Chapter 1

THE PROBLEM AND ITS SETTING

Background of the Study

According to Boyle (2012), newborn screening includes a blood test,

hearing screening, and, in some hospitals, screening for critical congenital

heart defects. Newborn screening is important because even if your baby

looks healthy, some medical conditions can’t be seen just by looking. If

your baby was not born in a hospital or was not screened before leaving

the hospital, take your baby to the doctor’s office or hospital to be screened

as soon as possible. Just as important as the screening is making sure your

baby’s doctor gets the results. If your baby’s doctor doesn’t tell you about

your baby’s newborn screening results, ask for them! If your baby fails any

of the screening tests, make sure that he or she gets any additional tests or

necessary treatments right away – don’t wait! Talk to your baby’s doctor to

find out what is needed. (Boyle, 2012)

Globally, study shows that newborn screening is a new method that

many mothers are not yet aware of (Newborn Screening Reference Center,

2012). This tends to conform to the 2010 statistics on NBS which covers
 2

different countries of the world. Compared to the Asia Pacific Region

which includes Japan, Hong Kong, Taiwan, Singapore, Australia and New

Zealand where NBS coverage is almost 100% of babies. (Padilla, 2003)

Although countries may exhibit high levels of newborn screening

coverage, there is wide variation in the number of disorders screened.

(Raho, 2005)

In the Philippines, complete compliance to this diagnostic procedure

is still difficult despite the enactment of the law on Newborn Screening

(R.A. 9288) in 2004. The alarming number of newborns not subjected to

NBS may be also attributed to a provision of the aforementioned act under

Article 3, Section 7 which states that parents have the right to refuse

Newborn Screening for their offspring’s (Padilla, 2003).

As of December 2010, there are 2,389,959 (35 %) babies that have

undergone NBS and based on these data, the incidences of the following

disorders are: CH (1: 3,324); CAH (1: 9,446); PKU (1: 149,372); Gal (1:

108,635) and G6PD deficiency (1: 52). The program has saved the

following numbers of newborns from complications and/or death: 719

from CH, 253 from CAH, 22 from Gal, 16 from PKU and 44 273 from G6PD

deficiency. (DOH, 2011)

 3

In selected purok in Barangay Mankilam, there were approximately

275 0r 49% out of 558 newborns who underwent newborn screening in the

year 2012. However, in the year 2013 approximately 136 or 45% out of 304

newborns underwent the newborn screening test wherein (3 or 4%) out of

136 screened newborns were positive of G6PD. It is very evident that there

is a problem on the compliance of the mothers on newborn screening.

There are 16 newborn screening centers in Tagum City, 13 centers were

active in conducting newborn screening test and there were 3 inactive

newborn screening centers. (Villa Patricia Mankilam Health Center, 2014)

Based on the above mentioned problem, we, the researchers, are

highly motivated towards conducting the research for us to know the

significant influence of awareness on newborn screening and the

compliance of mothers.

Statement of the Problem

This study aims to determine relationship of Awareness of Newborn

Screening and Compliance among Mothers in Barangay Mankilam of

Tagum City:

Specifically, we had sought answers to the following questions:

 4

1. What is the extent of Awareness of Newborn Screening among

Mothers in terms of:

1.1 Availability;

1.2 Nature and Benefits of Newborn screening; and

1.3 Parent Education

2. What is the level of Compliance among Mothers in Barangay

Mankilam, Tagum City in terms of:

2.1 Family Income;

2.2 Attitude; and

2.3 Accessibility of Newborn Screening Centers

3. Is there a significant relationship between the extent of Awareness of

Newborn Screening and level of Compliance among Mothers in

Barangay Mankilam, Tagum City?

Hypothesis

There is no significant relationship on the extent of the Newborn

Screening Implementation and Compliance among Mothers in selected

Puroks in Barangay Mankilam of Tagum City.

 5

Review of Related Literature and Study

This part reviews the literature and concepts of experts that

support facts and principles in the study. The following information serves

as guide for the analysis of the problem under study.

Availability. Newborn screening is available in practicing health

institutions (hospitals, lying-ins, Rural Health Units and Health Centers).

If babies are delivered at home, babies may be brought to the nearest

institution offering newborn screening. Newborn Screening, specifically

sample collection, is expected to be present in all hospitals and lying-in

clinics following the order requiring these institutions to offer NBS for

licensing purposes (http://www.scribd.com/doc/27447985/Newborn-

Screening, Date Retrieved: August 12, 2014)

According to the American Academy of Pediatrics has

recommended that all parents should receive information about the

availability of expanded screening so that if they choose to do so they can

receive this at their own expense. Under federal directives, Kansas

Department of Health and Environment (KHDE) programs started

providing family educational materials about availability of newborn

screening. Advice to parents about the availability of expanded newborn

 6

screening through a website. (http://mchb.hrsa.gov/screening/summary,

Date Retrieved: August 12, 2014)

This test is already available in specialized settings and is not even

extraordinarily expensive relative to many other diagnostic procedures

routinely applied to newborns with abnormal characteristics. We hope

that the method will become routine under appropriate circumstances.

However, experience tells us that many medical tests are used routinely

just because they are available, not because of any clear evidence of utility.

(Genome Science, 2012)

Newborn screening results are available within three weeks after the

NBS Lab receives and tests the samples sent by the institutions. Results are

released by NBS Lab to the institutions and are released to your attending

birth attendants or physicians. Parents may seek the results from the

institutions where samples are collected.

(http://www.scribd.com/doc/73355769/Newborn-Screening-Brochure,

Date Retrieved: August 12, 2014)

Nature and Benefits of Newborn screening. Early detection of

infant diseases and disorders can often prevent long-term serious illness or

death (George Krucik, 2013).

 7

According to Newborn Screening Contingency Plan, newborn

screening is an essential, preventive public health program for the early

identification of medical conditions that can lead to catastrophic health

problems. If left untreated, the cost of these conditions is enormous, both

in human suffering and in economic terms. Therefore, continuity of

services is a priority for newborn screening programs. (Newborn

Screening Contingency Plan, July 2010)

A screening shows that your baby might have a condition, the health

care provider or the state health department will call you. It is important to

follow up quickly. Further testing can verify whether your baby has the

condition. If so, treatment should start right away. (MedlinePlus, August 5,

2014)

One of the nature and benefits of newborn screening as a public

health activity aimed at the early identification of infants who are affected

by certain genetic/metabolic/infectious conditions. Early identification of

these conditions is particularly crucial, since timely intervention can lead

to significant reduction of morbidity, mortality, and associated disabilities

in affected infants. This is the practice of testing all babies for certain

disorders and conditions that can hinder their normal development. Babies

with these conditions appear healthy at birth but can develop serious
 8

medical problems later in infancy or childhood. Early detection and

treatment can help prevent intellectual and physical disabilities and life-

threatening illnesses. (Carmencita David-Padilla, et. al, 2010)

Although there are concrete benefits of newborn testing such as

prevention of further complications, there are also troubling consent and

privacy issues raised by the screening, storage, and use of the samples.

(Vani Kilakkathi 2012)

For most conditions screened, affected babies are at risk of

intellectual disability, physical disabilities and even death if they are not

diagnosed and treated early. Comprehensive newborn screening gives you

the opportunity to protect your baby from the preventable complications

of certain undiagnosed medical conditions. If your baby is affected by one

of the conditions, newborn screening can play a key role in allowing your

baby to live a better life. Lack of diagnosis and proper treatment and

management can lead to extensive hospital stays in intensive care, or even

death. Screening can identify the risk to a baby early in life, and prompt

testing can be done to confirm the diagnosis. If your baby's test is normal,

comprehensive newborn screening can give you some peace of mind about

the conditions included in the screening.

 9

(http://www.savebabies.org/pregnant_faqs.html, Date Retrieved: August

12, 2014)

Support expanding existing provision of newborn screening to

include screening for a wider range of inherited metabolic conditions as a

means of preventing death and severe disability. (Burton and Moorthie,

2010)

In terms of diagnosing these different diseases being screened in

the Newborn screening test soon after birth can help prevent some serious

problems, such as brain damage, organ damage, and even death. (Clifton,

2010)

Newborn screening identifies conditions that can affect a child's

long-term health or survival. Early detection, diagnosis, and intervention

can prevent death or disability and enable children to reach their full

potential. (Frieden, 2012).

The beneficence is defined as the doing good, and in regards to

genetic screening it refers to a procedure that will contribute to the welfare

of an individual. There are two components of newborn tests that

determine beneficence. The first is the seriousness of the disease and the
 10

second involves the ability to intervene in order to achieve an improved

outcome. The latter will be dealt with first. (Mark Goebel, et al, 2003)

Parent Education. Mothers need to be provided with comprehensive

information about the newborn screening test at a time which is conducive

for the assimilation of this information. In addition, whilst supporting

health related research using newborn screening samples (Davey, 2005)

According to a website created by Harwood, Claire (2013),

increasing knowledge of the disorder of screened in newborn tests, one of

the main challenges is the implementation of the workflow of a clinic so

that it has maximum benefit. Using educational tools like this website may

have a public health benefit by decreasing disparities in NBS services

across the United States, since lack of awareness can lead to anxiety and

failure to comply with recommendations for follow-up. (Harwood, Claire

2013)

Parent educational materials for newborn-screening programs are

important variations between programs in the information provided to

parents. Continuing research is needed to measure progress toward the

goals outlined within the blueprint and to assess how these changes
 11

impact the care provided through newborn-screening programs.(Fant et.al,

2005)

Parents described consistency in the timing of and methods used to

inform them about NBS. Mothers with higher income were 3.69 times

more likely to receive information before their infants' births than mothers

with lower income. Parents recommended improving verbal and written

communication with parents about NBS at multiple junctures from

preconception to the infant's first few days of life. Parents states that

providers takes time to explain the purpose and importance of NBS, which

diseases are included in testing, and when parents can expect results

(Tluczek et.al, 2010)

Parent education means the various means of providing parents or

legal guardians, information about the newborn screening. (R.A. 9288 Art

2 Sec.4, Legarda, 2004)

Newborn screening begins within 24 to 48 hours of a child's birth

when a few drops of blood are obtained from a heel stick. The blood spots

are sent to a laboratory that is a part of the state or territorial public health

department. The spots are analyzed by several different laboratory

methods to test for biochemical and genetic markers that reveal hidden

congenital (present at birth) disorders. If such markers are found, the

 12

newborn screening follow-up program notifies the parents and physicians

so that the baby can receive immediate attention. Follow-up programs

arrange for diagnostic tests to confirm the newborn screening results.

Follow-up programs also refer the child to a treatment center to provide

access to the essential medical services needed to minimize the effects of

the underlying disorder. (U.S. Department of Health and Human

Services,Centers for Disease Control and Prevention,National Center for

Environmental Health,Division of Laboratory Sciences, October 2008)

To illustrate the impact of newborn screening performance, let’s

review best case-worst case scenarios as they are currently encountered in

different parts of the US when it comes to newborn screening with tandem

mass spectrometry. There are more than 4 million babies born in the US

each year. In the best case, the false-positive rate of a screening program is

0.07% and the positive detection rate is one true positive in 2,249 live

births. That would identify 1,780 affected babies per year and 2,800 false-

positives. The positive predictive value of tandem mass spectrometry

screening would be 39%, and based on a population of 100,000 babies per

year, 1.4 babies would have to undergo unnecessary follow-ups per week.

(http://www.mayomedicallaboratories.com/articles/hottopics/transcript

s/2008/2008-07-sns2tier/07-8.html Date Retrieved: March 13, 2014)

 13

A system of nomination and evidence review has resulted in the

adoption of a uniform newborn screening panel of thirty-one core and

twenty-six secondary conditions. The majority of these disorders are

inborn errors in metabolism and tandem mass spectrometry is most often

used to screen for these disorders. To enable and facilitate the clinical

validation of cut off target ranges for these metabolic disorders by tandem

mass spectrometry, a web-based application for the collection and

reporting of analytical results has been developed and widely adopted into

the routine practice of newborn screening laboratories worldwide.

(https://www.nbstrn.org/research-tools/lab-performance-database Date

Retrieved March 13, 2014)

According to Article 3 of Republic Act No. 9288 or Newborn

Screening Act of 2004, SEC. 6 Performance of Newborn Screening, states

that newborn screening shall be performed after twenty-four (24) hours of

life but not later than three (3) days from complete delivery of the

newborn. A newborn that must be placed in intensive care in order to

ensure survival may be exempted from the 3-day requirement but must be

tested by seven (7) days of age. It shall be the joint responsibility of the

parent(s) and the practitioner or other person delivering the newborn to

ensure that newborn screening is performed. An appropriate

 14

informational brochure for parents to assist in fulfilling this responsibility

shall be made available by the Department of Health and shall be

distributed to all health institutions and made available to any health

practitioner requesting it for appropriate distribution.

It is normal hospital procedure to screen every baby regardless of

whether the parent asks for it and whether the parents have health

insurance. The screening test is normally included in the forms

for standard medical procedures that the newborn may need after birth.

Parents sign this form upon arrival at the hospital for the birth of their

baby. All states require screening to be performed on newborns, but most

will allow parents to refuse for religious purposes. Any decision to decline

or refuse testing should first be discussed with a health professional, since

newborn screening is designed to protect the health of the baby. (Health

Resource and Service Administration (HRSA), 2013)

Newborn screening laws have been on the books for

approximately 40 years in some states. Most states have newborn

screening statutes; however, some allow parents and/or guardians to

refuse the screening, while other statutes require a refusal to be based on a

religious exemption. Some statutes simply require the existence of a

 15

program and allow state public health agencies to identify required tests at

their discretion. (Burke et al, 2006)

According to RA 9288 Art 3 SEC. 7 Refusal to be Tested states

that a parent or legal guardian may refuse testing on the grounds of

religious beliefs, but shall acknowledge in writing their understanding that

refusal for testing places their newborn at risk for undiagnosed heritable

conditions. A copy of this refusal documentation shall be made part of the

newborn's medical record and refusal shall be indicated in the national

newborn screening database. (Legarda, 2004)

RA 9288 (April 7, 2004), AN ACT PROMULGATING A

COMPREHENSIVE POLICY AND A NATIONAL SYSTEM FOR

ENSURING NEWBORN SCREENING, cited one of objectives which

states that parents recognize their responsibility in promoting their child's

right to health and full development, within the context of responsible

parenthood, by protecting their child from preventable causes of disability

and death through newborn screening. Thus, the health practitioner, prior

to delivery, inform the parents or legal guardian of the newborn of the

availability, nature and benefits of newborn screening. Appropriate

notification and education regarding Performance of Newborn Screening,

Refusal to be tested and Parent Education (Philippine Laws and

 16

Jurisprudence Databank, Republic Act No. 9288 of April 07, 2004, Date

Retrieved: August 6, 2014).

Article 3 cited the following: SEC. 6. Performance of Newborn

Screening. - Newborn screening shall be performed after twenty-four (24)

hours of life but not later than three (3) days from complete delivery of the

newborn. A newborn that must be placed in intensive care in order to

ensure survival may be exempted from the 3-day requirement but must be

tested by seven (7) days of age. It shall be the joint responsibility of the

parent(s) and the practitioner or other person delivering the newborn to

ensure that newborn screening is performed. An appropriate

informational brochure for parents to assist in fulfilling this responsibility

shall be made available by the Department of Health and shall be

distributed to all health institutions and made available to any health

practitioner requesting it for appropriate distribution. SEC. 7. Refusal to

be Tested. - a parent or legal guardian may refuse testing on the grounds

of religious beliefs, but shall acknowledge in writing their understanding

that refusal for testing places their newborn at risk for undiagnosed

heritable conditions. A copy of this refusal documentation shall be made

part of the newborn's medical record and refusal shall be indicated in the

national newborn screening database. While Article 2 Section 4 stated that

 17

Parent education means the various means of providing parents or legal

guardians information about newborn screening. This is also emphasized

in SEC. 8. Continuing Education, Re-education and Training Health

Personnel. - The DOH, with the assistance of the NIH and other

government agencies, professional societies and non-government

organizations, shall: (i) conduct continuing information, education, re-

education and training programs for health personnel on the rationale,

benefits, procedures of newborn screening; and (ii) disseminate

information materials on newborn screening at least annually to all health

personnel involved in material and pediatric care (Philippine Laws and

Jurisprudence Databank, Republic Act No. 9288 of April 07, 2004, Date

Retrieved: August 6, 2014).

Family Income. Newborn screening test costs vary by state because

individual states finance their newborn screening programs in different

ways. Most states collect a fee for screening, but health insurance or other

programs often cover all or part of it. Babies will receive newborn

screening regardless of health insurance status. (Health Resource and

Service Administration (HRSA), 2013)

Other states specify required tests in statute. Thirteen states have

established specific funds to finance newborn screening, while others

 18

provide discounted rates for certain services if there is no other means to

pay. (Kraszewski et al, 2006)

Attitude. Acceptance of newborn screening programs is high but

mothers consider the need for consent to be mandatory. They have

concerns about discrimination children with genetic illnesses may face.

(Quinlivan, et.al, 2006)

According to Genomics, Society and Policy (2005), it is reasonable to

anticipate that the attitudes of parents whose child has been diagnosed

through newborn screening may be different from those parents whose

child was found not to have an inborn error of metabolism, or from the

community in general.

Documenting the attitudes of parents and other consumers toward

genetic technologies establishes the framework for discussions on the

appropriateness of molecular newborn screening for hearing loss and

informs specialists about potential areas of public education necessary

prior to the implementation of such screening.(Burton et.al, 2006)

Accessibility of NewbornScreening centers. The services

available are creating pressure to introduce or expand screening

programmes, often before adequate safeguards and regulatory

frameworks are in place (Wilson and Jungner 2010).

 19

According to the United Nations General Assembly (2010),

access to effective care is at the heart of the discourse on how to achieve

the health-related Millennium Development Goals. Researchers have

identified a range of simple and inexpensive interventions that hold the

prospect of saving the lives of many of the infants, children and mothers

now dying unnecessarily.

Even in the poorest countries, some people, often those living in

capital cities, are able to obtain care, however many more are not. Greater

provision of facilities that can deliver effective care is necessary but is not

sufficient. The concept of access that goes beyond many contemporary

paradigms that is explicitly or, more often, implicitly, in widespread use.

(Martin McKee & Barbara McPake, 2009)

Theoretical and Conceptual Framework

According to RA 9288 (2004), AN ACT PROMULGATING A

COMPREHENSIVE POLICY AND A NATIONAL SYSTEM FOR

ENSURING NEWBORN SCREENING, states that parents recognize their

responsibility in promoting their child's right to health and full

development, within the context of responsible parenthood, by protecting

 20

their child from preventable causes of disability and death through

newborn screening. Thus, the health practitioner, prior to delivery, inform

the parents or legal guardian of the newborn of the availability, nature and

benefits of newborn screening. Appropriate notification and education

regarding Performance of Newborn Screening, Refusal to be tested and

Parent Education.

Furthermore, this study is supported by Guinid et al (2013) who

stated that newborn screening is the practice of testing every newborn for

certain harmful or potentially fatal disorders that are not otherwise

apparent at birth. The level of awareness on NBS is promoted through

materials posted in health facilities such as posters and pamphlets that

provide basic information. The quality of the mothers of having

knowledge or being conscious on the early detection and treatment of the

newborn disease which are mostly genetic is greatly affected by providing

proper parent education, information on the performance of the test and

refusal to be tested. (Guinid et al, 2013)

On the other hand, this study is supported by the concept of Davey

(2010) that women heard about newborn screening, however desired

further information in order to acquire a more comprehensive knowledge

of the test. Furthermore, mothers need to be provided with comprehensive

 21

information about the newborn screening test at a time which is conducive

for the assimilation of this information. The awareness of mothers, their

attitude towards the test as well as the accessibility of the newborns

screening centers greatly affect the mothers’ compliance on sending their

babies to undergo the newborn screening test for early detection and

treatment of newborn screening disorders. (Davey, 2010)

Figure 1 below schematically presents the variables of the study. The

independent variable is the Awareness of Newborn Screening.

Consequently, the dependent variable is the Compliance among Mothers

in Barangay Mankilam, Tagum City. Both the independent and dependent

variable has three indicators. The independent variable this were the

Performace of Newborn, Implementation, Refusal to be tested and Parent

Education, while in the dependent variable this were the Family income,

attitude and accessibility of Newborn Screening Center.

 22

Independent Variable Dependent Variable

Compliance among mothers:

Awareness of Newborn
 Family Income
Screening:
 Attitude
 Availability
 Accessibility of
 Nature and Benefits of
Newborn
 Screening Centers

23

Figure 1. Conceptual Paradigm Showing Variable of the Study

Significance of the Study

The result of the study on the Awareness of Newborn Screening and

Compliance among Mothers in Barangay Mankilam of Tagum City is

significant because it will provide information that is useful to the:

Mothers. The outcome of the study will help the postpartum mothers to

understand the nature of newborn screening, its importance as well as the

benefits of early detection of diseases so that early treatment can be done.

 24

Student Nurses. This study will help create awareness for the student

nurses regarding the importance of having the newborns to be undergone

with newborn screening test. In this manner, they will be able to provide

enough knowledge so that mothers will be encouraged to have their babies

screened.

Barangay Health Care Team. This will make them to become more

informative and efficient enough in providing knowledge and awareness

to the perinatal mothers regarding newborn screening test. This will also

help them establish various ways of providing information such as giving

leaflets, booklets and symposiums if possible.

Definition of Terms

To give the readers clearer and better understanding of the terms

used in this study, the following items are conceptually and operationally

define:

Availability. Indicates that something is easily obtainable and ready for

use.(http://www.vocabulary.com/dictionary/availability Date Retrieved:

August 12, 2014). In this study, it shows the availability of newborn

 25

screening in a specific area that is convenient to people who lives within

the vicinity of that area.

Nature and Benefits of Newborn screening. According to Goodman,

2011, the early detection of disorders and conditions detectable through

newborn screening is vital. Although the newborn screening detects

conditions that cannot be cured, early management can be beneficial in

most cases. (Goodman, 2011). In this study, it refers to the advantages of

having the baby screened through Newborn screening test.

Parent Education. Parenting Education has been defined as: "programs,

support services and resources offered to parents and caregivers that are

designed to support them or increase their capacity and confidence in

raising healthy children" (Carter, 2010). In this study, it refers to talks,

seminars, symposium and counselling provided by health care

practitioners to mothers regarding newborn screening test.

Family Income. Refers to the total family income which includes primary

income and receipts from other sources received by all family members.

(http://www.nscb.gov.ph/ru12/DEFINE/DEF-INC.HTM Date retrieved:

March 12, 2014)In this study, it refers to the ability of the family to pay the

allotted amount when it comes to Newborn Screening Test.

 26

Attitude. An attitude is an expression of favor or disfavor toward a

person, place, thing, or event (the attitude object). Prominent psychologist

Gordon Allport once described attitudes "the most distinctive and

indispensable concept in contemporary social psychology." .Attitude can

be formed from a person's past and present. Attitude is also measurable

and changeable as well as influencing the person's emotion and behavior.

(Merriam-Webster, 2012). In this study, it refers to the attitude of mothers

on complying to newborns screening test.

Accessibility of Newborn Screening Centers. Means that Mothers can

contact the baby’s doctor or the local health department to schedule

follow-up testing. ( Dreyzhener, 2013). In this study, it refers to the

influence of the accessibility of Licensed Newborn Screening Facilities

towards the Mothers Compliance on Newborn Screening test.

Mothers. The Woman who gives birth to an individual (Merriam-Webster,

2012). In this study, it refers to the Woman who has a child aging 0-1year

old.
 27

Chapter 2

METHODOLOGY

This chapter presents the research process employed to attain the

objectives of the study. It includes the research design, research

participants, distribution of respondents, research instrument, data

gathering procedures, and statistical treatment being used to interpret the

statistical result.

Research Design
 28

A Descriptive-Correlation Method of research was employed in this

study. It is a design to estimate the proficiency to which different variables

are related to one another in the population or sample of interest. (Venson,

2004)

This design is used to develop knowledge throughgathering

information about Newborn Screening Implementation and Compliance

among Mothers in selected Puroks in Barangay Mankilam of Tagum City.

This design was adopted since the main problem of the study is to

identify if there is an effect between the extent of Newborn Screening

Implementation and Level of Compliance among Mothers in Selected

Puroks in Barangay Mankilam of Tagum City.

Research Participants

The sampling that was used would be the purposive sampling

wherein there are a total of 30 Mothers on Selected Puroks in Brgy.

Mankilam, Tagum City: 3 in Purok Garciaville 1, 3 in Purok Garciaville 2, 3

in Purok Garciaville 3, 3 in Purok Country Homes 1, 3 in Purok Country

Homes 2, 3 in Purok Margarita, 3 in Purok Pag-Ibig, 3 in Purok Lynville,

3 in Purok Union and 3 in Purok Galingan. Table one, shows the

distribution of the research participants.

 29

Table 1

Distribution of Respondents

Purok Number of Mothers

Garciaville 1 3

Garciaville 2 3

Garciaville 3 3

Country Homes 1 3
 30

Country Homes 2 3

Margarita 3

Pag-Ibig 3

Lynville 3

Union 3

Galingan 3

TOTAL 30

Research Instrument

The instrument that was used in the study is a researcher-made

questionnaire-checklist which was submitted to and validated by pool of

expert. A Likert Scale type of survey was used to guide the respondents in

answering the questions.

Parameter Descriptive Description

Limit Equivalent

4.50-5.00 Very Extensive This means that the extent of

Awareness of Newborn
 31

screening is felt or

observed in all occasions.

3.50- 4.49 Extensive This means that the extent of

Awareness of Newborn

screening is felt or

observed in most occasions.

2.50-3.49 Moderately This means that the extent of

Awareness of Newborn

screening is felt or

observed in some occasions.

1.50-2.49 Less Extensive This means that the extent of

Awareness of Newborn

screening is felt or

observed in rarely occasions.

1.0-1.49 Not Extensive This means that the extent of

Awareness of Newborn

screening is not

felt or observed at

all.
 32

For the dependent variable, the same instrument was used to collect

data. However, Likert Scale rating with a different description had

made and accomplished the items in the questionnaire by the

respondents.

Parameter Descriptive Description

Limit Equivalent

4.50-5.00 Very High This means that the level of

Compliance among mothers is

evident in all occasions.

3.50- 4.49 High This means that the level of

Compliance among mothers is

evident in most occasions.

2.50-3.49 Moderate This means that the level of

Compliance among mothers is

evident in some occasions.

1.50-2.49 Low This means that the level of

Compliance among mothers is

rarely seen.
 33

1.0-1.49 Very Low This means that the level of

Compliance among mothers is

not observed at all.

Data Gathering Procedures

The researchers took the following procedures in order to gather

data needed for the study:

Seeking Permission to Conduct the Study.The researcher will ask

permission from the school president thru the research director of St.

Mary’s College of Tagum, Inc., Tagum City to conduct the study. The

researcher will also ask permission from the Barangay Captain thru the

Barangay officials and the health care team members of Barangay

Mankilam, Tagum City to conduct the study in their area.

Administration and Retrieval of Data. After the questionnaire

checklist will be validated, the researchers will ask the permission from the

Barangay Officials. After which, the researchers will personally visit the
 34

respondents in their respected houses and conduct an interview with the

use of the questionnaire. In that way, data will be collected on the same

day.

Checking, Collating and Processing of Data. After the conduct of

the study, the data will be checked, collated, and processed.

Statistical Treatment

The responses to the item in the questionnaire were tallied and

recorded respectively. The results were analyzed and interpreted in the

light of the purpose of this study using the appropriate statistical

treatment as follows:

Mean. It is the average of the set data used to determine the extent

ofnewborn screening implementation and compliance among mothers on

selected puroks in Barangay Mankilam of Tagum City to answer problem

1 and 2.

Pearson r or Product Moment Correlation. This is a method used to

compare the degree of linear relationship of two variables. This text was

used to determine the degree of linear relationship between the extent of

 35

the Newborn Screening Implementation and Compliance among mothers

in selected puroks in Barangay Mankilam of Tagum City.

Figure 2. Villa Patricia Subdivision, Barangay Mankilam, Tagum City Map

 36

Chapter 3

RESULTS AND DISCUSSIONS

Summary of Findings

In this chapter, the researchers discuss the findings and results from

the data gathered. The researcher also tested the null hypothesis

formulated in this study.

Table 2 Explains the Extent of Awareness of Newborn

Screening among Mothers in terms of Availability.

The first item, “I am aware that all of the hospitals in Tagum City are

implementing newborn screening test,” got the highest average weighted

mean of 4.30 with a descriptive equivalent of extensive. It is followed by

the second item, “I am aware that lying-ins also conduct newborn screening

test,” got an average weighted mean of 3.97 with a descriptive equivalent

 37

of extensive. The fifth item, “I am aware that results are readily available in the

institutions where samples are collected,” got the third highest average

weighted mean of 3.90 with a descriptive equivalent of extensive. Fourth

in rank is the third item, “I am aware that the newborn screening test is

routinely done in a hospital and even in lying-ins,” with an average weighted

mean of 3.67 and descriptive equivalent of extensive. The fourth item, “I

am aware that newborn screening results are available within three weeks,” got

the lowest average weighted mean of 3.33 with a descriptive equivalent of

extensive.
 38

Table 2

Extent of Awareness of Newborn Screening among Mothers

in terms of Availabilities

Items AWM Description

1. I am aware that all of
the hospitals in Tagum City
4.30 Extensive
are implementing newborn
screening test.
2. I am aware that lying-
ins also conduct newborn 3.97 Extensive
screening test.
3. I am aware that the
newborn screening test is
3.67 Extensive
routinely done in a hospital
and even in lying-ins.
4. I am aware that
newborn screening results Moderately
3.33
are available within three Extensive
weeks.
5. I am aware that results
are readily available in the
3.90 Extensive
institutions where samples
are collected.
MEAN 3.83 Extensive
 39

The Extent of Awareness of Newborn Screening among Mothers in

terms of Availability got a mean of 3.83 with a descriptive equivalent of

extensive. This means that the mothers are aware of the availability of

newborn screening test in most occasions.

This test is already available in specialized settings and is not even

extraordinarily expensive relative to many other diagnostic procedures

routinely applied to newborns with abnormal characteristics. We hope

that the method will become routine under appropriate circumstances.

However, experience tells us that many medical tests are used routinely

just because they are available, not because of any clear evidence of utility.

(Genome Science, 2012)

 40

Table 3 Explains the Extent of Awareness of Newborn Screening among

Mothers in terms of Nature and Benefits of Newborn Screening.

The second item, “I am aware that newborn screening refers to a

procedure that will contribute to the newborns welfare,” got the highest average

weighted mean of 4.20 with a descriptive equivalent of extensive. It is

followed by the third item, “I am aware that all newborns should be submitted

to newborn screening for their protection,” got an average weighted mean of

4.13 with a descriptive equivalent of extensive. The first item, “I am aware

that the test is done for the early detection of disorders so that proper treatment

can be given and complications can be prevented,” got the third highest average

weighted mean of 3.93 with a descriptive equivalent of extensive. Fourth

in rank is the fifth item, “I am aware that after detection of the disorders further

assessment, medical management and follow-up are vital responsibilities of both

parents and healthcare provider.” with an average weighted mean of 3.83 and

descriptive equivalent of extensive. The fifth item, “I am aware that timely

 41

intervention can lead to significant reduction of morbidity, mortality, and

associated disabilities in affected infants,” got the lowest average weighted

mean of 3.77 with a descriptive equivalent of extensive.

Table 3

Extent of Awareness of Newborn Screening among Mothers

in terms of Nature and Benefits of Newborn Screening

Items AWM Description

1. I am aware that the test is
done for the early detection
of disorders so that proper
3.93 Extensive
treatment can be given and
complications can be
prevented.
2. I am aware that newborn
screening refers to a
procedure that will 4.20 Extensive
contribute to the newborns
welfare.
3. I am aware that all
newborns should be
submitted to newborn 4.13 Extensive
screening for their
protection.
4. I am aware that timely
intervention can lead to
significant reduction of
3.77 Extensive
morbidity, mortality, and
associated disabilities in
affected infants.
 42

5. I am aware that after

detection of the disorders
further assessment, medical
management and follow-up 3.83 Extensive
are vital responsibilities of
both parents and healthcare
provider.
MEAN 3.97 Extensive

The Extent of Awareness of Newborn Screening among Mothers in

terms of Nature and Benefits of Newborn Screening got a mean of 3.97

with a descriptive equivalent of extensive. This means that the mothers are

aware of the nature and benefits of newborn screening in most occasions.

Support expanding existing provision of newborn screening to

include screening for a wider range of inherited metabolic conditions as a

means of preventing death and severe disability. (Burton and Moorthie,

2010)
 43

Table 4 Explains Extent of Awareness of Newborn Screening among

Mothers in terms of Parent Education.

The first item, “I fully understand my responsibility in the newborn

screening of my child,” got the highest average weighted mean of 4.17 with a

descriptive equivalent of extensive. It is followed by the fifth item, “I am

aware that newborn screening shall be performed after twenty-four (24) hours of

life and should not be later than three (3) days from complete newborn delivery ,”

got an average weighted mean of 4.10 with a descriptive equivalent of

extensive. The third item, “I am aware that if the newborn is diagnosed with the

disorders (newborn screening) the child needs serious medical attention,” got the

third highest average weighted mean of 4.07 with a descriptive equivalent

of extensive. Fourth in rank is the second item, “I have seen materials posted

in health facilities such as posters and pamphlets that provide basic information.”

with an average weighted mean of 3.60 and descriptive equivalent of

extensive. The fourth item, “I am aware that refusal to the test is influenced by

religious beliefs and acknowledgement in writing should be executed by me.,” got

 44

the lowest average weighted mean of 3.17 with a descriptive equivalent of

moderately extensive.

The Extent of Awareness of Newborn Screening among Mothers in

terms of Parent Education got a mean of 3.82 with a descriptive equivalent

Table 4

Extent of Awareness of Newborn Screening among Mothers

in terms of Parent Education

Items AWM Description

1. I fully understand my
responsibility in the
4.17 Extensive
newborn screening of my
child.
2. I have seen materials posted
in health facilities such as
3.60 Extensive
posters and pamphlets that
provide basic information.
3. I am aware that if the
newborn is diagnosed with
the disorders (newborn 4.07 Extensive
screening) the child needs
serious medical attention.
4. I am aware that refusal to
the test is influenced by
Moderately
religious beliefs and 3.17
Extensive
acknowledgement in writing
should be executed by me.
5. I am aware that newborn
screening shall be performed
after twenty-four (24) hours
of life and should not be 4.10 Extensive
later than three (3) days
from complete newborn
delivery.
 45

MEAN 3.82 Extensive

of extensive. This means that mothers are aware and acquainted regarding

newborn screening test in most occasions.

Mothers need to be provided with comprehensive information about

the newborn screening test at a time which is conducive for the

assimilation of this information. In addition, whilst supporting health

related research using newborn screening samples (Davey, 2005)

 46

Table 5 Explains Extent of Awareness of Newborn Screening among

Mothers.

The second item, “Nature and Benefits of Newborn Screening,” got the

highest average weighted mean of 3.97 with a descriptive equivalent of

extensive. It is followed by the first item, “Availability,” got an average

weighted mean of 3.83 with a descriptive equivalent of extensive. The

third item, “Parent Education,” got the lowest average weighted mean of

3.82 with a descriptive equivalent of extensive.

The Extent of Awareness of Newborn Screening among Mothers got

a mean of 3.88 with a descriptive equivalent of extensive. This implies that

mothers’ awareness on newborn screening was evident in most occasions.

According to Guinid et al, 2013, newborn screening is the practice of

testing every newborn for certain harmful or potentially fatal disorder that

are not otherwise apparent at birth. The level of awareness on NBS is

promoted through materials posted in health facilities such as posters and

pamphlets that provide basic information. The quality of the mothers of

having knowledge or being conscious on the early detection and treatment

of the newborn disease which are mostly genetic is greatly affected by

 47

providing proper parent education, information on the performance of the

test and refusal to be tested. (Guinid et al, 2013)

Table 5

Summary on the Extent of Awareness of

Newborn Screening among Mothers

ITEMS MEAN DESCRIPTION

1. Availability 3.83 Extensive

2. Nature and Benefits of

3.97 Extensive
Newborn Screening

3. Parent Education 3.82 Extensive

GRAND MEAN 3.88 Extensive

 48

Table 6 Explains the Level of Compliance among Mothers in Barangay

Mankilam, Tagum City in terms of Family Income.

The fifth item, “If I want something and my money is enough, I will

prioritize to have my baby screened,” got the highest average weighted mean

of 4.27 with a descriptive equivalent of extensive. It is followed by the

third item, “Even if it’s costly for me, I will allow my baby to be screened,” got

an average weighted mean of 4.13 with a descriptive equivalent of

extensive. The first item, “I can afford to avail the newborn screening test,” got

the third highest average weighted mean of 4.10 with a descriptive

equivalent of extensive. Fourth in rank is the second item, “Even if we still

have other basic needs to attain, I can still send my baby for the test,” with an

average weighted mean of 3.97 and descriptive equivalent of extensive.

The fourth item, “If I have twins, I can still afford to have both of my babies

screened even if it means I have to pay double ,” got the lowest average

weighted mean of 3.80 with a descriptive equivalent of extensive.

The Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Family Income got a mean of 4.05 with a

descriptive equivalent of extensive. This means that the compliance of

 49

Mothers in newborn screening is evident in most occasions most of the

time considering their Family Income.

Table 6

Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Family Income

Items AWM Description

1. I can afford to avail the
4.10 High
newborn screening test.
2. Even if we still have
other basic needs to attain, I
3.97 High
can still send my baby for
the test.
3. Even if it’s costly for
me, I will allow my baby to 4.13 High
be screened.
4. If I have twins, I can
still afford to have both of
my babies screened even if 3.80 High
it means I have to pay
double.
5. If I want something
and my money is enough, I
4.27 High
will prioritize to have my
baby screened.
MEAN 4.05 High
 50

Newborn screening test costs vary by state because individual

states finance their newborn screening programs in different ways. Most

states collect a fee for screening, but health insurance or other programs

often cover all or part of it. Babies will receive newborn screening

regardless of health insurance status. (Health Resource and Service

Administration (HRSA), 2013)

 51

Table 7 Explains the Level of Compliance among Mothers in

Barangay Mankilam, Tagum City in terms of Attitude.

The first item, “I will immediately send my baby for the test,” got the

highest average weighted mean of 4.30 with a descriptive equivalent of

extensive. It is followed by the third item, “I am willing to send my baby for

the test even if I’m not a Phil Health member,” got an average weighted mean

of 4.27 with a descriptive equivalent of extensive. The fourth item, “I am

willing to have my baby screened even if it means pricking my baby’s heel,” got

the third highest average weighted mean of 3.73 with a descriptive

equivalent of extensive. Fourth in rank is the second item, “I will allow my

baby to be screened even without consent,” with an average weighted mean of

3.63 and descriptive equivalent of extensive. The fifth item, “I will send my

baby for the test even if I’m unaware of its purpose,” got the lowest average

weighted mean of 3.30 with a descriptive equivalent of moderately

extensive. This means that the compliance of Mothers in newborn

screening in terms of Attitude is evident in most occasions.

The Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Attitude got a mean of 3.85 with a descriptive

equivalent of extensive.
 52

Table 7

Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Attitude

Items AWM Description

1.I will immediately send my
4.30 High
baby for the test.
2.I will allow my baby to be
screened even without 3.63 High
consent.
3.I am willing to send my
baby for the test even if I’m 4.27 High
not a Phil Health member.
4.I am willing to have my
baby screened even if it
3.73 High
means pricking my baby’s
heel.
5.I will send my baby for the
test even if I’m unaware of 3.30 Moderate
its purpose.
MEAN 3.85 High

According to Genomics, Society and Policy (2005), it is reasonable to

anticipate that the attitudes of parents whose child has been diagnosed
 53

through newborn screening may be different from those parents whose

child was found not to have an inborn error of metabolism, or from the

community in general.

Table 8 Explains the Level of Compliance among Mothers in

Barangay Mankilam, Tagum City in terms of Accessibility of Newborn

Screening Centers .
 54

The fourth item, “I can send my baby to a health care facility anytime,”

got the highest average weighted mean of 4.33 with a descriptive

equivalent of extensive. It is followed by the second item, “I can easily go to

a newborn screening facility,” got an average weighted mean of 4.23 with a

descriptive equivalent of extensive. The first item, “I am willing to send my

baby for the test even if the facility is far from our house,” got the third highest

average weighted mean of 4.17 with a descriptive equivalent of extensive.

Fourth in rank is the third item, “I can easily consult health care professionals

regarding newborn screening,” with an average weighted mean of 4.13 and

descriptive equivalent of extensive. The fifth item, “I can comply on newborn

screening test since the center is readily available in our area,” got the lowest

average weighted mean of 4.00 with a descriptive equivalent of extensive.

The Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Accessibility of Newborn Screening Centers got a

mean of 4.17 with a descriptive equivalent of extensive. This means that

Table 8

Level of Compliance among Mothers in Barangay Mankilam,

Tagum City in terms of Accessibility

of Newborn Screening Centers

 55

Items AWM Description

1. I am willing to send my
baby for the test even if the
4.17 High
facility is far from our
house.
2.. I can easily go to a
4.23 High
newborn screening facility.
3.I can easily consult health
care professionals regarding 4.13 High
newborn screening.
4.I can send my baby to a
4.33 High
health care facility anytime.
5.I can comply on newborn
screening test since the
4.00 High
center is readily available in
our area.
MEAN 4.17 High

the compliance of Mothers in newborn screening in terms of Accessibility

of Newborn Screening Centers is evident in most occasions.

The services available are creating pressure to introduce or

expand screening programmes, often before adequate safeguards and

regulatory frameworks are in place (Wilson and Jungner 2010).

 56

Table 9 Explains the Summary on the Level of Compliance among

Mothers in Barangay Mankilam, Tagum City.

The third item, “Accessibility of Newborn Screening Centers,” got the

highest average weighted mean of 4.17 with a descriptive equivalent of

extensive. It is followed by the first item, “Family Income,” got an average

weighted mean of 4.05 with a descriptive equivalent of extensive. The

 57

second item, “Attitude,” got the lowest average weighted mean of 3.85 with

a descriptive equivalent of extensive.

The Level of Compliance among Mothers in Barangay Mankilam,

Tagum City got a mean of 4.02 with a descriptive equivalent of extensive.

This implies that the Level of Compliance among Mothers in Barangay

Mankilam, Tagum City is evident in most occasions.

According to the concept of Davey (2010) that women heard about

newborn screening, however desired further information in order to

acquire a more comprehensive knowledge of the test. Furthermore,

mothers need to be provided with comprehensive information about the

newborn screening test at a time which is conducive for the assimilation of

this information. The awareness of mothers, their attitude towards the test

as well as the accessibility of the newborns screening centers greatly affect

the mothers’ compliance on sending their babies to undergo the newborn

Table 9

Summary on the Level of Compliance among Mothers

in Barangay Mankilam, Tagum City

ITEMS MEAN DESCRIPTION

1. Family Income 4.05 High

3.85 High
2. Attitude
 58

3. Accessibility of Newborn
4.17 High
Screening Centers

GRAND MEAN 4.02 High

screening test for early detection and treatment of newborn screening

disorders.
 59

Table 10 is the result of finding the relationship between the extent of

Awareness of Newborn screening and Level of Compliance among Mothers in

Barangay Mankilam, Tagum City.

The computed t-value of 1.791 is lesser than the tabulated t-value of 2.045.

“There is no significant relationship between the extent of the relationship

between Awareness of Newborn Screening and level of Compliance among

 60

Mothers in barangay Mankilam, Tagum City,” is accepted. The coefficient

correlation of 0.861 shows the degree of linear relationships between the extent

of Awareness of Newborn Screening and Compliance among Mothers which

connotes a moderate positive degree of correlation.

The value of 0.741 for the coefficient of determination (r 2) means that

74.1 percent of the extent of Awareness of Newborn Screening attributed to the

total variance in the compliance among mothers. The remaining 25.9 percent is

a chance variation on the awareness that contribute to the awareness of

newborn screening.

According to by Harwood, Claire (2013), increasing knowledge of the

disorder of screened in newborn tests, one of the main challenges is the

implementation of the workflow of a clinic so that it has maximum benefit.

Table 10

The relationship between the extent of Awareness of Newborn

screening and Level of Compliance among Mothers

in Barangay Mankilam, Tagum City.

T-value Decision
Interpre- Decision
VARIABLES R Com on
tation Tab on Ho
p Difference
 61

Awareness of
Newborn
Screening Moderately
Not
0.861 Positive 1.791 2.045 Accepted
Significant
Relationship
Compliance
among Mothers

Coefficient Determination = 0.741

Using educational tools like this website may have a public health

benefit by decreasing disparities in NBS services across the United States,

since lack of awareness can lead to anxiety and failure to comply with

recommendations for follow-up. (Harwood, Claire 2013)

 62

Chapter 4

SUMMARY, CONLUSION, AND RECOMMENDATIONS

Summary of Findings

After the data had been analyzed and interpreted, the following

summary of findings were enumerated based from the results discussed in

the preceding chapter.

1. The extent of awareness of newborn screening among its three

indicators, availability with weighted average of 3.83, nature and

 63

benefits of newborn screening with weighted average of 3.97 as the

highest and parent education with weighted average of 3.82 as the

lowest, has an overall mean of 3.88 with the descriptive equivalent

of extensively felt or observed in most occasions.

2. The level of compliance among mothers in terms family income with

weighted average of 4.05, attitude with weighted average of 3.85 and

accessibility of newborn screening center with weighted average of

4.17. These indicators have an overall mean of 4.17 with the

descriptive equivalent highly evident in all occasions.

3. There is no significant relationship between the extent of awareness

of newborn screening and the level of compliance among mothers in

Barangay Mankilam, Tagum City were shown in table 10, presents

that, the coefficient correlation of 0.861 shows the degree of linear

relationships between the extent of Awareness of Newborn

Screening and Compliance among Mothers which connotes a

moderate positive degree of correlation.

Conclusion

In the light of the aforementioned findings of the study, the

following conclusions are grown;

 64

1. The extent of awareness of newborn screening is extensively felt or

observed in most occasions.

2. The level of compliance among selected mothers in Barangay

Mankilam, Tagum City is highly evident in most occasions.

3. There is no significant relationship between the extent of awareness

of newborn screening and the level of compliance among mothers in

Barangay Mankilam, Tagum City, which connotes a moderate

positive degree of correlation.

The students were able to conduct a study which helps them

Recommendations

After a well thought-out review that was drawn from the findings

and conclusions of the study, the following recommendation are made.

Mothers

1.) Encouraged to attend seminars and/or symposiums regarding the

newborn screening test to increase knowledge about the said test, its

purposes, importance benefits and even the procedures on how the

newborn screening test being done. To be given by the barangay health

workers, community nurses and even the physicians.

 65

2.) Advised ask any health care provider like barangay health worker,

community nurses and midwives for any clarifications about newborn

screening test in order to answer the questions in their mind.

3.) Encouraged the mothers in prenatal stage to have more information

regarding the newborn screening test for them to prepare themselves for

the procedures, finances and to remove their doubts in terms for their

compliance for the test.

4.) Encouraged mothers ask about the early and immediate treatment for

those newborns who were diagnosed with disorders (newborn screening),

in order to prevent further complications.

5.) Encouraged to the mothers to collaborate with local, state, and national

partners is essential for promoting actions and policies that will optimize

the function of the newborn screening systems and ensure that families

receive the full benefit of them.

Student Nurses

1.) Provide increase knowledge opportunities and to emphasize the major

purposes of the Newborn Screening test. This can be done by attending

symposiums, giving out fliers and/or pamphlets regarding the importance

of this program to be given by the barangay health care team like the
 66

community nurses, barangay health workers and midwives within the

hospitals and even in the lying-in centers. Moreover, adherence to latest

programs spearheaded by the Department of Health (DOH) can improve

the quality of care provided to all clients.

2.) Encouraged to help provide the mothers, parents further explanations

through regarding the test in order for them to comply a hundred per cent

without hesitation and will fully understand the newborn screening

objectives.

3.) Advised to read articles regarding newborn screening to help update

selves most especially to the disorders, new treatment, and new

procedures that can be an aid to answer questions of mothers when they’re

in doubt to comply.

Barangay Health Care Team

1.) Community Nurses. Encouraged to monitor mothers and inform them

that the baby should undergone the newborn screening test not just

because it’s mandatory but for the benefit of the baby.

Barangay Health Worker

1.) Encouraged to make a follow-up with the pregnant mothers in the

community and provide proper information regarding newborn screening

 67

test as early as possible. Encouraged to make a follow-up with the

pregnant mothers in the community and provide proper information

regarding newborn screening test as early as possible.

2.) Advised to inform pregnant mothers in the community about the

procedure and benefits of the newborn screening test months prior to

expected delivery of the baby.

3.) Encouraged to give proper information of the newborn screening fee to

pregnant mothers for them to prepare the amount needed.

 68

APPENDIX C

Questionnaire

Questionnaire on determining Awareness of Newborn Screening and

Compliance among Mothers in Barangay Mankilam, Tagum City

Name (optional): ___________________________________ Age: _____

Civil Status: ___________________________________

Dear Respondents,

Praised be Jesus and Mary!

Please accomplish this questionnaire very carefully and honestly.

The purpose of this questionnaire is to determine your awareness on
newborn screening test as well as your compliance on the test. After
answering, please return it to the researchers. Rest assured that your
answers will be kept confidential and private. Your response will be highly
appreciated as it will be of great help for this study’s fulfillment.

Sincerely yours,

The Researchers

Direction: This is a two part test. This first part is to know the extent of
your Awareness on Newborn screening. The second part is to know the
level of your compliance to the test. Please feel free to rate the following
 69

statements honestly by putting a check mark (/) on the space that best
described the way you feel about each statement. Please do not leave any
item unanswered. The two Likert Scales are presented respectively, to
guide you in answering each item.

Parameter Descriptive Description

Limit Equivalent

5 Very Extensive This means that the extent of

Awareness of Newborn
screening is evident in all
occasions.

4 Extensive This means that the extent of

Awareness of Newborn
screening is evident in most
occasions.

3 Moderately This means that the extent of

Extensive

Awareness of Newborn
screening is evident in some
occasions.

2 Less Extensive This means that the extent of

Awareness of Newborn
screening is rarely seen.

1 Not Extensive This means that the extent of

Awareness of Newborn
screening is not observed at
all.
 70

Part I. The extent of Awareness of Newborn Screening

A. Availability 5 4 3 2 1
I am aware that…
1. all of the hospitals in Tagum City are implementing
newborn screening test.
2. lying-ins also conduct newborn screening test.
3. the newborn screening test is routinely done in a
hospital and even in lying-ins.
4. newborn screening results are available within three
weeks.
5. results are readily available in the institutions where
samples are collected.

B. Nature and Benefits of Newborn screening 5 4 3 2 1

I am aware that…
1. the test is done for the early detection of disorders so
that proper treatment can be given and complications
can be prevented.
2. newborn screening refers to a procedure that will
contribute to the newborns welfare.
3. all newborns should be submitted to newborn
screening for their protection.
4. timely intervention can lead to significant reduction
of morbidity, mortality, and associated disabilities in
affected infants.
5. after detection of the disorders further assessment,
medical management and follow-up are vital
responsibilities of both parents and healthcare provider.

C. Parent Education 5 4 3 2 1
I…
1. fully understand my responsibility in the newborn
screening of my child.
 71

2. have seen materials posted in health facilities such as

posters and pamphlets that provide basic information.
3. am aware that if the newborn is diagnosed with the
disorders (newborn screening) the child needs serious
medical attention.
4. am aware that refusal to the test is influenced by
religious beliefs and acknowledgement in writing
should be executed by me.
5. am aware that newborn screening shall be performed
after twenty-four (24) hours of life and should not be
later than three (3) days from complete newborn
delivery.

Parameter Descriptive Description

Limit Equivalent

5 Very High This means that the level of

Compliance among mothers is

evident in all occasions.

4 High This means that the level of

Compliance among mothers is

evident in most occasions.

3 Moderate This means that the level of

Compliance among mothers is

evident in some occasions.

2 Low This means that the level of

Compliance among mothers is

rarely seen.

1 Very Low This means that the level of

Compliance among mothers is

not observed at all.
 72

Part II. The level of Compliance among Mothers

A. Family Income 5 4 3 2 1
1. I can afford to avail the newborn screening test.
2. Even if we still have other basic needs to attain, I can
still send my baby for the test.
3. Even if it’s costly for me, I will allow my baby to be
screened.
4. If I have twins, I can still afford to have both of my
babies screened even if it means I have to pay
double.
5. If I want something and my money is enough, I will
prioritize to have my baby screened.

B. Attitude 5 4 3 2 1
1. I will immediately send my baby for the test.
2. I will allow my baby to be screened even without
consent.
3. I am willing to send my baby for the test even if I’m
not a Phil Health member.
4. I am willing to have my baby screened even if it
means pricking my baby’s heel.
5. I will send my baby for the test even if I’m unaware
of its purpose.

C. Accessibility of Newborn Screening Centers 5 4 3 2 1

1. I am willing to send my baby for the test even if the
facility is far from our house.
2. I can easily go to a newborn screening facility.
3. I can easily consult health care professionals
 73

regarding newborn screening.

4. I can send my baby to a health care facility anytime.
5. I can comply on newborn screening test since the
center is readily available in our area.

References

A. Books

Boyle, John James Ph.D, FAAN . Newborn Screening Program . Lippincott

Williams & Wilkins. Boston, United States of America. 5 th
Edition. Copyright ©2012.Pp. 56-79.

David-Padilla, Carmilita et al. All about Newborns Screening. Newborn

Screening. Rex Bookstore Manila, Philippines.Copyright © 2007. 6th
Edition. Pp. 67 & 78.

Raho, Joseph Research Analyst. Changing Moral Focus on Newborn

Screening. Learning Ace.Journal of Inherited Metabolic Disease.
Merit Publishing International. Copyright © 2005. Pp 486,487 & 488

George, Krucik BSC, MRCP. The Importance of Having Newborn

Screening test. Essential Newborn screening Program. Pearson, Inc.
New Jersey, United States of America. 7th Edition. Copyright ©
2013. Pp. 45-47.

Vani, Kilakkathi. Newborn screening. State Program Tests. Crowell

Publishin Company. 3rd Edition. Copyright © 2012. Pp. 55-60.
 74

Dr. Moothie, Burton S. et al. Expanded newborn screening: A review of the

evidence. Phg Foundation. Merit Publishing House. Copyright ©
2010. Pp. 33-25.

Clifton, Johnford K. Foundations of Screening. Newborn Procedures.

Williams & Wilkins. New Yok City, United States of America.
Copyright © 2010. Pp. 30-40.

Frieden, Jonathan J. More on Newborn screening test. Screening Facts.

Delmar learning house. 4th Edition. Volume 3. Copyright © 2012. Pp.
56-60.

Davey, Angela et al. Comprehensive information about the newborn

screening test. Journal of Newborn Screening test. Merit Publishing
House. 4th Edition. Vol 3. Copyright © 2010. Pp. 90-95

Guinid, Philip Ph.D, et al. Quality of Knowledge. Evaluation for Newborn

screening. International Main Publishing House. Texas, United
States of America. Copyright © 2013. Pp. 23-35.

Goodman, James RN, MSN. More about the screening tests. World
Screening Program. Williams and Wilkins. Chicago, United States of
America. Copyright © 2011. Pp. 40-55.

Carter, Austin Ph.D, RN, MSN. Quality Care tests. Journal of Nursing.
Johnson Publishing House. Vol. 3. Copyright © 2010. Pp. 56-62
 75

B. Electronic Media

Andrews, James MD (2009). Information about Newborn screening.

http://www.scribd.com/doc/27447985/Newborn-Screening. Date
Retrieved: August 12, 2014)

Danielson, Ivy Stacy L. (2005). “Screening Important Act”

http://mchb.hrsa.gov/screening/summary. Date Retrieved: August
12, 2014

Bayley, Leslie; & Sherman, Gary (2003) . “Best Prevention Intervention”

http://www.scribd.com/doc/73355769/Newborn-Screening-
Brochure. Date Retrieved: August 12, 2014

Henson, Donna J.; Walters, Courtney H.; & Adamson, Anna O.

(2013). Importance of Newborn screening.
http://www.savebabies.org/pregnant_faqs.html. Date Retrieved:
August 12, 2014.

Harwood, Claire (2013). Evaluation of the Impact of a Web-based

Educational Tool on Awareness of Newborn Screening and Carrier
Testing. Master's Thesis, University of Pittsburgh. http://d-
scholarship.pitt.edu/18341/. Date retrieved: September 1, 2014.

Roule, Doug K. (2007). Main Topic: Newborn Screening.

http://www.mayomedicallaboratories.com/articles/hottopics/tran
scripts/2008/2008-07-sns2tier/07-8.html Date Retrieved: March 13,
2014
 76

Polper, Mari G. (2003). The Performance for the screening.

https://www.nbstrn.org/research-tools/lab-performance-database.
Date Retrieved March 13, 2014

Ferdinand, Jose T.; & Reymonds, Karlo (2008). Definitions of Words.

http://www.vocabulary.com/dictionary/availability. Date
Retrieved: August 12, 2014.

Yara, Kim Q. (2012). Public Information.

http://www.nscb.gov.ph/ru12/DEFINE/DEF-INC.HTM Date
retrieved: March 12, 2014

Palki, Yany T.; Tani, Kiff P. (2005). “The Benefits of Screening”.

http://www.ikscreening.com/benefits. Date Retrieved: March 7,
2014

Goebel, Mark et al, (2003). “Tests for the Quality of Care of Newborn”.
http://www.tqnewborn.org/postpartum_fbct.html. Date
Retrieved: August 22, 2014.

Fant, Marky et.al, (2005). “Centers in the Community.

http://www.centernbs.org/mother_html. Date Retrieved: June
12, 2014.

Tluczek, Rovic et.al, (2010). “Newborn Natures”.

http://www.nbsnature.org/. Date Retrieved: August 22, 2014.

McKee, Martin;& McPake, Barbara (2009). “Expanded Newborn Over the

years” http://pediatrics.aappublications.org/content/117/6/2290.
Date Retrieved: May 14, 2014
 77

C. Other References

Legarda, Loren. RA 9288 An Act Promulgating A Comprehensive Policy

And A National System For Ensuring Newborn Screening. R.A.
9288 Art 2 Sec.4 Definition Of Terms. April 07, 2004. Pp. 2

Legarda, Loren. RA 9288 An Act Promulgating A Comprehensive Policy

And A National System For Ensuring Newborn Screening. Article
3 of Republic Act No. 9288 or Newborn Screening Act of 2004,
SEC. 6 Performance of Newborn Screening, April 07, 2004. Pp. 3

Legarda, Loren. RA 9288 An Act Promulgating A Comprehensive Policy

And A National System For Ensuring Newborn Screening.
Philippine Laws and Jurisprudence Databank. Date Retrieved:
August 6, 2014.

Hanson, Harvey Ph.D,MD. “Newborn Services”. U.S. Department of

Health and Human Services,Centers for Disease Control and
Prevention,National Center for Environmental Health,Division of
Laboratory Sciences. Copyright © October 2008
 78

Curriculum Vitae

I. PERSONAL DATA

Name: Pinky Rose Jean Muyoco Marfil

Parents: Pepe Dabalos Marfil

Roselyn Muyoco Marfil

Date of Birth: June 5, 1994

Place of Birth: Calapagan, Lupon, Davao Oriental

Civil Status: Single

Residence: Tibagon, Pantukan, Comval Prov.

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Tibagon Elementary School 2007

Secondary: Cor Jesu High School of Mabini 2011

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science of Nursing

III. AFFILIATIONS
 79

Club Position

Philippine Student Nurses Association Member

Red Cross Youth Member

I. PERSONAL DATA

Name: John Patrick Lebas Redondo

Parents: Pablito Fernandez Redondo

Juliet Lebas Redondo

Date of Birth: October 27, 1993

Place of Birth: Madaum, Tagum City

Civil Status: Single

Residence: San Antonio, Mabini Comval Province

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Mabini Central Elementary School 2006

Secondary: Cor Jesu High School of Mabini 2010

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science of Nursing

III. AFFILIATIONS
 80

Club Position

Philippine Student Nurses Association President

Red Cross Youth Member

I. PERSONAL DATA

Name: Julian Mae Calamba Batacan

Parents: John Culanag Batacan, Sr

Columba Calamba Batacan

Date of Birth: July 29, 1994

Place of Birth: Tecaro Polyclinic, Davao City

Civil Status: Single

Residence: Angelica Homes, Tipaz, Tagum City

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Magugpo Pilot Central Elementary School 2007

Secondary: Arriesgado College Foundation, Inc 2011

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science in Nursing

III. AFFILIATIONS

Club Position

Philippine Student Nurses Association Member

Red Cross Youth Member

 81

I. PERSONAL DATA

Name: Rondel Adrian Dadula

Parents: Rodel Alicando Flores

Lucita Degorio Dadula

Date of Birth: April 13, 1995

Place of Birth: Panabo, Davao del Norte

Civil Status: Single

Residence: North Eagle Homes 2, Tagum City

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Assumpta School of Tagum 2007

Secondary: Assumpta School of Tagum 2011

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science of Nursing

III. AFFILIATIONS

Club Position

Philippine Student Nurses Association Member

Red Cross Youth Member

 82

I. PERSONAL DATA

Name: Rodgeliz Arquiza Javier

Parents: Rogelio Bulawan Javier (Deceased)

Primitiva Arquiza Javier (Deceased)

Date of Birth: October 9, 1989

Place of Birth: Bungabong, Pantukan, Comval

Civil Status: Single

Residence: Merville Subdivision, Tagum City

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Bungabong Elementary School 2002

Secondary: Bungabong Elementary School 2006

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science of Nursing

III. AFFILIATIONS

Club Position

Philippine Student Nurses Association PIO

Red Cross Youth Member

 83

I. PERSONAL DATA

Name: Eliezer Bernacer Merto

Parents: Elesier Capoy Merto

Luzminda Bernacer Merto

Date of Birth: June 18, 1993

Place of Birth: Poblacion Maco, Comval

Civil Status: Single

Residence: San Mateo I, Poblacion Maco, Comval

II. EDUCATIONAL BACKGROUND

Year Completed

Elementary: Maco Heights Central Elementary School 2006

Secondary: Letran de Davao of Maco 2010

Tertiary: Saint Mary’s College of Tagum

present

Degree:

Bachelor of Science of Nursing

III. AFFILIATIONS

Club Position

Philippine Student Nurses Association Member

Red Cross Youth Member

 84

“We are who we are, the best among the rest”