UNIVERSITY OF SANTO TOMAS

CPH: Community and Public Health Fieldwork

First Term, AY 2015-2016
Output # 2: Action Plan (HEALTH PROJECT) PROPOSAL
ALTAPRESYON, BIGYANG ATENSYON!
4-F Medical Technology
Group 1
Barangay 58, Zone 5
Aurora Health Center
District 1
Alda, Reece Lawrence Coronado, Claude Ericson Gabriel, Rebecca Mae
Alday, Pauline Valerie Mae Corpuz, Al-iya Corazon Gammad, Rico Isabelo
Arzadon, Kyla Clarisse Cruz, Danielle Wyneth Hernandez, Charise Jastine
Ballador, Paulleen Meyr De Guzman, Jan Peter Jason Levy, Daniel Adam
Caligayahan, Margaret Anne Dela Cruz, Michael Ray Lopez, Benjamin
Chan, Pamela Bianca Delos Santos, Jefferson Lucas, Ma. Femina
Co, Arvina Endozo, April Gabrielle Marasigan, Rose Sheena
Comiso, Timothy Eric Felipe, Shirley Ann Masangkay, Einor John
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City of Manila

Faculty Preceptor:
Asst. Prof. Ruby SP. Garcia-Meim, RMT, MSMT
Department of Medical Technology
Faculty of Pharmacy
UNIVERSITY OF SANTO TOMAS
October 2015

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Chapter 1

Introduction

Tondo, Manila - formerly known as The Kingdom of Tondo, is over 1100

years old. According to the Laguna Copperplate Inscription, which can be found at

the National Museum of the Philippines, stated that Tondo already existed in the year

900 AD. Also, according to this document, The Kingdom of Tondo also extended all

the way to the modern-day province of Bulacan particularly around Lihan, and

Gatbuca, now Malolos, and Calumpit, respectively.

Tondo was ruled by a line of lakan, or filipino nobility, which stopped up until

the Spanish conquest.

After the Spaniards conquered Tondo in January of 1571, they established the

Province of Tondo with the City of Manila as its center. The then province occupied

numerous territories in North Luzon, namely Pampanga, Bulacan, and Rizal. Tondo

was even reported to share the same dialect with the natives located in Pampanga,

with only Pasig River to separate the Kapampangans and the Tagalog.

Tondo was one of the first provinces to declare rebellion against Spain in

1896. There was a major reorganization of political divisions, with the Province of

Tondo being dissolved, and some of its towns given to the provinces of Rizal, and

Bulacan during the American Colonial Regime in 1911.

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 UNIVERSITY OF SANTO TOMAS 2

Today, Tondo just exists as a district in Metro Manila, which is further divided

into Barangays.

Barangay 58 is one of the many barangays now found in Tondo, Manila. It is a

semi-depressed community with a land area of approximately 35,000 sq. meters with

a population of 3,261 with its territory enclosed within Fajardo St., Estero dela Reina,

Perla Exit & Callejon Tsina, and Juan Luna St. Other streets found within the area are

R.A Reyes St., Nicodermus Ext., Coral St., and Samahang Bato. The area is

predominantly residential with establishments ranging from livelihood to functional

and commercial establishments such as numerous sari-sari stores, water stations,

bakeries, computer shops, a basketball court, and a barangay hall to name a few.

Despite being a semi-depressed community, the garbage collection and

waterworks system of Barangay 58 is highly organized. From the placing of garbage

from respective homes to the designated collection areas, to the maintenance of

continuous clean water supply for the residents, such is well-established. Housings in

the surveyed area are made of material varying from hard wood; thin metal sheets,

commonly known as yero; cement; and/or a mixture of these materials. Most of

these homes are adequately ventilated as well. Majority of surveyed residents either

(a) own the houses they live in, or (b) are staying with a relative who owns the

property, whereas a small number rent the houses they live in. The communitys

literacy rate is very high. Most of the surveyed individuals have obtained a diploma in

either the High School or College level. Only a few were not able to graduate or even

be able to study at all. In terms of religion, a large chunk of the surveyed population

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 UNIVERSITY OF SANTO TOMAS 3

are Roman Catholics, while a small number of the surveyed residents are either Born-

Again Christians or members of Iglesia ni Cristo. Most of the working population

have blue collar jobs. A few local immigrants reside in the area and a majority of the

population were born and raised there.

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 UNIVERSITY OF SANTO TOMAS 4

Chapter 2
Community Assessment
2.1. Situational Analysis

2.1.1. Setting in the community

Barangay 58, District 1, Zone 5 is a semi-depressed community located in

Tondo, Manila. The Barangay is set within the borders of Fajardo Street in the north;

Juan Luna Street in the west; Perla Exit. and Callejon Tsina in the south, and Estero

Dela Reina in the east side. Juan Luna Street is a one-way street that serves as a major

access road to the barangay, while Estero Dela Reina is an inlet canal, or ditch, that

divides Barangay 58 from the next barangay. The barangay is situated near a major

street therefore there are varieties on modes of transportation in reaching the barangay

like pedicabs, tricycles, jeepneys, motorcycles owned by the residents, and even by

foot. Given the location of the barangay, which is at the heart of Metro Manila,

accessibility would not be an issue due to the various modes of transportation readily

available to one who wishes to visit the community namely; pedicabs, tricycles, and

even some jeepneys pass by the premises of the barangay. Train stations such as the

Philippine National Railways and the nearest LRT station, Tayuman, are within the

area also.

The barangay is mostly occupied by residential areas consisting of either

registered residents or informal settlers, beknownst to Filipinos as squatters. There are

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 UNIVERSITY OF SANTO TOMAS 5

numerous establishments within the barangay that can be a source of livelihood for

the residents. Good examples of such are sari-sari stores, internet shops,

karinderyas, and a few junk shops. Important establishments such as pharmacies,

clinics, bakeries and a water-refilling station are also present in the community. The

houses are within close proximity of each other. Streets are narrow and cemented;

alleys are present around the area making the task of reaching out to other residents in

the barangay difficult. Stray animals such as dogs and cats were also seen. Chicken

are also being grown by some households.

The barangay hall is located alongside the day care center on R.A. Reyes

Street, the street where the barangays basketball court is also located. CCTV cameras

are strategically installed in different areas around the community for continuous

monitoring of the community s security. Unfortunately, this area isnt utilized for its

intended purpose of recreation as it was made as a parking lot by residents living near

the premises. As houses move away from Juan Luna Street, and get closer towards

Estero Dela Reina, the house materials being used get lighter. The issue of flooding

in the barangay has been settled after rehabilitation programs that were conducted by

the government addressing the issue like declogging of the drainages, and cleaning of

the estero.

Upon observation on the residents of the barangay, given the close proximity

between houses, the whole neighborhood seems to know one another. Children of

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 UNIVERSITY OF SANTO TOMAS 6

very young age play along the streets barefoot while those in their

prepubescent/adolescent years can be seen playing computer games and/or arcade

games in establishments present in the area. Some adults were seen smoking in the

area while other elderly people are sitting outside their homes or talking with their

neighbors.

2.1.2. Population Demography

2.1.2.1. Total population of the barangay

There are a total of 3,261 residents in Barangay 58, Tondo, Manila.

Approximately 25%, or 895, of the total population was surveyed.

2.1.2.2. Total population of the families surveyed

196 households were surveyed. A house-to-house survey was conducted in

order to obtain sufficient information about the demographic, economic, and health

indices. Convenience sampling, also known as accidental or opportunity sampling

was used since this the researchers opted a non-probability method without prior

selection of correspondents.

2.1.2.3. Sex ratio

+,-."/$)0$-&1"2
!"#$%&'() = $ $#$100!
+,-."/$)0$0"-&1"2

462
!"#$%&'() = $ $#$100!
433

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 UNIVERSITY OF SANTO TOMAS 7

!"#$%&'() = $94!

There is a sex ratio of 94 males for every 100 females among the residents

surveyed. There are an almost even amount of males for every female, which suggests

a good ratio between the two.

2.1.2.4. Age and Sex Distribution

Population*Pyramid
>60
55*to*59
50*to*54
45*to*49
40*to*44
35*to*39
30*to*34 female
25*to*29
20*to*24 male
15*to*19
10*to*14
5*to*9
1*to*4
<1
!0.06 !0.04 !0.02 0 0.02 0.04 0.06 0.08

Figure 1. Population Pyramid of the Respondents Surveyed in Barangay 58,

Zone 5, District 1, Tondo, Manila

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The data collected is based on population of those surveyed. The graph

suggests that the population currently has a low birthrate and high life expectancy,

with a huge fraction of the surveyed individuals being above 60 years of age for both

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 UNIVERSITY OF SANTO TOMAS 8

the male and female demographic. Most of the population lies within the independent

age group (15-50) meaning a healthy economic community.

2.1.2.5. Civil Status

CIVIL*STATUS

Single
Married
Separated
Widow

Figure 2. Percentage Distribution Showing the Civil Status of the Individuals

Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

Among the households surveyed, 48% of the residents are married, 46% of the

residents are single, 5% are widowed, while only 1% are separated. The minute

percentage of the community are separated which suggests good family relations in

the community.

2.1.3. Economic Indices

2.1.3.1. Age Dependency Ratio

:;"$<"="+>"+?@$%&'()
A)=,1&'()+$)0$0 14$@/2$)1> + =)=,1&'()+$)0 65$@/2$)1>
= $#$100!
A)=,1&'()+$)0$15 64$@/2$)1>

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FGGHIJK
:;"$<"="+>"+?@$%&'() = $#$100!
LLM

:;"$<"="+>"+?@$%&'() =$62!

The overall dependency ratio of the Philippines is 58!for!the!year!2014.

The age-dependency ratio of the barangay is 62. This indicates that for every

100 persons in the economically-productive age group, there are 50 dependents to be

supported. The community is very economically active, having almost double the

amount of people who are able to provide, compared to those who need to be

supported. However, the ratio might switch on the future, depending on those born

and the life span of the current generation.

2.1.3.2. Occupation

Occupation

Blue*collar
White*collar
Unemployed

Figure 3. Percentage Distribution Showing the Occupation of the Individuals

Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

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 UNIVERSITY OF SANTO TOMAS 10

Of the 554 individuals in the working-age groups, 12% are unemployed.

Among the employed population surveyed, 39% have white collar jobs while 49%

have blue collar jobs. There is a percentage of people still unemployed in the

community, which suggests the lack of employable positions available in the

community and in the surrounding area.

2.1.3.3. Average Income

Income

>15000
13000!
11000!
9000!
7000!8999
Income
5000!6999
3000!4999
1000!2999
<1000

0 20 40 60 80 100

Figure 4. Income of the Individuals Surveyed in Barangay 58, Zone 5, District 1,

Tondo, Manila

Based from the graph, there are a significant amount (37%) of people who

earn more than minimum wage, however majority (63%) of the population still earn

less than minimum wage. From the data given it can be inferred that only a portion of

the community is economically stable. However there are still a small percentage

(8%) of the community who are still earning less than a thousand pesos per month.

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 UNIVERSITY OF SANTO TOMAS 11

2.1.4. Socio-Cultural Indices

2.1.4.1. Educational Attainment

Educational*Attainment
250

200

150

100

50

0
None Elementary*Elementary*High*School*High*School* College* College*
level graduate level graduate level graduate

Figure 5. Educational Attainment of the Individuals Surveyed in Barangay 58,

Zone 5, District 1, Tondo, Manila

Based on the graph Majority are only high school graduates (23%), but there is

still a significant amount of people who have graduated from college (21%). That

being said, the community has many people still undergoing formal education. So

based on the data, implementation of projects will be made easier because most of the

residents have sufficient educational backgrounds to understand the concepts and

importance of the projects. Therefore information dissemination will not be a problem

among the residents.

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2.1.4.2 Religion

Religion

Catholic
Christian
Iglesiani*Cristo
Born*Again

Figure 6. Percentage Distribution Showing the Religion of the Individuals Surveyed

in Barangay 58, Zone 5, District 1, Tondo, Manila

According to the graph above, 94% of the community are Catholics; the next

most prominent religions are Iglesia ni Cristo (3%) then Born Again (3%). Since the

community is mostly one religion, religious segregation is uncommon if not non-

existent. Those in the minority mostly have no problems, as they are free to practice

their beliefs.

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2.1.4.3 Place of Origin

Place*of*origin

Luzon
Visayas
Mindanao
NCR

Figure 7. Percentage Distribution Showing the Place of Origin of the Individuals

Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

The data collected shows that majority (60%) of the surveyed

population have already been in the NCR and have lived in the community for a

significant amount of time, if not since birth. 30% of the community lived around

Luzon before moving to their current location, which means they have not moved in

from the farther regions of the Philippines, unlike those coming from the Visayas

(8%) and the Mindanao region (1%).

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2.1.4.4 Population Movement

Length*of*Residency

10*years*and*above

6*years! 10*years

1*year* 5*years

6*months!1*year

<*6*months

0 50 100 150 200 250

Figure 8. Length of Residency of the Individuals Surveyed in Barangay 58,

Zone 5, District 1, Tondo, Manila

Data collected shows that 89% of residents have lived in their current home

for over 10 years, meaning the community if possibly very well established. Also

there are families who have already stayed in the community for a significant amount

of time, 7% have already been settled for 1 year to 10 years, and only 4% having

stayed for less than a year.

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2.1.4.5 Housing

Housing*material

Strong
Mixed
Light
Makeshift

Figure 9. Percentage Distribution Showing the Housing Material of the Families

Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

Based on the graph, 51% of houses are made of strong an satisfactory

materials, 35% are made of a mixed of strong and other materials, 8% are made of

light material, and 6% are made of makeshift and unsatisfactory material. More than

half the homes are considered strong and satisfactory. The other half maybe at risk if

natural disasters were to happen.

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2.1.4.6 Home Ownership

Home*Ownership

Rent!free
Own
Rented

Figure 10. Percentage Distribution Showing the Type of Home Ownership of the
Families Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

The graph shows the percentage of the surveyed families based on their

ownership of their home. 68% of families currently own the home they are taking

residence, 25% are renting the home they are staying in and 7% are staying rent free.

Majority of families own a house, suggesting that the community is well established

and stable in terms of housing. It is very unlikely that residents losing their homes will

be a major problem.

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2.1.4.7 Ventilation

Ventilation No. of Families %

Inadequate 79 40

Adequate 117 60

Table 1. Percentage Distribution Showing the Ventilation of the Families Surveyed in

Barangay 58, Zone 5, District 1, Tondo, Manila

Based on the graph, only 60% of the homes have adequate ventilation, and a

significant 40% of homes do not have proper ventilation. This may be due to the lack

of open space between and around the houses as well as the lack of windows,

openings and mechanical ventilation. Human density is also a problem with many

people possibly living in one house of unsatisfactory human density per square meter.

The criteria for the adequacy of ventilation is based on the WHO Guidelines for

Indoor Air Quality.

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2.1.4.8 Water Supply

Water*supply

Level*1:*Point*source

Level*2:*Communal*faucet*
system
Level*3:*Waterworks*
system

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Figure'11.!Percentage!Distribution!Showing!the!Water!Supply!of!the!Families!Surveyed!in!
Barangay!58,!Zone!5,!District!1,!Tondo,!Manila!

The graph above shows that the majority of the population (80%) of the

community is actually using a water supply that is of the Level 3, meaning they

receive water from a Water Works System. Very few from the surveyed population

are using Level 1: Point source (5%) and Level 2: Communal faucet (15%) water

supplies which means that majority are being provided with cleaner water. In line

with this having cleaner water means that there are less health risks being imposed

upon in the community since their water supply is mostly their primary drinking water

at home.

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2.1.4.9 Excreta Disposal

Excreta*Disposal

Level*1:*Pit*Latrines
Level*2:*Pour*flush*toilets
Level*3:*Flush*toilets
Balot

Figure 12. Percentage Distribution Showing the Excreta Disposal of the Families
Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

Based on the graph above, Majority of the households surveyed are using

Level 2: Pour flush toilets (84%), followed by Level 3: Flush toilets (12%). While

there is minor usage of the Level 1: Pit Latrines (2%) and the Balot system (2%).

Overall it could be said that majority of the households are practicing modern

hygienic methods in Excreta Disposal, rather than old-fashioned methods.

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2.1.4.10 Garbage Disposal

Garbage Disposal No. of Families %

DPS 184 94

Water Segregation 9 5

Open Dumping 2 1

Table 2. Percentage Distribution Showing the Garbage Disposal of the Families

Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

With regards to the graph, most of the people in the community practice DPS

(94%), followed by a small number using Waste Segregation (5%), and a counted few

who practice Open Dumping (1%). It could also be noted that there was no household

in the surveyed population practicing Burning of their garbage disposal. This is an

indicator that majority of community are practicing a much more sanitized and

orderly way of disposing their trash which could lead to better heath from a cleaner

environment.

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2.1.5 Health Indices

2.1.5.1 Food Storage

Food*Storage

Refrigerated

Non*refrigerated!
covered
Non*refrigerated!
exposed

Figure 13. Percentage Distribution Showing the Food Storage of the Families
Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

Based on the given graph above majority of the households in the community

actually have refrigerators which is the dominant food storage choice of the

community (54%), while Non-refrigerated: covered (41%) type of food storage is

close by. Lastly there is a small minority practicing the Exposed Non-refrigerated

(5%) method of food storage. Those practicing the non-refrigerated method as a food

storage could acquire some diseases due to the fact that the food not refrigerated

would expire more easily. Also, those who are practicing the Non-refrigerated

exposed food storage method would have their food be exposed to the environment

and insects which risks the food in being contaminated.

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2.1.5.2 Infant Feeding

Infant*feeding
20
18
16
14
12
10
8
6
4
2 Infant*feeding
0

Figure 14. Means of Infant Feeding in the Families Surveyed in Barangay 58,
Zone 5, District 1, Tondo, Manila

As seen in the chart above it can be noted that majority in the community are

actually practicing Breastfeeding (19) as their feeding method for their infants. This is

followed by the Mixed powdered (14) which is a combination of both Breast feeding,

and Bottle feeding via Powdered milk. Lastly, and certainly close by is Bottle-feeding

using powdered milk (11). It is also seen that no one from the surveyed community is

practicing the method of Bottle-feeding and Mixed feeding using Evap or Condensed

milk which is noteworthy considering that there are more nutritional benefits for then

infants in Powdered milk than of the others.

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2.1.5.3 Immunization

Immunization

BCG
DPT
OPV
HEPA*B
AMV

Figure 15. Percentage Distribution Showing the Immunization of Infants in the

Families Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

The graph shows that the prevalent vaccination for the infants in the surveyed

community is BCG (23%), DPT (23%), and Hepa B (23%). This is closely followed

by OPV immunization which has a 19% prevalence among the infants and finally

AMV which has a prevalence of 13%. As seen in the data, it can be suggested that the

infants having incomplete vaccination could be in the risk of having all sorts of

diseases which could lead in to a high mortality rate in the infants.

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2.1.5.4 Health Seeking Behavior

Health*Seeking*Behavior

Hospital
Health*center
Private*clinic

Figure 16. Percentage Distribution Showing the Health Seeking Behavior of the
Families Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

The graph shows the health seeking behavior of the surveyed community. The

majority of which are inclined to Hospitals (47%) as primarily their health seeking

behavior, followed closely by Health centers (39%). While certainly being the most

expensive of them all, Private Clinics are certainly still being utilized by the

community as a health seeking behavior even though it may only be a small portion of

the community (14%).

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2.1.5.5 Source of Health Information

Source*of*Health*Information

Hospital
Health*center
Private*clinic
Multimedia

Figure 17. Percentage Distribution Showing the Source of Health Information of the
Families Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

Based on the graph above it can be seen that majority of the population

surveyed are using Hospitals (49%) as their primary source of Health information,

followed by Hleath Centers (40%), then a number via Private Clinics (7%), and

finally a small group who uses Multimedia (4%) as their source of Health

information. It can be noted that those following Multimedia as their primary source

for Health Information may be fed with wrong facts since Media tends to be

misleading when stating the general facts from the opinions.

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2.1.5.6 Sources of Healthcare Services

Sources*of*Healthcare*
Services

Hospital
Health*center
Private*clinic

Figure 18. Percentage Distribution Showing the Sources of Health Care Services of
the Families Surveyed in Barangay 58, Zone 5, District 1, Tondo, Manila

As seen in the graph above the primary Sources of Healthcare Services of

the surveyed community are actually Hospitals (56%), next are the Private Clinics

(24%), and surprisingly followed by the Health centers (20%).

2.1.6 Summary of Factors Affecting Health Status/ Health Services

Some of the factors affecting the health status of Barangay 58 are the

following: Orange card, Estero dela Reina, the presence of many computer shops, and

the overall cleanliness of the barangay. The Orange card is widely used in the

barangay. Upon its presentation in hospitals, registered residents on this project may

avail health services from hospitals for free or for a discounted fee. Estero dela Reina

is a river between two barangays that serves as its border. The cleanliness of the river

is not that maintained which could bring of pathogens from the waste dumped into the

river. As observed from the barangay, teenagers are often seen in computer shops or

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arcade establishments in the area. An added factor to this is that numerous

establishments are in existence in the barangay. Lastly, the overall maintenance of the

the cleanliness of the area is also to be considered. Areas in the barangay vary from

the type of housing and setting as it is considered to be a semi-depressed community.

Certain areas need cleaning especially the one near Estero dela Reina. An amount of

animal feces could also be seen scattered around the area.

2.1.7 Limitations

This study is limited to the surveyed residents of Barangay 58, that is the 25%
of its population.

2.2 Community Diagnosis (Health Status)

2.2.1 Data and Sources

According to the Centre for Disease and Prevention; hypertension, diabetes

and heart related problems such as heart disease and stroke have hereditary risk

factors. If one member of the family has the disease, it is possible that other members

may possess the same disease due to genetics.

(http://www.cdc.gov/bloodpressure/risk_factors.htm)

Smoking Tobacco, drinking alcohol, unhealthy lifestyle, poor diet, insufficient

physical exercise, obesity, age and gender are other major health risk factors which

can greatly affect health status of an individual.

(http://www.aihw.gov.au/risk-factors/)

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Table'2.!Family!histories!of!surveyed!individuals!of!Barangay!58,!Zone!5,!District!1,!Tondo,!
Manila!
Hereditary Disorders No. of Family %

Families with History of Hypertension 58 60.04

Families with History of Diabetes 41 42.70
Families with History of Heart related problems 32 33.33

Table 2. On the other hand there were 41 families with history of diabetes this

includes 42.70& of the total number of families surveyed. 32 families had a history of

heart related problems this consists of 33.33% percent of the total families surveyed.

Based on these data, it is most probable for the inhabitants of barangay 58 to develop

disease with related to hypertension.

Table'3.!Exercise!pattern!of!surveyed!individuals!of!Barangay!58,!Zone!5,!District!1,!
Tondo,!Manila!
Exercise pattern No. of Individuals %

Does Exercise regularly 41 42.70

Does not exercise regularly 55 57.29

According to the data presented on table 3, 41 individuals or 42.70% of the

surveyed population have physical activities which they do daily and act as their

exercise. On the other hand, 55 individuals or 57.29% does not do any exercise daily.

Based on this data, disease such as diabetes and hypertension has a probability of

developing due to lack of physical activity of more than half of the population.

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Table 4. Blood Pressure Classification of surveyed individuals of Barangay 58, Zone

5, District 1, Tondo, Manila

Levels of Blood Pressure No. of Individuals %

Normotensive 61 63.54
Prehypertensive 21 21.87
Hypertensive 14 14.58

Based on the data gathered from the community, there were 61 people or

63.54% of the surveyed population having normal blood pressure values. On the other

hand, there were 21 and 14 people or 21.82% and 14.58 which are prehypertensive

and hypertensive respectively. Normal blood pressure were seen among children,

teenagers and some middle aged people. Prehypertensive people come mostly from

the middle aged group while hypertensive people are mostly elderly. Parameters used

for gauging the classification of blood pressures of surveyed individuals were taken

from the AHA or the American Heart Association. The data shows that almost half of

the surveyed population have blood pressure higher that 120/80. This indicates almost

half of them have high blood pressure which can be attributed to peoples lifestyle and

food choices.

(http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBlood

Pressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp)

As mention above, obesity is one of the major risk factor for many of the

diseases. To determine obesity, the BMI or Body Mass Index of the surveyed

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 UNIVERSITY OF SANTO TOMAS 30

individuals were computed. The height and weight of the individuals were used in the

computation to determine the classification of the individual. Based on the parameters

and ranges given by the WHO, a BMI of less than 18.5 is considered as underweight:

18.5-24.99 is considered as normal, 25-29.99 is considered as overweight and more

than 30 is considered as obese.

(http://apps.who.int/bmi/index.jsp?introPage=intro_3.html)

Table 5. Body Mass Index of surveyed individuals of Barangay 58, Zone 5, District 1,
Tondo, Manila
Body Mass Index No. of Individuals %

Underweight (<18.50) 7 7.29

Normal (18.50-24.99) 45 46.87

Overweight (25-29.99) 29 30.20

Obese (>30.00) 15 15.62

According to Table 5, there were 46.87% among the individuals surveyed

whose body mass index is considered normal. However, there are still 30.20% of the

population that are overweight and 15.62% who are obese. A small percentage of

7.29% of the individuals surveyed are classified as underweight though almost half of

the respondents have normal BMI, still a large percentage are classified as overweight

and obese. Being overweight and obese increases risk of complications due to

diabetes mellitus and having hypertension. It should be addressed among the

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 UNIVERSITY OF SANTO TOMAS 31

community to prevent the said risk from occurring for the improvement of the

capability of wellness of the individuals in the barangay.

2.3 Problem Analysis (Problem Identification and Prioritization)

2.3.1 Identification and Analysis of Problem

List of Problems

1.! Hypertension

2.! Diabetes

3.! Upper Respiratory Tract Infection

2.3.2 Analysis of Current Problems

2.3.2.1 Hypertension

Hypertension is another name for high blood pressure. It is not only a disease

but a biomarker for risk to develop cardiovascular disease (CVD) such as stroke, heart

attacks, or heart/renal failure. Casual factors such as excess body weight, excess

dietary sodium intake, inadequate intake of fruits and vegetables, sedentary lifestyle

and excess alcohol, have been identified as risk factors of hypertension.

Upon assessing the community, specifically Barangay 58, Zone 5, District 1

Tondo, Manila, data showed that 60.42% of the population surveyed has a family

history of hypertension, although only 36.46% has experienced hypertension.

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 UNIVERSITY OF SANTO TOMAS 32

Based on the result of the survey, 84.38% of the sample population have a

healthy diet; however, lack of exercise (47.70%) can be one of the underlying causes

that trigger hypertension. Despite having a healthy diet, survey showed that 30.20%

of the sample population are overweight adding that 15.62% are obese. Many medical

studies have shown a relation between obesity and high blood pressure. In fact, obese

people have a higher blood pressure than people with a normal Body-Mass Index.

Data also showed that majority of the sample population (20.83%) smoke every day

and there are 36.46% that experience second hand smoking. While smoking has not

been conclusively proven to cause high blood pressure, each cigarette temporarily

increases blood pressure.

2.3.2.2 Diabetes Mellitus

Diabetes mellitus describes a group of chronic metabolic disorders in which an

individual has an elevated glucose level due to the unresponsiveness of the insulin

receptors on the cells which hinders the uptake and usage of glucose by the cells or

the production of antibodies against the pancreas averting insulin secretion. Persons

with diabetes mellitus experience polyuria (frequent urination), polyphagia (frequent

hunger) and polydipsia (feeling of thirst). Its more common in adults, increasingly

affects children as childhood obesity increases. DM can be managed by eating

healthy, exercising and maintaining a healthy lifestyle.

Among the respondents surveyed 42.7% has a history of Diabetes Mellitus in

their family however, only 16.67% of the sample population of the barangay currently

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 UNIVERSITY OF SANTO TOMAS 33

has Diabetes Mellitus. Healthy diet comprising fruits and vegetables and eating white

meat may be one of the causes of the low occurrence of this disease. Despite the

healthy diet of the individuals in the community, 57.29% of the population surveyed

doesnt engage in exercising. In addition, 30.20% of the samples BMI is classified

are overweight and 15.62% of the sample are obese.

2.3.2.3 Upper Respiratory Tract Infections

One of the top three health concerns in Barangay 58 is acute upper respiratory

tract infections. AURTI represents the most common acute illness evaluated in the

community. AURTI range from the common cold typical, mild, and self-limited to

life threatening illness such as epiglottis. Smoking is one of the main causes of having

AURTI according to our gathered data in the risk assessment, there were 26.31%

registered active, first-hand smokers while 50% of the respondents were registered as

second-hand smokers or someone living with a smoker.

Being a chronic medical condition, AURTI can lead to many different kind of

respiratory conditions. Symptoms such as nasal congestion, runny nose, nasal

discharge, nasal breathing, sneezing, sore or scratchy throat, painful swallowing and

cough were observed in the community which implicated the true social status of the

barangay. There were several measure that can reduce the risk of infections like hand

washing, avoiding contact with people infected, proper cleaning and vaccination.

2.3.3 Criteria for Selection of Problem

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 UNIVERSITY OF SANTO TOMAS 34

2.3.3.1 Nature of the condition(s)/ Problem(s) Presented

Hypertension and Diabetes Mellitus is a health status problem since its

among the leading causes of morbidity. Also, both reduce the capability of wellness

of an individual affected. Common cold typical, mild, and self-limited rhinitis,

pharyngitis, etc., which are categorized as acute upper respiratory tract infection is a

health related problem since the environment of the community and the social

function of an individual is the underlying causes that aggravates the said disease.

2.3.3.2 Magnitude of the Problem/s

2.3.3.2.1 Hypertension

Based on the data gathered from the risk assessment conducted within the

community, 60.42% of the population in Barangay 58, Zone 5, District 1, Tondo,

Manila, has a history of hypertension, whereas only 36.46% has experienced

hypertension.

2.3.3.2.2 Diabetes Mellitus Type II

Upon assessment of the barangay, data showed that 42.71% of the sample

population has a family history of diabetes mellitus type II. In addition, 16.67% has

the said disease.

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 UNIVERSITY OF SANTO TOMAS 35

2.3.3.2.3 Upper Respiratory Tract Disease

Based on the data given by the Aurora Health Centre, upper respiratory tract

disease is included in the top ten leading causes of morbidity in Barangay 58, Zone 5,

District 1, Tondo, Manila.

2.3.3.3 Modifiability of the Problem/s

After identifying the problems within the barangay using the risk assessment

survey conducted, it was concluded that hypertension would be the most modifiable

since it can be easily alleviated with a healthy lifestyle and better health-seeking

behavior. Hypertension can be regulated by having a different perspective on the way

a person lives, having a healthy lifestyle both prevents and controls high blood

pressure. Occasionally, high blood pressure requires drug therapy because of its

severity or because it does not respond to lifestyle changes and self-help measures.

Although these drugs do not cure hypertension, it can however effectively help keep

blood pressure in healthier ranges.

Diabetes is moderately modifiable, since there are a number of non-modifiable

risk factors that can contribute to a persons likelihood of developing the disease such

as family history, age, race and ethnicity thou a healthy lifestyle, proper diet and

exercise may prevent the complications of the said disease. Upper respiratory tract

infection is one of the most common illnesses, it is much harder to control and prevent

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 UNIVERSITY OF SANTO TOMAS 36

since it is caused by various environmental factors and the different social functions

of individuals in the community.

2.3.3.4 Preventive Potential

Hypertension is the most significant risk factor for cardiovascular diseases.

Hence, precluding of hypertension becomes an essential objective to regulate blood

pressure and reduce the incidence of hypertension-related cardiovascular

complications and outcomes. It has the utmost preventive potential because

distinguishing the risk factors are easy to modify. It can be mitigated by having a

healthy lifestyle and even prevent its development. Prevention of the complication of

Diabetes Mellitus is potentially possible by also having a healthy lifestyle through

good eating habits, regular exercise and continuous monitoring and maintenance of

medicines. While the Upper respiratory tract infection is the least modifiable because

it is environmentally related which is uncontrollable but somehow it can be reduced

by means of proper hygiene, sanitation and minimization of contact with infected

people.

2.3.3.5 Social Concern

According to the survey, 60.42% of the population in Barangay 58, Zone 5,

District 1 of Tondo, Manila has a family history of hypertension and 36.46% has

experienced hypertension, which is a lifetime disease. With this being said, their

immediate concern lies with the prevention and treatment of the said disease.

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 UNIVERSITY OF SANTO TOMAS 37

Furthermore, the respondents also stated their concerns on the matter since it greatly

affects the heart. Meanwhile, diabetes and AURTI pose the same concern, with

diabetes being an acceptable fundamental burden and AURTI as common placed

acute transient disease. Although all are concerns of the community, urgent attention

is not given.

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 UNIVERSITY OF SANTO TOMAS 38

2.3.4 Decision Matrix

Table 2. Decision Matrix

DIABETES
CRITERIA HYPERTENSION MELLITUS AURTI

Nature of the Problem

a)! Health Status 3 3 3 1

$1 $1 $1
b)! Health Resources 2 3 3 3
O$ 1 P. RR
c)! Health Related 1

Magnitude of the Problem

a)! 75-100 % Affected 4

3 2 1
b)! 50-74 % Affected 3 $3$ $3 $3
4 4 4
c)! 25-49 % Affected 2
S. ST O. T P. UT
d)! <25 % Affected 1

Modifiability of the Problem

a)! High 3
3 2 1
b)! Moderate 2 $4 $4 $4
3 3 3
c)! Low 1
4 S. VU O. RR
d)! Not Modifiable 0

Preventive Potential

a)! High 3 3 2 1
$1 $1 $1
b)! Moderate 2 3 3 3
1 P. VU P. RR
c)! Low 1

Social Concern

a)! Urgent Community Concern 2

1 1
$1 1 $1
b)! Recognized as a problem but not 1 2 $1 2
2
making urgent attention
P. T P. T
c)! Not a Community Concern 0 P. T

Total 8.75 6.34 4.92

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 UNIVERSITY OF SANTO TOMAS 39

2.3.2 Review of Existing Health Projects

In coordination with Department of Health's goal to deliver quality healthcare

to every person residing in the Philippines, Aurora Health Center conducted several

projects to improve the health status of its people. One of its projects includes Libreng

Bakuna for babies. Vaccines against Chickenpox, Hepatitis, Measles, and Flu were

administered for free. Medical missions were also conducted for the benefit of the

people. Free eye check-ups and Kontra Tigdas at Polio were also held for the

awareness and welfare of the residents.

The Barangay with its utmost effort in bringing security to its people installed

CCTVS around the area to maintain a safe and secure environment for the elderlies,

children, as well as all the residents living in the community. In order to keep a clean

and orderly surrounding, the barangay together with its people conducted a

declogging program to decrease the risk of getting sick from dirty environment. Every

year for the month of July the barangay celebrates Nutrition Month which aims to

increase knowledge and awareness in proper nutrition. A summer basketball league

was also held to encourage a healthy and active lifestyle among the younger age

group. Lastly, with the help of Mayor Joseph Estrada, an Orange Card Program was

developed to aid the needs of its holders for free and easy access in health care

services of all the hospitals located in Manila.

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 UNIVERSITY OF SANTO TOMAS 40

Chapter 3
The Core Problem

3.1 Problem Tree

Death!

Decreased!quality!
of!life!

Increased!risk!of! Increased!risk!of! Decreased!budget!

heart!attack! Stroke!

Additional!expenses!for!medication!

HIGH!PREVALENCE!OF!
HYPERTENSION!AMONG!
RESIDENTS!OF!BARANGAY!58!

More!people!at!risk! Lack!of!health! Sedentary!lifestyle!

information!

Large! Increase!Rate! Lack!of!exercise! Smoking!and!

population!of! of!Obesity! alcoholism!
people!over!
40!
Youth!entailed! Underutilized! Lack!of!motivation!to!
too!much!in! Basketball! use!the!active!
computer!shops! Court!due!to! recreational!facilities!
for!recreation! cars!parked!in! available!
the!area!
Figure 20. Problem Tree Illustrating the Causes and Effects of the High Prevalence of
Hypertension in Barangay 58, Zone 5, District 1, Tondo, Manila 2015

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 UNIVERSITY OF SANTO TOMAS 41

As illustrated in Figure 20, several root causes were identified for the high

prevalence of hypertension among the residents of the barangay. One direct cause is

the large population of elderly in the community. Age is a major risk factor in

hypertension. Blood pressure increases with age in both men and women, and, in fact,

the lifetime risk for hypertension is nearly 90%. The risks for high blood pressure

increases in men over age 45 and women over age 55. (Simon et al.,2013). Thus, age

is a major contributing factor in hypertension. Another direct cause is the unhealthy

lifestyle of the residents which may be attributed to smoking, alcoholism, lack of

exercise and most especially poor nutritional diet. Cigarette smoking is one of the risk

factors for high blood pressure. Added to cigarette smoking, too much consumption of

alcohol can also relatively increase blood pressure. Poor nutritional diet and lack of

physical activity might increase the risk of being overweight thus, increasing the risk

of getting hypertension. (Simon et.al, 2013). The inclination of the teenage groups to

computer games could also be factor that may lead to hypertension.

With the high prevalence of hypertension, this can lead to other possible

health consequences. There is a higher risk for health related problems like heart

attack, stroke, or worst, death may occur. In addition, there is a need for the individual

to have higher expenses on medication to live a normal life despite of their condition.

Ultimately, high prevalence of hypertension can lead to mortality, lesser productivity

and decreased quality of life.

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 UNIVERSITY OF SANTO TOMAS 42

3.2.1 Objective Tree

Decreased!deaths!

Improved!quality!
of!life!

Decreased!risk!of! Decreased!risk! Increased!budget!

heart!attack! of!Stroke!

Decreased!expenses!for!medication!

LOW!PREVALENCE!OF!
HYPERTENSION!AMONG!
RESIDENTS!OF!BARANGAY!58!

Less!people!at!risk! Adequate!health! Healthy!lifestyle!

information!

Increased!physical! Decreased!smoking!
Large! Decreased!Rate!
activity!and!exercise! and!alcoholism!
population!of! of!Obesity!
people!over!
40!
Youth! Access!to! Adequate!motivation!
encouraged!to!go! Basketball! to!use!the!active!
outside!and!play! Court!to!do! recreational!facilities!
for!recreation! various! available!
physical!
activities!

Figure 21. Objective Tree Illustrating the Possible Causes and Effects of the Low
Prevalence of Hypertension in Barangay 58, Zone 5, District 1, Tondo, Manila 2015

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 UNIVERSITY OF SANTO TOMAS 43

The main objective is to reduce the risk of the residents in the aforementioned

barangay from Hypertension.

To address the very roots of the core problem, that is Hypertension, the

researches have come up with the following objectives. The community is classified

as a semi-depressed barangay. Residents economic status vary from a well

compensated family to a no income at all, putting their health prioritization the least

of their needs. Access to health centers and hospital or thru media are one of the many

ways of obtaining health information, but due to reasons such as insufficient budget

and limited access to health information on media, and residents who are not fond of

availing the Health Centers services or hospital these residents overall lifestyle is

affected. Proper information and orientation of the residents regarding their health

could alarm them that even the little things such as lighting a cigarette stick could

affect their whole being. With proper information, it would improve their overall

lifestyle that could lessen their risk for hypertension. With proper information

supplied to these residents, it would be enough to motivate them for a change, not

abruptly, but slowly engaging themselves in physical activities and lessening their use

of cigarette and drinking of alcohol.

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 UNIVERSITY OF SANTO TOMAS 44

3.2.2 Alternative Tree!

Decreased!deaths!

Improved!quality!
of!life!

Decreased!risk!of! Decreased!risk! Increased!budget!

heart!attack! of!Stroke!

Decreased!expenses!for!medication!

LOW!PREVALENCE!OF!
HYPERTENSION!AMONG!
RESIDENTS!OF!BARANGAY!58!

Less!people!at!risk! Adequate!health! Healthy!lifestyle!

information!

Increased!physical! Decreased!smoking!
Large! Decreased!Rate!
activity!and!exercise! and!alcoholism!
population!of! of!Obesity!
people!over!
40!
Youth! Access!to! Adequate!motivation!
encouraged!to!go! Basketball! to!use!the!active!
outside!and!play! Court!to!do! recreational!facilities!
for!recreation! various! available!
!
physical!
activities!

Figure __. Alternative Tree Illustrating the Possible Causes and Effects of the Low
Prevalence of Hypertension in Barangay 58, Zone 5, District 1, Tondo, Manila 2015

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 UNIVERSITY OF SANTO TOMAS 45

The alternative tree shown presents the specific points that need to be focused

on to decrease prevalence of hypertension in the community. To work out the problem

of the community, there must be an adequate knowledge on proper diet, exercise,

active and healthy lifestyle of the target population. The key to a healthy lifestyle is

making simple changes such as to increase their physical exercise or decrease

smoking and alcoholism habits as to decrease the prevalence of hypertension. Hobbies

keep the mind and body moving that is why physical activities can greatly lower the

case of hypertension. Philippine games and Zumba to promote healthy lifestyle may

be used in order to decrease cases among the target group of the community.

3.2.3! Timeline

Project implementation will run for 2 consecutive Saturdays. On the first day,

A seminar will be conducted in the basketball court about Hypertension with a guest

speaker. As for the second Saturday, the activities set for the residents such as Zumba

and Palarong Pinoy will take place. Disengagement will also be done on the same

day.

3.2.4 Budget

For a detailed breakdown of expenses, please refer to appendix.

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3.2.5 Organizational/ Job Description

Brgy. 58 Barangay Aurora Health

Chairman: Ernersto Department Health
Aro Timbol Officer:

Community Project Title: Altapresyon

Bigyang Atensyon!
Group Leader: April Gabrielle C. Endozo
Preceptor: Asst. Prof. Ruby SP. Garcia-
Meim, RMT, MSMT

Group 1 CPH of 4FMT

DAY 2:
Group 1 CPH of 4FMT ZUMBARANGAY: IGILING
DAY 1: SEMINAR THE ANG BILBIL PARA
HYPERTENSION SESSION ALTAPRESYON AY
TUMIGIL
Head: ALDA
Head: FELIPE

BATA, BATA WAG KA

MAGPATABA

Head: MARASIGAN

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Chapter 4
The Community Health Plan (CHP)

Title of Community Health Plan: Altapresyon, Bigyang Atensyon!

Problem Identified: Poor health status leading to hypertension among middle aged

citizens of Barangay 58, Tondo, Manila.

Goal: To improve the health status by preventing Hypertension through the

implementation of programs and projects that shall target the identified risk factors of

hypertension

General Objective/ Purpose: To add on to the knowledge of the community

regarding Hypertension through seminars and workshops; and to also promote a

healthy and active lifestyle among the all age groups through different sports and

aerobic activities.

4.1. Title of the Community Health Plan

The community health plan is entitled, Altapresyon, Bigyang Atensyon!

4.2. Problems Identified

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 UNIVERSITY OF SANTO TOMAS 48

Hypertension was the problem identified as risk factor in Barangay 58, Tondo

Manila. The main focus of the projects to be implemented lie under the unhealthy

lifestyle of the residents due to lack of exercise and the lack of health information.

4.3. Goal

The goal of the Community Health Plan is to prevent hypertension among the

members of the community.

4.4. General Objective/Purpose

To prevent the cases of hypertension through conducting seminars and

activities that will tackle the chosen risk factors to be tackled.

4.5. Specific/Component Objectives

There are three component objectives of the Community Health Plan. Our first

component objective is to provide adequate health information about the causes,

effects, pathophysiology, and ways to prevent Hypertension in order to decrease the

rate of obesity, to decrease smoking and alcoholism, and to promote healthier

lifestyles

. Our second objective is to encourage the use of the available recreational facilities for

outside games and activities in order to increase the physical activity and promote exercise

among the members of the community. The third component objective is to ensure the

sustainability of the projects through the creation of a core group.

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 UNIVERSITY OF SANTO TOMAS 49

4.6. Strategies/Outputs

The Community Health Plan should be able to increase the knowledge on the

causes, risk factors, pathophysiology of, and ways to prevent hypertension. Knowing

the different risk factors, such as drinking and alcoholism, will encourage them to stay

away from these vices. The importance of keeping a healthy and active lifestyle in

order to prevent Hypertension will be underscored, thus, encouraging the members of

the community to also engage in regular exercise and active lifestyles.

4.7. Activities

A week before the first Saturday of field work implementation, designated

members of the group will go to the barangay to give out flyers for the activities.

Attached to these flyers will be stubs that will serve as reservation or pre-registration

for each activity.

On the first Saturday of field work implementation, there will be a Seminar

entitled The Hypertension Seminar. This talk will be given by the chosen physician.

This will be an informative seminar to provide adequate knowledge to community

members on Hypertension, its causes, risk factors, pathophysiology, and how to

prevent it. There will be a pre-test and a post-test to be given by the speaker in order

to test the output of the seminar. During this seminar, there will also be a Free Lipid

Profile Booth with free consultation.

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 UNIVERSITY OF SANTO TOMAS 50

On the second Saturday of field work implementation, there will be two

activities to promote the incorporation of exercise and an active lifestyle among the

members of the community. The first activity will be the Zumbarangay: Igiling Ang

Iyong Bilbil Nang Altapresyon Moy Tumigil and the second activity will be Bata

Bata Wag Ka Magpataba.

4.8. Target Population

The targeted population of each activity will be limited to the number of slots.

The seminar will only allot 50-60 members of the middle-aged bracket of the

community, the Lipid Profile Booth will allot 50 members of the middle-aged bracket

of the community, the Zumba will allot 50-60 participants of adults of the community,

and the Philippine Games will allot 50-60 children of the community.

4.9 Timeframe

Day 1

a.! The Hypertension Session

Activities Time

Opening and Pre-Test Seminar 8:30 AM 9:10 AM

Talk Proper 9:10 AM 9:45 AM

Post Test and Closing Remarks 9:45 AM 10: 45 AM

*A Lipid Profile booth will be provided while the seminar is on going

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 UNIVERSITY OF SANTO TOMAS 51

Day 2

a.! Zumbarangay: Igiling Ang Iyong Bilbil Nang Altapresyon Moy Tumigil

Activities Time

Opening 8:30 AM 9:00 AM

Zumba 9:00 AM 9:25 AM

Snacks for Zumba Participants 9:25 AM 9: 45 AM

And Setting Up For Phil. Games

b.! Bata, Bata Wag Ka Magpataba

Activities Time

Philippine Games (Includes Children Pre- 9:45 AM 10:15 AM

Test and Post-Test)
Snacks for Philippine Games Participants
Preparation for Awarding and
10:15 AM 10: 25 AM
Disengagement

Awarding and Disengagement

10:25 AM 11: 00 AM

4.10 Locus of Responsibility

The members of Group 1 are divided into different tasks with one person

spearheading the said activity and the other members divided into committees as seen

on the Organizational/ Job description.

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 UNIVERSITY OF SANTO TOMAS 52

4.11 Resources Required

Laptops, projectors, sound system, chairs, tables, and tents (optional) are the

resources needed for the aforementioned activities. Prizes for raffles, tubes, syringes,

tourniquet, cotton, and micropore also will be needed for the Lipid Profile booth that

will be set up on the 1st day of activity.

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APPENDIX A
FINANCIAL REPORT

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APPENDIX B
SPOT MAP

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APPENDIX C
PARAPHERNALIAS USED
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