Republic of the Philippines

DEPARTMENT OF HEALTH
Office of the Secretary
BAGONG PILIPINAS

November 20, 2024

DEPARTMENT MEMORANDUM
No. 2024- D476

FOR: ALL REGIONAL DIRECTORS CENTERS FOR HEALTHOF

DEVELOPMENT (CHD) AND MINISTER OF HEALTH BANGSAMORO

AUTONOMOUS REGION IN MUSLIM MINDANAO (MOH-BARMM)

Attention: CHD and MOH BARMM Barangay Health Worker

Coordinators

SUBJECT: Barangay Health Worker (BHW) Connect and Toolkit for Implementation

Pursuant to Section 4 of Republic Act No. 7883, otherwise known as “The Barangay Health Workers’
Benefits and Incentives Act of 1995,” the Department of Health (DOH) is mandated to maintain a national
registry of Barangay Health Workers (BHW).

In line with this mandate, the DOH-Bureau of Local Health Systems Development (BLHSD), in
collaboration with the Knowledge Management and Information Technology Service (KMITS), has
established and maintained the National Barangay Health Worker Registry System since 2015. However,
the findings of Department Memorandum No. 2022-0273, dated June 27, 2022, titled "National Barangay
Health Workers Registry System (NBHWRS) Report," identified two key challenges in data collection at
the LGU level, specifically: (1) late submission of local BHW registry data to Centers for Health
Development (CHDs) and (2) incomplete or non-validated data. The DM also recommended
enhancements to the system to improve its responsiveness and relevance to stakeholders.

To address the challenges as mentioned above and recommendations, the BHW Connect System has been
developed to replace the NBHWRS. The BHW Connect Toolkit, enclosed with this memorandum, guides
its implementation and appropriate action.

If you have any inquiries or need clarification, please contact Ms. Riza Santiago at (02) 650-7800, local
1307-1308, or via email at [email protected].

Your cooperation in this matter is highly appreciated.

By Authority of the Secretary of Health:

KENNETH G/RONQUILLO, MD, MPHM, CESO ITI

Undersecretary Healh of
Universal Health Care — Policy and Strategy Cluster
 Barangay Health Worker (BHW) Connect Toolkit

TABLE OF CONTENTS

I. System Rationale

IL. Objectives

III. Definition of Terms

Iv. System Implementation and Timelines

Vv. System Maintenance

VL Features of the System

VIL Guidelines on the issuance of BHW Identification cards

VIII. Roles and Responsibilities

IX. BHW Connect reference links

X. Frequently Asked Questions

XI. Annex
I. System Rationale

Section 4 of Republic Act No. 7883, also known as the “Barangay Health Workers’
Benefits and Incentives Act of 1995,” mandates the Department of Health (DOH) to maintain a
national registry of Barangay Health Workers (BHWs). In compliance with this mandate, the
Bureau of Local Health Systems Development (BLHSD), in partnership with the Knowledge
Management and Information Technology Service (KMITS), developed the National Barangay
Health Worker Registry System in 2015. This web-based platform is designed to register BHWs
who provide voluntary primary health care services in communities across the country.

InDepartment Memorandum No. 2022-0273, issued on June 27, 2022, and titled “National
Barangay Health Workers Registry System (NBHWRS) Report,” the BLHSD in collaboration
with Centers for Health Development (CHDs) and the Ministry of Health-Bangsamoro
Autonomous Region of Muslim Mindanao (MOH-BARMM) conducted a survey among BHW
Coordinators. The survey assessed the implementation of the NBHWRS from 2015 to March 2022.
Two main challenges were identified in the data collection process at the Local Government Unit
(LGU) level: delayed submission of local BHW registries to CHDs and incomplete or unvalidated
data. The memorandum recommended system enhancements to improve its relevance and
responsiveness to stakeholders.
Over the years, it has become clear that the existing data in the system is inadequate to
effectively address gaps in policy development and support for BHWs. A more comprehensive
and enhanced registry system is essential to ensure the BHW registry serves as a reliable basis for
the allocation of resources and support from the DOH, local government units, and other
stakeholders. Therefore, the BHW Connect System has been developed to better meet the evolving
needs of its users and to support informed decision-making in the health sector.
IL Objectives

The BHW Connect Toolkit is designed to provide comprehensive information and

guidance to the Centers for Health Development (CHDs), the Ministry of Health in the
Bangsamoro Autonomous Region in Muslim Mindanao (MOH-BARMM), and Local Government
Units (LGUs) for effectively utilizing and navigating the BHW Connect System.

The specific objectives of the toolkit are to:

a. Provide step-by-step guidance for encoding, updating, and maintaining accurate profiles of
Barangay Health Workers (BHWs).
b. Facilitate the generation of key documents, including:
b.1. Detailed statistical reports to support strategic planning, policy development, and
decision-making at various levels of government.
b.2. Identification cards for registered and accredited BHWs, ensuring formal recognition and
to
facilitating access benefits.
b.3. Certificates of Service, detailing the duration and nature of voluntary services provided by
registered and accredited BHWs, as a basis for incentives and recognition.
c. Outline the roles and responsibilities of each stakeholder, including the BLHSD, CHDs, MOH-
BARMM, LGUs, and other relevant partners, to ensure the effective implementation and
sustainability of the BHW Connect System. This includes clear instructions on system
management, data validation, and timely reporting.
111. Definition of Terms

Barangay Health Workers (BHWs): As defined Section 3, a Barangay Health

in RA 7883,
Worker is
a person who has undergone training an accredited government or non-
programs under
government organization and voluntarily provides primary health care services in the community
after accreditation by the Local Health Board, following DOH guidelines.

BHW Connect: A web-based platform developed by the Department of Health (DOH) to register
and maintain the national database of Barangay Health Workers (BHWs), facilitating efficient
tracking, reporting, and management of BHW profiles and services.

BHW Certification: A document generated by the BHW Connect that certifies the length and
type of voluntary services rendered by registered and accredited BHWs, signed by the Regional
Director or MOH-BARMM representatives.

BHW Identification card: An official identification card issued to registered and/or accredited
BHWs through the BHW Connect.

Data Validation: The process of ensuring the accuracy, completeness, and consistency of data
entered into the BHW Connect System by comparing it with verified documents and ensuring it
meets established criteria.

Provincial Barangay Health Worker Federation (PBHWF): An organization composed of

Municipal or City BHW Federations. The PBHWF supports service delivery, resource access,
and the enhancement of BHW capacities and assists the Provincial Health Office in updating the
list of BHWs in
the province.

Service Request Form: A form used to log requests for revisions, updates, or data generation
within the BHW Connect System. It is used by stakeholders when technical issues or system
updates are required.

IV. System Implementation and Timelines

The BHW Connect, a web-based platform developed by the Bureau of Local Health Systems
Development (BLHSD), can be accessed via the link: https://bhw.doh.gov.ph

The process for encoding and updating the profiles of Barangay Health Workers (BHWs) in
the BHW Connect System consists of three key steps:

DOH Representative will review and

g attest to the veracity of the information
and supporting documents provided
Provides Technical Assistance, Capacitate and
°= Monitor Performance
~~

==
Oo LGU BHW Coordinator directly encode the MHO Validates and approves
= BHW Profiles, take pictures or upload completely profiled BHWs
= BHW certification/registration accreditation

Figure 1. Data Collection, Validation, and Attestation Flow

 Encoding: The municipal/City Health Office encoder is responsible for encoding or
updating the profiles of registered and/or accredited BHWs guided by the approved master
list by the Local Health Board (LHB). This step ensures that accurate and complete data is
entered into the system.

Validation: Once the BHW profiles have been encoded, they must be validated by the
Municipal/City Health Officer or the designated BHW Coordinator. This step ensures that
the data entered is accurate and reflects the actual status of each BHW.

Attestation: After validation, the DOH Representative assigned to the municipality will
review and attest to the veracity of the
information and supporting documents provided.
This attestation confirms the integrity and accuracy of the data and ensures that the BHW
profiles are complete and ready for use in planning and reporting.

Inaddition to the above steps, the Provincial Health Office (PHO) plays a crucial role in
supporting the implementation of the BHW Connect system by:

Capacitating Local Government Units (LGUs): Providing training and capacity-

building activities to ensure that LGUs can effectively use the system.

Providing Technical Assistance: Offering guidance and support to LGUs in case of

technical or procedural challenges.

Monitoring LGU Performance: Regularly overseeing the implementation of the system

at the municipal level to ensure compliance and data accuracy.

Approving System Access: The PHO is responsible for approving access to the BHW
Connect System for each municipality within its jurisdiction.

At the regional level, the Centers for Health Development (CHDs) serve as the Regional
Administrators and are responsible for:

Monitoring Performance: Overseeing the implementation of the system at the

provincial level to ensure effective use and compliance.

Providing Technical Assistance and Support: Offering guidance and technical

assistance to PHOs and LGUs to
ensure smooth operations and system updates.

Approving Accounts: CHDs are responsible for approving access and accounts theat
provincial level to ensure that the right stakeholders have the necessary permissions to
manage the system.

The Bureau of Local Health Systems Development (BLHSD) will conduct annual
synchronous online training sessions for all stakeholders at every level, ensuring that all
Municipal/City Health Office encoders, BHW coordinators, Provincial Health Offices, and
CHD/MOH-BARMM personnel are properly equipped to use the BHW Connect System. These
training sessions will be held every 3rd week of January. Following the training, the encoding of
BHW profiles will commence in February of each year. All Barangay Health Workers (BHWs)
must be encoded, and their profiles must be validated and attested by the end of May 31 of the
current year. After this deadline, the system will be locked to prevent further data modifications.
 The system will reopen with the same timeline and schedule for encoding and attestation ensuring
a structured and consistent data management process each year.

V. System Maintenance

The BLHSD is responsible for addressing program errors and bugs and implementing
features or functionalities outlined in the approved functional and technical design document.
Major revisions to forms or updates in the implementation policy that impact the system's current
operations shall undergo assessment and review by BLHSD. Minor troubleshooting is within the
purview of CHD or MOH BARMM and can be escalated to BLHSD, if necessary, using the
Service Request Form (SRF) attached as Annex 2.

VL Features of the System include the following:

Online and Offline (KOBO) platform accessibility.

Searchable database for Barangay Health Worker (BHW) statistical data.
Dashboard displaying profiles of registered and accredited BHWs, including graphical
representations of statistical data.
Capability to upload/download BHW profiles and reports, with disaggregated data on BHWs
by sex, educational attainment, and age group.
wn
Generation of identification cards for registered and accredited BHWs.
Creation of certifications documenting BHW inclusion in the system and length of service.

VIL Guidelines on the issuance of BHW Identification cards

Upon approval by the CHDs or MOH BARMM, BHW IDs will be generated in BHW
Connect.
Each BHW ID card issued by a CHD will be electronically signed by the Secretary of Health,
following the recommendation of the respective CHD Directors MOH BARMM
BHW ID cards will only be issued to duly registered and accredited BHWs who are actively
and regularly performing their duties, as confirmed by the concerned Local Health Boards.
CHDs/MOH BARMM are directed to ensure that registered and accredited BHWs display or
use their BHW ID cards while providing health services in the catchment community.
The following are the specifications of BHW ID to be reproduced:
o Size: 2.5” x 4.5"
o stock:200 gsm
o Color: full color (CMYK) 2 side print; Green is C-90, M-34, Y-100, K-27
o PVC ID Card Sheet with ID lace and printed name of DOH.

VIIL Roles and Responsibilities

A. Bureau of Local Health Systems Development

Oversee the overall implementation of the BHW Connect System, ensuring its alignment
with national policies and objectives.
Develop, design, maintain, and manage the BHW Connect platform, updating it regularly
to meet evolving needs.
Enhance and update guidelines for BHW Connect, including user guides, tutorials, and best
practices, in consultation with relevant stakeholders.
 Provide technical assistance to DOH Central Office Bureaus, Centers for Health
Development (CHDs), MOH-BARMM BHW Coordinators, Encoders, and LGU Encoders as
needed.
Conduct orientation and capacity-building activities for CHD/MOH-BARMM BHW
Coordinators on using and managing the BHW Connect System.
Maintain communication channels, such as social media group chats, for a Helpdesk to
support CHD/MOH-BARMM BHW Coordinators in real-time troubleshooting and inquiries.
Monitor and evaluate the system's performance, providing feedback for continuous
improvement.

B. Knowledge Management and Information Technology Service

1. Provide and configure the server environment that meets the specific needs and
security requirements of the BHW Connect System.
Implement robust cybersecurity measures to protect sensitive BHW data, in accordance
with RA 10173 - Data Privacy Act.
Conduct regular vulnerability and penetration testing to ensure system security and
reliability.
Provide ongoing technical support for server maintenance, performance optimization,
and troubleshooting.
“w Ensure high availability of the platform, minimizing downtime and ensuring a seamless
experience for users.

DOH Central Office Bureaus

Leverage the BHW Connect data for planning, policy-making, and decision-making
processes concerning the development and support of Barangay Health Workers (BHWs).
ro Collaborate with BLHSD and CHDs to use BHW data for health system improvements
and resource allocation.
w Advocate for the integration of BHW Connect insights into national health programs to
enhance BHW support and management.

D. DOH Centers for Health Development (CHDs) / MOH-BARMM BHW Coordinators

Computer Maintenance Technologist
Ensure up-to-date data in the BHW Connect System, as mandated by Section VI, Rule 1

of RA 7883.
Id Provide timely access to LGUs and ensure they utilize the BHW Connect for managing
BHW profiles.
Designate dedicated staff to monitor, manage, and maintain LGU accounts and data,
ensuring accuracy and completeness.
Provide technical assistance to LGU BHW Coordinators and Encoders for system usage,
data encoding, and troubleshooting.
Promote the use of BHW Connect among LGUs for planning and policy development.
Attest to the veracity of BHW profiles and their supporting documents through the DOH
Representatives.
Issue BHW Identification Cards, ensuring that:
© Only registered and/or accredited BHWs are issued IDs.
© The standard number coding system is followed for ID issuance.
© A budgetis allocated for ID card reproduction.
8. Utilize the BHW Connect data for policy development, planning, and decision-making
at the regional level.

E. Provincial Health Offices

1. Capacitate and provide technical assistance to LGUs, ensuring that all LGU health
offices and BHW Coordinators are well-trained in the use of the BHW Connect System.
2. Monitor the implementation of BHW Connect at the municipal/city level, ensuring
compliance with data entry, validation, and reporting processes.
3. Approve and grant access to the BHW Connect System for municipal and city health
offices under their jurisdiction.
4. Coordinate with CHDs to resolve any issues and provide timely technical support to LGUs
in the system's use.
5. Support the reproduction of BHW ID cards, ensuring proper budget allocation and
adherence to ID coding standards.
6. Review and validate LGU reports on BHW profiles, providing guidance on any
discrepancies or incomplete data.
7. Utilize the BHW Connect data for policy development, planning, and decision-making
at the provincial level

F. Municipal/City Health Offices

1. Utilize the BHW Connect System to manage and support BHWs within their jurisdiction.
2. Ensure timely data collection, validation, and submission of BHW profiles using the
prescribed BHW Registry forms.
3. Encode and update BHW profiles in the system, ensuring the accuracy of entries and the
inclusion of required documentation.
4. Designate a dedicated staff member for managing the BHW Connect System.
5. Allocate the necessary budget for the reproduction of approved BHW ID cards.
6. Utilize the BHW Connect data for policy development, planning, and decision-making
at the municipal level.

G. Provincial and City BHW Federations

Assist Rural Health Midwives/Nurses in completing the BHW master list or templates for
accurate encoding into the BHW Connect System.
Ensure that all registered and accredited BHWs are included in the BHW Connect.
Monitor and report updates, notifying the Rural Health Midwives/Nurses or LGU BHW
Coordinators when updates to BHW profiles are needed.

IX. BHW Connect Reference links

e BHW Connect https://bhw.doh.gov.ph

e BHW Profiling Tool https://bit.ly/BHWProfilingtoolform

e Service Request Form https://bit.ly/SRF _BLHSD

eo BHW Connect Toolkit https://bit.ly/BHWConnectToolkit

X. Frequently Asked Questions
1. What is the BHW Connect?
BHW Connect is a web-based platform developed by the Department of Health to register
and manage the profiles of barangay health workers (BHWs). It helps ensure that accurate
and up-to-date data about BHWs is available for planning, decision-making, and policy
development.

2. Who can access the BHW Connect?

Access to the BHW Connect System is granted to designated personnel from the
Municipal/City Health Offices, Provincial Health Offices, Centers for Health Development
(CHDs), MOH-BARMM, and other authorized DOH representatives involved in managing
BHW data.

3. What is the purpose of the BHW ID card?

The BHW ID card is an official identification issued to registered and accredited BHWs,
enabling them to provide primary health care services in their respective catchment areas. It
also helps recognize their voluntary service and facilitates access to benefits.

4. How is data entered into the BHW Connect?

Data entry follows a three-step process:
® Encoding: The LGU BHW Coordinator encodes BHW profiles using the approved master
list.
e Validation: The Municipal/City Health Officer or BHW Coordinator validates the accuracy
of the data.
e Attestation: The DOH Representative attests to the veracity of the information, confirming
its accuracy.

5. What should I do if there is an error in the attested BHW profile?

If you encounter an error in a BHW profile, submit a Service Request Form (SRF) through the
BHW Connect. This request will trigger the necessary updates or revisions in coordination
with the relevant authorities.

6. What are the roles of the Provincial Health Office (PHO) in BHW Connect?
The PHO is responsible for capacitating LGUs, providing technical assistance, monitoring the
implementation of the BHW Connect System, and approving system access for municipal and
city health offices. They also ensure accurate data submission and review BHW profiles.

7. Who is responsible for issuing BHW ID cards?

The Centers for Health Development (CHDs) or MOH-BARMM, in
coordination with the
Provincial Health Offices, are responsible for issuing BHW ID cards to duly registered and
accredited BHWs, following a standard auto-generated number coding system.

8. What is the role of the BHW Federations in the BHW Connect System?
The Provincial and City BHW Federations assist in ensuring that all registered and accredited
BHWs are included in the system. They help Rural Health Midwives/Nurses in completing
master lists, monitoring system updates, and report discrepancies to LGU BHW Coordinators.

9. How is the BHW profile data used?

The data from the BHW Connect System is used for strategic planning, policy formulation,
decision-making, and resource allocation at various government levels, ensuring better
support and management of Barangay Health Workers. The personal information of BHWs

8
 shall be held under strict confidentiality and shall be used only on the declared purpose in
line with RA 10173 — Data Privacy Act.

10. What happens if a BHW becomes inactive?

The BHW Connect tracks both active and inactive years of service for each BHW.
Inactive years should be recorded in the system, and appropriate actions, such as
revalidation or updating the profile, should be taken when the BHW becomes active again.

11. How are technical issues with the system resolved?

For minor technical issues, the CHDs or MOH-BARMM provide troubleshooting assistance.
For major issues or system bugs, the Bureau of Local Health Systems Development
(BLHSD) will address them using the SRF.

XI. Annex

1. BHW Connect Metadata Annex |

2. SRF Form Annex 2
3. Sample template of BHW ID Annex 3
 Annex 1

BHW Connect Metadata

a. Barangay Profile (Step 0)

Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules

Municipality Income Latest official Income classification of Dropdown Select One (1st, 2nd, 3rd, Required Field
Class the Municipality or City based on 4th, 5th, 6th)
Department of Finance

Total Registered BHW Total Registered (Not Accredited) BHW Numeric Minimum value: 1

Required Field
(Not Accredited) by Barangay

Total Registered and Total Registered and Accredited BHW Numeric Minimum value: 1
Required Field
Accredited BHW by Barangay

Total Unregistered Total Unregistered BHW by Barangay Numeric Minimum value: 1

Required Field
BHW

b. BHW Registry

Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules

BHW Catchment Area

Province The province where the Barangay Dropdown (system), Refer to Official PSA Required Field (System
Health Worker (BHW) serves. Text (paper form) List/PSGC auto-generated based on
encoder registration)

City/Municipality The city or municipality where the Dropdown (system), Refer to Official PSA Required Field (System
BHW serves. Text (paper form) List/PSGC auto-generated based on
encoder registration)
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
Barangay The barangay where the BHW provides Dropdown (system), Refer to Official PSA Required Field
health services. Text (paper form) List/PSGC

BHW Personal Information

Registered Barangay Indicates whether the BHW is registered Radio button (Yes/No) Yes, No Only Registered BHWs can
Health Worker? with the LGU (Yes/No) be encoded in the system.

First Year of The year the BHW was first registered Year (YYYY) Four-digit year (e.g., 2015) Warning: Registration prior
Registration in the LGU. to 1995 should show
document proving such
registration.

Required Field.

Registration No. The unique registration number assigned Number Alphanumeric NO Special characters
to the BHW. allowed

Did the BHW have Indicates if the BHW had any inactive Radio button (Yes/No) Yes/No Required Field
inactive years from the years since registration (Yes/No).
time of registration?

Inactive Years of Years the BHW has been inactive since Calendar Year/s (selection) Required Field
Service registration.

Total Active years in Total number of years the BHW has Number Number (calculated by the N/A
service been active since registration system)
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
Accredited Barangay Indicates whether the BHW is accredited Radio button (Yes/No) Yes/No Required Field
Health Worker?

Year of Accreditation The year the BHW received Year (YYYY) Four-digit year (e.g., 2018) Skip if answer to the
accreditation. previous question is “NO”

Accreditation Number The unique accreditation number Alphanumeric Unique identifier (letters Skip if the answerto the
assigned to the BHW. and numbers) previous question is “NO”

Number of Households The number of households within the Number Positive integer Required Field.
Covered by BHW BHW?’s catchment area.
rr
Minimum = |

Maximum = 500

Last Name The last name of the BHW. Text Free Text Required Field

First Name The first name of the BHW. Text Free Text Required Field

Middle Name The middle name of the BHW. Text Free Text Required Field
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
Suffix The suffix of the BHW (e.g., Jr., Sr., III, Free Text (paper form) Jr., Sr. IL, I1I., NA Required Field
Ed
1c.).
Combo box (system)

Sex The biological characteristic of the Radio button Male/Female Required Field
BHW (Male/Female).

Birthdate The date of birth of the BHW. Date MM/DD/YYYY Valid date format

Minimum age = 18 years

old

Maximum = 90 years old

Birthplace The place of birth of the BHW Free Text Place Required Field

Personal Address A place where the BHW resides. Free Text (Street, Place Required Field
Building, Lot)

Dropdown (Province,
Municipality,
Barangay)

Civil Status The civil status of the BHW Dropdown (Select one) Single, Live-in, Married, Required Field
Divorced, Separated,
Widowed
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
Blood Type The blood type of the BHW Free text (paper form) A+, A-, B+, B-, AB+, AB-, Required Field
O+, O-, Unknown
Drop down (system)

Highest Educational The highest level of education the BHW Free text (paper form) EL Elementary level
- Required Field
Attainment has completed. Drop down (system) EG - Elementary graduate
HL - High school level
HG - High school graduate
CL - College level
CG - College graduate
MD - Masteral degree
VD - Vocational degree
NFE - No formal education

Indigenous Peoples
(IP)?
if
Indicates the BHW belongs
Indigenous Peoples (IP)
to an Radio Button (Yes/No) Yes/No Required Field
group (Yes/No).

Ethnicity/Indigenous The specific ethnic or IP group to which Free text (paper form) Refer to the NCIP list Required Field
Peoples (IP) Group the BHW belongs.
Drop down (system)

Training

TESDA Barangay Indicates whether the BHW has Radio Button Yes/No Required Field
Health Services completed the TESDA BHS NC 11
(Yes/No)
National Certificate course (Yes/No).
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
(BHS NC) IICourse
Training Completed?

Year Training was The year the BHW completed the BHS Year (YYYY) Four-digit (e.g., 2019) SKIP if “TESDA Barangay
Completed NC II training. Health Services National
Certificate (BHS NC) II
Course Training
Completed?” is NO

BHS NC II Certified? Indicates whether the BHW is certified Radio button (Yes/No) Yes/No Required Field
for BHS NC II (Yes/No).

*BHW may be certified if he/she passed

the assessment even if they have not
undergone the BHS NC II training.

Year Certified The year the BHW received the BHS Year (YYYY) Four-digit (e.g., 2019) SKIP if “BHS NC 11

NC II certification. Certified?” is NO

BHW Reference Indicates whether the BHW has Radio button Yes/No Required Field
Manual Training 2022 completed the 2022 version of the BHW
Version Reference Manual Training (Yes/No).
Training Completed?

Year of Training
Completed
The year the BHW completed the 2022
version of the training.
Year (YYYY) Four-digit: Only 2022 to the
current year allowed
SKIPif “BHW Reference
Manual Training 2022
 Field Description Type of Variable Acceptable Value/Entry Skip/Validation Rules
Version Training
Completed?” is NO

Other Training Lists other training programs the BHW Text, Year (YYYY) Paper form: Free Text, four- Previous 5 years only. (e.g.,
Programs for BHW + has completed, along with the year of [Paper form) digit year 2020 to 2024)
Year of Training each training.
Selection Radio button, System: Yes/No, four-digit
Year (YYYY) year
[System]

Honorarium

Honorarium Regional Honorarium received at the regional Number Amount (currency), Required Field
Level level, including frequency and amount. Frequency (monthly,
quarterly, etc.)

Honorarium Province Honorarium received at the provincial Number Amount (currency), Required Field
Level level, including frequency and amount. Frequency (monthly,
quarterly, etc.)

Honorarium Honorarium received at the Number Amount (currency), Required Field

Municipality/City municipal/city level, including Frequency (monthly,
Level frequency and amount. quarterly, etc.)

Honorarium Barangay Honorarium received at the barangay Number Amount (currency), Required Field
Level level, including frequency and amount. Frequency (monthly,
quarterly, etc.)
 i
Annex 2

Ne tr 0
DEPARTMENT OF HEALTH Page No. i
Page 1 of 1

Bureau of Local Health System Development

ere
bomemmeeeean Leemmemmmmeeeees
Revision
cress
i

No.
Service Request Form i
Effectivity: January 2024

Reference Code: 00001

1) Date of Request

2) Name of Contact Person:

Last Name First Name Middle Name

3) Office:
4) Address:
5) Landline: 6) Fax No.
[
7) Mobile No. [

8) DESCRIPTION OF REQUEST: (Please clearly write down the details of the request.)

9. APPROVED BY:

Name & Signature Date Signed

Position
(For BLHSD only)

10. Date Received (mm/dd/yyyy): / / 11. Time Received (hh:mm) : OAM OPM
12. ACTIONS TAKEN: (Use separate sheet if necessary)
DATE TIME ACTION TAKEN ACTION OFFICER SIGNATURE
(a) (b) (c) (d) (e)

13. NOTED BY:

Name and Signature of Supervisor Position Date Signed

DOH-BLHSD-SRF
 Annex 3

© Republic of the Philippines

Department of Health N

ID No. 06-06004-000005

LW EG{EN AWN
a T

Registered & Accredited BHW

LPP
(VI
400

BLOOD TYPE DATE OF BIRTH

As Jun 26, 1992

MARIA DELA CRUZ

Barangay Health Worker

Cc
2%
le
TEODOROJ. WEKBUSA ML.
Secretary of Health