MINGLANILLA SCIENCE HIGH

SCHOOL

Población Ward 1 Minglanilla, Cebu

Assessment of Primary Healthcare Facilities and Equipment Quality in Minglanilla

Rural Health Unit-II

Cristin Aulil Arong

Valerie Grace Batidor

Abegail Panes

Trisha Faye Pasay

Harrel Jade Porio

Anne Therese Zarate

Researchers

Jean Alad-Morales

Research Adviser
Rationale (ANGKAS)

Primary medical care is essential for every individual in the society and it is one of the
government's obligations to provide a unit especially in rural areas that helps aid the needs of
the people with regards to their health. Currently, most of the government does not supply
enough facilities and equipment. With this, patients are provided with a referral paper to
transfer to another unit or hospital for the service they need

A Rural Health Unit (RHU) is a unit that primarily provides physicians health care
services to medicare beneficiaries and medicaid recipients in rural areas who experience
shortage of personal health services or primary care manpower. In Minglanilla, the main RHU
is located in the Tiber and the other unit is in Lipata where the researchers have done their work
immersion.

In a study conducted by state think tank Philippine Institute for Development Studies
(PIDS) evaluating the Health Facilities Enhancement Program (HFEP) of the government, it
was noted that hospitals and infirmaries that received funding from the government to upgrade
their facilities showed higher volume of services than those that did not.

For this reason , this study is conducted to implement a better quality service for the
patients with improved equipment and facilities to provide in RHU II, Lipata.

Related Literature (OLIL)

● https://www.ajol.info/index.php/samj/article/view/88000
In this study, decentralisation of ART initiation by professional nurses was shown to increase
ART uptake and reduce workload at referral facilities, enabling them to concentrate on
complicated cases. However, it is important to ensure capacity building, training and
mentoring of nurses to integrate HIV services in order to reduce workload and provide a
comprehensive package of care to patients. Engaging and having buy-in from DoH/CoJ
partners in rolling out NIMART was crucial in increasing outputs as well as for sustainability
of the NIMART programme.
● https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2024642/ (1955 nga nindot)
● https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0838-8
Applying WHO criteria [17], the collection and analysis of data on facility infrastructure by
using the rapid assessment tool will enable health authorities (1) to improve the performance
of a health care system by detecting and eliminating infrastructural deficiencies; this leads to
better services, for example by assuring the availability and functioning of the required
technical medical equipment; (2) to respond to threats by improving the reporting on facility
infrastructure and related problems; (3) to improve health of the population which is, as
above cited research proves, the consequence of improving accessibility, availability and
quality of health services by providing good facility infrastructure. The instrument is ready
and available for application.
● https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052842/
As other infectious diseases, healthcare workers are at risk of infection because they
have to work at the frontline, often without protections. However, even with
protective clothing, a healthcare worker can be contaminated if removal is not done in
a manner that prevents exposure [13-15]. A limited numbers of studies have been
performed regarding contamination with PPE usage.
● https://europepmc.org/article/med/10915307

The Problem

Statement of the Problem (ANTET)

This study aims to assess the quality of facilities and equipment in Minglanilla Rural

Health Unit-II. Specifically, this study aims to answer the following questions:

1. What is the quality of facilities and equipment in Minglanilla Rural Health Unit-II?

2. What is the service quality of employees towards patients in Minglanilla Rural Health Unit-

II?

3. Is there a significant correlation between facility and equipment state and service quality

of employees towards patients in Minglanilla Rural Health Unit-II?

Hypotheses (VAL)

Alternative Hypothesis
There is a significant correlation between facility and equipment state and service
quality of employees towards patients in Rural Health Unit-II.

Null Hypothesis
There is no significant correlation between facility and equipment state and service
quality of employees towards patients in Rural Health Unit-II.
Research Methods (PASAY)

I. Gathering / Preparing for the materials

A request letter will be sent to the principal of Minglanilla Science High School (MSHS)asking

permission to conduct the study. After the approval of the principal, a letter of request will also

be sent to the industry supervisor of Minglanilla Rural Health Unit-II for the approval to

conduct our study.

II. Gathering of Data

The data to be gathered will be measured. Through the responses on questions regarding

various health services, a composite measure of healthcare facility quality is determined. The

items are service availability, service readiness and processing of equipment for reuse.

References (ALL-CUT & PASTE ANG LINK GUYS)

Definition of the Terms ‘Medical Device’ and ‘In Vitro Diagnostic (IVD) Medical Device’,
Global Harmonization Task Force, 2012

Ehiri, J. E., Oyo-Ita, A. E., Anyanwu, E. C., Meremikwu, M. M., & Ikpeme, M. B. (2005).
Quality of child health services in primary health care facilities in south-east Nigeria. Child:
Care, Health and Development, 31(2), 181–191. doi:10.1111/j.1365-2214.2004.00493.x

Lim, S. M., Cha, W. C., Chae, M. K., & Jo, I. J. (2015). Contamination during doffing of
personal protective equipment by healthcare providers. Clinical and experimental emergency
medicine, 2(3), 162.

May, C. R., Cummings, A., Girling, M., Bracher, M., Mair, F. S., May, C. M., … Finch, T.
(2018). Using Normalization Process Theory in feasibility studies and process evaluations of
complex healthcare interventions: a systematic review. Implementation Science,
13(1).doi:10.1186/s13012-018-0758-1

Nair, M., Baltag, V., Bose, K., Boschi-Pinto, C., Lambrechts, T., & Mathai, M. (2015).
Improving the quality of health care services for adolescents, globally: a standards-driven
approach. Journal of Adolescent health, 57(3), 288-298.
Scholz, S., Ngoli, B. & Flessa, S. Rapid assessment of infrastructure of primary health care
facilities – a relevant instrument for health care systems management. BMC Health Serv Res
15, 183 (2015) doi:10.1186/s12913-015-0838-8

Woodward, C. A., Ostbye, T., Craighead, J., Gold, G., & Wenghofer, E. F. (2000). Patient
Satisfaction as an Indicator of Quality Care in Independent Health Facilities: Developing and
Assessing a Tool to Enhance Public Accountability. American Journal of Medical Quality,
15(3), 94–105. doi:10.1177/106286060001500303

WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean
Care Is Safer Care. Geneva: World Health Organization; 2009. Appendix 1, Definitions of
health-care settings and other related terms.

Zhang, X., Yu, P., Yan, J. et al. Using diffusion of innovation theory to understand the factors
impacting patient acceptance and use of consumer e-health innovations: a case study in a
primary care clinic. BMC Health Serv Res 15, 71 (2015) doi:10.1186/s12913-015-0726-2

CHAPTER 1

THE PROBLEM AND ITS SCOPE

Rationale (ANGKAS)

Theoretical Background

Related Theories (OLIL)

The study was supported by the two following theories: Normalization Process Theory

(NPT) and Diffusion of Innovation (DOI) Theory.

The Normalization Process Theory (NPT) recognizes and emphasizes the procedures

which promote current health techniques. This means that the theory discusses mechanisms
that have been empirically demonstrated to motivate and shape implementation processes and

affect their outcomes. From this, tools were developed to assist implementation practitioners

and researchers in thinking through and measuring important elements of implementation

processes.

Diffusion of Innovation Theory was used in some studies as a theoretical framework

to examine and explain the impact of factors, in particular, the characteristics of innovations

and innovation decision-making processes, on patient acceptance and ongoing usage of an

EAS service.

Related Literature (OLIL)

The following provides an overview of research done on Primary Healthcare Facilities

and Equipment including its definitions and indications, characteristics, factors that can affect

Research Performance.

Primary health-care centre. A centre that provides services which are usually the first

point of contact with a health professional. They include services provided by general

practitioners, dentists, community nurses, pharmacists and midwives, among others.

Medical devices requiring calibration, maintenance, repair, user training and

decommissioning – activities usually managed by clinical engineers. Medical equipment is

used for the specific purposes of diagnosis and treatment of disease or rehabilitation following

disease or injury; it can be used either alone or in combination with any accessory, consumable

or other piece of medical equipment. Medical equipment excludes implantable, disposable or

single-use medical devices.

Related Studies (OLIL)

 Primary Healthcare Facilities are infrastructures that enable health authorities (1) to
improve the performance of a health care system by detecting and eliminating infrastructural
deficiencies; this leads to better services, for example by assuring the availability and
functioning of the required technical medical equipment; (2) to respond to threats by
improving the reporting on facility infrastructure and related problems; (3) to improve the
health of the population which is the consequence of improving accessibility, availability and
quality of health services by providing good facility infrastructure.

As other infectious diseases, without primary health care equipment sanitation,

healthcare workers are at risk of infection because they have to work at the frontline, often
without protection. However, even with protective clothing, a healthcare worker can be
contaminated if removal is not done in a manner that prevents exposure. A limited number of
studies have been performed regarding contamination with PPE usage.

Conceptual Framework (ANGKAS)

The theoretical background which shows the conceptual framework of the study in the

schematic diagram is shown in Figure 1.

Figure 1. Schematic Diagram of the Theoretical- Conceptual Framework of the Study

As shown in Figure 1
The Problem

Statement of the Problem (ANTET)

This study aims to assess the quality of facilities and equipment in Minglanilla Rural

Health Unit-II. Specifically, this study aims to answer the following questions:

1. What is the quality of facilities and equipment in Minglanilla Rural Health Unit-II?

2. What is the service quality of employees towards patients in Minglanilla Rural Health Unit-

II?

3. Is there a significant correlation between facility and equipment state and service quality

of employees towards patients in Minglanilla Rural Health Unit-II?

Hypotheses of the Study (VAL)

Alternative Hypothesis
There is a significant correlation between facility and equipment state and service
quality of employees towards patients in Rural Health Unit-II.

Null Hypothesis
There is no significant correlation between facility and equipment state and service
quality of employees towards patients in Rural Health Unit-II.

Significance of the Study (VAL)

The results of the study would benefit the following:

the citizens could acquire proper and quality health care and avoid negligent and

inaccurate service in a public health unit;

 the employees could execute proper health services and satisfy the demands of the

general public ;

the government could be aware of the facilities and equipment required for improved

service quality in rural health units; and

the community could depend on the accurate and appropriate health services of the

rural health unit.

Scope and Delimitation of the Study (ANTET)

The general purpose of this study is to assess the quality of facilities and equipment for

an improved and sustained quality of care in health facilities and equipment for quality service.

The study will be conducted at Minglanilla Rural Health Unit-II located inside Lipata Central

Elementary School, Linao-Lipata, Minglanilla, Cebu.

Definition of Terms (ABE)

The following operational definition of terms is provided for terms having special application

in this study.

Assess.Refers to evaluating or estimating the nature, ability, or quality of.

Competent.Refers to having suitable or sufficient skill, knowledge, experience for some

purpose.

Correlation.Refers to a technique used to measure the relationship between two or more

variables,when two things are correlated, it means that they vary together.

Equipments.Refers to the necessary items for a particular purpose.

Facilities.Refers to a place provided for a particular purpose.

Online Information Literate. Refers to the people who recognizes misleading and false

information,sorts through data and interprets the information intelligently.

CHAPTER 2

RESEARCH METHODOLOGY

This chapter presents the research design, research environment, research respondents,

data gathering procedure, research instrument, and the statistical treatment of data.

Research Design

This is a descriptive study of the quality of facilities and equipment of Minglanilla Rural

Health Unit-II. Quality was defined and assessed using the framework for quality assessment

developed by Donabedian (2005). This framework has been widely validated and successfully
used in a range of other studies of healthcare quality (Karel 1993; Haller et al. 1998; Handler

et al. 2001; Hirst & Hewison 2001; Milner 2001).

Research Environment

This study was conducted at Minglanilla Rural Health Unit-II located inside Lipata

Central Elementary School, Linao-Lipata, Minglanilla, Cebu. The RHU 2 caters to a total

population of 84,762 coming from the different barangays of Minglanilla 2 namely: Calajoan,

Camp 7, Camp 8, Cuanos, Linao, Lipata, Manduang, Pakigne and Tungkil which is under their

scope of responsibility.

Research Respondents

The respondents of this study are the selected Minglanilla Rural Health Unit-II staff

primarily:the resident physician,the assigned nurses, midwives and barangay health workers.

Data Gathering/ Research Procedures

A request letter will be sent to the principal of Minglanilla Science High School

(MSHS) asking permission to conduct the study. After the approval of the principal, a letter of

request will also be sent to the industry supervisor of Minglanilla Rural Health Unit-II for the

approval to conduct our study.

The informants will answer the health facility questionnaire namely Kenya Service

Availability and Readiness Assessment and Mapping (SARAM). After answering the survey

questionnaire, the answers will be consolidated and analyzed.

Research Instrument

The researchers will use the Kenya Service Availability and Readiness Assessment and

Mapping (SARAM) which was developed by the World Health Organization. The survey
questionnaire has been field-tested in several countries and has already been widely used,

whether for baseline evaluation before programme implementation begins, for periodic

evaluation of progress, or to compare the quality of care in areas with or without programme

intervention.

Programme decisions based on survey findings contribute to improved and sustained

quality of care in health facilities and are complementary to other facility-based quality

improvement methods. Combined with periodic population-based outcome evaluations and

mapping of public health data, HFS are powerful instruments for improving service delivery.

Statistical Treatment of Data

Quantitative data arising from the study were analysed using the Statistical Package for

the Social Sciences, Version 11.0 (SPSS Inc 2001). Consistent with standard practice,

univariate statistics were used to assess patterns of responses to the questionnaire items. Chi-

square (c2 ) tests were used to assess differences between the categories, and using the Yates

correction for continuity, P-values of less than 0.05 were considered significant. Indicators of

quality include qualifications of health workers, in-service training attended, availability of

drugs and vaccines, availability of equipment/utensils for selected childhood services,

regularity of services offered, clinical skills of health workers in the management of diarrhoea

and ARI as well as the quality of scheduled supervision of health workers. Quality scores were

assigned to indicators to reflect adequate, fair, and inadequate quality. During analyses, options

for the multiple-choice items in the self-completion questionnaire were re-coded as follows:

correct response = 1, incorrect response = 2, and their overall scores were calculated.

Determination of correct and incorrect responses was based on the literature and on the

provisions of the Standing Orders.