PH 186: WORKSHOP ON HEALTH PROJECT PLANNING

Community: Cabalan, Pag-asa Group Members: Ryan Andrew Alfonso, Dieza Atchel Aninao, Ray Anthony Bartolome, Pearl Joy Retiban, Ruth Joy Segovia, Milanny Lace Sison

WORKSHEET 1 COMMUNITY DIMENSION SECONDARILY RELATED TO HEALTH Brief Description of Situation Health Problems and Health-related Area Problems Municipality Barangay Backgrou Founded in 1578 by Initially a sitio of Lifestyle from Spanish and Portuguese nd and Franciscan Missionaries Barangay Linga heritage Setting Initially named as Gained autonomy in 1928 stresses the importance of siesta Pagalangan Officially became a insatiable taste for pork Dubbed as bayang barangay before WWII impractical extravagance when Pinagpala started. celebrating festivities Declared as National Historical Landmark by Geography: Geography and Climate: National Historical Coastal barangay Lack of land productivity Institute on May 17,2000 6 stations: Puroks 1-6 Floods and drought due to seasonal area: 143.10 ha climate. Geography: land: for residential destruction of crops Flat terrain purposes only; the rest Largest proportion of the are idle and unproductive soil is the Calumpang clay has its own river: Total land area: 3120 ha. Bulusukan River Subdivided into 17 barangays which are Climate: further subdivided into 79 type 1 climate: 2 types of puroks seasons (wet and dry) 80 km from Manila rainy days: July to October Surrounded by: sunny days: January to North: Limasawa de Bay April South: Liliw East: Sta. Cruz West: Victoria Climate: type 1 climate: 2 types of

seasons (wet and dry) rainy days: July to October sunny days: January to April

Demogra phy

Geographic distribution Geographic Distribution Geographic Distribution (2006) average growth rate: in relation to the growth rate of the highest: Sta. Clara Sur 3.79% Philippines, the growth rate of Cabalan second: Cabalan population: 5,121 which is higher. last: Bukal are distributed in approx. 1059 families Age-Sex Sructure Age-Sex Structure from the dependency rate, it can be Dependency Rate: 87.29% Age-Sex Structure inferred that the population is young. 53.40% of the popln Dependency rate: There is a high dependency rate but belong to the working age 87.27% unemployment rate is 52% hence the grp 53.40% of the popln majority of the working age group children (0-14 yo) make up belong to the working cannot support their dependents. 43.15% of the total popln age grp only 3.44% are 65 yo and children (0-14 yo) make Ethnic Distribution above up 43.16% of the total There is a risk of incidence of diseases More males than females popln not native to the area because of but the sex ratio is still 1:1 only 3.43% are 65 yo and migrants above Ethnic Distribution More males than females 99% Pure Tagalog but the sex ratio is still 1% Bisaya 1:1 Tagalog is the main dialect At present, there are now Population Density Bicolanos, Ilocanos, 35.79 persons/hectare Pampanguenos etc. Population Density 15.72 persons/hectare

Primary source of livelihood: farming, fishing, employment, and gardening Sources of income: employment in private or government agencies, farming and fishing, selfemployment, remittances from overseas workers and professional practices Presence of waterrefilling stations

Economic Aspect

Primary source of living: duck raising ; catching snails for ducks food Fishing and farming Most common occupation: blue collar jobs (vendor) Other jobs: government employees 1320 residents are unemployed Presence of Card Bank Microfinance and other several commercial industries No medium to large enterprises Common agricultural products: rice, corn, rootcrops, vegetable, fruit trees Most common livestock/poultry: swine, goat, chicken, ducks and cattle Other products: fish, seaweeds, rattan, charcoal or firewood, wild bamboos, candies and handicrafts One elementary school & one day care center present No secondary school Low level of educational

Snails possible source of water based parasites Seasonal availability of snails may affect the duck raising industry High unemployment rate and low level of education may cause scarcity of job opportunities which may lead to insufficient family income and malnutrition of children Absence of larger establishments and investors mean lack of available jobs

Social Aspect

Presence of 21 elementary schools and 3 High schools Total number of enrolled students: 11, 455 (75.32% are in public school)

Rampant unemployment at 52% Inadequate number of teachers Insufficient municipal secondary schools Low level of education Scarcity of job opportunities

Recreational facilities: 24 Basketball courts; 20 playgrounds; cockpit, tennis court, reading center, gym

attainment Only one teacher for kinder classes High number of drop-out cases 50% have telephone lines; 70% have mobile phones major source of info is TV (93%) major form of transportation is tricycles(93%) 19% of households are located along the main road 100% of households have electricity Materials used in house construction: concrete or semi-concrete, some wood, nipa or bamboo Type of houses: most are bungalow type; some barong-barong Average number of persons/household: 5 Crowding index: 3.33 Presence of basketball courts (2), cockpit, playing billiards Presence of Baranggay hall and councils Government Organizations: Tanglaw ng Pagkakaisa, Multipurpose cooperative,

Drug use and drug related crimes are major problems

OTRDEV,KLBL Civic Organizations: Baranggay Development council; samahan ng Kababaihan; Kooperatiba Baranggay based Community Organizations: Bench club; Solo club; Batang Showbiz club Baranggay government: headed by Chairperson; 7 Baranggay council members; 1 Brgy Secretary; 1 Brgy Treasurer Secured by Bantay Bayan: 10 Tanod members According to Community Profile Study: peaceful and crime-free community The major leading source of crimes is drugs.

PH 186: WORKSHOP ON HEALTH PROJECT PLANNING

WORKSHEET 2 COMMUNITY DIMENSION DIRECTLY RELATED TO HEALTH Brief Description of Situation Health Problems and Health-related Area Problems Municipality Barangay Health General Indicators of Status Health 2004 2004 Prevalence of intestinal High prevalence of communicable Prevalence of intestinal parasitism is 2 per 1 000 disease parasitism is 46 per 10 000 Absenteeism and low productivity 2005 Incomplete vital statistics 2005 leading causes of leading causes of death mortality include animal control include myocardial cerebrovascular accident Occurrence of an unusual communicable infarction and Pulmonary and myocardial infarction disease (leprosy) Tuberculosis leading cause of Prevalent food and water-borne diseases leading cause of neonatal morbidity includes Acute mortality rate is stillbirth (6 Respiratory Infection per 1000 deaths) (ARI) leading causes of infant mortality rate include 2006 sepsis neonatorum (22 per leading causes of 10 000), severe mortality include malnutrition (22 per 10 cerebrovascular accident 000), and aspiration and cancer of all types pneumonia (22 per 10 leading cause of 000) morbidity includes Acute

leading cause of morbidity is Acute Respiratory Infection (ARI) Prevalence of intestinal parasitism is 33 per 10 000

Respiratory (ARI)

Infection

2006 leading cause of death includes cerebrovascular diseases leading cause of neonatal mortality rate is stillbirth (13 per 1000) leading cause of infant mortality rate includes aspiration pneumonia (2 per 1000) leading cause of morbidity is Acute Respiratory Infection (ARI) *animal bites constitute majority of the new cases of infectious diseases; there is a case of leprosy *among the notifiable diseases are acute bloody diarrhea, acute watery diarrhea, mumps (twice in males), influenza, chicken pox, herpes zoster Environmental Indices Water Supply

Water Supply

10 Sanidad Accredited

67% of households have level I water supply safe drinking water is a bit of a problem water refilling stations in adjacent barangays alleviate the problem of shortage of drinking water

Contamination of a level I water distribution can lead to an epidemic Procurement of drinking water from water-refilling stations entail extra expenses Lack of safe public drinking water source The presence of unsanitary toilets or the absence of sanitary toilets leads to spread of parasitic infections Lack of sanitary disposal for poultry and piggeries can lead disagreeable odor Lack of wastewater disposal facilities

stations provide safe drinking water No households have access to level III water source Majority have level I water source

Barangay Nutrition Action Plan of 2005 report artesian wells and deep wells as the common sources of drinking water.

Disposing of wastewater to Limasawa Bay can lead to eutrophication

Excreta Disposal

Excreta Disposal

Most of the houses, 84.99%, in Pag-asa have sanitary toilets But still a number have unsanitary toilets or no toilet at all.

Wastewater disposal

Pag-asa has no wastewater disposal facilities Wastewater is disposed in one of two ways through an open canal that ends in Limasawa Bay stagnates in their backyard and allowed to dry.

95.56% of Cabalan households have sanitary toilets, with a majority of water sealed toilets Unsanitary toilets do not exist in the barangay, but a number, 29, still have no toilet at all. Piggeries and poultry industries have no sanitary means of animal waste disposal

Vermin and Insect control

Insects pose no problem Alarming health concern because the food establishments are unregulated and dont follow standards Mobile food stalls have questionable food preparation practices

Vermin and Insect control

Insects pose no problem Protocol procedure is in place the moment dengue cases emerge Kiti-kiti surveys are done, together with larvicidal

procedure. People perform residual spraying for their own protection Mosquito fogging id done when an epidemic, 12 cases occur

Food Establishments

401 functioning food establishments operate in Pag-asa. Majority are sarisari stores barely half of the establishments have health certificates only 13 out of 401 operators are trained barely half of food handlers have health certificates Public market is a few kilometres away, so residence buy food from mobile food stores or carinderias

Solid Waste Disposal

The barangay council suggests segregation, burning, or composting Dumping, burning and composting are a common practice

There is no waste solid collection system in the barangay. An overwhelming majority of households practice unsanitary waste disposal like burning, dumping waste on vacant lots and burying the garbage. Unsanitary waste disposal burning contributes to air pollution dumping produces leachate that contaminate groundwater

dramatic increase in malnutrition food shortage possible increase in nutritional deficiencies inaccessibility to food establishments

Most recent Timbang

Operation

Solid Waste Disposal

A few barangays in Pagasa have their waste collected for them Sanidad survey show 85% of households practicing sanitary garbage disposal like composting, sanitary landfills, etc.

In 2007, the prevalence of malnutrition is 3.90% Among the 616 preschoolers, 3.90% are malnourished. 2.44% are boys and 1.46% are girls.

The rest of the households however practice Food Sources unsanitary garbage disposal Farming, poultry raising, and fishing are the main Food and Nutritional means of livelihood. Indices Most commonly produced foods are sitaw, rice, Most recent Operation gabi, and chicken. Timbang Candies are also popular especially espasol, Had a malnutrition average pastillas, and yema. of 6.37% 5759 preschoolers in the 17 barangays were weighed Food Production 656 or almost 11% are Main sources of food malnourished supply are the sari-sari Nutrition Status: store and market. Very low- 0.56% Low 9.62% Normal 88.61% Nutritional Deficiencies Above Normal 1.22% Secondary and tertiary malnutrition Food Sources Household Food The public market is only a Expenditures few kilometres away from Most of the families the municipality. spend Php100.00 for Farming, fishing, and food. gardening are the main sources of livelihood. The most common Usual Food or Nutritional products of fishing are Practices tilapia, mudfish, kanduli, Fish and vegetables are mamalit, and shrimp. the popular food eaten by the residents. Food Production

Fresh food from food stores Cooked food carinderias

mobile from

Nutritional Deficiencies Malnutrition

2 medical technologists and 2 doctors in rural health unit one midwife assigned in the northern area of Pagasa

Health Manpowe r

All 6 puroks have two barangay health worker except in purok II wherein only one BHW is assigned Two Barangay Nutrition Scholars are assigned in the whole barangay RHU doctor visit the Barangay Health Station (depending on the sched of the doctor and the workload in the RHU)

Inadequate health workers People who sick may not be attended to properly and efficiently.

Health Facilities

No established hospital present There are seven private medical, four dental, and three rehabilitation clinics. RHU: municipality is provided with one RHU, situated in Brgy. Bulilan Norte. It

No RHU present One barangay health unit

No hospital for admission of patients with severe conditions

branches out to 17 barangay health units, one in each barangay.

equipments: 4 weighing scales found in the timbangan section; 2 microscopes, 2 centrifuges, 1 hemocytometer and 1 microhematocrit centrifuge found in the laboratory; 1 computer and 1 typewriterin the Sanidad section; 1 dentists chair in the Public Health Dentists Room; one computer in the Municipal Health Office; and 4 beds, stethoscopes, 2 detecto, 1 saulter type of scale, 2 televisions and 2 VHS players for the whole RHU.

Collaborat ion for

Health

Nutritional interventions done by GOs and NGOs

Nutritional interventions done by GOs and NGOs

General Operation Timbang among preschoolers Garantisadong Pambata 2006

General Operation Timbang Mass Feeding of rice with Vitamin A

Health Programs Agencies and Red Cross Agencies STD Clinics, Anti-Rabies Control Unit Infectious Diseases Unit Provincial Population Office (Family Planning) Programs Safe Motherhood and Family Planning Child Care Immunization Child birth Healthy Lifestyle Prevention and control of Infectious Diseases Environmental Health Services Food, Water, and Vermin Control Solid Waste and Human Excreta Garantisadong Pambata 2006

Programs only nutritional programs are being implemented such as the Operation Timbang and Mass Feeding of rice with Vit. A Staffing pattern: all 6 puroks are assigned with: 2 BHWs, 1 only in Purok II 2 BNSs for the whole barangay a doctor who visits the station depending on the schedule and the workload in the RHU

insufficient health programs for Cabalan the doctor is not always available absence of health agency in Cabalan low budget for health

all children 12-59 months were given vit. A 200,000IU 2x a year all pregnant women from 1st month of pregnancy up

in Cabalan, majority of the health workers present are the active BHWs (92) and the trained birth attendants (39). There are a little number of other health officials (medical technologists, dentists,etc.) present in the community. There is no health agency

to one month after delivery are given ferrous sulfate tablets (iron preparation) Staffing pattern: 1 midwife assigned in the Northern area of Pag-asa, covering 4 barangays (Labuin, Cabalan, Tubuan, Aplaya) with a ratio of 1: 10 677

in Cabalan. For Cabalan: 7% of the total budget of the barangay or P18,000 is allotted for health

PH 186: WORKSHOP ON HEALTH PROJECT PLANNING

WORKSHEET 3 PROBLEM CLASSIFICATION Existing or Potential? Problems Identified Existing Potential 1. Lifestyle from Spanish and Portuguese 2. Lack of land productivity 3. Floods and drought due to seasonal climate 4. In relation to the growth rate of the Philippines, the growth rate of Cabalan is higher. 5. There is a high dependency rate. 6. There is a risk of incidence of diseases not native to the area because of migrants 7. Seasona l availability of snails may affect the duck raising industry 8. High unemployment rate 9. Absence of larger establishments and investors mean lack of available jobs 10. Inadequate number of teachers 11. Insufficient municipal secondary

Health Status

Type of Problem Health Service

Others

schools 12. Low level of education 13. Drug use and drug related crimes are major problems 14. High Prevalence of Communicable diseases 15. Absenteeism and low productivity 16. Incomplete vital statistics 17. Lack of animal control 18. Contamination of a level I water distribution can lead to an epidemic 19. Occurrence of unusual communicable disease like leprosy 20. Prevalent food and water-borne diseases 21. Procurement of drinking water from water water-refilling stations entail extra expenses 22. Lack of safe public drinking water source 23. The presence of unsanitary or the absence of a toilet can lead to spread of parasitic infections 24. Lack of sanitary disposal for poultry and piggery waste can lead to disagreeable odor

25. Lack wastewater disposal facilities 26. Disposing of wastewater to Limasawa de Bay can lead to eutrophication 27. Alarming health concern because food establishments are unregulated and do not meet health standards 28. Mobile food stalls have questionable food preparation methods 29. There is no solid waste collection system in the barangay 30. An overwhelming majority of house practice unsanitary waste disposal like burning, dumping on vacant lots, and burying 31. Dramatic increase in malnutrition 32. Food shortage 33. Possible increase in nutritional deficiencies 34. Inaccessibility of food establishments 35. People who sick may not be attended to properly and efficiently. 36. Inadequate health workers 37. Insufficient health programs for Cabalan

36. The doctor is not always available 37. Absence of health agency in Cabalan 38. Low budget for health 39. No hospital for admission of patients with severe conditions