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High Prevalence of Individuals with Uncontrolled Hypertension

Approximately 1.13 billion people are diagnosed with hypertension worldwide. In the year 2015, one in four men (1 in 4) and one in five (1 in 5) women had hypertension, while less than one in five people have the problem under control. The Philippines is no exception to this persistent problem as it remains to be the leading cause of mortality and morbidity in the country. Over twelve million people are burdened with this disease yet more than half are still unaware of their condition. Barangay Bag-Ong Dalaguete, a home to approximately four hundred seventeen (417) individuals is not spared by this disease. Based on the initial house-to-house survey, 12.73% are identified as Pre hypertensives (35 of 275), while 17 individuals were already diagnosed with hypertension, 12 out 17 (70.59%) have uncontrolled hypertension and admitted to be non-compliant to their maintenance medications.

To increase the number of controlled hypertensives from 17% to 90% in Barangay Bag-ong Dalaguete, Mahayag, Zamboanga del Sur by the year 2020.

Goal:

CUES:
1. Lack of programs and strategies against hypertension in the barangay level.
2. Lack of training experiences and/or seminars of the barangay health worker in proper monitoring and referral of hypertensive individuals.
3. 12.73% (35 out of 275 adults) of the total population were identified to be pre-hypertensives.
4. 6.18% 17 out of 275 adult individuals are identified hypertensives.
5. Among the identified hypertensive individuals, 70.59% (12 out of 17 hypertensives) have uncontrolled hypertension.
6. Among the identified hypertensive individuals, only 47.06% (8 out of 17 hypertensives) are enrolled to the local hypertension club
7. Absence of monitoring and referral system for hypertensive clients at the barangay level.
8. 61% of the population are identified cigarette smokers
9. 64% of the population indulge in alcoholic beverage drinking.

Specific objectives:

1. Identification of target hypertensive individuals and BP monitoring

2. Formulation of strategic plan with the community leaders to ensure their cooperation in finding solutions to manage hypertension.

3. Increase knowledge and awareness of community residents regarding hypertension, importance of medication compliance and healthy lifestyle promotion

4. Strengthening of the referral system of hypertensive clients in collaboration with the Rural Health Unit and local hospital

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Accomplishments and Updates

Update as of 2020

Progress of Hypertensive Residents in Barangay Bag-Ong Dalaguete, Mahayag, Zamboanga del Sur. 

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Specific objective 1: Identification of target hypertensive individuals and its monitoring with in the community population.

"Identification of Hypertensive Individuals"

Beginning the community exposure since 2016, several health problems were identified but the one that directly hit home was the high incidence of uncontrolled hypertensive individuals that was found after a series of assessment linked to poor diet and lifestyle practices and even more so with poor health seeking behaviors. The team came up with a community health plan targeting different aspects to solve this health problem and the factors that contribute to it.

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"Mass Diagnosis & Enrollment of Hypertensive individual to RHU's Hypertension Club"

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The team reassess and monitor hypertensive individuals through house-to-house survey and mass assembly every 6 months to assess & evaluate improvement of their blood pressure status and to enroll newly identified hypertensives in the community. 

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For the past four years, at least once every community exposure the team has sought to it that we monitor all hypertensive individuals. We see to it that we assess all individuals that are above 18 years old. We have visited every household for a minimum of 7 times, we have conducted house-to-house surveys, monitoring, and announcements more or less than 10 times. We are welcomed by it’s individuals that we see our selves as part of the community.

"Reassessment and monitoring of Hypertensive Individuals"

Specific objective 2: Formulate strategic plan with the community leaders to ensure their cooperation in finding solutions to manage hypertension.

"Empowering Community: Oplan Bantay Presyon Program"

To empower the community and hypertensive individuals to take charge of their health, the team created a Hypertension monitoring team composed of BHW, Kagawad for health, and selected wiling community residents who are also hypertensives to be part of Hypertensive Monitoring Team. 

BP Patrollers Series of Training 2018, 2019 & 2020

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"DETECT - PROTECT - CORRECT"

Return Demontration additional training of BP Patrollers

The team conducted another series of training and return demonstration for additional BP Patrollers in the community. In this event, a Focus Group Discussion on the topics listed below were also discussed.

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Training of additional volunteers for BP taking. In line with one of our community health problems of “High Prevalence of Uncontrolled Hypertensives”, our team envisions a self sustained community, able to move independently and is knowledgeable on what to look for and do next when it comes to hypertension. When left alone our active volunteers are able to take and monitor your blood pressure, they also know when and whom they should refer to in special cases like hypertensive urgencies and of the sorts. ALTAPRESYON, AKSYUNAN. 💊💉

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"Turn Over of BP Apparatus to each Purok BP Patrollers"

As part of the team’s solution in tackling the problem of hypertension, for sustainability we created and taught a health monitoring team skills on BP taking, assessment and hypertension referral. These independent skills will be left with the community even after we have left the community and have graduated. BP Apparatuses were also turned over to each purok patrollers for monitoring of blood pressure of each purok constituents. 

Specific objective 3: Increase knowledge and awareness of community residents regarding hypertension, importance of medication compliance and healthy lifestyle promotion

"Health Education Series"

The team conducted another series of health education activities to augment or correct the knowledge of community residents as well as to raise awareness of hypertension, importance of medication compliance and healthy lifestyle promotion.

Evaluation of Knowledge: Pre & Post Testing

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Lecture and Interactive discussion on Hypertension and its effects, risk factors, prevention by living a healthy lifestyle with accompanying proper diet, management and control, importance of medication compliance and identification of complications related to hypertension

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The high incidence of uncontrolled hypertensive individuals is not only the problem of those who have hypertension but everyone who are at risk to have it, making the whole community a part of the solution to the problem. With this, for every mass assembly we see to it that we can impart health education to the people. We impart knowledge and solutions from a medical, individual and community perspective. Solving a problem involves several factors to be addressed and with the right knowledge on how to prevent a problem leads to a conclusion that there may not be a need to solve a problem that will not be there.

"Mass Diagnosis of Hypertension & Arthritis (Dec. 2019)"

Working hand in hand with our Rural Health Unit headed by our MHO Dr. Wilson Lumapas to help in early detection, and to enroll our hypertensive patients in Hypertensive Club for monthly supply of maintenance medication and for continuous health education activities.

Thank you Doc and Mahayag RHU for your continuous support to our community!

"Meds & BP Monitoring Booklet Distribution"

To improve the monitoring and medication compliance of the diagnosed hypertensive patients, the team created a self monitoring booklet for our community. The contents were based on Philpen. Aside from booklet, we also provided ginger powder "salabat" to our community residents. 

"Ensure Availability of Anti-hypertensive medications"

All identified hypertensives were enrolled to the Rural Health Unit's Hypertension and Diabetes club of the Municipal. All enrolled individuals are given monthly supply of medication which is turned over to the community nurse or Kagawad for health. Our heartfelt gratitude to our Munipal Health Officer, Dr. Wilson Lumapas and his team!

"Establishment of 5 BP Stations"

Establishment of BP stations “BP Patrol Program” headed by the hypertension monitoring group living in the most accessible area per purok. They were given BP apps and monitoring logbooks

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The team imparted hypertension monitoring booklets, BP apparatuses, and set up BP stations found in each purok in the barangay for easy accessibility in monitoring those with hypertension or assessing those with similar symptoms. The team aims to make Bag-Ong Dalaguete an independent community taking the lead in taking care of their own health. Empowering the people, empowers the community.

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"Construction of Walk-in Digital BP Outlet"

To increase compliance of people and to empower them to place health within their hands, the team together with the community build a BP cabinet which consists of digital bp apparatus, logbook and pamphlets headed by the very own "panday" carpenter of Dalaguete, Mr. Marciano Gilbolingo. 

The BP cabinets were installed into a strategic place "Sari - Sari Store" where residents can rest and check their blood pressure on their own. Residents will have to record their BP into the logbooks found in the cabinet. 

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Installation of BP Cabinets in 5 Puroks

"Hypertension Jar Banks"

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As part of the Hypertension Community Health Plan, the team adapted this concept from our seniors' burus bank.

While with available medication at the moment, hypertensives will continuosly and religiously deposit coins in preparation for the time that when hypertensive medications are out of stock from the local health unit. Instead of stopping to take their maintenance medication, they will be able to buy their own medication with their hard earned money. Prioritizing their health, prioritizing their life.

1 peso for 30 days = ₱30 or;

5 pesos for 30 days = ₱150 or;

10 pesos for 30 days = ₱300

For a peso a day, you keep yourself insured for medication instead of stopping when it runs out of supply.

For a peso a day you keep yourself away from spending for complications or hospitalizations after chronic hypertension.

According to transferwise, Healthcare in the Philippines: A guide to the Filipino healthcare system

One night hospital stay is worth ₱2,500

Emergency Room visit is around ₱2,500

Doctor's office visit is at ₱500

Instead of spending so much for treatment we can spend little by little with prevention.

#ProteksyonLabanAltapresyon

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"IHATAW ISAYAW, ZUMBA SESSIONS"

Ihataw Isayaw! 💃🏻🕺

Purok 3 is a hilly rolling area where you have to cross 5 mountains before you reach the barangay's center (barrio hall) making it difficult for the residents to access activities despite their enthusiasm.

Team Dalaguete is Bringing our activities closer to the reach of people. 👫

The community that dances together, stays  healthy together

...continuation

Purok 1, 2, 4 and 5 are also getting their bodies moving to the beat!

Sinong magaakalang hypertensives ang mga participants na ito. ♥️

#ForAHealthierDalaguete

Another day to beat the dancefloor! But first, warm ups and BP taking was conducted, followed by dispensing of medications.