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II. List of figures
III. List of tables
2 The Philippines
2.1 Aklan and its communities
2.2 The household approach
2.3 The Projects
2.3.1 Peoples Initiative Network of Aklan (PINA)
2.3.2 Medical Mission Group (MMG)
3 Research Question
4.1 Qualitative Research
4.1.1 Identification of Community Health Needs through Focus Group Discussions
5 Results and analysis
5.1 The Barangays - the villages
5.2 The households - the sample
6 Indicators of Vulnerability for poverty in rural communities in the Philippines
6.2 Core dependencies
6.3 Sub-dependencies: Health
6.4 Sub-dependencies: Agricultural Situation
6.5 Sub-dependencies: Economical situation
6.6 Sub-dependencies: Environmental Situation
6.7 Sub-dependencies: Community integration
6.8 Sub-dependencies: Education
7 Limitations and summary
7.3 Summary and conclusion
Figure 2: Indicators of vulnerabilities for poverty in rural communities in the Philippines
Figure 4: Sub-dependencies of health
Figure 5: First contact point with health problems versus perceived health situation of the family (in %)
Figure 6: Sub-dependencies in the agricultural sector
Figure 7: Factors which affects the agricultural productivity
Figure 8 Pest as factor of a loss of harvest versus the use of chemicals
Figure 9: Sub-dependencies of economical situation.
Figure 11: Environmental sub-dependencies
Figure 12: Nature and extent of health impairment versus frequency of use of the well with pump (in %)
Figure 13: Sub-dependencies of community integration
Figure 14: Type of assistance vs. frequency of assistance on the farm (in %).
Figure 16: Desire of spending spare money on different factors of life...
Table 1 Source: Dimensions of vulnerability adapted from Davies;
Table 2: Demographic data - Barangays/Municipalities (Frequencies)
Table 3: Demographic data
Table 4: First contact point of the family with health problems
Table 5: Cross table between used water source (well with pump) and the occurrence of diarriah (in %)
This paper outlines different categories of vulnerabilities for poverty and their intertwining dependencies. Risks and vulnerabilities limit the activities and opportunities that can be undertaken to reduce poverty. Beside adverse events such as climate change, typhoons, floods and droughts, the livelihood can be seen as the primary source of vulnerability. In consequence a process of environmental degradation, a lack of opportunities and a lack of agricultural inputs is arising out of ignored vulnerabilities.
Through a standardized questionnaire a broad range of underlying factors, processes and different constructions of vulnerabilities are compared and analyzed. 247 rural Philippine households in twelve different communities contributed to the survey. The comparison of different factors (health, economy agriculture, environment, education and community integration) highlights a set of indicators to measure vulnerabilities for poverty. Moreover, core dependencies and their intertwining sub-dependencies have been emphasized.
Triangulation completes the picture of poverty and its vicious circle. A qualitative research through focus group discussions has drawn an overview of the community health needs. Furthermore the results have been underpinned by literature research. The output of the study results in indicators of vulnerabilities to poverty. These indicators allow the objective measurement of poverty and consequently the increase of local capacities on a cross sectoral basis. Addressing risks, vulnerabilities and poverty on current data is essential to meet the needs of the communities and to achieve sustainability.
The rural Philippines are a fragile environment which is extremely important to the livelihoods of the peasant poor. The connection between population, health, environment, and the economy are particularly significant. The health and the livelihoods of the people in the Philippines become more vulnerable. While health cannot be polluted, it can be deteriorated through certain factors. The reliability of food and water supplies in rural areas become more uncertain and the infrastructure and sanitation facilities are not in line with promotion of good health.
By pushing the farmers to produce beyond their capacity, the land becomes degraded and the production of the agricultural lands and the fisheries decline (De Souza, 2006, p. 3). Around 11 million Philippinos are employed in agricultural, hunting, forestry, and fishing activities. The loss of the agricultural productivity has an extreme negative effect on the livelihoods and well-being of the rural population, and the entire nation. Another threat to the national and environmental security is the fertility rate of 3.5 (lifetime birth per women). The negative impacts of population growth and environment trends are increasing the poverty levels (De Souza, 2008, p.11).
Population, health, environment, and agriculture are deeply intertwined and complex. Collaborative efforts of Pos (Peoples organizations), NGOs, and GOs that address the complexity of these interconnections could improve Philippinos’ health, economy, and future. Therefore it is essential to ensure health and wellbeing for their families and communities and the natural resources upon which they depend (De Souza, 2006, p. 12).
According to the Article 25 of the universal declaration of human rights (United nations, 1948, Art. 25):
―Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
Globally, there are many regions, like the Philippines, in which communities are exposed to environmental, economical, and social risk factors. Risk factors make communities vulnerable to adverse events, such as climate change, typhoons, floods and droughts, and reduce the ability to recover from the latter. Effects of vulnerabilities and adverse events result in lower opportunities and lower access to social services within the community (Dror & Preker, 2002, p. 370).
In a common sense, the meaning of vulnerability is to be prone or susceptible to damage or injury. In a socio-economical sense of individual, household or other social groups, it can be also referred to their capacity for analyzing and coping with an impact of a natural hazard. Furthermore it is to resist and to recover from the impact of such events and the ability to reestablish ones livelihood. Livelihood is an important word when talking about vulnerability and poverty. It is the right of an individual, of a family or community to income, resources, and the access to opportunities. This involves information, knowledge, social networks, legal rights, tools, technologies, land, and other physical resources, in order to deal with such vulnerabilities and hazards to which people in rural areas are exposed. The root causes of vulnerabilities are unsafe conditions and inequalities. Underprivileged people have to deal with lack of education, low access to health, lack of infrastructure which makes them vulnerable to their environment and adverse events (Wisner et.al., 2007, p. 11-16).
In the World Development Report of 2000 and 2001 the World Bank underscores the interrelation between empowerment, security, opportunity, and poverty in order to overcome the latter. At the same time, the use of the term “vulnerability” has been brought into context with poverty, risk, and the efforts to manage risks. Risks such as lack of education, unsafe water sources, no sanitation and irrigation create vulnerable households and communities which lead to a high probability of experiencing a loss in the future. This vulnerability and the high probability of a future socio-economical loss are caused mainly by uncertain events and changes, the degree of the characteristics of the risk, and the households’ ability to respond to the risk. Vulnerable households and Communities become and stay poor because of their limited access to a social security system, health, education, etc. - simply, access to an equitable welfare system (World Bank, 2000, p. 31).
Davies (1996) distinguishes between two dimensions of “vulnerability”: (a) He differs between livelihood resilience and livelihood sensitivity. Livelihood resilience allows a system, if it has a high sensitivity, to utilize or even benefit from a change. Where resilience is high, it requires a major disturbance to overcome the limits to change in a system. (b) On the other side he states livelihood sensitivity, which is the degree to which a given system (household/community/state) undergoes change due to natural forces, following human interference.
Table 1 Source: Dimensions of vulnerability adapted from Davies; 1996 (cited in Clark, 2006, p. 674)
illustration not visible in this excerpt
Table 1 ―Dimensions of vulnerability” adapted from Davies (1996) explain that a community or household experiences high vulnerability when the sensitivity is high and the resilience is low. While the resilience is high and the sensitivity is low the community and the households will be scaled as not vulnerable (Davies, 1996, p. 26). Consequently a secure livelihood meets the basic needs of the poor such as food needs through primary production. Households are able to cultivate biodiversity and are able to harvest at least a year’s food supply. Additionally they are able to get income from secondary activities which can be used as accumulate assets and to meet non-food consumption needs such as water- sanitation, health, education, housing etc. On the other side a secure household can cope with adverse events and is able to recover without a fundamental shift in livelihood (Dietz et.al., 2004, p. 133 -135).
Vulnerabilities and community risks such as inadequate sanitation, lack of education, low access to health facilities, and an inadequate infrastructure easily leads to poverty. The United Nations defined poverty in 1998 as […] a denial of choices and opportunities, a violation of human dignity. It means lack of basic capacity to participate effectively in society. It means not having enough to feed and cloth a family, not having a school or clinic to go to, not having the land on which to grow one’s food or a job to earn one’s living, not having access to credit. It means insecurity, powerlessness and exclusion of individuals, households and communities. It means susceptibility to violence, and it often implies living on marginal or fragile environments, without access to clean water or sanitation.‖ (cited in Gordon, 2005, p.4)
To draw a holistic picture and to measure poverty amongst individuals, households and communities the severe deprivation of basic human needs has to be taken into account on following levels:
- Food - Health
- Safe drinking water - Shelter
- Sanitation facilities - Education
- Information - Access to services
Geographically, the Philippines are a tropical archipelago located in South-east Asia. It is situated between the Philippine Sea, the South China Sea and in the east of Vietnam. Furthermore it consists out of 7.100 Islands, with a total land area of some 300,000 square kilometres.
illustration not visible in this excerpt
Figure 1: Geographical map of the Philippines
Source: Western Washington University
Politically their government is voted by democratic election which is a major prerequisite for the positive development of the Philippines (Caldecott et.al., 1996, p.93).
In 1991 the Philippines made a major step towards their strategy for Sustainable Development by integrating environmental, population, and social welfare concerns into decision-making and development planning. The Local Government Code (LGC) of the Philippines (1991) included the promotion of environmental education and citizen’s participation in resource management. The code transferred many responsibilities from central government to the various levels of local government units (LGUs). This decision for decentralization included 73 provinces, 1,554 municipalities, and 41,882 Barangays1.
Poverty and vulnerability of rural communities in the Philippines: A pilot study According to Hengstenberg et al. (1999, p. 84) the two major issues of the LGC are decentralization and democratisation. Additional major points on the agenda of the LGC are:
- Transfer of local initiatives and local institutions from national ministries to the municipalities and communities (land reform and agricultural extension, forestation, health care, social welfare, infrastructure, tourism, etc)
- Improving the financial situation of municipalities and communities by increasing the share of joint taxes (from 20 % to 40 %). - Expansion of possibilities of independent municipal tax collection. - Citizen participation at local level through representative participation of civic organizations (People’s Organization) and non-governmental organizations (NGOs) in development councils (Local Development Councils, LDCs). - Integration of the municipalities into the poverty reduction program of the government which included the Social Reform Agenda (SRA) consisting of social and structural policy measures.
For the Philippines and the local initiatives the LDC was a major step for the development of communities. Here decentralization means a curtailing of bureaucratic control at the national centre and a development process more oriented to the country side with initiatives flowing from the bottom up (Riedinger, 1995, p. 211).
Aklan is the smallest province on the Island of Panay, which belongs to the archipel of the Philippines. Aklan and its citizens are strongly dependent on their agrarian products, which are mainly rice, coconut, banana, abaca2, and wheat. Although the province of Aklan is highly associated with agriculture, one-third of its land area are slopy and 709 hectares of the country still maintain as virgin forests. Local initiativesin Aklan are strongly based on the idea of participation . Therefore the household approach is used to develop the environmental, social and economical situation of the families and communities.
The development of communities is increasingly demanding current and detailed demographic and socio-economic data of individuals, households, and communities. Development planning, program management, and decision making at all levels requires current data (Hoff, 1998, p.5).
For many development programs, the household is the key to the development of the individual, the community, and the nation. According to More (2001) the household approach is based on six different principles:
- The family is the first social institution that forms the individuals system of beliefs and values.
- The individuals system of beliefs and values shape the structure that prevails in a society.
- Change is sustained when it impacts on the family.
- The family is the basic unit of society - it is the small government
- it is the small church.
- Democracy is first learned in the family. Transparency is a belief and a value formed out of cumulative practice in the family.
- The strength and stability of an economy is dependent on the purchasing capacity of the family.
The following projects are based on the household approach. The efforts to develop the community and the Barangays are done through developing single households and their individuals. The projects and the research is a practical effort to underpin the theoretical part and consequently the importance of community based and grass roots initiatives.
The Integrated Health Care Project (IHCP) is an experimental program of the collaboration between “Peoples Initiative Network of Aklan (PINA)” and the “Medical Mission Group of Aklan (MMG)” both funded by “Swiss Catholic Lenten Fund (SCLF)”. Both organizations (PINA and MMG) play an important role in the execution of the survey and the answering of the research questions.
As the leading organization of the Community Project PINA deals with 12 communities in which 254 households are benefiting from PINAs work. Target of PINA is to provide knowledge, enhance skills, and teach the beneficiaries of different techniques in community development. The project in Aklan incorporates elements of information dissemination as well as training in organic agriculture, disaster management and information gathering. Training culminated in the formation of voluntary Community workers.
MMG is a cooperative and one of many ambulatory clinics in Aklan. The clinic was established by physicians and paramedical staff (when would be interesting maybe). Furthermore it is constituted and organized as a cooperative. Basically the aim of this cooperative is the acquisition of capital to serve the purpose of their medical and paramedical beneficiaries.. Furthermore, a goal of MMG is to serve the people of Aklan with good quality treatment at low price. The joint venture of different physicians with different specialties makes a broad range of offers possible. Beside the clinic, which builds the financial backbone of the project, MMG runs an “Integrated Health Care Project”. MMGs target is to serve 12 different communities with primary health care. The target of the “Integrated Health Care Project” is to provide trainings and information about common health issues and to sustain the health of the project members. The idea is to complement the agricultural effort of PINA with education about health in order to provide a holistic approach for community development.
To measure the progress of a health initiative needs indicators tailored for the particular community. Therefore the empirical study should provide information about the overall situation of the communities in order to assess vulnerabilities and risks. Based on the information measurable, reliable and feasible indicators should be established to simplify the progress of evaluation.
First of all this research wants to examine the needs of the population in the communities. Particular households (n=247) were surveyed in order to be conscious about vulnerabilities and risks which affects the livelihood of the households. For measuring the progress of development different indicators should be extracted out of the information gathered.
Referring to different categories such as health, agriculture, economic situation, behaviour, and infrastructure, different households in different communities were surveyed. Furthermore this study wants to answer how these households and their livelihoods are affected by different environmental and socioeconomic risks. Following research question should limit the area of research:
What kind of risks are causing poverty and vulnerability to rural households/communities in the Philippines?
This research question should be answered by looking at the situation of the different households through the questionnaire. Risks and vulnerabilities should be extracted out of the results of the questionnaire.
What kind of prerequisites for sustainable development does a community in the rural Philippines have?
Conditions such as the environment, economical situation, education and health are possible prerequisites for sustainable development.
How can indicators look like to measure the progress of development and sustainability?
Indicators are important instrument to measure sustainability and development. Out of the information about vulnerabilities and risks indicators should be extracted to measure the progress of the households and communities.
1 The Barangay is the lowest political unit of the Philippine local government system, and corresponds approximately to ”village“ in terms of size and cohesive quality.
2 Abaca is a species of banana native to the Philippines. The plant is harvested for its fiber and generally called Manila hemp.
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