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CHAPTER 1 INTRODUCTION Barangay 421, zone 43, district IV is a community located at the heart of urban Manila.

It is a few blocks away from the LRT 2 station. The barangay is led by Francisco Manahan and regularly receives health services from the Manila health department which provides basic vaccines. The Manila Health Department has also established a community health center for the residents of the barangay. The community is in an urban setting and is surrounded by industrial establishments like the San Miguel warehouse, and the CLYK commercial office building. The Philippine National Railway and the LRT 2 are located a few blocks away from the community. The primary method of transportation in the community is by tricycles and jeepneys. Some families have their own private vehicles. Squalor and pollution is evident because of the communitys urban and industrial settings. There are a few private preschools found in the area. There is also a basketball ring used by residents for entertainment but it is placed in the middle of a street. On July, 2011, the University of Santo Tomas Medical Technology Interns conducted an interview in the area. The interview was done to gather essential data about the community. As of July 2011 there are 77 males for every 100 females in the said community, there is also a high number of middle aged people in the barangay. Most of the working age people who live in the area are single and earns more than 19,000 pesos per month. The occupations are generally mixed, but most occupations generally fall into the blue collar bracket. The education background of the community is poor as more than half of the population did not finish college. Majority of the population is Roman

Catholic. The survey also shows that most of the population has lived in the barangay for more than 10 years and their province of origin is generally from the island of Luzon. The materials used to build the houses in barangay 421 are generally mixed of light and strong materials but ventilation is quite adequate; also, most of the people who live in the community say that they are renting the house that they live in. Water supply is not much of a problem; Maynilad is in charge of water distribution in the area. Garbage collection is managed by the City government and occurs every week. The community generally has a level II excreta disposal system. Majority of the families in the community has refrigerators used for food storage. Mothers were also interviewed in their practice of infant feeding, majority of the babies were not breastfed but were given powdered milk. Six children below 1 year old were involved in the survey and out of the six children in the survey only one was fully immunized by the community health center. Most residents of barangay 421 go to hospitals to seek medical treatment but majority of the health information is received from the health center.

CHAPTER 2

2.1 SITUATIONAL ANALYSIS 2.1.1 SETTING OF THE COMMUNITY

Figure 1. Spot Map of Barangay 421, Zone 43, District IV as of July 2011

2.1.2 POPULATION

Total population of the Families Surveyed:

255

Sex ratio: 77.1 , There are 77 males for every 100 females of Barangay 421, zone 43, district IV as of July 2011

2.1.2.1 Age and Sex distribution TABLE 1. Age & Sex Distribution of Barangay 421, Zone 43, District IV as of July 2011 Age Male Female Total f <1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65 TOTAL 3 11 9 7 10 13 13 8 11 9 6 4 3 2 4 111 % 2.70% 9.91% 8.11% 6.31% 9.01% 11.71% 11.71% 7.21% 9.91% 8.11% 5.41% 3.60% 2.70% 1.80% 3.60% 100.00% f 2 12 14 10 11 17 12 9 23 9 12 5 2 1 3 144 % 1.39% 8.33% 9.72% 6.94% 7.64% 11.81% 8.33% 6.25% 15.97% 6.25% 8.33% 3.47% 1.39% 0.69% 2.08% 100.00% f 5 23 23 17 21 30 25 17 34 18 18 9 5 3 7 255 % 1.96% 9.02% 9.02% 6.67% 8.24% 11.76% 9.80% 6.67% 13.33% 7.06% 7.06% 3.53% 1.96% 1.18% 2.75% 100.00%

Figure 2. Population Pyramid of Barangay 421, Zone 43, District IV as of July 2011

Analysis: There are more women than men in Barangay 421 zone 43, district IV as of July 2011. Also, there is a high percentage of individuals aged 35 to 39 years old. In general, population declines at the age of 40. The health program would most likely target the 20 to 39 y/o group. 2.1.2.2 Civil Status TABLE 2. Percentage Distribution showing the Civil Status of Individuals 15 y/o and above. Civil Status Single Married Separated Widow TOTAL f 120 75 8 5 208 % 57.7% 36.1% 3.8% 2.4% 100%

Barangay 421 , Zone 43 , District IV as of July 2011

Figure 3. Civil Status of Individuals 15 y/o and above of Barangay 421, Zone 43, District IV as of July 2011

Analysis: Majority or 57.7 % of individuals 15 y/o and above of Barangay 421, Zone 43, District IV are single as of July 2011. 2.1.3 ECONOMIC INDICES: 2.1.3.1 Dependency Ratio Ever 100 persons of economically productive age groups are supporting 42 dependents.

2.1.3.2 Occupation TABLE 3. Percentage Distribution Showing the Types of Occupation of Earning Individuals. Barangay 421, Zone 43, District IV as of July 2011 Occupation Brgy. Tanod Dietician supervisor Virtual asst. Law firm Driver Maid Mechanic Clerk Accountant Asst. Admin Bussinessman Bussinesswoman Call center agent Engineer Data analyst Factory worker Football coach Manager Promotizer Secretary Statistician Store owner Waiter Teacher Security guard Police Cook Associate Nurse TOTAL f 1 1 1 1 1 5 4 1 3 2 1 2 5 1 4 1 3 1 2 5 1 1 7 2 1 1 1 1 1 1 62 % 1.60% 1.60% 1.60% 1.60% 1.60% 8.06% 6.45% 1.60% 4.80% 3.23% 1.60% 3.23% 8.06% 1.60% 6.45% 1.60% 4.80% 1.60% 3.23% 8.06% 1.60% 1.60% 11.30% 3.23% 1.60% 1.60% 1.60% 1.60% 1.60% 1.60% 100%

Analysis: The table shows that occupation of residents of Barangay 421, zone 41, district IV as of July 2011 has mixed kinds. Having a store is the most common occcupation in the said barangay. With 30 different occupations found in the Barangay which includes store owners, nurses, statisticians, etc., 11% of the population owns their own store in the Barangay while majority are commuters to their workplaces. 2.1.3.3 Average Income TABLE 4. Percentage Distribution showing the Average Income of Earning Individuals. Barangay 421, Zone 43, District IV as of July 2011 Income/Month f % <1,000 0 0% 1,000-2,999 8 13.8% 3,000-4,999 6 10.3% 5,000-6,999 3 5.2% 7,000-8,999 10 17.2% 9,000-10,999 3 5.2% 11,000-12,999 3 5.2% 13,000-14,999 5 8.6% >15,000 20 34.4% TOTAL 58 100% Figure 4. Bar Graph showing the Percentage Distribution of the Average Income of Earning Individuals. Barangay 421, Zone 43, District IV as of July 2011 Analysis: Approximately 29.3 percent of the earning individuals of Barangay 421, zone 43, district IV is not receiving the minimum wage which is 426 pesos per day (according to Per Wage Order No. NCR-16) and is experiencing poverty as of July 2011. 2.1.4 SOCIO-CULTURAL INDICES

2.1.4.1 Educational Attainment TABLE 5. Percentage Distribution Showing the Educational Attainment of Individuals Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Educational Attainment f % No formal education Elementary Level Elementary Graduate High School Level High School Graduate College Level College Graduate TOTAL 6 18 2 11 19 27 46 129 4.7% 14.0% 1.6% 8.5% 14.7% 20.9% 35.7% 100%

Figure 5. Percentage Distribution Showing the Educational Attainment of Individuals Surveyed in Barangay 421, Zone 43, District IV as of July 2011 AnalAnalysis: 20.9% of the population of barangay 421, zone 43, district IV did not finish college, 43% of population are students, while 35.7% graduated college as of July 2011. 2.1.4.2 Religion TABLE 6. Percentage Distribution Showing the Religion of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Religion f % Roman Catholic 117 95.90% Christian 1 0.80% Pentecostal 2 1.60% Born Again 1 0.80% Protestant 1 0.80% TOTAL 122 100%

Analysis: Majority or 95.9% of the population of Barangay 421 , zone 43, district IV, are Roman catholic as of July 2011. Therefore, there would be little or no problem to traditions of other religion that would affect the acceptance of the heath program to be planned. 2.1.4.3 Place of Origin: TABLE 7. Percentage Distribution Showing Place of Origin of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Place of Origin f % Luzon 44 54.30% Visayas 14 17.30% Mindanao 11 13.60% NCR 12 14.80% TOTAL 81 100%

Figure 6. Percentage Distribution Showing Place of Origin of Families Surveyed in Barangay 421, Zone 43, District IV as of July 2011

Analysis: Majority of the population of Barangay 421, zone 43, district IV are originally from provinces of Luzon. Traditions of one province to another may contradict and may cause problem. But since their population movement (table below) says that majority of the residents have lived in the said barangay for more than ten years already, they must have been used to the traditions of Manila.

2.1.4.4 Population Movement: TABLE 8. Percentage Distribution Showing the Length of Residency of Families surveyed. Barangay 421, Zone 43, District IV as of July 2011 Length of Residency f % <6 months 4 5.5% 6 months- 1 year 0 0.0% 1 years -5 years 11 15.0% 6 years -10years 9 12.3% 10 years and above 49 67.1% TOTAL 73 100%

Figure 7. Bar Graph Showing Percentage Distribution of the Length of Residency of Families surveyed in Barangay 421, Zone 43, District IV as of July 2011

Analysis: Majority or 67.10 percent of the population of Barangay 421, zone 43, district IV lived in their present residence for more than ten years and counting as of July 2011. 2.1.4.5 Housing: 2.1.4.5.1 Types of Houses TABLE 9. Percentage Distribution Showing the Types of Housing of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Type of Housing f % Makeshift 2 3.7% Light 1 1.9% Strong 22 40.7%

Mixed TOTAL

29 54

53.7% 100%

Figure 8. Pie Graph showing the Percentage Distribution of the Types of Houses of Families Surveyed in Barangay 421, Zone 43, District IV as of July 2011

Analysis: More than half of the population of Barangay 421 , zone 43, district IV, have houses that are made up of mixed light and strong materials as of July, 2011. One of the dangers of poor quality of materials of a house may include building-up of molds and easy deterioration caused by typhoons and this may affect health conditions like having asthma or other respiratory-related problems. 2.1.4.5.2 Ownership TABLE 10. Percentage Distribution Showing Housing Ownership of Families Surveyed. Barangay Ownership Rent-free Owned Rented TOTAL f 4 11 39 54 % 7.4% 20.4% 72.2% 100%

421, Zone 43, District IV as of July 2011

Figure 9. Percentage Distribution Showing Housing Ownership of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011

Analysis: 72.2 percent of the population of Barangay 421, zone 43, district IV rent their houses as of July 2011. Budget in every need of the family is counted

and paying for rents is additional burden to the family every month. The basic health care requirement of the family may be forgotten or less prioritized.

2.1.4.5.3 Ventilation TABLE 11. Percentage Distribution Showing Ventillation of Houses of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Ventilation f % Adequate 40 74.0% Inadequate 14 25.9% TOTAL 54 100%

Analysis: Majority of the population of Barangay 421, zone 43, district IV have adequate ventilation in their houses as of July 2011. This may implicate that most of them are not crowded in a house. Respiratory-related health problem may arise if there is inadequate ventilation in a house. 2.1.5 ENVIRONMENTAL INDICES: 2.1.5.1 Water Supply TABLE 12. Percentage Distribution Showing Water Supply of families Surveyed. Barangay 421, Level I. Point Source II. Communal Faucet System or Standpost III. Waterworks System TOTAL Zone 43, District IV as of July 2011 f 6 0 48 54 % 11.1% 0.0% 88.9% 100%

Analysis: Waterworks sytem level III, particulary Maynilad is the major source of water of Barangay, zone, district as of July 2011. This is a good sign of clean water circulating in the said area. Hence, water-borne diseases may be avoided.

2.1.5.2 Excreta Disposal TABLE 13. Percentage Distribution Showing Excreta Disposal of Families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Excreta Disposal f % Level I. Pit Latrines 0 0.0% Level II. Poor-Flush Toilet 39 72.2% Level III. Flush Toilets 14 25.9% Balot System/ Wrap & Throw 0 0.0% Others, Specify: Shared 1 1.9% TOTAL 54 100%

Analysis: Majority of the population of Barangay 421, zone 43, district IV have level II excreta disposal which is poor-flush toilet as of July 2011. This may imply that proper way of disposing excreta is practiced within the said area. 2.1.5.3 Garbage Disposal TABLE 14. Percentage Distribution Showing Garbage Disposal of Families Surveyed. Barangay Garbage Disposal DPS (Collected) Open Dumping Burning Waste Segregation TOTAL 421, Zone 43, District IV as of July 2011 f 54 0 0 0 54 % 100% 0% 0% 0% 100%

Analysis: Garbage disposal is not a problem in Barangay 421, zone 43, district IV as of July 2011 because garbage is collected in a specific time for them. There is low risk of environment and health problem that may arise beacuse of garbage.

2.1.6 HEALTH INDICES 2.1.6.1 Food Storage TABLE 15. Percentage Distribution Showing Food Storage Practice of Families Barangay 421, Zone 43, District IV as of July 2011 Food Storage f Refrigerated 31 Not Refrigerated a. Covered 12 b. Exposed 0 TOTAL 43

Surveyed. % 72.1% 27.9% 0.0% 100%

Analysis: Majority or 72.1 percent of Barangay 421 , zone 43, district IV have refrigerator where they can store their food as of July 2011. Refrigerator is an important factor in health for the reason that food spoilage or food contamination may be avoided if food is inside a refrigerator. 2.1.6.2 Infant Feeding Practice TABLE 16. Percentage Distribution Showing Infant Feeding Practice of Families Surveyed Barangay 421, Zone 43, District IV as of July 2011 Types of Infant Feeding f % breastfeeding 0 0% bottlefeeding a. evaporated b. condensed c. powdered 5 50%

mixed a. evaporated b. condensed c. powdered total

5 10

50% 100%

Analysis: Among the infants of less than 1 year in Brangay 421, zone 43, district IV as of July 2011, 50 percent of them are fed by powdered milk alone and 50 percent of them are fed by both breastfeeing and powdered milk. Suceptibilty to infection is low since proper milk is being fed to the infants. 2.1.6.3 Immunization Status TABLE 17. Percentage Distribution showing Immunization Status of Children <1 year the families Surveyed. Barangay 421, Zone 43, District IV as of July 2011 Antigen no. of children Accomp BCG 6 5 DPT1 6 3 DPT2 6 3 DPT3 6 3 OPV1 6 2 OPV2 6 2 OPV3 6 2 HEP B 1 6 3 HEP B 2 6 3 HEP B 3 6 3 AMV 6 1

old among % 83.4 50 50 50 33.3 33.3 33.3 50 50 50 16.7

Analysis: Out of 6 children <1 y/o among families surveyed in Barangay 421, zone 43, district IV, only one child is fully immunized of all the above antigens as of July 2011. The reason that the group gathered from the mothers is because the scheduled date for the next vaccine is yet to come.

2.1.6.4 Health Seeking Behavior TABLE 18. Percentage Distribution Showing Health-Seeking Behavior of families Surveyed. Health Facility Hospital Health Center Private Clinic Others, Specify TOTAL f 77 8 24 109 % 70.6% 7.3% 22.0% 100%

Barangay 421, Zone 43, District IV as of July 2011

Figure 10. Pie Graph showing Percentage Distribution of the Health-Seeking Behavior of families Surveyed in Barangay 421, Zone 43, District IV as of July 2011

Analysis: Barangay 421, zone 43, district IV residents mostly go to a hospital for medical service as of July 2011 though according to them they were aware of the health center of their barangay. This implies that more residents are financially capable of seeking medcal treatment other than the health center. 2.1.6.5 Source of Health Information TABLE 19. Percentage Distribution Showing the Source of Health Information of Families surveyed. Barangay 421, Zone 43, District IV as of July 2011 Source f % Hospital 10 18.5%

Health Center Media Others, Specify TOTAL

27 17 54

50.0% 31.5% 100%

Figure 11. Pie Graph showing Percentage Distribution of the Source of Health Information of Families surveyed in Barangay 421, Zone 43, District IV as of July 2011

Analysis: As of July 2011, the Barangay 421, zone 43, district IV residents majority source of health information is the health center. This implies that they are aware of the health center and its services. 2.1.7 SUMMARY OF FACTORS AFFECTING HEALTH STATUS/ HEALTH SERVICES; INTERRELATIONSHIP OF FACTORS DESCRIBED IN

SITUATIONAL ANALYSIS Age is a major factor when comes to acquiring non-communicable diseases. With the majority of the population ranging between 20 and 39, the community is at greater risk of acquiring work related illnesses as compared to genetic ones. The people in the area appear to be earning sufficiently for basic needs as well as proper health care. Conflict of interest are of little concern when it comes to culture and religion as majority of the population have been staying in the area for more than 10 years and are Roman Catholics therefore there should be little problem in implementing projects due to cultural or religious beliefs. With 53.7% of the houses found in the area made of mixed light and strong materials while 25.9% show inadequate ventilation, the risk of airborne and droplet transmitted infections are increased. There should little problems sanitation-wise as 100% of the garbage are collected daily and disposed properly, water supply is assured

by Maynilad, and all households have toilets. 72% of households have refrigerators while there are sufficient stores in the Barangay for easy access of food when food storage is impossible.

2.2 COMMUNITY DIAGNOSIS 2.2.1 DATA AND SOURCES TABLE 20. Leading Causes of Morbidity in Paltoc for the month of January 2011 (Source: Paltoc Health Center)

Disease HEENT ANP ATP URTI PTB Bronchitis UTI AGE Derma Surgery Infectious HPN Anergy Malnutrition Osteoarthritis Myalgia Anemia E.Preg. U. Acid(increased) DMType II TOTAL

MALE 4 5 0 49 6 2 2 1 1 5 6 9 1 1 0 0 0 0 0 0 92

FEMALE 3 12 1 52 7 3 9 2 2 6 4 8 1 3 2 2 2 2 1 1 123

TABLE 21. Leading Causes of Morbidity in Paltoc for the month of February 2011 (Source: Paltoc Health Center)

Disease HEENT ANP ATP URTI Bronchitis Pneumonia PTB UTI AGE Constipation Gastritis Derma Infectious Surgery Hypertensio P. Neuropathy Anergy Anemia Malnutrition Hypercritiesteanemia Osteoathritis Hyperluricemia Costochondritis TOTAL

MALE 5 7 5 58 4 1 4 4 5 0 2 3 15 0 6 1 1 0 5 0 1 0 0 127

FEMALE 8 1 1 53 1 0 4 18 3 1 1 5 21 2 7 0 3 1 1 2 0 1 1 135

TABLE 22. Leading Causes of Morbidity in Paltoc for the month of March 2011 (Source: Paltoc Health Center)

Disease HEENT ANP ATP URTI Pneumonia PTB/F Bronchitis AGE Derma UTI Nephropathy AGN Infectious Malnourished Myalgia Hypertension Allergy Osteoarthritis OB Surgery Anemia TOTAL

MALE 3 5 1 35 1 9 5 2 1 0 1 0 10 3 0 6 1 0 0 0 0 83

FEMALE 10 5 0 53 0 8 2 1 1 6 0 1 12 4 2 15 3 1 2 2 2 130

TABLE 23. Leading Causes of Morbidity in Paltoc for the month of April 2011 (Source: Paltoc Health Center) Disease MALE FEMALE HEENT ANP ATP URTI Cong. & OSE PTB/ T/C PTB IPT Bronchitis AGE Constipation APO UTI / T/C UTI Derma Infectious Surgery G6PD Def. Hypertension Myalgia DM 3 3 2 15 1 12 1 0 2 0 1 0 3 10 2 0 5 1 1 3 1 5 13 0 2 1 5 1 3 1 5 3 13 1 1 8 2 0

Anemia Osteoarthritis Vertigo T. Abortion Malnutrition Angina TOTAL

0 1 1 0 0 1 65

4 1 0 1 2 0 76

TABLE 24. Leading Causes of Morbidity in Paltoc for the month of May 2011 (Source: Paltoc Health Center) Disease MALE FEMALE HEENT ANP ATP URTI Bronchial Asthma UTI AGE APD Derma Infectious Surgery 4 0 1 20 0 0 1 1 7 9 2 3 2 2 13 2 1 2 1 7 6 2

Hypertension Myalgia Malnutrition Osteoarthritis HPSTY Rxn. Menorrhagia PTB IPT D. Syndrome TOTAL

3 2 1 0 0 0 4 1 0 56

8 1 0 1 1 1 3 0 1 57

TABLE 25. Leading Causes of Morbidity in Paltoc for the month of June 2011 (Source: Paltoc Health Center) Disease MALE FEMALE HEENT ANP ATP 5 5 2 7 3 1

URTI Pneumonitis PTB Bronchitis Bronchial Asthma AGE Constipation APD UTI Derma Infectious Surgery Hypertension Anemia E. Pregnancy Amenorrhea T. Abortion Ovarian Cyst Anergy Osteoarthritis Malnutrition Myalgia DMII P. Neuropathy TOTAL

26 0 2 4 2 2 0 2 2 9 8 3 1 0 0 0 0 0 0 1 1 1 1 0 77

25 1 4 1 0 3 1 1 11 9 9 3 8 2 1 1 1 1 1 2 4 1 0 1 102

2.2.2 LIST OF RELEVANT INDICATORS TABLE 26. Ten Leading Causes of Mobidity in Barangay 421, Zone 43, District IV, January to June 2011 Diseases No. of cases 1 2 3 4 5 6 7 8 9 10 URTI Infectious HPN PTB UTI HEENT Derma ANP Surgery Bronchitis 412 123 84 65 58 58 51 49 29 27

2.3 PROBLEM ANALYSIS 2.3.1 IDENTIFICATION AND ANALYSIS OF PROBLEMS The barangays leading causes of morbidity include upper respiratory tract infections. A factor to this illness that can be seen here includes the inadequacy of ventilation per household due to the crowding seen. Several households in the community comprises of college students whom rent apartments in the area most of this boarders come in groups of more than 5 sharing the space. As well as the students, the adults

commute outside the area to their workplaces due to lack of local jobs. This results to the increased amount of jeeps that are seen parked around the community. Having to commute to school or work every day increased stress in the part of the people as well as human contact which increases susceptibility of the people in transmitting this droplet and airborne infections. Another possible way of transmitting upper respiratory infections includes the sharing of food, water, and utensils, and is possibly avoided by using serving spoons. The second leading illness in the area is hypertension. This is a noncommunicable disease usually obtained by the elderly. Known as the silent killer, hypertension should be a community concern as it is a significant risk factor for several other fatal conditions such as stroke and heart problems. A key factor to hypertension is age; but with a population of young adults, the more probable factors to cause this illness are obesity, stress, alcohol intake, and smoking. Obesity is common in well-off communities due to abundance of food and overindulgence. Stress can easily be associated to the fact that several adults in the community high stress jobs including statisticians, businessmen, call center agents, etc. Smoking and alcohol is simply common vices which can be found in the country especially fitting in the Filipino lifestyle. Although there are many medicines used to lower a persons blood pressure, the proper lifestyle change is the most essential part in maintaining a healthy blood pressure. Awareness of the proper actions and regular consultations with the physician is the best way of avoiding any complications that are caused by this condition. Pulmonary tuberculosis is another leading illness in the community. Being a common disease in third world countries, the Philippines is certainly not an exception to transmitting the bacteria Mycobacterium tuberculosis. PTB has the same risk factors as

upper respiratory tract infections which include talking, sneezing, coughing, and the sharing of food. Pulmonary tuberculosis is a more serious case as it is sometimes caused by a drug resistant strain of bacteria and is very infectious. TABLE 27. Decision Matrix of the Problem Prioritization for Barangay 421, Zone 43, District IV Criteria URTI HPN PTB Nature of the Problem Health Status 3 Health Resources 2 Health Related 1 Magnitude of the Problem 75-100% Affected 4 50-74% 3 25-49% 2 <25% 1 Modifiability of the Problem High 3 Moderate 2 Low 1 Not modifiable 0 Preventive Potential High 3 Moderate 2 Low 1 Social Concern Urgent Community Concern 2 Recognized as a problem but not making urgent attention 1 Not a Community Concern 0 Total (3/3)x1= 1 (3/3)x1= 1 (3/3)x1= 1

(2/4)x3= 1.5

(1/4)x3= 0.75

(1/4)x3= 0.75

(3/3)x4= 4

(2/3)x4= 2.7

(2/3)x4 = 2.7

(3/3)x1= 1

(2/3)x1= 0.67

(2/3)x1= 0.67

(1/1)x1= 1

(1/1)x1= 1

(2/1)x1= 2

8.5

6.12

7.12