The advent of Republic Act 7160 or the Local Government Code of 1991 postulates a community-based health service provider. A decentralization processes were initiated which institutionalized the Barangay Health Workers (BHWs) as essential human resource component for health service delivery at the local level in collaboration and supervision of the Barangay Local Government Unit (BLGU) Officials. BHWs in every barangay were initially conceived as functional partners in meeting the critical health needs of the community.
In 1991, the Local Government Code of the Philippines devolved responsibility for public health, primary care, and selected hospital services to local governments, municipal and city governments take full responsibility for the operation of rural health units and barangay health stations, and provincial governments take full responsibility for the operation of district and provincial hospitals. According to the World Bank, “the devolution of health care to Local Government Units under the Local Government Code of 1991 has not improved services to the most needy, due mainly to the lack of preparation at the local level on the basics of health delivery and health financing” (World Bank 2009).
One of the major mandates of every BLGU is the establishment of BHW Association which composed of volunteers from every puroks who will look into the health needs of the populace and to serve as front liners in the delivery of basic health service in every barangay. BHWs serve as assistants to the midwifes of Barangay Health Units and primary providers in the treatment of simple symptoms, immunization, family planning, and basic health education for their community. Allocation of funds for health services must be likewise observed by the Barangay Administration.
It is admitted that there is a growing lack of medical manpower in remote areas that are not served by government doctors. A perennial problem in health service delivery in the Philippines that needs to be addressed by the Local Government Units (both Municipal and Barangay). An attempt remedy on this is the application of traditional and alternative health care in the community level as embodied in the intent of the Republic Act 8423 or the Traditional and Alternative Medicine Act (TAMA) of 1997. The local government units in collaboration with the Department of Health thru the Philippine Institute of Traditional and Alternative Health Care (PITAHC) should initiate programs and activities that would strengthen the capabilities of BHWs who are the frontliners in health service delivery and enable them to treat common illnesses in their communities utilizing available local resources. But what capability development undertakings for BHWs initiated by PITAHC so far?
On the other hand, the BLGU is the smallest administrative division in our country which possibly, most importantly, is the level to which health care administration has been decentralized. Hence, health care implementation and decision making occurs at this level. Understanding the state of health service delivery in the barangay/ community is an imperative factor to that effect. The awareness of the BLGU officials on its responsibility in ensuring health services to the barangay folks can be gauged somehow on how they support, utilize, and improve the capability of their appointed Barangay Health Workers.
Aside from becoming an assistants to the midwifes assigned to their respective barangays and other routenary activities of the BHWs (such as; basic health data gathering, immunization, family planning, and etc.), there must be local initiatives affecting health sector (specially concerning preventive measures) that are feasible and adoptable to the community. The meager resources of the barangay government on the mandatory appropriation for health services should not only be exhausted on honorariums and purchases of medicines and medical equipment. A comprehensive quality health service delivery system must integrate the conventional medicine and traditional and alternative health care to be employed by the BHWs – the frontline health service providers.