FACTORS AFFECTING THE FREQUENCY OF UTILIZATION OF

SELECTED CITIZENS IN BARANGAY LAPOLAPO I,

SAN JOSE, BATANGAS

A Research Project Presented to the Faculty of

Senior High School Department

De La Salle Lipa

IN PARTIAL FULFILLMENT FOR THE REQUIREMENTS

In the Subject

INQUIRIES, IMMERSIONS, AND INVESTIGATION

By:
Villanueva, Neil Piolo P.
Candava, Maria Yzabelle C.
Diaz, Shaira Aliyah A.
Honrade, Monica A.
Latayan, Maria Claire A.
Neri, Joy Jemarie H.
Reyes, Kristine Marien M.
Reyes, Ma. Katherine Grace B.
Villafuerte, Pauline Erykah C.
March 2018
 TABLE OF CONTENTS

List of Figures

List of Appendices

Chapter 1: The Problem and its Background

1.0 Introduction and Background of the Study 1
1.1 Statement of the Problem 7
1.2 Scope and Delimitation 8
1.3 Significance of the Study 9
1.4 Review of Related Literature and Studies 10
1.4.1 Review of Related Literature 10
1.4.1.1 Foreign Literature 10
1.4.1.2 Local Literature 20
1.4.2 Review of Related Studies 28
1.4.2.1 Foreign Studies 28
1.4.2.2 Local Studies 36
1.4.3 Synthesis 43
Chapter 2: Theoretical Framework
2.0 Theoretical Framework 50
2.0.1 Conceptual Framework 52
2.1 Assumption and Hypotheses 54
2.2 Definition of Terms 55
Chapter 3: Research Methodology
3.0 Research Design 58
3.1 Sampling Design and Respondents 58
3.2 Instrumentation 60
3.3 Data Gathering, Presentation and Analysis 61
3.3.1 Validity and Reliability 63
3.3.2 Statistical Treatment 61
References/Bibliography 67
 LIST OF FIGURES

Figure 1: Conceptual Model of Demographic Profiles, 52

Frequency of Utilization of Herbal Medicines and its Influencing Factors
 LIST OF APPENDICES

Appendix A: Survey Questionnaire 76

 CHAPTER 1

THE PROBLEM AND ITS BACKGROUND

1.0 Introduction and Background of the Study

In the face of modernization and globalization, the search for the immediate

emergence of innovation to ease daily human activities has immensely

intensified for various purposes. All aspects and fields in a human’s daily life

have posed the urgency for the virtually inevitable use of the rapidly emerging

advancements in the contemporary times. Ranging from the measliest task of

starting a conversation, even up to curing illnesses, the contemporary times call

for the use of modernization and globalization to its advantage. Nonetheless,

through time, numerous problems have emerged which are left unnoticed due

to the dominant presence of modernization’s mask of integrality of perfection.

Consequently, some parts of the world has seen the declination of the use of

traditional methods in coping with life’s natural ways that has historically

addressed the complexity of human’s evolving needs (Macfoy, 2013).

Furthermore, although the concept of the contemporary modernization

encompasses the expansion of accessibility to basic human needs, traditional

methods in satisfying one’s primary needs have not received exemption in the

declination, for instance, using herbal medicines to address one’s health needs

(Neel, 2016). However, amidst the positive impacts of modernization in the

contemporary society, say, the foreseen expansion of access to primary needs,

it is highly feared that a natural selection will re-occur in the untouched areas

once the individuals cannot cope with the requirement to utilize various

advancements – among which are those who have limited access to healthcare
and medicine across the globe. (Gulliford & Morgan, 2013). The wide

encompassment of the concern of global access to healthcare services affect

all individuals despite the diversity of social and personal backgrounds (Zhou &

Nunes, 2015). This implies that the demographic profiles of an individual do not

exempt one from the need of accessing healthcare services. However, the

problem still persists across the globe despite the availability of medicine as

88.1% of the population in developing countries is distant from facilities that

render healthcare services while 40.4% does not have access to medical care

due to financial barriers (Seager, 2012). Similarly, in the Philippine setting, 8

out of 10 Filipinos do not have access to healthcare services including medical

checkups, dental checkups, and physical examinations, and 28% of all Filipino

women do not undergo skilled birth attendance. Consequently, the Philippines

ranks last in the Southeast Asian Region in terms of measuring the best access

to healthcare from which even poorer countries like Laos and Cambodia are

deemed to have easier access to healthcare services (Romualdez, 2012).

Despite the efforts to mobilize the access to healthcare services by establishing

health centers for each community, the problem still continues to pose

adversities among the citizens of specific communities, such as Barangay

Lapolapo I, San Jose, Batangas, as inconsistency in the operation of the

aforementioned government-owned establishment has materialized. To

combat the inefficiency of the national government’s effort to improve access

to healthcare, especially among rural areas, the Municipality of San Jose

conceptualized a new healthcare system that requires an individual to

exchange the collected garbage for the needed medicine in the Barangay Hall.

However, the local program was short-lived due to lack of budget, and unclear

2
universal instructions. Furthermore, the universal understanding that the

concept of good health is a common need for every individual shall pave way

for the emergence of intensified efforts in order to increase the accessibility to

healthcare services. The inclusion of all individuals across the globe in the

encompassment of health proves that no specific gender, nationality, and

financial status is superior in order to escape the possible adversities in relation

to one’s health. Nonetheless, though the face of modernization is highly present

in addressing the health needs of every individual such as the emergence of

medicine and technology to address different illnesses, the limited access to

the aforementioned innovations are holes that give space for the traditional

ways that once solved health problems and impeccably increased accessibility

to alternative healthcare in the history (World Health Organization, 2014).

Similar to the wide encompassment of health, the use of herbal medicine

across the globe has recently reached its peak of popularity. Both developed

and developing countries have seen the population of users of herbal medicine

as alternative to primary healthcare increase for the last three decades from

which 80% of the global population has been reliant on herbal medicine (World

Health Orgnization, 2013). For instance, in the United States, one out of five

adults have been using herbal medicine as alternative healthcare to specific

illnesses such as arthritis, cough, and cold (Sultz, 2013). On the other hand, in

developing countries in Southeast Asia, such as Thailand and Malaysia, herbal

medicines are prevalently being used as alternative to expensive prescribed

medications. Consequently, both countries have developed ontologies to widen

the knowledge of the population regarding herbal medicine in general, and have

statistically proven that the accessibility to healthcare among the citizens has
increased (Harper & Amrith, 2014). Thus, despite the differences in terms of

economic stature, countries across the globe heavily consider the use of herbal

medicines as alternative to primary healthcare. In connection, this leaves the

Philippines as the nation which widely practices the use of herbal medicines

only in urban cities, where citizens have easier access to healthcare services

in comparison to those who live in rural areas, and among the cultural minorities

(Guillermo, 2012). This is despite the fact that the Philippines possesses the

potential to exhibit high level of inclination toward the utilization of herbal

medicine because of two vital components which are the abundance of natural

resources to satisfy the demand for the use of herbal medicines, and a rich

trace of grassroots that could serve as a foundation towards a thriving practice

of usage of herbal medicine in the community (Busia, 2016). Similarly, this is

strongly against the geographical landscape of the Philippines where wide

variety of herbal medicines could be used and are also scientifically approved

by the head department. Moreover, most of the herbal medicines are situated

in rural areas where lesser impact of modernization and industrialization is

being experienced, among which are alkapulko, ampalaya, bawang, bayabas,

lagundi, niyog-niyogan, sambong, tsaang gubat, ulasimang bato, and yerba

buena, which pose questions on the lesser popular usage of herbal medicines

in the aforementioned areas in the country (Tomlinson, 2015). The lesser

inclination of the Filipinos in utilizing herbal medicine is also in contrary to the

historically wide usage of the aforementioned alternative to healthcare. Dating

back to the precolonial period, the Filipinos were already using herbal medicine

even before the Spaniards came to the country (Ong, n.d.). This practice was

widely influenced by Chinese practices on the traditional medicine systems

4
which were brought in the Philippines during barter trades. Thus, the historical

records prove that the Philippines once highly considered the usage of herbal

medicines which has slowly declined through the years. Given the

aforementioned traits in the Philippines, it could be inferred that the Philippines

has two vital components in order to resort to herbal medicines as alternative

healthcare. The two vital components include the ability to satisfy the demand

in terms of natural resources, and the rich grassroots of a country. However,

the level of inclination of the Filipinos in utilizing the herbal medicines imply

otherwise which poses questions on the factors that may have affected such

behavioral phenomenon. Nonetheless, generally, the aforementioned state of

herbal medicines in different nations prove that herbal medicines are being

popularly used as alternatives in order to increase the access to healthcare.

Consequently, it is integral to take the use of herbal medicine into lens as well

as identifying the factors that may have affected the usage of herbal medicines

by individuals in the rural areas. In the same way, this will relive the historical

and cultural richness of the Philippines, and could possibly allow the citizens’

access to healthcare to increase despite utilizing the traditional methods. Thus,

giving prime on the usage of herbal medicines and the factors that may be

affecting a specific area’s usage of the traditional medicine plays a vital role not

only in promoting the use of herbal medicines but also in increasing the access

to healthcare as a whole. Furthermore, the aftermath is greatly aligned in the

Philippine context as the country eyes to contribute in the attainment of different

sustainable development goals as proposed by United Nations in 2030. In this

case, improving the access to healthcare by mobilizing the medicines through

the promotion of the usage of the herbal medicines would propel toward the

5
actualization of good health among the Filipino communities. This is greatly in

accordance to the fulfillment of the prerequisites of achieving good health in a

community which includes accessibility to medicine while disregarding its form

(Browne, 2017). This means that although the herbal medicines are not the

products of scientific modernization, finding alternative ways in improving the

access to healthcare is a way in order to contribute in the attainment of the

sustainable development goals.

Nonetheless, despite the cultural and historical richness of the Philippines

in the usage of herbal medicines, and the abundance of resources to satisfy the

demand for the possible usage of herbal medicine in the country, the slow

declination of the prominence of the alternative medicines call for the attention

to conduct an in-depth research regarding the topic of herbal medicine.

Consequently, this study will shed light on the aforementioned topic which aims

to discuss the lack of access to healthcare in the Philippines from which

alternative methods could be utilized in addressing the pressing problem.

Moreover, the discussion entails the frequency of the usage of herbal medicine,

and determining the factors that may affect the frequency of usage of herbal

medicine in Barangay Lapolapo I, San Jose, Batangas. By placing the aforesaid

variables as the subjects for research, it is reflected that the research aims to

positively affect the usage of herbal medicine in the small communities in the

Philippines as alternatives for healthcare, and to present the perspective of the

social facet regarding the factors that may affect individuals in using herbal

medicine and the frequency of using herbal medicines that will be aided by valid

research instruments and credible researches. Hence, through the research,

not only will the topic regarding herbal medicine be promoted among small

6
communities but the research will also allow the emergence of a more

comprehensive understanding about how one, given the circumstances, still

improve the access to healthcare, which is a global sustainable development

goal, toward generally having good health as the result.

1.1 Statement of the Problem

This research entitled seeks to assess the utilization of medicinal plants in

Brgy. Lapolapo I, San Jose, Batangas through the following questions:

1.1.1 What is the demographic profile of the residents in terms of:

a. Age;

b. Sex;

c. Educational attainment;

d. Monthly income; and

e. Period of residency in the community?

1.1.2 What is the frequency of the utilization of medicinal plants by the

respondents in terms of:

a. Always;

b. Often;

c. Seldom; and

d. Never?

1.1.3 What factors influence the utilization of medicinal plants in terms of:

a. Personal Factors;

b. Behavioral Factors; and

c. Environmental Factors?

7
 1.1.4 Is there a significant relationship between the frequency of

utilization of medicinal plants and:

a. Age;

b. Sex;

c. Educational attainment;

d. Monthly income; and

e. Period of residency in the community?

1.1.5 Is there a significant relationship between the frequency of

utilization of medicinal plants and its influencing factors?

1.2 Scope and Delimitation of the Study

The proposed study aims to investigate the utilization of medicinal plants of

the residents of Brgy. Lapolapo I, San Jose, Batangas. Frequency of utilization

and the factors that influence utilization will be assessed and correlated to

various demographic profiles such as age, sex, educational attainment,

monthly income, and period of residency in the community to gain a more

comprehensive understanding of the role of medicinal plants in the health

sector of the barangay.

Quantitative type of research, correlational to be specific, would be used in

order to examine the frequency of utilization of medicinal plants of the citizens

and the varying factors which affect such utilization. Data will be sourced from

questionnaires that will be distributed to thirty respondents in order to study the

utilization of medicinal plants in Brgy. Lapolapo I, San Jose, Batangas.

The study will not go beyond the specified variables and will not include

other concerns, for instance, usage of plants not specified in the questionnaire

8
or not scientifically tested and approved by the Department of Health,

discussions of superiority between traditional and modern medicine, etc.

External factors such as unwillingness of respondents to participate, conflicts

regarding the availability of the respondents, and attitude of the respondents

towards the research material may also restrict the accuracy of the results.

Furthermore, the results of the study may not be applicable to other barangays

or communities since the respondents of the study are only limited to the

residents of Barangay Lapolapo I, San Jose, Batangas.

1.3 Significance of the Study

The proposed study covers the assessment of the utilization of medicinal

plants in Brgy. Lapolapo I, San Jose, Batangas, to address the state of the

health sector of the community.

As such, the main beneficiaries of the study are as follows:

Social Importance

Residents of Barangay Lapolapo I. The conduct of the study will raise

awareness regarding medicinal plants and will encourage its use as alternative

for primary healthcare amongst the citizens of the barangay.

Barangay Health Workers. Assessing the utilization of medicinal plants will

assist the health workers in addressing different health concerns and issues of

those residing in the barangay.

Political Importance

9
 Barangay Officials. The study on medicinal plant usage will aid the officials

in systematizing the health sector of the community and in providing feasible

solutions for the varying health problems within the barangay.

Intellectual Importance

Future Researchers. The findings of the study will serve as a reference for

subsequent research regarding the utilization of medicinal plants, for validating

and cross-checking information that may aid in formulating new theories or

solutions in the future.

By and large, the study seeks to promote awareness and use of medicinal

plants, as part of the initiative to alleviate the lack of access to healthcare in the

barangay and improve the overall wellness of the residents.

1.4 Review of Related Literature and Studies

1.4.1 Review of Related Literature

1.4.1.1 Foreign Literature

Access to Healthcare: The Global Perspective

In the face of a crisis threatening human civilization, it is no surprise that

medical services have become of great importance, from improving one’s

abilities, from common colds to surgical success, and to advance life-enhancing

treatments. However, there is still a hindrance these days that healthcare

services cannot accommodate everyone, especially those who need it most. In

a global report, it was found that 400 million people are short in access to

healthcare. Also, it has been observed that even the most disadvantaged

societies are those who are not provided even the basic needs of healthcare

10
regarding 37 countries that 6% of the population who are sunk into extreme

poverty because of having to pay for healthcare services (WHO, 2015). Even

so, some countries have taken the lack of medical access into account and

have provided citizens with a more affordable universal healthcare. For

example, Canada with its 1984 Health Act also known as Medicare, or Qatar,

France, and a policy for Norway of free access to healthcare for ages 16 and

below. Along with New Zealand, Belguim, Germany, Israel, Australia, Hong

Kong, Sweden, Netherlands, Japan, Switzerland, Singapore and Luxembourg

(Martin, 2017). Although, not only has universal healthcare been a necessity it

is now known as right in the country of Brazil, in which they both have a private

and public healthcare system; wherein 80% of their population depends on

public care (Park, 2012).

Herbal Medicines in China and its Uses

Since the 18th century, China has been widely recognized as the initiators of

the use of herbal medicine as a means of providing treatment to illnesses. This

dated back to the history in China due to the affliction of various moral beliefs

provided by Confucianism and its respect to the natural way of things (Alitto,

2015). Moreover, its effectivity could be proven through the wide use of the

herbal medicines from China as even the Western countries use such products.

Due to the infusion of the modernization from Western influence, and the

traditional ways in the Orthodox, China has discovered ways to combine the

traditional ways with the modernization in treating various health illnesses.

However, among numerous Chinese herbal medicines, three are most

commonly used nowadays (Liu, Tseng, & Yang, 2014).

11
 First, Chong Chi Tang is made up of Scallion and Prepared Soybean

Decoction. This herbal medicine is usually consumed in its decocted form to

treat common colds, headache, neck pain, back pain, and muscle pain. It

provides warmth when used and resembles the feeling of applying modern-day

metholated topical ointment.

Ma Huang Fu Zi Xi Xin Tang, on the other hand, is made up of Ephedra,

Asarum, and Prepared Aconite Decoction. This could be consumed in its

decocted form and is known to treat severe sore throat. This modernized herbal

medicine causes temporary numbness to ease the pain.

Lastly, Xiao Feng San, is made up of several Chinese herbal medicines. It

is made up of Jing Jie Sui, Bo He, Qiang Huo, Fang Feng, Chuan Xiong, Jiang

Chan, fried Chan Tui, Fu Ling, Chen Pi, Hou Po, and Dang Shen. This

modernized Chinese medicine is widely used to treat skin rashes, and itchiness.

In its powdered form, it could also be used to treat ringworm.

Overall, it could be seen that China has established its own name in terms

of herbal medicine. This, however, proves that different herbal medicines arise

per country. Nonetheless, it could be inferred, considering the large demand for

Orthodox Traditional medicine, that the use of herbal medicine is still widely-

sought in some countries across the globe.

Efficacy and Utilization of Traditional/Herbal Medicine across the Globe

Traditional medicine has long been recognized as a mainstay in the field of

healthcare. Archaeological evidence points to the usage of plants, in particular,

as therapeutic agents dating back to the prehistoric times in phytotherapy, or

12
the medical practice using plant-derived traditional approaches or knowledge

with a scientific basis. The first recorded uses of herbal medicine are as early

as 5,000 years ago in China (Rivera, et al., 2013). Cuneiform tablets of

Sumerians from 1600 BC highlighted herbal remedy specialists and medicinal

knowledge from Mesopotamia. In ancient Europe, Greek physician

Dioscorides compiled ‘De Materia Medica’ which became the primary source of

information regarding plant medicine until the Renaissance. Built on centuries

upon centuries of lore and tradition and a long history of popular use, supporters

of this practice have advocated its relative safety when used in common doses,

despite having insufficient scientific evidence. However, when extensive

experimentation on the medicinal properties of herbs was made possible

through the modernization of technology, a shift to rational phytotherapy based

on evidence as opposed to traditional knowledge has occurred. Nowadays,

traditional medicine, as well as complementary or alternative medicine, is

widely perceived and utilized as auxiliaries for conventional medicine (Royal

Pharmaceutical Society, 2012).

Over the years, the use of herbal medicine has gained considerable

popularity in both developed and developing countries across the globe. An

estimated 80% of the world’s entire population is thought to be using medicinal

herbs, particularly in the developing countries, wherein percentages can raise

to as high as 70 to 95 percent (Royal Pharmaceutical Society, 2012). In China,

40% of all healthcare services is constituted by herbal medicine use. In other

prominent countries, of their population, 70% for Canada, 75% for France, 48%

of Australia, 42% for USA, and 38% for Belgium has used herbal medicine

despite the availability of conventional medicine and good access to healthcare

13
services (Ekor, 2013). Meanwhile in middle-income countries with high

populations, it has been found that in India, 11.9% consider traditional medicine

as their primary source of healthcare, while in Ghana, Mexico, Russia and

South Africa, there is a much lower percentage of less than 3%. In addition, it

has also been noted that the socio-economically disadvantaged in the

aforementioned countries have a higher tendency of gravitating towards the

use of traditional medicine (Oyebode, et al., 2016).

Reasons of Using Herbal Medicine in a Developed, and a Developing Country

Despite the wide encompassment of the need for access to effective

healthcare, the varying factors that may have affected the health system of

each nation also causes the emergence of different reasons why individuals

across the globe may consider utilizing herbal medicines as alternative.

Nonetheless, it is a well-known fact that both developed and developing

countries see the utilization of herbal medicines as beneficial in providing

treatment to various illnesses. Thus, it is vital to know the reasons why every

individual, considering the differences in origin, exhibit specific levels of

inclination toward utilizing herbal medicine in improving the access to

healthcare.

In the developed countries, where the economic stature is stable and

continues to develop annually, the backbone of the economy is usually leaning

on the industrial sector to thrive (Gordon, 2012). This is heavily accounted to

the country’s ability to fund industries and establishments that give way for the

emergence of wide array of institutions like those offering educational,

recreational, and healthcare services. In the developing countries, however,

14
only the highly-urbanized places are able to sustain numerous establishments

and institutions which leave the rural communities with lesser evidences of

industrialization, making the access to primary needs more challenging than

thriving communities (Hatem, 2013). Moreover, despite the inevitability of the

need of the access to healthcare, the disparity in the access to healthcare in

different communities across the globe caused by the varying capabilities to

cope with advancements and the globalization is highly evident. Consequently,

in order to improve the access to healthcare, communities have learned to

adjust to human’s complexity by considering alternative methods to satisfy

one’s health needs. Hence, despite the disparity, the use of traditional

medicines has thrived among diverse communities – some of which are in the

United States of America, and Guinea.

In the United States of America, a developed country which ranks 37 th out

of 190 countries in terms of the best healthcare systems in the world, the

citizens of the aforementioned country are still inclined toward the utilization of

herbal medicine (The Patient Factor, 2017). Despite being a developed country

with the advanced technologies to mobilize healthcare services to the people,

such behavior in utilizing herbal medicine as alternative healthcare poses a

question. The presence of vast healthcare services in the aforementioned

country such as the 911 services should have made a huge impact in boosting

the country’s access to healthcare. This is aligned with the fast response of

ambulances in case of emergency that has saved numerous lives tracing back

to history (Rasmussen, 2012). However, the modernization may not be applied

to everyone as one out of five adults in the United States of America uses herbal

medicine as an alternative way of providing treatment to various illnesses

15
(Rivera, Loya, & Ceballos, 2017). In the most recent survey in 2012, it revealed

that the most popular reason of using herbal medicine for the adults is to ensure

good health. Out of over 863 respondents, 75% of the respondents voted for

the aforementioned reason. This covers the belief that using the herbal

medicine can improve energy, prevent or treat colds and flu, improve memory,

and prevent or treat serious illnesses (O’Mathuna & Larimore, 2012). On the

other hand, the same survey also revealed that some of the citizens of United

States of America prefer utilizing herbal medicine over prescription

medications. Over 43% of the respondents prefer natural products than the

over-the-counter medications. This is connected to the belief that natural

products are less harmful than the pharmaceutical drugs. Moreover,

approximately 86% of the Americans believe that consuming natural products

is automatically safe. Consequently, this boosts the population which uses

herbal medicines due to its naturalness. This could be proven as 14% of the

respondents in the survey believes that using herbal medicines is more

effective while 6% of the respondents asserts that using herbal medicines is

more gentle or mild. In addition 21% of the respondents believe that herbal

medicines have lesser side effects than the pharmaceutical drugs. Given the

presented data, it could be inferred that the adults in the United States of

America places the trust on herbal medicine due to its deemed effectivity and

naturalness. This, however, leaves the only economic reason, of being less

expensive than pharmaceutical drugs, with only 8% of respondents who

believes in the aforementioned reason. The reason is highly accounted to the

high economic stature of the United States of America, whereas, the income of

the middle class in the nation amounts to over $59,039 annually.

16
 Furthermore, aside from the economic disparity between the developed and

developing countries, the two classifications of the economic situation of the

country also allow the differences in terms of healthcare. Consequently, the

differences could be seen on the reasons why citizens of a developed country

use herbal medicines from the reasons why citizens of a developing country

use herbal medicines.

Using Guinea as an example, a developing country in West Africa, one out

of three patients in the country prefer using herbal medicine due to various

reasons (Colfer, 2012). Out of over 397 participants in the study, 74% believes

in the efficacy of herbal medicines. This suggests that more than half of those

who are inflicted with diseases are most likely inclined to use herbal medicine

in treating various illnesses. On the other hand, 70% uses herbal medicine

because of its high accessibility. Given the vast natural resources in the

country, it is highly expected for the citizens of Guinea to exhibit such behavior.

Furthermore, the country has yet to reach its peak in modernizing different

facilities which propel individuals to heavily rely on the natural products more

than the pharmaceutical drugs. On the other hand, for a developing country, it

is highly expected that economic reasons shall receive much attention. In this

case, for Guinea, the survey revealed that 48% of the patients use herbal

medicine due to its lower cost. This, however, leaves only 37% of the patients

who believes that herbal medicines could provide complete cure to various

illnesses. Nonetheless, there are other factors which affected the inclination of

the citizens of Guinea in using herbal medicine as alternative healthcare. Over

85% of the patients were satisfied with the results after using herbal medicine

17
which signifies its effectivity, while 78% of the patients were deeply persuaded

by the firsthand users of the herbal medicine.

Thus, given the aforementioned reasons why citizens of a specific

country, developed and developing countries in particular, it could be inferred

that there are wide differences given the diverse contexts per country. The most

evident difference, however, was the economic disparity, whereas the citizens

of the developing country value the expenses it may deal than those living in a

developed country. The general differences, nonetheless, may suggest that the

factors affecting one’s frequency of utilization of herbal medicine, too, may differ

per community given the circumstances a community faces.

Good Health as United Nations Sustainable Development Goal

The United Nations envisions a world with improved access to healthcare

services and universal health coverage for the countries across the globe.

Consequently, the United Nations conceptualized the third sustainable

development goal, Good Health and Well-being (United Nations Development

Programme, 2018). With the hopes of combatting pandemics that have caused

the deaths of millions worldwide, some of which are AIDS, Tuberculosis, and

Malaria, it is highly expected that once every nation contributes in the

attainment of the aforementioned sustainable development goal, by 2030, there

would be a massive change in the global statistics in terms of health.

Furthermore, the world has witnessed the declination of child mortality rate

since 1990. However, the problem regarding health still persists as more than

6 million children die every year which is heavily accountable to the preventable

diseases like measles and tuberculosis – diseases that see the death of

18
approximately 16,000 children every day. These diseases, however, could

have been avoided had there been an easier access to medicine and vaccines

for the people. As a result, the United Nations Development Programme has

emphasized the sole prerequisite for the sustainable development goal to

materialize and be felt across the globe.

In the pursuit of improving the state of health across the globe, it is

imperative for every nation to improve the access to healthcare services before

expecting any health improvement (United Nations Development Programme,

2017). The improved access to healthcare services, however, encompasses

the achievement of universal health coverage, financial risk protection, access

to quality healthcare services, and access to safe and effective medicines and

vaccines. In addition, this does not disregard the possibility of utilizing

alternative medicines in order to mobilize healthcare especially among the

marginalized communities. Nonetheless, this method should involve the

medical practitioners’ recommendation for effective usage.

The components of improving the access to healthcare should be met in

order for a nation to be classified as one of the countries which has improved

access to healthcare. First, the universal health coverage pertains to how every

individual despite the differences in financial stature receives benefits in

accordance to a country’s statue on health. This implies that even the

marginalized communities should receive equal treatment like that of those who

are in the middle-class and the elites (World Health Organization, 2017). On

the other hand, access to healthcare could easily be improved once there is

financial risk protection. This component ensures every individual a justifiable

cost for treatments to various illnesses including the treatments in different

19
form, specifically, the traditional methods to address one’s health needs

(Saksena, Hsu, & Evans, 2014). Third, the access to quality healthcare services

include how one could easily receive treatment for various health causes. This,

however, requires the sufficient equipment and knowledge in using the

technology in order to treat individuals inflicted with diseases. Generally, this

component requires both the manpower and the effective use of the innovations

in order to satisfy the requirements of the component (World Health

Organization, 2012). Lastly, the main focus of the prerequisite, access to safe

and effective medicines and vaccines. This component covers how medicines,

which are tested and proven to be effective, reach all walks of life of the different

sectors of the community (Rago, Sillo, Hoen, & Zweygarth, 2014). Hence, once

the given components are satisfied and met, the materialization of the

improvement of access to healthcare could easily be realized.

Overall, it could be inferred that it is extremely integral for a nation to improve

the access to healthcare in order to fully contribute in the attainment of the

sustainable development goal. This, however, could not be achieved until the

components of the prerequisite are satisfied and met. Thus, every nation must

take into consideration the components of the prerequisite in order to see the

materialization of the sustainable development goal, Good Health and Well-

Being.

1.4.1.2 Local Literature

Access to Healthcare: The Philippine Perspective

Undeniably, the Philippines is the second largest archipelago in the planet,

with over 7,107 island and a population of 92.3 million during 2010 with a growth

20
rate of 1.9% per year (WHO & DOH Philippines, 2012). Although, despite that

the Philippines have a national health insurance agency – PhilHealth, it has

resulted into a high out-of-pocket payment due to the limited span and depth of

coverage (David, et al., n.d). The totality of the country’s health expenses grew

from Php 593 billion in 2015 to Php 655 billion in 2016, and that the household’s

out-of-pocket payment had the highest expenses of Php 342 billion or 54.2%,

with government schemes coming in second with a Php 216 billion or 34.2%,

and voluntary healthcare payment with a Php 73 billion or 11.6% in totality

(Bersales, 2017). Consequently, due to the fact that the Philippines is currently

a middle class country, most of the citizens reside in rural areas with barely any

healthcare facilities open for the public for places like Barangay Lapolapo I San

Jose, Batangas. Also, traditional medicines is widely practiced across the

country, and have been used for thousands of years in order to provide the

most basic of healthcare, which is the responsibilities stated in Traditional and

Alternative Medicine Act of 1997. Consequently, herbal medicines are

regulated and are listed in the Philippine National Drug Formulary, with over

2,000 herbs identified. Needless to say, herbal medicine has given rural areas,

and financially troubled citizens a better chance at attaining basic healthcare

services (WHO & DOH Philippines, 2012). Nonetheless, despite identifying

over 2,000 herbs, only ten medicinal plants were proven to provide treatment

to various illnesses such as akapulko, ampalaya, bawang, bayabas, lagundi,

niyog-niyogan, sambong, tsaang gubat, ulasimang bato, and yerba buena.

Herbal Medicines in the Philippines and its Uses

Given the abundance of natural resources in the Philippines, ranging from

the wide lands and rich waters, it is virtually impossible for the nation to see the

21
absence of herbal medicines. The increasing use of traditional medicine in

providing treatment to various illnesses is heavily accountable to the

excessively high cost of medicines in the market. In addition, traditional

medicine has been a way for individuals to access healthcare even in its

alternative forms. In contrary, medicinal plants are easy to find because of the

fertile lands in the Philippines where herbal medicines are more likely to grow.

Moreover, more than 1,000 herbal medicines could be found in the Philippines.

However, only 10 herbal medicines have been scientifically approved by

Department of Health, The National Integrated Research Programme on

Medicinal Plants, Philippine Council for Health Research and Development,

and the Department of Science and Technology. In this regard, communities in

rural areas have used the traditional medicines more; however, such behavior

in the rural areas does not encompass all communities even the presence of

the dire need for access to healthcare. Nonetheless, these plants are highly

recommended to the public given the involvement of medical practitioners’

recommendation (Sia, Galvez-Tan, 2014).

First, Akapulko or also known as Cassia alata is easily found in the

Philippines. Usually, this herbal medicine is often mistaken as a decorative

plant due to its attractive flowers which come in vibrant yellow. However, this

herbal medicine is known to treat asthma and bronchitis, and is also used as

ingredient in shampoos, soaps, and lotions. Nonetheless, its leaves contain

chrysophanic acid, which is handy in treating fungal infections like ringworms,

and eczema.

On the other hand, Ampalaya or also known as Momordica Charantia is a

medicinal herb found it tropical countries. In the Philippines, this is used as an

22
ingredient in many native dishes. Its bitterness, however, is proven to lower

sugar levels, and counter diabetes.

In addition, Bawang or Allium sativum L. is widely known across the globe

to serve as a spice to various dishes. However, aside from its natural flavor,

this plant could also be used as a means of providing treatment to various

health causes. This herbal medicine is proven to reduce cholesterol level in

blood, and treat infections.

Moreover, Bayabas or psidium guajava is a medicinal plant which is easy to

be found in tropical countries especially in the Philippines. Its leaves are usually

used as a substitute for toothpaste. In addition, it has been proven that chewing

its leaves is a way in order to treat toothache and gum swelling.

Next, Lagundi is also known as Vitex negundo. This shrub could easily be

seen in some countries in Asia and Southeast Asia particularly in India, and the

Philippines respectively. The use of this herbal medicine could be extracted in

its leaves and roots which is proven to prevent or to cure asthma and coughs.

Furthermore, Niyog-niyogan or also known as Quisqualis indica is a large

climbing, woody shrub that is native in Southeast Asian countries including the

Philippines, Myanmar and Malaysia. Nonetheless, this herbal medicine could

also be found in other tropical countries like India, and South Africa. This is

highly publicized by the Department of Health due to the flowers’ deworming

properties, and are also proven to cure headaches, fever, and inflammation of

kidneys.

In connection, Sambong or also known as Blumea balsamifera L. DC, a

medicinal herb, could easily be found in tropical countries like the Philippines,

23
India, and Africa. This medicinal herb is proven to treat kidney stones, coughs

and colds, hypertension, and provide first aid to wounds and cuts.

Similar to the local context, Tsaang gubat or also known as Carmona retusa

is one of the 10 herbal medicines recommended by the Philippine's Department

of Health for safe use. This medicinal herb, like sambong, is usually found in

tropical countries in Asia. Using its leaves, Tsaang gubat is proven to cure

cough, diarrhea, and even diabetes.

Nonetheless, Ulasimang bato or Pansit-pansitan or also known as

Peperomia pellucida is also a common herb in the Philippines. This herbal

medicine is known to increase the mobility of individuals as Ulasimang bato or

Pansit-pansitan is widely used in treating arthritis and gout.

Lastly, Yerba buena or mentha arvensis linn is known for its minty flavor and

aroma. This plant grows across the globe especially in North America and Asia.

This herbal medicine needs to be boiled and is proven to be an effective

treatment to headaches, toothaches, and joint pains. Some studies, however,

suggest that Yerba Buena could cure stomach aches.

Generally, the 10 aforementioned herbal medicines have passed through

studies in the Philippines. Thus, the herbal medicines could be widely used in

order to treat various illnesses especially in the Philippines where such

resources are abundant.

Efficacy and Utilization of Traditional/Herbal Medicine in the Philippines

It is evident in history that Filipinos have always had a great inclination

towards traditional medicine, and the use of medicinal plants as a source of

24
healthcare. As a melting pot of various different cultures spanning from pre-

colonial, Chinese, Christian, Islamic, Spanish, to American, the Philippines

serves as home to various medical practices and traditions founded upon

different belief systems. Practitioners like the mumbaki, babaylan, and

albularyo played a vital role in providing prevention measures and treatment for

various illnesses when modern medicine was not yet available (Mendoza,

2016).

In the present times, herbal medicine and other alternative healing practices

are still being considered as a supplement for modern medicine in helping

diagnose, prevent, treat or alleviate both physical and mental ailments. It is

especially valued in palliative healthcare, wherein patients with terminal

illnesses are given other options which will help alleviate the pains that

conventional medicine can no longer remedy. Herbal medicine, Chinese

traditional medicine, homeopathy, chiropractic, Ayuverda, and acupuncture are

some of the traditional and complementary medicines that an estimated 70%

of the Filipino population are known to be patronizing. nizing. However, while

the use of alternative medicine has been steadily flourishing, herbal medicine

has not been receiving the same increasing positive reception. Of the 70% that

uses traditional and alternative medicine, only 20% admitted to utilizing

medicinal plants for treatment (World Health Organization and Department of

Health, 2012). This can be attributed to different circumstances such as

perception towards herbal medicine and lack of awareness and knowledge of

preparation methods of medicinal plants in certain rural communities (Baleta,

et al., 2016), thus leading to lower inclination towards the utilization of herbal

medicine.

25
Reasons of Using Herbal Medicine in the Philippines

The use of traditional medicine in the Philippines is commonly perceived as

a rural custom, but the knowledge and utilization of the aforementioned remedy

in the urban areas can also be observed. As can be gleaned on the country’s

historical background, the use of medicinal plants has been part of the culture

of many indigenous and ethnic groups since the late 18th century (Madelano et

al., 2015). Moreover, traditional remedies in the form of herbs were used in the

remote communities who have limited access to pharmaceutical medications.

People in the province preferred using medicinal plants even before western

pharmaceutical companies manufactured drugs from plants for the following

reasons: first, the herbal plants are widely available in the community; second,

the various preparations made from the aforementioned herbs work for

common illnesses such as cough, diarrhea, fever, wounds or massaged to

relieve the pain associated with osteoarthritis; lastly, the herbal counterpart is

cheaper than the processed medication made by foreign pharmaceutical

corporations (Lim-cheng et al., 2014). However, despite the strong inclination

of the aforementioned treatment to the Philippine culture, it cannot be denied

that in the present times, herbal medicine is being neglected and consequently

lost touch with its traditional herbal heritage. The knowledge about modern

medicine has started to reach many marginalized communities, and local

knowledge of herbal medicine is slowly fading away (Hartanto et al., n.d.). While

many benefits can be derived from the use of herbs, potential negative

outcomes from the use of it started to spread which leads to depreciation and

loss of value in some rural communities (Morilla et al., 2014).

26
Philippines’ Take in the Attainment of Good Health, a Sustainable

Development Goal

In the quest to improve the access to healthcare and promote Good Health

and Well-being among individuals across the globe, through the United Nations,

it is highly expected that each nation shall give prime on the aforementioned

sustainable development goal. However, in the local context, the Philippines

chose to give more attention to other areas specifically in rapid poverty

reduction, massive employment generation, social inclusion, effective risk

reduction management, and environmentally sustainable development, from

which the promotion of good health and well-being is nowhere to be found

(Balisacan, 2015).

Amidst the evident need of the country to give attention to the health aspect

of the Filipinos, the priorities of the government in financing different causes still

do not cover health. This is despite the fact that over 2,403,900 people are born

every year, while 582, 700 of the same number die upon birth. In addition, the

leading cause of death among adult Filipinos include the heart disease which

sees the death of over 87,900 people in 2012, tuberculosis which placed the

lives of over 26,200 people at the expense during the same year, 15,900 deaths

are accounted to kidney failure, and over 12,300 deaths are caused by asthma.

Throughout the years, the deaths caused by the same diseases have risen by

as much as 2% given the newly-introduced products and methods to counter

the aforementioned diseases. Given the aforementioned numbers, it could be

inferred that the Philippines highly needs support in the improving the state of

health of the Filipinos (World Health Organization, 2015). Nonetheless, the

absence of health in the top priorities of the government in line with the United

27
Nations Sustainable Development Goals caused only the partial fulfillment of

the prerequisite of the promotion of Good Health and Well-Being.

Thus, the presented data reveal that the Philippines poses urgency in terms

of the country’s health aspect. As a response, it is vital for the nation to address

the problem by giving prime to the promotion of Good Health and Well-being in

line with the attainment of sustainable development as foreseen by the United

Nations.

1.4.2 Review of Related Studies

1.4.2.1 Foreign Studies

Frequency of the Utilization of Herbal Medicine in connection with Age, Sex,

Highest Educational Attainment, Estimated Monthly Family Income in

Developed and Developing Countries

Throughout the history, plants have been widely used for both nutritional and

medicinal purposes. Medicinal herbs are plants or parts of plants such as the

roots, leaves, and stems which have organic chemicals with effective healing

properties and immunity to contamination, deterioration, and disparity in

composition (Goelz, S., 2013). Due to these, herbal plants gained substantial

historical use in spite of great developments observed in conventional medicine

in the past years.

Various factors have been determined to affect a citizen’s inclination in using

medicinal herbs, namely a person’s age, sex, highest educational attainment

and monthly family income (Waasie, S., Aragie, L., Taye, B., and Mekonnen,

L., 2015). Herbal medicines are great in demand not only in the developing

countries but also, in the developed countries due to its reliable safety and

28
efficacy (Hussain, S., 2013). In fact, the gap between the frequency of utilization

of herbal medicine in developed and developing countries appears to be an

unnoticeable fine line. For instance, Kenya, a developing country, depends on

herbal medicines to meet healthcare needs (Ondicho, J., Ochora, J., Matu, E.

and Mutai, J., 2015). Specifically, 68.9% have a positive attitude toward the

utilization of herbal medicine.

Elaborating the data, 87.50% of those belonging to the age group from 60

and above prefer to use herbal medicine, which may be a manifestation of older

people being traditionally and culturally inclined with the beliefs and traditions

in using herbal medicines (Rivera, J., Loya, A., Ceballos, R., 2013). On the

other hand, the lowest percentage of individuals who favor the utilization of

alternative medicines belong to the age group of thirty-one to forty years old

with only 61.50%. This is because this age group has all the means such as

money and transportation in having the proper medication in esteemed

hospitals and clinics.

Furthermore, as sex was also discovered to be one of the factors of

one’s inclination in the utilization of herbal medicine, it is vital to take into

perspective this demographic variable to determine the difference of male and

female in terms of using alternative medicines for healthcare needs. It was

revealed that the percentage of men, being at 70%, when it comes to the

inclination in using herbal medicines is much higher as compared to women at

67.20%, which may indicate that women living in Kenya are less likely to

consume herbs as medicine.

In addition, respondents who did not undergo formal schooling received the

highest percentage of inclination to herbal medicines with 83.30% because

29
herbs are much more affordable considering the financial status of not being

able to receive formal education. On the other hand, the group with the least

frequency of utilization of herbal medicines are those who graduated in tertiary

level at 44.40% because professionals trust hospitals more than the

naturalness of the herbal medicines.

Nonetheless, in terms of the estimated monthly family income of the

residents in Kenya, it could be seen that the socio-economic factor, the income

greatly affects the inclination to utilize herbal medicine as alternative healthcare

in treating various illnesses (Gatheru, 2012). 63% of those who are earning less

than or equal to 5,000 Kenyan Shilling is utilizing herbal medicine. This is a

relatively high percentage as the leading factor to consider utilizing herbal

medicine is its affordability compared to the expensive pharmaceutical drugs.

On the other hand, those who earn more than 25,000 Kenyan Shilling recorded

only 13% of the individuals who is utilizing herbal medicine. The group of people

who earn more than 25,000 Kenyan Shilling are considered as the individuals

who could afford professional healthcare services in private healthcare

institutions.

On the other hand, in the developed countries, the use of herbal medicines

still thrive despite the dominant presence of the modernization and rapidly

emerging innovations, specifically in Canada (Williams, A., Kitchen, P., & Eby,

J., 2012). Different variables, such as age, sex, highest educational attainment,

and estimated monthly family income, have been proven to directly affect the

inclination on the utilization of herbal medicine.

In terms of age, 68% of the population in Canada, whose age belongs to the

classification “65 and over,” is using herbal medicine as an alternative way for

30
treatment. This is heavily accountable to the traditional ways that emerged

during the earlier times prompting the individuals to incline more on the

traditional methods than the newly-introduced pharmaceutical drugs. On the

other hand, 54% of the females is using herbal medicine while only 24% of the

males use herbal medicine. Unlike in Kenya, Canadian women see the

utilization of herbal medicine as a means to heal wounds from pregnancy, while

consuming herbal medicine in treating common illnesses only ranks second for

the aforementioned sex. Moreover, in terms of the highest educational

attainment, those who were unable to finish high school recorded the highest

inclination in utilizing herbal medicine. 83.7% of those who only finished

elementary is using herbal medicine as an alternative while only 12.3% of those

who are pursuing graduate studies is using herbal medicine. This implies that

the educational attainment greatly affects an individual’s ability to have access

to the modernized ways of treating illnesses including professional healthcare

services and pharmaceutical drugs. In connection, the estimated monthly family

income of the respondents clearly made an impact in the inclination of utilizing

herbal medicine. 87% of those who earn less than 20,000 dollars is utilizing

herbal medicine while only 29.6% of those who earn more than 80,000 dollars

is utilizing herbal medicines. Likewise, this demographic variable sees the

affliction of one’s capability to have access to either the less expensive methods

of getting treated or the modern way of treating illnesses which is more

expensive.

Overall, the presented data clearly imply that there is the slightest difference

in terms of how the demographic variables affect the utilization of herbal

medicine in the developed and developing countries. Nonetheless, it cannot be

31
denied that the presented data also signify that despite the economic disparity

between the two classifications of nations, the use of herbal medicines still

thrive given the presence of modernization.

Factors Affecting the Frequency of Usage of Herbal Medicine across the Globe

Whether a citizen never, seldom, often, or always uses herbal plants in order

to treat an illness, there will always be a factor influencing each of the frequency

levels mentioned; whether it is based on personal, behavioral, or environmental

factors, an individual utilizes traditional medicine because of the

aforementioned factors.

One of the factors include considering herbal medicine to be cheaper than

those of the medicines available in drugstores, and based on the study by Elvis,

Michael, Patrick, Dorcas, and Eunice (2013), 36.67% of its thirty respondents

chose to use traditional medicine because “it is cheaper.” This may imply that

citizens prefer traditional medicine over alternative medicine because it has a

lower price. Furthermore, 50% of the research’s respondents agree that herbal

medicines “provide better cure” than those which can be bought from

drugstores. This may indicate that the residents of Agogo Gyidim Community

experience more effectivity in healing when using herbal plants as medicine

than alternative medicines. Lastly, 60% of the respondents of the

aforementioned research claim to be cured from illnesses after using traditional

medicine. This may suggest that herbal medicines are indeed effective when

curing specific types of sickness, especially to the residents of the said

community.

32
 Other factors were coined based on the research entitled “Factors

Associated with Use of Herbal Medicine among Patients in Herbal Clinics in

Gucha District, Kenya” by Ondicho, Ochora, Matu, and Mutal (2015) including

the impact of the respondents’ relatives when it comes to utilizing traditional

medicine because 37.7% of 167 respondents claimed to be influenced because

the respondents’ kin were using herbal plants as medicines, this factor has the

highest percentage among the other factors mentioned in the aforesaid study.

This may infer that citizens are undeniably trusting of relatives’ decisions as to

curing sicknesses. Additionally, 27.5% of the respondents seemed to use

traditional medicine because of its “minimal side effect” in terms of curing an

illness. This may be strengthened using the research conducted by Githinji

(2014) because 59.8% of its 323 respondents said that using traditional

medicine does not produce any side effects to the user. This may indicate that

alternative medicines are not being chosen by citizens because utilizing

traditional medicine may be proven to be effective with less side effects in a

sick person’s body.

Advertisements can also be a factor to be considered when utilizing

traditional medicines to cure specific illnesses. It has been proven in the

research done by Opara and Osayi (2016) because according to 45.1% of its

600 respondents, these individuals use herbal medicine because it has already

been featured in magazines, books, televisions, and the radio. This may be

denoted that citizens are being influenced of the adverts which made them

decide to use traditional medicine instead of alternative medicine.

To recapitulate, the factors that influence the utilization of traditional

medicine for the respondents of the mentioned studies are affordability,

33
effectivity, influence, and safeness. These influences may be able to create an

impact to the citizens of Barangay Lapolapo I, San Jose, Batangas because

even if alternative medicine also possesses such qualities, considering

Barangay Lapolapo I as a rural community, it may be more practical for the

aforementioned barangay to utilize traditional medicine instead of alternative.

Ways to Improve the Access to Healthcare

The utilization of alternative medicine is indisputably widespread throughout

the whole nation because of the continuous globalization and modernization in

order to supply to the needs of the people of the 21 st century. However, the use

of traditional medicine must not be gradually brought into a halt not only

because herbal products may be a barricade in the phase of modernization.

Canada, being on the 16th place among the list of countries in the whole

world with the best healthcare systems (Martin, 2017), is one of the nations that

utilize herbal medicine up to this day. During 2004, the government of Canada

has institutionalized a healthcare system that will help its citizens utilize herbal

products in various uses – whether as a food, vitamins, medicine, and other

products like amino acids and essential body fats (Wallace, Boilard, Eagle,

Spall, Shokralla, & Hajibabaei, 2015). The licensed products are sold in an

affordable price and can be bought even without a physician’s prescription for

it is found to be “safe, effective, and of high quality under the recommended

conditions of use” (Smith, Jogalekar, & Gibson, 2014). Furthermore, Canada

consumes its natural resources at its extent by providing its people the

healthcare service the citizens deserve; products that are licensed to be Natural

Health; and products which are made from marine and plant sources for

34
omega-3 and essential fatty acids, fiber, antioxidants, and protein (Malla,

Hobbs, & Sogah, 2013). Thus, it is evident that even developed countries with

one of the best healthcare services in the world like Canada prioritizes the

utilization of herbal products in order to promote its citizens well-being.

The predominant utilization of herbal medicine, nonetheless, does not only

discontinue in the developed countries but also in the countries that are yet to

be developed. For instance, the country of Suriname in South Africa, being

identified as a developing country, highlights the usage of traditional medicine

among its citizens. According to the research conducted by Andel and

Carvalheiro (2013), 86% of the 270 respondents of the study utilizes herbal

medicine. The respondents’ motives in using traditional medicine circulated

around being accustomed to using herbal medicine, which obtained 92 votes

from the 213 respondents who uses herbal medicine, seeing better results in

using herbal medications than using alternative medicine, which acquired 71

votes, and experiencing no side effects in utilizing herbal medicine, which

gained 51 votes. Therefore, given the adversities that the country of Suriname

is lacking the access to modern healthcare, the community utilizes its natural

resources in order to treat specific illnesses of its people and keep its tradition

in using herbal medicine as a source of medication.

Developed countries that are currently facing globalization and

modernization like Canada still promotes the usage of herbal products not only

because the country desires to utilize its natural resources but also because it

wants the citizens to become healthy through the use of herbal products with

various vitamins needed by the body. On the other hand, developing countries

which are still trying to adapt to the changes brought about by globalization and

35
modernization like Suriname does not disregard the utilization of traditional

medicine because of the medicine’s effect on its people. Hence, the difference

is nonexistent when it comes to the utilization of traditional medicine in

developed of developing countries. The factors influencing the utilization of

herbal medicines may vary, but it is unquestionable that whether a country is a

first-world country or not, the nation still chooses to utilize herbal medicine

because it is proven safe and effective among its citizens.

1.4.2.2 Local Studies

Frequency of the Utilization of Herbal Medicine in connection with Age, Sex,

Highest Educational Attainment, Estimated Monthly Family Income in the

Philippines

Developing countries experience a strong reliance on the utilization of

medicinal plants as a pillar of medical healthcare. However, there are specific

factors that affect the citizens’ inclination on the utilization of herbal medicine

per country. Nonetheless, the Philippines is not an exemption from the

countries whose citizens’ inclination on the utilization of herbal medicine is

heavily affected by the demographic variables such as age, sex, highest

educational attainment, and estimated monthly family income.

In a study conducted by Roces and Torres (2014), 34.4% of the respondents

aged 21 to 34 years old had the most positive attitude toward the utilization of

medicinal herbs. On the other hand, the age bracket of 61-70 recorded only

6.3% of individuals who has a positive attitude in utilizing medicinal herbs.

Despite contradicting the studies in different countries, this is heavily accounted

36
to the adult Filipinos’ dependency on the services of the limited healthcare

institutions in the Philippines.

In terms of gender, 65.6% of females have a higher level of positive reception

in using herbal medicines while the males only recorded a total of 6.3% out of

222 respondents who has utilized herbal medicine. This indicates that Filipino

women support the usage of herbal medicines more than Filipino men because

mothers are more hands-on in addressing health problems in the family in the

Philippine context. Moreover, this is greatly affected by the reason that Filipino

women want to manage self-treatment by using herbal medicines more than

consulting medical practitioners.

With regards to educational attainment, those who are elementary

graduates, with 40.6%, have the highest probability in using medicinal herbs for

healthcare purposes because they exhibit the highest level of perception in

using herbs as medicines. On the other hand, those who are college graduates,

with 6.3%, have the lowest possibility in considering the usage of herbal

medicines. This is similar to the case in the developed countries as the highest

educational attainment of an individual highly affects one’s ability to access

either professional healthcare services or the traditional methods of treating

various illnesses.

Similarly, 63.2% of those who are earning less than 10,000 pesos has

considered using herbal medicine. This leaves those who earn more than

60,000 pesos with only 29.1% of the individuals using herbal medicine. The

large difference in the data imply that the economic factor greatly affects one’s

perception about utilizing herbal medicine as alternative means of treating

various illnesses. It could be inferred that in the Philippine context, those who

37
generate more income are less inclined on using traditional medicines than the

low-income earners.

Clearly, it could be seen that given the differences in terms of age, sex,

highest educational attainment, and estimated monthly family income, there are

also differences which arose in terms of the inclination on the utilization of

herbal medicine. Nonetheless, despite the statistical differences in each

demographic variables’ variations, it cannot be denied that there are different

factors that affect the inclination on the utilization of herbal medicine in the

Philippines.

Factors Affecting the Frequency of Usage of Herbal Medicine in the Philippines

In a developing country like the Philippines, it may be unquestionable that

the factors that influence the utilization of herbal medicine is no different than

of the factors that influence the utilization of herbal medicine in developed

countries. As a country known for its bountiful natural resources, herbal plants

are indeed abundant in the aforementioned country for it is mentioned in various

studies like Stuart (2017) that as of the latest update, there are 1,100 herbal

plants discovered and utilized in the Philippines. Thus, the usage of herbal

medicine may be prevalent because of a citizen’s personal factors, behavioral

factors, and environmental factors.

Affordability have always been the main reason why the citizens use

traditional medicine in order to treat specific illnesses because according to the

thesis entitled “Medicinal Plants and Other Forms of Traditional Medicine Used

by the Residents of Dasma 3 Golden City, Barangay Salawag, Dasmariñas

City, Cavite” conducted by Atrillano & Cipriano (2014), 16% of 20 respondents

claim to use herbal medicines because it is cheaper than of the alternative

38
medicine. This may imply that citizens prefer herbal medicine because of how

accessible it may be acquired through its affordability. Another reason is

because herbal medicines have no harmful chemicals which obtained 14% of

the respondents of the aforementioned study. This may suggest that citizens

are more into natural products because it has minimal side effects than of the

alternative medicine. Furthermore, not only is the safety of traditional medicine

the reason why individuals utilize herbal medicine but also its effectivity.

According to 12% of the respondents of the study, herbal medicines are stated

to be effective as a cure to specific illnesses like cough, runny nose, or stomach

pains. This may indicate that citizens utilize herbal medicine for it is an efficient

source of treatment. Lastly, 12% of the respondents say that they utilize herbal

medicines because it is the only kind that is available. This may signify that the

residents of the community choose to buy and use herbal medicines because

alternative medicine is not accessible in the residency.

Similarly, a research that Catublas (2016) conducted suggests that 30

respondents agree that herbal medicines are more effective than alternative

medicine. This may indicate that when treating specific illnesses, using

traditional medicine is what the residents prefer when curing sicknesses that

require first aid. Furthermore, the respondents of the said research strongly

agree that herbal medicine tend to be less expensive than of alternative

medicine, thus, leading to the utilization of traditional medicine. This may

suggest that not only do the residents use herbal medicine because it may be

more effective than conventional medicine, but the citizens also use herbal

medicine because it costs less than of the conventional medicine. In addition,

the respondents agree that it is not dangerous to utilize traditional medicine

39
while using alternative medicine. This may mean that even if a citizen is

currently practicing on using alternative medicine, that individual may use

herbal medicine alongside utilizing conventional medicine because of its

minimal side effects. Lastly, having to teach the respondents’ children on how

to utilize herbal medicine may be considered as a practice to the respondents

of the study because most of the respondents strongly agree to educating

children in using traditional medicine. This may indicate that citizens are willing

to pass on the utilization of herbal medicine to one’s offspring in order to instill

in the youths' minds that there are still other ways to cure illnesses other than

alternative medicine.

Various explanations have been identified as to why citizens utilize herbal

medicine, and this include affordability, safeness, and effectivity. Consequently,

the aforementioned factors may pave way in the emergence of the utilization of

traditional medicine especially in rural areas like Barangay Lapolapo I, San

Jose, Batangas though through globalization and modernization, the use of

alternative medicine is most prevalent. Furthermore, in remote places just like

the abovementioned community, it may be seemlier for the residents to utilize

traditional medicine instead of alternative medicine because using herbal plants

as medicine may be more accessible to the citizens.

Ways to Improve Access to Healthcare in the Philippines

Healthcare has been a pressing problem in the developing countries. Access

to healthcare system is a key to obtain the attention that maintains or improves

health status of individuals in search of care (Peabody, J., Taguiwalo, M.,

Robalino, D., et al, 2012). However, simple access is not enough for the

40
improvement and development of healthcare, therefore, improving the access

to medical healthcare is vital for the addressment of healthcare needs of

citizens.

In the Philippine context, health status has been improved for the past years

but not as much as other countries. Long-term objectives and measures has

been implemented in the country to ensure the health of Filipinos such as

PhilHealth, Maxicare and Medicare. However, despite the efforts exerted by the

government and other remarkable health institutions within the country,

Philippines’ access to health care is still insufficient and inefficient in terms of

the number of people covered, benefits assured to each group, and the quality

of such services (Cetrangolo, C., Lago, C., Lazaro, G., Carisma, S., 2013).

Expounding the data, there is an extreme gap between the registered

population and those who are eligible to use the benefits (Cetrangolo, C. et al

2013). This is due to the growing population of the Philippines in the past

decades wherein the health sector has not kept up with. Thus, healthcare

provider coverage expansion and beneficiaries selection improvement are

considered as pillars to the improvement of access to health care. For instance,

civil society groups such as religious bodies, non-governmental organizations

and cooperatives should be encouraged to participate in the provision of

healthcare because these groups play a key role in promoting the principles of

equity and solidarity in society. These organizations need to participate in

national dialogues to advance the extension of coverage to excluded groups

and to explain the functioning of the system and the use of health services.

41
 Since the aforementioned dimensions are not independent, it is also critical

to expand the coverage of the healthcare programs and provisions. This is to

deal with the limited benefits guaranteed to the citizens. Subsequently, most of

the healthcare providers have restricted facilities and services. Therefore,

improvement of service coverage should be prioritized as well. For instance,

the outpatient consultation and routine diagnostic services should be offered to

all members in order to achieve fairness across programs. Also, the inclusion

of drugs and medicines in the outpatient benefit package needs to be secured

given that drugs and medicines account for approximately 50% of total out-of-

pocket health expenses of households.

Furthermore, the quality of healthcare services also remains inconsistent

across the country with the inefficient decentralization of healthcare functions

and resources. Inequality among the different regions and provinces of the

country is evident as 67.5% in Northern Mindanao are covered but only 17.5%

in ARMM are ensured with the healthcare benefits (Cetrangolo, C. et al 2013).

With this, covering the existing gaps in service delivery capacity, particularly in

some regions, often the most deprived and underserved in the country and

searching for new methods of transporting resources to these areas are

necessary. Moreover, incentives that allot expenditure in order to expand

service provision for the underprivileged should be integrated.

To strengthen all these ways in improving access to healthcare in the

Philippines, the government should do its part as well. These are increasing the

public spending on health, designing public policies that predict future changes

in the demand of intervention and evaluating the possibility of incorporating the

performance-based grants, as positive incentives, to local efforts in order to

42
improve governance, local revenue mobilization, and matching grants that

balance fiscal capacities of local governments. The Philippines has started

mobilizing healthcare services by approving the use of herbal medicines with

the help of Department of Health. However, its implementation and guidelines

should be revived especially in times when modernization causes the gradual

declination of the traditional ways. Lastly, the Department of Health’s

coordinator role accompanied by the administration of financial resources who

guides the system should be empowered.

Thus, it could be inferred that there are many ways in order to improve the

access to health care. However, the efforts must come from both the

government and other sectors of the civil society in order to see the changes

sooner. The Philippines already has its foundations; therefore, it is imperative

for the nation to let the foundation prosper in the form of improved access to

healthcare services.

1.4.3 Synthesis

With the accumulation of information coming from different reliable

published sources locally and internationally, a general understanding of the

topic of herbal medicine and healthcare can be consolidated.

Regarding the public’s access to healthcare, the literature demonstrates that

despite the ever-increasing importance of healthcare with the passage of time,

many countries still experience difficulties in providing the appropriate services

and treatment required to address the needs of the citizens. In particular, the

costliness of healthcare services has led to exorbitant expenditures in the

Philippines (David, et al., n.d) and indigence in other countries (WHO, 2015).

43
While a few countries can afford to provide inexpensive healthcare, the likes of

the policy of the Norwegians and the Canadians (Martin, 2017), the Philippines,

in comparison, does not exhibit the economic capability to mimic the policies of

other developed countries, given its middle-class status. Contrary to the

organized public healthcare systems in Brazil (Park, 2012), rural communities

in the Philippines face the brunt of the country’s difficulties of providing

accessible healthcare, which the government attempts to augment through the

promotion of herbal medicine and other traditional medicine as alternative

source of healthcare (WHO & DOH Philippines, 2012). In accordance to what

was stated, it can be inferred that the matter of improving the accessibility of

healthcare for the public is still widely considered as a struggle which requires

attention necessary for refining the state of living across the globe, most notably

those of lesser-developed nations.

Despite these growing healthcare issues, however, the enduring prevalence

of herbal medicine is brought to light. Similar to China - an established pioneer

of the use of herbal medicine particularly in the forms of Chong Chi Tang, Fu Zi

Xi Xin Tang, and Xiao Feng San (Liu, Tseng, & Yang, 2014) – the Philippines

also has its own share of medicinal plants, specifically akapulko, ampalaya,

bawang, bayabas, lagundi, niyog-niyogan, sambong, pansit-pansitan and

yerba buena made possible through the country’s abundance of natural

resources (Sia, Galvez-Tan, 2014). The different literature proves the

unquestionable predominance of herbal medicine in different countries as

another provider of treatment to various ailments.

Meanwhile, the significance of herbal medicine is further investigated

through the analysis of its efficacy and its utilization. Various researches attest

44
to the deep roots of traditional medicine in the history of man, in phytotherapy

(Rivera, et al., 2013) and in accordance to the ways of the mumbaki, babaylan

and albularyo (Mendoza, 2016). There is a general consensus in both domestic

and overseas contexts that traditional medicine is an acceptable supplement

for conventional medicine (Mendoza, 2016), specifically in the field of palliative

healthcare (Royal Pharmaceutical Society, 2012). Despite its concrete

foundation in history, however, herbal medicine as a standalone still

experiences varying popularity across different nations. In the Philippines,

herbal medicine receives little reception (WHO and DOH, 2012) and is not

nearly as widely-used as in more developed countries like Canada and France

(Ekor, 2013), but more so in line with the usage of middle-income countries like

Ghana and Mexico (Oyebode, et al., 2016). As such, the literature in this

segment highlights the disparity of usage between developed and developing

countries, the reasons of which will be highlighted in the succeeding paragraph.

In terms of reasons behind the usage of herbal medicine, the literature has

outlined three - including effectivity, accessibility and economic value. Studies

from both developed and developing countries have agreed that citizens view

herbal medicine as safer and more effective alternatives to modern medicine.

While the users from USA stated the development of good health as the primary

reason, the users from the Guinea, on the other hand, noted the high

accessibility and low cost of herbal medicine (O’Mathuna & Larimore, 2012)

(Colfer, 2012). Contrary to the aforementioned, however, herbal medicine in the

Philippines faces a declination of usage due to fading knowledge and

decreasing interest and trust in the method (Morilla et al., 2014). Thus, the

literature verifies the motives behind the utilization of herbal medicine –

45
whereas diverse cultural and social contexts may play a vital role in influencing

the perceptions and inclinations of people towards herbal medicine.

Finally, in line with the United Nations’ sustainable development goals for

2030, specifically good health and well-being, the methods and situations for

different countries regarding health is discussed. With reports of increasing

deaths for similar diseases despite the emergence of medical advancements

not just in the Philippines, but in the rest of the world (World Health

Organization, 2015), it becomes increasingly mandatory to achieve universal

health coverage, financial risk protection, access to quality healthcare services,

and access to safe and effective medicines and vaccines. Therefore, the

literature reveals the urgency of providing better access to healthcare to attain

the goal of good health and well-being amongst the people.

Given the discussion pertaining to healthcare and herbal medicine, there

arises a visible and exigent requisite to address the hindrances which prevent

people from gaining access to healthcare services and treatment in accordance

to one’s needs – that of which may perhaps be remedied through alternative

means, specifically the usage of herbal medicine. The initiative to promote such

method and improve poor healthcare accessibility becomes mandatory in order

to ensure the well-being of societies across the globe.

On the other hand, whether in developed or developing countries, it was

revealed that there are certainly various factors that affect the frequency of

one’s utilization of herbal medicine namely age, sex, highest educational

attainment and estimated monthly family income (Waasie, S. et al, 2015). This,

however, could be seen in the preexisting studies conducted in both the

46
developed and developing countries. Some results, nonetheless, exhibit

differences with respect to the aforementioned demographic variables.

In terms of age, both developed and developing foreign countries (Ondicho,

J. et al, 2015; Williams, A. et al, 2012) has 60 years old and above as the age

bracket gaining the highest probability of using herbs as medicines. However,

the Philippines is an exception to this because ages 21 to 34 has the highest

inclination to medicinal herbs in the country (Cruzat & Fernandez, 2012). On

the other hand, both the Philippines and Canada discovered that females are

more into herbal medicines (Cruzat, R. et al 2014; Williams, A. et al, 2012) than

males while Kenya has males rather than females (Ondicho, J. et al, 2015).

However, both developed and developed countries found out that the lower

education attained and lower family income reflect a high inclination in the

usage of herbal plants in curing sicknesses and diseases. Thus, higher

education attained and higher family income result to a low preference of using

herbal medicines (Cruzat, R. et al 2014; Williams, A. et al, 2012; Ondicho, J. et

al, 2015; Roces et al, 2014) because these groups have all the means in having

proper medications in well-regarded health institutions.

Indeed, the frequency of utilizing herbal medicines is determined by factors

considered before deciding to use the aforementioned alternative. Aside from

the demographic variables affecting a citizen’s frequency of utilizing medicinal

herbs, other factors such as personal, behavioral and environmental factors are

also existent in various past studies. One of the most common factor is the

affordability of herbal plants as medicines than than pharmaceutical drugs and

hospital treatments (Elvis et al, 2013; Atrillano et al, 2014; Catublas, 2016).

47
Moreover, effectivity and safeness count as compelling reasons in using herbal

plants in curing illnesses because it factually cured illnesses with minimal side

effects (Ondicho et al, 2015; Elvis et al, 2013; Atrillano et al, 2014; Catublas,

2016). While the only factor in one’s inclination to usage of medicinal herbs in

foreign countries that has not been explored in the Philippines is the influence

and referral by relatives and advertisements (Ondicho et al, 2015; Opara et al,

2016).

Despite the strong reliance of both the developed and developing countries

in using herbal plants as medicines for various sicknesses and diseases,

access to healthcare is continuously being extensive as a problem not only in

the Philippines but also in the whole world because of globalization and

modernization. Thus, improving access to healthcare should be prioritized in

the face of innovation and transformation. There are many ways in attaining this

enhancement in order to mobilize healthcare to all people promoting equity. For

instance, in Canada, utilizing its natural resources as herbal products at its

extent to provide affordable medicines to its citizen without physician’s

prescription has been implemented (Smith, Jogalekar, & Gibson, 2014). On the

other hand, the Philippines has also institutionalized different measures in order

to ensure the healthcare needs of its citizen such as PhilHealth and Medicare

(Cetrangolo, C. et al, 2013). However, there are still many finer ways to improve

the access to healthcare brought by various healthcare problems encountered.

These are healthcare provider coverage expansion and beneficiaries selection

improvement to increase the population covered, healthcare programs

extension and service coverage improvement to deal with the confined benefits

ensured to the citizens and lastly, service delivery capacity upgrading and new

48
methodologies introduction to advance the quality of the services (Cetrangolo,

C. et al 2013).

Generally, there are similarities and differences that were revealed upon

placing the related literature and the related studies as the primary subjects.

Nonetheless, considering that the information were acquired from various

literatures and studies, it cannot be denied that countries across the globe,

though at varying levels in the contemporary times, still consider the utilization

of herbal medicine given specific factors that influence the inclination on the

traditional healthcare.

49
 CHAPTER 2

THEORETICAL FRAMEWORK

The chapter shall tackle overall theoretical framework and conceptual

framework that shall serve as the bases of the research study. In addition, this

chapter shall also cover the assumption and hypotheses of the researchers,

and the conceptual and operational definition of terms propelling toward the

emergence of an in-depth study.

2.0 Theoretical Framework

In order to fully analyze the frequency of utilization of herbal medicine of the

citizens and its influencing factors, the Rational Choice Theory could be used.

According to Sato (2013), the Rational Choice Theory views every individual as

a subjective creature who moves in an objective context. In addition, the

aforementioned theory perceives one’s frequency of utilization of herbal

medicine as a concept that is affected by the critical elements such as personal,

environmental and behavioral factors that are assumed to either restrict or

encourage an individual to utilize traditional medicines in the general context.

Thus, the theory highlights that the actions of an individual are manifestations

of the subjective choices that one makes.

In making a choice, one is faced with inescapable and emerging constraints

in various manifestations. The existence of constraints makes choice crucial,

and one feature of Rational Choice Theory is that it makes the trade-offs

between alternative choices very clear (Owumi, B. 2013). For instance, a typical

choice problem of a simple one-period consumer is the budget constraint, which

means that a person’s purchases of goods and services cannot be higher than
one’s income. Since herbal medicines are far more affordable than

pharmaceutical drugs and medical treatments, citizens choose to use herbal

medicines for healthcare purposes. In connection, Rational Choice Theory

primarily highlights an individual’s subjectivity in decision-making while

considering the possible outcomes. Nevertheless, an individual is greatly

inclined to making choices that would benefit one’s self before considering the

society. Hence, the aforementioned theory is originally individualistic before

considering the effects at a wider scale.

In addition, when taking the theory into further context, an individual makes

a subjective choice when one has sufficient knowledge about a certain

situation. This is because one’s decision will depend on the amount of

information a person has. In the case of the utilization of herbal medicine, a

citizen may consider using herbal medicine because the curing agent may be

proven to be effective, cost-efficient, and safe. Thus, the subjective decision of

an individual may be caused by objective facts that are evident and

predominant.

On the other hand, a citizen may consider not using herbal medicine

because alternative treatment may have cured more than traditional medicine,

and may have been prescribed by medical practitioners. As a result, one may

be faced with the freedom of choosing from the options between using and not

using medicinal herbs in curing sicknesses and illnesses. Both options,

however, serve as possible alternatives from varying perspectives. Therefore,

alternatives are critical elements that pose uncertainty in eventually exhibiting

a constant or occasional frequency of utilizing medicinal herbs.

51
 Moreover, Rational Choice Theory emphasizes an individual's subjectivity in

decision-making; an individual's choices depends on what will be more

beneficial for oneself. For instance, the utilization of herbal medicine is caused

by its effect on the individual; whether a citizen uses traditional medicine

because it is more effective than alternative medicine, or a citizen does not use

traditional medicine because alternative medicine is a better cure for the

individual. Therefore, an individual may consider the possible outcomes in

terms of decision-making but it is still the individual's personal advantage which

is important when making choices in one's life.

Thus, the Rational Choice Theory encompasses the general perspective but

highlights the subjectivity of one’s choice. Though various elements may exhibit

uncertainty in measuring the frequency of utilization of herbal medicines of the

citizens, it cannot be denied that the emphasis on one's subjectivity in an

objective context could effectively and accurately measure the frequency of

utilization of herbal medicine of a citizen and determine its influencing factors.

2.0.1 Conceptual Framework

Figure 1: Conceptual Model of Demographic Profiles, Frequency of

Utilization of Herbal Medicines and its Influencing Factors

52
 As evinced in Figure 1, the frequency of the utilization of medicinal plants

and the factors that influence the use of medicinal plants of the citizens of

Barangay Lapolapo I, San Jose, Batangas may be related to one another to

further investigate and explore the two concepts. Moreover, the two

aforementioned variables were derived from the research paper entitled,

“Utilization of Herbal Plants in the Aeta Community: An Assessment” published

on October 2014 by Roses and Torres. This study will be anchored on a pre-

existing research paper to guarantee the accuracy of the data that will be

gathered since the research instrument that will be used is valid. Additionally,

the instrument was also proven effective and credible because it has been

verified through the execution of the pre-existing study about the utilization of

medicinal plants of the Aeta community.

Furthermore, the demographic profiles of the respondents, which are

situated at the top part of the figure, are classified in terms of the citizens’ age,

sex, educational attainment, monthly income, and the period of residency in the

community. Connected to the demographic profiles are the factors that

influence the utilization of medicinal plants situated at the bottom right part of

the figure that had been classified into personal factors, behavioral factors, and

environmental factors which are predetermined based on the research

instrument of this study.

Nonetheless, the two concepts are then connected to one of the variables

of the study – the frequency of the use of medicinal plants situated at the bottom

left part of the figure. This will pave way for the researchers to ascertain if the

citizens of the barangay always, often, seldom, or never use medicinal plants.

In this study, the frequency of the use of medicinal plants is connected to the

53
demographic profiles by a two-headed arrow to discern if a citizen’s social

status has a significant relationship between the resident’s frequency in using

herbal plants for medicinal purposes. Additionally, the factors that influence the

utilization of medicinal plants will be associated with the demographic profiles

of the respondents to discern if a citizen’s social status has a significant

relationship between the factors that may affect a citizen’s use of medicinal

plants. Lastly, the frequency of the use of medicinal plants will also be

connected to the factors that influence the use of medicinal plants by a two-

headed arrow to verify if specific factors affect a citizen’s frequency in utilizing

medicinal plants.

Generally, the study will give prime on measuring the frequency of utilization

of medicinal plants in Barangay Lapolapo I, San Jose, Batangas, and identifying

the factors that may have affected the frequency of utilization. This, however,

will be related in accordance to the citizens’ demographic profiles to see

whether there is an existing relationship between the demographic profiles and

the variables, and between the frequency of utilization of medicinal plant and

factors affecting one’s frequency of utilization of medicinal plant. Nonetheless,

this will assure the acquirement of comprehensive and accurate data, and an

in-depth research as a result.

2.1 Assumption and Hypotheses

In conducting a study on the utilization of medicinal plants in Brgy. Lapolapo

I, San Jose, Batangas, the following assumptions were made:

2.1.1 Most respondents would manifest cooperation and provide responses

with considerable reliability.

54
 2.1.2 It is likely that the respondents will not exhibit a high frequency usage

of medicinal plants.

2.1.3 Factors such as personal, behavioral and environmental have a

substantial influence on the frequency of utilization of medicinal

plants of the respondents.

2.1.4 Demographic profiles such as age, sex, educational attainment and

period of residency in the community significantly affects the frequency

of utilization of medicinal plants of the respondents.

Ho1: There is no significant relationship between the demographic

profiles and the frequency of utilization of medicinal plants.

Ho2: There is no significant relationship between the demographic

profiles and the factors influencing the frequency of utilization of

medicinal plants.

Ho3: There is no significant relationship between the factors that

influence the utilization of medicinal plants and the frequency of

utilization of medicinal plants.

2.2 Definition of Terms

The following terms are defined conceptually and operationally:

Alternative Healthcare. The term refers to a group of diverse medical and

healthcare systems, practices, and products that are not presently considered

to be part of standard medical practice. In the Philippines, the spread of healing

rituals, tribal arts and the practice of provincial diversities with inclination

towards folklore and mythologies are common due to the nation’s religious

55
nature and long colonial history. Moreover, the alternative healthcare practices

that are commonly used in the remote communities includes: herbal therapy,

fringe therapy, faith healing and hilot.

Health. The term signifies the state of complete physical, social and mental

well-being, and not merely the absence of disease or illness. Within the context

of health promotion, the term is defined as a means to an end which can be

expressed in functional terms as a resource which permits people in the

community specifically, of Barangay Lapolapo I, San Jose, Batangas to lead an

individually, socially and economically productive life. Nevertheless, the term

clearly implies positive concept which emphasize the social and personal

resources as well as physical capabilities of the residents in a given community.

Healthcare. The term signifies the efforts made to maintain or restore

physical, mental, or emotional well-being especially by trained and licensed

professionals. This includes the set of services provided by a country or an

organization for the treatment of individuals in a community. In the Philippines,

the Department of Health (DOH) is responsible for developing health policies

and programs, regulation, performance monitoring and standards for public and

private healthcare. In the context of Barangay Lapolapo I, San Jose, Batangas,

healthcare services are delivered through the means of barangay health

centers and barangay outpost.

Modern medicine. The term refers to the science of diagnosing and treating

disease or injury and maintaining health encompassing treatment by drugs,

diet, exercise, and other nonsurgical means. In the Philippine context, most of

the pharmaceutical medicines that are being developed are in the form of herbal

56
due to the mandate of the Government to the Department of Science and

Technology and Department of Health to distribute inexpensive medicine to the

poor, to propagate the use of herbal preparations with proven medicinal efficacy

and identify scientifically validated medicine that would improve the health and

well-being of every sitios and barangays including Barangay Lapolapo I, San

Jose, Batangas.

Traditional Medicine. This term is defined as an ancient medical practice

that existed in human civilization before the application of modern science to

health. It refers to using a plant's seeds, berries, roots, leaves, bark, or flowers

for medicinal purposes. In the Philippines, the citizens are more inclined to use

traditional medicine due for its long history of use in health maintenance and

availability in disease prevention and treatment, particularly for chronic

diseases. Moreover, the traditional medicines that are scientifically tested and

proven to be effective by the Department of Health includes: sambong,

akapulko, ampalaya, bawang, bayabas, lagundi, niyog-niyogan, tsaang-gubat,

pansit-pansitan, and yerba buena.

57
 CHAPTER 3

RESEARCH METHODOLOGY

This chapter shall discuss the overall methodology in conducting the

research. This is a complete and detailed presentation of the different statistical

tools used to interpret the data, and the different procedures in gathering the

data which are vital in conducting an in-depth study.

3.0 Research Design

Quantitative method of research will be used in this study to explore the

Factors Affecting the Frequency of Utilization of Herbal Medicines of the

Selected Citizens of Barangay Lapolapo I, San Jose, Batangas. Nevertheless,

to clearly illustrate and elaborate the variables, the frequency of utilization of

herbal medicines and factors affecting the frequency of utilization of herbal

medicines, correlational research design shall be used. This will pave way for

the researchers to determine whether a significant relationship exists between

the two aforementioned variables.

3.1 Sampling Design and Respondents

In determining the respondents of the study, non-probability technique,

specifically purposive sampling, was used. This sampling design is integral in

the success of the research as the respondents, who are the main sources of

data in the study, were chosen according to specific characteristics. This allows

one to answer the questions in the research instrument for one surely

possesses the characteristics in order for the researchers to measure the

frequency of utilization of herbal medicine, and the factors affecting the

frequency of utilization of herbal medicine in Barangay Lapolapo I, San Jose,

Batangas. In this case, each respondent should be residing for at least three

years in Barangay Lapolapo I, San Jose, Batangas, and should at least be

eighteen years of age. The aforementioned characteristics do not only filter the

possible respondents in the study but also assures the emergence of an in-

depth study as the result as the respondents that were chosen have sufficient

knowledge about Barangay Lapolapo I, San Jose, Batangas in general.

On the other hand, to gather comprehensive results for the research, the

researchers selected the respondents of the study which were thirty-nine

citizens of Barangay Lapolapo I, San Jose, Batangas who met the criteria that

were set. The chosen respondents will be those of legal age, 18 years old and

above, and there will also be certain factors to be considered such as one’s

sex, highest educational attainment, and the estimated monthly family income,

in order to identify if it affects the citizen’s of frequency of utilization of herbal

medicines for this research will focus on the herbal medicines’ significance for

the citizens especially in terms of frequency of use, and the factors affecting

such frequency. The citizen should be residing in Barangay Lapolapo I, San

Jose, Batangas for at least three years and should at least be eighteen years

of age to ensure that sufficient knowledge about the community has been

gained through the period of stay and maturity. The number of years, on the

other hand, is required to assure that the citizen has had the opportunity to

utilize herbal medicines given that Barangay Lapolapo I, San Jose, Batangas

is agriculturally-inclined, and has vast lands where the herbal medicines, due

to its low maintenance, could easily flourish.

59
3.2 Instrumentation

For this study, a questionnaire will be the main instrument in gathering the

data. The questionnaire will be formed into checklist figure which answers from

1-4 with varying oral interpretations while some part are in average form which

will be tabulated in order to measure the frequency of utilization of herbal

medicines and the possible factors affecting the frequency of utilization of

herbal medicines of the citizens in Barangay Lapolapo I, San Jose, Batangas.

As a tool for measuring the frequency of utilization of herbal medicines and

the factors affecting the frequency of utilization of herbal medicines of the

citizens in Barangay Lapolapo I, San Jose, Batangas, the generated

questionnaire of the thesis, “Utilization of Herbal Plants in the Aeta Community:

An Assessment” will be used measure and determine the aforementioned

variables. The said questionnaire was conceptualized by Roces and Torres

(2014) and was tested to validate the effectivity and accuracy of the

questionnaire.

The questionnaire, nevertheless, contains detailed queries of the research

problem of the study regarding the factors affecting the frequency of utilization

of herbal medicines of the citizens in Barangay Lapolapo I, San Jose, Batangas

which shall be interpreted depending on the weight for each option of the

collective responses of the participants of this study. Moving on to the

frequency of utilization of herbal medicines of the citizens in Barangay Lapolapo

I, San Jose, Batangas, numerical symbols starting from 1-4 are stated which

will mean the respondents have either always, often, seldom, never utilize

herbal medicines. The combined answers will be interpreted through the range

60
or scale starting from 3.5-4 which means the citizens always utilize herbal

medicines, 2.5-3.49, which indicates that the citizens often utilize herbal

medicines, 1.5-2.49, which shows that the citizens seldom use herbal

medicines, and 1-1.49 which manifests that the citizens never utilize herbal

medicines. On the other hand, with regards to the factors affecting the

frequency of utilization of herbal medicines of the citizens, numerical values

ranging within 1-4 will be given as choices for the respondents in order to

identify whether one is strongly agreeing, agreeing, disagreeing, or strongly

disagreeing to the specified factors classified to personal, which contains of six

items, behavioral, which is composed of six items, and environmental, which

comprises six items. After the accumulation of the respondents’ answers, the

researchers will interpret the responses through the scale with the highest point

as 3.5-4, which signifies that the respondents strongly agree to a particular

factor, 2.5-3.49, which illustrates that the respondents agree to a specified

factor, 1.5-2.49, which explains that the respondents disagree to a given factor,

and the lowest point as 1-1.49, which represents that the respondents strongly

disagree to a specific factor.

3.3 Data Gathering, Presentation and Analysis

In order to complete this study, the researchers identified what aspect of

Barangay Lapolapo I, San Jose, Batangas may be focused on. Afterwards, the

researchers adapted a questionnaire that has already been utilized in a

research, “Utilization of Herbal Plants in the Aeta Community: An Assessment,”

in order to determine the factors affecting the frequency of utilization of herbal

medicines, and the frequency of utilization of herbal medicines of the selected

citizens in Barangay Lapolapo I, San Jose, Batangas. Consequently, the

61
researchers also determined the procedure as to how the respondents will be

gathered for this study, which is through the purposive sampling method.

Thereafter, a recruitment screener was created to distinguish the type of

respondents needed for the completion of the study; this served as the criteria

of the citizens of the Barangay that were selected as respondents in the study.

Then, the questionnaires were disseminated to the chosen respondents of the

study with the assurance that there are no right or wrong answers and with a

reminder for the respondents to answer with absolute honesty for the success

of the research. While the respondents were answering the research

instrument, pictures of the herbal medicines were shown to enhance the

respondents’ familiarity about the primary variables of the research. In this way,

accuracy of data could be ensured as every respondent was familiar with the

questions that need to be answered in the research instrument. Thus, given the

steps that the group has done in order to gather data, it could be inferred that

the data that were gathered were accurate for the sources of data are firsthand

experiencers, and the research instrument that was used was reliable and valid

in order to effectively measure the frequency of utilization of herbal medicine in

Barangay Lapolapo I, San Jose, Batangas, and to identify the factors affecting

the frequency of utilization of herbal medicine in the same community.

On the other hand, after gathering the data, the researchers shall analyze

and interpret the data that were gathered based on the instrument that was

used. The researchers will use statistical procedure in order to determine the

significance of the frequency of utilization of herbal medicine and the factors

that influence the frequency of herbal medicine utilization of the respondents.

62
3.3.1 Validity and Reliability

The validity and reliability of the whole research is heavily anchored on the

research instrument that was used. Nonetheless, it is essential to note that the

researchers of the study being conducted adapted an existing questionnaire

from a thesis by Roces and Torres (2014) entitled “Utilization of Herbal Plants

in the Aeta Community: An Assessment.” The adapted questionnaire

underwent evaluation and analysis from the panelists from the College of

Nursing in De La Salle Lipa from which the results of the study were scrutinized

while paying attention to the generated instrument of the study to assess the

utilization of Herbal Plants in the Aeta Community. In this way, one could infer

that the main instrument that was used to gather data for the study possesses

validity and reliability leading to an in-depth research study.

3.3.2 Statistical Treatment

The interpretation and analysis of data will be performed with the aid of the

following statistical tools:

Frequency Distribution. This statistical tool is a representation of the

gathered data grouped into mutually exclusive classes or intervals, and the

number of occurrences within each given class. The actual value of the

observations that fall within each interval will be illustrated in tabular form, and

as such, the distribution of the demographic profiles (age, sex, educational

attainment, and monthly family income) and the variables involved (the

frequency of utilization of herbal medicine and the factors that affect the

frequency of herbal medicine) will be summarized using the frequency

distribution table.

63
 Percentage Distribution. This is another useful tool for the interpretation of

data, for it shows the distribution of the values of the given variables in relation

to the entirety of the data set. The calculation of percentage distribution

involves dividing the class frequency by the total number of grouped values,

then multiplying the quotient by 100. The use of percentage distribution will be

employed in order to ascertain specific characteristics of the population which

is shown in the demographic profiles, including age, sex, educational

attainment and monthly family income. It will also be utilized for the

summarization of the resulting data from the interpretation of the values of the

frequency of utilization of herbal medicine and its influencing factors.

𝐹
𝑃= × 100
𝑁

Where:

P = percentage

F = frequency

N = total sample

Weighted mean. This method involves assigning weights to each value in

the data set to determine its relative importance on the average. It will be used

for the interpretation of the respondents’ self-assessment regarding the

frequency of utilization of herbal medicine and the factors that influence the

frequency of herbal medicine utilization of the residents of Barangay Lapolapo

I, San Jose, Batangas.

The following formula demonstrates how to compute the weighted mean:

64
 𝐹𝑊
𝑊𝑀 = 𝛴
𝑁

Where:

WM = Computed Weighted Mean

∑ = Summation Symbol

F = Frequency for each option

W = Assigned Weight

N= Total number of Frequencies

Slovin’s Formula. To pinpoint the number of respondents that will be

surveyed, Slovin’s formula was utilized with a marginal error of 14.7%. 45 out

of 1892 residents of Barangay Lapolapo I, San Jose Batangas were selected

to be part of the study.

Formula:

𝑁
𝑛 =
1 + 𝑁𝑒 2

Where:

n = number of samples

N = Total population

E = Margin of error

Pearson Product-Moment Correlation/Pearson R test. This is a measure

of the strength of the relationship between two given variables, wherein the

resulting value is denoted by r. The method will be used in order to determine

the significance of the relationship between the frequency of utilization of herbal

65
medicine and the demographic profiles, as well as the relationship between the

factors affecting herbal medicine utilization frequency and the demographic

profiles.

Formula:

𝑵 ∑ 𝒙𝒚 − (∑ 𝒙)(∑ 𝒚)
𝒓=
√[𝑵 ∑ 𝒙𝟐 − (∑ 𝒙)𝟐 ][𝑵 ∑ 𝒚𝟐 − (∑ 𝒚)𝟐 ]

Where:

N = number of pairs of values

∑xy = sum of the products of the paired values

∑x = sum of x values

∑y = sum of y values

∑x2 = sum of squared x values

∑y2 = sum of squared y values

66
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 APPENDIX A
(Survey Questionnaire)

Greetings of Peace!

We are Grade 12 students of De La Salle Lipa who are currently in the process
of conducting a research study entitled “Factors Affecting the Frequency of
Utilization of Herbal Medicine of the Selected Citizens in Barangay Lapolapo I,
San Jose, Batangas.”

In line with this, we would like to request the items of our questionnaire to be
answered with all honesty and cooperation.

Rest assured that all information disclosed will be kept confidential.

We greatly appreciate your generous support to these endeavors.

Thank you very much and God Bless!

Respectfully Yours,

C. Latayan, J. Neri, K. Reyes, K.M. Reyes, M. Honrade,

P. Villafuerte, P. Villanueva, S. Diaz, Y. Candava
Researchers

Ms. Gina Ocampo

Subject Professor, INQUIRE

____________________________________
Signature over printed Name of Participant

Date: ______________

76
Pangalan (Optional) _____________________________________

I. PROFILE
Kasarian Edad
Lalaki 18 - 35
Babae 36 - 59
60 - pataas

Tinapos na Edukasyon Pangbuwanang kita

Hindi nakapagtapos ng elementarya 10,000 pababa
Nakapagtapos ng elementarya 10,001 – 20,000
Hindi nakapagtapos ng sekondarya 20,001 – 30,000
Nakapagtapos ng sekondarya 30,001 – 40,000
Hindi nakapagtapos ng kolehiyo 40,001 – 50,000
Nakapagtapos ng kolehiyo 50,001 – 60,000
60,001 – 70,000
70,001 – 80,000
80,001 – 90,000
90,001 – 100,000
100,001 pataas

77
II. PAGGAMIT NG MGA HALAMANG GAMOT
Panuto: Lagyan ng tsek ang kolum na magsasabi kung gaano mo kadalas
ginagamit ang halamang gamut na nakalista sa ibaba.
4 – Palagi
3 – Madalas
2 – Madalang
1 – Hindi

HALAMANG GAMOT 4 3 2 1
Alkapulko
Ampalaya
Bawang
Bayabas
Lagundi
Niyog-Niyogan
Sambong
Tsaang Gubat
Ulasimang Bato o Pansit-
Pansitan
Yerba Buena
Iba pa:

III. MGA SALIK NA NAKAIIMPLUWENSIYA SA PAGGAMIT NG HALAMANG

GAMOT
Panuto: Lagyan ng tsek ang kolum na magsasabi kung gaano ka sumasang-
ayon o hindi sumasang-ayon sa mga pahayag sa ibaba.
4 – Lubos na sumasang-ayon
3 – Sumasang-ayon
2 – Hindi sumasang-ayon
1 – Lubos na hindi sumasang-ayon

PERSONAL FACTORS 4 3 2 1
1. Ako ay mas nakakatipid ng
pera kapag ang ginagamit ko
ay halamang gamot kesa sa
mga gamut na nabibili sa
botika.
2. Ang halamang gamot ay
pinaniniwalaang mabisa ng
aking mga magulang at ito ay

78
 walang epekto sa aking
katawan.
3. Napatunayan ko na ang
halamang gamot ay tunay na
mabisa.
4. Ang paggamit ng halamang
gamot ay di kinakailangan ng
reseta galing sa doktor.
5. Wala akong nararamdamang
kakaiba pagkatapos kong
gumamit ng halamang gamot.
6. Ang mga gamot na binebenta
sa botika ay gawa sa mga
halamang gamot.
BEHAVIORAL FACTORS
1. Binabahagi ko ang aking
kaalaman tungkol sa
halamang gamot sa aking
mga kaibigan at kakilala.
2. Gumagamit ako ng halamang
gamot kahit hindi ko pa
nakokonsulta ang aking
doctor.
3. Gumagamit ako ng halamang
gamot kesa sa mga gamot na
nabibili sa botika.
4. Sa tuwing ako ay
magkakasakit, ako ay
gumagamit ng halamang
gamot.
5. Alam ko na mas epektibo ang
halamang gamot kesa sa
mga gamot sa botika.
6. Itinuturo ko sa aking mga
anak ang aking kaalaman
tungkol sa halamang gamot.
ENVIRONMENTAL FACTORS
1. Ang aking mga magulang ay
matagal ng gumagamit ng
halamang gamot.
2. Ang mga nakatia sa lugar na
ito ay gumagamit ng
halamang gamot.
3. Maraming halamang gamot
ang meron dito sa aming
lugar

79
4. Nakikita ko sa mga telebisyon
na ang halamang gamot ay
pinagbebenta sa palengke.
5. Nakita ko na gumaling ang
aking mga kapamilya kapag
gumagamit ng halamang
gamot.
6. May mga nagtatrabaho sa
ospital na sinusuportahan
kami sa paggamit ng
halamang gamot.

80
INTERPRETATION
II. Pag-gamit ng mga Halamang Gamot (Frequency of Utilization of Medicinal
Plants)

Mean Values Verbal Interpretation

3.5 – 4 (4) Always (Palagi)
2.5 – 3.49 (3) Often (Madalas)
1.5 – 2.49 (2) Seldom (Madalang)
1 – 1.49 (1) Never (Hindi)

III. Mga Salik na Nakaiimpluwensya sa Paggamit ng Halamang Gamot

(Factors which Influence the Utilization of Medicinal Plants)

Mean Values Verbal Interpretation

3.5 – 4 (4) Strongly Agree (Lubos na sumasang-ayon)
2.5 – 3.49 (3) Agree (Sumasang-ayon)
1.5 – 2.49 (2) Disagree (Hindi sumasang-ayon)
1 – 1.49 (1) Strongly Disagree (Lubos na hindi sumasang-ayon)

81