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LICEO DE CAGAYAN UNIVERSITY

RODOLFO N. PELAEZ BOULEVARD, CARMEN, CAGAYAN DE ORO CITY, PHILIPPINES

College of Nursing

In Partial Fulfillment of Related Learning Experience HEALTH ECONOMICS

HEALTH AND ECONOMIC PROBLEMS OF BELOW POVERTY COMMUNITY

DATE SUBMITTED: MARCH 16, 2009

SUBMITTED BY: DERIX JELL ONG NEPTHALIE MONTOYA CRISTINA LAVANZA MADONNA MANQUIQUIS AKIMA GRACE MATIAS ZOLAICA MACARAMBON

TABLE OF CONTENTS

I.

Introduction

II.

Acknowledgement

III.

Data Analysis

IV.

Daily Diary

V.

Individual Personal Insights

VI.

Pictorials w/ Formal Captions

VII.

Courtesy Letter

VIII.

Survey Forms

I. INTRODUCTION

Health economics is a branch of economics concerned with issues related to scarcity in the allocation of health and health care. Family in a traditional society forms the primary economic unit. This economic role has gradually diminished in modern times, and in societies it has become much smaller ± except in certain sectors such as agriculture and in a few upper class families. Family is a very important social institution that performs two major functions ± reproduction and socialization.

It is influence by the health status of individuals in the family and health units . It undergoes an ongoing evolution in structure, function, and process. Generally, it is considered as the basic unit care in the community health nursing. It also performs health-promoting, health- maintaining and disease ± preventing activities. Family is the focus of decision ± making on health matters.

A community is a group of interacting organisms sharing an environment.

Health care is the value of understanding which touches our lives. Everybody visits the doctor and most of us have been treated in an hospital, health care centers and other health facilities. The future of the Philippine Health Care System consistently surfaces as one of the most important issues which people believe is facing the Philippines in the present. Yet health care seems to be in almost permanent crisis - there are shortages of hospital beds and patients are left to lie in corridors while politicians argue endlessly over whether more or less is being spent on the Health.

II.

ACKNOWLEDGEMENT

The self-effacing activity wouldn¶t come this far without peers and associates who gave support for this given project. The creation of ³The Simpsons´ would like to acknowledge our positive reception and gratefulness to the people who extended their help for the transition of this project from the sphere of thoughts into the field of authenticity. Exceptional thanks to Mrs. Lourdes Echem, Barangay Captain of Macahambus, Burgos, for giving us the opportunity to carry out a community survey of the health and economic problems within the society. And also for the help of Ms. Zolaica Macarambon who gave an assistance in giving the courtesy letter to the Barangay Captain. However, we still have to express our thanks partially to our few members in our social group and associates who imparted their valuable time in helping us through it. To Ms. Cristina Lavanza for the gadget in helping us for the pictorials and the venue for making such documentation. We are above all grateful to Mrs. Azenith Jabagat, for the supervision and unstinting support throughout the achievement of this project. And to our adored parents for the financial supports and motivation. And most of all, to our mighty God for allowing us to thrive in all difficulties we had faced in making this project.

III.

DATA ANALYSIS

Health economics is concerned with issues related to scarcity in the allocation of health and health care. Typically however, it pertains to cost benefit analysis of pharmaceutical products of cost-effectiveness of various medical treatments. We are tasked to have an interview w/ regards to the health economic problems in the community and we are assigned to be in low poverty area. As we go along with the interview, we¶ve chosen the households living near in Isla de Oro as our source of information. We¶ve encountered different households with different sources of income. The place is somewhat prone to flashfloods and it has complications within the home and environment. After the interview of different households, we have observed that most of the residents within the Barangay have an income of below 4,000 and it clearly shows that it isn¶t enough to provide the needs of a particular family. Moreover, in relation to their specific occupation, most of them are unemployed. Within that case, some of them couldn¶t afford to send a family member for hospitalization. In relation to that, majority preferred to go in reflexologies due to financial tribulations. Most of the residents gain sources of information about health on Health Centers that are near their households. Thus, it was easy for us to answer and explain their questions of about the given health programs within the community.

TABLE 1 OCCUPATION GOVERNMENT EMPLOYEE PRIVATE EMPLOYEE SELF- EMPLOYED II IIII ± I 2 6 10% 30% TALLY II FREQUENCY 2 PERCENTAGE 10%

UNEMPLOYED

IIII ±IIII

10

50%

TOTAL

20

20

100%

TABLE 2
MONTHLY INCOME TALLY FREQUENCY PERCENTAGE

BELOW P4000

IIII ± IIII ± IIII

15

75%

P4001-P6000 P6001-P10,000 P10,001-P15,000 P15,001-P20,000 ABOVE P20,001 TOTAL

IIII

5 0 0 0 0

25%

20

20

100%

TABLE 3 MONEY SPENT FOR MEDICINE YEARLY BELOW P500 P500-P1,000 P1,001-P5,000 P5,001-P10,000 ABOVE P10,000 TOTAL I 20 IIII ±IIII IIII ±IIII 9 10 0 0 1 20 5% 100% 45% 50% TALLY FREQUENCY PERCENTAGE

TABLE 4
MONEY SPENT FOR HOSPITALIZATION YEARLY BELOW P1,000 P1,001-P5,000 P5,001-P10,000 P10,001-P20,000 ABOVE P20,000 NONE TOTAL IIII 20 IIII ±IIII III I I 10 3 1 1 0 5 20 25% 100% 50% 15% 5% 5% TALLY FREQUENCY PERCENTAGE

FOR HOSPITALIZATION
60% 50% 40% 30% 20% 10% 0%

BELOW P1,000 P1,001-P5,000 P5,001-P10,000

P10,001-P20,000 ABOVE P20,000 NONE

TABLE 5 HEALTH PREFERENCES GOVERNMENT HOSPITAL PRIVATE HOSPITAL HEALTH CENTER MEDICAL DOCTOR HILOT OTHERS (SPECIFY) TOTAL 34 II IIII ± I I IIII ± IIII ± III 2 6 1 13 0 34 100% 5.88% 17.65% 2.94% 38.24% IIII ±IIII ± II 12 35.29% TALLY FREQUENCY PERCENTAGE

TABLE 6 HEALTH PROBLEMS ENCOUNTERED HEADACHE FEVER AND FLU COUGH COLDS LUNG DISEASE HEART DISEASE OTHERS (SPECIFY) TOTAL III IIII ±IIII ±IIII IIII ±IIII ±IIII ± III IIII ± IIII ±IIII ± II II I IIII 61 3 14 18 17 2 1 5 61 4.92% 22.95% 29.51% 27.87% 3.28% 1.64% 8.197% 100% TALLY FREQUENCY PRECENTAGE

TABLE 7
DO YOU HAVE HEALTH INSURANCE

TALLY IIII ± IIII ± IIII ±II III 20

FREQUENCY 17 3 20

PERCENTAGE 85% 15% 100%

YES NO TOTAL

TABLE 8
WHAT TYPE OF INSURANCE

TALLY IIII ± IIII ± IIII

FREQUENCY 15

PERCENTAGE 71.43%

PHILHEALTH

SSS GSIS TOTAL

IIII ± I

6 0

28.57%

21

21

100%

TABLE 9 IF NO, SOURCES OF MONEY FOR MEDICINES AND HOSPITALIZATION SAVINGS FAMILY FRIENDS CHARITY OTHERS (SPECIFY) TOTAL 7 II IIII 2 5 0 0 0 7 100% 28.57% 71.43% TALLY FREQUENCY PERCENTAGE

SOURCES OF MONEY 0
28.57%
SAVINGS FAMILY FRIENDS CHARITY OTHERS (SPECIFY)

71.43%

TABLE 10
AWARE OF INDIGENT PROGRAM OF PHILHEALTH

TALLY IIII ± IIII ±III

FREQUENCY 13

PERCENTAGE 65%

YES

NO TOTAL

IIII ± II 20

7 20

35% 100%

TABLE 11
SOURCE OF INFORMATION ABOUT HEALTH

TALLY IIII ± IIII ± III

FREQUENCY 13

PERCENTAGE 72.22%

HEALTH CENTERS

TV RADIO NEWSPAPERS FRIENDS / RELATIVES OTHERS (SPECIFY) TOTAL

I I I

1 1 1

5.55% 5.55% 5.55%

II 18

2 18

11.11% 100%

Based on the data gathered, it shows that the majority of the residents in the said community were unemployed and majority of their monthly income were ranges below P4,000. For last year and so far this year, the amount they spend for medicine just ranges below P500 and for hospitalizations ranges only to P1,000. This means that for the last and current year, they¶re not prone to illness. Based also on the data gathered, most of family we interviewed was able to avail to Phil Health. Upon knowing the monthly income of each resident, you could say that their income is not enough to

support all the needs of each members of the family since it is just enough for food and sometimes they lacking. Conclusion Based on the survey we conducted, we concluded that people living in Isla de Oro were really considered to part in a below poverty. We based it on their monthly income and number of family members in a family. Even though most of the family we interviewed has availed to Phil health, still their source of money for needs of individuals cannot be met by their monthly income. They don¶t have a savings for emergency matter like being hospitalized and etc.

IV.

DAILY DIARY

MACARAMBON, ZOLAICA A.

DAILY DIARY FEEDBACK

BEFORE: The community survey is characterized by series of plans. The making of courtesy call letter for the Barangay captain is part of which in the activity and most of all, the maximum of 20 households that should be interviewed. Basically, the questions that we have to ask to the residents are of about their income and health insurances. On our group survey, we have to show the value of respect for us to gain their cooperation and trust. The plans of having them involved in our community survey could give a possible and great outcome for our assigned activity. Thus, it is important to communicate well and be a good listener to every resident thatµll be interviewed.

AFTER: It has been a long day for the group to encounter such community survey on a certain Barangay. We had our answers completely given. Indeed, we were so welcomed in their place and I had thought of my hardships that were totally paid off. Residents of the Barangay are good enough to mingle with and fun. It wasn¶t hard for us to ask questions from them because we gained their respect and cooperation through it. We took pictures of the Barangay officials for our Documentation before we left so that we could have a memorandum of this community exposure. Overall, the activity was done successfully.

PERSONAL INSIGHTS Being involved in this community survey, made my skills develop in communicating with other people. And I also had the ability of accepting one¶s uniqueness for every individual within the community. I have learned that good communication and making friends made us achieve the cooperation and trust of the residents. Moreover, respect is the very basic value of showing them what a community really is. Patience is also another way of giving importance to the people whom you planned to approach with. I thought of realizing the effective ways of having a good communication. Through it, I had used to demonstrate a genuine interest of doing the activity. And within the art of listening, I had applied mainly to accept assurance of confidentiality because taking answers to the questions of about their income isn¶t that easy. The resident should be guaranteed that everything about in the discussed survey will not be shared to anyone. I had also known of using the time wisely in communicating, in that way, I could keep the conversation as ease and natural as possible. For communicative influence, I had learned to base it by their values in the community, especially gaining in return the respect that you have shown for them. And lastly, the attention, that could give us a clear distinction to concentrate on a definite conversation.

ONG, JELL DERIX H.

DAILY DIARY FEEDBACK

BEFORE: Last month, I and my group mates passed a courtesy letter to the brgy. Captain in order to have our community survey. We must interview 20 households in isla de oro. I hope that the people will be kind to us and accept our interview. The most basic question that we would ask to them is all about income. My group mates and I will do our best to finish our community survey as soon as possible. AFTER: At the day we have able to interview 20 households. I¶m very happy because the people are very kind to us and accept our interview to them. The place is an adventurous place to us especially of some of my group mates because we pass unto a bridge. Some of my group mates is afraid to pass in to the bridge but we don,t have no choice, we have to continue our interview. The result of our interview was very successful because we commit our goals to have an interview with 20 households.

PERSONAL INSIGHTS

I learned that having a community survey is not an easy task because we don¶t know the styles and the attitude of the people within that community but I¶m happy because the people are very respectful and very kind to us. I hope that if we will do an interview for our higher years the people will be the same like the people we interview in isla de oro. I feel happy because our community is successful.

MANQUIQUIS, MADONNA BLAISE N.

DAILY DIARY FEEDBACK

BEFORE: Last Feb. 27, 2009, we planned to have our immediate survey/interview at isla de oro as our chosen source of information about income and health insurance. Before we¶ve started to visit households in that certain place, we passed our courtesy letter to the Barangay. We were expecting to finish 20 respondents and that all of us will be welcome and successful in each of the households we are going to encounter.

AFTER: At the end of that tiring day, we were able to accomplish what we¶ve expected which was to finish 20 respondents. We were so happy because most of the people there were very approachable and hospitable though they were ashamed of us at first. It was an adventurous day for me because that was the very first time I¶ve encounter to pass on a hanging bridge. But indeed, that was challenging for me.

PERSONAL INSIGHTS I¶ve learn so much things during the community survey we¶ve done. Although that was just a short period of time, there are things in life that I¶ve realized to value. One of those things is to be thankful enough that I am living a comfortable life compared to the people who were living in that place that is prone to flashfloods. And that some of the people were illiterate because of financial problems. I also learned to be more confident in dealing with other people. In the end, the survey was successful and we¶ve gather all the information¶s we needed.

MATIAS, AKIMA GRACE

DAILY DIARY FEEDBACK

BEFORE: Before having our community survey for our Health Economics, we first agreed were to conduct it and the day we are going to that agreed place. We then agreed that the perfect place is in Isla de Oro. Before going there one of my group mates gave a courtesy call to the Barangay captain for formality sake. We went there on Friday morning, February 27, 2009. When we arrived there we went directly to the Barangay Hall and then proceed to the area. We to prepare ourselves upon entering to every household because we know that were going to encounter different types of people. And we have to finish interviewing 20 households which is not easy to do.

AFTER: After finishing our interview we went again to the Barangay Hall and took some pictures together with some of the Barangay officials. We felt relieved because we were able to finished interviewing 20 households. And we¶re grateful to the people because almost all of them were hospitable and accepted us nicely. Though it was tiring still it was worth it. I for myself enjoyed that kind of experience.

PERSONAL INSIGHTS: It was a good and a learning experience for us most specially for me. We were able to impart some of our knowledge to them. I was able to touch people¶s lives in a simple way. It¶s true that not all are fortunate enough to have a good life that¶s why I should be thankful because despite some circumstances I can still say that I¶m lucky enough because I am able to study in a good school. I also learned how our government took them for granted. I¶ve learned to appreciate simple things in my life because of that experience. That¶s why students like me must study hard to have a better future and be good future leaders of our country.

CRISTINA LAVANZA

DAILY DIARY FEEDBACK

BEFORE: In our community survey last month, we conducted it at Isla de Oro. We have decided to conduct our survey there since we are required to interview 20 families who are living below poverty. The day before our survey to be conducted, I already visualized things that might happen. I expect that people will be accommodating and willing to share and help us in our requirement. Of course, before we conduct our community, we first send a courtesy letter to the Barangay hall of the said community to show formality and respect to the Barangay officials. Before going to Isla de Oro, we have already prepared questions to be asked to the residents for our survey to be organized. AFTER: After our survey, we visited the Barangay hall and took pictures with the Barangay officials. We thank them for letting us conduct our survey there. After our activity, I could say that my expectations were met. The people were accommodating and very willing to share something about their life condition. I see that people living there really need attention from our government since not all of them have enough income for their family. It is a relieved for us since we were able to finish our interview in one day. We were able to interview 20 different families. PERSONAL INSIGHTS For me, what we have done is a learning experience since I was able to mingle to other people and because of this experience I was able to realize many things. I realized that I¶m so thankful that our way of living was different from them, that my parents were able to send me to school and lean me enough, actually more than enough money to be spend by me and that I can eat the foods that I need and want. But my realizations don¶t mean that I underestimated them because I believe that God created fortunate people to help the less fortunate one. If there were disabled, the able people should help them in order to survive. This is a lesson that all people should learn for our country to have progress.

NEPTHALIE MONTOYA

DAILY DIARY FEEDBACK

BEFORE: During February 27, 2009, we conducted our survey in Isla de Oro. Before conducting the survey, me and my group mates plan and prepared things first. We send courtesy letter to the Barangay hall to show respect to the Barangay officials. We ready our survey tools and prepare our questions to be asked to the residents in the community. We are expecting that we could finish interviewing 20 families in the community. And we are expecting that people there will be friendly and willing to communicate with us.

AFTER: After the community survey I¶ve learned so many things in our interview. Interviewing the 20 households is not an easy task. You have to take a risk because you don¶t know what would be happen. Because the people have different attitude some are good and some are bad. But luckily were fortunate because the 20 households that we interview all of them are kind, approachable and respectful.

PERSONAL INSIGHTS During the interview I saw the different faces of life. It¶s a fact that most of us must not take for granted that not all of us are lucky enough to be blessed with a good life. I¶ve learned how these people find ways just to be able to feed their family as much as possible three times a day. It¶s painful for me to know how our government takes them for granted. I was inspired by their stories of hard work. I admired them for their courage in facing life¶s difficulties. That¶s why I am now more dedicated to finish my studies for someday I could be one of this country¶s leaders if God permits me. And I will make sure that I will prioritize those less unfortunate ones.

February 24, 2009

Ms. Lourdes Echem Barangay Captain Macahambus Burgos St., CDOC

Dear Madam;

A pleasant day to you ma¶am!

I am Zolaica Macarambon, an AHSE student from Liceo de Cagayan University; I and my group mates would like to conduct a survey regarding the health status of each household from your Barangay, as a requirement of the Health Economics.

With this, In behalf of my group mates, I would like to ask your consent to have a survey in your barangay with the purpose of assessing the data about the health status of each household.

I am willing to go to your office to talk personally regarding this matter. You can contact with my phone number 09063475588.

I hope that your response would be favorable for us. Thank you and God bless!

Respectfully yours,

Zolaica Macarambon