Fostering Community Engagement in Environmental Sanitation to Reduce

Mosquito Breeding Sites: A Community Health Nursing Case Study

In Partial Fulfillment of the Requirements In

Related Learning Experience
(RLE)

Presented to:
Mr. Michael Angelo V. Amaut, RN

By:
Abongan, Jodie Marie A.
Anter, Daniela
Bargio, Rangeline
Nicolai Blaire Lagang,

BSN 2-A

September 2023
 ACKNOWLEDGEMENT
The student nurses would like to express their heartfelt appreciation and gratitude to
the following individuals for their contributions and support in the fulfillment of this
family case study.
To Ms. Joan Calzada, RN, MN, Program Head, College of Nursing, for allowing us to
have this community exposure and for the utmost support;
to Mr. Michael Angelo V. Amaut, RN, our community clinical instructor for the
patience and time he extended in checking the nursing problem sheets, family
nursing care plan, manuscript and other paperworks and for sharing suggestions and
constructive criticisms and for guiding us during the community health nursing
exposure, which meant so much for the completion of this study;
to Ms. Paula B. Leanillo, RN, AB, MN, Ms. Josefina Balote, RN, MN, to Ms. Agnes I.
Jose, RN, RM, who gave their constructive criticisms, for us to learn and improve our
approach in conducting our study in the community.
To Cpt. Elpidio Marquez, Kgwd. Jhonny Robie and other barangay officials, for the
warmest welcome and giving us a chance to have a community exposure in their
barangay, San Vicente, Sto. Tomas, Davao Del Norte.
To the citizens of San Vicente, we are grateful for the warmest welcome and for
allowing us to be part of their lives even in just a brief period of time. For the fruits
they gave and smiles they have shown, it was an unforgettable experience.
To Family C, respondents of this study, for being approachable, cooperative and for
spending their time in answering all the questions being asked, for opening their
homes for us to be able to fulfill our duties as a student nurse in identifying the
problems of the family, as well as in addressing it. We couldn’t do all of this without
their utmost participation in this study;
To the beloved family of the researcher, for extending their hands in the times of
needs of their children, for their unending emotional, moral, spiritual, and financial
support;
To our classmates, who helped us and shared the struggles with one another, lend
their hands to make everything less hard, couldn’t be more grateful and proud to
have such support systems;
and most of all, the student nurse would like to extend wholeheartedly the gratitude
and praise to ever loving and merciful God for touching and bringing together those
people who literally shared their abundant resources, talents, skills, time and effort
for the completion of the study.
Abongan,
Anter,
Bargio,
Lagang.
 ABSTRACT
Mosquito-borne diseases persist as a formidable public health challenge,
particularly in communities where environmental sanitation practices fall short
of optimal standards. This comprehensive case study delves into the intricate
implementation of a community health nursing intervention, meticulously
tailored to mobilize and engage the local residents of San Vicente, Sto. Tomas,
Davao del Norte. This specific area stands as a poignant example, grappling
with both a high prevalence of mosquito-borne diseases and the stark reality of
limited access to healthcare resources. The core objective of this intervention
is to empower community members with the requisite knowledge and practical
tools necessary to identify and effectively eliminate potential mosquito
breeding sites. This multifaceted approach weaves together elements of
education, participatory workshops, and collaborative action planning. By
equipping the community with these essential skills, the study aims to foster
self-reliance and proactive involvement, thereby laying the groundwork for
sustainable mosquito control and disease prevention efforts. Crucial to this
study's design is the utilization of primary data, meticulously gathered directly
by the researchers. Employing a descriptive qualitative research design, this
approach permits an in-depth exploration of the community's attitudes,
knowledge, and practices related to environmental sanitation and mosquito
control. Pre- and post-intervention assessments act as the vital yardsticks,
meticulously gauging the extent of transformation within the community.
Preliminary findings from this endeavor paint a promising picture. They unveil
a remarkable upswing in community awareness and active participation,
particularly in strategies geared toward reducing mosquito breeding sites.
Such tangible improvements signal the effectiveness of the intervention in
igniting positive change within the community. In broader terms, this study
serves as a beacon, illuminating the pivotal role played by community health
nursing in cultivating enduring, community-driven solutions to combat the
scourge of mosquito-borne diseases. The significance of healthcare
professionals in driving meaningful change within communities cannot be
understated. Furthermore, the implications of these findings ripple through the
realm of public health interventions, resonating with a call for heightened
community engagement in environmental sanitation efforts, specifically aimed
at vector-borne disease prevention and control. The resonance of these
lessons extends beyond the confines of San Vicente, transcending
geographical boundaries and offering valuable insights for similar challenges
faced by communities worldwide. As this case study imparts invaluable
knowledge, it also calls for a wider exploration. It beckons for further research
endeavors, seeking to unveil the scalability and long-term sustainability of
community-driven initiatives in a multitude of diverse settings. By doing so,
the potential for transformative change and the alleviation of mosquito-borne
diseases may find its path well illuminated, guiding future efforts in the battle
against this pervasive public health threat.

Key Terms: Breeding Sites, Vectors, Community Engagement, Environmental

Sanitation
TABLE OF CONTENTS
 Chapter 1

INTRODUCTION

Background of the study

Mosquitoes have long been considered the most dangerous animals on the

planet. Mosquitoes play an important role in the spread of several dangerous

illnesses and parasites, particularly arboviruses and protozoa. They act as a vector

for diseases such as malaria, dengue fever, West Nile virus, chikungunya, yellow

fever, and Zika virus, which kill hundreds of thousands of people each year.

Mosquitoes have been identified as the most dangerous animal by the World Health

Organization because they are known to carry pathogen-transmitting organisms.

Understanding the various environmental factors that contribute to the spread of

these vectors is one of several tactics utilized to combat them

If there are mosquitoes around people, it may suggest that the town or region

lacks an adequate environmental sanitation program. It was established that

mosquito and mosquito-borne disease control should engage the whole public.

Collaboration between health care providers and the general public is critical.

osquitoes can thrive in an environment where inadequate waste management,

stagnant water accumulation, and poor hygienic conditions are present. The research

being conducted will look at these intricate links in depth, examining how

improvements in environmental sanitation, waste disposal systems, and community

hygiene directly affect the incidence and durability of mosquito breeding sites. By

shedding light on these associations, we hope to provide evidence-based

recommendations that will enable communities to implement targeted sanitation

measures, thereby reducing the threat of mosquito-borne diseases, contributing to

enhanced public health and community well-being in San Vicente, as well as

promoting a healthier living environment for residents.

 In India, Mosquitoes are vectors for a number of major vector-borne illnesses

(VBDs), including malaria, dengue fever, chikungunya, Japanese encephalitis (JE),

and lymphatic filariasis (LF). These VBDs are a huge public health concern around

the world, especially in India. The information about vector mosquitoes in Tamil

Nadu's Thiruvarur area is either unknown or unreported The immature collection

yielded 4879 mosquitoes, and species identification confirmed the prevalence of both

vector and non-vector species. Five important mosquito vectors collected were -

Aedes albopictus, Ae. aegypti, Culex tritaeniorhynchus, Cx. gelidus, and Cx.

quinquefasciatus.The major breeding sites were discarded plastic containers,

discarded tyres, open sintex tanks (water storage tanks), cement tanks, discarded

fibre box, pleated plastic sheets, tree holes, bamboo cut stumps, coconut spathe,

and coconut shells. Seasonal differences in the entomological parameters of Aedes

breeding potential were discovered using immature vector surveillance. The high

indices detected imply a high Aedes breeding density and, as a result, a higher risk

of dengue/chikungunya outbreaks in Thiruvarur district's rural areas. The current

research calls for increased surveillance and vector control efforts to prevent

outbreaks and vector-borne diseases. Prior to the monsoon, health education and

community engagement in awareness camps, as well as societal commitment, will

aid in improving source reduction, anti-larval operations, and anti-adult efforts to

combat vector-borne diseases, particularly dengue. ( Shukla, A., et. Al, 2020)

In the Philippines Dengue fever is considered as an arboviral infection caused

by the dengue virus. Symptomatic dengue infection results in a wide range of clinical

symptoms, ranging from mild dengue fever (DF) to potentially lethal diseases like

dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Control and

eradication of vector breeding places are the primary goals of community-based

control programs, which divide the community into different groups based on their

education level and understanding of vectors and disease. These mosquito-

eradication operations have proven to be effective in several nations, when the

populace has demonstrated a high level of knowledge of the vector. A successful

community-based control, on the other hand, is dependent on people's knowledge,

education, and conduct, as well as realistic strategies. Training and information

dissemination develop a new level of education in individuals, allowing them to

identify and implement preventive actions for vector and vector habitat elimination, as

well as raise population awareness. It was demonstrated in research conducted in

Thailand using media to raise awareness. (Wang, W. H., 2022)

In Davao del Norte, dengue remains a major public health concern due to the

tropical climate which has two distinct seasons. The increasing dengue incidence is

caused by various variables, the most important of which are meteorological ones.

Changes in these factors are thought to have an impact on people's health through

the spread of vector-borne diseases. It aims to investigate the effects of local

meteorological variables, which are one of the major driving causes behind dengue

transmission. Since we expected that local meteorological elements may have an

impact on dengue incidences in Davao Region specifically in Davao del Norte,

Philippines, this will allow us to determine the period of high risk of dengue infection.

Clarifying the effects of various meteorological parameters on dengue could provide

insight into the disease's seasonal mechanisms, allowing researchers to better grasp

the complex link between meteorological conditions and health.

This study is driven by a sense of urgency and motivation stemming from

several critical factors. To begin, mosquito-borne diseases such as malaria, dengue

fever, Zika virus, and West Nile virus continue to pose serious health threats around

the world, particularly among vulnerable populations. Second, the effects of climate

change are changing the distribution and behavior of disease vectors, worsening the

incidence of these diseases in new locations. Third, community participation in

environmental sanitation is critical for long-term, community-driven solutions. The

study's goal is to empower people to take an active role in eliminating mosquito

breeding habitats, especially in resource-limited contexts. Finally, pursuing global

health equity emphasizes the need of addressing health inequities and improving the

well-being of vulnerable people who are disproportionately afflicted by these

diseases.

Purpose of the study

The main purpose of this case study is to perform a thorough and in-depth

examination of the critical role played by community health nursing interventions in

creating significant improvements in environmental sanitation. Our primary goal is to

limit the number of mosquito breeding areas within communities. We know that

environmental sanitation is critical to public health, and by focusing on mosquito

breeding places, we are able to tackle a key vector responsible for delivering

devastating mosquito-borne diseases. Our study's precise objectives are

multifaceted: first, to rigorously examine the existing condition of environmental

sanitation within a chosen community, investigating sanitation practices, waste

management, water supplies, and potential mosquito breeding areas. Following that,

we will launch a well-structured and community-driven intervention plan, headed by

community health nurses, to address the identified sanitation concerns, with an

emphasis on mosquito breeding site reduction. The robustness of our investigation is

supported by a thorough evaluation approach that tracks changes in mosquito

breeding site prevalence and the resultant drop in mosquito-borne illness cases. The

main objective of this case study is to lessen the breeding sites of mosquitoes.

Theoretical lens

The information for this study came from the Health Belief Model by, which

serves as the foundation for community health nursing. Individuals' health-related

behaviors are determined by their views about the severity of a health issue, their
susceptibility to it, the advantages of preventative acts, and the barriers to adopting

those steps. The Health Belief Model posits that people's health-related behaviors

are influenced by their perceptions of the severity of a health issue, their

susceptibility to it, the benefits of taking preventive actions, and the barriers to taking

those actions. (Jones, C.L., 2015). This concept is consistent with the study's

emphasis on community participation in environmental cleanliness to combat

mosquito breeding areas. Researchers and community health nurses can acquire

useful insights on the factors influencing community members' desire to assist in

sanitation activities by using the Health Belief Model. Understanding how community

members perceive the severity of mosquito-borne diseases or their susceptibility to

these diseases as a result of mosquito breeding, for example, might influence

targeted treatments and communication initiatives. Furthermore, addressing

perceived impediments, such as limited resources or a lack of understanding,

becomes critical in increasing community engagement and reducing the frequency of

mosquito breeding places. This case study aims to empower communities to

proactively address mosquito breeding sites by aligning environmental sanitation

initiatives with the principles of the Health Belief Model, thereby contributing to

improved public health outcomes and reduced mosquito-borne disease transmission

within communities.

Definition of terms

Breeding site. A breeding site is a specific location or habitat where organisms

engage in reproduction by depositing their eggs, offspring, or reproductive materials.

These sites are chosen based on factors that ensure the survival and development of

the species' young, including suitable environmental conditions and the availability of

necessary resources. Breeding sites can vary widely among different species,

reflecting their unique adaptations and reproductive strategies. (Yang, P.L., 2020)
Vectors. Vectors are living organisms, typically arthropods like mosquitoes, ticks,

and flies, or even certain animals, that can transmit pathogens such as bacteria,

viruses, or parasites from one host to another. These organisms play a crucial role in

the transmission of diseases, acting as intermediaries between infected hosts and

susceptible individuals. Vectors are a critical component in the spread of many

infectious diseases and are a focus of public health efforts to control and prevent the

transmission of these diseases. (National Human Genome Institute, 2023)

Community Engagement. Community engagement refers to the active involvement,

participation, and collaboration of community members, organizations, and

stakeholders in decision-making processes and initiatives that affect their lives and

well-being. It encompasses a range of activities, including community-based

planning, consultation, and volunteering, aimed at addressing local needs, promoting

social cohesion, and achieving shared goals. Effective community engagement

fosters empowerment, inclusivity, and a sense of ownership, ultimately leading to

more sustainable and responsive solutions to community challenges. ( Schiavo,.R

2021)

Environmental Sanitation. Environmental sanitation is the practice of maintaining

cleanliness and hygiene in the natural and built environment to protect public health

and the well-being of communities. It involves the management of waste, sewage,

and pollutants to prevent the spread of diseases, reduce environmental pollution, and

ensure the sustainable use of resources. Effective environmental sanitation

encompasses a range of activities, including waste disposal, water treatment, air

quality management, and the promotion of healthy living conditions (VarVargová, M.,

2020).
Limitations and delimitations

In conducting the case study several limitations were encountered. Firstly,

there may be possible sample bias because the study community and homes were

chosen based on practical factors and accessibility, thereby restricting the

generalizability of the findings to other groups. Secondly, the study's findings are

context-specific to the chosen geographical location, and extending them directly to

places with different environmental and socio-cultural circumstances may not be

appropriate. Thirdly, survey respondents' self-reported data may include recollection

bias or social desirability bias, thereby impacting the accuracy of reported actions

and views. Lastly, due to budget and time restrictions, the study focuses on short-

term changes in mosquito breeding site reduction and community participation,

leaving the long-term sustainability and impact of these interventions unexplored.

In contrary, the study also had well-defined delimitations that shaped its

scope. It purposely narrowed the research viewpoint by focusing on the unique role

of community health nursing in fostering community engagement for environmental

cleanliness. The study purposefully chose to focus on a specific neighborhood,

providing for detailed insights into this setting but acknowledging that it may not fully

represent the diversity of difficulties and approaches in other communities.

Furthermore, resource constraints, such as financing and available staff, limited the

scope of interventions and data collecting. The research focused on mosquito

breeding locations in the context of environmental sanitation, rather than diving

further into other environmental elements that may influence mosquito populations,

such as climate or vegetation. Finally, the study acknowledged the selected

community's size and demographic composition, noting that these factors may affect

the transferability of findings to communities of various sizes or demographics. These

constraints and limitations give critical context for interpreting the study's findings and

conclusions. Furthermore, this study was carried out during the first semester of the
school year 2022-2023 under the Nursing Program at St. Mary/'s College of Tagum,

Inc.
 Chapter II

REVIEW OF RELATED LITERATURE

The present study investigated the theories, facts, information, views that are related

to the Community Engagement in Environmental Sanitation to Reduce Mosquito

Breeding Sites

COMMUNITY ENGAGEMENT

Community engagement, according to the World Health Organization, is the

‘’process of building relationships that enable stakeholders to work together to

address health-related issues and promote well-being to achieve positive impact and

outcomes. Mutual understanding and strong communication practices among the

various actors at all levels is important. By creating partnerships, building networks

and establishing long-term relationships, community engagement initiatives can profit

from sustainability and effectiveness. Incorporating these factors at an early stage of

implementation will ensure maximum impact. Local intersectoral coalitions can have

a direct impact on the sustainability of engagement initiatives based on established

collaborative partnerships. Building on the work on ‘healthy settings’ and recognizing

the power of communities is the key to achieving better health for all. Community

engagement works towards sustainability, efficiency, and resilience of national health

systems, by meeting the financial need of health programs and services, and

supporting initiatives of local communities. It strengthens local knowledge, skills and

competencies, and promote involvement in public health programs (WHO, 2020).

In some areas, a non-governmental group called Gawad Kalinga aids in

community development. Other regions, particularly in the National Capital Region,

are simply re-blocked in an effort to increase resilience, promote multifaceted

development, and make available the fundamental infrastructures needed for a

community to advance (such as water supply and sanitation facilities). The goal of
GK's health and sanitation programs for their villages is not just to provide access to

properly working sanitation systems, but also to promote community health and

prevent aggravating their already vulnerable water systems through their respective

effluents. Any facility's construction has been no issues to up to date. However,

validating the impact and quality of the villages’ final effluent to receiving water

bodies is very much wanting. (CAPS, 2011)

Moreover, in the face of climate change, urban areas around the world are

grappling with a growing health threat: mosquito-borne diseases like dengue and

Zika. These diseases are becoming increasingly challenging to manage due to shifts

in mosquito behavior and distribution caused by changing climate patterns. Our study

delves deep into the complexities of this issue, shedding light on the hurdles cities

face when it comes to mitigating the urban health burden of mosquito-borne

illnesses. One of the key challenges we uncovered is the urban heat island effect. As

temperatures rise due to climate change, cities are becoming even more conducive

to mosquito breeding and survival. These warm urban environments provide

mosquitoes with ideal conditions to thrive, making it a pressing concern for public

health officials. Urbanization and population growth further exacerbate the problem.

Cities offer a rich array of breeding sites for mosquitoes, from stagnant water in

discarded containers to clogged drainage systems. Additionally, the influx of people

into cities means more potential hosts for these disease vectors. In essence, urban

areas have become fertile ground for the transmission of mosquito-borne diseases.

(Ligsay, A., et al, 2021)

In addition, water-storage containers are widespread in families where water

is scarce, and they frequently serve as breeding grounds for vector mosquitoes.

Bacteria in these containers may play a role in attracting or repelling ovipositing

mosquitos. (Nilsson, L. K., et. al, 2018). In water-scarce areas, water-storage

containers are a common necessity but often inadvertently become breeding sites for
disease-carrying mosquitoes. Recent research has highlighted the role of bacteria

within these containers in attracting or repelling mosquito oviposition. Some bacteria

seem to lure mosquitoes to lay their eggs, while others might deter them. This

emerging literature underscores the intricate link between container microbes and

mosquito breeding behavior, offering valuable insights for mosquito control and

vector-borne disease prevention in water-scarce regions.

Globally, mosquitoes have long been considered the most dangerous animals

on the planet. Mosquitoes play an important role in the spread of several dangerous

illnesses and parasites, particularly arboviruses and protozoa. They act as a vector

for diseases such as malaria, dengue fever, West Nile virus, chikungunya, yellow

fever, and Zika virus, which kill hundreds of thousands of people each year.

Mosquitoes have been identified as the most dangerous animal by the World Health

Organization because they are known to carry pathogen-transmitting organisms.

Understanding the various environmental factors that contribute to the spread of

these vectors is one of several tactics utilized to combat them (Olagunju E. A., 2023).

It is undeniable that mosquitoes are such a bothersome to anyone due to the

fact that mosquitoes’ saliva has a reaction when it reaches into human’s body

resulting to itchiness and bump (Sullivan, 2019). Aside from giving annoyance and

inconvenience to people it also brings diseases like dengue. A study from World

Health Organization (WHO) on the year 2019, states that through a bite of a

mosquitoes specifically the female it can spread this kind of disease.

Over the last few decades, many methods have been developed for their

control and the main goal of these strategies is to reduce the number of mosquito

populations to overcome the epidemic situations. Though despite continuous efforts

of the present interventions being deployed in the vector control programs we are

unable to control the disease transmission and outbreaks. Lack of proper

surveillance systems pertaining to insecticide resistance and behavior of vectors can

also weaken the vector control interventions. Also, the lack of coordination between

governmental and non-governmental organizations may influence vector control

interventions. To predict the spread of VBDs, pathogens, reservoirs, and vector

before the onset of transmission season, mathematical and statistical methods are

being prepared. These types of models can help in providing information to public

health authorities so that they can plan their vector control interventions accordingly

(Taruna, K. et al., 2022).

Dengue prevention and control needs an effective intersectoral approach,

requiring coordination between the lead ministry (usually the Ministry of Health) and

other relevant ministries and governmental agencies, the private sector (including

private health-care providers), nongovernmental organizations and local

communities. Resource sharing is an important aspect of coordination, and is critical

in emergency situations when scarce or widely dispersed human and material

resources must be mobilized rapidly and their use coordinated to mitigate the effects

of an epidemic. (WHO, 2020).

Furthermore, different localities in the country recognize the threats brought

about by these diseases and consider different strategies in looking after

the welfare of the general population. Children in schools are recognized as

important vulnerable groups in the Philippines, as their burden of mosquito-

borne diseases is great as they may be hospitalized, suffer long-term disabilities,

incur foregone opportunities by missing out in school, and, in worse conditions,

even die. Most vector surveillance activities in the country have been directed in

the communities, and to date, no study has explored vector surveillance activities in

populous places like schools. This study aimed to assess the species

composition of mosquitoes collected from ovitraps in selected public schools

in the National Capital Region in the Philippines. Ovitraps are proven to be

sensitive in detecting mosquitoes ike the Aedes populations even in low

infestation levels and in indoor and outdoor environments. Results pertaining to

this study are significant, as they enable us to understand the vector’s dynamics

and help government and communities in formulating comprehensive vector

control operations in public spaces like school. (Myra S. Mistica et.al 2019)

Due to its importance for sustainable livelihoods and development,

environmental sanitation management (ESM) has become a hot topic in global

development. The UN Sustainable Development Goals (SDGs) urge all nations to

concentrate on policies and programs that put ESM at the forefront of their

development agenda in order to ensure sustainable livelihood transformation

because they recognize the implications of ESM for livelihood for sustainable

development. Given the significance of coastal livelihoods in the development

process, experts like Small and Nichols find this to be a serious worry. Due to its

unique centrality, coastal areas typically experience rapid population expansion.

They serve as the transition between the land and the sea and generate income

through tourism, fishing, salt production, maritime trade, and transportation (Kruijssen

and Asare 2013).

Furthermore, according to Tsekleves, E,. (2023), evidence demonstrates that

personal and environmental hygiene minimizes infection spread and is the most

essential cornerstone in the control of infectious disease in the home and

environment. The environment is inextricably related to our lifestyle choices, with

cleaning methods having an important role in microbial exposure and infection

(viral/bacterial) transmission. Although the routes of dust transmission in the home

environment are well understood, it has not been investigated how to prevent

bacterial infection in the home environment and thus diminish resistance. Because

modern environments lack a clear hygiene indication, individuals are unclear about

the true dangers present, leading to confusion about the nature of real threats such
as bacterial illnesses, which remain unseen. This has resulted in a more surface

approach to household cleaning, with speed and appearance taking precedence over

hygiene and disease prevention on a deeper level.

 Chapter III

METHODOLOGY

Study Design

In this study, the researchers used qualitative research design, specifically,

descriptive, which according to (Hamilton & Finley, 2019) Because they help in

addressing complicated issues like how and why efforts to implement best practices

may succeed or fail as well as how patients and providers perceive and arrive at

healthcare decisions, qualitative methods are an important part of implementation

research. The most effective way to learn what people think about a new idea and

efforts to implement it is probably through one-on-one interviews, small groups, or

focus groups. This focuses in understanding a research query as humanistic or

idealistic approach. Qualitative method is used to understand people’s beliefs,

experiences, attitudes, behavior, and interactions. It generates non-numerical data.

Research Participants & Information

The participant of this study includes the researcher themselves, and the

mother of the family that the researchers chose as the participant from San Vicente

Prk. 8, Sto. Tomas, Davao Del Norte, of the study. The family consist of 5 members,

but during the series of interviews, only the mother and the 1 year-old daughter is

available. The informant of the study was selected based on their availability at the

time of the interview. Only one member was selected to serve as an informant for the

study, as they were found have a more readily available than the other members.

Name: Mrs. C

Age: 30 years old

Nationality: Filipino

Occupations: Housewife, and managing Family business.

Religion: Roman Catholic

Educational Attainment: High School graduate, ALS graduate.

Data Sources

The researchers used a primary data source for this investigation. Primary

data are information that has been gathered directly by the researcher. (Ajayi, 2017).

An interview is an easy and flexible data collection method in qualitative research. It

broadly refers to a category of research approaches that produce findings without

reliance on quantitative measurement or statistical analysis (Corbin and Strauss

2015). The researchers made sure that the data was not misinterpreted and changed

and was analyzed carefully.

Data Collection Procedure

In gathering the data, the participants were chosen based on the population

of the families residing in San Vicente. The researchers conducted thorough

analysis and detailed documentation throughout the course of the study. The

researchers meticulously records strategies that could help them with identifying

acute focus on challenges encountered. The researchers gather some information

from the participant, and analyzed the data by the use of critical thinking skills to

have accurate interpretations. The researchers gathered numerous literatures and

filtered them according to its relation and use in generation of the result of the study.

Data Gathering Procedure

The student nurses opened the interaction with the Family C during the data

collecting procedure by introducing themselves in a pleasant and respectful manner.

They took the effort to establish rapport and create a welcoming environment at the

family's home. To ensure transparency and comprehension, the student nurses then

offered a clear and straightforward explanation of the entire data collection

procedure, describing the goal of the study as well as the exact questions they would
be asking. This stage was critical in ensuring that Family C understood the research

objectives and the nature of the interview. Following that, the student nurses

respectfully asked written informed consent from each family member participating in

the study, reiterating that their participation was entirely voluntary and that they had

the right to withdraw at any time without consequence. To protect the privacy and

security of Family C's personal information, ethical concerns were strictly followed

throughout the process, with a rigorous adherence to ethical norms and informed

consent procedures. This ethical approach to data collection not only adhered to the

principles of informed consent, but also fostered a trusting and collaborative

relationship between the researchers and Family C, fostering an environment

conducive to candid discussions about chronic pain and its impact on their lives.
 Chapter IV
RESULTS & FINDINGS
FIRST LEVEL OF ASSESSMENT
Home & Environment
The Family of Mr. DC and Mrs. BC, resides in a house wherein, the isn’t full
renovated yet. The household has inadequate living space. They don’t have no
windows, and door, they only rely on a bedsheet and other spare blanket that they
could use to cover as a shield from cold, rain, and/or insects at night. They share
comfort room with their nearby house, which is Mrs. BC’s parents.
They are surrounded with some plants and rice field at the back of their house which
add gives fresh air that makes you very relaxing and
General Family Relationship/Dynamics
When it comes to general family dynamics, in their family there is no such
thing as ‘Patriachy’ or any form of …. That someone has the upper hand in the family
or household. Communication and teamwork was a setting created in the household
to better understand each other. Due to the line of work of Mr. DC, the
communication within the family is facilitated to two primary methods those were:
face-to-face and through mobile phones that helps them maintain communication
despite the distance. Through these channel, it help to retain a close knitted family. A
family that can freely express, communicate, and bond.
Kind of Neighborhood
The family of Mr. DC and Mrs. GC live in a neighborhood wherein there is no
chaos or feud against other family withing their community. In a community where
there is a lot of kids, it helps them to have better ties with each family. The closeness
of their kids conveys strong family ties within the neighborhood, which can be
convenient to them when in times of need of support with various family matters.
Social and Health Facilities Available
Mrs. GC testifies that they have access to their Barangay’s Health Office,
wherein they come to when they need basic healthcare services. Mrs. GC said that
she done her prenatal at their health center because aside from the fact that it is
near, it’s for free as well. The participant said that the healthcare facility there is their
valuable and accessible source when it comes to their healthcare needs, as it
provides a great source for information on health related information and basic
healthcare services. Having such access can make it easier to spread knowledge
and information, and regular check-ups, which are essential for maintaining family’s
overall health.
Communication and Transportation Facilities
The family has one gadget that they utilize for communication, which enables
them to still in contact with family members and as well as to access information
needed. When it comes to transportation, Mrs. GC mentioned that it is a challenge to
them to find easy transportation as they don’t own any vehicles and vehicles barely
pass by their street which is so inconvenient at times.
Values, Habits, Practices on Health Promotion, Maintenance & Disease
Prevention
 While assessing the family’s health related values and practices, it was noted
that the family haven’t done any booster or Covid vaccine. Regarding their daily
lifestyle habits, the wife is incharged in taking care of the kids, and as well as
responsible for managing the household chores, which Mrs. GC said that her daily
routine. Mr. DC and Mrs. GC has no maintenance, but the kids are taking their
vitamin. It was also noted that Mr. DC has this habit of smoking since he was
teenager up until now. It is essential to address these aspects of health promotion,
maintenance, and illness prevention through proper interventions and education in
order to ensure their long-term health.
Health Status
While assessing the health status of the family, it appears that Mrs. GC have
no current health issues reported, she was overall healthy same with their youngest
baby DC. It was also noted that their first -born experienced infection that turned into
kidney infection, when he was 9-year-old and now reported to be already fully healed
from it with regular check up and the prescribed Fish oil supplement. The two kid
DJC and DAC was found malnourished and now part of their school’s feeding
program. Mr. DC also experience frequent cough, which Mrs. GC said herself, but so
far that was the only health related issue Mr. DC is experiencing. It was also noted,
that the family go to hospitals immediately whenever they feel something unusual to
their body, which is good act to assure accuracy, and to updated with ensure their
overall health and well-being.
SECOND LEVEL OF ASSESSMENT
Subjective:
The house was not properly arranged, outside and inside. There is only one room
house with five (5) persons living in it. The house It consist of their bedroom, kitchen,
and sink with common/shared comfort room and no window and door which allows
the insects from outside the house to freely entire the household. Some things from
outside the house are left unattended, such as flower pots, liquor bottles that has
water in it, and scattered things at the side part of the house, that could possibly be a
breeding or resting site of the mosquitoes and other insects that could bring
inconvenience to the family.
Objective:
In the conducted assessment, the researchers have identified objectives. First is the
inadequate living space, due to inadequate family resources, most specifically
financial constraints, as evidenced by five (5) person living in a one (1) room house,
that is not properly arranged, some things unattended, outside and inside. As
evidenced by the verbalization of ‘’Kung naa sya diri (Mr. DC) mag bunot rag lubi’’
‘’naay bibe usahay kuan 1500 ra among halin, unya ang feeds 1700, losing’’ ‘’Naga
masa pod sya pero panagsa rapod, 350 and adlaw’’. Second, Unsanitary Waste
Disposal (shared comfort room) As evidenced by a small and unsanitary comfort
room, and by the verbalization of ‘’Oo dira rapod mi, isa rapod mi. Common ra sa kay
wala paman’’. And lastly the Presence of Breeding or Resting sites of Vectors, due to
lack/inadequate knowledge of Hygiene and sanitation, as evidenced by the
verbalization of ‘’ Naa daghan kaayog lamok. Karungm ga panahona, lamok, stem
borer amo jud nay kalaban namo ron’’
General Health Observation:
Upon assessing the family and their house, it clearly shows that the family, has
inadequate resources, specifically financial constraints or sources that somehow like
a domino, affects almost all of the aspects of their daily life, that also effect their
overall well-being.

FAMILY FAMILY SUPPORTING DATE DATE

NURSING NURSING DATA/ CUES IDENTIFIED RESOLVED
PROBLEMS PROBLEMS
1st level 2nd level
assessment assessment

A.INADEQUATE A. Inability to A. -Supporting August 29, September 5,

LIVING SPACE provide a Cues: 2023 2023
home
- As evidenced
environment
by, 5 person
conducive to
living in a 1
health
room house.
maintenance
Not properly
and personal
arranged
development
things inside
due to.
and outside
Inadequate the house;
family verbalization of
resources, "kung naa sya
specifically: dri(the
husband) mag
Financial bunot rag lubi"
constraints/ "naay bibe,
limited usahay kuan
financial 1500 ra among
resources.
halin, unya
ang feeds
1700, losing";
"Naga masa
pod siya, pero
panagsa rapod
350 ang
adlaw"

B. B. Lack of B. Supporting August 29, September 5,

UNSANITARY /inadequate Cues: 2023 2023
WASTE knowledge of
-As evidenced
DISPOSAL importance of
by small space
(SHARED hygiene and
and unsanitary
COMFORT sanitation.
comfort room,
ROOM)
and by the
verbalization of
 "Oo dira rapod
mi, isa rapod
mi. Common
ra sa kay wala
paman"

C .PRESENCE C. Lack of/ C. Supporting August 29, September 5,

OF BREEDING Inadequate Cues: 2023 2023
OR RESTING knowledge of
-As evidenced
SITES OF importance of
by
VECTORS Hygiene and
verbalization of
sanitation.
"Naa daghan
kaayog lamok.
Karung mga
panahona
lamok, stem
borer mao jud
nay kalaban
namo ron" and
visible
unsanitary
household
environment,
the presence
of pests within
the area,
stacked
objects. The
drainage/canal
is dirty. In the
poultry for
ducks, there is
dirt and
stagnant water
where
mosquitoes
can lay eggs
or breed.

PRIORITIZATION OF NURSING HEALTH PROBLEMS

Inadequate Living Space

CRITERIA SCORE WEIGHT COMPUTATI RESU JUSTIFICATIO

ON LT N
Nature of the It is a health risk
problem that doesn't
necessitate for
SCALE immediate
Wellness State action, because
3 1 2/3x1 .67 infections and
Health Deficit microbes can
3
Health Threat easuly be
2 transferred in
Foreseeable this setting
1
Crisis (Maglaya, 2004)

Modifiability of 2/3 x 2 It is going to

the problem require quite a
bit of money for
SCALE
1.33 increasing the
Easily
living area, also
Modifiable 3 2 the tidiness of
Partially
the home. Given
Modifiable
the other issues,
Not Modifiable 2 the family's
resources are
currently
1 insufficient.
(Maglaya,
2004).

Preventive 2/3x1 .67 Increasing the

potential living space will
SCALE A. A.
1 Lessen
High the
3
Moderate likelihoo
2 d of
Low contagio
1 us
infection
s being
transferr
ed.
B. Provide
privacy
to
member
s
C. Provide
everyone
more
room to
walk
around
when
doing
 househol
d chores
and
participat
ing in
shared
recreatio
nal,
leisure,
or play
activities.
(Maglaya
, 2004)
Salience ½x1 .5 It is felt as a
problem by the
SCALE family that
A Serious
2 needs
Problem,
immediate
Immediat 1 action (Maglaya,
e Action
1 2004)
Needed
A Problem
0

TOTAL 3.17

Unsanitary Waste Disposal (Shared Comfort Room)

CRITERIA SCORE WEIGHT COMPUTATI RESUL JUSTIFICATIO

ON T N

Nature of the It is a health

problem threat, because
this shared type
SCALE
.67 of common
Wellness State comfort room
3 1 2/3x1 can harbor
Health Deficit different
3
Health Threat microbial germs
2 that can affect
Foreseeable the health
1
Crisis situation of the
families living in
the same area.
(Cuevas, P. F.,
2007).

Modifiability of the ½ x2 Resources are

problem not available
 SCALE and
Easily interventions
Modifiable 0 are not feasible.
Partially 3 2
Modifiable
Not Modifiable
2

Preventive 3/3x1 1 Occurrence of

potential parasitism and
other
SCALE
1 communicable
High disease can be
3 reduced or
Moderate minimized.
2
Low (Cuevas, P. F.,
1 2007).

Salience 0/2 x1 0 It is not

perceived by the
SCALE family as a
A Serious
2 health threat
Problem,
Immediate 1
Action
Needed 1

A Problem
0

TOTAL 1.67

Presence of Breeding or Resting Sites of Vectors of diseases specifically

mosquitoes

CRITERIA SCOR WEIGH COMPUTATIO RESUL JUSTIFICATIO

E T N T N

Nature of the It is a health

problem threat that
needs
SCALE immediate
action, because
 Wellness State 3 1 2/3x1 .67 if the
community fails
Health Deficit 3 to clean its
Health Threat 2 environment
and the
Foreseeable 1 breeding sites
Crisis for aedes
mosquitoes are
found
everywhere;
then, the
community will
have a higher
risk for
contracting
dengue fever
since the
mosquito vector
will be
prevalent in the
area. (Cuevas,
F. P., 2007)

Modifiability of 2/2 x 2 Cleaning the

the problem surrounding in
their backyard
SCALE
2 doesn’t require
Easily
too much labor,
Modifiabl 3 2 yet some of the
e
breeding sites
Partially
in their poultry
Modifiabl 2 in the backyard
e
and it can’t be
Not Modifiable cleaned totally
1 because of their
ducks

Preventive 3/3x1 1 If the

potential surroundings
will be at least
SCALE
1 cleaned once a
High week and the
3 canals will also
Moderate be cleaned then
2
Low the likelihood to
1 have diseases
from pests can
possibly be
prevented.
(Cuevas, F. P.,
2007)
 Salience 1/2 x1 .5 It is perceived
by the family as
SCALE health threat
A Serious
2 and sees it as a
Problem,
problem that
Immediat 1 needs an
e Action
1 immediate
Needed
action.
A Problem
0

TOTAL 4.17

The Prioritized Health Problems:

The list of health condition or problems ranked according to priorities is
presented:
 Presence of Breeding or Resting Sites of Vectors of diseases specifically
mosquitoes - 4.17
 Inadequate living space and Sanitation -3.17
 Unsanitary Waste Disposal (Shared Comfort Room) - 1 .67

FAMILY FAMILY OBJECTIVES OF PLAN OF DATE

HEALTH NURSING/ NURSING CARE ACTION/NURSING IMPLEMENTED
NEEDS INTERVENTION
HEALTH
PROBLEMS
 (Diagnosis)

Adequate Inability to After implementing 1. Broaden September 5,

space for provide a the nursing the 2023
the family home interventions, the knowledge
and clean environment family will: of the family
environmen conducive to the
A. Arrange their importance
t health
homes to of hygiene
maintenance
have and
and adequate sanitation
personal living space 2. Discuss the
development for the five possible
due to members of infections
inadequate the family and health
family B. Recognize problems
resources: the they may
Inadequate importance of get if
living space hygiene and hygiene
and sanitation at and
sanitation home sanitation is
due to Clean their living not
financial space to avoid realized.
constraints/ contamination 3. Explore
limited with the
family ways
financial
of
resources.
implementin
g measures
to maintain
hygiene
and
sanitation
within the
home
setting
4. Conduct a
general
cleaning in
the house
together
with the
members of
the family
and other
groupmates

III. FAMILY NURSING CARE PLAN

 Inadequate Living Space and Sanitation

 UNSANITARY WASTE DISPOSAL (SHARED COMFORT ROOM)

FAMILY FAMILY OBJECTIVES PLAN OF DATE
HEALTH NURSING/ OF NURSING ACTION/NURSING IMPLEMENTED
NEEDS CARE INTERVENTION
HEALTH
PROBLEMS
(Diagnosis)

Proper • Lack of After 1. To provide the September 5,

and inadequate implementing family the right 2023
sanitary knowledge the nursing hygiene
comfort of intervention
2. Provide
room. importance the family:
effective
of hygiene
A. Can be information
and
educated about the
sanitation.
about the various
Unsanitary
importance of diseases that
waste
hygiene and the family can
disposal
sanitation, acquire with
(shared
emphasizing inappropriate
comfort
the potential toilet facility.
room) due
health risks
to; Not 3. To be aware of
associated
having their the danger that
with
own comfort may occur if
unsanitary
room. necessary
waste
actions would
disposal in
not be initiated.
shared
comfort 4. Demontrate to
rooms. the family the
proper ways of
B. Can learn
cleaning.
the proper
hygiene
practices by
providing
teaching
sessions on
handwashing
techniques
and personal
cleanliness,
ensuring that
individuals
understand
and
implement
appropriate
sanitation
measures.
C. We will
aim to
 collaborate
with
community
leaders and
local
authorities to
advocate for
improved
sanitation
facilities and
access to
private
comfort
rooms, aiming
to address
the root
cause of the
unsanitary
waste
disposal issue
to the family.

 PRESENCE OF BREEDING OR RESTING SITES OF VECTORS OF

DISEASES (MOSQUITOES)

FAMILY FAMILY OBJECTIVE PLAN OF DATE

HEALTH NURSING/ S OF ACTION/NURSING IMPLEMENT
NEEDS NURSING INTERVENTION ED
HEALTH CARE
PROBLEMS
(Diagnosis)

Clean Lack After 1. Discusse September

Environm of/inadequate implementat d the 5, 2023
ent knowledge of ion of the possible
importance of nursing sources
Hygiene and intervention: of the
sanitation: recognition presence
of the of stem
Presence of borer,
problem:
breeding or mosquito
Poor
resting sites of es, and
environment other
vectors of al sanitation insects.
diseases(mosquit is evident 2. 2.
oes) due to with the Explain
improper criteria of: to the
drainage system
as evidenced by A. Aware of family
stagnant water presenc the
where e of the possible
stagnant harmful
 mosquitoes can waters effects
lay eggs or breed. in that
different these
area/par vectors
t of the can
house. cause to
B. Family the
will be
health of
able to
the entire
demonst
rate family.
understa
nding of
the
health
teaching
s with
the
regards
of the
possible
causes
and
effects
of the
presenc
e of the
vectors.

EVALUATION OF CARE
 Inadequate Living Space

DATE FAMILY NURSING SIGNATURE

 NURSING/ OBSERVATIONS,

HEALTH ACTIONS, AND

PROBLEM EVALUATION OF

PROGRESS

Septenber 6, Inability to provide After implementing

a home the nursing
2023 environment interventions, the
conducive to family was able to:
health
maintenance and A. Arrange their
personal homes to
development due have
to inadequate adequate
family resources: living space
Inadequate living for the five
space and members of
sanitation due to the family
financial B. Recognize
constraints/ limited the
financial resources importance of
hygiene and
sanitation at
home
C. Clean their
living space to
avoid
contamination

 UNSANITARY WASTE DISPOSAL (SHARED COMFORT ROOM)

DATE FAMILY NURSING SIGNATURE

NURSING/ OBSERVATIONS,

HEALTH ACTIONS, AND

 PROBLEM EVALUATION OF

PROGRESS

Lack of inadequate After implementing

knowledge of the nursing
importance of intervention the
hygiene and family was able to:
sanitation.
A. Understand
Unsanitary waste
about the
disposal (shared
importance of
comfort room) due
hygiene and
to; Not having their
sanitation,
own comfort room.
emphasizing the
potential health
risks associated
with unsanitary
waste disposal in
shared comfort
rooms.
B. Learn the proper
hygiene practices
by providing
teaching sessions
on handwashing
techniques and
personal
cleanliness,
ensuring that
individuals
understand and
implement
appropriate
sanitation
measures.

 PRESENCE OF BREEDING OR RESTING SITES OF VECTORS OF

DISEASES (MOSQUITOES)

DATE FAMILY NURSING SIGNATURE

NURSING/ OBSERVATIONS,
HEALTH ACTIONS, AND

PROBLEM EVALUATION OF

PROGRESS

After
implementation of
the nursing
intervention the
family was able to
A. Be aware of
presence of
the
stagnant
waters in
different
area/part of
the house.
B. Family will
be able to
demonstrat
e
understandi
ng of the
health
teachings
with the
regards of
the possible
causes and
effects of
the
presence of
the vectors.
C. Clean their
houses and
environmen
t to have a
safe and
clean
environmen
t.
D. Have a
better
understandi
ng on the
importance
of
environmen
tal
sanitation.
E. Cleaned
 their
surrounding
s every
morning to
lessen the
presence of
breeding
sites and
vectors

Chapter V

IMPLICATION TO NURSING PRACTICE

 Promoting community participation in environmental cleanliness to eliminate

mosquito breeding places is a crucial undertaking for community health nursing.

Nurses are at the forefront of this effort, serving as educators, activists, and

collaborators. They teach communities about the dangers of mosquito breeding

places and emphasize the significance of proper garbage disposal and water

management. Nurses detect potential breeding places and track illness changes

through examinations and surveillance. They form alliances with local groups and

leaders to develop a coordinated response while respecting cultural values along the

way. Nurses provide a data-driven strategy by lobbying for legislation that support

cleanliness programs and gathering data to drive interventions.

Chapter VI

CONCLUDING REMARKS
Recommendations

To advance our understanding and effectiveness in fostering community

engagement for environmental sanitation and mosquito control, several research

recommendations should be pursued. Longitudinal studies are needed to examine

the long-term effectiveness of community participation projects. Investigating the

behavioral and social aspects that influence community engagement can lead to

more targeted treatments. Investigating new technologies and doing cost-benefit

evaluations can provide useful insights into efficient and cost-effective techniques.

Furthermore, research on community health worker training, policy effects, and

ecosystem-based mosquito control measures can improve sanitation implementation

and scalability. Understanding how environmental sanitation initiatives affect health

equity, particularly in disadvantaged populations, is critical, and research on

knowledge translation and dissemination strategies can guarantee that study findings

effectively reach and empower communities. These research recommendations help

to more comprehensive and impactful community-driven sanitation activities,

reducing mosquito breeding sites and the burden of mosquito-borne diseases in the

long run.

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APPENDICES