Exploring the Role of Social Networks in Facilitating Health Service Access Among Low-Income Women in the Philippines: A Qualitative Study
Despite efforts to implement universal health care coverage (UHC) in the Philippines, income poor households continue to face barriers to health care access and use.
by caremin
Abstract
Despite efforts to implement universal health care coverage (UHC) in the Philippines, income poor households continue to face barriers to health care access and use. In light of recent UHC legislation, the aim of this study was to explore how gender and social networks shape health care access and use among women experiencing poverty in Negros Occidental, Philippines.
Semi-structured interviews were conducted with women (n = 35) and health care providers (n = 15). Descriptive statistical analyses were performed to report demographic information. Interview data were analyzed thematically using a hybrid deductive-inductive approach and guided by the Patient-Centred Access to Health Care framework. Women’s decisions regarding health care access were influenced by their perceptions of illness severity, their trust in health care facilities, and their available financial resources. Experiences of health care use were shaped by interactions with health professionals, resource availability at facilities, health care costs, and health insurance acquisition. Women drew upon social networks throughout their lifespan for social and financial support to facilitate healthcare access and use. These findings indicate that social networks may be an important complement to formal supports (eg, UHC) in improving access to health care for women experiencing poverty in the Philippines.
Authors
Kathy Luu, Laura Jane Brubacher, Lincoln L Lau, Jennifer A Liu and Warren Dodd
Background
Social networks play an important role in influencing health outcomes and facilitating health care access. Women, in particular, may draw upon family or broader community networks for health information, resources, and social support. Not only can strong social ties facilitate women’s emotional and psychological well-being, but they can also promote access to health care services through, for instance, the provision of child care or other financial supports. These supports may be especially significant in contexts where gender inequalities and gender-based norms amplify barriers to health care access.
Despite the known benefits of social networks to health and health care access, catastrophic health expenditure is one such persistent barrier to health care access and use among women in South East Asia. A patchwork of Universal Health Coverage (UHC) schemes have been implemented across South East Asian countries in recent years with the aim of eliminating out-of-pocket payment for health services, reducing the incidence of catastrophic health expenditure, and facilitating equitable health care access for women.16 However, for women living in poverty, additional indirect and opportunity costs associated with health care may deter care-seeking behavior, in spite of UHC policies.
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