V.

FILIPINO CULTURE, VALUES, AND PRACTICES IN RELATION TO MATERNAL

AND CHILD CARE.
Chapter Outline
1. Nursing Care Planning to Respect Cultural Diversity
2. Myths and Beliefs related to Pregnancy
Birth practices of Selected Cultural Groups

I. LEARNING OUTCOMES

At the end of this chapter, the students are expected to:

1. Customize nursing interventions for mothers and children based on Philippine

culture and values.
2. Demonstrate caring as the core of nursing, love of God, love of country, and
love of people in the care of mother and child.
3. Manifest professionalism, integrity and excellence.
4. Project the positive professional image of a Filipino Nurse with respect to
cultural diversity.

II. LEARNING CONTENT

NURSING CARE PLANNING TO RESPECT CULTURAL DIVERSITY

CULTURAL DIVERSITY -the existence of a variety of cultural or ethnic groups within a

society.

Cultural Diversity is the quality of diverse or different cultures as opposed to

monoculture, the global monoculture or homogenization of cultures, akin to
cultural decay. Also refer to having different cultures respect each other’s
differences.
Culture- is a view of the world and a set of traditions that a specific social group uses
and transmits to the next generation.

Cultural Competency Terminology for Nurses

Cultural values- are preferred ways of acting based on those traditions.

Ethnicity- refers to the cultural group into which a person was born, although the term is
sometimes used in a narrower context to mean only race.

Race- refers to a category of people who share a socially recognized physical characteristic.

Actions that are not acceptable to a culture are called taboos. Three taboos that are
universal are murder, incest, and cannibalism. Issues such as abortion, robbery, and
lying are controversial because these are taboos only to some people, not to everyone

Cultural values are formed early in life and strongly influence the manner in which
people plan for childbearing and childrearing, as well as the way they respond to health
and illness (Whitley & Kirmayer, 2008).
Cultural Destructiveness- Making everyone fit the same cultural pattern, and excluding
of those who don’t fit—forced assimilation. Emphasis on differences and using
differences as barriers.
Cultural Blindness - Do not see or believe there are cultural differences among people.
Everyone is the same.
Cultural Awareness- Being aware that we all live and function within a culture of our
own and that our identity is shaped by it.
Cultural Sensitivity- Understanding and accepting different cultural values, attitudes,
and behaviors.
Cultural Competence - The capacity to work effectively and with people, integrating
elements of their culture—vocabulary, values, attitudes, rules, and norms. Translation of
knowledge into action. Cultural competence, also known as intercultural competence, is
a range of cognitive, affective, and behavioral skills that lead to effective and appropriate
communication with people of other cultures. Intercultural or cross-cultural education are
terms used for the training to achieve cultural competence

Acculturation -refers to the loss of ethnic traditions in this way.

Acculturation is the transfer of values and customs from one group to another.
Example: Japanese people dressing in Western clothing. The modification of the culture
of a group or individual as a result of contact with a different culture.

Cultural assimilation -means that people have adopted the values of the dominant
culture.
• A child sees a new type of dog that they've never seen before and
immediately points to the animal and says, "Dog!"
• A chef learns a new cooking technique.
• A computer programmer learns a new programming language

Ethnocentrism- belief that one’s own culture is superior to all others. Ethnocentrism
can lead to prejudice (believing that some people are less than others based on their
physical or cultural traits) because the feelings and ways of other cultures cannot be
understood or appreciated without the philosophy that the world is large enough to
accommodate a diversity of ideas and behaviors and that there is probably no “best”
way to accomplish anything. Discrimination is the act of treating people differently based
on their physical or cultural traits.
Example: in culture is the Asian cultures across all the countries of Asia. Throughout
Asia, the way of eating is to use chopsticks with every meal. These people may find it
unnecessary to find that people in other societies, such as the American society, eat
using forks, spoons, knives, etc.
Cultural competence, or respecting cultural differences, allows you to plan culturally
competent care and the integration.
Cultural differences occur not only across different ethnic backgrounds but also different
lifestyle behaviors such as drinking alcohol or smoking cigarettes (Angstman et al.,
2007).
Differing cultural values can be a major source of conflict between parents and children
as children see opposing values in friends and school peers. Nurses can be
instrumental in helping relieve this type of conflict by always including a cultural
assessment at a health care visit (Gound et al., 2007). Diversity means there is a
mixture or variety of lifestyles and beliefs in a population.

Nursing Process
Area of Assessment
Ethnicity
Communication
Touch
Time
Occupation
Pain
Family Structures
Male and Female roles
Religion
Health beliefs
Nutrition
Community

Nursing Diagnosis
1. Powerlessness related to expectations of care not being respected
2. Powerlessness related to sociocultural isolation
3. Impaired verbal communication related to limited English proficiency
4. Nutrition, less than body requirements, related to unmet cultural food
preferences
5. Anxiety related to a cultural preference for not bathing while ill
6. Fear related to possible discrimination related to ethnicity

Planning
The plan of care may include arranging for variations in policy, such as
1. the length of family visiting hours,
2. types of food served, or
3. type of childcare provided.
Such planning is beneficial not only because it can make health care more
acceptable to a child or family but also because it can motivate providers to examine
policies, question the rationale behind them, and initiate more diverse care.

Implementation
Appreciate that cultural values are usually unchangeable.
1. to make arrangement for a new Native American mother to take home the placenta
after birth of her child if that is important to her
2. planning home care for a Chinese American child whose family believes in herbal
medicine.
3. to establish a network of health care agency personnel or personnel from a nearby
university or importing firm to serve as interpreters.
4. to educate a child, family, or community about the reason for a hospital practice.
 There may be situations in which the health care provider or agency is unable to
adapt to the particular cultural situation. This may call for both sides to adjust (cultural
negotiation).

Outcome Evaluation
1. Parents list three ways they are attempting to preserve cultural traditions in their
children.
2. Child states she no longer feels socially isolated because of cultural differences.
3. Family members state they have learned to substitute easily purchased foods for
traditional foods unavailable in local stores to obtain adequate nutrition.
4. Child with severe hearing impairment writes that he feels communication with
ambulatory care staff has been adequate.

Sociocultural Assessment
Almost all nations also have minority or disadvantaged groups—groups not
necessarily fewer in number but who hold less power and wealth. When assessing
families regarding whether there are socioeconomic or cultural influences that will
make special considerations of care necessary, several categories of information
related to the structure (composition) and function (roles and actions) of a family can
be examined.
1. Communication Patterns
2. Work and School Orientation
The predominant culture in the United States stresses that everyone should
be employed productively (called the Protestant work ethic) and that work
should be a pleasure and valued in itself (as important as the product of the
work).
3. Family Orientation
Family structure and the roles of family members are other lifestyles that are
culturally determined. In most cultures, the nuclear family (mother, father, and
children) is most common. In other cultures, extended families (nuclear family plus
grandparents, aunts, uncles, and cousins) and single-parent families (one parent
and child) may be more common.
4. Male and Female Roles
In most cultures, the man is the dominant figure. In such a culture, if approval for
hospital admission or therapy is needed, the man is the one to give this approval.
5. Religion
There are wide variations in religious practices, and many of these are culturally
determined. Because religion guides a person’s overall life philosophy, it influences
how people feel about health and illness, what foods they eat, and their preferences
about birth and death rituals (Miklancie, 2007).
6. Health Beliefs
Health beliefs are not universal. For example, most people are familiar with the
current controversy about whether male circumcision is necessary. More surprising
to many people is a belief that female circumcision (amputation of the clitoris and
perhaps a portion of the vulva) is thought to be necessary in some cultures (Braddy
& Files, 2007).
7. Nutrition Practices
Foods and their methods of preparation are strongly culturally related. In many
instances, people cannot find any food on a hospital menu that appeals to them
because of cultural preferences. A Japanese diet, for example, includes many
 vegetables such as bean sprouts, broccoli, mushrooms, water chestnuts, and
alfalfa.
8. Pain Responses
A person’s response to pain is a final category that is both individually and culturally
determined (Jacob et al., 2008). Although all people may have the same threshold
sensation (the amount of stimulus that results in pain), their pain threshold (the
point at which the individual reports that a stimulus is painful) and pain tolerance
(the point at which an individual withdraws from a stimulus) vary greatly.

Strategies to help recognize cultural influences on pain perception are to

1. appreciate that the meaning of pain varies among cultures,
2. appreciate that not all people communicate or express their level of pain in the
same way.
3. recognize that communication of pain may not even be acceptable within a
culture, (d) develop an awareness of your personal values and beliefs and that
they may affect how you respond to people in pain, and
4. use an assessment tool, such as a 1-to-10 scale, to assist in measuring pain
so you are certain that you are being as objective as possible (Giger &
Davidhizar, 2008).

MYTHS AND BELIEFS RELATED TO PREGNANCY

1. “Paglilihi” or Pregnancy Cavings.

2. Post-labor Stomach binding
3. Eating twin bananas can lead to twin babies
4. “Usog” or the Stranger’s devil’s eye

Other Myths and Facts Related to Pregnancy

MYTH 1: “’Pag matulis ang tiyan ng nanay, lalaki ang anak. ’Pag mabilog naman, babae.”
FACT: Belly shape is merely an indication of the baby’s position inside the uterus or baby’s
movements as he develops.

MYTH #2: “Ang laki ng ilong mo! Babae ’yan.”

FACT: Physical changes are normal—regardless of whether they’re expecting a boy or a girl.

MYTH #3: Did you say severe morning sickness? Congratulations, you’re having a girl!
FACT: A Swedish study found that 56 percent of women who suffered from severe nausea and
vomiting of pregnancy (NVP) gave birth to baby girls, though many obstetricians argue that the
percentage is too small to confirm the link between morning sickness and female fetuses. So yes,
you may have a slightly bigger chance of having a girl if you’re experiencing unbearable NVP, but
44 percent is still enough to prove you wrong.

MYTH #4: “Nangingitim ba ang kili-kili at leeg mo? Ah lalaki ‘yan!”

FACT: “Hyperpigmentation has absolutely nothing to do with the baby’s gender,” confirms Dr.
Nucum.

MYTH #5: You’ll twist your child’s umbilical cord around his neck if you hang a towel over your
shoulder.
FACT: Entanglement or cord coil is not in any way related to hanging a towel over your shoulder.

MYTH #6: “Huwag kang uminom ng malamig o maligo sa gabi. Magkaka-sipon ang anak mo.”
 FACT: Babies can’t develop a cold while inside the womb. The amniotic fluid helps stabilize the
temperature, so he doesn’t feel the difference if you’re hot or cold.
“Pregnant women feel [warmer] because they undergo a lot of metabolic changes due to the
increasing demands of the fetus. For this reason, they are all the more advised to take regular
baths,” says Dr. Nucum.

MYTH #7: “I watched Leonardo di Caprio movies all throughout my pregnancy, so I know my
baby will be tisoy, gwapo, and talented!”
FACT: A pregnant woman’s pinaglilihian will not affect her baby’s physical appearance. A baby’s
looks are developed from the parents’ DNA.

MYTH #8: “Kung mahaba ang buhok mo, mahihirapan kang manganak.”
FACT: “Delivering a baby is affected by a lot of factors that may be summed up by the three P’s:
the ‘passenger,’ [which is] determined by the size of the baby, the ‘passage,’ [or] the adaptation
of the fetus to the mother’s bony pelvis, and the mother’s ‘push.’”

MYTH #9: If you’re giving birth at home, lie down with your legs facing the door. The bigger the
door, the easier it will be for you to give birth.
FACT: Just remember the three P’s.

MYTH #10: A baby born at nighttime will stay awake during the evening. So when giving birth, try
to hold it until the next morning.
FACT: Newborns are usually asleep 90 percent of the day, and their sleeping patterns continue
to vary as they grow older.

MYTH #11: More pregnant women experience labor pains or give birth when the moon is full.
FACT: There is no scientific truth to this claim.

III. LEARNING TASKS

Critical Thinking Exercises: GROUP ACTIVITY

1. Bontisa, primigravida, a CM (cultural minority), states that before coming to
the clinic she wants to visit an albularyo, who will both predict her child’s sex
and guarantee a safe birth. Would recommending that she have a sonogram
(which also could predict the fetal sex) likely be as satisfying for her?
2. Mashakit is a vegetarian for religious reasons, in her meal tray for lunch is
humburger. What would be your best action? Insist her to eat because she
needs protein for healing? or ask a replacement of food of her choice?
3. Mr. Photol family tells you that Maddi’s accident that caused her broken arms
was “God’s will,” and not Maddi’s fault. Would it be best to educate Maddi
about street safety, or would doing so interfere with the family’s cultural
beliefs?

IV. REFERENCES

Flagg, JoAnne Silbert, Pilliteri, Adele. (2018). Maternal and Child Health Nursing.
Care of the Childbearing and Childrearing Family. 8th Edition. Wolters
Kluwer/Lippincott Williams and Wilkins, Philadelphia, New York.

Pilliteri, Adele. (2014). Maternal and Child Health Nursing. Care of the
Childbearing and Childrearing Family. 7th Edition. Wolters Kluwer/Lippincott
Williams and Wilkins, Philadelphia, New York.
 http://filipinonurses.org/index.php/2012/03/five-shocking-health-myths-that-most-
filipinos-believe/
http://healthaspect.wordpress.com/tag/craving-paglilihi/
http://www.health.qld.gov.au/multicultural/health_workers/filipino-preg-prof.pdf )
http://www.babycenter.in/x1049750/will-using-a-corset-or-tying-a-cloth-around-
my-stomach-help-it-regain-its-pre-pregnancy-shape
http://www.huggies.com.ph/pregnancy-myths-facts.aspx

VI. MATERNAL and CHILD CARE ENTREPRENEURIAL OPPORTUNITIES

Introduction

Previously, the maternity care and birthing clinic operations in the country are
only given to doctors and midwives but not nurses, who pass rigid four-year health
care courses and are required to pass a nursing licensure examination. The
Department of Health (DOH) has finally allowed registered nurses as among the
healthcare providers who can own, manage and operate birthing clinics and facilities.

I. LEARNING OUTCOME

At the end of this chapter, the students are expected to:

1. Identify opportunities for intrepreneurial nursing practice in maternal and child care.
2. Apply strategic interventions to address health-related concerns of mother and child.

II. LEARNING CONTENT

Rosendo Sualog of the DOH-Health Facilities and Services Regulatory Bureau

(HFSRB) said the new policy seeks to drastically reduce mother and child mortality
rate due to lack of birthing facilities in various areas in the country.

“Nursing birthing clinics is now within the reach of every nurse, within the reach of
every community, within the reach of every mother, infant and child,” said Ang Nars
Partylist Representative Leah Paquiz

Under the new provisions of Administrative Order No. 2012-0012, nurses are now
included among the healthcare providers who may operate birthing clinics.
Paquiz, together with other leaders of the nursing profession, lauded the DOH,
specifically the HFSRB for amending the administrative order.

“After more than a decade, it has now been finally settled through harmonization of
policies that nurses are indeed one of the healthcare providers that can perform
actual delivery of new born babies,” Paquiz said.

Philippine Health Insurance Corporation president Alex Padilla said the state-run
health insurance firm will cover the birthing clinics that will be run by nurses in the
same manner hospitals and maternity clinics are covered.
 Carmencita Abaquin, chairperson of the Professional Regulatory Board of Nursing,
said that the legal basis for allowing nurses to operate and own child birth facilities is
embodied in Republic Act 9173 or the Philippine Nursing Act of 2002.

Under the law, nurses may perform nursing services that include nursing care during
conception, labor, delivery, infancy and even childhood.

The country has over 800,000 nurses registered with the Professional Regulations
Commission, at least 400,000 of them still unemployed or underemployed, Paquiz
said. (Sunnex).
V. LEARNING TASKS
Group Activity: Each member of the group will give the reactions regarding this
opportunity for nurses. Submit by group together with the Critical thinking Exercises in
Chapter V.
VI. REFERENCES

https://www.sunstar.com.ph/article/2954/Business/DOH-allows-nurses-to-own-
birth-clinics April 12, 2015.
https://hfsrb.doh.gov.ph/?page_id=9
FINAL TERM EXAM/ Assessment

End of Module 2