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The community engagement revolves around developing a comprehensive understanding of Barangay Lindang’s demographic, geographic, and health profiles. This is done through the thorough collection and analysis of data on the residents’ livelihood and lifestyle for the primary goal of identifying the top health issues prevalent in Barangay Lindang. The data collected will be pivotal in tailoring the necessary health education and intervention programs to fit the specific needs of the people in the community.
Thus, the following are the identified TOP 5 HEALTH PROBLEMS in the Barangay.
TOP 1: High Prevalence of Hypertension
Hypertension is identified as the top health problem as it is a pressing health concern in the Barangay, supported by its ranking as the second leading cause of morbidity in the community.
Cues:
Hypertension ranked as the second leading cause of morbidity in the barangay as of 2023.
Three of recent mortalities reported in January 2024 have been attributed to acute myocardial infarction (the second leading cause of mortality) caused by chronic hypertension.
Non-communicable diseases records from the RHU shows that 54 people in Barangay Lindang are clinically diagnosed with hypertension for 2024.
Survey of 183 residents revealed that 62 people (34.1%) reported a history of hypertension. However, 36% of those who said they had no history of hypertension had blood pressure readings higher than normal.
12% of the population are smokers, a significant risk factor for hypertension.
General Objective: To evaluate Barangay Lindang’s hypertension management strategy, with an emphasis on screening, diagnosis, and referral procedures, identification of risk factors, and patient response and attitude to medication. The goal is to develop strategies to improve adherence and compliance, reduce hypertension risk, and enhance overall hypertension management.
Specific Objectives:
To determine the process of screening, diagnosis, referral, and monitoring of the individuals who are at risk and diagnosed with hypertension.
The outcomes of each evaluated aspect reveals that:
Screening: Based on interview with barangay health workers, monthly risk assessment reports are generated for about 40 individuals, and the health center calls these people for monitoring.
Diagnosis: Based on interview with barangay health workers, they are not able to diagnose hypertension but consecutive elevated blood pressure readings are referred to the Diplahan Rural Health Unit for further assessment.
Referral: Interview with the municipal health officer shows that necessary laboratory tests are conducted along with a physical examination in the RHU. If the patient is diagnosed with hypertension after further risk screening, initial treatment and instructions for maintenance and lifestyle improvements are provided.
Health station operational capacity: Based on an interview with the barangay health workers using a checklist based on NC II course by TESDA, it was revealed that the barangay health station has only one sphygmomanometer and one stethoscope, both broken, making them unusable.
To conduct hypertension risk assessments for individuals aged 20 and above, focusing on hereditary and lifestyle factors.
The outcomes of each evaluated aspect reveals that:
Identification: 55% of the 426 individuals aged 20 and above are included in the risk assessment.
Risk Assessment: Using the PhilPEN 2018 risk assessment tool (2018) on the 55% of the target population, it was revealed that:
FAMILY HISTORY:
32 individuals (13.6%) have a family history of hypertension, 23 (9.78%) have a family history of kidney disease, 24 (10.2%) have a family history of heart disorders, and 7 (3%) have a family history of cancer.
PHYSICAL CONDITION:
80 individuals (34.04%) are overweight, 15 (6.38%) are classified as obese class 1, and 1 individual is classified as obese class 2.
105 individuals (44.7%) have a waist circumference above normal standard measurements.
Out of 45 hypertensive individuals on maintenance medication, 26 (57.77%) have had uncontrolled blood pressure.
LIFESTYLE:
57 individuals (24.4%) are smokers, while 20 individuals (8.5%) are exposed to smoke.
103 individuals (43.8%) are alcoholic drinkers, with 16 individuals (6.8%) being regular drinkers.
DIET:
73 individuals (31%) consume more than 2000 mg of sodium daily.
To assess adherence, effectiveness, and compliance to treatment among diagnosed hypertensive individuals.
The outcomes of each evaluated aspect reveals that:
Service Delivery: Based on interview with barangay health workers, hypertension maintenance medications are provided by the midwife/nurse, 30 pieces per patient to the barangay health station; however, over the past year, medication supplies have been provided for only six months, necessitating that the Barangay use its own funds to cover the shortfall.
Compliance to medication: Based on interview with diagnosed hypertensive patients, 28.5% (18) out of the 63 diagnosed hypertensive residents do not take medications due to fear, lack of knowledge about the effects, and other factors.
Medication Adherence: With the use of the Morisky Medication Adherence Scale (MMAS-4), 16 (35%) out of the 45 residents taking maintenance medications scored 4 on the Morisky Medication Adherence Scale, 6 (13.3%) scored 3, 12 (26.6%) scored 2, 3 (8.57%) scored 1, and 8 (17.7%) scored 0.
To determine the effectiveness of the current antihypertensive therapy for individuals with hypertension.
The outcomes of each evaluated aspect reveals that:
Type of therapy: Based on interview with diagnosed hypertensive patients, 22.22% (10) are on combination therapy with antihypertensive medications, while 77.77% (35) are receiving monotherapy.
Blood pressure stability: Out of 45 hypertensive individuals on maintenance medication, 26 (57.77%) had uncontrolled blood pressure readings.
Monitoring: 44 out of 63 known hypertensive patients consulted the barangay Health station for blood pressure measurement as of 2023; and only 5 are having regular monthly blood pressure monitoring.
TOP 2: High Prevalence of Malnutrition Among Children Aged 0-59 months old
Malnutrition is a significant issue in Barangay Lindang, where nine malnourished under-five children were identified during the 2024 Operation Timbang Plus Program. Malnutrition weakens the immune system, making children more prone to infections and illnesses. It can also lead to stunted growth, impaired brain development, and reduced academic performance, affecting their long-term health and potential. Thus, addressing malnutrition is crucial for improving children's well-being.
Cues:
In March 2024, 12.77% (6/47) of children aged 0-59 months old were reported by the Barangay Nutrition Scholar (BNS) to be Stunted, while 4.26% (2/47) of which were Severely Stunted.
Additionally, 1 out of the 47 children (2.13%) was identified as having Moderate Acute Malnutrition (MAM), while 3 out of the 47 children (6.38%) were found to have borderline MAM.
Moreover, 4 out of 47 children (8.51%) were reported to be Underweight, while 1 was classified as Severely Underweight.
General Objective: To assess the factors affecting the nutritional health of children aged 0-59 months in Barangay Lindang, with the goal of developing targeted strategies to reduce the prevalence of malnutrition in the barangay.
Specific Objectives:
To assess mothers’ knowledge, attitude, and practices concerning child nutrition and feeding practices.
The outcomes of each evaluated aspect reveals that:
Knowledge:
Only 5 out of the 47 mothers (10.64%) were able to identify food sources of at least one of the following: Protein, Vitamin A, Calcium, Iron, and Vitamin C
All 47 respondents (100%) are unaware of the Pinggang Pinoy and Nutritional Guide Pyramid developed by the Food and Nutrition Research Institute (FNRI), which provides recommendations on the appropriate portion sizes and meal frequencies included in a child’s meal
23 out of the 47 mothers (48.94%) indicated that the recommended duration of exclusive breastfeeding is 0-6 months
Attitude:
11 out of 47 mothers (23.40%) had difficulty in controlling portion sizes for children.
All respondents (100%) believed that skipping meals affects a child's growth.
Practices:
100% of the respondents consume cereals and grains on a daily basis
Regular milk consumption was observed in 27.5% of children, whereas 30% of children reported consuming fish at least seven times weekly.
36 out of 47 respondents (76.60%) stated that their children consume three meals per day
To assess the state of food security and availability, and to identify barriers affecting food security among households with children in the barangay.
Food Availability:
Commonly accessible foods in Lindang include fish from the Zamboanga Sibugay River, vegetables from own gardens, and rice harvested from local farms.
Vegetable gardens in most households within the barangay usually consists of malunggay, kamote, tanglad, eggplant, alugbati, kalabasa, and pechay.
Staple Food Consumption:
Residents prefer buying daing, bagoong, noodles, sardines, and other canned goods from sari-sari stores near them due to its affordability, long shelf life, and convenience.
Resource Constraints:
11 out of 47 mothers (23.40%) admitted that they have skipped meals due to difficulty in accessing food
31 out of the 47 mothers (65.96%) reported that distance is the main challenge in accessing nutritious food.
Due to limited supplies within the barangay, residents often travel to the Diplahan market for their needs. Since residents face financial limitations, they tend to purchase from nearby local markets and sari-sari stores, opting for whatever items are available.
To assess referral procedures for children identified with nutritional problems, identify gaps in the referral system in the barangay, and evaluate growth monitoring procedures.
Referral Procedures:
Based on the interview, the BNS is mandated to report detected cases of MAM or SAM to the MNAO, who notifies the DOH nutritionist for case verification.
MAM or SAM cases are identified by the BNS through the e-OPT (Electronic Operation Timbang Plus Tool)
Confirmed cases will be reported to the Rural Health Unit (RHU) for the provision of RUTF and/or ORS to affected children. The BNS monitors the child’s growth.
Challenges in Referral:
Nutritionist’s visits to the municipality have decreased. Records indicate that the last visit occurred in March 2024, which was also the first visit of the year. The nutritionist's current focus is exclusively on barangays with confirmed cases of MAM and SAM.
Growth Monitoring Procedures:
Monthly monitoring of height and weight is conducted from January to December wherein the growth records are compiled in the e-OPT system.
Height board was utilized to measure the children’s height, while their weight was measured using a calibrated weighing scale that has been borrowed from another barangay.
BNS Trainings:
The current BNS in Lindang has not received any training on referral procedures since she was newly hired. Despite the absence of formal training, the BNS are equipped with a handbook detailing their duties, including growth monitoring, nutritional importance, and referral procedures at a barangay level.
BNS participated in a training conducted by the MNAO from February 5-9, 2024, focusing on the basic nutrition assessment including weighing, height measurement, MUAC (Mid-Upper Arm Circumference), and proper utilization of e-OPT.
To assess referral procedures for children identified with nutritional problems, identify gaps in the referral system in the barangay, and evaluate growth monitoring procedures.
Referral Procedures:
MAM or SAM cases are identified by the BNS through the e-OPT (Electronic Operation Timbang Plus Tool) and is reported to the MNAO then the DOH nutritionist.
Confirmed cases will be reported to the Rural Health Unit (RHU) for the provision of RUTF and/or ORS to affected children.
0 case of SAM and no referral done in the past
The current BNS in Lindang has not received any training on referral procedures since she was newly hired.
However, the BNS are equipped with a handbook detailing their duties, including growth monitoring, nutritional importance, and referral procedures at a barangay level.
No missed cases of MAM or SAM for the year 2024.
There is a MAM case before, which was managed successfully with a feeding program and close monitoring.
Due to limited resources at the barangay level, residents exhibiting symptoms of SAM directly seek treatment at healthcare facilities.
Growth Monitoring Procedures:
Monthly monitoring of height and weight is conducted from January to December.
Growth records are compiled in the e-OPT system.
The BNS participated on a seminar focusing on the basic nutrition assessment
There is 1 height board that is utilized to measure the height, while the calibrated weighing scale is borrowed from other barangay
To identify existing intervention programs of the barangay, as well as their compliance with the local intervention programs regarding the nutrition of children aged 0-59 months old.
Local Intervention Programs:
Deworming is administered twice annually, on January and July
January 2024: 64.29% (36 out of 56 DOH estimated population) successfully dewormed
July 2024: 67.86% (38 out of 56 DOH-estimated population) were successfully dewormed
July 2024 primary survey revealed full immunization coverage for all children, with mothers demonstrating adherence to the immunization schedule.
The BNS stated that children dislike the taste of the MNP, preventing them from completing the recommended dosage and duration of treatment
Barangay Intervention Programs:
Barangay has implemented feeding programs annually in collaboration with the Department of Social Welfare and Development (DSWD), BNS, and barangay officials.
The majority of feeding programs relies heavily on the barangay's financial capacity. With the recent feeding program, the BNS reported the budget allocation of Php 1,500 for the whole duration of Nutrition Month.
The nutritional feeding program focuses on addressing the nutritional needs of underweight, stunted, and malnourished children, with a particular focus on the pre-school and school-age population.
FGD participants, including Barangay Health Workers and the Barangay Officials, confirmed awareness of malnutrition cases as the BNS regularly reports the results of growth monitoring.
BHWs and barangay officials identified food insecurity, financial constraints, children's dietary preferences, and inadequate maternal knowledge as primary factors contributing to malnutrition within the barangay.
TOP 3: Prevalence of Adolescent Pregnancy
Adolescent pregnancy remains to be one of the top concerns of Barangay Lindang to date. There have been a total of 8 adolescent pregnancies throughout the years 2021 to 2024. There has not been a year since 2021 where there were no recorded instances of adolescent pregnancies, making this a recurrent problem and a health concern risk for the adolescent population of the barangay.
Cues:
Presence of 8 pregnant adolescents in the community as supported by primary data, from years 2021 to 2024
The 15 - 19 year old population makes up the second most in the population of Barangay Lindang (10%) and is most at risk for recurrence of teenage pregnancy
Lack of sexual knowledge on certain topics as identified by surveyors in the community.
General Objective: To determine and understand the factors contributing to adolescent pregnancy in Barangay Lindang, with the aim of developing interventions and program that can effectively address the issue of yearly teenage pregnancies.
Specific Objectives:
To assess the knowledge related to sexual health and contraception among adolescents aged 15-19 in barangay Lindang
The outcome of each evaluated aspect reveals that:Knowledge:
30 respondents (40.5%) were informed about sexual education through school while 4 (5.1%) respondents mentioned learning from their parents.
34 respondents (37.8%) failed to pass the Sexual Intercourse portion of the exam
22 respondents (24.4%) failed the contraception portion
To identify the risk of possible unplanned adolescent pregnancy based on changes in social and environmental factors.
The outcome of each evaluated aspect reveals that:Behavior:
6 out of 6 (100%) participants were reviewed by the team using the risk assessment tool
6 participants (100%) scored beyond 30+ in the risk assessment tool.
Social Factors:
6 out of 6 (100%) of the participants have supportive peers.
5 out of 6 (83.33%) mothers responded that they have a family member with history of teenage pregnancy
Only 1 (16.67%) out of 6 had history of alcohol use
Environmental Factors:
6 out of 6 (100%) participants responded that they live in a neighborhood with a high conception rate
However 3 (50%) of them have plans on returning for education or do not consider permanent exclusion from education
To identify the perception of adolescent mothers on early pregnancy based on cultural and religious beliefs.
The outcome of each evaluated aspect reveals that:
Culture:
6 out of 6 (100%) participants attended the scheduled FGD.
5 out of 6 participants (83.33%) were forced to assume traditional gender roles and stated that gender equality played a factor in their pregnancy.
However, a collective 6 out of 6 (100%) participants all agreed that if they were given a choice, they would pursue a meaningful career rather than be a housewife
Religion:
6 out of 6 Respondents (100%) agreed that religion did not play a factor in their decision to get pregnant.
The 3 most dominant religions in the barangay: Roman Catholic (65%), Seventh Day Adventist (10%) and Primitive Baptist Church (9%) were studied through structured interviews regarding their views on early pregnancy and marriage.
All three religions highly discourage premarital sex in any form.
All religions do not limit sexual intercourse or pregnancy for females once they enter the age of 18 and are married.
To evaluate the existing plan and interventions of the barangay health station and educational system with regards to family planning
The outcome of each evaluated aspect reveals that:
Protocols:
Initial screening for eligibility of the type of contraception including risk assessment for contraindications such as hypertension, diabetes, suspected breast carcinoma and the like are solely done by one Barangay Health Worker.
Other BHWs cannot distribute contraceptives for the residents of the barangay
The barangay health nurse visits once a month and assumes the responsibility of contraceptive distribution in the barangay.
Service Delivery:
Sexually active individuals as early as 15 years old are given access to contraceptives as long as they inquire and are given proper instruction by the BHW
Referral:
Inquiring residents are referred to the local RHU where they can be assessed by the MHO and re-referred to a local hospital that offers said procedures
Education:
Sex Education is not actively included in the curriculum, instead topics related to it are added as competencies or objectives in the students’ homeroom guidance or catch up Friday lessons which last for one to two hours a week.
Lessons are initiated when students reach Grade 8 (1st Year) at 13 - 14 years old and continue until students finish high school.
TOP 4: Prevalence of Dengue
Dengue fever remains a significant public health concern in the Philippines, with the disease burden fluctuating annually. In 2010–2014, an estimated 794,255 annual episodes of dengue occurred, resulting in approximately 516,266 hospitalizations and 1,500 fatalities each year. More recently, in 2022, the country reported 226,500 dengue cases ( PSA, 2022). Furthermore, at 2023, different disease reporting units in Zamboanga Peninsula report a total of 4,258 dengue cases (PIA, 2023). These statistics reveal the persistent challenge of dengue in the Philippines, as yearly case rates continue to fluctuate without significant improvement, highlighting the urgent need for ongoing preventive measures and public health interventions especially on the barangay level, where healthcare accessibility is variable.
Cues
Dengue is the second leading cause of morbidity in Barangay Lindang as supported by secondary data.
Presence of 9 total cases of Dengue throughout the year 2021 to 2024 according to secondary data.
Presence of flood prone areas in the barangay.
There are no existing ordinances and active programs implemented by the barangay for dengue prevention.
General Objectives: To assess the factors affecting the number of dengue cases in Barangay Lindang. With the ultimate goal of increasing the awareness of the people about dengue prevention and preventive measures.
Specific Objectives:
To identify the environmental factors contributing to the increase in dengue cases in Barangay Lindang:
Location:
There are 20 (12%) of households that are at risk for flooding.
From the 20 households that are at risk 7 (35%) of these households reside in Purok 2, 5 (25%) reside in Purok 1 both of which are located in close proximity to the Sibugay river. 8 (40%) of the remaining households are located in Purok 7 which are in low-ground areas.
Environment:
Among the 166 households, 40 (24%) have mosquito breeding sites located within 5 meters of their premises.
To assess the role of sanitation and water storage practices in influencing the prevalence of dengue cases.
Practices:
Out of 166 households surveyed, 89 (54%) households store water using drums, 50 (30%) use pails and 27 (16%) use gallons.
119 (72%) of these households cover their water containers while 47 (28%) leave them open.
To investigate common household interventions for dengue prevention in Barangay Lindang.
Interventions:
Among the 166 households surveyed, 29 (17%) utilize katol, 21 (12.65%) employ fogging, 11 (6.6%) use mosquito nets, 8 (4.8%) apply mosquito repellents, and 4 (2.4%) take measures to eliminate mosquito breeding sites. The remaining 93 households (56%) do not implement any preventive measures against mosquitoes.
TOP 5: Unsafe Water Source
The potability of the water sources in the Barangay raises significant concerns as the majority of the households (167 out of 195) rely on Level 1 water sources such as deep wells for consumption and domestic purposes. Note that, level 1 is the lowest when it comes to access to basic safe water supply.
A worrisome 58.2% of households do not practice water sterilization. This lack of water treatment becomes particularly critical due to the fact that most of the water comes from level 1 sources and typhoid fever, a waterborne disease, is the leading cause of morbidity in the barangay. This makes the potability of the unsafe water sources the top 2 identified health problem.
Cues:
28 diarrhea and vomiting cases present within the past year.
12 cases of diarrhea alone
2 cases of vomiting alone
14 cases of diarrhea with vomiting
Data from the Diplahan Rural Health Unit reveals typhoid as the top leading cause of morbidity- waterborne disease.
Majority of households utilize Level I water sources for consumption which is the lowest level for water supply/source.
General Objectives: To assess the safety and quality of drinking water sources in Barangay Lindang. The primary aim is to identify gaps and propose effective measures to ensure safe drinking water for residents.
Specific Objectives:
To conduct water sampling to evaluate contamination levels in the primary water sources used by the Barangay residents.
The outcomes of each evaluated aspect reveals that:
Identification: Out of the 183 households, 70.3% of the households rely on deep wells, followed by 38.5% utilize mineral water from water refilling stations, and 3 households rely on the river/springs.
Mapping: Primary Water Source Distribution Map (refer to figure below). An electric pump well in Purok 4 supplies water to multiple areas, including Puroks 2, 4, 5, and 6. Deep wells are located in Puroks 1, 3, 6, and 7, providing water to portions of their respective areas.
Water Contamination Risks: 5 households are at risk of flooding during rainy seasons.
Water Sampling: Three water samples are collected purok 1, 7, and 4.
Water Sample Analysis: The samples have been analyzed for water quality, and the results are currently being processed; they will be available in due course.
To assess the community practices related to water sanitation and disinfection.
The outcomes of each evaluated aspect reveals that:
Water Contamination: 1 of the households do not have a water container for drinking water as it is collected directly from the source, 67.21% (123) of the households use a gallon for storing drinking water, and 32.24% (59) utilize a jar as a method of storing drinking water. 2 households do not cover their water containers for primary water use.
Water Disinfection Practices: 58.2% of households do not practice any form of water disinfection; 34.5% of households use straining as their method of water disinfection; 4.4% of households use chlorination for water disinfection; 2.2% of households rely on boiling as a method of water disinfection; 1.6% of households use solar methods for disinfecting water.
To determine the protocols implemented by sanitary inspectors in the barangay to ensure safe water.
The outcomes of each evaluated aspect reveals that:
Water Safety Classification: The main indicator of water not being safe for consumption is the presence of Total coliform (fecal coliform such as E. coli).
Water Monitoring and Frequency: For over three (3) years, water sampling has not been conducted on the primary water sources to detect contamination or assess their safety for consumption.
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