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SENTRONG SIGLA: A FORMATIVE ASSESSMENT STUDY
AND PROGRAM IMPLEMENTATION REVIEW

Project Director:      Exaltacion E. Lamberte
Funding Agency:    United States Agency for International Development

The project sought to a) review the process of Sentrong Sigla Program implementation; b) determine the perceptions of key stakeholders (Department of Health and regional program personnel, provincial/city and municipal level health service providers, community leaders, clients/households); c) ascertain the results and effects, gaps and problems in program implementation, taking into consideration the stakeholders’ perspectives; and d) map out recommendations to enhance SSM implementation at the national and local levels.

Data collection strategies for the study were a) client exit interviews; b) structured interviews with respondents; c) structured observation guided by a checklist instrument; and d) use of secondary data available in the facility and the community.  Five groups of respondents are sought for the study: clients and households (women of reproductive age, 15 to 49 years old, married, single, or living in consensual union); local government officials (mayor, councilor on health, planning and development officer, barangay officials); health service providers (health officers, nurses, midwives, sanitary inspectors, and barangay health workers); Department of Health personnel (regional and provincial levels); and NGOs and community-based private organizations.

The study covered the provinces of Cagayan and Camarines Sur in Luzon, Negros Oriental and Leyte in Visayas, and South Cotabato and Maguindanao in Mindanao, as well as Pasay City, Caloocan City, and Las Piñas City in the National Capital Region.

Key words: Sentrong Sigla program, Department of Health, women of reproductive age, health service providers, local government officials 

 

REVIEW OF SELECTED INITIATIVES IN THE PHILIPPINES FOR IMPROVING QUALITY OF PRIMARY HEALTH CARE
Project Director:          Exaltacion E. Lamberte
Funding Agency:        World Health Organization

As early as the 1990s, the Department of Health introduced quality service improvement initiatives in some areas of the country. The implementation of some of the program’s efforts has been completed, while others are ongoing. This project aimed to address the information gap with regard to the adequacy of the documentation of these efforts.  A scientifically directed research and documentation of the efforts and local experiences of public health service agencies in bringing about an improved quality of health care service provision was undertaken.  An in-depth analysis on the experiences and struggles of the local health organizations that have experiences in implementing quality improvement initiatives was conducted. The analysis centered on: (1) whether or not QA initiatives have been sustained, and what factors have been found to contribute to the continued implementation of the QA initiatives; (2) whether other agencies or the local health organization have built upon their previous experiences with the end goal of pursuing further quality improvement efforts; (3) the workable/useful indicators and methods being used to monitor progress and improvement quality efforts; and (4) the action and strategies undertaken to overcome obstacles and difficulties encountered while in the process of implementing the program.

The project concluded that while there are many types of quality initiatives implemented in the country, no clear QA management approach is discernible.  The prospects for acceptance and success of quality improvement activities are favorable in the light of the enthusiasm and willingness shown by the local health managers and frontline service providers to introduce quality improvement initiatives in their respective local health facilities.  Ability of the health service providers to withstand difficulties and come up with a creative solution to address existing bottlenecks is a plus factor to the promotion of the program. However, motivating service providers and sustaining the activities remain a challenge to quality management efforts. 

Key words: quality service improvement initiatives, public health service agencies, local health managers, frontline service providers

 

ASSESSMENT OF QUALITY OF FAMILY PLANNING COUNSELING   
Project Director:          Exaltacion E. Lamberte
Funding Agency:        Johns Hopkins University Population/Communication Services                                            

The project aimed to: a) conduct an inventory of studies done on the quality of FP counseling service provision in the Philippines; b) assess the actual performance of the FP counseling service provision in the service delivery points, taking into consideration the viewpoints of the clients, health service providers, and their supervisors and community leaders; c) identify the strengths, weaknesses and gaps in FP counseling service provision performance; and d) make recommendations to strengthen the performance of the FP counseling provision.

The study used both qualitative and quantitative research designs to assess in-depth the quality of client participation and provider performance in reproductive health interpersonal communication and family planning counseling. This assessment process entailed seeking views from different stakeholders—namely, the clients, service providers, health managers, local government units and other stakeholders of family planning in both government and private service delivery points.

The sampling considered the level of performance of the areas and the clinics as well. It consisted of two private/NGO FP clinics and two public health centers in each of two selected cities from the four major geographical regions, namely Luzon, Visayas, Mindanao and National Capital Region. The research areas are as follows: For Luzon: Rizal and Pampanga; for Visayas: Tacloban and Bacolod; for Mindanao: Butuan and Davao; and for NCR: Pasay and Quezon City.

The data gathering process commenced in July 2002, utilizing various strategies to capture all information relevant to the study, namely: a) conduct of stakeholder meetings; b) face-to-face interviews with FP providers and supervisors/program coordinators; c) observation and audio-taping of actual FP counseling, utilizing the Quick Investigation of Quality (QIQ); d) exit client interviews; and e) face-to-face interviews with the non-clients/households represented by women of reproductive age. 

Key words: family planning counseling, reproductive health, service delivery, qualitative and quantitative research design, client participation and provider performance

 

ORIENTATION AND TRAINING FOR LEADERSHIP AND ADVOCACY
IN RESEARCH AND DEVELOPMENT

Project Director:          Exaltacion E. Lamberte
Funding Agency:        Department of Health

An orientation and training for leadership and advocacy in research and development was held for the research staff and coordinators of the Department of Health’s central office and centers for health and development from March 18 to 20 and March 20 to 22, 2002.  Two batches of participants attended the sessions held at the Charles Huang Conference Center in Batulao, Batangas.

The orientation and training had two-pronged goals:  First, to update the research and development coordinators on the present research-related institutional processes and management mechanisms of the DOH; and second, to upgrade the research perspective and skills of the participants.

Key words: research and development, institutional processes, management mechanisms

 

MAPPING AND TRACKING POVERTY THROUGH THE USE
OF NON-INCOME POVERTY AND WELFARE MEASURES

Project Director:          Exaltacion E. Lamberte
Funding Agency:        National Statistics Office

The study envisioned a measure that would proximate income as a gauge of poverty.  It was methodological in nature. It had two components:  a) combining the 1997 Family Income and Expenditure Survey (FIES) and the 1998 and 1999 Annual Poverty Indicators Survey (APIS) to track improvement in poverty and welfare status in the Philippines using a priori measures; and b) developing improved non-income poverty measures and welfare indicators.

The general objectives of the study were to a) map the poverty and welfare situation in the Philippines using a priori non-income poverty and welfare measures within and across time, with a focus on geographic location and type of households (based on size); b) ascertain the changes in poverty and welfare status among the panel survey household respondents across time and across regions/provinces; c) construct sensitive, parsimonious, and reliable non-income poverty and welfare measures as well as indices; d) ascertain the content domain distinction between non-income poverty measures and welfare indicators; e) map poverty and welfare status within and across time using empirically developed and constructed non-income poverty and welfare indices; f) recommend empirically established sound measures that may be used in mapping and monitoring poverty and welfare status of Filipinos across time; and g) recommend policy and program of action strategies for poverty reduction efforts.

The research made use of the data generated from the following nationwide surveys and census: a) the 1998 and 1999 APIS, which is a survey initiated by the National Statistics Office with support from the World Bank and the United Nations Development Program (UNDP); and b) the 1997 FIES, which is a survey that the NSO conducts every three years to gather data for the Philippines’ official poverty estimates.

The research combined and integrated these data sets meaningfully, and consequently analyzes them in accordance with the above-mentioned objectives.

Key words: non-income poverty measures, welfare status, poverty reduction efforts, Philippine census

 

PUBLICATION OF “INTEGRATING DOMESTIC FAMILY VIOLENCE ISSUES
IN THE NURSING CURRICULUM”

Project Director:          Pilar Ramos-Jimenez
Funding Agency:        The Ford Foundation

Silliman University, through its College of Nursing and Allied Health Sciences, in cooperation with SDRC’s Task Force on Social Science and Reproductive Health, prepared a series of learning modules in Domestic Family Violence to be included in the BS Nursing curriculum.  The overall goal of the project was to develop cultural, gender sensitive and compassionate students with effective communication and counseling skills.  Specific competencies to be developed are 1) understanding the roots of violence in the context of culture, gender, and other social aspects; and 2) identification of high-risk family/domestic violence cases/situations for a) primary interventions, particularly collaborating/networking with other professionals; and b) secondary interventions, especially crisis management such as the identification of victims of violence, understanding basic legal procedures, and preservation of evidence and referrals.

Ten learning modules were prepared as guides for self-directed learning.  Each student is encouraged to study the different lessons and learning activities before they are taken up in the classroom.  Each learning module has an accompanying teacher’s guide, designed to help the teacher in creatively facilitating the learning of key concepts and also the enrichment of the learning activities.

The ten modules were designed to be integrated in the different subjects common to the nursing curriculum in the Philippines.  Learning modules for three subjects in general education—Culture and Society, the Philosophy of the Human Person, and Philippine Government and Constitution—were prepared. The rest of the learning modules were to be used in the subjects taken only by nursing students.

It has been recommended that some tasks be undertaken to ensure that the learning modules provide the skills necessary to improve health services for survivors of family/domestic violence. In the immediate and long run, it is important to follow up the  graduates of  Silliman University’s College of Nursing and other nursing colleges as well as the graduates of Cebu Doctors’ College to determine whether they will practice what they have learned from their formal training. 

Key words: domestic family violence, BS Nursing curriculum, self-directed learning, crisis management, communication and counseling skills

 

SURVIVING CRISIS: HOW SYSTEMS AND COMMUNITIES COPE
WITH INSTABILITY, INSECURITY, AND INFECTION

Project Director:          Pilar Ramos-Jimenez
Funding Agency:        United Nations Development Program, World Bank, The Social, Economic and Behavioural Research Committee of the Tropical Disease Research Program of the World Health Organization, and SDRC

The workshop was held from April 3 to 7, 2002, at the Angelo King International Center. It sought to review existing explanations and concepts regarding the relationship between communicable diseases and instability/insecurity; focus attention on how communities and systems cope with adverse conditions and instability in order to address communicable diseases; and identify researchable questions and methods of coping with and overcoming adversity.

Twenty-seven participants—consisting of social scientists, researchers, practitioners, and NGO representatives from Afghanistan/Pakistan, Angola, Colombia, DR Congo, East Timor, Mozambique, Philippines, Sri Lanka, Sudan, and Uganda—attended the workshop.

Key words: communicable diseases, coping with adversity

 

YOUNG MEN AND THEIR REPRODUCTIVE HEALTH DECISION-MAKING (TAGBILARAN CITY, BOHOL, PHILIPPINES)
Project Director:          Pilar Ramos-Jimenez
Funding Agency:        EngenderHealth

The goal of the research was to understand the influence of gender roles on sexual behavior and reproductive health among this group. The components of the study assigned to SDRC-DLSU were: a) a brief review of Philippine legislation, policies and available social as well as health services for young people to determine the government and private sector’s responses to the social, mental and reproductive health needs of this sector, particularly Filipino male adolescents; b) eight three-day workshops with selected young men and women between the ages of 13-25 in Tagbilaran City; and c) the administration of a self-administered questionnaire concerning sexual and reproductive health behavior to the 96 young men and women participants in the three-day workshops.

The study showed that Filipino youth and adolescents are recognized by the national and local governments as sectors with specific concerns and needs.  The legislation and policies made for the benefit of young people focused on the prevention of and penalty against sexual abuse and exploitation, and drug abuse; and on the provision of free education.  Some policies were also made to provide protection and care for young people in especially difficult circumstances, particularly armed conflict.

In designing a male adolescent and youth RH program, it was suggested that young people should be involved to be able to respond to their needs adequately.  The prospective intervention program must foster partnerships among various stakeholders in the public and private sectors to ensure institutionalization and sustainability of such a venture.  An operations research may be conducted so that the process of program implementation can be documented and disseminated to the various stakeholders at the national and local levels.

Meanwhile, the workshops with in- and out-of-school males and females aged 15-24 covered the following topics about young people’s:  a) roles and responsibilities in their communities, families and romantic relationships; b) definition of masculinity, femininity, and sexuality; c) sexual and reproductive behavior; d) gender norms/rules in romantic relationships; e) communication on sexual and reproductive health; f) involvement in sexual and reproductive health decision-making; and g) recommendations for adolescent health services.

Key words: Filipino youth and adolescents, sexual behavior and reproductive health, Philippine legislation, Tagbilaran City

 

TXT-ING SELVES:  CELLPHONE AND PHILIPPINE MODERNITY
Project Director:          Raul Pertierra
Funding Agency:        Embassy of Finland and Nokia, Philippines.  

The project a) aimed to examine the social consequences of cellphone use, and b) investigated the political and cultural implications of cellphone use. To attain the first objective, it attempted to provide answers to the following questions:  a) With cellphone use, did oral modes persist in the Philippines and did they extend beyond spatial boundaries? and b) Did cellphone use, as in texting, alter social relationships? To address the second objective, the following questions were asked: a) Has mobile information technology become a significant weapon in the political struggles of diverse groups?  b) Do cellphone users share new transclass and age-generational identities? and c) How are sexual identities constituted, transformed and reproduced?

The authors observed that the Philippines is presently undergoing its third major conversion.  The first was the rapid Christianization of the islands by Spanish friars during the 16th century; the second was its assimilation of Yankee values as taught by enthusiastic American teachers. The third has been the cellphone revolution.  However, as the French say, plus ca change, plus c’est la meme chose: things remain much the same in the face of radical change.

The study further observed that the deep affect of cellphones on the lives of Filipinos should by now be evident.  The precise nature of this effect, its likely consequences and future developments are, however, more difficult to analyze.  Like the earlier conversions, cellphones are significant but also apparently inconsequential.  They have been so easily assimilated into the routines of everyday life that their effects on social relationships remain unperceived and are part of the taken-for-granted. Their intrusion and penetration into aspects of peoples’ innermost lives have to be critically assessed and delicately dissected.

Finally, the authors posit that the country is still mired in poverty and no communications revolution will solve its economic backwardness.  The global condition destroys locality before replacing it.  Moreover, this replacement is ontologically insecure, since it can only result in virtual locality, a simulacrum of the original.

Key words: cellular phone use, texting, mobile information technology, social relationships


 

 

 

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