Republic of the Philippines

Department of Health
Regional Office II
Carig Norte, Tuguegarao City
Telephone Number: 304-6585, 304-8737, 846-7261 & 8467230
e-mail address: [email protected]/[email protected]
TeleFax no. 304-6523

DETAILED RESEARCH PROPOSAL

Capacity of Rural health Units in Region 2 on Disaster Risk Reduction and Management: A
Basis for Capacity Building Program

Nina Anne Bernadette P. Paracad, RN, MSN

Medical Colleges of Northern Philippines
0916-473-1031/ [email protected]

Funding Agency: Department of Health

Cooperating agencies: Department of Health,

Department of Interior and Local Government (Local Government Units),

(2) Table of contents

PAGE
Introduction 2
Program/project title 3
Program/project leader 3
Implementing agency 3
Cooperating agency 4
Significance of the proposal 4
Literature review 4
Objectives 6
Expected Output 6
End-users/target beneficiaries 7
Program/project duration 7
Methodology 7
Plans for data processing and analysis 8
Ethical/biosafety clearance 8
Research utilization 8
Estimated budgetary requirements 9
Curriculum vitae 10
Bibliography 12
Work plan schedule ANNEX A

Page 1 of 25
 Questionnaire ANNEX B
Informed Consent ANNEX C
Line Item Budget ANNEX D

(3) Introduction

Cagayan Valley Region is home of vast bodies of water such as the Cagayan River, the Pacific
Ocean and the China Sea; six active volcanoes; the Cordillera Mountain Ranges; and Magat Dam,
one of the largest dams in the country to date. These natural resources among others have paved
way to its agricultural and tourism industry, however, the geographical location of Cagayan Valley
posts threats and vulnerability towards natural hazards and disasters. In fact, among the eight major
cities in the Philippines that are included in the top ten cities most at risk to natural disasters
worldwide, Tuguegarao city ranked second. (NHRA, 2015). Tuguegarao City situated in the province
of Cagayan is the capital of the province and the regional center of Cagayan Valley. Furthermore, in
an assessment made by the Department of Environment and Natural Resources Mines and
Geosciences Bureau in 2016, forty-five (45) municipalities in Cagayan Valley Region were identified
to be landslide prone areas, (Cagayan (9), Batanes (9), Isabela (12), Nueva Vizcaya (11), Quirino
(4)); and Seventy three (73) municipalities were identified flood prone areas (Cagayan (28), Batanes
(0), Isabela (31), Nueva Vizcaya (9), Quirino (5)).

The most recent catastrophe that the region has endured was super typhoon Lawin (Haiyan) in 2016,
considered the strongest and most destructive typhoon that hit the region in decades left 12,715
families affected; 208,551 totally damaged houses; P5.29 billion worth of damage in agriculture; and 8
people dead. A year after the devastating typhoon, the provinces specially Cagayan and Isabella, has
yet to fully recover, as some families are still homeless, and physical infrastructures were not yet
reconstructed. The people may overcome their loss of homes and properties, but for some, they will
forever grieve the loss of their love ones, families and friends.

The Sendai Framework for Action is a global initiative of formulating policies on disaster risk reduction
and preparedness. Countries around the world including the Philippines stated to adopt these policies
in 2015 after the Hyego Framework for Action, the predecessor of the Sendai Framework came to
conclusion. The framework emphasized the necessity for multi-sectoral approach and community
based actions. Among the sectors highlighted in the said framework was the health care delivery
system. Four out of the seven global targets are directly related to health. Furthermore, there is great
emphasis on the necessity to enhance the resilience of national health system integrating disaster
risk management into primary secondary and tertiary care by strengthening the capacity of the health
workers in DRR approaches. (UNISDR,2015)

The National Disaster Risk Reduction and Management Plan, the country’s framework for disaster
risk reduction and management delegated the functions of the health care delivery system
spearheaded by the Department of Health as (1)Health Services; (2) Nutrition; (3) Water, Sanitation
and Hygiene (WASH); and (4) Mental Health and Psychosocial Support Services. (NDRRMP, 2014).
The implementation of these roles and functions are critical especially in disaster prone regions and
municipalities, and in far-flung underserved communities given that one of the biggest challenges of
the health care delivery system up to these days is inadequate facilities. In Region II, there are only

Page 2 of 25
four regional hospitals and thirteen district hospitals to cater for five provinces, and these facilities are
located in cities and in major municipalities that are not easily accessible to other communities,
especially those located in coastal and mountainous areas. This situation is not only observed in the
region but in the whole country as well. Recognizing the challenges of resource mobilization, the
Disaster Risk Reduction and Management for Health (DRRM-H) envision a goal of building disaster
resilient communities through community participation, and capacity building of Rural Health Units in
the implementation of the health services in the four phases of disaster management namely Disaster
Risk Reduction and Mitigation, Disaster Preparedness, Disaster Response and Disaster Recovery
and Rehabilitation.

Rural Health Units are the frontlines in providing health care services, and implementing the health
care programs and reforms of the Department of Health. It is a health facility that provides basic
clinical, preventive, promotive, curative, and rehabilitative services for the municipality/city. (R.A. No.
1082) In recent years, the functionality of Rural Health Units were challenged by social, political and
geographical factors as their financial resources largely depend on Local Government Units, hence
the inequity of health services being delivered by a high class municipality compared to middle class
and low class municipalities. In an assessment made by the Health Emergency Management System
of the Department of Health Region II among 98 Rural Health Units in the region of their capacity to
institutionalize the HEMS guidelines, it was evident that majority of the RHU’s are still lacking in
emergency facilities, and trained workers. Furthermore, most of the RHUs were not able to present
specific guidelines and policies on disaster management for their facility but are largely dependent on
the Local Government Unit.

Public Health Facilities are vital in the attainment of disaster-resilient communities, hence the need to
evaluate their capability of providing communities with essential public health services during disaster
risk management, and build capacity for sustainability, Maldonado et al (2012)asserted that public
health facilities must perform in accordance with standards set, and recommended the use of a
specific assessment approach to evaluate their performance, which will serve as basis for building
partnership and capacity for long term goals and sustainability.

The goal of this study is to find out the capacity among Rural health Units in Region II specifically on
the implementation of health services, nutrition, water sanitation and Hygiene, and Mental Health and
Psychosocial Support Services in their respective communities to become a basis in determining
areas where capacity building can be facilitated.

(4) Program/project title

Capacity of Rural health Units in Region II on Disaster Risk Reduction and Management: A Basis for
Capacity Building Program
(5) Program/project leader

Nina Anne Bernadette P. Paracad, RN, MSN,

(with 48 units in Ph.D major in Science Education)
Research Assistant, Medical Colleges of Northern Philippines
0916-473-1031/ [email protected]

The Program leader may render 16 hours to this research project.

Page 3 of 25
(6) Implementing agency

MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Peñablanca, Cagayan
Telefax No.: (078)304-1010/ 846-7549
Website: www.mcnpisap.com
E-Mail Address: [email protected]
(7) Cooperating agency

Department of Health
Department of Interior and Local Government (LGUs)
National Disaster Risk and Reduction and Management Council (NDRRMC)

(8) Significance of the proposal

Preparing and responding to disaster is a public health priority that needs attention especially in an
environment of constrained resources. However, it has been observed that the roles and functions of
the Rural Health Units and other components of the Health care Delivery System were not explicitly
discussed nor delineated in the National Disaster Risk Reduction Management Plan, the country’s
framework in Disaster Management, even in the Disaster Management Plan of the Department of
Interior and Local Government.

Recognizing the vital roles of the Rural Health Units as frontlines in raising awareness and
responding to disasters to safeguard the lives of the people in communities, the researcher proposes
to undergo a study that will evaluate the capability of the RHUs and determine areas where
improvements can be made. The results of this study will be a basis in crafting a capacity building
program among the Rural Health Units in Region II.

(9) Literature review

Capacity Building among Rural Health Facilities

According to the NDRRP, Capacity is defined as “a combination of all strengths and resources
available within a community, society or organization that can reduce the level of risk, or effects of a
disaster. Capacity may include infrastructure and physical means, institutions, societal coping
abilities, as well as human knowledge, skills and collective attributes such as social relationships,
leadership and management. Capacity may also be described as capability”. (NDRRP vol 1, 2015
ed.). There are four core responsibilities of the Department of Health in Disaster Management, these
are (1) health services; (2) Nurition; (3) Water, Sanitation and Hygiene (WASH); (4) Mental Health
and Psychosocial support services. (NDRRMP, 2015). Health services include promotional, curative
and rehabilitative services, before, during and after a disaster, (HEMS, 2008) The implementation of
these services largely depend on the Local Government Units trough the Rural Health Units.

Public Health Facilities are vital in the attainment of disaster-resilient communities, hence the need to
evaluate their capability of providing communities with essential public health services during disaster
risk management, and build capacity for sustainability, Maldonado et al (2012)asserted that public
health facilities must perform in accordance with standards set, and recommended the use of a
specific assessment approach to evaluate their performance, which will serve as basis for building
partnership and capacity for long term goals and sustainability.

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Veenema (2015) affirmed that the best way to enhance response capacity and to ensure
sustainability of this capacity is through workforce development. Standardized disaster curricula,
training guidelines, and performance measure across all levels of health personnel especially nurses
is necessary to ensure foundational ability to keep clients safe. This is supported by Labrague et al
(2015) who strongly recommended that medical schools must ensure that health professionals are
equipped with knowledge and skills to handle situations related to disasters, and for health agencies
and hospital administrators to support personnel development programs such as trainings and
seminars. Furthermore, he stressed the necessity for formulation of disaster protocols and provide
essential disaster training for nurses.

Pourhossenti et.al (2015) concluded that health sector requires potentiality and relationships with
other sectors. If this relationship is well established before a disaster occurs, we will have fewer
problems in the response stage. The information obtained from the knowledge and experience of
disaster managers can be the basis for operational planning of healthcare services in disasters.

There are four distinct yet equally vital priority areas in Disaster Risk Reduction Management,
namely, (a) disaster prevention and mitigation; (b) disaster preparedness; (c) disaster response; and
(d) disaster recovery and Rehabilitation. Each areas are given strategies and policies toward a
common goal, to create disaster-resilient communities. (NDRRMP Vol.1, 2015 ed.). Among main
areas to consider during the pre-disaster period, or disaster prevention and mitigation and disaster
preparedness are knowledge of the administrative units; understanding of risks; and awareness of the
means of actions. During disaster response, basic laws on civil protection and relief plans; information
management; the setting up of a joint crisis committee by the governor or senior divisional officer; the
creation of command posts; and the implementation of relief organization plans must be given priority.
(Bang, 2011) These strategies were outlined in the National Disaster Risk Reduction Management
Plan, the roadmap of the country to Disaster Preparedness and response, however, scarcity of
resources in developing countries such as the Philippines, and lack of facilities for disaster
management result into greater vulnerability among communities and individuals on the impact of
natural hazards. (Mishra, 2012)

The Department of Health Created the National Policy Framework on Health Emergencies and
Disasters which serve as guide for health facilities and personnel on the strategies and interventions
before, during and after health emergencies and disasters. This is recommended for health facilities
to ensure comprehensive and integrated health sector emergency management system to prevent
loss of lives during emergency and disasters. ( HEMS, 2008)

Health Services, WASH, Nutrition and Mental and Psychosocial Health Services

WHO considers health risk assessment and surveillance as one of the most crucial role of public
health facilities. Part of the assessment is on the hazard analysis, Vulnerability analysis and capacity
analysis.Among he various risk factors for human vulnerability are low income, low socioeconomic
status, lack of home ownership, single-parent family ,Age: older than 65 years, Age: younger than 5
years, Female sex , Chronic illness, Disability, and social isolation or exclusion. These factors are
commonly encountered in developing countries such as the Philippines. (WHO, 2013)

World Health Organization (WHO) recognizes the health risks during and after disasters such as
infectious diseases (e.g. Hepatitis A, Cholera, Typhoid, Malaria). Infection can be transmitted through
consumption of contaminated water or food; Hand to mouth transmission when there is inadequate
source of clean water used for personal hygiene; and vectors such as flies and mosquitoes which
breed near water sites and stagnant water. The main goal of WASH during disaster is to reduce
Page 5 of 25
faeco-oral transmission of disease and exposure to disease-bearing vectors among the affected
communities, (WHO,2011).

In the Philippines, the Millennium Development Goal (MDG) for water and has made good progress
toward the MDG for sanitation. While human resources strategies exist for water, sanitation and
hygiene, not all of the gaps have been filled. This is an issue at the local government level where
positions for provincial or city sanitary engineers do not exist; legislation would be needed to create
such positions. Because these positions do not exist, emigration has become a major constraint to
WASH human resources. Additionally, the lack of colleges or universities offering courses related to
WASH and the lack of promotion of WASH related courses to attract more students are also issues.
An area where the lack of human resources is noticed is in rural water quality testing. Rural drinking-
water quality is not usually tested due to a lack of staff and the prohibitive costs of testing all water
quality parameters. (GLAAS, 2014)

The National Nutrition Council (NCC) defines Nutrition in emergencies as “the nutrition servces that
are part of the emergency preparedness, response and recovery to prevent deterioration of nutritional
status and death.” It includes nutritional assessment, infant and young child feeding promotion,
protection and support, management of acute malnutrition, micronutrient supplementation and other
interventions which can be food or non-food based interventions.

According to NDCC (2014), there are three nutritional problems of concern during emergency
situation; Acute malnutrition characterized by severe deterioration in nutritional status over short
period of time such as immediate past 3 months of insufficient intake of food and/ or suffering from
infections and other illness; Chronic malnutrition characterized by long-term undernutrition which
made an impact to the nutritional status; and micronutrient deficiencies in Vitamin A, Iron, and Iondine
which are common during emergencies because of disrupted food supply, incidence of infectious
diseases particularly diarrhea which impairs absorption of nutrients.

The minimum nutrition service package for nutrition in emergency and disaster provide for a guide in
nutritional management pre-disaster, Alert phase, Pre-emptive phase, within the first 24 hours of
impact; within 25-71 hours after the impact; and more than 72 hours after the impact. The local
nutrition cluster is deemed responsible in the formulation of emergency preparedness plan on
nutrition, provde capacity building and resource mapping and prepositioning. During the pre-disaster
phase, update the inventory of resources such as vitamin A capsule and other micronutrients,
weighing scales, height boards, supplementary food, antibiotic and deworming tables, human milk
banks, breastfeeding kits, etc.. While during the pre-emptive evacuation phase, se-up of
supplementary feeding for 6-59 months old children, pregnant and lactating women, Vitamin A
supplementation, setting-up of breastfeeding corners/spaces in evacuation centers, and referral of
severe cases of acute malnutrition with infection to hospitals are expected to be conducted. Within the
first 24 hours of impact, the local cluster is mandated to deploy assessment team and conduct rapid
nutritional assessment. After the first 24 hours of impact the local cluster is expected to conduct
assessment of infant feeding in emergencies, cluster coordination, planning and implementation of
nutritional interventions, information management, referral for psychosocial high-risk cases and policy
monitoring of the Milk Code (EO 51). (NNC 2014)

Psychological first aid provided by the volunteers is an early intervention, implemented in the
immediate aftermath of disaster, designed to reduce the initial distress and foster adaptive
mechanism for survivors of all ages. Effective intervention restores function and enhances recovery;
creates a safe and secure environment; reduces uncertainty, fear and anxiety; and mobilizes family

Page 6 of 25
and social supports. (Cabral, 2009)

Challenges of Primary Health Care on Disaster Risk Reduction and Management

In an assessment made after the Yolanda disaster, it was evident that the Local Government Unit has
yet to fully implement and institutionalize the policies of DRRM. One of the key areas found is the lack
of coordination and prompt action of the local health sectors during and after the disaster. (COA,
2016)

Being at the forefronts, communities need to have capacity to respond to threats themselves. It is for
this reason that communities should be involved in managing the risks that may threaten their well-
being. While different community empowerment programmes related to disaster mitigation have
achieved their objectives, they are often short term, and issues on sustainability in these efforts are
rarely addressed. (Pandey and Okazaki, 2011)In a study conducted by Olu, et al (2016) among
primary health care facilities in Africa, several weaknesses were found crucial in the performance of
its role on disaster management. Some of the findings were (1) most of the strategies of health care
are only focused on epidemics and disease outbreaks and were not integrated to disaster dtrategies;
(2) There is poor assessment of health and disaster risk in communities which results into poor
disaster risk management planning; (3) lack of multisectoral approach to implement health disaster
risk management; (4) Weak health System; (5) limited practical exercise in managing emergency
responses; and (6)inadequate engagement and mobilization of communities for health DRM. Threats
in the health care system were also enumerated such as (1) draining of resources; (2) noncompliance
of health professionals to disaster risk management strategies; (3) insufficient funding, resources and
trained disaster risk management staff; and (4) Unavailability of scientific evidence on the nexus
between health system and DRM.

Labrague (2015) concluded that in the Philippines, nurses perceive that they are not fully aware of
disasters and their impact, and are not knowledgeable on management protocols on disaster risk
reduction management. The lack of awareness on disaster risk reduction management among health
professionals greatly affect their capacity to provide services during disaster.

Pourhosseini, et. al (2014) established eleven themes affecting healthcare management in disasters
related to human resources management, resources management, victims’ management transfer,
environmental hygiene monitoring, nutrition management, mental health control, inter-agency
coordination, training, technology management, information and communication management, and
budget management.

In the past years, Philippines together with other developing countries has endured the tremendous
impact of disasters in their economy, as development has been haltered and billions worth of
resources were damaged, the country also mourned the death of its people. This has brought
realization to that long term goal and strategies must be employed in order to lessen the risk and
vulnerability of the people and the country to disasters and their impacts, and create communities
capable of responding to disasters, or disaster-resilient communities. Despite the effort, it has been
observed that agencies which play vital roles in Disaster Risk Reduction and Management, especially
in rural communities such as the Rural Health Units have not been given attention for capacity
building, hence, the need to have an evaluation that will serve as basis for capacity building and
empowerment.

(10) Objectives

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General Objective: This study aims to assess the capacity of the RHUs on Disaster Risk Reduction
and Management as basis for the formulation of Capacity Building program

Specifically it aims to answer the following questions:

1. What is the profile variables of the Rural Health Units in terms of:
1.1. Municipality Class
1.2. Municipality Internal Revenue Allotment (IRA)/ Budget allotted for DRRM
1.3. Number of Barangays catered
1.4. Number of Health Centers
1.5. Human Resource
1.6. Site and Accesibility
2. What is the capacity of Rural Health Units in Region II on Disaster Risk Reduction and
Management on the following key areas:
2.1. Health Services
2.1.1. Disaster Risk Reduction and Mitigation
2.1.2. Disaster preparation
2.1.3. Disaster Response
2.1.4. Disaster Rehabilitation
2.2. Nutritional Support
2.2.1. Disaster Risk Reduction and Mitigation
2.2.2. Disaster preparation
2.2.3. Disaster Response
2.2.4. Disaster Rehabilitation
2.3. Water, Sanitation and Hygiene (WASH)
2.3.1. Disaster Risk Reduction and Mitigation
2.3.2. Disaster preparation
2.3.3. Disaster Response
2.3.4. Disaster Rehabilitation
2.4. Mental Health and Psychosocial Support Services
2.4.1. Disaster Risk Reduction and Mitigation
2.4.2. Disaster preparation
2.4.3. Disaster Response
2.4.4. Disaster Rehabilitation
3. What are the recommendations made by the two groups of respondents on building capacity in
the Rural Health Units?
4. Is there a significant difference in the capacity of Rural Health Units in Region II on the four key
areas of Disaster Risk Reduction Management when grouped according to profile variables?

(12) End-users/target beneficiaries

The result of this study will be beneficial to the Local Government Unit of Cagayan Valley Region as it
will provide an outlook on the current status of the Rural Health Units’ capacity of delivering services
and assistance to the community people during the phases of disaster management. It shall serve as
a basis of developing programs to augment the needs and deficiencies of the RHUs.

Furthermore, the findings of the study will serve as an evaluation of the Department of Health on the
implementation of the emergency and disaster services of the Rural Health Units. As such, can be a
basis of providing greater trainings, seminars and orientations among health care professionals on
Disaster Management.

Ultimately, the capacity building among RHUs as the end goal of this study will benefit the community
people in Cagayan Valley specially those living in disaster prone areas, and the underserved and

Page 8 of 25
deprived communities in the province.

(13) Program/project duration

The proponent of the project proposed for a 1 year duration for the completion and implementation.

(14) Methodology

Study design

A descriptive-inferential research design to describe and test relationship between and among the
variables of the study. The study focused on the capacity of Rural Health Units in region II on Disaster
Risk Reduction and Management on areas on health services, Water Sanitation and Hygiene,
Nutrition and Mental Health and Psychosocial Support Services.

Study population

The National Health Facility Registry of the Department of Health will be a basis in determining the
Rural Health Units in the Region that will be subject to evaluation. Participants of the study will include
the Municipal Health Officers and Public Health Nurse of the RHU since they have direct participation
in the planning and implementation of the disaster risk reduction and management plan of the RHU.

The second group of participants will be selected through purposive sampling method. They will be
selected based on the following criteria: (a) must be a bonafide resident of the municipality catered by
the RHU for at least 1 year; (b) has experienced at least one natural disaster in the duration of his
residency; (c) has benefitted from RHU programs. A total of 10 participants will be selected for each
RHU.

Site of the study

The study will be implemented in the 98 Rural health Units in Region II registered under the National
Health Facility Registry of the Department of Health and considered in Active status.

Study plan

A structured questionnaire will be utilized in gathering data for the study based on the implementing
guidelines of the Department of Health in four areas of disaster management. A structures
questionnaire based on the guidelines of the WHO and DOH-HEMS on Disaster Risk Reduction and
Management in Health will be utilized. It is a six- part questionnaire, the first part will gather the basic
demographic profile of the RHU, the second part will be an evaluation of the capacity of the RHU in
providing health services, the third will evaluate the capacity of RHU in delivering water sanitation and
hygiene, the fourth part will be an assessment of the ability of RHU to deliver nutrition services, and
the fifth will assess the capability of the RHU to deliver psychosocial rehabilitation and recovery
services after a disaster. A four point likert scale will be used as gauge to the capacity of the RHUs
with the following descriptive values; (4- Very much Capable; 3- Capable; 2- slightly capable; 1- not
capable). A Structured interview of the participants will be employed to elicit their recommendations
on improving the capacity of the Rural Health Units.

Structured interview will also be used to gather data from the resident-participants to ask for their

Page 9 of 25
recommendations in the improvement of the capacity of the RHU in delivering disaster management
services.

The reliability and validity of the questionnaire will be tested through a pilot study and will be
subjected to Cronbach’s alpha, a statistical tool used to test the validity of questionnaires. (Please
see ANNEX B for copy of questionnaire)

Upon identification of the different Rural Health Units, the project leader will communicate with the
cooperating agencies for their approval and cooperation. Prior to gathering of data and information,
an informed consent will be sought from the identified participants after presenting to them the
objectives of the study and their rights as participants. To ensure the credibility of the data and
information provided by the participants, the project leader and research assistant shall hand the
questionnaires personally to the participants and will monitor them while answering. Questionnaires
will be retrieved immediately to avoid loss of data. Upon retrieval, the data will be coded and tallied for
statistical analysis.

Results shall be disseminated to all concerned agencies for utilization.

(15) Plans for data processing and analysis

Weighted Mean will be used to determine the assessment of the participants on the Capacity of the
RHUs in the four areas of DRRM-H.

Analysis of Variance (ANOVA) will be utilized to determine the significant difference on the capacity of
the RHUs in the four areas when they are grouped according to the region where they are located.

Data gathered will be subjected to statistical analysis using the Statistical Package for the Social
Sciences (IBM SPSS, 2015).

(16) Work plan schedule

Please see attachment
(ANNEX A)

(17) Ethical/biosafety clearance

---To follow---

(18) Research utilization

The results of this study will be disseminated to the cooperating agencies, and recommendations will
be given as basis in formulating a program for capacity building on Disaster Risk Reduction and
Management among Rural Health Units in Region II.

(19) Estimated budgetary requirements

Please Refer to the LIB

Page 10 of 25
(20) Curriculum vitae

NIÑA ANNE BERNADETTE P. PARACAD

Address: Dulig Street, Barangay Leonarda, Tuguegarao City
Cellphone #: 09164731031
E-Mail Address: [email protected]

PERSONAL DATA

Name: Niña Anne Bernadette P. Paracad

Age: 28 years old

Birthday: October 31, 1989

Civil Status: Married

Address: Dulig St. Brgy. Leonarda, Tuguegarao City

Height: 5 feet 5 inches

Weight 60 kilograms

EDUCATIONAL BACKGROUND

 2014-Present, Doctor of Philosophy Major in Science Education

Cagayan State University, Andrews Campus, Tuguegarao City
48 Credited Units

 2013-2014, Master of Science in Nursing

University of Saint Louis Tuguegarao

 2009-2012, Bachelor of Science in Nursing

University of Saint Louis Tuguegarao
Academic Distinction Awardee

 2001-2006 Secondary Education

Laboratory High School, Cagayan State University, Gonzaga Campus, Gonzaga, Cagayan
Valedictorian

 1995-2000 Grade School

Baua Elementary School, Baua, Gonzaga, Cagayan
Valedictorian

ELIGIBILITY

 LICENSED IV THERAPIST
 NURSING LICENSURE EXAMINATION PASSER

Page 11 of 25
PROFESSIONAL ORGANIZATION

 PHILIPPINE NURSES ASSOCIATION INC.

 PHILIPPINE ASSOCIATION OF EXTENSION PROGRAM IMPLEMENTORS INC.

EXPERIENCE

Research Assistant ( May 2017- Present)

Medical Colleges of Northern Philippines and International School of Asia and the Pacific

Clinical Instructor (2ND Semester SY 2015-2016)

Medical Colleges of Northern Philippines

Subjects Handled:

 Anatomy and Physiology Lecture and Laboratory, (2nd Semester, SY 2015-2016)

 Maternal and Child Nursing ( NICE Program), (2nd Semester, SY 2015-2016)
 Psychiatric Nursing, (2nd Semester, SY 2015-2016)
 Course Audit (Psychiatric Nursing), (2nd Semester, SY 2015-2016)
 Nursing Health Assessment, (Summer, SY 2015-2016)
 Nutrition and Diet Therapy (Midwifery), (Summer, SY 2015-2016)
Positions Handled:

 Community Outreach and Extension Coordinator, College of Nursing

November 2015-Present
 Research Coordinator, College of Nursing
April 2016- Present
 Class Adviser (BSN III)
2nd Semester, SY 2015-2016

Nurse Training Officer

Holy Infant Hospital, Tuguegarao City
February- Present

Staff Nurse
Holy Infant Hospital, Tuguegarao City
April 2013- January 2015

SEMINARS AND TRAININGS ATTENDED

Research Proposal Writing Workshop for Health Researchers in Region 02

Participant
Dumlao Farmers’ Training Center, Nueva Vizcaya State University, Bayombong, Nueva Vizcaya
November 15-17, 2017 \

2017 Regional Pre-Service Teachers’ Research Colloquium (PreTRec)

Co-Author, “Knowledge, Beliefs and Practices on HIV-AIDS among Senior High School Students in
ISAP”
Quirino State University, Diffun, Quirino
October 30, 2017

Regional Higher Education Research and Extension Conference

Page 12 of 25
Participant
CHEDRO 2 Auditorium, Regional Development Center, Carig Sur Tuguegarao
July 1, 2016

2nd SPUP International Research Conference

St. Paul University Philippines
January 14-16, 2016

Third East Asian Seas Youth Environmental Forum

Partnership in Environmental Management of the Seas of East Asia (PEMSEA)
Changwon Moonsung University, Changwon City, South Korea
Philippines Representative, July 2012

Orientation on the 2013 Revised NTP Manual Procedures

Department of Health and Tuguegarao City Health Office
Las Palmas De San Jose Hotel, Resort and Restaurant, Tuguegarao City, Cagayan
January 30, 2015
3-Day Basic Intravenous Therapy Training Program
Association of Nursing Service Administrators of the Philippines (ANSAP)
Tuguegarao City People’s General Hospital
February 22,23, and 24, 2013

Core Competency Standards and the Nursing Licensure Exam Test Framework
School of Health Sciences, Saint Paul University Philippines
September 18, 2012

31st Annual National PACSA Convention and Seminar Workshop for Student Leaders
Philippine Association of Campus Student Advisers (PACSA)
Teachers Camp, Baguio City
November 26-29, 2010

The Basic of Maternal and Pediatric Care

University of Saint Louis Tuguegarao, Tuguegarao City
August 23, 201

AWARDS

 Top 7 Regional, December 2012 Nursing Licensure Examination

 Academic Distinction Award, March 2012 (University of Saint Louis Tuguegarao)

 Pope John Paul II Leadership Award, March 2012 (University of Saint Louis Tuguegarao)

 Consistent Dean’s Lister, 2009-2012 (University of Saint Louis Tuguegarao)

 Best Speaker, Regional Athena Debate Cup, November 2011

Page 13 of 25
  Most Outstanding Student Leader of the Cagayan State University, 2006

References

RYAN C. FONTANILLA, RN, MSN

Research Coordinator
Medical Colleges of Northern Philippines and International School of Asia and the Pacific

REYNALDO M. ADDUCUL, RN, RM, MSN, LLB

Dean, College of Nursing
Medical Colleges of Northern Philippines

ELADIO GUMABAY, RN, MSN, DNS

Assistant Research Coordinator
University of Saint Louis

(21) Endorsement from the agency head

To Follow

(22) Bibliography
Association of Public Health Nurses Position Paper 2nd edition (2014), The Role of the Public Health

Nurse In Disaster Preparedness, Response, and Recovery

Baack, S., (2013), Nurses’ Preparedness and Perceived Competence in Managing Disasters, Journal

of Nursing Scholarship, 2013;45:3,281–287, doi:10.1111/jnu.12029

Bang, H., (2014). General Overview of the disaster management framework in Cameroon, Journal for

Disaster (2014), doi:10.1111/disa.12061

Gowan, M., et. al, (2014). Building resiliency: a cross-sectional study examining relationships among

health-related quality of life, well-being, and disaster preparedness, Health and Quality of Life

Outcomes 2014, 12:85 doi:10.1186/1477-7525-12-85, ISSN 1477-7525

Health Emergency Management Staff (HEMS) of the Philippine Department of Health (DOH) 2008,

Guidelines for Health Emergency Management 2nd ed.

Labrague, L., et. al, (2015). Disaster Preparedness in Philippine Nurses, Journal of Nursing

Scholarship, 2016;48:1,98–105, doi:10.1111/jnu.12186

Page 14 of 25
Maldonado, T.G., et. al, (2012), Building Capacity for Community Disaster Preparedness: A Call for

Collaboration Between Public Environmental Health and Emergency Preparedness and Response

Programs

Mishra, V., et. al, (2012). Enhancing disaster management by mapping disaster proneness and

preparedness, MEDSURG Nursing, November-December 2015 • Vol. 24/No. 6

Nash, T., (2015). Unveiling the Truth about Nurses’ Personal Preparedness for Disaster Response: A

Pilot Study, MEDSURG Nursing, November-December 2015 • Vol. 24/No. 6

National Disaster Risk Reduction and Management Council, National Disaster Preparedness Plan

vol. 1 2015-2018, 2015 edition

Olu, O., et. al., (2016). Strengthening health disaster risk management in Africa: multi-sectoral and

people-centred approaches are required in the post-Hyogo Framework of Action era, BMC Public

Health (2016) 16:691 DOI 10.1186/s12889-016-3390-5

Pandey, B. and Okazaki, K., (2015) Community Based Disaster Management: Empowering

Communities to Cope with Disaster Risks

Shoaf, K., et, al, (2000), The Role of Public Health in Disaster Preparedness, Mitigation, Response,

and Recovery, University of California-Los Angeles Los Angeles, California 90024 USA

Veneema, T, (2015). Nurses as Leaders in Disaster Preparedness and Response—A Call to Action,

Journal of Nursing Scholarship, 2016;48:2,187–200, doi:10.1111/jnu.12198

(23) Line Item Budget (LIB)

Please Refer to ANNEX D

Page 15 of 25
 ANNEX A (WORK PLAN SCHEDULE)

Strategies July mar Aug Sep

Apr OCt May Nov June
Dec Jan July Feb

Weeks 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

Conceptualization
and finalization of
research proposal
Pilot testing and
test of validity and
reliability of
research
instrument
Communication/
Meetings with
cooperating
agencies
Survey to Rural
Health Units in
Cagayan and
Communication
with the Mayors
and Municipal
Health Officers
Survey to Rural
Health Units in
Isabela and
Communication
with the Mayors
and Municipal
Health Officers
Survey to Rural
Health Units in
Nueva Vizcaya
and Quirino and
Communication
with the Mayors
and Municipal
Health Officers
Survey to Rural
Health Units in
Batanes and
Communication
with the Mayors
and Municipal
Health Officers
Gathering of data
from participants
in Cagayan
Gathering of data
from participants
in Isabela
Gathering of data
from participants
in Nueva Vizcaya
Gathering of data
from participants
in Quirino
Gathering of data
from participants
in Batanes

Page 16 of 25
 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

Coding and
treatment of data
Interpretation of
results
Finalization of
Manuscript
Presentation of
research findings to
DOH and other
cooperating
agencies
Dissemination of
research findings
among Participating
RHUs
Formulation of
capacity building
programs based on
research findings

Page 17 of 25
 ANNEX B

QUESTIONNAIRE

I. Demographic Profile
Direction: Please provide the necessary information about yourself and your RHU. Rest assured
that these information will be kept confidential.

Name: _________________ RHU: ___________________

(Optional)
Municipality Class: ________
Age: ______
Municipality Internal Revenue Allotment (IRA):
Sex: ____________________________________

 Male Budget allotted for DRRM: __________________

 Female
Number of Barangays catered: ________________
Position: _________________
Number of Health Centers: _____________
Years in Service: ___________

Human Resource: (Please Indicate the number of health personnel being asked)

Physicians/ Doctors: ______Male _____Female

Dentists: ______Male _____Female
Nurses: ______Male _____Female
Midwives: ______Male _____Female
Medical Technologies: ______Male _____Female
Sanitary Engineers: ______Male _____Female
Sanitary Inspectors: ______Male _____Female
Nutritionist: ______Male _____Female
Active Barangay Health Workers: ______Male _____Female

Structural, Site and Accessibility of the RHU: (Check the statements that describe the site
and accessibility of your RHU. Select all the apply)

____ Hospital is located along/ near good roads readily accessible to the community with
adequate means of transportation

____ Well paved access roads are properly identified with directional signages available and
properly fastened

____ The building is located in safe area away from edge of a slope; not near the foot of the
mountain; not in flood prone areas; and not near bodies of water.

____ The building is structurally stable without cracks and leaks in its floor, walls and columns.

____ The building has a secured roofing system that is fastened and well cemented.

Direction: Please assess the capacity of your Rural Health Units on Disaster Risk Reduction and

Page 18 of 25
Management by checking the appropriate box that correspond to the capacity of your RHU.

4-------------- Very Much Capable

3-------------- Capable
2-------------- Slightly Capable
1-------------- Not Capable
Health Services 4 3 2 1 Remarks

DISASTER RISK REDUCTION AND MITIGATION

1. Promote Awareness among community people

through seminars, posting of posters in public
facilities, distribution of flyers, giving of
advisories, and participation in the monthly
celebration of disaster month..
2.

3. Conduct risks and needs assessment in the

community, and communicate results to the LGU.
4. Basic First Aid trainings and seminars in managing
emergencies at home, schools, work place, public
places, etc. are conducted by the RHU..
5. Trainings on emergency and disaster preparedness
are being conducted to all employees of the RHU.
(e.g BLS, ACLS, PCLS etc.)
DISASTER PREPAREDNESS

6. Policies, procedures and protocols on disaster

management are available
7. Have referral system in place during emergency

8. Emergency drugs, fluids and first aid equipment are

available. Regular inventory of these equipment is
conducted.
9. Ambulance and other mode of transports are
available
10. Rescue equipment are functional and available.

11. Communication equipment such as landline and

mobile phones are readily available and accessible
12. Early warning devices are installed in the RHU

13. Complete Personal Protective Equipment are

available in the RHU
DISASTER RESPONSE

14. The RHU facilities are kept safe during emergency

and disaster situations.
15. The RHU has active participation in the search and
rescue operations
16. Emergency epidemiological surveillance for vector-
borne diseases, vaccine preventable diseases and
diseases of epidemic potential is conducted
17. Provision of medical and health services in
evacuation centers.
18. Provide First Aid Measures and primary medical
care during and after a disaster

Page 19 of 25
19. Referral system to hospitals and health facilities
such as blood banks and diagnostic centers are
observe.
20. Have management of the Dead and the Missing
Program/activities during a disaster
DISASTER REHABILITATION

21. Evaluation and debriefing activities are conducted to

assess the performance of the RHU in response to
the disaster
22. Establishment/ re-establishment of health
information system
23. Restoration of preventive health care services such
as EPI, MCH, etc
24. Restoration of services for non-communicable
diseases/obstetrics
25. Structural damages of the RHU is promptly
addressed
26. Provision of care for the disabled

Water, Sanitation and Hygiene (WASH) 4 3 2 1 Remarks

DISASTER RISK REDUCTION AND MITIGATION

1. Conduct clean drives and environmental

sanitation activities.
2. Promote hygienic practices in the community
through awareness programs and use of IEC
materials
3. Strict implementation of proper waste disposal in the
municipality
4. Reduction of vector breeding sites through
environmental control program (e.g. proper excreta
and waste disposal, proper drainage)
5. Conduct regular assessment of water source,
drainage and sanitation in the community.
DISASTER PREPAREDNESS

6. The RHU has existing policies and guidelines in the

implementation of WASH prior, during and after a
disaster
7. RHU Staff are trained on WASH. Key persons on
WASH are identified.
8. Availability of appropriate and adequate Toilet
facilities in the RHU. (1 seat per 20 outpatients).
Separate toilets for men and women are available in
the facility.
9. Availability of clean water and soap in the facility for
handwashing.
10. Water source of the facility is kept regularly
monitored for its quantity and quality.

DISASTER RESPONSE

Page 20 of 25
 11. Ability to meet minimum water needs for the Rural
Health Unit:
5 L/ person/ day
Approximately 70 L/ working staff in PPE/day
Back-up water supply for at least 3 days water
need/demand
12. Ability to provide Minimum Survival Water Need
(drinking, Basic Hygiene and basic cooking) 7.5-1.5
L/ person per day in evacuation centers
13. Water Purification/ treatment options such as boiling
and chlorination are possible in cases of water
contamination as per SPHERE or WHO
recommendation
14. Implementation of proper waste disposals in the
evacuation centers.
15. Maintenance of toilets in evacuation centers.
Prevention of defecation especially in children which
could contaminate water supplies
16. Handwashing area is made available in the
evacuation centers
17. Hygiene kits are distributed to affected families.
Health teachings on Sanitation and hygiene are
discussed.
18. Communicable disease prevention and control
services are available.
19. Assessment of Water Needs of the affected
population is conducted during the disaster.
DISASTER REHABILITATION

20. Assessment of Water Needs of the affected

population is conducted during the disaster.
21. Continuous surveillance of cases of communicable
diseases and vector-borne diseases in the
population.

Nutrition 4 3 2 1 Remarks

DISASTER RISK REDUCTION AND MITIGATION

1. Programs and activities on nutrition are implemented

in the community such as celebration of the nutrition
month, IEC materials for nutrition.
2. Nutritional surveillance is undertaken regularly.
Logistics for nutritional status in the community is
kept and updated.
3. Strict Implementation of the Milk Code.

4. Supplementary feeding to vulnerable populations are

initiated
DISASTER PREPAREDNESS

1. An emergency preparedness plan on nutrition is

available
2. Trained personnel on nutrition in emergency
management.
3. Update inventory of resources
Weighing scales, weight for height reference table,
height board, Antibiotics, deworming tablets.

Page 21 of 25
 4. Ensure availability of essential micronutrients and
other resources for nutrition supplementation.
DISASTER RESPONSE

5. Reinforcement of breastfeeding in the general

population. Set-up breastfeeding corners/spaces in
evacuation centers
6. Maintain Effective line of communication to the
partner agencies such as the Nutrition Council and
DSWD
7. Rapid screening for acute malnutrition

8. Set-up supplementary feeding for 6-59 months old

children, pregnant and lactating women
9. Promotion of desirable complementary feeding
practices before, during and after disaster and
management of micronutrient deficiencies
10. Participation in the provision of ration to the affected
population
DISASTER REHABILITATION

11. Promotion, protection and support of infant and

young child feeding
12. Referral to WASH, health clusters and other
interventions
13. Cluster coordination

14. Policy monitoring of the Milk Code (EO 51)

Mental Health and Psychosocial Support Services 4 3 2 1 Remarks

DISASTER RISK REDUCTION AND MITIGATION

1. Conduct of mental and psychosocial awareness

activities in the community.
2. Implement strategies for reducing discrimination
and stigma of people with mental illness and/or
mental disability
3. Promote gender- and age-disaggregated health
information systems that cover essential mental
health data
4. Conduct assessments of mental health and
psychosocial issues
DISASTER PREPAREDNESS

1. RHU staff are trained and oriented on MHPSS

2. Organize orientation and training of aid workers
in mental health and psychosocial support
3. With an existing policies and programs in mental
health
4. Incorporate MPHSS in all aspects and sectors of
Disaster Plan (Health Services, WASH, Nutrition)

Page 22 of 25
 DISASTER RESPONSE

5. Family tracing and reunification activities

6. Assisted mourning and communal healing
ceremonies
7. Mass communication on constructive coping
methods
8. Supportive parenting programs
9. Formal and non-formal educational activities in
evacuation centers
10. Debriefing activities
11. Crisis counseling. Provision of counseling areas
in evacuation centers to maintain privacy and
confidentiality
12. Stress management activities across ages
specially in evacuation centers
13. Referral of psychiatric cases to mental health
facilities
DISASTER REHABILITATION

5. Facilitate conditions for appropriate communal

cultural, spiritual and religious healing practices
6. Home visit follow up of clients who experiences
stress and trauma during the disaster
7. Debriefing of RHU staff

8. Evaluation of programs and activities during the

disaster response.

Recommendations:_______________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________

Thank You!

(The Questionnaire is still subject for reliability and validity test, hence, changes can still be made)

Page 23 of 25
 ANNEX C

Informed Consent

Dear Participants,

I, Nina Anne Bernadette P. Paracad, a nurse instructor at the Medical Colleges of

Northern Philippines is currently undertaking a research study entitled, “Capacity of Rural
Health Units in Region II on Disaster Risk Reduction and Management: A Basis for Policy
Development and Capacity Building Program”. The said study is funded by the Department
of Health Region II in partnership with the Department of Science and Technology and
Medical Colleges of Northern Philippines. Recognizing the vital roles of the Rural Health
Units as frontlines in raising awareness and responding to disasters to safeguard the lives
of the people in communities, the researcher through this study will assess the capability
of the RHUs and determine areas where improvements can be made. The results of this
study will be a basis in crafting a capacity building program among the Rural Health Units
in Region II.

Your participation will involve answering survey questions, which will take
approximately 10 minutes of your time. Your participation in this study is voluntary, if you
choose not to participate or to withdraw from the study at any time; you can do so
without penalty or loss of benefit to yourself. The results of the research study may be
published but your identity will remain confidential and your name will not be disclosed to
any outside party. In this research, there are no foreseeable risks to you.

As a participant in this study, you should understand the following:

1. You may decline to participate or withdraw from participation at any time without
consequences.
2. Your identity will be kept confidential.
3. The researcher has thoroughly explained the parameters of the research study and
all of your questions and concerns have been addressed
4. You understand that the information from the recorded interview may be
transcribed.
5. The researcher will structure a coding process to assure that anonymity of your
name is protected.
6. Data will be stored in a secured and locked area.
7. The research results will be used for publication.

By signing this form, you acknowledge that you understand the nature of the study,
the potential risks to you as a participant, and the means by which your identity will be
kept confidential. Your signature on this form also indicates that you are 18 years old or
older and that you give your permission to voluntarily serve as a participant in the study
described.
Page 24 of 25
LINE ITEM BUDGET

Page 25 of 25
 Particulars/Items Unit Cost Quantity Frequency Duration Total Cost
I. Personal Services (PS)
a. Salaries
Research Assistant (3) 4,800 3 1 9 129,600
Encoder 6,000 1 1 1 6,000
b. Honoraria
Project Leader 8,800 1 1 12 105,600
Consultant 3,000 1 8 24,000
Statistician 6,000 1 1 1 6,000
II. Data Gathering Expenses
a. Transportation allowance (Persons)
Cagayan (32 RHU) 500 3 42 63,000
*Calayan 500 2 2 2,000
Isabela (39 RHU) 500 3 50 75,000
*Palanan 2,500 2 2 10,000
*Maconacon 2,500 2 2 10,000
Nueva Vizcaya (15 RHU) 500 3 25 37,500
Quirino (6 RHU) 300 3 15 13,500
Batanes(6 RHU) 5,500 2 2 22,000
*Itbayat 500 2 2 2,000
*Sabtang 250 2 2 1,000
TEV 800 3 100 DAYS 240,800
III. Supplies and Materials
Expenses
a. Printing and Binding Expenses 10,000
IV. Other Expenses
a. Training Expenses 500 4 2 4,000
b. Communication Expenses
Prepaid Card Allowance 300 2 12 7,200
V. Ethics Review 15,000 1 1 1 15,000
VI. Expert Panel Review Fee for 1,500 5 1 7,500
the Newly developed
questionnaire
VII. Mentoring and monitoring of 3,000 6 18,000
the review board

VIII. Insurance of field researchers 2000 3 1 1 6,000

Total 814,900

Page 26 of 25
Page 27 of 25