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Rural and Urban Poor

Rural and Urban Poor

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Family and Community Med III
RURAL AND URBAN POOR

Rosa Marie N. Flores, M.D., MPH, FPAFP, DFM
2nd Shifting /August 29, 2008
Trans group: JaViCi Code

[Classmates, eto yung lec dapat ni Dra. Flores last week, kaya
lang di ma-open yung file. Ngayong Wed na lang nya nbigay
powerpoint. Self-study na l ang. Un lang. =)]

RURAL and URBAN POOR
RURAL POOR
Goal
\ue000Health and nutrition of rural poor families are
improved
NATIONAL OBJECTIVES FOR HEALTH by 2004
Health National Objectives

1. Reduce the percentage of newborns with birth
weights less than 2.5 kilograms (Baseline data is
established in 2000)

2. Reduce the percentage of severely and
moderately underweight children under five
years old. (Baseline data is established in 2000)

3. Reduce the incidence of diarrhea cases among children below five years old. (Baseline data is established in 2000)

4. Reduce the percentage of death due to
preventable causes (Baseline in 2000)
Risk Reduction Objectives
1.Increase the percentage of infants breastfed for
at least six months
(Baseline data is established in 2000)
2.Increase the percentage of poor families availing
health services
(Baseline is established in 2000)
3.Increase the percentage of families utilizing any
type of sanitary toilet
(Baseline data established in 2000)
Service and Protection and Objectives

1. Increase the percentage of pregnant and
lactating mothers provided with iron and iodine
supplements.
(Baseline data established in 2000)

2. Increase the percentage of deliveries attended
by trained personnel

3. Increase the percentage of fully immunized
children
(Baseline data is established in 2000)

4. Increase the percentage of pregnant women given two or more doses of tetanus toxoid . (Baseline data is established in 2000)

5. Increase the provision of food supplements
using indigenous / local processed foods to
underweight infants aged 6-24 months old and

iron drops to LBW and diagnosed anemic infants
6-11 months old.
(Baseline data is established in 2000)

6. Increase the percentage of severely and
moderately underweight under 5 \u2013year-old
children registered in feeding programs.

7. Increase the percentage of couples provided with family planning service.(Baseline data is established in 2000)

8.Increase the percentage of households with
sanitary toilets. (Baseline data is established in
2000)
9. Increase the percentage of households with
access to safe water supply.
10. Develop a package of health services for rural
poor families.
POVERTY
\ue001\u201cAdeprivation in relation to a social standard,

or a lack of the minimum entitlements of
households in society, which the government
must seek to provide either directly or
indirectly.\u201d

POVERTY in the context of human development
\ue001\u201cThe sustained inability of a household to meet
its minimal set of basic needs (MBN).\u201d
\ue001Extending people\u2019s capabilities sufficiently for
them to meet their MBN makes the alleviation of
poverty a human development approach.
POVERTY THRESHOLD
\ue001In the Philippines, poverty is measured against
a total poverty threshold.
\ue001Thisthreshold is determined by a \u201cminimum

income requirement needed by a family to
purchase a specific set of freely provided basic
goods and services\u201d.

POVERTY INCIDENCE
\ue001The proportion of families falling below the
threshold is called poverty incidence.
\ue001Between 1988 and 1991 the poverty incidence in
the country hardly improved from 40% (1988)
to 39% (1991).
\ue001The number of poor families actually increased
by 11%.
The Presidential Commission to Fight Poverty

broadly categorized MBN indicators into three:
(1) Survival;
(2) Security; and

MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY TLE JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC
PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MACKY VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU
RACHE ESTHER JOEL GLENN TONI

Subject:
Topic:
Page 2 of 6
(3) Empowerment (or enabling needs).

Eight Basic Indicators of the Index of Deprivation
in the country relating to the MBN(set by the
Commission)

1. Number of families below the official poverty
line.
2. Incidence or proportion of poor families below
the poverty line
3. Infant mortality rates
4. Malnutrition rates

5. Cohort survival rates
6. Adult illiteracy rates
7. Proportion of households without access to safe

water.
8. Proportion of households without access to
sanitary toilets
The 10 provinces with the lowest MBN index

1. Sulu
2. Maguindanao
3. Masbate
4. Cotabato
5. Ifugao

6. Zamboanga del Sur
7. Basilan

8. Zamboanga del Norte
9. Lanao del Sur
10. Agusan del Sur

The Specific Groups of the Poor Predominant in
Each Area:
(For which the content of the government\u2019s anti-poverty

programs in each of these provinces depended on)
1. Lowland landless agricultural workers
2. Lowland small farm owners and cultivators.

3. Upland farmers
4. Subsistence fisherfolks
5. Industrial wage laborers
6. Hawkers and macroenterpreneurs
7. Scavengers
o
Low productivity and income is the result of
the low level of literacy and skills among the
poor.
o
This situation is worsened by the lack of
access to basic infrastructure services that
can raise production outputs.
o
Moreover, an inadequate basic social service

results in poor health and welfare that limits
its prospects of the rural poor for a better
life.

o
Since the rural poor have the least
occupational alternative they depend on
inferior resource bases that yield low
income.
o
Migration to urban centers and resource-rich
areas becomes an option.
o
Mechanisms that deliver basic services to
the rural poor are often unresponsive to
their fate and needs.
o

Because the nature and intensity of their
needs are diverse and the causes of poverty
vary, solutions to their problem differ.

o
The approach to poverty alleviation needs to

distinguish between the different poor groups , between the poor and the \u201ccore poor\u201d ,between the less poor and the \u201csubsistence poor\u201d.

Five Principal Strategies Adopted by the
Commission:
(Because the poor has different causes of poverty and
because their needs are diverse)
1. Revive economic growth to create employment
and livelihood
2. Sustain growth based on people friendly

approaches
3. Expand social services to provide MBN
4. Foster sustainable income generating

community projects
5. Build capabilities of the poor to help themselves.
6. Emphasize the importance of local action

The MBN approach to poverty alleviation which focuses
program resources on identified priority poor
municipalities aptly addresses social inequities among
various groups of the poor.

Top Five MBN identified in the country
1. Family with income below subsistence threshold

level
2. Family without sanitary toilet
3. Family without access to potable water within

250 meters
4. Children 3 to 5 years old not attending day care
or preschool
5. Housing not durable for five years,

The CIDSS set a20% target to meet unmet MBN in priority provinces for one year, but achieved a higher average of52% reduction of the top MBN.

MBN Projects for the Rural Poor include:

\ue002Nutrition
\ue002Maternal and child health
\ue002Dental health
\ue002Care for the elderly
\ue002Communicable disease prevention, and

control
\ue002Traditional medicine

These community health projects were provided
especially to fifth and sixth class municipalities using
poverty alleviation funds.

________________________________________
URBAN POOR
GOAL

\ue000Health and nutrition of urban poor families
are improved.
Subject:
Topic:
Page 3 of 6
NATIONAL OBJECTIVES FOR HEALTH BY 2000
1.Reduce the infant and child mortality and
morbidityrates in the urban poor areas.
(Baseline data is established in 2000)
2.Reduce the maternal mortality and morbidity
due to direct obstetrical causes.
3.Reduce protein- energy malnutrition (PEM) and

micronutrient deficiencies among children below
5 years old.
(Baseline is established in 2000)

Risk Reduction Objectives

1. Increase the practice of multi-mix daily diet
among under- two- year old children to 90%.
(Baseline data is established in 2000)

2. Increase the practice of multi-mix daily diet
among women to 90 %.

3. Increase the percentage of infants exclusively breastfed up to six months to 80% (Baseline 58% in 1996, UHNP)

4. Improve personal hygiene and sanitary practices
(Baseline data established in 2000)

5. Increase the percentage of mothers and
children availing of maternal and child health
services to 90%. (Baseline data is established in
2000)

Service and Protection Objectives

1. Increase the percentage of urban poor with
access to quality MCH care, nutrition and other
health services at the local level to 90% .
(Baseline is established in 2000)

2. Increase the percentage of infants fully
immunized to 95%.
(Baseline data is established in 2000)

3. Formulate and concretize the urban poor
development plan at the local level

4. Establish empowered community level health
and social support groups.
(Baseline is established in 2000)

5. Increase the percentage of households with
access to safe water to 80%.

6. Increase the percentage of households with
access to sanitary toilet facilities to 70%.
(Baseline 64.6 % in 1996, UHNP)

7. Develop a package of health services for urban
poor communities.
DOMESTIC ENVIRONMENT \u2013 Urban Poor
\u2022

Rapid urbanization and migration have brought
about negative consequences such as slums and
squatters , overcrowding , poor sanitation,
environment degradation and pollution.

\u2022

Studies and field researches have shown that
the that the urban poor have less access to
educational services. Only about 6% of urban
poor had no schooling whereas 10% of rural
poor had none.

\u2022

Overall 35.9 % had an income below the poverty
line and 21.3% had an income below the food
line.

\u2022
About three-fourths were employed.
\u2022
The median monthly income was P933.
\u2022

Based on a study of urban poor communities,
72.2 % of households had access to piped water
or tube wells.

\u2022
Seventeen % of water samples were heavily
contaminated by fecal organisms at source.
\u2022

Two thirds of households tried to protect their
drinking water and more than one-fourth boiled
it.

\u2022

Many households lacked sufficient water to wash utensils properly and their water containers and water handling practices were inadequate.

\u2022

Over 16% of households lacked toilet. The
consequences were that 21.4 % of people
defecated into a waterway and 14 % used the
so-called \u201cwrap and throw\u201d method.

\u2022
28 % of households reported that garbage was
not collected at all.
\u2022

Most commonly uncollected garbage was burnt
(17. 6 %) dumped elsewhere (14. 6 % ) or
thrown into waterways (8.1 % ).

\u2022

Other environmental problems include the
proliferation of mosquitoes and other insects,
rats, and domestic animals.

\u2022

The commonest cooking methods was gas,
followed by kerosene and electricity. The
remainder used biomass fuels such as wood,
coconut shell and charcoal.

\u2022
Households were unlikely to store uncooked
food.
\u2022
Most households slept in one room.
\u2022
The mean number of persons who slept in the
house was 5.5
MATERNAL HEALTH
\ue000The total fertility rate of urban poor women 15-
49 years old (4. 04 births) was lower than rural
women (4.82 births).
\ue000The crude birth rate was 34 per 1000 among the
urban poor much higher than the rural poor
population (30.9 per 1000)
\ue000Maternal death rate in the urban poor

communities under the Urban Health and --
Nutrition Project (UNHP) was at least 3 deaths
per 1000 live births a year

Prenatal Visits
\u2022

Seven percent of women had three prenatal visits to
a health facility and 62.2 % made four or more
visits. Only 8% of women failed to have prenatal
visits at all.

\u2022

Problems related to the quality of prenatal care
include inadequate laboratory examination;
inadequate iron tablet supplementation and poor
referral of high risk group.

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