tally sheet of survey
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Tally sheet COpar .. survey
Transcript of tally sheet of survey
purok 2AGE dea charm mardi gia
MALE 0-11 mos. 0 1-4 1 1 25 to 9 0 1 110 to 14 015-19 020-24 1 125-29 1 1 2 330-34 0 1 135-39 040-44 1 145-49
50-54
55-59
60-64
65 &above 1 110
AGE
0-11 mos. 0 2 2 1-4 0 1 15 to 9 010 to 14 1 115-19 1 120-24 1 1 225-29 2 230-34 1 135-39 1 140-44 1 145-49
50-54
55-59
60-64
65 &above
12
CIVIL STATUS
4 4Child 1 5 6
Single 1 5 1 7Married 2 2 4Married but separeted
Widow 1 1widower 22
RELIGION
9 9Roman Catholic 1 9 3 13Protestant
INC
Born again Christian
Jehova’s witness
Muslim
Others
22
2 2Pre-elem 1 1Elem. Level
Elem. Undergrad 1 1 2Elem graduate 1 1 2Highschool Level 2 2Highschool undergrad 1 4 2 7Highschool graduate 1 1College Level
College undergrad 1 1College graduate
Post grad
Vocational
Short Courses
None 2 2Not yet in age 2 2
22
Type of Work
Regular full time 1 1 2 4Regular part time
Contractual 6 mos. 1 1Contractual every week
Contractual every day 2 2 4Seasonal
HIGHEST EDUCATION COMPLETED
Self employed
Unemployed 3 6 1 10Not yet in age to work 3 3
22
LOCATION
Within the community 1 1 3 2 7Within the municipality
Outside the municipality 2 2Outside the country
9
PLACE
Office
Factory 2 3 5Field 1 1 2 4
9
PLACE OF ORIGIN
NCR 1 9 10Central Luzon 8 2 10Northern Luzon
Southern Luzon
Visayan Region 1 1 2Mindanao Region
22
LENGTH OF RESIDENCE
0-11 mos. 1 2 3 1-4 1 2 1 49-May 1 114-Oct 1 1 2 415-19 1 120-24 2 1 325-29 1 130-34 1 135-39 1 140-44 2 245-49
50-54
55-59
60-64
65 &above 1 122
Membership
Nuclear 1 1 2 4Extended 2 2Single Parent
Dyad
homosexual 2 2Cohabiting/common-law
TOTAL 1 8
Authority
Matriarchal 2 2Patriarchal 3 2 5Egalitarian 1 1matricentric
Patricentric
TOTAL 1 8Location
Patrilocal 3 2 1 6Matrilocal
Neolocal 1 1 28
dominant
Father 1 2 3Mother 2 2both 2 2Family
Others 1 18
conflict With 2 2None 1 3 2 6
8
2 2 4Discusses about it and the father decides on the issue/concern
2 2
Involves significant others
no discussion at all 1 1 28
Monthly income(combined)
less than 5,000 1 1 2 2 65,001 – 10,000 2 210,001 – 15,000
15,001 – 20,000
20,001 – 25,000
25,001 – 30,000
30,001 – 35,000
35,001 – 40,000
40,001 – 45,000
45,001 – 50,000
50,001 and above
8
Financial Source
Employment 1 2 2 2 7Business
Pension
help from relatives/friends 1 1others,
8
Monthly family Expenditure
less than 5,000 1 3 2 2 85,001 – 10,000
10,001 – 15,000
15,001 – 20,000
20,001 – 25,000
25,001 – 30,000
Discusses about it and the mother decides on the issue/concern
Both parents discuss and decides on the issue
All family members discuss and decides on the issue/concern
30,001 – 35,000
35,001 – 40,000
40,001 – 45,000
45,001 – 50,000
50,001 and above
8
Priorities and Expenditure
Food 1 3 2 2 8Clothing
Education
utilities
Health
Recreation
Savings
8
decision maker
Father 1 2 3Mother 1 1both 2 1 3family
others 1 18
Adequacy of family income
adequate 1 3 2 1 7inadequate 1 1
8
Cultural orientation
1 2 3
a punishment from God
caused by other person 2 2caused by change in weather 1 2 3others
caused by physiologic factor e.g infections
caused by supernatural phenomenon e.gkulam, balis
8
Cultural belief
can be restored by faith healers
2 2
1 3 2 68
Cultural practice
2 2
1 3 2 6
8
Community Involvement
2 2
2 2does not actively join 1 1 2 4
8
2 2owned 2 2 4rented
rent- free 1 1 2lease to own
8
Construction materials used
light 2 2 4mixed 1 1 2
can be restored by God/ other spiritual faith
can be restored by supernatural power e.g Tawas. Hilot, hula
can be restored by health personnel e.g doctors, nurses
always practices local cultural practice about health matters
sometimes local cultural practice about health matters
never local cultural practice about health matters
actively joins fiesta, religious processions, local cultural practices
a. Ownership
strong 1 1 2TOTAL 1 8
0 2 1 31 1 1 1 32 1 1 23
4
5
TOTAL 1 8
2 2adequate 1 2 3 6inadequate
8
electricity 1 2 2 3 8kerosene
others
TOTAL 1 8
2 2adequate 1 2 3 6inadequate
total 1 8
adequate 1 2 2 3 8inadequate
TOTAL 1 8
water supply
a. Number of rooms used for sleeping:
a. Adequacy of space
a. Lighting facility
a. Adequacy of lighting
a. Ventilation
private/own household use 1 2 2 3 8Public
TOTAL 1 8
deep well
local water district 1 2 3commercial 2 3 5
TOTAL 1 8
yes 1 2 2 3 8no
TOTAL 1 8
none (direct from faucet or pipe) 1 2 3large covered container with faucet
2 3 5
TOTAL 1 8
refrigerator 1 1 2cabinet
basket 2 2table 1 1 2 4TOTAL 1 8
If table:
covered 1 1 2 4uncovered
TOTAL 1 4
a. Ownership
a. Source
a. Potability
a. Storage
large uncovered container without faucet
a. Storage
a. Cooking facility
electric stove
gas stove 2 2 1 5firewood/charcoal 1 2 3
TOTAL 1 8
plastic bag 2 2 3 7None 1 1Container
TOTAL 1 8If container:
Open
Covered
TOTAL
Practiced 2 2 3 7not practiced 1 1TOTAL 1 8
If practiced: method of disposal
hog feeding
open dumping
burial in pit
collected 2 2 3 7composting
TOTAL 7
Reason for practicing:
environmental friendly 2 2 4barangay ordinance 3 3used for business
others
TOTAL 7
1. Storage
1. Waste Segregation
If NOT practiced: method of disposal
hog feeding
open dumping
burial in pit
open burning
garbage collection 1 1Composting
TOTAL 1 1
Reason for not practicing
not aware of effects
no time to do it 1 1long time practices of family
1
toilet facilities
owned 1 2 2 5shared/public 3 3none
TOTAL 1 8
less than 20 ft 2 220 ft. and beyond 1 2 3 6
TOILET
balot
open pit
close pit
overhung latrine
antipolo type
water sealed 1 2 2 3 8bored hole latrine
others
TOTAL 1 8
Drainage
open drainage
blind drainage
none 1 2 2 3 8
not a barangay ordinance/not strictly monitored
1. Ownership
1. Location from source of water
8
Condition
flowing
stagnant
TOTAL
with 5 1 6without 1 1 2TOTAL 1 8
Kind
Dog 1 3 1 5Cat 2 2TOTAL 7
Where Kept
Inside the yard 1 5 6Free roaming 1 1
TOTAL 7
Vaccination
With regular vaccination 3 1 4Without vaccination 1 2 3
TOTAL 7
practices to control insect
Fumigation
Insecticides 3 3setting traps
cleaning the yard 1 2 2 5None 2TOTAL 1 8
Presence of animals that are rabies carriers
presence of breeding sites
None 2 2 1 5With 1 2 3TOTAL 1 8
FLIES
MOSQUITOES 1 2 3
TOTAL 1 3
home
Very good
Good 1 2 2 1 6Poor 2 2
8
water
Very good 2 2Good 1 2 3 6Poor
8
food and waste management
Very good 2 2Good 1 2 3 6Poor
8
PRESENCE OF INDUSTRIAL
yes
1 2 2 3 8TOTAL 1
small scale
none
IF YES:
large scale
KIND OF NEIGHBORHOODaccommodating 1 1approachable 1 1 1 3 6Friendly
busy
refusing
not available 1 1TOTAL 1 8
Takes a bath regularly
PRACTICEalways 1 3 2 2 8sometimes
NOT PRACTICE
Brushing the teeth
PRACTICE 2always 1 3 2 8sometimes
NOT PRACTICE
Hand washing before/after eating
PRACTICE 2always 1 3 1 7sometimes 1 1
NOT PRACTICE
Nail Cutting
PRACTICEalways 1 3 2 6sometimes 2 2
NOT PRACTICE
Use of Hygienic Products
PRACTICEalways 3 2 1 6sometimes 1 1 2
NOT PRACTICE
Ear Cleaning
PRACTICEalways 3 2 5sometimes 1 2 3
NOT PRACTICE
Regular change of clothes
PRACTICE 2always 1 3 2 8sometimes
NOT PRACTICEsleeps 8 hoursPRACTICEalways 2 2sometimes 1 2 3
NOT PRACTICE 3 3
takes nap/ rest period with in the day
PRACTICEalways 2 2sometimes 1 2 3
NOT PRACTICE 3 3
Perform Regular exercise everyday
PRACTICEalways 2 2sometimes 2 2
NOT PRACTICE 1 3 4
Performs recreational activities
PRACTICEalways 2 2sometimes 2 2
NOT PRACTICE 1 3 4
PRACTICEalwayssometimes 2 2
NOT PRACTICE 1 3 2 6
PRACTICEalwayssometimes
NOT PRACTICE 1 3 2 2 8
Use safety devices when necessary
PRACTICEalwayssometimes 1 3 2 6
NOT PRACTICE 2
smoker
yes 2 2 4no 1 3 4total 8
If yes, #of smoker
total 2 2
If yes, age of smoker
Has regular medical checkup (once a year
Has regular dental checkup ( every months
< 10 years old
10 TO 14
15-19
20-24
25-29 2 230-34
35-39
40-44
45-49
50-54
55-59
60-64
65 & above
2
Age started smoking
< 10 years old
10 to 14
15-19 2 220-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 & above
TOTAL 2
Years of smoking
< 1 year
1 to 4
5 to 9
10 to 14 2 215 -19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 & above
TOTAL 2
Frequency
< 5 sticks per day
5-9 sticks per day 1 110-14 sticks per day 1 115-19 sticks per day
1 pack
2 packs
3 packs
4 packs
5 packs & above
TOTAL 2 2
alcohol drinker
yes 2 2 4no 1 3 4total 8
If yes, #of Alcoholic Beverages drinker
total
< 10 years old
10 to 14
15-19
20-24
25-29 2 230-34
35-39 2 240-44
45-49
50-54
55-59
If yes, age of Alcoholic Beverages drinker
60-64
65 & above
4
Age started drinking Alcoholic Beverages
< 10 years old
10 to 14
15-19 2 2 420-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 & above
TOTAL 4
Years of drinking Alcoholic Beverages
< 1 year
1 to 4
5 to 9
10 to 14 2 2 415 -19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 & above
TOTAL 4
Frequency
Everyday
Every other day
Every week 1 1Every month
Every year
occasionally 2 1 34
Kinds of Alcohol
BEER 2 2 4
TOTAL 4
1 bottle
2-3 bottles 2 24-5 bottles
6-7 bottles 2 28-9 bottles
10 bottles & above
TOTAL 4
BMI
1 3 4
TOTAL
First Choice
meat only
Volume intake/bottle(s) per drinking spree
N – Normal (within 2SD of median IRS)
UW – Underweight (< -2SD of median IRS
OW – overweight (> + 2SD of median IRS
Fish only 2 2 1 5vegetable only 1 1mixed 1 1 2others
TOTAL 1 8
Number of Servings:
1 1 2 32--3 1 2 2 54-5 & above 2
TOTAL 1 8
Second choice
meat only
Fish only 1 1vegetable only 3 1 1 5mixed 1 1 2others
TOTAL 1 8
Number of Servings:
1 1 2 32--3 1 2 2 54-5 & above
TOTAL 1 8
Reasons for choices
2think it’s healthy 3 5own preference 1 1affordability 2 2personal belief/practice
health condition
TOTAL 1 8
Reason for not choosing other options
not healthy 2 2own preference 1 2 3not affordable 1 2 3personal belief/practice
health condition
TOTAL 1 8
2everyday 1 3 6every 3 days 2 2once a week
others
TOTAL 1 8
2prepared at home 1 3 2 8bought outside
TOTAL 1 8
How often?
2everyday 1 3 1 7every 3 days 1 1once a week
others
TOTAL 1 8
If bought outside, is it from a:
restaurant/fast food
carinderia
Food Cart
TOTAL
Reason for above choice
convenience
From above response, how frequent is the intake?
How is food prepared for mealtime?
cheaper
healthy
variety of choices
others
TOTAL
Everyday
every other day
every week 2 2Sometimes 1 3 2 6Never
TOTAL 1 8
Takes/ eat fried foods
everyday
every other day 1 1every week 2 2 4sometimes 3 3never
TOTAL 1 8Drinks carbonated drinks
2occasionally 1 3 1 7weekly 1 1everyday
TOTAL 1 8
Heart dse 3 3Hpn
Cancer
Kidney dse
Dm
3
Takes/eat canned preserved food ex. Lucky me, maling
History/Presence of Non Communicable Diseases in the
Family
TOTAL 3
Chicken pox 1 1Measles
TOTAL 1
Blood pressure below normal range 1 2 3
Blood pressure within normal range 1 1
Blood pressure above normal range
3TOTAL 1 4
Complete accdg to age
Imcompleteaccdg to age
Fully immunized child
TOTAL
doctor 3 2 1 6nurse 1 1midwife
hilot
albularyo
faith healer
elderly 1 1
History/Presence of Communicable Diseases in the Family
Blood Pressure Record for ages 35 above
Personnel mostly consulted in times of sickness
TOTAL 1 8
consult a private health worker 1 1see a known community healer 2 2consult a rural health team 1 2 2 5self-medicate
none
TOTAL 1 8
prescribed by doctor 2 2over the counter/ self-medication 1 3 2 6herbals
others
TOTAL 1 8
# of pregnant women
ASOG
TOTAL
Regular Check-upNot Regular Check upWithout
Tetanus Check up
Measures taken in times of sickness/illness
Medication/treatment in times of sickness/illness
regular not regularwithout
Family Planning
2acceptor 1 2 5non – acceptor 3 3
TOTAL 1 8
Reason for accepting
2good for health of family 2 4personal belief
religious belief
influenced by others 1 1others
TOTAL 1 5
Reason for NOT accepting
good for health of family
personal belief 3 3religious belief
influenced by others
others
TOTAL 3
Methods used:
2Natural 2 4artificial 1 1permanent
TOTAL 1 5
2Aware 1 3 2 8unaware
TOTAL 1 8
Awareness of health Services offered by the BHC/RHU
2Brgy. Captain 1 3 2 8Kagawad
Elderly
BHW
Influential person
Religious Leader
Neighbor
TOTAL 1 8
gossip
drugs
alcohol drinking 2 2 4personal/familial conflict 1 3 4riot
TOTAL 1 8
1 3 2 2 8brgy. Hearing
endorsed local pulice
TOTAL 1 8
Recognized leader and any key person
Conditions/events/issues that causes social conflict/upheavels
within the community
Practices/Approachesthat are effective in setting issues and
concerns within the community
settelement among involved parties
