CHAPTER ONE

INTRODUCTION

1.1 Background

Diarrhea is a symptom of an infection in the intestinal tract, caused by a variety of

bacteria, viruses and parasites. Infection can be spread through contaminated food or

drinking-water, or from person-to-person. During a diarrheal episode, water and

electrolytes are loss through liquid stools, vomit, sweat, urine and breathing, making

dehydration as the main cause of death when these losses are not replaced. (World Health

Organization, 2013)

Diarrhea remains the leading cause of morbidity and mortality in children under

five years old worldwide, the majority of deaths related to diarrhea take place in Africa

and South Asia (Mengistie et al, 2013).

Globally, the Centers for Disease Control and Prevention (2012) estimated that

diarrhea kills 2,195 children every day—more than AIDS, malaria, and measles

combined that accounts for 1 in 9 child deaths worldwide, making diarrhea the second

leading cause of death among children under the age of five.

Epidemiologic studies show that factors determining the occurrence of diarrhea in

children are complex and the relative contribution of each factor varies as a function of

interaction between socio-economic, environmental and behavioral variables (Mengistie

et al, 2013). Worldwide, 780 million individuals lack access to improved drinking-water

and 2.5 billion lack improved sanitation (World Health Organization, 2013)

1
 Despite the sobering statistics, in addition to rotavirus vaccination and

breastfeeding, diarrhea prevention focused on safe water and improved hygiene and

sanitation is not only possible, but cost effective (Centers for Disease Control and

Prevention, 2015).

A study in Bangladesh showed that a child whose mother completed primary

school is 20% more likely to survive than a child whose mother has not received any

formal schooling, and a child born to a mother who attended secondary school is 80%

more likely to survive (Zeleke, 2014)

The odds of developing diarrhea was 59% less among children whose mothers

washed their hands after cleaning their child’s bottom. Studies showed the importance of

hand washing in reducing the occurrence of childhood diarrhea (Zeleke, 2014).

In the Philippines, United Nations International Children’s Emergency Fund

(2013) stated that almost 90 percent of child deaths are due to diarrheal diseases caused

by contaminated water, lack of sanitation or inadequate hygiene.

Coastal barangays namely Fuerte, Pandan, Puro, Pantay Tamurong and Villamar

are amongst the 17 barangays in the Municipality of Caoayan, Ilocos Sur, Philippines

with an estimated total population of 9,277 (Barangay Health Centers, 2016). Garbage

disposal are one of the major concerns of the said barangays, garbage is dumped as one

on an area of the barangays. Another concern is the inadequate source of water, there are

only limited numbers of water pumps that serve as the means of household and drinking

water for coastal barangays, wherein sanitation of the water is uncertain.

2
1.2 Problem Statement

In spite of the advancement of the health care system in delivering effective and

efficient means of diagnosing and treating different diseases, still, diarrhea is a long way

battle amongst the developing countries that significantly influences the health of the

children.

Diarrheal disease due to unsafe water and lack of sanitation are the biggest cause

of morbidity and mortality in under-five children in the world especially in poor

countries. Where a child dies every 15 seconds from diarrhea caused largely by poor

sanitation and contaminated water supply. Behavioral factors associated with acute

childhood diarrhea include lack of hand-washing, poor infant and young child feeding

practices and lack of child immunizations (Zeleke, 2014).

In the Philippines, over 30 million people do not have access to improved

sanitation facilities. Out of this, 7.8 million people, or roughly 8 percent of the country's

population don't have access to sanitation facilities at all. Every day nearly 10 million or

1 in 10 Filipinos defecate in open places or use a plastic bag that is then thrown out with

the trash (Ebora, 2015). The National Statistical Coordination Board (2010) reported that

16% of Filipino households lacked access to clean and potable water.

According to the health records obtained from the Provincial Health Office of

Ilocos Sur, diarrhea is among the top 10 causes of morbidity in year 2014 and 2015.

Morbidity rate is high among the under-five children with an approximate 2,453 cases

from year 2014 to 2015. In 2015, based on the health records of Rural Health Unit of

Caoayan, Ilocos Sur, the top five leading causes of morbidity and mortality in the coastal

barangays are the following: Acute Respiratory Infection as rank one, followed by
3
hypertension, musculoskeletal related illnesses, dental problems and lastly diarrhea.

Amongst the five diseases, diarrhea is more common to under-five children. Poor

sanitation practices and lack of protected water sources are considered factors associated

with diarrhea in the said barangays. However, whether these risk factors have contributed

to the diarrhea situation in the study areas is not documented. This research therefore,

intends to establish and explore the factors resulting to diarrhea and improve the health of

the respondents with the collaboration of the mothers, community and rural health unit by

delivering community-based services.

1.3 General Objectives

This study aims to identify the socioeconomic, environmental and behavioral

determinants associated with the occurrence of diarrhea among the under- five children in

coastal barangays of Caoayan, Ilocos Sur

Specific Objectives

a. To determine the under-five prevalence and incidence of diarrhea.

b. To assess the associated socioeconomic factors of diarrhea, link with

the following:

i. Family economic status

ii. Household size

iii. Maternal age

iv. Educational attainment and occupation of the parents/ caregiver

v. Marital status of the parent/s

c. To determine the associated environmental factors of diarrhea in

relation with the following:

4
 i. Type and distance of water source

ii. Amount of daily water consumption

iii. Availability of latrine

iv. Livestock in the house

v. Waste disposal

d. To determine the behavioral factors of diarrhea associated with the

following:

i. Water drawing and storage practices

ii. Feeding practices

iii. Healthcare practices for diarrhea

iv. Duration of breastfeeding & time of introducing supplementary

feeding

e. To determine the point and two- week period prevalence and incidence

of diarrhea in under- five children.

f. To determine the association of socioeconomic, environmental and

behavioral factors in the occurrence of diarrhea.

1.4 Significance of the Study

The significance of this study is that it will provides data that can greatly enhance

a better understanding of the social, environmental, economic and behavioral factors

associated with the occurrence of diarrhea among the under-five children in coastal

barangays of Caoayan, Ilocos Sur. Such data is important in making recommendations on

possible focal points for child- health programs that aims to reduce the high rate of

diarrhea in under-five children not only in the coastal barangays of Caoayan Ilocos Sur

5
but, hopefully, elsewhere in the Philippines. The findings of the study therefore should be

of use to the Rural Health Unit of Caoayan, Provincial Health Office of Ilocos Sur and

other stakeholders such as NGOs in designing and implementing child health intervention

programs and projects.

1.5 Scope and Limitation of the study

This study intends to explore the socioeconomic, environmental and behavioral

factors associated with the occurrence of diarrhea in coastal barangays of Caoayan, Ilocos

Sur.

The independent variables are the socioeconomic status that include family

economic status, household size, and maternal age, educational attainment of the parents/

caregiver, number of children, occupation and marital status. Another, the environmental

sanitation that include the type of water source, distance to the water source, amount of

daily water consumption, availability of latrine, number of rooms, livestock in house and

waste disposal. Lastly, the behavioral factors that include method of water drawing and

storage, feeding practices, action for diarrhea, duration of breast-feeding and time of

introducing supplementary feeding. The dependent variable is the occurrence of any

episode of diarrhea from the given point and two- week period.

The source and study population are the under- five children of the coastal

barangays of Caoayan, Ilocos Sur. Since the children were too young at under five years

of age to be interviewed, verbal consent will be taken from the mothers or caregivers,

provided that the mothers and the caregivers of the respondents are also willing to

participate in the study by answering the questionnaire and interview.

6
 One of the limitations of this study is that the specific etiologic agent causing the

diarrhea to the respondents will not be identified, because the study will only focus to the

factors associated with diarrhea.

Another limitation is related to the definition of the term “diarrhea”. There may be

difference among mothers in perceiving their child’s health.

7
 CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter presents the related literature and studies after the thorough and in

depth search done by the researchers that provides an overview of previous research on

knowledge sharing and intranets. It introduces the framework for the case study that

comprises the main focus of the research described in this study.

The review of related literature studied by the researchers is divided in to

following categories:

• Overview of diarrhea

• Socioeconomic factors of diarrhea among under-five children

• Environmental factors of diarrhea among under-five children

• Behavioral factors of diarrhea among under-five children

2.1 Overview of diarrhea

According to the report of WHO in 2008, diarrhea cases each year results in 1.5

million deaths and mostly contributed by children. Total number of deaths cause by

unsafe water and insufficient hygiene is 860,000 deaths per year in children under the age

of 5. Diarrhea results from an imbalance in the absorption and secretion properties of the

intestinal tract; if absorption decreases or secretion increases beyond normal, diarrhea

will occur. It can range in severity from an acute, self-limited annoyance to a severe, life-

threatening illness.

According to Khalili, B. et al 2009, they defined diarrhea as the passage of three

19
or more watery stools per day . There are three clinical types of acute, chronic or
8
persistent and dysentery. Acute diarrhea is defined as the abrupt onset of 3 or more loose

stools per day and lasts no longer than 14 days. Chronic or persistent diarrhea lasts longer

than 14 days; and the last type is dysentery or bloody diarrhea 18 .

2. 2 Socioeconomic Factors

The socioeconomic profile of a family is one of the major risk factor that will

have a direct effect on diarrhea morbidity in children under five years old.

According to World Health Organization and the Pan-American Health

Organization, among the identified determinants of diarrheal incidence, material factors

and resources such as material standards of living, financial difficulties or insecurity,

economic resources, neighborhood characteristics, employment status, or physical and

organizational working conditions have been shown strong connections in health status

and mortality 14.

A disease such as diarrhea remains high despite the decreasing rate of mortality

and morbidity, the study conducted by Diouf et. al in 2014 shows that the low and middle

income countries are mostly afflicted 2. According to the study conducted by Siziya et al

in 2013, children that comes from poor homes had higher diarrhea incidence than

children that comes from medium wealth and high wealth homes. But they also

hypothesized another factor such as the possibility from parents, that some condition

where children who lives in a medium to high wealth home who has a wealthy parents,

parents may be unable to decrease the risk of exposure because such factors are beyond

their control, such as contaminated community environments or lack of water. However,

9
the knowledge and wealth of the parents or caregivers may allow them to use healthcare

services more effectively than uneducated women 5.

According to a study conducted by Alelign T. et al in 2016, there is an

association between the risk of having diarrhea and the mother’s education. Incidence of

diarrhea was found out to be higher in children whose mothers or caregivers that had no

formal education while those children with mothers or caregivers who had formal

education had a lower incidence of diarrhea. This study also emphasized a specific part

that education is important to change healthcare seeking behaviors and practices of

mothers and caregivers 1. Another study that supports the previous statement by Samwel

M., et al, they hypothesized that children who have mothers that had no formal education

were about 3 times higher to have diarrhea when compared to children of mothers that

had a higher education.

Family size is an important risk factor for childhood diarrhea. In the case of a

large number of children in a household, a child is more likely to have diarrhea because

of crowding and poor hygienic practice 3. In a community where many people live

together and manifest a crowded area, the chance of having contact with many types of

pathogens increases, and the result is the hygiene will be affected. Beside crowding,

another factor within the household might affect the child to have diarrhea which is a

competition for mother’s time and attention. The mother or the caregiver must take

seriously the act of hygiene. The probability of having diarrhea was about 60% higher in

households that has six or more than six children compare in households with less than

three children 6.

10
 The place where the child live is also one of the predictors of child health in

general, also in diarrhea. According to the study conducted by Woldemichael G. children

living in an urban area are 46% less likely to have diarrhea, compared to the children

living in an rural area. Furthermore, the study stated that children in urban area where

practice of hygiene is proper and with good sanitation water are available, and treatment

that is more modern is more reachable will have a lower prevalence of diarrhea 6.

Maternal age has a significant role in the occurrence of diarrhea. In the study

conducted by Mabgua S., et al in 2008-2009, the risk of childhood diarrhea steadily

declines with maternal age, children with mother’s age from 15 to 19 years old has a

higher prevalence of diarrhea than mothers aged 35 years or over 4.

Parents with comprehensive knowledge about diarrhea and what cause the disease

were less likely to have poor hygiene practice such as washing hand properly. Children

who received clean water, hygiene and sanitation education have decrease the prevalence

of diarrhea 9.

Diarrhea episodes are usually found in children that lives in a poor sanitation

conditions. Infants who are weaning have increased risk in having diarrhea especially if

they are exposed to environment that is contaminated particularly in a condition where

there is poor sanitation 11.

Children in the lowest socioeconomic group were approximately half as likely to

have diarrhea in the previous two weeks in a condition which their household was in the

good hygiene, compared to the opposite poor hygiene group. In addition to these health

impacts, the effects of socioeconomic and other social factors that relates to health

11
behaviors may influence the disease outcomes that only manifest later in life.

Neighborhood socioeconomic disadvantage and lower availability of fresh products

produce and few recreational opportunities, can lead to poorer nutrition and less physical

activity 11.

2. 3 Environmental Factors

Diarrhea prevalence can be reduced through hygiene education and point-of use

household water treatment such as boiling. In order to maximize the impact on children’s

health in the given rural setting, future interventions must assure systematic and regular

hygiene education at the household and community level 1.

According to the report of WHO in 2011 type of water resource is an important

aspect of the drinking-water quality. Prevention of water contamination brought by

microorganism and chemicals are challenge to health care providers. Management for

polluted water source and human activity that causes unclean water will influence water

quality. This will have an impact on the treatment steps required to ensure safe water, and

preventive action may be preferable to upgrading treatment. The effect of drinking water

on the incidence of diarrhea among children of age 6 months to 5 years living in rural

communities is proven by the study conducted by McGuigan et al. 18.

Health gains increase from improving service level in two key stages: the delivery

of water within 1 km or 30 minutes of total collection time; and when supplied to a yard

level of service. Further health gains are likely to occur once water is supplied through

multiple taps inside the house, as this will increase water availability for diverse hygiene

12
practices. Hygiene practices and accessible to improve water was associated with a lower

risk of diarrhea 18.

Estimates of the volume of water needed for health purposes vary widely. In

deriving World Health Organization (2011) guideline values, it is assumed that the daily

per capita consumption of drinking-water is approximately 1 liter for children, although

actual consumption varies according to climate, activity level and diet. Special situations

require additional water intake in diarrheal disease 17.

Yiman et al, stated that poor practice such as limited utilization of sanitary

facilities contaminates the environment and water sources. Access to safe water and

improved sanitation must come hand in hand to achieve proper sanitation. Hygienic

condition of latrine and educational status of mothers were significant predictors of

satisfactory latrine utilization. The most common reason for not utilizing latrine by the

households was long live habit and considering open defecation comfortable. Progress in

improving sanitation in developing countries has been slow, studies show that latrines are

effective in reducing the disease by about 30% and improve the child growth. Households

with a latrine has lower episodes of diarrhea than households without a latrine. Latrines

should be cleaned daily to prevent disease transmission through contact with faces and

flies and, perhaps more crucially, insanitary conditions and odor which may deter people

from using them. Households which have hygienic latrines were more likely to utilize

latrine compared with latrines not hygienic. The strong association between hygienic

condition of latrine and utilization could be attributed to fear of contamination, odor and

flies that are major problems of unhygienic latrines 16.

13
 According to the study by Ngure in 2013, in rural Zimbabwe, fecal bacteria from

soil and chicken feces are often contaminated with E. coli. Infant and young children who

are frequently expose with the soil are at high risk to expose to the bacteria. Accidental

ingestion of chicken feces and soil containing chicken feces will eventually lead to a

huge burden of pathogenic bacteria, which later may cause diarrhea 20

2.4 Behavioral Factors

A study reported that water handling practices and sanitation within households

and the improvement in hygiene are the important factors in the eliminating diarrhea. It is

proven that poor drinking water handling and poor storage within household, improper

hand-washing without soap before preparing food and after defecation are major risk

factors for diarrhea among children less than five years. The risk of diarrhea was

significantly higher among children whose mothers did not wash hands with soap before

food preparation, before feeding their children and after leaving the toilet 10.

Exclusive breast feeding as well as predominant breast feeding give a protection

against diarrhea that is proven according to a study conducted in Nigeria, while bottle

feeding and introduction of complementary foods were risk factors for diarrhea.

Community and facility based initiatives are needed to improve feeding practices, and to

reduce diarrhea prevalence. Prevalence of diarrhea within infant on their 1st hour of birth

who were not exclusively breastfed, and infants who were prematurely introduced to

complementary foods was higher among children whose mothers did not initiate breast

feeding. Early initiation of breast feeding was significantly associated with lower risk of

14
diarrhea. Exclusively breastfed infants were less likely to develop diarrhea compared to

non-exclusively breastfed infants 8.

15
 CONCEPTUAL FRAMEWORK

SOCIOECONOMIC FACTORS
Family economic status
Household size
Maternal age
Educational attainment of
parents/caregiver
Occupation the parents/ caregiver

ENVIRONMENTAL FACTORS
Type and distance of water source
Amount of daily water consumption
Ability of latrine
Waste Disposal
Livestock in the house

BEHAVIORAL FACTORS
Water drawing and storage practices
Feeding practices
Healthcare practices for diarrhea
Duration of breastfeeding & time of
introducing supplementary feeding

CHILDHOOD
DIARRHEAL
MORBIDITY

16
DEFINITION OF TERMS

Socioeconomic: This refers to the personal characteristics of the respondents who are

included in this study such as family economic status, place of residence, household size,

maternal age, education, ethnicity, number of children, occupation and marital status

Place of residence: this refers to place and environment where the respondent

lives such as rural or urban

Household size: this refers to the number of person living together in one house

Maternal age: this refers to the age of the mother at the time of delivery; the

maturity of the mother when she has her children

Education: this refers highest level of formal education achieved by the parents of

the respondent

Number of children: this refer to the respondent that live in the family

Occupation: this refers to the source of income in the family of the respondent

Marital status: this refers to the condition of being married or unmarried in the

family of the respondent

Religion: this refers to the religious affiliation of the respondents.

Monthly family income: this refers to the total monthly earnings of the family

derived from the family members’ salaries and other income generating activities.

Behavioral determinants: This refers to the factors that control or influence on how the

under-five children response to their environment and how it will affect their health

status.

Diarrheal disease: This refers to the frequent passage of the loose or watery stool at least

three or more times in a day.

17
Acute diarrhea: This refers to the diarrheal disease that lasting for less than 14 days.

Chronic diarrhea: This refers to the diarrheal disease that lasting for more than 14 days.

Index child: refers to a child that was included in the study from a household to have

information on the demographic and health characteristics, and also to calculate the

prevalence and incidence of diarrhoea

Environmental sanitation practices: this refers to the type of water source, distance to the

water source, amount of daily water consumption, availability of latrine, number of

rooms, livestock in house and waste disposal.

Cross-sectional: refers to the collection and assessment of data regarding diarrhea within

two-week period.

Barangay: this refers to a unit of society that consists 50-100 families.

18
 CHAPTER III

METHODOLOGY

A. Research Design

This study will utilize the descriptive cross-sectional method of research. It will

examine the households’ socioeconomic, environmental and behavioral factors associated

with diarrhea of under-five children in the different coastal barangays in Caoayan, Ilocos

Sur as the exposure variables and diarrheal morbidity in under-five children as the

outcome variable.

B. Locale of the study

The study will be conducted in the coastal barangays of Caoayan, Ilocos Sur. The

municipality is bounded by the City of Vigan in the north, Municipality of Santa in the

east and the South China Sea in the south and on the west by the southern barangays of

Vigan City. According to the records of Provincial Health Office of Ilocos Sur, the total

population of Caoayan is estimated to be 19,260 as of 2014 census. The municipality is

subdivided into 17 barangays and among them 5 are in the coastal area which are

Barangay Fuerte, Pandan, Pantay-Tamurong, Puro and Villamar.

The aforementioned barangays’ main livelihood is fishing and other related work like

boat-sailing. Some of the residence are also engaged into farming mainly rice and corn.

19
 C. Unit of the study

The source population will be the households with under- five children of the selected

coastal barangays of Caoayan, Ilocos Sur while the subjects are the mothers or guardians

in the household that had under-five child.

If the household have more than 1 under-five child, the index child will be the

youngest that will be selected to collect information on the child’s demographic and

health characteristics.

D. Sampling Design

The sample size was calculated using the G*Power 3.1.9.2 Software using the Power

Analysis method while purposive sampling was used to determine the respondents of the

study. The distribution of the respondents is presented in Table 1.

Table 1

Distribution of the Respondents

Barangay N n

Fuerte 323 41

Panday 126 16

Pantay-Tamurong 276 35

Puro 82 10

Villamar 240 31

TOTAL 1047 134

20
 E. Data Collection Technique

The main instrument to gather data for this study will be a structured questionnaire

adopted from the study of Teklu Mulegata entitled “Socio-economic, Environmental, and

Behavioral Factors associated with the occurrence of Diarrhoeal Disease Among

Underfive Children, Meskenena Mareko Woreda, Southern Ethiopia”. Revisions will be

made to adjust to the setting and respondents of this study and the content will be

validated by a pool of experts.

The questionnaire will be divided into four parts. Part I will gather information

regarding Socioeconomic Conditions. Part II will be about the Environmental Health

Conditions. Part III will gather information on the different Behavior Aspects. Part IV

will ask about the Information of the Index Child.

The study instrument will contain a combination of open-ended and closed-ended

questions.

To determine the prevalence of diarrhea, the mothers or guardians will be given each

a card. An identity number and household number will be shown in the card. The mothers

or guardian will be asked if their child has diarrhea at the time of the first interview which

will serve as the point prevalence of the study. Also in the first interview, the researchers

will explain to the mother or guardian a diarrhea is that if ever their child gets it in the

subsequent 2 weeks they will have to mark any sign on the card. At the second interview,

the researchers will collect the cards and recorded diarrhea cases, if there are any. The

recorded diarrhea cases at the second interview will serve as the period prevalence of the

study.

21
 F. Data Gathering Procedure

The researchers will ask permissions to the Mayor of Caoayan, Ilocos Sur and

Barangay Officials of the selected coastal barangays for the conduct of the study.

Likewise, permission will also be requested to the Provincial Health Office and

Municipal Health Office for the review of records and identification of respondents.

After permissions are granted, the questionnaires will be personally administered in a

face to face interview. The questionnaire will be first prepared in English and then

translated to Iloko.

G. Tools of Analysis

The following statistical tools are to be used to treat and analyze data that will be

gathered:

1. Frequency and percentage for the socioeconomic, environmental conditions,

behavioral factors and also the occurrence of diarrhea.

2. Simple linear correlation analysis that will ascertain the relationship between

the variables that will be studied.

22
BIBLIOGRAPHY

23
BIBLIOGRAPHY

(1) Alelign T., Asegidew W. and Abera A., A Cross Sectional Study on the Incidence
and Risk Factors of Diarrheal Illness among Children Under-Five Years of Age in Debre
Berhan Town, Ethipioa. J Health Med Econ. 2016

(2) Diouf K., Tabatabai P., Rudolph J. and Marx M., Diarrhoea Prevalence in
Children
Under Five Year of Age in Rural Burundi: An Assessment of Social and Behavioural
Factors at the Household Level. 2014

(3) Eshete N., Beyene A and Terefe G., Implementation of Community-led Total
Sanitation and Hygiene Approach on the Prevention of Diarrheal Disease in Kersa
District, Jimma Zone Ethiopia. 2015

(4) Mabgua S., Musikoyo E., Ndungi F., Sang R., Kaumau-Mbuthia E. and Ngotho
D., Determinants of Diarrhea among Young Children under the Age of Five in Kenya,
evidence from KDHS. 2008-2009

(5) Siziya S., Muula AS., Rudatsikira E., Correlates of Diarrhea among Children
below the Age of 5 years in Sudan. 2013

(6) Woldemichael G. Diarrhoeal Morbidity Among Young Children in Eritrea:

Environmental and Socioeconomic determinants. J Health Popul Nutr. 2001

(7) Avisek Gupta, Gautam Sarker, Arup Jyoti Rout, Tanushree Mondal, and Ranabir Pal,
Risk Correlates of Diarrhea in Children Under 5 Years of Age in Slums of Bankura,
West Bengal. 2015

(8) Ogbo F., Page A., Idoko J., Claudio F. and Agho K,. Diarrhoea and Suboptimal
Feeding Practices in Nigeria: Evidence from the National Household Surveys. 2016

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(9) Mashoto K.O., Malebo H.M., Msisiri E., Peter E., Prevalence, One Week Incidence
and Knowledge on Causes of Diarrhea: Household Survey of Under-fives and
Adults in Mkuranga district, Tanzania. 2014

(10) Oloruntoba E.O., Folarin T.B, and Ayede A.I, Hygiene and sanitation risk factors of
diarrhoeal disease among under-five children in Ibadan, Nigeria. 2014.

(11) Braveman, P., Gottlieb, L. The Social Determinants of Health: It's Time to Consider
the Causes of the Causes, 129(Suppl 2): 19–31, Jan-Feb. 2014

(12) Deeks, A., Lombard, C., Michelemore, J., Teede, H. 2009. The Effects of Gender on
Health Related Behaviours, 9:213, Jun 30.

(13) Sentell, T., Zhang, W., Davei, James., Baker, K, K., Braun, K, L. 2014. The
Influence od Community and Individual Health Literacy in Self-reported Health
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(14) Ohman, A., Reickson, M., Goicolea, I. 2015. Global Health and Action, 8:26908.

(15) Greenpeace Southeast Asia. 2007. The State of Water in the Philippines.
http://www.greenpeace.org/seasia/ph/Global/seasia/report/2007/10/the-state-of-
water-inthe-phil.pdf (accessed on December 7, 2016)

(16) Yiman, Y, T., Gelaye, K, A., Chercos, D, H. 2014. Laterine Utilization and
Associated factors Among People Living in Rural Areas of Denbia Distric,
Northwest Ethiopia, 2013, a Cross-Sectional Study, 18:334, August 26.

(17) Farthing, M., Mohammed, A., Greger, L., Petr, D., Igor, K., Eduardo, S, L.,
Balakrishnan S, R., Lee, G, K., Alan, T., Aamir G, K., Justus, K., Anton, L. 2013
Acute Diarrhea in Adults and Children A Global Perspective. 47:1, January.

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(18) World Health Organization, 2011. Guidelines for drinking water quality. 4th edition.

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26
APPENDICES

27
 APPENDIX A

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Vigan City

COLLEGE OF MEDICINE

HON. JUAN PAOLO ANCHETA

Mayor
Municipality of Caoayan, Ilocos Sur

Sir:

We, the undersigned third year medical students of the University of Northern Philippines
College of Medicine, are required to conduct a study entitled “Socioeconomic,
Environmental, Behavioral Factors associated with the occurrence of Diarrhea among
Under-five Children in the Coastal Barangays of Caoayan, Ilocos Sur”.

In this connection we would like to request permission to conduct our study from your
municipality. We plan to gather information regarding the different socioeconomic,
environmental, behavioral factors associated with the occurrence of diarrhea among
under-five children in the coastal barangays of Caoayan, Ilocos Sur namely Barangays
Fuerte, Panday, Pantay-Tamurng, Puro and Villamar.

Thank you very much and we are anticipating a favorable response regarding this matter.

Very truly yours,

AGCAOILI, PHOEBE NICOLE Y. CHRISSANTI, DIANA L.

DAET, RYAN I. RACHO, KIM SZYDNEY L.

TJAKRAPAWIRA, AGNES

Noted by:

PABLO R. QUEDADO, M.D.

Dean, College of Medicine

28
 APPENDIX B

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Vigan City
COLLEGE OF MEDICINE

December 6, 2016

EDNA RABENA, MD
Municipal Health Officer
Caoayan, Ilocos Sur

Ma’am:

We, the undersigned third year medical students of the University of Northern Philippines
College of Medicine, conducting a study entitled “Socioeconomic, Environmental,
Behavioral Factors associated with the occurrence of Diarrhea among Under-five
Children in the Coastal barangays of Caoayan, Ilocos Sur”

In this connection, we would like to ask your good office to lend us data on the following
as a basis of our study:
1. Incidence of diarrheal diseases in Caoayan, Ilocos Sur for the calendar years
2014, 2015, 2016
2. Incidence of diarrheal diseases among 0-5 years old children in Caoayan, Ilocos
Sur for the calendar years 2014, 2015, 2016
3. Incidence of diarrheal diseases in Barangays Fuerte, Panday, Pantay-Tamurng,
Puro and Villamar, Caoayan, Ilocos Sur for the calendar years 2014, 2015, 2016
4. Incidence of diarrheal diseases among 0-5 years old children in Barangays Fuerte,
Panday, Pantay-Tamurng, Puro and Villamar, Caoayan, Ilocos Sur 014, 2015,
2016
5. Total population of the municipality of Caoayan, Ilocos Sur as of the calendar
year 2016
6. Total population of Barangays Fuerte, Panday, Pantay-Tamurng, Puro and
Villamar, Caoayan, Ilocos Sur as of the calendar year 2016
7. Total population of children ages 0-5 years old in Barangays Fuerte, Panday,
Pantay-Tamurng, Puro and Villamar, Caoayan, Ilocos Sur as of the calendar year
2016
8. Programs of the Municipal Health Office in addressing the different diarrheal
diseases

Rest assured that any information gathered will be treated with utmost confidentiality.
We hope for your favorable response regarding this matter.
29
Thank you very much and may the good Lord bless you.

Respectfully yours,

AGCAOILI, PHOEBE NICOLE Y. CHRISSANTI, DIANA L.

DAET, RYAN I. RACHO, KIM SZYDNEY L.

TJAKRAPAWIRA, AGNES

Noted by: Approved by:

PABLO R. QUEDADO, M.D. EDNA RABENA, MD

Dean, College of Medicine Municipal Health Officer

30
 APPENDIX C

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Vigan City

COLLEGE OF MEDICINE

Name of Barangay Chairman

Name of Barangay
Municipality of Caoayan, Ilocos Sur

Sir/Ma’am:

We, the undersigned third year medical students of the University of Northern Philippines
College of Medicine, are required to conduct a study entitled “Socioeconomic,
Environmental, Behavioral Factors associated with the occurrence of Diarrhea among
Under-five Children in the Coastal Barangays of Caoayan, Ilocos Sur”.

In this connection we would like to request permission to conduct our study from your
Barangay. We plan to gather information regarding the different socioeconomic,
environmental, behavioral factors associated with the occurrence of diarrhea among
under-five children in the coastal barangays of Caoayan, Ilocos Sur namely Barangays
Fuerte, Panday, Pantay-Tamurng, Puro and Villamar.

Thank you very much and we are anticipating a favorable response regarding this matter.

Very truly yours,

AGCAOILI, PHOEBE NICOLE Y. CHRISSANTI, DIANA L.

DAET, RYAN I. RACHO, KIM SZYDNEY L.

TJAKRAPAWIRA, AGNES

Noted by:

PABLO R. QUEDADO, M.D.

Dean, College of Medicine

31
 APPENDIX D

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Vigan City

COLLEGE OF MEDICINE

I, ____________________________________________________, of legal age,

single/married/divorce, currently residing at _______________________________,
voluntarily participates in the study entitled “Socioeconomic, Environmental, Behavioral
Factors associated with the occurrence of Diarrhea among Under-five Children in the
Coastal Barangays of Caoayan, Ilocos Sur”, conducted by the group of third year medical
students of the University of Northern Philippines. The goal of the said study has been
clearly presented to me and that the procedures that need to be done have been properly
discussed with me. I Have been advised that I may withdraw my participation anytime I
wish, and any information given will be kept confidential.

Signed this ________day of ________, 2017, Brgy. ____________,Caoayan, Ilocos Sur.

_________________________
Signature Over Printed Name

32
 APPENDIX E

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Vigan City

COLLEGE OF MEDICINE

Siak ni __________________________________, addaan iti usto a tawen,

naasawaan/divorsiado/baro weno balasang/balo, madama nga agnanaed iti Barangay

_______________________, ket sisipakada nga maki-partisipar iti research dagiti

estudyante iti College of Medicine iti University of Northern Philippines a addaan iti

titulo na a “Socioeconomic, Environmental, Behavioral Factors associated with the

occurrence of Diarrhea among Under-five Children in the Coastal Barangays of Caoayan,

Ilocos Sur”. Naiisplikar kanyak a nasayaat no ana iti pagserbian detoy a reasearch.

Naiisplikar pay kanyak no ana dagiti naduma-duma nga impormasyon nga alaen da

kanyak. Nabagaan nak pay a mabalinak a agbabawi iti pinagpartisipar ko anyaman a oras.

Naiisplikar pay kanyak nga anyaman nga impormasyon a maala da kanyak ket para iti

pinagbasa da laeng ken haan maamwan iti sabali no awan pammalubos ko.

Pinirmaan iti aldaw ti _____, 2017, Brgy. _______________, Caoayan, Ilocos Sur.

_____________________

Pirma ken Nagan

33
 APPENDIX F

Identification Number:

House Number:

NAME OF THE No. of Sex Age Diarrhea at the

INDEX CHILD Diarrheal

(in time of the
Episodes
months) survey**
within 2

weeks

** Check if the child has diarrhoea, and mark “X “if he hasn’t

34
 APPENDIX G

QUESTIONNAIRE

IDENTIFICATION

001. House number: __________

002. Number of persons in the household___________

003. Number of under-five children in the household_________

List all under-five children present in the household

No NAME OF THE CHILD SEX AGE DIARRHEA AT THE

(In months) TIME OF THE SURVEY**

** Check if the child has diarrhoea, and mark “ X “ if he hasn’t

35
PART I. SOCIOECONOMIC CONDITIONS

NO. QUESTIONS AND FILTERS RESPONSES

Q101 Relation of the respondent to the 1. Mother

child
2. Caretaker

Q102 Age of the mother/caretaker __________ Years

Q103 Marital status of the 1. Married

mother/caretaker
2. Divorced

3. Single

4. Widowed

Q104 Religion of parents/caretaker 1. Catholic

2. Born-again Christian

3. Other (specify)

Q105 Educational level of 1. Formal education (last grade

mother/caretaker
completed)

2. Read and write

3. Read only

4. Neither

36
Q106 Occupation of the 1. Housewife

mother/caretaker
2. Government employee

3. Private gainful work

4. Other (specify)

Q107 Age of the child's father __________Years

Q108 Educational level of the father 1. Formal education (last grade

completed)

2. Read and write

3. Read only

4. Neither

Q109 Occupation of the father 1. Government employee

2. Fisherman

3. Farmer

4. No job

5. Other (specify)

Q110 Perceived economy (compared to 1. Very poor 4. Rich

the neighbors)
2. Poor 5. Very

rich

37
 3. Average 6. No

response

Q111 Does the family own television? 1. Yes

2. No

Q112 Does the family have livestock? 1. Yes 3. No

response

2. No

Q113 If yes, for Q113, number & type

of livestock?

Q114 Does the family produce cash 1. Yes

crop?
2. No

3. No response

Q115 If yes for, Q114, what type of 1. Rice 3. Both

cash crop do you produce?

2. Corn 4. Other

PART II. ENVIRONMENTAL HEALTH CONDITIONS

NO. QUESTIONS AND FILTERS RESPONSES

Q201 Type of floor material of the living 1. Mud 3. Cement

house

38
 (OBSERVATION) 2. Wood 4. Other (specify)

Q202 Type of roof material of the living 1. Nipa palm leaves

house
2. Corrugated iron sheet

(OBSERVATION)
3. Other (specify)

Q203 Do animals live in the same house 1. Yes

where the members of the family

2. No
live?

(OBSERVATION)

Q204 Number of rooms in the house ________

Q205 Is latrine available? 1. Yes

2. No (If No, skip to Q208)

Q206 Ownership of the latrine 1. Privately owned

2. Shared with neighbors

Q207 Is feces seen around the pit-hole 1. Yes

(or on the floor)?

2. No

(OBSERVATION)

Q208 Is feces seen around the house (or 1. Yes

in the compound)?
2. No

(OBSERVATION)

39
Q209 If the family has no latrine, where 1. Open field

do you dispose human waste?

2. Other (specify)

Q210 How do you dispose refuse? 1. Pit 3. Open field

2. Burning 4. Garbage

can

5.Other

Q211 From where do you get water for 1. Pipe

drinking?
2. Protected well/spring

(OBSERVATION)
3. Unprotected well/spring

4. Jetmatic water pump

5. Other (specify)

Q212 Distance from the house to the __________ Minutes

water source

Q213 Type of collection container 1. Pot 4. Jerry

can

2. Plastic bucket 5. Other

3. Iron bucket

Q214 How did you transport the 1. In a covered container

collected drinking water to the

house yesterday?
40
 2. In an uncovered container

3. Other (specify)

Q215 Capacity of the container, which _______ Liters

you used to collect drinking water

yesterday?

Q216 How many times did you collect

water for drinking yesterday?

PART III. BEHAVIORAL ASPECTS

NO. QUESTIONS AND FILTERS RESPONSES

Q301 Does the child take other food 1. Yes

than breast milk?

2. No (If No skip to Q305)

Q302 Do you separately prepare food 1. Yes

for the child, using a separate

2. No
material?

Q303 What food/fluid is the child 1. Cow's milk 4. Adults'

mostly receiving (if the child is food

not on exclusive breastfeeding)?

2. Powder milk 5. Other

3. Gruel

41
Q304 What do you use to feed the child? 1. Hand 4. Bottle

2. Cup and spoon 5. Other

3. Cup

Q305 Does the drinking-water storage 1. Yes

container have a cover?

2. No

Ask the respondent to show you

the storage container.

Q306 Is there a separate can for taking 1. Yes

drinking water from the storage

2. No
container?

Ask the respondent to show you

the can

Q307 How do you take water from the 1. Pouring

drinking water storage container?

2. Dipping

Q308 Do you know that flies can 1. Yes

transmit diseases?
2. No

Q309 If “Yes”, can you tell me the name 1. Diarrhoea

42
 of the diseases? 2. Typhoid fever

3. Cholera

4. Trachoma

5. Do not know the names

6. Other (specify)

Q310 Do you know that excreta of 1. Yes

children can be a cause of

2. No
diseases?

Q311 If “Yes”, what do you do to avoid

this problem?

Q312 In your opinion, what is/are the

use of latrine?

PART IV. INFORMATION OF THE INDEX CHILD

Ask the mother/caretaker about the child with diarrhea, or if there is no child with

diarrhea, ask about the child who is younger than others.

NO. QUESTIONS AND FILTERS RESPONSES

Q401 Age of the index child ________ Months

Q402 Sex of the index child 1. Male 2.

43
 Female

Q403 Where was your child born? 1. Health institution 2.

Home

Q404 Birth order of the child 1. First 3. Third

2. Second 4. Fourth

&above

Q405 Do you (the mother/caretaker) 1. Yes

have a history of diarrhoea in the

2. No
past two weeks?

Q406 Have you ever breast-fed your 1.Yes 2. No (Skip to

child? Q408)

Q407 For how long did you breastfed __________Months

your child?

Q408 What is his/her current 1. Exclusive breastfeeding

breastfeeding status?
2. Partial breastfeeding

3. Not breastfeeding

Q409 At what age the child started ________ Months

supplementary /weaning food?

Q410 Did the child receive measles 1. Yes, (by the response of the

vaccination?

44
 respondent)

Ask for children of age greater 2. Yes, (by checking the card)

than nine months

3. No

Q411 Do your child have diarrhea 1. Yes

today?
2. No

Q412 For how long the diarrhea last? 1. Less than 14 days

2. Greater than 14 days

Q413 If the child has diarrhea today, 1. Three times

how many times a day he/she

2. More than three times
passes stool?
3. Don't know

Q414 The type of diarrhea that the child 1. Watery

had
2. Blood and mucus

Q415 What actions do you take to 1. Take him/her to health

treat/stop the diarrhea?

institution

2. Take him/her to traditional

healer

3. Increase feeding

4. Give him/her ORS

45
 5. Give him/her cereal based

fluids

6. Stop/decrease feeding

7. Homemade treatment

8. Other (specify)

Date of interview-------------------
Name of the interviewer------------------------------ Signature---------------

46
 APPENDIX H

Numero iti paka-ladawan:

Numero iti Balay:

Nagan iti Anak Naminano Sexo Edad Panagtakki iti

nga tiempo ti
(bulan)
nagtakki iti panagsaludsod**

napalabas

nga duwa a

lawas

**Kitaen no agsuyot ti ubing, markaan ti “x” no saaan

47
 APPENDIX I

KUESTIONARIO

PANANGILADAWAN

001. Nagan ti ina/mangtartaraken: _______________

002. Numero ti balay: __________

003. Bilang ti tao iti sangkaamaan ___________

004. bilang ti ubbing nga agtawen ti nababbaba ngem lima iti sangkaamaan _________

llista amin nga ubbing nga agtawen ti nababbaba ngem lima iti sangkaamaan.

BILANG NAGAN TI UBING SEXO EDAD PANAGTAKKI ITI

TIEMPO TI
(BULAN)
PANAGSALUDSOD**

48
**Kitaen no agsuyot ti ubing, markaan ti “x” no saaan

PARTE I. SOCIO-EKOMOMIKO A KASASAAD

NUMERO SALUDSUD SUNGBAT

S101 Relasyon iti respondente iti 1. Ina

ubing
2. Mangayaywan

S102 Tawen ti ina/mangayaywan __________ Tawen

S103 Estado a sibil ti 1. Naasawaan

ina/mangayaywan
2. Divorsiada/Divorsiado

3. Baro/Balasang

4. Balo

S104 Relihion ti 1. Katoliko

nagannak/mangayaywan
2. Born-again Christian

3. Dadduma pay (ispesifikaren)

49
S105 Nivel ti edukasion ti 1. Formal nga edukasion

ina/mangayaywan (naturpos a grado)

2. Makabasa ken makasurat

3. Makasurat laeng

4. Awan kadagitoy

S106 Pagsapulan ti ina/mangayaywan 1. Agtagibalay

2. Empleyado ti gobierno

3. Privado a pagsapulan

4. Dadduma pay (ispesifikaren)

S107 Edad ti Ama ti ubing __________ Tawen

S108 Nivel ti edukasion ti ama 1. Formal nga edukasion

(naturpos a grado)

2. Makabasa ken makasurat

3. Makasurat laeng

4. Awan kadagitoy

S109 Pagsapulan ti ama 1. Empleyado ti gobierno

2. Mangngalap

50
 3. Mannalon

4. Awanan pagsapulan

5. Dadduma pay (ispesifikaren)

S110 Pannarigan ti panagbiag 1. Nakakurkurapay

(kumpara kadagiti kaarruba) 2. Nakurapay

3. Apagisu lang

4. Nabaknang

5. Nakabakbaknang

6. Awan sungbat

S111 Adda kukua a television ti 1. Adda

familia?
2. Awan

S112 Adda dinguen iti familia? 1. Adda

2. Awan

3. Awan sungbat

S113 No adda ti sungbat iti S112,

bilang ken tipo ti dinguen?

S114 Adda produkto a mulmula a 1. Adda

mabalin a pangkwartaan iti

51
 familia? 2. Awan

3. Awan sungbat

S115 No adda ti sungbat iti S114, 1. Pagay

bilang ken tipo ti dinguen? Ania

3. Mais
a tipo ti mulmula ti produkto?
2. Isuda a dua

4. Dadduma pay

PARTE II. KINASAYAAT TI KASASAAD ITI AGLAWLAW

NUMERO SALUDSUD SUNGBAT

S201 Tipo ti material ti suelo ti 1. Pitak

pagnaedan
2.Kayo

(OBSERVASION)
3. Semento

4. Dadduma pay (ispesifikaren)

S202 Tipo ti material ti atep ti 1. Labig

pagnaedan
2. Galva

(OBSERVASION)
3. Dadduma pay (ispesifikaren)

S203 Agnaed kadi dagiti ayup ken 1. Wen

miembro ti familia iti maymaysa

52
 a balay? 2. Saan

(OBSERVASION)

S204 Bilang ti kuarto iti balay ________

S205 Adda kasilyas? 1. Adda

2. Awan (No “Awan”, lumibtaw

ti S208)

S206 Agtagikkua ti kasilya 1. Bukod a panagtagikkua

2. Pagraramanan ti

sangakarubaan

S207 Adda makita a takki iti 1. Adda

rungarong ti erodoro (wenno

2. Awan
suelo)

(OBSERVASION)

S208 Adda makita iti aglawlaw iti 1. Adda

balay (wenno iti arubayan)

2. Awan

(OBSERVASION)

S209 No awan kasilyas, ayan na 1. Bengkak

ngarud ti pagtakkian ti familia?

2. Dadduma pay (ispesifikaren)

53
S210 How do you dispose refuse? 1. Iyabot

Kasano ti pinangibellengyo iti 3. Puuran

rugit?
2. Bengkag

4. Lata a pagibasuraan

5. Dadduma pay

S211 Paggapuan ti mainom a danum? 1. Tubo

(OBSERVASION) 2. Naakkuban a bubon

3. Awan proteksionna a bubon

4. Bomba/poso

5. Dadduma pay (ispesifikaren)

S212 Distansia ti paggappuan ti __________ Minuto

danum manipud ti balay?

S213 Tipo ti pagkargaan ti naummong 1. Banga

a danum
2. Plastik a timba

3. landok a timba

4. Lata

5. Dadduma pay

54
S214 Kasanu ti panangilatiwmo ti 1. Naakkuban a pagkargaan

naurnong a mainum a danum iti

2. Awanan akkub a pagkargaan
balay idi kalman?
3. Dadduma pay (ispesifikaren)

S215 Kaadu ti malaun a mainum a _______ Liters

danum ti pagkargaan a naurnong

idi kalman?

S216 Naminanu a daras ti nagurnong

idi kalman ti mainum a danum?

PARTE III. ASPETO A GALAD

NUMERO SALUDSUD SUNGBAT

S301 Adda kadi ipapauneg ti ubing 1. Adda

malaksid ti gatas ti ina?

2. (No “Awan”, lumibtaw ti

S208)

S302 Maisaganaan kadi ti ubing iti 1. Adda

sabali a makan, nga’ti maaramat

2. Awan
a gameng ket maisupadi?

55
S303 Ana ti kankanen iti ubing 1.Gatas ti Baka

malaksid iti gatas ti ina?

2. Powdered Milk

3. Gruel

4. Nataengan a makan

5. Dadduma pay

S304 Ania ti usarem a pangpakan iti 1. Ima

ubing?
2. Tasa ken kutsara

3. Tasa

4. Botelya

5. Dadduma pay

S305 Nakaluban met laeng ti 1. Wen

pagkargaan ti danum a mainum?

2. Saan

Dawaten ti respondent nga

ipakitana ti pagkargaan.

S306 Ada nailasin a pagsakdo iti 1. Wen

danum manipud idiay

2. Saan
pagkargaan?

56
 Dawaten ti respondent nga

ipakitana ti pagkargaan.

S307 Kasano iti panangalam iti 1. Ibukbok

danum a mainum manipud iti

2. Ideppel/isawsaw
pagkargaan?

S308 Ammum a dagiti makaiwaras ti 1. Wen

sakit dagiti ngilaw?

2. Saan

S309 Nu “wen”, pakiibagam dagiti 1. Panagtakki

nagan ti sakit
2. Tipos

3. Kolera

4. Trakoma

5. Di ammu ti nagan ti sakit

6. Dadduma pay

(ispesifekaren)

S310 Ammum a makaited sakit ti 1. Wen

takki dagiti ubbing

2. Saan

S311 No “Wen”, ania ti aramidem

tapnu maliklikan daytoy a

problema?

57
 S312 Iti kapanunutam, ania ti usar ti

kasilyas?

PARTE IV. IMPORMASION ITI PAGIBASARAN NGA UBING

Saludsuden iti ina/mangayaywan maipanggep iti ubing nga agtakki, no awan agtakki,

saludsudem ti maipanggep iti kaubingan.

NUMERO SALUDSUD SUNGBAT

S401 Edad ti ubing ________ Bulan

S402 Sexo ti ubing 1. Lalaki

2. Babai

S403 Nakaiyanakan ti ubing? 1. Ospital

2. Balay

S404 Maikamano a naiyanak 1. Umuna 3. Maikatlo

2. Maikadua 4. Maikapat

ken nangatngato pay

S405 Adda pakasaritaan (ina/ 1. Adda

58
 mangayaywan) ti panagtakki iti 2. Awan

napalabas a dua-lawas?

S406 Napadasmo a pinasuso iti 1.Yes 2. No (Skip to

anakmo? Q408)

S407 Kasano kabayag a pinasusom ti __________ Bulan

anakmo?

S408 Ana ti agdama nga estado ti 1. Puro a gatas ti ina

pinagsuso ti ubing.
2. Ada nayun ti gatas ti ina

3. Haan pulos napadasan a

nagpasuso

S409 Ania nga edad a nangrugi a ________ Bulan

nangan ti ubing?

S410 Nabakunaanen ti ubing para iti 1. Wen, (no isu ti sungbat ti

kontra kamuras? respondente)

2. Wen, (markaan ti tsek)

Saludsod para ti ubing nga 3. Saan

agtawen nangatngato ngem

siam a bulan?

S411 Agtakki diay ubing ita nga 1. Wen

aldaw?
2. Saan

59
S412 Kasanu ti kaatiddog ti aldaw ti 1. Nabibiit ngem 14 nga aldaw

panagtakkina?
2. Nabaybayag ngem 14 nga

aldaw

S413 Nu agtakki ti ubing ita nga 1. Mamin tallo

aldaw, mamin-anu a tumakki?

2. Adaddu ngem mamin tallo

3. Diak ammu

S414 Tipo ti takki ti ubing 1. Nabasa

2. Sobra a natangken

S415 Ania dagiti ubraem tapnu 1. ipaospital

maagasam ti panagtakki ti
2. ipan iti mangagas
ubing?
3. Nayunan ti makan

4. Ipakatan ti ORS

5. Ipakatan cereal based fluids

6. Isardeng/kissayan ti maan

7. Agas ti balay

8. Dadduma pay (ispesifikaren)

60
 APPENDIX J

Distribution of the Respondents

Barangay N n

Fuerte 323 41

Panday 126 16

Pantay-Tamurong 276 35

Puro 82 10

Villamar 240 31

TOTAL 1047 134

61
 APPENDIX K

Map of Caoayan

(Retrieved from www.wikimapia..org)

62