Abstract Introduction: BHWs have long been central to the Philippines' primary health care system, bridging communities and formal health institutions. The enactment of Republic Act 7883 institutionalized their roles and benefits, while the UHC Act of 2019 expanded their responsibilities as frontline implementers of health promotion and service delivery. This study examined how BHWs' roles and responsibilities have evolved under UHC implementation in the Province of Surigao del Norte, identifying policy gaps and exploring their lived experiences and capacities to fulfill emerging tasks. Methodology: A mixed-methods approach was employed, integrating a self-administered questionnaire, desk review, key informant interviews (KIIs), and focus group discussions (FGDs) among BHWs, supervisors, and local health officials. Data were analyzed thematically to identify patterns in policy coherence, operational structures, and workforce challenges. Results: The study revealed significant gaps in policy coherence and operational clarity. BHWs encountered overlapping tasks, inadequate training, irregular incentives, and limited institutional backing. Supervisors cited the absence of standardized guidelines defining BHW functions, resulting in role ambiguity and inconsistent implementation across municipalities. Nevertheless, BHWs demonstrated adaptability, commitment, and continued community engagement despite systemic challenges. Conclusion: A unified national policy rationalizing BHW functions is urgently needed to align competencies with UHC priorities. Standardized recruitment, competency-based training, and strengthened legal and institutional protections are essential to sustain BHW performance and reinforce the equity and resilience of the Philippine primary health care system.
Dingding et al. (2026) studied this question.