LECTURE WITH PAMPHLET IN IMPROVING MATERNAL KNOWLEDGE AND SKILLS ON HOME MANAGEMENT OF FEVER, COUGH AND DIARRHEA IN CHILDREN 0-5 YEARS OLD IN BARANGAY BATU, SIAY, ZAMBOANGA SIBUGAY

LECTURE WITH PAMPHLET IN IMPROVING MATERNAL KNOWLEDGE AND SKILLS ON HOME MANAGEMENT OF FEVER, COUGH

AND DIARRHEA IN CHILDREN 0-5 YEARS OLD IN BARANGAY BATU, SIAY, ZAMBOANGA

SIBUGAY PROVINCE

A RESEARCH PAPER PRESENTED TOTHE FACULTY OF

ATENEO DE ZAMBOANGA UNIVERSITYSCHOOL OF MEDICINE

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF

DOCTOR OF MEDICINE

BY:

CRISTAL JOYCE S. TEO

2015

APPROVAL SHEET

This research entitled “LECTURE WITH PAMPHLET IN IMPROVING MATERNAL KNOWLEDGE AND SKILLS ON HOME MANAGEMENT OF FEVER, COUGH AND DIARRHEA IN CHILDREN 0-5 YEARS OLD IN BARANGAY BATU, SIAY, ZAMBOANGA SIBUGAY PROVINCE” prepared and submitted by CRISTAL JOYCE S. TEO, in partial fulfillment of the requirements for the degree of DOCTOR OF MEDICINE, is hereby accepted.

Dr. Anna Eunice Aujero-SapasapAdviser

Approved by the Oral Examination Committee with a grade of PASSED.

Dr. Mario R. ArciagaChairman

Dr. Anna Eunice Aujero-Sapasap Dr. Afdal B. KuntingMember Member

ACCEPTED in partial fulfillment of the requirements for the degree of DOCTOR OF MEDICINE.

_________________Dr. Mario R. Arciaga

Associate Dean for ResearchAteneo de Zamboanga University

School of Medicine

TABLE OF CONTENTS

APPROVAL SHEET i

LIST OF FIGURES iv

LIST OF TABLES iv

ACKNOWLEDGMENT v

ABSTRACT vi

CHAPTER I INTRODUCTION 1Background of the Study 1Statement of the Problem 5Research Objectives 5Hypotheses of the Study 6Conceptual Framework 7Significance of the Study 8Scope and Delimitation 8

CHAPTER II REVIEW OF RELATED LITERATURE 9

CHAPTER III METHODOLOGY 14Research Design 14Research Setting 14Respondents 15Sampling Design 15Research Instruments 15Research Intervention 19Data Gathering Procedure 20Data Analysis 21Flow of Activities 22

CHAPTER IV RESULTS 23

CHAPTER V DISCUSSION 30

CHAPTER VI CONCLUSION AND RECOMMENDATION 34

BIBLIOGRAPHY 36

APPENDICES

A. Questionnaire (English Version) 38B. Questionnaire (Visayan Version) 40C. Skills Checklist 42D. Knowledge Scores of the Respondents 44E. Skills Assessment Scores of the Respondents 47F. Lecture Module (English Version) 50G. Lecture Module (Visayan Version) 54H. Pamphlet (English and Visayan Version) 58

CURRICULUM VITAE 62

LIST OF FIGURES

Figure Page

1. Conceptual Framework 7

2. Flow of Activities 22

LIST OF TABLES

Table Page

1. Demographic Profile of the Respondents 23-24

2. Comparison of Knowledge Mean Scores of Mothers before 26 and after the intervention

3. Number of Passers on the Skills Assessment before and after 27the intervention

4. Comparison of Skills of Mothers before and after the intervention 28using McNemar’s Test

ACKNOWLEDGEMENT

Indeed, no man is an island. Without the support of these people, I wouldn't be able to successfully complete my research. Hence, I would want to give credit to the following:

First and foremost, I would like to praise and thank my Creator, God Almighty, for giving me the gift of life and for the other countless blessings He has given me. Undeniably, nothing is impossible to You.

To Dr. Sam Cristobal, thank you so much for making it possible for me to be one step closer to reaching my lifelong dream of becoming a doctor. I would not be where I am right now without your help. You are truly a blessing and an inspiration.

To the members of the research committee, most especially to my research adviser Dr. Anna Eunice Aujero-Sapasap, thank you for all the helpful advices since the start of my research.

To our community preceptor Dr. Ruhida Sarabi-Saydil, a huge thanks to you for the guidance and support in our community projects and research activities. Also, to the community residents of our second home, salamat kaayu sa inyung tanan. Dili posible mahuman ang akuang research kung wala ang inyuhang suporta.

To Kuya Yrl and Mary Doll, thank you for sharing your expertise in the Visayan dialect.

To Kuya Dave, thank you for always being there, and also for teaching me how to run the statistics of my research.

To United Laboratories (UNILAB), I am indebted to you for granting the financial assistance needed to complete this research.

To the ROCKISTAs (Su, King, John, Kah Jeh, Shenna, Iard, Ly, & Kah Pre), thank you for “rocking” my world. Despite our differences, we managed to meet halfway and live peacefully and happily in our own version of “PBB House”. To my DREAMERS family, finally, we are almost near in making our childhood dream a reality. Thank you for the friendship and support.

To my beloved Ahia and Achi, thank you for constantly reminding me that I can do it. I love you both.

To Mon-Mon, you’re the best partner I could ever have. I consider myself blessed to have you in my life. I love you 5ever. I also owe a huge debt of gratitude to Mami & Dadi for they’ve shown me great love and care. Thank you for making me feel that we’re already a family.

Lastly, to my Mama and Papa, I dedicate this paper to you, my heroes. Thank you for everything you have done for me. I am who I am because of your love. I love you so much Ma and Pa.

Tal-Tal

ABSTRACT

Diarrhea and pneumonia continue to be among the leading causes of under-5 mortality in many

developing countries like the Philippines. Knowledge and skills deficits on proper home

management of fever, cough and diarrhea were evident in Barangay Batu based on the survey

conducted. This pre- and post-intervention study aimed to determine if lecture with distribution

of pamphlets are effective in improving the maternal knowledge and skills on basic assessment

and home management of fever, cough and diarrhea in children 0-5 years old in Barangay Batu,

Siay, Zamboanga Sibugay Province. The convenience method of sampling was employed. The

knowledge of the 82 respondents was assessed using a questionnaire composed of fifteen (15)

multiple choice questions. To evaluate the skills of the mothers before and after the intervention,

a checklist was used. The skills assessment was composed of 6 stations, evaluated with a pass or

fail rating. The skills evaluated were the following: temperature taking, detection of danger signs

in a child with fever, counting of respiratory rate, detection of danger signs in a child with

cough, detection of danger signs in a child with diarrhea, and preparation of homemade oral

rehydration solution (ORS). Data collection was carried out before, immediately after, and two

months after the educational intervention. Data were analyzed using SPSS version 20 with

repeated measures ANOVA for knowledge and McNemar’s test for the skills. There was a

significant increase in the mean knowledge score of the mothers from 5.8537 before the

intervention to 11.7805 right after the intervention. Knowledge decay 2 months after the

intervention was noted from the decrease of the scores from post-intervention 1 (11.7805) to

post-intervention 2 (10.6098). For the skills, results revealed that there was an improvement on

the skills of the mothers on all of the stations right after the intervention with a P-value of 0.000.

Unlike the knowledge wherein significant decay was noted, the skills of the mothers were

retained 2 months after the intervention. This study then concludes that lecture with distribution

of pamphlets were effective in improving maternal knowledge and skills on basic assessment and

home management of fever, cough and diarrhea in children 0-5 years old.

CHAPTER I

INTRODUCTION

Background of the Study

Around 29,000 children under the age of five die every day, that is approximately 21

child deaths every minute, mainly from easily preventable and treatable illnesses such as

diarrheal dehydration and acute respiratory infections (ARI) (UNICEF, 2005). Diarrhea and

pneumonia continue to be among the leading causes of under-5 mortality in many developing

countries like the Philippines. The difficulties faced because of these diseases are especially

evident in rural or peri-urban communities in developing countries. According to a study

conducted in the rural areas in India, this could be attributed to lack of information among

mothers and caregivers of under-5 children on how to manage these illnesses at home and when

to bring the child to the nearest heath facility (Mane, Dohare, & Gitte, 2010).

A significant challenge in developing countries is to devise strategies with established

effectiveness extensively available to disadvantaged or underserved populations due to

socioeconomic disparities. Key interventions that were considered effective in decreasing child

morbidity and mortality due to diarrhea and pneumonia are vaccinating against the major causes

of pneumonia and diarrhea, encouraging infant breastfeeding, improving access to clean water

and sanitation, offering antibiotics for pneumonia and rehydration solutions for diarrhea, and

improving key family practices to better prevent illness in the home, managing illness when it

occurs and seeking preventive and curative services when necessary (World Health

Organization, 2011). The knowledge and skills gap is addressed by one of the strategies of the

Integrated Management of Childhood Illnesses (IMCI), that is to equip the mothers or the

primary caregivers with the knowledge and skills needed to properly manage childhood illnesses

at home and to promptly refer the child to the nearest health facility, thus reducing child

mortality.

The gaps in maternal knowledge and skills were apparent in Barangay Batu, Siay,

Zamboanga Sibugay Province where the two leading causes of child morbidity and mortality

from 2012-2014 were ARI and diarrhea (Barangay Batu Health Center Records, 2012-2014).

Last June 2014, the researcher conducted a house-to-house survey among 118 mothers with

children 0-5 years old regarding their practices on home management of fever, cough and

diarrhea. The following highlight the practices of mothers: in managing fever alone, 36% of the

mothers give antibiotic medications such as Cotrimoxazole, Chloramphenicol and Amoxicillin,

without seeking medical consult. For the management of acute cough in children, 68% of the

mothers administer antibiotic medications such as Amoxicillin and Cefalexin, mostly from

previous prescriptions and from the neighbors’ advice. In managing diarrhea at home, according

to 68% of the mothers, they give antibiotics such as Cotrimoxazole and Metronidazole to their

children. Forty-six percent (46%) of the mothers expressed that they let their children have soda

drinks, mostly Sprite. A number (17%) of the mothers give antidiarrheal to decrease the bowel

movements of their children. Despite the promotion of oral rehydration solutions (ORS) thru

advertisements in the media and procurement by the Department of Health of ORS packets for

giving away at barangay health centers nationwide, only 22% of the mothers give ORS to their

children at the first sign of diarrhea. Regarding awareness of ORS, 79% of the mothers are aware

of its existence. Despite these mothers being aware of ORS, only 32% actually tried giving ORS

to their children. Reasons for not giving ORS were lack of knowledge on the preparation of

homemade ORS, the diarrhea was not severe and the unavailability of the solution. These

improper practices make a difference in a child’s life; hence, it is vital to change these wrong

practices to correct ones.

Every time a child gets sick, the parents, who are the primary caretakers, are the first to

respond. They are the first ones to make a quick judgement regarding the signs and symptoms,

especially looking into the severity of the illness and what management could be done to treat the

ailment. The major determinant of the amount and type of care that a child receives is the

knowledge of the mother and caregivers (Kamau-Thuita, Omwega, & Muita, 2002). Thus, health

education targeting the mothers is vital. When the mothers are properly educated on important

health information such as the signs and symptoms of pneumonia and diarrhea, timely

recognition of the onset of disease, proper home management which includes prompt and correct

fluid replacement and timely medical consult with compliance to antibiotic treatment, they can

save the lives of their children.

Health education has already established its effectiveness in improving key family

practices. As stated by Das et al. (2013) in their study on the effect of community-based

interventions on childhood diarrhea and pneumonia, community-based health education

interventions led to significant rise in care-seeking behaviors with 13% and 9% increase in care-

seeking for pneumonia and diarrhea respectively. These interventions were associated with 160%

increase in the use of ORS. There was a 75% decline in the unnecessary use of antibiotics for

diarrhea and a 40% decrease in treatment failure rates for pneumonia (Das, Lassi, Salam, &

Bhutta, 2013). Also, involvement of health care personnel and medical students in targeted

health education classes is efficacious. Educational interventions done by health care

professionals may prove more effective than formal general health education classes taught by

uninterested, unenthusiastic, untrained school teachers (Agble & Arafa, 1999).

Regardless of so many educational strategies, the oldest and most commonly used

approach in delivering information is lecture. The lecture has many advantages which include

providing information to a large number of people, covering a large amount of material quickly,

and providing cost-effectiveness and efficient use of time (Comello, Russell, & Wright, 2007). In

the study conducted by Sarmiento (2008) on traditional healers, it was concluded that lecture is

an effective tool in improving the knowledge and skills of the respondents. But then, the

respondents who failed were subjected to tutorials to improve and to sustain retention of their

skills over time.

As stated by Tyler (2009), lectures will only address part of the learning cycle and appeal

most to participants who are primarily auditory learners or have an assimilating learning style,

while others may disengage from the presentation of the material. Therefore, other educational

strategies will be of benefit to supplement lecture in addressing the issues on various styles of

learning and deterioration of knowledge and skills.

Distribution of pamphlets is another effective strategy in conveying health information.

The advantages of pamphlet include its cost-effectiveness, convenience, and ease of preparation,

production and distribution. The pamphlet also serves as a reminder to the mother what to do

every time her child has an illness. Another advantage is that mothers who cannot read can find

the pictures helpful, or they can have a family member or friend read out the written instructions

on the pamphlet, thus other people will also learn from the pamphlet (Wadhwani, 2014). It was

stated in the study Knowledge Retention from Preoperative Patient Information that the use of

pamphlets to inform patients and to improve retention of skills is warranted (Stern & Lockwood,

2005).

Thus, the researcher would like to conduct a study on the effectiveness of the

combination of lecture and pamphlet distribution on the knowledge and skills of mothers. The

driving force for this study is the perceived health issue associated with knowledge and skills

deficit on basic assessment and proper home management of fever, cough and diarrhea.

Strategies to improve the knowledge and skills of the mothers in this community will be helpful

to avoid the consequences of improper home management of these illnesses and late referral to

the health care facility.

Statement of the Problem

Is lecture with pamphlet distribution effective in improving the knowledge and skills of

mothers on home management of fever, cough and diarrhea in children 0-5 years old in Barangay

Batu, Siay, Zamboanga Sibugay Province?

General Objective

To determine the effectiveness of the educational intervention through lecture with

distribution of pamphlets in improving the knowledge and skills of mothers on home

management of fever, cough and diarrhea in Barangay Batu, Siay, Zamboanga Sibugay Province.

Specific Objectives

1. To determine the knowledge of mothers on home management of fever, cough and

diarrhea before and after the lecture with pamphlet distribution.

2. To compare the knowledge of mothers on home management of fever, cough and

diarrhea before and after the lecture with pamphlet distribution.

3. To determine the skills of mothers on home management of fever, cough and diarrhea

before and after the lecture with pamphlet distribution.

4. To compare the skills of mothers on home management of fever, cough and diarrhea

before and after the lecture with pamphlet distribution.

Hypothesis

1. Null Hypothesis

The lecture and pamphlet have no effect on the knowledge and skills of mothers on home

management of fever, cough and diarrhea in Barangay Batu, Siay, Zamboanga Sibugay

Province.

2. Alternative hypothesis

The lecture and pamphlet have a positive impact on the knowledge and skills of mothers

in Barangay Batu, Siay, Zamboanga Sibugay Province regarding home management of

fever, cough and diarrhea.

Conceptual Framework

Figure 1. Conceptual Framework

It was noted that in this community, mothers resort to home management first in treating

child illnesses such as fever, cough and diarrhea, however, with inadequate knowledge and

improper skills. The combination of two educational interventions (lecture with pamphlets) will

be assessed as to their effectiveness in improving the knowledge and skills of mothers regarding

home management of fever, cough and diarrhea.

PROBLEM

ARI and diarrhea – two leading causes of under-five morbidity and mortality in Siay Knowledge and skills deficit on proper home management of fever, cough and diarrhea

RESULT

Improvement of maternal knowledge and skills

RESULT

No effect on maternal knowledge and skills

Educational intervention thru lecture with pamphlet distribution

Significance of the Study

The primary importance of this study is to determine the effectiveness of lecture with

pamphlet in improving the knowledge and skills on home management of fever, cough and

diarrhea among mothers. If these educational strategies are proven to be effective in improving

maternal knowledge and skills, health information drives conducted by community health

workers can then include lecture with distribution of pamphlets.

Scope and Delimitation

This study was designed to concentrate on the knowledge and skills of mothers who have

a child 5 years old and below on home management of three common childhood signs/symptoms

– fever, diarrhea and cough. Two educational interventions, lecture and pamphlet, were used in

combination to determine their impact on maternal knowledge and skills. The content of the

lecture and pamphlets included information on the basic assessment and home management of a

sick child with fever, diarrhea and cough. Information on basic assessment included the vital

signs (temperature and respiratory rate) taking and the danger signs or the manifestations that

should be closely monitored or looked for prompting the parent to seek immediate medical

advice. On home management, the content focused on promotion of breastfeeding, appropriate

drug use and preparation of homemade oral rehydration solution.

CHAPTER II

REVIEW OF RELATED LITERATURE

According to the Philippine Health Statistics, ARI and diarrhea remained to be the 1 st and

3rd leading causes of mortality of Filipino children less than 5 years old from 2004 to 2009. The

Pediatric Infectious Disease Society of the Philippines have also expressed that around 37

Filipino children below five years old die every day because of pneumonia and it is followed by

diarrhea which claims the lives of 13 children in this age group daily. Despite the availability of

preventive measures such as the vaccines, these two childhood illnesses remain to be the top

killers of Filipino children.

The study Determinants of Two Major Early Childhood Diseases and their Treatment in

the Philippines: Findings from the 1993 National Demographic Survey of the Philippines looked

into the levels of healthcare utilization which revealed that overall, only 52% of the children who

had suffered from ARI during the two-weeks before the survey had seen a doctor or other health

care professional. Of the children who had suffered diarrhea, 45% had seen a health care

professional, and only 18% had received ORS. This shows that mothers or other primary

caregivers resort to home management first before seeking medical treatment from health care

professionals. Also, it was discovered in this research that although efforts had been made to

recommend the use of ORS in the treatment of diarrheal diseases and to make it available, a

number (17%) of Filipino families were still treating diarrhea with expensive and inappropriate

medications such as antibiotics and antidiarrheal. Through the results of this study, they have

concluded that the Philippine Department of Health needs to continue to extend its services,

despite the commendable outcomes already seen (Costello, Lleno, & Jensen, 1996).

To answer these problems, the World Health Organization and United Nations Children

Funds have developed the Integrated Management of Childhood Illnesses (IMCI). IMCI is a

well-studied and integrated approach to child health that aims to reduce mortality, illness and

disability, and to promote improved growth and development among children under five years of

age. IMCI includes both preventive and curative elements that can be implemented not only by

health care workers, but also by families. One of the three components of IMCI, Community

IMCI, highlights the importance of action at the level of the home and community because the

practices of caretakers are crucial to preventing and treating child illness effectively. Community

IMCI delivers child health interventions to mothers and children who need them. It does this by

improving key family practices to better prevent illness in the home, managing illness when it

occurs and seeking preventive and curative services when necessary. Activities included in

community IMCI focus on improving availability and quality of health education, community-

based services, essential commodities and infrastructure (World Health Organization, 2011).

Effective educational techniques are essential for educating parents about proper child

care and home management of common childhood illnesses. Many studies have been done to

establish the effectiveness of different educational interventions in improving the knowledge and

enhancing the skills of their respondents.

The research entitled The Effect of Health Education on the Knowledge and Attitude

regarding Responsible Self –Medication on Common Illnesses among Mothers of Barangay San

Jose, Aurora, Zamboanga del Sur by Gapor (2006) showed that health education intervention

through lecture is an effective tool in improving the knowledge of mothers on responsible self-

medication. His study emphasized that health education through lecture is an effective method

to increase knowledge, but still additional strategies are recommended to sustain knowledge

retention. Immediately after the intervention, an increase in knowledge mean score was noted,

from a mean score of 21.29 to 24.26. This pointed out that the respondents had gained

knowledge after the intervention was done. However, one month after the intervention, a

decrease in mean knowledge score was noted, from 24.26 to 22.64. The decrease in mean

knowledge score was significant. This indicated that the respondents had knowledge decay. The

effect of health education on the attitude remains to be proven otherwise, as the respondents in

this study already had a positive attitude on the topic.

Sarmiento (2008) conducted a research on the effect of health education on the

knowledge and skills of traditional healers on the assessment and management of fever, ARI and

loose bowel movement (LBM) in 5 selected barangays of Sergio Osmeña, Sr., Zamboanga Del

Norte. Results had shown a significant increase in the knowledge mean score of respondents

from 6.67 before the intervention to 8.94 immediately after the intervention. The results of the

study revealed that lecture on fever, ARI and LBM as an interventional tool is effective in

improving the knowledge and skills of traditional healers.

The study The Effect of Lecture versus Lecture with Pamphlet on the Knowledge and

Practices of Mothers regarding Proper Use of Antibiotics in Alicia, Zamboanga Sibugay

Province conducted by Hassan-Samain (2010) revealed that the combination of lecture with

pamphlet is a better tool in increasing the knowledge of the respondents, improving their

practices and producing more compliance than using lecture alone. She concluded through this

research that lecture was indeed effective in enhancing the knowledge and practices of the

respondents but the combination of a lecture and pamphlet was more effective as people tend to

remember things if they are presented visually. The pamphlet served as a constant reminder

which they can read from time to time, unlike lecture which was conducted only once.

In Nepal, a study conducted by Ansari, Ibrahim, & Shankar (2012) entitled Mothers’

Knowledge, Attitude and Practice regarding Diarrhea and its Management in Morang Nepal: An

Interventional Study revealed that the effect of a sustained, meaning done again 1, 3 and 6

months after the first lecture discussion, educational interventions were beneficial in significantly

improving mothers’ overall knowledge, attitude and practices of managing diarrhea at home. The

median scores of knowledge, attitude and practice increased from 14, 7, 6 to 26, 9, 13,

respectively, due to the repeated interventions. The interventions were carried out in the form of

educational sessions (containing both text as well as pictures) in which the informational

contents were based on the protocol that was developed on the basis of United States Agency for

International Development (USAID) and WHO guidelines. The main limitations of the series of

educational interventions were financial and time constraints.

Tan (2014) conducted a study, which also focused on mothers, on the effect of health

education on the knowledge and skills on home management and prevention of diarrhea in

children 0 - 5 years of age in Barangay Paradise, Diplahan, Zamboanga Sibugay Province. The

objectives of his study was to determine the knowledge and skills of mothers regarding detection

of danger signs, timely referral, proper hand washing, preparation of oral rehydration solution

and management of acute diarrhea at home. He used a combination of lecture, visual aids,

pictures, actual demonstration, and return demonstration of skills by the respondents. The results

of his study showed that the educational interventions he utilized were effective in improving the

knowledge and skills, however, with noted knowledge and skills decay after 2 months.

The studies cited pointed out that different educational strategies have a positive impact

on improving the knowledge and skills of their respondents. Numerous studies have proven that

mothers, even if they have no educational background on health matters, can be taught so that

they can properly and promptly manage the common childhood illnesses at home. Different

modes of teaching or information dissemination have different advantages and disadvantages.

Also, Akmam (2001) from Japan emphasized in his study Maternal Education as a Strategy for

Children's Survival and Health in Developing Countries that in order to ensure children's

survival, the governments of third world countries, world organizations, donor countries and

Non-Government Organizations, must take initiatives to ensure literacy and sufficient health-

knowledge for the mothers and also provide appropriate conditions and environment for them to

apply that knowledge. Due to the health burden on the three child illnesses – fever, diarrhea and

cough, and with the established fact that the complications from these illnesses can be prevented

with proper health education among primary caregivers, the research on the effectiveness of

lecture with pamphlet on the knowledge and skills of mothers on home management of

childhood illnesses deemed significant.

CHAPTER III

METHODOLOGY

Research Design

This study utilized a pre- and post-interventional research design to determine the effect

of the combination of two educational interventions which are lecture and distribution of

pamphlets on the knowledge and skills of mothers on home management of fever, cough and

diarrhea in children 0-5 years old in Barangay Batu, Siay, Zamboanga Sibugay Province.

Research Setting

The study was conducted in Barangay Batu, Siay, Zamboanga Sibugay Province.

Barangay Batu has a total land area of 892 hectares, including 20 hectares of irrigated land. It has

10 puroks and most are located along the highway. Purok 6 is near the coast line while Purok 7 is

in the mountain area. The barangay has one health center manned by a rural health midwife

where the people could seek medical consult. For conditions which the rural health midwife

could not manage, the patient is referred to the Rural Health Unit located at Poblacion, with an

estimated distance of 11 kilometers, which could be reached by riding a motorcycle or bus.

Based on the data gathered at the Rural Health Unit, the three leading causes of morbidity

and mortality among children under five years of age in the municipality of Siay last 2013 were

upper respiratory tract infection, diarrhea and pneumonia. In Barangay Batu, the two leading

causes of morbidity among children 0-5 years old were also upper respiratory tract infection and

diarrhea.

Respondents

Mothers were the respondents for this study since according to the survey they are the

primary caregivers and the decision-makers when it comes to health issues. At first, the mothers

with a child aged 0-5years old were identified by the researcher through house-to-house survey.

A list of identified mothers was created, after which a series of home visits were done to

establish rapport and to ask the consent of the mothers to be the respondents for this study.

Drop-out Criteria

Respondents who failed to take the post-intervention questionnaire 1 and/or post-

intervention questionnaire 2.

Sampling Design

Convenience sampling was used in selecting the respondents. The study sample

comprised of mothers with children 5 years old and below who were available and were willing

to be respondents of this study. Only 89 mothers were available during the pre-intervention

assessment and all of them have taken the pre-intervention knowledge and skills exams.

However, 7 respondents were considered drop-outs after failing to complete the post-intervention

knowledge and skills assessment due to unavailability during the time allotted for the

assessment.

Research Instruments

The research instruments used were self-administered questionnaire and checklist. The

questionnaire was utilized to evaluate the knowledge of mothers on home management of fever,

cough and diarrhea, whereas the checklist was used to evaluate the skills of the mothers on

proper home management of fever, cough and diarrhea.

Questionnaire

A questionnaire was formulated with most of the questions adapted from the

questionnaire devised by Sarmiento (2008) in his study The Effect of Health Education on the

Knowledge and Skills of Traditional Healers on the Assessment and Management of Fever, ARI

and LBM in 5 Selected Barangays of Sergio Osmeña, Sr., Zamboanga Del Norte. Questions from

Sarmiento’s study that were not applicable to the respondents of this study were revised by the

researcher to make it more relevant to the mothers.

The questionnaire was composed of two (2) parts. The first part focused on the socio-

demographic profile of the mother and the second part concentrated on the knowledge of

mothers on home management of fever, cough and diarrhea in children. The first part included

data on name, age, occupation, religion, ethnicity, civil status, educational attainment, family

monthly income and the number of children aged 5 years and below. The second part of the

questionnaire contained fifteen (15) multiple choice questions; five (5) questions were allotted

for each child manifestation/illness – fever, cough and diarrhea. Knowledge questions focused on

the important assessment findings such as vital signs (temperature and respiratory rate) and the

danger signs or the manifestations that should be closely observed prompting the parent to seek

medical advice and on proper home management and timely referral to a health care facility.

The questionnaire formulated in English (see Appendix A) was translated to Bisaya (see

Appendix B), the local dialect of the respondents, by a Level IV Medical Student of Ateneo de

Zamboanga fluent in the said dialect. This was translated back by a registered nurse proficient in

the English language and Visayan dialect with the intention of verifying the accuracy and clarity

of the questionnaire. The questionnaire was pre-tested among twelve (12) mothers residing at

Barangay Coloran, Siay, Zamboanga Sibugay. The barangay was chosen because it has similar

sociocultural features with Barangay Batu. The pre-testing served as an opportunity wherein

terms and questions that were unclear were clarified and corrected.

Checklist

For the assessment and evaluation of the skills of the mothers pre- and post-intervention,

an all-or-none checklist (see Appendix C) was used. There were a total of 6 stations; 2 stations

for every child illness. Each respondent was evaluated on a one-on-one basis, based on their

ability to assess and manage simulated cases on fever, cough and diarrhea. The skills were

graded as pass or fail, meaning the respondents must obtain a pass rate in all items for each

station in order to get an overall pass rate for the skill. The skills evaluated were the following:

1. Fever

a. STATION 1: Temperature taking

To pass this station, the mothers should be able to demonstrate the four steps

in taking the temperature of the child correctly. The following are the four

steps: shake down the thermometer until it reads below 35°C, insert the

thermometer into the armpit, leave the thermometer in place for 3 to 5

minutes, and read the thermometer where the line of mercury ends.

b. STATION 2: Detection of danger signs and timely referral

To pass this station, the mothers should be able to enumerate at least 2 danger

signs to look for in a child with fever and to give the proper management for

the case, which is to refer the child to the nearest health care facility and

sponge bath the child on the way to the health care facility. The following are

the danger signs to look out for in a child with fever: bleeding at different sites

(nose, stools, gums, vomitus), generalized rashes, body rigidity or stiff neck,

pus draining from the eyes and mouth ulcers.

2. Cough

a. STATION 3: Counting of respiratory rate

To pass this station, the mothers should be able to demonstrate the proper

steps in counting the respiratory rate of the child and to give the correct actual

respiratory rate and fast breathing rate for the child.

b. STATION 4: Detection of danger signs and timely referral

To pass this station, the mothers should be able to detect chest indrawing and

stridor in a child with cough and to give the proper management for the case,

which is to refer the child to the nearest health care facility and to ensure

adequate ventilation.

3. Diarrhea

a. STATION 5: Detection of danger signs and timely referral

To pass this station, the mothers should be able to identify sunken eyes versus

normal eyes, to identify poor skin turgor, to check for the child’s general

condition and to give the proper management for the case, which is to offer

the child with fluids and to refer the child to the nearest health care facility.

b. STATION 6: Oral rehydration solution preparation

To pass this station, the mothers should be able to demonstrate accurately how

to prepare homemade oral rehydration solution with the correct amount of

ingredients.

Research Intervention

Lecture Guide

The lecture (see Appendices F & G) was based on the teaching module formulated by

Sarmiento (2008) in his study The Effect of Health Education on the Knowledge and Skills of

Traditional Healers on the Assessment and Management of Fever, ARI and LBM in 5 Selected

Barangays of Sergio Osmeña, Sr., Zamboanga Del Norte. Sarmiento’s teaching module was a

simplified version of the Integrated Management of Childhood Illness guidelines. The content of

this teaching module included information on the basic assessment and home management of

fever, cough and diarrhea.

1. Fever

a. Temperature taking

b. Danger signs to look out for when the child has fever

c. Home management of fever

2. Cough

a. Respiratory rate counting

b. Fast breathing rate per age group

c. Danger signs to look out for when the child has cough

d. Home management of cough

3. Diarrhea

a. Physical assessment (skin turgor, eyes)

b. Danger signs to look out for when the child has diarrhea

c. Home management of diarrhea (to include ORS preparation)

The researcher served as the lecturer in the health education sessions. Integrated

Management of Childhood Illness training video presentations were used for better appreciation

and understanding of the lecture.

Pamphlet

The pamphlets distributed have basically the same content with the lecture which was

adapted from the lecture module devised by Sarmiento (2008). The pamphlet (see Appendix H)

formulated in English was translated to Bisaya by a Level IV Medical Student of Ateneo de

Zamboanga fluent in the said dialect. Before distribution, the pamphlet was referred to the rural

health midwife to assess the content for clarity and correctness.

Data Gathering Procedure

Pre-intervention (October 3, 6 and 7, 2014)

A house-to-house visit was conducted to identify mothers who qualify for the study and

to obtain consent from them. Each participant was assured the right of confidentiality. With all

due respect, all other rights were upheld. The mothers who qualified and consented to participate

were gathered in their purok meeting place where pre-interventional assessment of knowledge

and skills was conducted. For those who were not able to go to the purok meeting place but were

willing to participate in the study, a house-to-house pre-interventional assessment was done. The

respondents were allowed to answer the questionnaire in 30 minutes. After that, they were

informed regarding the date, time and place of the scheduled small group lecture per purok.

Intervention (October 9-10, 2014)

During the pre-intervention assessment, the selected respondents were informed

regarding the date, time and place of the lecture on home management of fever, cough and

diarrhea in children. The lecture was conducted in groups of thirty mothers at their respective

purok meeting places. The 30-minute lecture session was conducted by the researcher. Visual

aids were used to show pictures on important assessment findings in children with diarrhea.

Video presentations from IMCI were also utilized to demonstrate how to assess for stridor and

chest indrawing in a child with cough, and also how to assess the hydration status of a child with

diarrhea. The mothers were allowed to attend only one lecture session. Two sessions of lecture

were conducted on the first day (one in the morning and one in the afternoon) and the last session

was conducted on the next day. The pamphlets were distributed before the start of the lecture.

Post-Intervention (October 9-11, 2014, December 5-7, 2014)

Two (2) post-intervention assessments were completed for this study. The first post-

intervention assessment of knowledge and skills was conducted right after the intervention. The

respondents answered the same questionnaire as the one given during the pre-intervention

assessment. The respondents were given 30 minutes to answer the questionnaire. After

answering the questionnaire, the respondents were evaluated on their skills on home

management through simulated cases on fever, cough and diarrhea. The medical students

assigned in Barangay Batu helped in proctoring the skills examination.

The second post-intervention assessment was held 2 months after the intervention to

assess for knowledge and skills retention. The same questionnaire and checklist were utilized.

Data Analysis

Data on socio-demographic profiles of the respondents were analyzed by frequency and

percentage. In comparing the knowledge of the participants before and after the educational

intervention, repeated measures ANOVA was used. In measuring the skills of the respondents

before and after the intervention, McNemar’s statistical analysis was utilized. These data were

analyzed using the Statistical Package for Social Sciences (SPSS) version 20.

Flow of Activities

PREPARATION PHASE: Lecture modules

Pamphlets Questionnaires & Checklists

SELECTION OF RESPONDENTS (Mothers)

PRE-TESTING AND FINALIZATION OF QUESTIONNAIRES

PRE-INTERVENTION ASSESSMENT

INTERVENTION PHASE:LECTURE with PAMPHLETS

POST-INTERVENTION ASSESSMENT 1 (immediately after the intervention)

POST-INTERVENTION ASSESSMENT 2(2 months after the intervention)

DATA COLLECTION, ANALYSIS AND

INTERPRETATION

Figure 2. Flow of Activities

CHAPTER IV

RESULTS

DEMOGRAPHIC PROFILE

There were a total of 89 mothers who participated in the study. These are the identified

mothers with children 0-5 years of age in Barangay Batu, Siay, Zamboanga Sibugay Province.

However, only 82 mothers were able to complete the post-intervention exams. Table 1

summarizes the demographic profile of the 82 respondents.

Table 1. Demographic Profile of the Respondents

Variables Frequency PercentageAge

21-2526-3031-3536-4041-4546-5051-55

62118171433

7.3%25.6%22.0%20.7%17.1%3.7%3.7%

Civil Status

MarriedWidowedSeparated

7741

93.9%4.9%1.2%

Occupation

HousewifeHelperFish Vendor

7343

89.0%4.9%3.7%

Farmer 2 2.4%Educational Attainment

Elementary LevelElementary GraduateHigh School LevelHigh School GraduateCollege LevelCollege Graduate

2713191562

32.9%15.9%23.2%18.3%7.3%2.4%

Ethnicity

BisayaSubanenIlonggoKalibogan

581743

70.7%20.7%4.9%3.7%

Religion

Roman CatholicIglesia Ni CristoFilipinistaKKDASeventh Day AdventistChurch of the Body ofChrist

54107722

65.9%12.2%8.5%8.5%2.4%2.4%

Family Monthly Income

0-500501-10001001-15001500-20002001-25002501-30003001-35003501-40004001-45004501-50005001-5500

10810178884342

12.2%9.8%12.2%20.7%9.8%9.8%9.8%4.9%3.7%4.9%2.4%

Number of children 0-5 years old

123

54226

65.9%26.8%7.3%

As shown in the table, the age of most mothers which comprise 25.6% of the group

ranges from 26 to 30 years old. Only 6 (7.3%) belong to the 21-25 years old age group, 18 (22%)

belong to the 31-35 years old age group, 17 (20.7%) are part of the 36-40 years old age group,

and 14 (17.1%) belong to the 41-45 years old age group. The least number of respondents belong

to the two oldest age groups (46-50 and 51-55 years old) with each comprising 3.7% of the total

respondents.

Most of the respondents are married. In terms of the occupation of the mothers, 73 or

89% stay at home as housewives, 4.9% of the respondents are helpers, 3 or 3.7% of them are fish

vendors, and 2 or 2.4% are farmers. As to the respondents’ educational attainment, 32.9% of the

mothers have only reached elementary level, followed by those who reached high school level

(23.2%). Sixteen percent (16%) have graduated from elementary and 18.3% have graduated from

high school. Only 7.3% of the respondents have reached college level and 2.4% graduated from

college.

Bisaya is the predominant ethnicity or tribe of the mothers accounting to 70.7%, followed

by Subanen (20.7%). Sixty-six percent (66%) of the respondents are Roman Catholics. The

family monthly income of most respondents (20.7%) ranges from 1,500 to 2,000 pesos. Sixty-six

percent (66%) of the mothers have only 1 child age 5 years old and below. While 26.8% have 2

and 7.3% have 3 children.

KNOWLEDGE

The knowledge of the 82 respondents was assessed using a questionnaire composed of

fifteen (15) multiple choice questions - five (5) questions for each childhood

manifestation/illness – fever, cough and diarrhea. To compare the knowledge of the mothers

before and after the educational intervention, repeated measures ANOVA was used.

Table 2. Comparison of Knowledge Mean Scores of Mothers before and after the intervention

Test Comparison Mean Score Mean Difference P-valuePre-interventionand Post-intervention 1

5.853711.7805

5.9268 0.000*

Pre-interventionand Post-intervention 2

5.853710.6098

4.7561 0.000*

Post-intervention 1and Post-intervention 2

11.780510.6098

1.1707 0.004*

*significant at P-value of <0.05

Based on the results seen in Table 2, there was an increase in the mean knowledge score

of the mothers from 5.8537 during the pre-intervention phase to 11.7805 right after the

intervention with a mean difference of 5.9268. The increase was significant with a P-value of

0.000. Therefore, the educational intervention was effective in improving the knowledge of the

mothers.

After which, the second post-intervention exam was given two months after the

intervention. Results revealed that there was an increase in the mean knowledge score from

5.8537 before the intervention to 10.6098 two months after the intervention with a mean score

difference of 4.7561. The mean score difference was also significant with a P-value of 0.000.

To evaluate for knowledge retention, the scores from post-intervention 1 to post-

intervention 2 were compared and analyzed. Mean score difference from these two exams was

1.1707. The decrease was significant with a P-value of 0.004. This indicates that there was

knowledge decay 2 months after the intervention.

SKILLS

To evaluate the skills of the mothers on assessment and home management of fever,

cough and diarrhea before and after the intervention, a checklist was used. The skills assessment

was composed of 6 stations, assessed with an all-or-none checklist to be rated as pass or fail as

the final rating for each skill. The respondents must obtain a pass rate in all items for each station

in order to get an overall pass rate for the skill.

Table 3. Number of Passers on the Skills Assessment before and after the intervention

Skills Pre-Intervention Post-Intervention 1 Post-Intervention 2Home Management Of Fever

(Temperature Taking)0 (0%) 65 (79.3%) 60 (73.2%)

Home Management Of Fever(Detection Of Danger Signs)

0 (0%) 57 (69.5%) 53 (64.6%)

Home Management Of Cough(Counting Of Respiratory Rate)

0 (0%) 28 (34.1%) 25 (30.5%)

Home Management Of Cough(Detection Of Danger Signs)

0 (0%) 44 (53.7%) 41 (50%)

Home Management Of Diarrhea(Detection Of Danger Signs)

0 (0%) 46 (56.1%) 39 (47.6%)

Home Management Of Diarrhea(Preparation Of ORS)

0 (0%) 67 (81.7%) 71 (86.6%)

As shown in Table 3, all of the respondents failed the six stations before the intervention.

Right after the intervention, there was an increase in the number of respondents who were able to

properly execute the skills on basic assessment and home management of fever, cough and

diarrhea. However, there was a noted decrease in the number of passers 2 months after the

intervention in all of the stations except for the station on preparation of oral rehydration

solution.

Table 4. Comparison of Skills of Mothers before and after the intervention using McNemar’s Test

Skills Test Comparison P – value

Home Management Of Fever(Temperature Taking)

Pre-intervention – Post-intervention 1 0.000*Pre-intervention – Post-intervention 2 0.000*

Post-intervention 1 – Post-intervention 2 0. 332

Home Management Of Fever(Detection Of Danger Signs)


Post-intervention 1 – Post-intervention 2 0.388

Home Management Of Cough(Counting Of Respiratory Rate)



Home Management Of Cough(Detection Of Danger Signs)



Home Management Of Diarrhea(Detection Of Danger Signs)



Home Management Of Diarrhea(Preparation Of ORS)


Post-intervention 1 – Post-intervention 2 0.541*significant at P-value of <0.05

Table 4 shows the improvement of skills after the intervention and the skills retention or

decay 2 months after intervention. Results revealed that there was an improvement on the skills

of the mothers on all of the stations right after the intervention with a P-value of 0.000. Also,

there was an improvement on the skills from the pre-intervention to post-intervention assessment

conducted 2 months after the intervention.

To note for skills decay or retention, results of the assessment between the 1 st and 2nd

post-intervention were compared. Results revealed that there was no skills decay on all of the

stations. The deterioration in skills from the 5 stations was not significant with a P-value of 0.332

for the station on temperature taking, P-value of 0.388 for detection of danger signs in fever, P-

value of 0.581 for the station on counting of respiratory rate, P-value of 0.700 for the station on

detection of danger signs in cough, and P-value of 0.281 for the station on detection of danger

signs in diarrhea. Likewise, the improvement of skills for the station on preparation of ORS was

also not significant with a p –value of 0.541.

CHAPTER V

DISCUSSION

Educational interventions employed at the grassroots level is essential in order to

effectively ensure that primary caregivers, even before they refer the sick child to the health care

facility, will be able to initiate basic assessment and proper home management of child illnesses.

According to the 2005 Cambodia Demographic and Health Survey, mothers and other primary

caretakers do not have the adequate knowledge of the danger signs alerting them to bring the

child to the nearest health facility. This was also the problem in Barangay Batu, Siay,

Zamboanga Sibugay Province. Hence, educational interventions are deemed important in

improving the knowledge and skills of the mothers on basic assessment and home management

of fever, cough and diarrhea in order to avoid consequences such as increased complications and

mortality.

A simplified version of the IMCI guidelines for fever, cough and diarrhea devised by

Sarmiento (2008) was used as the reference for the educational interventions. The content of the

lecture and pamphlet include information on basic assessment and home management of fever,

cough and diarrhea. The respondents of this study were mothers with children age 5 years old

and below residing at Barangay Batu, Siay, Zamboanga Sibugay Province. Majority (89%) of the

mothers were housewives which is the usual situation in a rural community. Most (90.3%) of the

respondents were not able to go to college. The socioeconomic statuses of the mothers, most

especially the educational attainment, deserve attention since these have an effect on the

perceptions and behaviour on health and child care. As stated by Akmam (2001), general

education equips the mothers with literacy, giving her access to books and to the mass media,

which keeps her up-to-date regarding new information on health affairs.

KNOWLEDGE

The knowledge of 82 mothers on home management of the three most common child

illnesses was assessed using the 15-item questionnaire. The mean knowledge score before the

intervention was only 5.8537. This indicates poor maternal knowledge which is also evident in a

study conducted in India entitled “Child Health: Understanding the home care practices in some

illnesses among Underfive children in IMNCI implemented rural area”. It was concluded in this

study that there were gaps in the knowledge of mothers on home-based management of fever,

ARI and diarrhea, thus indicating a need to address this knowledge gap in the community (Mane,

Dohare, & Gitte, 2010).

Immediately after the intervention, the mean knowledge score significantly increased to

11.7805 with a P-value of 0.000. This evident increase indicates that the lecture with distribution

of pamphlets was definitely effective in improving the knowledge of the mothers on basic

assessment and home management of fever, cough and diarrhea. The study result was similar to

that of Sarmiento (2008) that utilized lecture in increasing the knowledge of the traditional

healers on assessment and management of fever, cough and diarrhea.

Despite the positive results shown on the knowledge right after the intervention, decay

was significant two (2) months after the intervention. From a knowledge mean score of 11.7805

right after the intervention, it has decreased to 10.6098 two (2) months after the intervention.

This outcome can be explained by several theories that elucidate why retaining information in

our memory is of limited capacity and period. One of these theories is the Decay Theory which

believes that knowledge acquired simply dissolves over time unless we go over or review the

new information (Decay Theory, 2014). The Displacement Theory by Miller (1956) also

explains knowledge decay by proposing that our memory has only limited slots that can be filled.

Thus implying that old information already present in our memory is gradually replaced by new

information.

SKILLS

Lecture with distribution of pamphlets have also shown to be effective in improving the

skills of the mothers on basic assessment and home management of fever, cough and diarrhea.

The skills assessed were temperature taking, detection of danger signs in a child with fever,

counting of respiratory rate, detection of danger signs in a child with cough, preparation of ORS

and detection of danger signs in a child with fever.

All of the mothers failed the skills evaluation for all the six (6) skills before the

introduction of the educational interventions. This indicates that mothers have improper skills in

home management of these three common childhood illnesses. To a remarkable degree, maternal

skills have significantly improved after the lecture and distribution of pamphlets with a P-value

of 0.000. The study result is congruent to that of several other studies concluding that lecture can

effectively improve the skills of their respondents. A study by Tan (2014) entitled The Effect of

Health Education on the Knowledge and Skills of Mothers in the Home Management and

Prevention of Acute Diarrhea in Children 0 – 5 Years Old in Barangay Paradise, Diplahan,

Zamboanga Sibugay Province showed that health education through lecture is effective in

improving the skills of the mothers on home management of diarrhea. Moreover, Sarmiento

(2008) also stated in his study that lecture is effective in improving the skills of the traditional

healers on management of fever, ARI and diarrhea.

Unlike for the knowledge wherein decay was noted, the skills of the mothers were

retained 2 months after the intervention. In Sarmiento’s study, the traditional healers who failed

the skills evaluation were immediately subjected to tutorials until the respondents were able to

demonstrate the correct skills, thus their skills continued to improve and were retained over time.

However, in this study utilizing lecture with pamphlet as educational interventions, mothers were

not given tutorials after the evaluations, but remarkably, their skills were retained. This could be

attributed to the effectiveness of the distribution of pamphlets as a supplementary educational

intervention to lecture in sustaining skills retention. In the study A Comparative Study on the

Effectiveness of Pamphlet versus Pamphlet with Actual Demonstration on Breast Self-

Examination Among Women Ages 30-60 of Barangays Adante and North Poblacion Pinan,

Zamboanga del Norte, Fronda (2003) concluded that pamphlet with actual demonstration was

effective in improving the skills of the respondents on breast self-exam. The obtained results in

this study then further support that a combination of passive and active educational intervention

is effective in improving the skills of the respondents. According to Wadhwani (2014), the

pamphlet has several advantages. The pamphlet serves as a reminder to the mother what to do

every time her child has diarrhea. Another advantage is that mothers who cannot read can find

the pictures helpful, or they can have a family member or friend read out the written instructions

on the pamphlet, thus other people will also learn from the pamphlet.

CHAPTER VI

CONCLUSION AND RECOMMENDATION

Conclusion

Analysis of the results concluded that the educational interventions lecture with pamphlet

were effective in improving the knowledge and skills of the mothers on basic assessment and

home management of the three most common childhood illnesses - fever, cough and diarrhea.

The positive effect of the lecture and pamphlet on maternal skills was evident. Before

the intervention, all of the mothers failed to execute the six skills properly. Right after the

intervention, there was a significant improvement in maternal skills. Also, there was no skills

decay noted two months after the intervention. The distribution of pamphlets is therefore an

effective supplementary educational intervention to lecture in sustaining skills retention.

Comparing the knowledge of the mothers before and after the introduction of the

interventions, their knowledge on basic assessment and home management of fever, cough and

diarrhea has significantly increased. However, there was noted knowledge decay 2 months after

the intervention.

Recommendation

The researcher recommends the following:

A. Assessment of the baseline maternal knowledge and skills on home management of

fever, cough and diarrhea in different barangays/municipalities in the Philippines,

especially those areas having pneumonia and diarrhea as their top causes of morbidity

and mortality. Through this, appropriate interventions can be planned and devised to

fill the knowledge and skills gaps.

B. Training of the health workers such as the midwives and barangay nutritional scholars

to conduct series of health teaching and to distribute pamphlets utilized by the

researcher since these interventions have been proven to be effective in enhancing the

knowledge and improving the skills of the mothers.

C. Designing a pamphlet with illustrations that effectively conveys the important

information on basic assessment and home management of other common childhood

illnesses, besides the ones included in this study.

BIBLIOGRAPHY

Philippines Global Health Initiative Strategy Document for 2012-2016. (2011). Retrieved August 3, 2014, from U.S. Government Interagency: http://www.ghi.gov/whereWeWork/docs/PhilippinesStrategy.pdf

(2012-2014). Barangay Batu Health Center Records. Barangay Batu Health Center.

Decay Theory. (2014). Retrieved January 12, 2015, from Wikipedia: http://en.wikipedia.org/wiki/Decay_theory

Agble, Y., & Arafa, M. (1999). Health Education in schools: The Tabuk experience. Saudi Med J, 649-650.

Akmam, W. (2001). Maternal Education as a Strategy for Children's Survival and Health in Developing Countries, with Special Reference to Bangladesh. Eubios Journal of Asian and International Bioethics 11, 76-78.

Althabe, F., Bergel, E., Cafferata, M., Gibbons, L., Ciapponi, A., Aleman, A., et al. (2008). Strategies for Improving the Quality of Health Care in Maternal and Child Health in Low and Middle Income Countries: Overview of Systematic Reviews. Retrieved June 2, 2014, from World Health Organization: http://www.who.int/rpc/meetings/MCH_QI_strategies.pdf

Ansari, M., Ibrahim, M., & Shankar, P. (2012). Mothers’ Knowledge, Attitude and Practice regarding Diarrhea and its Management in Morang Nepal: An Interventional Study. Tropical Journal of Pharmaceutical Research October 2012, 847-854.

Comello, R., Russell, A., & Wright, D. (2007). Teaching Strategies Promoting Active Learning in Healthcare Education. Journal of Education and Human Development.

Costello, M., Lleno, L., & Jensen, E. (1996, August). Determinants of Two Major Early Childhood Diseases and their Treatment in the Philippines: Findings from the 1993 National Demographic Survey of the Philippines. Retrieved June 2, 2014, from Ateneo Social Science Research Center.

Das, J., Lassi, Z., Salam, R., & Bhutta, Z. (2013). Effect of community based interventions on childhood diarrhea and pneumonia: uptake of treatment modalities and impact on mortality. Retrieved June

2, 2014, from BioMed Central Public Health: http://www.biomedcentral.com/1471-2458/13/S3/S29

Fronda, C. R. (2003). A Comparative Study on the Effectiveness of Pamphlet versus Pamphlet with Actual Demonstration on Breast Self-Examination Among Women Ages 30-60 of Barangays Adante and North Poblacion Pinan, Zamboanga del Norte. ADZU-SOM.

Gapor, L. E. (2006). The Effect of Health Education on the Knowledge and Attitude regarding Responsible Self –Medication on Common Illnesses among Mothers of Barangay San Jose, Aurora, Zamboanga del Sur. ADZU-SOM.

Hassan-Samain, S. (2010). The Effect of Lecture versus Lecture with Pamphlet on the Knowledge and Practices of Mothers regarding Proper Use of Antibiotics in Alicia, Zamboanga Sibugay Province. ADZU-SOM.

Integrated Pronvincial Health Office. (2013). Vital Health Indices.

Kamau-Thuita, F., Omwega, A., & Muita, J. (2002). Child care practices and nutritional status of children aged 0-2 years in Thika, Kenya. Retrieved June 1, 2014, from National Center for Biotechnology Information, U.S. National Library of Medicine: http://www.ncbi.nlm.nih.gov/pubmed/12635757

Mane, A. B., Dohare, S., & Gitte, S. (2010). Child Health: Understanding the home care practices in some illnesses among Underfive children in IMNCI implemented rural area. International Journal of Biological & Medical Research, 1251-1254.

Sarmiento, C. R. (2008). The Effect of Health Education on the Knowledge and Skills of Traditional Healers on the Assessment and Management of Fever, ARI And LBM in 5 Selected Barangays of Sergio Osmeña, Sr., Zamboanga Del Norte . ADZU-SOM.

Stern, C., & Lockwood, C. (2005, April). Knowledge Retention from Preoperative Patient Information. Retrieved December 2014, from US National Library of Medicine National Institutes of Health: http://www.ncbi.nlm.nih.gov/pubmed/21631744

Tahil, S. (2005). The Effectiveness of Pamphlet versus Lecture on the Knowledge Enhancement of Women Ages 15-45 Years on Common Menstrual Complaints in Sergio Osmeña, Sr. Municipality, Zamboanga del Norte. ADZU-SOM.

Tan, N. A. (2014). The Effect of Health Education on the Knowledge and Skills of Mothers in the Home Management and Prevention of Acute Diarrhea in Children 0-5 Years Old in Barangay Paradise, Zamboanga Sibugay Province. ADZU-SOM.

Tyler, I. (2009, March). An Environmental Scan of Best Practices in Public Health Undergraduate Medical Education. Retrieved December 2014, from The Association of Faculties of Medicine of Canada: https://www.afmc.ca/pdf/Teaching%20Methods%20Final.pdf

UNICEF. (2005). Millennium Development Goals Report. Retrieved May 29, 2014, from UNICEF: http://www.unicef.org/mdg/childmortality.html

Wadhwani, N. (2014). Medical Education: Teaching Medical Students about Diarrhoeal Diseases. Retrieved December 1, 2014, from Rehydration Project: http://rehydrate.org/diarrhoea/tmsdd/4med.htm

World Health Organization. (2011). Community IMCI. Retrieved June 1, 2014, from World Health Organization: http://www.wpro.who.int/child_adolescent_health/documents/info_package5.pdf?ua=1.

APPENDIX A

QUESTIONNAIRE(ENGLISH VERSION)

GENERAL DATA:

NAME: _______________________________ AGE: ____________ PUROK: ___________

OCCUPATION: ________________________ CONTACT No.: ____________________________

RELIGION: ____________________________ ETHNICITY: ______________________________

CIVIL STATUS: □SINGLE □ MARRIED □ WIDOW □ SEPARATED

EDUCATIONAL ATTAINMENT:

□ ELEMENTARY LEVEL □ HIGH SCHOOL LEVEL □ COLLEGE LEVEL □ VOCATIONAL

□ ELEMENTARY GRADUATE □ HIGH SCHOOL GRADUATE □ COLLEGE GRADUATE □ NONE

FAMILY MONTHLY INCOME:

□ 0 – 500 □ 1,501 – 2,000 □3,001 – 3,500 □ 4,501 – 5,000

□ 501 – 1,000 □ 2,001 – 2,500 □3,501 – 4,000 □ 5,001 – 5,500

□ 1,001 – 1,500 □ 2,501 – 3,000 □ 4,001 – 4,500 □ OTHERS _______________

KNOWLEDGE ASSESSMENT:Encircle the letter corresponding to your best answer.

HOME MANAGEMENT OF FEVER

1. How many minutes should you put the thermometer in the axilla before reading it?

NAME OF CHILDREN 0-5 YEARS OLD AGE1.

2.

3.

4.

A. 10 seconds C. 2 minutesB. 30 seconds D. 5 minutes

2. What is the normal upper limit of axillary body temperature?A. 36.7 °C C. 38.7 °CB. 37.7 °C D. 39.7 °C

3. What are the danger signs to look for when the child has fever?A. Convulsion C. BleedingB. Body rigidity D. All of the above

4. How will you manage a child with fever without danger signs?A. Give antibiotics C. Sponge bathB. Cover the child with many blankets D. All of the above

5. How will you manage a child with fever and convulsion?A. Observe B. Refer immediately to the health center or hospitalC. Bathe child in cold waterD. Give antibiotics

HOME MANAGEMENT OF COUGH

6. What is the range of fast breathing for 2 months to 1 year of age?A. 60 breaths per minute or more C. 40 breaths per minute or moreB. 50 breaths per minute or more D. 30 breaths per minute or more

7. Which of the following is a danger sign to look for when the child has cough?A. Unable to drink C. Wheezing B. Nose bleeding D. Productive cough

8. How will you manage a child with cough of 2 days duration?A. Give antibiotics (such as Amoxicillin) C. ObserveB. Increase fluid intake D All of the above

9. A 3-year-old child is breathing fast if the respiratory rate is:A. 22 breaths per minute C. 42 breaths per minute B. 35 breaths per minute D. 30 breaths per minute

10. How will you manage a child with cough and fast breathing?A. Give antibiotics (such as Amoxicillin) C. ObserveB. Increase fluid intake D. Refer to health center or hospital

HOME MANAGEMENT OF DIARRHEA

11. What are the danger signs to look for when the child has diarrhea?A. Convulsion C. Difficult to awakenB. Sunken eyes D. All of the above

12. How will you manage a child with diarrhea of 1 day duration without danger signs?A. Give antibiotics C. Give antidiarrheal (Loperamide)B. Give soft drinks such as Sprite D. Give ORESOL

13. How is homemade oral rehydration solution (ORESOL) prepared?A. 1 liter of clean water, 8 teaspoons of sugar, 1 teaspoon of saltB. 1 liter of clean water, 1 teaspoon of sugar, 8 teaspoons of salt

C. 1 liter of clean water, 5 teaspoons of sugar, 2 teaspoons of saltD. 1 liter of clean water, 10 teaspoons of sugar, 5 teaspoons of salt

14. The prepared oral rehydration solution (ORESOL) should be consumed within:A. 12 hours C. 3 daysB. 24 hours D. 1 week

15. How will you manage a child with diarrhea, blood in the stools and sunken eyes?A. Observe C. Give

antibioticsB. Refer to health center or hospital D. Give

antidiarrheal (Loperamide)

APPENDIX B

QUESTIONNAIRE(VISAYAN VERSION)

GENERAL DATA:

NGALAN: _______________________________ EDAD: _________ PUROK: _________

TRABAHO: _____________________________ CONTACT No.: _______________________

RELIHIYON: ____________________________ TRIBO: ______________________________

CIVIL STATUS: □ULITAWO □ MINYO □ BALO □ BULAG

NAHUMAN SA PAG-ESKWELA: □ ELEMENTARY LEVEL □ HIGH SCHOOL LEVEL □ COLLEGE LEVEL □ VOCATIONAL

□ ELEMENTARY GRADUATE □ HIGH SCHOOL GRADUATE □ COLLEGE GRADUATE □ WALA

BINULAN NGA KITA SA PAMILYA:

□ 0 – 500 □ 1,501 – 2,000 □3,001 – 3,500 □ 4,501 – 5,000

□ 501 – 1,000 □ 2,001 – 2,500 □3,501 – 4,000 □ 5,001 – 5,500

□ 1,001 – 1,500 □ 2,501 – 3,000 □ 4,001 – 4,500 □ UBAN _______________

MGA PANGUTANA KABAHIN SA NAHIBALOAN:Linginan ang letra sa hustong tubag.

PAG-ATIMAN SA BATA NGA NAAY HILANAT

1. Unsa ka dugay ibutang ang termometer sa ilalum sa ilok ayha basahun?A. 10 ka segundo C. 2 ka minutoB. 30 ka segundo D. 5 ka minuto

NGALAN SA BATA 0-5 KA TUIG EDAD

1.

2.

3.

4.

2. Hangtud pila ang normal nga temperatura sa ilok?A. 36.7 °C C. 38.7 °CB. 37.7 °C D. 39.7 °C

3. Unsa ang mga delikadong sinyales nga kinahanglan pangitaon sa bata nga naay hilanat?A. KombulsyonB. Pag-gahi sa lawasC. PagdugoD. Ang tanan nga nahisulat

4. Unsa-on nimo pag-atiman sa bata nga naay hilanat?A. Pa-imnon og antibiotics C. Trapuhan ang kalawasan og basa nga labakaraB. Habolan ang bata D. Ang tanan nga nahisulat

5. Unsa-on nimo pag-atiman sa bata nga naay hilanat og kombulsyon?A. ObserbahanB. Dad-on dayon sa health center o ospitalC. Paliguan ang bata gamit ang bugnaw nga tubigD. Pa-imnon og antibiotics

PAG-ATIMAN SA BATA NGA NAAY UBO

6. Pila ang paspas nga pag-ginhawa sa 2 ka bulan hangtud 1 ka tuig nga bata?A. 60 ka ginhawa kada minuto o labaw pa C. 40 ka ginhawa kada minuto o labaw paB. 50 ka ginhawa kada minuto o labaw pa D. 30 ka ginhawa kada minuto o labaw pa

7. Unsa ang mga delikadong sinyales nga kinahanglan pangitaon sa bata nga naay ubo?A. Dili makainom C. Gihubak na pag-ginhawaB. Pagsunggo D. Ubo nga naay plema

8. Unsa-on nimo pag-atiman sa bata nga naay 2 ka adlaw nga ubo?A. Pa-imnon og antibiotics (Amoxicillin) C. ObserbahanB. Pa-imnon og daghan nga tubig D. Ang tanan nga nahisulat

9. Paspas ang pag-ginhawa sa 3 ka tuig nga bata kung ang iyang gininhawaan muabot og:A. 22 ka ginhawa kada minuto C. 42 ka ginhawa kada minutoB. 35 ka ginhawa kada minute D. 30 ka ginhawa kada minuto

10. Unsa-on nimo pag-atiman sa bata nga naay ubo og paspas nga pagginhawa?A. Pa-imnon og antibiotics (Amoxicillin) C. ObserbahanB. Pa-imnon og daghan nga tubig D. Dad-on dayon sa health center o ospital

PAG-ATIMAN SA BATA NGA NAAY KALIBANGA

11. Unsa ang mga delikadong sinyales nga kinahanglan pangitaon sa bata nga naay kalibanga?A. Kombulsyon C. Lisud pukawonB. Lalum ang mata D. Ang tanan nga nahisulat

12. Unsa-on nimo pag-atiman sa bata nga naay 2 ka adlaw nga kalibanga nga walay delikadong sinyales?A. Pa-imnon og antibiotics C. Pa-imnon og antidiarrheal (Loperamide)B. Pa-imnon og soft drinks (Sprite) D. Pa-imnon og ORESOL

13. Pila ka tubig, asukar ug asin ang kinahanglan sa paghimu og homemade oral rehydration solution (ORESOL)?A. 1 ka litro nga limpyu nga tubig, 8 ka kutsarita nga asukar, 1 ka kutsarita nga asinB. 1 ka litro nga limpyu nga tubig, 1 ka kutsarita nga asukar, 8 ka kutsarita nga asinC. 1 ka litro nga limpyu nga tubig, 5 ka kutsarita nga asukar, 2 ka kutsarita nga asin D. 1 ka litro nga limpyu nga tubig, 10 ka kutsarita nga asukar, 5 ka kutsarita nga asin

14. Hangtud kanus-a pwede mainom ang gihimo nga oral rehydration solution (ORESOL)?A. Sa sulod sa 12 oras C. Sa sulod sa 3 adlawB. Sa sulod sa 24 oras D. Sa sulod sa 1 semana

15. Unsa-on nimo pag-atiman sa bata nga nagkalibanga nga naay sagol dugo ang ta-e og lalum ang mata?A. Obserbahan C. Pa-imnon og antibioticsB. Dad-on dayon sa health center o ospital D. Pa-imnon og antidiarrheal (Loperamide)

APPENDIX C

SKILLS CHECKLIST

NAME: PUROK:

HOME MANAGEMENT OF FEVER:TEMPERATURE TAKING

PRE POST-1 POST-2

Shook down the thermometer until it reads below 35°C.Inserted the thermometer into the armpit.Left the thermometer in place for 3 to 5 minutes.Read the thermometer where the line of mercury ends.Gave Paracetamol to the child with fever.Did sponge bath.OVERALL RATE:

HOME MANAGEMENT OF FEVER:DETECTION OF DANGER SIGNS

PRE POST-1 POST-2

Looked for bleeding at different sites (nose, stools, gums, vomitus).Looked for generalized rashes.Looked for body rigidity or stiff neck.Looked for pus draining from the eyes.Looked for mouth ulcers.

Management: Brought the child to the health center/hospital.Did sponge bath.OVERALL RATE:

HOME MANAGEMENT OF COUGH:COUNTING OF RESPIRATORY RATE

PRE POST-1 POST-2

Expose the abdomen for clearer view.Calm the child before counting the respiratory rate.Count the respiratory rate in 1 full minute.Did the mother tell the correct respiratory rate.Correct fast breathing rate for the child.

OVERALL RATE:

HOME MANAGEMENT OF COUGH:DETECTION OF DANGER SIGNS

PRE POST-1 POST-2

Looked for and able to detect for chest indrawing.Detected for stridor.Management: Brought the child to the health center/hospital.Ensure adequate ventilation.OVERALL RATE:

HOME MANAGEMENT OF DIARRHEA:DETECTION OF DANGER SIGNS

PRE POST-1 POST-2

Looked for sunken eyes. Identified sunken eyes versus normal eyes.Identified poor skin turgor. Demonstrated skin pinch.Checked for general condition. (Restless and irritable, abnormally sleepy or difficult to wake.)Offered child some fluid, looked for increased thirst/ unable to drink.Management: Referred the child to the health center/hospital.OVERALL RATE:

HOME MANAGEMENT OF DIARRHEA:PREPARATION OF ORESOL

PRE POST-1 POST-2

Used 1L (5 cups) of clean drinking water.Dissolved 1 tsp. of salt into the 1L bottle of water.Dissolved 8 tsp. of sugar into the 1L bottle of water.Discard after 1 day/ 24 hours.OVERALL RATE:

APPENDIX D

KNOWLEDGE SCORES OF THE RESPONDENTS

PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 21 2 4 5 1 4 3 2 5 5 5 13 132 3 5 5 2 4 4 2 5 5 7 14 143 3 5 5 1 5 5 3 5 4 7 15 144 3 5 5 1 5 5 2 5 4 6 15 145 2 5 5 2 5 5 3 5 4 7 15 146 3 5 5 1 3 4 1 5 5 5 13 147 1 5 2 4 4 3 3 3 4 8 12 98 4 4 5 2 4 3 2 5 1 8 13 99 2 5 4 1 2 2 3 5 4 6 12 10

10 3 3 2 1 1 2 2 3 3 6 7 711 3 4 2 1 3 1 2 4 4 6 11 712 3 4 4 4 5 3 1 5 3 8 14 1013 1 3 2 2 2 2 3 3 4 6 8 814 3 3 3 1 4 2 2 4 4 6 11 915 1 4 2 1 3 0 1 3 4 3 10 616 1 4 3 1 5 4 3 4 4 5 13 1117 2 4 3 2 4 3 2 3 5 6 11 1118 2 3 4 2 3 2 1 5 5 5 11 1119 3 3 3 0 5 5 4 5 5 7 13 1320 1 5 3 2 3 4 3 5 5 6 13 1221 1 5 5 1 5 2 3 5 4 5 15 1122 2 2 4 1 2 4 3 5 4 6 9 1223 1 3 3 0 2 2 2 3 4 3 8 924 1 3 4 2 1 4 2 3 5 5 7 1325 3 4 2 0 4 2 4 5 5 7 13 926 2 5 3 1 5 4 2 5 5 5 15 12

RESPONDENTSHOME MANAGEMENT

OF FEVER (5 ITEMS)HOME MANAGEMENT OF COUGH (5 ITEMS)

HOME MANAGEMENT OF DIARRHEA (5 ITEMS)

TOTAL (15 ITEMS)

50

27 1 3 3 0 2 2 3 5 4 4 10 928 1 3 1 3 2 2 3 4 2 7 9 529 1 3 3 1 2 3 2 3 4 4 8 1030 2 3 3 1 3 5 2 4 5 5 10 1331 2 5 3 2 5 4 3 5 5 7 15 1232 2 5 3 1 5 4 3 3 5 6 13 1233 2 5 4 3 4 2 2 5 2 7 14 834 2 4 3 0 2 1 2 5 1 4 11 535 1 4 3 1 5 5 2 4 4 4 13 1236 2 5 5 1 5 5 2 5 4 5 15 1437 2 3 3 1 3 2 3 4 4 6 10 938 2 4 3 1 3 2 3 4 4 6 11 939 1 3 3 2 2 2 3 4 4 6 9 940 1 3 2 1 3 2 2 4 4 4 10 841 2 4 2 1 3 2 4 3 4 7 10 842 3 5 4 1 4 2 3 4 4 7 13 1043 3 5 4 1 4 2 3 4 4 7 13 1044 2 5 3 1 4 3 3 4 5 6 13 1145 2 5 4 1 5 4 4 5 4 7 15 1246 2 4 5 1 3 4 2 4 5 5 11 1447 3 5 5 2 4 4 3 4 5 8 13 1448 2 5 5 3 3 5 3 4 5 8 12 1549 3 5 5 2 3 4 0 5 5 5 13 1450 0 3 4 1 4 2 3 4 4 4 11 1051 4 4 3 1 2 1 2 4 3 7 10 752 2 5 5 1 5 5 3 5 5 6 15 1553 3 4 4 3 4 2 3 5 4 9 13 1054 0 2 2 1 1 2 2 1 3 3 4 755 1 5 3 3 2 3 3 3 4 7 10 1056 2 3 3 2 3 3 1 4 4 5 10 1057 3 4 4 2 3 2 3 5 4 8 12 10

51

58 3 4 3 1 2 1 3 4 4 7 10 859 1 4 3 0 4 3 3 4 4 4 12 1060 4 4 4 3 4 3 3 5 4 10 13 1161 2 5 4 2 5 5 2 5 4 6 15 1362 3 5 3 3 4 2 3 5 4 9 14 963 1 2 3 1 3 1 1 3 3 3 8 764 1 4 4 2 3 5 2 4 5 5 11 1465 2 4 3 2 3 3 2 4 4 6 11 1066 2 2 2 1 1 1 2 2 2 5 5 567 3 5 2 2 4 4 3 5 5 8 14 1168 1 3 4 1 2 2 1 4 4 3 9 1069 4 5 4 2 5 2 2 4 4 8 14 1070 3 5 4 1 5 4 2 5 5 6 15 1371 3 5 5 1 5 4 2 5 5 6 15 1472 2 5 5 0 3 4 2 4 4 4 12 1373 2 4 4 1 5 5 2 5 5 5 14 1474 2 4 5 2 4 4 2 5 4 6 13 1375 1 2 4 2 2 1 4 4 4 7 8 976 2 5 5 0 3 4 3 3 5 5 11 1477 1 4 4 0 5 5 3 5 4 4 14 1378 0 5 2 1 2 1 4 5 3 5 12 679 0 4 3 1 3 3 2 5 4 3 12 1080 3 5 2 0 5 2 2 4 4 5 14 881 4 5 5 1 4 3 2 5 5 7 14 1382 1 3 2 1 3 2 3 3 4 5 9 8

TOTAL 480 966 870MEAN SCORE 5.853659 11.78049 10.60976

52

APPENDIX E

SKILLS ASSESSMENT SCORES OF THE RESPONDENTS

PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 2 PRE POST 1 POST 21 0 1 1 0 1 1 0 1 0 0 1 1 0 1 1 0 1 12 0 1 1 0 1 1 0 1 1 0 0 1 0 1 1 0 1 13 0 1 1 0 1 1 0 1 1 0 1 1 0 1 0 0 1 14 0 1 1 0 1 1 0 1 1 0 1 1 0 1 0 0 1 15 0 1 1 0 1 1 0 1 1 0 1 1 0 1 0 0 1 16 0 1 1 0 1 1 0 0 0 0 1 1 0 1 1 0 1 17 0 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 18 0 0 1 0 1 1 0 0 0 0 0 1 0 1 0 0 1 09 0 1 1 0 1 1 0 0 0 0 1 0 0 1 0 0 1 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 112 0 0 1 0 1 1 0 1 0 0 1 1 0 1 0 0 1 013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 115 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 116 0 1 1 0 1 1 0 1 1 0 1 1 0 0 1 0 1 117 0 1 1 0 0 0 0 0 0 0 1 1 0 1 1 0 0 118 0 0 1 0 0 1 0 0 0 0 0 0 0 1 1 0 1 119 0 1 1 0 1 0 0 1 1 0 1 1 0 1 1 0 1 120 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 121 0 1 1 0 1 1 0 1 0 0 1 0 0 1 1 0 1 022 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 123 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 124 0 1 0 0 1 1 0 0 0 0 1 1 0 0 1 0 0 125 0 1 0 0 1 1 0 1 0 0 1 0 0 1 1 0 1 126 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 127 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1

DETECTION OF DANGER SIGNS PREPARATION OF ORESOLHOME MANAGEMENT OF DIARRHEA

RESPONDENTSHOME MANAGEMENT OF FEVER HOME MANAGEMENT OF FEVER HOME MANAGEMENT OF COUGH HOME MANAGEMENT OF COUGH HOME MANAGEMENT OF DIARRHEA

TEMPERATURE TAKING DETECTION OF DANGER SIGNS COUNTING OF RESPIRATORY RATE DETECTION OF DANGER SIGNS

53

28 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 029 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 130 0 1 1 0 1 0 0 0 1 0 0 1 0 0 1 0 1 131 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 132 0 1 0 0 1 1 0 1 1 0 1 0 0 0 1 0 1 133 0 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 1 034 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 035 0 1 1 0 1 1 0 1 1 0 1 1 0 0 0 0 1 136 0 1 1 0 1 1 0 1 1 0 1 1 0 1 0 0 1 137 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 138 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 139 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 140 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 141 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 142 0 1 1 0 1 1 0 0 0 0 1 1 0 0 1 0 1 043 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 1 044 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 1 145 0 1 1 0 1 1 0 1 1 0 1 1 0 1 0 0 1 146 0 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 1 147 0 1 1 0 1 1 0 1 1 0 1 1 0 0 1 0 1 148 0 1 1 0 1 1 0 0 1 0 1 0 0 1 1 0 0 149 0 1 1 0 1 1 0 0 0 0 0 0 0 1 1 0 1 150 0 0 1 0 0 1 0 0 0 0 1 1 0 0 0 0 1 151 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 052 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 153 0 1 1 0 1 1 0 1 0 0 1 0 0 1 0 0 1 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 157 0 1 1 0 1 1 0 0 0 0 0 1 0 1 0 0 1 1

54

58 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 159 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 0 1 160 0 1 1 0 1 1 0 1 0 0 0 1 0 1 1 0 1 161 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 162 0 1 1 0 1 1 0 0 0 0 1 1 0 1 1 0 1 063 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 164 0 1 1 0 1 1 0 0 1 0 0 1 0 0 1 0 1 165 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 067 0 1 0 0 1 1 0 0 0 0 1 0 0 1 1 0 1 168 0 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 1 169 0 1 1 0 1 1 0 1 0 0 1 1 0 1 1 0 0 170 0 1 0 0 1 1 0 1 1 0 1 1 0 1 1 0 1 171 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 172 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 1 173 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 174 0 1 1 0 1 1 0 1 1 0 0 0 0 1 1 0 1 175 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 176 0 1 1 0 1 1 0 0 1 0 1 1 0 0 1 0 1 177 0 1 1 0 1 1 0 0 1 0 0 0 0 1 1 0 1 178 0 1 1 0 1 0 0 0 0 0 1 0 0 1 0 0 1 179 0 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 1 180 0 1 0 0 1 0 0 1 0 0 1 1 0 1 1 0 1 181 0 1 1 0 1 1 0 1 1 0 0 1 0 1 1 0 1 182 0 1 1 0 0 0 0 0 0 0 1 1 0 1 0 0 0 1

PASSERS 0 65 60 0 57 53 0 28 25 0 44 41 0 46 39 0 67 71

55

APPENDIX F

Module 1: Assessment and Management of Children with Fever

Objectives:At the end of the lecture, mothers will be able to:1. Identify the danger signs of fever.2. Know when to bring the child to the nearest hospital.3. Learn how to use a thermometer.4. Learn how to sponge bath a child with fever.

Materials needed:1. Thermometer2. Sponge cloth

3. Basin4. Water

How to use thermometer:Step 1 - Shake down the thermometer until it reads below 35 degrees.Step 2 - Insert the thermometer into the armpit.Step 3 - Leave the thermometer in place for 3 to 5 minutes.Step 4 - Read the thermometer where the line of mercury ends.

Clean a glass thermometer with soap and water. Sterilize it by soaking it in alcohol.

Sponge bath

Give Paracetamol for high fever (38.5°C or above).

Do not over-dress or under-dress the child, or wrap the child in heavy blankets.

Encourage the child to drink fluids regularly.

Seek medical consult in 2 days if fever persists.

No danger signs

Make sure the child with danger signs is referred IMMEDIATELY to the health center or hospital.

Sponge bath the child on the way.

A child with danger signs needs URGENT attention.

If with one or more danger

signs

Danger Signs of fever

Does the child have:

Fever 3 days in duration

Convulsion

Persistent vomiting

Bleeding/ Bloody

o Noseo Gumso Vomito Stools

Black vomitus

Black stools

Look for:

Generalized rash

Body rigidity or stiff neck

Pus draining from the eyes

Mouth ulcers

Module 2: Assessment and Management of Children with Cough

Objectives:At the end of the lecture, mothers will be able to:1. Identify the danger signs of cough/ acute respiratory infection (ARI).2. Know the range of fast breathing per age group.3. Know when to refer a child with cough/ acute respiratory infection.

Materials needed:1. Watch

AGE OF CHILD: FAST BREATHING IS:Less than 2 months old 60 breaths per minute or more2 months up to 1 year old 50 breaths per minute or more1 year to 5 years old 40 breaths per minute or more

Encourage the child to drink fluids regularly.

Breastfeeding.

Hygienic practice to avoid spread of infection to others by oro-nasal droplet

Do not give antibiotics unless prescribed by the physician.

Seek medical consult in 5 days if cough persists or conditions worsen.

No danger signs

Loosen constrictive clothing and clear the airway from any obstruction.

Ensure adequate ventilation.

Restrict any fluid intake.

Make sure the patient with danger signs is referred immediately to the health center or hospital.

If with one or more danger signs

Danger Signs of cough/acute

respiratory infection:

Not able to drink or feed

Vomit everything

Convulsion

Cough of 3 days in duration

Look (the patient must be calm):

Abnormally sleepy or difficult

to awaken

Difficulty of breathing

Cyanosis

Chest indrawing

Stridor

Fast breathing

Module 3: Assessment and Management of Children with Diarrhea

Objectives:At the end of the lecture, mothers will be able to:1. Identify the danger signs of diarrhea and dehydration.2. Know when to refer the child with diarrhea.3. Know the indications and benefits of rehydration solutions and breast feeding.4. Learn how to prepare oral rehydration solutions.

Materials needed:

1. Refined sugar2. Salt

3. Boiled water 4. Water container

Breast-feeding Has valuable nutritional and immunological properties. Decreases stool volume and prevents hypernatremia.

Rice Water Solution Reduce stool output and lessen frequency of watery stools. Should be offered together with other semi-solid foods.

Oral Rehydration SaltsDirection: dissolve 1 sachet (27.9 g) in 1 liter of cooled freshly boiled water. Use solution within 24 hours only.

Homemade Oral Rehydration SolutionSubstitute for Oral Rehydration Solution (ORS) when ORS is not available

Ingredients: 1 teaspoonful fine salt 8 teaspoonful of refined sugar 1 liter drinking water Dissolve the salt and sugar in the water. Use solution within 24 hours only.

Make sure the child with danger signs is referred IMMEDIATELY to the health center or hospital.

Continue breastfeeding. If able to drink, give ORS.

Let the child consume as much as he/she can.

A child with danger signs needs URGENT attention

Danger Signs of diarrhea:

Voluminous diarrhea Vomit everything Convulsion Blood in the stool Diarrhea of 3 days in

duration Sunken eyes

Observe: Abnormally sleepy or

difficult to awaken Restless and irritable

Offer fluid: Not able to drink or

drinking poorly Drinking eagerly or thirsty

Pinch the skin of the abdomen:Does it go back -

Very slowly (longer than 2 seconds)

Slowly

If with one or more danger

signs

No danger signs

Continue breastfeeding.

If able to drink, give ORS. Use ORS for volume per volume replacement of fluids. Let the child consume as much as he/she can.

Do not give antibiotics unless prescribed by the physician.

Seek medical consult in 5 days if diarrhea persists or condition worsens.

Kinahanglan dad-on dayon ipakunsulta sa health center o ospital

Ipadayon ang pagtrapo sa bata samtang ginahatud.

Ang bata nga na-a sa peligro kinahanglan og DAYONG pagtagad.

APPENDIX G

Module 1: Pag-atiman sa bata nga naay Hilanat

Katuyoan:Pagkahuman sa pag-tuon ang mga inahan:1. Mahibalo sa pag-bantay sa peligrong sinyales sa hilanat.2. Kahibalo kanus-a ang bata ipakunsulta sa iyang kahimtang.3. Kahibalo unsa-on pag-gamit sa termometer.4. Mahibalo unsaon pagtrapo (sponge bath) sa pasyente nga dunay hilanat.

Mga gamiton:1. Termometer2. Gamay nga tualya o labakara

3. Palanggana4. Limpyong tubig

Ang pamaagi sa paggamit sa termometer::Una – Uyogon ang termometer hangtod sa mabasa kini 35°C paubos.Ikaduha – Iipit ang termometer sa ilok.Ikatulo – Ipabilin ang termometer nga nakaipit sulod sa 3-5 ka minutos.Ikaupat – Pagabason ang termometer kung asa ang linya sa mercury miundang.

Hugasan ang termometer pinaagi sa tubig ug sabon. Kung e-isterelays ihumol sa alkohol.

Peligrong Sinyales sa Hilanat:

Ang bata ba naay:

Hilanat nga tulo na ka adlaw

Kombulsyon

Walay undang ang pagsuka

Pag-dugo sa

o Ilongo Laguso Sukao Ta-e

Itum nga suka

Itum nga ta-e

Unsa ang pangitaon:

Pula-pula sa kalawasan

Pag-gahi sa kalawasan o li-og

Pag-nana sa mata

Lu-as

Kung usa odaghang

peligrosongsinyales nga

maobserbahan

Kung walaypeligrosong

sinyales

Trapuhan ang kalawasan og basa nga labaka.

Hatagi og Paracetamol kung ang temperatura moabot na og 38°C pataas

Kinahanglan husto ra ang pagsuot og sanina, dili kulang o pasobrahan.

Gina awhag sa regular nga pagpainom og tubig.

Ipakonsulta human sa 2 ka adlaw kung nagpadayon o mas nagrabe ang sakit.

Abrihan ang mga guot nga sapot aron maayo ang paggihawa.

Pag-hatag og hamugaway nga pagginhawa.

Ayaw pag hatag og mainom.

Kinahanglan dad-on dayon ipakunsulta sa health center o ospital.

Module 2: Pag-atiman sa bata nga naay Ubo

Katuyoan:Pagkahuman sa pag-tuon ang mga inahan:1. Mahibalo sa pag-bantay sa peligrong sinyales sa ubo.2. Kahibalo sa han-ay na paspas nga pag-ginhawa uyon sa edad.3. Kahibalo kanus-a ang bata ipakunsulta sa iyang kahimtang.

Mga gamiton:2. Relo (adunay segundo)

EDAD: PASPAS NGA PAG-GINHAWA< 2 ka bulan 60 kada minuto og labaw pa2 ka bulan - 1 ka tuig 50 kada minuto og labaw pa1 – 5 ka tuig 40 kada minuto og labaw pa

Peligrong Sinyales sa Ubo:

Dili maka-inum o kaon

Kanunay mosuka

Kombulsyon

Ubo sa tulo ka adlaw

Unsa ang pangitaon

(kinihanglan kalmado ang bata):

Kanunay katulgon o lisud

pukawon

Maglisod mag-ginhawa

Mag lagum

Pag-lalum sa gusok

Banha o paspas nga pag-

ginhawa

Dunga-gan o padaghanon ang pagpa-inom og tubig.

Pag-tambag sa bata nga likayan mu-ubo og sikma sa lain nga tawo.

Ayaw hatagi og antibiotic kung dili giprescribe sa doctor.


Kung usa odaghang


maobserbahan


sinyales

Module 3: Pag-atiman sa bata nga naay Kalibanga

Katuyoan:Pagkahuman sa pag-tuon ang mga inahan:1. Mahibalo sa peligrosong sinyales sa kalibanga o mahut-dan og tubig sa lawas.2. Mahibalo kung kanus-a ipakunsulta ang bata nga dunay kalibanga3. Mahibalo sa mga benipisyo sa pag-inom ug oresol og ang pagpasuso.4. Mahibalo unsaon pag-andam sa mga inumon (oresol) para sa batang dunay kalibanga.

Mga gamiton:

1. Puti nga asukal2. Asin

3. Limpyong tubig4. Sudlanan sa tubig

Pagpasuso sa Bata Dunay hataas nga kalidad sa nutrisyon og pagsanta sa mga sakit. Pag-kunhod sa kantidad sa ta-e.

Tubig Gikan sa Bugas Pag-kunhod sa pag-tae og pagkalibang nga basa. Gikinahanglan inumon uban sa mga dili gahi nga mga pagkaon.

Oral Rehydration SaltsI-timpla ang usa ka pakete (27.9 gramo) sa isa ka litro nga pinabugnaw nga pinabukalang tubig. Gamiton ang oresol sulod sa 24 oras lamang.

Homemade Oral Rehydration SolutionUnsaon paghimo sa asukal og asin nga ORESOL?

Mga Gamit:

1 ka kutsaritang pino nga asin 8 ka kutsaritang puting asukar 1 ka litro nga tubig mainom Itimpla ang asin og asukal sa tubig. Gamiton ang oresol sulod sa 24 oras lamang.

Kinahanglan dad-on dayon ipakunsulta sa health center o ospital.

Kung ginapasuso, pagpadayon og pasuso.

Kung makainom, taga-an og ORESOL. Kung wala, taga-an og limpyong tubig. Painom hangtud sa iyang mahurot.

Peligrong Sinyales sa Kalibanga:

Kalibanga nga daghan Gisuka ang tanang kina-on Kombulsyon Dugo sa Ta-e Kalibanga sa tulo ka adlaw Lawom og mata

Obserbasyon: Kanunay katulgon og lisud

pukawon Dili mahimtang og irritable

Tagaan og tubig: Dili muinom og tubig Perme uhawon

Kusi-on ang panit dapit sa tiyan:Mubalik ba kini-

Dugay kaayo (abot 2 ka segundo) mubalik

Dugay

Kung ginapasuso, pagpadayon og pasuso.

Kung makainom, taga-an og ORESOL. Kung wala, taga-an og limpyong tubig. Pa-imnon og ORESOL sama sa kadaghanon sa tubig nga muguwas sa lawas sa bata.

Ayaw hatagi og antibiotic/antidiarrheal kung dili giprescribe sa doctor.


Kung usa odaghang


maobserbahan


sinyales

FEVER

Danger signs:

Fever 3 days in duration Convulsion Persistent vomiting Bleeding/ Bloody

- Nose - Vomitus - Gums - Stools

Black vomitus Black stools

Look for: Generalized rash Body rigidity or stiff neck Pus draining from the eyes Mouth ulcers

Management:

WITH Danger sign/s

Refer IMMEDIATELY Sponge bath the child on the way

WITHOUT Danger sign

Sponge bath Paracetamol for high fever (38.5°C or above) Do not over-dress or under-dress Encourage to drink fluids regularly Seek medical consult in 2 days if fever persists

COUGH

Danger Signs:

Not able to drink or feed Vomit everything Convulsion Cough of 3 days in duration

Look (the patient must be calm): Abnormally sleepy or difficult to awaken Difficulty of breathing Cyanosis Chest indrawing Stridor Fast breathing

Management:

WITH Danger sign/s

Ensure adequate ventilation Restrict any fluid intake Refer IMMEDIATELY

WITHOUT Danger sign

Encourage to drink fluids regularly; breastfeeding Hygienic practice to avoid spread of infection Do not give antibiotics unless prescribed by the

doctor Seek medical consult in 5 days if it persists or

worsens

DIARRHEA

Danger Signs:

Voluminous diarrhea Vomit everything Convulsion Blood in the stool Diarrhea of 3 days in duration Sunken eyes Abnormally sleepy or difficult to awaken Restless and irritable Not able to drink or drinking poorly Drinking eagerly or thirsty

Pinch the skin of the abdomen: It goes back very slowly (longer than 2

seconds)

Management:

WITH Danger sign/s

Refer IMMEDIATELY Continue breastfeeding If able to drink, give ORS

WITHOUT Danger sign

Continue breastfeeding If able to drink, give ORS Do not give antibiotics unless prescribed by the

doctor Seek medical consult in 5 days if it persists or

worsens

APPENDIX H

AGE OF CHILD: FAST BREATHING IS:< 2 months old ≥60 breaths per minute

2 mos - 1 yr old ≥50 breaths per minute1 yr - 5 yrs old ≥40 breaths per minute

HOME MANAGEMENT OF COMMON

CHILDHOOD ILLNESSES: FEVER, COUGH and

DIARRHEA

Prepared by:Cristal Joyce S. Teo

Sources: WHO/UNICEF Integrated Management

of Childhood Illness (2014),National Center for Disease Control

and Prevention - Department of Health

How to prepare packaged Oral Rehydration Solution (ORS)

How to prepare homemade Oral Rehydration Solution (ORS)

Use ORESOL within 24 hours only.

HILANATPeligrosong sinyales:

Hilanat nga tulo na ka adlaw

Kombulsyon Walay undang ang pagsuka Pag-dugo sa

- Ilong - Suka - Lagus - Ta-e

Itum nga suka Itum nga ta-e

Unsa ang pangitaon: Pula-pula sa kalawasan Pag-gahi sa kalawasan o li-og Pag-nana sa mata Lu-as

Pag-atiman sa bata nga naay Hilanat:

Kung naay peligrosong sinyales nga maobserbahan


Ipadayon ang pagtrapo sa bata samtang ginahatud.

Ang bata nga na-a sa peligro kinahanglan og DAYONG pagtagad

Kung walay peligrosong sinyales Trapuhan ang kalawasan og basa nga labaka

(sponge bath) Hatagi og Paracetamol kung ang temperatura

moabot na og 38.5°C pataas Kinahanglan husto ra ang pagsuot og sanina, dili

kulang o pasobrahan Gina awhag sa regular nga pagpainom og tubig Ipakonsulta human sa 2 ka adlaw kung

nagpadayon o mas nagrabe ang sakit.

UBOPeligrosong sinyales:

Dili maka-kaon o inum Kanunay mosuka Kombulsyon

Ubo sa tulo ka adlaw

Unsa ang pangitaon (kinihanglan kalmado ang bata): Kanunay katulgon o lisud pukawon Maglisod mag-ginhawa Mag lagum Pag-lalum sa gusok Banha o paspas nga pag-ginhawa

Pag-atiman sa bata nga naay Ubo:

Kung naay peligrosong sinyales nga maobserbahan Abrihan ang mga guot nga sapot aron maayo ang

paggihawa. Pag-hatag og hamugaway nga pagginhawa.

Ayaw pag hatag og mainom Kinahanglan dad-on dayon ipakunsulta sa health

center o ospital

Kung walay peligrosong sinyales Dunga-gan o padaghanon ang pagpa-inom og

tubig Pag-tambag sa bata nga likayan mu-ubo og sikma

sa lain nga tawo Ayaw hatagi og antibiotic kung dili giprescribe sa

doctor Ipakonsulta human sa 5 ka adlaw kung

nagpadayon o mas nagrabe ang sakit.

KALIBANGA

Peligrosong sinyales:

Kalibanga nga daghan Gisuka ang tanang kina-on Kombulsyon Dugo sa Ta-e Kalibanga sa tulo ka adlaw

Lawom og mata Kanunay katulgon og lisud pukawon Dili mahimtang og irritable Dili muinom og tubig Perme uhawon

Kusi-on ang panit dapit sa tiyan: Dugay kaayo (abot 2 ka segundo) mubalik

Pag-atiman sa bata nga naay Kalibanga:

Kung naay peligrosong sinyales nga maobserbahan


Kung ginapasuso, pagpadayon og pasuso Kung makainom, taga-an og ORESOL. Kung wala,

taga-an og limpyong tubig. Painom hangtud sa iyang mahurot.

Kung walay peligrosong sinyales

Kung ginapasuso, pagpadayon og pasuso Kung makainom, taga-an og ORESOL. Kung wala,

taga-an og limpyong tubig. Pa-imnon og ORESOL sama sa kadaghanon sa tubig nga muguwas sa lawas sa bata.

Ayaw hatagi og antibiotic/antidiarrheal kung dili giprescribe sa doctor


EDAD: PASPAS NGA PAG-GINHAWA

< 2 ka bulan 60 kada minuto og labaw pa

2 ka bulan - 1 ka tuig 50 kada minuto og labaw pa1 – 5 ka tuig 40 kada minuto og labaw pa

MGA SIMPLENG PAMAAGI SA PAGTAMBAL SA MGA

SAKIT PAMBATA (HILANAT, UBO ug

KALIBANGA) SA PANIMALAY

Prepared by:Cristal Joyce S. Teo

Sources: WHO/UNICEF Integrated Management

of Childhood Illness (2014),National Center for Disease Control

and Prevention - Department of Health

UNSAON PAG-ANDAM SA ORESOL

PACKAGED

HOMEMADE

Gamiton ang oresol sulod sa 24 oras lamang.

CURRICULUM VITAE

PERSONAL INFORMATION

Name: Cristal Joyce S. Teo

Age: 25 years old

Sex: Female

Civil Status: Single

Date of Birth: February 10, 1990

Address: 3rd floor Chan building, Canelar, Zamboanga City

Religion: Roman Catholic

Father: Mr. Luke L. Teo

Mother: Mrs. Margaret S. Teo

EDUCATIONAL BACKGROUND

GRADUATE

Doctor of Medicine

Ateneo de Zamboanga University

School of Medicine

April 2015

COLLEGE

Bachelor of Science in Nursing

Ateneo de Zamboanga University

College of Nursing

March 2010

HIGH SCHOOL

Zamboanga Chong Hua High School

March 2006

ELEMENTARY

Zamboanga Chong Hua High School

March 2002

LECTURE WITH PAMPHLET IN IMPROVING MATERNAL KNOWLEDGE AND SKILLS ON HOME MANAGEMENT OF FEVER, COUGH AND DIARRHEA IN CHILDREN 0-5 YEARS OLD IN BARANGAY BATU, SIAY, ZAMBOANGA SIBUGAY

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