De Jesus, Lovelle Grace E.

BSN 2Y – 2

CASE SCENARIO 1: PAMILYA BETOBETO

The Betobeto Family lives in Sitio San Ysiro, Barangay San Jose. 18/7-year-old Zaide is a farmer and his 16-year-old wife Juanita, is a
laundry woman. She is pregnant with their first child. Her prenatal care is done at the Rural Health Unit (RHU). A midwife reports once a week, at
which time, the RHU opens. Juanita’s mother Julia supervised her pregnancy and ensured that she takes nutritious meals and vitamin supplements,
as well as the required laboratory exams were done; her maternity booklet was also updated during her prenatal visits by the midwife. A primary
hospital is located three hours away from where the family lives; a private Maternity Clinic is also located a few kilometers away from the said
hospital. On her sixth month of her pregnancy, the anti-tetanus injection was refused, as her mother believes she was too young for it, the midwife
advised them to undergo an ultrasound and to start preparing for Juanita’s admission to a bigger hospital in Marikina, should circumstances during
require additional procedures. Aling Julia, for her part considers taking her daughter to the maternity clinic, which is nearer, when her time to deliver
comes.

Questions:
1. Describe the level of care that is in Sitio San Ysiro.
2. What would be the nature of intra-natal care that Juanita will need.
3. Contrast the available health resources and required health resources for Juanita and her family.
4. Discuss the options for financial assistance that the family may qualify.
5. What does Pamilya Betobeto show us about the health care delivery system. Illustrate.
 Aling Julia
Zaide Juanita
Juanita
PROBLEM 1: Presence of Health Threats: Lack of Immunization of Anti-tetanus
Family Nursing Supporting Goal of Care Objectives of Care Intervention Resources Evaluation
Problem Data Cues Measures

Inability to make The mother After the nursing After the nursing 1. Provide health Visual aids After the nursing
decisions with stated that she intervention, intervention, Mother teaching that needed to intervention, Ms.
respect to taking believes teaching, and Julia would be able would enlighten discuss the topic Julia exhibited more
appropriate Juanita is too appropriate to: the mother/family of immunization. awareness and
health action due young to be persuasion, Ms. a. Acknowledge the regarding the understanding of
to misconception immunized for Julia will feel relevance of importance of Time and effort the importance of
or erroneous anti-tetanus. encouraged to having her immunization of the student immunization of
information So, she take Juanita to pregnant child during nurse and the anti-tetanus to a
about the refused it. the RHU to have immunized, pregnancy. family. pregnant woman
propose course her immunization b. Understand the 2. Correct their despite her age and
of action. with anti-tetanus importance of misconception expressed a desire
and follow the following correct regarding to have her
next schedule immunization immunization of pregnant child
given by the schedule. anti-tetanus. immunized.
midwife. c. Be aware of the 3. Impart
availability of the knowledge with
said health care regards to the
service in the risk of not having
community. immunization
d. Utilize the and how it can
community’s prevent.
resources for
health care for
the welfare of the
pregnant mother
and her child.
PROBLEM 2: Presence of Health Threats: Health Care Delivery Consideration
Family Nursing Supporting Goal of Care Objectives of Care Intervention Resources Evaluation
Problems Data Cues Measures

1. Lack of The mother After the nursing After the nursing 1. Provide health Visual aids After the nursing
knowledge of mentioned that intervention, intervention, Mother teaching about needed to intervention, Mother
community she considers Mother Julia will Julia would be able the benefits of discuss the Julia exhibited more
resources for taking her feel encouraged to: going into bigger topic. awareness and
health care. pregnant to choose the health care understanding of
daughter to a safest and the A. Differentiate the delivery system. Time and effort the importance of
2. Failure to maternity clinic best health care maternity clinics 2. Explain the of the student choosing the right
utilize since it is hospital for her and hospitals. possible risk of nurse and the health care delivery
community nearer when pregnant B. Perceive the not taking into family. system for her
resources for her time to daughter and the benefits of consideration the pregnant child,
health care deliver, despite baby. various hospitals required health
due to failure what midwife within their resources.
to perceive advised. community. 3. Provide more
the benefits C. Prioritize the best options in
of health for her child and choosing the
care/services. the baby. proper health
care system.

PROBLEM 3: Presence of Foreseeable Crisis: Unplanned Pregnancy

Family Nursing Supporting Goal of Care Objectives of Care Intervention Resources Evaluation
Problem Data Cues Measures

Inability to Juanita: 16 After the nursing After the nursing 1. Explain the Visual aids After the nursing
recognize the years old intervention, the intervention, the importance of needed to intervention, the
presence of family betobeto couple would be able family planning. discuss the couple/family
foreseeable Zaide: 18/7 will decide on to: 2. Provide health topic. shows a strong
crisis due to lack years old appropriate A. Recognize the teaching about understanding and
of knowledge. action(s) to presence of the the different awareness of their
maintain family problem. contraceptive situation. Through
size based on a B. Explain what (natural and Materials that, the couple
sense of building a family artificial). needed for the decided to choose
responsibility. is all about. 3. Demonstrate the demonstration. what family
C. Choose a proper use of planning they take
method that is contraceptive and Brochures in.
appropriate to discuss the
them. disadvantages Time and effort
D. Consult the and advantages. of the student
nurse after 4. Refer to health nurse and the
delivery for center for DOH family.
guidance programs and
alternative/ free consultations
method chosen regarding family
planning and
contraception.
1. Describe the level of care that is in Sitio San Ysiro.
The level of care in Sition San Ysiro is Primary Health Care, “usually the first contact between the community members and other health facilities. It
is also a center for physicians, public health nurses, rural health midwives, and traditional healers.”

2. What would be the nature of intra-natal care that Juanita will need.
With regards to the situation of Juanita, she will bear a child at the age of 16. The advised of midwife to the mother, Juanita must undergo an ultrasound
and start preparing for Juanita’s admission to a bigger hospital in Marikina, should circumstances require additional procedures.

In accordance with Dr. Uyan, intra-care refers to care given to the mother and baby at the time of delivery. And the main objectives here are:
1. Cleanliness
2. Smooth delivery without injuring the mother or baby
3. Preventing complications
4. Delivery resuscitation for the baby

There is a special concern for pregnant teens, even though they are biologically able to produce healthy babies, they often depend on whether they
receive adequate medical care – especially in those critical early months of pregnancy. Teens who receive proper medical care and take care of
themselves are more likely to have babies. Those who don’t receive medical care are at greater risk for:

1. Fetal Death
2. High Blood Pressure
3. Anemia
4. Labor and Delivery Complication (such as premature labor and stillbirth)
5. Low birth-weight infant

3. Contrast the available health resources and required health resources for Juanita and her family.
 The difference between the available health resources and required health resources are the length distance to travel. The available health resources
in the community for Juanita and her family are the primary hospital, private maternity clinic, and rural health unit (RHU). On the other hand, the
required health resource for Juanita is the bigger hospital in Makati, as advised by the midwife. Considering the case of Juanita, she is having her first
child at the age of 16, she is at risk of labor and delivering the baby. So, bigger hospitals are better and more complete in terms of medical professionals
and equipment’s in case of emergency.

4. Discuss the options for financial asistance that the family may qualify.
• DSWD and POPCOM - SOCIAL PROTECTION PROGRAM FOR TEENAGE MOTHERS WHO ARE MINOR AND THEIR CHILDREN AS
MANDATED UNDER THE SPECIAL PROVISION OF THE 2021 GENERAL APPROPRIATIONS ACT OF 2021.

SPPTMC seeks to prevent teenage pregnancies and establish sufficient and accessible measure to protect the well-being of teenage mothers and
their children, as envisioned in the Philippine Development Plan and the 203 Agenda for Sustainable Development.

• The Program for Young Parents (PYP) is the United States Agency for International Development’s (USAID) response to the problem of increasing
teen pregnancies in the Philippines
• Safe Motherhood Program – DOH
• Organizations/Charities

5. What does family betobeto show us about the health care delivery system. Illustrate.
- The family Betobeto shows us the reality of the health care delivery system here in our country, the Philippines. There are still places or communities
that cannot acquire quality and accessible health care for various reasons. One is the lack of medical professionals within their barangays and RHU.
Second is the lack of pieces of equipment for delivering a baby, and lastly, the lack of financial support. Some individuals who seek health care still
choose the nearest hospital rather than spending time traveling just to get quality health care.
References:

Vera, M., BSN, & R.N. (2012, January 24). Levels of Health Care Referral System. Nurseslabs. https://nurseslabs.com/levels-of-health-care-

referral-system/#:~:text=There%20are%203%20different%20levels

Department of Health. (2012). National Safe Motherhood Program | Department of Health website. Doh.gov.ph. https://doh.gov.ph/national-safe-

motherhood-program
When Your Teen Is Having a Baby (for Parents) - Nemours KidsHealth. (n.d.). Kidshealth.org. Retrieved September 22, 2022, from
https://kidshealth.org/en/parents/teenpregnancy.html#:~:text=Special%20Concerns%20of%20Pregnant%20Teens&text=fetal%20de
ath
Introduction to Prenatal, Intranatal and Postnatal Care - By Dr. Uma. (n.d.). Lybrate. https://www.lybrate.com/topic/introduction-to-
prenatal-intranatal-and-postnatal-care/09d48f98086e82c78f099f4226697363