Pabasa Sa Nutrition

Nutrition is recognized as a basic human right, vital to the survival, growth and development of children according to the United Nations Children’s Fund (UNICEF). And proper nutrition is a key to having a happy, healthy life, but despite this pronouncement, millions of people around the world suffer from malnutrition and continues to claim millions of lives, with more than 5.5 million children under-five years of age dying annually. (Devpulse, 2008). There were 925 million malnourished people in the world in 2010, an increase of 80 million since 1990, despite the fact that the world already produces enough food to feed everyone (6 billion people) and could feed the double (12 billion people).

Protein-energy malnutrition (PEM) and micronutrient deficiencies remain the leading nutritional problems in the Philippines which rank eighth in countries who have five million or more undernourished people. There were 15.2 million undernourished people in 2001–2003, according to the Food and Agriculture Organization. This represents the number of people consuming less than the minimum amount of food energy (measured in kilocalories per capita per day) necessary for the average person to stay in good health while performing light physical activity.

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From 2005 to 2008, there was a significant increase in the proportion of underweight children aged 0-5 from 24.6 percent to 26.2 percent, according to the National Nutrition Survey (NNS). A very high prevalence of underweight preschoolers was noted in Regions IV-B, V, VI, VIII, and IX, where data on the proportion of underweight-for-age children registered at greater than or equal to 30 percent. The status of micronutrient malnutrition is likewise an important concern in the country.

According to WHO (2009) the vitamin A status of the country is considered severe subclinical deficiency affecting children 6 months - 5 years (8.2%) and pregnant women (7.1%). Iron deficiency anemia is the most alarming of the micronutrient deficiencies affecting a considerable proportion of infants (56.6%), pregnant women (50.7%), lactating women (45.7%) and male older persons (49.1%). Malnutrition in the Philippines is caused by a host of interrelated factors – health, physical, social, economic and others.

Food supply and how it is distributed and consumed by the populace have consequent impact on nutritional status. While some reports indicate that there is enough food to feed the country, many Filipinos continue to go hungry and become malnourished due to inadequate intake of food and nutrients. Children are mostly affected not only because of the lack of food. Their lives are also placed at risk by poor feeding and care practices, poor health conditions of pregnant and breastfeeding women, lack of access to health services, and unsanitary conditions. According to 2011 National Nutrition Results, only 52 per cent are breastfed within one hour of delivery; 47 per cent of children 0-6 months are exclusively; 45 per cent of children 6-23 months are breastfed, and fed with adequate and safe nutritious complementary food. Due to the lack of nourishing food and nutrition education, hunger and malnutrition are still dominant in this country. (Food and Agriculture Organization 2011). In fact, these problems have been linked with high rates of poverty and an increasing population growth.

Adequate intake of micronutrients is essential for preventing common micronutrient disorders, such as vitamin A and iron deficiencies. According to Aphane et al. (2003), most countries have to improve the micronutrient status of the population by changing practices at the household level and by protecting the nutritional benefits of traditional practices that are eroding because of factors such as urbanisation and modernisation. In addition, according to The Micronutrient Initiative improving and diversifying the food that is eaten by the poor is therefore the most fundamental (though still not comprehensive) approach towards controlling vitamin and mineral deficiency. Unfortunately, it is also the approach that is most dependent on rising incomes. When income increases, people often reduce breastfeeding, stop gathering wild foods and eat fewer green leafy vegetables due to ignorance or poor knowledge of nutrition. Nutrition education and counseling are one of the government’s strategies to combat malnutrition especially in children.

The education and counseling practices teach the correct feeding procedures and improving personal knowledge of pediatric areas to improve health care in the Philippines. One of the DOH program to answer malnutrition is through Pabasa sa Nutrition. It is an innovative approach in strengthening the implementation of the five(5) Impact Programs (Home, School and Community Food Production, Micronutrient Supplementation, Food Fortification, Nutrition Education and Food Assistance) of the Philippine Plan of Action for Nutrition (PPAN). Through Pabasa, mothers are grouped into 10-12 per class informally discussing health and nutrition using behaviorally designed materials developed by the Nutrition Center of the Philippines (NCP). Pabasa is designed to empower women in reducing their family’s vulnerability to malnutrition through the adoption of proper nutrition practices and healthy lifestyles. The NCP provides training and materials for local government units and NGOs that plan to implement Pabasa.

Guldan et al (2000) states, nutrition education has shown a significant benefit in increasing nutritional knowledge and improving infant feeding practices amongst mothers who receive nutrition education compared to mothers who do not receive nutrition education. (Ladzani et al. (2000) reported that a nutrition education programme had significantly improved breastfeeding and infant feeding practices in rural areas amongst local women who had been trained. It was also shown that teaching mothers about complementary feeding improved the mother’s knowledge and the children’s diets (Ilett & Freeman, 2004). In addition, Guldan et al. (2000) indicated that children of mothers who received nutrition education had lower rates of anaemia and were significantly heavier and taller than the control group.

STATEMENT OF THE PROBLEM

The purpose of this study is to assess and determine the effectiveness of Pabasa sa Nutrisyon on the knowledge, attitudes and practices as acquired by the mothers of selected barangays in Hindang, Leyte.

Specifically, this study sought answers to the following:
1. Describe the profile of the respondents.
a. Age
b. No. of children
c. Religion
d. Highest Educational Attainment
e. Estimated Monthly Family Income

2. Identify the level of knowledge through the pretest and post test scores of the respondents on the Pabasa sa Nutrisyon

3. Determine the attitude and practices through actual observation with the use of structured checklist.

4. Draw out implications from the study.

Null Hypothesis: There is no significant difference between the pre-test and post-test scores of the respondents on the knowledge, attitudes and practices on the Pabasa sa Nutrisyon.

SIGNIFICANCE OF THE STUDY
Results of this study would be beneficial to the following institutions and entities, to the mothers so that they will be guided and be informed on the importance of good nutrition for the family, the Barangay Health Worker that they will be guided in collecting data for the nutritional status of their clients thus they will promote conducting Pabasa sa Nutrisyon to guide mothers, The RHU staff and nurses that will be more aware on the proper program to delivered to their clientele, to the Department of Health that the said institution will not only help but endorse and provide funds on the implementation of Pabasa sa Nutrisyon, To NGO’s that it will give them insights of ensuring better nutrition to Filipinos, thus decreasing the rate of malnutrition in our country, and lastly to the future researchers that findings of this study will serve as their baseline to further improve result.

To the Department of Health .This study can help the said institution to successfully continue the implementation of the Pabasa sa Nutrisyon. To other Private Agencies. This study will provide them an insight of ensuring better nutrition to Filipinos, thus decreasing the rate of malnutrition in our country. Barangay Health Center. Barangay Health Workers will be guided on the nutritional status of every individual . Through this, they will be able to help conducting Pabasa sa Nutrisyon that will promote good nutrition. To Rhu Staff and Nurses. This study would help the rhu staff and nurses to be responsible in conducting Pabasa sa Nutrisyon. Mothers. This study would also be beneficial to the parents that in a way help them in providing proper guidance and knowledge to their family. Future Researchers. The findings of this study could further serve as a baseline data for further research.

SCOPE AND LIMITATION
This study aims to know and focused only on the effectiveness on Pabasa sa Nutrisyon on the knowledge, attitudes and practices acquired by mothers of selected barangays in Hindang Leyte. The participants on Pabasa sa Nutrisyon are mothers residing in selected barangays in Hindang, Leyte, namely, Brgy. Doos del Sur, Brgy.San Vicente, Brgy. Tabok and Brgy. Bontoc. This study also included the demographic profile of the mothers as the intervening variable such as: age, no. of children, religion, highest educational attainment, and estimated monthly income. Moreover, the dependent variable of the study is the knowledge, attitude and practices of mothers. The researchers conducted the study on September 2014 to October 2014. Furthermore this study is limited only to those mothers who participated the Pabasa sa Nutrisyon. The researchers have chosen the following barangays because of the accessibility of each of the researcher to the different barangays.

THEORETICAL FRAMEWORK
Energy and Instinct from Psychoanalytic theory of Sigmund Freud viewed each human being as a machine that consumes food, water and oxygen and converts these into energy, which is then expended in both physical and mental work. He proposed that instinctive physiological needs are based within the id. Bodily needs lead to conscious desires and to the behavior necessary to satisfy the need. When the need is satisfied, the organism comes to rest until another need arises. There are individual differences in the means adopted to satisfy each need. Virginia Henderson on her theory of 14 Basic Human Needs viewed health as a quality of life and is very basic for a person to function fully. As a vital need, health requires independence and interdependence.

Since health is a multifactor phenomenon, it is influenced by both internal and external factors which play independent and interdependent roles achieving health. She also gave emphasis in prioritizing health promotion as more important care of the sick. Sister Callista Roy’s theory of Adaptation viewed humans as biopsychosocial beings constantly interacting with a changing environment and who cope with their environment through biophysical adaptive system. This theory focuses on the ability of individual, families, groups, communities, or societies to adapt to change. The degree of internal or external environmental change and the person’s ability to cope with that change is likely to determine the person’s health status. She also proposes that being an open system; the individual is vulnerable to inputs and stimuli from both self and the environment

CONCEPTUAL FRAMEWORK

Schematic diagram showing the relationship of the variables in the study.
The respondent’s demographic profile namely, age, no. of children, religion,highest educational attainment and estimated monthly income are theorized to affect the pre-test scores of the respondents. In our study, the researchers seek to determine the relationship between the pre-test and post-test scores of the respondents after conducting Pabasa sa Nutrisyon.

DEFINITION OF TERMS
In order to facilitate better understanding of the study, the following terms are defined conceptually and operationally. Pabasa sa Nutrisyon - the mothers are grouped into 10-12 per class informally discussing health and nutrition. Knowledge-a familiarity, awareness or understanding of something. Attitude- is an expression of favor or disfavor toward a person, place, and thing. Practices-the actual application or use of an idea.

Mothers- who undergone Pabasa sa Nutrisyon

METHODOLOGY
This chapter discusses the researcher design, the research locale, the selection of respondents, sample size, data gathering instrument, general procedures and statistical tools that were used.

RESEARCH LOCALE
This study was conducted in Hindang, Leyte. It is a fifth class Municipality in the province of Leyte. In the north, it boarders with the town of Inopacan Leyte while it boarders with the town of Hilongos in the south. According to the 2014 projected population, it has 20,868 people with 4184 households. Among 20 barangays of Hindang, Brgy. Pob. 1, Doos del Sur, San Vicente, Tabok and Bontoc were the selected barangays for the study. The researchers selected these areas for accessibility and convenience of the study. These areas are the hometown and were the researchers worked. SELECTION OF RESPONDENT AND SAMPLE SIZE

The respondents of the study included all mothers who participated the Pabasa sa Nutrisyon in Four Baragays of Hindang Leyte. The respondents were chosen according to their availability at that time and in the place where the gathering of data was conducted. RESEARCH DESIGN

The researchers utilized one group pretest-posttest study which is basic experimental research design. The group administered a pretest with the use of questionnaire composed of multiple choices, true or false and Self-structured questions. Same questionnaire is given for posttest. An analysis of the variables quantitatively was done which served as basis for the interpretation, implications and recommendations that were formulated. RESEARCH PROCEDURE

Permission was sought from the barangay chairman of the different barangays. The data were collected by the researchers themselves from September 2014 to October 2014. The respondents were instructed to sign the consent form before answering the questionnaires. They were requested to individually accomplish the pretest questionnaires by writing their chosen answer in the sheet. Another set of questionnaires for the post test were given after three days. Accomplished questionnaires were retrieved by the researchers. RESEARCH INSTRUMENT

The questionnaire is composed of three (3) major parts. Part I, elicit data on the profile of the mothers in terms of age, no. of children, religion, highest educational attainment and estimated monthly family income. Part II elicits data from the Pabasa sa Nutrisyon questions to determine the knowledge of the participants. Part III elicits data from the self-structured questionnaire to determine the attitude and practices of the mothers. A table was made and the respondents were asked to fill in their answers by putting a check mark. Statistical Treatment of Data

The data gathered from the questionnaire were analyzed according to their corresponding quantitative equivalents. The responses were also categorized according to the nature of the specified questions asked. The profiles of respondents were analyzed using frequency tally and percentages. The following formula in determining percent was used:

P= f/n x 100%

where: P – Percent
f – frequency
n – number of respondents

To test for the significant difference on the pre-test and post-test scores of the respondents on the Pabasa sa Nutrisyon. The machine formula follows: (Walpole, 1982: Introduction to Statistics) t=(X ̅_1-X ̅_2)/√(S_p (1/n_1 +1/n_2 ) )

All computations and analysis were tested using 5% level of significance.