In Partial Fulfillment of Family Medicine and Community Health

COMMUNITY DIAGNOSIS OF

BARANGAY 177, ZONE 16, DISTRICT II

TONDO, MANILA

JUNE 29, 2017

ABIGAILE A. MARCELO-VOSOTROS, M.D.

Post Graduate Intern- Tondo Medical Center
ACKNOWLEDGEMENT

To people who adopted me for two months, the staff of Patricia Health Center, Dr. Arnel
Crescini, Sir Dennis, Sir Robert, Sir Joel, Maam Jasmin, Ate Ana, Ate Ara, Ate Elsie, Maam
Jed, Sir Ben, Kuya Hector, thank you for the help, support, and warm welcome and goodbye.
TABLE OF CONTENTS:

ACKNOWLEDGEMENT 2

INTRODUCTION 4

OBJECTIVES 4

SPECIFIC OBJECTIVES 4

METHODOLOGY 4

LIMITATION OF THE STUDY 5

I. SETTING OF THE COMMUNITY 5

II. POPULATION 6
III. ECONOMIC INDICES 9
IV. SOCIO-CULTURAL INDICES 10
V. ENVIRONMENTAL INDICES 14
VI. HEALTH INDICES 16
VII. SUMMARY AND CONCLUSION 19
VIII. PROBLEMS IDENTIFIED 20
IX. SUGGESTIONS/ RECOMMENDATIONS 20
X. ACTION PLAN 21

References 21
INTRODUCTION

Barangay 177, Zone 16 is said to have the highest population among barangays under the
Patricia Health Center. It is composed of commercial and residential areas. Also, It is composed
of families with different statuses in life. The chosen barangay encompasses the quality of a good
sample for a study because it has aspects that may be equated or can represent the whole
community under Patricia Health Center.

RATIONALE

This study was done to assess community health, such as health practices, health care
information and services, present socio-economic and environmental condition of the residents.
To identify problems and to create programs that will benefit the community.

STATEMENT OF OBJECTIVES

a. General Objectives

This study aims to assess quality of life and diagnose health status of the 25 surveyed
families as well as the whole community of Brgy 177, Zone 16, District II of Tondo, Manila.

b. Specific Objectives
1. To determine the present demographic data of the barangay.
2. To determine the community population, socio-cultural, economic, environmental
and health indices.
3. To identify the top 10 leading causes of morbidity of the barangay in the past year
4. To present one cause of morbidity and develop a program to reduce risk and/or
prevent occurrence of incidence.

METHODOLOGY

Twenty five families from Barangay 177, Zone 16, Tondo, Manila was the chosen
community since it is identified as one of densely populated area. Ocular survey was done with
the assistance of Barangay health workers. House to house visit was done and residents were
randomly selected. Community Health Survey Form from the Manila District Health Training
Office was utilized. Data were collected, collated and correlated with the present health status of
the community.
LIMITATION OF THE STUDY

Population of the study was limited to 25 families, who were present at the time of
interview, from the entire population of Brgy. 177. A questionnaire used was based on the survey
form given by the Manila Health Training Office.

I. SETTING OF THE COMMUNITY

This study was conducted at Brgy. 177, Zone 16, Tondo, Manila, which is one of a
densely populated area. It has a total population of 3,249 as of December 2016. The area is
commercialized with variety of establishments such as sari-sari stores, drug stores, public
market, eatery, playground, and basketball court. Nearest public health care facility is the
Patricia Health Center. The nearest schools are under a different barangay. Means of
transportation were public utility jeepneys, pedicabs, tricycles and private vehicles. Medium of
communication were personal conversations, use of mobile phones and multimedia.

SPOT MAP (Patricia Health Center, Barangay 177, Zone 16)

Houses
Interviewed
II. POPULATION
2.1 Total population of the Barangay: 3,249 (September 2016)
2.2 Total Population of the Family Surveyed: 100
2.3 Sex Ratio:
Formula:

= 100%

49
= x 100% = 96%
51

Barangay 177 has a total population of 3,249. Twenty-five families composed of 100
individuals were randomly selected and interviewed. The sex ratio computed in this study is
96%, which means that there are 96 males for every 100 females in the barangay.

2.4 Age and Sex Distribution

Table 1. Age and Sex Distribution of Brgy 177, Zone16, District II, May-June 2017

AGE MALE PERCENTAGE MALE FEMALE PERCENTAGE FEMALE TOTAL PERCENTAGE

<1 1 2.04 1 2 2 2

14 4 8.2 5 9.8 9 9

59 5 10.2 5 9.8 10 10

10 14 5 10.2 9 17.7 14 14

15 19 5 10.2 4 7.8 9 9

20 24 6 12.24 3 5.9 9 9

25 - 29 6 12.24 10 19.6 16 16

30 34 4 8.16 4 7.8 8 8

35 39 3 6.12 2 3.9 5 5

40 44 4 8.16 3 5.9 7 7

45 49 3 6.12 0 0 3 3
50 54 1 2.04 2 3.92 3 3

55 59 1 2.04 2 3.92 3 3

>60 1 2.04 1 1.96 2 2

TOTAL 49 100 51 100 100 100

Analysis:

There is a high percentage of growing members of the population who contribute little on work
force and are still very dependent on earning individuals for basic needs.

The age-sex ratio distribution is important to provide information for the priority
programs in the community. Health teaching programs should be intensified because majority of
the population belong to the middle aged to elderly group where non communicable diseases like
diabetes and hypertension are common. As the majority of the Philippine population, young
individuals are still greater in number compared to older individuals which depicts a typical
picture that of most developing countries like the Philippines.

The percentage distribution as to age of Barangay 177 is composed mostly of the 15-44
year old age group.
 BY PERCENTAGE
>60

55 59

50 54

45 49

40 44

35 39

30 34

25 - 29

20 24

15 19

10 - 14

59

14

<1

-25 -20 -15 -10 -5 0 5 10 15

PERCENTAGE MALE PERCENTAGE FEMALE

Fig.1 Representation of the age and sex distribution of the 25 families surveyed at Brgy. 177,
Zone 16, District II, Tondo, Manila

Analysis:

As shown in the graph, it has a broad base. The majority of the population belongs to the
young -age group, 1-29 years old. A broad base indicates an increase in crude birth rate, which
means a large population of children ages 0-14 years. The middle part of the pyramid denotes
large population of reproductive age (15-39 years old) which means there is an increase in
general fertility rate. The apex of the pyramid has the lowest number on the population which is
the old age group of 55 years and above.
 2.5. Civil Status

Table 2. Percentage distribution showing the Civil Status of Individuals 15 y/o and
above. Barangay 177, Zone 16, District II, Tondo Manila

Civil Status f %
Single 23 35.4
Married 15 23.1
Live-in 25 38.4
Separated 0 0
Widow 2 3.1
TOTAL 65 100

Analysis:

Based on the percentage distribution showing the civil status of individuals 15

years old and above, majority of them belong to the live-in status. It shows lack of
capacity to marry. Although most of them were living-in together for a long time, they
lacked the necessity to marry each other. This also shows that next to many who have
living-in status, most individuals 15 years old and above were still single, contributing to
greater work force in the community.

III. ECONOMIC INDICES

3.1. Dependency Ratio:

. 014+65
DR =
1564
x 100%

35 +0 35
DR = = x 100 = 53.8%
65 65

Analysis:
There is 53.8 % dependency ratio, only meaning 46.2% belonged to the work
force. The difference may be small, but it has great impact on the family and in the
community. It may also be attributed to the increase in young population in the
community.
3.1 Occupation

Table 3. Percentage Distribution showing the Average Income of Earning Individuals.

Barangay 177, Zone 16, District II, Tondo Manila

Income/Month f %
<1,000 0 0
1,000-2,999 4 6.15
3,000-4,999 15 23.08
5,000-6,999 6 9.23
7,000-8,999 8 12.31
9,000-10,999 9 13.85
11,000-12,999 13 20.0
13,000-14,999 6 9.23
>15,000 4 6.15
TOTAL 65 100

Analysis:

This table showed that most of the people living in barangay 177 has income less than
that of a recommended income for a family to live a decent and normal life. Most people
with this kind of income lives in a day-to-day basis where most of the time eat only once or
twice a day and no savings in case of emergency.

3.2 Average Income

Table 4. Percentage Distribution showing Types of Occupation of Earning Individuals.

Barangay 177, Zone 16, District II, Tondo Manila

Occupation f %
Government Employee 4 6.153846154
Merchandiser 3 4.615384615
Construction worker 6 9.230769231
Security Guard 3 4.615384615
Pension 2 3.076923077
House helper 10 15.38461538
Maintenance 5 7.692307692
BHW 1 1.538461538
Cook 3 4.615384615
Medical Representative 1 1.538461538
IT 1 1.538461538
 Carpenter 5 7.692307692
Driver 5 7.692307692
Factory Worker 6 9.230769231
Sales Clerk 4 6.153846154
Tour Guide 2 3.076923077
Airline employee 1 1.538461538
Printing Staff 3 4.615384615
TOTAL 65 100

Analysis:

The percentage distribution of types of Occupation showed that most of the people with
low-income also came from low-paying occupations like house helper, construction worker,
driver, and factory workers.

IV. SOCIO-CULTURAL INDICES

4.1 Literacy Rate
. 8
LR =
. 8
89
LR = x 100 = 100%
89

Analysis:

Barangay 177 families are literate to read and write. Most of them, if not all can read and
write. But this literacy rate cannot determine the level of understanding of a person, whether they
understand the situation in the community.

4.2 Educational Attainment

Table 5. Percentage Distribution Showing the Educational Attainment of Individuals Surveyed.

Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Educational Attainment f %
No Formal Education 0 0
Elementary Level 20 22.47
Elementary Graduate 17 19.10
High School Level 24 26.97
High School Graduate 5 5.62
College Level 9 10.11
College Graduate 14 15.73
TOTAL 89 100
Analysis:

Educational attainment of person can be a measurement of how they understand what

they need and what is happening in the community. Like for example health teachings, you can
determine who among them can fully understand what you teach. In Barangay 177, most of them
are high school and elementary graduates, which may also be the reason why the community
belongs to low-paying jobs resulting to low-income for the family.

4.3 Religion
Table 6. Percentage Distribution showing the Religion of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Religion F %
Roman Catholic 22 88.0
Christian- Born Again 1 4.00
INC 2 8.00
TOTAL 25 100

Analysis:

The community is composed mainly of Catholics. In this regard, it can be said that most
people in barangay 177, understands the culture and practices of each other. Though the Catholic
Church is against contraceptives, which the Health Center is implementing, the religious
influence on this type of health seeking behavior is minimal.

4.4 Place of Origin

Table 7. Percentage Distribution showing Place of Origin of Families Surveyed.
Brgy. 177, Zone 16, Tondo, Manila

Place of Origin F %
Luzon 7 14.0
Visayas 3 6.0
Mindanao 0 0
NCR 40 80.0
TOTAL 50 100

Analysis:

The place of origin of the families is important because some cultures from where they
came from may affect/ influence the health seeking behavior of the family. But, since most
people in the community were from NCR, Health seeking behavior is easy and of importance.
 4.5 Population Movement
Table 8. Percentage Distribution showing the Length of Residency of Families
Surveyed. Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Length of Residency f %
< 6 months 0 0
6 months 1 year 0 0
1 year 5 years 0 0
6 years 10 years 4 16.00
10 years and above 21 84.00
TOTAL 25 100

Analysis:

The length of residency of families in barangay 177 showed that people in that
community has been there for a long time so they were capable to know their community and the
health center that can cater their needs for health.

4.6 Housing
a. Types of Houses
Table 9. Percentage Distribution showing the Types of Housing of Families
Surveyed. Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Type of Housing f %
Makeshift 0 0
Light 7 28.00
Strong 5 20.00
Mixed 13 52.00
TOTAL 25 100

Analysis:

Most of the housing in the community is made of mixed materials, some are made from
light material and few houses are made from strong materials. Its impact on the communitys
health is still minimal.

b. Ownership
Table 10. Percentage Distribution showing House Ownership of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

House Ownership F %
Rent-free 2 8.00
Owned 15 60.00
 Rented 13 52.00
TOTAL 25 100

Analysis:

In Barangay 177, there is balance between owning and renting residents, but in renting
families, there is additional burden for them. House rent ranges from 1000-5000 monthly aside
from other basic commodities like water and electricity. It affects the health-seeking behavior of
the family because they always thought that they seeking consult will cost them a fortune.

c. Ventilation
Table 11. Percentage Distribution showing Ventilation of Houses of Families
Surveyed. Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Ventilation f %
Adequate 15 60.00
Inadequate 10 40.00
TOTAL 25 100

Analysis:

Ventilation is important because it connotes the flow air around the house which may
greatly affect the health not only of an individual but of the whole family. This percentage
distribution showed that adequately ventilated houses were greater than that of the inadequate
but 40% is large number, to which may be attributed the increased number of respiratory
infections in the community.

V. ENVIRONMENTAL INDICES
5.1 Water Supply
Table 12. Percentage Distribution showing Water Supply of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Level f %
I. Point Source 0 0
II. Communal Faucet
0 0
System or Standpost
III. Waterworks System 25 100
TOTAL 25 100
Analysis:

All families in the community were supplied by Maynilad, hence it can claim clean water
for daily use, but not for drinking.

5.2 Excreta Disposal

Table 13. Percentage Distribution showing Excreta Disposal of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Excreta Disposal f %
Level I. Pit Latrines 0 0
Level II. Pour-Flush Toilets 20 80.00
Level III. Flush Toilets 2 8.00
Balot System/Wrap & Throw 3 12.00
TOTAL 25 100

Analysis:

As you can see from the above table, most have pour-flush toilets, but what caught
attention was the presence of the Balot System in the community. Those houses were near the
Estero, and said that their excreta were thrown in the Estero. It is indeed an alarm for the
communitys health.

5.3 Garbage Disposal

Table 14. Percentage Distribution showing Garbage Disposal of Families Surveyed.

Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Garbage Disposal f %
DPS (collected) 25 100.00
Open Dumping 0 0
Burning 0 0
Waste Segregation 0 0
TOTAL 25 100

Analysis:

Garbage of the community is collected thrice a week, which is a good sign because it
could lessen the garbage thrown at the estero. But still, there is lot of garbage in the estero from
domestic houses. It can greatly affect the community by spreading bacteria and may cause
different skin diseases and low immunity.
 VI. HEALTH INDICES
6.1 Food storage
Table 15. Percentage Distribution showing Food Storage Practice of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Food Storage f %
Refrigerated 15 60.0
Not Refrigerated
a. Covered 10 40.0
b. Exposed 0 0
TOTAL 25 100

Analysis:

Most families have refrigerator in their houses and those who have none cover their foods or
use a Styrofoam ice chest to cool their foods. It can avoid food contamination which may cause
digestive tract diseases.

6.2 Infant Feeding Practice

Table 16. Percentage Distribution showing Infant Feeding Practice of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Type of Infant Feeding f %

Breastfeedng
Bottlefeeding
a. Evaporated
b. Condensed
c. Powdered
Mixed
a. Evaporated
b. Condensed
c. Powdered 2 100
TOTAL 2 100

Analysis:

Most mothers in community breastfeed their babies for the first 3 months and switch to
mixed feeding because they have to go back to work. But breastfeeding is greatly advocated in
the Health Center. As have observed, most babies who arent purely breastfed for the first 6
months are more susceptible to infections and or diseases.
 6.3 Immunization Status
Table 17. Percentage Distribution showing Immunization Status of Children <1 year old
Among the Families Surveyed. Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

No. of Targeted
Antigen Accomplished %
Children
BCG 2 2 100.00
Penta HiB 1 2 2 100.00
Penta HiB 2 2 2 100.00
Penta HiB 3 2 2 100.00
OPV 1 2 2 100.00
OPV 2 2 2 100.00
OPV 3 2 2 100.00
AMV 2 2 100.00

Analysis:

With this table, it can be seen that children in the community were fully immunized
because mothers are aware of the free vaccines given in the health centers.

6.4 Health Seeking Behavior

Table 18. Percentage Distribution showing Health Seeking Behavior of Families Surveyed.
Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Health Facility F %
Hospital 4 16.00
Health Center 17 68.00
Private Clinic 4 16.00
TOTAL 25 100

Analysis:

Most people in the community seek health consult at the health center since it is easily
accessible and gives free medicines. The Barangay health center staff informs and educates the
people of the community of the free services they can get from the health center. Also, since the
community belongs to low-income population, they always want to seek consultation for free
and given medicines also for free.

6.5 Source of Health Information

Table 19. Percentage Distribution showing the Source of Health Information of Families
Surveyed. Brgy. 177, Zone 16, Gagalangin, Tondo, Manila

Source f %
Health Center 18 72.00
Media 7 28.00
TOTAL 25 100

Analysis:

This table shows that the health information known to the families were mostly from the
health center. According to the families, the health center is giving free lectures for the
community to be informed. Also, it has been said that at times the health staff goes house-to-
house to inform and educate patients.

6.6 Top 10 Leading Causes of Morbidity at the Health Center, 2016

Table 20. Percentage Distribution showing the Top Ten Leading Causes of Morbidity
during January 2016-December 2016 in Patricia Health Center

Diseases - 2016 f %
1. Respiratory Tract Infection 964 40.8821
2. Hypertension 431 18.2782
3. Diabetes 267 11.3232
4. Tuberculosis 154 6.53096
5. Influenza 131 5.55556
6. Acute Gastroenteritis 108 4.58015
7. Urinary Tract Infection 96 4.07125
8. Pneumonia 95 4.02884
9. Animal Bite 68 2.8838
10. Impetigo 44 1.86599
TOTAL 2,358 100
Analysis:

The leading causes of the Morbidity include respiratory tract diseases, hypertension
diabetes, tuberculosis, influenza, acute gastroenteritis, urinary tract infection, pneumonia, animal
bite and impetigo. This may be correlated to increased percentage of poorly ventilated houses,
poor lifestyle of the families due to low-income and improper waste disposal as have mentioned
earlier.

Figure 2. Graphical Re[resentation of the 10 Leading Causes of Morbidity in Brgy.

177, Zone 16, Gagalangin, Tondo, Manila

Top 10 Leading Causes of Morbidity

January - December 2016
1,200
1,000
800
600
400
200
0

No. of Individual Cases

VII. SUMMARY AND CONCLUSION

Barangay 177 is densely populated composed of families belonging to class C and class
D who has low income or non-income generating at all. Younger generations compose most
of the community than the older generations. Male population is almost equal to the female
population. Most of the people in the community had low-level of education causing to have
low-level income. The houses in barangay 177 are mainly built from mixed materials and are
adequately ventilated, but there is high percentage of inadequate ventilation in the
community causing diseases of the respiratory tract. The community has good health seeking
behavior and is well-informed of the services given by the health center. They are also
informed of the current diseases surrounding the community but some families were not
practicing what is taught of them because of the presence of the Balot System and the
improper disposal of garbage in the Estero, which may cause communicable diseases.

In conclusion, the community in Barangay 177 is a mix of people with good and bad
attitude towards health but they can be motivated with proper teaching and informative
lectures that are understandable to them. The community may belong to the lower class but
majority of the community avails the free services of the health center to ensure that they are
healthy to work harder for their family and ensure that the children in the community are free
of disease.

VIII. PROBLEMS IDENTIFIED

Problems identified in the community are the following:
1. Improper disposal of garbage in the estero
2. Increased number of inadequately ventilated houses
3. Mixed attitude towards health seeking
4. Presence of the Balot system in the community

IX. SUGGESTIONS/RECOMMENDATIONS

It is highly recommended that the Balot system be removed from the community and the
estero be cleaned thoroughly and inform the families of the consequences of their actions.
More health teachings should be done and it should be done barangay-per-barangay so it will
be more accessible to the families and that they will have no reason not to attend and be
informed. Also, I suggest that non-communicable diseases like hypertension and diabetes be
screened early to prevent the debilitating consequences of such diseases. Hopefully,
screening tests and/or laboratory tests be made available to every health center and be offered
free for the low-income generating communities, to be able to manage the patients properly. I
also suggest that the types/ kinds of medicines in the health center be added because there are
diseases that cannot be treated with the basic medicines in the health center that should be
bought by the patients, which may add burden to their families.

X. ACTION PLAN
TITLE: OPLAN LINIS ESTERO de MAYPAJO
GENERAL OBJECTIVE: To make Estero de Maypajo, under barangay 177 free of
domestic garbage.
Specific Strategies / Time frame Locus of Resources Evaluation
Objectives Activities Responsibility
To make Health Monthly for Barangay Health Human Decreased
estero de teachings on the 12 months Center Staff workforce incidence of
Maypajo consequences of
diseases
free of improper
garbage disposal of acquired
garbage from the
To make
dirty Estero.
estero de
Maypajo Weekly Weekly for 12 Manila Garbage Manila Maintenance
free of removal of months or collecting Agency City hall of the
Balot garbage from until all
trucks and cleanliness
system or the Estero garbage
human removed cleaning of the Estero
waste equipments
Daily Daily for 6 Barangay Captain Human Improved
monitoring of months and Barangay workforce attitude of
the garbage Policemen
the families
disposal activity
of the families towards
living around garbage
the estero
disposal.