THE MOUNTAINEER

Plight of b’gay health workers
EDISON L. BADDAL

BAUKO, Mountain Province -- In a lecture delivered here at Mt. Data Hotel recently in which I delved on the provisions of Republic Act 7883, the Barangay Health Workers Benefits and Incentives Act of 1995, many participants, all of whom were BHWs, decried their lack of barangay honoraria.

Others complained of their lack of proper appointment by the punong barangays in their respective areas of operation and arbitrary change of accredited BHWs among others. They assailed abusive acts of some PBs, notably newly elected ones, who refused to reappoint duly registered and accredited BHWs.

Concerned BHWs claimed they formerly enjoyed the perks of having regular honoraria with an appointment from their predecessors or from those who were re-elected, during their earlier term. The main point of contention was that inasmuch as they were serving barangay inhabitants, they should have been entitled to honoraria enjoyed by the rest of barangay officials like the treasurer, secretary, lupon members and barangay tanods .

I was jolted when one of the facilitators, an employee connected with Provincial Health Office, aired the misconception that the DILG has the power to discipline outright erring punong barangays. The latter referred to those who refuse to give honoraria to BHWs serving their barangay or those who arbitrarily change accredited BHWs with their supporters upon their assumption to office even if said appointees never underwent mandatory Department of Health-accredited BHW training programs with government agencies or non-government organizations.

I almost raised my hackles on such an abysmal misconception on what he supposed were the powers and responsibilities of the DILG. However, I took pains to elaborate that the DILG has no such power and that the power to discipline erring PBs lies with the mayor.

I added this can be done after an administrative complaint has been duly lodged and verified by the sanggunian concerned. The body then conducts its administrative investigation accompanied by hearings then comes up with a decision which is implemented by the mayor. I wasn’t sure if they understood me on that point although I hoped they did as the participants were generally high school graduates.

They also claimed that the devolution of health services to Local Government Units including barangays, made it obligatory for barangays to give token honoraria to the BHWs being the frontliners in the delivery of primary health care to inhabitants therein.

I countered that the BHWs as frontliners in rendering primary health care service to communities was out of the question although obligating the barangay to grant honoraria to BHWs did not hold water. I said BHWs were basically volunteers as defined in Sec. 3 of the law. Hence, as volunteers they were expected to render service “on their own volition or free will in response to health needs of the community they were serving without expecting compensation or benefit much less an appointment.” Ironically, the nature of their service negates the merit of their plaints.

Pointing at the voluntary nature of their service, I said their problem was rooted on the allowance granted to them by barangay officials and the appointment issued to them by the punong barangay.

These twin matters directly contravened the voluntary nature of their service. In effect, the
allowances which weree allocated from the barangay and the appointment which bestowed the PB a measure of authority over them, were the main reasons why some PBs act arbitrarily on matters concerning BHWs.

On the contrary, BHWs don’t need an appointment as their accreditation by the local health board after satisfying some requirements was an appointment itself as it legalized their service.

Accordingly, the barangay honoraria which BHWs were clamoring for were not among the incentives and benefits in which BHWs were entitled to as enumerated in section 6 of RA 7883 much less in Rule VII of its Implementing Rules and Regulations.

The law only provided the following as benefits and incentives of the BHWs, to wit: subsistence allowance, hazard allowance, TECEPs (training, education and career enhancement programs), one-child scholarship, civil service eligibility, free legal assistance and preferential access to loans and loan facilities of government lending institutions.

Gleaned from abovementioned benefits/incentives, BHWs were entitled to an allowance but only the subsistence and hazard allowance. These types of allowances did not partake of the nature of a regular allowance or honoraria as categorically defined by the Commission on Audit being “basic compensation for services rendered.” On the other hand, the subsistence and hazard allowances are not themselves mandatory but only given subject to certain conditions.

Hazard allowance, according to section 6 of the law, is given to accredited “volunteer BHWs in rural and urban areas, exposed to situations, conditions or factors in the work environment or place where danger or risks exist which adversely endanger his/her health or life and/or increase the risk of producing adverse effect on his person in the exercise of his duties.”

Hazardous areas as defined by the national compensation circular no. 76 dated March 31,1995 literally dovetails with certain “situations, conditions or factors in the work environment or place where danger or risks exist” as mentioned above. These refer to strife-torn work areas which is the site of armed encounters between government or enemy forces; a “difficult/distressed/isolated work areas characterized by distance, inconvenience of travel due to bad roads and other extreme conditions”; work areas “affected by volcanic activity/eruption”; work areas “which offer risks or danger to health and safety due to exposure to radiation, contagious diseases and dangerous biological hazards” and others.

Meanwhile, subsistence allowance is given to accredited “bhws who render service within the premises of isolated barangay health stations in order to make their services available at any and all times equivalent to the meals they take in the course of their duty….” Barangay health stations are considered isolated if characterized by the following conditions exist, to wit: no roads or trails, no roads but trails only, accessible only by hiking or animal-drawn vehicle, irregular schedule of transportation service and lack of and/or inadequate communication facilities.

As these are the only allowances that a BHW is entitled to under RA 7883 on no account then should they be given regular allowance by the LGU. If they desire an allowance then they should volunteer to be assigned in isolated and dangerous working areas. Meanwhile, the law failed to specify what LGU will pay these allowances so it could be granted either by a barangay, municipality or city.

At any rate, there’s no reason for BHWs to fret in the absence of a regular allowance as compensatory benefits are given to them in exchange for having rendered active, continuous and exemplary service at specific period of time. Accredited BHWs could avail of formal health sciences education with certificate or diploma courses offered by institutions recognized by the CHED, including institutions with step-ladder curricula.

They could likewise avail of formal vocational course in health offered by institutions accredited by the CHED and other trainings and courses on health with or without certificate which could be recognized as credits in higher institutions of learning. Another is the civil service eligibility (sub-professional) which is granted to an accredited BHW after rendering five years of continuous service and after having completed at least two years of college education. An accredited BHW can also avail of free legal assistance from the Public Attorney’s Office for any violence, threat or intimidation that prevents him/her from performing his/her duty.

Lastly, an accredited BHW who is a member of an organized BHW group is benefited by the latter’s preferential access to loans from government financial and lending institutions. But that is if said organized BHW group is functioning as an independent and autonomous NGO with validated assets.

But notwithstanding the fact that BHWs are serving as volunteers and therefore no regular allowance, it is incumbent with the municipality or city to grant regular allowance to BHWs. Inasmuch as it is the local health board of the municipality or city that is tasked under the law to register and accredit BHWs as well as recommend the grant of hazard and/or subsistence allowance to them by LGUs concerned, it is the duty of its members to source out regular allowance for the BHWs from the resources of the municipality or city as the case may be.

This is in line with one of the tasks of the LHB which is “to propose to the sanggunian concerned . . . annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality (italics mine), city or province, as the case may be.”

In the foregoing, primary health service care being rendered by BHWs in the barangays is among the services being maintained in the municipality. Hence, the municipal/city health board should include, by all means, budgetary allocations for regular allowances of the BHWs. Ditto with the subsistence and hazard allowance, if warranted, so as not to strain the meager financial resources of the barangays.

Besides, primary health care is a program of the DOH at the village level hence the necessity for the agency should assist the LHBs lobby the LGUs (municipalities, cities and provinces) to appropriate BHW regular allowances in the budgets of local health boards.

Nothing is farther from the truth when one BHW coordinator tartly commented during the seminar
that “nobody wants to serve as a volunteer.” Surely, a regular allowance can make BHWs take good account of themselves as primary health care service frontliners.