INTRODUCTION

          Community health nursing is one of the two major fields of our course academic,

as holistic approach that both enhances and profound our professional health skills and

knowledge to implement feasible and practical interventions. But what is community

health nursing?

          According to the Nurses Association, community health nursing is mainly a

practice that promotes and preserves the health of the population by integrating the

skills and knowledge relevant to both nursing and public health that partners the

individuals, families and community geared to a common goal. This is always been the

guideline of our nursing community education that brings about comprehensive practice,

general care and continual preventive measures which are the core nature of our

nursing practice.

          Significantly focused on the said nursing practice, supervised by our professor

and equipped with health knowledge and skills, we are opted to promote and carry on

our objectives that will have optimal nursing care output from our chosen community

that may show also and employ our qualities and capabilities as registered nurses.

          Through the end of this case study material, that we, students of Graduate

Studies – Group No.___, may be able to present ourselves and persuade our panels

that we have progressed after our community exposure and activities last January 21,

24, 25 and January 27 2012 in Barangay San Roque, Tarlac City specifically Block 2

under the supervision of our Professor Mr. Apollo Facun. Furthermore, uphold the core

nature and essence of community health nursing.

 

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GOALS AND OBJECTIVES

GOALS:

To assess the community’s current health status

To recognize possible relationships/ trends that may affect the community’s

health condition

To render appropriate health care services for health promotion and disease

prevention 

OBJECTIVES:

1. To gather and update the health data of the residents through a

comprehensive community survey, and prepare an initial data base per

household containing data on family structure, characteristics, and

dynamics; socio-economic and cultural characteristics; home and

environment conditions; health status of each member; and health beliefs,

practices, and values.

2. To assess the health needs of the household/community and render basic

health services such as health education programs (health teachings), as

the situation calls for.

3. To recognize present and possible health threats in the community,

through observation and data interpretation/correlation.

4. To assist all sectors involved, especially the family, in organizing a plan of

action, possibly through the utilization of available community health

resources, which will address recognized health problems in the

community.

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TARGET COMMUNITY PROFILE

Barangay San Roque is one of the nine barangays enclosed in the Metro District Division of Barangays in Tarlac City. It is bounded by Barangay San Vicente on the West, Barangay Ligtasan on the East, Barangay San Sebastian on the South, and Barangay Cut-Cut 1st on the North.

Barangay San Roque is classified as Urban Barangay, it has a total population of eight thousand one hundred forty-six (8,146) as of December 2011, and an estimated household population of 1,800.

HISTORICAL BACKGROUND

Barangay San Roque serves as the Southern porter to the political, religious and economic hub or center of the City and Government of Tarlac. It is one of Tarlac City’s biggest barangays with a population of 7,487 as of May 1, 2000 Statistics. An account of 1849 City that Tarlac grew into 13 Barrio’s, though there was not yet the San Roque toponym also it became part of the history where the Guardia Civil executed Col. Francisco Tañedo in January 1898 during the Spanish regime. The same year, San Roque was already mentioned in documents as one of the center of operations of General Francisco Macabulos against Spaniards.

Barrio San Roque named after San Roque or Saint Rock who is the Powerful Patron of the Sick and the suffering. During the 30 th century, it said that many people who were afflicted with dreaded diseases healed through his intercession.

It was March 07, 1969 when a kind couple gave hope for the rise of San Roque Parish. It was through the generosity of the Dr. Ernesto G. Cruz and Mrs. Ursula Magat that the 692 Square meter lot intended for the site of a Chapel for the Roman Catholic Church of Barrio San Roque.

Barangay San Roque celebrates their feast Day every August 16 as a thanksgiving to their Patron Saint Roch (San Roque).

The Socio-Economic and Physical profile is produced to provide baseline and benchmark in terms of livelihood, health and sanitation, peace and order, education, shelter, basic utilities and people's participation among others. This shall hopefully assist decision maker in the barangay to the highest level of government and non-government organizations by providing insight programs and projects for the development of the barangay.

GEOGRAPHIC PROFILE

Barangay San Roque has nine (9) blocks, namely: Block 1, Block 2, and Block 3 to Block 9. It is approximately 1.0 kilometer away from city proper. It has a total land area of 96.51 hectares. Mostly the whole parts of this area designated to business establishments and residential area.

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PHYSICAL AND NATURAL CHARACTERISTICS

1. Climate- the barangay has a temperate climate. It has two (2) distinct seasons: wet and dry. The months of November to April are generally dry while the rest of the year is the rainy season. It receives its continuous rainfall during the southwest monsoon period from June to November, which corresponds with the wet season. The northeast monsoon period from the months of November to May with the dry season.

2. Topography and Slope- the topography is characterized predominantly level to gently sloping (0-3% slope gradient) covers 90.84% or 38, 633.44 hectares which is suitable for urban expansion and settlements development. This slope ranges has lower susceptibility to erosion.

3. Soil Type- Tarlac Clay Loam, Gravelly Phase, this type of soil occurs as areas of lighter soils, with reddish brown to red, gravelly and concretion filled profile.

4. Water Bodies- the city of Tarlac has various communal bodies of water. The main tributary is Tarlac River, which is more or less 16 miles long located

COMMUNITY FACILITIES

Waiting Shed

Health Center

Barangay Hall

Cell Site

Schools

Apartments

Boarding House

Jeepneys and Tricycles

Business firms

Government Offices

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ORGANIZATIONAL CHART

HON. GELACIO MANALANG

Municipal Mayor

HAZEL MIEMEE B. LEGASPI

Barangay ChairwomanPeace and Order and

Beautification

JERJOHN V. VIRAYWays and Means and

Education

YOLANDA B. PUNOHealth and Environment

ALLAN M. BAUTISTAAppropriation and Public

Works

CONSTANTE S. NAVARRO

Peace and Order and Ways and Means and

Education

ROMMEL B. SORIANOPeace and Order and

Beautification

ROLANDO S. SANTIAGO

Health and Environment

DANILO P. SALVADORAppropriation and Public

Works

CHRISTIAN ROMAR D. QUIROZ

Sangguniang Kabataan Chairman

JULIET F. NUNAGBarangay Secretary

ALETHEA M. ALFONSOBarangay Treasurer

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HEALTH CENTER PROFILE

VISION and MISSION

VISSION:

“To render quality and effective service in the community with dedication and

commitment, uplifting the guidelines embodied on the nutrition program this producing

healthy and productive Tarlaquenos”

MISSION:

“That malnutrition will no longer be a problem in the city - a MALNOURISHED -

FREE CITY”

PROGRAMS and SERVICES

A. Maternal/ Women’s Health Care

Pre-natal/ Post natal check-up

Family planning services

Counseling

Home visit

Morbid (sick)

B. Under Five Children (UFC)

Immunization

Well baby check-up

Nutrition services (weight monitoring, nutrition counseling, deworming,

micro-nutrient supplementation, iodine- testing of salt)

C. Environmental Services

Sanitary toilet facilities

Garbage disposal (solid waste management)

Others: community clean- up drive

D. Referral of Cases

E. IEC- Info, Education, Communication

Individual teaching/ Bench Conferences

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Mother’s/ Father’s Class

Barangay/ Community Assembly

Program for Tuberculosis

OPT Program

CLINIC SCHEDULE

DAY VENUE ACTIVITY PERSON IN-CHARGE

MONDAYS Barangay Health Center Clinic Day Nurse I

Casual Nurse

TUESDAYS Barangay Health CenterAraw ng mga

Buntis

Nurse I

Casual Nurse

Midwife I

WEDNESDAYS Barangay Health Center Immunization Day Nurse I

Casual Nurse

THURSDAYS Block 1 – 5 Home Visit Health Workers

FRIDAYS Block 6 – 9 Home Visit Health Workers

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NEMIA L. LUMIBAOMidwife III

ESPERANZA C. BALIGADMidwife II

DULCE B. CATLIMidwife II

NANCY C. JUNIOMidwife I

MERCEDEZ G. ROLDANMidwife I

AILEEN C. SOLIMANMidwife I

ELIZABETH R. ESTEBANMidwife I

TERESITA M. APOSTOLBHW

ESPERANZA D. SEREZOBHW

MELITA B. SANCHEZBHW

CITY HEALTH CENTER I ORGANIZATIONAL CHART

DR. SHIERLY I. TIGLAO

City Health Physician

ANICETA D. LOPEZ

Nurse II

SALVE D. CAPIANNurse I

SHIELA MAIE C. ASUNCION

Casual Nurse

ADORME S. MERGAS

Nurse I

SIR RUBEN C. TIMBOL

Casual Nurse

JEANY ROSE G. JUNIO

Casual Nurse

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COMMUNITY ASSESSMENT

POPULATION PROFILE

Total Estimated Population of Barangay (2011): 8, 146Total Population of Area Surveyed: 297Total Number of Families Surveyed: 63Total Number of Households Surveyed: 48

SOCIO-DEMOGRAPHIC PROFILE

Table I. Distribution of Population according to Gender

Frequency Percentage (%)Male 138 46.46Female 159 53.54

Total 297 100%

GENDER DISTRIBUTION

Males

Females

Based on the table above, majority of the population residing in Block 2 compose of

females. Along with the table on top is the pie graph that shows the percentage of

males and females with 46% and 54% respectively. Meanwhile the sex ratio of males

for every 100 females in the population is 86.79 for the area that was catered.

Table II. Distribution of Population according to Age

Frequency Percentage (%)0 – 5 years old 30 10.106 – 10 years old 36 12.1211 – 20 years old 60 20.2021 – 30 years old 78 26.2631 – 40 years old 36 12.1241 – 50 years old 18 6.0651 – 60 years old 27 9.0961 – 70 years old 12 4

Total 297 100%

9

0%

5%

10%

15%

20%

25%

30%

AGE DISTRIBUTION

0 - 5 years old6 - 10 years old11 - 20 years old21 - 30 years old31 - 40 years old41 - 50 years old51 - 60 years old61 - 70 years old

Since the majority belongs to the 21 years old and above age group, this suggests that

the community is economically productive yet at a relatively high risk for health

problems brought about by work, social and family responsibilities, and age. The

number of dependents that need to be supported by every 100 individuals in the

economically active group is 35.61.

Frequency Percentage (%)1-29 days 2 months – 1 year old(Infancy)2 – 4 years old(Toddler)5 – 6 years old(Pre-school Age)7 – 11 years old(School Age)12 – 18 years old (Adolescence)19 – 34 years old(Young Adulthood)35 – 50 years old(Middle Adulthood)50 years old and above(Old Adulthood)

Total

Table III. Distribution of Population according to Civil Status

Frequency Percentage (%)Child (0 – 12 years old) ? ?Single 186 62.62Married 102 34.34Widow 6 2.02Widower 2 0.67

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Separated 1 0.33Total 297 100%

Child (0 - 18 years old)

Single Married Widow Widower Separated0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

CIVIL STATUS DISTRIBUTION

I & a

Table IV. Distribution according to Religion

Frequency Percentage (%)Roman Catholic 27 56.25Iglesia Ni Cristo 12 25Born Again Christian 3 6.25Others 6 12.5

Total 48 100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

RELIGION DISTRIBUTION

OthersBorn AgainOthersIglesia ni CristoRoman Catholic

Health is directly related to the religious endeavors of an individual. His/her religion

somehow influences the decisions one makes, even those that are health-related. Since

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majority is Roman Catholics, this may place them at a higher risk for health problems

due to the openness of the religion to its believers’ practices.

Table V. Distribution according to Ethnicity

Frequency Percentage (%)Kapampangan 27 56.25Ilocano 3 6.25Kapampangan & Ilocano 9 18.75Others 9 18.75

Total 48 100%

ETHNICITY DISTRIBUTION

KapampanganIlocanoKapampangan & IlocanoOthers

The large number of Kapampangan in the community implies that prevalent health

beliefs and practices in the community are from their group’s culture. This also suggests

that the most common medium of communication is the Kapampangan dialect. Both of

which may affect the acceptance and channeling of health information.

Table VI. Distribution according to Family Type

Frequency Percentage (%)Nuclear 18 37.5Extended 30 62.5

Total 48 100%

Nuclear Extended0%

20%

40%

60%

80%

100%

FAMILY TYPE

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An extended family type is predominant in the area which represents 62.5% in the

graph. It points out that the dependency ratio is significantly high based on the

percentage shown on the graph and supported with the dependency ratio of 35.61 as

mentioned on Table II.

Table VII. Distribution of Families according to Length of Residency

Frequency Percentage (%)Below 6 months6-11 months1 year2 years3 years4 years5 years and above

Total 100

Below 6 months

6 - 11 months

1 year 2 years 3 years 4 years 5 years and above

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

LENGTH OF RESIDENCY

I & a

SOCIO-ECONOMIC INDICATORS

Table VIII. Distribution of Population according to Educational Attainment

Frequency Percentage (%)Nursery 3 0.5Kinder 0 0Preparatory 3 0.5Elementary Graduate 3 1Elementary Level 51 17.17Highschool Graduate 36 12.12Highschool Level 60 20.20College Graduate 66 22.22

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College Level 54 18.18Vocational 0 0Not Applicable (babies) 21 7.07

Total 297 100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%EDUCATIONAL ATTAINMENT

Nursery

Kinder

Preparatory

Elemntary Graduate

Elementary Level

Highschool Graduate

Highschool Level

College Graduate

College Level

Vocational

Not Applicable

The high percentage of college graduates entails a possibly high level of awareness

and better comprehension especially of health issues and practices. It also increases

the productivity level of the community since there is a higher chance of employment

among college graduates.

Table IX. Distribution according to Employment

Frequency Percentage (%)Employed 33 68.75Unemployed 3 6.25Self employed 12 25

Total 48 100%

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Employed

Unemployed

Self-employed

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

EMPLOYMENT

EMPLOYMENT

The above data reflects the high productivity level of the community which in turn

provides more income for the community’s health needs; however the engagement of

most of the population to work also increases the risk for the development of health

problems brought about by the nature of their job and the demands of their working

environment.

Table X. Distribution according to Monthly Income

Frequency Percentage (%)Less than Php 2,000 9 18.75Php 2,000 – 5,000 15 31.25Php 5,000 – 8,000 9 18.75More than Php 8,000 15 31.25

Total 48 100%

MONTHLY INCOME

Less than 2,0002,000 - 5,0005,000 - 8,000More than 8,000

I & a

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Table XI. Distribution according to Type of Dwelling

Frequency Percentage (%)Concrete 21 43.75Mixed 15 31.25Wood 12 25

Total 48 100%

TYPE OF DWELLING0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

ConcreteMixedWood

I & A

Table XII. Distribution according to Ventilation

Frequency Percentage (%)Poor 15 31.25Good 33 68.75

Total 48 100%

Table XII. Distribution according to Lightning

Frequency Percentage (%)Adequate 42 87.5Inadequate 6 12.5

Total 48 100%

ENVIRONMENTAL INDICATORS

Table XIII. Distribution according to Surroundings

Frequency Percentage (%)Clean 36 75Dirty 12 25

Total 48 100%

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Table XIV. Distribution of Households according to Source of Water

Frequency Percentage (%)Artesian well 0 0NAWASA 72 87.5Deep well 4 12.5Others 0 0

Table XV. Distribution of Households according to Toilet Facilities

Frequency PercentageFlush 18 37.5Pit privy 3 6.25Owned 27 56.25

Total 48 100%

Table XVI. Distribution according to Garbage Disposal

Frequency Percentage (%)Collection 48 100BurningGarbage cansBuryingOpen dumpingOthers

Total 48 100%

Table XVII. Distribution according to Presence on Animals

Frequency Percentage (%)Dogs 18 33.33%Pigs 0 0%Cats 9 16.67%Others 9 16.67%None 18 33.33%

HEALTH PROFILE

Table XVIII. Distribution according to Food Storage

Frequency Percentage (%)Covered 30 62.50Refrigerated 15 31.25Uncovered 3 6.25

Total 48 100%

Table XIX. Distribution according to Storage of Water

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Frequency Percentage (%)Refrigerated 18 37.5Uncovered 0 0Covered 30 62.5

Total 48 100%

Table XX. Distribution according to Containers of Water

Frequency Percentage (%)Plastic 45 78.95Bottles 12 21.05

Total 48 100%

Table XXI. Distribution according to Backyard Gardening

Frequency Percentage (%)Vegetables 3 5.88%Fruit bearing 3 5.88%Herbal 9 17.65None 36 70.59%

Table XXII. Distribution according to Food Preference

Frequency Percentage (%)Fish 6 12.5Meat 0 0Fruits/vegetables 6 12.5Mixed 36 75

Total 48 100%

Table XXIII. Distribution according to Utilizing Health Center

Frequency Percentage (%)a. Goes for check-up 9b. Goes only when sick 21c. Does not go for check-up 33

Total 63 100%

With majority of the respondents does not go for check-up even when they are sick,

there is therefore a generally increased risk of developing diseases especially

asymptomatic and chronic types. Another possible implication is a decreased level of

awareness of the residents about health conditions and issues.

On the other hand, failure of most respondents to have regular check-ups were claimed

to be due to lack of time, financial constraints, and the notion the absence of

signs/symptoms means the absence of an illness.

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Table XXIV. Distribution according to Immunization

Frequency Percentage (%)Complete 15 31.25Not Complete 6 12.5Not Applicable 27 56.25

Table XXV. Distribution of Couples based on Perception/Usage of Family

Planning

Frequency Percentage (%)Acceptor 12 25Non-Acceptor 36 75

Total 48 100%

Since majority of the couples opt not to use any family planning method, it may be

implied that the community’s population may increase in the near future; however, it can

also be inferred that the couples may have already opted to practice natural birth

spacing methods.

Table XXVI. Distribution according to Infant Feeding

Frequency Percentage (%)Breast 0 0Mixed 21 70Bottle 9 30

MORBIDITY

DISEASE No. of Cases

Acute Upper Respiratory Infection 75

Hypertension 15

Urinary tract infection 14

Abscess 5

Bronchopneumonia 5

Acute Gastro Enteritis 4

Acute Tonsilitis 3

Conjunctivitis 3

Allergic Rhinitis 3

Infected Wound 2

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IDENTIFICATION OF HEALTH PROBLEMS

A. Present Illnesses

>

B. Environmental Problems

> Poor home/environmental sanitation specifically improper garbage disposal

> Open drainage system

> Presence of breeding sites for insects, mosquitoes and rodents

> Pet ownership responsibilities

> Usage of Family Planning

> Presence of accident prone zone

> Inaccessibility to Health Care Center

> Inadequate Monthly Income

PRIORITIZATION OF IDENTIFIED HEALTH PROBLEMS

A. Present Illnesses

PRESENT ILLNESS FREQUENCY RANK

The identified present health problems were ranked based on the number of cases - the more persons affected with the illness, the higher the rank, the more it is prioritized.

B. Environmental Problems

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1.

Criteria Score WeightHighest score

Computation Total Justification

1. Nature of the problem

> 2.Modifiability of the problem

>3. Preventive potential

>4.Salience

>Total:  

2.

Criteria Score WeightHighest score

Computation Total Justification

1. Nature of the problem

> 2.Modifiability of the problem

>3. Preventive potential

>4.Salience

>Total:  

3.

Criteria Score WeightHighest score

Computation Total Justification

1. Nature of the problem

> 2.Modifiability of the problem

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>3. Preventive potential

>4.Salience

>Total:  

4.

Criteria Score WeightHighest score

Computation Total Justification

1. Nature of the problem

> 2.Modifiability of the problem

>3. Preventive potential

>4.Salience

>Total:  

5.

Criteria Score WeightHighest score

Computation Total Justification

1. Nature of the problem

> 2.Modifiability of the problem

>3. Preventive potential

>4.Salience

>Total:  

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CURRENT PROGRAMS IN THE COMMUNITY

PROGRAMS PROGRESS TIME FRAME

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