Journal of Natural and Allied Sciences

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Stakeholders’ Complaince on the Department of Health’s Dengue

Preventive Measures

Antonette T. Melegrito
Moriones High School
Anettorres21@yahoo.com

Abstract – This quantitative research determined and described the level of awareness and the level of
compliance of different healthcare stakeholders to the Department of Health’s implemented programs for
dengue awareness and prevention. A descriptive-correlational and causal comparative method of research
was used. The main instrument of the study is a researcher-made electronic tool based on the DOH
dengue prevention policy. The respondents were the DOH stakeholders of the municipality of Pura,
Tarlac. The actual sample size is 512 respondents. The following conclusions were drawn based on the
result of the statistical analysis: (1) Majority of the respondents are from the teachers’ group with less
than 5 officers, and with 11 to 20 members and is funded by the government. (2) The respondents are
aware of the Department of Health’s dengue preventive measures. (3) The respondents complied to all the
DOH dengue preventive measures along the search and seek components, self-protection measures, early
consultation policy and the systematic supporting fogging, spraying and misting program of the DOH’s
dengue preventive measure. (4) The level of compliance varies significantly by stakeholder affiliation,
number of members in the stakeholder group and the group’s source of fund. Post hoc test suggests the
respondents belonging to the DSWD 4Ps group, the local business group, the group with less than 5
members, and the group whose funding is based on solicitation and member initiative have significantly
lower level of compliance. (5) The level of awareness affects the level of compliance to the DOH dengue
preventive program. (6) There is a plan of action to standardized the implementation of the DOH dengue
preventive measures.

Keywords – dengue, policy compliance, preventive measures, stakeholders, public health.

INTRODUCTION
Better health is central to human happiness and
well-being. It also makes an important contribution to
economic progress, as healthy populations live longer,
are more productive, and save more. Many factors
influence health status and a country's ability to provide
quality health services for its people. Healthcare offices,
such as the Department of Health and its underlying
bureaus, are important actors, but so are other
government departments, donor organizations, civil
society groups, communities and educational
institutions themselves. Government offices invests in
roads that can improve access to health services,
inflation targets can constrain health spending, and civil
service reform can create opportunities - or limits - to
hiring more health workers. But the interconnectedness
of the community and the health offices is one of the
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greatest measures in which the country will be kept
healthy and safe. Thus, the stakeholders play a great
role in keeping their community healthy and this role
can be further enhanced by providing them information
on their role in the healthcare practices.
Stakeholders plays an important in the promotion of
health and safety awareness in the community. In a
parlance, the term stakeholder, according to [1] is “an
organization… or any group or individual who can
affect or be affected by the achievement of the
organization’s objectives”. In the healthcare services,
the term stakeholder typically refers to those entities
that are integrally involved in the healthcare system and
would be substantially affected by reforms to the
system. The major stakeholders in the healthcare system
are patients, physicians, employers, insurance
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companies, pharmaceutical firms and government [2].
In some cases, the term may be used in a more narrow
or specific sense — say, in reference to a particular
group or committee — but the term is commonly used
in a more general and inclusive sense.
Dengue control can be effectively addressed with
stakeholder involvement. Combatting and spreading
awareness regarding dengue is a responsibility shared
by many, and intersectoral cooperation is a strategic
approach for successful interventions. [3], [4], [5], [6].
Community-based programs have aimed at modifying
health-risk behaviors and the conditions that produce
and support them. These programs have included
community-wide health education, risk factor
intervention, and efforts designed to change laws or
regulatory policy in areas where health is affected.
These undertakings rely on community organization
techniques to boost community leadership and
resources, and to plan interventions [7]. Most
community-based programs for dengue control have
focused on eliminating domestic repositories of the
mosquito vector and ensuring that they are free of
Aedes mosquitous. Stakeholder participation research
has concentrated on neighborhoods which are subject to
intervention and/or are vulnerable communities; such
research has not considered groups who implement and
could sustain these interventions, or are responsible for
disease control [8].
Societal sectors that have some interest in, or
responsibility for the control of dengue have been
identified: national control programs, local
governments, environment and urban planning,
education, science and technology, the media, the
private sector, and communities in endemic areas [6],
[9], [10]. These stakeholders at community level (e.g.
households, primary health care workers) need to
interact with technical officers at the local government
level (e.g. sanitation inspectors) in order to create
positive effects.
In the province of Tarlac, a reported cases of 2989
individuals are contacted with the disease last July 2,
2018 and 1,629 individuals for the same period last
year. Most of the victims are school children based on
the report of the Provincial Epidemiology and
Surveillance Unit (PESU). This quarter alone a total
eleven deaths were reported by the PESU, six of which
came from the town of Paniqui, three from Gerona, one
each from Concepcion and Mayantoc. This alarming
state needs not only prevention but an increased
awareness regarding the disease.
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The researcher, therefore, aims to describe the level
of aware and level of compliance of different healthcare
stakeholders to the Department of Health’s
implemented measures [11] in controlling and
combating the dengue disease. The researcher also aims
to determine the interrelatedness of the respondents’
level of awareness and level of compliance to the
DOH’s dengue preventive measures A framework for a
more intensive dengue awareness program will then be
proposed by the researcher as an output of this study.
OBJECTIVES OF THE STUDY
This quantitative research determined and described
the level of awareness and the level of compliance of
different healthcare stakeholders to the Department of
Health’s implemented programs for dengue awareness
and prevention. Specifically, it looked into the profiles
of the DOH stakeholders in the Municipality of Pura
along type of organization, number of officials, number
of members, and source of funds. It also determined the
level of awareness and level of compliance of the
stakeholders to the DOH dengue preventive measures.
Additionally, it also determined the significant
difference between the level of compliance of the
stakeholders when they are grouped according to their
profile variables. And finally, the study also determined
the significant relationship between the stakeholders’
level of awareness on the DOH dengue preventive
measures and the level of compliance to the same
policy. Based on the statistical findings, a plan of action
was proposed to enhance the implementation of the
DOH dengue preventive measures.
.
MATERIALS AND METHODS
Methodology
The study utilized the causal-comparative
method to compare the significant differences
the level of compliance to the DOHs dengue
preventive measure when the respondents were
grouped according to their profile variables.
Also, the researcher utilized the correlational
design. This design was used to determine the
between the stakeholders’ level of awareness
and level of compliance to the DOH’s dengue
preventive measures.
Data Gathering
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To gather pertinent data needed to answer the problems (1.37%), Pastoral Fellowship’s group
of the study, the researcher developed a self-made (1.17%), Senior Citizens group (2.73%)
instrument. The instrument has three parts. The first and SK Federation group (2.93%).
part of the instrument is a checklist which will gather
relevant information regarding the demography of the Majority of the respondents belong to
stakeholders such as type of stakeholder group they a group with less than 5 officers
belong, the numbers of officers and members of the (29.88%) while the rest are distributed
group as well as the group funding. mostly evenly with groups having 6 to 10
The second part of the questionnaire is a 5- officers (24.61%), 10 to 15 officers
point Likert scale while will gather information (22.66%) and more than 15 officers
regarding the stakeholders’ level of awareness (22.85%).
to the DOH’s dengue preventive measure. The
third part is also a 5-point Likert scale which
will determine the level of compliance of the Table 1. Distribution of Respondents
stakeholders to the DOH’s dengue preventive Stakeholder
measures. This part of the questionnaire was Frequency Percentage
Affiliation
developed in cognizant with the existing DOH Teacher 73 14.26
Policies on dengue prevention. The Barangay Health
questionnaire was then transcribed as an 45 8.79
Worker
electronic tool using Google Forms. Municipal Health
41 8.01
Worker
Data Validation School Nurse 39 7.62
School Administrators 38 7.42
After the instruments were constructed, it was Local Business 37 7.23
submitted for content validation by five (5) validators Public Safety (Fire
that are in the medical field using Bolarinwa’s pooled- Protection, Road 37 7.23
judgment validation. Comments and suggestions will be Safety, etc)
considered for the final draft. It was evaluated and Barangay LGU 35 6.84
approved by the adviser and critic reader before it was Medical Practitioner 33 6.45
be administered to the respondents. They were provided Municipal LGU 32 6.25
with a copy of the instruments and score card for them Law Enforcement 32 6.25
to rate each question item with reference to the criteria DSWD 4Ps Recipient 28 5.47
stipulated in the score card. SK Federation 15 2.93
Senior Citizens’
RESULTS AND DISCUSSION 14 2.73
Group
BPO 7 1.37
Profiles of the Respondents Pastoral Fellowship 6 1.17
Number of Officers Frequency Percentage
A total of five-hundred and twelve
Less than 5 153 29.88
(512) respondents participated in the
6 to 10 126 24.61
study. Majority (73 or 14.26%) of the
10 to 15 116 22.66
respondents belongs to the Teachers’
More than 15 117 22.85
group, Barangay Health Workers’ group
(8.79%) and Municipal Health Workers’ Number of Members Frequency Percentage
group (8.01%) while the others are less than 10 95 18.55
distributed mostly evenly on the other 11 to 20 105 20.51
stakeholder groups. 21 to 30 72 14.06
31 to 40 63 12.30
more than 50 93 18.16
Other stakeholder groups were
represented by 8.20% of the respondents Number of Officers Frequency Percentage
and are distributed among the BPO group Government Fund 407 79.49
Private Corporation 81 15.82
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Solicited fund 14 2.73 I am aware of the
Member Initiative 10 1.95 DOH’s policy of
fogging, spraying and
Majority of the respondents belong to a group with misting areas which 4.05 Aware
11 to 20 members (20.51%). There are also 95 are identified as
(18.55%) respondents who belong to a group with less dengue hotspot.
than 10 members and 93 (18,16%) belong to a group
with more than 50 members. Eighty-four (84) or I am aware of the
16.41% belongs to a group whose members are 41 to 50 DOH’s Policy
4.05 Aware
persons while 72 (14.06%) belongs to a group with 21 regarding self-
to 30 members. Lastly, 63 (12.30%) of the respondents protection measures.
belong to a group with 31 to 40 members. Majority of I am aware of the
the respondents (79.49%) belong to a group whose importance of
funding came from the government. Eighty-one (81) or sustained hydration
4.04 Aware
15.82% of the respondents belong to a group who have when having a fever
private funding, while 14 (2.73%) and 10 (1.95%) of for more than 2 days.
the respondents belong to a group whose funding is
from solicitation and the initiative of the members I am aware of the
respectively. DOH’s enhanced 4S
4.03 Aware
program.
Level of Awareness to the DOH Dengue Preventive
Measure I am aware of the
DOH’s 4’o clock
4.03 Aware
Table 2. Level of Awareness habit.
WM VI
I am aware of the I am aware of the
importance of importance of using
checking and organic and non-
3.99 Aware
eliminating mosquito chemical mosquito
4.11 Aware repellent.
breeding grounds in
my house and in the
community. I am aware of the
implementation of the
I am aware of dengue “Search and Seek” 4.11 Aware
prevention through the program.
use of implements `
such as mosquito nets, 4.10 Aware Average Weighted
4.06 Aware
long sleeves clothing Mean
and the like.
The level of awareness was measured using the
I am aware of the research instrument and the purpose of it is to determine
importance of seeking the level of awareness of the stakeholders with regards
medical attention on to the DOH dengue prevention program. The result
the onset of fever with 4.09 Aware shows that the respondents are aware of the DOH’s
possible dengue enhanced 4S program (WM = 4.04, Aware) as well as
symptoms. the DOH’s 4’o clock habit (WM = 4.03, Aware). They
are also aware of the implementation of the “Search and
Seek” program (WM = 3.99, Aware). Findings suggests
that the respondents are aware of the dengue Vector
Control program of the government. The respondents
are also aware of the DOH’s self-protection measures
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(WM = 4.05, Aware). In general, the respondents are
aware of the DOH’s dengue preventive measure.
Level of Compliance to the DOH Dengue Prevention
Program
Table 3. Level of Compliance
DOH Dengue
AWM VI
Preventive Measures
Seek Early
4.50 Complied
Consultation
Support Fogging,
Spraying and Misting 4.47 Complied
Self-Protection
Measures 4.42 Complied
Search and Seek 4.41 Complied
Overall Weighted
4.45 Complied
Mean
In terms of the level of compliance, he respondents
comply to the “Search and Seek” program of the DOH
(WM = 4.41, Complied). Findings suggest that the
respondents comply with the DOH’s 4’o clock habit,
search for containers and other possible mosquito
breeding sites, change the water in plant pots or jars
every week, clean the drain for blockages every 7 days
and convince others to always put all garbage into
closed bins. This means that the respondents have
complied to the said policy.
Also, the respondents comply to the Self-Protection
Measures of the DOH’s dengue prevention policy (WM
= 4.42, Complied). This means that they wear long
pants and long sleeves shirt early in the morning and
late in the afternoon, use mosquito repellant to reduce
the possibility of getting bitten, use mosquito nets when
sleeping, clean their surroundings of my house to
eliminate mosquitoes breeding grounds and they don’t
usually go to places that are identified as dengue
hotspot. This finding suggests that the respondents have
complied to the Self-Protection Measures of the DOH’s
dengue prevention policy.
The respondents comply to the early consultation
policy of the DOH’s dengue preventive measure (WM
= 4.50, Complied). This suggests that the respondents
immediately bring family members who have fever and
symptoms of dengue to the nearest health station,
recommend sustained hydration when a family member
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has a flu, educate their household and neighbors about
the early symptoms of dengue fever and follow the
recommendations of doctors to prevent further
complications. This finding shows that the respondents
have complied to the early consultation policy of the
DOH’s dengue preventive measure.
The respondents comply to the systematic fogging,
misting and spraying during dengue outbreak (WM =
4.47, Complied). This means that the respondents
support fogging, spraying and misting in designated
dengue hotspot areas, allow health authority to inspect
and fog my house anytime, support the information
campaign of the DOH regarding the importance of
fogging, spraying and misting, support the local health
unit’s method of identifying places that are in need of
fogging, spraying or misting and report immediately to
the local health unit areas that are in need of fogging,
spraying or misting. This finding suggests that the
respondents have complied to the systematic fogging,
misting and spraying program of the DOH during
dengue outbreak. In general, the respondents comply
(WM = 4.45) to the DOH dengue preventive measures.
Difference in the Level of Compliance of the
Stakeholders
Table 4. Statistical Difference
Profile Wilk’s p- Interpretation
Variable λ value
Stakeholder
Affiliation 0.774 0.001 Significant
Number of
Officials 0.974 0.381 Not Significant
Number of
Members 0.924 0.008 Significant
Source of Fund 0.948 0.011 Significant
A MANOVA was used to determine the
significant difference between the level pf
compliance of the respondents when they are
grouped according to their profile variables.
The result shows that there is a significant
difference between the level of compliance to
the DOH dengue preventive measures in terms
of stakeholder affiliation (0.001), number of
members (0.008) and source of fund (0.011)
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but not significant in terms on the number of Plan of Action to Enhance the
officers (0.381). Implementation of the DOH Dengue
Preventive Measures
Result of the post hoc test showed that
those respondents belonging to the DSWD 4Ps Based on the findings of the study, a plan of
group, local business group, those who are in action was proposed to enhance the
the group with less than 5 members, and whose implementation of the DOH dengue preventive
funds are from solicitation and member’s measures. The plan of action involves the
initiative have significantly different and low municipal and barangay health unit in programs
level of compliance compared to those who that will re-evaluate the implementation of the
belong in other groups. DOH dengue preventive measures in the
community level.
Relationship between Level of Awareness
and Level of Compliance CONCLUSION AND RECOMMENDATION

Table 5. Statistical Relationship It could be inferred that Majority of the

Level of Awareness respondents are from the teachers’ group with
Level of less than 5 officers, and with 11 to 20 members
p- Interpretation
Compliance r-value and is funded by the government. From this
value
Search and Seek .215 0.000 Significant finding it was recommended that that the local
government unit should put emphasis on
Self-Protection .090 0.042 Significant activity that will improve the stakeholder’s
Measures awareness of the dengue preventive measures.
Teachers from the municipality may be tapped
Seek Early .345 0.000 Significant by the local government as an instructional
Consultation support unit that will help barangay health
officials in the promulgation of the DOH
Support .249 0.000 Significant dengue preventive measures. Findings also
Fogging, suggests that the respondents are aware of the
Spraying and Department of Health’s dengue preventive
Misting measures and that respondents complied to all
the DOH dengue preventive measures along the
Overall level of .281 0.000 Significant search and seek components, self-protection
compliance measures, early consultation policy and the
systematic supporting fogging, spraying and
To determine the relationship between misting program of the DOH’s dengue
respondents’ level of awareness and their level preventive measure. The enhance and maintain
of compliance to the DOH’s dengue preventive this level of awareness and compliance a strict
measures, the researcher utilized the Pearson’s group monitoring should be conducted by the
r statistical test. municipal health unit to determine the extent to
which the DOH dengue preventive is being
The statistical test showed that There is a observed in the barangay level, as well as in
significant relationship between the level of business and in private and public schools.
awareness and compliance along the
stakeholders to all the DOH preventive One notable finding of the study is that the
measures along search and seek (0.000), self- level of compliance varies significantly by
protection measures (0.05), seek early stakeholder affiliation, number of members in
consultation policy (0.000) and support to the stakeholder group and the group’s source of
systematic fogging, misting and spraying fund. Post hoc test suggests the respondents
(0.000). belonging to the DSWD 4Ps group, the local
business group, the group with less than 5

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members, and the group whose funding is
based on solicitation and member initiative
have significantly lower level of compliance.
Thus, An extensive re-orientation program
should also be conducted by the municipal
health unit to address the differences in the
level of compliance of the different
stakeholders group giving special attention to
those who belong in the 4Ps group and business
group.
Lastly, it could also be inferred that the
level of awareness affects the level of
compliance to the DOH dengue preventive
program. In this regard, The municipal health
office should also focus in enhancing the level
of awareness of the stakeholders on the DOH
dengue preventive measures by providing
seminars in the community-level as well since
it was found out the these will have an impact
on the respondent’s level of compliance to the
DOH dengue preventive programs.
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