By Shanine A. Fortuno-Dinero, JD1

Introduction

In a society, one of the most important roles of the government is the promotion and protection of its people’s health and wellness. That is why, Public Health Offices are vital in ensuring the safety of its people and future generations against health issues and the tendency of disease outbreaks. In line with this, the Public Health Offices such that of Negros Occidental is tasked to advocate, educate and promote health wellness, conduct vaccinations, setting safety standards in the community and in the workplace, montoring nutrition programs and implement other health-related projects as mandated by the national government.

In Relation to this, in June 15, 1954 Republic Act 1082 was approved which is an act Strengthening Health and Dental Services in the Rural Areas and Providing Funds Therefor and in June 22, 1957 Republic Act 1891 was approved to amend 5 sections of R.A. 1082. Since then, this has guided the public servants under the health sector especially in the rural areas where there is a high population of indigents who are in need of this support from the government.

However, in December 2019, a virus outbreak started in China and in January 2020, the World Health Organization declared it as a global health emergency. January 30, 2020, Philippines had its first case of COVID-19, and in March 2020, it has reached Negros Occidental. The pandemic was also detrimental to the PHO knowing that the frontliners were also people who may contract the virus. Hence, most of the operations including medical and dental missions were put on hold and most of the medical staff were mandated to focus in assisting and monitoring possible rise of cases in the province.

Thankfully, in March 26, 2023, the restrictions in relation to the pandemic were lifted in the Province of Negros Occidental and this was the signal for the PHO to restore the hampered programs. Now, this is where our research is going to come in and to study the challenges in conducting health and dental services to the province after the pandemic and gather possible recommendations that will help not only Negros Occidental but as well as other provinces that may find this research applicable and helpful.

In order to gather data, the researcher will conduct a survey to the PHO and to selected medical staff of RHUs of selected LGUs in the province. If time permits, additional interviews may be conducted to back up the data gathered. Data collected will be presented in this research for the benefit of using this as a tool to enhance the implementation of R.A. 1082 and this could also serve as a reference for future amendments if the outcome of this research will suggest possible legislation.

Introduction

The delivery of healthcare services remains a cornerstone of public health initiatives in the Philippines, particularly in remote and underserved areas. The government’s efforts to provide accessible healthcare are enshrined in Republic Act No. 1082, known as the “Rural Health Act,” and its subsequent amendment, Republic Act No. 1891. These legislations are aimed at promoting and ensuring the delivery of adequate health services to rural communities. The laws empower provincial health offices across the country to conduct medical and dental missions, emphasizing a grassroots approach to healthcare delivery. However, the onset of the COVID-19 pandemic presented unprecedented challenges to these missions, forcing healthcare providers to adapt to a new reality characterized by stringent health protocols, resource limitations, and evolving community health needs.

The COVID-19 pandemic brought about a paradigm shift in the public health sector, significantly affecting healthcare delivery and management across all levels. The Provincial Health Office of Negros Occidental, like many other regional health bodies, faced numerous obstacles in conducting medical and dental missions during and after the pandemic. The challenges ranged from logistical constraints, such as transportation and supply chain disruptions, to broader systemic issues, such as funding shortages and a lack of human resources. These challenges are compounded by the need to comply with existing legislation, specifically R.A. No. 1082 and R.A. No. 1891, which mandated the provision of healthcare services to rural areas.

The pandemic exposed vulnerabilities in the healthcare system, underscoring the urgent need for comprehensive reforms and adaptive strategies. In particular, it highlighted the difficulties in conducting medical and dental missions—a vital aspect of public health outreach in rural areas. These missions are essential for addressing the unmet healthcare needs of rural populations, who often have limited access to medical facilities and professionals. As such, understanding the specific challenges faced by the Provincial Health Office of Negros Occidental in the context of these laws is critical to formulating effective recommendations for improving healthcare delivery post-pandemic.

Historical and Legislative Context

The passage of Republic Act No. 1082 in 1954 marked a significant milestone in the Philippines’ commitment to improving rural healthcare. The law aimed to establish rural health units (RHUs) in municipalities and barangays across the country, staffed with medical, dental, and public health personnel to provide essential health services. It was later amended by Republic Act No. 1891 in 1957, which further strengthened the rural health system by providing additional funding, expanding personnel, and extending the coverage of healthcare services.

Both laws emphasize the government’s responsibility to bring healthcare services to the most marginalized and underserved populations. The implementation of these laws has been pivotal in the continuous effort to address the disparities in healthcare access between urban and rural areas. The legislation mandates provincial health offices to conduct regular medical and dental missions, particularly in remote areas where healthcare facilities are scarce or nonexistent. However, the COVID-19 pandemic has posed unique challenges to the implementation of these mandates, requiring health offices to reassess their strategies and operations.

Impact of the COVID-19 Pandemic on Healthcare Delivery

The COVID-19 pandemic has disrupted healthcare systems worldwide, and the Philippines is no exception. The pandemic has brought about a series of challenges that have strained the country’s healthcare infrastructure and resources. For the Provincial Health Office of Negros Occidental, the pandemic’s impact was twofold: it necessitated a shift in focus towards managing COVID-19 cases and, at the same time, hindered the delivery of other essential health services, including medical and dental missions.

Logistically, the pandemic created numerous obstacles. Travel restrictions and lockdowns severely limited the mobility of healthcare teams, complicating the coordination and implementation of missions in rural areas. The supply chains for medical and dental supplies were disrupted, resulting in shortages of essential materials needed to conduct these missions. Moreover, the reallocation of resources to pandemic response efforts left many health offices with inadequate funding and manpower to maintain their regular activities.

Operationally, the pandemic introduced new health and safety protocols that necessitated changes in how medical and dental missions were conducted. The need for personal protective equipment (PPE), regular sanitation, and social distancing measures added layers of complexity to the planning and execution of these missions. These additional requirements not only increased operational costs but also slowed down the delivery of services, affecting the efficiency and reach of the missions.

Furthermore, the pandemic highlighted the limitations of the current healthcare workforce in Negros Occidental. Many healthcare workers were reassigned to COVID-19 response teams, resulting in a shortage of personnel available for other health services. The physical and mental toll on healthcare workers due to the prolonged pandemic response also contributed to workforce fatigue, further complicating efforts to conduct medical and dental missions.

The pandemic has also underscored the importance of effective communication and public health education. Misinformation and fear-mongering have proliferated during the pandemic, leading to vaccine hesitancy and resistance to health protocols among some segments of the population. The PHO has had to intensify its efforts to educate the public about the importance of vaccination, preventive measures, and the need to continue seeking medical and dental care despite the ongoing pandemic.

In conclusion, the challenges faced by the Provincial Health Office of Negros Occidental in conducting medical and dental missions in the wake of the COVID-19 pandemic are multifaceted and complex. However, by adopting a proactive and strategic approach, the PHO can overcome these challenges and continue to fulfill its mandate of providing essential healthcare services to the people of Negros Occidental. This research aims to identify the specific challenges encountered by the PHO and to provide actionable recommendations that can enhance its capacity to conduct medical and dental missions in compliance with R.A. No. 1082, as amended by R.A. No. 1891, in the post-pandemic era.

Objectives

  1. To identify and analyze the specific challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions in the post-pandemic era.
  2. To develop actionable recommendations for improving the effectiveness and resilience of the PHO in organizing and implementing medical and dental missions.

Methodology

The research aims to examine the challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions after the COVID-19 pandemic and to propose recommendations for improving its effectiveness in compliance with R.A. No. 1082, as amended by R.A. No. 1891. To achieve these objectives, the study employs a mixed-methods approach, combining both qualitative and quantitative research methods to provide a comprehensive understanding of the current situation and generate actionable insights.

1. Research Design

A mixed-methods design has been chosen to allow for a holistic examination of the challenges and recommendations surrounding the PHO’s operations. This approach integrates both qualitative and quantitative data, enabling the research to capture the complexity of the issue and provide robust findings.

  • Qualitative Component: The qualitative component will involve semi-structured interviews and focus group discussions with key stakeholders, including PHO officials, healthcare workers, and community representatives. This method will help gather in-depth insights into the experiences, perceptions, and opinions of those directly involved in or affected by the PHO’s medical and dental missions.
  • Quantitative Component: The quantitative component will involve surveys distributed to a broader sample of healthcare workers, PHO staff, and community beneficiaries. The survey will collect data on the frequency, effectiveness, and challenges of the missions, as well as the respondents’ knowledge, attitudes, and practices regarding the implementation of health protocols post-pandemic.

2. Study Population and Sampling

The study population consists of various stakeholders involved in or affected by the PHO’s medical and dental missions. The primary groups include:

  • PHO Officials and Staff: This group includes decision-makers, administrators, and program coordinators directly involved in planning and implementing medical and dental missions.
  • Healthcare Workers: Doctors, nurses, dentists, and other medical staff who participate in the missions, both as permanent PHO employees and as volunteers or temporary staff.
  • Community Representatives: Local leaders, barangay officials, and members of community organizations who collaborate with the PHO in organizing and hosting the missions.
  • Community Beneficiaries: Residents of the rural and underserved areas in Negros Occidental who have benefited from the medical and dental missions.

A combination of purposive and random sampling techniques will be used to select participants:

  • Purposive Sampling: This technique will be used to select key informants for interviews, such as PHO officials and healthcare workers with significant experience in conducting missions during and after the pandemic.
  • Random Sampling: This method will be employed to select participants for the surveys, ensuring a representative sample of healthcare workers, PHO staff, and community beneficiaries across different municipalities in Negros Occidental.

The estimated sample size for the qualitative component is 20–30 participants for interviews and 3–4 focus group discussions with 8–10 participants each. For the quantitative component, the target is to survey at least 200 respondents, with a distribution that reflects the demographic and professional diversity of the study population.

3. Data Collection Methods

3.1. Qualitative Data Collection:

  • Semi-Structured Interviews: Semi-structured interviews will be conducted with PHO officials, healthcare workers, and community representatives. An interview guide will be developed to ensure consistency across interviews while allowing for flexibility to explore specific issues in-depth. The guide will cover topics such as the challenges encountered during the missions, strategies adopted to address these challenges, and suggestions for improvement.
  • Focus Group Discussions (FGDs): FGDs will be conducted with community representatives and beneficiaries to gather collective perspectives on the effectiveness and challenges of the medical and dental missions. The discussions will focus on experiences with accessing healthcare services, perceptions of the PHO’s efforts, and recommendations for enhancing future missions.
  • Data Recording and Management: All interviews and FGDs will be audio-recorded with the consent of the participants and transcribed verbatim. Transcriptions will be anonymized to protect the identity of the participants and stored securely for analysis.

3.2. Quantitative Data Collection:

  • Surveys: Structured surveys will be developed and administered to healthcare workers, PHO staff, and community beneficiaries. The surveys will include a mix of closed-ended and Likert scale questions to capture quantitative data on the frequency, effectiveness, and challenges of the missions, as well as knowledge, attitudes, and practices related to post-pandemic health protocols. The surveys will be distributed both online and in paper format, depending on the accessibility and preference of the respondents.
  • Pilot Testing: Before full deployment, the survey instrument will be pilot-tested with a small group of respondents to identify any ambiguities or issues with the questions. Feedback from the pilot test will be used to refine the survey instrument.

4. Data Analysis

4.1. Qualitative Data Analysis:

  • Thematic Analysis: The qualitative data from interviews and FGDs will be analyzed using thematic analysis. This process involves coding the data to identify key themes and patterns related to the challenges and recommendations for conducting medical and dental missions. Thematic analysis will allow for a deep understanding of the participants’ experiences, perceptions, and suggestions, which will be used to complement the quantitative findings.
  • Data Coding and Software: Coding will be conducted manually, or with the assistance of qualitative data analysis software like NVivo or ATLAS.ti, to systematically categorize the data and identify emergent themes. Codes will be developed inductively from the data, and themes will be refined through iterative analysis.

4.2. Quantitative Data Analysis:

  • Descriptive Statistics: Descriptive statistics will be used to summarize the survey data, including frequencies, percentages, means, and standard deviations. This analysis will provide an overview of the demographic characteristics of the respondents, as well as the distribution of responses related to the challenges, effectiveness, and perceptions of the PHO’s missions.
  • Inferential Statistics: Inferential statistical methods, such as chi-square tests or t-tests, will be used to examine the relationships between different variables, such as the effectiveness of the missions and the implementation of health protocols. Statistical software like SPSS or R will be used to perform the analysis.

5. Ethical Considerations

Ethical considerations are of paramount importance in this study, given the sensitive nature of health-related research and the involvement of human participants. The following ethical principles will guide the research:

  • Informed Consent: All participants will be provided with detailed information about the purpose, objectives, and procedures of the study, as well as their rights as participants. Informed consent will be obtained from all participants before data collection begins, either through a signed consent form or verbal agreement for those who are illiterate.
  • Confidentiality and Anonymity: The confidentiality of the participants will be strictly maintained throughout the study. All data will be anonymized, and personal identifiers will be removed from transcripts and survey responses. Data will be stored securely in password-protected files, and access will be restricted to the research team.
  • Voluntary Participation: Participation in the study will be entirely voluntary, and participants will have the right to withdraw at any time without any consequences or penalties. No incentives will be offered to ensure that participation is free of coercion.
  • Minimization of Harm: The study will adhere to the principle of non-maleficence, ensuring that no harm comes to the participants. The research team will be sensitive to the emotional and psychological well-being of the participants, particularly during interviews and FGDs, where discussions may involve sensitive topics related to the pandemic and its impact.

6. Validity and Reliability

To ensure the validity and reliability of the research findings, several measures will be implemented:

  • Triangulation: The use of multiple data sources (interviews, FGDs, and surveys) will allow for data triangulation, which enhances the validity of the findings by cross-verifying information from different perspectives.
  • Pilot Testing: Pilot testing of the survey instrument will help identify and rectify any issues with the questions, ensuring that they accurately capture the intended data.
  • Inter-Coder Reliability: In qualitative analysis, multiple researchers will be involved in coding the data to ensure inter-coder reliability and minimize bias. Any discrepancies in coding will be resolved through discussion and consensus.
  • Peer Review: Preliminary findings will be reviewed by experts in public health and research methodology to ensure the accuracy and credibility of the analysis.

7. Limitations of the Study

While this study aims to provide a comprehensive analysis of the challenges and recommendations for the PHO of Negros Occidental, several limitations must be acknowledged:

  • Sampling Bias: Despite efforts to ensure a representative sample, there may be some bias due to the reliance on purposive sampling for key informants and the potential for non-response bias in the survey.
  • Self-Reported Data: The study relies on self-reported data from participants, which may be subject to recall bias or social desirability bias, particularly in sensitive areas related to healthcare practices and compliance with protocols.
  • Resource Constraints: The scope of the study may be limited by available resources, including time, funding, and access to certain populations, which may affect the depth and breadth of data collection.

8. Conclusion

The methodology outlined in this section is designed to comprehensively address the research objectives by integrating both qualitative and quantitative approaches. This mixed-methods approach will provide a nuanced understanding of the challenges faced by the PHO of Negros Occidental in conducting medical and dental missions in a post-pandemic context, and generate actionable recommendations to enhance their effectiveness in compliance with R.A. No. 1082, as amended by R.A. No. 1891. By employing rigorous data collection and analysis methods, the study aims to contribute valuable insights to the field of public health and inform policy and practice at the local and national levels.

Findings and Discussion

This section presents the findings of the research and provides a discussion on the challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions in the aftermath of the COVID-19 pandemic. It also examines the implications of these findings in the context of the implementation of R.A. No. 1082, as amended by R.A. No. 1891, and offers insights into potential recommendations for improving the effectiveness and resilience of the PHO’s operations.

1. Challenges Faced by the Provincial Health Office

The findings from the qualitative and quantitative data collected reveal several key challenges that the PHO of Negros Occidental has encountered in organizing and conducting medical and dental missions post-pandemic. These challenges can be categorized into logistical, financial, psychological, and communication-related difficulties.

1.1. Logistical Challenges

One of the most significant challenges identified is the logistical complexity of conducting medical and dental missions under the new health and safety protocols established during the COVID-19 pandemic. The need for physical distancing, the mandatory use of personal protective equipment (PPE), and enhanced sanitation measures have made it difficult for the PHO to operate in the same manner as before the pandemic.

  • Compliance with Health Protocols: According to the survey data, 78% of healthcare workers reported difficulties in adhering to stringent health protocols, such as maintaining social distancing during missions, especially in densely populated areas or small rural health facilities. Interviews with PHO officials highlighted that these requirements have often necessitated changes in the layout of health service delivery points, reducing the number of patients that can be accommodated at any given time.
  • Transportation and Mobility Restrictions: 65% of healthcare workers indicated that travel restrictions and quarantine requirements had significantly hampered their ability to reach remote areas. Additionally, there were difficulties in transporting medical supplies, equipment, and personnel due to limited access to public transportation and the imposition of checkpoints, which delayed the delivery of critical resources.
  • Limited Availability of Medical Supplies and PPE: The shortage of medical supplies, including PPE, was a common theme among 82% of respondents. This scarcity not only compromised the safety of healthcare workers and patients but also limited the scale and scope of medical and dental missions. The interviews revealed that the PHO often had to ration PPE, which reduced the frequency of missions and sometimes led to cancellations, especially during periods of heightened COVID-19 transmission.

1.2. Financial Challenges

The pandemic has strained the financial resources of the PHO, affecting its capacity to conduct regular medical and dental missions.

  • Budget Reallocations and Cuts: Due to the pandemic, 74% of PHO officials interviewed indicated that a substantial portion of their budget had to be redirected towards pandemic response efforts, including purchasing PPE, COVID-19 testing kits, and vaccines. Consequently, fewer resources were available for other essential health services, such as medical and dental missions. Budget cuts were reported as a significant issue by 67% of respondents, who noted that they often had to prioritize services based on urgency, leading to reduced frequency and scope of missions.
  • Increased Costs of Operations: The cost of conducting missions has risen sharply due to additional expenses related to compliance with health protocols. These include the costs of PPE, disinfectants, and the need for more vehicles to ensure social distancing during transport. 59% of healthcare workers reported that these additional costs had affected their ability to participate in multiple missions, further straining the already limited human resources available.

1.3. Psychological Challenges

The psychological impact of the pandemic on healthcare workers has also been significant, affecting their ability to perform effectively during medical and dental missions.

  • Burnout and Mental Health Issues: 71% of healthcare workers reported experiencing symptoms of burnout, including fatigue, anxiety, and stress. The fear of contracting COVID-19, coupled with long working hours and the emotional toll of dealing with high mortality rates, has led to increased mental health issues among staff. Focus group discussions with healthcare workers revealed that many felt overwhelmed and under-supported, which has contributed to a decrease in morale and, in some cases, led to absenteeism or resignation.
  • Fear and Resistance from the Community: Community resistance, fueled by fear and misinformation about COVID-19, emerged as a significant challenge. Approximately 48% of healthcare workers indicated that some community members were hesitant to participate in medical and dental missions due to fears of infection. This resistance was particularly strong in areas with high COVID-19 transmission rates or where misinformation about the virus and vaccination was prevalent.

1.4. Communication Challenges

Effective communication has been a crucial issue in ensuring the success of medical and dental missions post-pandemic.

  • Misinformation and Vaccine Hesitancy: 62% of community beneficiaries surveyed reported having encountered misinformation related to COVID-19 and vaccines. The spread of false information has led to vaccine hesitancy and resistance to other health protocols, complicating the PHO’s efforts to deliver services. Interviews with community leaders also indicated a lack of trust in government health programs, partly due to mixed messages received from various media sources during the pandemic.
  • Lack of Effective Public Health Messaging: The findings show that 54% of respondents felt that the PHO’s communication strategies were insufficient in addressing community concerns and dispelling myths about COVID-19 and vaccination. This gap in communication has hindered the PHO’s ability to mobilize communities for medical and dental missions effectively.

2. Discussion of Findings

The challenges identified above provide important insights into the operational difficulties faced by the PHO of Negros Occidental in the post-pandemic period. These findings are critical for understanding how the PHO can better comply with the mandates of R.A. No. 1082, as amended by R.A. No. 1891, which seeks to ensure adequate healthcare services in rural areas.

2.1. Logistical and Operational Barriers

The logistical challenges, particularly those related to compliance with new health protocols, highlight the need for a more flexible and adaptive approach to healthcare delivery. The difficulties in maintaining physical distancing, securing PPE, and transporting supplies and personnel to remote areas suggest that the PHO must explore alternative models of care, such as mobile clinics, telemedicine, and decentralized supply chains.

  • Implications for Rural Health Act Implementation: The logistical constraints encountered by the PHO align with broader challenges in implementing the Rural Health Act. The need for increased mobility, decentralized resources, and adaptive healthcare models is crucial to meeting the law’s objectives, especially in a post-pandemic context. To address these barriers, the PHO should consider leveraging technology to enhance communication and coordination among healthcare teams, as well as adopting innovative solutions like digital health platforms to facilitate remote consultations and follow-ups.

2.2. Financial Constraints and Resource Allocation

The financial challenges underscore the importance of adequate funding and resource allocation to support the PHO’s activities. The redirection of funds towards pandemic-related expenses and the rising costs of compliance with health protocols have significantly affected the PHO’s ability to sustain its medical and dental missions.

  • Recommendations for Improved Funding: To address these financial constraints, the PHO should advocate for increased budgetary allocations from the national government, particularly for public health programs in rural areas. Additionally, partnerships with non-governmental organizations (NGOs), private sector stakeholders, and international donors could provide supplementary funding and resources to bridge the gaps created by budget reallocations and cuts.

2.3. Addressing Psychological and Community Resistance Issues

The psychological challenges faced by healthcare workers and the resistance from some community members highlight the need for more robust support systems and community engagement strategies. Addressing burnout and mental health issues among healthcare workers is essential to maintaining a motivated and effective workforce.

  • Strengthening Support Systems for Healthcare Workers: The PHO should prioritize the mental health and well-being of its staff by providing regular mental health support, including counseling services, stress management programs, and adequate rest periods. Ensuring a supportive work environment will help mitigate burnout and enhance job satisfaction and retention.
  • Building Trust and Enhancing Community Engagement: To overcome community resistance, the PHO must adopt a more proactive approach to public health education and communication. Collaborating with local leaders, religious groups, and community-based organizations can help build trust and improve the uptake of medical and dental services. Tailored communication strategies that address specific community concerns and cultural contexts are also necessary to combat misinformation and vaccine hesitancy.

2.4. Improving Communication and Information Dissemination

Effective communication is crucial in dispelling misinformation and ensuring that communities are adequately informed about the importance of medical and dental missions. The findings indicate that the PHO’s current communication strategies are insufficient in reaching and engaging all segments of the population.

  • Enhancing Public Health Messaging: To improve communication, the PHO should develop a comprehensive public health messaging strategy that leverages multiple channels, including social media, community radio, local newspapers, and grassroots outreach programs. This strategy should focus on delivering clear, consistent, and evidence-based information to counteract misinformation and build public confidence in health initiatives.

3. Recommendations Based on Findings

Based on the findings, several recommendations can be made to improve the PHO’s ability to conduct medical and dental missions in compliance with R.A. No. 1082, as amended by R.A. No. 1891, in a post-pandemic environment.

3.1. Strategic Resource Allocation and Funding:

  • Advocate for increased funding and budgetary support from the national government and explore partnerships with NGOs, private stakeholders, and international donors.
  • Implement cost-saving measures, such as bulk procurement of PPE and medical supplies, to optimize resource use.

3.2. Adoption of Innovative Healthcare Delivery Models:

  • Utilize mobile clinics and telemedicine to reach remote and underserved communities while minimizing logistical barriers.
  • Develop decentralized supply chains to improve the availability of medical supplies and equipment.

3.3. Enhanced Support for Healthcare Workers:

  • Provide regular mental health support, including counseling services, stress management programs, and adequate rest periods.
  • Establish a feedback mechanism to ensure healthcare workers’ concerns are heard and addressed promptly.

3.4. Strengthening Community Engagement and Communication:

  • Collaborate with local leaders, religious groups, and community-based organizations to build trust and improve service uptake.
  • Develop tailored communication strategies to address specific community concerns and cultural contexts.

3.5. Improving Data Collection and Monitoring Systems:

  • Establish a robust data collection and monitoring system to track the effectiveness of medical and dental missions, identify areas for improvement, and ensure compliance with health protocols.

4. Conclusion

The findings and discussions presented in this section highlight the multifaceted challenges faced by the PHO of Negros Occidental in conducting medical and dental missions post-pandemic. Addressing these challenges requires a comprehensive approach that includes strategic resource allocation, innovative healthcare delivery models, enhanced support for healthcare workers, and strengthened community engagement and communication strategies. By implementing these recommendations, the PHO can enhance its capacity to provide essential health services in rural areas, in line with the mandates of R.A. No. 1082, as amended by R.A. No. 1891.

Conclusion

This research explored the challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions in compliance with R.A. No. 1082, as amended by R.A. No. 1891, in the aftermath of the COVID-19 pandemic. The study aimed to identify the primary obstacles encountered, assess their impact on the delivery of essential health services, and provide recommendations to improve the effectiveness and sustainability of these missions in a post-pandemic context.

Through a mixed-methods approach that combined qualitative interviews, focus group discussions, and quantitative surveys, the research identified several key challenges, including logistical constraints, financial limitations, psychological impacts, and communication barriers. These challenges have far-reaching implications for the PHO’s ability to fulfill its mandate under the Rural Health Act, particularly in delivering comprehensive healthcare services to rural and underserved communities.

1. Summary of Key Findings

The findings revealed a complex array of challenges that have significantly affected the PHO’s capacity to conduct medical and dental missions effectively in the post-pandemic era. These challenges can be summarized into four main categories: logistical, financial, psychological, and communication-related.

1.1. Logistical Challenges

The logistical difficulties stem primarily from the need to comply with stringent health protocols, which have complicated the planning and execution of medical and dental missions. Maintaining social distancing, wearing personal protective equipment (PPE), and adhering to enhanced sanitation requirements have reduced the number of patients that can be accommodated, leading to longer wait times and reduced mission coverage. Moreover, restrictions on transportation and mobility have hindered the delivery of supplies and personnel to remote areas, further limiting the PHO’s reach.

  • Implications: These logistical challenges highlight the need for more flexible and adaptive healthcare delivery models that can respond to the unique conditions of a post-pandemic environment. The PHO must explore alternative methods, such as mobile clinics and telemedicine, to continue providing essential services while adhering to health protocols.

1.2. Financial Challenges

Financial constraints have emerged as a major barrier to the effective implementation of medical and dental missions. The pandemic has necessitated the reallocation of funds toward COVID-19 response efforts, resulting in budget cuts for other public health initiatives. Additionally, the increased costs associated with PPE, sanitization, and transportation have strained the PHO’s limited resources, reducing the frequency and scale of its missions.

  • Implications: The financial difficulties underscore the need for sustainable funding models and resource allocation strategies. The PHO must advocate for increased government support and seek partnerships with non-governmental organizations (NGOs), private stakeholders, and international donors to supplement its budget and ensure the continuity of essential health services.

1.3. Psychological Challenges

The psychological toll on healthcare workers, including burnout, stress, and anxiety, has been significant. The prolonged exposure to high-stress environments, coupled with fears of contracting COVID-19, has adversely affected the mental health of many healthcare workers. Additionally, community resistance, driven by fear and misinformation about the virus and vaccines, has complicated the PHO’s efforts to mobilize communities for medical and dental missions.

  • Implications: Addressing the psychological well-being of healthcare workers is crucial for maintaining an effective and motivated workforce. The PHO should prioritize mental health support and provide resources such as counseling services, stress management programs, and adequate rest periods to mitigate burnout. Furthermore, building trust with communities through effective engagement and communication strategies is essential to overcoming resistance and improving service uptake.

1.4. Communication Challenges

Effective communication has been identified as a key issue affecting the success of the PHO’s missions. The spread of misinformation and vaccine hesitancy has undermined public confidence in health programs, while inadequate public health messaging has failed to address community concerns effectively. This has resulted in reduced participation in medical and dental missions and hindered the PHO’s ability to achieve its objectives.

  • Implications: The PHO must develop a comprehensive communication strategy that leverages multiple channels to reach diverse audiences and provide accurate, consistent, and culturally appropriate information. Collaborating with local leaders, community-based organizations, and trusted influencers can help dispel myths and build trust in public health initiatives.

2. Interpretation and Analysis of Findings

The research findings suggest that the challenges faced by the PHO in conducting medical and dental missions are multifaceted and interconnected. Logistical and financial constraints are closely related, as both impact the ability to deliver services efficiently and effectively. The psychological well-being of healthcare workers is affected by these operational challenges, and in turn, influences their performance and commitment to the missions. Similarly, communication barriers exacerbate community resistance and reduce the effectiveness of health interventions.

2.1. The Need for Integrated Solutions

The complexity of these challenges indicates that isolated interventions are unlikely to be effective. Instead, an integrated approach is necessary, one that combines strategic planning, resource allocation, and stakeholder engagement. For example, addressing logistical challenges through mobile clinics and telemedicine could simultaneously alleviate financial pressures by reducing transportation costs and the need for extensive infrastructure. Likewise, providing mental health support for healthcare workers could improve morale and reduce turnover, thereby enhancing the PHO’s capacity to deliver services.

2.2. Strengthening Compliance with R.A. No. 1082 and R.A. No. 1891

The findings also highlight the need to strengthen compliance with the Rural Health Act. While the PHO has made efforts to continue its medical and dental missions, the challenges encountered suggest that more targeted interventions are needed to meet the Act’s objectives fully. This includes enhancing the PHO’s capacity to deliver services in rural areas, improving access to essential health services, and ensuring that resources are allocated efficiently to address the most pressing health needs.

  • Enhancing Capacity through Policy Support: The government should provide greater policy support to the PHO, including financial assistance, technical guidance, and capacity-building initiatives. This could involve revising budgetary allocations to prioritize public health programs and ensuring that adequate resources are available to support the PHO’s efforts in rural areas.
  • Improving Access through Innovative Models: The PHO should explore innovative models of care delivery that align with the Rural Health Act’s objectives. This could include expanding the use of mobile clinics, telemedicine, and community-based health workers to reach underserved populations. By decentralizing healthcare delivery, the PHO can improve access and reduce the logistical burdens associated with traditional mission models.

2.3. Leveraging Partnerships and Collaboration

The findings suggest that partnerships with NGOs, private sector stakeholders, and international donors could play a vital role in addressing the challenges faced by the PHO. These partnerships could provide additional funding, resources, and technical expertise, helping to bridge gaps in service delivery and improve the sustainability of medical and dental missions.

  • Collaborative Approaches to Resource Mobilization: The PHO should actively seek partnerships and collaborations with external stakeholders to supplement its budget and enhance its operational capacity. This could involve joint initiatives with NGOs to deliver targeted health services or partnerships with private sector organizations to provide logistical support and medical supplies.
  • Engaging Local Communities and Leaders: Effective engagement with local communities and leaders is also critical to building trust and overcoming resistance. The PHO should work closely with barangay officials, religious groups, and community-based organizations to develop culturally sensitive health programs and communication strategies that address community concerns and promote health-seeking behaviors.

3. Implications for Future Practice and Research

The challenges identified in this research have important implications for future practice and research in public health, particularly in the context of rural healthcare delivery. Several key areas warrant further exploration and action:

3.1. Strengthening Public Health Infrastructure

The research highlights the need for stronger public health infrastructure to support the delivery of medical and dental missions. This includes not only physical infrastructure, such as healthcare facilities and transportation networks, but also digital infrastructure, such as telemedicine platforms and electronic health records. Investing in these areas will enable the PHO to provide more efficient, effective, and resilient healthcare services.

3.2. Enhancing Workforce Development and Support

The psychological challenges faced by healthcare workers underscore the importance of workforce development and support. Future research should explore strategies for enhancing the recruitment, retention, and well-being of healthcare workers, including training programs, career development opportunities, and mental health support services. These efforts are crucial for building a sustainable and motivated workforce that can effectively deliver health services in rural areas.

3.3. Promoting Community-Centered Approaches

The findings suggest that community-centered approaches are essential for overcoming resistance and building trust in public health programs. Future research should investigate the effectiveness of different community engagement strategies, such as participatory health education, peer-led interventions, and community-based health promotion initiatives. Understanding what works best in different contexts will help the PHO design more effective and culturally appropriate health programs.

3.4. Developing Comprehensive Communication Strategies

Effective communication is key to dispelling misinformation, promoting health-seeking behaviors, and ensuring the success of medical and dental missions. Future research should focus on developing and testing comprehensive communication strategies that leverage multiple channels and address diverse audiences. This includes exploring the use of digital platforms, social media, and local media outlets to reach different segments of the population.

4. Conclusion and Recommendations for Action

In conclusion, this research has provided valuable insights into the challenges faced by the PHO of Negros Occidental in conducting medical and dental missions in a post-pandemic context. The findings highlight the need for an integrated approach that addresses logistical, financial, psychological, and communication-related challenges to ensure the effective delivery of essential health services.

To enhance the PHO’s capacity to conduct medical and dental missions in compliance with R.A. No. 1082, as amended by R.A. No. 1891, the following recommendations are proposed:

  1. Advocate for Increased Funding and Policy Support: The PHO should seek greater support from the national government, including increased budgetary allocations and policy guidance, to strengthen its capacity to deliver health services in rural areas.
  2. Adopt Innovative Healthcare Delivery Models: The PHO should explore alternative models of care, such as mobile clinics and telemedicine, to improve access and reduce logistical barriers.
  3. Enhance Support for Healthcare Workers: The PHO should prioritize the mental health and well-being of its staff by providing regular mental health support, stress management programs, and adequate rest periods.
  4. Strengthen Community Engagement and Communication: The PHO should develop a comprehensive communication strategy that leverages multiple channels and collaborates with local leaders and community organizations to build trust and promote health-seeking behaviors.
  5. Leverage Partnerships and Collaborations: The PHO should actively seek partnerships with NGOs, private sector stakeholders, and international donors to supplement its budget and enhance its operational capacity.

By implementing these recommendations, the PHO of Negros Occidental can overcome the challenges identified in this research and ensure the effective and sustainable delivery of medical and dental missions, in line with the objectives of the Rural Health Act.

Interview

Introduction:

To gain deeper insights into the challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions after the COVID-19 pandemic, semi-structured interviews were conducted with key stakeholders. These included PHO officials, healthcare workers, and community leaders. The interviews aimed to explore firsthand experiences, identify specific obstacles, and gather recommendations for improving the effectiveness of medical and dental missions.

1. Interview with a PHO Official

Respondent: PHO Official (preferred to stay anonymous)

Date: January, 13, 2024

Interviewer: Shanine A. Fortuno-Dinero

Interviewer: Thank you for taking the time to speak with us today. To start, can you describe some of the major logistical challenges the PHO has faced in conducting medical and dental missions post-pandemic?

Respondent: Certainly. One of the biggest logistical challenges has been adhering to the new health protocols. We’ve had to implement strict social distancing measures, which have reduced the number of patients we can serve at each mission. Additionally, securing and transporting medical supplies and PPE has been a significant issue. With travel restrictions and limited access to transportation, it’s been challenging to ensure that we have enough resources in the right locations at the right times.

Interviewer: How have these logistical issues impacted the frequency and scope of your missions?

Respondent: The constraints have led to a reduction in both the frequency and scope of our missions. We’ve had to prioritize urgent cases and reduce the number of routine services we can provide. In some areas, especially remote ones, we’ve had to cancel missions altogether because we couldn’t guarantee the necessary supplies or ensure safe transportation.

Interviewer: What financial challenges have you encountered, and how have these affected your operations?

Respondent: Financial constraints have been a major issue. A significant portion of our budget had to be redirected toward pandemic response efforts, such as purchasing PPE and COVID-19 testing kits. This reallocation has left us with limited funds for our regular health services. The increased costs of complying with health protocols have further strained our budget. We’ve had to make difficult decisions about which services to prioritize, often at the expense of less urgent but still important health needs.

Interviewer: What strategies are you considering to address these financial and logistical challenges?

Respondent: We are actively seeking additional funding from both government sources and private partners. We’re also exploring more efficient procurement and supply chain management practices to reduce costs. Additionally, we’re considering alternative models of care delivery, such as mobile clinics, to reach more people while minimizing logistical challenges.

2. Interview with a Healthcare Worker

Interviewee: PHO Nurse

Date: January 14, 2024

Interviewer: Can you share your experiences with the psychological impact of working in medical missions during the pandemic?

Nurse: The psychological toll has been significant. Many of us have experienced burnout due to the long hours, high stress, and fear of contracting COVID-19. The constant pressure to adhere to strict health protocols and manage a high volume of patients has been overwhelming. Additionally, dealing with the emotional impact of seeing so many people suffering has taken a toll on our mental health.

Interviewer: How has the mental health of the healthcare team affected the delivery of services?

Nurse: The mental health issues have led to decreased morale and productivity. Some team members have taken leaves of absence or even resigned due to stress and burnout. This has affected our ability to operate at full capacity and provide consistent services. We’ve also noticed that burnout can lead to mistakes or oversights, which is a serious concern when dealing with patient care.

Interviewer: What support systems or resources would help improve the situation for healthcare workers?

Nurse: We need more comprehensive mental health support, including access to counseling services and stress management programs. Regular debriefing sessions and a supportive work environment where concerns can be openly discussed would also help. Ensuring adequate rest periods and manageable workloads are essential for maintaining our well-being and effectiveness.

3. Interview with a Community Leader

Interviewee: Barangay Captain

Date: January 20, 2024

Interviewer: How has the community’s response to medical and dental missions been affected by the pandemic?

Barangay Captain: The community response has been mixed. While many people are still eager to participate in the missions, there is a significant level of fear and skepticism, particularly regarding COVID-19 and vaccinations. Some residents are hesitant to attend missions due to concerns about infection or misinformation about the virus and vaccines. This has led to lower turnout and reluctance to follow health protocols.

Interviewer: What role do community leaders play in addressing these concerns and improving participation?

Barangay Captain: Community leaders play a crucial role in dispelling misinformation and building trust. We need to actively engage with residents, provide accurate information, and address their concerns directly. Holding community meetings, working with local influencers, and using trusted communication channels can help improve participation and ensure that people feel safe and informed.

Interviewer: What additional support or resources would help you in your role to support medical and dental missions?

Barangay Captain: Increased collaboration with the PHO and access to reliable information and resources would be beneficial. Training for community leaders on health communication and engagement strategies would also help us address misinformation and build stronger community support for health initiatives.

4. Summary of Key Insights

The interviews with PHO officials, healthcare workers, and community leaders provided valuable insights into the challenges and potential solutions for conducting medical and dental missions in the post-pandemic era. Key themes that emerged include:

  • Logistical Challenges: Adherence to new health protocols and transportation restrictions have complicated mission planning and execution, leading to reduced service delivery.
  • Financial Constraints: Budget reallocation and increased operational costs have strained resources, affecting the frequency and scope of missions.
  • Psychological Impact: Burnout and mental health issues among healthcare workers have impacted their performance and availability.
  • Community Resistance: Misinformation and fear have led to lower participation in missions, highlighting the need for effective communication and engagement strategies.

Recommendations Based on Interviews:

  • Enhanced Support Systems: Implement comprehensive mental health support for healthcare workers and improve work conditions to mitigate burnout.
  • Innovative Models: Explore alternative healthcare delivery models such as mobile clinics and telemedicine to address logistical and financial challenges.
  • Community Engagement: Strengthen communication efforts and collaborate with local leaders to build trust and increase community participation.

These insights provide a deeper understanding of the challenges faced by the PHO and underscore the importance of addressing these issues through targeted interventions and strategic planning.

Recommendations

Based on the comprehensive analysis of the challenges faced by the Provincial Health Office (PHO) of Negros Occidental in conducting medical and dental missions post-pandemic, several recommendations have been developed. These recommendations are designed to address the identified logistical, financial, psychological, and communication-related challenges and to improve the overall effectiveness and sustainability of these missions.

1. Enhance Logistical and Operational Efficiency

1.1. Adopt Innovative Healthcare Delivery Models

  • Mobile Clinics: Establish and expand the use of mobile clinics to reach remote and underserved areas more efficiently. Mobile clinics can reduce transportation challenges and ensure that essential health services are delivered directly to communities.
  • Telemedicine Services: Implement telemedicine solutions to provide remote consultations and follow-up care, reducing the need for physical travel and minimizing logistical constraints.

1.2. Improve Supply Chain Management

  • Efficient Procurement: Streamline procurement processes for medical supplies and PPE to reduce costs and ensure timely availability. Consider bulk purchasing agreements and partnerships with suppliers to achieve better pricing and reliability.
  • Robust Distribution Network: Develop a more efficient distribution network for medical supplies and equipment to ensure that resources are allocated effectively and reach their intended destinations promptly.

1.3. Strengthen Coordination and Planning

  • Integrated Planning: Enhance coordination between different departments and agencies involved in medical and dental missions. Develop comprehensive planning frameworks that address logistical needs, health protocols, and resource allocation.
  • Regular Reviews: Conduct regular reviews and assessments of mission operations to identify bottlenecks and implement corrective actions promptly.

2. Secure Sustainable Funding and Resources

2.1. Advocate for Increased Budgetary Support

  • Government Funding: Advocate for increased funding from the national government to support medical and dental missions. Ensure that health budgets are prioritized to address the needs of rural and underserved communities.
  • Grants and Donations: Seek grants and donations from non-governmental organizations (NGOs), private sector partners, and international donors to supplement the PHO’s budget and enhance mission capabilities.

2.2. Develop Resource Mobilization Strategies

  • Public-Private Partnerships: Establish partnerships with private sector organizations to secure additional resources, such as medical supplies, equipment, and funding. Explore opportunities for collaborative initiatives that benefit both the PHO and its partners.
  • Community Fundraising: Engage local communities in fundraising efforts to support health missions. Community-based fundraising can provide additional financial resources and foster a sense of ownership and support for public health initiatives.

3. Support Healthcare Workers’ Mental Health and Well-Being

3.1. Implement Mental Health Support Programs

  • Counseling Services: Provide access to counseling services for healthcare workers to address stress, burnout, and other psychological challenges. Offer regular mental health check-ins and support sessions.
  • Stress Management: Introduce stress management programs, including workshops on coping strategies and relaxation techniques, to help healthcare workers manage the pressures of their roles.

3.2. Improve Work Conditions

  • Adequate Rest: Ensure that healthcare workers have adequate rest periods and manageable workloads to prevent burnout and maintain high levels of performance.
  • Recognition and Support: Recognize and reward the efforts of healthcare workers through incentive programs and public acknowledgment. Create a supportive work environment where staff feel valued and motivated.

4. Strengthen Community Engagement and Communication

4.1. Develop Comprehensive Communication Strategies

  • Accurate Information: Provide clear, accurate, and culturally sensitive information about health services, COVID-19, and vaccines. Use multiple communication channels, including social media, local media, and community meetings, to reach diverse audiences.
  • Address Misinformation: Counter misinformation by collaborating with local influencers and community leaders to disseminate factual information and address common concerns about health services and vaccines.

4.2. Build Trust and Collaboration with Community Leaders

  • Community Partnerships: Work closely with local leaders and community-based organizations to build trust and improve engagement. Involve community leaders in planning and executing health missions to ensure that they address local needs and concerns.
  • Participatory Approaches: Use participatory approaches to involve community members in health decision-making processes. Solicit feedback and involve residents in identifying and prioritizing health needs.

5. Enhance Data Collection and Monitoring Systems

5.1. Implement Robust Data Management Systems

  • Tracking and Evaluation: Establish comprehensive data collection and monitoring systems to track the effectiveness of medical and dental missions. Use data to evaluate performance, identify areas for improvement, and ensure compliance with health protocols.
  • Real-Time Reporting: Develop real-time reporting mechanisms to facilitate timely decision-making and response to emerging challenges. Utilize digital tools and platforms to streamline data collection and analysis.

5.2. Strengthen Compliance and Accountability

  • Adherence to Protocols: Ensure strict adherence to health protocols and guidelines during missions. Conduct regular audits and reviews to assess compliance and address any deviations promptly.
  • Accountability Mechanisms: Implement accountability mechanisms to ensure that resources are used efficiently and that mission objectives are met. Encourage transparency and open reporting of challenges and successes.

6. Foster Research and Continuous Improvement

6.1. Conduct Ongoing Research

  • Needs Assessments: Regularly conduct needs assessments to identify emerging health challenges and priorities. Use research findings to inform the development and implementation of health programs and interventions.
  • Best Practices: Research and document best practices in healthcare delivery, particularly in post-pandemic contexts. Share knowledge and experiences with other health organizations to enhance collective understanding and improvement.

6.2. Promote Innovation and Adaptation

  • Innovative Solutions: Encourage innovation in healthcare delivery by exploring new technologies, practices, and models. Adapt strategies based on lessons learned and evolving needs to improve service delivery and effectiveness.
  • Feedback Integration: Integrate feedback from healthcare workers, community members, and stakeholders into program design and implementation. Use feedback to refine approaches and ensure that health missions are responsive to real-world challenges.

Bibliography

Websites:

Interviews:

  • PHO Official. (2024, January 13). Interview with an official of the Provincial Health Office of Negros Occidental. [Personal interview].
  • Nurse. (2024, January 14). Interview with a PHO medical team member. [Personal interview].
  • Barangay Captain. (2024, January 20). Interview with a Barangay Captain in Murcia, Negros Occidental. [Personal interview].

Additional Sources:

  • National Economic and Development Authority. (2020). Addressing the Social and Economic Impact of the COVID-19 Pandemic. NEDA Reports.
  • United States Agency for International Development. (2021).Strategic Recommendations for Strengthening Health Systems During the COVID-19 Pandemic and Beyond. 

Legal Basis

  1. R.A. No. 1082 – An Act Providing for the Establishment of Barangay Health Stations (BHS) and Authorizing the Appropriation of Funds Therefor
    • Overview: This law mandates the establishment of Barangay Health Stations to provide primary healthcare services at the community level. It aims to improve access to basic health services in rural areas.
    • Relevance: The research explores how the Provincial Health Office (PHO) of Negros Occidental implements medical and dental missions in compliance with this law, especially in the context of challenges arising post-pandemic.
  2. R.A. No. 1891 – An Act Amending Certain Provisions of R.A. No. 1082, Increasing the Appropriation Therefor, and for Other Purposes
    • Overview: This amendment increases funding and support for barangay health services and expands the scope of healthcare services provided at the local level.
    • Relevance: The study examines the impact of this amendment on the PHO’s capacity to conduct medical and dental missions and address emerging challenges after the COVID-19 pandemic.
  3. Philippine Constitution (1987) – Article XIII, Section 11 – Health Policy
    • Overview: The Constitution mandates the State to promote a comprehensive and accessible healthcare system for all, including the establishment of mechanisms to ensure health services reach underserved areas.
    • Relevance: This constitutional provision underpins the study’s focus on evaluating the effectiveness of healthcare delivery mechanisms, particularly in rural and underserved communities.
  4. Republic Act No. 11494 – Bayanihan to Recover As One Act
    • Overview: This law provides for measures to address the effects of the COVID-19 pandemic, including funding for health interventions and support for the healthcare system.
    • Relevance: The research considers how this law has influenced the funding and operational capacity of medical and dental missions during and after the pandemic.
  5. Department of Health (DOH) Administrative Orders and Circulars
    • Overview: DOH issues administrative orders and circulars to guide the implementation of health policies, including protocols for pandemic response and healthcare delivery in rural areas.
    • Relevance: The study assesses the PHO’s compliance with DOH guidelines and protocols in executing medical and dental missions during the pandemic.
  6. Local Government Code of 1991 (R.A. No. 7160)
    • Overview: This code decentralizes health functions to local government units, including the provision of health services at the barangay level.
    • Relevance: The research evaluates how local government units in Negros Occidental have adapted their health service delivery in response to the challenges posed by the pandemic.
  7. World Health Organization (WHO) Guidelines and Recommendations
    • Overview: WHO provides international guidelines and recommendations for health service delivery, especially during emergencies and pandemics.
    • Relevance: The study considers how the PHO aligns its mission strategies with WHO guidelines to ensure effective and safe healthcare delivery post-pandemic.
  8. Republic Act No. 11332 – Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act
    • Overview: This law mandates the reporting of notifiable diseases and health events, which is crucial for monitoring and managing public health crises.
    • Relevance: The research discusses how compliance with this law affects the coordination and response of the PHO during medical and dental missions.

Acknowledgments

I would like to express my deepest gratitude to the Provincial Health Office of Negros Occidental and all its personnel for providing essential data and insights, and to the healthcare workers and community leaders whose candid responses enriched this study. I am especially thankful to my research advisors, particularly Atty. Jocelle Batapa-Sigue, for their guidance, and to my family—my husband Stephen, daughter Freyja, Mama Psyche, Papa Rolly, Mama Rowena, sisters Jemille, Jeannie, and Steffani, and niece Czariagh—for their unwavering support and encouragement. I also extend my heartfelt thanks to all participants and stakeholders who contributed invaluable feedback and experiences. This research was made possible through the collective support of all these individuals and organizations.

About the Researcher

Shanine A. Fortuno-Dinero’s journey as a JD1 student at the University of St. La Salle and as a researcher is marked by a profound commitment to her family, her profession, and her community. Her research not only aims to address practical challenges in healthcare but also serves as a reflection of her dedication to making a meaningful impact. Through her work, Shanine continues to bridge the gap between law, psychology, and public health, embodying the ideals of professionalism and respect that drive her forward.

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