1

I. Introduction

Community Health Nursing (CHN), according to the American Nurses

Association (2016), is the synthesis of nursing practice and public health practice
applied to promoting and preserving the health of populations. It is also defined
by Jacobson (2000) as learned practice discipline with the ultimate goal of
contributing, as individual and in collaboration with others, to the promotion of the
client's optimum level of functioning through teaching and delivery of care.
In this Community Health Nursing rotation, the Community Organizing
Participatory Action Research (COPAR) approach is utilized. COPAR aims to
transform the apathetic, individualistic, and voiceless poor into dynamic,
participatory and politically responsive community. It is also a process by which a
community identifies its needs and objectives in order for them to develop
confidence in taking action for the resolution of their issues and concerns in the
community. (Vera, M., 2012)
Through the use of COPAR, the community is able to develop itself as well
as emposer its people. COPAR has four phases namely: Pre-Entry Phase, Entry
Phase, Organization-building Phase, and sustenance and strengthening phase.
Currently, the BSN students are in the Entry Phase which is crucial in
determining which strategies for organizing would suit the chosen community.
Success of the activities depend on how much the community organizers has
integrated with the community. The activities in this phase involve establishing
rapport with the people in the community and deepening social
investigation/community study. This phase signals the actual entry of the
community worker/organizer into the community.
In this rotation, the BSN 4C presented and validated the data to the
community, after which problems were identified and ranked according to priority.
The people also gave their recommendation to address the identified problems.
This community diagnosis will serve as blueprint and reference for the
nursing department of San Pedro College, Inc. and Barangay Talandang in the
implementation of health- and health-related programs for community
development.
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II. Objectives

General Objectives

Within our 4 weeks span of community exposure at Barangay Talandang,

Tugbok district, the students of BSN 4C aims to come up with a comprehensive
community diagnosis which will help us gain wide-range knowledge and vital
information about the factors that affects the people in the community.

Specific Objectives

The group aims to achieve the goal specifically through:

a. Allocate a budget for certain expenses;

b. Formulate a structured plan assigned to different divisions by the logistics,
food committee, and artists;
c. Conduct courtesy call to the barangay officials of talandang;
d. Set a date with the barangay council and residents for the presentation
and validation of data;
e. Present the data to the community with interpretation and analysis;
f. Validate the data presented;
g. Prioritize the identified problems using a standardized scale for
prioritization;
h. Discuss the results of the prioritization of problems with the state holders
of the community;
i. Establish a memorandum of understanding between SPC and barangay
talandang for the community development program and;
j. Have insights and reflections gained from the community exposure.
 3

A. Presentation and Validation of Data

Figure 1. Population Distribution of Participants in Terms of Age and Sex

PUROK TISA PUROK LANZONES PUROK SANTOL

30.00%

24.44%
25.00%
21.67%
17.50% 17.19% 20.31%
20.00%
15.83% 16.67%
15.83%
14.44%
15.00%
12.50% 15.56% 12.50%
10.16%
10.00% 18.75%
10.83%
11.72%
5.00% 7.78% 7.78%

0.00%
0 to 5 6 to 12 13 to 18 19 to 30 31 to 45 46 to 59

In Purok Tisa, mostly of the population belongs to 19-30 years old with a

percentage of 21.67%. The second highest population belongs to 0-5 years old

(17.50%), followed by 6-12 years old (15.83%) and 31-45 years old (15.83%). In

Purok Lanzones, 20.31% of the population are in ages 31-45, followed by 18.76%

which is in 19-30 years old. In Purok Santol, majority of the population are in ages

19-30 with a percentage of 24.44% and followed by the ages 46-59 which is

16.67% of the population.

According to Philippine Statistics Authority, Philippines was recorded for

having a total of 100, 981, 437 household population or non-institutional population

in the year 2015. From the 100.9 million household populations in the Philippines,

50.25 percent were males and 49.32 percent were female. This resulted in a sex
 4

ratio of 102 males per 100 females. In terms of the distribution by age range,

31.84% of the total population belonged to the 0 to 14 years old age, 63.41% were

in the 15 to 64 years old age and only 4.74% were in the 65 years old and above

age. Based on this statistics, the population composed mostly of 15-64 years old.
 5

Figure 2. Population Distribution of Participants in Terms of Educational

Attainment

PUROK TISA PUROK LANZONES PUROK SANTOL

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%

The graph above shows that in Purok Tisa, 18.33% of the population’s

educational attainment is elementary undergraduate. Followed by, high school

undergraduate and elementary levels which are both 15% respectively, and lastly,

11.67% are high school graduates. In Purok Lanzones, mostly of the population

are in elementary level and high school undergraduate with a percentage of

15.40% respectively. While in Purok Santol, high school graduate has the highest

frequency with a percentage of 22.20%, followed by high school undergraduate

which is 16.70%.
 6

According to Freudenberg, N. (2007), a good education leads to a good

health in a several ways. First, the more schooling people have, the more money

they earn, enabling them to purchase better housing in safer neighbourhoods,

healthier food, better medical care and health insurance, and more education.

Each of these factors is associated with improved health. Each one allows

individuals to move up the occupational and income ladder, giving them more

prestige and power, both of which are associated with better health. High school

completion is also the gateway into college, which offers even greater benefits than

high school alone. Furthermore, education facilitates healthier behaviour choices

by offering learners access to health information and tools to acquire help and

resources such as smoking cessation programs. Education helps people to gain a

sense of control over their lives, an outcome associated with better health.

According to Byun, et. al (2012), the disparities in educational attainment of

rural areas is affected by a comprehensive set of factor that constrain and support

youth’s college enrolment and degree completion. Results confirmed that rural

students lagged behind non-rural students in attaining a bachelor’s degree largely

due to their lower socioeconomic background.

 7

Figure 3. Distribution of Participants in Terms of Household Size

1 to 5 6 to 10 11 above
100%
88% 84%
90%
79%
80%
70%
60%
50%
40%
30%
20% 17% 12.50% 16%
10% 3% 0% 0%
0%
Lanzones Tisa Santol

The data gathered shows that most families in purok Lanzones, Tisa, and
Santol consist of 1 to 5 members followed by families consisting of 6 to 10
members. And lastly, only purok Lanzones has a family that consist of 11 members
and above.

According to Philippine Statistics Authority, in the year 2016, the average

members in one family are 4-6. As household size increases, according by
McKinnon (2017), grocery purchasing behaviour was observed to be less
consistent with dietary guideline recommendations due to financial constraints and
big family size.
 8

Figure 4. Distribution of Working Members in Terms of Occupation

Farmer Laborer
Business Employee
Factory Worker Housekeeper
Landkeeper Home Managers (Housewife)
Retiriee Student
Banan packer Driver
Avon seller Carpenter
40%
35.80%
35%
32%
29.80%
30%
26% 26.30%
25%
21.70%
20% 17.90% 17.50%
16%
15% 13%
11.30% 10.50%
10% 8.80%

5% 5.70%
5% 4% 3.50%
3%
1.90% 1.80%
1% 0.90%
1.80%
0%
Lanzones Tisa Santol

The graph above shows that the most common occupation is home
manager (housewife), followed by farmers, then laborers, with carpenter, avon
seller, and land keeper as the least common occupations.

According to Robert Leahy, Ph.D (2013), unemployment is not a minor

problem because it can lead to a loss of income. If one does not work, he would
not be able to get any income to support the family and buy goods and services.
In addition, Dr. Leahy has showed that unemployed people are more likely to have
poor health habits, characterized by excess drinking, smoking, lack of exercise,
 9

and a sedentary lifestyle. Recognizing unemployment as health factor both for

mental and physical health and providing the services to help people cope can
have long-lasting preventive effects. The stress coming from overthinking of where
to look for means to feed the family and to provide the needed goods and services.
 10

Figure 5. Distribution of study participants in terms of Religion

120
96 %
100

80
65%
60
72% Purok Santol
40
Purok Lanzones
20 9% 13% 6% 3% 6% Purok Tisa
4% 6% 3% 3% 3% 3%
3% 3%
0

Base on the data gathered, there are different religious sectors that can be
found at barangay Talandang, Tugbok district. Majority of the resisdents are
members of the Roman Catholic with an average of 78% for the three puroks.
Other religious sectors are Christian in time (10%), Jehova’s Witness (5%),
Assembly of God (3%), Baptist (6%), Islam (3%), Protestant (3%), Voice of God
(3%), Dating Daan (3%), and Alliance (6%). Accoding to Flory (2007), religion has
a positive contribution to the community. We include religion it is because religion
has a big influence in our decision making. It is where they base what kind of health
services they want to avail and because of the different beliefs in each religion,
there are some health services that are contraindicated to their belief.
 11

Figure 6.Distribution of Participants in Terms of Philhealth Membership

80
72%
70
60%
60
59%
50
40% Purok Santol
40
32% Purok Lanzones
30 24% Purok Tisa

20 17%

10 6%
0
Member Non-Member IP N/I

Based on the data gathered, the percentage of Philhealth membership with an

average of 64% for the 3 puroks including the Indigenous People (IP)
category(17%), is much higher than non-Philhealth member. We can see in the
graph that there were still members in the community who are not a member of
Philhealth because there were some who were not aware of the benefits of it. In
the Philippines, Philhealth is one of the most known and one who has a numerous
member of the social health insurance program of the government. According to
Ureta (2016), Healthcare is one of the most important aspects in a community. Its
mandate was to “provide all citizens of the Philippines with the mechanism to gain
financial access to health services.” One of the benefits of it is on the Hospital bill,
if you’re a Philhealth member; you will received a deduction and pay lesser than
you’re original bill.
 12

Figure 7. Distribution of Participants in Terms of Family Monthly Income

25

65.6 %
20
Number of Household

52 %
15
Purok Santol
41 %
40 % 31.2 % Purok Lanzones
10 36 %
Purok Tisa

20 %
5
7%
4%
3.1 %
0
5,000 below 5,000-10,000 10,000-20,000 30,000-40,000
Monthly Family Income

This graph shows the distribution of participants in terms of family monthly

income. All the puroks have the highest number of households having the monthly
income of P5,000 and below with an average percentage of 52.53%. Followed by
a family monthly income of P5,000-P10,000 with an average percentage of
36.07%. Then, family monthly income of P10,000-P20,000 with an average
percentage of 10.03%. And lastly, one Purok has a family with a monthly income
of P30,000-P40,000 with a percentage of 4%.

According to Family Income and Expenditure Survey (FIES), in year 2012,

Filipino families have an average income of P235,000 every year. Those families
who earned an annual income of P715,000/year or P60,000/month are considered
as rich families. On the other hand, they considered a family in the poorest decile
if they are earning an average annual income of P69,000 or about P6,000 monthly.
Furthermore, according to Saloni and Cheng (2016), the socio-economic groups
 13

who are coming from the more misfortunate side have a higher chance of
experiencing poor health-related quality of life due to the different approaches of
coping methods.
 14

Figure 8. Distribution of Participants in Terms of Water Source

30

76%
25
88%
Number of Household

20
53.1%

15 Purok Santol
Purok Lanzones
31.2% Purok Tisa
10
24%

5
12% 15.6%

0
Level 1 Level 2 Level 3

Water Source

This graph shows the distribution of participants in terms of Water Supply.

Majority of the puroks have the supply from the level 2 facility with the average
percentage of 72.37%. This was followed by level 1 water facility with an average
percentage of 22.4%. And lastly, one purok has a family which is using the level
3 water facility with a percentage of 15.6%.

Water service levels are classified in the Philippines under three types,
depending on the method by which the water is made available to the consumers.
Level 1 provides a protected well or a developed spring with an outlet but without
a distribution system. Level 2 is composed of a source, reservoir, a piped
distribution network, and communal faucets. And lastly the Level 3 includes a
source, a reservoir, a piped distribution network, and individual household taps.
The standard used for drinking water is supplied by Level II and III water facilities.
It is considered potable or water that can be consumed directly by drinking without
risk of immediate or long-term harmful effects.
 15

Figure 9. Distribution of Participants in Terms of Water Storage

18
55% 33.3%
16

14
Number of Household

29%
12 26%
31%
10 18.7% 21%
18.7% Purok Santol
8 Purok Lanzones
Purok Tisa
6
14%
4

0
Gallon Drum Pail
Water Storage

This graph shows the distribution of participants in terms of water storage.

Majority of the families interviewed from the 3 puroks are using gallons as their
means of storing water with an average percentage of 34.23%. It is closely
followed by using pail with an average percentage of 28.43%. And lastly, few of
them are using the drum for their water storage with an average percentage of
19.57%.

According to Skipton (2010), it is important to have an emergency water supply

in case of water shortage. It is important for water is one of the most important
nutrients in the body. Moreover, according to Magtibay (2015), access to safe
drinking water is one of the most important public health concerns. There are three
components of drinking water system- source, storage and the process of the
storage. That is why water storage is also important in order to have clean water.
Water storage refers to a place for storing or water in a depository for future use.
 16

Figure 10. Distribution of Participants in Terms of Garbage Disposal

30

25 24
23

20
20

BURNING
15
BURYING
COMPOST PIT
10 9
7 7

5 4
3 3

0
LANZONES SANTOL TISA

In this graph, it presents the top 3 ways of how Barangay Talandang

disposes their garbage. The top 3 ways are Burning, Burying and Compost pit. For
Purok Lanzones, 23 households are burning their garbage, 9 households are
burying their garbage and 7 households are making a compost pit to dispose their
garbage. Next, for Purok Santol, 20 households are burning their garbage, 3
households are burying their garbage and 4 households are making a compost pit
to dispose their garbage. Lastly, for Purok Tisa, 24 households are burning their
garbage, 7 households are burying it and 3 households are making a compost pit
as a method of garbage disposal.

According to the Republic Act 9003, the Solid Waste Management Act, it
stated at the Chapter 4, Section 48, item 3, that the open burning of solid waste is
prohibited. Burning of garbage contributes to the air pollution and it may harm the
health because inhalation of burned garbage has some carcinogenic chemicals in
it. However, small scale burning of garbage such as leaves is allowed but it should
be controlled. The community confirmed that they do segregate their garbage and
burn only those things that are not harmful to burn.
 17

Figure 11. Distribution of Participants in Terms of Livestock

30

25
25 23

20
16
CHICKEN
15 14
PIG
11
GOAT
10

5 3
2 2
1
0
LANZONES SANTOL TISA

In this graph, it shows the top 3 livestock that the Barangay Talandang
prefers to raise according to the survey conducted. The top 3 livestock raised are
Chickens, Pigs and Goats. For Purok Lanzones, 23 households have chickens as
their livestock, 11 households have pigs and 2 households have goats. Next, for
Purok Santol, 14 households have chickens, 1 household has pigs and 2
households have goats as their livestock. Lastly, 25 households have chickens, 16
households have pigs and 3 households have goats as their livestock.

Livestock species plays a very important economic, social and cultural roles
or functions for rural households once they contribute to improve income and
wellbeing of the farm family. It has an important contribution for food supply of rural
and urban areas and contributes to the family nutrition (Bettencourt, et al, 2015).
 18

Figure 12. Distribution of Participants in Terms of Food Storage

80% 75%

70%
59%
60%
48%
50% 45% Container
None
40%
31% Refrigerator
30% Cellophane
20%
20%
5% 7%
10%

0%
Purok Santol Purok Tisa Purok Lanzones

Overall, 61% of the population surveyed in Barangay store their food in

covered containers and 22% store their food in their refrigerator. According to the
Food and Drug Administration (FDA, 2014), food should be stored in a cool
environment such as the refrigerator, freezer or cooler. This is because a cool
environment slows bacterial growth and replication resulting in a longer shelf life,
thus being practical and convenient. But since not every household owns a
refrigerator or a cooler, some store their food in containers such as tupperwares,
plastic containers and the like. According to FDA, if food were to be stored in
containers, the containers should be closed or covered to minimize exposure to
insects, bacteria and air.
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Figure 13. Distribution of Participants in Terms of Method of Food Preparation

88%
90% 84%
80%
70%
60%
48%
50%
38%
40% 29% 30% 31%
28%
30% 20%
20% 14%

10% 5%
1%
0%
Purok Santol Purok Tisa Purok Lanzones

Fry Soup Boil Grill Vinegar Stew Adobo Sautee

Based on the data presented above, 52% of the population surveyed in

Barangay Talandang prepare their food by frying it while 18% of them grill their
food. According to the Department of Health (DOH, 2011), habitual eating of fried
foods may lead to illnesses such as diabetes mellitus, hypertension and heart
disorders while eating grilled foods can also lead to heart disorders and cancer in
the liver, lung, colon and other types of cancer.
 20

Figure 14. Distribution of Participants in Terms of Leftover Storage

50%
44%
45%
40% 38%
36%
34%
35% 31% 31%
30% 27%
25% 21%
20% 16%
14%
15%
10% 8% 8%
4% 4%
5%
0%
Purok Santol Purok Tisa Purok Lanzones

Feed to animals container covered on table inside cauldron

Bowl no left over refrigerator plasticware

In totality, 34% of the surveyed population give their leftovers to their pets
and livestock while 36% of the population store their food in containers or
plasticwares. It is good that leftovers are being given to their pets and livestock so
the left overs are actually being made use of. But also, there are leftovers that
families don’t give to their animals so they can still eat later in the day. Most of
them store their leftovers in plasticwares and covered containers. . According to
the Food and Drug Administration (FDA, 2014), food should be stored in a cool
environment because a cool environment slows bacterial growth and replication
resulting in a longer shelf life. If leftovers are to be stored in containers such as
tupperwares, plastic containers and the like, it should be closed or covered to
minimize exposure to insects, bacteria and air.
 21

Figure 15. Distribution of Participants in Terms of Toilet Facility

30

25 24 24

20
17
15
11
10
5
5 3
1
0
Purok Lanzones Purok Tisa Purok Santol
Water Sealed Latrine Antipolo Type Open Pit Others

The graph presents the toilet facility among the participants in Barangay
Talandang. For Purok Lanzones, 24 families are using the water sealed latrine
facility; 5 families are using the antipolo type. For Purok Tisa, 17 families are using
the water sealed latrine, 11 families are using the antipolo type, 3 families are using
the open pit facility and 1 family has been using with their neighbors. Lastly, for
Purok Santol, 24 families are using the water sealed latrine facility and 1 family are
using the antipolo type.

According to World Health Organization (WHO), since 1990, the number of

people gaining access to improved sanitation has risen from 54% to 68% but some
2.3 billion people still do not have toilets or improve latrines. Benefits of improved
sanitation reduces the risk of diarrhea. These include reducing the spread of
intestinal worms and schistosomiasis. The water sealed latrine is the most effective
tool that our wastes will be properly dispose. It reduces risk of any diseases that
can be transmitted through oral-fecal. Open defecation perpetuates a vicious cycle
 22

of disease and poverty, making the insects have an access to human waste, thus
have the possibility to spread transmissible disease.

According to Recto (2015), it is very essential and necessary to own

sanitary toilet facility to prevent the spread of diseases such as cholera and typhoid
fever. Educating people especially children in proper waste disposal, helps in
making a better quality healthy life.
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Figure 16. Distribution of Participants in Terms of Nutritional Status

40

35
36
30

25

20

15
16 16
14
10
9
5 7 7 6 6 6
4 2
0
Purok Lanzones Purok Tisa Purok Santol
normal underweight overweight obese

The graph presents the nutritional status of individual- adult and children
in Barangay Talandang. For Purok Lanzones, 36 individuals have a normal weight;
7 individuals are underweight; 9 individuals are overweight and 4 individuals are
obese. For Purok Tisa, 16 individuals have a normal weight; 14 individuals are
underweight, 7 individuals are overweight and 6 individuals are obese. Lastly, for
Purok Santol, 16 individuals have a normal weight, 6 individuals are underweight,
6 individuals are overweight and 2 individuals are obese.

Nutrition is the process of providing or obtaining the food necessary for

health and growth. Nutritional status is the level of nutrients in the body and ability
of those levels to maintain normal metabolic integrity. A study in California State
University states that Malnutrition is a dangerous condition develops when your
body does not get enough nutrients to function properly. It can be caused by a lack
of food or an unbalanced diet that’s missing or insufficient in one or more nutrients.

According to Torres (2014), overnutrition such as overweight and

obesity is a serious health concern. Obesity is closely associated with an increased
 24

risk of cardiovascular diseases, cancer, hypertension, diabetes mellitus and other

medical problems. According to National Nutrition Council (2015), Physical
inactivity is the major factor in the prevalence of obesity in the Philippines. The
Department of Health has urged the public to engage in physical activity for at least
2 hours per day. Eating a well-balanced diet at the right time will surely prevent an
individual to become malnourished or overweight.
 25

Figure 17. Distribution of Study Group (Adult) in Terms of Blood Pressure

90 83.33% 84.6%

80 74%

70

60

50
Normal
40 Hypertensive
30 26%

20 16.17%

10
1.8%
0
Tisa Santol Lanzones

Based on the above data, 83.33% of all 42 participants have normal blood
pressure, while 16.17% are hypertensive in Purok Tisa. Next, in Purok Santol 74%
has normal blood pressure, while 26% were hypertensive. Lastly, in Purok
Lanzones out of 39 adults, 84.6% of the adult’s blood pressures were normal and
15.4% of them were hypertensive.

According to a recent study conducted this year, hypertension is “the

leading, greatest, and most important risk factor for multiple health related
maladies”. Hypertension is the elevation of blood pressure. As a person grows
old, his body organs gradually deteriorate, hence, making him more vulnerable to
diseases related to failing body systems. Hypertension, however is highly
preventable. Avoidance of salty and fatty foods such as dried fish, lechon, pork,
etc. is needed. Exercise is also advised to help the body’s metabolism and
maintain muscle strength. In hypertension, prevention is always better than cure.
 26

Figure 18. Distribution of Under 5 Children in Terms of Nutritional Status

80
72%
70 67%

60

50
38.1%
Normal
40
33% Underweight
30 Overweight

20 14% 14% 14.3%

10
3%
0
Tisa Santol Lanzones

As you can see in the graph above, Purok Tisa shows that 4 out of 6 children
has a normal nutritional status, and 1 or 14% has underweight nutritional status
and 1 or 14% has obese nutritional status. Purok Santol, out of 9 children, 6 or
67% has normal body mass index, 3 or 33% are overweight. However, out of 21
children there are about 14.3% that has normal body mass index, 38.1% are
underweight, 4.8% are overweight, and 9.5% are obese in Purok Lanzones.

Discussing and fully understanding the current nutritional status of children

helps the parents to prepare for their children’s future. Nutrition is the process of
providing or obtaining the food necessary for health growth. Having normal body
weight means you are being provided with the right food in the right amount
according to your body’s needs. Underweight children are those children who are
consuming food that insufficient for their growth and development. Underweight
children are known to have low immune system and are susceptible to diseases.
Due to these reasons, their educational capabilities are somehow affected.
Overweight children are still considered malnourished children because they are
consuming too much food. According to a study conducted in California, obese
 27

children will likely be obese until adulthood. They will be more prone to
noncontagious diseases such as diabetes and heart problems. Parents must know
these things in order for them to give their children adequate amount food needed
for proper growth and development.
 28

Figure 19. Distribution of Participants in Terms of Immunization Status of Under

Five Children

50.00%
43.50%
45.00%
38.50% 38.50%
40.00%
35.00% 30.40%
30.00% 26.10%
23%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
Purok Santol Purok Tisa
Fully Immunized Incomplete immunization ongoing immunization

PUROK LANZONES
18
16 16 16
16
14 14
14 13

12

10
8
8 7 7

6 5 5 5

2 76% 76% 76% 67% 33% 67% 33%

24% 24% 62% 38% 24%
0
BCG Pentavalent PCV OPV Measles MMR
Immunized % of immunized Not immunized % of not immunized

Based on the data presented above for immunization of under-five children,

Purok Santol has 38.5% of children who completed the immunization. Another
38.5% have not completed the immunization and 23% are still in the process of
 29

completing the immunization. In Purok Tisa, 43.5% of the children completed the
immunization while 26.10% have not completed the immunization and 30.4% are
still in the process of completing the immunization.

According to the Barangay Health Worker of Barangay Talandang, there

were really children who have not completed the immunization because some
families moved out of the Barangay and there were also new families who moved
in. In addition, some of the children were not immunized because of illnesses that
would be a contraindication in administering the vaccines such as fever, seizure,
cough and colds and some of them fail to return to the health center.

Childhood vaccination is one of the most cost-effective public health

interventions to reduce child morbidity and mortality. Besides attainment of high
coverage with potent vaccines, receiving child full course of recommended
immunization doses administered at the appropriate age is essential to curb the
incidence of vaccine preventable diseases in children. According to World Health
Organization 2013, globally it is estimated that about 22.6 million children under
one year of age were partially protected. One out of five infants worldwide does
not receive 3 life-saving doses of the diphtheria, tetanus and pertussis vaccine. In
1976, the Department of Health of Philippines established the Expanded Program
on Immunization (EPI) to ensure that infants/children and mothers have access to
routinely recommended infant/childhood vaccines. Six vaccine-preventable
disease were initially included in the EPI: tuberculosis, poliomyelitis, diphtheria,
tetanus, pertussis and measles. In the Comprehensive Program review on 1986,
it showed that there are 21.3% “fully immunized” children less than fourteen
months of age. The result study of Yenit, Assegid, and Abrha (2015) showed that
factor associated with childhood incomplete vaccination are related to health
service and mother/child related characteristics. The major predictors for
incomplete vaccination were antenatal care, postnatal, misconception about
vaccine contraindication, child place of delivery, number of live children and child
age.
 30

Figure 20. Distribution of Participants in Terms of Vices

70.00%

60.00% 65.90%
63.40%

50.00%

40.00%

30.00% 36.50%
34.10%

20.00%
21%
10.00% 14%

0.00%
Purok Santol Purok Tisa Purok Lanzones
Alcoholism Smoking

Presented in the chart in the distribution of participants in terms of vices, the

most common vices in the area are alcoholism with an average of 50.1% and
smoking with an average of 28.2% for the three puroks.

According to Centers for Disease Control and Prevention (2017), cigarette

smoking harms nearly every organ of the body, causes many diseases, and
reduces the health of smokers in general. Cigarette smoking causes more than
480,000 deaths each year in the United States. This is nearly one in five deaths.
Some of the effects that may be experienced after smoking tobacco include: initial
stimulation, then reduction in activity of brain and nervous system, increased
alertness and concentration, feelings of mild euphoria, feelings of relaxation,
increased blood pressure and heart rate, decreased blood flow to fingers and toes,
decreased skin temperature, bad breath, decreased appetite, dizziness nausea,
abdominal cramps and vomiting, headache, coughing, due to smoke irritation.
 31

According to National Institute on Alcohol Abuse and Alcoholism, drinking

too much – on a single occasion or over time – can take a serious toll on your
health. Effect of drinking alcohol can weakens heart muscles, which can affect the
lungs, liver, brain and other body systems, and also cause heart failure. Binge
drinking and drinking heavily over longer periods can cause the heart to beat
irregularly (arrhythmia) and has been linked to cases of sudden death.
 32

Figure 21. Distribution of Participants in Terms of Diagnosed Disease

8
TISA

7
28%
SANTOL
6
20.7
LANZONES
5

4 13.8
%
12
3 %
58.
3% 6.9
2 8% 8% 6.9
6.9 % %
%
25 25
1 % 25 4%

0
HYPERTENSION DIABETES ASTHMA URINARY PNEUMONIA
TRACT
INFECTION

The graph shows the top 5 Diseases of the 3 Puroks (Tisa, Santol,
Lanzones) of Barangay Talandang. The first disease is Hypertension which is
elevated blood pressure which affects 7 households in Purok Tisa, 3 in Purok
Santol, and 6 in Purok Lanzones. The second disease is Diabetes Mellitus , it is
the increase of sugar level in the blood that affects 2 households in each 3 Purok.
The third disease is Asthma which is a respiratory condition marked by spasms in
the bronchi of the lungs, causing difficulty in breathing. For asthma, 2 households
in each 3 Purok are asthmatic. The fourth disease is Urinary Tract Infection, it is
an infection that cause by bacteria that affect the kidney, ureter, bladder, or
urethra. The last disease is Pneumonia, it is a lung inflammation caused by
 33

bacterial or viral infection, in which the air sacs fill with pus and may become solid.
Pneumonia affects 1 household in Purok tisa and 4 in Purok Lanzones.

According to Department of Health of the Philippines the most

common diagnosed disease among Filipinos are Hypertension because many
Filipinos likes to eat salty food, does not exercise, smoking, and drinking which
can cause hypertension. It is also necessary that we should avoid eating too much
food that are rich in sugar because we are at risk of getting diabetes. If an individual
is asthmatic it is important to stay away from things that we are allergic because it
can trigger asthma. Next is Urinary Tract Infection, it is more common in women
than men. It is very important that an individual must do proper hygiene and to
increase water intake. Pneumonia is the inflammation of the lung parenchyma that
is cause by bacteria or viral. Pneumonia is a communicable disease, it is very
important that we should protect ourselves by wearing protective gear when going
to community such mask and handkerchief.
 34

Figure 22. Distribution of Participants in Terms of Illness in the Past 6 Months

18

16

14 32.5% TISA
42.5%
12
36% 27.8% 27.8 SANTOL
10 %

8 50 LANZONE
17.5% S
%
6
45%
30
4

0
FEVER COUGH COLDS

As shown in the graph above are the 3 common illnesses that Purok Tisa,
Santol, and Lanzones of Barangay Talandang are fever, cough, and colds. First is
fever which affected 17 households in Purok Tisa, 6 in Purok Santol, and 13 in
Purok Lanzones. Second disease is cough that 13 in Purok Tisa, 10 households
in both Purok Santol and Lanzones. Last is colds, there are 7 households acquired
colds in Purok Tisa, 9 in Purok Santol, and 10 in Purok Lanzones.

According to Department of Health of The Philippines, the common

illnesses that an individual can acquire are fever, cough, and colds due to climate
change. It is very necessary that once you have these 3 illnesses, we must consult
to the nearest hospital or to the health center to prevent further complications.
 35

Figure 23. Distribution of Households in Terms of Health – Seeking Behavior

100%

90%

80% 92%

70%
80%
60%
Physician
50%
Hilot
40% 56%
Self - Medication
48%
30% 44%
35%
20% 27%
21% 25%
10%

0%
Tisa Santol Lanzones

This graph shows the distribution of households in terms of health-seeking

behaviour in Brgy. Talandang, specifically, the Purok Tisa, Santol and Lanzones.
All the Purok shows highest incidence of administering self-medication. Followed
by seeking physician except in Purok Lanzones wherein Hilot is much higher than
seeking physician. According to the barangay health worker in barangay
Talandang, they do not have a doctor in their health center. She also added that
since they are under Tugbok District, then the doctor for their barangay can be
found and the Rural Health Unit located in Tugbok Proper.

According to O’Donnell (2017), effective health care interventions are

underutilized in the developing world, and income-related disparities in use are
large. Causes of the problem are also identified: insufficient system resources;
inappropriate allocation of resources across levels of care, programs and regions;
inadequate quality; insufficient household income; lack of access to credit;
prohibitive charges (formal and informal); travel costs; cultural barriers to the
acceptability of services; and misperceptions of illness and the effectiveness of
care.
 36

Figure 24. Distribution of Women Participants ages 15-45 years old in Terms of
OB-History

Purok Tisa

14

12
13 12
10
12 12 Gravida
Parity
8
Term
6 Preterm
Abortion
4
4 4 4 4 Living
2
1 0 1 1 1 0 1
0
1-3 Freq 4-6 Freq Above 7

Purok Santol
14

12 13 13 13

12
10
Gravida

8 Parity
Term
6 Preterm
Abortion
4 Living

2
2
1 1 1 1 0 0 1
0
1-3 Freq 4-6 Freq
 37

Purok Lanzones

6%
22%
0-3 Prgenancies
4-6 Pregnancies
7 & above Pregnancies
72%

The graph above shows the distribution of women 15-45 years old in terms
of ob-history. In Purok Tisa, Santol, and Lanzones, most of the women has a
gravida of 1 to 3 with one preterm and two abortion in purok Santol while there is
only one abortion and no preterm in purok Tisa. According to the barangay health
worker in barangay Taladang, they have free pre-natal check-up available in their
health center.

According to Eunice Shriver, a health researcher of the National Institute of

Child Health and Human Development, high risk pregnancy is one of that threatens
health or life of the mother or the fetus. One of the risk factor is multiple
pregnancies, which raises the risk of a woman dying during pregnancy or
childbirth.
 38

Figure 25. Distribution of Couples in terms of Family Planning

16 15
14 13
12
12 11
10

8 7
6
4
4 3
2
0 0
0
YES NO NO ANSWER
Purok Lanzones Purok Tisa Purok Santol

The graph presents the usage and non-usage of family planning among the
couples in Barangay Talandang. For Purok Lanzones, 13 couples are using family
planning; 12 couples are not using family planning; and 4 couples have no answer
to the particular question. Next, for Purok Tisa, 15 couples are using family
planning and 7 couples are not using family planning. Lastly, for Purok Santol, 11
couples are using family planning and 3 couples are not using family planning.

To achieve fertility reduction is family planning’s service delivery

component. This program benefits the family through promoting the health of the
mother after delivery, able to give time to parents to give attention to their children,
and give enough time for the mother to heal from illness (Famorca, Z., Nies, M., &
McEwen, M., 2013).

According to World Health Organization (WHO), Birth spacing (less than 12

months) might increase the risk of mortality and long birth spacing intervals can
also cause increase in maternal mortality. For maternal morbidity, very long
intervals were associated with more adverse effects like intra-partum fever. In this
 39

manner, we can give health teachings to women like the ideal birth spacing. In line
with this the WHO recommended that waiting for at least 2-3 years between
pregnancies reduces infant and child mortality, and also it benefits maternal health.
 40

Figure 25A. Distribution of Family Planning Acceptance in Terms of Method Used

10
9
9
8 8
8
7
6
5
5
4
3 3
3
2
2
1 1 1 1 1
1
0 0 0 0 0 0
0
Purok Lanzones Purok Tisa Purok Santol
IUD Pills Calendar Withdrawal Condom Tubal Ligation

The graph presents the different kinds of methods of family planning used
by each households in Barangay Talandang. For Purok Lanzones, 8 households
are using IUD; 3 households for Pills; and 1 household for Calendar and
Withdrawal. Next, for Purok Tisa, 8 households are using IUD; 5 households for
Pills; 2 households for Calendar; and 3 households for Withdrawal. Lastly, for
Purok Santol, 1 household is using IUD; 9 households for Pills; and 1 household
for Condom and Tubal Ligation.

According to Najafi-Sharjabad (2012), Family planning has been cited

as essential to the achievement of Millenium Development Goals (MDG). Family
planning has a direct impact on women’s health and consequence of each
pregnancy. The use of modern contraception among Asian women is less than
global average. In Asia, a majority of unintended pregnancies are due to using
traditional contraceptive or no methods which lead to induced unsafe abortion.
There were obstacles to modern contraceptive practice among Asian women
namely: cultural attitudes, lack of knowledge of methods and reproduction, socio
 41

demographic factors, and health service barriers. Culturally sensitive family

planning program, reforming health system, and reproductive health education
through mass media to create awareness of the benefits of Planned Parenthood
are effective strategies to improve modern contraceptive practice among Asian
women.
 42

Figure 26. Distribution of Women in Terms of Tetanus Toxoid Injections

Received

25

20
20 18
15
15 14
12
11
10 9
7
6 6
5
5 4
2
1
0
0
TT1 TT2 TT3 TT4 TT5
Purok Lanzones Purok Tisa Purok Santol

The graph presents the tetanus toxoid injections received by the women
during pregnancy in Barangay Talandang. For Purok Lanzones, 18 women
received TT1; 15 women for TT2; 12 for TT3; 9 for TT4; and 7 for TT5. Next, for
Purok Tisa, 20 women received TT1; 14 for TT2; 11 for TT3; 6 for TT4; and 5 for
TT5. Lastly, for Purok Santol, no one received TT1; 4 received TT2; 6 for TT3; 1
for TT4; and 2 for TT5.

In cases of mother who is not immunized with the correct number of doses
of tetanus toxoid vaccine, neither she nor her newborn infant is protected against
tetanus at delivery. The main purpose of giving this vaccine to women of
childbearing age and to pregnant women is to protect them from tetanus and also
to protect their newborn infants against neonatal tetanus. Tetanus vaccination
produces protective antibody levels in more than 80% of recipients after two doses.
Poverty, poor hygiene and limited access to health services increase the risk of
maternal and neonatal tetanus (WHO, 2002).
 43

B. Community Diagnosis

COMMUNITY DIAGNOSIS Score for Social Concern

Common Illnesses (Cough, Colds, and Fever) 1
Lack of Immunization 1
Garbage Disposal (burning) 0
Nutritional Status (Obese, Overweight and 1
Underweight)
Pneumonia 1
Low Income (5K pesos and below per family) 1
Self-medication 1
Asthma 1
Food Preparation (Fried and Grilled) 1
Hypertension 1
Diabetes Mellitus 1
Water Source (Level 1) 1
Toilet Facility (Antipolo and Open Pit) 1
Vices (Smoking and Alcoholism) 2
No Philhealth Insurance or Non-Philhealth 1
member
Unemployment 1
Big Family Size 1