IV.

SOCIOECONOMIC

SOCIO ECONOMIC, CULTURAL, AND DEVELOPMENTAL ASSESSMENT There are great many factors that affect the health of a family. As a result, the health status of each family is different. These factors may be social, economical and/or cultural. These factors need to be assessed to determine accurately the health status of the family. In this chapter, these are depicted through assessment.

A. TYPE OF FAMILY

The Alphabet Family is classified under nuclear type. A nuclear type family refers to a household consisting of a father, a mother and their children all in one household. The advantage of a nuclear type of family is there is a genuine support during crisis.

The structure of family that the Alphabet Family has is Patriarchal. Patriarchal is a social system in which the father is the head of the family and men have authority over women and children (http://www.thefreedictionary.com/patriarchy).

The family is composed of six members: Father A and Mother B, and their children: C, D, E, F, eldest to youngest respectively. The family practices the traditional expected duty that each family member must perform.

B. DOMINANT FAMILY MEMBERS IN TERMS OF DECISION MAKING

The assessment of familys decision making process and the identification of the dominant family member would enable the student nurses to identify the predominant decision maker and how the family interacts with each other. This would greatly influence their perception of the identified problem and the familys pattern of decision making particularly on health issues.

Being a nuclear type of family, as the head of the family or the father, the decision making revolves around Father A. As the head of the family, he works and supports the family with their financial needs, and he has the final decision on issues like physical, emotional, and financial and other aspects that are involved in the family except for health in which Mother B is the one who take charge.

C. SOURCE OF INCOME, EXPENDITURES

Father A, as the head of family, works hard to provide the basic needs of each member. Father A earns roughly P 233 per day. His work is contractual, so approximately he earns P 7000 a month which is not sufficient to support the family. Each family member only gets P 1166.66 per month which is according to National Economic and Development Authority (NEDA) monthly poverty threshold is P 2,768.60 per individual.

The familys income is allotted for the following expenses per month: EXPENSES FOOD ELECTRIC BILL SCHOOL EXPENSES WATER OTHER EXPENSES TOTAL: AMOUNT 3000 300 1000 500 2200 P 7000

With this, the family is considered poor. This means that they need an additional income of P1, 601.94 a month in order to meet the qualification of National Economic and Development Authority (NEDA). Their income is not sufficient to meet their basic needs. Also, according to the mother they have no extra savings to finance their needs whenever there is an emergency.

D. WORKING HOURS

Father A is the primary worker of the family. He works as a contractual gardener. His working time is from 6:00 a.m. to 6:00 p.m. Mother B usually stays at home to do the household chores and takes care of her children.

E. ETHNIC BACKGROUND AND RELIGIOUS AFFILIATION

The assessment of ethnic background and religious affiliation of a family affects the familys norms, belief and practices especially in decision making. Given the information regarding their respect of familys identity, it would give the group a background as to how the family would interact, perceive and address the problems that are to be identified during the conduction of family case analysis.

Father A's family of origin came from the province of Batangas, on the other hand Mother B is originally from Pampanga. Father A was born in Batangas but was later on, brought up and raised in Pampanga. Father A spent most of his life in Pampanga after his family decided to move out from Batangas to find a better source of income. Through the years he spent in Pampanga he finally settled in Macapagal Village, Clarkfield after he met his wife. They first met while Father A was working as a gardener in Balibago, while Mother B was working as a maid in the same household. They had a civil marriage. Father A works for the Alphabet Family. The family is affiliated to Roman Catholic Church. His wife, Mother B, is a local who owns a parsel of land, inherited from her parents, in Macapagal village wherein they established their family. Soon after they was fortunate enough to have four children and found a job nearby, still as a gardener working at Fontana Leisure Park.

F. SIGNIFICANT OTHERS ROLE

The relatives of the family are not involved in any of the decision making within the family. In terms of financial insufficiency and emergency, the mother of Mother B usually helps them by lending them some money.

G. HEALTH HABITS AND BELIEFS

The familys health habits and practices are traditional. When asked if they believe in herbolarios and hilots, Mother B said, yes. As being practiced, when a family member is sick, Mother B immediately takes her children to the Barangay Health Center. And when the Barangay Health Center does not have the necessary medications, they will just stay at home and ask for the assistance of herbolarios and hilots.

During the assessment, the student nurses have noticed that the family has a poor personal hygiene. They were observed wearing dirty clothes and all of them have long finger nails and toenails with presence of dirt as well as their hands and feet.

H. FAMILYS INVOLVEMENT IN COMMUNITY ACTIVITIES

The Family do not participate much in community activities because they think that there are a lot more important things to do other than that. Like earning money for the family and looking after the children. But the family joins a feeding program

whenever it is held in Macapagal Village. Mother B used to attend Mothers Classes as well.

The Alphabet family, although Father A's work takes up most of his time, he makes sure that he, together with his family finds time to participate in the community they belong to. They particularly involve themselves through programs such as "Tapat mo Linis Mo" program through responsibly cleaning around their family's vicinity. The family also often takes part in community gatherings such as Fiestas that are celebrated in their village. They are also well entailed in their religious roots through joining prayer vigils, novenas and the like.

I. FAMILYS UTILIZATION OF COMMUNITY SERVICES/ RESOURCES

When a family member becomes sick, the family utilizes the health center. Aside from consultations, the children also got their immunizations in the health center.

Aside from the health center, the community has its own basketball court near the barangay health center, where the children utilize it for fun and enjoyment.

There are also "sari-sari" stores in the community, wherein the family gets their daily necessities like food, and the like.

J. HOUSING CONDITION

The type of house the family is light for it is made up mainly of plywoods, galvanized iron and cartons. Their house has living room, bed room, dining area, and kitchen where mostly separated by improvised dividers. The family owns the house.

The house measures 3m x 4m. The total floor area is 12 m2. It shows that there is no adequate space since most of the spaces inside the house are being occupied by different furniture and garments. Required space for each member is 3 m2 for adult and 1.5 m2 for children and the space they have for each member is 1 m2 .

COMPUTATION OF ADEQUACY OF LIVING SPACE Floor Area = = = Length x width of the house 4m x 3m 12m2

Adequacy of Living Space = = = = = = 2 adults x 3 m2 6 m2 4 children x 1.5 m2 6 m2 6 m2 + 6 m2 12 m2

But due to the different furniture and garments scattered inside the house, this space makes inadequate for the family.

The family sleeps beside each other. The family has bed frame located inside the living room. With regards to the adequacy of lighting, the students had also classified it as inadequate. There is inadequate lighting during daytime because upon the entrance to the house, they had observed that a person could not read properly. There is not enough sunlight entering the house. There is only one window that is open. The family only uses an incandescent bulb (75 watts) during night time.

K. FOOD RESOURCES, STORAGE, AND COOKING FACILITIES

Food sources, storage and their present cooking facilities must be adequate to sustains familys nutritional needs. Since this greatly affects the family in proper handling of food.

The family usually eats vegetables and fish meat. They cook viand that fits their budget. The family buys their food in a nearby "sari-sari" store. Mother B said that she only prepares one viand of food since their budget would not allow them to have more. Also, they do not have a refrigerator or a cabinet to store their food. They make use of plates to cover leftover foods, but most of the time they tend to finish what is prepared for them. The family does not have enough cooking utensils they only have one casserole and frying pan, and a clay pot, two soup ladles, and one knife. Their cooking facility is

situated inside their house. Also, it is situated in a low area, which can be easily reached by the children, which is a hazard for the family.

L. WATER SUPPLY

Water is very vital to human life because it is our main source of fluid. If water source is unsafe and infected it can cause diseases that are brought by harmful microorganisms Thus, health can be compromised. Water potability should also be assessed.

The Alphabet family and majority of the households in Macapagal Village procure their water supply from the communal faucet. Early in the morning, Mother B would prepare containers wherein water would be stored coming from the water supply. She would wait in line and pay two pesos per gallon of water she would need.

M. DRAINAGE SYSTEM

The assessment of drainage system is necessary to determine the presence of water stagnation or flow in the household. Poor drainage induces stagnation of water that may result to presence of mosquitoes and eventually can cause diseases.

Their drainage system is an open type, stagnant and is trashed with candy wrappers, plastics and filled with mud. This is the reason why it emits a very foul odor. It fosters environmental vectors to thrive in and eventually can cause diseases in the family.

N. TOILET FACILTY

Toilet facility is assessed in order to determine if the family practices proper hygiene, sanitation that could greatly affect human health. This is also essential in maintaining cleanliness in their surroundings.

The family owns a toilet facility that does not have flush and water carriage. It is situated at the back portion of the house. The toilet facility is not well maintained. There is a foul odor coming from it. Breeding sites for rodents were also noted inside the facility specifically mosquitoes.

O. SOCIAL AND HEALTH FACILITIES AVAILABLE

The health center in Macapagal Village, Clarkfield, Pampanga is usually utilized by the family because of free vaccines. Their children got their immunization in the Brgy. Health Center.

Social facilities the Alphabet family utilizes include the nearby barangay hall where they perform their general assembly.

P. COMMUNICATION AND TRANSPORTATION FACILITIES

The family owns two cellphones as means of communication. According to Mother B, they use their cellphones to communicate with their relatives in Batangas and to easily reach Father A in case of emergency.

As for transportation, the family owns a bicycle. It is the Fathers means of getting to his work. Usually the rest of the family members just walk to reach nearby places. Whenever they really need to go to the far places like hospital, mall, parks, and the like, they usually ride a tricycle and at times, a jeepney if they had it scheduled at night.