Promoting equitable access to local health care services: A governance framework for sustainability

This study examined the effectiveness of local governance in promoting equitable access to health care services in three selected barangays of Tangub City, Misamis Occidental, Philippines, during the calendar year 2024. Using a descriptive-quantitative research design, data were collected from 150 community residents and 30 health care personnel to assess accessibility and availability of health services across four dimensions: physical accessibility, affordability, availability, and quality of services. Governance effectiveness was evaluated in terms of policy implementation, resource allocation, transparency, and community participation. Findings revealed that while health services were generally accessible and affordable, significant gaps persisted in workforce adequacy, medicine availability, emergency response, and facility quality. Statistical analyses showed significant relationships between selected demographic variables, particularly monthly income and frequency of health service utilization, and perceived equity of access. Governance effectiveness was significantly associated with equitable health care delivery across all four governance dimensions (p < 0.001). Based on the findings, a governance framework for sustainability is proposed, emphasizing infrastructure development, strengthened health workforce capacity, expanded PhilHealth coverage, and active community engagement. The study concludes that strengthening local governance mechanisms is essential for achieving equitable and sustainable health care systems at the barangay level.