research protocol- group 15 revised
TRANSCRIPT
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De La Salle Health Sciences Institute- College of MedicineDepartment of Family and Community Medicine
Comparison of Malnutrition among Institutionalizedand Non-Institutionalized Children in Paco, Manila as
determined by Body Mass Index
Research Protocol2nd year, Sec. B, Group 15
Matel, Ma. CarolinaNazareno, Christine
Panghulan, Aldee RayParao, AngeloReyes, Kevin
Sampelo, Ma. CarmelaTee, Jan Raemon
Preceptor:
Josephine M. Carnate M.D., MPHNovember 8, 2011
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INTRODUCTION
Research Question
Is the prevalence of malnutrition generally higher in institutionalized children in
orphanages compared to non-institutionalized children in Paco, Manila during the year
2011
Research Hypothesis
The prevalence of malnutrition is generally higher in institutionalized children
compared to non-institutionalized children. There is a direct relationship between the
childrens environment (socio-economic and demographic factors such as location and
condition of household, presence or absence of biological parents) and their nutrition
status.
Background of the Study
Malnutrition has long been recognized as a consequence of poverty. It is widely
accepted that higher rates of malnutrition will be found in areas with chronic widespread
poverty [1]. Malnutrition is believed to be caused by marginal dietary intake, combined
with infection. In turn, malnutrition is an interplay of household food insecurity, lack of
clean water, lack of knowledge on good sanitation, and lack of alternative sources of
income. It is also compounded by inadequate care, gender inequality, poor health
services, and poor environment. Measures of child nutritional status can help capture
certain aspects of welfare, such as distribution within the household which are not
adequately reflected in other indicators. Child malnutrition standards are applicable
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across cultures and ethnicities. Studies have proven that the relationship between child
nutritional status and poverty is more evident at the lower bracket of the income range
[2].
Based on the study of the International Food Policy Research Institute, there are
exactly fours strong determinants to malnutrition in 63 developing countries. The four,
ranked by their strength of impact, are women's education, national food availability,
womens status relative to men's, and health environment quality [3]. Recent studies have
also pointed out those women who were malnourished as children are more likely to give
birth to low birth-weight children and thus there is an intergenerational effect of child
malnutrition.
RESEARCH OBJECTIVES
General Objective
To be able to compare the prevalence of malnutrition among institutionalized
children in orphanages and non-institutionalized children located in Paco, Manila during
the year 2011.
Specific Objectives
To determine the body mass index (BMI) of institutionalized children in
orphanages and non-institutionalized children.
To compare the Body Mass Index (BMI) of institutionalized children in
orphanages and non-institutionalized children.
To correlate the absence or presence of biological parents to the frequency
of malnutrition among institutionalized children in orphanages and non-
institutionalized children.
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REVIEW OF RELATED LITERATURE
Epidemiology of Disease Interest
It was estimated that nearly 30% of infants, children, adolescents, adults and
elderly in the developing world are suffering from one or more of the multiple forms of
malnutrition[4]. About 20 million children under five years old worldwide are severely
malnourished, which leaves them more vulnerable to illness and early death. Nearly 10
million children under the age of five die every year, more than 1,000 every hour[5].
Almost all of these children could survive and thrive with access to simple, affordable
interventions. These children could survive and escape death if they are given access even
to the simplest and most affordable interventions. Our country today is suffering from
poverty, and thus children belonging to the lower class are the ones who are severely
affected.
Malnourished Filipino Children
Underweight and under height are two of the parameters that are considered in
malnutrition. A number of Filipino children who were underweight and under height or
stunted increased from the year 2005 to 2008. The prevalence of underweight children
aged 0-5 years increased from 24.6% to 26.2%, about 3.35 million children. The rate of
children who are under height increased from 26.3% to 27.9%, representing 3.57 million
children. There was also a significant increase in the prevalence of underweight children
aged 6-10 years from 22.8% in 2005 to 25.6% in 2008, which is equivalent to 2.6 million.
The number of under height children in this age group likewise increased from 32% to
33.1%. A very high level of acute malnutrition among preschoolers (aged 0-5) was noted
in six regions, namely Mimaropa, Bicol, Western Visayas, Eastern Visayas, Zamboanga
Peninsula and Soccsksargen where the underweight-for-age prevalence was at least 30%.
Chronic malnutrition affected a very high percentage of preschoolers in the provinces of
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Masbate, Biliran, Northern Samar, Western Samar, ZamboangaSibugay, Sarangani, Abra
and Mountain Province. About 30% of Manila's 50,000-75,000 street children are
estimated to be moderately or severely malnourished. According to international
standards, both male and female were seriously underweight (lowest 8%) and underheight
(lowest 2.5%).
Malnourished Institutionalized Children
49% of the 10.4 million deaths occurring in children below 5 years of age in
developing countries are linked with protein-energy malnutrition[5]. Although this kind
of malnutrition occurs more frequently in low-income countries, several children from
higher-income countries (Children from large urban areas and low socio-economic status,
children with chronic disease, and children who are institutionalized) are also affected.
Orphans represent an important sector in any society, because they are mostly
children in crucial phases of physical and mental growth, so they need special nutritional
and health care with guidance. Another study reported that the nutritional status of
orphans in Sana'a was miserable, especially when it was compared with that of orphans in
different countries[6]. 75% of the children were found to be underweight, and 37 %
severely so. The prevalence of wasting, which indicates acute or current malnutrition was
27%. 12% of children suffered from moderate or severe wasting. Some 74% of children
suffered from stunted growth, and 40% were moderately or severely stunted.
All of these percents were mainly higher in the Al-Aitam orphanage, and boys
were particularly affected. The study also found that 12% of orphans were anemic. The
percentage was higher in boys, at 13%, whereas only 8% of girls were anemic. Also, Al-
Aitam Orphanage had the highest percentage of anemics, at 14%, compared with just 8%
in the Al-Rahmaa Orphanage.
http://opinion.inquirer.net/inquireropinion/talkofthetown/view/20100724-282969/Malnutrition-among-Filipino-kids-uphttp://opinion.inquirer.net/inquireropinion/talkofthetown/view/20100724-282969/Malnutrition-among-Filipino-kids-uphttp://opinion.inquirer.net/inquireropinion/talkofthetown/view/20100724-282969/Malnutrition-among-Filipino-kids-uphttp://opinion.inquirer.net/inquireropinion/talkofthetown/view/20100724-282969/Malnutrition-among-Filipino-kids-up -
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In another study comparing institutionalized children and children living in a
permanent household, institutionalized children have significantly lower height & weight
percentiles[7]. Institutionalized children have significantly lower weight for age and
height for age measurements (P 0.05). Using the CPC RCMAS and the DAPT, the scores
of institutionalized children were inferior to those of the domiciled children (P 0.05).
Epidemiology of exposure/ factor of interest
Risk Factors of the Disease (Possible Confounding Variables)
In the Philippines poverty and pervasive malnutrition are not limited to families
of deprived seasonal workers. Undernourishment is endemic and increasing throughout
most of this archipelago of some 7,107 islands, and is compounded by the prevalence of
intestinal parasites and gastrointestinal diseases which health workers estimate deprive
youngsters of at least 5-10% of the nutritional value in food they do consume. This
problem is particularly prevalent in rural villages and city slums where many people eat
with their fingers. Philippine National Nutrition Survey provides benchmarks to gauge
the countrys progress toward achieving the Millennium Development Goals, including
the eradication of hunger, reduction of child mortality and improvement of maternal
health.
Infectious diseases, especially the intestinal parasites, affect a high rate of
children in orphanages in 3rd world countries. Entamoebahistolytica was the most
common intestinal parasite affecting orphans, especially boys[7]. Such habits facilitate
more infections that lead to nutritional problems. Crowded orphanages facilitate
transmission of those infections. Lack of frequent health assessments and programs that
can discover and track the orphans nutritional and infectious problems in early stages
make them more exposed to disease. The inability of orphanages to cover the expenses
of proper food and medical treatments also makes children vulnerable.
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stunted growth due to malnutrition, and 33 of 100 among the age group 1119 are
underweight.
Having established that the nutritional status of children depends on the kind of
care they receive (from the kind of care mothers receive while pregnantmaternal care
programsto vitamin supplementation, information sharing, and others), this should be
continuously pursued. Since breastfeeding is vital to infant nutrition, massive information
campaign on its benefits and proper practice should be continued. Incentives for
breastfeeding may likewise be offered to ensure that conducive and safe breastfeeding
places, for both mother and infant, are available in areas they frequent such as hospitals
and malls. Since mothers are crucial in effective infant-feeding practices, vital
information should be made available to them. A widespread program providing better
access to water and sanitary facilities should be launched as these have a major effect on
malnutrition. In the Philippines, DOHs FHSIS reports that in 2007, 85.7% of households
have access to safe water, and 77.5% of households have sanitary toilet facilities.
NUTRITIONAL STATUS OF FILIPINO SCHOOL-AGE CHILDREN
AMONG DIFFERENT INCOME GROUPS
There are disparities in the nutritional status of our school-age children across
income groups there are more underweight, stunted, anemic, and iodine deficient in the
lower income groups, and more overweight in the higher/highest income groups
.
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Majority have normal nutritional status, at least 6 out of 10 children have either normal
weight-for-age, height-for-age, or weight-for-height, or not anemic; and 9 out of 10 are
not iodine deficient. But at least 3 out of 10 children have poor nutritional status (either
low weight-for-age, low height-for-age or are anemic, compromising these childrens
development potential).
Are orphans at increased risk of malnutrition in Malawi?
The nutritional statuses and health problems of village orphans, non-orphans, and
orphanage children were compared by a cross-sectional study conducted in three
orphanages and two villages near Blantyre, Malawi. Seventy-six orphanage children, 137
village orphans and 80 village non-orphans were recruited. It was reported that children
below 5 years of age manifested the prevalence of undernutrition, with 54.8% compated
to village orphans and non-orphans with 33.3% and 30%, respectively. Another
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significant finding was that 64% of young orphanage children experienced stunted growth
compared with 50% of village orphans and 46.4% non-orphans. Conversely, older
orphanage children (age equivalent to 5 years old and above) were less stundted and
wasted than orphans and non-orphans in villages. Illness of children in the last month
was reported to be higher in the non-orphan group, especially diarrhoeal disease, which
occurred in 30% compared with 10.8% of village orphans and 6.6% of orphanage
children. More than three children in a family being cared for by guardians was
significantly associated with undernutrition. Children who had been admitted to an
orphanage for more than a year were less malnourished. In village orphans, there was no
association between undernutrition and duration of stay in extended families. Age and
education of guardians were not associated with the nutritional status of children.
Young orphanage children are more likely to be undernourished and more stunted
than village children and older orphanage children seem to have better nutrition than
village orphans [12]. There was no significant difference in nutritional status between
village orphans and non-orphans.
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CONCEPTUAL FRAMEWORK
Non-institutionalized
children
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METHODOLOGY
Research Design
Operational definition of variables:
Dependent variable
In this study, the prevalence of malnutrition would be the dependent variable.
This variable would be determined using BMI. Values less than 18.5 is regarded as
underweight while a BMI value greater than 25 is considered overweight and above
30 is considered obese.as set by WHO.
Independent variables
The independent variables in this particular study would be either being an
institutionalized child or being a non-institutionalized child. Institutionalized children
for this matter will be defined as those living in the orphanages for at least 6 months.
Non-institutionalized children are those who are living in a permanent residence with
either or both biological parents.
Confounding variables
Confounding variables include age, sex, lifestyle,diet, environment and
physical activity.
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Research Design:
Type of study to be employed
A cross-sectional type of study will be utilized to identify the relationship
between being in an orphanage and/or being in a non-institutionalized child and the
prevalence of malnutrition.
Definition of study population/study groups and source of subjects
Children, both male and female, ages 6 to 10 would be the target subjects of
this study. They will be randomly selected from a study population which will come
from an orphanage in Paco, Manila (for the representatives of the Institutionalized
children). To represent non-institutionalized children, the areas within the vicinity of
the orphanage will be surveyed to build the sample population. This is done to
eliminate any factors and variables which may affect the outcome of the study like
the availability of certain food groups, environmental hazards, degree of pollution et
cetera.
Steps to be undertaken/ Procedure to be followed
The samples from the aforementioned locations would be randomly
numbered and selected using a randomizer (table of random numbers or automated
random number generator) to eliminate selection bias. The heights and weights
would be determined using a standard balance and height meter respectively. Survey
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questionnaires would also be given out to the parents and care takers of the
orphanages. The data gathered from the questionnaires would be sorted, analyzed and
by statistics association of the risk factors involved in acquiring malnutrition for the
institutionalized and non-institutionalized children would be done.
Schematic Diagram of the Research Design
Biases/Limitations
Much consideration had been given to the selection of the ages from 6 to 10
primarily which is the facilitation of the measuring of the heights and weights to
determine accurate Body-mass indices. This range has also the advantage of being
able to confirm and validate certain information from the survey questionnaires which
in most cases will be answered by the parents or care takers of the orphanage.
Likewise, the degree of cooperation tends to increase from ages 6 and up. Therefore
the study was decided to be limited to this age range. Another limitation to this study
is the inability of the researchers to determine and eliminate confounders like inherent
defects in metabolism which may significantly affect the outcome of the study.
Likewise, the difficulty of defining and determining factors such as crowding limits
Institutionalized
Children
and Non-
institutionalized
Children
Randomly selected
children ages 6-10
Street Child (+)malnutrition
Street Child (-)malnutrition
Institutionalized Child (+)malnutrition
Institutionalized Child (-)malnutrition
Non-institutionalizedChild (+) malnutrition
Non-institutionalizedChild (-) malnutrition
Institutionalized Child (+)
malnutrition
Institutionalized Child (-)malnutrition
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the study to some extent. Other quantitative determinants of malnutrition will also not
be included in this study which will solely rely on BMI data to report malnutrition.
The extent of association between the availability of some food groups, presence of
pollution and other variables would not be discussed intensively but their individual
possible contribution to malnutrition would be thoroughly discussed.
Selection bias may follow the tendency of the researchers to opt for
malnourish-looking individuals in hopes of generating a large sample population with
a very high percentage of positive malnutrition. This will be circumvented by using
random selection of samples from the representative population.
Study Population
The focus of this study is the population of Non-institutionalized children and
Institutionalized children in Paco, Manila.
Sample population
An orphanage is chosen by location as approved by Esperanza C. Gutierrez, the
president of the Associacion de Damas Filipinas, Inc. Settlement Homes in Paco,
Manila. Through simple random sampling 50 children (the sample population) will be
selectedusing the inclusion criteria: (1) is a Filipino citizen; (2) ages between 6-10
years old; (3) has stayed in the orphanage for at least 6 months. For the sampling of
non-institutionalized children, selection will be based following these criteria: (1) a
child whom either parents has a source of income; (2) reside within 5 km radius of the
named orphanage; (3) ages between 6-10 years old. Exclusion criteria for both
samples include; the child has pre-existing and/or an illness during selection; has no
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consent from the parents or guardian as well as the childs consent if he/she is 7-10
years of age.
Sampling frame
A list of all the names of the orphans in Associacion de Damas
Filipinas, Inc. Settlement Homes in Paco, Manila staying, at the least, since March
2011 as certified by the administration of the aforementioned orphanage. For the non-
institutionalized children, a list will be generated through the local barangay registry.
Sampling Unit
This will be taken from the study population, Filipino orphans,
ages 6-10, from AssociaciondeDamas Filipinas, Inc. Settlement Homes, who stayed
for at least 6 months(Institutionalized children). For non-institutionalized children,
Filipinos ages 6-10 living within a 5 km radius from the orphanage will be selected.
Elementary Unit
Filipino orphans, ages 6-10, from Associacion de Damas Filipinas,
Inc. Settlement Homes, who stayed for at least 6 months(Institutionalized children).
For non-institutionalized children, Filipinos ages 6-10 living within a 3 km radius.
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Selections
Subjects
The target population of the study is the institutionalized and non-
institutionalized children in Paco, Manila. Since the population is relatively
homogenous for the orphanage, simple random sampling will be used and
randomization will be achieved via computer generated random numbers. This will be
done to avoid selection bias which may arise. For the non-institutionalized children
population, which is heterogenous, stratified random sampling will be conducted.
Sampling Design
The study that will be done is a cross-sectional type. The
population is relatively homogenous for the orphanage therefore, simple random
sampling will be used and randomization will be achieved via computer generated
random numbers. This will be done to avoid selection bias which may arise. For the
non-institutionalized children population, which is heterogenous, stratified random
sampling will be conducted.
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Definition of the Variables used in Data Collection
p1
The p1 variable is the estimate of the sample population for
orphans located within the vicinity of the subject orphanage who are malnourished.
The value that will be used for this study is 54.8% as taken from the literature
reviewed. The value for p1 was obtained from the journal article Are Orphans At
Increased Risk of Malnutrition in Malawi? by Annals of Tropical Paediatrics:
International Child Health, Volume 19, Number 3, 1 September 1999, pp. 279-285(7),
in which the statistical value is 54.8% in favour of institutionalized children.
p2
The p2 variable is the estimate for the sample population of non-institutionalized
children located within the vicinity of the subject orphanage who are malnourished.
The value that would be used is 24.6 which was taken from the study conducted by
the Philippines Food and Nutrition Research Institute (FNRI) as published in the
Philippines Midterm Progress Report on the Millennium Development Goals.
Alpha
Alpha () is the probability of committing Type I error in which
the null hypothesis is rejected when it is true. In this study, is the probability of
rejecting the claim stating that the percentage of malnutrition among the non-
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institutionalized children and institutionalized children is the same, when in fact, it is
true. A 90% confidence interval will be used, hence is 0.1.
Beta
Beta () is the probability of committing Type II error or failing to
reject the null hypothesis. In this study, is the probability of failing to reject the
claim that the percentage of malnutrition among non-institutionalized children is the
same among institutionalized children. The power of the study is 80%, therefore is
0.20.
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Direction of the test
The study is a two-tailed test. The critical region is split into two
parts. The null hypothesis states that there is no association between being a non-
institutionalized children and malnutrition if the value that will be obtained is greater
or lesser than that of the alternative hypothesis. The alternative hypothesis states that
there is an association between being a non-institutionalized children and malnutrition.
VALUES OF THE VARIABLES FOR CALCULATIONS
Variables Values
p1 54.8%
p2 24.6%
Alpha 0.10
Beta 0.20
SAMPLE SIZE COMPUTATION
A cross-sectional analytic study regarding the relationship of malnutrition
between institutionalized and non-institutionalized children in Paco, Manila will be
conducted. The percent of malnutrition of unexposed with outcome, which are the
non-institutionalized children is 24.6%, while the percent of exposed with outcome,
which are the institutionalized children is 54.8%. At a confidence level of 90% and a
power of 80%, 38 institutionalized children and 38 non-institutionalized children will
be selected randomly to obtain a sample size of 76 Filipino children, ages 6-10.
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VARIABLES AND DATA TO BE COLLECTED
Weight Values
One(1) Platform type weighing scale will be used to obtain the weight of each
subject. Only one researcher will be allowed to measure the weight of the subject at
the same time of the day for accurate and precise data collection. Each subject will be
asked to remove his or her footwear and make sure there is nothing on his or her
pocket. Have the child or teen remove shoes and heavy clothing, such as
sweaters.Have the subject stand with both feet in the center of the scale. Record the
weight to the nearest decimal fraction. The set of data will be obtained using a will be
recorded with the KILOGRAM unit.
Height Values
Same platform type of weighing scale with height rod will be used. Only one
researcher will be allowed to measure the height of the each subject. The subject will
be asked to remove his footwear, bulky clothing, and hair ornaments, and to unbraid
hair that interferes with the measurement. Have the subject stand with feet flat,
together, and against height rod. Make sure legs are straight, arms are at sides, and
shoulders are level. Make sure the child is looking straight ahead and that the line of
sight is parallel with the floor. Use a flat headpiece to form a right angle with the
height rod and lower the headpiece until it firmly touches the crown of the head.
Lightly mark where the bottom of the headpiece meets the height rod. Accurately
record the height to the nearest 1/8th inch or 0.1 centimeter.
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BMI Values
This set of data will be obtained by dividing the weight values obtained (in kg)
over the square of the height values obtained (m2) and will have a final unit of kg/m2.
Values less than 18.5 and greater than 25 will be considered as positive disease cases
(malnutrition).
Method for elimination of confounding variables
The frequency of malnutrition may be influenced by several factors other than
the childrens environment, which pertains to having a proper shelter and guidance
from their biological parents. These other factors, which we call confounding
variables, include the childrens age, sex, and their physical activity. In order to
eliminate these confounding variables, an interview with the help of a standardized
questionnaire will be carried out prior to collection of height and weight. This will
elicit information regarding these variables and will determine if the participant is
qualified to participate in this study. Since the participants are not of the legal age,
their guardian will be the representative or informant for the interview.
There will be separate questionnaires for the institutionalized children and
non-institutionalized children. The initial questions in the said interview will comprise
of the childrens general data such as their name, age, sex, address or location of the
childrens shelter, name of guardian or family members present in the household and
their salary per day to obtain their socio-economic status. Then, the representative of
the participants will be asked several questions regarding their lifestyle and daily
activities from the time they wake up in the morning until the time they go to bed.
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Further on, they will be asked about their daily diet, which pertains to the quality and
quantity of food they usually consume and the frequency of food consumption per
day, if it is once, twice, or thrice a day.
If the children do not qualify the aforementioned criteria, with the age range of
6- 10 years old, residing within the 5 km radius of the chosen orphanage for non-
institutionalized children, duration of stay of 6 or more months inside the orphanage,
then the particular participant will not qualify as one of the participants in the study.
Method for data collection
For the purpose of this study, Observation by making use of equipment and
tools is the preferred method for data collection. Specifically, the use of standardized
and calibrated platform type of weighing scale with height rod will be used for taking
weight and height measurements respectively.
This method was chosen over other data collection methods primarily because
the key element in this study is the determination of BODY MASS INDEX to
determine the nutritional status of the subjects. This data is quantifiable and
measurable by using the height and weight measurements of the subjects. While it can
be argued that observing the physical appearance, behaviour and characteristics of the
subject may be used as a method for nutritional status determination, it is very much
prone to subjective bias from the observers and will not give accurate results unlike
the proposed method of data collection. The same reason holds true in justifying
observation using equipment and tools as choice for data collection over Focus Group
Discussion and Questionnaires/interview which will not give appropriate and
quantified results.
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Data Collection Tool
1. Letter of Consent for the Participation of Institutionalized Children
De LaSalle Health Sciences Institute
College of Medicine
Mrs. Esperanza C. Gutierrez
President
Associacion de Damas Filipinas, Inc.
Settlement Homes
Paco, Manila
Maam
Good day!
We are second year medical students from De La Salle Health Sciences Institute,
Dasmarinas City, Cavite. As part of our course requirement in Community Medicine 2,
we are conducting a comparative study on the nutritional status among institutionalizedand non-institutionalized children. For the former category, we will specifically be
assessing those children living in the orphanages.
In light of this, we would like to ask permission from your good office to allow us
to conduct our study in your institution. Aside from the assessment of nutritional status,our study will also include analysis on the factors which affect the nutrition and health
status of street and institutionalized children. We believe that this study would be able
to provide you with valuable input during your general improvement planning for the
institution and we would be very glad to share the results of our study with you. We alsoassure you that we will only use information necessary for the study and any sensitiveand other data concerning the children and the institution will not be published. Allinformation obtained shall be limited for the purpose of the study ONLY and access to the
files shall be restricted to the research team. Documents will be stored in a concealed
envelope which is only accessible to the research team. Once the research process is
completed all files will be destroyed. Do understand that this is a nonprofit study and that nomonetary compensation would be handed out. You will also be asked to sign a consent form,
which contains the details of the data collection method, for each of the participants (76 in
total, 38 of which will be coming from your institution). Likewise, we are very much open
to discussing these important terms with you if you deem it necessary to do so.
Should you agree to the terms discussed above, kindly affix your signature at thebottom of this page.
We are looking forward to meeting and working with you regarding this study
and it is hoped and prayed for that you would grant us permission to do so. Thank you
and may our good Lord bless you more.
Thank you for your kind consideration.
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Conformed :
___________________________________
Mrs. Esperanza C. Gutierrez
Sincerely yours,
__________________
Angelo Parao
Noted by:
___________________________
Josephine M. Carnate, MD, MPH
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2. Consent Form (for Parents/Guardians of Institutionalized and Non-
institutionalized children)
Magandang araw!
Kami ay mga estudyante ng medisina sa De La Salle Health Sciences Institute at
kasalukuyang nagsasagawa ng pag-aaral ukol sa pagkokompara ng malnutrisyon sa mgabatang nakatira kasama ang kanilang mga magulang at mga batang nasa bahay-
ampunan sa Paco, Manila para sa taong kasalukuyan.
Layunin ng pagaaral na ito na malaman ang body-mass index (relasyon ng timbang sa
taas ng isang indibidwal) ng mga batang mga batang nakatira kasama ang kanilang mgamagulang at mga batang nasa bahay ampunan. Titingnan din ng pagaaral na ito ang ilang
salik sa kadalasan ng pagkakaroon ng malnutrisyon katulad ng pagkakaroon ngmagulang o guardian. Random sampling ang gagamitin sa pagkuha ng mga partisipante. Sakabuuan, 76 na kalahok ang kakailanganin sa pag-aaral na ito : 38 na bata mula sa ampunan at
38 na nakatira kasama ang kanilang magulang.
Bagaman walang tulong na pinansyal ang pagsusuring ito, makakadagdag naman ito samga panibagong impormasyon at kaalaman ng buong lipunan. Sa kadahalinanang ito,
nais naming hingin ang inyong tulong sa pagsagot ng ilang mga simpleng katanungan.Bibigyan naming kayo ng 5 hanggang 10 minuto upang sagutan ang mga tanong na ito.
Kung mayroon kayong hindi maintindihan maaari lamang na pakilapitan ang mga
researchers na nagbihay sa inyo ng papel na naglalaman ng mga tanong.
Nais ng mga researchers linawin na maaring tumanggi na sumailalim sa pagsali sapagaaral o pagsusuri ng nasabing paksa.
Sa pagsagot ng mga tanong dito, inyo pong kinukumpirma na maliwanag at nauunawaan
ninyo na:
- Boluntaryo ang inyong pagsagot sa mga katanungan at sumasangayon kayo na
sumali sa pagaaral na ito ng walang kapalit na tulong pinansyal.
- Na nauunawaan nyo na mananatiling lihim ang mga maseselang impormasyon
na hindi naman kailangan sa pagaaral na ito. At ang anumang ibinahagi nyo ay
para lamang sa kaalaman ng mga researchers at para sa pagaaral na ito at hindi
isasapubliko
-
Sa pagkuha ng timbang, isang uri ng Platform Weighing Scale ang gagamitin upangmakuha ang bigat ng bawat bata. Isang researcher lamang ang pinapayagan upang
masukat ang timbang ng bawat bata sa parehong oras ng araw para sa wasto at
tumpak na pangongolekta ng datos. Ang bawat bata ay pakikiusapan na alisin ang
kanyang tsinelas o sapatos at siguraduhin na walang laman ang kanyang bulsa.
Dagdag pa dito, pakikiusapan din na alisin ang mga mabibigat na damit tulad ng
jacket, sweaters, atbp. Sa pagsusukat ng timbang, ang bata ay patatayuin sa parehong
mga paa sa gitna ng timbangan saka irerekord ang bigat ng bawat bata.
- Sa pagkuha ng taas o tangkad ng bawat bata, parehong uri ng Platform Weighing Scal
ang gagamitin. Ang bata ay muling pakikiusapan na alisin ang kanyang tsinelas,
malalaking damit, mga ipit o burloloy sa buhok nito na makakasagabal sa pagsusukat.
Ang bata ay patatayuin sa nasabing platform at titiyaking ang binti ay tuwid, braso ay
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nasa gilid at balikat ay pantay. Sa pagrerekord ng datos, mamarkahan kung saan ang
pinakamlapit na sukat.
- Sumasang ayon din kayo bilang magulang o guardian ng isa sa mga batang
kukuhanin naming ng timbang na ipagamit ang datos ukol sa timbang, bigat at
iba pang kailangang impormasyon. Kayo din ay nagbibigay pahintulot sa mga
researchers na gawin ang mga kailangang pamamaraan upang makuha ang
sukat ng mga ito .
________________________
Lagda
Maraming salamat sa inyong pagtulong at pakikibahagi sa pagaaral na ito!
Sumasainyo,
__________________________________
Angelo E. Parao, Researcher
Contact number : (0926)680-8970
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3. Questionnaire
De La Salle Health Scineces Institute- College of Medicine- Community Medicine 2
MGA KATANUNGAN
Pangalan ng Anak/ Inaalagaan : _________________
Edad ng bata:_____
Kasarian ng bata : ______________
Pakilagyan ng tsek ang item/mga item na sa tingin nyo ay pinakamahusay na sumasagot
sa katanungan
1. Ano po ang malimit nyong kainin sa pang araw-araw? (Maaaring lagyan ng tsekang ISA HANGGANG TATLONG pagpipilian sa baba)
[ ] Manok [ ] Kanin [ ] Tinapay
[ ] Baboy [ ] Noodles [ ] Pampalasa (Asin,toyo, ketchup)
[ ] Isda [ ] Prutas [ ] Sabaw
[ ] Gulay [ ] De Lata [ ] Iba pa : _____________________ (pakisulat)
2. Ano ang nagdedetermina ng pagpili nyo ng ihahanda bilang pagkain ?
( Pumili lamang ng dalawa)
[ ] Kung ano ang kaya ng pera
[ ] Kung ano ang mura pero masustansya para sa bata
[ ] Kahit mahal ang presyo basta masustansya para sa bata[ ] Kung ano ang malapit bilihin
[ ] Kung ano ang mas nakakabusog (mabigat sa tyan )[ ] Kung ano ang masarap.[ ] Iba pa _________________________ (pakisulat)
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4. Assent Form ( for Children seven years old and above )
P A H I N T U L O T
Ako si _________________, ____ taong gulang ay nagbibigay pahintulot na gamitin ang mgaimpormasyon ukol sa aking timbang, taas at ilan pang bagay na kakailanganin sa pag-aaral na ito.
Naunawaan ko ang kahalagahan at naisin ng pag-aaral na ito at ako ay sumasang-ayon na maging
kabahagi ng pagsasaliksik na ito. Ako ay hindi pinilit na maging kalahok nito at ako ay nagbibigay
ng pahintulot na gawin nila ang kinakailangan (katulad ng pagtanggal ng damit pang-itaas) upang
makakuha ng wastong sukat ng timbang at taas. Nauunawaan ko din na ang pagtanggi ko dito ay
hindi makakaapekto sa akin o sa aking pamilya at wala itong maidudulot na anumang
kapahamakan.
Bagaman walang tulong na pinansyal ang pagsusuring ito, makakadagdag naman ito sa
mga panibagong impormasyon at kaalaman ng buong lipunan. Sa kadahalinanang ito, nais
naming hingin ang inyong tulong sa pagsagot ng ilang mga simpleng katanungan. Bibigyan
naming kayo ng 5 hanggang 10 minuto upang sagutan ang mga tanong na ito. Kung mayroon
kayong hindi maintindihan maaari lamang na pakilapitan ang mga researchers na nagbihay sa
inyo ng papel na naglalaman ng mga tanong.
Nais ng mga researchers linawin na maaring tumanggi na sumailalim sa pagsali sa pagaaral o
pagsusuri ng nasabing paksa.
Sa pagsagot ng mga tanong dito, inyo pong kinukumpirma na maliwanag at nauunawaan ninyo
na:
- Boluntaryo ang inyong pagsagot sa mga katanungan at sumasangayon kayo na sumali sapagaaral na ito ng walang kapalit na tulong pinansyal.
- Na nauunawaan nyo na mananatiling lihim ang mga maseselang impormasyon na hindinaman kailangan sa pagaaral na ito. At ang anumang ibinahagi nyo ay para lamang sa
kaalaman ng mga researchers at para sa pagaaral na ito at hindi isasapubliko
- Sa pagkuha ng timbang, isang uri ng Platform Weighing Scale ang gagamitin upang
makuha ang bigat ng bawat bata. Isang researcher lamang ang pinapayagan upangmasukat ang timbang ng bawat bata sa parehong oras ng araw para sa wasto at tumpak
na pangongolekta ng datos. Ang bawat bata ay pakikiusapan na alisin ang kanyang
tsinelas o sapatos at siguraduhin na walang laman ang kanyang bulsa. Dagdag pa dito,
pakikiusapan din na alisin ang mga mabibigat na damit tulad ng jacket, sweaters, atbp.
Sa pagsusukat ng timbang, ang bata ay patatayuin sa parehong mga paa sa gitna ng
timbangan saka irerekord ang bigat ng bawat bata.
- Sa pagkuha ng taas o tangkad ng bawat bata, parehong uri ng Platform Weighing Scal anggagamitin. Ang bata ay muling pakikiusapan na alisin ang kanyang tsinelas, malalaking
damit, mga ipit o burloloy sa buhok nito na makakasagabal sa pagsusukat. Ang bata ay
patatayuin sa nasabing platform at titiyaking ang binti ay tuwid, braso ay nasa gilid at
balikat ay pantay. Sa pagrerekord ng datos, mamarkahan kung saan ang pinakamlapit na
sukat.
- Sumasang ayon din ako na kukuhanin ang aking ng timbang at taas bilang datos ukol sa
kailangang impormasyon. Ako din ay nagbibigay pahintulot sa mga researchers na gawin
ang mga kailangang pamamaraan upang makuha ang sukat ng mga ito .
________________________
Lagada ng kalahok
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5. Mass Index Determination Sheet