FHN-operational Definition of Terms
FHN-operational Definition of Terms
Institute of Nursing
Community Health Nursing
1. Family - a group of persons usually living together and composed of the head and other persons related to the
head by blood, marriage, adoption or interests. There should be awareness that they are family. Presence of a
provider and a decision maker should be considered in identifying families in a household. In our study, we count
the number of families, not households.
2. Head of the family: the family member considered to be the leader or primary decision-maker, not necessarily
the provider
3. Complete Address: the address of the usual residence of the family including the unit number of the house,
house number, street name and complete name of barangay
4. Length of residency: refers to the length in years and months that the family or couple (if no child) live as a unit
of society in the barangay
- Transient (less than 6 months)
- Permanent (6 months and longer)
5. Place of origin: refers to the place/ municipality and province that the family (not only the head) originated before
living in the present residence.
6. Ethnic background (ethnicity): refers to ethnic minorities, selected cultural and sometimes physical
characteristics used to classify people into groups or categories considered to be significantly different from
others. (EX: Mangyan, Aeta, Ivatan, Igorot, T’boli, Maranao etc.) These people may be considered as indigents or
having special needs
7. Primary dialect spoken: language primarily used by the family to communicate with family members inside the
house, and to the community.
8. Control #: a number or a series of number and letters assigned to a family respondent in the survey. It Is the
same number to represent the family in the masterlist and in the spotmap, and the number to be written on survey
stickers.
9. Family structure: indicate structure as to nuclear, extended type etc. In terms of decision-making, we use
matriarchal or patriarchal types.
Demographic Table
10. Family Member number (first column of the demographic table) – each family member is assigned a number
starting with 1 for the head , 2 for the spouse, and so on consecutively for the children and other members of the
household.
11. Name of members: write the names of all members and the rest of the family not currently present in the house
but affect resource generation and use. Write the surname first, hen the given name. In the case of the wife, indicate
her maiden name. in extended households, group members by family. If several members with the same surname
are listed, no need to write the surname for the succeeding members.
12. Relationship to the head: indicate the relationship of members to the head (wife, son, daughter, etc.)
17. Religion – indicate religion for each family member. Note: in case of children (0-14), they assume the mother’s
religion as articulated in the Family Code of the Philippines. Indicate religious sect
18. Highest educational attainment: refers only to the highest level completed in the regular and formal system of
education, i.e. elementary, high school and collegiate education. Excluded are attendance in nursery and
kindergarten schools and in purely vocational courses such as dressmaking and carpentry.
Enter only the last level of education completed and not the one the person is in at the time of assessment. For
elementary, write EU (elementary undergraduate) or EG (for elementary graduate), HU (high school
undergraduate), HG (high school graduate), CU (college undergraduate), CG (college graduate/ degree holder,
write the degree), and GS (for those who completed graduate studies).
Write NONE if the person is over 7 years old and has not gone to school. Leave the column blank for children below
7 years old.
19. Educational status – (particularly those who are 7-20 y/o who are expected to be currently studying) indicate status
for each member of the family. Indicate whether he/she is:
- PS: presently studying and highest completed level: Pido Dido CS- grade 5
- OSY: had stopped studying and highest completed level: : Pedro Penduko Had Stopped- 2nd year high
school
- No formal education – has never had any formal education (elementary, high school, college)
Literacy Rate – in the Philippines, persons aged 15 years old and above who are unable to read AND write are considered
illiterates.
Literacy rate = # ppl 15 y.o. and above who can read AND write x 100
# ppl aged 15 and above
20. Occupational status: target respondents are the members in their economically productive age (15-64 y/o). Indicate
whether a member is E (employed or working for an employer with a job that corresponds to the level of education attained),
UE (under-employed or working for an employer with a job that is lower, labor-oriented and not corresponding to the level
of education attained), or X (unemployed, no occupation)
21. Type of work: indicate the nature of work the person is engaged in
22. Other sources of income: refers to the nature or type of livelihood sources of income or passive sources of income
(like revenues from leased apartments, farmland rents, pension, etc) other than the occupation
23. Total monthly income of each earning member: the sum of his/ her monthly salary from occupation and other sources
of income; net monthly income of each member in peso. If the member is waged, get the average monthly total income by
multiplying the daily salary to the number of days of work.
24. Total family monthly income: sum of incomes of all members. It will be gauged with the poverty threshold of worth
P10,000 for a family of 5 members or P2000 per member per month. This is done to identify who among the families are
“financially poor” or below threshold.
25. Land/ house ownership: indicate the ownership of the house and/or land. Check “owned” if the house and/or land is
owned by the family. Check “rented” if they do not own the house and land, and they rent it. Check “rent-free”, if they do not
own the house/land but they are allowed by the owner to live in the place. And check “rent-to-own” if they are paying monthly
mortgage but in a specified period of paying time, the title of the house and/or land will be given to them as owners.
26. Type of construction materials used: indicate the materials used to build the house. Light materials refer to houses
mainly built with wood, galvanized iron, bamboo, nipa, cogon, carton, plywood, lawanit, and plastic materials. Strong
materials refer to houses primarily made of cement, solid beam foundations and sturdy materials. Mixed types involve
combination of light and strong materials.
27. Crowding Index: is described by dividing the number of persons in a household with the number of rooms used by the
family for sleeping. The “room used for sleeping” may not necessarily be a room. In some cases, families use the kitchen
or the bathroom as sleeping area. In that example, the kitchen or bathroom will be counted as a room used for sleeping. A
high crowding index gives implication to the ease by which a communicable disease will be transmitted from one host to
another susceptible host in a household.
28. Prioritization of expenditures: The family’s monthly expenditures should be ranked according to their budget
allocation. It will reflect how much the family is willing to spend on health care, and what items occupy most of the family’s
budget allocation. Predetermined items for expenditure are already listed like food, (budget for food, food allowance, drinking
water, milk etc) shelter/housing (rent or mortgage, funds for house modification and maintenance, land tax and rents etc),
clothing (basic apparel/ clothing, school uniforms, etc), education (tuition fees, school expenses) utilities (water, electricity,
internet, cable, phone line, business-related bills, etc) health savings/ healthcare, (insurance payments, health cards,
personal emergency health savings, funds for medicines and vitamins, and funds for medical and dental consultation and
services) and other expenses not yet mentioned should be indicated and ranked based on priority.
29. Resources allotted for healthcare: refers to available resources the family can use for routine health maintenance
and monitoring, or in an event of illness or emergency health situations/ hospitalizations. It can be in the form of pension
from government or non-government system, cash or fund in the form of HMO/ medical insurance. Examples are SSS,
GSIS, PhilHealth etc. check the option “none” if there is no resource allotted for health.
30. Communication network necessary for disseminating health information or facilitate referral: refers to methods
used by the family to access health information and announcements from the health center, or refer a family member to
health institutions. For the purpose of the study, there are 2 types: formal and informal. Formal channels refer to downward,
vertical or horizontal communication of the family to the health institution or health authorities. Some examples are general
assembly, memorandum/bulletin announcement, flyers etc. On the other hand, informal communication refers to grapevine,
or indefinitely directed communication in the form of gossip.
31. Transportation system used to access health care facilities (health center, clinics, nearest hospital): refers to
method of transportation and road networks used by the family to get to health institutions. Accessibility of a facility should
pass 3 criteria: first, it should be within 5 km radius from the farthest house in the community; second, it should have
established road networks; third, there should be means of transportation going to the facility, like terminals PUVs. private
vehicle. Some predetermined answers include jeepney, tricycle, bus, barangay service/ shuttle. Other answers should be
specified.
32. Perception of a healthy person: the respondent will be asked of his/her main perception and idea of what a healthy
person is or how a healthy person should look or behave like. Some predetermined answers are placed in the survey tool,
depending on the characteristic of a healthy person the respondent will give. But the possible answers should be further
categorized into: physically healthy, emotionally healthy, mentally healthy, spiritually healthy and absence of disease.
33. Perception of what causes illnesses: refers to their belief of primary cause of disease. Some predetermined answer
are placed in the survey tool but is also further categorized based on the ecologic triad: biological, physical, chemical,
mechanical and nutritive. Other answers must be specified and categorized for ease and validity of collation
34. First person consulted in times of illness: refers to the first person approached by the family in an event of illness.
This bears significance on the succeeding interventions done to the ill member and expertise of the person consulted.
Categories of responses are further categorized into: healthcare professionals and allies, non-professionals or non-
healthcare persons, and none (if the family is not consulting anybody)
35. Medications taken during illness: identify whether or not the medications taken are advised by authorized healthcare
personnel, specifically the doctor/ physician, or not advised/ self medication/ over-the-counter.
36. Source of water supply: refers to source of water of the family. It can be categorized into:
Level I (point source) - a protected well or a developed spring with an outlet but without a distribution
system, generally adaptable for rural areas where the houses are thinly scattered. A Level I facility
normally serves an average of 15 households. Farthest household not more 25O meters
Level II (communal faucet system or standposts) - a system composed of a source, a reservoir, a piped
distribution network, and communal faucets. Usually, one faucet serves 4 to 6 households. Generally
suitable for rural and urban fringe areas where houses are clustered densely to justify a simple piped system.
Should not be located more than 25 meters from the farthest house
Level III (waterworks system or individual house connections) - a system with a source, a reservoir, a
piped distribution network and household taps. It is generally suited for densely populated urban areas. Ex
Nawasa, Maynilad
37. Sanitation method of drinking water: refers to ways of making water potable. Some of the accepted methods are
listed
Boiling
safest and surest way
should be boiled for at least 2 minutes more after reaching boiling point of 100 degree celsius to kill all
vegetative bacteria, viruses, fungi
at least 2 minutes is minimum suitable time of boiling water for low level locations and an additional 1 minute
per 1000m additional elevation. (water boils at higher temp at high altitude)
Filtration
done before boiling or disinfecting
common household filters used in the Phils : sand filters, cloth filters, intermittent water filter
Sedimentation
impurities in water are allowed to settle at the bottom of the container for 30 minutes - 1 hr and pouring the
top part in a new clean container without creating turbulence
Flocculation and sedimentation
use of aluminum sulfate (tawas) to form precipitates of the impurities found in the turbid water and allowing
them to settle at the bottom of the container
Aeration
transferring water from one container to another or by stirring water to create turbulence which in most
cases, remove objectionable attributes
Chemical disinfection:
Chlorination – normal dose= 1.5 mg / L
Disinfection – use of tincture of iodine – 2 drops / L
Buying commercially prepared water
38. % Population served by daily garbage collection system: indicate the frequency of garbage collection in the house
of the family.
Refuse – a general term applied to solid / semisolid waste materials other than human excreta
Garbage – left over vegetables, animal and fish material from kitchen / food establishments. These have the tendency to
decay and give off foul odors and sometimes serve as food for flies, rats, etc
42. Morbidity: refers to incidence of disease in a community. It can be computed by getting the prevalence and incidence
rates. For ease in data collection, reports of illness in the family will be limited to 1 year period (ex: Aug 1 2010 – Aug 1
2011). Family members who got ill during this period will be asked for the diagnosis of the physician and treatment, or, if
not checked by the physician, signs and symptoms. Data from community sources like the health center can also yield
details about leading causes of morbidity in adults and children.
43. Mortality: refers to the incidence of deaths in a community. For ease in data collection, reports of death/s in the family
will be limited to 1 year period (ex: Aug 1 2010 – Aug 1 2011). Family members who died during this period will be asked
for the underlying cause of death according to the death certificate.
44. Nutritional status of children 0-6 years old: Get the height and weight of all children 0-6 y/o and classify nutrition
status by comparing it with Filipino children weight-for-height table from the Nutrition Program of DOH (FNRI)*. The
nutritional status will be classified according to normal, mildly underweight, moderately underweight, severely underweight,
and overweight. Risk factors for malnutrition will also be assessed. Identified risk factors such as food threshold*, vitamin A
supplementation, iodized salt utilization, low birth weight, and regularity of intake of protein, carbohydrates and
micronutrients.
45. Health center programs, awareness and utilization: refers to which health programs given in the health center are
known to the family and are being utilized. It has a big impact on identifying the degree of participation and access of people
to services and programs.
46. Maternal and child care: upon identification of pregnant members of the family, the following information should be
completed
C. EDC/ EDD: expected date of delivery is calculated using standard method (LMP – 3 months + 7 days); done to screen
pregnant women approaching EDD who does not have prenatal check-up
D. Prenatal check up: at least 1 for 1st trimester, at least 2 if on 2nd trimester, at least 3 if on 3rd trimester, at least 4 if
approaching EDC. If the pregnant woman is complete with prenatal check-ups depending on her AOG, check “with”.
Otherwise, check “without”.
E. Tetanus Toxoid immunization: standards and schedule of TT immunization applies to all pregnant women (refer to
Public Health Nursing by Cuevas et al). For ease in data gathering and collation in this study, a pregnant woman who has
at least 1 TT dose (except for G1P0 with AOG of less than 5 months) will be considered “with” vaccination. If a pregnant
woman does not have at least 1 TT dose (except for G1P0 with AOG of less than 5 months) will be considered “without”
vaccination.
47. Risk Factor Assessment for High Risk Pregnancy: all pregnant women included in the survey will be screened if
there is high risk pregnancy by identifying who among them falls in at least 1 of the risk factors:
a. age below 18 or 34 y/o and above
b. weight of below 100 lbs, or obese (pregnancy BMI of 30 and above)
c. height of under 5 ft.
d. previous stillbirth, miscarriage/ abortion, preterm labor and/or delivery, small-for-gestational age baby,
large baby, pre-eclampsia or eclampsia
e. hypertension
f. diabetes
g. thyroid problem
h. more than 3 previous pregnancies
i. With preexisting illness: heart disease, AIDS, asthma, cancer, kidney disease, autoimmune disease, TB,
STD and other infections
j. Smoker (smokes at least 1 stick of cigarette per day, everyday), exposed to second hand smoking(at
least 1 household member is an active smoker), alcoholic (at least 1 bottle of beer, or 4 tbsp of hard liquor
per day, everyday) Taking illegal drugs (marijuana, methamphetamines, LSD, narcotics and other illicit
drugs)
48. Utilization of Family Planning Methods: (Applicable to married or common law women ages 15-44 y/o, and married or common
law men of all ages; answers should be per individual) for target individuals, identify whether the individual is an acceptor (using
at least 1 family planning method) or non-acceptor (not using any family planning method). Classify the type of family
planning method used (natural, artificial and permanent) (refer to Public Health Nursing by Cuevas et al) and write the specific
method/s used.
49. Immunization status of children 0-12 months of age: to determine who among the infants are fully immunized
(complete immunization from BCG to AMV), completely immunized (received complete immunization according to his/her
age in weeks/months), incompletely immunized (children below 9 months who missed at least 1 dose of immunization
depending on his/her age in weeks/months, or infants 12 months old who missed at least 1 dose of any immunization
belonging in EPI), and those who have no immunization at all. It is important to correctly identify the age of the baby in
weeks.
50. Recognition of authority (political/ leadership pattern or action potential): the first person consulted/ sought for
assistance or help in an event of a problem or dispute in the community is identified. It has its significance on methods of
settling disputes, formality of power structure and existence of significant people affecting decision-making in the
community other than the officials.
51. Utilization of barangay programs and services: upon identification of the programs, projects and services existing/
delivered in the barangay, identify who among the families are aware of the program but not utilizing or participating,
those who are aware of the program and utilizing/ participating, and those who are not aware or not utilizing the program.
The family must not be given any idea on the list of programs delivered in the barangay to accurately determine their
knowledge of the programs and services catered.
52. Conditions/ issues/ events that cause social conflicts/ upheavals: refers to situations, events, conditions or
issues which lead to social conflicts or disputes. Ask the family member to identify 1 situation.
53. Conditions that lead to social bonding/ unification: refers to events/ conditions which lead to, or promote unity,
cooperation and bonding among community people. Ask the family to identify 1 event.
54. Practices/ approaches effective in settling issues and concerns within the community: inquire on their
perception of the most effective approach used by the barangay in settling issues and concerns. Ask them to identify 1.
55. Perceived problems in the community: ask the respondents about their perception of the main problem in the
community. Ask them to identify 1.
56. Perceived solutions: ask the respondents about their perception of the solution to the main problem they have
identified. Ask them to identify 1.
57. Total Population: identify total population of the community, whether by census or according to existing records of
previous censuses or population projection. Knowing the population size allows the nurse to make comparisons about
population changes over time. It also helps her rationalize the types of health programs or interventions which are going to
be provided for the community. Identify the proportion of the population included in the study with the total population to
get the % coverage.
58. Population density: determines how congested a place is and provides implications in terms of the adequacy of
basic health services present in the community (refer to Nursing Practice in the Community 5th edition by Dr. Maglaya)
59. Urban-rural index: illustrates the proportion of the people living in urban compared to the rural areas (refer to Nursing
Practice in the Community 5th edition by Dr. Maglaya)
60. Household Size: in this study, household size will mean family size, since families are the basis of counting, and not
households. It has its impact on allocation of resources and prioritization.
61. Age and Sex Composition (represented by a population pyramid and the following indicators)
62. Population Pyramid: graphical presentation (frequency polygon) of the age and sex composition of the population.
Trends in population of children can be seen on the shape of the base of the pyramid and trends in death and geriatric
population can be seen on the shape of the apex of the pyramid. Trends in population growth of economically productive
age group can be described by the length of the bars corresponding to population of ages 15-64 y/o. and trends in
population growth of reproductive age can be seen on the length of bars corresponding to age – sex group females 15-44
y/o. The shape (type) and the slopes of the pyramid should also be described. The following indicators are associated
with the type and slope of the population pyramid:
63. Sex Ratio: comparison of number of males to number of females (number of males for every 100 females)
64. Growth Rate: determining the extent or % of population increase from births and deaths (natural increase, rate of
natural increase) and even migration (absolute increase, relative increase)
65. CBR (crude birth rate): number of livebirths for every 1000 population
66. GFR (general fertility rate): also called “true measure of fertility”; number of livebirths for every 1000 females 15-44
y/o
67. CDR (crude death rate): number of deaths for every 1000 population
68. In and out migration: refers to addition in population due to in-migration and reduction in population due to out-
migration. For this study, out-migration will not be of top priority. In-migration can be associated with the number of
“transient” residents in the time of data gathering.
69. Median age: the age that divides the population into two equal parts; it has to be compared with the median age of
the country to identify whether the population is younger or older than the national trend: Lcb + {[(n/2) - <cf] w}/f
70. Life expectancy at birth: the expected longevity of people assuming that the environment and circumstances remain
constant. For this study, the short method will be used (get the average of the ages of deceased males/ females).
71. Dependency ratio: number of dependent (people of ages 0-14 y/o and 65 y/o and above) for every 100 people
belonging to the economically productive age (15-64 y/o)
72. Proportion of salaried and wage earners to total economically active population:
No. of people 15-64 y/o who are currently salaried or wage earners X 100
No. of people 15-64y/o who are not salaried/waged and has no income
74. Land areas that contribute to vector problems: notable locations contributing to vector problems (stagnant
drainage, cracks on pavements, vacant lot etc)
75. Land usage in industry: pertains to distribution of land for different purposes; % land used for agricultural and crop
industry, % land used for residential purposes, % land used for call center industry, etc.
77. Maternal mortality: maternal deaths due to pregnancy, delivery and puerpuerium
78. Categories of health manpower available – health manpower refers to number of nurses, doctors, midwives, dentist,
medical technicians, BNS (Barangay Nutrition Scholar), BHWs and trained hilots (mga nagpapaanak) who are serving the
community and their corresponding time of availability
79. Geographical distribution of health manpower – how health manpower is distributed within the community
80. Manpower-population ratio – nurse-population ratio, doctor-population ratio (Refer to DOH book for their
recommendations)
Rural Health Physician = 1:20,000
Public Health Nurse = 1:20,000
Rural Health Midwife = 1:5,000
Rural Health Inspector = 1:20,000
Rural Health Dentist = 1:50,000
81. Distribution of health manpower according to health facilities – how health manpower is distributed to various
community health facilities (brgy health center, hospital, Rural Health Units etc.); Distribution of health manpower
according to type of organizations (government, non-government, health units, private)
82. Quality of health manpower – description or background information (training, seminars attended, extent of
experience etc.) of all available health manpower the community has.
83. Existing manpower development/ policies – Trainings, seminars that are conducted for manpower
development. Manpower related policies implemented in the community (tasks, rules and regulations etc.)
84. Health budget and expenditures: refers to budget allotment of community for health (c/o Kagawad for Health)
85. Formal power structures: with officially delegated and/or elected leaders
86. Informal- leaders considered out of legal mechanism
Reminders:
No two communities are exactly the same, so do not expect that the tools provided will be excellent for all
communities. Modifications can be made. Data to be gathered depends on the information acquired during
community profiling.
Risk factor assessment will depend on the leading cause of morbidity and mortality identified.
References:
Nursing Practice in the Community. 4th ed., Maglaya. AS. etal., Nangka, Marikina City. Argonauta Corp.
Public Health Nursing by Cuevas et al
Community Health Nursing Service in the Philippines (DOH), Reyala, JP etal. National League of Government Nurses. 2000.
Community Nursing in Developing Countries. Byrne, M. Great Britain. Oxford University Press, 1986.
Human Ecology and Public Health. Kilbourne, E. Toronto, Canada. Macmillan Company, 1993.
Module on Proper Excreta Disposal. NTTC Learning Resource Unit.
The Nurses’ Role In Safeguarding the Human Environment. International Council of Nurses. Geneva, Switzerland, 1986.
Various official websites of the following : DOH, DOLE, NSO
Personal communication with Ms. Maglaya