Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
First Regular Session

514

House Bill No.

Introduced by AKBAYAN Party-List Representatives
Hon. Kaka Bag-ao and Hon. Walden Bello

EXPLANATORY NOTE

From barangay health workers to midwives, nurses and doctors.

‘That the Philippine health sector is experiencing a brain drain is no hidden fact. Nurses
are leaving the country, and between 1994 to 2003 alone around 85,000 Filipino nurses
went abroad. Doctors have also joined the fray: 3,000 doctors left the country as nurses
from 2000 to 2005, while an additional 3,000 enrolled in nursing schools in 2006.

The migration of health professionals has impaired the country’s health sector. During the
past three years, 200 hospitals have closed down, while around 800 partially closed their
operations due to the lack of nurses and doctors. Recently, the secretary of the
Department of Health announced that the government might need to spend more on
health to ‘import’ nurses and doctors from South Asia.

AKBAYAN believes that a simple and innovative solution could help reverse the scenario.
‘According to the Department of Health, there are about 1.3 million barangay health
workers (BHW) all over the country. This provides the country with a potent workforce
that has the commitment and experience to deliver basic healthcare services in
communities where such services are direly needed. With the right training, our BHWs
could become midwives, dentists, nurses and doctors, filling up the gap left by medical
professionals who have opted to work abroad.

The “Bibong BHW Education and Training Program” proposed under this measure seeks
to scale up the capabilities of barangay health workers through the institutionalization of
an innovative ‘step ladder’ training program that the University of the Philippines has
initiated.

The bill has the following objectives: 1) establish an education and training program for
BHWs that integrates capability and skills-building with voluntary community health work;
2) strengthen the accreditation system for BHWs, thus professionalizing the volunteer
program, and; 3) provide additional incentives for BHWs.

The training and education component of the measure follows a ‘step ladder’ system, with
the following tiers:

+ Certificate of Barangay Health Work, a 3-month basic course on community
health work that shall be required to all BHWs. This shall include basic dental care,
reproductive health, STI and HIV/AIDS prevention, nutrition, physical therapy,
traditional and herbal medicine and reflexology.


60 * Bachelor of Science in Community Health, an 18-month program that shall include

61 courses on maternal and child healthcare, community nursing, advanced local

2 health research, community organizing, among others. BHWs may specialize in

6 midwifery, pharmacology, occupation therapy, dentistry, or physical therapy.

64 Graduates of this course shall be eligible to take the licensure examination for the
65 above specializations.

66

67 * Bachelor of Science in Nursing, a 15-month program that shall include all the

68 necessary courses on nursing. Graduates of this course shall be eligible to take the
69 Nursing Licensure Board Examination.

70

1 * Doctor of Medicine, a five-year program that shall include all courses on Medicine.
2 Graduates of this course shall be eligible to take the Physicians Licensure Board
B Examination.

4

75 In between each ‘step’, the trainees shall be required to go back to their communities to
76 work with local hospitals, rural health units, or community health centers for at least six
77 — months, BHWs may enter and exit at any level, provided that they take placement tests
78 that shall be administered by the Civil Service Commission.

80 The bill also grants additional benefits for BHWs, among them full scholarships, socialized
81 subsidies, or study now pay later schemes for those who wish to proceed to advanced

82 courses; an increase in their allowance to 4,500, exclusive of other allowances;

83 mandatory Philhealth membership for all accredited BHWs, and free medical services for
84 veteran BHWs.

86 _ In light of the foregoing, the immediate passage of this bill is earnestly sought.

MAG

Hon. WALDEN BELLO
Representative, Akbayan Party-list

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
First Regular Session

House Bill No.

Introduced by AKBAYAN Party-List Representatives
Hon. Kaka Bag-ao and Hon. Walden Bello

AN ACT CREATING THE BARANGAY HEALTH WORKER EDUCATION AND
TRAINING PROGRAM, APPROPRIATING FUNDS THEREFOR AND FOR OTHER
PURPOSES

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

Section 1. Title. - This Act shall be known as the “Bibong BHW Education and Training
Program”.

Section 2. Declaration of Principles. - The State declares its commitment to uphold
and promote the right to health of the people through the delivery of community-based
health care programs and services. It recognizes the importance and urgency of making
healthcare accessible at the community level, the frontline in the struggle to make each
and every Filipino fit and strong

The State likewise affirms and upholds the welfare of community-based health workers,
whose services and sense of volunteerism are crucial in preventive and primary health

care delivery. It is committed to provide continuing education and training and additional
incentives to community-based health workers to expand opportunities available to them.

Section 3. Definition. - For the purposes of this Act, the term "Barangay Health
Worker" refers to a person who has undergone basic training on Barangay Health Work
under any accredited government and non-government organization and who voluntarily
renders health care services in the community after having been accredited to function as
such by the provincial health board.

Section 4. Step Ladder Education and Training Program for Community-based
Health Workers. - The Department of Health, in coordination with the University of the
Philippines, shall develop a continuous, competency-based step-ladder education and
training curriculum for barangay health workers. The curriculum shall train the barangay
health workers as healthcare providers, community organizers, health service managers,
trainers and educators, and researchers.

The program shall have the following levels:

a.) Certificate of Barangay Health Work - a 3-month course that shall include basic
crientation and training on health programs and institutionalized health service
delivery system, primary healthcare, basic community organizing, local health
research, basic local resource generation and mobilization, training needs analysis,
basic report writing and communication skills, and program planning and
development. Courses on basic dental care, reproductive health, STI and

3


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HIV/AIDS prevention, nutrition, physical therapy, traditional and herbal medicine
and reflexology shall also be offered.

b.) Bachelor of Science in Community Health — an 18-month program that shall
include courses on maternal and child healthcare, community nursing, advanced
local health research, community organizing program development, organizational
development, and advanced resource generation. A program scholar shall be
required to choose any of the following for his or her specialization: midwifery,
pharmacology, occupation therapy, dentistry, or physical therapy. Graduates of
this course shall be eligible to take the licensure examination for midwifery,
pharmacology, occupation therapy, dentistry, or physical therapy.

[o

Bachelor of Science in Nursing a 15-month program that shall include all the
required courses on nursing. Graduates of this course shall be eligible to take the
Nursing Licensure Board Examination.

d.) Doctor of Medicine — A five-year program that shall include all courses on
Medicine. Graduates of this course shall be eligible to take the Physicians
Licensure Board Examination.

Section 5. Service Leave. - As a requirement for the completion of each level, program
scholars shall render health and community services in their own rural health units or
municipal or provincial hospitals for a minimum of six months to integrate lessons in the
course work with community healthcare services delivery. The Service Leave shall be
supervised and/or facilitated by the program’s faculty members and representatives or
leaders from the scholars’ community.

Section 6. Placement Examinations. - The Department of Health, in coordination
with local governments and the Civil Service Commission, shall conduct regular placement
examinations to determine the eligibility, competency, skills, and knowledge of program
applicants or scholars who wish to enroll at any level.

Section 7. Educational Requirement for Program Admission. ~ 4 minimum of high
school education shall be required to be eligible for admission to the program, with the
exception of the Doctor of Medicine component, eligibility for which shall require college
education or completion of the Bachelor of Science in Nursing component of the program.

To help non-high school graduates to enter the program, the Department of Education
shall conduct regular diploma placement tests and shall develop and establish a
secondary education acceleration program, both of which shall be provided for free for
individuals willing to volunteer to deliver community-based health care services.

Section 8. Program Implementation. - With the support and assistance of the
Department of Health, provincial governments, in coordination with municipal
governments, and city governments are hereby mandated to provide and implement the
Barangay Health Work program. Local Government Units may likewise authorize DOH-
accredited non-governmental organizations (NGOs) to conduct the training program.

The Department of Health, in coordination with the Commission on Higher Education,
shall accredit State Universities and Colleges or private educational institutions to offer the
advanced courses.

Section 9. Support for Program Scholars. - The basic course shall be offered to
community health workers free of charge. The Department of Health shall offer full
scholarships, socialized subsidies, and “study now pay later” schemes for community
health workers taking the advanced courses.

Section 10. Accreditation for Barangay Health Workers. — To be accredited as a
Barangay Health Worker, completion of the Certificate of Barangay Health Work shall be
required. Graduates of the basic level courses shall be accredited by the Provincial Health
Board, with the participation of TESDA, PhilHealth, and accredited training NGOs.

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Graduates of the Nursing and Medicine courses shall be accredited by the Department of
Health or DOH-accredited State Universities and Colleges.

Section 11. Non-discrimination policy. Discrimination on the basis of age, sex,
gender, sexual orientation, gender identity, economic background, religion, ethnic
heritage or race, and disability in the accreditation of barangay health workers is
prohibited, A non-discrimination policy shall be crafted and enforced by the Department of
Health, in coordination with the Provincial Health Board, to ensure the implementation of
this provision.

Section 12. Automatic Accreditation. — Individuals who have served as barangay
health workers for at least five years upon the enactment of this measure shall be
deemed graduates of the Certificate of Barangay Health Work course and shall
automatically be granted accreditation.

Section 13. Compensation and Other Incentives. -—

a.) All accredited Barangay Health Workers shall be entitled to monthly basic pay of
four thousand five hundred pesos (P4,500). Subsistence allowance, including a
Christmas bonus equivalent to their one (1) month salary. Furthermore, they shall
be entitled to subsistence allowance, hazard allowance, and travel allowance, the
amount of which shall be determined by their respective local government units.

b,) All accredited Barangay Health Workers shall be entitled to insurance coverage
under the National Health Insurance Program. Premium contributions for the
insurance enrolment shall be covered by the provincial, city or municipal
government concerned.

c.) The Philhealth is hereby mandated to accredit Barangay Health Workers for the
delivery of certain health services. They shall receive compensation from
Philhealth for services delivered.

d.) Barangay Health Workers who have served for at least five years shall receive free
medical treatment and services in public health clinics or hospitals.

Section 14. Appropriation. — a.) An initial allocation of Fifty Million Pesos
(P50,000,000.00) shall be included in the General Appropriations to support the policies
and objectives under this Act. Congress shall provide subsequent appropriations in the
annual budget of the Department of Health under the General Appropriations Act.

b.) Cost Sharing for Local Government Units. — Local governments shall adopt a cost-
sharing financing scheme for the implementation of the basic course on Barangay Health
Work depending on the income level of the concerned local government units.

Section 15. Implementing Rules and Regulations. — With ninety (90) days from the
approval of this Act, the Department of Health and the University of the Philippines,
together with the Department of Education and the Commission on Higher Education shall
promulgate the rules and regulations necessary for the implementation of this Act.

Section 16. Repealing Clause. - A\l laws, decrees, executive orders, rules and
regulations, or parts thereof, which are inconsistent with the provisions of this Act are
hereby repealed or modified accordingly.

Section 17. Effectivity. - This Act shall take effect after fifteen (15) days following the
completion of its publication in the Official Gazette or in at least two (2) newspapers of
general circulation.

Approved.