Chapter 1

BACKGROUND OF THE STUDY

Introduction

There is demand as well as supply side of barriers to health care services.

When inadequacies exist, a balance may not be met between health services

demand and supply. In most health facilities in remote areas of municipalities and

rural areas of newly developing cities, health services are often not available.

The service delivery point may not be open at the right time or supplies and

equipments may not be adequate, as such, patients do not receive services of

their choices when needed. Likewise, Midwives play an important role in

rendering health care services. By responding rapidly to emergency cases and

initiating treatment, midwives can substantially reduce mortality and morbidity.

Nursing skills cannot be performed without utilizing supplies and equipments,

and the adequacy of those is very essential.

This study has set its parameters through the use of the independent

variable-dependent variable model. The paradigm of the study shows the

independent variables, which consist of the supplies and equipments as

described in terms of: medical instrument, health care facilities and medical

supplies. It also includes the services offered as described in terms of: prenatal,

intra-natal and post natal care. On the other hand, the dependent variable

covered the quality of nursing care services and adequacy of supplies and

equipments.
 Theoretical / Conceptual Framework

The conceptual framework of the study is presented in the conceptual

paradigm as shown in Figure 1. The study will be utilized the Independent

Variable-Dependent Variable model.

Independent Variable Dependent Variable

Supplies and Equipments

 Medical instrument

 Health care facilities

 Medical supplies
 Nursing care
Services Offered
services
 Prenatal, intra-natal and post
 Adequate supplies
natal care
and equipment
 Out-patient Department (OPD)

 Emergency, first-aid and minor

medical cases management

 Family planning and health

teachings
 Figure 1. Conceptual Framework of the Study

The variables in this study were anchored to the following legal basis

which governs the practice of nursing in the Philippines and guidelines in the

operation of the Angeles City Public Birthing Station.

The Republic Act No. 7305 also known as the “Magna Carta of Public

Health Workers.” The Declaration of the Policy as indicated in the Section 2

which says that: The State shall instill health consciousness among our people to

effectively carry out the health programs and projects to the government

essential for the growth and health of the nation. Towards this end, this Act aims:

(a) To promote and improve the social and economic well-being of the health

workers, their living and working conditions and terms of employment; (b) To

develop their skills and capabilities in order that they will be more responsive and

better equipped to deliver health projects and programs.

The Republic Act No. 4704 is the Act that broaden the scope of nursing

practice to circumscribe the whole management of the care of patients and the

acts constituting professional practice of nursing spelled out to include such

services as reporting, recording and evaluation of a patient’s case, supervision of

persons contributing to the nursing care of patients, execution of nursing

procedures and techniques, direction and education to secure physical and

mental care and the application and execution of physician’s orders concerning

treatment and medication.

 Presidential Decree No. 791 is the Revised Population Act which defines

the objectives, duties and functions of the Commission on Population

(POPCOM). Among others, it empowers nurses and midwives to provide,

dispense and administer acceptable methods of contraception after having

undergone training and having been granted authorization by the POPCOM in

consultation with the appropriate licensing bodies.

Angeles City Public Birthing Station has its Manual of Operations and

Standard Operating Procedures which serves as a guide to the Management,

Service Providers and Personnel of the Angeles City Public Birthing Stations in

the provision of quality services and care to its mothers, newborn babies and

patients. Along with this, this study will also be based to the Angeles City Public

Birthing Stations’ Mission: To provide excellent and quality maternal and health

care patient and promote health well being. And together with its Vision: A Health

care provider dedicated to promote quality health care to expectant mother,

pregnant woman and newborn babies through management of health concerns

accompanied with respect and courtesy during treatment.

Standards of professional Performance describes a competent level of

behavior in the professional role, including activities related to quality of care,

performance appraisal , education, collegiality, ethics, collaboration, research,

and resource utilization, this document serves as objective guidelines for

midwives to be accountable for their actions, their patients, and their peers . The

standards provide a method to assure clients that they are receiving high-quality

care, that the health care providers know exactly what is necessary to provide
nursing care, and that measure are in place to determine whether the care meets

the standards. .

Significance of the Study

This study is deemed significant to the following:

Department of Health. The result of this study may hopefully catch the

attention of the Department of Health to closely monitor the health institutions

and make sure that they have a complete supplies and equipments based on the

services they provide.

City Administrators. This study will call the attention of the city

administrators specifically the procurement officer, for them to utilize the budget

properly and purchase the necessary supplies and equipment that in effect will

lead to quality health care services rendered by nurses.

Midwives and Nurses. They may also benefit to the result of the study by

gaining more integrity to their noble profession and boost their morale for they

know that they provide a holistic care to patient.

Patients. Quality and free health care services will be received which in
turn, will lead to healthy population of the community.
 Definition of Terms

The following terms were defined conceptually and or operationally as a

reference for clarity of ideas:

Health care facilities. Any place where people receive health care—eg.,

hospital or clinic.

Intra-natal care. A nursing service renders to patient who is about to give

birth particularly in normal spontaneous delivery.

Medical instrument. Also known as medical device. Any article or

healthcare product intended for use in the diagnosis of disease or other

condition, or for use in the care, treatment or prevention of disease, which does

not achieve any of its primary intended purposes by chemical action or by being

metabolized.

Medical supplies. Any item that is essential for treating illness or injury. In

the working parlance, medical supplies are usually understood to mean articles

which are low-cost, disposable, and used in high enough volume that the

purchasing department has standing orders in place to ensure that the items of

interest (e.g., gloves, gauze, needles and syringes)are never out of stock.

Nursing care services. The services rendered by members of the health

professions for the benefit of a patient.

 Out-patient Department. An establishment where patients are admitted

for special study and treatment by a group of health care professionals practicing

together.

Patients. A person who is ill or is undergoing treatment for disease.

Prenatal care. A nursing intervention defined as facilitating entry of a

pregnant patient into a health care facility to monitor pregnancy.

Post natal care. A nursing service renders to patient who has been

already gave birth whether caesarian section or normal spontaneous delivery.

 Statement of the Problem

The purpose of this study is to describe the quality of services rendered by

the public health workers to patients in terms of supplies and equipments at

Angeles City Public Birthing Station

Specifically, this study seeks to answer the following questions:

1. How may the supplies and equipments at Angeles City Public Birthing

Station be described in terms of:

1.1 medical instrument;

1.2 health care facilities; and

1.3 Medical supplies?

2. How may the nursing care services be described in terms of:

2.1 prenatal, intra-natal, and post natal care;

2.2 out-patient department (OPD);

2.3 emergency, first-aid and minor medical cases management;

2.4 family planning and health teachings; and

2.5 Patient’s feedback?

3. Is there a significant relationship between adequacy of supplies and

equipments and nursing care services rendered to patients in Angeles City

Public Birthing Station?

4. What are the implications of the findings of the study to improve nursing
care services?
Mission:

To promote community health through availability and adequate health

services and health education to all sectors and members of the community.

Vision:

To ensure a healthy community that assures everyone will be given

adequate, available and quality health services through a well trained staff and

sufficient facilities.