Summary of Project Performance, Province of Iloilo, Philippines, as of April 30, 2023
| RE-AIM Dimensions/ Indicators | Projected, No. (%) | Post-Intervention Performance, No. (%) | Means of Verification | Remarks |
|---|---|---|---|---|
| Reach | ||||
| Proportion of population that was registered to a primary care providera | 420,000 (≈20.0) | 405,826 (19.3) | Facility-level data and program reports | The cumulative total population registered with a primary care provider includes individuals registered before the study. However, a substantial portion of the overall result can be attributed to the interventions implemented during the study. |
| Effectiveness | ||||
| Number of individuals that had FPE (including health profiling) | 72,000 (100.0)a | 110,795 (153.9) | Facility-level data; program reports | Our observations indicate that the rotating barangay-based model, which involved conducting scaled-down mass registration activities in each barangay (village) without the need for additional personnel, had a greater impact on the increase in first-patient encounters compared to both continuous facility-based model and mass registration approaches. |
| Number of WRA given FP services | 3,240 (100.0)b | 10,369 (320.0) | Facility-level data; program reports | The total number of WRA with contraceptive methods initiated was not accurately tracked. However, we were able to document 1,099 WRA as new or other acceptors, and the remaining only received FP counseling services. |
| Number of individuals given COVID-19 vaccination | 33,957 (100.0)c | 15,628 (46.0) | Facility-level data; program reports | The primary COVID-19 vaccine series coverage was already high at the start of the study. However, the lower-than-expected results can be attributed to challenges in closely monitoring adaptive measures for vaccination and vaccine supply shortages during the study period. |
| Adoption | ||||
| Number of primary care facilities who participated in the intervention | 43 (100.0) | 36 (81.4) | Program reports | Only 36 of all 43 public primary care facilities participated in the study. Among the 36 facilities, 27 were accredited by PhilHealth by the end of the intervention. |
| Implementation | ||||
| Fidelity (adherence to steps and intervention protocol) | Consistency between recommended and implemented processes in the intervention protocol | See remarks | Minutes of mid-implementation review and pause-and-reflect sessions; focus group discussion transcripts | Modifications in the registration activities were made. Initially, the registration format consisted of 2 designs: (1) facility-based registration and profiling setup and (2) a mass registration activity held once per local government unit with additional workforce support. Adopted a patient-centric approach through the rotating barangay-based model. Also, a vaccine hesitancy survey was later introduced to gather additional information on the topic. |
| Maintenance | ||||
| Number of primary care facilities continuing to implement the intervention after the study period | 36 (100.0) | 36 (100.0) | Observation checklist; post-implementation review; facility-level data | To date, the facilities are actively implementing the intervention, and the ReachHealth project continues to provide the necessary technical assistance to ensure sustained implementation in these sites. Furthermore, a select number of consultants were hired directly by the primary care facilities in the months after the engagement as full-time staff and continue to implement the model. |
| Increase in the amount of health insurance reimbursements |
No target indicated; baseline was <PhP4,000 or US$80 | PhP553,915 or US$11,078 | Observation checklist; post-implementation review; facility-level data | At the beginning of the activity, the participating health facilities generated less than PhP4,000 in health insurance reimbursements. The significant increase at post-intervention assessment was considered a critical driver for sustained financing of the intervention. |
Abbreviations: FPE, first patient encounter; FP, family planning; PhilHealth, Philippine Health Insurance Corporation; PhP, Philippine peso; WRA, women of reproductive age.
↵a Based on a 30–35 daily average count of FPE considering the available medical consultants and number of days allocated to conduct the FPE within the intervention period.
↵b Based on the proportion of WRA among the target population estimated using the family planning estimation tool; potential reach was adjusted for an anticipated higher attendance, particularly among stay-at-home mothers, given the type of outreach activities.
↵c Based on the estimated reach of 10% of eligible individuals who had not received COVID-19 vaccination among the target population.