Effects of the COVID-19 Pandemic on the Implementation of NCD Care at the Primary Care Level in the Philippines: A Qualitative Inquiry

TJ Robinson T. Moncatar, RN, MPH, PhD; Aliya Vanessa D. Gomez; Fely Marilyn E. Lorenzo, RN, MPH, DrPH; Ofelia P. Saniel, MPH, PhD; Emerito Jose A. Faraon, MD, MBA; Roberto Antonio F. Rosadiaa, MD, MPH, MHA; Fernando B. Garcia, Jr., PhD

doi:10.47895/amp.vi0.7678

TJ Robinson T. Moncatar, RN, MPH, PhD Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila https://orcid.org/0000-0001-9661-6640
Aliya Vanessa D. Gomez College of Public Health, University of the Philippines Manila
Fely Marilyn E. Lorenzo, RN, MPH, DrPH Nurses Christian Fellowship, Philippines
Ofelia P. Saniel, MPH, PhD Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila
Emerito Jose A. Faraon, MD, MBA Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila
Roberto Antonio F. Rosadiaa, MD, MPH, MHA Independent Consultant
Fernando B. Garcia, Jr., PhD Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila

DOI: https://doi.org/10.47895/amp.vi0.7678

Keywords: COVID-19, noncommunicable diseases, primary care, qualitative research, Philippines

Abstract

Background and Objective. The focusing of resources to COVID-19 response hampered and disadvantaged primary care services including that for Non-Communicable Diseases (NCDs), compromising continuity of care and hence, patients’ disease status. However, studies from low- and middle-income countries (LMICs) remain sparse; therefore, evidence generation on how the pandemic impacted the provision of these primary care services in LMICs will help further understand how policies can be reframed, and programs be made more efficient and effective despite similar crises. To bridge this gap, the study investigated how the pandemic affected the implementation of NCD care at the primary care level in the Philippines.

Methods. Thirty-one online focus group discussions via Zoom Meetings were conducted among 113 consenting
physicians, nurses, midwives, and community health workers from various facilities — community health centers and stations, free-standing clinics, infirmaries, and level 1 hospitals — located within two provinces in the Philippines. All interviews were video-recorded upon participants’ consent and transcribed verbatim. Inductive thematic analysis was employed through NViVo 12® to generate themes, identify categories, and describe codes.

Results. The impact of COVID-19 on NCD care at the primary care level revolved around heightened impediments to service delivery, alongside worsening of pre-existing challenges experienced by the healthcare workforce; subsequently compelling the public to resort to unhealthy practices. These detriments to the primary healthcare system involved resource constraints, discontinued programs, referral difficulties, infection, overburden among workers, and interrupted training activities. Citizens were also observed to adopt poor healthcare seeking behavior, thereby discontinuing treatment regimen.

Conclusion. Healthcare workers asserted that disadvantages caused by the pandemic in their NCD services at the primary care level possibly threaten patients’ health status. Besides the necessity to address such detriments, this also emphasizes the need for quantitative studies that will aid in drawing inferences and evaluating the effect of health crises like the pandemic on such services to bridge gaps in improving quality of care.