Family Health Assessment Tool

I. Demographic data

Family surname: Achas

House No. _____________________ Street: _____________________________________________
Barangay: Brgy. 2 District: Poblacion
Municipality/City: Talakag Contact No.: 0967-586-5760
Source(s) of information: head of household/observation
Data gathered by: Jhazzy Angelique Ribbonette Mayol Date: October 8, 2021

Household members

Name Age Relationship to head of household

Joanne M. Villena 39 Head of household
Zeus Achas 40 Live in partner / Fiance
Amari Zeke Jakobi Mayol 5 Child

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Note: Make a genogram depicting three generations of the family members, family tree (indicating health
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problems of individual members), and/or ecomap.

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II. Family characteristics

Family members living outside the household

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Name, age and relationship to head of household

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1. Jhazzy Angelique Ribbonette Mayol – 21 years old - child

2. Mikhail Annelliv M. Villena – 18 years old - child
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3. Jesmhail M. Villena – 17 years old - child

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4. Julius Jadz M. Villena – 13 years old – child

Location of family member(s)

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Cagayan de Oro City, Zamboanga City, Iloilo City

Frequency and duration of contact

Almost everyday in contact, whole day constant communication
Means of communication
Facebook, messenger, call, text

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 Family mobility
Length of time at current address
____5 years_________________________________________________________________________
Address of previous residence(s)
____#25 Dove St., Morning Mist Village, Brgy. Upper Carmen, Cagayan de Oro City______________
Frequency of geographic moves
____once___________________________________________________________________________

Family dynamics
Emotional bonding of family members
Siblings are close, parents are openly talking to their children, parents are supportive, siblings support each other

Distribution of authority and power

Head of the household makes decisions upon consultation with the live in partner and children who are mature
enough to understand

Degree of individual autonomy

Children are able to decide on their own with proper consultation to the head of household

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How members communicate
Communication is done virtually or personally

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How decisions are made

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Made through proper communication and has a certain process before arriving to that certain decision
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How problems are solved
Through talking virtually or personally

How conflict is handled

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Some conflicts are not immediately handled due to tension but if the tension subsides, talks are done in order to
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handle the conflict

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Division of labor
Head of household is the current money maker of the family while the other members of the family are helping in
terms of household chores and managing the online business
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III. Socioeconomic and cultural characteristic

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Family social integration

Language(s) or dialect(s) spoken
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English and bisaya/cebuano

Literacy (ability to read or write in language(s))

All members of the family are literate except for the 5-year-old child
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Degree of social network with friends, neighbors, and other relatives

Has a close relationship with a few friends, good relationship with neighbors and other relatives

Network with religious organizations

Not part of any religious organizations

Network with social organizations

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 Not part of any social organizations

Educational experiences
- Head of the household has finished some years of college
- Live in partner graduated college (BS-Criminology)
- 3 children are in college
- 1 is in junior high school
Work history
- Head of household used to work in an office
- Live in partner was a police officer but got dismissed due to a case he was wrongly accused of
- Eldest child used to work as an accounting clerk
Adequacy of financial resources
Not adequate but financially sustained by the former partner and grandparent of the children
Leisure time interests
Road trips, watching movies or series, relaxing at home, food trip

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Cultural influences: values, attitudes, and beliefs about:

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Spirituality

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Highly influenced by the Roman Catholic religion__________________________________________

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Rituals (holidays and celebrations)

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Observe holidays or celebrations by the Roman Catholic Church, Observes National Holidays_______
Dietary habits
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None_______________________________________________________________________________

Health
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Often believes in “mabuyagan”__________________________________________________________

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Folk diseases
None_______________________________________________________________________________

Traditional healers
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“manghihilot”________________________________________________________________________
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IV. Family environment

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Family residence
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Adequacy of size
House has only 1 room that is only good for 3 to 4 people, the overall structure of the house is adequate to the
current members of the household
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Structural safety
The house is mainly out of cement but the interior is composed of light materials like wood, the roof of the house
is made out of metal.

Water sanitation
Water is polluted since their source of water is the mountains nearby and their water is not being processed before
its gets distributed to the residents of Talakag

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 Food preparation and storage
Proper food handling is observed and they store unconsumed food in a container then in the refrigerator
Sewage
There is an open “canal” on the side of the house where the sewage passes then to the main sewage irrigation of
the whole barangay

Garbage disposal
Garbage disposal is through the end of the canal and then they don’t know where the garbage ends up, Talakag
does not have any garbage collection system so the residents do dispose their garbage on their own

Excreta disposal
There is a proper and clean bathroom for excretal disposal

Pest and vermin control

Sometimes they do “paaso” in the area especially during rainy seasons to kill mosquitos that can be the cause of
dengue

Family neighborhood
Location (e.g. urban or rural, subdivision, slum area)

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The family’s location is in a rural area that is 30 to 45 minutes away from the city of Cagayan de Oro

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Type (e.g., residential, semicommercial)

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Residential________________________________________________________________________

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Safety
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One way streets are mostly found in the area, lighting on the streets are not available in some areas, security is
done by the police or the barangay tanod

Population density
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Approximately 1,602 people are residing in Brgy. 2, Talakag, Bukidnon_____________________________

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Sources of pollution
Air & Water_____________________________________________________________________________
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 V. Family health and health behavior

Activities of daily living (how family spends a typical day)

Usually stays at home, busy dealing with online business, children are on online classes________________

Health history (pregnancy, illness, death within the past 5 years/health attendance)
Last pregnancy was 2016, head of the household’s father died because of COVID-19 last June 2021, live in
partner’s father has stage 4 cancer and was operated on the throat this year

Self-care (health promotion and disease prevention)

Vitamins are regularly taken, proper hours of sleep are observed, diet has been changed recently

Risk behavior
Occasionally drinking alcohol_______________________________________________________________

Health status (problems and priorities)

Head of the family has high sugar level, hypertension, and is overweight; one of the children was diagnosed with

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anxiety; one of the children also experienced seizure

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Home remedies

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“tuob” and drinking “tawa-tawa” when experiencing fever

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Health care resources
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Barangay health center or relatives who are licensed physicians____________________________________
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Health workers
Nurse, doctors____________________________________________________________________________
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Health agencies
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Phil-health______________________________________________________________________________
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____________________________________________________________________________________
Adapted from Nies and McEwen, 2011. Community/public health nursing, 5th edn. Saunders
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Summary of significant assessment findings

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Area of assessment Findings

Demographic data Achas family lives in Brgy. 2, Poblacion, Talakag, Bukidnon. The main
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source of information is the head of household and also through my

observation. There are currently three (3) household members including
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the head of household. The head of the household is Joanne Villena who
is 39 years old. Along with her is her live-in partner or fiancé, Zeus
Achas who is 40 years old and their child Amari Zeke Jakobi Mayol
who is 5 years old.
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Family characteristics
Socioeconomic and cultural
Family is composed of 7 people and most of them don’t live under the
same roof. The family has only geographically moved once. They have
been living in Talakag, Bukidnon for 5 years already. In terms of family
dynamics, the family is open to each other and communicates with each
other openly. Children are given independency in deciding for
themselves. Members of the family help each other in terms of the work
within the house.
Family members can speak English and bisaya/Cebuano. All members

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 characteristic of the family except one is literate enough to read and write. Members
of the family have friends, neighbors, and relatives who they have a
stable relationship with. Most members of the family reached college
level in terms of educational attainment. Family members also have
work history. Financial resources are not enough that is why the family
is also sustained by ex-partner of the head of household and the head of
household’s mother. They are not part of any religious or social
organization. Family spends their leisure time by going on road trips
(before the new normal came into context), watching movies or series,
relaxing at home, or having a food trip. Their spirituality is highly
influenced by the Roman Catholic religion. They often believe in
“mabuyagan” and “manghihilot.”
Family environment The house of the Achas family is adequate to their family size. Although
the house is primarily made out of cement, there are still parts of the
house that are made out of lightweight materials like wood while the
roof is made out of metal roofing. Their water is polluted since it comes
from the mountains nearby and it is not being processed before it gets
distributed to the residents of Talakag. Family observes proper food
handling and proper food storage. They have an open sewage canal just

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beside their house where their sewage wastes pass through. Garbage are

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thrown in the “canal” also. Family has clean and proper bathroom for

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excretal disposal. They do “paaso” annually especially during rainy

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season to kill mosquito that can cause dengue. The family is located 30-

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45 minutes away from Cagayan de Oro City. Their house is located in a

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residential area, most of their streets are well lighted at night and some
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are not, one way routes are found in the area, and safety is done by
police and barangay tanod. Brgy. 2 has an approximate population of
1,602 people and their main source of pollution are air and water.
Family health and health Achas family usually spends their days at home. Last pregnancy was
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behavior back in 2016. A family member died last June 2021, a family member is
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also diagnosed with cancer and had an operation on the throat this year.
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The family takes vitamins regularly, proper hours of sleep is being

observed, and they have also changed their dietary habits recently.
Some members of the family occasionally drink alcohol. Some members
of the household have high sugar level, hypertension, overweight,
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anxiety, and seizure. They do home remedies like “tuob” and drinking
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“tawa-tawa” when experiencing fever. Primary health care resources

are the barangay health center and relatives who are licensed
physicians. Health workers are nurses and doctors. The family members
are Philhealth beneficiaries.
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Assessed by________________________________________Date_______________Score__________
(For C.I. only)
Rating:______________________________Remarks:_______________________________________
___________________________________________________________________________________
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___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

C.I.____________________________________Signature______________________Date__________

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