CHN

History
Act No. 157- Creation of Board of Health of the Philippine (BON)
Act No. 147- A!olish BOH "#$%
1&1& 'rs. Car(en "el )osario * 1
st
+ilipino N,rse -,per.isor
1&&-1&&/ * $ocal )e.ol,tionary Code of 1&&10 )A 711 )e.ol,tion Code
National to local
"efinition
Health * (2HO) state of co(plete physical0 (ental and social 3ell !ein40 not (erely
the a!sence of disease or infir(ity
P,!lic health * ("r. C.5. 2inslo3) the science and art of pre.entin4 disease0
prolon4in4 life0 pro(otin4 health and efficiency thro,4h or4ani6ed
co((,nity effeort.
Co((,nity Health N,rsin4 (7aco!son)- is a learned practice discipline 3ith the
,lti(ate 4oal of contri!,tin4 as indi.id,al and in colla!oration 3ith others to
the pro(otion of clients opti(,( le.el of f,nction thro,4h teachin4 and
deli.ery of care.
+actors affectin4 Opti(,( $e.el of +,nction (O$O+)
1. Political
/. Beha.ioral
8. hereditary
4. Health Care "eli.ery -yste(
5. 5n.iron(ental #nfl,ences
1. -ocio econo(ic #nfl,ences
Concepts
1. 9he pri(ary foc,s of co((,nity health n,rsin4 practice is on health
pro(otion.
/. Co((,nity health n,rses are 4eneralist in ter( of their practice thro,4h life
!,t the 3hole co((,nity.
8. Co((,nity health n,rses are 4eneralist in ter(s of their practice thro,4h
life contin,ity in its f,ll ran4e of health pro!le(s and needs.
4. 9he nat,re of CHN practice re:,ires that c,rrent ;no3led4e deri.ed fro(
the !iolo4ical0 social science0 ecolo4y0 clinical n,rsin4 and co((,nity health
or4ani6ations !e ,tili6ed
5. Contact 3ith the client and or fa(ily (ay contin,e o.er a lon4 period of ti(e
3hich incl,des all a4es and all types of health care.
1. 9he dyna(ic process of assessin40 plannin40 i(ple(entin4 and inter.enin4
pro.ide (eas,re(ents of pro4ress0 e.al,ation and a contin,,( of the cycle
,ntil the ter(ination of n,rsin4 is i(plicit in the practice of co((,nity
health n,rsin4.
Principles
1. CHN is !ased on reco4ni6ed needs of co((,nities0 fa(ilies0 4ro,ps and
indi.id,als.
/. 9he co((,nity health n,rse (,st ,nderstand f,lly the o!<ecti.es and
policies of the a4ency she represents.
8. #n CHN0 the fa(ily is the =nit of ser.ices.
4. CHN (,st !e a.aila!le to all re4ardless of race0 creed and socioecono(ic
stat,s
5. Health teachin4 is a pri(ary responsi!ility of the CHN.
1. 9he co((,nity health n,rse 3or;s as a (e(!er of the health tea(.
7. 9here (,st !e a pro.ision for period>s e.al,ation of co((,nity health tea(.
?. Opport,nities for contin,ation staff ed,cation pro4ra(s n,rses (,st !e
pro.ided !y the CHN a4ency. 9he co((,nity health n,rse also has a
responsi!ility for his@her o3n professional 4ro3th.
&. 9he co((,nity health n,rse (a;es ,se of a.aila!le co((,nity health
reso,rces.
1. 9he co((,nity health n,rse ,tili6es the already eAistin4 acti.e or4ani6ed
4ro,ps in the co((,nity.
11. 9here (,st !e pro.ision for ed,cati.e s,per.ision CHN
1/. 9here sho,ld !e acc,rate recordin4 and reportin4 in CHN.
P,!lic Health N,rse
1. Planner@pro4ra((er
/. Pro.ide of N,rsin4 Care@Care4i.er
8. 'ana4er@-,per.isor
4. Co((,nity Or4ani6er
5. Coordinator of -er.ice
1. 9rainer@ Health 5d,cator@ Co,nselor
7. Health (onitor
?. )ole 'odel
&. Chan4e A4ent
1. )ecorder@ )eporter@ -tatistician
11. )esearcher
Co((,nity Health Process
Assess(ent
Collection of data0 collected fro( fa(ily0 4ro,ps and co((,nity.
5Aa(plesB "e(o4raphic "ata
Cital Health -tatistics
Co((,nity "yna(ics
Health -tat,s
5d,cation
'ethodsB Co((,nity -,r.ey
#nter.ie3
-tatistics
5pide(iolo4ical st,dies
Co((on indicators of health stat,s
'or!idity
'ortality
Cate4ories of Health Pro!le(s
1. Health "eficit (H")- instances of fail,re in health (aintenance ( dse0
disa!ility0 de.>tl la4)
-eA. "se@ illness- =)9#0 (aras(,s0 sca!ies0 ede(a
disa!ilities- !lindness0 polio0 color!lindness0 deafness
de.>tl pro!le(s li;e (ental retardatA0 4i4antis(0 hor(onal0
d3arfis(
Health 9reat (H9)- conditions cond,ci.e to dse0 accidents or fail,re to reali6e
one>s health potential
healthy people
eA. +a(ily hA of illness- hereditary li;e "'0 HPN
n,tritional pro!le(s- eatin4 salty foods
personal !eha.ior- s(o;in40 self-(edication0 seA,al practices0
dr,4s0 eAcessi.e drin;in4
inherent personality char- short te(peredness0 short attn span
short cross infectA
poor ho(e en.i
lac;@inade:,ate i((,ni6ation
ha6ards- fire0 falls0 or accidents
fa(ily si6e !eyond 3hat reso,rces can pro.ide
+oreseea!le Crisis (+C)- anticipated periods of ,n,s,al de(and on indi.
or fa( in ter(s of ad<,st(ent or fa(ily reso,rces ( nat,re sit,atAs)
eA. 5ntrance in school
adolescents (circ,(cision0 (enarchs0 p,!arche
co,rtship (fallin4 in lo.e0 !rea;in4 ,p)
(arria4e0 pre4nancy0 a!ortion0 p,erperi,(
death
,ne(ploy(ent0 transfer or relocation
4rad,ation0 !oard eAa(
#dentify the ffB
5AB Acti.e 9B- H"
45 yr0 old (ale s(o;e- H9
-edi(entary health style- Ht
5arly pre4nancy- +C
+ather of fa(ily losses his <o! +C
"eath in the fa(ily- +C
Patient is sic; d,e to pne,(onia- H"
Children 3ho are not i((,ni6ed- H9
$ac; of prenatal chec; * ,p- H9
5cla(psia- H"
2or;in4 ha6ard- H9
Hypertensi.e- H"
2ith (easles DchildE- H"
+a(ily (e(!ers has liprosy ((icro!actria liporea)- H"
'arria4e- +C
Co((,nity dia4nosis
A. Physical Characteristics
B. Pop,lation Characteristics
C. 5n.iron(ental factors
". Fno3led4e0 attit,de0 practices of the people
5. Co((,nity reso,rces and facilities
Plannin4B Based on the act,al and potential pro!le(s that 3ere identified and
prioriti6ed
%oalB "eclaration of p,rpose or intent0 4i.es essential direction to action
-pecific o!<ecti.esB 'ade in ter(s of acti.ities of daily li.in4
#(ple(entationB
Carries o,t n,rsin4 proced,res 3hich are consistent 3ith n,rsin4 3ith
n,rsin4 care plans.
#n.ol.e the patient 3ith his@her fa(ily
=tili6ed s,pport syste(
5.al,ation
+ra(e 3or;s
a. -tr,ct,ral ele(ents
!. Process ele(ents
c. O,tco(e ele(ents
N,rsin4 Proced,res
Clinic Cisit
1. Pre-cons,ltation conference
/. 'edical eAa(ination
8. N,rsin4 inter.ention
4. Post cons,ltation conference
Ho(e Cisit- face to face contact 3ith the client
Principles
1. A ho(e .isit sho,ld ha.e a p,rpose or o!<ecti.e
/. Plannin4 for a ho(e .isit sho,ld ,se e.ery a.aila!le infor(ation a!o,t the
fa(ily0 and indi.id,al
8. Plannin4 sho,ld re.ol.e aro,nd the essential needs of the indi.id,al
4. Plannin4 of a contin,in4 care in.ol.e the indi.id,al or fa(ily
5. Plannin4 sho,ld !e fleAi!le and practical
Ba4 techni:,e- 9ool
P,!lic health !a4- is an indispensa!le e:,ip(ent of the p,!lic health n,rse
Principles
1. Pre.ent the spread of infection
/. -a.e ti(e and effort
8. sho,ld not shado3 the concern for the patient
4. Can !e perfor(er in a .ariety of 3ays
Gippira( sol,tion- disinfectant
N,rsin4 Care in the Ho,se
Principles
1. N,rsin4 care ,tili6es a (edical plan of care and treat(ent.
/. Perfor(ance of n,rsin4 care ,tilities s;ills that 3o,ld 4i.e (aAi(,(
co(fort and sec,rity.
8. N,rsin4 care at ho(e sho,ld !e ,sed as a teachin4 opport,nity.
4. Perfor(ance of n,rsin4 care sho,ld reco4ni6ed dan4ers in the patients> o.er-
prolon4ed acceptance of s,pport and co(fort.
5. N,rsin4 care is an opport,nity for detectin4 a!nor(al si4ns and sy(pto(s.
#solation 9echni:,es
All Articles ,sed !y the patient sho,ld not !e (iAed 3ith the articles ,sed !y
the rest of the (e(!ers of the ho,sehold.
+re:,ent 3ashin4 and airin4 of !eddin4s and other articles and disinfectants
of roo( are i(perati.e
9he one carin4 for the sic; (e(!er sho,ld !e pro.ided 3ith a protecti.e
4o3n that sho,ld !e ,se 3ith in the roo( of the sic;.
All dischar4es0 especially fro( the nose and throat of a co((,nica!le
disease patient sho,ld !e caref,lly dischar4ed.
Articles 3ith dischar4es sho,ld !e first !oiled for 8 (in,tes !efore
la,nderin4. 9hos co,ld !e !,rned0 sho,ld !e !,rned.
"OH
CisionB H5A$9H +O) A$$ BH / I H5A$9H #N 9H5 HAN"- O+ 9H5
P5OP$5 BH //
'issionB 5ns,re accessi!ility and :,ality of health care to i(pro.e the :,ality of
life of all +ilipinos0 especially the Poor.
National O!<ecti.es
1. #(pro.e 4eneral health stat,s
/. )ed,ce (or!idity0 (ortality and disa!ility rates
8. 5li(inate p,!lic health pro!le(s
4. 5radicate polio(yelitis
5. Pro(ote healthy lifestyle
1. Pro(ote health and n,trition
7. Pro(ote en.iron(ental health
Basic Principles
1. =ni.ersal access to !asic health ser.ices
/. Health and n,trition of .,lnera!le 4ro,ps
8. 5pide(iolo4ical shift fro( infectio,s to de4enerati.e
4. Perfor(ance of the health sector (,st !e enhanced
Pri(ary strate4ies to achie.e health 4oals
a. #ncrease in.est(ent for pri(ary health care
!. "e.elop(ent of national standards and o!<ecti.es for health
Her!al 'edicine
1. aro(atic- has .olatile oil for tA of fe.er0 co,4h0 colds0 itchiness and 4as pain.
$,ya0 !a3an40 si!,yas0 yer!a B,ena0 ore4ano0 (an6anilla0 tan4lad0 sa(!on40
la4,ndi0 JJJ or petals of sa(pa4,ita0 <as(ine I rosal
$,ya- shd not !e ta;en on an e(pty sto(ach
5liAir- JJJJJJ
-ha;e 3ee; after 3ee;KtA for 9B
Ba3an4 cr,sh 1 ear I drin; it
9inct,re of !a3an4 1B5
Add 5 t!sp. of 4inL 1 t!sp chopped !a3an4
-ha;e 1 (ins for 1 3ee; * 4ood for s,perficial 3o,nds
9an4lad- le(on 4rassKfor fe.er
-a(!on4Ksto(achache
-,ha@;ala(ansi- for fe.er0 9-B
/. astrin4ent-tastin4- !itter- has tannin I pectin for diarrhea I 3o,nd
A .ocado lea.es
B aya!as lea.es
F a(ilo lea.es
" ,hat lea.es
- a4in4 lea.es (sa!a c,t into chips0 let dry0 p,l.eri6e then add to JJJJJ)
8. !itter-tastin4
a. s;in pro!le(s--Acap,lco0 ;alach,chi0 (al,n44ay0 ;a;a3ati0 ina;a!,hay
!. depressants- to p,t hyper people to sleep--dapdap0 dita0 (a;a!,hay0
(a;ahiya
c. anti-cancer dr,4-- tsitsiri;a
d. aches I pains-- sa(!on40 da(on4 arya
e. asth(a- tala(p,4ay- can ca,se psychosis
4. seeds- fiAed oils0 anti-hel(entics- niy,4-niyo4an (,rine)0 patola0 ipil-ipil0 !etel n,t
or !,n4a0 !alanyo40 s:,ash seeds0 lan6ones- do not thro3 peelin4s instead0 !,rn itK
4ood insect repellant
5. 4rass fa(ily- di,reticsK;a4on0 t,!o0 tan4lad0 pandan0 p,4o-p,4o0 !,to-!,tones0
4atas-4atas0 ata<,o ;ahol0 pansit-pansitan or ,lasi(an4 !ato0
stones- (eis hair(0 HPN- palay
1 'edicinal PlantsB
$ a4,ndi- asth(a0 co,4h0 colds
= lasi(an4 !ato- ,ric acid0 HPN
B a3an4- HPN
B aya!as- "iarrhea
H er!a B,ena- arthritis0 toothache0 s3ollen 4,(s0 co,4h I colds
- a(!on4- co,4h and colds0 renal stones
A (palaya- "'
N iy,4-nyo4an- ascariasis
9 saan4 4,!at- diarrhea
A cap,lco- f,n4al infection0 sca!ies
)A ?4/8- ,tili6ation of (edicinal plants as alternati.e for hi4h cost (edications.
5pide(iolo4y- st,dy of distri!,tion and dyna(ic of disease occ,rrence in h,(an
pop,lation
5nde(ic- constant presence of disease or infection a4ent 3ith in a 4i.en 4eo4raphic
area
5pide(ic- occ,rrence in a co((,nity or re4ion of cases of an illness clearly in
eAcess of eApectancy
Pande(ic- epide(ic so 3idely spread that .ast n,(!ers of people in different
co,ntries are affected
-poradic- disease that occ,rs only occasionally or in a fe3 isolated places
-,r.eillance- a contin,in4 scr,tiny of all aspects of occ,rrence and spread of a
disease that is pertinent to effecti.e control ( pro(otion0 pre.enti.e
patient and reha!ilitati.e)
-entinel sites- are health facilities 3hich are selecti.e as representati.es of 3hat is
happenin4 in areas 3hose reports are acc,rate0 co(plete and pro(pt
(health center)
-tatistics- that science in.ol.ed in the collection0 or4ani6ation0 analysis and
interpretation of n,(erical data
Biostatistics- the scientific discipline concerned 3ith the application of statistical
(ethods to pro!le(s in !iolo4ical and (edicine.
+ertility )ate
1. CB) (Cr,de !irth rate)- relati.e pop d,e to !irths
9otal n,(!er of !irths in a calendar year
CB)M Birth A 1
Pop eA. /5.?M CB)
9here are /1 !irths in e.ery 1 pop
/. %eneral +ertility )ate (%+)) - tr,e fertility rate * specific se4(ents of pop that is
fertile
%+)M JJJJJJJJBirthJJJJJJJJJJJ A 1
Pop of 3o(en (15 to 44 yo)
5A. %)+M8/ 9here are 8/ !irths in e.ery 3o(an in 15-44
'ortality )ates
1.Cr,de "eath )ate JJJJ A 1
"ecrease in pop d,e to death
C")M death A 1
Pop
5A. C")M 1 there are 1 in e.ery 1 pop
/. -pecific 'ortality )ate- can apply to any pop 4rp
-') M death fro( or partic,lare 4rp A 1
Pop of that 4rp
a. -') ((ales) M death ((ales) A 1
pop of (ales
!. -') (fe(ales) M death of fe(ales 15-44
pop of fe(ales 15-44
#nfant 'ortality )ateB #')M "eath -1 year A 1
Births
Neonatal 'ortality )ateB N')M deaths -/? days A 1
Births
Post Neonatal 'ortality )ateB PN') M deaths /? days to 1 year A 1
Births
N') N PN') M #')
Neonatal deaths N Post neonatal deathsM #nfant deaths
5A. Birth /
N')M /
"eath * /? to 1
N') N PN') M #')
/ N 1 M 8 (AN-)
/ J A 1 M 1 M 1
/ 1
'aternal 'ortality )ate (''))
'')M death of 3o(en r@t pre4nancy0 deli.ery0 I p,erperi,( A 1
Births
5A. #') M 8 9here are 8 infant deaths in e.ery 1 !irths
N') M / 9here are / neonatal deaths in e.ery 1 !irths
PN') M 1
'') M .&/
Proportionate 'ortality )ate M P') ( for any 4rp)
P')M death fro( a partic,lar 4rp A 1
total death
5A. 5/O P') of (ales M deaths of (ales A 1
total deaths
#n e.ery 1 death0 5/ are (ales
P') M deaths -1 A 1
.1 total deaths
P)OPO)9#ONA95 'O)9A$#9H #N"#CA9O)
A. -3aroop>s #ndeA M -#
-# M death of 5 yrs I ,p A 1
total deaths
9he -#0 the !etter the sit,ation isP
B. )elati.e i(portance of a ;iller ( 9B0 heart dse0 diarrhea)
"eath d,e to 9B A 1
total deaths
P') M 8O
9B
--#n e.ery 1 deaths0 8 are d,e to 9B
Case +atality )ate (C+))
Ho3 is s,r.i.al rate0 ho3 stron4 is ;illin4 po3er0 pro4nosis
C+)M death d,e to part ca,se A 1
total cases
5A. C+) M &?
H#C
JJJdeath H#CJJJ A 1
9otal cases of 9B
#n e.ery 1 cases of H#C0 there are &? deaths
Ca,se-of-death )ate ((ortality rate)
)an; as a ;iller
C of ")M death d,e to partic,lar ca,se A 10
total pop
5A. C of ") M8/
9B
#n e.ery 10 pop there are 8/ deaths d,e to 9B
Pre.alence )ate M ('or!idity rate)
)an; as a co((on dise
P) M old and ne3 case of 9B A 10
9B total pop
5A. P) M old I ne3 case of 9B A 10
9B
5A. P) M 8/1
9B
9here are 8/1 cases of 9B o,t of 10 pop,lation.
#ncidence )ate
#)M JJJne3 casesJJJ A 10
pop at ris;
-3aroff>s #ndeA
9otal death of a person a4in4 a!o.e 5 Q 1
9otal n,(!er of deaths of all a4es
-it,ationB Baran4ay Q has a total pop,lation of 181/ for the year 1&&&-/ !ases
on the follo3in4 date0 sol.e for the s3aroff>s indeA0 infant (ortality rate0 cr,de
death rate and the (aternal (ortality rate
-3arrof>s indeAM 7@57 A 1M 1/.?
#')M 17@1/&4 A 10 M 18 #)M 1@181/ A 10M 4&
CB)M 1/&4@181/ A 10 M &5
C")M 57@181/ A 10M 4/
'')M 8@1/&4 A 10 M /.88
5ssential Health -er.ices
(5$5'5N9-) of PHC
5- 5d,cation on (ethods of pre.entin4 and controllin4 health pro!le(s
$- $ocal ende(ic disease pre.ention and control
'- 'aternal and child care incl,din4 fa(ily plannin4
5- 5ssential dr,4s
N- N,trition
9. 9reat(ent
-- -anitation and H/O s,pply
+o,r Corner stone@ Pillar in PHC
1. Acti.e co((,nity participation
/. #ntra and inter sectoral lin;a4es
8. =se of appropriate technolo4y
4. -,pport (echanis( (ade a.aila!le
$e.els Health Care
Pri(ary- Bran4ay D district (id3ife@ trained health 3or;ersE
-econdary- )e4ional@"istrict DN=)-5E
9ertiary- Hearth Center0 $,n4 Center etc. - doctor
)eprod,cti.e Health ()H)
CisionB reprod,cti.e health practices as a 3ay of life for e.er (an and 3o(an
thro,4ho,t life
ConceptB
a. (arried co,ples has the capa!ility to reprod,ce
!. reprod,cti.e health is eAercise of reprod,cti.e ri4ht
c. p,rpose of enhance(ent of life and personal relation
d. safe pre4nancy0 safe deli.ery
e. protection fro( ,n3anted pre4nancy
f. protection fro( har(f,l reprod,cti.e practice and .iolence
4. ass,res access to infor(ation on seA,ality to achie.e seA,al
en.iron(ent
"eter(inants of )HB
1. socio- econo(ic
/. stat,s of 3o(en
8. social and 4ender iss,es
4. !iolo4ical0 c,lt,ral and psycho-social factors
%OA$-B 'CH AN" N=9)#9#ON
R e.ery pre4nancy sho,ld !e intended
R e.ery !irth sho,ld !e healthy
R e.ery seA act sho,ld !e free of co erection and infection
R achie.e desired fa(ily si6e
9en 5le(ents of )H
1. 'aternal and child health n,trition
/. +a(ily plannin4
8. Pre.ention and (ana4e(ent of a!ortion co(plication
4. Pre.ention and treat(ent of reprod,cti.e tract infection0 respiratory
infection and -9"0 H#C@ A#"-
5. 5d,cation and co,nselin4 on seA,ality and seA health
1. Breast and reprod,cti.e tract cancer
7. Other 4ynecolo4ical condition
?. 'en>s )H
&. Adolescent )H
1. Pre.ention and treat(ent of infertility
9etan,s 9oAiod
91- anyti(e d,rin4 pre4nancy
9/- 4 3ee;s of pre4nancy
98- 1(onths@ /44 3ee;s of pre4nancy
94- 1 year old
95- a!o.e 1 year
SPP" &&1 i((,ni6ation pro4ra(
Caccine )o,te "osa4e +re:,ency
BC% half life 4ho,rs
$i.e atten,ated !acteria
Dstored T /-?de4ree Celsi,s
) dorsal
"eltoid
$ "eltoid
.5@(l
.1@(l
At !irth
-chool entrance
"P9 half life ? ho,rs
2ea;ened toAin
;illed !acteria stored T/
2ea;ened toAin to ? de4ree
Celsi,s
#'
)i4ht@ $eft@
)i4ht
.5@(l "P9 1- 1
th
3ee;s
"P9 /- 1 3ee;s
"P9 8- 8 U (onths
OPC Oral /-8 4tts 1 3ee;sT 8 doses
Hepa B #' anterior
thi4h
left@ri4ht@
left
.5@(l 1 3ee;s/ 8 doses 4
th

3ee;s
inter.al
'easles -V o,ter
part of the
ar(
.5(l & (onths
-ide effects
1. Foch>s pheno(enon- /-4 days after .accines
- ac,te infla((ation
deep a!scess- deeper in<ection
tAB incession @ draina4e@ #NH po3der
/. +e.er- after and last for 1 day
- 9AB antipyretics
- (ore that /4 ho,rs after dose D local soreness at the siteE
SA!scess- 3ron4 in<ection techni:,e
9AB incision and draina4e
SCon.,lsion- rare and occ,rs 8 (onths d,e to pirtosis of .accine-
(don>t contin,e)
8. -al; * #'
NO -#"5 5++5C9-
-a!in * Oral
4. +5C5) and )ash * 5 * 7 days D.accinationE
- last 1-8 days
- 'ana4e(entB antipyretic
$eprosy Control Pro4ra(
- ',lti "r,4 therapy 1&?? )A 478
- Chronic disease of the s;in and peripheral ner.es ca,sed !y 'yco!acteri,(
$eprea or Han>s Bacill,s
5arly s@sB
Chan4e in s;in color- reddish or 3hite
$oss of sensation
"ecrease hair 4ro3th- der(is
$oss of s3eatin4- eAocrine
',scle 3ea;ness- ner.es
9hic;ened@ painf,l ner.es
=lcer that do not heal
$ate s@s
'adiacrosis
$a4ophthal(os- ina!ility to close the eye lids
Cla3in4 of fin4ers and toes
Contract,res
-in;in4 of nose !rid4e
%yneco(astia
Chronic ,lcers
Pne,(onia
-i4ns
+ast !reathin4
Chest in dra3in4
Con.,lsion
A!nor(ally sleepy
-e.ere ,nder n,trition
Not a!le to drin;
-tridor ,pon inhalation- a,sc,ltation
2hee6in4- ,pon eAhalation
+e.er or lo3 !ody te(p.
'ana4e(ent of pne,(oniaB (ost pne,(onia deaths are pre.enta!le if treated
early
9A is !ased B
early reco4nition of pne,(onia
pro(pt treat(ent of non se.ere cases at ho(e 3ith standard
anti!iotics and 4ood s,pporti.e care
:,ic; identification if se.ere cases and :,ic; referral to the
hospitals- pre.ent death
9reatent (ay incl,de
anti!iotics
ad.isin4 (others to 4i.e ho(e care
treatin4 fe.er and 3hee6in4
Ho(e CareB (child 3ith co,4h and colds)
no anti!iotics needed
feed the child
increase fl,id inta;e
clear nose
;eep child 3ar( and co(forta!le
-@- that the child (,st !e !ro,4ht to health care facilityB
fast !reathin4
diffic,lty !reathin4
,na!le to drin;
feedin4 pro!le(
)ole of "r,4s in control of infection
children 3ith co,4h and colds 3ith no pne,(onia (,st not !e
4i.en anti!iotics
anti!iotics sho,ld only !e 4i.en to cases pne,(onia0 se.ere
pne,(onia and .ery se.ere disease
CO9)#'OQAGO$5
A.aila!ity of "r,4s
1. Cotri(oAa6ole
/. in<ecta!le penicillin
8. othersB O/ (ay !e deli.ered as a life sa.in4
(eas,re
co,4h s,ppressant- antit,ssi.e
antihista(ine- !ronchodilator
Pre.ention of Pne,(onia
1. 9i(ely i((,ni6ation a4ainst (easles and pert,ssis
/. 5Acl,si.e B+ for the 1
st
4-1 (onths of life
8. %ood n,trition
4. Cit. A s,pple(entation
5. )ed,ce eApos,re to ho,se s(o;e fro( coo;in4@to!acco
1. Feepin4 yo,n4 infants 3ar(- pre.ent O/ loss
7. Practicin4 4ood hy4iene
Control of "iarrhea "isease
'ana4e(ent of patient 3ith diarrheaB
,se this chart for patients 3ith
a. loose 3atery stools
!. loose stools 3ith !lood
-tep 1- Asses yo,r patient for dehydration
-tep /- Asses for other pro!le(s
1. $oo; at conditionB 3ell alert
5yeB nor(al
9earsB present
'o,th and ton4,eB (oist
9hirstB drin;s nor(ally0 not thirsty
/. +eel- -;in PinchB 4oes !ac; :,ic;ly
8. "ecideB No dehydration
4. 9reat(entB treat(ent A
9reat(ent Plan A
R to treat diarrhea at ho(e
R ,se this plan to teach the (other to
1. Contin,e to treat at ho(e her child>s c,rrent episode of diarrhea
/. 4i.e early treat(ent for f,t,re episode of diarrhea
9reat(ent Plan C
(-e.er dehydration)
Can yo, 4i.e #C+ ------------Hes--------tart #C+ i((ediately DPN-- and .& O NaCl

NO
#s #C neAt a.aila!le-----------Hes--------end patient 3ithin 8 (in,tes
NO
Are yo, trained 9o------------Hes-------tart 3ith O)-
=se N%9 for
)ehydration
NO
Can the patient-----------------Hes-------tart 3ith O)- per ore(
"rin;
)ehydration
=)%5N9P
-end the patient for #C or N%9
2ater "econta(ination
Boilin4 /-8 (in,tes
Chlorine
1 drop of 5O Na Hypo chloride in 1 $ H/O
-tat for /-8 (in,tes
Aerate
'"9
PB non infectio,s 'B- infectio,s
9,!erc,loid $5pra(ato,s@ Borderline
#ndeter(idiate
1-& (onths /4-8 (onths
"ay 1@ /-? "ay 1@ /-/?
)ifa(picin@"apsone )ifa(picin
Clofa6i(ine
"apsone
)O'- )ifa(picin. OfloAacin0 'inocyclinc
Pre.ention- BC%
Pne,(onia
Cery -e.ere -e.ere Pne,(onia No Pne,(onia
=na!le to drin; +ast !reath +ast !reathin4 No fast !reathin4
Con.,lsion Chest indra3in4 No chest indra3in4 No chest indra3in4
"iffic,lt to 3a;e
stridor
9! Net3or;B N,rse
Physician
'id3i.es
5arly case 'ed 9ech
+indin4s
Cate4ory 1 Cate4ory / Cate4ory 8
Ne3 (N) cases P9B
-erio,sly #$$
a. #ntensi.e Phase
Ad.ance p,l(onary 9B
!. 5Atra p,l(onary 9B
/ (onths
) ifa(picin
# sonia6id
P yra6ina(ide
5 tha(!,tol Dsho,ld
not ,sed 1 years old
!elo3 !eca,se of .is,al
dist,r!ance
4 (onths
) ifa(picin
# sonia6id
/-? (onths (aintenance
9reat(ent replaces
+ail,re
/ (onths 8 (onths
) )
# #
P P
5 5
-- strepto(ycin D#'E
5 (onths
)
#
5
P9B (ini(al(-) 8A
sp,t,( s(ear
A-ray P9B (ini(al
5Atra 9PB (not serio,s)
/(onths / (onths
) )
# #
P
ENVIRONMENTAL SANITATION
Environmental Sanitation is defined as the study of all factors in mans physical environment,
which may exercise a deleterious effect on his health, well-being and survival.
Goal: to eradicate and control environmental factors in dse transmission through the provision of
basic services and facilities to all households.
1. Water upply anitation !rogram
1 types of "pproved Water upply #acilities
$evel 1
!oint ource
$evel %%
&ommunal #aucet system or stand
posts
$evel %%%
Waterwor's system or
individual house
connections
" protected well of a
developed sprung with an
outlet but without a
distribution system for rural
areas where houses are
thinly scattered.
" system composed of a source, a
reservoir, a piped distribution
networ' and communal faucets,
located at not more than () meters
from the farthest house in rural areas
where houses are clustered densely.
" system with a source, a
reservoir, a piped distributor
networ' and household
taps that is suited for
densely populated urban
areas.
Water must pass the *ational tandards for +rin'ing Water set by the +,-.
(. !roper .xcreta and ewage +isposal ystem
/ types of "pproved 0oilet #acilities
$evel 1 $evel ( $evel /
*on- water carriage toilet facility: ,n site toilet facilities of the Water carriage types
- !it $atrines
- 1eed ,dorless .arth &loset
- 2ored--ole
- &ompost
- 3entilated improved pit
0oilets re4uiring small amount of water to
wash waste into receiving space
-pour flush
-a4ua privies
water carriage type with
water sealed and flushed
type with septic vault5tan'
disposal facilities.
of toilet facilities
connected to septic
tan's and5or to
sewerage system to
treatment plant.
1ural "reas- 6blind drainage7 type of wastewater collection and disposal facilities shall be
emphasi8ed until such time that sewer facilities and off-site treatment facilities are available.
/. !roper olid Waste 9anagement
- refers to satisfactory methods of storage, collection and final disposal of solid wastes.
1efuse
Garbage
1ubbish
( ways to 1efuse +isposal
-ousehold &ommunity
-2urial
: deposited in 1m x 1m deep pits covered with
soil, located ()m away from water supply
- open burning
- animal feeding
- composting
- grinding and disposal sewer
-anitary landfill or controlled tipping
: excavation of soil deposition of refuse and
compacting with a solid cover of ( feet
- %ncineration
;. #ood anitation !rogram
!olicies:
#ood establishment are sub<ect to inspection =approved of all food sources containers
and transport vehicles>
&omply with sanitary permit re4uirement
&omply with updated health certificates for food handlers, helpers, coo's
"ll ambulant vendors must submit a health cert to det presence of intestinal parasite
and bacterial infection.
/ points of contamination
!lace of production processing and source of supply
0ransportation and storage
1etail and distribution points
). -ospital Waste 9anagement
Goal:
0o prevent the ris' of contraction contracting nosocomial infection from type disposal of
infectious, pathological and other wastes from hospital
?. !rograms related to health-ris' minimi8ation secondary to environmental pollution
0hese include the following:
"nti-smo'e 2elching campaign and "ir !ollution &ampaign
@ero olid Waste 9anagement
0oxic, chemical and -a8ardous Waste 9anagement
1ed tide &ontrol and 9onitoring
%ntegrated !est 9anagement and ustainable "griculture
!asig 1iver 1ehabilitation 9anagement
A. .ducation of prevailing health problems
"ccepted activitiy at all levels of public health used as a means of improving the health of
the people through techni4ues which may influence peoples thought motivation,
<udgement and action.
0hree aspects of -ealth education:
%nformation- provision of 'nowledge
&ommunication- exchange of information
.ducation- change in 'nowledge, attitudes, and s'ills
e4uence of teps in -ealth .ducation
&reating awareness
&reating motivation
+ecision ma'ing action
HIV/ STI PREVENTION AND CONTROL
,perational trategies:
!romotion of health5 health education
+isease detection
0reatment program
&ontact tracing
&linical services
!rogram components:
&ase-finding
&ase management
0raining
9onitoring
1eporting system
,perations research
MENTAL HEALTH
- " state of well-being where a person can reali8e his or her own abilities, to cope with
the normal stresses of life and wor' productively
- 0he emotional ad<ustment the person achieve in which he can live with reasonable
comfort, functioning, acceptably in the community where he5she lives
- %nvolves the promotion of a healthy state of mind amont the whole pop through
+eveloping positive outloo' in life
trengthening coping mechanisms
3ulnerable group to the dev of 9ental %llness:
Women
treet children
3ictims of torture or violence
%nternal refugees
3ictims of armed conflicts
3ictims of natural and man-made disasters
&omponents of 9ental -ealth !rogram
". tress
2. +rugs and "lcohol "buse 1ehabilitation
&. 0reatment and 1ehabilitation of 9entally-ill !atients
+. pecial !ro<ect for 3ulnerable Groups
tresses in the environment of children such as times of disasters and natural calamities,
disintegration of the values, structure and functions of the family and urbani8ation, migration,
drugs, and physical and sexual abuse and poverty have direct effects on physical and mental
health.
G,,+ $B&CD