Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines

# Background The study describes the conditions of public health sector in the Island Municipality of Jomalig, Quezon Province in Luzon, Philippines. Located at the far north-eastern side of the Quezon Province, Jomalig Island can be reached through a motor boat at around 4-5 hours (or more depending on the sea condition). Given the geographical disadvantage, challenges in economic and social services in the island are apparent. That includes deficiencies in basic public utility services such as water and electricity. The paper showcases a needs assessment on public health facilities and services in a far-flung municipality in the Philippines. This study examines the challenges in public health aspirations in a location considered to be a geographically isolated and disadvantaged area (GIDA). # Methods The study made use of key informant interviews (KIIs) among health professionals and village health workers in the island. Aside from the KIIs, the study included the World Health Organization's (WHO) tracer checklist on general readiness. The checklist was administered but in interview style. The participants were the public health staff in the island. The researcher was able to interview the health professionals (nurses and a midwife) manning the main public health facility in the island municipality while in the case of the other villages, health volunteers or the Barangay Health Worker (BHWs) were interviewed. # Results There are deficiencies in facilities, offered services and health staff. Deficiencies are seen too based on the domains under the WHO Tracer Checklist. Mortality and morbidity rates were not at alarming rate though reports of hypertension and diarrhea are common. The relatively "complete" health services are only available at the island's main health center yet unfortunately, some people who seek treatment and health care could not visit due to distance and the accompanying expenditures. Other factors affecting health status of the population include the reliance to "faith healers" (quack doctors or Albularyos) and the delay of parental reports of their health condition and the condition of their children, both of which result to the "escalation" of illness. Among others, challenges and aspirations of the island's public health sector include electric supply, better budgetary allocation for their facilities, and equipment and additional training for the barangay (village) health workers. # Conclusions Enduring the underfinanced and undermanned health facilities, the island's population also suffers the consequences on overall health owing to limited movements and communication due to the geographical characteristics of the municipality. Emergency boats per village, health education campaign that focuses on eliminating open defecation and reliance on quack doctors, stand-by generators for the health centers, and radio communication system are strongly recommended to mitigate the negative impacts of living within GIDA communities.