INTRODUCTION

Community health nursing has gradually changed the health status of individuals. It
provides care and health information usually not obtained within the family or even in
schools. It focuses not only on one person, but more on the population where he belongs.
Overall, community health nursing is directed to the community as a whole.

According to the Department of Health, community health nursing is “a unique blend

of nursing and public health practice woven into human service…”It is not just all about
caring and curing the sick but it is more on developing the individual as part of the
community. It is unique in such a way that the client has a role in developing his own self.
There is an open communication between the nurse and the client thus, creating an
atmosphere of interaction and understanding between them. The community health nurses
emphasize the possible disturbance of certain environmental factors in the maintenance of a
healthy living. The promotion and observance of different health values may be affected by
the social status of the community. Starting from the health beliefs up to the dreaded health
problems, all are being reflected by the kind of community an area has. With that in mind,
community diagnosis is being held.

Community diagnosis, as part of community health nursing provides basis for the
health condition of the community. It is an overview of what possible health problems affect
the community as shown by certain factors and variables. It imparts knowledge on the
community health nurses on what aspect of health the community is in crisis. Community
diagnosis assesses the community’s health status, thus providing hints on what and where the
community health nurse must focus to promote and further maintain health.

RATIONALE:

As student nurses, it is very important to undergo the process of Community

Diagnosis or CDx because this will be the guide in determining the health profile of the
studied community as well as the health problems present. In addition to that, the Community
Diagnosis is a stepping stone in resolving the health needs and problems of the community.

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The role of a student nurse in undergoing the process of CDx is to know the health needs and
problems in the community which affect their total health condition.
Student nurses, being new in the field of community health nursing, should take part
in the administration of community health diagnosis. In collaboration with the health teams,
the student nurses should apply their knowledge in maintaining and promoting quality health.
They may impart knowledge and provide necessary information about the proper way of
preventing diseases which may truly help the whole community. They may also promote
health by suggesting health programs and seminar related with the commonly occurring
diseases for early detection and prevention

METHODOLOGY

To formally start the Community Diagnosis, the student nurses had a courtesy call at
the Barangay Hall last July 7, 2009, Tuesday, to seek permission from the Barangay Officials
headed by Chairman Gloria Lipana and to inform them about the purpose and objective of
the community survey. They were assisted and accompanied by their clinical instructor and
the Barangay Health Worker from Mabini Health Center to the said barangay.

Afterwards, the student nurses had an ocular observation to assess the barangay’s
environmental conditions and interview a total of 25 families as mere representatives of
Barangay 394. This was done through random sampling based on the availability of the
household members. A survey questionnaire was utilized to gather pertinent data about the
socio-economics, cultural-demographic, and environmental profile of the barangay. The data
gathered were carefully tallied, thoroughly analyzed, and were clearly interpreted for the use
of the Community Diagnosis.

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 OBJECTIVES

General:

After seven days of community exposure, the student nurses should have assessed
and acquired the essential demographic, socio-economic-cultural, environmental, and health
resources of Barangay 394, Zone 40, District III of Manila.

Specific:

1. To obtain the community’s demographic characteristics including its total

population and geographical distribution, topography, and its trends.
2. To consider the community’s socio-economic-cultural variables that affects their
health status.
3. To observe and check the environmental variables such as water, air, food,
housing, and waste disposal that plays an important role with the community’s
health and wellness.
4. To acquire necessary health statistics of the community including births,
morbidity, and mortality.
5. To identify the sources in the community that provides health services and meet
their health related needs.
6. To recognize the community’s political and leadership patterns that is of
significance with their well- being of safety, peace and order..
7. To be able to apply and practice nursing theories and knowledge in the
community, that may increase the student nurses’ capabilities and critical
thinking; and be prepared for real nursing situations.

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 SCOPE AND LIMITATION OF THE STUDY

The study covers twenty-five families composing of 135 individuals merely

representing the residents of Barangay 394 Zone 40, District III of Manila last July 7, 2009.

Data gathered were based from the interview made by the student-nurses to the head
of the family or any family member who is knowledgeable and capable of answering the
essential information of their family.

The data collected from the survey-questionnaire includes the family members’
background – education, occupation, income, religion, origin and residency. It also pertains
to the respondents’ way of living including their housing condition, water supply, excreta
disposal and garbage disposal. Other topics covered in the survey include their food storage,
infant feeding practice and immunization status, health seeking behaviors and sources of
health information.

Due to time constraint, only the pertinent data were gathered and this will merely
serve as a basis to determine the health needs and problems of Barangay 394 Zone 40.

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 ORGANIZATIONAL CHART OF BARANGAY 394, ZONE 40,

DISTRICT III OF MANILA

Gloria B. Lipana

Chairwoman

Rolando R. Ramos Aderito A. Montenegro

Secretary Treasurer

Froilan Jacquili
Isabelo
Jennifer Pastor E. M. ne L.
Ernesto G. Rodolfo M. Daniel P.
L. Macalanda Doming Lobo
Verdonazo E. Bazaro Alvaro Pineda
Camacho Jr. o
SK
Kagawad Kagawad Kagaw Kagawad Chair-
Kagawad Kagawad Kagawa
ad woman
d

5
 I.
SETTING OF THE
COMMUNITY

6
Description of the Community

Barangay 394, Zone 40 was established in the 1970’s through the appointment by the
mayor. It is located at the District III of Manila, bounded by Quezon Boulevard (G. Puyat) in
the North, Raon G. Puyat in the East, Quezon Boulevard (Escaldo) in the West, and Z. P. De
Guzman in the South. As of July 20, 2009 the barangay has a total population of 1, 183.

The said barangay exhibits a tropical climate. It is located beside a river and has some
areas which can be considered depressed physically. The houses were built close to one
another and vacant lots are also present in the area.

The location of the barangay provides accessible reach to the means of transportation.
Jeeps, sidecars, and tricycles are always available. Major roads are near to the barangay.
Business establishments are present in the area; they cater for the barangay’s consumption.
Water works systems run through the barangay, providing them with accessible water almost
anytime they need it.

Most of the barangay members are literate, who actually have undergone at least one
level of education in their lives. This made them capable of communicating with one another
through speaking, reading, and writing.

The above details describe the setting of the barangay. It is an overview of its status,
specifically the physical, environmental, and social aspects.

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8
9
10
 II.
POPULATION

1. The Total Population of the Barangay is 1,183

2. The Total Population of the Families is 135 (25 families)

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3. Sex Ratio:

No. of Males

Formula: SR = ------------------------ x 100 %

No. of Females

= (63/72) x 100

= 87.5%

Sex Ratio= 87 males: 100 females

Analysis and Interpretation:

The computation above shows that for every 100 females there are 87 males
on the families surveyed. This implies that there are more females than males in the
community. With this data, it could be suggested that the health programs offered be
more focused on the welfare of the females as they make up majority of the
population. Programs and health services like health education on maternal and child
care, pre-marital and responsible parenthood, family planning, prevention of diseases,
and promoting healthy lifestyle must be established in the local health center.

Table 1
Age and Sex Distribution of Barangay. 394, Zone 40,
District III of Manila as of

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 July 7, 2009

Age Male Percentage Female Percentage Total Percentage

(f) % (f) % %
<1 0 0% 2 1.48% 2 1.48%
1 to 4 7 5.18% 12 8.89% 19 14.07%
5 to 9 3 2.22% 8 5.92% 11 8.15%
10 to 14 5 3.70% 7 5.18% 12 8.89%
15 to 19 15 11.11% 9 6.67% 24 17.78%
20 to 24 8 5.92% 7 5.18% 15 11.11%
25 to 29 6 4.44% 3 2.22% 9 6.67%
30 to 34 4 2.96% 6 4.44% 10 7.41%
35 to 39 3 2.22% 3 2.22% 6 4.44%
40 to 44 5 3.70% 2 1.48% 7 5.18%
45 to 49 3 2.22% 8 5.92% 11 8.15%
50 to 54 3 2.22% 4 2.96% 7 5.18%
55 to 59 1 0.74% 0 0% 1 0.74%
60 to 64 0 0% 0 0% 0 0%
65 above 0 0% 1 0.74% 1 0.74%
Total 63 46.67% 72 53.33% 135 100%

Figure 1
Age and Sex Distribution of Barangay 394, Zone 40,

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 District III of Manila as of
July 7, 2009

Analysis and Interpretation:

Table 1 shows the frequency of male and female in the community. The data shows
that the productive age group that consists of 66.6%at the respondents is the highest in
number. This is the age group ranging from 15 up to 64 years old of the respondents –
35.53% of this group is males and 31.09% are females. Since the dominant genders are
males, there will be a possibility that they can do heavy work and this indicates that there will
be a possibility that they can support their basic needs.

Age that ranges from 15-44 years old is classified under fertility age group and also
fall under the category for civil status and reproductive age group. The dominant gender
among these groups is the males. Since the males are the dominant, this implies that there
will be a lesser tendency that the population will increase over time. However, even if there
are lesser females in these groups, proper programs should still be carried out to educate
them about the maternal and child care since these are the age brackets wherein they are
capable of bearing a child. One of the programs that may be implemented would be would be

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Reproductive health education that will teach them about the importance of having a child in
the right age. Through this, their values formation will be strengthened that will make them
realize the importance of their acts. Another method that can be used to limit the population
would be the responsible parenthood that could help them identify the ideal family size
depending upon the budget to accommodate the basic needs. The Manila Health Department
may conduct programs focusing on maternal and child health care such as Micronutrient
Supplementation, Monitoring of Malnourished Pregnant Women, Tetanus Toxoid
Immunization, and Safe Motherhood and Women’s Health like the Pre-marital and
Responsible Parenthood Counseling and Kangaroo care Management for the mother to
ensure her safe pregnancy and delivery.

The dependent age group ranging from 0-14 and 65 years old and above has 33. 33%
of the total respondents. The females in this area which has 22.21% dominates the males that
only have 11.1% of the respondents since these are children and senior citizens representing
the community programs like supplemental feeding of rehabilitation of Malnourished
Children; Home, School, Community Food Production, Promotion of Fortified Foods to
inform the target respondents about the importance of proper nutrition to the body. In
addition to this, programs like book giving, free school supplies and scholarship programs
provided by the community officials or other private sectors may help the children to be
motivated and determined to perform at their best in school.

Table 2

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 Percentage Distribution Showing the Civil Status of Individuals
15 years old and Above, Barangay 394,
Zone 40, District III of Manila,
as of July 7, 2009

Civil Status Frequency Percentage

(f) (%)
Single 52 57.14%
Married 34 37.36%
Separated 1 1.01%
Widow 4 4.396%
Total 91 100%
Analysis and Interpretation:

Table 2 accounts to the civil status of the interviewed respondents. The respondents
were grouped accordingly to whether they are single, married, separated or widowed based
on their personal statements. As the table shows, the community exhibited a relatively high
fraction of single and married individuals, 57.14% and 37.36% respectively.

This single group of the community represents those individuals who do not have
civil partners and those couples who were not legally married. A ratio of 52 out of 91
respondents was observed in the conducted survey showing the dominant civil status group.
The high fraction of these single individuals is mainly due to the young nature of the
population sample as noted in table 1. The bulk of the population is in the 15-19 years old
age range, an age range where in maturity is just beginning to develop and marriage is not yet
possible. The high number of these teenagers in the community arise the main concern for
sexual, intellectual and moral maturity for such individuals. The teens shall be molded
properly to instill the right values and intellects that are necessary for their maturity. They
will be taught their rights and responsibilities as growing individuals and how can they affect
their community as they start to participate to it. Frequent and proper health teachings and
seminars about topics such as sex education and values formation headed by the health
department or the community may greatly help in strengthening the foundations of these
youngsters in their way to their maturity. Constants follow-ups for such programs may be

16
needed to remind the individuals how important is their part to the and how can they help for
the betterment of the community.

The second most dominant group of the community, the married ones, comprises
another significant amount of individuals of 34 out of 91 surveyed respondents. This
considerable number of couples leads us to the majority of the community’s reproductive
bracket or the group in the population that is inclined to family creation. The high frequency
for married couples signifies also a high reproductive bracket in the community, meaning an
elevated risk of increase of the rate of population increase. Regarding this, the concern of the
community will be focused on the limitation of the population increase through the
implementation of different thrust programs offered by the Manila Health Department, most
specifically those concerning about safe motherhood and responsible parenthood.
Responsible parenthood and family planning counseling and health teachings may be done in
the community not only to preserve the welfare of the couple but also to protect the good of
their children. Aside from this, the community could also do couple-assemblies to talk about
the matters concerning the population growth factors and means on how to limit it. Through
this, in lined with constants follow-ups and individual initiatives of the population the risk of
radical population increase due to the high number of married individuals can slowly be
decreased.

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 III.
ECONOMIC INDICES

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Dependency Ratio

DR = number of population of 0 – 14 years old + 65 years old and above X 100

Population of 15 – 64 years old

= 44+ 1 X 100
90

= 50.00%

Analysis and Interpretation:

Based from the above mentioned computation, for every 100 productive individuals,
there are 50 dependents. This shows that the ratio of the supporting population and the one
they are supporting is 2:1. Initially, the ratio signifies an ideal weight for the productive and
non-productive group of the population. Two productive individuals are supposed to work
for every single non-productive individual.
The community exhibited an ideal to good rate of dependency ratio. That is if all the
productive group of the population would work and have decently fair wages, the community
can be able to minimize their economic difficulties. The population’s working group is large
enough to support the dependents. The only thing that is needed is to utilize this working
group by providing them with jobs that would give enough income for them to satisfy their
physiologic needs. Income generating livelihood programs may be a good way of helping the
working group stabilizes their jobs as well as incomes if the community will provide so.
The other factors involved in the productivity of the community such as occupational
status, types of jobs, and incomes of the productive group will be discussed in the next tables
(Tables 3, 4, and 5).

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 Table 3
Percentage Distribution Showing the Occupational Status of Productive
Individuals (15 to 64 years old) of Barangay 394,
Zone 40, District III of Manila,
as of July 7, 2009

Occupational Status Frequency Percentage

(f) (%)
Employed 11 12.22%

Self-employed 30 33.33%

Unemployed 49 54.44%

Total 90 100%

Analysis and Interpretation:

Table 3 shows the frequency and rate of productive individuals. It is noted that
12.22% of the sample population is employed. This means that they have the ability to
support themselves to have the basic needs for everyday life. 33.33% of the productive
respondents are self-employed. This group has a less stable income and might have the
possibility to unemployment due to several factors like laws …The respondents that falls
under the unemployed category occupies the remaining 54.44% of the age bracket.

This reflects that there were only a few numbers of respondents in the age group that
has a definite and stable work. Since the employed respondents are less than the unemployed,
the dependent respondents will just pile up with the dependent group of the community
causing the economic status of most respondents to drop down to near poverty level which
indicates a major problem to consider in the community. This possibility might arise to
insufficient budget causing incapability to accommodate basic needs resulting to a low
capacity to rehabilitate themselves, poor hygiene or even severe illnesses.

This low unemployment rate can be lessened by conducting livelihood projects like
rug making and bag making for the target respondents. Government agency can also attend to
this to this problem by providing free trainings and vocational courses to orient the
respondents about the work they chose. Cooperative relationships and actions of both the
community and health team would be necessary to achieve a healthy lifestyle.

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 Table 4
Percentage Distribution Showing the Types of Occupation
of Earning Individuals in Barangay 394, Zone 40,
District III of Manila as of July 7, 2009

Occupations Frequency Percentage

(f) (%)
Blue-collar
Vendor 20 48.78%
Driver 8 19.51%
Worker (Construction, Factory) 3 7.32%
Police 1 2.44%
Embalmer 1 2.44%
Rubber Stamper 1 2.44%
Service Crew 1 2.44%
White-collar
Nurse 2 4.88%
Government Employee 2 4.88%
Real Estate Agent 1 2.44%
Pink-collar
Florist 1 2.44%
Total 41 100%

Analysis and Interpretation:

Table 4 shows the percentage distribution of the types of occupation that the earning
individuals have. Majority of the respondents are vendors having a percentage of 48.78. On
the other hand, the least types of occupation all have 2.44% include the Police, Embalmer,
Florist, Real Estate Agent, Rubber Stamper, and Service Crew.
The occupations are categorized under blue, white, and pink collar. First, a blue collar
worker is a member of the working class who performs manual labor and earns an hourly
wage. Their work may be skilled or not, and may involve construction trades, mining,
manufacturing, mechanical work, and maintenance operations. Majority of our respondents
are under this category, like the vendors and drivers. They are prone to diseases, which can
easily be transferred by physical contact because they are exposed to many different people.
The same thing goes with the drivers; there are also physical contacts with other people. In

21
addition, they are more likely to get involved in a vehicular accident. Their working
environment is exposed to different kinds of pollution, such as noise and air pollution, which
can lead to ear problems and respiratory diseases. There are also several construction and
factory workers in the community. They are doing very heavy works that may cause body
pains and fatigue. Their work may also cause accidents and Upper Respiratory Infections
(URI). Blue-collar jobs also include the embalmer, who is prone to inhaling fumes and
chemicals used in their job. Another occupation under the blue-collar job is the field police in
which their lives are always at risk. They are mostly involved in shootouts, in protecting the
citizen, and in chasing down the criminals, which may lead to major wounds in the body.
There is also a service crew in the respondents. Their work is mostly subjected in cleaning
their working place. They may also have physical contact with their customers. These blue-
collar works, in general, are exposed to unfavorable and dirty areas, and have physical
contact with different people. So, the health care providers may promote programs like
“communicable disease control”, proper hygiene, and sanitation techniques. Second, a white-
collar worker refers to an educated worker or a salaried professional who performs semi –
professional office works, administrative and sales coordination tasks. This category includes
the nurses. They are more prone to health threatening diseases because they have contact
with the patients. Since they know that their health is at risk in their profession, they may do
preventive measures so that the disease of the patient will not be transferred to them. There is
also a real estate agent who is always in contact with various types people especially when
dealing with different clients. This member of the blue-collar job is also exposed to health
threatening diseases especially those infectious ones. Since they are less aware of their health
than nurses are, they must be specified by the necessary health information regarding the
probable illnesses that they may acquire. Lastly, a pink collar worker is employed in a job
that is considered to be a female occupation. The term arose to distinguish women in pink
collar works from white collar works because their work did not require as much professional
training. In this job, the workers are women, so the health care providers may suggest or
conduct maternal programs as well as programs concerning hygiene. And in the case of the
florist, she must also be aware if she has any allergy or other flower-pollen related illnesses
so that she can cope with her situation accordingly.

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 Table 5
Percentage Distribution Showing the Average Income of Earning Individuals
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Income Per Month Frequency Percentage

(Php) (f) (%)
< 1,000 5 12.20%
1,000 - 2,999 6 14.63%
3,000 - 4,999 14 34.15%
5,000 - 6,999 10 24.39%
7,000 - 8,999 1 2.44%
9,000 - 10,999 3 7.32%
11,000 - 12,999 0 0%
13,000 - 14,999 1 2.44%
15,000 above 1 2.44%
Total 41 100%

Analysis and Interpretation:

Table 5 shows that about sixty percent of the earning respondents have a monthly
income not greater than five thousand pesos (Php 5, 000); this implies that most respondents
are considered to be below the poverty line, while only about 39% of the respondents are
considered to be above the poverty line. Falling below the line, most of them do not receive
the right amount of money needed to comply with their basic needs. Having insufficient
funds to support their daily lives, the respondents cannot afford to spend anymore on their
health and wellness related concerns, thus, they become vulnerable to health complications
such as malnutrition, infections, and certain diseases, while only a few can meet their basic
needs and give attention on health concerns.

Poverty line refers to the cost of the basic food and non- food requirements (valued in
peso). In the Philippine official methodology, the poverty line maybe viewed as the
minimum income required meeting the food requirements and other non- food basic needs.
According to the National Statistical Coordination Board (NSCB), to meet their most basic
food and non- food requirements, a Filipino family consisting of five members should be
earning a combined monthly income of Php 6,195. A breadwinner for a family of five

23
members residing in the NCR (National Capital Region) is expected to have a more difficult
time raising his/ her family above poverty line if he/ she earn at most Php 265 per day. The
National Economic Development Authority (NEDA) gave a parallel assessment of the
country’s poverty line with that of the NSCB. According to NEDA, a Filipino should earn an
income of Php 40. 72 a day or earn Php 14, 866 annually.

Falling below the poverty line most of the community’s earning members struggle to
make ends meet, and there is even a possibility for them to turn to crimes to provide for their
families. In relation to Table 3, for every one hundred productive persons there would be
fifty persons depending on them, but in the community, not all productive individuals are
earning for those depending on them, thus worsening the situation.

In these cases, the earning individuals falling under the poverty line can look for ways
to increase their income such as engaging in part-time jobs, small businesses and livelihood
projects, or even consider education that maybe provided by the community. Another is for
them to cut their expenses, so teachings regarding saving and disease preventions are
important to be given to them.

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 IV.
SOCIO-CULTURAL
INDICES

25
Literacy Rate
No. of pop. 8 years old and above who can read and write
LR = ----------------------------------------------------------------------- x 100
Total no. of pop. 8 years old and above

= 102 x 100 = 99.03%

103

The computation shows that for every 100 individuals under the literacy group, there
is one who is not able to read and write.. This implies that almost all of the people under the
literacy group in the community have the ability to read and write which are the basic skills essential
for education.

As a result, it will be easier for the health care providers, as well as for the health
officials, to render information about health and wellness and to promote preventive
measures against common and chronic diseases. Furthermore, this will also lessen the
mortality and morbidity rates of the community.

Based on the gathered data, one of the respondents does not have any formal
education and he is also illiterate. In order to help him, the community may assist that
respondent in learning how to read and write. In addition to that, the community may also
carry out a program that can help other individuals who are also illiterate and can give
another chance to those individuals who want to continue their studies but are only hindered
by their poverty.

Table 6
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 Percentage Distribution Showing the Educational Attainment of Individuals
(8 years old and above) Surveyed, Barangay 394,
Zone 40, District III of Manila,
as of July 7, 2009

Educational Attainment Frequency Percentage

(f) (%)
No Formal Education 1 0.97%
Elementary Level 13 12.62%
Elementary Graduate 5 4.85%
High School Level 37 35.92%
High School Graduate 26 25.24%
College Level 15 14.56%
College Graduate 6 5.83%
Total 103 100%

Analysis and Interpretation:

Table 6 shows the percentage distribution of the educational attainment of the
respondents 8 years old and above. Majority of them belong to the High School Level,
having a percentage of 35.92. Some of these respondents are currently studying in High
School Level while the others have stopped. Unfortunately, 0.97% of the respondents have
no formal education at all.
Education is a constantly changing phase. Every now and then, there are new ideas
and things that are discovered and modified. If an individual decided not to have any formal
education or not to continue his studies for several reasons, that individual might not enjoy
the benefits of having education and having to learn a lot of interesting things. It is very
important for an individual to have formal education because this will help them understand
the things that are currently happening to the surroundings. A respondent who graduated
from college or who have a higher educational attainment has the possibility of a better
future because they will have a stable work depending upon the course that they had pursued.
This will also make their lives easier because they know how to solve their problems and
they can find a way to provide their basic needs. In the case of the respondents who have
stopped, they should not just rely on the few things that they learned in school. They may

27
actually take up free vocational courses offered by government agencies like TESDA, and
they may join free training for several jobs to help them support their families.

Table 7
Percentage Distribution Showing the Religion of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Religion Frequency Percentage

(f) (%)
Roman Catholic 44 88%

Protestant 4 8%

Iglesia ni Cristo 2 4%

Total 50 100%

Analysis and Interpretation:

The table shows that most of the respondents asked, specifically forty-four or eighty-
eight per cent of them, are baptized Roman Catholics. Eight per cent or four of the
respondents are Protestants and four per cent or two respondents are Iglesia ni Cristo.

All of the respondents are Christians. As Christians, they give big value to the gift of
life. They are more conscious of health conditions particularly because they respect the body
as the Temple of the Holy Spirit. The religion may have influenced how the respondents look
at health problems and how they respond to them. Sometimes, people rely too much on faith.
Christians, particularly, are driven and motivated by this strong faith. Their every action must
not deviate from their common concepts and beliefs and must always be parallel to their
faith. They believe that a Supreme Being or God would heal their health problems either
immediately or in a matter of time to the extent that they neglect consulting professional
help. Certain religious activities of the Catholics affect health conditions like their traditional
celebration of the feasts of saints and patrons in their religion. Fasting is also one of the

28
activities wherein instead of eating their meals, they spend the time meditating, reflecting,
and talking to God. These may cause complications due to deficit or imbalanced diet or
nutritional intake. Programs like Health Education and Nutrition Information could be of
great help to the people living within the community.

Table 8
Percentage Distribution Showing the Place of Origin of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Place of Origin Frequency Percentage

(f) (%)
Luzon 26 52%

Visayas 12 24%

Mindanao 0 0%

NCR 12 24%

Total 25 100%

Analysis and Interpretation:

The table above shows that most of the respondents, fifty-two per cent of the sample
population or twenty-six respondents, are from the provinces of Luzon . Twelve respondents
or twenty-four per cent came from the Visayan region while no respondent is from Mindanao
. Twelve respondents or twenty-four per cent are from the National Capital Region.

A number of respondents are rooted in many different provinces of the country. Most
of them are from the provinces of Luzon . It is observable that the people from Luzon are
inconsiderably stingy. They set a tight budget even for the supplication of their basic needs.
Individuals from the Visayan Region generally are happy-go-lucky people. They have no
restrictions on the food they eat, often disregarding the negative effects of some foods.
Majority of the people residing in Mindanao are Muslims. They have a belief that they

29
should avoid eating pork because pigs are dirty animals according to their religion. They do
not eat just any food but only Halal foods or meat products from animals butchered with
respect.

In general, the Filipinos have practices that they apply in their daily lives. They
sometimes eat with their bare hands. This may cause bacterial infections when proper hand
washing is not performed. Walking barefooted in the house could also cause infections
specially when there are open wounds in the lower extremities of the body. Health Education
emphasizing the proper nutrition, proper treatment and prevention of common diseases could
be considered to be worked out in the community.

Table 9
Percentage Distribution Showing the Length of Residency of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Length of Frequency Percentage

Residency (f) (%)
Below 6 mos 0 0%

6 mos to 1 year 0 0%

1 to 5 years 1 2%

6 to 10 years 6 12%

11 years and
above 43 86%

Total 25 100%

Analysis and Interpretation:

30
 Table 9 illustrates the average length of residency of the respondents in the
community surveyed. It was noted in the table that the bulk, 86%, of the respondents has
stayed at the community for 11 years or more while some even stated that they were already
at the community since their birth. The other respondents have stayed there for some quite
shorter time, like 1 to 10 years, but still long enough to be acquainted to the community.

The lengthy stay of the individuals in the said community provides them with the
necessary knowledge and information about the location and regulations in that region. They
are more familiar about the physical features as well as the common positive and negative
phenomena happening in the community so they are capable of moving to the places that
corresponds to their needs. They are already able to adapt in the environment and able to find
adequate solutions to the constant problems that they are encountering. The respondents have
gained stability in the region then the purpose of the community would just be the uplifting
of such stability to a much higher standard. It would be easier since the people are well
informed about their resources and their possible resolutions for the betterment of the
community. General meetings and community conferences aiming for the majority’s good
may be of great help not only for the betterment of the barangay as a whole but also for the
individual family’s good. With the known information by the residents about the region, their
individual initiatives and right plan of the group, the community could enrich the
neighborhood and make the most out of all their resources.

In line with the community’s health status, the community most likely has the idea
about the different health services that are being offered by the health team. So for the part of
the heath personnel, it would be a lot easier to give the free services offered by the team since
the people are aware of their privileges while for the part of the individuals, they already
know where to go in times of health need and assistance. The relay of health information
will be a lot easier for well-oriented individuals but still the health team must still be readily
accessible and outreaching for everyone to promote healthy and well living.

Table 10

31
 Percentage Distribution Showing the Types of Housing of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Types of Housing Frequency Percentage

(f) (%)
Makeshift 0 0%

Light 16 64%

Strong 1 4%

Mixed 8 32%

Total 25 100%

Analysis and Interpretation:

Sixteen families who comprise sixty-four per cent of the sample population have
houses built of light materials. One family, four per cent, has a house built with strong
materials, concrete and with strong walls and posts. Eight families, or thirty-two per cent,
have houses of mixed materials, wood and blocks, while no family is living in a makeshift
house.

The purpose of a house is to provide shelter to the residents. An ideal house is one
made of strong materials like blocks and bricks. A house made of light materials can not
efficiently protect the residents from harm. The roofs may not be able to stand heavy rains,
the walls may easily give in, and the house itself might collapse any time. Since the type of
housing is weak, the residents would be more vulnerable to diseases and health
complications. Moreover, when houses made of wood start a fire, it would most likely spread
to the neighboring houses; thus, the whole community would suffer loss of properties and
even physical injuries. On the other hand, living under strong houses gives residents comfort
and ease even during heavy rains or other calamities. The danger is, these strong materials
used for the house could collapse at an earthquake. This could also cause serious physical
injuries because such materials are heavy.

32
 Table 11
Percentage Distribution Showing House Ownership of Families Surveyed,
Barangay 394, Zone 40, District III of Manila
as of July 7, 2009

Ownership Frequency Percentage

(f) (%)
Rent-free 25 100%

Owned 0 0%

Rented 0 0%

Total
25 100%

Analysis and interpretation:

Of the 25 families interviewed, 100% responded that their shelters are all rented free.
According to the local officials of Brgy.394, the land where the target area is located is
owned by the government. Under the “Urban Land Reform and Housing” section of the
Philippine Constitution, the government must provide shelter especially to the poor and
deserving citizens as part of social justice in the country. In this case, the City of Manila has
provided not actually a shelter, but an area where the said families can stay.

It is really advantageous on the part of the target residents to have a free place to be
called their home. Instead of spending money in renting a house, they can add it up on their
budget to further meet the basic needs of their families. It will be a burden for such indigent
citizens to purchase or rent a house to live at, especially most of them have unstable and
some have no job at all. It is, indeed, that through the privilege given to the residents of
Brgy.394, the families can save more money and at the same time, they can afford to supply
their everyday needs. They don’t need to worry for paying a house rent but instead, they will
be more focus on fulfilling their necessities in life.

Based on Table 10, the house structures of most residents are made of used lumbers
and light materials. What further can be concluded is that, despite the fact of having a free
area to live at, the structure of their houses do not provide quality living. Therefore, the
33
government should not only provide a location for such indigent families but as well as
quality and efficient place to be called a home

Table 12
Percentage Distribution Showing Ventilation of Houses of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Ventilation Frequency Percentage

(f) (%)
Adequate 8 32%

Inadequate 17 68%

Total 25 100%

Analysis and Interpretation:

This table shows the percentage distribution of the kind of ventilation that the houses
of the respondents have. Based on the given data,, 68% of the respondents have inadequate
ventilation in their houses while only 32% have adequate ventilation.

Ventilation is the circulation of air in an area. In houses with adequate ventilation, the
air can enter and go out easily because there are enough windows and air passages. The
respondents who are residing in these houses may feel relax and comfortable. On the other
hand, the respondents who are situated in a house with inadequate ventilation may feel more
tired, stressed, and not at ease because the temperature inside the house is above the normal.
Furthermore, it is said that viral contamination spreads rapidly in a closed environment.
Since majority of the respondents have houses with inadequate ventilation, there is a high
risk of disease spread inside their houses. This is due to the lack of air circulation inside the
house. Therefore, the virus is trapped inside and cannot find a way to go out.

34
 In order to help these respondents, the health care providers may start several
programs which include proper hygiene, sanitation techniques, and communicable disease
control to prevent the spread of disease.

35
 V.
ENVIRONMENTAL
INDICES

Table 13
Percentage Distribution Showing Water Supply of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

36
 Level Frequency Percentage
(f) (%)
I. Point Source 0 0%
II. Communal Faucet System or Stand post 0 0%
III. Waterworks System 25 100%
Total 25 100%

Analysis and Interpretation:

Table 13 shows that one hundred percent of the respondents get their water supply
from water works systems. Since they get their supply from water systems, there is quality in
the kind of water reaching them. It would be more accessible and requires less effort than
point sources or stand posts since water runs through the systems almost all the time. On the
other hand, one disadvantage of water systems is that if there would be leaks in the pipes,
there would be contamination of the water used by the community, and it would take a lot of
time and resources to fix it.

In the area the residents store water in exposed and unclean areas. This kind of
storage makes their supply vulnerable to external harmful factors such as disease- causing
microorganisms. Because of this, the residents are very much at risk for water- borne
diseases and water related dermatological problems.

Water is one of life’s necessities. It is primarily used for drinking and cleaning. In
order to avoid problems concerning water, it would be best to make sure that the water you
will be using is clean or potable if for drinking, and keep its storage area clean and away
from contamination. For the community, maintenance of pipelines should always be
observed, and the reporting of leaks in the pipeline is necessary to prevent contamination.
Boiling and chemical disinfection of water should also be done in order to eliminate the
possible presence of microorganisms in water, thus, being sure of its quality and purity. For
the benefit of the respondents, health teachings about their water should be rendered so that
they can have the necessary information in treating and using water.

37
 Table 14
Percentage Distribution Showing Excreta Disposal of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,
as of July 7, 2009

Excreta Disposal Frequency Percentage

(f) (%)
Level I Pit Latrine 2 8%
Level II Pour Flush Toilet 22 88%
Level III Flush Toilets 0 0%
Balot System/ Wrap and Throw 0 0%
Others ( hole to the river) 1 4%
Total 25 100%

Analysis and Interpretation:

Table 14 shows the types of excreta disposal and the number of families using such
kind of systems. The table shows that 88% (majority) of the respondents have level II pour
flush toilet for their excreta disposal but a more alarming data is its absence of any level III
flush toilets and even the presence of the so-called “hole to the river” system of disposal in
the community.

The presence of “hole to the river” system and absence of flush toilets signifies a poor
excreta disposal management in the community. A poor excreta disposal contributes to a
variety of diseases that may be due to the actual stool or the environment where in the stool
was disposed. The primary concern of the community would be the prevention of the spread
of such diseases. Although it cannot be made that every house should have a flush toilet, the
health center could help to stop or minimize the use of “hole to the river” system in the
community through teaching the proper heath information about the importance of proper

38
excreta disposal for a healthy and clean living. Lectures about the proper means of disposing
excreta and about the adverse effects concerning health rooted to the incompliance to such
may be offered by the health personnel to give emphasis to the importance environmental
hygiene. As a community, the members of the population may also gather up and form a
group or an ordinance prohibiting the use of such kind of waste disposal. Through this and
the individual initiatives of the members of the population, the use of mentioned excreta
disposal will slowly be wiped out of the community, thus promoting a better environment
that is essential for a healthy community.

As for the majority who are using pour flush toilets, the importance of frequent and
proper hand washing is the focus of the community. The absence of a direct water supply in
pour flush toilets makes it prone to dirt and bacteria, which can easily cause diseases,
especially those concerning the digestive track, when ingested. To avoid the spread of fecal-
oral diseases are common to such kinds of toilets, hand-washing demonstrations and
teachings may be implemented in as a program in the community. Health seminars may be
conducted in the community to increase their awareness about the importance of hygiene to
their health and how hand washing could decrease the possibility of acquiring gastrointestinal
illnesses.

Table 15
Percentage Distribution Showing Garbage Disposal of Families Surveyed,
Barangay 394. Zone 40, District III
as of July 7, 2009
Garbage Disposal Frequency Percentage
(f) (%)
DPS (Collected) 25 100%

Open Dumping 0 0%

Burning 0 0%

Waste Segregation 0 0%

Total 25 100%

39
Analysis and Interpretation:

In the 25 respondents of Brgy.394, 100% said that their garbage is being collected by
a waste disposal unit. The Republic Act No.9003, “The Philippines Ecological and Solid
Waste Management Campaign” makes way for the creation of organizations such as the
Department of Public Service, which is responsible for the proper management and disposal
of garbage. In line with that is the promotion of Presidential Decree 856, the “Code on
Sanitation.” It is the responsibility of each individual to maintain and observe cleanliness not
only inside their homes but as well as their surroundings. Through proper waste disposal, the
environment is not just only conserved but mostly, the spread of microorganisms and bacteria
causing diseases is being lessened. In the end, any form of violation against the promotion of
a healthy environment must be put into action. Such individuals must be educated and
properly informed about the importance of cleaning the environment.

To have a healthy body is to have a healthy and clean environment. It must be

everyone’s initiative to promote a healthy lifestyle through the maintenance of a surrounding
free from garbage and pollution.

40
 VI.
Health Indices

41
 The health indices reflect the health status, practices, trends, and health problems in
the community. It includes the following indices: first, the food storage which indicates if the
respondents place their food inside the refrigerator, or cover it to protect it from spoiling, or
just leave it exposed. It also gives the importance of food storage to avoid food
contamination. Second, the infant feeding practice, which discusses how the infants are being
fed by their parents. It shows if the infants are being breastfeed, bottle feed (evaporated,
condensed, powdered milk) or used a mixture of both types of feeding. It also discusses the
effects of the type of infant feeding to the susceptibility of the infants to infections and
diseases. Third is the immunization status of the infants among the respondents. In order to
be considered as a Fully Immunized Child (FIC), an infant must able to receive all the
necessary immunizations like BCG, DPT (1,2,3), OPV (1,2,3), HBV (1,2,3) and AMV. It
takes account of the number of children who are fully immunized, and also the reasons why
the respondents were not fully immunized or given immunization. Fourth, the health seeking
behavior of the respondent, which indicates the health institutions where the respondents go
and seek for medical advice and treatment to the health problems that they are encountering.
In addition to that, the main source of health information is also identified in this chapter.
And lastly, a comparative analysis of the 3 leading causes of morbidity at the Mabini Health
Center during the first half of 2008 and first half of 2009 is also discussed and interpreted.

42
 Table 16
Percentage Distribution Showing Food Practice of Families Surveyed,
Barangay 394 Zone 40, District III of Manila,
as of July 7, 2009

Food Storage Frequency Percentage

(f) (%)
Refrigerated 9 36%

Not Refrigerated 16 64%

a. Covered 14 87.5%

b. Exposed 2 12.5%

Total 25 100%

Analysis and Interpretation:

As shown in Table 16, there are nine families or thirty-six percent of the total who
keep their food in refrigerators. On the other hand, sixteen families or sixty-four percent do
not store their food on refrigerators. There is a greater percentage of people who don’t keep
their food on refrigerators – which then heightens the risk of food spoilage and
contamination. In that case, there were fourteen families who stated that they cover their food
though not refrigerated; and the remaining two families keep their food exposed in the open.

The table highlights the need for proper food storage and handling because food
sanitation is not adequate in the community. The food, when contaminated or spoiled, loses
its original nutritional value, texture, and flavor. Thus, the food becomes harmful to people
and unsuitable to eat. This can be caused by bacterial or fungal growth, infestations from
insects or rodents and the temperature of the surroundings. Once the food is not properly
stored, it would lead to an increase in the gastro-intestinal diseases existing in the
community.

In order to promote awareness regarding the right food practice, health lectures and
teachings may be conducted. The residents of the community should take note with the four
simple things to remember when it comes to proper food sanitation - starting with the Right
43
Source. In order to ensure the safety of the food to be eaten, the ingredients like vegetables
and raw meat must be fresh and clean including the water to be used is potable and
decontaminated. Next, the Right Preparation: Hands must be washed thoroughly before
handling food. Then cross-contamination must be prevented – wherein the fruits or
vegetables should not be prepared on surfaces used for the preparation of uncooked meats,
poultry or fish. The preparation surface and the utensils to be used must be clean and
sanitized to prevent contamination. Also, toxic substances should be well labeled and kept
away from the preparation area. Persons with skin infection, open sore or illness should not
handle food to prevent the transfer of disease. Third: the Right Cooking. The food must be
well-cooked to be able to kill the bacteria present in the food to be eaten. In this way, the risk
of food contamination is lessened. Lastly: the Right Food Storage. This is maintaining the
proper food temperature and storing the food in such a away as to keep it clean and safe prior
to the time it will be eaten. The food must also be covered well to prevent vermin entry and
contamination.

In the case of the sixty-four percent who do not store their food on refrigerators, they
should be aware of the amount of food to be cooked for the day. It should be just enough for
the whole family to consume wherein there would be no excesses. In this way, food spoilage
can be avoided and there would be no waste of money and time

Table 17
Percentage Distribution Showing Infant feeding Practice of Families Surveyed,
Barangay 394. Zone 40, District III of Manila
as of July 7, 2009

44
 Type of Infant Feeding Frequency Percentage

(f) (%)

Breast Feeding 0 0%

Bottle Feeding 2 100%

a. Evaporated 0 0%

b. Condensed 0 0%

c. Powdered 2 100%

Mixed 0 0%

Total 2 100%

Analysis and Interpretation:

Table 17 shows that of the two discovered infants in the 25 families surveyed, both
babies are said to be bottle fed. The parents have chosen to feed their babies with
commercially available milk products instead of the best feeding method for infants,
breastfeeding.

Executive Order 51, also known as the “Milk Code” states that “breastfeeding is the
most far reaching and the least costly strategy for the alleviation of poverty.” It provides
nutrients for the infants and is accessible as always. Instead of buying infant formulas,
breastfeeding must be promoted. It is not just favorable on the part of the family since it is
free, but it offers optimum nutrition in children. Infant formulas specifically powdered milk
usually contains pathogenic microorganisms that may disturb the normal body function of
infants. Thus, they must be prepared and used appropriately.

45
 In the case of the respondents, despite the fact that breastfeeding offers both health
and economic benefits, they have chosen to feed their babies with commercially available
infant formulas. They must be educated more on breastfeeding in accordance with R.A.7600,
“The Rooming-In and Breastfeeding Act.” This further encourages, protects and supports the
practice of breastfeeding especially for infants whose age ranges from 0-6 months.

Table 18
Percentage Distribution Showing Immunization Status of Children,
Barangay 394, Zone 40 District III of Manila,
as of July 7, 2009

Antigen Targeted Infants Accomplished Percentage

%
BCG 2 2 100%

HBV1 2 2 100%

HBV2 2 2 100%

HBV3 2 2 100%

DPT1 2 2 100%

DPT2 2 2 100%

DPT3 2 2 100%

OPV1 2 2 100%

OPV2 2 2 100%

OPV3 2 2 100%

AMV 2 1 50%

46
Analysis and Interpretation:

The child is one of the most important assets of the nation and every effort should be
exerted to promote his welfare and enhance his opportunities for a productive and happy life.
This is according to the Presidential Decree 996 which is “Providing for Compulsory Basic
Immunization for Infants and Children below eight years of age” - Wherein, children can be
protected against death, disease, and disability through an integrated and comprehensive
basic immunization program. Together it works with Presidential Proclamation No. 46,
“Reaffirming the Commitment to the Goal of Child Survival Thru Immunization on Polio
Eradication,”; Presidential Proclamation No. 6, “Implementing a United Nations Goal on
Universal Child Immunization by 1990.” and Republic Act 7846, “An Act Requiring
Compulsory Immunization Against Hepatitis-B For Infants and Children Below Eight (8)
Years Old”. Thus, basic immunization shall include: (a) BCG Vaccination against
tuberculosis and leprosy – to be given anytime after birth; (b) DPT Inoculation against
diphtheria, pertussis, and tetanus, (c) Immunization against Hepatitis B, (d) Oral
poliomyelitis immunization - which are all given 6 weeks after birth with one month
interval; (e) AMV or protection against measles to be given on the ninth month; and (f) such
other basic immunization services which is in accordance with the Department of Health.

With the above mentioned statement, mothers should make sure that their children are
Fully Immunized in the given time period and interval – or at the time the infant reaches the
age of one year old.

In relation with Table 18, there are two infants (children 0-12 months), from two
different families in the reference population out of the twenty-five families surveyed. The
eleven month infant was able to receive all the necessary immunizations and therefore
considered as a Fully Immunized Child (FIC). On the other hand, the other infant which is
seven months of age was not yet given the AMV for it shall be given nine months after his
birth.

Table 19
Percentage Distribution Showing Health Seeking Behavior of Families Surveyed,
Barangay 394, Zone 40, District III of Manila,

47
 as of July 7, 2005

Health Facility Frequency Percentage

(f) (%)
Hospital 2 8%

Health Center 22 88%

Clinic 1 4%

Total
25 100%

Analysis and Interpretation:

As presented in table 19 are the health institutions, the respondents seek for their
health and medical concerns. Majority or eighty- eight percent of them go to the health center
to meet their health needs, being the most accessible health provider in the community, while
eight percent go to hospitals, and four percent go to clinics.

The health center, unlike other institutions, provides free health services to the
community, which is very suitable for the respondents since most of them fall below the
poverty line, in accordance with Table 5. One of the advantages of seeking health centers is
that the center could readily implement the programs given by the Department of Health to
the community, which is of advantage to the respondents. The center’s manpower usually
consists of a physician, dentist, nurses, and barangay health workers; together they provide
the services needed by the community.

Providing health services to the communities for free, health centers should be one of
the government’s priorities, since it is one of the institutions directly connected with the
community’s needs. Its facilities should always be maintained and improved as well as its
manpower to bring quality in the services provided to the community.

Table 20

48
 Percentage Distribution Showing the Source of Health Information Of Families
Surveyed, Brgy. 394 Zone 40, District III of Manila,
as of July 7, 2009

Frequency Percentage
Source
(f) (%)
Hospital 0 0%

Health Center 9 36%

Media 16 64%

Total 25 100%

Analysis and Interpretation:

Table 20 shows that sixteen families or sixty-four percent of the twenty-five families
chose the Media as their primary source of health information. This can be through the
television, radio, newspapers and the like. The media is likely the most influential when it
comes to dispersing information to the public and also because of it convenience. The only
conflict is that there is no interpersonal connection between the respondent and the media.
There wouldn’t be consultations and follow-up questions regarding the dispersed
information.

The remaining nine families, which comprises thirty-six percent of the total said that
they get information regarding health issues and concerns in the Health Center. It ranked next
to the Media due its accessibility – the walking distance location from the target population
and the understandable approach and medium of instruction used – of which the residents’
main language is Tagalog and therefore this is the language used by the healthcare providers
in the Health Center to communicate. Thus, an interpersonal connection occurs between the
respondent and the healthcare provider. They are able to give free consultations and
questions that are brought up are answered in the right manner for they are the ones who are
knowledgeable in the specific field. Other means of providing health information in the
Health Center are through posters, flyers, pamphlets, health teachings and seminars. The
poster, flyers and pamphlets, which tackles about new diseases and health issues are posted

49
or distributed to promote health awareness. Likewise, the health teachings and seminars
educate the residents of the community about the early preventive measures, right treatment
and care and to the steady maintenance of health.

Lastly, there are none of the respondents who considered the Hospital as their primary
source of information. They seldom go to hospitals – usually just in cases of the severity of
the diseases and due to its distance and travel time.

Table 21
Comparative Analysis of the 3 Leading Causes of Morbidity at the
Mabini Health Center during January to June of 2008 and
January to June of 2009

Jan – June Jan – June Percent

(2008) (2009) Difference
Diseases Number Number (%)

URI/ Bronchitis 790 719 8.99 %

Diarrhea 50 74 48%

Pneumonia 35 44 25.71%

Figure 21
Comparative Analysis of the 3 Leading Causes of Morbidity at the
Mabini Health Center during January to June of 2008 and
January to June of 2009

50
Analysis and Interpretation:

Table 21 shows the comparative analysis of the top 3 diseases at the Mabini Health
Center from January – June of years 2008 and 2009. First in rank is the Upper Respiratory
Infection which includes Bronchitis. In many cases, Bronchitis develops as a complication of
the common colds. In others, allergy plays a role. Furthermore, exposure to cold environment
without proper clothing or adaptation may lead to Bronchitis. The body resistance is lowered,
and the germs take advantage of the opportunity to break through the productive tissues.
Cigarette smoking is also one of the major factors that contribute to the occurrence of
Bronchitis. There are certain irritants such as coal dust, cotton fibers, and asbestos fibers that
are carried by the air into the lungs that aggravate this disease.

There is an 8.99% decrease of the known cases of URI/Bronchitis from the first half
of 2008 and the first half of 2009. This decrease of number manifests that there is only a
minimal change in the health status of the community since last year. It is possible that there
is a decrease in number of cigarette smoker in the community, the ventilation improved, and
they learned sanitation and hygiene practices that contributed to its decrease. However, these
are not enough to eradicate it in the list of the top 3 diseases in the community.

51
 The health care providers may continue programs for the maintenance of good health.
In addition to that, they may also suggest on providing programs and seminars about the bad
effects of cigarette smoking in the health of the whole community as well as the disease
Bronchitis.

Second in rank is Diarrhea. It is the watery or soft excretion of feces for more than 3
times a day. It is usually caused by eating food and drinking water that are contaminated with
disease germs that came from flies that are common especially during the warm climates.

There is a significant increase of 48% in the number of cases of Diarrhea from

January – June of 2008 to January – June of 2009. Food storage may be one of the factors
that caused the increase. Table 16 shows that 64% do not have refrigerators, thus the food
may get easily spoiled and contaminated. Another factor that may cause diarrhea, especially
in infants and young children, is contaminated milk. Based on table 17, 100% of the parents
of the infants in the surveyed community feed their babies with powdered bottled milk. There
is a high risk of contamination in this activity because of the carelessness in preparing the
milk. In addition, there are cases when spoiled milk is given to the baby, and this can
definitely cause diarrhea. In other children, overindulgence to candy, soft drinks, pastry, or
unripe or overripe fruit may be responsible to diarrhea, while in adults, the cause may be
these or other indiscretions in diet.

In order to help them, the health care providers may start and emphasize
Environmental Sanitation programs, which include “Food and Water Sanitation” program in
the community. The respondents must be educated to promote proper food and water storage.
They must boil their drinking water. However, health care providers prefer breastfeeding for
the first six months of the babies. Moreover, to avoid food spoilage that may further lead to
diarrhea, they must learn to cook food just enough for one meal. The health care providers
may also promote the use of Oral Rehydration Salt or ORESOL which is a kind of drink that
substitutes to the lost water in the body due to diarrhea. If ORESOL is not available, one may
prepare a home made ORESOL using one mixture of one liter of boiled water, 1 tsp of salt,
and 4 tsp of sugar.

52
 In general, the community must be taught about the “hygienic practices” that may
prevent diarrhea as well as other diseases. These include proper washing of the hands before
and after eating, drinking and eating in a clean place, right storage and cooking of food, right
way of disposing garbage, and maintaining a clean environment.

Third in rank is Pneumonia. It is a disease of the lungs in which delicate lung tissue
becomes acutely infected. There is noticeable increase of 25.71% in the number of known
causes of Pneumonia from the first half of 2008 until the first half of 2009. Since most of the
houses of the respondents have inadequate ventilation, the transmission of the viral disease is
easier and thus, contributes to the high number of Pneumonia cases in the community.

In order to decrease the number of cases of Pneumonia in the community, the health
care providers may conduct health teachings about Pneumonia as well as “Communicable
Disease Control” programs. These may also include a lecture about general supportive care
like bed rest, adequate fluid intake, mild diet that is high in protein and vitamins, and
hydrotherapy.

VII. SUMMARY AND CONCLUSION

Community is a social group determined by location, norms, and interests; the

members interact with each other socially and functions collectively to create founding
values and institutions. Health problems inevitably arise within a community. That is why it
calls for the need of a diagnosis. Community Diagnosis is an essential process to undertake in
order to have an understanding about the community’s demographic, socio-economic-
cultural, health resources, and environmental conditions. This would be of big help in
effectively promoting health actions and programs to the community.

After seven days of community exposure, the student nurses have obtained pertinent
data to diagnose and conclude the health conditions of the community. They had found out
that majority of the respondents are single and are dominated by females. The data gathered
also shows that many of them are unemployed and that they economically fall below the
poverty line, most having a monthly income of 3,000-4,999 Pesos. Majority of the employed

53
productive respondents are vendors who are under the blue collar class. The data reflects that
most of the respondents had attended high school and also, most are Catholics. It is shown
that a number of respondents came from Luzon areas and most had lived in the community
for eleven years and above. The houses of all the respondents are rented-free. They are
commonly made of light materials and also have inadequate ventilation. The water of the
respondents is supplied through waterworks system. Most of them also use pour flush toilets
and they dispose their garbage through DPS collection. Regarding their health status, the
gathered data shows that most respondents do not have refrigerators. Furthermore, most
mothers patronize bottle-feeding rather than breast feeding; however, the mothers have had
their children receive complete immunization for their children’s protection. According to the
data of morbidity in Mabini Health Center, the top leading cause of morbidity in the
community is Bronchitis. The student nurses also found out that the respondents seek help
from the health center whenever they experience deviations on their health. Also, the data
shows that almost all respondents receive health information from television and newspapers.

Having collected such data from the community pointing to poor health conditions,
there is therefore a need for the cooperation and interaction of the sectors involved .

The authorities should implement laws and give adequate budget that would support
the delivery of quality healthcare. The health sector should ensure that laws and budget are
being rendered efficiently and the community should respond to the given programs and do
their best to improve and maintain their health. Through the joined effort of the three sectors
it is expected that the condition of the people in the Barangay will be uplifted and therefore
the problems in the community would be diminished.

VIII. PROBLEMS IDENTIFIED

After seven days of exposure, the student nurses were able to assess the condition of
Barangay 394, Zone 40, District III of Manila. The major problems identified in the

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community focused on two aspects, namely: environmental and socio-economic status of the
area.

Environment is an important element in life as it affects every phenomenon and every

action that takes place. The environmental condition, for instance will reflect the possible
health status of each individual. In the study conducted, the student nurses were able to
identify the environmental problems present in the community such as:

1. Insufficient Ventilation. It was seen in the respondents’ individual houses, which are
mainly constructed from light materials without having sufficient passageway for air
circulation. In this case, the people are not able to work efficiently towards
productivity. Furthermore, the lack of enough ventilation would cause rapid
transmission of viral diseases.

2. Poor Hygiene and Sanitation Practices. This is considered as one of the major
problems that needs priority in the community. Despite the free water supply, the
respondents do not observe proper water storage and sanitation with the common
pour flush kind of toilets in the area. Moreover, it is a fact that one of the families
dispose their wastes directly to the river. The residents are not able to practice proper
hygiene efficiently as manifested by the overcrowding of families within a house.

3. Light Structural Foundation of Houses. Safety of the family members is not assured
since their houses are made up of light materials that cannot provide sufficient
protection for the individuals especially in the occurrence of natural disasters.

Likewise, Socio-Economic factors also play an important role in the general condition
of the community. These factors affect the residents’ way of living, one way or another –

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relating with the above mentioned environmental factors. The following are the identified
socio-economic factors in the study conducted:

1. Poverty. This was the observable state in the community studied. With the
said condition, the residents do not have enough money to take care of basic needs
such as food, clothing, and housing. Thus, more problems would arise. Instead of
giving priority to their health needs, they are likely directed to providing their basic
necessities disregarding other important needs.

2. Low Educational Attainment. Most of the residents in the area are

undergraduates. In that case, they do not have permanent jobs and therefore leads to
an increase in the unemployment status of the community.

3. Unemployment. Due to the low educational attainment, there are no stable

jobs and thus resulting to unemployment. With more than half of the population of
the community being unemployed, they have no steady and enough income to suffice
the needs of the family.

4. Health Unawareness. The knowledge of the residents’ regarding the right

health practices are inadequate and are often mislead by wrong health practices. This
is usually caused by their limited range of information – learning merely from what
they only hear or see from other people. Hence, there is a great possibility in
increasing the morbidity rate of the community.

IX. SUGGESTIONS AND RECOMMENDATIONS

Based on the problems identified in the respondents of Barangay 394, the student nurses
recommend further cooperation among the family, community and health officials of the

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government in the maintenance and promotion of both the health and well-being of the
population.

1. Family and Community. Each family must learn to care of themselves chiefly through
the practice of proper hygiene and sanitation. They must focus on the maintenance of
a clean environment to prevent the possible spread of microorganisms that may lead
to different infections and diseases. Being the basic unit of the community, they must
learn to communicate and cooperate with other families; higher organizations and
health teams through the establishment of different beneficial programs that may help
uplift the status of the community.

2. Barangay Health Officials. Giving primary health assistance to the community, they
may implement programs that may help develop the practice of good hygiene,
promotion of well ventilation and proper food preparation. Seminars and health
information dissemination headed by the health care providers will be of great help.
Conducting monthly visits in each barangay to further assess the condition of the
community can also be held.

3. Government. For the government itself, they must provide the sufficient budgets to
the community and health departments to meet the physiologic needs of each
community. It would be better if they could construct income-generating programs to
help the people in their economic deficiencies. They may develop lectures and
seminars concerning the identified problems for the betterment of the community.
The government must focus on increasing the livelihood of the members of the
community so that each family can further meet the basic necessities in life and in the
end, will help promote a healthy living.

4. Health Care Providers. As the ones knowledgeable in the field of providing health
care, the health care providers should always be prepared in times of sickness in the

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community. They must earn the trust of the residents by providing quality healthcare
and doing the best of their abilities. In the health center, they may conduct pre-clinic
lectures every morning before admitting patients to be able to maximize their time in
giving the residents the health information they need. Likewise, they may also
implement programs that would increase the knowledge and awareness of the
residents regarding health issues and concerns.

Pictures of Barangay 394, Zone 40,

District III of Manila

Barangay 394’s Barangay Hall

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 Community’s entrance point

Houses of barangay 394’s surveyed respondents

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One of the sari-sari stores in the community

Layered houses in the community

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Vacant lot beside Guzman College Institute of
Science and Technology

Pipe meters supplying the water of the entire

community

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“Tunnel” formed by compartmented houses

Public toilet found in the community

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Creek found beside the surveyed community

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