Community and Public Health

(Bronchitis)

Group 2 MD2Y2-3 PROF. Gianne Ulanday, RMT, MPH

Chapter I ANALYSIS OF THE COMMUNITY SITUATION

A. Situational Analysis: Vital statistics for 2007-2009 yDescription of the state of health development

a.

CHARACTERISTIC OF THE PHYSICAL TOPOGRAPHY

Valenzuela City is located in the Philippines' National Capital Region of Metro Manila, with approximately 594,355 residents in 32 barangays, which are divided into two Congressional districts. Valenzuela has a land area of 44.59 km2 divided into several domain: residential, industrial and cultural. It is bordered by Meycauayan City, Quezon Cityand northern Caloocan City to the east; by Obando in Bulacan to the west; by Malabon City, southern Caloocan City and Tullahan River to the south.

TRANSPORTATION
Two major highways traverse Valenzuela City the MacArthur Highway and the North Luzon Expressway. The proximity of the North Luzon Expressway to the city center makes Valenzuela a northern gateway to Metro Manila and a choice location for business. Public transportation within the city, like in most of the urban areas in the Philippines , is facilitated mostly using inexpensive jeepneys and buses. Tricycles are used for short distances, while taxi cabs are used by the upper middle class to navigate any course.

SANITATION
Valenzuela mayor Sherwin Gatchalian reorganized the city's AntiDengue Task Force (ADTF).http://en.wikipedia.org/wiki/Valenzuela,_Philippines cite_note-decline_dengue-39 The task force is headed by Gatchalian, as the chairperson with the city health officials and workers as members. ADTF was tasked to, primarily, disseminate information drives on how to prevent and clean mosquito-breeding sites, cleanliness campaign against dengue, and house-to-house inspection. At areas with serious dengue infection, regular fogging and larvae-trapping are applied. According to Health secretary Francisco Duque III, even though the city has high infection rate to dengue, it only have very low fatality rate.

In September 2009, the Department of Health distributed free Olyset antidengue nets treated permethrin insecticide to Gen. T. de Leon High School. Over 150 rolls of the nets were given and installed to the windows of the said school, as part of DOH's "Dalaw sa Barangay: Aksyon Kontra Dengue" (Visit Barangay: Action against Dengue) campaign. For Tampoy II, a sitio in Valenzuela; an interview with one of the member of the community and a representative from the baranggay stated that sanitation within their is maintained through a sudden visit by the local street cleaners, other than that, there are no other remaining means of maintaining sanitation in the community.

b. Characteristics of the population for the year 2007-2009 ( Valenzuela )

Figure b.1

Source: Valenzuela, City Health Office

The Population in Valenzuela City

has increased

from 555,272 in the year 2007, 581,514 in the year 2008 and 594,355 in the year 2009.

Sitio Tampoy population for the year 2007-2009 9,058 Sito Tampoy has a total population of

Sex Ratio of the year 2007-2009 (Valenzuela)

Figure b.2
Source: Valenzuela, City Health Office

The graph above shows how many males are there in every 100 women in Valenzuela. From a low rate of 107.72 in the year 2007, it suddenly increased to 110.16 in the year 2008 and later on, once again decreased to 104.88 in the year 2009.

c. Health status of the population

Nutritional Status of the year 2007-2009 (Valenzuela)

For

the span of 2007-2009 the Nutritional status of

Valenzuela, the bigger portion of the population is under normal state, while a portion of 6% out of 100 is severely underweight and underweight for the year 2007 and 2009, and reaches its increase on 2008 by 1%, totalling it to 7%. And through the 3 consecutive years, the percentage rate of people under the overweight group remains constant by 1%.

Crude Birth Rate of the year 2007-2009 (Valenzuela)

Figure c.4
Source: Valenzuela, City Health Office

From a low rate of 14.48 in the year 2007, Crude Birth Rate increased to 15.19 in 2008 but partially made its way down to 14.83 in the year 2009.

Crude Death Rate of the year 2007-2009 (Valenzuela)

Source: Valenzuela, City Health Office

Figure c.5

As seen from the graph, compared to the year 2008, the year 2007 and 2009 was an increasing year for Crude Death Rate. from 3.70 down to 3.15 then increased to 3.67.

Maternal Mortality Rate of the year 2007-2009 (Valenzuela)

Source: Valenzuela, City Health Office

Figure c.6

The Maternal Mortality Rate sloped down to 0.34 in the year 2008 from a high rate of 0.62 in the year 2007, and it once again increased to 1.13 in the year 2009.

Infant Mortality Rate of the year 2007-2009 (Valenzuela)

Figure c.7

Source: Valenzuela, City Health Office

Infant Mortality Rate slightly went down to 13.82 in the year 2008 from a rate of 13.93 in 2007, but increased to 15.89 in 2009.

Under Five Mortality Rate of the year 2007-2009 (Valenzuela)

Source: Valenzuela, City Health Office

Figure c.8

2008 is a year of decline for Under Five Mortality Rate, from a higher rate of 19.15 in 2007 and an increased of 29.11 rate in 2009.

Death by sex per year of the year 2007-2009 (Valenzuela)

Source: Valenzuela, City Health Office

Figure c.9

As the graph shows, for 3 years in a row, there is a consistent higher death rate of the male population than the female population, but the total death rate decreased in the year 2008 and increased in the year 2009.

Leading causes of mortality of the year 2007-2009 (Valenzuela)

Count of count

Column Labels

Row Labels

2007

2008

2009

Grand Total

Cancer, all forms

Diabetes Mellitus

Diseases of the Heart

Hypertension

Pneumonia

Grand Total

15

Source: Valenzuela, City Health Office

Source: Valenzuela, City Health Office

Figure c.10

From our gathered data about leading causes of mortality, we found the diseases consistently present within the 3 years of scope. And we found out that Cancer of all forms, Diabetes Mellitus, Diseases of the Heart, Hypertension, Medico-legal Cases, and Pneumonia.

Leading causes of morbidity of the year 2007-2009 (Valenzuela)

Row Labels

Sum of Count

Upper Respiratory Tract Infection

105659

Bronchitis

22189

Dermatological Conditions

15701

Urinary Tract Infection

11334

Hypertension

10799

Grand Total

165682

Figure c.11
Source: Valenzuela, City Health Office

The table is based from our gathered data about the Leading Causes of Morbidity in Valenzuela, and as it had been analyzed, we tried to find out the consistent diseases present for 3 consecutive years. And as the data shows it, there are 5 consistent diseases namely: Bronchitis, Dermatological

conditions, Pneumonia, Upper Respiratory Tract Infection and UTI.

CLUSTER HEALTH PROGRAMS

I. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1.

Prevention and Control of Communicable Diseases Maternal and Child Health Rabies STD/AIDS Dengue Cholera Malaria Mumps Diphtheria Tuberculosis Pertussis Hepatitis 12. Poliomyelitis 13. Leprosy 14. Tetanus 15.Measles 16. Typhoid Fever 17. Pneumonia 18. Amoebiasis 19. Filariasis 20. Helminthiasis / Other Parasitism 21. Reproductive Tract Infections 22. Dental Caries

II. Family Health and Special Population 1. Family Health / Special Population 1. Woman in Difficult Circumstances

1. 1. 1.

Nutrition Family Planning Newborn and Infants

10. Persons with Disabilities 11. Rural Poor 12. Urban Poor

1. 1. 1.

Adolescents / Youth Protection Adults Senior Citizens

13. Indigenous People 14. Migrants 15. Violence and Abusive Behavior

1.

Children in Need of Special Protection

16. Physical Activities and Fitness

III. Environment and Occupational Health

1.

Occupational Health

1.

Sanitation and Environmental Health

1.

Disaster

1.

Health-related Behavior and Practices

IV. Epidemiology, Management Information System, Research and Development

V. Health Education and Promotion Programs

Chapter II IDENTIFICATION AND ANALYSIS OF PROBLEMS AND PRIORITIES

A. Problem Identification and Prioritization

a. Selection of problem
As the data of the municipality shows, leading causes of mortality in Valenzuela are Cancer of all forms, Diabetes Mellitus, diseases of the heart, Hypertension, Medico-legal Cases, and Pneumonia while the leading causes of morbidity are Bronchitis, Dermatological conditions, Pneumonia, Upper Respiratory Tract Infection and UTI. As it is seen in the above tabulation, a leading cause of morbidity which is Bronchitis; an upper respiratory tract infection, should be prevented from spreading more, considering that such disease are known to be airborne and could be transfered easily from person to person, or from an object to person.

b. Prioritization of problem
b.1. magnitude of the disease b.2. severity of the disease b.3. support from the health center of Tampoy b.4. Ability to change the status of the community related to the disease

Magnitude of the disease- To determine what disease spread thoroughly to know how affected the community is by the disease. We multiplied it by five because, for us, preventing a certain wide spread disease from enlarging its number is better than preventing a non-wide spread disease.

Severity of the disease- To know how serious a disease could damage a certain community in determining which disease needs attention due its impact in public health. We also multiplied it by five so that the infection will be prevented early.

Support from Health Care- We need the approval of health care workers from health center, (elysian) to have a full support in making our program possible. We multiplied it by three because even if their support is important, we would not know if we would still have their full support.

Ability to Change the status of the community related to the disease- In this criteria would know if our program has been able to make a certain change in the community, multiplying it by 4 makes it not too safe and not too perfect as a criteria, because it all depends on our program to be made.

c .Decision Matrix

Magnitude (5x)

Severity (5x)

Support from Health Center (3x)

Ability to change (4x)

Total

Pneumonia Bronchitis Hypertension

1(5) 3(15) 2(10)

2(10) 1(5) 3(15)

1(3) 3(9) 2(6)

2(8) 3(12) 1(4)

26 41 35

D. Identification of Problem

d.1 Problem Tree

nemployment

absenteeism

Cases of death

Weak body

Health cost

When disease became chronic

The problem tree shows that increased cases of bronchitis is due to a dirty environment, an environment that lacks proper sanitation is due to lack of information and good maintenance headed by the baranggay officials in cooperation with the health center but since good connection within the baranggay officials health workers and members of the community is not present, the needs of the community, may it be regarding health or poverty is not addressed accordingly to what the community really needs. If such cases especially in terms of diseases wont be responded rightfully by the community leaders, widespread of such problem all over the community wont be controlled, and unwanted results would soon appear and later on might affect the whole society.

To be able to avoid such matters to happen, we need to target the problem by its roots and that is the lack of awareness on both Bronchitis and sanitation and especially on sanitation since its the basis of a healthy living; if people are not aware of what Bronchitis is and how would they acquire the disease, and if what bad sanitation would cause them, they would not be determined to act for their own prevalence.

d.2 Objective Tree

To prevent another increase and future cases of Bronchitis, we need to address a certain problem that causes the main factor for acquring the disease. Since Bronchitis is known to be an airborne disease and originates from all lung irritants, specifically dust and other harmful gases present in the air, we need to consider that the only thing that could avoid cases of such diseases is to attain a good and well-

organized sanitation within the community; and to be able to accomplish that, we need to encourage the people to work together and be responsible for themselves. To encourage them in doing such things, the first thing we have to do and primarily focus on is to increase the awareness of the community about their present status in both matters; cases of Bronchitis and Sanitation.

To be able to accomplish our objective of increasing awareness within the community, we should: a. Attain good information dissemination within the community -As we try to understand and analyze the situation of the people in Tampoy II, we came to find out that most of them doesnt know what Bronchitis is, of what is its symptoms and how would they get such disease. Supporting this realization is the fact that the municipal has no programs for Bronchitis though its cases had been present for 3 consecutive years.

Such findings prove that the members of the community is are not well informed about the matter. They are not aware that everyone in their community is susceptible to Bronchitis. For this, we need to initiate the dissemination of information, so that the community would now be aware of what to do and if ever they would encounter cases of Bronchitis. And also, with good information, people would be determined to work on theyre on improvement and achieve of what is needed and that is to attain good sanitation and for them to prevent diseases like Bronchitis and other diseases caused by bad sanitation.

b. Promote good connection between the health workers, baranggay officials and members of the community -Tampoy II is located near Our Lady of Fatima University but we discovered that there is no accessible health center in their community, if they need health assistance from the health center, they would travel all the way to B.B (elyssian health center) to seek help. With this kind of system, people wont report anymore about their health status in the health center, thus such access would create misunderstanding on the part of the initiators of the projects for the community (health workers and brgy. officials) and the members of the community itself.

Possibility of implementing improper projects for the community can be seen upon the situation due to incompatibility of the project to what the community really needs. So we need to promote a good connection or cooperation between the community and their leaders that would provide them assistance for what they really need.

c. Alternative Tree

Awareness on sanitation

Good dessimination of information in the community through IEC materials and seminar

Promoting togetherness in the community to attain good sanitation

To be able to accomplish our desired outcome for our project, we need to have a good foundation to start everything. To accomplish awareness, we need to have good dissimination of information by distributing IEC materials; distribution of IEC materials within the community would inform people in the simplest way, and to further expand the information, we would conduct a seminar that could explain and answer all their questions.

But to be able to attain full awareness of the community, we should be able to promote togetherness within the community, so that information would pass on in every member and they could all together act upon accordingly to their own will for their own sake. With both of these put together; good dissemination of information and promotion of togetherness in the community, full awareness of sanitation is not all that they could achieve, but also full sanitation of the whole community.

PROJECT PLAN PROJECT TITLE: Duming dulot ay Bronchitis, puksain ng tulong tulong na Paglilinis AND Think Green, Aim Green

Background and Significance of the project: We constructed a project concentrating on awareness on both matters of the community; Bronchitis and Sanitation. We found out that the municipality of Valenzuela has no current programs for Bronchitis, and for the matter of sanitation in Tampoy, as we questioned some baranggay officials and members of the community, sanitation in their community is maintained through a sudden visit of municipal cleaners. For that, we suddenly have a thought; why not let the community be independent and have their own ways.

. If we could make the people aware of what bronchitis is, and what harm it could do on them, hence the fact of making them aware that they should attain good sanitation on their own even without much help from the government; because we believe that if the people themselves would have the initiative of improving their ways of living and would start to care for themselves, it would be more healthy for them instead of waiting what the local government has for them. Focusing on two matters wont be any means of confusion because we referred sanitation as the best source for preventing Bronchitis is good sanitation.

Project goal: To decrease the number of cases of Bronchitis Program aim: To increase awareness within the community about Bronchitis and sanitation

Component Objectives: To promote the togetherness in the community in achieving good

sanitation A happy community is a healthy community; in promoting togetherness we can avoid misunderstanding between the community leaders and the community members, hence if they would be united they will achieve proper sanitation by helping one another in maintaining a clean surrounding.

To inform people within the community about our concerns

To distribute IEC materials and conduct a seminar are the simplest ways to infrom the people and encourage them on doing actions for themselves.

SCHEDULE OF ACTIVITIES

Activity Develop program schedule Planning for pamphlet or IEC materials Search for venue Printing of IEC materials Selection of guests Venue arrangements Marketing for food IEC Materials distributions Finalizing the whole program TOTAL

Duration 2 days 1 day 2 days 1 day 2 days 1 day 1 day 3 days 1 day 14 days

Pax requirement 5 pax 2 pax 3 pax 2 pax 2 pax 5 or more pax 5 pax all pax 2 pax Approx.30+

Amount Php 10 0 Php 100 Php 500 Php 100 Php 100 Php 1000 0 Php 100 Php 1910.00

Man-days

Expected outputs As we are planning our programs, we have expectations that served as our inspiration to further do more than what people in that community expects from us. We expected that after our seminar and distribution of IEC materials, people in the community would also be inspired to help themselves in improving for the better.

Component objectives yTo promote the togethernes-s in the community in achieving good sanitation yTo inform people within the community about our concerns

Activities y show a short movie about; what unity could do in accomplishi-ng tasks y distribute IEC materials and conduct a seminar

Reason involved ymembers of the community, representati-ves of the baranggay officials and health workers ymembers of the community, representati-ves of the baranggay officials and health workers

Expected output ywe expect that after showing them that short film, the people will now know the difference of working together from working alone and would realize that being united and having a good connection are the best answer in any community problems. yWe expect that after informing the people, they would be more aware on their situation and also they would know through our information on how they would face their current situation

Chapter III IMPLEMENTATION, MONITORING, AND EVALUATION

A.

Reviewing of Records of RHU and LGU

The data that we gathered from the municipality has been analyzed, to be able to come up of which problem to target and of what other needs we could somehow give the community. Interpretation of each data would help us lessen the possibility of implementing the wrong program for the community.

B.

Accomplishments, Result of Activities, Issues

and Challenges
a. In achieving our problem goal, we have to made a step by step process by attaining first our component objectives. We promoted togetherness within the whole community and we have also informed people; after accomplishing our component objectives we our now one step ahead in achieving our problem goal and that is to decrease the number of cases of Bronchitis

Output: The members of the community learned and at the same time
showed an interest about the topics we presented them. To be able to attain our problem goal, we have accomplished all our component objects by executing all the planned activities lined up. We finished distributing IEC materials and we already conducted a seminar for the members of the community to be informed and aware of what they need to know about Bronchitis and sanitation. We also showed a short film we made about what unity can do in obtaining good sanitation. We also facilitated an open forum between our respondents and our speaker to be able for to answer all the questions of our seminar attendees that have been formulated to their minds during the seminar.

Chapter IV PLAN FOR DISENGAGEMENT

As we finished all the activities we planned for our implementation, such as conducting a seminar, showing a film and distributing IEC materials, we have to consider that it is not the end of everything; for us to be said successful there should be someone who would continue what we started. So to be able to maintain what we started, we planned to leave a copy of the film we made in the day care center where we conducted our seminar, we are also lucky because the teacher of that day care center was encouraged and voluntarily accepted the film and agreed that she will teach it to all her students. With her showing the film to her students and teaching the concepts of sanitation it would be a big help to scatter the information within the community, and we also believed that the teacher would impart the things she had known in our seminar not only with her students but also to her family members and friends. The film is about what unity can do in the community and that they could achieve a healthy living lifestyle by working all together.

CHAPTER V EVALUATION

. Our program Duming dulot ay Bronchitis, puksain ng tulong-tulong na paglilinis, back to back with Think Green, Aim Green, is designed to increase awareness within the community and to make them realize that they could have their own safety within their hands and that they could initiate good sanitation within themselves, in each and every family and that it would lessen their dependency in the municipal government. Our program is just a simple seminar and distribution of pamphlets; to be able to catch the attention of the people in Tampoy II, knowing that they have the tendency to be hardheaded and not open for improvement, we had a cake raffle promo, and actually it worked, people were excited to attend seminar, but only limited number of persons could only be accommodated because we have a small venue.

Though our whole project plan did not contain many activities only seminar and distribution of IEC materials, we were able to attain our component objectives and we can say that the awareness of people increased from nothing to informed. We believe that it doesnt matter how many activities we implement it is how we do it, and we are happy with the result of our program and so as the people who attended it.