DESCRIPTIVE STUDY ON PRENATAL HEALTH SEEKING BEHAVIOR

IN BARANGAY GREENVALLEY HEALTH CENTER, MOLINO, BACOOR, CAVITE

IN THE YEAR 2016

In Fulfillment of the Requirements of the

Elective Course in Obstetrics and Gynecology

Submitted by
Acdal, Strawberry
Azucena, Shergie
Macachor, Celito-Jose
Tayag, Mary Grace

March 16, 2017

Table of Contents

Title page

Introduction

General Objectives

Specific Objectives

Scope and Limitations

Methodology & Instrumentation

Data analysis

Results

Discussion

SWOT Analysis

Conclusion

Recommendations

References
Introduction:

Prenatal care is the use of health care during pregnancy. It is composed of screening for
health conditions that are likely to increase the possibility of adverse pregnancy outcomes,
providing therapeutic interventions and educating pregnant women about planning for safe child
birth. Its importance on maternal and infant health is ascertained by different medical literature
(DOH, 2009).
In the Philippines, prenatal care is a widely accepted practice. Almost 96% of mothers
had visited a health provider for their prenatal care (NSO and Macro International, 2010).
Despite the high prenatal care coverage, morbidity and mortality related to pregnancy are still
high. Infant and maternal mortalities are still major problems, where 26 infants in every 1000 live
births die and 162 women per 100,000 die due to childbirth. These put the Philippines IMR still
above its Millennium Development Goal target of 19/1000 live births and its MMR way above
the target of 52/100,000 live births in 2015 (NSCB, 2010).
In this light, extrapolating the other dimensions of prenatal care like quality and
comparing it by prenatal attendant (doctors, nurses/midwives and traditional birth attendants)
are necessary to further understand these shortcomings.
Prenatal care quality is an important indicator for maternal and infant health status.
However, quantity of prenatal care visit is the most commonly used indicator while the quality of
prenatal care is seldom used (Alexander, 2001; Alexander and Kotelchuck, 1996; Barber and
Bertozzi, 2007. To date, no existing standard protocol is used to measure quality of prenatal
care. Some popular studies have used contents of prenatal care (e.g. tetanus toxid or doctors
advice) to measure the overall quality (Alexander et al, 2001; Victora, 2001). This practice,
however, may pose a possible problem especially when important features or components of
prenatal care are not taken into account. In this light, this study attempts to develop an antental
quality index based on the contents adapted from DOH and WHO recommendations.
Using the 2003 and 2008 National Demographic Health Survey (NDHS), this study
constructs a scoring system to measure the quality of prenatal care and compares the estimates
derived from 2003 and 2008 surveys. This study also examines the quality of prenatal care
services provided by different health care providers, and identify the relationship between socio-
economic variables of pregnant women and the quality of prenatal care. Finally, the study
suggests improvements on the quality of prenatal care in the
Philippines.

Promotion and maintenance of health at the community level requires immersion into the
community. Because lack of access to health care is a multifactorial problem, this paper would
like to gain a birds eye view of several factors that may influence health systems. By assessing
the resources available to the community, future research and projects can be made in
accordance to the communitys needs.

This project is an effort of the fourth year medical students of the University of Perpetual
Help - Jonelta Foundation School of Medicine, whose aim is to get a view of the scope of
Obstetrics and Gynecology patients who are covered by the Green Valley Health Center.

General Objectives:

The main goal of the students of the UPHR-JFSM 4th year students of batch 2017 is to
create a community and demographic profile based on the outcome of a review of records on
the Obstetrics and Gynecology patients catered by the Green Valley Health Center, Molino,
Bacoor, Cavite, for the period covering March 03, 2014 to March 16, 2017, focused in identifying
 specific needs and problems of the community to be able to contribute to the development and
promotion of health programs of Green Valley Health Center, Molino, Bacoor, Cavite.

Specific Objectives:

The specific objectives surrounding this study are as follows:

1. To conduct a review of records in the Green Valley Health Center, Molino, Bacoor, Cavite
2. To interpret and analyze the data collected from the review of records
3. To create a community profile based on the data gathered from the community survey
4. To illustrate the health care providers in Green Valley Health Center

5. To describe the prenatal checkup status of pregnant women in Barangay Green Valley
Health Center in 2016
6. To describe the healthcare services available during prenatal check up among pregnant women
in the health center
7. To use the data gathered regarding the community status of obstetrics and gynecology to serve
as a basis for recommending health and medical programs tailored to the specific needs and
problems in the community

1 To determine the age group who completed their prenatal check up

2 To determine which barangay has highest number of prenatal checkup.
3 To determine the most common gravid patients who is more compliant with prenatal
check up
4 To determine the number of patients who had undergone delivery in Barangay Green
Valley Health Center.
5 To determine what family planning method is most commonly used among patients who
had their prenatal check up in Barangay Green Valley Health Center in 2016

Scope and Limitations:

1. The group will limit themselves to the Obstetrics and Gynecology patients catered by the Green
Valley Health Center who are available at the time of interview, and will be using data gathered
from residents with no further verifications other than a signature attesting that the data
gathered is true to their knowledge, as well as what can be verified at the time of the interview.
2. The study is of a descriptive nature, and will thus have no definitive conclusions suggesting
association or causality of any factors towards access to care

Instrumentation & Methodology:

The study will make conduct a review of records specific data relevant to creating a
community profile. The questionnaire will be administered as a community survey per
household. The questionnaire will include questions on the familys basic structure, religious
affiliations, occupational and educational background, dietary habits, family income, health
status, history and current health practices, type of home environment including waste disposal,
drainage system and water supply.

The researchers will conduct review of records in the Green Valley Health Center,
Molino, Bacoor, Cavite.

After data collecting, the researchers will then collate and analyze the data and these
data will be presented through tables and graphs.

Statistical method

Due to the descriptive nature of the study, the group will be using frequencies and
present the data with graphs and tables.

Results

DEMOGRAPHICS

Bacoor is strategically located at the gateway to Metro Manila. A sub-urban area, the city
is located 15 kilometres (9.3 mi) southwest of Manila, on the southeastern shore of Manila Bay,
at the northwest portion of the province with an area of 52.4 square kilometers. It is bordered to
the east by Las Pias and Muntinlupa, to the south by Dasmarias, to the west
by Kawit and Imus, and to the north by Bacoor Bay an inlet of Manila Bay. Bacoor's is separated
from Las Pias by the Zapote River and from Imus and Kawit by Bacoor River.

Most of the city is composed of flat, formerly agricultural lands, with some areas such as the
coastal barangays of Zapote, Talaba, Niog, and Panapaan lying below sea level. Some
barangays such as Molino and Queens Row are situated on the hills that form valleys along the
upstream portion of Zapote River.

EPIDEMIOLOGY

To address the health concerns of the city's ageing population and urban poor
population, several public and private hospitals have been established in the city. The local
government also initiated a discount program for senior citizens in city wherein they can avail of
discounted medical care and medicines in hospitals in and outside of Bacoor.

Bacoor has one major public hospital and 7 major private hospitals aside from a number of
small private clinics.

Bacoor District Hospital

Bacoor Doctors Medical Center
Crisostomo General Hospital
Metro South Medical Center
Molino Doctors Hospital
Southeast Asian Medical Center
St. Dominic Medical Center
St. Michael Medical Hospital
CHARACTERISTICS

In the 2016 census, the population of Bacoor, was 600,609 people,with a density of
13,000 inhabitants per square kilometre or 34,000 inhabitants per square mile. It is the second
most populous city in the province after Dasmarias.

The city owes its large population to the influx of low and middle-income settlers who availed of
the various housing projects and subdivisions in it.

Bacoor is currently experiencing a rapid shift from an agriculture-based economy to a

residential/commercial urban center. Nowadays, retail, manufacturing, banking and service
sectors are Bacoor's primary income earners. Commercial activities are sporadic throughout the
city ranging from wholesale to retail establishments, restaurants and eateries, hardware and
construction supplies and other service-related industries, especially those located in SM City
Bacoor where it serves as the city's main income earner.

Meanwhile, agricultural area has lessened to only 100 hectares while fishponds which likewise
decreased to almost half of the original 760 hectares. Salt production, fishing, oyster and
mussel culture, which are now being threatened to near extinction because of pollution and
overpopulation, are the other sources of income of the residents. These industries are also
threatened by the construction of the Cavite Coastal Road Extension which directly affected the
Bacoor shoreline.

HEALTH CARE SYSTEM: Organizational Chart

PRE-NATAL/POST-NATAL CARE

Prenatal care is the use of health care during pregnancy. It is composed of screening for
health conditions that are likely to increase the possibility of adverse pregnancy outcomes,
providing therapeutic interventions and educating pregnant women about planning for safe child
birth. In this Health Center, health care providers follow the guidelines in the manual of
Integrated Management of Pregnancy, Childbirth, Postpartum, and Newborn Care: A guide for
essential practice in Philippine setting. The recommended content of prenatal care has three
main categories: (1) Assessment (including history-taking, physical examination and laboratory
tests to identify problems or risk factors), (2) Health promotion (including advice on nutrition,
planning the birth, information about danger signs of pregnancy and contingency planning,
subsequent contraception and breastfeeding), and (3) Care provision (including iron and folate
supplements, tetanus toxoid immunizations, psychosocial support and record-keeping).

FAMILY PLANNING

With the regards to the family program of the community, DOH provide natural and
artificial methods of family planning. The artificial method that they provide were, pills, IUD,
injection of depot methoxyprogesterone acetate, condom, vasectomy and bilateral tubal ligation.
On the other hand, the natural family planning methods they recommending were cervical
mucus method, basal body temperature method, symptom thermal method, standard days
method and lactation amenorrhea method.

For the year of 2016, the mostly used artificial family planning method was the use of
injection of depot methoxyprogesterone acetate. Out of 78 previous acceptors of artificial family
planning method there are 39 women who continued to use DMPA injection, 33 women who still
refer to use pills, 5 women who uses condom and 1 women who still refer IUD. For the new
acceptors of artificial family planning method, the women in the community, the most commonly
used was pills. Out of 150 new acceptors, there are 39 women who chose to use pills, 37
women prefers injection of DMPA, 6 women for the use of condom and 1 woman for IUD.

For the natural family planning method, the only method that they recorded was mothers
who are practicing lactation amenorrhea method. There are 72 who maintain to practice method
and 73 mothers who were new to do this natural way of family planning.

STI PREVENTION & MANAGEMENT

GRO Screening

Social Hygiene Clinic

This clinic is located in Brgy. Panapaan 1, Bacoor, Cavite. It mainly aims to educate the
community about HIV/AIDS and other STDs and to increase awareness, promote prevention
and reduce the stigma of these diseases. This offers free HIV testing, confidential consultation
and STD meds, HIV/AIDS testing and post-test counseling, dissemination of informational
materials, referrals to other hospitals and peer counseling groups. The clinic provides HIV
prevention, testing and treatment services primarily to men who have sex with men (MSM) and
transgender people. They are seeing patients at all levels of society, from the upper
socioeconomic level to the poorest of the poor. Meanwhile, the challenge of identifying and
retaining HIV individuals across the continuum of care is being addressed by the clinics ever-
expanding team of peer outreach educators led by Dr. Mike Marquez. The peer educators are
skilled at taking a contacts history. It is also going to take part in efforts to better map the
communities, to help with community population size estimations, including for MSM and
transgender people, people who inject drugs, and children and young people living with HIV.

Discussion

Molino 6 4
Molino 7 3
San Nicolas 3 372
Others 12
391
 Chart Title

3% 1% 1% Molino 6
Molino 7
San Nicolas 3
Others

95%

Objective 3
Among the 3 Barangays that catered by the Green Valley Health Center, San Nicolas 3
has the most number of pregnant women who attended their prenatal check ups.

SWOT Analysis

Conclusion

Recommendation