Western Mindanao State University

COLLEGE OF NURSING GRADUATE SCHOOL

MASTER OF NURSING PROGRAM

Zamboanga City

DEMANDS FOR CHILDREN’S HEALTH CARE AMONG LOW INCOME FAMILIES

IN SELECTED BARANGAYS IN ZAMBOANGA CITY

Presented By:

Shallyda J. Ajijul

Precious Jane Enriquez

Mary Dianne S. Mendoza

Sheila C. Villanueva

Financial Management
Field of Specialization

Presented To:

Prof. Leila D. Benito RN, MN

Adviser
 DEMANDS FOR CHILDREN’S HEALTH CARE

Table of Contents

Title of the Paper ……………………………………………………… 1

Table of Contents ……………………………………………………… 2

ABSTRACT ……………………………………………………… 4

CHAPTER I – INTRODUCTION

A. Background of the Study……………………………………………………… 5

B. Objectives ……………………………………………………... 7

C. Significance of the Study ……………………………………………………... 8

D. Scope and Delimitation …...………………………………………………... 8

E. Operational Definition of Terms …………………………………………. 9

CHAPTER II – THEORETICAL FRAMEWORK

A. Review of Related Literature ……………………………………………… 11

B. Related Studies ……………………………………………………… 17

C. Conceptual Framework ……………………………………………………. 20

CHAPTER III – METHODOLOGY

A. Research Design ……………………………………………………… 21

B. Research Locale ……………………………………………………… 21

C. Sample and Sampling Technique…………………………………………… 21

D. Research Instrument ……………………………………………………… 21

E. Validity and Dependability ………………………………………………. 22

F. Data Analysis and Procedure ………………………………………………. 22

G. Ethical Consideration ………………………………………………… 23

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CHAPTER IV

Analysis and Interpretation .……………………………………………….. 24

CHAPTER V

Conclusion …………………………………………………. 29

REFERENCES …………………………………………………. 30

List of Figures

Figure 1.0 Conceptual Framework …………………………………………..…. 20

Figure 1.1 Common Types of Conflict in Tertiary Hospital ………………………. 24

Figure 1.2 Least Types of Conflict in Tertiary Hospital ………………………. 24

List of Tables

Table 2.0 Head Nurses Analysis Score Sheet for Conflict Management

Questionnaire …………….……………………………………. 25

Table 2.1. Supervisor’s Analysis Score Sheet for Conflict Management

Questionnaire …………….……………………………………. 26

Table 2.2 Nurse Manager’s Analysis Score Sheet for Conflict Management

Questionnaire …………….……………………………………. 27

APPENDICES

Part 1 Questionnaire …………….……………………………………. 31

Part 2 Questionnaire …………….……………………………………. 32

Part 3 Questionnaire …………….……………………………………. 33

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ABSTRACT

Income instability is an important and understudied dimension of the established empirical

relation between family income and children’s health. To be a child in a family with inadequate

income often means to be a child deprived of the health care needs. Because child development

during the early years lays the foundation for later health and development, children must be

given the possible start in life. Family income is a key determinant of healthy child development.

This study is a non-experimental quantitative type of research to discover the demands for

children’s health care among low income families in selected barangays in Zamboanga City and

to help indicate clearly that income makes difference to children’s health care and that financial

resources in early childhood matter most. This study will identify the health care demands of

every child in the family, are the health care needs of every child in the family being addressed,

what are the manner to address the health care demands of every child in the family and the

impact to children’s health who belongs to low income families. Respondents of this study are

the low-income families in selected barangays in Zamboanga City particularly with children ages

from 0-6 years old. The study uses a Questionnaire Checklist to gather information needed and

screening tools to identify the low income family in the said barangays. There are 30 respondents

which are the families from different barangays in Zamboanga City, with an income below

10,000php. Recommendations are offered to improve children’s health in every family,

especially those children below 6 years old. Income and an aware of the free services regarding

health that government is providing, can affect children’s health status.

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CHAPTER I

INTRODUCTION

A. BACKGROUND OF THE STUDY

Health is a fundamental human right, universally recognized and agreed upon by states.

Health is one of the prime concerns of mankind. Normally the context individual lives, it is very

vital and significant for his/her health status and quality of life. The burden of ill-health is

greatest among the poor. Poor children are therefore denied their fundamental right to health and

development. They do not have a fair chance of a healthy start life. With the current cost of

health care services, not all are able to avail of proper health care services from health

institutions particularly those who belong in the lower classes.

The death of a child is something a parent should never have to experience. Yet in

Zamboanga City, newborns and children from poor families are twice more likely to die than

those from wealthier families. The most dangerous part of a person’s life is the day they’re born.

Not all Filipino children can make it to their 1st birthday. Why? Poor nutrition is among

the culprits. The Philippines ranks 9th in the world for having the most stunted children – those

too short for their age. In fact, 1 in 2 Filipino children is stunted. Stunting is caused by consistent

poor nutrition, and its effects can be long-lasting. Stunting delays both body and brain

development, hence it may affect children’s school performance and future career.

Despite the relentless efforts to reduce infant and child mortality with the introduction of

National Expanded Programs on Immunization (EPI) in 1979, major disparities still exist in

immunizations coverage across different population subgroups.

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 DEMANDS FOR CHILDREN’S HEALTH CARE

Children are a country’s future. If we let down today’s children, what will happen to the

City in the years to come?

B. OBJECTIVES

This study aims to answer the following:

1. What are the health care demands of every child in the family?

2. Is the amount of medical care received by a child related to family income?

3. What is the estimated income living in Zamboanga City that can provide for the health

care needs of every child in the family?

4. What is the impact to children’s health who belongs to low income families?

C. SIGNIFICANCE OF THE STUDY

The findings of this study will help identify the demands for children’s health care among low

income families in selected barangays in Zamboanga City and will indicate clearly that income

makes difference to children’s health care and that financial resources in early childhood matter

most.

D. SCOPE AND DELIMITATION

Respondents of this study are the low-income families in selected barangays in Zamboanga City

particularly with children ages from 0-6 years old. There will be a total of 30 low-income

families and will be the main subject of the study.

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E. OPERATIONAL DEFINITION OF TERMS

1. DEMANDS - refers to the health care needs of every children in the family.

i.e. immunization and nutrition

2. CHILDREN – Is a human being between the ages of 0 to 6 years old.

3. LOW INCOME FAMILIES – a family for making less than 10,000php monthly.

4. POOR NUTIRTION – refers to an insufficient or poorly balanced diet or by a medical

condition.

5. IMMUNIZATION STATUS – refers to reduce morbidity and mortality among

children against the most common vaccine-preventable diseases. All health facilities

(health centers and barangay health stations) have at least one health staff trained on REB

(Reaching Every Barangay).

6. FULLY IMMUNIZED CHILD- Infants who received one dose of BCG, three doses

each of OPV, DPT, and Hepatitis B vaccines, and one dose of measles vaccine before

reaching one year of age.

7. DECISION MAKING - Families of low income group having to choose between two

or more courses of actions in manners of health care from the family’s and health care

provider’s perspective.

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 DEMANDS FOR CHILDREN’S HEALTH CARE

8. COMPREHENSIVE CARE - Levels of care the family is willing to undergo to

improve the health status of the child/children.

9. HEALTH INSURANCE AND FINANCE SERVICES - Adequacy of health care

insurances and finances for individual families having low income.

10. EARLY SCREENING FOR SPECIAL HEALTH CARE NEEDS - Preventive

potential and level of knowledge of families towards the health care needs of the

child/children.

11. COMMUNITY BASE SERVICES - Health Care services offered by government

sponsored health centers such as vaccines and screenings.

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CHAPTER II

REVIEW OF RELATED LITERATURE

Children’s Needs

To be a child in a family with inadequate income often means to be a child deprived of the

kinds of food he needs to grow to healthy adulthood. It often means living in overcrowded

quarters, with no decent place to play; going without preventive health care; and having little

chance for more than a high school education. For about 1 in 4 it means that there is no father in

the home; mother is likely to work while the child is still very young. The National Health

Survey, like previous surveys, found that the amount of medical care received by a family was

related to the family income. The frequency of visits to the dentist provides not only a measure

of the amount of dental care received but the index of ability to obtain preventive health care in

general. It is therefore significant that there are substantial variations with family income in the

number of physician’s visits by children. Among children aged 5-14, for example, those families

with income of 10,000php or more visited a dentist three times as often as did the children in

families with incomes of less 10,000php. The variations would be more apparent if data were

available for finer income intervals. Children in families with incomes of 10,000php or more

also visited physicians more frequently than those in lower-income families. The differences are

most striking at the younger ages 0-4 and 5-14 where children in the higher-income families saw

a doctor one and one-half times as often as children in lower-income families. It is clear from

the Survey that the difference does not reflect variations in need for medical care. The amount of

family income using the broad income classification was not related to the number of days

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missed from school because of illness or the number of days of restricted activity or days spent

in because of disability.

RELATED STUDIES

Health Care

Health care or healthcare is the maintenance or improvement of health via

the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental

impairments in human beings. Healthcare is delivered by health professionals (providers or

practitioners) in allied health fields. (Bojo,2015)

Health Care Needs

The term, “children with special health care needs,” includes those with a broad range of

chronic health conditions, from major physical or developmental disabilities to often less

limiting conditions such as attention deficit disorder or asthma. One-quarter of children with

special health care needs are, according to parents’ report, usually or always affected by their

condition, while about one in three (35 percent) are never affected in their ability to do things

that other children their age do. (Appendix 2) In 2000, children with special health care

needs accounted for 34 percent of all health care costs among children, more than twice their

share of the child population. (Montgomery,2017)

Growth and Development

Soon after birth, an infant normally loses about 5% to 10% of their birth weight. By about

age 2 weeks, an infant should start to gain weight and grow quickly. By age 4 to 6 months, an

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infant's weight should be double their birth weight. During the second half of the first year of

life, growth is not as rapid. Between ages 1 and 2, a toddler will gain only about 5 pounds (2.2

kilograms). Weight gain will remain at about 5 pounds (2.2 kilograms) per year between ages 2

to 5. Between ages 2 to 10 years, a child will grow at a steady pace. A final growth spurt begins

at the start of puberty, sometime between ages 9 to 15. The child's nutrient needs correspond

with these changes in growth rates. An infant need more calories in relation to size than a

preschooler or school-age child needs. Nutrient needs increase again as a child gets close to

adolescence. A healthy child will follow an individual growth curve. However, the nutrient

intake may be different for each child. Provide a diet with a wide variety of foods that is suited to

the child's age. Healthy eating habits should begin during infancy. This can help prevent diseases

such as high blood pressure and obesity (Puca,2017)

Intellectual Developmental and Diet

Poor nutrition can cause problems with a child's intellectual development. A child with a

poor diet may be tired and unable to learn at school. Also, poor nutrition can make the child

more likely to get sick and miss school. Breakfast is very important. Children may feel tired and

unmotivated if they do not eat a good breakfast. The relationship between breakfast and

improved learning has been clearly shown. There are government programs in place to make

sure each child has at least one healthy, balanced meal a day. This meal is usually breakfast

(Froya,2014).

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Socio-economic

Access to health care may vary across countries, communities, and individuals, largely

influenced by social and economic conditions as well as the health policies in place. Countries

and jurisdictions have different policies and plans in relation to the personal and population-

based health care goals within their societies. Healthcare systems are organizations established to

meet the health needs of targeted populations. Their exact configuration varies between national

and subnational entities. In some countries and jurisdictions, health care planning is distributed

among market participants, whereas in others, planning occurs more centrally among

governments or other coordinating bodies. In all cases, according to the World Health

Organization (WHO), a well-functioning healthcare system requires a robust financing

mechanism; a well-trained and adequately paid workforce; reliable information on which to base

decisions and policies; and well maintained health facilities and logistics to deliver quality

medicines and technologies (Jihan, 2016).

Psychosexual Development

In Freudian psychology, psychosexual development is a central element of

the psychoanalytic sexual drive theory, that human beings, from birth, possess

an instinctual libido (sexual energy) that develops in five stages. Each stage – the oral, the anal,

the phallic, the latent, and the genital – is characterized by the erogenous zone that is the source

of the libidinal drive. Sigmund Freud proposed that if the child experienced sexual frustration in

relation to any psychosexual developmental stage, he or she would experience anxiety that would

persist into adulthood as a neurosis, a functional mental disorder (Bryants,2015).

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• Oral stage

The first stage of psychosexual development is the oral stage, spanning from birth until the

age of one year, wherein the infant's mouth is the focus of libidinal gratification derived from the

pleasure of feeding at the mother's breast, and from the oral exploration of his or her

environment, i.e. the tendency to place objects in the mouth. The id dominates, because neither

the ego nor the super ego is yet fully developed, and, since the infant has

no personality (identity), every action is based upon the pleasure principle. Nonetheless, the

infantile ego is forming during the oral stage; two factors contribute to its formation: (i) in

developing a body image, he or she is discrete from the external world, e.g. the child understands

pain when it is applied to his or her body, thus identifying the physical boundaries between body

and environment; (ii) experiencing delayed gratification leads to understanding that specific

behaviors satisfy some needs, e.g. crying gratifies certain needs (Pene,2016).

 Anal stage

The second stage of psychosexual development is the anal stage, spanning from the age of

eighteen months to three years, wherein the infant's erogenous zone changes from the mouth (the

upper digestive tract) to the anus (the lower digestive tract), while the ego formation continues.

Toilet training is the child's key anal-stage experience, occurring at about the age of two years,

and results in conflict between the id (demanding immediate gratification) and the ego

(demanding delayed gratification) in eliminating bodily wastes, and handling related activities

(e.g. manipulating excrement, coping with parental demands). The style of parenting influences

the resolution of the id–ego conflict, which can be either gradual and psychologically uneventful,

or which can be sudden and psychologically traumatic (Pene,2016)

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Psychosocial Development

Erikson's stages of psychosocial development, as articulated by Erik Erikson, in

collaboration with Joan Erikson, is a comprehensive psychoanalytic theory that identifies a series

of eight stages, in which a healthy developing individual should pass through from infancy to

late adulthood. All stages are present at birth, but only begin to unfold according to both a

natural scheme and one's ecological and cultural upbringing. In each stage, the person confronts,

and hopefully masters, new challenges. Each stage builds upon the successful completion of

earlier stages. The challenges of stages not successfully completed may be expected to reappear

as problems in the future.(Pene,2016).

Hope: Trust vs. Mistrust (oral-sensory, infancy, 0–2 years)

The first stage of Erik Erikson's theory centers around the infant's basic needs being met by

the parents and this interaction leading to trust or mistrust. Trust as defined by Erikson is "an

essential trustfulness of others as well as a fundamental sense of one's own trustworthiness." The

infant depends on the parents, especially the mother, for sustenance and comfort. The child's

relative understanding of world and society comes from the parents and their interaction with the

child. A child's first trust is always with the parent or caregiver; whoever that might be, however,

the caregiver is secondary whereas the parents are primary in the eyes of the child. If the parents

expose the child to warmth, regularity, and dependable affection, the infant's view of the world

will be one of trust. Should parents fail to provide a secure environment and to meet the child's

basic needs; a sense of mistrust will result. Development of mistrust can lead to feelings of

frustration, suspicion, withdrawal, and a lack of confidence (Pene, 2016).

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Will: Autonomy vs. Shame/Doubt (early childhood, 2–4 years)

As the child gains control over eliminative functions and motor abilities, they begin to

explore their surroundings. Parents still provide a strong base of security from which the child

can venture out to assert their will. The parents' patience and encouragement helps foster

autonomy in the child. Children at this age like to explore the world around them and they are

constantly learning about their environment. Caution must be taken at this age while children

may explore things that are dangerous to their health and safety.At this age children develop their

first interests. For example, a child who enjoys music may like to play with the radio. Children

who enjoy the outdoors may be interested in animals and plants. Highly restrictive parents,

however, are more likely to instill in the child a sense of doubt, and reluctance to attempt new

challenges. As they gain increased muscular coordination and mobility, toddlers become capable

eethemselves, and use the bathroom.(Pene,2016)

Purpose: Initiative vs. Guilt (locomotor-genital, preschool, 4–5 years)

Initiative adds to autonomy the quality of planning, undertaking and attacking a task for the

sake of just being active and on the move. The child is learning to master the world around them,

learning basic skills and principles of physics. Things fall down, not up. Round things roll. They

learn how to zip and tie, count and speak with ease. At this stage, the child wants to begin and

complete their own actions for a purpose. Guilt is a confusing new emotion. They may feel guilty

over things that logically should not cause guilt. They may feel guilt when this initiative does not

produce desired results(Pene,2016).

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Cognitive Development

To Piaget, cognitive development was a progressive reorganization of mental processes

resulting from biological maturation and environmental experience. He believed that children

construct an understanding of the world around them, experience discrepancies between what

they already know and what they discover in their environment, then adjust their ideas

accordingly. Moreover, Piaget claimed that cognitive development is at the center of the human

organism, and language is contingent on knowledge and understanding acquired through

cognitive development (Pene,2016).

Expanded Program on Immunization

The Expanded Program on Immunization (EPI) was established in 1976 to ensure that

infants/children and mothers have access to routinely recommended infant/childhood vaccines.

Six vaccine-preventable diseases were initially included in the EPI: tuberculosis, poliomyelitis,

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diphtheria, tetanus, pertussis and measles. In 1986, 21.3% “fully immunized” children less than

fourteen months of age based on the EPI Comprehensive Program review. In 2002, WHO

estimated that 1.4 million of deaths among children under 5 years due to diseases that could have

been prevented by routine vaccination. This represents 14% of global total mortality in children

under 5 years of age. The immunization coverage of all individual vaccines has improved as

shown in Figure 1: (Demographic Health Survey 2003 and 2008). Fully Immunized Child (FIC)

coverage improved by 10% and the Child Protected at Birth (CPAB) against Tetanus improved

by 13% compared to any prior period. Thus, the Philippines has now historically the highest

coverage for these two major indicators(DOH,2018)

RELATED LITERATURE

More efforts have been put in place to increase full immunization coverage rates in the

last decade. Little is known about the levels and consequences of delaying or vaccinating

children in different schedules. Vaccine effectiveness depends on the timing of its

administration, and it is not optimal if given early, delayed or not given as recommended.

Evidence of non-specific effects of vaccines is well documented and could be linked to timing

and sequencing of immunization. This paper documents the levels of coverage, timing and

sequencing of routine childhood vaccines. The study was conducted between 2007 and 2014 in

two informal urban settlements in Nairobi. A total of 3856 children, aged 12–23 months and

having a vaccination card seen were included in analysis. Vaccination dates recorded from the

cards seen were used to define full immunization coverage, timeliness and sequencing.

Proportions, medians and Kaplan-Meier curves were used to assess and describe the levels of full

immunization coverage, vaccination delays and sequencing. The findings indicate that 67 % of

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the children were fully immunized by 12 months of age. Missing measles and third doses of

polio and pentavalent vaccine were the main reason for not being fully immunized. Delays were

highest for third doses of polio and pentavalent and measles. About 22 % of fully immunized

children had vaccines in an out-of-sequence manner with 18 % not receiving pentavalent

together with polio vaccine as recommended. Results show higher levels of missed opportunities

and low coverage of routine childhood vaccinations given at later ages. New strategies are

needed to enable health care providers and parents/guardians to work together to increase the

levels of completion of all required vaccinations. In particular, more focus is needed on vaccines

given in multiple doses (polio, pentavalent and pneumococcal conjugate vaccines) (Gula,2015).

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Conceptual Framework

Health
Care
Needs of Health Status
Children
(0-6y.o.)

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CHAPTER III

METHODOLOGY

This chapter presents research method, and design being used. Discussion of the population

and sample techniques will also be included. Furthermore, this chapter presents the data

collection strategy and its ethical consideration.

RESEARCH DESIGN

This study is a non-experimental quantitative type of research to discover the demands for

children’s health care among low income families in selected barangays in Zamboanga City and

to help indicate clearly that income makes difference to children’s health care and that financial

resources in early childhood matter most.

RESEARCH LOCALE

Data collection in personal interviews with the participants will be in their respective residences

or choice of venue in selected barangays in Zamboanga City.

STUDY POPULATION AND SAMPLING DESIGN

This research will use a Non-Probability sampling method to identify twenty (30) families with

low family income and with children ages 0-6 years old in selected barangays in Zamboanga

City.

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SCREENING TOOL

The researchers will develop a specific criterion that will screen the families and will provide an

overview as to categorize them as a low-income family or not. The respondent’s answer will be

analyzed and contrasted to the set of criteria and categorize them accordingly.

The study will use a Questionnaire Checklist to gather information needed and a screening tools

to identify the low in come family in the said barangays. The questionnaire checklist consisted

of two (2) parts. The first part contains the personal profile of the respondents, second, part

pertains to questions what are the demands for children’s health care among low income families

in selected barangays in Zamboanga City. The researcher will conduct will take place according

to participant’s choice, this include the time, availability and the venue. To gather comprehensive

first-hand data for this study, different sets of tools will be used for data gathering. The tools

will include structured questionnaire and interview guide. The researchers will ensure

participant’s confidentiality and understand that people’s consciousness may affect their honesty

and effectiveness in answering the question, and so, therefore the respondents will be given the

option of being anonymous for participating in the research.

RESEARCH INSTRUMENT

The researcher will utilize an interview guide as an instrument of the study. It consists of several

questions that will elicit answers and allow researchers to obtain a deeper understanding

regarding the study.

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VALIDITY AND DEPENDABILITY

The research tool will be validated by the Nursing professors in Western Mindanao state

University to ensure that items could comprehensively investigate the demands for children’s

health care among low income families in selected barangays in Zamboanga City. The evaluators

will give their comments and suggestions as to how items could be further improved before the

pilot testing. Pilot testing of the questionnaire will be before the actual collection of data. This

will help develop and demonstrate the effectiveness of selected measures and methods of this

study.

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CHAPTER IV

ANALYSIS AND INTERPRETATION

As stated, the 30 statement correspondents to the five health determinants of

health status. For each answer on the questionnaire, the researcher transfers the score to the
analysis scoring table, the number that corresponds to the chosen answer by the research
informant. Once the research informant was done, the researchers added the scores in each
horizontal row and enter the sum on the last column. After adding all the answers of the research
informants, transfer the sum on the next table corresponding numbers. To determine the health
needs by each of the family, total the points in the respective categories. The one with the highest
score indicates the most commonly used determinants and the one with the lowest score indicates
the least used determinants.

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CHAPTER V

CONCLUSION

This study identified the health care demands of every child in the family, the health care needs

of every child in the family being addressed, and the manner to address the health care demands

of every child in the family and the impact to children’s health that belongs to low income

families. As reiterated throughout this study, it is in the national interest to place a higher priority

on children’s health. In the short term, this will result in children whose health and quality of life

is improved and who are more ready and able to learn. Children have important value in their

own right and are worthy of this type of societal commitment. There are two reasons for

children’s health that have longer term implications. First, the continuing viability of society

depends on a citizenry and a work-force that are properly equipped to be productive and

committed to serving the nation. Second, failure to improve children’s health will have

substantial long-term consequences for the health of the adult population, especially in terms of

the incidence, timing of onset, and severity of chronic conditions. Events in early childhood can

contribute to the physical and mental health morbidity that is often evident and only measurable

later on. This study is a non-experimental quantitative type of research to discover the demands

for children’s health care among low income families in selected barangays in Zamboanga City

and to help indicate clearly that income makes difference to children’s health care and that

financial resources in early childhood matter most. Income and an aware of the free services

regarding health that government is providing, can affect children’s health status. Our view,

investing to children’s health now is the better alternative for all the reasons above and because it

is the right thing to do.

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Akin, John S., Charles Griffin, David Guilkey, and Barry Popkin. 1986. The Demand for
Primary Health Care Services in the Bicol Region of the Philippines, Economic Development and
Cultural Change, 34.4:755 - 782

Brunner, K., Meltzer, A.H., 1990. Money Supply. In: Friedman, B.M., Hahn, F.H. (Eds.),
Handbook of Monetary Economics, Vol. 1. North-Holland: Amsterdam.

Acton, J. 1975. Nonmonetary Factors in the Demand for Medical Service: Some Empirical
Evidence, Journal of Political Economy, 83.3:595B614. Adair L., B. Popkin, J. Van Derslice, J.
Akin, D. Guilkey, R. Black, J. Briscoe, and W. Flieger. 1993. Growth Dynamics During the First
Two Years of Life: A Prospective Study in the Philippines, European Journal of Clinical
Nutrition,

Butler, J. S., R. V. Burkhauser, J. M. Mitchell, and T. P. Pincus. 1987. Measurement .. Review of

Economics and Statistics 69.4:644-650.

Ching, P. 1995. User Fees, Demand for Children's Health Care, and Access Across Income
Groups: The Philippine Case, Social Science and Medicine 41.1:37-46.

Donabedian, A. 1980. Volumes 1 and 2: The Definition of Quality and Approaches to its
Assessment and Monitoring, p. 1-163, 3-383, Health Administration Press, Ann Arbor, Mich.,
U.S.A.

Dor, A., P. Gertler, and J. van der Gaag. 1993. Nonprice Rationing and the Medical Provider
Choice in Rural Côte d Ivoire, Journal of Health Economics, 6.4:291-304.

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PARTICIPANT’S PROFILE
(Respondent #___)

Name: Gender:
Age: Sex:
Address: Civil Status:
Position in the family:
Monthly Income of the Family:

This is a Questionnaire Guide concerning DEMANDS FOR CHILDREN’S HEALTH CARE

AMONG LOW INCOME FAMILIES IN SELECTED BARANGAYS IN ZAMBOANGA
CITY. It is our hope that information obtained from this study will help or benefit the health
status of the children among low income families,
Study Information:
We are master’s in nursing students of Western Mindanao State University – Graduate
School. We respectfully ask you to take part in our research study entitled, “DEMANDS FOR
CHILDREN’S HEALTH CARE AMONG LOW INCOME FAMILIES IN SELECTED
BARANGAYS IN ZAMBOANGA CITY”. This interview will require only a few minutes of your
time and we assure you that there are no anticipated risks or discomforts related to this
research. Participation in this research is completely voluntary and you may refuse to
participate, and your decisions will be respected correspondingly without consequence. We the
researchers will respect your privacy and will ensure that you as participant is not personally
identifiable, except in exceptional circumstances and then only with clear, unambiguous
informed consent. We will respect confidentiality and will ensure that information or data
collected about individuals are appropriately anonymized and cannot be traced back by other
parties. If you require any information about this study or would like to speak to one of the
researchers, you may contact ____________________ at 09757171101.

Thank you for your consideration. Your help is greatly appreciated!

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 DEMANDS FOR CHILDREN’S HEALTH CARE

QUESTIONNAIRE

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 DEMANDS FOR CHILDREN’S HEALTH CARE

HOW TO SCORE THE QUESTIONNAIRE:

As stated, the 30 statements correspond to the five health determinants of health status. To

find the most commonly used determinant. The one with the highest score indicates the most

commonly used determinant. The one with the lowest score indicates the least used determinant.

Health determinant status: Total: The tables represent the questions above.

DECISION MAKING: From questions of Table A

COMPREHENSIVE CARE: From questions of Table B

HEALTH INSURANCE AND FINANCING SERVICES: From questions of Table C

EARLY SCREENING FOR SPECIAL HEALTH CARE NEEDS: From questions of Table D

COMMUNITY BASED SERVICES: From questions of Table E

Adding each of the tables’ total score indicates the most used determinant health status of each

family.

Brief Description of the Five Determinants of Health Status

Decision Making: Choosing between two or more courses of actions in manners of health care
from the family’s and health care provider’s perspective.
Comprehensive Care: Levels of care the family is willing to undergo to improve the health
status of the child/children.
Health Insurance and financing services: Adequacy of health care insurances and finances for
individual families having low income.
Early Screening for special health care needs: Preventive potential and level of knowledge
towards the health care needs of the client.
Community Based Services: Health Care services offered by government sponsored health
center such as vaccines and screenings.

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 DEMANDS FOR CHILDREN’S HEALTH CARE

ANALYSIS SCORE SHEET FOR THE DETERMINANT FOR HEALTH CARE

Determinants Respondents Total

of Health care (30 Families from different Barangays in Zamboanga City) Score
needs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

DECISION
MAKING
From questions
of Table A
COMPREHENSIVE
CARE
From questions
of Table B

HEALTH
INSURANCE AND
FINANCING
SERVICES
From questions
of Table C
EARLY
SCREENING FOR
SPECIAL HEALTH
CARE NEEDS
From questions
of Table D
COMMUNITY
BASED SERVICES
From questions
of Table E
QUESTIONNAIRE

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DEMANDS FOR CHILDREN’S HEALTH CARE

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