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OUR LADY OF FATIMA UNIVERSITY

COLLEGE OF MEDICINE

FAMILY MEDICINE AND COMMUNITY HEALTH 2

Family Case Presentation

“Carrido Family”
SECTION B: GROUP 1

Madrid, Reina Lee L.

Magat, Raizza M.

Magbata,Don John Lazaro A.

Magdula, Aika D.

Dr. Macario Reandelar


Preceptor
Table of Contents

I. Introduction
II. Objectives
III. Location, Housing, Environment
a. Spot Map
b. Floor Plan
IV. Description of the Family
V. Family Structure
VI. Family Function
VII. Stages in the Family Life Cycle
VIII. Family Psychodynamics
IX. Impact of Illness in the Family
X. Socio-Cultural Factors Affecting the Family
XI. Economic Status of the Family
XII. Tools in Family Assessment
a. Family Genogram
b. APGAR I
c. APGAR II
d. SCREEM
e. Family circle
XIII. Application of Preventive Medicine
XIV. Application of Primary Health Care
XV. Documentation
I. INTRODUCTION

“In truth a family is what you make it. It is made strong, not by number of heads counted at
the dinner table, but by the rituals you help family members create, by the memories you
share, by the commitment of time, caring, and love you show to one another, and by the
hopes for the future you have as individuals and as a unit.”
- Marge Kennedy

Family is the basic unit of a community primarily composed of a mother, a father and a child. One
family could be distinguished from another by their own structure, psychodynamics and adaptations that
are affected by financial status, educational attainment, culture, religion and health status of its members.

Filipino family has the unique characteristic of being closely knit that most families are of
extended type in terms of structure. Leadership is also distinctive in that it is externally patriarchal but
internally matriarchal. These distinctive characteristics of Filipino family warrants a look into how these
affects the wellness of the family concerning health or illness.

World Health Organization defined health as the state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity. A family that has a healthy lifestyle, with
each of its member at the state of good health can perform well in his daily living as well as its relationship
to his or her family. The family is not only a potential source of problem but also a major resource in health
care, especially because society expects families to have a sense of responsibility towards their members.
The family acts as the greatest ally in the treatment of the sick member. It is through the family where an
individual acquires his knowledge, attitudes, beliefs, and practices with regards to health. In the broad
sense of a family, one must not look only into how a disease affects the member of the family but the
illness that it brings to every member of the household or family. Illness affects how the family as a whole
must function so that they can cope up ideally with the pressing situation.
Family medicine is one of the fields of medicine, which promote health of individuals, families and
communities through its excellent community-based teaching, research and services. In this field of
medicine, we as the health care provider gets in touch with the community people, especially with the
assigned family to get involved or be knowledgeable of how a family functions regarding health beliefs
and coping mechanisms primarily, and also about how they interact with their environment which could
affect their health condition. Community based medicine is more focused on primary health care which is
about prevention of disease or promotion of health and it is more appropriate to be applied in a
developing country like the Philippines where curative services are not affordable by the masses.
Physicians considers family as partners in health care. It is therefore important for the physicians to work
with the family in the promotion of health. It has been long realized that health is not only a right of every
citizen but is also a personal responsibility that’s why health promotion is the key to a better health.

II. OBJECTIVES

I. General Objective
To write a comprehensive family case report after interacting and interviewing
with the family/index patient assigned.

II. Specific Objectives


1. Describe the structure of the family
2. Discuss the function of the family
3. Discuss the family life cycle
4. Discuss the family psychodynamics
5. Discuss the socio-cultural factors that affect the health of the individual and the
family
6. Discuss the impact of illness on the family
7. Apply tools of family assessment
8. Apply preventive medicine in the family
9. Discuss the role of family in primary health care
10. Apply communication skills and interviewing techniques
III. LOCATION, HOUSING ENVIRONMENT
A. Spot Map

The index patient’s house is in an apartment which is not too far from the Bitik
Health Center, the roads are not obstructed which will make it easy to go to the main road
if emergency happens

B. House Plan

Carrido family’s apartment approximately measures 5m x 5m in floor area. There


is not so much space for the couple to share which might hamper their private decision
making and transmission of communicable disease is very likely. It will be too small if the
new member of the family grows up.
IV. UNDERSTANDING THE FAMILY

A. Family Description

Janine Caparino and her husband Ruben Carrido is currently living at Barangay Bitik, Valenzuela City
together with the latter’s parents and younger brother. The apartment which they are renting is in the
second floor of a 2-storey building.

Mrs. Caparino is from Masbate and his husband is originally living at Valenzuela City. Janine, 22 years
old, was born on September 20,1995, is the second of six siblings, while Ruben, 28 years old, is also the
second of four siblings. They met in 2016 while Janine was working as a sales lady in a private mall. After
a year of living together, they were blessed with a healthy baby boy which was delivered via a caesarian
section in a public hospital. They are not yet married but she uses her husband’s family name after having
their own baby. The family of Mrs. Janine Carrido can be classified as cohabitation because they are
unmarried couple who lives together for almost 2 years. Based on residence they are considered
“patrilocal” because the couple choose to stay with the groom’s parents. Mrs. Janine is a hands-on mom
to their son Prince Javen who is now 1-year-old. Janine said that she got no problems with her in-laws and
they were supportive of their relationship. Her husband Mr. Ruben provides for their family by working
at a construction site as a (line man). According to Mrs. Janine her husband’s salary from 7:30 to 4 pm
every day is P 650 which is somewhat enough to sustain the needs of their child, Prince Jayven. According
to the index patient their expenses such as food, electric bill, rent, and water were shouldered by her
husband’s parents, and her husband as well.

V. FAMILY STRUCTURE

1. Classification According to Structure: EXTENDED


The Carrido family is an extended family wherein three separate generations are seen
sharing the same household. The index patient, Janine lives together with her husband, their
own son, father-in-law, mother-in-law and brother-in-law.
2. Classification Based on Residence: PATRILOCAL
The family is considered to be Patrilocal since Janine and her family are residing in the
apartment where his husband grew up.
3. Classification Based on Descent: BILATERAL
The index patient claims that she can always count on both her own parents and her
husband’s parents. She said that will also have their son know the descent of both families.
4. Classification Based on Authority: PATRIARCHAL
Their family is considered “patriarchal” because the groom and the groom’s
father who is the oldest male in the family has the authority in the family.
5. Classification According to Set-up: DEMOCRATIC
The index patient shares authority in the household rules and can decide freely on her
own volition especially matters about their own son.
6. Classification Based on Naming: PATRONYMIC
The members of the family are using the index patient’s husband’s surname and
therefore, the family is classified as patronymic.
7. Classification According to Relationship: COHABITATION
Although the index patient is not married yet to her husband, they have plans to be
married in a civil wedding.
8. Classification According to Social Class: LOWER MIDDLE CLASS
According to the NEDA social classification according to income, the Carrido family
belongs to the lower class because the monthly net income falls below P51,000.00.

VI. FAMILY FUNCTION

1. Biologic
Janine is the one who is left in their house to take care of their one-year-old son while the
other members of the household are working. She is the one who looks for the nutrition and well-
being of her son. She is the one who does all the household chores while they are away. Food
preparation for dinner and breakfast is done by her mother-in-law when she comes home every
afternoon.
2. Economic
The expenses for the house is handled by everybody; husband, father-in-law, mother-in-
law and brother-in-law. The rent which costs 3000 pesos and expenses for their son is shouldered
by Janine’s husband. Food expenses and bills are paid by the in-laws.
3. Educational
The index patient and her husband are high school graduates, both of them values
education and would try their best to have the means for their son to finish schooling.
4. Psychologic/Affectional
Family members seem to be caring for each other, no signs of hostility were noted and
Janine was very thankful that she is very welcomed by her husband’s family. She also seems to
be very caring for their son and husband as well.
5. Sociocultural
The Caparino Family has a good relationship with their neighbors. They are not involved
with any issues or arguments with other members of the community. Problems are managed
among themselves in ways that they know. They are a typical Filipino which exercises their faith
by going to church every Sunday or by having their son christened in a traditional Roman Catholic
way. They also like to go out every payday to eat and relax.

VII. STAGE OF FAMILY LIFE CYCLE

Based on the data we have gathered Janine’s family is in the stage of a “family with young
children” with them having their one-year old baby starting to take on the parenting role and having to
adopt with the realignment of relationship with extended family.

FIRST ORDER CHANGES


 Meeting predictable and unexpected costs of family life with a small child.
 Sharing responsibilities within the extended family members
 Maintaining mutually satisfactory sexual relationship
SECOND ORDER CHANGE
 Taking on parenting role
 Realignment of relationship with the extended family to include parenting and grand parenting
roles
PROBLEMS ENCOUNTERED BY PARENTS
 Medical
o Family planning
o Episodic medical problems
 Emotional and Social
o Communication problems with them seeing each other only at night and Sunday’s
o Financial difficulties that add up to the stresses of life

PROBLEMS ENCOUNTERED BY CHILD


 Medical
o Proper nutrition
o Childhood diseases
PROBLEMS ENCOUNTERED BY GRANDPARENTS
 Medical
o Work related stress
o Episodic medical problem
 Emotional and Social
o Financial difficulties

VIII. FAMILY PSYCHODYNAMICS


Janine Caparino, 22 years old house wife with only one child describes her family as functional.
She has been living with her husband Ruben Carrido, 27 years old for 2 years already but they are not
married yet. Together with them are Ruben’s family namely his father Roberto, mother Yolanda and his
youngest brother Roland. Her only son Prince Javen is only of one year of age. Janine is a hands-on mom
to their son while his husband is the one providing for their family. She and her child are only the ones
left in their apartment during the day as each one in the family have their own work during the day. Janine
described her husband as someone who is kind, very understanding and someone who don’t know how
to argue. She noted that in their 2 years old relationship they did not had a big fight yet, only small ones
about parenting roles and are also resolved by time, she said they are not the ones who talk about the
problem but only let the problem pass or what is commonly known as silent treatment. Going to church
is their only family bonding due to her husband’s work as she also said. While Janine described herself as
not the jealous type and not the strict one.

Janine’s relationship with her in laws Roberto and Yolanda are harmonious, she described herself
as someone who is lucky to have such good in laws. She noted that her father in law takes the role as the
head of the family. She also said that both of them are good and modest. While Janine’s relationship with
Ruben’s youngest brother Roland is of good term also. And also their relationship with their neighbors are
also in peaceful state.

While she lived with her husband and in laws, her father Zaldy and mother Lucy together with her
five siblings namely Jerric, Junnie, Juliet, Jurex, and Jingo are in the province of Masbate. She described
her relationship with her family as a close one, she often calls them via cellular phone. She also noted that
the last time she went home was last year and stayed there for 5 months together with her baby to rest
while her husband was in Manila still working and providing for them.

IX. IMPACT OF ILLNESS IN THE FAMILY


The distinction between the disease and illness is that the former affects the body primarily and
the latter affects not only the person’s own psyche and emotions but also those around him/her.

According to Janine, all the members of her family are apparently well and does not have any
kind of disease but this does not guarantee that all the family members are healthy and does not have
any underlying diseases as they do not have regular check-ups. The only incidence that caused Janine to
worry is when her husband got skin allergies. She went home to her province together with her son to
visit her family, her husband was left alone in Valenzuela because he has to work. After two days away
from her husband, her partner developed skin allergies probably because of his work environment. This
caused him body malaise and redness on his skin, Janine prompted to go home immediately as she worries
about the condition of her partner. They consulted the doctor, medicated him and finally recovered.

Sickness among the family members caused suffering and disruptions in the family. The support
system in the family helps the ill member to recover fast and feel that he is not alone on his illness. Every
day schedules may change because the limitations of the ill member and the demands of treatment may
require that others be more available. On that incidence, Janine took care of her partner and lessen her
attention towards her son and made her mother-in-law to take over the needs of her child. The incidence
made Janine have her husband be careful of dusts in the workplace and to always bring an extra cloth.
X. SOCIO-CULTURAL FACTORS AFEECTING THE FAMILY
The Carrido family lives in a fairly well community where they have not felt any hostility with their
neighbors. They can seek support from their neighbors in times of need and they seem to live
harmoniously.
Their family’s religion is Roman Catholic and they have their son baptized in the same faith, they
attend Mass every Sunday. Janine claimed that she and her husband don’t have any vices. The only
member of the family who has a vice is the father-in-law and they have nothing bad about it.
Janine claimed that her mother-in-law still believes in Filipino superstition and they claim that it
is not hindering their day to day activity, they also believe in herbal medicines. She claims that she believes
too much about herbal medicines or concoctions posted on Facebook. We warned her about the rampant
spread of misinformation in Facebook and detailed only about the DOH prescribed medicinal herbs.
The main concern of the family is their day to day survival. They place a lesser value on long term
goals like saving money for emergencies and rather focus on short term planning. Though they are only
high school graduates, they dream of having their son finish college education.

XI. ECONOMIC STATUS


Families may need to share responsibilities; this helps all members feel they are contributing to
the welfare of each other. According to Janine, all the members of the family commits on their daily
expenses and monthly bills. Her father-in-law works as a construction worker earning 14,000 a month,
while her mother-in-law works at CDO earning 10,000 a month. Her brother-in-law who works in an
insurance company earns 10,740 while her partner has a total monthly income of 18,200 as a welder.

MONTHLY INCOME OF THE CARRIDO FAMILY

Family members that provide income Income

Mother-in-law 10,000.00 php/ month


500/day for 5 days
Father-in-law 14,000.00 php/month
550/day for 7 days
Brother-in-law 10,740.00 php/month
537/day for 5 days
Partner 15,600.00php/month
650/day for 6 days
GROSS TOTAL 50,340.00 PHP/month

This is just the gross total, if transportation fee and lunch or snacks will be deducted, she said that
only 3/5 of the gross income will be the net income of the whole family or about 30,204.00 php/month

Since Janine has a 1-year-old child most of their daily expenditure goes to the welfare of the baby.
Every 15 days they buy formula milk which costs 1,000 pesos, diaper for 600 pesos and for the purified
water which is 340 pesos. Daily expenses like food is about 700 pesos. All the members of the family
commits with their monthly expenses, Janine and her partner pays for the rent of their apartment, while
the monthly dues goes with her in-laws like the electricity and water. Despite of their average monthly
income, still the family Carrido has no budget for their medical health.

MONTHLY EXPENDITURE OF THE CARRIDO FAMILY

Expenses Amount

Electric bill 800-1000.00 php/month

Water Bill 800.00 php/month

House rent 3000.00 php/month

Baby budget 3,880.00 php/month

Food and other basic commodities 20,000.00 php/month

TOTAL 28,680.00 PHP/month

Deducting the total expenditure of the family from the net income of 30204.00 php, they will only
have 1524.00 php allowance per month. This allowance is used in buying things like clothes, personal care
products or in paying borrowed money. This leaves them with no extra money for health care and is the
reason why they have to borrow money from Ruben’s older sister whenever someone gets sick.
XII. TOOLS IN FAMILY ASSESSMENT
a) Family Genogram

b) APGAR 1

Pangalan ng Pamilya: Carrido Lokasyon: Barrio Bitik, Valenzuela City


Pangalan ng Impormante: Janine Carrido

Palagi Paminsan- Halos Hindi


(2) minsan (1) (0)
Ako ay nasisiyahan dahil nakakaasa
ako ng tulong mula sa aking pamilya sa oras ng
pangangailangan.
Ako ay nasisiyahan sa paraan kung paano naming
pinag-uusapan sa aming pamilya ang tungkol sa
mga problemang dumarating sa amin.
Ako ay nasisiyahan sapagkat ang aking pamilya ay
tinatanggap at sinusuportahan ang mga bagay na
nais kong gawin na maaaring maging daan ng
aking pag-unlad.
Ako ay nasisiyahan sa paraan kung paano
ipinadadama sa akin ng aking pamilya ang
kanilang pagmamahal pati na rin ang kanilang
pag-unawa sa aking mga damdamin tulad ng galit,
lungkot at pagmamahal.
Ako ay nasisiyahan sapagkat ako at ang aking
pamilya ay nagkakaroon ng oras at panahon para
sa isa’t isa.

Total score= 6 (moderately functional family)


c) APGAR 2
Sinu-sino ang nakatira sa inyong tahanan? Kumusta ang iyong relasyon sa bawat isa?
Pangalan at Edad Kasarian Mabuti Hindi Hindi
Relasyon gaanong mabuti
mabuti
Ruben Carrido 50 Lalake
Sr.

Yolanda 49 Babae
Carrido

Ruben Carrido 27 Lalake


Roland Carrido 23 Lalake

Prince Jayven 1 Lalake


Carrido

Kung hindi ka nakakahingi ng tulong sa iyong Kumusta ang iyong relasyon sa bawat isa?
pamilya, kani-kanino ka humihingi ng tulong?
Pangalan at Edad Kasarian Mabuti Hindi Hindi
Relasyon gaanong mabuti
mabuti
Chona Jayme 40 Babae
Angelica
Cortero 42 Babae

Adaptation:
Janine is able to rely on Ruben for help and for support. She could also rely on her in-laws in
financial problems.
Partnership:
Decision making regarding the household is done by the family of Janine’s husband mostly. She
could only participate equally with her husband in decisions regarding her own family.
Growth:
Janine is satisfied with the way her husband and, in-laws support her decisions. This is shown by
the way her in-laws take turns in accompanying her husband to the health center when she got sick and
in looking after their son also.
Affection:
Janine is able to show affection towards her child and most especially, her husband.
Resolve:
Janine spends time with her child every day. She spends quality time with her husband when he
comes home from work.
d) SCREEM RES

RESOURCES Mga Tanong Lubos na Sumasang- Hindi Lubos na


Sumasang- ayon Sumasang- hindi
ayon ayon Sumasang-
ayon
SOCIAL Ang bawat isa sa aming
pamilya ay
nagtutulungan.
Natutulungan kami n
gaming mga kaibigan
at kasamahan sa
komunidad.
CULTURAL Ang aming kultura ay
nagpapatatag ng loob
ng aming pamilya.
Ang kultura ng
pagtutulungan at
pagmamalasakit sa
aming komunidad ay
nakatutulong sa aming
pamilya.
RELIGIOUS Ang aming
pananampalataya at
relihiyon ay
nakatutulong sa aming
pamilya.
RELIGIOUS Natutulungan kami ng
aming mga kasamahan
sa simbahan o sa
grupong relihiyoso.
ECONOMIC Sapat ang naipong pera
ng aming pamilya para
sa aming mga
pangangailangan.
Sapat ang kinikita ng
aming pamilya para sa
aming mga
pangangailangan.
EDUCATIONAL Sapat ang aming
kaalaman upang
maintindihan ang mga
impormasyon tungkol
sa sakit.
Sapat ang aming
kaalaman upang
maalagaan ang
maysakit.
MEDICAL Madaling makakuha ng
tulong medikal sa
aming komunidad.
Natutulungan kami ng
mga doctor, nars at
health workers.

PATHOLOGY Mga Tanong Lubos na Sumasang- Hindi Lubos na


Sumasang- ayon Sumasang- hindi
ayon ayon
sumasang-
ayon
SOCIAL Ang aming pamilya ay
hindi nakikihalubilo sa
iba pang mga tao sa
aming komunidad.
CULTURAL Ang aming pamilya ay
nakakaramdam ng
pagkahiya dahil sa
aming mga kultura at
nakagisnang tradisyon.
RELIGIOUS Ang aming relihiyon ay
hindi nakakatulong sa
aming pamilya.
ECONOMIC Hindi sapat ang
naipong pera o ang
kinikita ng aming
pamilya para sa aming
mga pangangailangan.
EDUCATIONAL Hindi sapat ang aming
kaalaman upang
makapag-alaga ng may
sakit at hindi naming
EDUCATIONAL kayang mag-alaga ng
may sakit dahil may
kani-kaniyang
problema kami sa
aming kalusugan.
MEDICAL Hindi kami nakakahingi
ng tulong medikal sa
aming komunidad at
hindi rin kami
natutulungan ng mga
doctor at nars.

e) Family Circle
Interpretation:

Family circle can show the level of


significance and the closeness of family
members. In our index patient, Janine Carrido,
the family circle she filled up is about those who
are above and below her name. Those who are
above are those who she lives with today who
she can depend on quickly and those who are
below her name are her family who she misses
and wishes to be with also. This also shows that
the family of Janine and her husband’s family
don’t know so much about each other because
they have just been together for two years.

XIII. APPLICATION OF PREVENTIVE MEDICINE


Preventive medicine in the family is a medical discipline which focuses on preventing diseases
and promoting a general state of health and well-being, by promoting physical, social and mental health.
Levels of prevention may be classified to 3 categories: (1) Primary Prevention, (2) Secondary
Prevention and (3) Tertiary Prevention. In the case of Carrido family, the major health concern for the
household is the smoking habit of Roberto. yet they don’t see it as a major health concern for himself
since he had not felt any symptoms regarding the effects of smoking, but they know the bad effects of
smoking not only for the smoker but for those around him. This is the reason, as a preventive measure,
why they have him smoke only outside or far away from the house because they are concerned about
Prince Jayvens health.

For the primary prevention, Mrs. Janine said that she is aware about the healthy diet, but she is
not the one who decides about the type of food that will be served during meals but her husband’s family
who like meaty dishes or preserved foods, though she likes to eat vegetables, and would have them always
if she only could decide, she can cook it only when the other family members are at work. Their apartment
is small for the six of them but it is always kept tidy, the garbage is regularly collected and they have no
pets to look upon. Although the family members don’t have periodic health examination, Mrs. Janine said
that all of them have received complete vaccination and their son is also getting the age specific vaccines
from the health center. Her husband, Ruben, who always suffer from back ache and sneeze due to work,
was advised to have a towel or to change clothes, mask was also suggested to be worn to avoid the dusts
in the construction area from being inhaled.

For secondary prevention, which includes early diagnosis, prompt treatment and disability
limitation, the family fail to always seek early diagnosis and prompt treatment from a medical center.
Whenever symptoms arise like cough or fever, they will try to self-medicate first by buying antibiotics in
a Sari-sari store. We warned and taught them about the adverse effect of self-medication, and taught
them about the alternative Herbal Medicine which could alleviate the symptoms in times when they really
can’t go to a medical center for a prompt diagnosis and treatment. We also discussed to them about the
effect of smoking but they don’t have a plan to have Roberto. take a physical examination because of
financial constraints. Nevertheless, the family strictly follows doctor’s prescription if they ever went for a
consultation.

Lastly for the tertiary prevention which is about rehabilitation, there is no member of the family
who has chronic diseases that is subject for rehabilitation.

In general, Carrido family’s preventive measure is typical of a Filipino family where they see health
not a priority to prepare upon and would only be concerned if symptoms arise. With our index patient,
whose main problem or health concern is the mental stress or anxiety brought upon by the work related
problems to her husband’s health and the workload in the house. She is also anxious whenever they are
away because this leaves her alone with her son, making her the one to decide when there is an
emergency. They are planning to buy and live on their own house probably by next year. This is a good
plan according to her because she could now decide for their food and maybe she could do some errands
to have more income for the family and somehow save for her family.

XIV. APPLICATION OF PRIMARY HEALTH CARE


Primary health care is “essential health care based on practical, scientifically sound and socially
acceptable methods and technology made universally accessible to individuals and families in the
community through their full participation and at a cost that the community can afford to maintain at
every stage of their development in the spirit of self-reliance and self-determination” (WHO/UNICEF 1978,
in Stanhope and Lancaster, 1992:172)

Primary health care for some of the developing countries like of the Philippines is the only
practical means of providing any form of health for its expanding population. The primary health care
delivery in our country includes community organization resulting to the formation of a Barangay Health
Committee. The Barangay Heath Center serves as the venue in order to provide primary health care
services into its people in the said barangay. Some of the programs are emphasized on Child survival and
Maternal Heath.

In the area of our index patient, public education or participation element of primary health care
regarding information dissemination is not evident, this is based on the lack of knowledge of Mrs. Janine
about the local government programs like seminars. She said that she is willing to participate in such
programs if there are such. She knew about the immunization program of the government and had her
child have it on a government clinic where she gave birth. The issue about dengvaxia somehow affected
her view about vaccines or immunization but she said that the government must explain what is the issue
about dengvaxia because it prompted her to consult with her neighbors first before having the other
vaccines.

Mrs. Janine believes that Bitik health center is a private one and would only refer her to the
hospital if she would consult there, making her just go directly to the hospital whenever they need
consultation. She noted that when her son had an episode of convulsion she brought her son in the center
but then was referred to another bigger hospital which was 3s Hospital in Karuhatan, Valenzuela. She
knew that the barangay had a physician but was only scheduled for Mondays of the week. Other than his
son’s condition, she and her family had not taken counsel with any other medical conditions with the Bitik
Barangay Health Center.

For the nutrition and food supply of the family, they cannot afford to have a balanced diet every
day because of financial constraints. She said that vegetables nowadays are costlier than meat or other
food choices. The government can help in this situation by putting food caravans or by encouraging people
to do urban gardening.

The family has no problem with sanitation because the garbage is regularly collected by the city
government. They also have their own comfort room and water supply is always plenty.

XV. DOCUMENTATION