CHAPTER I

THE PROBLEM AND ITS BACKGROUND

This chapter contains the background of the study along with the

statement of the problem, hypothesis including the significance of the study,

scope and delimitation and terms used in the study were also defined for deeper

understanding of the readers.

INTRODUCTION

Shots may hurt a little, but the diseases the infants can acquire if not

vaccinated are a lot worse. Some are even life-threatening. Immunization shots,

or vaccinations, were already proven to be essential in the lives of children (1

year and below of age) because of their weak body immune system. They

protect against things like measles, rubella, hepatitis B, polio, diphtheria, tetanus,

tuberculosis, leprosy and pertussis (whooping cough). Immunizations are

important for adults but more especially for children who are at high risk in

acquiring these immunizable diseases.

Your immune system helps your body fight germs by producing

substances to combat them. Once it does, the immune system "remembers" the

microorganisms / germ and can fight it again. Vaccines contain germs that have

been killed or weakened. When given to a healthy person, the vaccine triggers

the immune system to respond and thus build immunity. (Hoekstra, Edward.

"Immunization: Injection Safety". UNICEF Expert Opinion (UNICEF).Retrieved

2007-05-12).

1
 Before vaccination, people became immune only by actually getting a

disease and surviving it. Immunizations are an easier and less risky way to

become immune. Vaccineshelp make you immune to serious diseases without

getting sick first. Without a vaccine, you must actually get a disease in order to

become immune to the germ that causes it. Vaccines work best when they are

given at recommended ages (as early as possible before the exposure to

different microorganisms).Certain studies about immunization procedures which

were proven to be beneficial for children gave birth to the establishment of the

Expanded Program on Immunization (EPI) in 1976 worldwide to ensure that

infants/children and mothers have access to routinely recommended

infant/childhood vaccines. With the commitment of our country to the Universal

Child Immunization (UCI) Goal, acceleration of EPI coverage had begun in 1986

here in the Philippines.

In the Philippines, the government highly supports its program on the

elimination of the number of mortality and morbidity of infants through the

process called vaccination. Vaccines are now readily available at the health

centers where it is free and can easily reach the community people. However,

the 2 vaccines (Bacillus Calmette Guerin for anti – tuberculosis and leprosy, and

Hepatitis B vaccine for anti-Hepatitis B) that should be given right after the child’s

birth are also available in hospitals. But, oftentimes newborn babies 1 year of age

are vaccinated at the rural health units and barangay health stations. Thus,

mothers who rear these children should comply with the principles, protocols,

kinds and routine of the vaccines including the guidelines in medicating

2
discomforts in order to strengthen the implementation of the program, eliminate

their common fears as effect of the administration of the different vaccines and

most especially to support the Municipal Health Office in attaining their

immunization goals, assessing the effectiveness of their strategies in

implementing the said DOH program.

BACKGROUND OF THE STUDY

Immunization is the process of creating immunity or protection against a

particular disease. Immunization service is one of the most important and

equitable preventive health care service made available even to population in

areas that are hardest to reach. Each year, millions of children are receiving

vaccinations that help protect them from infectious, sometimes deadly, vaccine

preventable diseases. These include, but not limited to, polio, measles, tetanus,

Hepatitis B, Rubella, diphtheria, pertussis, tuberculosis, and others.

The Department of Health (DOH) in cooperation with the Local Health

Government provide free basic immunization services. It shall then be the duty of

the parents, guardian, or person having custody of the infant or child to see to it

that such infant or child is presented for basic immunization services at such

place and time specified by the Municipal Health Office.

Palaganas (2003) states that the Philippines’ Infant Mortality Rate (IMR)

shows that over 78,000 babies die every year before they turn one year old.

There are indications that programs such as immunization may help in bringing

3
down infant deaths toll from diseases such as Diphtheria, Whooping Cough,

Polio, Tetanus, and most importantly measles.

The health of children is important to future generations and mothers have

social and ethical responsibility to ensure that their newborns are provided with

opportunities which optimize their health and wellbeing. High cost of

hospitalization could have been prevented if only mothers will comply on

newborn vaccination program implemented by the Department of Health in

cooperation of the municipal health office of every local government unit. It is

then important that parental compliance must be strictly imposed. Compliance of

mothers speaks not only in bringing their infants to the health center for

immunization but also in conforming and submitting to the principles, protocols of

the program including the kinds and routine of the vaccines, guidelines in

medicating discomforts in order to attain the primary goal of EPI program which

is to protect the children from the different immunizable diseases.

Mothers being the primary health care provider of their children needed to

be educated by the principles, protocols, kinds and routine of the Expanded

Program on Immunization and also the medicating discomforts of the different

vaccines. These would possibly increase their compliance with the existing

program after due understanding about its benefits for them especially their

infants who are weak after birth, prone to acquire different diseases that are

highly preventable through the vaccines.

4
 Sad to say, not all mothers fully understand both the concept and practice

of immunization. Reasons of mothers who rear children on their 1st year of life

for their compliance to the said DOH program vary. These reasons were often

found around them; sometimes problems were only within themselves which

hinder their desire to comply with the program on immunization. Negative

attitudes and misconception about immunization prevent mothers from submitting

their newborn for immunization. High morbidity and mortality rate of

communicable diseases remains remarkable. This problem can be attributed to

poor compliance of mothers to EPI. As responsible public health workers, we

need to identify these and take actions to help the woman bring her child during

the immunization schedule. This study then seeks to determine the degree of

compliance of mothers with the program of the government on immunization to

take necessary interventions to help them comply with the program for the

protection of their children’s life.

THEORETICAL AND CONCEPTUAL FRAMEWORK

The study framework is an illustration of the Paradigm of the Study which

is best explained below.

5
Inputs Process Output

I. Profile of the Determining and Enhanced

respondents as to: assessing the implementation of
1.1 Age; compliance of the the Expanded
1.2 Purok Address; Program on
mothers in the
1.3Occupation; Immunization
1.4 Civil Status; implementation of (EPI).
1.5 Number of EPI at MHO
children; Saguday, Quirino.
1.6 Monthly Income; Measuring their
1.7 Educational degree of
attainment compliance to the
II. Compliance of
program through
mothers in EPI as
implemented by the the utilization of the
MHO of Saguday, Likert Scale
Quirino. Method.
2.1 Principles of EPI
2.2 Protocols of EPI
2.3 Kinds and Routine
of EPI
2.4 Guidelines in
Medicating
Discomforts
2.5 Benefits of
Vaccination
2.6 Strategies used by
the MHO in the
implementation of EPI

FEEDBACK

Figure 1: Research Paradigm

This study utilized the system analysis approach which consists of the

Input – Process – Output components.

The Input consists of the demographic profiles of the respondents as first

determined. These include their age, barangay address, occupation, civil status,

6
number of children, socio-economic status and educational attainment. The

respondents were then asked about the degree of their compliance in the

program in the aspects of Principles of the Expanded Program on Immunization

(EPI), Protocols of EPI, Kinds and Routine of Immunization, Guidelines in

Medicating Discomforts, Benefits of Vaccination to the Children and the

Strategies used by the MHO of Saguday, Quirino in the implementation of the

said DOH program. The response of the mothers to these questions would

greatly help in the determination and assessment of their compliance to the

immunization program.

The Process Component of this study includes the research instruments

as used in gathering the study information as started from the input component.

Assessment was done with the use of questionnaires.

The Output Component which focused towards the results will help the

provider contribute to the enhancement and improvement of the EPI program the

MHO of Saguday, Quirino is implementing.

A directional arrow starting from the input to the process towards the

output represent the direction on the flow in conducting the study.

The feedback arrow that connects the output to the input represents the

realization of the objectives and significance of this study as supported from the

data extracted from the input formation.

7
STATEMENT OF THE PROBLEM

This research work aimed to determine the degree of compliance of

mothers in the Expanded Program on Immunization implemented by the

Municipal Health Office of Saguday, Quirino.

Specifically, it focused in answering the following questions:

1. What is the profile of the respondents in terms of the following demographic

variables:

1.1. Age;

1.2. Barangay Address;

1.3. Occupation;

1.4. Civil Status;

1.5. Number of Children;

1.6. Monthly Income;

1.7. Highest Educational Attainment?

2. What is the degree of compliance of the respondents in the following aspects

of:

2.1 Principles of the Expanded Program on Immunization;

2.2 Protocols of the Expanded Program on Immunization;

8
 2.3 Kinds and Routine of Immunization;

2.4 Guidelines in Medicating Discomforts;

2.5 Benefits of Vaccination to the Children;

2.6 Strategies used by the MHO of Saguday, Quirino in the

implementation of EPI?

SIGNIFICANCE OF THE STUDY

The findings of the study were to help the Municipal Health Office of

Saguday, Quirino in determining how the mothers support the program of the

government regarding the immunization of infants ages 1 year and below.

Hence, the result of this is significant to the following individuals and

institutions:

MUNICIPAL HEALTH OFFICE – the study aim to help them realize their

objectives in the immunization program, to eliminate possible deaths to infants

caused by the diseases that can be prevented through immunization. This would

also be a great tool for them to determine their strengths and weaknesses with

regards to the implementation of EPI for them to create new strategies that would

be beneficial both for the providers and recipients of the program.

MIDWIVES – the study hopes to inspire them in doing their great role as

frontliners in the community and reminds them to be more responsible in the

administration of the different vaccines to the infants and also to eliminate fears

9
of the mothers about the possible side effects of vaccination in order to gain the

rapport and support of the parents in the implementation of EPI.

BARANGAY HEALTH WORKERS – this endeavor will serve as a great

challenge for them in fulfilling their tasks as health leaders in the barangays they

were assigned and also to exert more effort in helping the midwives in the

dissemination of important information about the schedule and setting of

immunizations.

MOTHERS – the study hopes to help them as primary health care givers to their

infants for them to have a greater understanding about the immunization

program, to lessen the occurrence and spread of diseases to their children and

also to support the Municipal Health Office for their goal in their immunization

setting through their strict compliance.

MUNICIPALITY OF SAGUDAY, QUIRINO – With this study, the Local

Government including the citizens of Saguday, Quirino would work hand in hand

for the improvement of the program on immunization of the Department of

Health. This would also be an eye opener for the municipal officers to see the

special needs of the community and allocate funds to support more the program.

THE RESEARCHER – The result of the study will always remind the researcher

about her role as midwife in the community. Also, this serves as a way of

assessing the effectiveness of the different strategies a rural health midwife use

to encourage mothers in complying with the said program.

10
THE FUTURE RESEARCHERS – the outcome of this study will serve as a

related study to the next researchers who wish to conduct the same or related

studies about factors affecting the implementation of the EPI program such as

the compliance of the mothers of children. This would also serve as their basis

for other future studies along similar fields.

SCOPE AND DELIMITATION

This study was concentrated and limited to the 114 mothers living in the 9

barangays of Saguday, Quirino. The respondents were combinations of adults

and teens with different cultures, tribes and dialects but all were rearing children

who are 1 year and below of age and still under the immunization schedule. They

came from different economical strata and with different educational attainment

but majority of them were housekeepers in work.

The study covered January till December, 2014 composing of the 114

respondents which have similar immunization schedules.

This study delved deeper into assessing the degree of compliance of the

mothers with the principles, protocols, kinds and routine of the immunization

including the guidelines in medicating discomforts of infants after each

administration of the different vaccines.

DEFINITION OF TERMS

The following terms used by the researcher in the study are contextually

defined:

11
Bacillus Calmette Guerin (BCG) – It is a vaccine prepared from a living

attenuated strain of tubercle bacilli and used to vaccine human beings against TB

(Wikipedia, 2008)

Compliance – The act of conforming and submitting of mothers in the

immunization of their children. (Seron, 1989)

Department of Health – It refers to thePhilippine Department of Health (Filipino:

KagawaranngKalusugan, abbreviated as DOH or KNKL) is the executive

department of the Philippine government responsible for ensuring access to

basic public health services by all Filipinos through the provision of quality health

care and the regulation of all health services and products. It is the government's

over-all technical authority on health.

Diphtheria –It is an acute infectious disease chiefly of children characterized by

severe inflammation of throat, heart and nervous system. (Mosbys Pocket

Dictionary of Medicine, 2002)

Expanded Program on Immunization (EPI) – Program of the Department of

Health in the Philippines aimed to provide free immunization to children 0-12

months old against the 6 immunizable diseases namely: TB, DPT, Poliomyelitis

and measles. (Seron, 1989)

German Measles – It is an infectious disease caused by the rubella virus of the

genus Rubivirus, characterized by mild fever and skin rash. German measles can

cause congenital defects if a woman is exposed during early pregnancy. Also

called rubella.(Microsoft Encarta, 2009)

12
Germs – It is a microscopic organism or agent, especially one that is pathogenic,

such as a bacterium or virus.

Hepatitis B – It is an infection of the liver that is caused by a DNA virus, is

transmitted by contaminated blood or blood derivatives in transfusions, by sexual

contact with an infected person, or by the use of contaminated needles and

instruments. The disease has a long incubation and symptoms that may become

severe or chronic, causing serious damage to the liver. Also called serum

hepatitis.

Immune System – This refers to the body system in humans and other animals

that protects the organism by distinguishing foreign tissue and neutralizing

potentially pathogenic organisms or substances. The immune system includes

organs such as the skin and mucous membranes, which provide an external

barrier to infection, cells involved in the immune response, such as lymphocytes,

and cell products.

Immunity – It is the protection of the body from a disease caused by an

infectious agent, such as a bacterium or virus. Immunity may be natural (that is,

inherited) or acquired.

Immunization – Itis the process by which an individual's immune system

becomes fortified against an agent (known as the immunogen). (Seron, 1989)

Implementation – It is the act of implementing (providing a practical means for

accomplishing something); carrying into effect. (Webster Dictionary 2000)

13
Infant– This refers to the child in the earliest period of life, especially before he or

she can walk.

Kinds of Vaccine – This refers to the types of vaccine given during

immunization with different sites and route of administration such as DPT, BCG,

OPV and many more.

Leprosy – It is an ancient disease and is a leading cause of permanent physical

disability among the communicable diseases. It is a chronic mildly communicable

disease that mainly affects the skin, the peripheral nerves, the eyes and mucosa

of the upper respiratory tract.

Measles – This refers to a disease caused by a virus amd is common in children

characterized by fever and skin eruption. Also called rubeola. (Microsoft Encarta,

2009)

Medicating Discomforts – It is the mental or bodily distress; something that

disturbs one's comfort as result of medical procedure / intervention.

Mother– This refers to a female who has borne offspring; female parent.

Municipal Health Office of Saguday, Quirino– This is the only public health

care agency of the municipality of Saguday which is in charge in delivering the

different health care programs of the government in the public like the

immunization program.

Pertussis (Whooping Cough) – This refers to an infectious disease of the

respiratory mucous membrane caused by the bacterium Bordetella pertussis and

14
characterized by a series of short, convulsive coughs followed by a whooping

intake of breath. (Mosbys Pocket Dictionary of Medicine, 2002)

Poliomyelitis – It is serious infectious viral disease caused by inflammation of

gray matter of spinal cord characterized by fever, motor paralysis, muscular

atrophy, often resulting permanent deformity. (The World Book Encyclopedia,

1998)

Principles – It is a basic generalization that is accepted as true and that can be

used as a basis for reasoning, conduct or management.

Protocols – It is the plan for a course of medical treatment or for a scientific

experiment;

Routine of Vaccination – It is an appropriate time / schedule of vaccination

Tetanus – It is a disease marked by painful tonic spasm of the jaw caused by

bacterial infection of the wound. Also called lockjaw. (The World Book

Encyclopedia, 1998)

Tetanus Toxoid – It provides protection (immunity) against tetanus (lockjaw) in

adults and children 7 years or older. Tetanus vaccine is usually first given to

infants with 2 other vaccines for diphtheria and whooping cough (pertussis) in a

series of 3 injections.

Tuberculosis (TB) – It is an infectious disease caused by the

bacterium Mycobacterium tuberculosis that is transmitted through inhalation and

is characterized by cough, fever, shortness of breath, weight loss, and the

15
appearance of inflammatory substances and tubercles in the lungs. Tuberculosis

is highly contagious and can spread to other parts of the body, especially in

people with weakened immune systems.

Vaccination – It is also known as immunization wherein it is a process of

providing protection against communicable diseases by use of killed or

weakened strains of causative agents (Bacteria, virus, etc.) to produce antibodies

(Microsoft Encarta, 2009)

Vaccines – It is a biological preparation that improves immunity to a particular

disease. A vaccine typically contains an agent that resembles a disease-causing

microorganism and is often made from weakened or killed forms of the microbe,

its toxins or one of its surface proteins. The agent stimulates the body's immune

system to recognize the agent as foreign, destroy it, and keep a record of it, so

that the immune system can more easily recognize and destroy any of these

microorganisms that it later encounters. (The World Book Encyclopedia, 1998)

World Health Organization (WHO) – WHO is the directing and coordinating

authority for health within the United Nations system. It is responsible for

providing leadership on global health matters, shaping the health research

agenda, setting norms and standards, articulating evidence-based policy options,

providing technical support to countries and monitoring and assessing health

trends.

16
 CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the different literatures and studies both foreign and

local, which are all related in the development of the study.

RELATED LITERATURE

Foreign Literature

The Expanded Program on Immunization (EPI) has made considerable

progress towards immunizing the world's women and children, preventing 3.2

million child death episodes per year from measles, neonatal tetanus, and

pertusis, as well as 440,000 cases of paralytic poliomyelitis. Vaccinations

provided through the EPI are believed to be one of the most cost-effective child

survival interventions at a cost between $5 and $10 per child. However, variation

exists in the average cost per fully immunized child, depending upon the type of

vaccine technology and delivery strategy utilized, the scale of operation, and

country and environmental characteristics. Recent evidence on the cost-

effectiveness of immunization strategies raise concerns over the affordability of

national immunization programs by governments and highlights the need for

continued donor support, identification of other financing mechanisms, or

reconsideration of policies aimed toward accelerating and maintaining

immunization coverage.

The World Health Organization (WHO) initiated the Expanded Program on

Immunization (EPI) in May, 1984 with the objective to vaccinate children

17
throughout the world. Ten years later, in 1984 the WHO established a

standardized vaccination schedule for the original EPI vaccines: Bacillus

Calmette – Guerin (BCG), Diptheria – Perussis – Tetanus (DPT), oral polio, and

measles.

Over 3 million deaths from measles, neonatal tetanus and pertussis are

prevented by vaccination each year. In the Americas, poliomyelitis has been

eliminated, and measles is close to elimination. Globally, reported poliomyelitis

incidence has declined by over 80% since 1988.

Strategies have evolved from strengthening routine childhood

immunization services, to establishing disease surveillance and defining specific

activities for disease control and elimination. Efforts to ensure the supply and

quality of vaccines are underway. New vaccines against major pathogens will be

licensed soon. Some of these will be used for groups other than mothers and

infants, requiring re-definition of the ‘EPI target groups’.

Despite global successes, in 1995, six of the world's most populous

developing countries reported coverage levels below 70% and coverage is below

50% in several African countries. Immunization programs will need to be tailored

to the level of economic and health systems development of a country.

Industrialized countries must offer sustained support to expand immunization

programs in ways that strengthen health systems in developing countries.

In 1999, the Global Alliance for Vaccines and Immunization (GAVI) was

created with the sole purpose of improving child health in the poorest countries

18
by extending the reach of the EPI. The GAVI brought together a grand coalition,

including the United Nation’s agencies and institutions (which include WHO,

UNICEF, and the World Bank), public health institutes, donor and implementing

countries, the Bill and Melinda Gates Foundation and the Rockefeller

Foundation, the vaccine industry, non – governmental organization (NGO’s) and

many more. The creation of the GAVI has helped to renew interest and maintain

the importance of immunizations in battling the world’s large burden of infectious

diseases.

The current goals of the EPI are: to ensure full immunization of children

under one year of age in every district, to globally eradicate poliomyelitis, to

reduce maternal and neonatal tetanus to an incidence rate of less than one case

per 1,000 births by 2005, to cut in half the number of measles – related deaths

that occurred in 1999, and to extend all new vaccine and preventive health

interventions to children in all district in the world.

In addition, the GAVI has set up specific milestone to achieve the EPI

goals: that in 2010 all countries should already have routine immunizations

coverage of 90% of their child population, that Hepatitis B be introduced in 80%

of all countries in 2007, and that 50% of the poorest countries have HiB vaccine

in 2005.

Setting up an immunization program is multifaceted and contains many

complex components including a reliable cold chain systems, transport for the

delivery of the vaccines, maintenance of vaccine stocks, training and monitoring

19
of health workers directly involved in immunization’s program, outreach

educational program and most important is the timely compliance of mothers.

Local Literature

The Expanded Program on Immunization (EPI) in the Philippines began in

1986 with the commitment of the country to Universal Child Immunization (UCI)

Goal acceleration of EPI coverage. The achievement of the fully immunized child

(FIC) coverage of 80% was noted one year ahead of the target date of UCI in

1990. This was attributed to the strong political will and support from international

partners, better program management, and improvement in cold chain facilities

for better performance at all levels of health facilities. The development of the

EPI Manual of Operations with its clear guidelines for better planning, correct

targeting, correct immunization procedures, strategies appropriate for better

linkaging / coordination and program implementation had contributed much for

the success of the program. Hepatitis B immunization has been integrated into

the EPI in1992 among infants 0-1 year of age. Due to high cost of vaccines, only

40% of eligible targets were prioritized and given with vaccination. This was the

period of EPI Acceleration (1987-1992) that system has been put in place.

There are laws in the country that have been passed in order to mandate

Compulsory Immunization for children such as the Presidential Proclamation

No.6 signed by the late President Corazon C. Aquino last April 3, 1986, and the

Presidential Proclamation No.46 signed by the former President Fidel V. Ramos

reaffirming the commitment of the Philippines to the Universal Child and Mother

20
Immunization goal and finally the establishment of the Republic Act 7846 last

December 30, 1994 requiring compulsory immunization against Hepatitis B for

infants and children below 8 years old and also the Presidential Proclamation No.

1066 passed last August 26, 1997 declaring a neonatal tetanus elimination

campaign starting 1997. As such, Expanded Program on Immunization became a

useful tool in decreasing the number of mortality and morbidity in the country.

The conceptualization and the introduction of the disease reduction

initiative in early 90’s contributed to the declined of numerous cases of the

immunizable disease. The four major strategies include: 1.) Sustaining high

routine FIC coverage of at least 90% in all provinces and cities, 2.) Sustaining the

polio free country for global certification, 3.) Eliminating measles by 2008, 4.)

Eliminating neonatal tetanus by 2008.

Every Wednesday is designated as immunization day and is adopted in all

parts of the country. Immunization is done monthly in Barangay Health Stations,

quarterly in remote areas of the country. The standard routine immunization

schedule for infants in the Philippines is adopted to provide maximum immunity

against the seven vaccine preventable diseases in the country before the child’s

first birthday. The fully immunized child must have completed BCG1, DPT1,

DPT2, DPT3, OPV1, OPV2, OPV3, HepaB1, Hepa B2, Hepa B3 and measles

vaccines before the child is 12 months of age.

21
RELATED STUDIES

Foreign Studies

The first vaccine developed was against smallpox by Edward Jenner,

English “country” physician, in Berkeley. He found that dairy maids with cow pox

were relatively immune to small pox. He took the exudates and secretions from a

cowpox pustule on the hand of dairymaid Sarah Nelmes and inserted it into the

arms of an 8-year old boy James Phipps on May 14, 1796.

The vaccination was effective since the boy did not catch small pox even

when he was infected with small pox virus six weeks after the vaccination.

Jenner published his findings in 1798. Despite oppositions, vaccination soon

became accepted practice.

Louis Pasteur generalized Jenner’s idea by developing what he called a

rabies vaccine (now termed as an antitoxin), and in the 19 th Century compulsory

vaccination laws were passed. The golden age of vaccine development, did not

come until after World War II, when several new vaccines were developed in a

relatively short period. Their success in preventing diseases such as polio and

measles changed the history of medicine altogether.

In 1967, the World Health Organization (WHO) spearheaded a massive

immunization campaign against small pox. Within ten years, this disease had

been vaccinated out of existence.

22
 Wild – virus – polio, which one circulated wildly in nearly every region of

the world, is now present in only a handful of countries, without a case diagnosed

in the United States since 1979.

Measles, mumps, rubella, diphtheria and pertussis were reduced from

frightening epidemics to rare outbreaks within a few decades.

Local Studies

Maturing programs on child immunization and diarrheal diseases, a

community-based research project, and a rational drug-use program facilitated

the launching in 1989 of a nationwide Philippine Control of Acute Respiratory

Infections program (Phil-CARI). From 1990 to 1991 the Phil-CARI expanded

rapidly, training >80% of its middle managers and frontline health care providers

(midwives) on the case-management protocols of the World Health Organization

for acute respiratory infection. This is one of the great accomplishments of the

Philippines in terms of the immunization program.

A key method of reducing morbidity and mortality is childhood

immunization, yet in 2003 only 69% of Filipino children received all suggested

vaccinations. Data from the 2003 Philippines Demographic Health Survey were

used to identify risk factors for non- and partial-immunization. Results of the

multinomial logistic regression analyses indicate that mothers who have less

education, and who have not attended timely the scheduled immunization for

their children are less likely to have fully immunized children. To increase

23
immunization coverage in the Philippines, knowledge transfer to mothers must

improve.

SYNTHESIS

Studies about immunization both on foreign and local showed the

importance of vaccination to human especially the infants who are vulnerable in

developing and acquiring different diseases. It assessed the implementation of

the immunization program more on to the compliance of the mothers which is the

focus of this research. However, there is still a need for the improvement of the

existing program through determining the degree of compliance of the mothers to

this program especially so that they were the primary health care givers to their

children. Thus, importance of immunization should be emphasized and proper

education about the principles, protocols; routine of the vaccines including the

medicating discomforts should be included during the mother’s class.

24
 CHAPTER 3

METHODS AND PROCEDURES OF THE STUDY

This chapter presents the research methods and procedures which

include the research design, locale of the study, the respondents, the data

gathering instrument, the data gathering procedures and treatment of data.

METHODS OF RESEARCH USED

A descriptive design was used in the study. This type of research was

intended to determine how mothers complied with the Expanded Program on

Immunization of the Municipal Health Office of Saguday, Quirino.

LOCALE OF THE STUDY

This research study was conducted inSaguday, Quirino. It lies on the

Northeastern part of Quirino. It is bounded on the North by the City of Santiago,

on the South by the Municipality of Cabarroguis, on the East by the Municipality

of Aglipay and Echague, on the West by the Municipality of Diffun, with a total

land area of 6,824 hectares. Saguday has a total projected population of 17,280

in 2015 growing at 1.6% annually. It composed of 9 Barangays wherein all of

these were utilized in the conduct of the study. Saguday is a 5 th Class

Municipality of the Province of Quirino, of which has the least number of

population, and is predominantly agriculture-based.

The Municipality of Saguday has 1 Rural Health Unit located at the center

most part of it and is managed by 1 Municipal Health Officer which is a doctor.

25
However it has also 5 barangay health stations wherein monthly schedule of

immunization is being conducted here by the 4 permanent midwives and 2

midwives under the DOH.

RESPONDENTS OF THE STUDY

This study cultured 114 respondents coming from the 9 Barangays of

Saguday, Quirino. These barangays include Rizal, Magsaysay, La Paz, Dibul,

Cardenas, Gamis, Salvacion, Sto. Tomas and Tres Reyes. Barangay Rizal has

the most numbered population of mothers rearing children 1 year and below

composing of the 32 respondents. It is followed by Barangay Magsaysay with 18

mothers, Barangay La Paz with 14 respondents, Barangay Dibul, Salvacion and

Sto. Tomas consist of 10 mothers; Barangay Cardenas has 8 respondents while

Barangay Tres Reyes has 7 and Barangay Gamis has the least number of

respondents which is 5. The respondents were all mothers rearing children 1

year and below who are under the immunization schedule. These respondents

which were chosen by the researcher were mothers of children who started the

immunization on the same time and expected to finish all immunizations on same

schedule also.

26
 BARANGAY RESPONDENTS
Rizal 32
Magsaysay 18
La Paz 14
Dibul 10
Salvacion 10
Sto. Tomas 10
Cardenas 8
Tres Reyes 7
Gamis 5
TOTAL 114

SAMPLING PROCEDURES

The researcher used the purposive type of sampling in selecting the

respondents for the conduct of the study. The sampler picked out a typical or

representative sample, mothers rearing children 1 year and below of age with

common immunization schedules. Since there were only 114 respondents, this

type of sampling is then useful and appropriate for a small number.

RESEARCH INSTRUMENTS USED

The researcher utilized survey – guide questionnaires for her to gather the

data necessary for the accomplishment of the study.

A. Questionnaires

The primary tool of gathering the data needed for the conduct of the study

was the use of a survey – questionnaire. Some of the questions were adopted

from the “American Medical Association, the Macmillan Guide to Family Health”,

1982 by Sammons, James H., M.D., which was further developed and modified

by the researcher.

27
 Most of the respondents were not able to understand English so the

researcher made a Tagalog translation of the questions given.

The survey questionnaire was divided into 3 major sections wherein each

of the part focused on answering the problem.

These include the demographic profiles of the respondents as the part I ,

degree of compliance of mothers as to the principles, protocols of the program,

kinds and routine of vaccines, guidelines in medicating discomforts and the

measures that can be done to enhance the program on immunization.

DATA GATHERING PROCEDURE

In the conduct of this study, a written permission from the Dean of

Graduate School of the University of La Salette was made. After the written

permission was approved, the researcher approached the Municipal Health

Officer of Saguday, Quirino which is Dr. Vivian A. Elizarde for her approval to the

conduct of the study within her area. She then endorsed the researcher to the

midwives who are directly involved in the immunization program. Through them,

names and address of mothers rearing children under the immunization schedule

starting January, 2014 and expecting to finish all vaccinations on December,

2014 were gathered. These mothers became the respondents chosen by the

researcher. During the immunization schedules, they were asked personally if

they would like to participate in the study by answering the questions prepared by

the researcher. Interview was done face to face by the Researcher. All the data

given by the respondents were treated confidentially.

28
STATISTICAL TREATMENT OF THE DATA

After conducting the interview and observing the respondents during the

immunization schedules, the survey questionnaires which were used primarily to

gather the data were returned and collected personally by the respondents ready

for the tabulations. Responses and answers of the mothers rearing children 1

year and below of age as respondents were all recorded after of which is the

tabulation of the data.

Thus, statistical treatment is necessary to find the natural tendencies,

means of evaluation and the majority trends of expressed opinions.

1. This study primarily utilized the Frequency and Percentage

Distribution in identifying the different demographic profiles of the respondents.

The formula is:

P = f/n x 100%

Where:

P = Percentage Distribution of the respondent’s answer to certain question

F = Frequency Distribution of respondent’s answers to a certain question

N = Total number of respondents being selected

2. The Mean was also used to indicate the point of concentration per item

because it would be more reliable and easy to understand. The general formula

for the computation of the mean is:

29
 X= Efx/n

Where:

X = Mean

E = the sum of the summation

f = Frequency

X = the rating (5, 4, 3, 2, 1) corresponding to the frequency obtained

N = Total Frequency

3. This present study also utilized the Likert Scale Method to determine

the degree of extent of the study variables. This is the criteria which served as a

basis for interpreting the results from the concept of boundary of numerals. This

Scale Rating includes:

SCALE LIMITS OF VERBAL

DESCRIPTION INTERPRETATION
5 4.50 – 5.00 Always
4 3.50 – 4.49 Often
3 2.50 – 3.49 Sometimes
2 1.50 – 2.49 Seldom
1 0.10 – 1.49 Never

30
 CHAPTER 4

PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter presents the analysis and interpretation of data gathered to

shed light on the problem of the study.

I. Profile of the Respondents

Table 1: Frequency distribution of respondents relative to age

AGE BRACKET FREQUENCY PERCENT

18 and below 15 13.16
19 – 25 32 28.07
26 – 30 24 21.05
31 – 35 17 14.91
36 – 40 15 13.16

31
 41 and above 11 9.65
TOTAL 114 100 %

As shown in Table 1, majority of the respondents belonged to age bracket

19 – 25 represented by 32 which is equivalent to 28.07 %. They were the

mothers rearing children 1 year and below of age. It was followed by 26 – 30

years old represented by 24 or 21.05 %. While ages bracket of 18 and below

including 36 – 40 has the same frequency which is 15 and has an equivalent

percentage of 13.16. Least of the respondents belonged to 41 and above years

old which is 11 and equivalent to 9.65 %.

Table 2: Frequency distribution of respondents relative to barangay residence

Barangay Frequency Percent

La Paz 14 12. 28
Gamis 5 4. 39
Tres Reyes 7 6. 14
Salvacion 10 8. 77
Sto. Tomas 10 8. 77
Rizal 32 28. 07
Magsaysay 18 15. 79
Dibul 10 8. 77
Cardenas 8 7. 02
TOTAL 114 100 %

Table 2 shows that of the 114 respondents, barangay Rizal has the

biggest population of mothers rearing children 1 year and below represented by

32 and is equivalent to 28.07%. Barangay Rizal was the biggest barangay in the

municipality of Saguday in terms of the overall population while Gamis has the

least population. Rizal was followed by Magsaysay which has 18 respondents

equivalent to 15.79%, La Paz composing of 14 mothers which has an equivalent

32
percentage of 12.28%, Salvacion, Sto.Tomas and Dibul has the same number of

respondents which is 10 equivalent to 8.77%, while Cardenas has only 8

respondents equivalent to 7.02%, Tres Reyes has 7 equivalent to 6.14% and

Gamis has 5 mothers equivalent to 4.39% respectively.

Table 3: Frequency distribution of respondents relative to occupation

Occupation Frequency Percent

Government Employee 5 4. 39
Private Employee 5 4. 39
Housekeeping 50 43. 86
Farming 44 38. 59
Others (owned a sari-sari 10 8. 77

store, carenderia and other

business establishments
TOTAL 114 100 %

As gleaned in Table 3, most of the respondents were housekeeping in

works and there were 50 which is equivalent to 43. 86%. They were the mothers

who were wives of farmers and carpenters and they were left at home to take

good care of their children. However, it is not also uncommon to find out that

there were 44 equivalent to 38. 59%mothers who engaged themselves in farming

considering the fact that agriculture is the main source of living in Saguday,

followed by 10 or 8. 77% of those who operates their own business like

managing a sari – sari store and carenderia, and the least numbered which is 5

with a percentage equivalence of 4. 39% were working in the government and

private sectors.

33
Table 4: Frequency distribution of respondents relative to civil status

Civil Status Frequency Percentage

Single Mother 8 7. 02
Married 98 85. 96
Separated 5 4. 39
Widowed 3 2. 63
TOTAL 114 100 %

Table 4 shows the profile of the respondents according to their civil status.

It has found out that out of the 114 respondents, there were 98 mothers (85.

96%) who were legally married. Still, there were 8 or 7. 02% who were single in

civil status followed by separated mothers represented by 5 equivalent to 4. 39%

and only 3 were widowed with a percentage equivalence of 2. 63%.

Table 5: Frequency distribution of respondents relative to number of children

No. of Children Frequency Percentage

1 9 7. 89
2–3 31 27. 19
4–5 51 44. 74
6 and above 23 20. 18
TOTAL 114 100 %

According to Table 5, majority of the mothers reared 4 to 5 children

represented by 51 (44. 74%). 31 of them has 2 to 3 children which is equivalent

to 27. 19%, followed by the 23 respondents who has 6 and above number of

children which is equivalent to 20. 18%, while there were only 9 who has only

one child equivalent to 7. 89%.Their compliance to the immunization program

34
was affected because they reared more than 1 child which most of the times they

could not leave them at home alone while they need to go to the health center to

attend the scheduled immunization.

Table 6: Frequency distribution of respondents relative to monthly income

Monthly Income (Peso) Frequency Percentage

Below 3,000 58 50. 88
3,000 – 5,000 42 36.84
5,001 – 7,000 8 7. 02
7,001 – 9,000 2 1.75
9,001 and above 4 3. 51
Total 114 100 %

Considering the occupation of the mothers, Table 6 shows their generated

monthly income. Since majority of them were housekeepers, 58 (50.88%) of the

114 respondents have a total monthly earnings of below P3, 000.00 which is

according to them an accumulated income of their husband. However, there

were 42 (36. 84%) of them who earnedan average income of P3, 000.00 – P5,

000.00, 8 respondents equivalent to 7. 02% has a monthly income of P5, 001.00

– P7, 000.00, 4 of them equivalent to 3. 51% earned P9, 001.00 and above, and

there were only 2 respondents equivalent to 1. 75% has an income of P7, 001.00

– P9, 000.00.

Table 7: Frequency distribution of respondents relative to educational attainment

Educational Level Frequency Percentage

Elementary Undergraduate 10 8. 77
Elementary Graduate 28 24. 56
High School Undergraduate 33 28. 95
High School Graduate 30 26. 32

35
 College Undergraduate 6 5. 26
College Graduate 6 5. 26
Post Graduate 1 1. 88
Total 114 100 %

Table 7 shows the profile of the respondents according to their

educational level. The above data proved that most of the respondents were high

school undergraduate represented by 33 mothers which has a percentage

equivalence of 28. 95%. According to them povertyis the main reason why they

were not able to finish high school ladder of education. But still there were 30

respondents equivalent to 26. 32% who were able to finish high school because

of the different scholarship grants they have availed from the politicians.It was

followed by elementary graduate (28) equivalent to 24.56% and elementary

undergraduate (10) equivalent to 8.77 respectively.College Undergraduate and

college graduate have the same number of respondents which is 6 equivalent to

5. 26%. And there is only 1 respondent who finished her post graduate studies

and she was a government teacher which is equivalent to 0.88%.

PART II Degree of Compliance of Mothers in the following Aspects of EPI

Table 8: Compliance of the respondents to the principles of EPI

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

1 Every infant needs to be vaccinated 4. 67 ALWAYS

against measles at the age of 9 months

36
 as part of the routine infant vaccination

schedule.
2 If the vaccination schedule is interrupted, 4. 36 OFTEN

it is not necessary to restart. Instead, the

schedule should be resumed using

minimal intervals between doses to

catch up as quickly as possible.

3 Immunization is a basic health service 4. 83 ALWAYS

and such it is integrated in to the health

services being provided for by the Rural

Health Unit, thus mothers should support

it.

4 Immunizations are very important 4. 76 ALWAYS

vaccines which children should receive.

TOTAL WEIGHTED MEAN 4. 65 ALWAYS

As shown in Table 8, the respondents were Always compliant on the

Principles of EPI represented by the Total weighted mean of 4. 65. As to the

vaccination of infants against measles at the age of 9 months (1), represented by

a mean of 4. 67 with a descriptive interpretation of Always as to the degree of

compliance. On the vaccination schedule (2), it has a weighted mean of 4. 36

which has a descriptive interpretation of Often as to the degree of compliance.

On item no. 3 which is the integration of immunization to the basic health

services in the RHU, represented by 4. 83 which has a corresponding descriptive

interpretation of Always as to the degree of compliance. And on item no. 4 which

37
is on the importance of vaccines to the children represented by a mean of 4. 76

which has a descriptive interpretation of Always as to the compliance of mothers

to the program on immunization.

Table 9: Compliance of the respondents tothe protocols of EPI

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

1 The mothers must be acquainted 4. 16 OFTEN

with how many vaccine shots should

be given to the child.

2 The mothers should be aware if 4. 46 OFTEN

there are booster doses after the

vaccine shots.

3 Attendance of mothers to the 3. 34 SOMETIMES

community health education for

them to be well known of the

different vaccines, the diseases they

prevented and also the side effects

of these vaccines after its

38
 administration.

TOTAL WEIGHTED MEAN 3. 99 OFTEN

Table 9 shows that mothers rearing 1 year and below at Saguday, Quirino

were oftentimes compliant on the protocols of EPI which is represented by a total

weighted mean of 3. 99. On item no. 1 which is on the acquaintance of mothers

to the number of vaccine shots that their children should receive, it has a mean of

4. 16 which has a descriptive interpretation of Often as to the degree of their

compliance. Item no. 2 pertains on the awareness of mothers regarding the

booster doses after the vaccine shots, and it has a mean of 4. 46 which means

that they Often complied on this protocol of immunization. And on the last item

which is about the attendance of the respondents to community health education

about immunization, the data reveal that mothers were sometimes compliant

which is represented by a mean of 3. 34.

39
 Table 10: Compliance of the respondents to the Kinds and Routine of EPI

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

1 Bacillus CalmetteGuerine (BCG) 4. 89 ALWAYS

should be received by a child at birth

or anytime after birth.

2 The proper age for the initial dose of 4. 63 ALWAYS

DiptheriaPertusis Tetanus (DPT) to an

infant is 6 weeks after birth.

3 Polio Vaccine is also given 6 weeks 4. 65 ALWAYS

after the child’s birth.

4 Hepatitis B Vaccine is given at birth. 4. 57 ALWAYS
5 Every infant needs to be vaccinated 4. 67 ALWAYS

against measles at the age of 9

months or as soon as possible after

the 9 months as part of the routine

infant vaccination schedule.

TOTAL WEIGHTED MEAN 4. 69 ALWAYS

40
 As shown in Table 10, the respondents were always compliant on the

kinds and routine of EPI represented by a total mean of 4.69: Item no. 1 states

that Bacillus CalmetteGuerine (BCG) should be received by a child at birth or

anytime after birth with a mean of 4.89 and a descriptive interpretation of always

as to the degree of compliance. Item no. 2 states the proper age for the initial

dose of DiptheriaPertusis Tetanus (DPT) to an infant is 6 weeks after birth

represented by a mean of 4.63 with a descriptive interpretation of always as to

their degree of compliance. Item no. 3 expresses that Oral Polio Vaccine is given

6 weeks after the child’s birth, and it has a mean of 4. 65 with a descriptive

interpretation of always as to the mother’s degree of compliance. Item no.4 says

that Hepatitis B Vaccine is given at birth represented by a mean of 4. 57 and with

a descriptive interpretation of always as to the degree of compliance. Lastly is

item no. 5 which states that every infant needs to be vaccinated against measles

at the age of 9 months or as soon as possible after the 9 months as part of the

routine infant vaccination schedule and it is represented by a mean of 4. 67

which shows that the respondents were always compliant to this.

41
 Table 11: Compliance of the respondents to the Guidelines in Medicating

Discomforts

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

1 If there is a fever, give plenty of 4. 33 OFTEN

water to drink and clothe your child

lightly.
2 Give your child a fever-reducing 4. 56 ALWAYS

medication.
3 If the child is fussy due to pain or 4. 56 ALWAYS

fever, give medication to reduce pain

or fever.
4 If the redness or tenderness of the 3. 41 SOMETIMES

injection site increases after 24

hours, call your clinic or health care

provider.
5 If the child’s leg or arm is swollen, 3. 33 SOMETIMES

apply a clean, cool, wet, washcloth

over the sore area for comfort.

TOTAL WEIGHTED MEAN 4. 03 OFTEN

42
 It could be gleaned in Table 11 the respondent’s degree of compliance on

the guidelines in medicating discomforts and it has a total mean of 4. 03

interpreted as often compliant. In terms of giving the child of plenty of water to

drink and clothing him lightly if there is fever after the vaccination, the mothers

were often compliant to this with a mean of 4. 33. Item no. 2 states that the child

should be given a fever – reducing medication after vaccine shots and it has a

mean of 4. 56 interpreted as always compliant. Item no. 3 tells that if the child is

fussy due to pain or fever, give medication to reduce pain or fever and it has a

mean of 4. 56 with a descriptive interpretation of always as to the degree of

compliance. Item no. 4 states that if the redness or tenderness of the injection

site increases after 24 hours, mothers should call the clinic or health care

provider and it is represented by a mean of 3. 41 interpreted as sometimes

compliant. The last guideline in medicating discomfort tells that if the child’s leg

or arm is swollen, apply a clean, cool, wet, washcloth over the sore area for

comfort and it has a mean of 3. 33 interpreted as sometimes compliant.

43
 Table 12:Compliance of mothers on the following principles regarding the

benefits of vaccination to their children

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

1 BCG is given at the earliest possible 4. 89 ALWAYS

age because it protects the possibility

of TB Meningitis and other TB

infectious diseases in which infants are

prone.
2 An early start with DPT reduces the 4. 66 ALWAYS

chance of severe pertussis.

3 The extent of protection against polio is 4. 68 ALWAYS

increased the earlier the OPV is given.

4 An early start of Hepatitis B vaccine 4. 73 ALWAYS

reduces the chance of being infected

and becoming a carrier. Prevents liver

cirrhosis and liver cancer which are

more likely to develop if infected with

Hepatitis B early in life.

5 At least 85% of measles can be 4. 61 ALWAYS

prevented by immunization at this age.

TOTAL WEIGHTED MEAN 4. 71 ALWAYS

Table 12 shows the respondent’s degree of compliance on the principles

regarding the benefits of vaccination to their children represented by a total mean

of 4. 71 with a descriptive interpretation of always compliant. The 1 st item states

44
that BCG is given at the earliest possible age because it protects the possibility

of TB Meningitis and other TB infectious diseases in which infants are prone and

it has a mean of 4. 89 interpreted as always compliant in terms of the

respondent’s compliance. The 2 nd item tells that an early start with DPT reduces

the chance of severe pertussis with a mean of 4. 66 which means that the

mothers were always compliant on the proper time of administration of DPT

vaccine. The 3rd item states that the extent of protection against polio is

increased the earlier the OPV is given and it has a mean of 4. 68 with a

descriptive interpretation of always in terms of the mothers’ compliance in the

proper time of giving the OPV. The 4 th item tells that an early start of Hepatitis B

vaccine reduces the chance of being infected and becoming a carrier and it has a

mean of 4. 73 with a descriptive interpretation of always compliant in the proper

time of anti – Hepatitis B administration. The 5 th and last item states that at least

85% of measles can be prevented by immunization at this age and it has a mean

of 4. 61 interpreted as always compliant in terms of this principle regarding the

benefit of vaccination to the children

Table 13: Compliance of mothers on the strategies used by the MHO in

the implementation of EPI:

ITEM ITEM WEIGHTED DESCRIPTIVE

NO. MEAN INTERPRETATION

45
 1 Monthly schedule of immunization in 4. 86 ALWAYS

every barangay of Saguday, Quirino.

2 Conduct of home visits to mothers 4. 33 OFTEN

who failed to bring their children in

the barangay health station during

the scheduled immunization.

3 Health education to the families in 3. 97 OFTEN

the community for deeper

knowledge and understanding about

the administration and effects of the

different vaccines.
4 Proper dissemination of information 4. 51 ALWAYS

whenever there is a change of

schedule in the usual day of

vaccination during the month.

TOTAL WEIGHTED MEAN 4. 42 OFTEN

Table 13 shows the respondent’s degree of compliance on the strategies

used by the MHO in the implementation of EPI represented by a total mean of 4.

42 with a descriptive interpretation of oftentimes compliant. (1.) Monthly schedule

of immunization in every barangay of Saguday, Quirino. Regarding to this

strategy, the mean of 4. 86 reveals that the mothers of Saguday, Quirino were

always compliant on the given schedule of immunization to their own barangay.

(2.) Conduct of home visits to mothers who failed to bring their children in the

barangay health station during the scheduled immunization. This strategy has a

mean of 4. 33 which further explain that the respondents only oftentimes

46
supported this conduct of home visits. (3.) Health education to the families in the

community for deeper knowledge and understanding about the administration

and effects of the different vaccines. This strategy of the MHO has a mean of 3.

97 which means that the respondents were oftentimes compliant on these public

health education about EPI. (4.) Proper dissemination of information whenever

there is a change of schedule in the usual day of vaccination during the month.

The last strategy of the MHO for the EPI implementation has a mean of 4. 51

interpreted as always compliant.

PART III: Overall Summary of Table 8 to Table 13

Table 14: Degree of compliance on the overall summary of tables

ITEM NO. ITEM WEIGHTED DESCRIPTIVE

MEAN INTERPRETATION
1 Principles of EPI 4. 65 ALWAYS
2 Protocols of EPI 3. 99 OFTEN
3 Kinds and routine of EPI 4. 69 ALWAYS
4 Guidelines in medicating 4. 03 OFTEN

47
 discomforts
5 Benefits of vaccination to 4. 71 ALWAYS

their children
6 Strategies used by the 4. 42 OFTEN

MHO in the implementation

of EPI
OVERALL WEIGHTED MEAN 4. 42 OFTEN

As disclosed by Table 14, the mothers rearing children 1 year and below

of age who are then called the respondents of this study were oftentimes

compliant in the implementation of the Expanded Program on Immunization at

Saguday, Quirino represented by the overall weighted mean of 4. 42. Item no. 1

which pertains on the Principles of EPI has a weighted mean of 4. 65 which

being interpreted as the mothers were always compliant on this aspect of the

immunization program. Item no. 2 speaks on the Protocols of EPI which is

represented by the mean of 3. 99 showing that the mothers were oftentimes

compliant regarding this. Moreover, item no. 3 pertains on the Kinds and routine

of EPI which has a weighted mean of 4. 69 which means that the mothers were

always compliant on this aspect of the program. Item no. 4 speaks on the

different Guidelines in medicating discomforts and it has a mean of 4. 03 which is

interpreted as the respondents were oftentimes compliant on this. Item no. 5 tells

of the Benefits of Vaccination to their children which has a weighted mean of 4.

71 being interpreted as always compliant. The last item speaks on the Strategies

used the Municipal Health Office of Saguday, Quirino towards a successful

48
implementation of the program on Immunization and it has a weighted mean of 4.

42 and the mothers oftentimes complied on this aspect of the program.

CHAPTER 5

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the Summary of Findings along with the

Conclusions and Recommendations by the researcher based on the analysis

made on the study.

SUMMARY OF FINDINGS

This study endeavored to assess the degree of compliance of the mothers

rearing children 1 year and below of age towards the implementation of the

49
Expanded Program on Immunization by the Municipal Health Office of Saguday,

Quirino.

This study revealed the following findings:

Part I. Profile of the respondents

1.1. Age – Majority of the respondents belonged to ages 19 – 25 years old

bracket (32) or 28.07 percent. The least were between the age bracket of 40

years old and above which accounts for 11 respondents or 9.65 percent.

1.2. Barangay Address – Greater part of the respondents (32 or 28. 07

percent) live in barangay Rizal which is also the most populated barangay in

Saguday, Quirino. While the smallest number of respondents came from

barangay Gamis which has 5 respondents equivalent to 4.39 percent.

1.3. Occupation – Most of the respondents were housekeepers depicted

by 50 mothers or 43.86 percent. Least of them were employed in the government

and private sectors represented by 5 mothers which accounts for 4.39 percent.

1.4. Civil Status – Majority of the mothers (98 or 85.96 percent)were

married in status. Only 3 of them were widowed or 2.63 percent.

1.5. Number of Children –51 or 44.74 percent of the mothers were rearing

4 – 5 children 1 year and below of age. 9 or 7. 89 percentrear 1 child.

1.6. Monthly Income – Most of the respondents had an average monthly

income of below 3,000 represented by 58 mothers or 50.88percent. Only 2 of

them earns an income of P7,001 – P9,000 equivalent to 1.75 percent.

50
 1.7. Highest Educational Attainment–Greatest number of the mothers

were high school undergraduate which accounts for 33 or 28.95 percent. There is

only 1 respondent (0. 88 percent) who finished her post graduate studies.

Part II. Degree of compliance of the mothers rearing children 1 year and below of

age regarding the implementation of the Expanded Program on Immunization

(EPI)

2.1. Principles of EPI – The respondents were always compliant on the

Principles of EPI represented by the Total weighted mean of 4. 65.

2.2. Protocols of EPI – The mothers rearing 1 year and below of age at

Saguday, Quirino were oftentimes compliant on the protocols of EPI which is

represented by a total weighted mean of 3. 99.

2.3. Kinds and Routine of EPI – Majority of the respondents were always

compliant on the kinds and routine of EPI represented by a total mean of 4. 69.

2.4. Guidelines in Medicating Discomforts – The respondent’s degree of

compliance on the guidelines in medicating discomforts has a total mean of 4. 03

interpreted as oftentimes compliant

2.5. Benefits of Vaccination to the Children – The respondent’s degree of

compliance on the principles regarding the benefits of vaccination to their

children is represented by the total mean of 4. 71 with a descriptive interpretation

of always compliant.

51
 2.6. Strategies used by the Municipal Health Office of Saguday in the

Implementation of EPI – The respondent’s degree of compliance on the

strategies used by the MHO in the implementation of EPI is represented by a

total mean of 4. 42 with a descriptive interpretation of oftentimes compliant.

Part III. Overall Summary of Tables

The mothers rearing children 1 year and below of age who are then called

the respondents of this study were oftentimes compliant in the implementation of

the Expanded Program on Immunization at Saguday, Quirino represented by the

overall weighted mean of 4. 42. The Principles of EPI has a weighted mean of 4.

65 which being interpreted as the mothers were always compliant on this aspect

of the immunization program. Moreover, the Protocols of EPI which is

represented by the mean of 3. 99 showing that the mothers were oftentimes

compliant regarding this. However, on the Kinds and routine of EPI which has a

weighted mean of 4. 69 which means that the mothers were always compliant on

this aspect of the program. Regarding on the different Guidelines in medicating

discomforts, it has a mean of 4. 03 which is interpreted as the respondents were

oftentimes compliant on this aspect of the immunization program. Moreover, on

the Benefits of Vaccination to their children which has a weighted mean of 4. 71

being interpreted as always compliant. The last item pertains on the Strategies

used the Municipal Health Office of Saguday, Quirino towards a successful

implementation of the program on Immunization and it has a weighted mean of 4.

42 and the mothers oftentimes complied on this aspect of the program.

52
Conclusions

Based on the findings of the study, the researcher finally presents the

following conclusions:

2. The chosen respondents of this study were mothers rearing children 1

year and below of age at Barangay, Rizal, Saguday, Quirino. Majority of

them, were 19 – 25 years of age, legally married, high school

undergraduate and lived at barangay Rizal. Most of them were

housekeeping in works, taking good care of their children at home since

they were wives of farmers and farming is the no.1 source of income in the

municipality and majority of them earn an average income of 3,000 –

5,000.00. They have 4 – 5 children and this number of children plays a

great factor in their compliance to the immunization program since most of

the times there were no other guardian left at home to take good care of

their children during immunization schedules.

3. The mothers who rear children 1 year and below of age were oftentimes

compliant in all of the aspects of the Expanded Program on Immunization.

Regarding on the principles of EPI, it has found out that the respondents

had religiously complied. However, on the protocols mandated by the

Department of Heath regarding the program, mothers had only oftentimes

complied on this. On the kinds of immunization and routine of

administrating these vaccines, the mothers so far always complied on this

aspect of EPI. Regarding on the different guidelines in medicating

discomforts brought by administering different types of vaccines, it has

53
 found out that they oftentimes complied on this. Moreover, they were also

aware of the various benefits of vaccines that’s why they were always

compliant on the right timing of bringing their children in the barangay

heath station for vaccination. Regarding on the strategies of the Municipal

Health Office of Saguday, Quirino towards a successful implementation of

the program on immunization, the mothers had only oftentimes complied

because according to them, they lack time to attend immunization health

education schedules.

Recommendations

In the light of the foregoing findings and conclusions, the following

recommendations are hereby offered:

1. The Municipal Health Office of Saguday, Quirino must strictly monitor

the extent of implementation of the Expanded Program on

Immunization in coordination with the Barangay Health Stations in the

9 barangays of Saguday. Assessment of the said program must be

done monthly by the midwives, nurses deployed in every barangay

assisted by the barangay health workers in order to find out if mothers

rearing children 1 year and below of age in every barangay of Saguday

are responsive and religiously complying with the different aspects of

the immunization program. Thus, in areas where they found difficulties,

enhancement and improvement of the program will be done.

54
 2. Mothers rearing children 1 year and below of age should be educated

by the midwives and barangay health workers regarding the right

timing of giving these vaccines. This is in order for them to understand

that it is their responsibility to bring their children during scheduled

immunizations.

3. Successful implementation of the Expanded Program on Immunization

is a hand in hand responsibility both of the community and the

Municipal Health Office of Saguday, Quirino. It is therefore a need to

establish partnership.

Bibliography

A. Books

Cuevas, 2007, Public Health Nursing in the Philippines

Elsevier, 2002, Mosby’s Pocket Dictionary of Medicine, Nursing and Allied

Health 4th Edition.

Funk &Wagnalls Publishing Company Incorporated and J.G Ferguson

Publishing Company, 1992, Webster Comprehensive Dictionary

Nisce, Zenaida P., January, 2000, “Community Health Nursing Section,

National League of Philippine Government Nurses, Inc. 9 th Edition

55
 Random House Incorporated, 2001, Random House Webster’s Easy

English Dictionary

Sammons, James H. M.D., 1982 “American Medical Association”. The

Macmillan Guide to Family Health”

B. Journal and Magazine

Parenting, April 2002, Vaccine Safety

D. On - line

http://www.doh.gov.ph/programs/epi

http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_Philippi

nes

http://en.wikipedia:org/wiki/Immunization

http://nursingcrib.com/expanded_program_forimmunization_epi/Expanded

APPENDICES

University of La Salette
Graduate School Department
Dubinan East, Santiago City

SURVEY QUESTIONNAIRE
I,Manilyn D. Gerardo, a student of the University of La Salette under
Master’s of Science in Public Health, Thesis Program is presently assessing
the compliance of mothers with children 1 year and below of age in the
Expanded Program on Immunization of the Municipal Health Office of Saguday,
Quirino. One of the evaluation tools that I am using for my Research study is this
questionnaire.
Please answer all questions as honest as possible. Your responses will be
treated with uttermost confidentiality. The result of this study will be useful for the
Municipal Health Office of Saguday, Quirino in determining the degree of

56
compliance of the mothers rearing children 1 year and below in the
implementation of EPI in order to improve and enhance strategies used for the
successful implementation of the said DOH program.
Your participation will greatly help me in the realization of this endeavor.
Kindly follow the given instructions below. Thank You!

DIRECTION: Please answer this questionnaire by filling the blanks with

the needed information and check ( / )the parentheses that correspond to your
answer. It will be a great help for the reliability of the study by not leaving any
question unanswered.

PART I. DEMOGRAPHIC PROFILE OF THE RESPONDENTS:

Name: (Optional) ____________________________________
Age: ( ) 18 and below ( ) 19-25 ( ) 26-30 ( ) 31-35
( ) 36-40 ( ) 40 above
Barangay: ________________________
Occupation: ( ) Government Employee ( ) Private Employee
( ) Housekeeping ( ) Farming
( ) Others: (please specify) _______________________
Civil Status: ( ) Single Mother ( ) Married ( ) Separated ( ) Widowed
Number of children: ( ) 1 ( ) 2-3 ( ) 4-5 ( ) 5 and above
Monthly Income: ( ) below P3, 000.00 ( ) P3, 000.00 – P5, 000.00
( ) P6, 000.00 – P8, 000.00 ( ) P9, 000.00 and above
Educational Attainment:( ) Elementary Undergraduate
( ) Elementary Graduate
( ) High School Undergraduate
( ) High School Graduate
( ) College Undergraduate
( ) College Graduate
( ) Post Graduate

57
PART II. WHAT IS THE DEGREE OF COMPLIANCE OF THE MOTHERS IN
THE PROGRAM OF IMMUNIZATION IN THE FOLLOWING ASPECTS GIVEN
BELOW:
DIRECTION: Please rate the degree of your compliance in the Expanded
Program on Immunization (EPI). Use the following rating scale: Just encircle the
number that corresponds to your answer:
5 - Always
4 - Often
3 - Sometimes
2 - Seldom
1 - Never

A. PRINCIPLES OF EPI:

1. Every infant needs to be vaccinated against measles at 5 3 2 1

the age of 9 months or as soon as possible after 9 months 5 4 3 2 1
as part of the routine infant vaccination schedule.
2. If the vaccination schedule is interrupted, it is not 5 3 2 2
necessary to restart. Instead, the schedule should be 5 4 3 2 1
resumed using minimal intervals between doses to catch
up as quickly as possible.

3. Immunization is a basic health service and such it is 5 3 2 2

integrated in to the health services being provided for by 5 4 3 2 1
the Rural Health Unit, thus mothers should support it.

4. Immunizations are very important vaccines which 5 2 1

children should receive. 5 4 3 2 1

B. PROTOCOLS OF EPI:

1. The mothers must be acquainted with how many 5 4 3 2 1

vaccine shots should be given to the child. 5 4 3 2 1

2. The mothers should be aware if there are booster 5 4 3 2 1

doses after the vaccine shots. 5 4 3 2 1
3. Attendance of mothers to the community health 5 4 3 2 1
education for them to be well known of the different

58
vaccines, the diseases they prevented and also the side 5 4 3 2 1
effects of these vaccines after its administration.

C. KINDS AND ROUTINE OF EPI: 5 4 3 2 1

1. Bacillus CalmetteGuerine (BCG) should be received by 5 4 3 2 1

a child at birth or anytime after birth. 5 4 3 2 1

2. The proper age for the initial dose of DiptheriaPertusis 5 4 3 2 1

Tetanus (DPT) to an infant is 6 weeks after birth. 5 4 3 2 1

3. Polio Vaccine is also given 6 weeks after the child’s 5 4 3 2 1

birth. 5 4 3 2 1

4. Hepatitis B Vaccine is given at birth. 5 4 3 2 1

5 4 3 2 1

5. Every infant needs to be vaccinated against measles at 5 4 3 2 1

the age of 9 months or as soon as possible after the 9 5 4 3 2 1
months as part of the routine infant vaccination schedule.

D. GUIDELINES IN MEDICATING DISCOMFORTS: 5 4 3 2 1

1. If there is a fever, give a plenty of water to drink and 5 4 3 2 1

clothe your child lightly. 5 4 3 2 1

2. Give your child a fever-reducing medication. 5 4 3 2 1

5 4 3 2 1

3. If the child is fussy due to pain or fever, give medication 5 4 3 2 1

to reduce pain or fever. 5 4 3 2 1

4. If the redness or tenderness of the injection site 5 4 3 2 1

increases after 24 hours, call your clinic or health care 5 4 3 2 1
provider.

5. If the child’s leg or arm is swollen, apply a clean, cool, 5 4 3 2 1

wet, washcloth over the sore area for comfort. 5 4 3 2 1

E.BENEFITS OF VACCINATION TO THE CHILDREN: 5 4 3 2 1

1. BCG is given at the earliest possible age because it 5 4 3 2 1

protects the possibility of TB Meningitis and other TB 5 4 3 2 1
infectious diseases in which infants are prone.

59
2. An early start with DPT reduces the chance of severe 5 4 3 2 1
pertusis. 5 4 3 2 1

3. The extent of protection against polio is increased the 5 4 3 2 1

earlier the OPV is given. 5 4 3 2 1

4. An early start of Hepatitis B vaccine reduces the chance 5 4 3 2 1

of being infected and becoming a carrier. Prevents liver 5 4 3 2 1
cirrhosis and liver cancer which are more likely to develop
if infected with Hepatitis B early in life.

5. At least 85% of measles can be prevented by 5 4 3 2 1

immunization at this age. 5 4 3 2 1

F. STRATEGIES USED BY THE MHO IN THE 5 4 3 2 1

IMPLEMENTATION OF EPI:

1. Monthly schedule of immunization in every barangay of 5 4 3 2 1

Saguday, Quirino. 5 4 3 2 1

2. Conduct of home visits to mothers who failed to bring 5 4 3 2 1

their children in the barangay health station during the 5 4 3 2 1
scheduled immunization.

3. Health education to the families in the community for 5 4 3 2 1

deeper knowledge and understanding about the 5 4 3 2 1
administration and effects of the different vaccines.

4. Proper dissemination of information whenever 5 4 3 2 1

there is a change of schedule in the usual day of 5 4 3 2 1
vaccination during the month.

60
 University of La Salette
Graduate School Department
Dubinan East, Santiago City

SURVEY QUESTIONNAIRE
(Tagalog Version)
“COMPLIANCE OF MOTHERS IN THE EXPANDED PROGRAM ON
IMMUNIZATION OF THE MUNICIPAL HEALTH OFFICE OF SAGUDAY,
QUIRINO”
UNANG BAHAGI:
Panuto: Pakisagutan ang mga sumusunod na katanungan. Isulat ang mga
hinihinging impormasyon sa nakalaang patlang. Malaking tulong ang pagsagot
sa lahat ng katanungan. Maraming Salamat!
Pangalan: (Hindi SapilitangIlahad) ____________________________________
Edad: ( ) 18 pababa ( ) 19-25 ( ) 26-30 ( ) 31-35

61
 ( ) 36-40 ( ) 40 pataas
Barangay: ________________________
Trabaho: ( ) Kawani ng Gobyerno ( ) Nagtratrabaho sa Pribado
( ) Nasa Bahay lamang ( ) Nagsasaka
( ) Iba pa: (pakilahad) __________________

Estado: ( ) Walang Asawa ( ) May Asawa ( ) Hiwalay sa Asawa ( ) Biyuda

BilangngAnak: ( ) isa lamang ( ) 2-3 ( ) 4-5 ( ) 5 pataas
Kita saIsangBuwan: ( ) mas mababa sa P3,000.00 ( ) P3,000.00 – P5,000.00
( ) P6, 000.00 – P8, 000.00 ( ) P9, 000.00 at pataas
AntasngPinag -Aralan: ( ) Hindi Tapos sa Elementarya
( ) Tapos sa Elementarya
( ) Hindi Tapos sa Sekondarya
( ) Tapos sa Sekondarya
( ) Hindi Tapos sa Kolehiyo
( ) Tapos sa Kolehiyo
PANGALAWANG BAHAGI:
Panuto: Pakilagyan ng markana (/) ang antas ng pagsunod (compliance) sa
programang immunisasyon na ipinatutupad ng Health Center sa inyong
Barangay.
5 - Palagiang Pagsunod
4 - Madalas naPagsunod
3 - Paminsan – Minsan na Pagsunod
2 - Madalang na Pagsunod
1 - Hindi Pagsunod

A. PANUNTUNAN SA PINALAWAK NA PROGRAMA 5 4 3 2 1

NG PAGBABAKUNA:

62
1. Ang sanggol ay kinakailangang bakunahan laban sa 5 4 3 2 1
sakit na ntigdas. 5 4 3 2 1

2. Kung ang iskedyul ng pagbabakuna ay nagkaroon ng 5 4 3 2 1

patlang, di kailangang simulan muli. Sa halip, ituloy ang 5 4 3 2 1
bakuna na magkakalapit ang araw ng pagbibigay.

3. Ang imunisasyon ay pangunahing serbisyong 5 4 3 2 1

pangkalusugan na ibinibigay ng Rural Health Unit sa 5 4 3 2 1
komunidad.

4. Ang imunisasyon ay nakakatulong sa pagpapababa ng 5 4 3 2 1

posibilidad na magkaroon ng sakit ang mga sanggol. 5 4 3 2 1

B. MGA DAPAT ISAALANG-ALANG SA PINALAWAK 5 4 3 2 1

NA PROGRAMA SA PAGBABAKUNA:

1. Ang mga ina ay kailangang may sapat na kaalaman sa 5 4 3 2 1

bilang ng mga bakuna na dapat ibigay sa bata. 5 4 3 2 1

2. Ang mgaina ay kailangang may kaalaman sa booster 5 4 3 2 1

na kasunod na bakuna. 5 4 3 2 1

3. Ang mga ina ay kailangang may sapat na kaalaman sa 5 4 3 2 1

mga sakit na maaaring maiwasan sa tulong ng mga 5 4 3 2 1
bakuna kung kayat ang pagsuporta sa programang ito ay
kailangang isaalang-alang.

C. URI AT PAGKAKASUNOD-SUNOD NG 5 4 3 2 1
IMUNISASYON:

1. Ang BCG ay binibigay pagkasilang o anumang araw 5 4 3 2 1

pagkasilang. 5 4 3 2 1

2. Ang tamang panahon ng pagbibigay ng DPT ay 6 na 5 4 3 2 1

lingo pagkatapos maisilang ang bata. 5 4 3 2 1

3. Ang bakuna sa polyo ay ibinibigay 6 na lingo mula 5 4 3 2 1

pagkasilang. 5 4 3 2 1

4. Ang Hepatitis B Vaccine ay kaagad na ibinibigay sa 5 4 3 2 1

mga bagong silang na sanggol. 5 4 3 2 1

63
5. Ang bakuna laban sa tigdas ay isinasagawa sa 9 na 5 4 3 2 1
buwang bata o pagkaraan ng 9 na buwan bilang parating 5 4 3 2 1
iskedyul.

B. PAALALA SA MGA DI MAGANDANG 5 4 3 2 1

NAOBSERBAHAN SA SANGGOL NA DULOT NG
BAKUNA :
1. Kung may lagnat, bigyan ng maraming tubig at damitan 5 4 3 2 1
ang sanggol ng di gaanong makapal. 5 4 3 2 1

2. Bigyan ng gamut na nagpapababa ng temperature o 5 4 3 2 1

lagnat kung mainit ang saggol pagkatapos matanggap 5 4 3 2 1
ang bakuna na indiksiyon.

3. Kung ang sanggol ay balisa o di mapakali dahil sa 5 4 3 2 1

pananakit ng bahagi ng katawan na nabakunahan, bigyan 5 4 3 2 1
ng gamut na pwedeng makabawas sa sakit.

4. Kung ang pamumula o pamamaga ay humigit sa 24 na 5 4 3 2 1

oras, isangguni agad sa inyong health worker. 5 4 3 2 1

5. Sa pagitan ng bahaging naindiksiyonan, dampian o 5 4 3 2 1

patungan ng malamig na tuwalya o bimpo sa bahagi ng 5 4 3 2 1
namaga.

E.KAPAKINABANGAN NG BAKUNA PARA SA 5 4 3 2 1

SANGGOL:

1. BCG ay proteksiyon ng sanggol laban sa sakit na TB 5 4 3 2 1

meningitis at leprosy 5 4 3 2 1

2. Ang maagang pagbibigay ng DPT ay proteksiyon para 5 4 3 2 1

sa di-pagkakaroon ng nasalsal na ubo ng bata. 5 4 3 2 1

3. Ang proteksiyon laban sa polyo ay mas mapapalawig 5 4 3 2 1

sa maagang pagbibigay ng OPV. 5 4 3 2 1

4. Ang maagang pagbibigay sa sanggol ng bakuna laban 5 4 3 2 1

sa Hepatitis B ay nakakatulong sa di-pagkakaroon ng 5 4 3 2 1
kanser sa atay, cirrhosis o pagkakasakit ng hepatitis.

5. 85% ng tigdas ay maiiwasan sa pagbibigay ng bakuna 5 4 3 2 1

sa gulang na ayon sa programang imunisasyon. 5 4 3 2 1

64
F. MGA ISTRATEHIYANG GINAGAMIT NG MUNICIPAL 5 4 3 2 1
HEALTH OFFICE PARA SA LALONG
PAGPAPAIGTING NG PROGRAMA SA IMUNISASYON:

1. Buwanang pagtatakda ng imunisasyon sa bawat 5 4 3 2 1

barangay. 5 4 3 2 1

2. Pagtatakdang pagbisita sa bahay ng magulang ng 5 4 3 2 1

sanggol na hindi nadala sa Health Center sa mismong 5 4 3 2 1
araw ng pagbabakuna.

3. Pagbibigay ng tamang kaalaman at impormasyong 5 4 3 2 1

pangkalusugan sa mga magulang hinggil sa mga 5 4 3 2 1
benepisyo ng bakuna at ang mga epekto nito para
mabawasan ang mga takot ng magulang at sila ay
susuporta ng buong puso sa programang ito.

4. Tama at agarang pagbibigay ng impormasyon sa mga 5 4 3 2 1

magulang tungkol sa iskedyul ng imunisasyon. 5 4 3 2 1

MANILYN D. GERARDO- RAMBAC

PERMANENT ADDRESS:
PurokNamnama, Magsaysay
Saguday, Quirino,
Philippines
CP #: 0905-9671-605

WORK EXPERIENCES:

QUIRINO STATE UNIVERSITY

Capitol Hills, Cabarroguis Quirino
Midwifery Department
Dean of Midwifery
October, 2015 - Present

65
 Clinical Instructor
October, 2008 – October, 2015
Clinical Coordinator
June, 2014 – October, 2014

Functions, Duties and Responsibilities:

 Supervises Midwifery students on their clinical duties and exposures at
Quirino Province Medical Center – Operating Room, Labor Room,
Delivery Room and OB / Gyne Ward.
 Supervises and assists second year Midwifery students on their clinical
practicum at Rural Health Unit of Saguday, Quirino for their Community
Organizing Participatory Action Research.
 Teaches students on how to admit and monitor patients especially
pregnant mothers and newborns.
 Handles Midwifery professional subjects such as Primary Health Care I,
Primary Health Care II and Professional Growth and Development.
 Conducts Intensive Review regarding the 5 Midwifery Board subjects to
graduating Midwifery students during their in – house review prior to
Midwifery Board Examination.

QUIRINO PROVINCE MEDICAL CENTER

Mangandingay, Cabarroguis Quirino
Casual Midwife at the Operating Room and Delivery Room
June, 2008 – October, 2008

Functions, Duties and Responsibilities:

 Works well with fellow medical practitioners in rendering quality health
care services to Quirinians and even patients outside the province.
 Discharges duties and responsibilities of a professional Midwife assigned
in the OR/DR.

EDUCATIONAL BACKGROUND:

POST GRADUATE:

MASTERS OF SCIENCE IN PUBLIC HEALTH

University of La Salette
Santiago, City, Philippines
October, 2015

BACHELOR OF SCIENCE IN PUBLIC HEALTH

University of La Salette
Santiago, City, Philippines
October, 2011

DIPLOMA IN MIDWIFERY

66
 Quirino Polytechnic College
Capitol Hills, Cabarroguis Quirino, Philippines
April, 2008

 Vice Governor’s Awardee

 Clinical Excellence Awardee
 Primary Health Care Awardee
 Consistent Top 1 Midwifery student

SECONDARY:

SAN AGUSTIN NATIONAL HIGH SCHOOL

Masaya Centro, San Agustin Isabela, Philippines

 First Honorable Mention

 Best in Science

SAN AGUSTIN CENTRAL SCHOOL

Masaya Centro, San Agustin Isabela, Philippines

 Salutatorian
 Best in Science
 Journalist of the Year

ELIGIBILITY:

Midwifery Licensure Examination- 83.65%

PERSONAL INFORMATION:

FULL NAME : MANILYN GERARDO – RAMBAC

DATE OF BIRTH : July 22, 1989
PLACE OF BIRTH : Maddela, Quirino
AGE : 26 years old
HEIGHT : 5’2”
WEIGHT : 48 kg.
CITIZENSHIP : Filipino
SEX : Female
RELIGION : Baptist Christian
SKILLS & HOBBIES : Singing, cooking, talking in front of people and
enjoy working in details and completing assignments accurately and on
time
CIVIL STATUS : Married
NAME OF HUSBAND: Hermenio P. Rambac, Jr.
OCCUPATION : Missionary / Pastor

67
 ……………………………………………………………………………………

CURRICULUM VITAE OF MANILYN D. GERARDO - RAMBAC

68