Saint Mary's University

THE NUTRITIONAL STATUS OF THE CHILDREN OF BAMBANG
NUEVA VIZCAYA AND ITS CORRELATES
Saint Mary’s University

THE NUTRITIONAL STATUS OF THE CHILDREN OF BAMBANG NUEVA
VIZCAYA AND ITS CORRELATES
A Thesis
Presented to the Faculty
of the School of Health and Natural Sciences
Bayombong, Nueva Vizcaya
In Partial Fulfillment
Of the Requirements for the Degree
Bachelor of Science in Nursing
By
Rafael Vidad Jr.

Juluis Ceasar Bicera
Maureen Joy Agmata
Lean Joy Yamo
November 2020
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CHAPTER I
THE PROBLEM AND ITS BACKGROUND
Introduction
Balanced nutrition is one of the most important aspects to build-up health, however,
based on records and national surveys, cases of undernourished children are continuously
rising. As presented by a survey conducted by UNICEF, it is one of the main reasons
behind morbidity and mortality among children in the Philippines (UNICEF, 2019).
Despite thorough study and effort to eradicate this problem, the Philippine government
still failed to apply significant actions to diminish cases of low nutritional status among
children. As the United Nations’ (UN) secretary general Ban Ki-moon (2015) stated,
“The MDGs helped to lift more than one billion people out of extreme poverty, to make
inroads against hunger, to enable more girls to attend school than ever before and to
protect our planet,” still, reports and journals about children morbidity and mortality still
rises because of undernourishment or malnutrition. There are around 45% death among
children under 5 years of age that are linked to undernutrition mostly occur in low and
middle income countries” (WHO, 2020).
Currently, the backbone of resources for the improvement of nutritional status lies
within the location itself. Some suffers from scarcity of resources because they live in
remote areas, while others have abundant resources because they live in highly improved
locale. As Whelan, J. et al (2018) stated in their Journal, “In rural and disadvantaged
communities, it is harder to access affordable food, affecting both food insecurity and the
health of rural residents.” Factors including lack of health care facility and healthy food
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resources will mainly affect natives’ and non-natives’ status of health. The impact of
maximizing the environment’s innovation, especially, establishing health care facilities in
a specific place, provides more opportunity for the resident to have facilitated and well-
monitored nutritional status compare to those who resides far from these facilities. There
will be lack of vaccination, health teaching, health monitoring, and improvement of
norms and conduct that affects their health, and these disadvantaged communities will
have harder access to secured, affordable, and healthy food. In addition, in regards to
health establishments; the more the population is dispersed, the harder to have access in
health facilities. As Rechel B., et al (2016) stated in their journal, “Where the population
is more dispersed and distances are greater, access to hospital and emergency services
may become problematic. Geographical distance could then lead to inequities in access
and underutilization of emergency hospital services among population in rural or remote
areas.”
Nevertheless, many of the population in remote areas acquire more complications
and diseases, and most of them are chronic diseases due to health behavior, health care
access, healthy food access and demographic characteristics. However, children are the
one who are most affected by this type of scarcity because they are required the most to
satisfy their nutritional requirement to support growth and development since they are
still on the process of developing their protective properties. As Hassan S. and Eldessouki
R. (2017) stated in their journal, “Infants and young children are the most vulnerable to
malnutrition due to high nutritional requirement for growth and development.”
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Globally, a data from the World Health Organization (WHO, 2017) estimates that
malnutrition accounts for 54 percent of child mortality worldwide, while for children age
of five years, childhood underweight accounts for 35% of all death worldwide. Nearly
half of all deaths in children under 5 are attributable to undernutrition; undernutrition outs
children in greater risk of dying from common infections, increases the frequency and
severity of such infections, and delays recovery, and at least half of all children under this
age suffer from hidden hunger: a lack of essential nutrients that goes unnoticed until it’s
too late. The interaction between undernutrition and infection create a potentially lethal
cycle of worsening illness and deteriorating nutritional status. Poor nutrition in the first
1000 days of a child’s life can also lead to stunted growth, which is associated with
impaired cognitive ability and reduced school and work performance (UNICEF, 2020).
Internationally, number of stunted children in all the continents except Africa starts
to decrease, while overweight and obesity, including Africa, increases at a much faster
rate (UNICEF, 2019). However, according to the 2015 Millennium development goal
(MDG) report presented by Akombi, B. J., et al (2016), sub-Saharan Africa accounts for
the one third of all undernourished children, highlighting that malnutrition still remains a
major health concern for children under 5. While in Asia Pacific, in the jointly released
report of Food and Agriculture Organization, the UN Children’s Fund, World Food
Programme, and World Health Organization, an estimated of 77 million under-five
children suffered from wasting, and stunting rates of exceeded 20 percent (Arkin, 2019).
Nationally, many children in rural areas suffers from undernourishment, and each
day, around 95 children in the Philippines die from malnutrition based from the report of
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UNICEF (Lina, 2020). Filipino children are increasingly suffering from poor diets,
inadequate nutrition, food system that is failing them, and food borne diseases that leads
to malnutrition. The State of the World’s Children: Children, Food and Nutrition
revealed that one in three Filipino children under five years old are stunted, which means
they are too short for their age, while roughly 7 percent of children are too thin for their
height (UNICEF Philippines, 2019). The increase of cases of undernourishment among
children under 5 in the country is alarming because there must no cases of deaths among
children, but due to inadequate health care facility, especially in remote areas, which
promotes health and well-being, and scarcity of resources to eat healthy food and potable
water, cases malnourishment and undernourished children inevitably increases.
Cases of undernourished children are seen worldwide and somehow inevitable
because of different factors including the inaccessibility of good facilitated health care
system, access to clean water, eating nutritious food, lack of knowledge and even their
location, where-in, this case is more rampant to remote areas. However, this study will
supplement the thorough study of local researchers and government agencies in
Bambang, Nueva Vizcaya and places alike to it, to help the children in the area to
improve their nutritional status by having a feasible and accessible health care facility.
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Statement of the problem
This study aims to determine factors that cause poor nutritional status among
children of Bambang, Nueva Vizcaya. Specifically, it aims to provide answers for the
following questions:
1. What are the profile characteristics of children in terms of:
1.1 Age
1.2 Weight
1.3 Height
1.4 Location
1.5 Educational Attainment of Parents/Guardian
2.1 What is the nutritional status of the respondents in terms of:
2.1 Body Mass Index (BMI)
2.2 Dietary Intake
3. Is there a significant relationship between profile characteristics of the respondents
and their nutritional status?
3.1 Age
3.2 Location
3.3 Educational Attainment of Parents/Guardian
Statement of Null Hypothesis
There is no significant correlation between nutritional status and location of

respondent.
There is no significant correlation between age and nutritional status.
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There is no significant correlation between educational attainment and dietary
intake of respondent.
There is no significant correlation between age of and BMI.
There is no significant correlation between educational attainment and BMI.
Conceptual Framework
The following are the relevant variables and their relations to each other:
INDEPENDENT DEPENDENT
VARIABLES VARIABLES
 Age Nutritional Status in
 Weight terms of:
 Height  Body Mass Index
 Location (BMI)
 Educational  Dietary Intake
attainment of
parents/guardian
OUTPUT
 Improving referral system of
the community’s health facility
 Conduct feeding program
 Conduct health education
among parents/guardians
Figure I describes the conceptual framework of the study wherein the
independent variables are composed of the following: Age of the respondent, their
weight, height, location, and educational attainment of their parents or guardian.
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On the other side, the dependent variables which consist of the Body Mass Index
(BMI) of the respondents and dietary intake.
As for the output, the researchers want to have an improved referral system of the
community’s health facility, conduct feeding program, and conduct health education
among parents/guardian.
Significance of the study
“Good nutrition is one of the keys to a healthy lifestyle”. The generalization of
this present study would be a great contribution to the vast knowledge in relation to
nutritional status of the young children. The study will also re-define the importance of
health care system in remote areas where the community, especially children, are not well
thought about the importance of being health. Vital results of this study could be highly
significant and beneficial specially to the following;
Parents. This study would be a great help to the them to know what are the things that
they need to know and be aware of specially when it comes to the health and nutritional
status of their children, on what ways do they need to improve it.
Barangay Health Workers: The study will help them to assess the age group who have
low nutritional status, and leads to providing them program to improve their health status.
Children: The study will benefit them since they are the respondents. Plan of action from
different sectors will be applied after knowing which group are disadvantaged in terms of
nutritional status.
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Community Health Nurses. That they may become more aware on their roles and
responsibilities on the community they belong. And by this study, health workers will be
able to gather those data and also that will help them to identify the health problem and
health needs of the children who have a poor nutrition and also with their parents who do
not have enough knowledge on what ways do they need to do in order to improve the
health status of their child.
Future Researchers. The results presented may be used as a reference data in
conducting new research or in testing for the validity of other related findings. This study
also will serve as their reference that will give them a background or an overview on their
future research.
Scope and Delimitation of the Study
This study encompasses 25-40 pre-schools, 25-40 school-aged and 25-40
adolescents without symptoms of digestive complications or fast metabolism, in five
most populated remote areas or barangays of Bambang, Nueva Vizcaya including
Barangay Manamtan, Indiana, Dullao, Aliaga, and Mabuslo. And for the data gathering,
this will be done tentatively on December 15 to January 31.
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Definition of Terms
The following terms are defined for better understanding.
Digestive Complication: This refer to the fast metabolism of respondents.
Economic Status: This refers to the education, income and occupation of the guardian or
parents.
Malnourish: This refers to the supplied with less than the minimum or an unbalanced
amount of the nutrients or foods essential for sound health and growth.
Nutritional status: Current status of children in terms of Body Mass Index (BMI), and
dietary intake.
Parents or guardian: This refers to the one who are involve in the care of the children.
Remote areas: This refers to the area that are seen in different Barangays of Bambang,
Nueva Vizcaya. Some areas are isolated that requires to pass a mountain and a bridge to
get there.
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Chapter 2
REVIEW OF RELATED LITERATURE AND STUDIES
Conceptual Literature
It is believed that ‘Health is Wealth’, when in fact, health is the only wealth.
People tend to realize how dreadful life can be when they are already in their death-bed,
wishing their last wishes, and praying to spare their lives from their sin. This will be the
time that they comprehend that only health must be treasured, but of course, not all
people are given the chance to have vaccines, to eat nutritious food, and some are kept
away from the industrialized environment, which means, vital information is not shared
equally that are supposed to affect people’s well-being, especially those who lives in
remote areas.
Being undernourished and underweight are relevant to those who lives in an
inaccessible place, where resources of nutritious food, clean water, and clean
environment are in scarcity. Usually, children are affected. Their physical and health
attributes are far different to those who have much source of healthy living, and educated
enough to know what nutritious food to eat.
Newman, T. (2020) stated to her journal article that nutrition is the study of
nutrients in food, how the body uses them, and the relationship between diet, health and
disease. Nutrition also focuses on how people can use dietary choices to reduce the risk
of disease, what happens if a person has too much or too little of a nutrient, and how
allergies work. Basically, it molds the nutritional status of one person. Infants’ parents or
guardian and older adults’ support system must be aware in terms of the infant’s and
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older adult’s nutritional status because as Asmare, B. and Tadedele, M. (2018) stated in
their research, “Nutrition is also a vital component of human life, and brain development
through the entire lifespan. Balance nutritious is crucial for endurance, physical, growth,
cognitive development and productivity.” For children, they are still growing, vital
nutrients are needed for them to grow normally. Many children have been reported to
develop diseases or complications due to malnutrition, and suffers from being
underweight. Some are seen to have frail bones, skinny, dehydrated skin, sunken eyes,
low body mass index, and many more. Study says that children must have adequate
amount of nutritious food every meal, including grains, vegetables, fruits, and liquids that
have enough nutrients to supply the need of the body which are significant for growth
and development. However, underweight children are very rampant, and it is one of the
main leading causes of morbidity and mortality among children. As Bubnis, D. (2018) to
his journal article, “Being underweight can represent as many health concerns to an
individual as being overweight can. If a person is underweight, their body may not be
getting the nutrients it needs to build healthy bones, skins, and hair.” Among children,
there are greater risk of forming complications because of the possibility that their
immune system is depressed when they are underweight or undernourished.
However, the manifestation of undernourishment among children are seen from
their Body Mass Index (BMI), their bones are prominent, dehydrated skin, and some may
have acquired further complications such as diarrhea, vomiting, and fever. They are poor
in nutrition, therefore their defense or immune system is depressed, and makes them
more susceptible to diseases.
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Lack of understanding to nutritional value is also one factor why children are
undernourished. This involves beliefs of many individuals, where-in, exotic foods are
eaten usually as substitute to non-exotic meat without knowing that these food types can
complicate more the body. Many children also are not fed by breastmilk in the required
span of time for breastfeeding, and turns-out, when they grow, they are frail and
undernourished.
Remote areas are actually secluded places where-in, they are located far away
from civilization. More often, remote places are low in health access, and resources for
daily living. The remoteness reflects the distance people have to travel to acquire
services, and most of the time, there’s a scarcity of basic needs including clean food,
clean water, and proper clothes. People who lives in tribes, located in remote areas, are
educated with their traditions in terms of feast, labor, spiritual life, and life management,
which leads to misconception especially in regards to health. This misconception to
health can lead to complications or even death. However, people in remote areas have
generally lesser access to healthcare than urban places. They also have fewer medical
practitioners, and health care facilities which affects the preventive measures of the area,
and longer time to emergency response. According to Weinhold, I. and Gurtner, S.
(2014), “In the context of health care, the term rural has also been associated with limited
public transport, poor road infrastructure, long distances to health care service facilities
and difficulties in recruiting and retaining professionals.” From this scarcity, new born
and children are widely affected. Due to lack of health care facility, no one will teach
newly pregnant or first time mothers about do’s and don’ts before and giving birth. With
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lack of knowledge about pregnancy, and without visiting the doctor once in a while,
there’s a possibility that the child will be born frail because of no vitamin intake,
misconception, and lack of supplements for the child’s growth and development. After
the child was born, mothers who are not thought about the importance of breastfeeding
will have a child with depressed immune system. In addition, nutritional status of
children is basically important and interconnected to the knowledge of their mothers, but
with lack of health teaching and vital measures for pregnancy until birth and child
continuously growing, the child will not grow and develop healthy. Due to lack of
healthy food resources, children may also suffer from undernourishment, making them to
have low body mass index which causes them to be underweight, and unhealthy until
they grow. Another factor resulting a child to have a frail body is the vaccines they
received. Since people in the remote areas doesn’t have enough, or good health care
services, vaccines and medicines for child’s growth and development aren’t given
properly or not even given at all, which causes them to acquire more complications.
Lowered immune system are evident to children in remote areas who didn’t
received any vaccines, healthy food, and only drinks uncleaned, tap water. It’s
understandable that children suffer from malnutrition because of the also, lack of health
teaching to mothers or newly pregnant mothers since it’s hard to acquire such because of
health care facility shortage.
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Related Literature
Malnutrition or undernourished is a disease that results from nutritional deficiency
or overconsumption. She also added that there ae two forms of malnutrition which are;
(1) Under-nutrition: not having enough protein, calories or micronutrients results in this
form of malnutrition. This results in low weight-for - height (wasting), height-for-age
(stunting) and underweight (underweight). (2) Over nutrition: Overconsumption of
some nutrients can also contribute to malnutrition, such as protein, calories or fat, Streit
(2018).
According to UNICEF, three major underlying factors can be classified as the
major causes of childhood malnutrition: household food insecurity, insufficient treatment
and unhealthy household climate, and lack of health services.
In relation to that, malnutrition was also associated with lack or insufficient prenatal
care, not routinely deworming infants, low birth weight, prior episodes of diarrhea, and
developmental delay and the lack of health services (Edem,M.A.T, Eric, K.S., and
Edmund, T.N, 2015).
Malnutrition can be also associated with chewing or swallowing problems, poor
appetite, restrictive dietary habits, or diseases digestive tract that prevent proper digestion
and absorption; malnutrition may result from poor eating (Swedish org.).
According to Australian Institute Health and Welfare (AIHW) compared with
those living in urban areas, people living in rural and remote areas have higher rates of
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hospitalization, death, disability, and reduced access to and usage of primary health
services.
In rural and remote areas, residents also have lower life expectancy, poorer health
outcomes, longer-term health problems, disabilities, risk factors for sickness, workplace
accidents and injuries, and poorer access to treatment than residents in major cities. In
rural and remote areas, the risk of suicide and self-harm is much greater (especially for
males). Poorer health habits, including smoking tobacco and excessive consumption of
alcohol, are higher in rural and remote regions (ELDAC).
The UN Children's Agency (UNICEF) warned, "An alarmingly high number of
children are suffering the effects of unhealthy diets and a food system that is failing
them." The State of the World 's Youth 2019: Youth, Food and Nutrition, found that
about 200 million children under the age of five are either undernourished or overweight,
while one in three globally-and nearly two-thirds of children between the vulnerable ages
of six months to two years-are not fed food that nurtures proper growth (UN News).
Addition to that Streit (2018) stated, Malnutrition can lead to severe health issues, such as
stunted growth, issues with the eyes, diabetes and heart disease. Which may increase the
number of mortality and morbidity if not prevented.
According to Lamar University, community health nursing, also called public
health nursing or community nursing, integrates primary healthcare and nursing practice.
Community health (CH) nurses provide families or populations with health
services, preventive care, intervention, and health education. Community health nursing
is an area that combines evidence-based studies along with developments in technology
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and innovative approaches to health change. The discipline takes into account the cultural
and socio-economic experiences of patients in the population in order to maintain proper
engagement and empathy when interacting with them. In a given area, a neighborhood is
a group of individuals, which encompasses areas where people meet, work and go to
school. Many persons belong to different kinds of groups. In regional regions such as
towns and remote communities, community health nursing is widely performed
(Northeastern State University 2017).
According to Center for American Progress, studies consistently indicate that
community health centers offer treatment that enhances their patients ' health outcomes.
These centers' patients are also more likely to find a common source of treatment and
report stronger relationships with their providers of health care.
Moreover, Whelan (2010) stated that before moving them to more specialized
hospital-based services such as the general specialist and super specialist, primary health
care centers provide skilled medical treatment for people based on a locality or group. In
reality, the critical component of the health system of a country is primary health care,
while helping tremendously in the socio-economic growth of the society. Both primary
health care clinics strive to concentrate more on the quality of the service rendered while
ensuring cost effectiveness.
To add up according to fox news there four reasons why health centers are
important in the community: (1) They are convenient. Community health centers offer
everyone access to care in a nation with abundant resources and advanced health-care
technology. No one, including Medicaid patients and those without insurance, is turned
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away from these centers. (2) They save money for the community. Some may wonder
whether community health centers cost money for the local area. They potentially save
money and, instead of going to hospital emergency rooms or racking up huge bills from
hospital stays, people pursue care at these facilities. They are an economical driver and
they are public health centers enhance the economy by offering jobs, paying taxes and
purchasing goods and services. They increase productivity. The centers provide a
continuum of treatment that helps patients cope with chronic conditions, such as high
blood pressure and diabetes. This means fewer missed days at work and more kids at
school, increasing company productivity levels and improving the outcomes of education.
Health Status and Health Care Access of Farm and Rural Populations stated that,
relative to their non-farm and urban counterparts, both farm and rural populations face
lower access to healthcare in terms of availability, proximity, and efficiency. Non-
metropolitan households are more likely to say that their ability to access coverage limits
the cost of health care. It can be expensive and burdensome for patients living in remote
rural areas to drive to a primary care provider, with sub-specialty care often much further
away.
To sum it up, community health centers are very important and plays a great role
in the community. It has many functions, serving various communities. The barangay
health station or health centees is an essential part of maintaining a safe community, from
immunizations, prenatal care, morbidity screening, to serving as part of the referral
system (Belcenia, 2018)
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Access for health care system differs from urban and rural areas, especially those
who lives in remote places. Since they are far from the civilization, it’s hard for them to
have a healthy lifestyle because they can’t afford to be health teach, consult a doctor,
receive proper medication, and acquire daily intervention for complications. Etienne, C.
(2013) stated that, “One of the challenges for achieving universal health coverage is
ensuring that everyone – especially people in vulnerable communities and remote areas –
has access to well-trained, culturally sensitive and competent health staff.” It is highly
needed to provide needs of any individual, but barriers from remote areas are bigger
when it comes to their health care facilities. This shortage will affect the well-being of
individual, including cognitive, spiritual, and physical status. Communicable and non-
communicable diseases transpire most due to lack of preventive measures that are
supposed-to-be established by community health workers.
Vries, H. et al. (2018) emphasize the concept of health which refer to the result of
interaction of different factors between an individual and its environment. Educating and
influencing about the health of people is modify as a health education which it is a
process to promote health, prioritizing people and its environment.
According to Nsiah-Asamoah, C. et al. (2018), a study entitled “Management and
care of malnourished children: gaps in their knowledge levels of final-year community
health nursing trainees”, community health nurses are health educators that determine
the condition of malnourished children. It considers that having capability to health
education, manage and prevent malnutrition among children. The results need to
strengthen the concept and content of nutrition status which suggests to extent the
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knowledge and consider further assessment for a better health education to malnourished
children.
Pryzbylska, D. et al. (2014) states the importance of health education in health care
system which it is used to prosper knowledge and skills, raise awareness and alter the
attitude of individuals regarding health. It is a process to facilitate and maintaining the
people’s perspective and able to learn how to handle their health and its community.
Furthermore, it is to allow people to focus in decision-making, using health education to
prevent and promoting health.
The study of Degarege, D., Degarege, A. & Animut, A. (2015) entitled
undernutrition and associated risk factors among school age children in Addis Ababa,
Ethiopia. Cross-sectional study was conducted and it shows that 31% of children were
undernoursihed due to higher birth order, larger family size, low meal frequency and mud
floor house, absence of hand-washing facilities were significantly connected related with
undernutrition. It suggests that undernutrition is prevalent and policy to implement
screening and interventions.
The study of Rogers, A. et al. (2016) was aimed to determine the process of
strengthen the food systems among remote indigenous Australians. Remote communities
diverse range engage to the process of multi-sectoral community-led action due to limited
success of security and nutrition. Remote indigenous Australians increases their
knowledge and availability and accessibility of healthy food improves.
Laska, M. et al (2010) studied the healthy food availability in small urban stores in
US which states that the healthy food availability is low and limited especially in single-
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aisle store and some stores are increased it availability of health foods due its store size.
Healthy food is very important to consider particularly to urban areas. It suggests that due
to lack of availability of healthy food may be compromised in promoting healthy foods in
low-income communities.
The study of Khattak, U. K., Iqbal, S. P., & Ghazanfar, H. (2017), entitled “The Role
of Parents' Literacy in Malnutrition of Children Under the Age of Five Years in a Semi-
Urban Community of Pakistan: A Case-Control Study”, it is to examined the relationship
between parental education and nutritional status particularly to malnutrition. A self-
constructed questionnaires and survey among mothers was conducted. The result shows
an increase number of mothers were uneducated (42.0%) while among fathers found
29.0%. Among children, 56.5% are normal nutritional status, 25.5% are first-degree
malnutrition, 13.0% are second-degree malnutrition and 5.0% are third-degree
malnutrition. This suggests that parents must be given and promote importance that focus
to security, literacy, justice, employment, food, shelter and social equality especially to
female parent.
Prendergast, A. (2015) states the malnutrition and vaccination in developing
countries. Malnutrition among children were estimated a 45% deaths in developing
countries. It described as the most common immunodeficiency globally and it concern
the effectiveness of vaccinations. Pathogenesis malnutrition described malnutrition is not
merely due to deficiency of food but it is a complex interaction between infection,
inflammation, mucosal barrier dysfunction, immune dysregulation and nutritional status.
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Vaccination is immunogenic in the context of malnutrition; it is an intervention tool
within multi-sectoral package in early life which design to prevent malnutrition.
Synthesis
Based on the variable stated above such as the studies respondents are parents of
undernourished children are the same because they are all concerned about the health of
the children. All health care providers and health care educators collaborated to
strengthen the health status of each malnourished child. Malnutrition can lead to different
severe health issues. Which may increase the number of mortality and morbidity if not
prevented.
Some study shows that community health centers offer treatments that enhances
their patients ' health outcomes. Teaching and affecting the health of individuals is altered
as a health education which may be a process to promote health, prioritizing individuals
and its environment. One of the creators stated that the significance of health education
within the health care framework that is utilized to thrive information and abilities, raise
mindfulness, and modify the state of mind of people with respect to health.
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Chapter 3
RESEARCH METHODOLOGY
This chapter presents the methodology of the study. Specifically, it is discussed
the research design, research environment, research respondents, data gathering tool, and
treatment of data.
Research Design
This research study employs the quantitative design utilizing correlational
technique with the use of a Likert scale where data will be collected from 25-40 pre-
schools, 25-40 school-aged and 25-40 adolescents in five most populated remote
barangay or area of Bambang, Nueva Vizcaya with the statistical basis of Non-
Probability Sampling, where-in, criteria will be utilized in selecting the study’s
respondents. This study will use a quantitative method of research. The quantitative data
measured include the independent variables such as the age and location, and dependent
variables including BMI and dietary intake.
The inclusion criteria for the study sample will be: 1) Pre-school (2 to 5 years old)
School-aged (6 to 12 years old) and Adolescent (13 to 19 years old); 2) Resident of the
five most populated remote barangay or area in Bambang, Nueva Vizcaya; 3) No signs or
symptoms of digestive complications or fast metabolism.
This study will be used to present the relationship between age and dietary intake,
educational attainment of respondents’ parents and dietary intake, and, age and BMI in
five selected remote barangays of Bambang, Nueva Vizcaya.
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Research Environment
This study will be conducted to preschool, school-aged and adolescents; without
symptoms of digestive complication, with their parents in five most populated remote
barangay or areas in Bambang, Nueva Vizcaya; the different barangays are located near
mountains and some are needed to get across a bridge to be able to get there, some roads
are not cemented, many fruit bearing trees, and transportations are limited.
Research Respondents
The selected research respondents are 25-40 pre-schools, 25-40 school-aged and 25-
40 adolescents; without symptoms of digestive complication, with their parents who are
currently residing at remote area/s in Bambang, Nueva Vizcaya.
Data Gathering Tool
The Likert Scale to be used will be adopted from the questionnaire attached to the
study of Khattak, Iqbal, and Ghazanfar (2017) entitled “The role of parents’ literacy in
Malnutrition of Children Under the Age of Five Years in a Semi-Urban Community of
Pakistan: A Case-Control Study. The researchers will also be adding different questions
to be able to gather more suitable data in-depth understanding the correlation between
health status of preschool, school-aged and adolescent, and living in remote area. The
gathered data will be tabulated and analyzed in order to identify the correlation between
health status of school-aged and living in remote area. (The questionnaire is attached in
the following pages).
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Data Gathering Procedure
The Likert scale was adapted and modified to be used as suitable questions for the
researchers’ study. In the questionnaire, Likert scale were used to determine the dietary
intake of the respondents. Copies are distributed to 25-40 preschools and 25-40 school-
aged with their parent/guardian and 25-40 adolescents itself. Participants were given time
to respond and then researchers collected the questionnaires afterwards. The data
gathered will be tallied and tabulated. The computation for interpretation is according to
the frequency of items checked by the participants by the use of Average Weighted Mean
method (AWM).
Treatment of Data
To assess the personal profile and dietary intake of the respondents, the researchers
will personally hand the Likert scale to the preschool and school-aged respondents’
parents, and respondents themselves for adolescent. Body Mass Index will be computed
by the researchers using the formula BMI=kg/m 2, and since respondents’ BMI may vary,
the researchers will get the most common BMI for preschool, school-aged and adolescent
by getting each mean (identifying the central position of results of respondents’ BMI by
ranging the gathered data from the lowest to highest result) of the three groups. This will
help the researcher to easily correlate the age groups from their nutritional status to where
they live.
For the statistical treatment of the relationship between age and dietary intake,
educational attainment of respondents’ parents and dietary intake, age and BMI, the
25

researcher adapted different statistical tools from the study of Idos, G., et al (2017). The
researchers will determine the average dietary intake of each test groups (preschool,
school-aged and adolescents) using the AWM method and separate scale for the
educational attainment of parents or guardian. In interpreting the computed AWM point
obtained, the formula is as follows,
For the average of dietary intake:
AWM = FX / N
Where: AWM = Average Weighted Mean
F = Frequency (How often did the respondents from preschool, school-aged, and
adolescent marked the given choices)
X = Weighted Value
N = total number of respondents’
For the Dietary Intake, this will be the scale:
Scale Average Weighted Mean Descriptive Interpretation

5 4.21- 5.00 Always
4 3.41- 4.20 Often
3 2.61- 3.40 Sometimes
2 1.81- 2.60 Seldom
1 1.00- 1.80 Never
The Qualitative description for the respondents’ nutritional status are the
following: for never to seldom = poor nutritional status; sometimes = fair nutritional
status; often to always= very good nutritional status.
For the Educational Attainment, this will be the scale:
Scale Average Weighted Mean Descriptive Interpretation

5 4.21- 5.00 College Graduate
26

4 3.41- 4.20 College Undergraduate
3 2.61- 3.40 High School Level
2 1.81- 2.60 Elementary Level
1 1.00- 1.80 No Education at all
The researchers will utilize this scale to know if there’s a relationship between
educational attainment of the parents and nutritional status of the test groups (preschool,
school-aged and adolescents).
To determine the relationship between age and dietary intake, educational
attainment of respondents’ parents and dietary intake, age and BMI, the researchers will
use the Pearson Correlation Coefficient. The computed value will be interpreted using the
scale below.
Value Descriptive Interpretation Value

-0.80 to -1.00 Strong Correlation 0.80 to 1.00
-0.50 to -0.79 Moderate Correlation 0.50 to 0.79
-0.20 to -0.49 Weak Correlation 0.20 to 0.49
0 to -0.19 No Correlation 0 to 0.19
Define reference population
Selection of the study population
Select suitable subjects
Get approval from the Dean and other faculty members
Obtain informed consent 27
Letter of approval

Ethical consideration
It is imperative that ethical issues are considered during the formulation of the
evaluation plan. Ethical considerations during evaluation include: Informed consent; the
main purpose of informed consent is that the participant is able to make an informed
decision as to whether they will participate in the evaluation or not. Additional
information should also be provided in the event that the participant becomes distressed
in any way during their participation. Informed consent is to allow the individual to make
an informed decision as to whether or not they will engage in the assessment. In the case
of the participant being distressed in some way during their participation, additional
details should also be given. Voluntary participation ensures that individuals participate
free of coercion in the assessment. Participants shall be free to withdraw their
participation at any time without adversely affecting their participation in future
programs or the current program and their relationships with any of the participating
researchers or research bodies. Encouraging high-risk adolescents to become active in a
program can be daunting and it is therefore difficult when participants choose not to
continue in a program. Do no harm may be both physical and/or psychological, and can
also be in the form of pain, discomfort, anxiety, reduced self-esteem, or privacy violation.
In any way, it is imperative that the assessment process does not harm. Participants,
unintended or otherwise. Confidentiality means that any identifying information is not
made available to or obtained by someone other than the coordinator of the program.
Confidentiality also guarantees that any reports or written records exclude any identifying
information. Given that in peer-based services there are always small numbers, it is very
28

important to understand how reports are written to ensure that even if names are not used,
there is no potential for individuals to be recognized. Anonymity is a stricter form of
anonymity than privacy, since the participant's identity remains undisclosed to the study
team. Only assess relevant components. Evaluate only certain elements that are
applicable to the program/initiative being carried out. In assessments, high-risk groups
are often used as a captive audience to ask all kinds of questions that are of interest to
organizations administering the program/initiative, but not important to the program or to
the community participating in the program. It is important to keep assessments as
straightforward as possible and to stay centered on the evaluation's purpose and what the
collected data will be used for.
29
Profile Information:
Good Morning/ Afternoon! We are students of Saint Mary’s University who seeks
for your help with our study. The purpose of this study is to know the relationship and
factors affecting the nutritional status of different age group who resides in remote areas.
May we request you to answer our questionnaire truthfully and we assure the information
requested in this questionnaire is voluntary and confidential, and is not used for any
purpose other than during an actual emergency. Also, the following answers coming from
you will help the researcher improve perspective and practices, especially in remote
areas.
Guardian’s Profile:
Name:
(optional/
nickname)
Educational No Elementary High College College
Attainment education Graduate School Undergraduate Graduate
at all Graduate
Child’s Personal Profile:
Name
To be filled-up by the researchers
Height
Weight
Body Mass Index
(BMI)
30
INSTRUCTION: The following are questions to assess the dietary intake of the
respondent. Kindly check the corresponding choice appropriate for the given
questions.
1 – Never, 2 – Seldom, 3 – Sometimes, 4 – Often, 5 – Always
QUESTIONS:
Never Seldom Sometimes Often Always
1. How often does your
child/Do you eat
vegetables?
child/Do you eat fruits?
child/Do you eat cheese
and eggs?
child/Do you eat fish?
child/Do you eat meat?
child/Do you eat root
crops (example: potato,
onion, ginger, carrots,
cassava, etc.)
child/Do you drink
milk?
child/Do you drink soft
drinks?
child/Do you eat
snacks?
child/Do you eat junk
foods?
child/Do you drink
water?
12. Does your child/Do you
have access to clean
31
water?
eat rice?
exercise?
15. Do you take a
vitamin/mineral
supplement?
16. Do you usually eat
everything that is
served to you plate?
17. Do you skip meals?
18. How often do you eat
sweets?
19. Do you choose the food
you eat in a day?
20. Do you usually
complete the 3 meals a
day?
32
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THE NUTRITIONAL STATUS OF THE CHILDREN OF BAMBANG

NUEVA VIZCAYA AND ITS CORRELATES

Saint Mary’s University

Rafael Vidad Jr.

Saint Mary’s University

THE PROBLEM AND ITS BACKGROUND

rising. As presented by a survey conducted by UNICEF, it is one of the main reasons

middle income countries” (WHO, 2020).

Saint Mary’s University

maximizing the environment’s innovation, especially, establishing health care facilities in

will be lack of vaccination, health teaching, health monitoring, and improvement of

and underutilization of emergency hospital services among population in rural or remote

Nevertheless, many of the population in remote areas acquire more complications

malnutrition due to high nutritional requirement for growth and development.”

Saint Mary’s University

Programme, and World Health Organization, an estimated of 77 million under-five

Saint Mary’s University

height (UNICEF Philippines, 2019). The increase of cases of undernourishment among

water, cases malnourishment and undernourished children inevitably increases.

Cases of undernourished children are seen worldwide and somehow inevitable

supplement the thorough study of local researchers and government agencies in

Saint Mary’s University

1. What are the profile characteristics of children in terms of:

1.5 Educational Attainment of Parents/Guardian

2.1 What is the nutritional status of the respondents in terms of:

2.1 Body Mass Index (BMI)

2.2 Dietary Intake

3. Is there a significant relationship between profile characteristics of the respondents

and their nutritional status?

3.3 Educational Attainment of Parents/Guardian

Statement of Null Hypothesis

There is no significant correlation between nutritional status and location of

There is no significant correlation between age and nutritional status.

Saint Mary’s University

There is no significant correlation between age of and BMI.

There is no significant correlation between educational attainment and BMI.

Figure I describes the conceptual framework of the study wherein the

weight, height, location, and educational attainment of their parents or guardian.

Saint Mary’s University

(BMI) of the respondents and dietary intake.

Significance of the study

“Good nutrition is one of the keys to a healthy lifestyle”. The generalization of

significant and beneficial specially to the following;

status of their children, on what ways do they need to improve it.

Saint Mary’s University

health status of their child.

Future Researchers. The results presented may be used as a reference data in

Scope and Delimitation of the Study

This study encompasses 25-40 pre-schools, 25-40 school-aged and 25-40

adolescents without symptoms of digestive complications or fast metabolism, in five

most populated remote areas or barangays of Bambang, Nueva Vizcaya including

this will be done tentatively on December 15 to January 31.

Saint Mary’s University

The following terms are defined for better understanding.

Digestive Complication: This refer to the fast metabolism of respondents.

Saint Mary’s University

REVIEW OF RELATED LITERATURE AND STUDIES

Being undernourished and underweight are relevant to those who lives in an