Integrated Community-Based Primary Healthcare Model to Strengthen Universal Health Coverage: Evidence from CHW Readiness, Service Quality, and Digital Health Acceptability in Selected CALABARZON LGUs
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https://doi.org/10.65166/tketyh24关键词:
Community Health Workers, primary healthcare, digital health, Universal Health Coverage, Philippines, healthcare access, service quality, health governance摘要
Universal Health Coverage (UHC) remains a global health priority, with strong primary healthcare (PHC) systems serving as the primary pathway for its achievement. In the Philippines, the Universal Health Care Act provides the policy framework for UHC, yet implementation gaps persist in community-level service delivery, particularly regarding the integration of community health workers (CHWs) and digital health tools. This study investigated community readiness for a scalable model strengthening PHC through formal CHW-digital health integration. A quantitative cross-sectional design was employed, collecting survey data from 633 household respondents across five local government units in the CALABARZON region. The assessment covered healthcare access barriers, perceived service quality, CHW engagement, and digital health readiness. Results indicated near-universal CHW awareness (99.7%), high trust (98.4%), and strong support for formal integration (98.9%), although CHW interaction was predominantly episodic (66.3% reporting only one contact in 12 months). Perceived service quality varied significantly across LGUs (p < .001, ε² = 0.134). Digital readiness was high (94% willingness to use digital tools), but confidence in data confidentiality was markedly lower (M = 2.72/5). Among respondents reporting access barriers, cost was dominant (91.7%). The findings suggest that CHW-digital health integration is socially acceptable and operationally feasible in the study contexts. Successful implementation, however, would require institutionalized CHW roles, locality-sensitive planning, robust privacy governance under trusted public custodianship, and complementary strategies addressing financial access barriers. An integrated community-based PHC model is proposed, structured around standardized CHW functions, digital workflow enablement, and scalable implementation conditions derived from empirical readiness signals.
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