The results and discussion section of this study brings to light the nuanced insights gleaned from the comprehensive data gathering process, shedding light on the perceptions of College of Engineering stakeholders regarding healthcare facilities and services. This section encapsulates the findings derived from the survey questionnaires and focus group discussions involving students (both graduate and undergraduate), faculty members, utility workers (permanent, contractual, and third-party), and staff.
I. Quantitative Assessment
The quantitative assessment of the survey responses involved the analysis of data collected from 50 participants, encompassing students, faculty members, and utility/staff within the College of Engineering at MSU-IIT. The breakdown of respondents revealed that a majority, 87.9%, identified as students, followed by 9% identifying as utility/staff, and 1% as faculty members.
A pivotal aspect of the survey focused on the utilization of medical services offered by the University. An overwhelming majority, 81.8%, affirmed having received medical services. Conversely, 18.2% of respondents indicated that they had not utilized medical services within the university. This finding underscores the significant reliance on and engagement with the health services provided.
In assessing the level of satisfaction with medical services, respondents were asked to rate their satisfaction on a scale of 1 to 10, with 10 representing complete satisfaction. The responses revealed that 39.3% of participants expressed full satisfaction, assigning the highest score of 10. In contrast, a small percentage, 3.6%, conveyed dissatisfaction, scoring below the midpoint on the scale. This distribution suggests a generally positive sentiment among those who have utilized medical services, with a notable minority expressing some level of dissatisfaction.
The observed high utilization rate aligns with literature emphasizing the importance of accessible healthcare services on university campuses, contributing to the overall well-being and academic success of students. The satisfaction levels reported resonate with findings that underscore the positive correlation between student satisfaction with health services and their overall campus experience. The presence of a minority expressing dissatisfaction mirrors studies highlighting the need for continuous improvement in healthcare provisions to address varying expectations and concerns within university settings.
This partially reflects the patterns and distribution of responses, providing a foundational understanding of the stakeholders' engagement with and satisfaction levels regarding healthcare services within the College of Engineering. The subsequent sections of the discussion will delve into the implications of these findings and their alignment with industry standards for public health in higher education.
II. Quantitative Assessment
Of the respondents who affirmed receiving medical services (81.8%), several recurring themes emerged in their qualitative feedback. A majority highlighted the perception of a high-tech clinic, modern equipment, and well-equipped facilities. Participants emphasized the qualifications and experience of healthcare professionals (HCPs), lauding their personalized and attentive patient care. The utilization of modern and well-equipped medical facilities garnered positive remarks, as did the welcoming and approachable nature of the HCPs. Overall, the qualitative responses underscore the perceived effectiveness of the healthcare system within the College, emphasizing the significance of competent and caring healthcare personnel.
Table 1
Matrix of Responses for Positive Aspects
Positive Aspects
|
Frequency
|
Modern facilities
|
72.70%
|
Qualified and experienced HCPs
|
66.70%
|
Personalized patient care
|
54.50%
|
Modern equipment
|
39.40%
|
Welcoming and approachable HCPs
|
33.30%
|
These positive perceptions align with existing literature emphasizing the importance of well-equipped facilities, qualified healthcare professionals, and personalized patient care in enhancing satisfaction with healthcare services on university campuses. The emphasis on modern equipment and high-tech clinics resonates with studies highlighting the positive impact of technological advancements on the perceived quality of healthcare in educational settings.
Respondents were asked about aspects of the public health system requiring improvement. A range of responses emerged, with concerns including waiting times, the need for more healthcare professionals and facilities, time management, infrastructure enhancements, and clearer signage within the clinic. The need for extended healthcare services to weekends, availability of specific supplies/medicines, and investment in modern healthcare equipment also surfaced as areas for improvement.
Table 2
Matrix of Responses for Aspects Needing Improvement
Aspects Needing Improvement
|
Frequency
|
Waiting times
|
27.30%
|
Need for more HCPs and facilities
|
27.30%
|
Time management
|
24.20%
|
Infrastructure improvements
|
21.20%
|
Clearer signage within the clinic
|
18.20%
|
Extended healthcare services to weekends
|
15.20%
|
Availability of specific supplies/medicines
|
15.20%
|
Investment in modern healthcare equipment
|
12.10%
|
No comment
|
9.10%
|
Health education
|
9.10%
|
Additional modern healthcare equipment
|
9.10%
|
Facilities, particularly laboratories
|
9.10%
|
Diagnostic tests
|
6.10%
|
Encouraging students to get checked
|
6.10%
|
A clearer services system
|
6.10%
|
Equipments/clinics in every department
|
3.00%
|
No basic medicines available
|
3.00%
|
Number of students they can accommodate
|
3.00%
|
The identified areas for improvement closely mirror challenges discussed in literature, such as long waiting times affecting patient satisfaction. Concerns about infrastructure and the need for clearer signage align with studies emphasizing the importance of a well-organized and navigable healthcare environment on university campuses.
When asked about current issues/concerns with the existing public health infrastructure, respondents cited concerns such as long waiting times, inadequate dental services, lack of specific medicines, and the absence of basic medicines during certain times. Additionally, issues related to service efficiency, availability of garbage bins, and the need for health education were highlighted.
Table 3
Matrix of Responses for Current Issues and Concerns with HC Services
Current Issues/Concerns
|
Frequency
|
Long waiting times
|
21.20%
|
Inadequate dental services
|
18.20%
|
Lack of specific medicines
|
15.20%
|
Absence of basic medicines at times
|
12.10%
|
Inefficient triaging processes
|
9.10%
|
Lack of accompaniment upon arrival
|
6.10%
|
Lack of utilization of available dental services
|
6.10%
|
Lack of available garbage bins leading to airborne diseases
|
6.10%
|
Cancellation of appointments due to long waiting times
|
6.10%
|
No identified concerns
|
6.10%
|
These concerns resonate with literature emphasizing the need for efficient patient management, adequate availability of essential medicines, and addressing specific healthcare needs within university settings (Hill et al., 2017; Patel et al., 2020; Bourner, 2019). The call for health education aligns with studies underscoring the importance of proactive health education programs in enhancing overall campus health (Guffey et al., 2020; Keyes et al., 2018).
The qualitative assessment provides valuable insights into stakeholders' perceptions, revealing areas of strength and pinpointing aspects that warrant improvement within the public health infrastructure of the College of Engineering at MSU-IIT. The findings set the stage for a comprehensive discussion and informed recommendations for optimizing the healthcare experience within the university setting.
Assessment of MSU-IIT’s readiness via the WHO Tracer
The World Health Organization (WHO) employs diverse tools and frameworks, such as the Global Health Emergency Risk Management and Strengthening of Health Systems: WHO Health Emergency Response Toolkit, to evaluate the general readiness of health systems. This toolkit serves as a valuable resource for countries in assessing their preparedness for responding to health emergencies, encompassing infectious disease outbreaks. The assessment criteria revolve around crucial components within health systems. Leadership and governance entail the presence of effective leadership and coordination mechanisms at both national and subnational levels, coupled with adequate legal and policy frameworks supporting emergency response.
Health information systems focus on effective surveillance and monitoring systems, facilitating early detection of health threats, and promoting data-sharing mechanisms with interoperability. The health workforce's readiness involves ensuring a sufficient and well-trained healthcare personnel equipped with expertise in emergency response, along with surge capacity to address increased demands during crises. Medical countermeasures and logistics consider the availability of essential medical supplies, pharmaceuticals, and equipment, as well as efficient logistics systems for their distribution and deployment.
Effective risk communication strategies to inform and engage the public, coupled with mechanisms for community participation and feedback in emergency response, characterize risk communication and community engagement. Health service delivery readiness entails ensuring the continuity of essential health services during emergencies and the capacity to rapidly expand services to meet heightened demand. Financial mechanisms and resources supporting emergency response activities, coupled with sustainable funding for preparedness and response efforts, are critical aspects in the finance category.
Table 4
SWOT Analysis Matrix of the MSU-IIT Public Health Infrastructure via FGDs
Strengths
|
Weaknesses
|
- Modern and well-equipped medical facilities
|
- Concerns about long waiting times
|
- High-tech clinic
|
- Inadequate dental services
|
- Qualified and experienced healthcare professionals
|
- Lack of specific and basic medicines
|
- Personalized and attentive patient care
|
- Challenges in triaging processes
|
- Positive perceptions of healthcare personnel
|
- Issues with accompaniment upon arrival
|
- Majority of respondents satisfied with services
|
- Lack of available garbage bins leading to airborne diseases
|
- Positive emphasis on modern equipment
|
- Cancellation of appointments due to long waiting times
|
- Positive views on welcoming and approachable healthcare professionals
|
- Limited utilization of available dental services
|
- No significant concerns identified by some respondents
|
- Limited infrastructure improvements mentioned
|
Opportunities
|
Threats
|
- Investment in modern healthcare equipment
|
- High demand for healthcare services leading to long waiting times
|
- Focus on time management and efficient processes
|
- Limited availability of specific medicines during certain times
|
- Infrastructure improvements based on stakeholder feedback
|
- Potential for airborne diseases due to lack of garbage bins
|
- Increased health education programs
|
- Challenges in managing high patient volumes
|
- Enhancing dental services based on stakeholder suggestions
|
- Limited accessibility of basic medicines during certain times
|
- Addressing concerns related to triaging processes
|
- Need for clearer signages in the clinic
|
- Extension of healthcare services to weekends
|
- Limited utilization of available healthcare facilities
|
- Strengthening of diagnostic testing capabilities
|
- Limited awareness of existing services among some stakeholders
|
Legal and policy frameworks emphasize clear regulations enabling a timely and coordinated response, aligning national laws and policies with international health regulations. Coordination and partnerships involve effective coordination mechanisms among relevant sectors and stakeholders, fostering collaboration with international partners and organizations for a coordinated response. Monitoring and evaluation mechanisms are crucial for regular assessments to gauge the effectiveness of emergency response activities, facilitating continuous learning and adaptation based on lessons learned from previous emergencies. These criteria collectively form a comprehensive approach tailored to the specific context of each country or region, aiding in the identification of strengths, weaknesses, and areas for improvement to enhance overall readiness for health emergencies.
Table 5. Scoring Sheet for MSU-IIT
Criteria
|
Score (1-5)
|
Leadership and Governance
|
3
|
Health Information Systems
|
3
|
Health Workforce
|
3
|
Medical Countermeasures and Logistics
|
2
|
Risk Communication and Community Engagement
|
2
|
Health Service Delivery
|
3
|
Finance
|
2
|
Legal and Policy Frameworks
|
2
|
Coordination and Partnerships
|
2
|
Monitoring and Evaluation
|
3
|
Average
|
2.5
|
A score of 2.5 achieved by MSU-IIT signifies a midpoint on the readiness scale, indicating a moderate level of preparedness concerning public health infrastructure. This average score reflects a balanced performance across various criteria while highlighting specific areas that could benefit from improvement. A nuanced exploration across different dimensions provides insights into the implications of this score. Within the context of Leadership and Governance, the average score suggests a potential need for strengthening mechanisms at both national and subnational levels. While existing frameworks exhibit moderate effectiveness, there is room for enhancement to ensure a more robust response during emergencies.
In terms of Health Information Systems, the moderate score indicates a mixed performance in surveillance and monitoring systems. While there is some effectiveness, there's an opportunity for improvement in early detection mechanisms and data-sharing interoperability to heighten responsiveness to health threats. The score of 2.5 in Health Workforce readiness implies a moderate level of preparedness among healthcare personnel. Addressing potential challenges during emergencies could involve additional training initiatives and surge capacity planning to fortify the workforce.
Within Medical Countermeasures and Logistics, the average score suggests a balance in the availability of medical supplies and logistics systems. However, there's a call for improvements to ensure more efficient distribution and deployment, particularly in times of heightened demand. Regarding Risk Communication and Community Engagement, the score of 2.5 points to a moderate performance. While effective strategies may be in place, there's an opportunity to take further measures in enhancing public communication and fostering community involvement during emergency situations.
In the context of Health Service Delivery, the moderate score implies a balanced continuity of essential health services. Yet, opportunities exist to improve the capacity for rapidly expanding services during emergencies, ensuring comprehensive coverage for the community. In the Finance category, the average score suggests a moderate level of financial support for emergency response activities. This indicates a potential for sustainable funding enhancements to fortify overall preparedness and response efforts.
Legal and Policy Frameworks earned a score of 2.5, implying a moderate alignment with international health regulations. Areas for improvement may involve ensuring clear regulations that facilitate a timely and coordinated response during health emergencies. Coordination and Partnerships received an average score, signifying a moderate level of coordination mechanisms and partnerships. Strengthening collaborations with relevant sectors and international partners could further enhance the effectiveness of a coordinated response. Within Monitoring and Evaluation, the moderate score indicates a balanced approach to assessing the effectiveness of emergency response activities. Opportunities exist to enhance continuous learning and adaptation based on lessons learned from previous emergencies.
The score of 2.5 serves as a baseline indicator of readiness, showcasing both strengths and areas for improvement within MSU-IIT's public health infrastructure. This evaluation acts as a valuable starting point, guiding targeted interventions and strategic enhancements in specific aspects to elevate the institution's overall preparedness for health emergencies. The nuanced analysis provides a comprehensive roadmap for focused efforts and resource allocation, fostering a more resilient and responsive health system at MSU-IIT.
Comparative Analysis
In the Mindanao Context
In the regional consultations, the top research priority identified was access to healthcare. It is imperative to identify region-specific risk factors for diseases. All regions expressed concerns related to geographical location and the physical provision of health facilities. The ARMM, Caraga, Zamboanga Peninsula, and Northern Mindanao reported challenges with dilapidated health infrastructure and insufficient medical provisions, severely testing their capacity to provide quality healthcare. Traditional medical treatment and birth assistance see high utilization.
Significant disparities in health service utilization among disadvantaged groups were prevalent in regions with marked income inequality. In Northern Mindanao, the unpredictable supply of contraceptives, dependent on USAID support, undermines gains from the Family Planning campaign. Throughout the Mindanao zone, overseas opportunities for nurses impact health service delivery. Caraga and SOCCSKSARGEN face a shortage of medical professionals, increasingly relying on barangay health workers and volunteer health attendants. The recommendation is to focus on nurturing other healthcare providers, providing relevant training and job security to enhance their capability in delivering basic health services.
Budget constraints affect the region's responsive health service delivery to address current and emerging health concerns. Region IX reports widespread adverse effects on the health sector due to budget cutbacks enforced by the local government. The devolution of health services to local government units exacerbates issues in sustaining operations, especially for special programs, as funding becomes subject to local politics in budget allocation. Technical, information, and budget support for health legislation and policies depend on resources provided by the LGUs. Some regions report a decline in donor grants for health programs.
Concerns about the regulation of counterfeit and substandard drugs were reported in Northern Mindanao and Zamboanga. Given the skewed deployment of trained professionals in the zone, the complementary role of alternative healthcare should be evaluated.
During the workshop organized by MSU-IIT in the mid-2000s, the group assigned to deliberate health issues related to women, children, and special groups encountered challenges in ranking the identified issues and concerns. Instead, they placed a higher emphasis on the discussions that ensued. The following major concerns were identified:
-
Health care practices among Indigenous Peoples and Muslims, encompassing rational and traditional health practices as well as drug use.
-
Issues and concerns regarding health care financing, including devolution, PhilHealth, HMOs, etc.
-
Health issues and concerns of internally displaced persons, externally displaced persons (deportees), including children, the elderly, differently-abled persons, and those in difficult situations.
-
Participation of civil society in health care delivery.
-
Utilization of health research results for policy formulation, programs, and projects.
-
Injuries research, examining causes, interventions, segregation by sex, age, areas, and preventive measures.
-
Effects of urbanization on poor women.
-
Diaspora of health workers.
-
Links between gender, sexuality, and violence.
There is also a recognized need for healthcare professionals to comprehend the cultural influences on the health-seeking behavior of the region's population. Regional reports underscore the imperative to address the health needs of special groups. Notably, concerns were raised about the health experiences of women, highlighting limited access to safe water and the prevalence of childbirth attended by traditional birth attendants in Caraga, Northern Mindanao, and the ARMM. In Region XII, concerns were expressed about the unhealthy lifestyles of the youth, including high rates of smoking and substance abuse. The ARMM and Davao consultations focused on maternal and infant health, diseases, and health-seeking behaviors of Indigenous Peoples within the context of their culture and belief. The Davao workshop also discussed health care for the elderly.
The forum recommended several actions to promote health and health research, including advocacy in various forums and consortia, values in research conduct (multi-disciplinary, culture-sensitive, ethical, responsive, action-based, and Mindanao-wide), organizing the health research network on a Mindanao-wide basis based on regional health development councils at DOST, allowing the academe and NGOs to select thesis/research topics, and packaging proposals for funding support in collaboration with RHRDC.
In the Philippine Context
In a case study conducted by Collado (2019), it is concluded that Jomalig Island, situated in Quezon Province, is far from an ideal location for medical treatment or even to be unwell. The health centers on the island are underequipped and understaffed, and the overall infrastructure, including roads and health facilities, does not create a supportive environment for delivering quality health services. The health centers can only address basic illnesses that do not require complex medical procedures and medication. Consequently, individuals with more profound health issues or those facing emergency cases necessitating major surgery and immediate medical attention must seek assistance outside Jomalig. Furthermore, dental services are unavailable.
Various factors, including travel costs, distance, transportation limitations, and poor network signals in certain areas, contribute to increased mortality and morbidity among the population. The very poor individuals in Jomalig, who are particularly susceptible to illness, face challenges reporting their illnesses due to the expensive travel costs from the sitios to health centers. Even if they manage to consult health professionals at local centers, cases that require treatment elsewhere, such as in Lucena, Polilio, Panganiban, or Manila, remain unresolved due to the prohibitive costs of travel and treatment. The term "pasahirap" is used to describe free boat ride passengers, underscoring the significance of a transportation system as a crucial strategy for serving the socially excluded population.
The negative impact of distance on accessing health services is compounded by inconsistent services provided by health workers. Some Barangay Health Workers (BHWs) reportedly lack consistency in attending training sessions and reporting cases in their respective areas due to travel costs. In emergency situations, the availability of transportation and the distance become critical factors in addressing patients' needs. Additionally, the island's network signal status poses challenges for communication among health authorities, hindering the timely provision of medical advice and other related instructions.
In the aforementioned study, it is highlighted that several factors negatively impact the health status of the population, including counter-scientific beliefs and stubborn attitudes among individuals. The proliferation of "albularyos" and the utilization of their services have sometimes resulted in the worsening of illnesses. Additionally, people's sanitation practices, such as open defecation despite local authorities' interventions, pose a significant problem, contributing to an increase in cases of diarrhea. Consequently, the community's reluctance to adopt health measures compounds the challenges faced by health centers in providing services on the island.
The health services on the island are far from being completely reliable. When assessed using the World Health Organization's (WHO) tracer for general readiness, the island's health centers demonstrate limited capacity. The absence of electricity, strong communication signals, emergency transport, proper facilities, and basic lab tests adds to the difficulties faced by health workers in delivering efficient and quality health services. To alleviate the impact of less effective health services on the island, the population must proactively work towards creating a better environment and dispelling outdated beliefs that hinder positive health outcomes. By transforming these beliefs and practices into behaviors aligned with efforts to achieve good health and preserve life, health centers on the island can more effectively monitor the actual health status of people within their jurisdiction, conserve government resources, and assist more patients in the process.
United States Public Health Infrastructure
In the United States, the primary responsibility for health protection and healthcare systems lies with the states, but the federal government plays a significant role in improving public health, preventing and managing diseases, and harmonizing health strategies between states. The US has a complex public health infrastructure that includes the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH), among others.
The US has also been working on developing talent for the digital transition and economic growth, launching a Talent for Growth Task Force that exchanges best practices and collaborates on training initiatives. Additionally, the US is addressing non-market economic policies and practices, particularly in the medical devices sector, to better understand their impact on US and EU companies.
European Union Public Health Infrastructure
In the European Union, public health policy aims to protect and improve the health of EU citizens, support the modernization and digitalization of health systems and infrastructure, improve the resilience of Europe's health systems, and equip EU countries to better prevent and address future pandemics. The EU has a more centralized approach to public health, with the European Parliament playing a significant role in policymaking. The EU has recently approved rules to improve the protection of its essential infrastructure, including healthcare facilities. Additionally, the EU is working on strengthening cooperation among member states for assessing health technology assessments (HTA), comparing the added value of new or existing health technologies, and evaluating their impact on human health.
The EU is also focusing on developing talent for the digital transition and economic growth, launching a Talent for Growth Task Force that exchanges best practices and collaborates on training initiatives. Furthermore, the EU is addressing non-market economic policies and practices, particularly in the medical devices sector, to better understand their impact on US and EU companies
While the United States and the European Union have different approaches to public health infrastructure, both organizations aim to improve the health of their citizens and support modernization in healthcare systems. They are working together in various areas, such as public procurement, digital infrastructure, and talent development, to share best practices and collaborate on training initiatives
Policy and Quality Review
In conducting a policy and quality review of MSU-IIT's assessed public health infrastructure, a thorough comparative analysis with current European Union (EU) and United States (USA) standards is essential. This examination will delve into key policy dimensions, quality assurance mechanisms, and best practices to benchmark MSU-IIT's practices against internationally recognized benchmarks.
Policy Frameworks and Regulations
The EU places a significant emphasis on a comprehensive legal framework for public health, ensuring harmonization across member states. Policies focus on health determinants, healthcare accessibility, and disease prevention. The USA, on the other hand, has a decentralized approach, with federal and state-level policies. MSU-IIT's policies should align with these frameworks, incorporating elements of disease prevention, health promotion, and ensuring equitable access.
Recommendations: MSU-IIT should review and enhance its policy framework to align with EU and USA standards, emphasizing disease prevention, health promotion, and equitable access to healthcare.
Quality Assurance in Healthcare Services
The EU emphasizes quality assurance through the European Commission's Joint Action on Health Workforce Planning and Forecasting. Quality is assured through accreditation processes and adherence to evidence-based practices. In the USA, quality assurance is facilitated through bodies like the Joint Commission. MSU-IIT must prioritize accreditation, robust quality assurance mechanisms, and the integration of evidence-based practices.
Recommendations: MSU-IIT should establish accreditation processes, prioritize evidence-based practices, and implement quality assurance mechanisms to ensure alignment with EU and USA standards.
Health Information Systems and Interoperability
Both the EU and the USA prioritize interoperable health information systems to enhance data-sharing and facilitate comprehensive care. The EU has initiatives like the eHealth Action Plan, promoting digital health, while the USA focuses on Electronic Health Records (EHR) through the Meaningful Use program. MSU-IIT should prioritize digital health initiatives, ensuring seamless data-sharing and interoperability.
Recommendations: MSU-IIT should invest in digital health initiatives, ensuring interoperability and adopting EHR systems to align with EU and USA standards.
Workforce Training and Development
The EU emphasizes continuous training through the European Centre for Disease Prevention and Control (ECDC). In the USA, workforce development is guided by the Centers for Disease Control and Prevention (CDC). MSU-IIT should prioritize continuous training for healthcare professionals, aligning curriculum with emerging public health challenges.
Recommendations: MSU-IIT should establish continuous training programs for healthcare professionals, aligning curriculum with emerging public health challenges, in line with EU and USA standards.
Emergency Preparedness and Response:
The EU's Health Security Committee guides member states in emergency preparedness. In the USA, the CDC's Public Health Emergency Preparedness (PHEP) program plays a pivotal role. MSU-IIT should establish robust emergency preparedness plans, conduct regular drills, and collaborate with local health agencies.
Recommendations: MSU-IIT should establish emergency preparedness plans, conduct regular drills, and collaborate with local health agencies to align with EU and USA standards.
Patient-Centered Care
Both the EU and the USA emphasize patient-centered care, ensuring that healthcare services are tailored to individual needs. MSU-IIT should prioritize patient-centered care, emphasizing communication, shared decision-making, and cultural competence in healthcare delivery.
Recommendations: MSU-IIT should emphasize patient-centered care, enhancing communication, shared decision-making, and cultural competence in healthcare delivery to align with EU and USA standards.
Public Health Initiatives and Community Engagement
The EU's Health Programme focuses on public health initiatives, while the USA prioritizes community health through initiatives like Healthy People 2030. MSU-IIT should integrate community health programs, engage in health promotion initiatives, and collaborate with local communities.
Recommendations: MSU-IIT should integrate community health programs, engage in health promotion initiatives, and collaborate with local communities to align with EU and USA standards.