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University of the CordillerasCorner Governor Pack Road, Baguio City

COLLEGE OF NURSING

Central Bayabas, Sablan, Benguet

(July 3 – October 4, 2004)

COMMUNITY DIAGNOSIS PROGRESS REPORT

In Partial Fulfillment of the Requirements for

The Course

Nursing Care Management 101

Presented by:

BSN III

Section 3

Groups A, B, C and D

NCM 101

Ms. Maribeth Esteban, RNClinical Instructor

Central Bayabas, Sablan, Benguet

ACKNOWLEDGEMENT

To our Almighty God, thank you for imparting wisdom,

strength and guidance. Thank you for the wonderful

creations you have shared and given to us that we may enjoy,

learn and care for it.

To our parents; for the years of sending us to school,

for believing in us, for the support, and for the

understanding despite the skepticism and doubt, thank you

very much.

To our clinical instructor, Ms. Esteban, thank you for

imparting your knowledge and opinions to us, for

accompanying us in every journey of our community life, for

lightening our burdens, thank you very much.

To the people of Central Bayabas, Sablan, thank you for

giving us a warm welcome, for letting us feel home, for

letting us experience your life, for letting us understand

your culture and tradition, for teaching us do the “raep

raep thing”, for sharing to us your bountiful fruits, for

letting us experience the spirit of the bugnay wine… once

again our gratitude.

To Mr. Oyam and the teachers, thank you for the

understanding, the support and for letting us stay in your

lovely school.

To the students of Central Bayabas Elementary School ,

thank you for cooperating with us, thank you for the games,

thank you for letting us play with you…

Thank you very much.

SECTION 3

I. Introduction

Community Health Nursing has long been in the forefront

in educating the people on basic health care and in

providing access to health services for vulnerable groups

and communities. Community Health Nursing is a synthesis of

nursing practice, public health practice, health promotion

and primary health care. The practice of community health

nursing expands into the areas of disease prevention, health

enhancement, empowerment, advocacy, community development

and research. The nature of community health nursing is

comprehensive and directed towards the individual, families

and the community at large. As community health nurses, we

fulfill a unique role in the community, promoting and

protecting the health of the community, while using a

framework of sustainability. We promote optimum health of

individuals and the community by promoting the right to

informed choice, advocacy and self-determination. We also

identify and challenge barriers to wellness and empower

people to change the agents that affect their health

adversely.

Pasdong is a rich land where farming is the primary

source of livelihood. As has been described previously by

observers, this place is only remote but not considered as a

depressed area. This means that majority of the constituents

of this are average in terms of economic well-being. This

now calls for further development towards socio-economic

progression. The land is well-cultivated for different crops

that are even exported for commercial consumption. Some of

these are the Pasdong sayote, camote and peanuts being

commercialized and popularized to the public consumers.

Also, the creation of the “Bugnay wine factory” owned by the

Cooperative give way to further commercialization agenda.

However, the locals needed more teaching on how to maximize

these for it to be globally competitive Furthermore; it is

inevitable that this approach would affirm to the idea of

linking wage growth with productivity. Equally important to

this is to provide the locals open doors for selling of

these products in a wider scope. This concern is rooted in

the view that the core of the poverty problem is

joblessness, thus highlighting the need to create new

employment opportunities in the area. At the same time, many

people who have jobs are under-employed and on low wages.

Associated with this is the need to improve the quality of

the workforce in terms of skills for productivity, as well

as the quality of employment, with respect to working

conditions, remuneration and welfare. Thus the employment

challenge calls for the formulation of coordinated

strategies to promote “full, decent and productive

employment” in both the formal and informal economy as a

means of alleviating poverty. To achieve this, the

Government appears to recognize that ultimately its role in

employment promotion is to provide a suitable policy

framework that enables the private sector to perform its

role as the primary source of employment generation.

In terms of health resources, there is only one doctor

provided for the entire place of Sablan. This state is a

reflection of the national-wide health issue governing the

unequal distribution of health facilities and health workers

in the local area. This goes back to the issue of those

missing doctors, nurses and teachers which are part of the

vast legions of overseas Filipino Workers (OFWs) - something

that leads former senator and vice-presidential candidate

Loren Legarda to cry over the international image of

Filipinos as "the groveling nomads of the world". In

relation to this, up to 8 million Filipinos are OFWs. Of

those, about 2.5 million are permanent foreign residents;

but the majorities are registered (42%) or illegal (58%)

overseas workers, at least 50% of them women. Without OFWs,

the Philippines would already have hit rock bottom: they are

sending about $8 billion back home per year, and counting.

Unofficially, the total amount of remittances may be 50%

higher, or more. On the other hand, there is a rest back of

this such as lacking health workers to cater to the needs of

the Filipino including those in the countryside and other

more remote places like Sablan.

Overall, there should be expanded employment for

everyone utilizing the resources in the community. Further,

national issues should be addressed through

institutionalized processes as to give solutions to the

local issues as well surrounding the provincial areas such

as Sablan. Through these institutions and processes, the

social partners participate with government in policy-making

and implementation and thereby play a major role in

addressing the social and labor market issues arising from

globalization.

Our exposures to Central Bayabas gave us the

opportunity to experience and understand how people in the

community deal with their daily lives particularly those

concerning health. We were able to extend health services,

health teachings and health monitoring in keeping up with

the Department of Health’s programs. We adhere to their main

purpose of improving and sustaining the health situation of

the most vulnerable individuals and communities eventually

making them self-sufficient in health care through

cooperation with LGUs and community members themselves.

OBJECTIVES:

GENERAL OBJECTIVES:

A) Deliver efficient health care services

B) Apply COPAR and primary health care principles

C) Appreciate community health nursing practice

SPECIFIC OBJECTIVES:

A) Promote health through health education and follow-up

care to identify their needs and formulate a plan of action

to attain these needs by focusing on their immediate and

long-term needs and problems.

B) Help the community health workers in generating community

participation in health development activities.

COMMUNITY DATABASE

Barangay Profile-Barangay Bayabas, Sablan, Benguet

I. GEOGRAPHICAL LOCATION AND ACCESS

Barangay Bayabas is located on the southern portion of

the Municipality of Sablan , Province of Benguet . It is

eight (8) and four (4) kilometers away from the Poblacion

and Naguilian Road , respectively. The center of the

Barangay is Bayabas proper which is 24 kilometers away

from the City of Baguio and 34 kilometers away from the

provincial capitol which is located in the Municipality

of La Trinidad .

II. POLITICAL

Barangay Bayabas is composed of twenty-five (25) sitios

- Monglo, Sedong, Abuloy, Amocao, Balococ, Kipa, Payda,

Bacbacan, Central Bayabas , Calamay, Colat, Teytey,

Beckes, Tongsul, Sacnib, Coplo, Mangi, Batwel, Kinakawan,

Kabaong, Talete, Pagalan, Pidawan, Bulala and Bagto.

III. LAND AREA

Barangay Bayabas is the biggest among the eight

(8)barangays of the Municipality of Sablan in terms of

land area. The Barangay has an area of 2,142 hectares and

it accounts to 26.67% of the total land area of the

municipality.

IV. POPULATION AND HOUSEHOLDS

The Barangay has a total population of 1,972 with 362

households based on the minimum basic needs survey

conducted in 1998.

V. LANGUAGE AND DIALECT SPOKEN

The most common dialect is Ibaloi followed by Ilocano,

Kankanaey, Ifugao, Bontoc and Pangasinense.

VI. HOUSING

Many of the housing structures in the Barangay are made

of timber and galvanized iron.

Houses belonging to above average income earners are

made to concrete structures.

VII. EDUCATION

Barangay Bayabas has two Public Elementary School-

Talete Elementary School and Bayabas Central Elementary

School . It has also two Day Care Centers- Monglo Day

Care Center and Bayabas Day Care Center.

VIII. LAND USE AND SOURCE OF INCOME

Eighty-five percent (85%) of the total area is

considered an agricultural land hence, the principal

source of income is diversified farming.

IX. MANAGEMENT

The Barangay Government of Bayabas is managed by the

following:

1 Punong Barangay

7 Barangay Kagawads

1 Barangay Secretary

1 Barangay Treasurer

1 Sangguniang Kabataan Chairman

12 Members of the Lupong Tagapamayapa

9 Action Members of the Barangay Tanods

10 Action Members of the BHW

2 NGO members of the Barangay Development Council

Barangay Bayabas is being developed with the future

generation’s welfare in mind. Sustainable developments

particularly in economic, social, and cultural sectors

are being pursued. The programs, projects, and activities of

the Barangay are geared towards empowering the people and

improving the quality of life of its constituent.

II. Community Problems According to Priority

Health Problems and Needs

The following are seen as health problems and needs of the community people:

With regards to health problems, there are a

significant number of populations that are hypertensive

especially the elderly. With this problem, the community

needs information dissemination on the diet and lifestyle

modification. Information about lifestyle is very vital to

be imparted to affected population like proper exercise,

limiting alcohol consumption and vices.

Another health problem that was observed in the

Barangay is that children don’t have proper hygiene and

grooming which may affect their health. These problems are

easy to manage, simple measures on explaining the importance

of proper hygiene and grooming to their health. Cooperation

between teachers and parents are very important that the

children will continually practice it.

One more problem is the unsanitary environment

involving the community’s toilet system and pig pens.

Some modifications with regards to the school is needed

so it may serve as a medium of effective and conducive

learning.

III. Community Diagnosis Action Plan


Objectives Strategies Expected Outcomes

1. Hypertension among elderly

After the health teachings to the adult community, they will be able to understand the importance of proper nutrition, and lessen, if not totally eradicate, the factors that can contribute to hypertension

Health Teachings/Home visits

The community people will be able to apply what we have taught them regarding proper management of the condition.

2. Personal Hygiene of the pupils of Bayabas Elementary School

After the physical assessment rendered to the pupils as well as the health teachings taught to them, they would be able to maintain proper

Physical Assessment and Health Teachings

The pupils will be able to understand and apply what are being taught to them.

personal hygiene. Furthermore, pupils that need referrals to health medications will comply with the said recommendations.

Pupils who need further medical medications will be given appropriate attention.

3. Unsanitary Environment

After teaching, people in the community would be able to provide solutions to their unsanitary toilets and foul smell emanating from the pig pen

Home visit The community people will result ways of doing proper sanitation that greatly affects their health.

4. a. Beautification of the School (School yard, H.E. room and School Library)

b. Cultivation of the herbarium, setting up of the compost pit

After the exposure in the community, we will be able to finish the beautification of the school

After the exposure in

Labor

Labor

The people will admire and appreciate the contribution of the group to the school

the community, we will be able to maintain and improve the herbarium as well as fix the compost pit.

The people will admire and appreciate the contribution of the group to the school.

Preserve the plants.

Use the herbal plants.

Use the compost pit.

IV. Implementation phase


Strategies Actual Evaluation

Hypertension among The groups The family

adults in the community

monitored the blood pressure of the community folks. Through health teachings, they were reminded about the factors which affect blood pressure, such as, foods to be avoided, proper diet, exercise, and the use of garlic to control hypertension.

listened attentively and asked questions about their present condition.

Personal hygiene of the pupils

Physical assessment, cephalocaudal assessment, to all the pupils of Bayabas Elementary School was done. Letters to parents/guardians of pupils who need further medical attention were given thru Sir Oyam, the head of the school.

Furthermore, health teachings to the pupils were done to emphasize the importance of proper personal hygiene.

All the pupils participated in the physical assessment.

The pupils listened attentively to the health teachings.

Unsanitary environment

Through health teachings, the concerned community folks were informed about the proper

The family listened attentively and asked questions about their

maintenance of clean toilet and pig pens

present condition.

Beautification of the school

The group helped in the beautification of the school specifically the H.E. Room, School Library, Schoolyard and Herbarium.

The school officials appreciated our effort for a job well done.

V. EVALUATION and CONCLUSION

Goals and objectives of the groups were satisfactorily

attained.

Based from the community exposure, the following

conclusions are drawn:

1. Community integration is important in building trust

with the community people.

We had implemented our ocular survey and courtesy call

to meet people.

We built trust by means of home visits and we had

taught the people measures in dealing with their

deficiencies.

2. The community had helped us learn to deal with

different cultures, values and belief of the people.

We were able to manage and gauge proper intervention

needed to cater to different sorts of people possessing

dissimilar qualities.

VI. RECOMMENDATIONS

In line with the conclusions, the following are

recommended:

1. The continuity of care of the pupils of Central

Bayabas Elementary School should be exercised.

This is to remind pupils that improper hygiene would

greatly affect their learning and may pose a greater

risk of emerging diseases.

2. The continuity of the beatification and cleanliness

of Central Bayabas Elementary School .

This is for the maintenance of their school’s

cleanliness to give way to effective and conducive

learning.

3. The continuity of home visits.

This is to facilitate effective health care

intervention for those people who are unable to reach

nearby health care facilities.

APPENDICES

Summary of Activities

Group A:

Dates of Duty: July 3 – 19, 2008

Members:

Binha-on, Claire Marie

Bondad, Kiezel

Calub, JF Nicole

Gayaso, Raqueline

Gumpac, Rizalino

Lachica, Regency Mae

Pingol, Christine

Quilala, Giezle

Sowaken, Mary Lynette

Tamayo, Kimberly

Timaan, Ma. Bernadette

Villar, Danzen Apple

WEEK 1: July 3-5, 2008

Our group departed from UC-BCF at 7am. We arrived at

the Municipal Health Office in Sablan at 8:30am. We had a

brief orientation conducted by Dr. Judith Codamon, Municipal

Health Officer and Ms. Olivia Lambayong, Midwife II-Central

Bayabas. Shortly after, we proceeded to Central Bayabas

Elementary School . We had a courtesy call to the School

Principal in the person of Mr. Nilo Oyam. After which, we

proceeded to the staff house which is the school library

where we reside during our 3 day stay at the community.

After putting things in order, we then went to a nearby

store to give courtesy to Mr. Teofilo Anasioco, Barangay

Captain of Sablan. Along with a Barangay Kagawad, he

oriented us as how many sitios are there in the area.

On the second day, our group went to our destination

which is Sitio Bekkes .We was divided into pairs to perform

ocular survey and home visit to the area.

On the third day, the group went for ocular survey and

home visit to nearby houses in Sitio Central Bayabas. We

went back to Baguio City from Sablan later in the afternoon.

WEEK 2: July 10-12, 2008

Coordination with Mr. Nilo Oyam regarding the following

the beautification of the school clinic was done as well

with Mr. Teofilo Anasioco for the upcoming case presentation

regarding End-Stage Renal Disease.

On the second day, our group went back to do thorough

assessment in selected households in Sitio Bekkes for the

preparation of our FNCP.

On the third day, the group stayed in the school for

the beautification of the School Clinic. We departed from

Sablan to Baguio City in the afternoon.

WEEK 3: July 17-19, 2008

The group stayed in the school for the arrangement and

beautification of the H.E. Room. During the rest of the

afternoon, we cleaned and arranged the herbal garden located

at the back of the school.

On the second day, the group did morning exercises

together with the teachers and students. In the afternoon,

we cleaned the school yard.

On the third day, the group had a general cleaning of

the school library. We departed from Sablan and proceeded to

Baguio City in the afternoon.

Group B:

Dates of Duty: July 24 – August 16, 2008

Members:

Cabfit, Domanay

Camarao, Mildred

Caw-as Naty

Espiritu, Maritess

Kimay, Jeanette

Madarang, Daisy

Manguba, Divina

Nemedez, Bernadette

Olat, Alvin

Osenio, Janice

Torres, Marie Antonette

Wallang Lilibeth

WEEK 1: July 24 - 26, 2008

Our ever first community immersion was full of

excitement, and anticipation of what community can bring

us. For some of us, they are less exposed as compared to

others since they lived all their lives in the comfort of

the city life and taking every task a challenge to win. The

hardships of hiking several mountains and the struggles of

breathing while taking our route up the mountains were much

easier to laugh about after arriving at the site. During

this week we did our ocular survey of our site visiting from

house to house to establish rapport to the people. During

the initial assessment, we took notes on the responses of

different household who took us in and even to some who were

hesitant to let us in to their homes at first. At some

point, when we weren’t able to enter all houses and seemed

welcomed us, we felt frustrated and figure out on ourselves

the possible reasons for this reaction among the locals.

First that we come out is that these people known for being

hardworking people are quite busy tending their own fields

waking up at very early which gives the reason why most of

the houses are closed. Another reason is that the people are

generally shy if not a little bit “hostile” towards

strangers which is manifested b their rigidity of some to

welcome us on their homes. However, we were determined as a

group to take this a test that we need to pass and at the

end of this immersion, things can be better for us all. We

also observed the natural fauna which is preserved by the

locals despite the introduction of roads at the core of the

mountainous terrain.

WEEK 2: July 31 - August 2, 2008

For the second week, we established rapport with the

community people as the initial step we always do in an

immersion. Unfortunately, the news came to us that our

patient suffering of chronic urinary disorder just passed

away so we decided to go to attend the burial. We have seen

how the burial rites go. The villagers were united during

the mourning sessions like this. There were all gathered at

the residential area of the dead. As a traditional way, the

family butchered pigs to cater in to the attendees. The

family was accommodating and the people showed as warmth as

we participate in the burial session. We have shown our

deepest condolence to the family while we also took part in

getting the blood pressure among the folks applying

therapeutic communication as we converse with them. We can

feel gradually that the barrier between us and the people

became lighter felt we gained trust as we respected them for

their tradition and actively and sincerely cooperated with

the events as it happened along the way.

WEEK 3: August 7 – 9, 2008

Third week it is. This was a bit more exciting for the

rest of us. We we’re invited to join the neighborhoods to

plant rice as planting rice is a community event or

traditionally done in “Bayanihan” order in such a way that

every rice field are planted by the members of the community

one after the other. Our group personally called this

activity as the “Let’s do the raep – raep thing”, of which

“raep” is the Benguet term for “plant”. We had fun even if

it was drizzling during that day.

The next event that we did is to organize a program for

the Nutrition Month in addition to feeding program. We

prepared a short skit or short stage play and invited the

children as well as the teachers to participate at the end

of the skit. In line with the Nutrition month, we

distributed the food that we prepared catering to all the

students in the school. The event is rewarding knowing we

were able to put smile on the faces of each child with our

small ways.

We also made a follow-up visits to the area.

Surprisingly, the villagers were more open to us at this

time. We were offered some few sip of coffee and hot

chocolate, in their homes while we lightened the

conversation with a spice of humor. We observed that the

people may be a little bit reserved when they speak but they

can also have a good sense of humor with them. We were also

offered “buko”, santol, guava and rambutan as our

“baon”. During the home visits, we made sure to meet our

objectives though. We assessed every home, took down

family’s health history, observed health practices and

lifestyle and listing all the data we need.

WEEK 4: August 14 - 16, 2008

This is the fourth and the last week of our immersion

with the community people. Starting our day was leading the

morning exercises for the students which they enjoyed since

some of the exercises we taught them were unfamiliar to

them. We were invited to the Bugnay factory owned by the

Coop for the Bugnay wine making. We observed the process and

listened while it was being explained to us every step. We

gained insights and we understood that making wine is not as

easy that what is seems. The process involved is critical

and that every step is crucial for the success of the entire

wine making with the goal of producing a fine or quality

product that can be available commercially. However, it was

also noted that funds can be a primary constraint to this

endeavor and that much work needed to be done in into its

progression.

Further, first aid teaching to the students were also

organized as part of our initial plan. After the teaching,

we allowed the children to demonstrate to us what they have

learned.

Finally, we did our last home visit particularly to the

area we haven’t visited. We performed the needed assessment

and took the BP of the residents while giving health

teachings as well. For some of our findings that needed

immediate attention, we referred them to the nearest local

clinic.

Group C:

Dates of Duty: August 22 – September 13, 2008

Members:

Bencio, Jennelyn

Budong, Rita

Cabote, Joanna Marie

Ebuenga, Therese

Facunla, Current Grace

Fontanilla, Ronnie

Opolento, Lilibeth

Pihoc, Rosemarie

Pletchetero, Dianna

Sagubo, Jovy

Sigabu, Arcel

Unay, Lyzette

WEEK 1: August 22-23, 2008

The group made an ocular survey in Colat and Teytey

WEEK 2: August 29-30, 2008

The group had home visits; also, we had conversations

with the clients.

WEEK 3: September 4-6, 2008

The group had home visits in Calamay. We also cleaned

the surroundings of Bayabas Elementary School .

WEEK 4: September 11-13, 2008

We had our last home visits in Sitio Calamay. We

cleaned the surroundings of the school as well as the school

library. Furthermore, we fixed the school compost pit.

Group D:

Dates of Duty: September 18 – October 4, 2008

Members:

Agasen, Clifton

Agrimor, Raiza Lea

Balingan, Ruthlyn

Carpio, Liza Lorraine

Cunanan, Precy

Dianso, Lucille

Estipular, Jennifer

Fernando, Mary Giselle

Focasan, Amyline

Malag, Marie Ann

Operana, Mariza

WEEK 1: September 18 - 20, 2008

Before heading to the community and since it was our

first exposure to the community, we first have our

orientation given by the municipal nurse on duty at the

municipal health center before we proceed to the barangay

office and have our courtesy call with the barangay captain

together with another group. On our first week of dwelling

within the community at the school library, we journeyed

towards the Sitio of Calamay for home visit with the

following goals: to establish and maintain the started

rapport with the community people, to evaluate and update

the general health status of the folks, to report and attend

initially to any encountered diseases or situations that

need immediate and further medical attention. We all did

these together with the supervision of our clinical

instructor.

WEEK 2: September 25 - 27, 2008

On our second week of stay, we continued our home

visit, this time towards the Sitio of Beckes, having the

above mentioned goals and also rendering our nursing

interventions to the community people who were in need.

Also, to encourage the people to change or improve their

practices affecting and alleviating diseases that brings

great effect to them as a functional citizen.

WEEK 3: October 2 - 4, 2008

During our last week, we carried out the order of our

Dean who visited us the past week and offered us to

accomplish physical assessment to the entire pupils of

Bayabas Elementary School ; this is to serve as their health

record. We assessed them thoroughly and accordingly

considering every aspect and we wrote a letter to the

parents of those students who need referral for medical

interventions. After this activity, we also integrated

health education emphasizing on the needs of the students

basing from our assessment, such as the need of the pupil to

be reminded and encouraged for their good and proper

hygiene. We also carried out our nursing interventions to

the folks who were in need as well as integrating our

termination phase with them. Moreover some activities and

moments of the group speak of through the pictures in the

succeeding pages.

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