Project BUSOG.pdf

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PROJECT B.U.S.O.G

Batang Undernourished Sagipin at BusOGin

Presented to

Division of Biological Sciences

University of the Philippines Visayas

Miag-ao, Iloilo

In partial fulfilment

For the requirements for

PH 195 Public Health Practice

Nicolo M. Doplayna

John Christopher L. Luces

Alyssa Marie T. Mallorca

Mel Vincent U. Oliva

JC Belle G. Saladar

Xyra Angelie M. Sanchez

April 2013

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TABLE OF CONTENTS

Page

I. Introduction 1

II. Sitio Selection 4

III. Situational Analysis 6

IV. Problem Analysis 20

V. Problem Tree 22

VI. Objective Tree 24

VII. Logical Framework 27

VIII. Project Monitoring 46

IX. Evaluation Plan 47

X. Project Timeline 54

XI. Accomplishment Report 57

XII. Problems and Constraints 69

XIII. Appendices 72

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LIST OF FIGURES

Page

Figure 1. Spot Map of Barangay La Paz, Nueva Valencia, Guimaras 8

Figure 2. Total Population in Barangay Lapaz 8

Figure 3. Sex Distribution of Population in Barangay Lapaz 9

Figure 4. Nutritional Status of Children Aged 3-12 years old in Sitio Lusong 58

Figure 5. Weekly Weight Monitoring of Malnourished Children 60

Figure 6. Nutritional Status of Children Aged 3-12 years old in Sitio Lusong 61

after project implementation

Figure 7. Total Caloric Intake of Children aged 3 years old in comparison with RENI 62

iii

LIST OF TABLES

Page

Table 1. Decision Matrix in the Selection of the Sitio 5

Table 2. Nutritional Assessment of Children Aged 0-6 14

Table 3. Decision Matrix in the Selection of the Major Disease 21

in Sitio Lusong

Table 4. Average Pre-test and Post-test Scores of mothers for each 64

lecture

Table 5. Pre-test and Post-test scores: Lecture on Infectious Diseases 66

and Proper Hygiene and Sanitation

Table 6. Pre-test and Post-test scores: Lecture on Infectious Diseases 67

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LIST OF APPENDICES

Page

A. Documentation 73

B. Letters 82

C. Certificates 87

D. Attendance 90

E. Questionnaire 92

F. Statistical Results 97

G. Nutritional Assessment 102

H. Budget 108

I. List of Recipes 113

J. Weekly Food Recall Sheet 115

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ACKNOWLEDGEMENT

There is no such thing as too impossible to spark a change. In just a matter of

seconds, experiences can be shared and memories can be made.

Our heartfelt thanks to the prople of Sitio Lusong, Barangay La Paz, Nueva

Valencia Guimaras, for the warm welcome and cooperation they have shown;

To the Gapasangra Family, for being our second family who lovingly supported

us along the way;

To our sponsor, Rotary Business Club of Iloilo, for the trust and financial aid they

have extended;

To our mentors, Sir Philip Ian Padilla, Mam Kathryn Jardeleza and Mam Mary

Ann Naragdao; for the guidance and assistance in formulating the pages of this study;

To Sir Lucifino Firmo for lending us Food Composition Table and Growth Charts

that was used in assessing the nutritional status of the children in Sitio Lusong;

To BIDANI with Mam Susan as the Program Director for lending us nutritious

recipes we used for our nutri-meal calendar;

To Dr. Felicito Lozarito (Provincial Health Officer) and Mercedita Esponilla

(Barangay Nutrition Scholar) for helping lending us the PABASA SA NUTRITION kit;

To Dr. Leslie Ann Luces for mentoring us on what specific activities we should do

for the community project;

To Dr. Sheila Gumabong (Municipal Health Officer), Dr. Riza Subade, Dr. Emilie

Quitasol, Dr. Mae and Melbert Divinagracia and the nurses for their help and support in

the success of our medical mission;

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Hon. Juan Gaitan, mayor of the municipality of Nueva Valencia for his precious

agreement on conducting the study;

The Barangay Captain Ramon Oritz and the Kagawads especially to Brgy. Kgd.

Mildred Ortiz of Barangay Lapaz for their selfless aid in the entire completion of this

undertaking;

To the resource speakers, Sir Teodoro Daguro and Maam Susan Garingalao

(Municipal Nutrition Action Officer) for sharing their knowledge to the mothers and

residents on Sito Lusong;

To our Asclepius Bia Kratus family for the the support, friendship and trust that

they gave;

To Mallorca and Doplaynas residence for welcoming us when we needed a

place to do our research;

To those special people who inspired the researchers;

To the family of the researchers as for the inspiration and untiring support, be it

emotionally or financially. We Love You!

To Ms. Adrienne Marrie Bugayong, for the unwavering support and for the

bagets and puyat moments;

Above all, to Lord Almighty God, for making these people instruments of His

grace and to those helping hands and kind hearts who we fail to mention but in one way

or another made this community project successful. A million of thanks!

TEAM BAM

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CHAPTER I

INTRODUCTION

Malnutrition is found to be one of the worlds health problems. It prevents children

from reaching their full physical and mental potential (Kandala et al, 2011). It may

originate from the deficiency or absence of any nutrient. The establishment and severity

of malnutrition depend on the cause, intensity and duration of the nutritional deficiency.

It can be caused, primarily, by an inadequate diet or, secondarily, by a deficiency in

gastrointestinal absorption and/or increase in demand, or even, by an excessive

excretion of nutrients (Rodriguez et al, 2011).

The most basic kind of malnutrition is protein-calorie malnutrition (PCM), also

known as protein-energy malnutrition. It is a pathological condition that results from a

lower ingestion of protein and calories, which occurs more frequently in children under

five years of age (Rodriguez et al, 2011). Underweight, stunting, and wasting forms of

PCM represent different histories of nutritional deficits. Linear growth retardation

(stunting) is frequently associated with repeated exposure to adverse economic

conditions, poor sanitation, and the interactive effects of poor energy and nutrient intake

and infection. Low weight-for-age indicates a history of poor health or nutritional

deficiencies, including recurrent illness and/or starvation. In contrast, low weight-for-

height is an indicator of wasting or thinness and is generally associated with recent

illness, weight loss or a failure to gain weight (Bloss et al, 2004).

Moreover, malnutrition accounts for 11% of all diseases worldwide and it causes

long-term poor health and disability. It is particularly prevalent in developing countries,

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where it affects one out of every three preschool-age children (WHO, 2011). In the

Philippines, Food and Nutrition Research Institute (FNRI) reported that the number of

Filipino children who were underweight and stunted increased from 2005 to 2008. The

prevalence of underweight children aged 0-5 years increased from 24.6 percent to 26.2

percent, which are about 3.35 million children. The stunted rate increased from 26.3

percent to 27.9 percent, representing 3.57 million children. There was also a significant

increase in the prevalence of underweight children aged 6-10 years from 22.8 percent in

2005 to 25.6 percent in 2008, equivalent to 2.6 million. The number of stunted children

in this age group likewise increased from 32 percent to 33.1 percent (Fernandez, 2010).

High level of acute malnutrition among preschoolers (aged 0-5) was noted in six

regions, namely MIMAROPA, Bicol, Western Visayas, Eastern Visayas, Zamboanga

Peninsula and SOCSARGEN, where the underweight-for-age prevalence was at least

30%. Also, high prevalence of stunted preschoolers was mostly observed in

MIMAROPA, Bicol, and all the regions in the Visayas and Mindanao (Fernandez, 2010).

Barangay La Paz is one of the barangays in the municipality of Nueva Valencia

in the province of Guimaras. It is divided into eight sitios, namely Alaman Sur, Alaman

Norte, Luzaran, Pototan, Sumirib, Tigcalayo, Tuguisan, and Lusong. The said barangay

ranked first in the municipality with the highest prevalence of malnutrition based on the

nutritional survey. Furthermore, sitio Lusong ranked second highest in the prevalence of

malnutrition.

Batang Undernourished Sagipin at Busogin (BUSOG) sa Lusong is a project

proposed by Team BAM to address the problem of malnutrition in Sitio Lusong, Brgy. La

Paz, Nueva Valencia, Guimaras. This project primarily aims to decrease malnutrition

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prevalence in Sitio Lusong among children ages 3-12 years by 70 %. The purpose of

this project is to increase the availability of nutritious foods through supplementation

programs, vegetable garden maintenance, lectures on food nutrition and proper hygiene

and sanitation, and proper detection of case.

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CHAPTER II

SITIO SELECTION

Barangay La Paz, Nueva Valencia, Guimaras was the chosen barangay for the

community immersion. Sitio Lusong, Sitio Lusaran and Sitio Sumirib were suggested by

the adviser for the Public Health students to select from. The three sitios were inspected

and evaluated based on their physical and social characteristics. Evaluation was done

through gathering data on health, demographic and socio-economic and environmental

profile. Decision matrix was then utilized to select the sitio. It made use of the Rank

Order Method based on the following criteria set by the Public Health students:

1. Acceptability

- Refers to the willingness and openness of the community upon visitation of the

group.

2. Accessibility

- Refers to the degree of accessibility of the sitio in terms of location, distance from

the town, road quality, as well as the means of transportation of reaching the

sitio.

3. Accommodation

- Refers to the availability of a secured place to reside during the community

immersion.

4. Communication Facilities

- Refers to the network coverage for mobile phones, as well as radio, television,

and other means of communication.

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5. Magnitude of the Problem

- Refers to the severity and urgency of current health problems that are of concern

to the residents of the sitio, which is important in ensuring that the project to be

drafted would be greatly helpful to the community and would have a great

significance for the betterment of the residents.

6. Manageability

- Factor in ensuring that the health problem to be tackled is feasible and

attainable, which will make sure that the health programs to be delivered will

have a higher efficacy rate in solving the problem in the sitio.

Table 1: Decision Matrix in the Selection of the Sitio

Each criterion was given the same weight. The sitios were ranked from 1 to 3

based on the criteria provided, with 1 as the highest and 3 as the lowest. The sitio with

the lowest total was chosen as the community site. Based on the decision matrix

presented in Table 1, Sitio Lusaran was the chosen community.

Sitio Criteria Total

Acce

pta

bili

ty

Acce

ssib

ility

Acco

mm

od

atio

n

Com

mu

nic

ation

Facili

tie

s

Ma

gn

itud

e o

f th

e

Pro

ble

m

Ma

na

ge

ab

ility

Lusong 2 1 1 1 2 2 9

Lusaran 1 2 3 3 3 3 15

Sumirib 3 3 2 2 1 1 12

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CHAPTER III

SITUATIONAL ANALYSIS

BARANGAY LAPAZ

A. Historical Background

At turn of the 19th century, when there was abundant rice harvest in some parts

of Negros Occidental, many of farms laborers from Guimbal, San Joaquin, Miagao,

Oton and Igbaras travelled between Iloilo and Negros Island. Playing the route were

sailboats which was popularly known as lorcha or dos palos, an old type of sea vessel.

During the month of October to January, when storm winds blew towards the northwest,

the boat load of the harvesters would seek shelter at Sitio Himal-os, popularly known as

Mal-os, halfway from Panay to Negros.

The harvesters would then recount to their families how their boats landed in

Sitio Himal-os, termed Luzaran (now a sitio adjacent to Himal-os). The entire island of

Guimaras was known as Himal-os then to the hometown of these harvesters in Panay

and even to their workplaces in Negros.

Sometime in 1893-1895, a family from Puyo or Santa Ana (part of Poblacion

Nueva Valencia) brought with them an image of Nuestra Seniora De La Paz y Buen

Viaje at Sitio Himal-os. From then on, the image became the Patron Saint of Sitio

Himal-os with the villagers celebrating her religious feast every 23-24th of January. The

village was eventually named Barangay La Paz in honor of the Patron Saint.

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B. Physical Profile

Barangay La Paz, located in the southern part of the municipality of Nueva

Valencia, is one of the 96 barangays of Guimaras. It is 16 kilometers away from the

municipality proper of Nueva Valencia, 40 kilometres away from Jordan Wharf and 32

kilometres away from the provincial capitol. It is bounded by Barangay Salvacion in the

north, Barangay San Roque in the west-northwest, Barangay Cabalgnan in the east-

northeast and Panay gulf in the south facing Sulu Sea.

It has a total land area of 590.5717 hectares, divided into eight sitios namely

Sumirib, Tigcalayo, Luzaran, Alaman Sur, Alaman Norte, Tuguisan, Pototan and

Lusong. It has a total population of 2,006 comprised by around 448 families and 414

households. Four old monuments denote the separation of Barangay La Paz to its

neighbouring barangays which are Barangay San

Jose, Barangay Salvacion and Barangay Cabalagnan.

Generally, the terrain of the barangay is rolling flat. It is gently sloping and

steeply undulating at the northwest and the northeast facing Barangay Cabalagnan and

Barangay San Roque. The elevation is approximately 524 feet above sea level. The soil

types are gravely loam, faroam, clay and beach sand.

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Figure 1. Spot Map of Barangay La Paz, Nueva Valencia, Guimaras

Figure 2. Total Population in Barangay Lapaz

661

395 327

233

148

121 92

44 Population

Sumirib

Lusong

Lusaran

Tigcalayo

Alman Norte

Alman Sur

Tugisan

Pototan

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C. Demographic Profile

Figure 3. Sex Distribution of Population in Barangay Lapaz

Barangay La Paz has a total population of 2,006 compounded of 1,018 males

and 988 females. Sumirib has the highest number of population followed by Lusong,

Lusaran, Tigcalayo, Alman Norte, Alman Sur, Tugisan and Pototan respectively. The

average family size is 6 members/ family. The ratio is 1:1.

D. Health Profile

The top five cases of mortality and morbidity for the barangay in recent years

were unavailable when the ocular inspection was conducted. Yet, based on the

nutritional survey conducted by the Provincial Health Office of Guimaras, Barangay La

Paz ranked first among the other barangays with the highest prevalence of malnutrition.

0

50

100

150

200

250

300

350 326

46 21

121

196

71

177

60

330

46 23

102

199

77

150

61

Male

Female

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Based on personal interviews by the Public Health students to the Barangay

Health Worker, malnutrition is the most severe problem in the area. Upper respiratory

tract infections, cardiovascular disease and diabetes for older persons are also

common.

In terms of health facilities, a health center is present in the barangay which

serves as a pre-natal center for pregnant women. Nueva Valencia District Hospital is

located in the nearby barangay of Lanipe. Once a week, the Municipal Health Officer

visits the barangay for consultation and giving of vaccines to infants. Every six months,

a deworming activity is held at La Paz Elementary School, wherein pupils are

administered with albendazole. Unfortunately, there is no monitoring of the pupils

infection. Also, no previous written record was shown as to whoever was administered

with the drug.

E. Socio-economic Factors

1. Economic Indices

Land Use Distribution

The land area is generally covered with naturally grown trees and scattered

patches of bush and shrubs are found in the hilly portion of the village. Only a tiny

portion of the area is cultivated for agricultural crops such as mango, rice, corn and

other cash crops.

Vegetable crops are poorly grown because the soil cannot support their growth

since it is generally made up of limestone and topsoil is not very fertile. Large area of

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the land is composed of fruit bearing trees such as cashew, mango, jackfruit and santol,

diminishing the availability for agricultural use.

The road is rough, hilly and dusty, making agricultural lands limited. Three creeks

cut across the barangay. Fishponds can also be found beside the shoreline of Alman

Norte, Alman Sur and Tuguisan. Mangrove trees are copious on the shoreline of Sitio

Pototan and Taklong Island.

Main Sources of Income

Barangay La Paz has a dual economy composed of farming and fishing. 80% of

the populations are fisher folks. There are about 426 fisher folks who are mostly heads

of the family.

However, residents cannot fish freely anywhere the vicinity because Taklong

Island is a protected area and a marine sanctuary. Limited area is allowed for fishing.

Because of this, farming became an alternative source of livelihood in the barangay.

About 90% of household heads are agricultural workers. Other sources of income are

livestock raising, fuel gathering and charcoal making.

Based on the Minimum Basic Needs (MBN) survey, the standard poverty

threshold level income of the barangay is Php 3,800.00 per month. 40% fall below

poverty line with 160 families having an income below subsistence threshold level and

246 families having an income above 3,800.00 per month. Survey indicated that 78.53%

of the total household heads are unemployed (no regular occupation) and 21.47% are

employed.

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2. Social Welfare Indices

Transportation

Public vehicles in the barangay are limited, making transportation difficult. From

Jordan Wharf, one needs to go to Alibhon transport terminal and ride a jeepney bound

for Cabalagnan. Since the barangay proper is away from the provincial road, one must

hire a motorcycle in La Paz junction to go directly to any sitio in the barangay. Other

means of transportation would include renting a van which would go directly to La Paz

but for a more expensive price.

Communication

The source of radio and television signals in the barangay is from Bacolod City

since the barangay faces Negros Island. Communication through cellular phones is very

difficult in the area because of the absence of cell sites. If the residents want to

communicate with their families or peers through wireless phones, one must go to Sitio

Sumirib or Sitio Lusong where the signal is somehow present.

Dissemination of information within the barangay is effective since house-to-

house method is used. In addition, each Barangay Kagawad is in-charge of a certain

sitio where he/she needs to inform the sitio residents of upcoming assemblies or

activities in the barangay.

Education

The literacy level of barangay population is estimated at about 80%. There is

only one existing primary school in the barangay, thus majority of the population are in

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the elementary level. There is also a nearby day care center that caters to children

aged 3-5 years old.

Housing

Houses in the barangay reflect typical rural homes. 77.19% are made up of light

materials (bamboo slits and nipa), 17.54% are made up of wood, cement and

galvanized roofing (semi-concrete) and 5.36% are permanent structures (made of

hallow blocks, cement and galvanized roofing).

Electrification

Electricity is supplied and distributed by the Guimaras Electric Cooperative

(GUIMELCO) in all sitios of Barangay La Paz. However, 144 houses still do not have

electricity. Gas lamps are used instead as an alternative source of light.

Infrastructure Facilities

A health center could be found in the barangay. Other structures present include

an elementary school, barangay hall, day care center and tanod outposts. A chapel also

stands near the barangay hall, but no regular masses are held. In addition, the UPV

Marine Research Station is also situated in the barangay as Taklong Island is part of it.

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3. Environmental Indices

Safe Water Supply

Residents of the barangay usually get their drinking water from deep wells. Other

households prefer to buy purified water which are being delivered twice a week. Some

residents from Sitio Alman Norte obtain drinking water from the creek.

Human Waste and Garbage Disposal

Problems arose in terms of human waste and garbage disposal which led to the

implementation of a regulation that every house must meticulously segregate their

garbage and must build their own compost pit.

Human excreta are disposed in open exposed areas near the river but in the

opposite direction of the wind. Burning of garbage is a common practice in the

community. The barangay lacks toilet per household, thus a communal toilet called the

antipolo was built for some of the residents.

Nutritional Indices

Table 2. Nutritional Assessment of Children Aged 0-6

Nutritional Status Number

Overweight 4

Normal 206

Underweight 33

Severely Underweight 13

Total Number Surveyed 256

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Eighteen percent of the children aged 0-6 that was assessed belongs to

underweight and severely underweight. 80.5% and 1.5% belongs to normal and

overweight categories, respectively.

4. Socio-cultural and Political Indices

Religion

Almost all of the residents are Roman Catholic (99.5%) while the rest are Born

Again Christians. There is a Catholic Chapel found in every sitio of Barangay La Paz

except in Sitio Pototan. Only Sitio Lusaran has a regular monthly mass, except during

sitio and patronal fiesta. For Sunday masses and Holy Days, they go to Nueva Valencia

or to San Miguel, Jordan.

Social Activity

Most men in the barangay are engaged in cockfighting, drinking (whisky, beer or

tuba) gambling (pusoy dos, tong hits and majong) and playing basketball. During night

time, some of them are watching TV while others prefer to listen to the radio. Among the

eight sitios, six have their own basketball courts.

Social Structure

The community has barangay officials who conduct sessions tackling the

problems and goals in the community such as maintaining peace and order, improving

health and sanitation, promoting education, upholding protection for women and

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children, sustaining environmental and marine protection, livelihood, infrastructures and

developing sports to achieve camaraderie in the community.

Political Structure

Barangay officials are from Punong Barangay down to Barangay Kagawads who

are assigned to different sitios, Barangay Health Workers, Barangay Council for the

Protection of Children, Barangay Tanods, Lupon ng Tagapayapa/Tagapamahala,

Sangguniang Kabataan, and other officials such as Day Care Worker, Nutrition Scholar,

Service Point Officer and Utility Worker.

Barangay Officials, especially kagawads, meet regularly to be updated on the

weekly and monthly activities of the barangay.

Components of the Health Sector

There are nine Barangay Health Workers and a Barangay Nutrition Scholar in the

barangay. They are tasked to provide high-quality health to the natives. They spearhead

routine deworming done every six months. They assist in medical missions from non-

government organizations. Prevention of malnutrition is the main target of the Barangay

Nutrition Scholar.

Health Facilities and Human Resources

The barangay has a health center located in Sitio Lusong which is not well-

equipped with needed facilities. A Rural Health Officer (RHO) visits the health center

once a week.

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SITIO LUSONG

Sitio Lusong is one of the eight sitios of Barangay La Paz. It got its name from

the famous material made of wood called lusong, which is used to mill the rice for food.

It serves as the entrance and exit point of all sitios as it is the first sitio that can be come

across as the barangay is entered. The sitio is under Brangay Kagawad Mildred Ortiz.

A. Sociodemographic Characteristics

Sitio Lusong is composed of 85 families, distributed to 83 households. Its total

population is 395 (196 males and 199 females), second highest in population next to

Sitio Sumirib.

1. Education

La Paz Elementary School is situated in Sitio Lusong where most of the children

are enrolled. During their secondary education, they enrol either in Salvation National

High School or in Cabalagnan National High School which are situated in the

neighbouring barangays. Some also attend private schools in Nueva Valencia proper or

in San Miguel, Jordan. For their college degrees or vocation courses, most enrol at

West Visayas College of Science and Technology located at Barangay Alaguisoc,

Jordan, Guimaras while others are enrolled in Iloilo City. Most parents are elementary

and high school graduates only. Some didnt even finish in grade school level.

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2. Religious Affiliations

Majority of the residents in Sitio Lusong are Roman Catholics. There is a Catholic

Chapel in the sitio with no regular masses except during Sitio and Patronal Fiesta. Sitio

fiesta is celebrated during the month of January.

B. Economic Profile

Most of the people in the sitio are into farming and fishing. Also, men/husbands

engage in carpentry and driving motorcycle vehicles for hire. Others are construction

and contractual workers in Iloilo City. Women are mostly housewives and are self-

employed by selling products and goods whenever they are available for extra income.

Other livelihood sources are livestock raising, fuel gathering and charcoal making.

C. Sociocultural Aspects

1. Housing Facilities

Majority of the houses are made up of light materials (bamboo slits and nipa)

while some include wood, cement and galvanized roofings and hollow blocks. Electricity

is distributed throughout the sitio.

2. Recreation and Recreational Facilities

Most men in the sitio engage in cockfighting, drinking and gambling, especially

during wakes. In the afternoon, residents prefer to sleep while some play basketball.

During night time, some are watching TV while others listen to the radio.

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3. Transportation and Communication

Sitio Lusong can be reached by a one and a half hour jeepney or van ride from

Jordan Wharf. A one kilometer walk or motorcycle ride from the provincial road will lead

to the houses in the sitio.

Since cellphone signal is scarce within the sitio, only a few residents have

cellphones. Means of communication are primarily via televisions, newspapers, radio

and group discussions.

D. Health and Sanitation

The common causes of morbity among the residents are cold, fever, cough

pneumonia, flu, diarrhea, sore eyes, stomach ache and head ache. Adults suffer

rheumatism and hypertension. Most of the residents go directly to the health center for

medical attention. For serious cases, patients are brought to Guimaras Provincial

Hospital, 30kms away or to Lanipe Community Hospital, 8kms away. Old age, cancer,

tuberculosis, heart failure and cardiac arrest were found to be the causes of mortality in

the sitio.

One prevalent case in the sitio, especially among children, is malnutrition,

according to the Operation Timbang conducted for Project Kalusugan at Kalinisan sagot

sa Kahirapan of the Unilabs Positive Ideas. Sitio Lusong with 16 malnourished children

from ages 4-10 ranked 2nd among the sitios in the barangay.

Moreover, most of the houses in the sitio have toilets and they practice waste

management measures through segregation.

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CHAPTER IV

PROBLEM ANALYSIS

A. Identification of the Problem

Problem identification in Sitio Lusong was done through ocular inspection,

situational analysis and interview with the households and with the Barangay Health

Worker to assess major health problems in the community. Three major problems were

identified by the group, namely hypertension, upper respiratory tract infection and

protein energy malnutrition.

A decision matrix was then devised by the group to identify the problem to be

prioritized. Problem prioritization was based on the following criteria:

1. Morbidity- refers to the frequency of the occurence a disease

2. Vulnerability of the solution- tells us how susceptible and effective a solution

is if applied to the community. This is divided into, prevention which is the

slowing down the action of a specific disease and cure refers to restoring an

ill person to health

3. Social concern- refers to how important the problem is to the community. This

takes into account the awareness of the community to several diseases and

how they react to or perceive such diseases.

4. Existing policies- refer to the present strategies, interventions, and on-going

actions and programs that may be utilized to address the problem identified

5. Feasibility and Sustainability- refer to the applicability and practicality of the

possible interventions to the identified problem based on resources and time

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available and whether these interventions can address the problem on a long-

term basis

Table 3. Decision Matrix in the Selection of the Major Disease in Sitio Lusong

PROBLEM

Mo

rbid

ity

Vu

lne

rab

ility

to S

olu

tio

n

So

cia

l C

on

ce

rn

Exis

ting

Po

licie

s

Fe

asib

ility

and

Su

sta

ina

bili

ty

Tota

l

Ran

k

Preventive Cure

Protein Energy

Malnutrition 1 2 2 1 1 2 9 1

Hypertension 2 3 3 2 2 3 15 2

Upper Respiratory

Tract Infections 3 1 1 3 3 1 12 3

The Rank Order Method was used for the decision matrix to determine which

problem will be chosen for field practice. One indicated the highest and three the lowest

in ranking the problem. The problem with the lowest number was prioritized and ranked

highest. Protein Energy Malnutrition, with the total score of 9 was ranked 1st and

therefore determined to be the priority problem.

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B. Problem Tree Analysis

There is a high prevalence of protein energy malnutrition among children ages 3

to 12 years old in Sitio Lusong, Barangay La Paz, Nueva Valencia, Guimaras. This

health problem severely affects children, affecting their physical and mental

development, and in the long run will lead to poor academic performance, unhealthy

living and prone to infections. Based on the last health survey, Sitio Lusong was ranked

2nd among sitios with highest cases of protein energy malnutrtion in Barangay Lapaz,

Nueva Valencia, Guimaras

The group will focus on children 3 to 12 years old because they are the most

vulnerable age group to such disease. The group has identified three immediate causes

of this problem which includes failure to detect malnutrition cases due to lack of trained

personnel, insufficient nutrient intake and increased susceptibility to infections. There is

insufficient nutrient intake due to lack of knowledge on proper nutrition as well as

insufficient sources of nutritious food. The lack of water supply as well as the

knowledge regarding vegetable garden maintenance may have contributed to the

insufficient harvest from the backyard garden.

The occurrence of protein energy malnutrition is brought about by not observing

good hygiene and proper environmental sanitation among residents. This is due to the

fact that they do not have adequate health education because of the lack of personnel

to conduct health education activities among the residents

24

Objective Tree for High Prevalence of Protein Energy Malnutrition among Children

Aged 3-12 Years Old of Sitio Lusong, Barangay La Paz, Nueva Valencia, Guimaras

25

C. Objective Tree Analysis

Team BAM aims to decrease the prevalence of protein energy malnutrition

among the residents of Sitio Lusong, Brgy. La Paz, Nueva Valencia, Guimaras, aged 3

to 12 years old. In doing so, two main steps are to be done. The curative and preventive

steps.

Included in the curative step are increasing the availability of nutritious food for

the residents in the area. Protein Energy Malnutrition is mainly due to insufficient intake

of food rich in needed nutrients leading to starvation and the development of life-

threatening conditions. With this, the team decides to distribute insumix as well as to

teach mothers how to prepare malunggay powder in order to increase nutritional intake

of the children. In addition, the group will help in maintaining vegetable gardens that are

present in the sitio to improve the availability of healthy food given the far distance from

the market.

One may be cured from malnutrition but the possibility of acquiring it again

remains. Thus, the group decided to perform the preventive step which would involve

improving the health education among residents. With this, the team will conduct a

series of lectures on proper food nutrition, nutritional needs of the family and different

types of malnutrition . Furthermore, there is a need to increase the knowledge, attitude,

and practice of parents on how to prevent getting their children malnourished. Lectures

on child and maternal health care as well as proper sanitation and hygiene will be

conducted to enhance the health of their families. Different health education materials

will also be given to the residents such as nutri-calendars, nutri-guides, etc. to

encourage the mothers to serve nutritious meal to their children

26

The group has identified five major objectives to reduce the prevalence of Protein

Energy Malnutrition among children aged 3 to 12 years old in Sitio Lusong distribution

of insumix, teaching mothers on preparing malunggay powder for supplementation as

well as properly maintaining vegetable gardens, improving health education among the

residents by conducting lectures on nutrition, proper hygiene and good sanitation, and

to improve proper detection of malnutrition cases. The execution of each objective will

be discussed in detail in their respective logical frameworks.

Particular objectives to solve the underlying and root causes of the core problem

were pointed out as presented in the Objective Tree above. With this, Team BAM has

determined the actions to combat Protein Energy Malnutrition in Sitio Lusong, Brgy. La

Paz, Nueva Valencia, Guimaras.

27

LOGICAL FRAMEWORK

Project: Buligan Ang Malnourished sa Lusong Team: BAM

NO.

NARRATIVE

SUMMARY

(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION (MOV)

IMPORTANT

ASSUMPTIONS/RISKS

Goal:

To decrease the

prevalence of protein

energy malnutrition

among children aged 3-

12 years old in Sitio

Lusong, Barangay

Lapaz, Nueva Valencia,

Guimaras by 70%

After the implementation

of the project, the

prevalence of malnutrition

among children aged 3-

12years old in Sitio

Lusong, Barangay Lapaz,

Nueva Valencia,

Guimaras is reduced by

70%

Operation Timbang:

Pre-weighing and post-

weighing of chosen

respondents

Solving for increased

nutritional intake

Assumption:

- Support of BHW, LGU,

and midwife

- Willingness of the

residents to participate

in the activities

- Updated and accurate

records

Risk:

- Lack of support by the

LGU

- Misdiagnosis of cases

- Lack of cooperation

among residents

- Unavailability of funds

and other resources

Purpose:

To decrease the

number of cases of

protein energy

malnutrition through

feeding and

supplementation

programs, vegetable

After the project, 70 % of

the children enrolled in

the project will have a

normal nutritional status

The residents will have

an increased knowledge

and awareness regarding

Operation Timbang:

Pre-weighing and post-

weighing of chosen

respondents

Pre-test and post-test

on level of awareness

Test core group on

Assumption:

- Willingness of the

focused group of

residents to join the

activities

- Availability of funds and

other resources

-

28

garden maintenance,

lectures on food

nutrition and proper

hygiene and sanitation,

and proper detection of

cases

proper health nutrition as

well as proper detection

of cases

detecting proper cases

of malnutrition

Risk:

- Lack of cooperation

among residents in

attending the activities

- Lack of funds

1

2

3

4

5

Component

Objectives:

To form and establish

an efficient, disciplined

and well-ordered core

group for the project

To increase nutritional

intake of 60 % of the

malnourished children

aged 3-12 years old in

Sitio Lusong

To increase knowledge

and awareness

regarding Proper

Nutrition and Protein

Energy Malnutrition

among residents of Sitio

Lusong by 60 %


and awareness

regarding Proper

Hygiene and Sanitation

by 60 %

29


about PEM and how to

identify malnourished

children by 60 %

30

V. LOGICAL FRAMEWORK

LOGICAL FRAMEWORK

Component Objective 1: To establish a well-organized, efficient and independent core group for Sitio Lusong to

facilitate the health programs in the absence of proponents

Project: Buligan ang Malnourished sa Lusong Team: BAM

No. NARRATIVE SUMMARY

(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION

(MOV)

IMPORTANT

ASSUMPTIONS/RISKS

1 General Assembly Residents of the

community assembled in

proper venue

Attendance Assumption:

Willingness to attend

Risk:

Absenteeism

Unforeseen natural

phenomena

2 Election of the members of

the Core Group

Discipline, Organized

and effective core Group


Willingness to be a member

Risk:

Rejection to be a members

3 Planning and discussion of

the program components

The plans and programs

are being discussed to

the core group


Approval and acceptance to

the proposed projects

Risk:

Disapproval of the proposed

projects

31

LOGICAL FRAMEWORK

Component Objective 2: To increase nutritional intake of malnourished children aged 3-12 years old in Sitio

Lusong by 60 %



(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION

(MOV)

IMPORTANT

ASSUMPTIONS/RISKS

1 Distribution of Insumix

among mothers

Increase nutritional

intake of malnourished

children by

supplementing this

insumix in their food

Pictures

List of mothers with

insumix

Post-survey

Assumption:

Mothers will use the insumix

in supplemeting their children

Risk:

Mothers will not use this

Availability of Fundsto make

insumix

2 Distribution of vegetable

seeds to the mother

To increase the source

of nutritious food in the

sitio


distributed seeds

Assumption:

Availability of Resources

Active participation of

residents

Risk:

Unavailability of resources

Community soil unable to

sustain plant growth

3 Demonstration of making

malunggay powder and

lemon grass tea

To increase the

knowledge of mothers

on how to prepare

malunggay powder and

lemon grass tea

Attendance

Pictures

Finished product

(Maluggay Powder,

Lemon Grass Tea)

Assumption:

Availability of resources


residents

Risk:

Absenteeism

4 Lecture on how to maintain To increase the Pre-test and Post- Assumption:

32

a vegetable garden knowledge of mothers

on how to maintain their

vegetable garden

test

Picture

Attendance

Mothers will participate in the

lectures

Risks:

Absenteeism

Residents not actively

participating

5 Cooking Contest To promote the mothers

in cooking nutritious

food

Attendance

Pictures

Copy of recipes

Food

Assumption:

Venue and facilities available

Participation from community

Risk:

Lack of interest among

residents

Availability of venue and

facilities

6 Nutrifest To promote the mothers


food

Pictures

Attendance

Food

Assumption:

Availability of resources


residents

Risks:

Unavailability of resources


participating

7 Biggest Gainer Award To encourage the

children to gain weight

Pre-and Post

Weighing results

Certificate

Assumption:

Mothers will apply their

learnings which may

contribute to the increase in

weight on their children

Risks:

Mothers will take all the

33

lessons regarding proper

food nutrition for granted and

not apply in their daily life

8 Healthiest Plate Award To encourage the

mothers to cook

nutritious meal for their

children

Weekly Food

Recall Sheet

Certificate

Trophy

Assumption:

Mothers will apply their

learning and will serve

nutritious meals for their

children

Risks:

Mothers will take all the

lessons regarding preparing

nutritious meal for granted

and not apply in their daily

life

34

LOGICAL FRAMEWORK

Component Objective 3: To increase knowledge and awareness regarding Proper Food Nutrition among residents

of Sitio Lusong by 60 %



(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION

(MOV)

IMPORTANT

ASSUMPTIONS/RISKS

1 PABASA SA NUTRISYON To increase the


regarding proper food

nutrition, nutritional

needs of the family,

different types of

malnutrition and food

safety

Attendance,

pictures

Pre-test and

Post-test results

Assumption:

Full participation from the

community

Risk:


facilities

Availability of resource

speaker


residents

2 Distribution of Nutri-Meal

Calendar

To promote the mothers


meal

Sample of Nutri-

meal calendar

Assumption:

Mothers will keep the

calendars and will apply the

recipes that was incorporated

into the calendar

Risk:

No interest in reading the

recipes that were

incorporated into the calendar

Not enough production of

pamphlets and posters

No funds for printing

35

3 Distribution of Nutri-guide

and Nutri-bookmark

This guide is a booklet

which will serve as a

summary of what we

have lectured. This will

increase the knowledge

of mothers food

nutrition, nutritional

needs of the family,

different types of

malnutrition and food

safety

Sample of Nutri-

guide and Nutri-

bookmark

Assumption:

Mothers will read and use the

intrigued and will apply their

learning in their everyday life

Risks:

No interest in reading the

Nutri-guide as well as the

nature-bookmark




4 Film showing and role

playing on children regarding

importance of eating

nutritious food

To increase the

knowledge of children

regarding the

importance of eating

nutritious food

Pictures

Attendance

Assumption:

Venue and facilities available

Participation of children

Risk:


children


facilities

5 QUIZ BEE

To evaluate if they have

learned something from

our series of lectures

Quiz bee result

Attendance

Pictures

Assumption:

Mothers will participate in the

lectures

Risks:

Absenteeism


participating

36

LOGICAL FRAMEWORK

Component Objective 4: To increase knowledge and awareness regarding Proper Hygiene and Sanitation by 60%



(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION

(MOV)

IMPORTANT

ASSUMPTIONS/RISKS

1 Lecture on Proper Hygiene

and Sanitation

To increase the


and children on proper

hygiene and sanitation

Attendance and

Pictures

Pre-test and

Post-test

Assumption:

Full participation of the

residents in the lecture

Risk:

Availability of resource

speaker

2 Lecture on Infectious

Diseases

To increase the


regarding the causes,

prevention and

treatment of infectious

diseases

Attendance and

pictures;

Assumption:

Involvement of the

community

Risk:


facilities and speaker

3 Distribution of Hygiene Kit

To encourage the

children to brush their

teeth and wash their

hands properly

Sample of all

pamphlets and

poster/s

Assumption:

Attendees of the lecture will

read the pamphlet and

posters as their guide

Risk:

No interest in reading

information materials




37

4 Search for Little Mr. and Ms.

Busog Lusong

To showcase the

talents of the children

as well as to promote

recycling

Pictures

Awards

Assumption:

Involvement of the

community

Risk:


facilities

Absenteeism

Children will not join the

contest

38

LOGICAL FRAMEWORK

Component Objective 5: Toincrease knowledge regarding PEM and to improve proper detection of malnourished

children



(Outputs)

OBJECTIVELY

VERIFIABLE

INDICATORS (OVI)

MEANS OF

VERIFICATION

(MOV)

IMPORTANT

ASSUMPTIONS/RISKS

1 Lecture on PEM and on how to

detect malnourished children

To increase

knowledge regarding

PEM and in

detecting

malnourished

children (Weight for

Age)

Attendance

Pictures

Assumption:

Mothers will be informed

regarding the problem in the

community and on how to


Risk:

Absenteeism

Lack of willingness to attend

the lecture

2 Distribution of Weight for Age

charts

To guide the

mothers in

identifying

malnourished

children

Weight for Age

charts

Assumption:

Mothers will use this chart to

guide them identify


Risk:

Mothers will not use this chart

39

PROJECT PLANNING FORM

Title: Batang Undernourished Sagipin at Busogin sa Lusong

Team: Team BAM

Goal: To decrease the prevalence of Protein Energy Malnutrition among children aged 3-12 years old in Sitio Lusong,

Barangay Lapaz, Nueva Valencia, Guimaras by 70 %

Purpose: To decrease the number of cases of Protein Energy Malnutrition through health education, alternative livelihood

seminars, feeding and supplementation programs, and proper detection of cases

Component Objective Output Activities

1. To establish a well-organized,

efficient and independent core

group for Sitio Lapaz to facilitate

the health programs in the

absence of the proponents

1.1 Establishment of core group 1.1.1 General Assembly with the

officials and residents of Sitio

Lusong

1.1.2 Election of core group members

1.1.3 Planning and discussion of the

program components

1.1.4 Meeting with core group and

40

orientation on the tasks and

duties for the Members of the

Core Group

2. To increase nutritional intake of

malnourished children aged 3-

12 years old in Sitio Lusong by

60 %

2.1 Biggest Gainer Award

2.2 Distribution of Insumix

2.3 Distribution of vegetable seeds

2.4 Lecture on the importance and

benefitsof malunggay and lemon

grass as well as on how to process

malunggay powder and lemon

grass tea

2.1.1 Identification of malnourished

children by pre-weighing and by

getting their initial height

2.1.2 Weekly monitoring of weight

2.1.3 Final OPT and Getting the Final

Height of malnourished children

2.2.1 Prepare the materials and

ingredients needed in making

insumix

2.2.2 Lecture on how to make insumix

2.2.3 Distribution of Insumix

2.3.1 Solicitation of vegetable seeds

2.3.2 Distribution of vegetable seeds

2.4.1 Preparation of materials

needed for malunggay powder

processing and lemon grass tea

2.4.2 Preparation of health

education materials and

lectures to be discussed

2.4.3 Lecture on the importance

and benefits of malunggay and

lemon grass

2.4.4 A video was shown on how

41

2.5 Lecture on how to maintain a

vegetable garden

2.6 Cooking Contest

to process malungggay powder

and lemon grass tea

2.4.5 Pre-test and Post-test will be

given

2.4.6 Documentation and

evaluation

2.5.1 Invite a resource speaker

2.5.2 Prepare materials needed for

the lecture

2.5.3 Lecture on proper

maintenance of vegetable

garden and choosing the right

crops

2.5.4 Pre-test and Post-test will be

given


evaluation

2.6.1 Meeting with the core group

2.6.2 Inform mothers regarding the

cooking contest

2.6.3 Invite judges who will critique

the foods

2.6.4 Preparation of venue

2.6.5 Cooking contest proper

2.6.6 Power Lunch

2.6.7 Awardings


42

2.7 Healthiest Plate Award

2.8 Nurifest

Evaluation

2.7.1 Distribution of Weekly Food

recalls sheet every week

2.7.2 Collection of Weekly food

recalls sheet

2.7.3 Solving for nutritional intake

2.7.4 Evaluate results

2.7.5 Awarding

2.7.6 Documentation

2.8.1 Inform mothers to contribute

nutritious food for the

culminating activity

2.8.2 Cook the food that will be

contributed by the team

2.8.3 Nutrifest

3. To increase knowledge and

awareness regarding Proper

Nutrition among residents of

Sitio Lusong by 60 %

3.1 PABASA SA NUTRITION

- Importance of Malunggay and

Lemon Grass

- Importance of Vegetable

Garden and Choosing the Right

Crops

- The 3 Basic Food Groups and a

Balanced Diet

- Proper Food Nutrition

- Nutritional Needs of the Family

- Malnutrition and Hidden Hunger

- Meal Planning and Food

3.1.1 Meet with the core group

3.1.2 Set schedule and venue for

activity

3.1.3 Invite Resource Speakers for

Lecture

3.1.4 Information dissemination

3.1.5 Preparation of venue

3.1.6 Conduct pre-test regarding

nutrition

3.1.7 Conduct Lecture

3.1.8 Conduct post-test regarding

nutrition

43

Selection

- Child and Maternal Health Care

3.2 Distribution of Nutri-meal calendar

3.3 Distribution of Nutri-guide and

Nutri-bookmark

3.4 Filmshowing and Role Playing on

malnourished children regarding

eating nutritious food

3.5 Quiz bee

3.1.9 Documentation of the activity

3.2.1 Get recipes from Bidani

3.2.2 Edit calendars

3.2.3 Print out calendars

3.2.4 Distribute Calendars


3.3.1 Research on topics to be

included in the nutri-guide

3.3.2 Make Nutri-guide

3.3.3 Print out Nurti-guide

3.3.4 Distribute Nutri-guide to all the

mothers of malnourished

children

3.4.1 Look for videos and film related

to the topic

3.4.2 Prepare a script for the

roleplaying

3.4.3 Prepare venue and materials

needed for the filmshowing

3.4.4 Inform children regarding the

filmshowing

3.4.5 Filmshowing and Roleplaying

3.4.6 Documentation


44

quiz bee

3.5.2 Prepare questions and

materials needed for the quiz

bee

3.5.3 Quiz bee proper

3.5.4 Give out the reward to the

winners

3.5.5 Documentation

4. To increase knowledge and

awareness regarding Proper

Hygiene and Sanitation by 75 %

4.1 Lecture on Infectious Diseases

and Proper Hygiene and

Sanitation

4.2 Distribution of Hygiene Kit

4.3 Little Mr. and Miss Busog Lusong

4.1.1 Meet with the core group

4.1.2 Set time schedule and venue

for the daily activity

4.1.3 Information dissemination

4.1.4 Preparation of the venue

4.1.5 Conduct pre-test

4.1.6 Conduct Lecture on Infectious

Diseases and Proper Hygiene

and Sanitation

4.1.7 Conduct post-test

4.1.8 Documentation

4.2.1 Buy toothbrush, toothpaste,

shampoo and soap

4.2.2 Repack the hygiene kit

4.2.3 Distribute the hygiene kit

4.2.4 Documentation


criteria and flow of the

45

program

4.3.2 Get the final list of contestants

4.3.3 Practice the contestants for the

production number

4.3.4 Prepare the stage for the

pageant

4.3.5 Pageant proper

4.3.6 Giving of Awards

4.3.7 Documentation

5. To increase knowledge on PEM and

to improve proper detection of


5.1 Lecture on PEM and training on

how to detect malnourished

children

5.2 Distribution of Weight for Age

Chart

5.1.1 Inform mother regarding the

lecture

5.1.2 Prepare venue

5.1.3 Conduct Pretest

5.1.4 Lecture on PEM and on proper

way of getting anthropometric

measures and how to detect


5.1.5 Conduct Post test


5.2.1 Make Weight for Age Chart

5.2.2 Print out WFA Chart

5.2.3 Distribution of Weight for Age

Chart

46

PROJECT MONITORING

PROJECT COMPONENT END USER

INDICATORS

FOR

MONITORING

MEANS OF

VERIFICATION

FREQUENCY

OF

MONITORING

TOOLS

FOR DATA

ANALYSIS

1. Organization of core

group

Community

residents

Attendance during

core group

meeting

Attendance, minute

of the meeting,

Gantt chart of

activities

Every meeting Descriptive

Narrative

2. Distribution of Insumix Mothers Usage of Insumix

in everything they

eat

Interview Every week

Descriptive

Narrative

3. PABASA SA NUTRITION Community

residents

Attendance,

comparison of

pretests and

posttests scores

Attendance, pre-

tests and post-tests

scores

Every session,

before and after

lectures

Descriptive

Narrative

4. Cooking Contest Community

residents

Attendance Registration,

Attendance

During contest

proper

Descriptive

Narrative

5. Biggest Gainer Malnourished

Children

List of the weight

and height of

children

Weight and Height

of Children

Every Week Descriptive

Narrative

6. Healthiest Plate Contest Mothers List of foods they

prepare every

week

Weekly Food

Recall

3rd, 4th and 5th

week

Descriptive,

Narrative

7. Improve proper detection

of cases

Core Group Attendance

Post test

Participation

Post-test scores

Every session Descriptive

Narrative

47

EVALUATION

Activity Evaluation Indicators

Results Reasons for Failure

to Accomplish

Objective 1: To establish a well-organized, efficient and independent core group for Sitio Lusong to facilitate the health programs in the absence of the proponents Facilitated the formation of the

core group

Formation of a core

group

Attendance

A core group composed of 10 members was established



to Accomplish

Objective 2: To increase nutritional intake of undernourished children aged 3-12 years old in Sitio Lusong by 60 % Demonstration on making

insumix and distribution of the product to the mothers

Distribution of Vegetable

Seeds to the mothers

Attendance Post-survey

List of mothers who

received

Feb 19: 8 mothers received insumix March 1: 14 mothers received insumix March 23: 18 mothers received insumix (All mothers used insumix)

18 mothers were able to receive vegetable seeds

during the culminating activity

Not all mothers were

able to attend the demonstration due to

bad weather

48

Demonstration on Malunggay Powder Processing and Lemon Grass Tea Making

Lecture on how to maintain a

vegetable garden and choosing the right crops

Inter-sitio Cooking Contest

Nutrifest

Biggest Gainer Award

Healthiest Plate Award

Attendance Pre-test and Post-

test scores


test scores

Recipes Attendance

Pictures

Food Pictures

Operation Timbang

Weekly Food Recall

22 mothers attended the demonstration

14 mothers attended the lecture

Percentage increase in knowledge: 58.65 %

A total of 65 mothers from Luzaran, Lusong, Sumirib,

Tigcalayo, Alman Norte and Alman Sur

Team Lusong ranked 3rd place in the cooking contest

Mothers contributed: pansit

bihon, juice, bread Team Bam contributed: Macaroni soup, gulaman

Initial Weighing: 26

malnourished children were identified

Final Weighing: 20 became normal and the one with the

biggest weight gain was awarded

(Angelo Galvez- gained 3 kilos)

This award was given to Ma.

Gracia Tumarong

49


Results Reasons for Failure to Accomplish

Objective 3: To increase knowledge and awareness regarding Proper Food Nutrition among mothers of malnourished children in Sitio Lusong

PABASA SA NUTRITION

- Lecture 1: Importance of Malunggay and Lemon Grass Tea

- Lecture 2: Importance of Vegetable Garden and Choosing the Right Crops

- Lecture 3: Nutritional Needs of the Family

- Lecture 4: Proper Food Nutrition

- Lecture 5: Malnutriton and hidden hunger

- Lecture 6: Meal Planning and Food Selection

- Lecture 7: Child and Maternal Health Care

- Graduation


test

Lecture 1: 22 mothers attended Percentage increase in knowledge: 20.06 % Lecture 2: 14 mothers attended Percentage increase in knowledge: 58.93 % Lecture 3: 14 mothers attended Percentage increase in knowledge: 46.44 % Lecture 4: 15 mothers attended Percentage increase in knowledge: 37.14 %% Lecture 5: 13 mothers attended Percentage increase in knowledge: 25.58 % Lecture 6: 13 mothers attended Percentage increase in

50

Distribution of nutri-meal

calendar, nutri-guide and nutri-bookmarks

Filmshowing and Role Playing

on malnourished children regarding eating nutritious


calendar, nutri-guide and nutri-

bookmark List of children who attended the event

knowledge: 20.46 % Lecture 7: 14 mothers attended Percentage increase in knowledge: 19.01 %

18 mothers graduated

Outstanding mothers: With Honors: Marlyn Garde Rhea Tablatin

2nd Honorable mention:

Marissa Tablatin

1st Honorable Mention: Hendrelyn Esponilla

Jasmine Gapasangra

Salutatorian: Ma. Sarina Gajardo

Valedictorian:

Shella Mae Omalde

18 mothers received nutri-meal calendars, nutri-guide

and nutri-bookmarks

20 children attended 17 mothers attended

51

food Quiz Bee

Attendance

Quiz Bee scores: Group 1: 37 Group 2: 45 Group 3: 37



to Accomplish

Objective 4: To increase knowledge and awareness regarding Proper Hygeine and Sanitation among residents of Sitio Lusong Lecture on Infectious

Diseases and proper Hygiene and Sanitation

Distribution of Hygiene Kit

Search for Little Mr. and Ms. BUSOG LUSONG


test List of Children who received the hygiene kit List of participants who joined the pageant Scoresheet from

18 mothers and 22 children

attended

Increase Percentage of Knowledge: 90.67 %

The children and mothers

performed the correct way of hand washing

26 children received the

hygiene kit

18 mothers and 26 children

attended Winners of Little Mr. and Miss

Busog Lusong:

52

the judges Most Photogenic: Valerie Garde

Raymond Estaction

Best in Production Number: Roystown Estacion

Jastine Gajardo

Best in Talent: Jiniffer Garde

Kristel Joy Romano

Best in Interview: EJ Gapasangra Sophia Gayas

Mr. and Ms. Eco-chick

Julius Omalde Sarah Jane Titular

2nd runners up: Jastine Gajardo Julius Omalde

1st runners up:

Roystown Estacion Sarah Jane Titular

Little Mr. and Ms. Busog

Lusong: EJ Gapasangra Sophia Gayas

Activity Evaluation Results Reasons for Failure

53

Indicators to Accomplish

Objective 5: To increase knowledge on PEM and to improve proper detection of malnourished children Lecture on PEM and how to


Distribution of Weight for Age chart


test scores

List of Mothers who received the charts

22 mothers attended the

lecture Percentage increase of knowledge: 103.68 %

18 mothers received WFA

charts

54

PROJECT TIMELINE (Component Objective 1)

Program: Project B.U.S.O.G (Batang Undernourished Sagipin at busOGin) TEAM: BAM

NARRATIVE SUMMARY WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6

1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6

1.1 Organization of Core group

1.1.1 Meet with residents of Sitio Lusong

1.1.2 Selection of Core group

1.1.3 General Assembly with officials and residents

1.1. 4 Planning and discussion of the program components

PROJECT TIMELINE (COMPONENT OBJECTIVE 2)

2.1 Distribution of Insumix WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6

1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6

2.1.1 Preparation of Ingredients

2.1.2 Make Insumix

2.1.3 Distribution of Insumix

2.2 Distribution of Vegetable Seeds

2.2.1 Solicit Vegetable Seeds

2.2.2 Distribute Vegetable Seeds

2.3 Malunggay Powder Processing and Lemon Grass Tea

2.3.1 Preparation of materials needed for malunggay powder processing and lemon grass tea

2.3.2 A video was shown on how to process malunggay powder and lemon grass tea

2.3.3 A sample of finished products was shown

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2.4 Lecture on How to maintain a vegetable garden

2.4.1 Invite Resource Speaker

2.4.2 Prepare materials needed for the lecture

2.4.3 Pre-test

2.4.4 Lecture proper

2.4.5 Post-test

2.5 Biggest Gainer Award

2.5.1 1ST Operation Timbang

2.5.2 Weekly Monitoring of Weight and Height

2.5.3 Final OperationTimbang

2.5.4 Awarding

2.6 Cooking Contest

2.6.1 Inform mothers regarding the event

2.6.2 Prepare venue

2.6.3 Contest Proper

2.6.4 Awardings

2.7 Healthiest Plate Award

2.7.1 Distribution of Weekly Food Recall Sheet

2.7.2 Collection of Weekly Food Recall sheet

2.7.3 Awardings

2.8 Medical mission

2.8.1 Solicit medicines and invite doctors for med mission

2.8.2 Screen patients who will have free consultation

2.8.3 Medical Mission

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2.9 Nutrifest

2.9.1 Inform mothers regarding the event

2.9.2 Cook the food that will be contributed by Team BAM

2.9.3 Nutrifest


3.1 PABASA SA NUTRITION

3.1.1 Lecture on the Importance of Malunggay and Lemon Grass

3.1.2 The Three Basic Food Groups and Balance Diet

3.1.3 Proper Food Nutrition

3.1.4 Nutritional Needs of the Family

3.1.5 Malnutrition and Hidden Hunger

3.1.6 Meal Planning and Food Selection

3.1.7 Child and Maternal Health Care

3.2 Distribution of Nutri-meal Calendar

3.2.1 Get recipes from BIDANI

3.2.2 Edit calendar

3.2.3 Print calendars

3.2.4 Distribute calendars

3.3 Distribution of Nutri-guide and Nutri-bookmarks

3.3.1 Research on topics that will be put in the guide

3.3.2 Printing of Nutri-guide and Nutri-bookmark

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3.3.3 Distribution

3.4 Filmshowing and Roleplaying among malnourished Children regarding the importance of eating a nutritious meal

3.4.1 Research on films and ads that promote proper food nutrition

3.4.2 Prepare venue and materials needed

3.4.3 Filmshowing and Roleplaying

3.5 Quiz Bee

3.5.1 Inform mothers regarding the quiz bee

3.5.2 Prepare questions and materials needed for the quiz bee

3.5.3 Quiz Bee


4.1 Lecture on Infectious Diseases & Proper Hygiene and Sanitation

4.1.1 Prepare materials

4.1.2 Pre-test


4.1.4 Post-test

4.2 Distribution of Hygiene Kit

4.2.1 Buy soap, shampoo, toothbrush and toothpaste

4.2.2 Distribute hygiene kit

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4.3 Search for Little Mr. and Ms. Busog Lusong

4.3.1 Inform mothers regarding the criteria and flow of the program

4.3.2 Get the final list of contestants

4.3.3 Practice the contestants for the production number

4.3.4 Prepare the stage

4.3.5 Pageant proper

4.3.6 Giving of Awards


5.1 Lecture on PEM and How to identify malnourished children

5.1.1 Prepare materials

5.1.2 Pre-test


5.1.4 Post-test

5.2 Distribution of Weight for Age Chart

5.2.1 Edit Chart

5.2.2 Print Chart

5.2.3 Distribute chart

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VI. ACCOMPLISHMENT REPORT

Objective # 1: To form and establish an efficient, disciplined and well-ordered

core group for the project

A week before the immersion started, the team visited Sitio Lusong for an ocular

inspection, pre-weighing and selection of core group. A meeting with the barangay

officials were held and from this, a core group was formed. The core group is mainly

composed of residents of the Sitio. There were representatives from the group of

mothers, fathers, barangay officials, and school principal. The core group has 10

members who volunteered to give service to the community

SITIO LUSONG CORE GROUP:

Head: Mildred Ortiz (Barangay Kagawad)

Members:

1. Corazon Endrigano (School Principal)

2. Susita Gapasangra (elder)

3. Jasmin Gapasangra (mother)

4. Shella Mae Omalde (mother)

5. Arlene Gamuza (mother)

6. Salvacion Titular (mother)

7. Roan Estacion (youth)

8. Eli Gapasangra (father)

9. Mercidita Espinolla (BNS)

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Objective # 2: To increase nutritional intake of undernourished children aged 3-12

years old in Sitio Lusong by 60 %

In order to select the target population, the pre-weighing or the first Operation

Timbang was done. Children aged 3-12 years old were weighed and using the Weight

for Age and Weight for Height Chart, malnourished children were identified.

Figure 4. Nutritional Status of Children Aged 3-12 years old in Sitio Lusong before and after project implementation.

Initial weighing showed that out of 77 children weighed, 26 were considered

undernourished (34 %): 11 undernourished (14 %), 15 undernourished and thin (20 %)

(see fig 4) .

As in results showed, there is an 11% increase of normal children. Out of the 26

initially classified as malnourished, only 6 remained. After 6 weeks of project

implementation, the group was able to achieve the goal wherein there was a 76.92 %

0 5 10 15 20

After Project

Before Project

Undernourished + Thin

Undernourished

61

decrease of malnutrition. Twenty children became normal (77 %) while 6 (23 %)

remained malnourished: 4 undernourished and 2 thin.

This was due to the activities done by the group in order for the children to gain

weight. One activity doned was the distribution of insumix, rich in protein and

carbohydrates, to serve as food supplements for their children. These products were

distributed thrice during the stay in the community. The insumix received by the mothers

were used and incorporated in their viands or rice and was even considered by the

mothers as palatable for their children.

These results were achieved also due to the lectures conducted by the

proponents and invited speakers from the municipal health office. These lectures

included importance of malunggay and lemon grass, backyard gardening and

maintenance. These lectures may have contributed to the knowledge of the mothers on

what crops to plant on their gardens and how malunggay powder and lemongrass tea

can be healthy for their children.

To motivate the children to eat more nutritious food, the proponents announced

that prizes will be given to theBiggest Gainer. The biggest gainer was used to

encourage the children to gain weight. This was based on the pre- and post-weighing

results. The winner for the biggest gainer was Angelo Galvez, who gained 3 kilos.

Another motivator, this time for the mothers, is the Heealthiest Plate. The healthiest

plate was based on the weekly food recall sheet given to us by the mothers where the

proponents would asses the nutritional contents of the meals prepared by the mothers.

The healthiest plate award was given to Mrs. Maria Gracia Tumarong.

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just for competition but also to teach and enable the mothers prepare and serve

a variety of nutritious food for their children.

Week #

Figure 5. Weekly Monitoring of Malnourished Children

One of the main goals of the project is to decrease the number of malnutrition

cases by 70 %. Every week, the changes in weight of the children were monitored.

Figure 5 shows that there is a decrease in malnutrition cases as the weeks go by from

week 1 to 5.

A t-test was performed to see if there is a significant difference in the

weights of the children before and after implementing the project. Results

showed that the mean weight of the children after six weeks is significantly lower

(p=0.000) compared before.

0

5

10

15

20

25

30

1 2 3 4 5

Weekly Monitoring of Malnourished Children

#

of

Mal

nou

rish

Chi

ldre

n

63

Figure 6. Nutritional Intake of Malnourished Children Aged 3-12 years old in Sitio Lusong

In terms of nutritional intake, weekly food recall was done. From this, the group

was able to compute the nutritional intake of children before and after the lectures on

proper food nutrition.

After the project implementation, the result showed that there is a 62.36 %

increase in protein intake, a 36.62 % increase in carbohydrate intake and 76.07 %

increase in fat intake for a total of 47.30 % increase in total caloric intake. All of the

percentage increase in nutrient intake is statistically significant except for the fat intake.

Even though the group wasnt able to achieve the goal of 60 % increase in the

total caloric intake, the result is still statistically significant since the p value is less than

0.05.

64

Figure 7. Mean Caloric Intake of Children before and after six weeks in comparison to

RENI

The group also compared the total caloric intake of malnourished children before

and after the lectures from the Recommended Energy and Nutrient Intake. The RENI

for energy for children ages 3 years old is 1070 calories, 1410 calories for 4-6 years

old, 1600 for 7-9 years old and 1920 for 10-12 years old. In this figure, it is shown that

before the conduction of lectures regarding proper food nutrition, the mean caloric

intake for all age groups was below the RENI. After the lectures, the mean caloric

intakes of all age groups increased and were even greater than the RENI for their

respective age groups. A series of successive lectures and activities indeed

contributed to the type of food the mothers prepare for their children, thus increasing

nutritional intake for the children.

0

500

1000

1500

2000

2500

3 y.o 4-6 y.o 7-9 y.o 10-12 y.o

Mean Caloric intake of the children before and after six weeks in comparison to RENI

BEFORE

RENI

AFTER

65

Objective # 3: To increase knowledge and awareness regarding Proper Food

Nutrition among residents of Sitio Lusong by 60 %

Primarily, in order to increase the knowledge of mothers regarding Proper Food

Nutrition, the group adopted the program PABASA SA NUTRISYON by the Nutrition

Center of The Philippines. This program is an information-sharing type of activity

wherein its purpose is to educate mothers of malnourished children in the proper

selection and preparation of family meals that is affordable yet nutritious for the

prevention and control of malnutrition. It also includes basic nutrition information and

nutritional requirements for different age groups, pregnant and lactating mothers.

The PABASA SA NUTRISYON kit is composed of several health education

materials such as Nutri-Guide, Flipchart, Play and Learn Kit and Community Guide.

These materials were used by the group to make the lectures interactive and fun.

The PABASA is composed of 7 lectures namely:

Lecture 1: Importance of Malunggay and Lemon Grass

Lecture 2: Importance of Vegetable Garden and Choosing the Right Crops

Lecture 3: Nutritional Needs of the Family

Lecture 4: Proper Food Nutrition

Lecture 5: Malnutrition and Hidden Hunger

Lecture 6: Meal Planning and Food Selection

Lecture 7: Child and Maternal Health care

Most of the lectures were lectured by the group while for lecture 2, 4 and 7 these

were headed by invited resource speakers namely: Teodoro Daguro (Agriculturist),

66

Susan Garingalao (Municipal Nutrition Action Officer), and Mercedita Espinolla

(Barangay Nutrition Scholar) respectively.

To evaluate if the mothers have learned something from the lectures, pre-test

and post-test were given every lecture. The test result for each lecture is as follows:

Table 4. Average Pre-test and Post-test Scores of mothers for each lecture

Pre-test n Post-test Difference Percentage

Increase

Lecture 1 9.72 1.65 11.67 1.03 1.95 20.06 %*

Lecture 2 5.77 1.2 9.17 0.99 3.4 58.93 %*

Lecture 3 7.17 1.42 10.5 1.58 3.33 46.44 %

Lecture 4 7 1.5 9.06 0.99 2.06 37.14 %

Lecture 5 7.39 1.6 9.28 1.27 1.89 25.58 %*

Lecture 6 5.67 0.91 6.83 0.71 1.16 20.46 %

Lecture 7 7.89 2.1 8.94 1.1 1.05 19.01 %*

Total 50.61 65.45 14.84 29.32 %*

From the table above, it can be observed that the knowledge of all mothers

increased after having lectures. However, only the percentage increase in lectures 1, 2,

5 and 7 are said to be statistically significant.

Since the pre-test scores of the mothers are already high, only a small

percentage of increase (29.32 %) in their knowledge was observed. This means that

the group failed to achieve their goal of 60 % increase. However, even though the

percentage increase is low, a significant relationship exists between the pre-tests and

post-test scores for PABASA. This signifies that the lectures conducted were effective.

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After the series of lectures, a quiz bee was held to test the mothers retention of r

knowledge from the lectures. This quiz bee was divided into three parts: the easy,

average and hard round. Three teams competed in this quiz bee and the group with

the highest score was declared the winner. In this game, group 2 have won with a total

score of 45 followed by both groups 1 and 3 with a score of 37. The winning group

received free yakult from the Rotary.

Aside from series of lectures, the group also distributed several health education

materials such as calendars with incorporated nutritious recipes and nutritional

guidelines, and bookmarks with 10 signs of good nutrition.

Nutri-guides were also distributed among the mothers. This is a colorful and easy

to follow guide for use by parents, health and nutrition workers and volunteers that

provide basic nutrition information, identifies malnutrition problems and suggests

solutions on how these problems can be solved in the most practical ways

Film Showing and Roleplaying were also done last March 9, 2013. The objective

of this activity is to promote and encourage the children to eat nutritious food especially

fruits and vegetable. After the said activity, parlor games were done and the kids

danced all throughout the activity.

To acknowledge the participation of mothers in the lectures, graduation

ceremony was held during the culminating activity. Certificates and ribbons were given

to the mothers as well as to children who participated in the program. Just like a typical

graduation, outstanding mothers were also awarded.

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Objective # 4: To increase knowledge and awareness regarding Proper Hygiene

and Sanitation

A lecture on infectious diseases as well as proper hygiene and sanitation was

conducted among the mothers and malnourished children in Sitio Lusong. The lecture

was headed by JC Belle Saladar wherein she also demonstrated proper hand washing

procedures. Pre-test and Post-test were also given to the mothers for evaluation.

In the table below, it can be observed that there is an increase in their

knowledge after the lecture by 90.67 %. This means that the group successfully

achieved their goal. Furthermore, a significant relationship exists between the pre-test

and post-test scores for this lecture. This shows that the lecture conducted was really

effective.

Table 5.

Documents

Project BUSOG.pdf