INEGRATED MANAGAMENT of CHILDHOOD ILLNESSES for BARANGAY HEALTH WORKERS

DEPARTMENT OF PEDIATRICS CAPITOL MEDICAL CENTER

Angela Pilar Marquez-Mendiola, MD DPPS
DECEMBER 2023

INTRODUCTION

ABOUT THE TRAINING:

The Department of health (DOH) -BLHSD with the HHRDB and the Health Promotion Bureau
(HPB) in 2022, released the updated Barangay Health Workers (BHWs) Reference Manual
designed to align the knowledge and skills of the BHWs with the provisions of the Universal
Health Care (UHC) Act of 2019, which puts emphasis on primary health care, health promotion,
and integration of health services. Since then, Quezon City (QC) health department ventured to
give the updates through a certified training program for the BHWs from the different
barangays under its jurisdiction.

In line with the direction of the Philippine government to improve national and local health
systems across an integrated portfolio, the Capitol Medical Center department of Pediatrics
joins the nation as it embarks to provide UHC by augmenting the BHWs recent training given by
the QC health department through a focused training on the care of children 0-5 years old
based on the Integrated Management of Childhood Illnesses (IMCI).

This manual will serve as the framework for the training of BHWs in the practice of IMCI in the
partner communities. The Technical Education and Skills Development Authority (TESDA)
Barangay Health Services (BHS) NC II competencies as well as the 2022 BHW reference manual
applicable in the practice of IMCI for BHWs were adapted in this training program.

THE INTEGRATED MANAGEMENT OF CHILDHOOD ILNESSES (IMCI):

The Integrated Management of Childhood Illnesses is a process of providing an integrated form

of care that focuses on the health and well-being of the child. IMCI aims to reduce preventable
mortality, minimize illness and disability, and promote healthy growth and development of
children under five years of age. IMCI includes both preventive and curative elements that can
be implemented by families, in communities and in health facilities.

The strategy includes three main components:

 Improving case management skills of healthcare providers;

 Improving health systems to provide quality care;
 Improving family and community health practices for health, growth and development.
In health facilities, the IMCI strategy promotes the accurate identification of childhood illnesses
in outpatient settings, ensures appropriate combined treatment of all major conditions that
affect a young child, strengthens the counselling of caretakers, and speeds up the referral of
severely ill newborns and children. In the home setting, it promotes appropriate care seeking
behaviors, improved nutrition and support for early childhood development, prevention of
illness, and correct implementation and adherence to treatment.

However, in the study of Reñosa,et al. which described the health care workers perspectives
on the key challenges to IMCI implementation in the health facilities, it was revealed that there
was an overwhelming inadequacy in terms of support system for IMCI execution including but
not limited to the following: lack of policy, unavailability of IMCI specific funding allocation,
limited resources for IMCI training and training structure, poor logistical support, low
community awareness and time consuming IMCI process. Part of the study’s recommendation
is to diversify ways to reach untrained HCWs and to harness community sensitization and
partnership, areas where BHWs can be a part of to further the cause of universal health care.

Training Barangay Health Workers (BHWs) for the Integrated Management of Childhood
Illnesses (IMCI) process involves a multifaceted approach, combining theoretical knowledge
with practical skills to ensure they can effectively manage common childhood illnesses and
promote child health within their communities.

Direct Relief has provided an example of such training in the Philippines, where in 2014, 50
BHWs from Concepcion's island barangays underwent Community Integrated Management of
Childhood Illness (CIMCI) training following the devastation of typhoon Haiyan This training
focused on how to manage common childhood illnesses such as coughs, colds, fevers, and
diarrhea. It employed the 'Sick Child' training module, developed collaboratively by UNICEF, the
World Health Organization (WHO), and the Philippines Department of Health, which highlights
12 key childhood illness danger signs. BHWs learned to monitor these signs in their
communities, refer children for further treatment through a clear CIMCI referrals process, and
regularly monitor malnutrition by taking Middle Upper Arm Circumference (MUAC)
measurements.

This course recognizes the importance of the BHWs in the primary health sector and aims to
train the BHWs in the process of IMCI based on the competencies set by the TESDA.

A BARANGAY HEALTH WORKER:

The term “Barangay Health Worker “refers to a person who has undergone training programs
under any accredited government and non-government organization and who voluntarily
renders primary health care services in the community after having been accredited to function
as such by the local health board in accordance with the guidelines promulgated by the DOH.
In community-based health care organizations, BHWs serve as the initial contact of the
community members and thus, it is imperative that they need to be trained to assist in the
provision of a comprehensive, accessible, coordinated, and continuous health care with
coordinated referrals to the necessary health care providers and health care delivery systems.

THE ROLE OF THE BARANGAY HEALTH WORKER:

The barangay health workers play an important role in the practice of primary health care in the
Philippines. Through the decades, they have given assistance in the delivery of basic health
services, campaigned for the participation of community members in local health initiatives and
provided health updates in the community on relevant health issues. The BHWs are managed
and supervised by the local government units (LGUs) and are stationed in the primary care
facilities (PCF) or barangay health centers (BHC). According to RA 7883 IRR or the BHW Benefits
and Incentives Act of 1995; RA 11223 IRR or the UHC Act of 2019; and AO 2021-0063 or Health
Promotion Framework Strategy 2030, the BHWs shall discharge his/her duties and
responsibilities as a community organizer, educator, and a primary health care service provider.

BARANGAY-LEVEL HEALTH EDUCATION AND PROMOTION OFFICER (HEPO) for IMCI

BHWs are expected to function as barangay-level Health Education and Promotion Officer
(HEPO) by promoting health literacy and creating healthy settings in their communities so that
the heathy behaviors are developed and practiced by everyone, every time and everywhere.
The 0-5 year old age group are vulnerable to common illnesses. According to the Philippine
National Demographic and Health Survey, the under-five mortality rate decreased from 54 to
26 per 1000 live births however the rates of decline from 2008 to 2022 have slowed down
compared to 1993 to 2003. Despite the government’s efforts to vaccinate, there is a rise in the
number of children, 12-23 months old with no vaccinations from 4 % in 2013 to 11% in 2022.
Twenty percent of children below 5 years old with Acute Respiratory Illness and 25% of those
with fever are brought to the Barangay Health Station making it a likely source of advice for
treatment. It is imperative therefore that as key members of the health workforce, the BHWs
are given health education updates and ways to strengthen collaboration with the health
professionals and the community members in the hope of improving the delivery of health
services for infants and children 0-5 years old.

COMMUNITY ORGANIZERS

As community organizers, they participate in organizing and mobilizing the community towards
self-reliance. This includes maintaining regular communication and linking the community with
the local leaders and the health professionals. They also assist the caregivers in the prevention
and identification of the common childhood diseases and together with Healthcare
professionals develop health plans including home treatment, feeding and well child care.
 HEALTH EDUCATOR:

BHWs play an important role in developing personal skills of the people in their communities.
This entails increasing options available to caregivers to exercise more control over the health
of their children. BHW’s contribute to enabling parents to learn continuously throughout their
lives and prepare themselves to care for the 0-5 year old infants and children.

In developing the personal skills, BHWs provide information, education and life skills training of
caregivers who are taking care of infants and children 0-5 years old..

IMCI PROCESS HEALTH CARE SERVICE PROVIDERS

As a health care service provider, BHWs shall also assist health professionals in rendering
primary care services through the IMCI process in the community. They shall aid health
professionals by monitoring the health status of the infants and children 0-5 years old, keeping
IMCI health records, and ensure availability of IMCI related charts and guidelines as well as safe
custody and maintenance of equipment and supplies for the full implementation of IMCI in the
community. Knowledge of the health data are vital for the planning and implementation of
IMCI.

TESDA BHS NCII COMPETENCIES

According to the curriculum designed by Technical Education Skills Development Authority

(TESDA) for BHWs, competencies will cover for the basic, the common and core qualifications
which they should possess. Basic competencies refer to the non-technical skills that BHWs need
to have in order to perform well in the workplace. Common competencies include skills such as:
implementation and monitoring of infection control policies and maintaining high standard of
patient services. The core competencies allows the BHWs to assist the household in identifying
health problems to promote health and well-being, share knowledge and skills among members
to provide information, education and communication (IEC) and /or household teaching in
disease promotion and control, ensure the proper maintenance of health station and safe
custody and its medical supplies, materials and health records, monitor health status of
household members under their area of service including maintenance of updated list/record of
health activities.

THREE DAY TRAINING DESIGN

Day 1 AM BASIC COMPETENCIES (2.5 h)

Mau Roles of BHWs in IMCI
Relevant Policies related to IMCI in the community
Working with the team
Problem Solving
Self-Management
Day 2 AM COMMON COMPETENCIES (2.5 h)
Jhess Responding Readily to difficult/challenging behavior
Jhess Maintaining High Standards of patient / client services
Jhess Implement and monitor infection control policies and
procedures

 What is infection Infection Control and Prevention

(Vaccination; Hand Washing)
 Ubokabularyo
 Avoiding Diarrhea
 Minimum Health Standards in the HC

Day 3 AM CORE COMPETENCIES (4 h)

Mau / Jam PRIMARY CARE SERVICES and NAVIGATION for the 0-5 years
old
Services for the 0-5 years old: Applying the IMCI process
SICK CHILD 2 mos to 5 years old

 Greet the caregiver and the child

 Identify problems
1. Ask: What are the problems
2. Record the problem
3. Look for signs of malnutrition
 Refer or Treat the child
1. With danger sign
2. Sick but no danger sign
 Treating the Children in the Community
1. Give oral medicine
2. Test and treatment for Malaria
3. Advise on home care
4. Check the vaccines
5. Follow up of sick children
6. Record treatments
 Refer if with danger sign
1. Begin treatment
2. Assist referral

Day 4 AM CORE COMPETENCY (4 h)

Bea / Jam SICK YOUNG INFANT AGE UP TO 2 MONTHS

 Identify the problems and refer

1. Ask, Look and Feel

2. Record the problem
 3. Look for signs of Infection, Jaundice,
dehydration, HIV infection (if available), feeding
problems or low weight for age
4. Assess breastfeeding
5. Check the immunization status
6. Assess other problems and Mother’s health
needs

 Urgent referral to a hospital if with possible serious

bacterial infection or severe disease, critical illness,
severe jaundice, severe dehydration, very low
weight

1. Begin treatment
2. Assist referral

 Treat the child in the community

1. Give oral antibiotic

2. Treat local infections, manage Jaundice, giving
of ORS, manage HIV infected or exposed young
infant
3. Check vaccinations
4. Breastfeeding support
5. Giving home care and counseling mother
6. Follow up care

Basic, core, and program-specific competencies in health

promotion for barangay health workers
Day 5 AM CORE COMPETENCIES (4h)
Syme Assist the household to identify health problems to
promote health and well-being for the 0-5 years old
Share knowledge and skills among members to provide
information and education, communication and household
teaching in disease prevention and control.

BHW as Barangay-level Health Promotion Officers

 Social Determinants of Health
 Interpersonal Communication
 Social and Behavioral Change Communication

Ensure Safekeeping of equipment, medical supplies,

 materials and health records in the health centers
 The barangay HC
 Equipment in the BHC
 Inventory of BHC Equipment
 Maintaining weighing scales
Managing supplies of medicines
Household Profiling and Master listing of Target Clients
Day 6 AM PIA Synthesis (3)
Total 20

BASIC COMPETENCIES

Competencies expected from the BHWs and the recommended minimum hours of training,
according to the TESDA Training Regulations on Barangay Health Services NC II are the
following:

BASIC COMPETENCIES Number of Hours

Roles of BHWs in IMCI 0.30
Relevant Policies related to IMCI in the 0.30
community
Working with the team 0.30
Problem Solving 0.30
Self-Management 0.30
Total 2.5 hours

1. PARTICIPATE IN WORKPLACE COMMUNICATION IN RELATION TO IMCI AS PART OF

PROMOTING THE UHC ACT of 2019.

ANG MGA TUNGKULIN NG MGA BHW KAUGNAY SA IMCI BILANG BAHAGI NG PAGSULONG SA
UHC ACT of 2019

This unit covers the knowledge, skills and attitudes required to gather, interpret and convey
information in response to workplace environment in particular the BHWs role as community
organizers, educators and health service providers directed towards achieving the goals of UHC
ACT of 2019 through IMCI.

LEARNING TEACHING-LEARNING METHODOLOGY EVALUATION HOURS

OUTCOMES ACTIVITIES
1.1 Obtain BHW to describe health Group Graded
and Convey programs present in Discussion on Recitation
workplace their community what the DOH
information catering to the 0-5 years programs are
specific for old age group with emphasis
the 0-5 years on IMCI
old age a. National Safe
group Kids Week (June) (sources: BHW
b. Expanded manual p 55-
Garantisadong 61; p 82 -84;
Pambata DOH and WHO
c. Infant and Young websites; IMCI
Child Feeding DLC SS 2014
Program manual 20-21 )
d. National
Deworming
Month
e. IMCI
f. Micronutrient
Supplementation
Program
g. Newborn
Hearing and
Screening
Program
h. Oral Health
Program (Feb)
i. Water Safety
Program
j. Violence and
Injury Program
k. Women and
Child Protection
Program

1.2 Perform BHW to describe their Read available List down

duties tasks in the different written notices ways on how
following areas ie Barangay HC, and instructions they can
workplace field work. from the LGU / expand their
instructions DOH / QH HD roles as
for infants community
and children Lecture organizer and
0-5 years old. Discuss importance of educators to
Care-seeking in the (Source: Care achieve UHC
community seeking in the for 0-5 years
 old
community p8-
10)
Emphasize the roles of
BHWs in promoting Lecture on UHC
health among the 0-5 Act of 2019 and
years old as part of the PHC for infants
UHC Act of 2019. and children
with
Emphasize their tasks as introduction to
community organizers IMCI and roles
for the needs of the 0-5 of the BHW
years old
(sources: BHW
reference
manual p 3-4; p
41-43 ; p 51-52;
p 54)
Orientation on
the UHC law
DOH website;
WHO website
IMCI manual
2019,
*Community
IMCI western
pacific region
WHO website)
1.3 Complete BHW to describe Group Display of
relevant communication with Discussion Contact
work related HCPs, LGU officials, details of
documents caregivers and referral (text messages, referral
centers. phone calls, centers,
social media, emergency
Practice: face to face numbers
interaction, etc) including
Taking and Recording of ambulance
the Vital Signs, Height, Lecture services
Weight
(Source: BHW Availability of
Familiarity with IMCI manual p 109- Chat groups
and Growth charts how 116; Video of with HCPs
to record information infant and child LGU,
with normal Community
 respiration; members
video of how to
get the
anthropometric
measurement Return
of 0-5 years old,
demonstration demonstration
of counting RR,
PR and getting
the
temperature)

*https://apps.who.int/iris/bitstream/handle/
10665/206920/9789290615361_package5_eng.pdf

2. Contribute to workplace innovation.

MGA POLISIYA SA BARANGAY HC- PAGSULONG NG 2019 UHC ACT SA PAMAMAGITAN NG

IMCI

This unit covers the knowledge, skills and attitudes required to make a pro-active and positive
contribution to workplace innovation. The UHC ACT of 2019 provides significant reforms in the
country’s health care sector, and then BHWs must be aware of all significant changes that may
happen due to the law.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
2.1 Identify Identify the BHWs to share List of present
opportunities to opportunities to their present practices and
do things better improve working practices other
conditions, information
involvement Lecture necessary for
with HCPs and them to do their
collaboration (Source: RA work efficiently.
with caregivers 11223 BHW
of children 0-5 manual p 5;
years old based Primary Care
on the UHC Act Workers’
of 2019 Orientation;
Integrated
course on
Primary Care
DOH e-academy;
include review
of IMCI in 16
countries in
Central Asia
and Europe by
Carai et al,
Direct Relief
following
Haiyan, Reñosa
et al)
2.2 Discuss and Communicate Lecture Brainstorming of
develop ideas the ideas for the reforms that
with others change with the (Source: Primary can be instituted
group Care Workers’ including people
Orientation; who can provide
Integrated support in ideas.
course on
Primary Care
DOH e-academy;
include review
of IMCI in 16
countries in
Central Asia
and Europe by
Carai et al,
Direct Relief
 following
Haiyan, Reñosa
et al)
2.3 Integrate Discuss the Group Reporting of the
idea with reforms and Discussion results of the
change in the ways on how to discussion with
workplace integrate the the end goal of
ideas to make it integrating the
into a reality. reforms in the
community.

Written report
of the reforms
addressed to the
leaders of the
community to
communicate
the results of
the
brainstorming.

3. PRACTICE ENTREPRENEURIAL SKILLS IN THE WORKPLACE

MGA POLISIYA SA BARANGAY HC NA MAY KINLALAMAN SA IMCI

This unit covers the outcomes required to apply entrepreneurial workplace best practices and
implement cost-effective operations. Under this competency the BHW should know relevant
policies on the MILK CODE of 1986 and its Revised Implementing Rules and Regulations, list of
materials needed to implement IMCI including list of recommended pharmaceutical products,
IMCI flip charts and other basic tools for physical examination.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
3.1 Apply Identify IMCI Review of the List of practices
entrepreneurial related policies opportunities to that are present
workplace best that are do things better. and new ideas
practice available that can be
including Brainstorming instituted in the
breastfeeding, workplace
immunization (Source: EO 51
 and other
related BHW manual p List of needed
programs, 5-6; AO 2015- materials and
reforms in the 0053 BHW tools.
workplace and manual p 6;
how it can be DOH Circular List of available
incorporated in 2021-0486 BHW sources of
the workplace man p 6) materials and
operations tools with
including ways contact details
on how to foster
cost-conscious
resource
utilization based
on industry
standards.

3.2 Discuss ideal Review of the List of

Communicate child health care opportunities to appropriate
entrepreneurial practices do things better persons to
workplace including and identify communicate
policies appropriate appropriate with regarding
persons to agencies or workplace
communicate point persons to operations to
with regarding help implement practice IMCI
operations and reforms
policy
3.3 Implement Discuss Criteria Discuss issues Written report
cost-effective for cost- of the ideas
operations effectiveness Brainstorming addressed to the
leaders of the
Lecture on local community to
health systems communicate
management the results of
tools from the the
DOH E Academy brainstorming.

4. DEVELOP CAREER AND LIFE DECISIONS

MGA POLISIYA SA BHC- ANG BHWs BENEFITS and INCENTIVES ACT of 1995
This unit covers the knowledge, skills, and attitudes in managing one’s emotions, developing
reflective practice, and boosting self-confidence and developing self-regulation. In particular,
BHWs will be made aware of the BHW Benefits and Incentives Act of 1995 and the RA 7883
Implementing Rules and Regulations.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
4.1 Manage Discuss topics Lecture Ability to handle 1/2
one’s emotions on Self unpleasant
Management situations based
Skills on scenarios

Discuss topics
on Time
Management
Skills

Discuss Basic
Problem
Analysis

Discuss
Personality
Development
Concepts
4.2 Develop Discuss Lecture Reflection on
reflective Strategies to previous
practice improve one’s Brainstorming situations and
attitude in the offering
workplace solutions for
better outcomes

4.3 Boost self- Discussion on Lecture Completion of

confidence and the benefits and the CSC Form 10
develop self- incentives Act of (Source: RA H
regulation 1995 and RA 7883 , BHWE
7883 IRR; civil service Sharing of plans
Barangay Health BHW manual p5) to be eligible as
Worker a recipient of
Eligibility in Civil the BHW
Service; local benefits and
 BHW
registration and Incentives Act of
accreditation; 1995.
filling out the
CSC Form 101-H,
revised for 2011 Demonstration
BHWs

Barangay Health Worker Eligibility in Civil Service available at

http://www.csc.gov.ph/barangay-health-worker-eligibility-bhwe.html

5. WORK IN A TEAM ENVIRONMENT

ANG BHW AT ANG KANYANG BARANGAY MAGKAISA SA PAGSASAGAWA NG IMCI

PAGGANAP NG TUNGKULIN BILANG MIYEMBRO NG HC TEAM SA PAGSULONG NG IMCI

This unit covers the skills, knowledge and attitudes to identify the BHW’s roles and
responsibilities as a member of a team including proper communication flow.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
5.1 Describe Discuss the Lecture on the List of identified
team role and group structure IMCI process; ways on how to
scope in the IMCI what the communicate
process in community with other team
relation to the workers can do members and
BHWs role in the (source: BHW ways on how to
workplace and manual p 7-8; improve the
ways of Caring for the present work
improving the sick child in the structure.
present community: A
structure. training course
for community
healthworkers ;
DOH E academy:
Barangay 1st
1000 days
Facilitator’guide
e training,
 Integrated
Course in
Primary Care)
5.2 Identify Discuss the Review roles of Role playing
one’s role and individual roles the BHW and
responsibility and the IMCI process
within the team responsibilities from the start to
within the team the end of a
environment given scenario
and identify
objectives.
5.3 Work as a Develop Lecture Written protocol
team member protocols in on the roles of
and develop reporting based (Source: BHW the BHWs
self- on the identified manual p 9 -10; including
management roles of the Better reporting in the
skills BHWs in the teamwork; practice of IMCI.
IMCI process Importance of
while taking into Self-
consideration management
standard skills;
company Communicating
practices and Effectively with
the culture of the members of
the barangay. the healthcare
team(DOH E
academy)

Sharing of their
past experiences
on working with
HCPs and their
fellow BHWs.

6 Top Tips for Better Teamwork by Indeed Editorial Team, Available at

https:://www.indeed.com/career-advice/career-development/tips-for-effective-teamwork

The importance of Self-Management Skills. Available at

https://www.glassdoor.com/blog/guide/self-management/

6. PRESENT RELEVANT INFORMATION

EPEKTIBONG KOMUNIKASYON SA PAGSULONG NG IMCI

This unit of covers the knowledge, skills and attitudes required to present data/information
appropriately in the practice of the IMCI process.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
6.1 Gather data / Discuss tips on Lecture Participation in
information how to have the discussion /
effective (source: BHW Recitation
communication manual p 10-11)

Discuss data on (Source: 2022

common Phil NDHS, 2018
childhood B. Paligsahan
illnesses health survey,
according to the IMCI DLC SS
Barangay manual 2014 p
records and 17 -18)
Philippine
statistics

Discuss Discussion on
community and what the DOH
National health programs are
projects with emphasis
designed to on IMCI
combat
common (sources: DOH
childhood and WHO
illnesses websites)
6.2 Assess Compare the Lecture on the Graded
gathered barangay data impact of the Recitation
data/information before and after health programs
interventions with emphasis
on IMCI, include
Discuss importance of
importance of accurate data
accurate data collection.
collection
(Sources: 2022
Phil NDHS, 2018
B Paligahan
health Survey
6.3 Record and Demonstrate Lecture on Return
 present patient effective demonstration
information interview and communication
recording of and how to
data using the conduct patient
IMCI chart interview

(source BHW
manual p 10-11,
p 52-54; WHO
website Caring
for the sick child
manual p 11,
p51; 7 Must
have soft skills
CHWtraining
webinar; IMCI
DLC SS manual
2014 p 34-38)

Video or live
demonstration
on the proper
way of getting
the height,
weight , MUAC
and Vital Signs
of children in
the 0-5 years
old.

(Source: WHO
website Caring
for the sick child
manual)

7. SOLVE / ADDRESS ROUTINE PROBLEMS

PAGKILALA SA MGA PROBLEMA AT PAGPLANO NG MGA SOLUSYON KAUGNAY SA IMCI

This unit covers the knowledge, skills and attitudes required to apply problem-solving
techniques to determine the origin of problems and plan for their resolution. It also includes
addressing procedural problems through documentation, and referral.
LEARNING TEACHING - METHODOLOGY EVALUATION HOURS
OUTCOMES: LEARNING
ACTIVITIES
6.1 Identify Sharing of Lecture on List of identified
routine common commonly problems
problems problems encountered
encountered in problems in the
the health care of the 0-5
center and in years old and
the community solutions.
related to their Including:
role as BHWs in Calibration of
the care of scale ;
children 0-5 Differences in
years old. Thermometers;
Giving of
medications /
ORS; Different
BP cuff sizes;
Breastfeeding
concerns; When
and Where to
refer
6.2 Look for Sharing of Lecture on
solutions for solutions that commonly
routine worked and did encountered
problems not work and problems in the
reasons behind care of the 0-5
years old and
solutions.
Including:
Calibration of
scale;
Differences in
Thermometers;
Giving of
medications /
ORS; Different
BP cuff sizes;
Breastfeeding
concerns; When
and Where to
refer
6.3 Recommend Discuss solutions Lecture on the Written
solutions to that can be IMCI process procedure for
problems implemented in implementation
the community (Source: in the different
Community IMCI workplaces
p 4-6; IMCI DLC
SS 2014 manual
The Five Why’s p 22-24)
tool in problem
analysis. Sample
cases in the
discussion are Discussion on
the following: the recognition Graded
and how to recitation
Bakit namatay address
sa pagtatae si common
baby? (in the childhood
manual) illnesses

Kailan dapat (Source: BHW

dalhin sa health ref manual p 11-
center o sa 13)
ospital si baby?

Bakit may tigdas

si baby?

Bakit hindi
nagtuloy ng
pagpapasuso si
Nanay?

8. PRACTICE OCCUPATIONAL SAFETY and HEALTH POLICIES and PROCEDURES

OCCUPATIONAL SAFETY AND HEALTH

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
7.1 Identify OSH Sharing of the Lecture on List of applicable
Compliance BHWs Occupational procedures in
 requirement experience in Safety and the health
disposal of Health center
needles and Standards
syringes and relevant to the
infection control IMCI process
process
(Source: BHW
ref manual p 13-
15; Exploratory
Study on OH
Hazards by
Faller et al.)
7.2 Prepare OSH Identify Lecture on List of resources
requirements resources Occupational for proper
for compliance necessary to Safety and execution of the
execute Health safety
hierarchy of Standards procedures
controls relevant to the
IMCI process

(Source: BHW
ref man p 13-15;
Exploratory
Study on OH
Hazards by
Faller et al.)
7.3 Perform Create scenarios Role Playing Written report
tasks with applying OSH on relevant OSH
relevant OSH policies and Source: BHW ref procedures for
policies and procedure man p 13-15; implementation
procedure relevant to the Exploratory in the workplace
IMCI process Study on OH
Hazards by
Faller et al.)

COMMON COMPETENCIES

ANG BHW BILANG FIRST RESPONDER

The common competencies expected from BHWs , and the recommended minimum hours of
training according to the TESDA training regulations on Barangay Health Services NCII are the
following
COMMON COMPETENCIES NUMBER OF HOURS
Responding Readily to difficult/challenging behavior 0.30
Maintaining High Standards of patient / client services 1
Implement and monitor infection control policies and procedures 1

 What is infection
 Infection Control and Prevention (Vaccination; Hand
Washing)
 Ubokabularyo
 Avoiding Diarrhea
 Minimum Health Standards in the HC

Total 2.5 hours

COMMON COMPETENCIES

1. RESPOND EFFECTIVELY TO DIFFICULT / CHALLENGING BEHAVIOR

MAAYOS NA PAGSAGOT SA KAKAIBANG UGALI

 This unit of competency covers the knowledge, skills and attitudes to effectively respond
to difficult or challenging behaviour of patient / client.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
1.1 Plan Sharing of Lecture on ways Graded
Responses difficult on how to deal Recitation
experiences in with difficult
the community behavior
while including verbal
performing their and non-verbal
duties as BHW cues.

(Source: BHW
manual p 18; dr
pia’s lecture;
DOH E academy
recognizing red
flags and danger
signs)
1.2 Apply Application of Demonstration Role playing
Responses appropriate on how to deal
strategies to suit with difficult
 particular behavior
instances of
difficult or (Source: Caring
challenging for sick children
behavior manual p 54;
IMCI DLC SS
manual 2014 p
34-39)
1.3 Report and Discussion on Lecture on Role playing
Review how to report policies and
Responses incidents based rules of health
on institutional professionals
policies involved with
the care of the
Discussion on patient.
how to seek
advice and (Source: BHW
assistance when manual p 52-54;
appropriate. DOH e academy-
Communicating
Effectively with
members of the
HC team)

2. Maintaining High Standard of patient/client services

MATAAS NA KALIDAD NG SERBISYO

This unit covers the knowledge, skills and attitudes required in the maintenance of high
standards of patient / client services.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
2.1Communicate Using effective Lecture on Observation and
appropriately listening communication feedback from
with patients / techniques techniques clients using a
clients form
Using (Source: BHW
appropriate
 verbal and non- manual p 18-19;
verbal
communication Dr pia’s lecture;
styles
DOH e
Applying oral academy:
and written Establishing
communication good patient
communication;
Displaying assessing and
problem solving managing
skills that patient in
includes using primary care;
available recognizing red
resources while flags and danger
prioritizing signs
workload
Caring for sick
Dealing with children manual
conflict p 54; IMCI DLC
SS manual 2014
Working with p 34-39)
others and
displaying Lecture on
empathy with quality of care
patient / client
and relatives (Source: Manual
on Quality in
Practicing intra Primary Health
and care)
Interpersonal
skills

Reporting and
documentation
with accuracy
2.2 Establish and Using effective Lecture on Observation and
maintain good listening communication Feedback from
interpersonal techniques techniques clients using a
relationship with form
patients / clients Using (Source: BHW
appropriate manual p 18-19;
verbal and non-
 verbal Dr pia’s lecture;
communication
styles DOH e
academy:
Applying oral Establishing
and written good patient
communication communication;
assessing and
Displaying managing
problem solving patient in
skills that primary care;
includes using recognizing red
available flags and danger
resources while signs
prioritizing
workload Caring for sick
children manual
Dealing with p 54; IMCI DLC
conflict SS manual 2014
p 34-39)
Working with
others and Lecture on
displaying quality of care
empathy with
patient / client (Source: Manual
and relatives on Quality in
Primary Health
Practicing intra care)
and
Interpersonal
skills

Reporting and
documentation
with accuracy

2.3 Acting in a Using effective Lecture on Observation and

respectful listening communication Feedback from
manner at all techniques techniques clients using a
times form
Using (Source: BHW
appropriate
 verbal and non- manual p 18-19;
verbal
communication Dr pia’s lecture;
styles
DOH e
Applying oral academy:
and written Establishing
communication good patient
communication;
Displaying assessing and
problem solving managing
skills that patient in
includes using primary care;
available recognizing red
resources while flags and danger
prioritizing signs
workload
Caring for sick
Dealing with children manual
conflict p 54; IMCI DLC
SS manual 2014
Working with p 34-39)
others and
displaying Lecture on
empathy with quality of care
patient / client
and relatives (Source: Manual
on Quality in
Practicing intra Primary Health
and care)
Interpersonal
skills

Reporting and
documentation
with accuracy

2.4 Evaluate own Identifying the Lecture on Reflection

work to maintain mode on communication
a high standard of communication techniques
patient / client appropriate for
service the situation (Source: BHW
 Applying modes manual p 18-19;
of
communication Dr pia’s lecture;

Implementing DOH e
standards for academy:
work Establishing
procedures good patient
communication;
Maintaining assessing and
standards for managing
work patient in
procedures primary care;
recognizing red
flags and danger
signs

Caring for sick

children manual
p 54; IMCI DLC
SS manual p 34-
39)

Lecture on
quality of care

(Source: Manual
on Quality in
Primary Health
care)

3. Infection Prevention and Control (IPC)

This unit is concerned with infection control responsibilities of employees with supervisory
accountability to implement and monitor infection control policy and procedures in a specific
work unit or team within an organization. This unit does not apply to a role with organization-
wide responsibilities for infection control policy and procedure development, implementation
or monitoring

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
 ACTIVITIES
3.1 Provide Discuss and Lecture Written
information to explain Examination
the work group transmission of (Source: BHW
about the infectious p20-22) Return
organization's diseases, Demonstration
infection control standards in
policies and infection
procedures. prevention and
control for
health facilities
and levels of
infection control

Discuss proper Demonstration-

handwashing, Return
cough etiquette Demonstration
and boiling of
drinking water (Source: BHW
manual p 23-25;
p 28, p 29; DOH
E Academy:
Behavioral
nudges of hand
hygiene

Discuss and Lecture

explain
minimum public (Source: BHW
health standards manual p25-26;
for primary care DOH Manual of
health facilities , National
infection Standards in IPC
control, for health
environmental facilities, 3rd ed;
and DOH E
institutional, Academy:
rules, guidelines, Bakuna
policies and champion)
procedures

3.2 Integrate the Discuss available Brainstorm List of plans to

organization's guidelines and improve
infection control incorporate new infection control
policy and ideas for
procedure into improvement
work practices
3.3 Monitor Discuss available Brainstorm Observation and
infection control guidelines and Feedback
performance and incorporate new
implement ideas for
improvements in improvement
practices

CORE COMPETENCIES

ANG MGA BHWs BILANG TAGAPAGSULONG NG IMCI

CORE COMPETENCY NUMBER OF HOURS
PRIMARY CARE SERVICES and NAVIGATION for the 0-5 4
years old
Services for the 0-5 years old: Applying the IMCI process
SICK CHILD 2 mos to 5 years old

 Greet the caregiver and the child

 Identify problems
1. Ask: What are the problems
2. Record the problem
3. Look for signs of malnutrition
 Refer or Treat the child
1. With danger sign
2. Sick but no danger sign
 Treating the Children in the Community
1. Give oral medicine
2. Test and treatment for Malaria
3. Advise on home care
4. Check the vaccines
5. Follow up of sick children
6. Record treatments
 Refer if with danger sign
1. Begin treatment
2. Assist referral

SICK YOUNG INFANT AGE UP TO 2 MONTHS 4

 Identify the problems and refer

1. Ask, Look and Feel

2. Record the problem
3. Look for signs of Infection, Jaundice,
dehydration, HIV infection (if available),
feeding problems or low weight for age
4. Assess breastfeeding
5. Check the immunization status
6. Assess other problems and Mother’s health
needs

 Urgent referral to a hospital if with possible

serious bacterial infection or severe disease,
critical illness, severe jaundice, severe
dehydration, very low weight

1. Begin treatment
2. Assist referral

 Treat the child in the community

1. Give oral antibiotic

2. Treat local infections, manage Jaundice,
giving of ORS, manage HIV infected or
exposed young infant
1. Perform primary health care services for the 0-5 years old
 This unit will focus on the primary health care services for the 0-5years old in relation to
the IMCI process.

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
1. Provide Discuss the Lecture
information on services in a
primary care primary care (Source BHW
services facility and the manual p 49-50;
importance of
proper health 1st 1000 days lec
care in the early of dr pia)
stages of 1st
1000 days and
how it impacts
the life stages
1.2. Apply IMCI Discuss how to Lecture on IMCI Observation
for the 2 months- greet the for the 2-5 years
5 years old caregiver and old Written test
the child
(Source: IMCI Demonstration
Discuss the self-study 2005; with
importance of IMCI chart questioning
assessment and booklet 2014;
classifying a sick IMCI DLC SSM
child manual 2014 p
22-33; BHW
Discuss how to reference
identify and manual p 51, p
record problems 55-59, p 60-61,
including signs p67-68, p 79, p
of malnutrition 82 p 108-116)
Discuss when to Return
refer or treat the
Demonstration
child
(Source: Caring
Discuss how to
treat the children for the sick child
in the facilitator’s 6-
community 102)
including how to
give oral Self-learning
medicine, test
 and treat
malaria, advise
on home care,
how to check the
vaccines, how to
follow up sick
children, record
treatments

Discuss when
and how to refer
if with danger
sign, how to
begin treatment
and how to give
assistance in
referring the sick
child.
1.3 Apply IMCI for Discuss the Lecture Observation
the 0-2 months importance of
old assessment and Return Written test
classifying sick Demonstration
young infants Demonstration
Role playing with
Discuss how to questioning
identify the Self-learning
including signs Graded Role
infections, (Source: IMCI playing
jaundice, management of
dehydration, the sick 0-2 mos
HIV infection, participant
feeding manual 2019,
problems or low BHW manual
weight for age; p51, p 55 p67-
record and refer 68, p82, p111-
to the doctor on 116)
duty.

Discuss
situations
needing urgent
referral to a
hospital,
treatment that
 can be given and
how to assist
the transfer of
patient.

Discuss and
demonstrate
how to give oral
medication and
ORS, how to
teach the
mother how to
treat local
infection ,
manage
jaundice and HIV
infected or
exposed young
infant at home

Discuss how to
check for
vaccinations;
discuss and
demonstrate
how to counsel
the mother on
breastfeeding
(positioning and
attachment,
how to express
BM, how to
feed by a cup);
advise home
care for the
young infant

Discuss how to
give follow up
care for the
different
conditions
1.4 Implement Discuss and Brainstorm Create a written
 IMCI process in Identify process proposal on
the workplace of interaction how IMCI can
with patients Role playing be implemented
from in the
assessment to (Source: Caring workplace
counseling and for the sick child
home care visits facilitator’s
notes p 111;

IMCI Facilitator’s
guide
Management of
the sick young
infant 0-
2months)

2. Assist the household to identify health problems and to promote health and well being

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
2.1 Collate Identify Lecture Graded return
records available demonstration
pediatric health Demonstration
records in the
community (Source: Caring
for the sick child
Discuss and facilitator’s
demonstrate notes p 147-161
how to fill out
information in IMCI Facilitator’s
the IMCI record guide
by the BHW and Management of
which areas are the sick young
only for the infant 0-
HCPs 2months p 60,
62)
Discuss the
contents of the
baby book
including the
vaccination
 record
2.2 Prepare DOH E academy:
reports from the
record system Managing
patient’s records

2.3 Assist the Discuss how to Lecture Graded role

caregiver in the give follow up playing
health planning to care for the Role playing
address identified different
needs of the child conditions (Source: Caring
for the sick child
facilitator’s
notes p 75-84
IMCI Facilitator’s
guide
management of
the sick young
infant 0-2
months p 50-52;
DOH E academy:
Counseling
Services in
general disease
prevention and
health
promotion,
providing
individual,
family and
community
healthcare)

3. Share knowledge and skills among members to provide information and education,
communication (IEC) and/or household teaching in disease prevention and control

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
3.1 Maintain Discuss ways on Brainstorming Number of
community how to establish responses from
and maintain (Source: DOH E community
community Academy: members using
 networks the different
networks sustaining the platforms
primary care
worker-patient
relationship

3.2 Promote basic Understand the Lecture List of key

primary health importance of messages and
services to the promoting Brainstorm dates of
community for primary health dissemination
the 0-5 years old services. (Source: BHW through social
reference media, home
Discuss and plan manual p 54; visits, tarpaulin
timing of announcements
dissemination DOH E academy: or flyers.
of key messages integrated
via the course on
platforms based primary care,
on community planning for
activities and/or continuing
DOH health care))
calendar
3.3 Provide Discuss PHC for Lecture on PHC Actual PHC
regular and the 0-5 years old for 0-5 years old lecture involving
updated basic BHWs with
health education Discuss available (Source BHW community
and/or household services in the manual p 51-54) members as
teaching to the community learners
community
Plan community
lectures on key
PHC topics in
collaboration
with HCPs
Define high risk
Identify children children:
in the
community with Premature, Low List of high risk
high risk for weight, children and
developing Malnutrition, management
infection or Non-breastfed plan including
malnutrition and infants, Chronic home visits
refer to the illness,
 HCPs incomplete
vaccination,
poor living
conditions

4. Ensure safekeeping of equipment, medical supplies, materials and health records in health
station

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
4.1 Conduct Discuss present Self-learning Checklist of the
physical inventory practice materials,
of equipment and (Source: BHW inventory,
medical supplies manual p 127- storage area
132; DOH E and working
academy basic condition
requirements
for primary care
facilities

4.2 Maintain Read guidelines Self-learning Folder of

community and protocols in guidelines and
facilities and the (Source: BHW protocols
equipment maintenance of manual p 127-
the equipment 132) List of suppliers
and repair
contacts

4.3 Organize Read how Self-learning Observation

health record records are
organized and (Source: BHW
kept manual p 127-
132)
5. Monitor health status of children 0-5 years old under his/her area of service coverage

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
5.1 Assist in the Understand the Lecture on IMCI Role play
consultation ff topics: for the 2-5 years
old and 0-2
1Receiving and months old
Assisting
patients (Source: Caring
for the Sick Child
2. VS participant’s
manual p38-44;
3. Caring for the
Anthropometric sick child
measurements facilitator’s
manual ANNEX
4. Interview E; IMCI chart
patient based on booklet 2014;
a checklist IMCI DLC SSM
manual 2014 p
5. Observe a 22-33; BHW
consultation reference
process manual p 52-54,
108-116)

(Source: IMCI
management of
the sick 0-2 mos
participant
manual 2019)

Self-learning
5.2 Update Understand the Lecture on IMCI Observation
client’s record ff topics: for the 2-5 years
old and 0-2
1. VS months old

2. (Source: Caring
Anthropometric for the Sick Child
measurements participant’s
 3. Interview manual p38-44;
patient based on Caring for the
a checklist sick child
facilitator’s
4. Observe a
consultation manual ANNEX
process E; IMCI chart
booklet 2014;
IMCI DLC SSM
manual 2014 p
22-33; BHW
reference
manual p 52-54,
108-116)

(Source: IMCI
management of
the sick 0-2 mos
participant
manual 2019)

Self-learning
5.3 Refer Understand the Lecture on IMCI Graded role
symptomatic following: for the 2-5 years playing
/asymptomatic old and 0-2
clients for 1. Referral months old
appropriate system
medical (Source: Caring
treatment 2. Health for the Sick Child
facilities participant’s
manual p38-44;
3. Available Caring for the
medical sick child
services facilitator’s
specially
around the manual ANNEX
area E; IMCI chart
including booklet 2014;
cost IMCI DLC SSM
manual 2014 p
4. Facilitate 22-33; BHW
referral reference
manual p 52-54,
 5. Available 108-116)
financial
support (Source: IMCI
program management of
the sick 0-2 mos
participant
manual 2019)

(DOH E
Academy:
Referring to a
specialty care
and higher
levels of care;
Assisting
patients during
referral)

Self-learning

6. Maintain updated list/records of health activities for the 0-5 years old

LEARNING TEACHING - METHODOLOGY EVALUATION HOURS

OUTCOMES: LEARNING
ACTIVITIES
6.1 Assist Understand the Brainstorming Updated list of
caregivers to following topics: health service
communicate Demonstration providers
with service 1. Available
providers for the health service Self-learning Algorithm for
0-5 year old providers the referral
population specially (Source: BHW system
around the manual p 117, p
area including 121-122) List of Financial
cost. support
program
2. Referral
System Updated list of
clients in the
3. Available community
financial
 support
program

4. Ensure
completeness
and accuracy
of client’s
data

6.2 Explain to Understand the Brainstorming Updated list of

service provider following topics: health service
for better Group providers
understanding of 1. Client’s needs Discussion
client and and concerns Algorithm for
community needs the referral
2. Available system
health service
providers
specially
around the
area including
cost.

3. Referral
System

4. Available
financial
support
program

5. Ensure
completeness
and accuracy
of client’s
data

6.3 Give support Understand the ff Brainstorm Logbook of

to clients when topics: clients who
accessing health Group were referred
services 1. Client’s needs Discussion to health care
and concerns providers
 outside the
2. Available (Source: DOH E health center
health service academy - and their
providers approach n present status
specially planning for
around the case
area including management)
schedule and
cost.

3. Referral
System

4. Available
financial
support
program

5. Ensure
completeness
and accuracy
of client’s
data

6.4 Update Create an Lecture Updated

lists/records of updated Masterlist
health workers masterlist of (Source: BHW
health workers manual p 117, p
including contact 121-122)
details and
service schedule
References:

https://doh.gov.ph

https://doh.gov.ph/node/3778

https://tesda.gov.ph/Downloadables/Barangay%20Health%20Services%20NC%20II.pdf

https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/child-
health/integrated-management

Reñosa, M. D. C., Bärnighausen, K., Dalglish, S. L., Tallo, V. L., Landicho-Guevarra, J.,
Demonteverde, M. P., Malacad, C., Bravo, T. A., Mationg, M. L., Lupisan, S., McMahon, S. A., &
National IMCI Evaluation Working Group (2021). "The staff are not motivated anymore": Health
care worker perspectives on the Integrated Management of Childhood Illness (IMCI) program in
the Philippines. BMC health services research, 21(1), 270. https://doi.org/10.1186/s12913-021-
06209-6

Philippine Statistics Authority (PSA) and ICF. 2023. 2022 Philippine National Demographic and
Health Survey (NDHS): Final Report. Quezon City, Philippines, and Rockville, Maryland, USA: PSA
and ICF

MacCalla, A. (2018, August 14). Training Health Workers in remote Philippine communities.
Direct Relief. https://www.directrelief.org/2014/04/training-health-workers-in-remote-
philippine-communities/

Community IMCI. Available at:

https://apps.who.int/iris/bitstream/handle/10665/206920/9789290615361_package5_eng.pdf

Carai, S., Kuttumuratova, A., Boderscova, L., Khachatryan, H., Lejnev, I., Monolbaev, K., Uka, S.,
& Weber, M. (2019). Review of Integrated Management of Childhood Illness (IMCI) in 16
countries in Central Asia and Europe: implications for primary healthcare in the era of universal
health coverage. Archives of disease in childhood, 104(12), 1143–1149.
https://doi.org/10.1136/archdischild-2019-317072

Manual on Caring for the Sick Child in the community. Available at:
https://www.who.int/maternal_child_adolescent

Facilitator’s Manual on Caring for the Sick Child in the community. Available at:
https://www.who.int/maternal_child_adolescent

7 Must Have Soft skills for CHWs in 2021. Available at: https://chwtraining.org/7-soft-skills-
forchws/#~:text=communicatin%20skills%20for%20CHWs%20includeperceiving%

Manual on IMCI Distance Learning Course Introduction 2014. Available at: https://www.who.int
Faller, E.M., bin Miskam, N. and Pereira, A., 2018. Exploratory Study on Occupational Health
Hazards among Health Care Workers in the Philippines. Annals of Global Health, 84(3), pp.338-
341. DOI: http://doi.org/10.29024/aogh.2316

Manual on Quality in Primary Health Care 2018. Available at: https://www.who.int

Occupational and Health Standard by DOLE. Available at:

https:/www.dole.gov.ph/phpassets/uploads/2019/04/OSH-Standards-2017-2.pdf

Department of Health. Manual of National Standards in Infection Prevention and Control for
Health Facilities, 3rd edition. Available at: youtube.com

IMCI Chart Booklet 2014. Available at: fctc.who.int

Management of the sick young infant aged up to 2 months chart booklet 2019. Available at:
https://www.who.int

Management of the sick young infant aged up to 2 months facilitator’s guide 2019. Available at:
https://www.who.int

Management of the sick young infant aged up to 2 months participant manual guide 2019.
Available at: https://www.who.int