe M, Advincula-Lopez LV. (2024) Gains and Challenges of the Barangay Health Worker (BHW)
Program during COVID-19 in Selected Cities in the Philippines. J Health Res. 2024; 38(1):-.
DOI: https://doi.org/10.56808/2586-940X.1060
Joebges and Biller-Andorno (2020). Ethical Challenges Experienced by Healthcare Workers Delivering Clinical
Care during Health Emergencies and Disasters: A Rapid Review of Qualitative Studies and Thematic
Synthesis. AJOB Empir Bioeth. 2022 Jul-Sep; 13(3): 179–195. Published online 2022 Apr 25. doi:
10.1080/23294515.2022.2063996
Marston, Reledo, and Miles (2020). Community participation is crucial in a pandemic. Published:May 04, 2020
DOI:https://doi.org/10.1016/S0140-6736(20)31054-0

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