Background Inequities in health access and outcomes persist in low- and middle-income countries. While strengthening primary care is integral in improving patient outcomes, primary care networks remain undervalued, underfunded, and underdeveloped in many LMICs such as the Philippines. This paper underscores the value of strengthening primary care system interventions in LMICs by examining their impact on job satisfaction and intention to stay among healthcare workers in the Philippines. Methods This study was conducted in urban, rural, and remote settings in the Philippines. A total of 36 urban, 54 rural, and 117 remote healthcare workers participated in the study. Respondents comprised all family physicians, nurses, midwives, community health workers, and staff involved in the delivery of primary care services from the sites. A questionnaire examining job satisfaction (motivators) and dissatisfaction (hygiene) factors was distributed to healthcare workers before and after system interventions were introduced across sites. Interventions included the introduction of performance-based incentives, the adoption of electronic health records, and the enhancement of diagnostic and pharmaceutical capabilities over a 1-year period. A Wilcoxon signed-rank test and a McNemar’s chi-square test were then conducted to compare pre- and post-intervention experiences for each setting. Results Among the factors examined, results revealed a significant improvement in perceived compensation fairness among urban (p = 0.001) and rural (p = 0.016) providers. The rural workforce also reported a significant improvement in medicine access (p = 0.012) post-intervention. Job motivation and turnover intention were sustained in urban and rural settings between periods. Despite the interventions introduced, a decline in perceptions towards supply accessibility, job security, and most items classified as job motivators was reported among remote providers. Paralleling this decline, remote primary care providers with the intent to stay dropped from 93% at baseline to 75% at endline (p < 0.001). Conclusion The impact of strengthening primary care on health workforce satisfaction and turnover intention varied across urban, rural, and remote settings. While select interventions such as improving compensation were promising for better-supported settings, the immediate impact of these interventions was inadequate in offsetting the infrastructural and staffing gaps experienced in disadvantaged areas. Unless these problems are comprehensively addressed, satisfaction will remain low, workforce attrition will persist as a problem, and marginalized communities will be underserved.
Objective. The main aim of this study was to determine patient satisfaction with nursing care (PSNC) in the medical wards of the UP-Philippine General Hospital (UP-PGH) using a valid and reliable locally developed UP-PGH PSNC questionnaire. Methods. The survey utilized a cross-sectional study design and was conducted in the medical wards of the UP-PGH in 2006. A total of 237 patients were included in the survey.Results. Over a third or 34.3% (95% CI 28%, 40%) and 35% (95% CI 26%, 44%) were highly satisfied with their experience regarding the nurses’ caring attitude and the nurses’ skill/competence respectively. Fewer respondents were highly satisfied with the nurses as information providers, with only 17.2% (95% CI 12%, 22%) saying they were highly satisfied. A little over half or 57.8% (95% CI 52%, 64%) were highly satisfied in the overall evaluation of care.Conclusion. The patients were satisfied with the nursing care provided in two dimensions: The nurse as a caring person and the nurse as a skilled and competent healthcare provider, although only about a third indicated that they were highly satisfied. Nevertheless, 57.8% were highly satisfied in the overallevaluation of care, but these patients may have considered other hospital services and cost. Other factors that might affect patient satisfaction need to be explored and the use of other evaluation tools to augment these findings is recommended.
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