[02.19] Health-Seeking Behavior and the Filipino Family V2.pdf

Physical well-being; being able to do one’s daily routine and relate well with others

For most people, what does health (kalusugan, baskug nga lawas) connote?

Health involves more than physiological balance; it encompasses other conditions and states, such as being able to deal with others

Beyond physiological balance, what else does health encompass?

Preventative and Therapeutic

In what two ways can health-seeking behavior be seen?

Practices and ideas pertaining to the prevention of sickness or disease

What is preventative health-seeking behavior?

The range of responses available when illness strikes

What is therapeutic health-seeking behavior?

Exercise & Diet

What is an example of a preventative measure to address the probability of heart disease?

Avoidance of particular places

What is an example of a preventative measure to avoid harm from the spirits?

Maintaining a certain quality of relationships

What is an example of a preventative measure to avoid coming under physical assault (kulam)?

Seeing a doctor for an illness

What is a therapeutic measure example for an illness?

Seeing a healer for treatment of (kulam)

What is a therapeutic measure example for the treatment of kulam?

Self-medication for headache and other minor ailments

What is a common therapeutic measure for minor ailments?

Social context, specifically the family and kinship network

What always shapes health-seeking behavior as a matter of individual choice?

Idealized immediate nuclear family and the extended kinship system

What does the "family and kinship network" refer to?

The locus of early socialization into the worldview of the community, including concepts of health, illness, and treatment

What is the role of the family and kin group in health concepts?

“Lagyan ng bimpo ang likod pag napawisan”

What is an example of early socialization into a health worldview related to sweat?

Hot and cold folk perspective on health

What is the source of the belief that putting a towel on the back when sweating prevents sickness?

If sweat dries on an individual’s back, they are predisposed to sickness

What is the belief behind placing a towel on the back when sweating?

Dried sweat feels cold while the body is hot; such an imbalance will result in sickness

What is the expression or reasoning behind the belief related to sweat and sickness?

A towel is placed to absorb sweat to avoid disruption of equilibrium

What is the outcome of the belief related to sweat and sickness?

Cultural aspects of health and illness can be explained in a material way

What is the implication of the example "Lagyan ng bimpo ang likod pag napawisan"?

“Huwag magpaulan, baka magkasakit ka”

What is an example of early socialization into a health worldview related to rain?

Hot and cold folk perspective on health

What is the source of the belief that avoiding rain prevents sickness?

Cold rain falling on an individual’s hot head will result in sickness

What is the belief behind avoiding rain to prevent sickness?

The top of the head (bumbunan) is hot due to the sutures where spirits and heat escape through

What is the folk logic behind covering one's head in the rain?

People cover their heads when it is raining but there is no proof that covering the head prevents illness

What is the outcome of the belief related to rain and sickness, and its scientific basis?

The behavior of covering one’s head is still present, however, the folk logic is missing

What is the implication when people cover their heads during rain, regarding folk logic?

There is an anomaly between what is practiced and what is believed

What phenomenon describes the discrepancy between practice and belief in folk health models?

Idealized monogamous, extended, matrilocal family

What is one variation of family and kinship patterns mentioned?

The presence of the other woman (or other man)

What family variation deals with extramarital relationships?

Step-parents (after annulment or death of one of the spouses)

What family variation involves new parental figures after marital changes?

Single parenthood

What family variation involves one parent raising children?

Absentee parent (OFW, in the province, etc)

What family variation describes a parent who is not physically present?

Surrogate parents

What family variation describes non-biological parents taking on parental roles?

Bicultural parents

What family variation describes parents from different cultural backgrounds?

Two daddies, two mommies

What family variation describes same-sex partnerships raising children?

Most basic unit of family

How is the nuclear family described?

Consists of parents and dependent children

What does a nuclear family consist of?

Includes 3 generations living together as a group

What characterizes an idealized monogamous, extended, matrilocal family?

The male lives with the bride’s family for a few years

Where does the male typically live when a new family sets up in an idealized monogamous, extended, matrilocal family?

Man adds to the income-generating capacity of the household

What is one reason for the male living with the bride's family in a matrilocal setup?

Man is also able to adjust to the parents in law and they can learn their roles vis-à-vis each other

What is another reason for the male living with the bride's family in a matrilocal setup, related to roles?

Illegitimate children’s operations must be signed for by the legitimate partner

What is a critical importance related to the presence of an "other woman/man" regarding illegitimate children's medical procedures?

Illegitimate partners cannot sign for medical consent

What is the limitation of illegitimate partners regarding medical consent?

After the death of the original spouse or after annulment of previous marriage

What are two scenarios that can lead to the presence of step-parents?

Dependent on the relationship of the step-parent and the natural children

What determines health-seeking behavior in families with step-parents after the death of the original spouse?

Seeking consent, acknowledging the extent of the illness, providing for medical treatment

If the relationship between step-parent and natural children is poor, what potential problems can arise?

Higher incidences of mental and emotional distress (depression and anxiety)

In countries where divorce is legal, what has been observed following the termination of a marriage?

Annulment

What legal process is available in the Philippines instead of divorce for terminating a marriage?

The erasure of the record of marriage, as though it never happened

What is annulment?

More tedious than divorce

How is annulment described in comparison to divorce?

To whose responsibility does the health of the children fall to?

What is a key question regarding access to health resources after an annulled marriage?

Children <17 years of age, living in a family unit with a single parent, another relative or non-relative

What defines single parenthood?

Loss of spouse by death, divorce, separation, desertion; Out of wedlock birth of a child; From adoption; Migration (OFWs)

What can result in single parenthood?

One of them is bisexual and got someone pregnant so that the female could bear them a child in exchange for money

What is one scenario mentioned for two men wanting biological children?

Consent must be given by the biological parent

Because of constraints upon same-sex marriage, if something happens to the child, who must give consent?

The non-biological parent can't do anything

What is the consequence if the biological parent is unavailable and the child is not legally adopted in a same-sex partnership?

Legal recognition of the unions

What are many people from the LGBTQ+ community pushing for, instead of same-sex marriage, to make healthcare access easier?

Acceptance of same-sex marriages is only true for a particular sector or economic segment that has access to education and exposure to these ideas

To what extent is acceptance of same-sex marriages true?

Role definitions and their changes; Internal power dynamics; Economic standing within the family; Political economy (macro setting); Access to various health models

What five factors may have an impact upon health-seeking behavior?

Gatekeepers and Decision-makers

What two roles need to be identified at the outset when considering health-seeking behavior?

Key people who can facilitate (or not) access to the patient and to the rest of the family

Who are gatekeepers (aka bantay)?

One of the family members

Who usually acts as a gatekeeper when seeking help on behalf of the patient?

Seeking an appointment with the doctor/healer; Accompanying the patient to the clinic or to buy medicines; Staying with the patient in the hospital room

What are examples of a gatekeeper's actions?

Handle the key decisions to be made in the course of seeking help

Who are decision-makers?

Who to go to, where, whether or not to have the patient admitted to the hospital

What types of decisions do decision-makers handle?

Assuming the patient is unable to make decisions

Under what condition do decision-makers primarily act?

In some cases, the roles of gatekeeper and decision-maker are embodied in the same person

What can be said about the overlap of gatekeeper and decision-maker roles?

One partner was unable to sign the waiver for his partner’s surgery

What is an example from same-sex marriage problems that illustrates how procedures impact cultural arrangements regarding decision-makers?

The OFW is the main breadwinner and acts as a decision-maker

In one example, who acts as a decision-maker if they are the main breadwinner and an OFW?

Anything having to do with treatment necessitates consultation with him/her

What consequence does an OFW's decision-making role have for treatment?

The spouse left behind

If an OFW is the main breadwinner, but not the decision-maker, who might handle the decision-making role?

Queridas

Who is mentioned as sometimes acting as decision-makers?

Grandparents, Uncles and Aunties

Who else might join in decision-making besides the immediate parents?

A dynamic of power at work

What is always present in every family?

Harmony or potential discord and disharmony

What are the prevailing themes in family power dynamics?

Age, Economic Standing, Scope of social network (who one knows)

What are the sources of differences in internal power dynamics?

How roles are played out in the kinship system

What is age-based power dynamics based on?

Older kin, whether siblings, parents, or parents’ siblings

Who may have a voice in decision-making due to age, despite not being the main decision-maker/gatekeeper?

How age and consequent role change affect who the gatekeeper is

What is an issue to consider regarding age in internal power dynamics?

Siblings split their decisions for the care and treatment of aged parents, and are therefore in conflict with each other

What is an example of age-related conflict in internal power dynamics?

It affects the doctor-patient relationship

What is the consequence of sibling conflict over aged parents' care?

Spouses in conflict over the decisions to treat their children

What is another example of internal power dynamics related to conflict?

Pronounced differences in income

What can affect decisions made in seeking treatment regarding economic standing?

The one with the most income

Who is often prevailed upon to assist the family when there are pronounced income differences?

He/she may take on the role of decision-maker (and gatekeeper)

What additional roles might the person with the most income take on?

The one with the least income (or no job)

Who may be tasked to watch over the patient (if in the hospital setting) due to economic standing?

False

All families have the same harmonious internal power dynamics. True or False?

Decision-makers

Who handles the key decisions to be made in the course of seeking help?

Issues of access to health services and service providers

What do political economic considerations refer to?

Cost of medicines; Choices between generic and branded medicines; Accessibility to health services and service providers

What are key issues related to political economic considerations?

Financial and geographic

What two aspects define accessibility to health services?

The number of health providers who can make a difference

Besides financial and geographic access, what else should be considered regarding health services?

CNS medications (to treat symptoms of depression and schizophrenia)

What type of medication is mentioned as one of the most expensive but sometimes provided for free by LGUs?

Quezon City LGU

Which LGU is mentioned as providing some expensive CNS medications for free?

Recognition of the increase in mental illnesses and its acceptance as a reason for getting a PWD card

Why does the Quezon City LGU provide these medications, despite limited procurement?

Some services are banned and classified as criminal acts (e.g., abortions)

What is an example of political economic considerations related to legal restrictions on services?

The parallel importation of drugs

What is mentioned as a counterbalance to the rising cost of medicines?

The use of animal medications (Ivermectin)

What controversial medication is mentioned as an example due to its cost per pill compared to COVID-19 treatment?

Professional Health Models, Folk Health Models, Lay Health Models

What are the three main types of health models discussed?

Health models espoused by the professional sector (doctors, nurses, therapists etc.)

What do professional health models refer to?