The Mediating Role of Health Center Capacity in the Relationship Between Work Motivation and Competency Among Barangay Health Workers
Frederick Allan A. Valenzuela
Discipline: Environmental and Public Health
Abstract:
This study investigated the determinants of competency among
Barangay Health Workers (BHWs) in the Province of Rizal within the framework
of the Universal Health Care (UHC) Law. Using a descriptive-correlational
design, the study examined the relationships among health center capacity
(based on WHO building blocks), work motivation (motivator-hygiene factors),
and level of competency (knowledge, skills, and attitudes). Data were gathered
from 314 BHWs across six municipalities using a four-part validated
questionnaire and analyzed through Pearson’s correlation and mediation
analysis. Results revealed a mature workforce (mean age 51) with high intrinsic
motivation, particularly in the sense of achievement (M = 4.73), yet facing
significant extrinsic challenges regarding salary and work security. While BHWs
demonstrated high competency in basic primary care, proficiency declined in
specialized administrative tasks. Mediation analysis confirmed that Growth
significantly impacts Skills (B = 0.278, p <0.001), but its influence on Attitude is
contingent upon the empowerment of the health workforce. Notably, a
suppressor effect was identified where excessive health facility reporting (B =
−0.047, p = .006) acts as an administrative bottleneck. The study concludes that
while BHWs are driven by communal duty, optimizing their role requires
transitioning from glorified volunteerism toward formalized employment,
streamlined reporting, and enhanced social protection to ensure sustainable
grassroots healthcare delivery.
References:
- Abdel-All, M., Putica, B., Praveen, D., Abimbola, S., & Joshi, R. (2022). Effectiveness of community health worker training programmes for cardiovascular disease management in low- income and middle-income countries: A systematic review. BMJ Open 2017;7:e015529. https://doi.org/10.1136/bmjopen-2016-015529
- Abdillah, A., Harum, H., Jumadi, H., & Pratiwi, S.W. (2024). Analysis of planning for health workforce needs at Lasinrang Pinrang Regional General Hospital. Journal of Community Health Provision, 4(2), 111–117. https://doi.org/10.55885/jchp.v4i2.422
- Acorda, V., & Santos, J. (2024). Training needs of barangay health workers of a university’s partner community. International Journal of Community Engagement and Sustainable Development, (eISSN-3082-3838) Vol. 1, No. 1. https://tinyurl.com/tp8fedfk
- Arcebido, M., Bungalan, G., Damasco, M., Engalgado, R., Paden, J., & Saburnido, M. (2024). Dimensions on work task motivation among barangay health workers. International Journal of Engineering Technology Research & Management, 11(5), 45–56. https://tinyurl.com/4schd27e
- Baliolaa, M., Golpe, M., & Advincula-Lopez, L. (2024). Gains and challenges of the Barangay Health Worker (BHW) program during COVID-19 in selected cities in the Philippines. Journal of Health Research. 2024; 38(1). https://doi.org/10.56808/2586-940X.1060
- Boniol, M., Kunjumen, T., Nair, T.S., Siyam, A., Campbell, J., & Diallo, K. (2022). The global health workforce stock and distribution in 2020 and 2030: A threat to equity and 'universal' health coverage? BMJ Global Health, 7(6), e009316. https://doi.org/10.1136/bmjgh-2022-009316’
- Borghi, J., & Brown, G. (2022). Taking systems thinking to the global level: Using the WHO building blocks to describe and appraise the global health system in relation to COVID-19. Global Policy, 13, 193–207. https://doi.org/10.1111/1758-5899.13081
- Carrillo, V., Dael, J., Retuya, K.M.A., Tangapa, L., Vistal, J., Yañez, D., & Faller, E. (2023). The situation of barangay health workers in the Philippines: A review. International Journal of Research Publication and Reviews, Vol 4, No 4, pp 5687–5690. https://ijrpr.com/uploads/V4ISSUE4/IJRPR12273.pdf
- Cordero, D., Jr. (2022). An evaluation of the Philippine healthcare system: Preparing for a robust public health in the future. Journal of Preventive Medicine & Public Health, 310–311. https://doi.org/10.3961/jpmph.22.154
- Dagohoy, R. (2021). Accounts of barangay health workers in geographically isolated and disadvantaged areas in the new normal. National Research Council of the Philippines. http://dx.doi.org/10.2139/ssrn.3907452
- Dorado, M.A.G., & Ramos-Florece, C. (2024). Competence and commitment of barangay health workers: An opportunity for better health promotion services. In 11th International Scholars Conference, Vol. 11, No. 1, pp. 92–104. https://jurnal.unai.edu/isc/article/view/3498/2437
- Golz, C., Peter, K.A., Müller, T.J., Mutschler, J., Zwakhalen, S., & Hahn, S. (2021). Technostress and digital competence among health professionals in Swiss psychiatric hospitals: Cross- sectional study. JMIR Mental Health, 8(11), e31408. https://doi.org/10.2196/31408
- Gonzales, A.M., Cariaso, A.J.L., Pechon, A.G.C., Salvador, M.N., Dote, A.B., Malbas, J.A.R., Ysibido, G.A., & Gamboa, D.M.C. (2024). Development of the training program on retooling barangay health workers in Occidental Mindoro, Philippines. Rural Extension & Innovation Systems Journal, 2024 20(2). https://tinyurl.com/ytcamc9f
- Hamoy, G., Opina-Tan, L., Pamittan, K.G., Cedicol, N., Jumangit, A., & Perez, M. (2026). Barangay health workers' perceived factors that affect performance in health service delivery in five upland municipalities of Cavite. Acta Medica Philippina, 60(1): 30–37. https://doi.org/10.47895/amp.vi0.10714
- Hartigan-Go, K., Prieto, M.L., Castillo, A.F.G., & Eleazar, E.M.C. (2025). Important but neglected: A qualitative study on the lived experiences of barangay health workers in the Philippines. Acta Medica Philippina, 59(9), 19–31. https://doi.org/10.47895/amp.vi0.9589
- Ibo, J.A. (2019). Assessment of workplace of barangay health workers in selected municipalities in the province of Albay, Philippines. BU R&D Journal, 22(1), 1–9. https://tinyurl.com/2wanzk52
- Johnson, L., Schopp, L., Waggie, F., & Frantz, J. (2022). Challenges experienced by community health workers and their motivation to attend a self-management programme. African Journal of Primary Health Care & Family Medicine, 14(1), 9 pages. https://doi.org/10.4102/phcfm.v14i1.2911
- Landingin, Q. (2024). Job performance of barangay health workers (BHWS): An assessment. International Journal of Advance Research in Community Health Nursing, 6(1):22–26. https://doi.org/10.33545/26641658.2024.v6.i1a.163
- Mallari, E., Lasco, G., & Sayman, D.J. (2020). Connecting communities to primary care: A qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines. BMC Health Services Research, 20, 860. https://doi.org/10.1186/s12913-020-05699-0
- Mirasol, X., & Gordoncillo, N. (2023). Factors correlated with the competency of barangay nutrition scholars in Cabuyao, Laguna in the implementation of the Family MUAC approach. Journal of Human Ecology and Sustainability, 1(1), 7. https://jhes.uplb.edu.ph/articles/202308/
- Nwadiuko, J., Doua, R., & Nyawira, L. (2025). Health worker unemployment in countries with critical health worker shortages: A rapid synthesis of evidence from 33 countries. BMJ Global Health. 10:e021574. https://doi.org/10.1136/bmjgh-2025-021574
- Reyes, A.T., Serafica, R., Kawi, J., Fudolig, M., Sy, F., Leyva, E.W., & Evangelista, L. (2023). Using the socioecological model to explore barriers to health care provision in underserved communities in the Philippines: Qualitative study. Asian/Pacific Island Nursing Journal, 7:e45669. https://doi.org/10.2196/45669
- Taburnal, M.V. (2020). Knowledge and competence of barangay health workers (BHWS). International Journal of Innovation, Creativity and Change, 14(1), 1301–1317. https://tinyurl.com/36ukvwwj
- Tan, T., & Waheed, A. (2011). Herzberg's motivation-hygiene theory and job satisfaction in the Malaysian retail sector: The mediating effect of love of money. Published in: Asian Academy of Management Journal, Vol. 16, No. 1: pp. 73–94. https://tinyurl.com/4t5vpbtb
Full Text:
Note: Kindly Login or Register to gain access to this article.
ISSN 2984-8385 (Online)
ISSN 2984-8288 (Print)