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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.
GOALS: To assess the communitys current health status To recognize possible relationships/ trends that may affect the communitys 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.
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 Citys biggest barangays with a population of 7,487 as of May 1, 2000 Statistics. An account of 1849 City that Tarlac grew into 13 Barrios, though there was not yet the San Roque toponym also it became part of the history where the Guardia Civil executed Col. Francisco Taedo 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 nongovernment 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.
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
ORGANIZATIONAL CHART
HON. GELACIO MANALANG Municipal Mayor
HAZEL MIEMEE B. LEGASPI Barangay Chairwoman Peace and Order and Beautification
CONSTANTE S. NAVARRO Peace and Order and Ways and Means and Education
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/ Womens 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
Mothers/ Fathers Class Barangay/ Community Assembly Program for Tuberculosis OPT Program
CLINIC SCHEDULE PERSON IN-CHARGE Nurse I Casual Nurse Nurse I Casual Nurse Midwife I Nurse I Casual Nurse Health Workers Health Workers
DAY MONDAYS
VENUE
Barangay Health Center
TUESDAYS
ANICETA D. LOPEZ
Nurse II
COMMUNITY ASSESSMENT POPULATION PROFILE Total Estimated Population of Barangay (2011): 8, 146 Total Population of Area Surveyed: 297 Total Number of Families Surveyed: 63 Total Number of Households Surveyed: 48
SOCIO-DEMOGRAPHIC PROFILE
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.
AGE DISTRIBUTION
30% 25% 20% 15% 10% 5% 0%
0 - 5 years old 6 - 10 years old 11 - 20 years old 21 - 30 years old 31 - 40 years old 41 - 50 years old 51 - 60 years old 61 - 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 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
Child (0 12 years old) Single Married Widow Widower Frequency ? 186 102 6 2 Percentage (%) ? 62.62 34.34 2.02 0.67
Percentage (%)
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Separated Total
1 297
0.33 100%
I&a
RELIGION DISTRIBUTION
0%
20%
40%
60%
80%
100%
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.
ETHNICITY DISTRIBUTION
The large number of Kapampangan in the community implies that prevalent health beliefs and practices in the community are from their groups 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.
FAMILY TYPE
100% 80% 60% 40% 20% 0% Nuclear Extended
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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.
LENGTH OF RESIDENCY
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Below 6 months 6 - 11 months 1 year 2 years 3 years 4 years 5 years and above
I&a
SOCIO-ECONOMIC INDICATORS
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54 0 21 297
100%
EDUCATIONAL ATTAINMENT
90% 80% Nursery 70% 60% 50% 40% 30% 20% 10% 0% 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.
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EMPLOYMENT
Self-employed
Employed
0%
20%
40%
60%
80%
100%
The above data reflects the high productivity level of the community which in turn provides more income for the communitys 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.
MONTHLY INCOME
Less than 2,000 2,000 - 5,000 5,000 - 8,000 More than 8,000
I&a
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50.00% 45.00% 40.00% 35.00% 30.00% Concrete 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% TYPE OF DWELLING Mixed Wood
I&A
ENVIRONMENTAL INDICATORS
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48
100%
HEALTH PROFILE
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Frequency 18 0 30 48
Table XX. Distribution according to Containers of Water Plastic Bottles Total Frequency 45 12 48 Percentage (%) 78.95 21.05 100%
a. Goes for check-up b. Goes only when sick c. Does not go for check-up Total
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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Since majority of the couples opt not to use any family planning method, it may be implied that the communitys 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.
MORBIDITY DISEASE Acute Upper Respiratory Infection Hypertension Urinary tract infection Abscess Bronchopneumonia Acute Gastro Enteritis Acute Tonsilitis Conjunctivitis Allergic Rhinitis Infected Wound No. of Cases 75 15 14 5 5 4 3 3 3 2
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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 Weight Highest score Computation Total Justification
1. Nature of the problem > 2.Modifiability of the problem > 3. Preventive potential > 4.Salience > Total:
2.
Criteria Score Weight Highest score Computation Total Justification
1. Nature of the problem > 2.Modifiability of the problem > 3. Preventive potential > 4.Salience > Total:
3.
Criteria Score Weight Highest score Computation Total Justification
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4.
Criteria Score Weight Highest score Computation Total Justification
1. Nature of the problem > 2.Modifiability of the problem > 3. Preventive potential > 4.Salience > Total:
5.
Criteria Score Weight Highest score Computation Total Justification
1. Nature of the problem > 2.Modifiability of the problem > 3. Preventive potential > 4.Salience > Total:
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