Digital health for Barangay Health Workers: a mixed-methods baseline assessment in Quezon, Philippines

Background: In the Philippines, Barangay Health Workers (BHWs) are a vital link to primary care in rural communities but face significant challenges. Digital technologies present a scalable opportunity to support and professionalize this workforce, but only if aligned with local contexts. CARE is developing the Healthy, Empowered, Accredited, Linked (HEAL) Hub, a digital platform for BHWs. A mixed-methods baseline and needs assessment was conducted in four municipalities in disaster-prone Quezon to inform HEAL Hub's design and rollout, and to establish a baseline for future evaluation. Results : The assessment, conducted between February and April 2024, included surveys with 55 BHWs and 120 community members, along with focus groups (BHW n = 13; community member n = 8) and key informant interviews (n = 8). BHWs are highly utilized (90.8% of community members sought services in six months) and trusted (79.0%). Key unmet community health needs included lack of mental health counselling (42.5%) and mobile-based communication (39.2%). BHWs were predominantly female (96.4%) and had over 10 years’ service (41.8%). The majority (87.3%) found existing support inadequate, citing low monthly honoraria, irregular training, and politicized appointments. Digital access was high (94.4% phone ownership), but proficiency was limited to basic tasks (>89% for calls/texts) and much lower for complex functions (<39% completing online forms). All BHWs desired digital training; most rated proposed tools, especially a BHW registry, disease surveillance, and structured referrals, as “extremely useful”. Conclusion : BHWs in Quezon are trusted and receptive to digital transformation. However, their effectiveness is constrained by systemic gaps in compensation, training, and governance. For sustainable impact, digital health platforms like HEAL Hub must be designed in partnership with frontline workers and thoughtfully integrated with their workflows and capacities. As key informants suggested: success also requires pairing implementation with structural reforms for compensation and accreditation. This study provides the first context-specific assessment of BHW digital readiness and service capacity in Quezon Province. This paper offers practical insights to guide digital health investments in similar underserved settings, inform targeted capacity-building, and support the professionalization of community health workers within broader efforts to strengthen primary care systems.