Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

HOUSE BILL NO. 8637

Introduced by HON. JOY MYRA S. TAMBUNTING

EXPLANATORY NOTE

Philippines are among the early adopters of the Community Health Workers model for the delivery
of primary health care. The Barangay Health Worker (BHW) programme has been around since
the 1980s, and is largely sustained by volunteers, most of which are mothers and women in the
communities. Despite being a vital force in the delivery of primary health care, BHWs remain to
be undercompensated.

‘As such, this measure is proposed in recognition of the vital role of barangay health workers
(BHW) who are at the frontline of primary health care, This proposed measure provides for the
institutionalization of incentives and benefits for BHWs which shall include a monthly honoraria
of not less than P3000, allowances, insurance coverages, leave credits, pension benefits, training
programs etc, This measure also recognizes and empower the rights of BHWs to self-organization,
security of tenure and other support mechanisms to enable them to perform their duties and
responsibilities effectively and efficiently to promote barangay health and well-being.

On behalf of the people of Parafiaque City’s Second District, and for the common good of the
Filipino people, the approval of the said measure is earnestly sought.

RAS. u (ida,
2rd District, Parafiaque City


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

8637
HOUSE BILL NO.

Introduced by HON. JOY MYRA S. TAMBUNTING

AN ACT
STRENGTHENING AND INSTITUTIONALIZING THE BARANGAY PRIMARY HEALTH
CARE PROGRAM, PROVIDING SECURITY OF TENURE, BENEFITS, AND INCENTIVES
TO BARANGAY HEALTH WORKERS, AND PROVIDING FUNDS THEREFOR

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:

SECTION 1. Short Title. — This Act shall be known as the "Barangay Health and Wellness
Reform Act."

SECTION 2. Statement of Policy. - The State shall protect and promote the right to health of
the people and to provide conditions for health empowerment, where each individual has access
to information and services that will bring about health and well-being. The Primary Health Care
‘Approach is recognized as the major strategy towards health empowerment, emphasizing the
need to provide accessible and acceptable health services through participatory strategies such
as health education, training of barangay health workers, community building and organizing.
Towards this end, this Act shall strengthen and institutionalize primary health care programs at
the barangay level by providing and upgrading vital and essential health facilities, human resource
development and fiscal support.

The government and all its instrumentalities shall recognize the rights and vital role of barangay
health workers (BHW) who are at the frontline of primary health care to organize themselves, to
strengthen and systematize their services for their community to make a venue for sharing their
experiences and recommending policies and guidelines for the promotion, maintenance and
advancement of their activities and services, to security of tenure, to decent living allowances
and other support mechanisms to enable them to perform their duties and responsibilities
effectively and efficiently to promote barangay health and well-being.

SECTION 3. Definition. — “Barangay health worker” refers to a person who is duly registered
with the municipal or city health board and who voluntarily renders primary health care services
in the community.


SECTION 4. Registration. - Barangay health workers shall register with the local health board
in the city or municipality in which they render service. The local health board, through the
provincial health boards in the case of municipalities, shall furnish a copy of such registry to the
DOH, which is hereby mandated to maintain a national register of barangay health workers. The
registered health workers shall be given appropriate proof of said registration.

The municipal or city local health board shall regularly update the BHW registry which shall
include, among others, the number of years of service of each BHW, trainings and seminars
attended, and accreditation as provided in Section 5 hereof, The municipal or city local health
board shall submit a copy of the updated registry to the provincial health board and the DOH
central office every year and post it in the municipal/city bulletin board and barangay health
centers.

SECTION 5. Accreditation. - The municipal or city health board shall accredit BHWs in
accordance with the guidelines promulgated by the Department of Health (DOH). It shall be the
duty of the municipal or city health board to ensure that all registered BHWs shall undergo training
programs under any accredited government and non-government organizations and/or the DOH
Provided, that the DOH shall develop a basic training course for newly recruited BHWs that can
be completed within a period not later than one (I) year upon their assumption to work.

To be accredited, a newly recruited BHW must have completed satisfactorily the basic training
course which will be certified by the municipal or city health officer concerned. Unless this
requirement is fulfilled, he shall be considered as a barangay health trainee.

SECTION 6. Number of Barangay Health Workers. - The DOH shall determine the ideal
ratio of barangay health workers to the number of households: Provided, that the total number
of barangay health workers nationwide shall not be less than one percent (1%) of the total
population.

SECTION 7. Incentives and Benefits. - In recognition of their services, all accredited
barangay health workers who are regularly performing their duties shall be entitled to the
following incentives and benefits:

a) A monthly honoraria of not less than Three Thousand Pesos (P3,000.00);

b) Hazard allowance in an amount to be determined by the local health board of the local
government unit concerned, but in no case less than One Thousand Pesos (P1,000.00)
per month;

9

Subsistence allowance equivalent to the meals they take in the course of their duty in
order to make their services available at any and all times which shall not be less than
One Hundred Pesos (P100.00) per day, to be computed in accordance with prevailing
circumstances as determined by the local government unit concerned;

d

Transportation allowance of not less than One Thousand Pesos (1,000.00) per month,
Provided, that official travels like seminars, conferences and transport of patients
outside of the barangay, shall be shouldered by the barangay LGU concerned and shall
not be deducted from the travel allowance of BHWs;


BHWs shall be entitled to ten percent (10%) discount in transportation fare during
their incumbency;

) Health benefits during their incumbency which shall include:

1) Free medical care when confined in any public hospital or health institution
including surgery and surgical expenses medicines, x-ray and other laboratory
fees;

Ten percent (10%) discount on professional fees of attending physicians in
private hospitals, private medical facilities, out-patient clinics and home care
services;

Ten percent discount (10%) and exemption from value added tax on the
purchase of medicines and such other medical supplies, accessories and
equipment unless confined in a public hospital or health institution;

4) Emergency assistance not exceeding the amount of Five Thousand Pesos
(P5,000.00) and chargeable to the barangay concerned, for expenses incurred
in the nearest private hospital or clinic in case of extreme emergency where
there is no available public hospital;

Mandatory and immediate membership to the PhilHealth as indirect
contributors which shall be borne by the LGU concerned, pending the full
implementation of Republic Act No, 11223, otherwise known as the Universal
Health Care Act.

2

3

5

The LGUs concerned shall also endeavor to provide such other health benefits to BHWs
not otherwise provided by the law;

f) Insurance coverage which shall include, but not limited to, temporary and permanent
disability, double indemnity, accident insurance, death and burial benefits.

All BHW s who have rendered at least one ( 1) year of continuous service shall also
be granted insurance coverage and benefits from the Government Service Insurance
System (GSIS) which shall be borne by the LGU concerned. Provided, that the national
government shall subsidize fifty percent (50%) of the contributions of fourth, fifth and
sixth class municipalities;

Sick, vacation and maternity leaves as may be prescribed in the implementing rules
and regulations of this Act. Provided that, the BHW s shall continue to receive their
monthly honoraria, hazard, travel and subsistence allowances while on leave, for such
period similar to existing laws and practices.

g

h) Christmas bonus or cash gift to be given every December which shall be not less than
their monthly honoraria, to be taken from the general fund of the barangay or from
such other funds appropriated by the national government for the purpose;


i) Retirement and pension benefits from the GSIS. Provided that, a BHW must have
rendered at least thirty (30) years of service;

Training, Education and Career Enrichment Program opportunities to be provided by
the DOH in coordination with the Commission on Higher Education, TESDA,
Department of Education and other concerned government agencies and non-
governmental organizations, to wit:

1) Educational programs which shall recognize years of primary health care
service as credits to higher education in institutions with stepladder curricular
that will entitle barangay health workers to upgrade their skills and knowledge
for community work or to pursue further training as midwives, pharmacists,
nurses or doctors;

Continuing education, study and exposure tours, training, grants, field
immersion, scholarships, etc.;

College scholarship grants or TESDA scholarships for at least two (2) children
of a barangay health worker who has rendered at least one (1) year of service.
The scholarship shall continue in case of death or permanent incapacity of a
barangay health worker arising out of and in the course of performing his duty.

2

3

k) A second grade Civil Service Eligibility which shall be granted to BHWs who have
rendered five (5) years of service. Provided, that should the barangay health worker
become a regular employee of the government, the total number of years served as
barangay health worker shall be credited to his/her service in computing retirement
benefits.

1) Free legal representation and consultation services which shall be immediately
provided by the Public Attorney's Office in cases of coercion, interference, and in other
civil and criminal cases filed by or against barangay health workers arising out of or in
connection with the performance of their duties, The DOH shall also endeavor to enter
into a Memorandum of Agreement (MOA) with the Integrated Bar of the Philippines
(IBP). Legal services provided to BHWs shall be credited to the Mandatory Continuing
Legal Education (MCLE) of lawyers, subject to the guidelines to be provided by the
Supreme Court.

m) Preferential Access to Loan for organized barangay health worker groups that have
community based income generating projects in support of health programs or
activities and livelihood projects. The DILG or the LGU in coordination with other
concerned government agencies shall provide, within one hundred eighty (180) days
after the effectivity of this Act, a mechanism to access to loan services by organized
health workers, The agencies providing loan services will set aside at leastone percent
(1%) of their loanable funds.

For this purpose, the LGUs, DOH, Cooperative Development Authority (CDA),
Department of Labor and Employment (DOLE), TESDA and other concerned agencies


shall provide assistance to BHWs in developing and promoting such health program
or activities and livelihood projects in pursuit of barangay health and wellness.

n) Loyalty Award to be given to a BHW for every five (5) years of continuous and
meritorious service rendered, as certified by the punong barangay concerned or by
the municipal or city health board. The loyalty award shall be equivalent to his one
month honoraria to be taken from the general fund of the barangay or as may be
subsidized by municipal, city or provincial LGU. This provision shall apply upon the
effectivity of this Act.

Barangay health trainees shall be entitled to benefits and incentives as provided in paragraphs
a), b), ©), d) and h)..

Such benefits and incentives that shall be shouldered by the LGUs may be increased, upon review
of the local health board, after considering, among others, the present consumer price index
(CPI) as published by the Philippine Statistics Authority (PSA).

SECTION 8. Security of Tenure. ~ The services of accredited barangay health workers shall
not be terminated even after the term of the punong barangay and sangguniang barangay
members, except for cause as provided by law and after due process. Provided, that if a BHW,
upon appeal, is found by the Civil Service Commission (CSC) to be unjustly dismissed from service,
he shall be entitled to reinstatement without loss of benefits and incentives from the time of his
termination up to the time of his reinstatement. The Civil Service Commission shall resolve
termination cases against BHWs judiciously not later that ninety (90) days from the receipt of a
complaint.

SECTION 9. Discrimination Prohibited. — A barangay health worker shall not be discriminated
against with regard to gender, civil status, creed, religious or political beliefs and ethnic groupings
in the exercise of their functions.

SECTION 40. Right to Self-Organization. - Barangay health workers have the right to freely
form, join or assist organizations to obtain redress of their grievances through peaceful concerted
activities for purposes not contrary to law, and with utmost regard to service to patients and the
continuous operation of barangay health services in the interest of public health, safety or survival
of patients.

SECTION 11. Role of Barangay Health Workers. - As one of the key partners in a reformed
local health care delivery system, the DOH and LGUs shall support the involving roles of BHWs in
a reformed health system as:

1) Advocate — to support, promote and/or champion current health programs, project,
and activities (PP As) to improve access to and quality health services towards the
improved health status of the community;

2) Educator — to guide, advise, counsel the community on the current DOH and LGU
health priorities as importance of birth plan and facility-based delivery in reducing
maternal and infant deaths; newborn screening for the early detection of congenital


metabolic disorders which may leads to mental retardation and even death, among
others;

3) Disseminator — to remain regular communication with local professional health
workers (e.g. MHO, PHN, RHM, DOH Rep, Hospital staff) on health events and updates
and concerns relevant to the community and inform the same to catchment
HH/community for appropriate action, if necessary;

4) Linker —to facilitate access to or association of the community with a relevant network
of or specific health and non-health service providers within or even outside the BHE
catchment, for instance: referral of pregnant women to a health facility which basic/
comprehensive emergency obstetric newborn care capacity; network with the
Technical Education and Skills Development Authority (TESDA) for training;

5

Record keeper — to maintain updated lists/records of health data, health
activities/events in the community, such as buy not limited to data/records on FICs,
OPT result, GP , pregnancy tracking, pre-natal and post-natal women ; exclusive
breastfeeding mothers, blood-letting activities.

No BHW shall be utilized or subjected to any partisan political activity,

SECTION 12. Representation in the Local Health Board and Health Care Provider
Network. — The president of the municipal or city association of BHWs shall be a member of the
municipal or city local health board. The Presidents of each component city and municipality of a
province shall elect among themselves the BHW representative to the provincial health board.

The BHWs shall also form part of the Health Care Provider Network as may be determined by the
DOH and LGUs concerned in the implementation of primary health care programs and services.

SECTION 13. Loca/ Health Plan. — Local government units are hereby mandated to formulate
their respective local health plans in harmony with the national health plan formulated by the
DOH. The BHWs shall actively take part in the formulation, implementation, monitoring and
evaluation of the health plans insofar as primary health care programs, projects and activities are
concerned.

SECTION 14. Barangay Health Center. - There shall be at least one (1) barangay health
center which shall have basic and essential facilities and provisions as prescribed by the DOH to
effectively carry out primary health care programs and services in the barangay.

‘The BHWs shall provide assistance in the barangay health centers and field school in coordination
with the city, municipal and provincial health offices. Provided, that the barangay health centers
shall assist in disaster risk reduction programs.

SECTION 15. Botika sa Barangay. - The DOH shall provide the guidelines in the establishment
and Management of "Botika sa Barangay" programs and services. The DOH and the Food and
Drug Administration (FDA) shall give appropriate trainings to BHWs, in consultation with relevant
professional organizations and associations.


The BHWs shall provide assistance to the Botika sa Barangay programs and services under the
supervision of the city/municipal health officer.

SECTION 16, Education and Information Campaign. — The DOH shall conduct an education
and information campaign that would enhance the knowledge and skills of BHW s on primary
health care through various forms including, but not limited to, online E-Learning and multi-media,
and in major Philippine dialects.

The DOH, in coordination with TESDA and other concerned agencies shall also assist the LGUs in
the development of education modules or materials to promote the collective experiences and
learnings of BHWs on primary health care, as well as to promote traditional and complementary
medicine,

The DOH shall also maintain an updated roster of registered and accredited BHWs that is
accessible to the general public.

SECTION 17. Funding. - Funds for the benefits and incentives of barangay health workers and
for the implementation of local health programs, projects and activities, shall be allocated from
the following sources:

1) Ten percent (10%) of the internal revenue allotment (IRA) for LGUs;
2) Ten percent (10%) of the LGUs share in the national wealth;

3) Ten percent (10%) of the tobacco excise tax;

4) At least ten percent (10%) of the LGUs' incomes derived from local economic
enterprises (LEE); and,

Ten percent (10%) of the LGUs' incomes derived from the LGUs' own sources of
revenue and local taxes in accordance with the Local Government Code.

Provided, that the LGUs concerned shall first fulfill the benefits and incentives due for BHW s in
accordance with this Act. Provided further, that any expenditure by the LGUs for the benefits and
incentives of BHWs shall be exempt from the forty-five percent (45%) limit on allocation for
personal services of LGUs in the case of first to third class LGUs, and fifty-five percent (55%) in
the case of fourth class or lower class LGUs,

5)

SECTION 18. Penalty Clause. — Any local government official concerned who violates any
provision of this Act may be administratively charged in accordance with law.

SECTION 19. Rules and Regulation. - The Department of Health and the Department of
Interior and Local Government, in consultation with the Department of Education, the Civil Service
Commission, the Government Service Insurance System, and other concerned government
agencies and non-governmental organizations, shall formulate, not later than one hundred eighty
days (180) from the effectivity of this Act, the rules and regulations necessary for its effective
implementation.

SECTION 20. Separability Clause. — If any provision of this Act is declared invalid, the
remainder of any provision hereof not affected thereby shall remain in force and effect.


SECTION 21. Repealing Clause. — Republic Act No. 7883 is hereby repealed. All laws, decrees,
executive orders, and other presidential issuances which are inconsistent with this Act are hereby
repealed, amended or modified accordingly.

SECTION 22. Effectivity. - This Act shall take effect fifteen days (15) after its publication in
the Official Gazette or at least in two (2) national newspapers of general circulation.
Approved,

Approved,