Yesterday Ugat ng Kalusugan carried out a mini-survey in Barangay Bagong Silang. Our purposes were two-fold: we wanted to test out our community health survey, and we wanted to get more information on one purok (area) of Bagong Silang because it is a possible site for our work.
Bagong Silang is a sea-front community with around 5,000 people – a third of whom are Cuyunon (a native group in Palawan), a third who are Bisaya (migrants from the Visayas) and a third Badjao. The Badjao are a traditionally marginalized group, looked down upon by non-Badjaos even in Islamic areas. Badjaos tend to be very poor and uneducated and are frequently beggars. The majority of the non-Badjao men are fishermen, and women either sell fish at the market, work at the local department store, NCCC, or stay at home. Some children go to school but many do not. Average families in Bagong Silang have four or more children – a bit above the national average. The average age for a first child is 19 but there are also mothers as young as 14 or 15 – particularly among the Badjaos. To read more about Bagong Silang, click here.
The results of our survey are summarized below. Before sharing these, there are several caveats. These survey results are not representative of the whole Barangay. We only interviewed women from nine different households, and only households in the Catholic portion of the community. We employed convenience or accidental sampling – a type of nonprobability sampling wherein the sample (interviewees) are selected from the general population because they are readily available and convenient. There is an added bias to the group we interviewed: they were all mothers whose children under five years of age were receiving their regular deworming and vitamin supplements distributed by the barangay health workers. We opted to accompany the barangay health workers as they went from home to home so they could provide an introduction for us to meet women within the community. Because our sample is comprised of women whose children are being cared for by the health workers, it is important to remember that they and their children are likely much healthier and better off than their counterparts who do not access any health professionals or receive any free medicine. We do hope to accompany the health workers again when they do their medicine distributions among the Badjao population of Bagong Silang.
While we cannot make any generalizations about the community based on our survey results, the results do offer some insights into this community, and we found some of the results interesting.
We interviewed nine women ranging in age from 20 to 51.
We asked the women we interviewed if they practice family planning. Two women answered that they do not use any family planning. One did not explain why, and the other said she does not use anything because she doesn’t have a husband — but she does have a two year old son.
The great majority of women do use some form of family planning. Two use natural methods (withdrawal and calendar method), three use pills, one uses an IUD and one used DMPA (Depo Provera). Of the women using artificial forms of family planning, only one pays for the medicine herself – the others rely on receiving them for free at the Barangay Health Center.
All of the women we spoke with think that the ideal number of children is between two and three. Just over half of the interviewees have the same number of children as this ideal, or one less child. Of the rest of the women, two reported having five children — and they explained that they really wanted to have a baby girl, so they kept trying beyond the ideal number they desired. One woman with six children reported achieving her ideal of two or three children — but did so with several different partners (!) One woman with five children said she had definitely wanted less children, but the five “had just happened”. She was one of the women who reported using contraception when it was given away for free.
All but one of the women we interviewed had prenatal check ups with their last pregnancy. Of those women who did get check ups, only one woman saw a doctor regularly from her first month of pregnancy until giving birth. The rest of the women saw a health professional between 2 and 4 times throughout their pregnancy.
When asked what type of health professional they consult when they or their children are sick, seven of the women answered that they consult doctors, three consult Barangay Health Workers, two consult a manghihilot (traditional healer), and one consults a nurse.
When asked what type of birth attendant they prefer, six stated doctors, two like nurses, and two women prefer midwives. One of the interviewees reported that for her last birth, she called a nurse to come but ended up having to give birth with a manghihilot (traditional healer) because the nurse got stuck in traffic and didn’t make it in time.
When asked where they prefer to give birth, two of the women listed their home and the local health center as places that would be ok, but 100% of the interviewees said that their first choice would be to give birth in a hospital. When asked why, most reasoned that a hospital setting is safest because there, they could have access to doctors and to any special equipment should there be any problems or complications with delivery. We did not ask the respondents where they did in fact give birth to their children, and will include this question in the next iteration of the survey.
Of the women we spoke with, only three had seen a health professional for a postnatal check up after their last pregnancy. None of the others had heard of the need for postnatal visits.
Beliefs about Family Planning
We asked the women we spoke with about their thoughts or beliefs relating to family planning. The following are some of their statements:
“I wanted to get a ligation but my blood pressure was
too high. So we just use the withdrawal method.
I don’t want to do pills or get the injectable type of
contraception – I heard those can lead to tumors.”
“You really should just have the right number of kids -
otherwise life will be full of hardship.”
“If your family is small, you’ll be able to satisfy the
needs of your family and be true to your beliefs.”
“It’s really hard to feed your family when you have too many children.”
“It’s good to plan your pregnancies because it is too hard
when the children come one right after another!”
“Life is very hard when you have too many children.”
Beliefs about Pregnancy
We asked the interviewees about beliefs they have regarding pregnancy. A few women answered that one should not drink or smoke while pregnant, and that one should always go for check ups and get a lot of sleep. We also heard the beliefs that a pregnant woman should never eat eggplant (no explanation) or drink cold water because that might make the baby get too big. Several women also said that a pregnant woman should wear black panties at night so that monsters or evil spirits will not be able to find the baby and harm it.
All the children of the mothers we interviewed were up to date with their immunizations – or will complete them shortly (for babies under 1). These immunizations include BCG (Bacille Calmette-Guérin – a vaccine against tuberculosis), three doses of DPT (DPT refers to a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis [whooping cough] and tetanus), three Hepatitis shots, and three doses of the Polio vaccine. These results are probably not typical. It is important to remember that the women we interviewed were the mothers of children receiving medicine from the Barangay Health Workers. There is a bias here – these children are receiving care from the health center and thus are more likely to have completed all the requisite immunizations. If we were to randomly sample families within the community, we might not find 100% compliance with these immunizations.
Finances and Employment
One woman’s monthly household income is P500-1,500 ($11-$32.) Another’s is P1,501-3,000 ($33-64.) Three women reported a monthly household income of P3,001-4,500 ($64-$97.) Another’s is P6,000-7,500 ($129-$161.) The wealthiest of the women represented had a monthly household income of PhP10,500-12,000 ($226-$258.) One of the women has no income and is being supported by her parents. Another woman had a monthly income of PhP1,500-2,000 ($32-$43) when her husband was alive, but he passed away last month and she and her two children are now being supported by her sister.
Only three of the women we spoke with are currently employed. One is a Barangay Health Counselor (and is the woman with the highest monthly household income), another takes care of pigs and another sells fish at the local market. One woman does laundry for her neighbors but does not have regular clients and sometimes has no work. Of the rest of the women without work, two expressed the desire to work if it was something they could do at home so they could care for their young children. Another respondent would like to be a saleslady and two expressed the desire for any kind of work – becoming a maid, a laundry washer, participating in a buy and sell scheme (like Avon) or anything else.
None of the children were receiving regular supplemental feeding, but a few of the children occasionally get some extra food from special feeding programs that the Barangay Health Center sometimes has funding for.
None of the families receive any regular support from any groups, but some have sometimes been able to avail of medical services or food from medical mission trips carried out by both foreign and local groups.