The Mediating Role of Health Center Capacity in the Relationship Between Work Motivation and Competency Among Barangay Health Workers

Abstract

This study investigated the determinants of competency among Barangay Health Workers (BHWs) in the Province of Rizal within the framework of the Universal Health Care (UHC) Law. Using a descriptive-correlational design, the study examined the relationships among health center capacity (based on WHO building blocks), work motivation (motivator-hygiene factors), and level of competency (knowledge, skills, and attitudes). Data were gathered from 314 BHWs across six municipalities using a four-part validated questionnaire and analyzed through Pearson’s correlation and mediation analysis. Results revealed a mature workforce (mean age 51) with high intrinsic motivation, particularly in the sense of achievement (M = 4.73), yet facing significant extrinsic challenges regarding salary and work security. While BHWs demonstrated high competency in basic primary care, proficiency declined in specialized administrative tasks. Mediation analysis confirmed that Growth significantly impacts Skills, but its influence on Attitude is contingent upon the empowerment of the health workforce. Notably, a suppressor effect was identified where excessive health facility reporting acts as an administrative bottleneck. The study concludes that while BHWs are driven by communal duty, optimizing their role requires transitioning from glorified volunteerism toward formalized employment, streamlined reporting, and enhanced social protection to ensure sustainable grassroots healthcare delivery.