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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