Facilitators and Barriers to Implementing an Integrated Primary Care Service, Province of Iloilo, Philippines

RE-AIM DimensionsFacilitatorsBarriers
  • Endorsement from the municipal health officer and mayor

  • Availability of human resources for health

  • Positive reception of the Konsulta package by local health teams

  • Close proximity of the primary care services to households

  • Lack of support from local chief executive

  • Insufficient human resources

  • Inadequate financial support for conducting mass registration activities

  • Considerable distance from the site of registration and profiling

  • Availability of vaccines and family planning commodities

  • Involvement of the family decision-maker

  • Presence of physician for patient persuasion, in contrast to other health care workers

  • Misinformation by organized local groups

  • Absence of vaccines and family planning commodities

  • Timing of profiling activity (weekdays meant fewer working individuals and more senior citizens)

  • High interest of municipal health officers

  • Provision of incentives for municipalities committed to implementation (i.e., augment human resources)

  • Initial funding for the hiring of medical consultants to provide technical support

  • Obtaining approval from local legislative body to participate in the intervention takes time

  • Unfavorable perception of the current capitation amount of the primary care benefit package considered to be below the market cost

  • Existence of efficient knowledge-sharing channels through multistakeholder group chats and frequent meetings

  • Effective utilization of weekly reports and regular feedbacking of implementation challenges

  • Lengthy process in securing primary care facility accreditation from public health insurance

  • Lack of resources to conduct mass registration in certain settings

  • Commitment of local chief executives and municipal health officers to generate reimbursements from implementing the intervention

  • Lack of support from local chief executives

  • Inadequate national-level support to address broader issues, such as accreditation of electronic medical records and changes and agile policies to respond to diverse circumstances

  • Abbreviation: RE-AIM, reach, effectiveness, adoption, implementation, and maintenance.