FCM Platinum PDF

FCM PLATINUM
And all you fellas leave your girl with her friends
cause it’s 11:30 and the club is jumpin’ jumpin’
1st SHIFTING
1.1 DOCTOR AND PUBLIC HEALTH
Definition: Public Health  Science and art of preventing disease, prolonging life and promoting physical and mental health
and efficiency thru organized community effort and voluntary and governmental agencies set
to carry out organized community health activities
Roles of a Public Health  Mnemonic: HEARS
Doctor/5-Star physician 1. Healer: being a healthcare provider
concept 2. Educator: making people understand and be aware of the health situation
3. Administrator: being a leader, manager
4. Researcher: lifetime learner; at the level of the community, he/she may conduct surveys or
outbreak investigations to understand the situation of the community
5. Social Mobilizer – influence or motivate the community in order to bring about change and
improve health outcomes
Definition: Primary Health  Essential health care based on practical, scientifically sound and socially acceptable methods
Care and technology made universally accessible to individuals and families in the community through
their full participation and at a cost that the community and the country can afford to maintain at
every stage of their development in the spirit of self-reliance and self-determination
Eight Elements of PHC  Mnemonics: ELEMENTS; ENS - Promotive; LEM – Preventive; ET – Curative
o Education for health (Promotive) - core
Memorize kung sino ung o Local / Endemic disease control (Preventive)
promotive, preventive and o Expanded Program of Immunization (Preventive)
curative o Maternal & Child health (Preventive)
o Provision of Essential drugs (Curative)
o Nutrition (Promotive)
o Treatment of common diseases (Curative)
o Safe water and Sanitation (Promotive)
PHC Approaches Partnership with the community
 Health for the people
o Community-oriented
o Health team decides
 Health with the people
o Community-based
o A partnership of health team and leader of the community
 Health by the people
o Community-managed
o Highest; community decides what their needs and health priorities are
Multi-sectoral coordination or linkages

 Intra-sectoral: within the community/sector
 Inter-sectoral: help of other sectors
Millennium Development  A set of time-bound, concrete and specific goals to reduce extreme poverty, illiteracy and disease by
Goals 2015
o Goal 1: Eradicate extreme poverty and hunger
o Goal 2: Achieve universal primary education
o Goal 3: Promote gender equality and empower women
o Goal 4: Reduce child mortality
o Goal 5: Improve maternal health
o Goal 6: Combat HIV/AIDS, malaria and other diseases
o Goal 7: Ensure environmental sustainability
o Goal 8: Develop a Global Partnership for Development
4,5,6 – directly related to health; 7 – indirectly related to health

1.2 PHIL. HEALTHCARE DELIVERY SYSTEM
Principles to Improve  Universal access to basic health services must be ensured
Health  The health and nutrition of vulnerable groups must be prioritized.
 The epidemiologic shift from infectious to degenerative must be managed.
 The performance of the health sector must be enhanced.
DOH  Principal health agency in the Philippines
 Ensuring access to basic public health services to all Filipinos through the provision of quality
health care and regulation of providers of health goods and services.
 Stakeholder in the health sector
 Policy and regulatory body for health
Philippine Health Insurance  Implement the national health insurance law, administers the medicare program for both public and
Corporation private sectors
Dangerous Drugs Board  Coordinates and manages the dangerous drugs control program
Kalusugan Pangkalahatan  Provide adequate financial risk protection to families, especially the poor
 Ensure that families have sustainable access to modern health care facilities and services
 Attain health-related Millennium Development Goals (MDG) through focused public health effort
Factors that increase IMR  Low educational status
 No antenatal and post natal care (Immunizations, new-born screening and breast feeding)
 Mothers <20 y/o &>40 y/o
 Male, small or very small infants
Mia. Guian. Ivy. Vim. Jeph Page 1 of 24

SHIFTING EXAM RECALLS
 Birth order of 7 and above

 Previous birth interval <2 years
 Respiratory and Pneumonia
Ten leading causes of 1. Respiratory conditions of the fetus & the newborn
INFANT MORTALITY 2. Pneumonia
3. Congenital anomalies
4. Diarrheal diseases
5. Birth injury & difficult labor
6. Septicemia
7. Meningitis
8. Avitaminosis & other nutritional disorders
9. Other diseases of the respiratory system
10. Measles
Ten leading cause of 1. Pneumonia
MORBIDITY 2. Diarrhea
3. Bronchitis
*Note the predominance of 4. Influenza
respiratory disorders 5. Hypertension
6. TB Respiratory
7. Diseases of the Heart
8. Malaria
9. Chickenpox
10. Measles
Ten leading cause of 1. Heart Disease
MORTALITY 2. Vascular System Diseases
3. Malignant Neoplasm
*Note the increase of lifestyle- 4. Pneumonia
related diseases 5. Accidents
6. TB (all forms)
7. COPD and allied conditions
8. Certain condition in perinatal pd
9. Diabetes Mellitus
10. Nephritits, Nephritic syndrome, and Nephrosis
1.3 MANILA HEALTH DEPARTMENT
Ten leading causes of 1. Acute respiratory infection
MORBIDITY in Manila 2. Bronchitis
3. Pneumonia
*Note the predominance of 4. Diarrhea
respiratory disorders 5. TB Respiratory
6. Hypertension
7. Dog Bite
8. Bronchial Asthma
9. Influenza
10. Measles
Ten leading causes of 1. Heart Disease
MORTALITY in Manila 2. Pneumonia
3. Malignant Neoplasm
*Note the increase of lifestyle- 4. Hypertension (HCVD)
related diseases 5. TB Pulmonary
6. Diabetes Mellitus
7. Utero Placental Insufficiency
8. Sepsis
9. Prematurity
10. Cardio Vascular Accident
Ten leading causes of 1. Pneumonia
INFANT MORTALITY in 2. Prematurity
Manila 3. Sepsis
4. Congenital Heart Diseases
5. Cord Accident
6. Asphyxia Aspiration
7. Congenital Anomalies
8. Meconium Aspiration
9. Gastro Enteritis
10. Biliary Atresia
Manila Districts  District 1 & 2 - highest mortality, morbidity rate, population density
 District 1 – highest % of contraceptive use/family planning
 District 2 – lowest % of fully immunized children and contraceptive use
 District 3 – highest % of exclusively breastfed infants
 District 5 – highest % of fully immunized children; lowest % of exclusively breastfed infants; highest
prevalence rate of PEM
 District 6 – lowest prevalence rate of PEM
Crude Birth Rate  Highest increase among the three indicators (versus crude death rate and infant MR)
Increase in child death  Health programs for children may be inefficient or inadequate
would indicate…?
Inadequate manpower in  Midwives
health centers…?  Dentist
1.3 EMERGING AND REEMERGING INFECTIOUS DISEASE
Definition: Emerging  Newly identified, previously unknown, that cause public health problems locally and
infectious disease internationally

 Previously known disease but are becoming to be a public health threat in the past two
decades.
 Disease that threaten to increase in near future
Definition: Reemerging  Known disease that reappear after being eradicated
disease  Infections that are increasing in incidence after they have been previously controlled
Contributors to Emerging  Changes in demographics
infections  Pressure on the environment
 International travel and commerce
 Food supply and food technology
 Microbial adaptation and changes
 Health systems breakdown
Antigenic Shifts  Exchange of RNA between human and animal strains inside an animal reservoir
 Increase contact between humans and these animals heightens likelihood of emergence of a new
influenza virus
 Influenza A
 Pandemic
Prerequisites for Influenza 1. Emergence of a new virus to which all are susceptible;
pandemic 2. Virus is able to replicate and cause disease in human;
3. New virus is transmitted efficiently from human-to-human
H5N1 virus has potential but it does not fulfill human-to-human transmission!
1.4 MALARIA CONTROL PROGRAM
High risk groups (Most  Under five
vulnerable)  Pregnant women
Blood smear microscopy  Gold standard
 Thin films
o allow species identification
o parasite's appearance is best preserved in this preparation
o determine parasite density
 Thick films
o Determine presence of parasite
o More sensitive than thin film
Serology  Detects antibodies against malaria parasites, using indirect immunofluorescence (IFA)
 Does not detect current infection but rather measures past exposure
PCR  Most specific and sensitive diagnostic test
Prevention and Control  Insecticide treated nets (ITN)
 Long-lasting insecticide nets (LLIN)
 Indoor residual spraying (IRS) on walls
 Zooprophylaxis
 Vitamin B complex
Risk Microstratification  Better tracking of malaria cases, prioritization of endemic areas to be assisted, and to ensure
more focused interventions
 Stable risk - at least 1 barangay that has a continuous presence of at least 1 indigenous malaria
case in a month for >6 months at any time during the past 3 years
o High endemic - >1000 average cases
o Moderate endemic – 100-999
o Low endemic - <100
 Unstable risk - at least 1 barangay that has a continuous presence of at least 1 indigenous malaria
case in a month for >6 months at any time during the past 3 years
 Epidemic/Sporadic risk
o With at least 1 barangay that has a presence of at least 1 indigenous malaria case at any time in
the past 5 years
 Malaria free
o Absence of indigenous malaria case for 5 past years even in the presence of malaria vector
Control vs Elimination vs Control – reduction in incidence, prevalence, morbidity and mortality to a locally acceptable level
Eradication Elimination – zero incidence in a defined geographic area
Eradication – zero cases worldwide
Important point in WHO  The Philippines is believed to be now ready to move to the direction of disease elimination.
 WHO has established a slide positivity rate (SPR) of <5% as a milestone indicating that a country
8
transition guide to
elimination is ready to move from control to elimination.
 An incidence of <1/1,000 marks the point at which a country is ready to shift from pre-elimination to
elimination.
1.5 NATIONAL DENGUE CONTROL AND PREVENTION PROGRAM
Vector comparison ANOPHELES MOSQUITO AEDES MOSQUITO
 Malaria vector  Dengue vector
 Night biter  Day biter
 Eggs float in water  Eggs sink in water
 Inhabits slow flowing  Fogging
streams with shade  Search and Destroy
 Indoor Residual Spraying/ breeding places
Mosquito net  Throw water and scrub
container
Progressive decrease in  Earliest abnormality in the full blood count
total white cell count
Immune enhancement  Patients with secondary infection with heterologous dengue serotype are at a higher risk for DHF
hypothesis and DSS
 Preexisting heterologous dengue antibodies from a previous dengue infection form complex with

the virus  virus is not neutralized and free to replicate in mononuclear cells
Migratory polyarthritis  Associated with Chikungunya
Lab confirmatory test Haemagglutination Differentiate between primary and secondary dengue
Inhibition test infections
Dengue igM Test Rises quickly and peaks at about 2 weeks, wanes by 60
days
Virus isolation Most definitive test
Polymerase chain reaction Diagnosis of dengue infection in the early phase (< 5
days of illness)
Non-structural protein-1 Hallmark of flavivirus infection in mammalian cells
Central Visayas/Region 7  Highest recorded cases

NCPCP Objectives  HEALTH STATUS OBJECTIVES:
o Reduce incidence from 32 cases/100,000 population to 20 cases/100,000 population
Note: Aralin kung saan under o Reduce case fatality rate by <1%
ung specific objective na yun o Detect and contain all epidemics
 RISK REDUCTION OBJECTIVES:
o Reduce the risk of human exposure to Aedes bite by House index of <5 and Breteau index of
20
o Increase % of household practicing removal of mosquito breeding places to 80%
o Increase awareness on DF/DHF to 100%
 SERVICES & PROTECTION OBJECTIVES:
o Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue
Surveillance.
o Increase the % of 1° and 2° government hospitals with laboratory capable of platelet count and
hematocrit
o Ensure surveillance and investigation of all epidemics
Enviromental modification  Environmental modification
versus manipulation o long lasting physical transformations of vector habitats
 Environmental manipulation
o temporary changes to vector habitat as a result of planned activity to produce conditions
unfavourable to vector breeding
Platelet count and  Baseline lab exam for case identification and management
hematocrit determination
4S strategy  Search and destroy all breeding containers

 Self-protection measures
 Seek early consultation at the nearest health center or hospital facility
 Say yes to fogging when there is an impending outbreak (hotspots)
Indicators  No. of health personnel trained
 No. of IEC materials produced and distributed
INPUT
 No. of laws and ordinances passed and implemented
INDICATORS
 No. of health education services / training conducted
 No. of consultations / coordination / meetings done
 Larval indices
OUTPUT INDICATORS
 Environmental index
 Case Fatality Rate of <1%
IMPACT INDICATORS  Mortality rate
 Morbidity rate
 No. of cases identified or managed
 Case management
SERVICE INDICATORS
 Referral cases
 Vector control measures
1.6 NATIONAL FILARIASIS ELIMINATION PROGRAM
Expatriate Syndrome  Experienced by individuals who grew outside regions endemic for filarial parasites
 Characterized by clinical and immunologic hyper-responsiveness to the mature or maturing worms.
Bancroftian filariasis  Hydrocoele
 More disfiguring than Malarian filariasis
Peripheral blood smear  Standard for diagnosing active infection
 Collection: 8PM-4AM
Immunochromatographic  Cases when microfilaremia is low and variable
test (ICT)  High sensitivity and specificity for circulating filarial antigen (CFA) detection
 Screening test
ARMM  Highest number of symptomatic filarial cases
Mass Treatment  6 mg/kg Diethylcarbamazepine/DEC + 400 mg Albendazole
 Aged 2 years and above in all established endemic areas once a year for 5-6 years
Selective Treatment  6 mg/kg diethylcarbamazinecitrate in 3 divided doses for 12 consecutive days
(+) for nocturnal blood
examination
Indicators for evaluation To establish infection
Antigen Rate
To characterize infection

Microfilaria Rate
Microfilaria Density
Clinical Rate
 To establish the vectors of the disease in the endemic areas

o Local vector species identification
o Man Biting Rate – average no. of mosquitoes biting man per hour or captured mosquitoes per
man per hour
o House Resting Density– No of mosquitoes collected in the house per man-hour
o Larval Index
o Annual Transmission Potential
Filariasis-free  Cumulative Incidence Rate over 5 years < 1 new case per 1000 susceptible individuals
1.6 NATIONAL SCHISTOSOMIASIS CONTROL AND ELIMINATION PROGRAM
Acute schistosomiasis/  Fever, cough, abdominal pain, diarrhea, hepatosplenomegaly, eosinophilia
Katayama fever
Chronic schistosomiasis  Egg deposition in host tissues
 Granuloma formation
Urinary Schistosomiasis  Schistosoma haematobium
Circumoval precipitin test  Method of choice for definitive diagnosis of infection
Praziquantel dosage Schistosoma species infection Praziquantel dose and Duration
Schistosoma mansoni, S. haematobium,

40 mg/kg per day orally in 2 divided doses for one day
S. intercalatum
S. japonicum, S. mekongi 60 mg/kg per day orally in 3 divided doses for one day
CARAGA Highest number of schisto cases

85% Target percent coverage of mass treatment of exposed population
Mass treatment 40 mg/kg Praziquantel single dose
5-65 year-old residents living in established endemic areas with prevalence rate of >10%
For provinces that have reached the elimination level of <1/100,000 prevalence for 5 consecutive
years, given to school children only
Selective treatment  600 mg/tab Praziquantel
o 60mg/kg body weight for 1 day taken in 2 divided doses at 4-6 hours interval with full stomach
WASHED Framework  Water, Sanitation, Hygiene Education, Deworming
1.8 FOOD AND WATERBORNE DISEASES PREVENTION AND CONTROL PROGRAM
Most common cause of  Cholera
diarrhea (Currently in focus)  Typhoid fever
 Hepatitis A
Main focus of the program  Health education
 Information dissemination
 Emphasis on the World Health Organization’sTen Golden Rules To Safe Food Preparation, Safe
Water Source, And Environmental Sanitation
Common errors associated  Preparation of food several hours prior to consumption, combined with its storage at temperatures
with foodborne disease which favorgrowth of pathogenic bacteria and/or formation of toxins
 Insufficient cooking or reheating of food to reduce or eliminate pathogens
 Cross contamination
 People with poor personal hygiene handling the food.
1.9 NATIONAL TUBERCULOSIS CONTROL PROGRAM
(+) PPD skin testing  Recent close contact
5mm induration  Patients with fibrotic or healed lesions on radiograph
 HIV-infected persons
 Patients with special medical conditions like diabetes mellitus or
Hodgkin’s Disease
8-10mm induration  Steroid use
 High prevalence regions or travel there
 Residents of congested homes/living conditions
15mm All others
Triad for pediatric TB  Exposure to an infectious case
diagnosis  (+) tuberculin test
 Abnormal radiograph or physical exam
Isoniazid preventive  10 mg/kg INH
therapy for 6 months  TB prophylaxis
 For asymptomatic cases who are household contacts of diagnosed TB cases
Baby born to mother with  Postpone BCG administration, start on INH for 3 months

rd
TB disease At 3 month, perform skin test,
o Negative: Stop IPT and give BCG
o Positive: Continue IPT until 6 months before giving BCG
TB Registration Group Registration Group Definition of Terms

A patient who has never had treatment for TB or who has taken
Note: Paki-aral „to ng mabuti, NEW
anti-TB drugs for <1 month.
madaming cases ung A patient previously treated for TB, who has been declared cured
lumabas dati or treatment completed in their most recent treatment episode,
RELAPSE
and is presently diagnosed with bacteriologically-confirmed or
clinically-diagnosed TB.
 A patient who, while on treatment, is bacteriologically-positive
at >5 months
 A patient with sputum not done or smear negative at the start
RETREATMENT
of treatment and became smear positive at the end of the
TREATMENT
intensive phase or anytime during the continuation phase
FAILURE
 A patient (child or extrapulmonary TB) for whom sputum
examination cannot be done and who does not show clinical
improvement anytime during treatment.
 Refer to specialist for possibility of failure or other diseases.
A patient who, after being lost to follow-up for >2 months,
AFTER LOST TO
returns for treatment and is diagnosed with either
FOLLOW-UP (ALF)
bacteriologically-confirmed or clinically-diagnosed TB.
PREVIOUS Patients who have been previously treated for TB but whose
TREATMENT outcome after their most recent course of treatment is
OUTCOME unknown or undocumented.
UNKNOWN
A patient who has been registered in a DOTS facility adopting NTP
TRANSFER-IN policies and is transferred to another DOTS facility with proper
referral slip to continue the current treatment regimen.
Patients that do not fit into any of the registration group listed
OTHER
above.
Recommended Treatment TX TYPE OF TB PATIENT REGIMEN
Regimen for Adults and  Pulmonary TB, new (whether
Children bacteriologically confirmed or
Category clinically diagnosed) 2HRZE/
I 4HR
 Extra-pulmonary TB (EPTB), new
(except CNS/ bones or joints)
Category 2HRZE*/
EPTB, new (CNS*/ bones or joints)
Ia 10HR
Previously treated drug susceptible
TB
 Relapse
2HRZES/
Category  Failure
1HRZE/
II  After Lost to Follow-up (ALF)
5HRE
 Other – (+)DSSM
 Other – (-) DSSM
 EPTB (except CNS, bones or joints)
Previously treated drug susceptible 2HRZES/
Category IIa TB 1HRZE/
 EPTB–CNS/bones or joints 9HRE
 Individualized once DST
Standard Regimen
result is available.
Drug Resistant Confirmed cases of MDR- or XDR-TB
 Tx duration for at least 18
(SRDR)
months
Individualized based on DST
Regimen for XDR XDR-TB result and hx of previous
treatment
VISION OF TB CONTROL A country where TB is no longer a public health problem
PROGRAM
GOAL OF TB CONTROL To reduce prevalence and mortality from TB by half by the year 2015 (Millennium Development
PROGRAM Goals)
TARGETS OF THE TB 1. Cure at least 85 % of the new sputum smear-positive TB cases discovered
CONTROL PROGRAM 2. Detect at least 70 % of the estimated new sputum smear-positive TB cases
SCHEDULE OF SPUTUM CATEGORY MONTH OF FOLLOW-UP
FOLLOW-UP EXAMS nd rd th th
I 2 ,3 ,4 ,6
II 3rd, 4th, 5th, 8th
III 2nd
nd
2 SHIFTING
NATIONAL LEPROSY CONTROL PROGRAM
Between 2 and 40 yrs with Incubation period of M. leprae
most cases occurring
within 5-7 years
Tuberculoid leprosy With lesions that are sharply demarcated, hypestehetic. AFB generally absent or few in number
0.35% Baseline date for % prevalence of leprosy in 2008
To m aintain and sustain Goal of NLCP
eliminations status
6 blister packs within Treatment completion foe Paucibacillary Regimen
9mos
Sensory loss Typical feature of skin lesions in leprosy
NATIONAL RABIES PREVENTION AND CONTROL PROGRAM
Cebu Province with highest rate of cases

(top 3: Cebu, M.oriental,

Bulacan)
Flourescent Antibody Test Gold standard for diagnosis of Human Rabies
DA Agency responsible for free vaccination of dogs
LGUs Ensure all dogs are immunized, registered, and given dog tag
Mass dog vaccination Mainstay method of control of canine rabies
NATIONAL AIDS AND STI PCP
Blood, Semen, Vaginal Mode of transmission of HIV
secretions, Breast milk
19% higher How much higher are the cases of May 2014 compared to same period of 2013
96% % male among the cases
28 y.o. Median age
Homosexual contact Most common mode of contact/transmission
RESPONSIBLE PARENTHOOD
Roles of POPCOM
Specific objectives of
Parenthood and Family
Planning Program
Family of orientation Family consisting of individual, parents and siblings. Family where individual was born and reared.
Authoritarian Style of parenting where children are expected to follow the strict rules of parents
Permissive Children have indulgent parents with ery few demands
Uninvolved Parents generally detached from children’s life
FAMILY PLANNING METHOD
Standard Days Method example of Calendar Based method
MATERNAL AND CHILD HEALTH PROGRAM
26.7 2015 target for under 5 mortality rate
19 2015 target for infant mortality rate
100 2015 target for proportion of children immunized against measles
34% (non-poor: 24%) Percentage of poor children exclusively breastfed
BCG, measles, and 3 of Fully immunized child
DPT, polio and hepa-B for
his first birthday
Skilled birth attendance
Hospital based BEmONC Offers blood transfusion services
Six signal fxns of

BEmONC
Reduction of child Goal of National Policy on Infant and Young Child Feeding
mortality and morbidity
through optimal feeding
of infants and young
children
Infants (0-11mos) Target beneficiaries of NPIYF
Young children (12-
36mos)
Maple Syrup Urine Breastmilk combined with special synthetic formulas low in the non-tolerated amino acids
Disease

AIMS of Breastfeeding
TSEK
30mins Babies born NSVD should be roomed-in within how many mins after birth
Expressed breastwork Milk is expressed by hand or by pump and fed to child via bottle, spoon, or NGT
Wet-nursing Feeding of an infant from another mother’s breast
Proper Latch
Safe motherhood initiative
IMCI
CHECK FOR DANGER first step in assessing the child or young infant
SIGNS
4 MAJOR SYMPTOMS  cough and difficulty of breathing
 diarrhea
 fever
 ear problem
any danger sign or chest  indicates severe pneumonia
indrawing or stridor
Lethargy, inability to drink General Danger Signs
or breastfeed, vomiting,
convulsions
TX for PNEUMONIA
COTRIMOXAZOLE Give 2 times AMOXICILLIN
daily for 5 days Give 3 times daily for 5 days
AGE OR WEIGHT
Adult tab. Syrup 40 mg Tablet 250 mg Syrup 125
80mg TMP 400 TMP 200 mg mg/5 ml
mg SMX SMX
2-12 mos 1/2 5.0 ml. 1/2 5.0 ml
12mos-5yrs 1 7.5 ml 1 10 ml.
Axillary T>37.5, rectal Guideline for fever

T>38
Axillary T<35.5, rectal Hypothermia
T<36
VITAMIN A VITAMIN A CAPSULE
SUPPLEMENTATION AGE
100,000 IU 200,000 IU
6 to 12 mos. 1 capsule ½ capsule
12 mos-5 yrs 2 capsules 1 capsule

CLASSIFICATION FOR CLASSIFY AS SIGNS IDENTIFY TREATMENT

DEHYDRATION
Two of the following signs: If child has no other severe classification:
 Lethargic or unconscious  Give fluid for severe dehydration (Plan C)

SEVERE  Sunken eyes If child also has another severe classification:
 Not able to drink or drinking
DEHYDRATION poorly  Refer URGENTLY to hospital with mother giving
 Skin pinch goes back very frequent sips of ORS on the way.
slowly  Advise the mother to continue breastfeeding If child is
2 years or older and there is cholera in your area, give
antibiotic for cholera.
Two of the following signs: Give fluid and food for some dehydration (Plan B)
 Restless, irritable If child also has a severe classification:

SOME  Sunken eyes
 Drinks eagerly, thirsty  Refer URGENTLY to hospital with mother giving
DEHYDRATION frequent sips of ORS on the way.
 Skin pinch goes back slowly
 Advise the mother to continue breastfeeding
 Advise mother when to return immediately.
 Follow-up in 5 days if not improving.
Not enough signs to classify as  Give fluid and food to treat diarrhea at home (Plan A).
NO DEHYDRATION some or severe dehydration  Advice mother when to return immediately.
 Follow-up in 5 days if not improving.
TREAT DEHYDRATION treatment for severe persistent diarrhea
BEFORE REFERRAL
UNLESS THE HILD HAS
ANOTHER SEVERE
CLASSIFICATION
if there is any general danger sign or with stiff neck
VERY SEVRE MALARIA
OLDER PERSONS
Cardiovascular Dses No. 1 cause of mortality (2000)
20% Discount and VAT exemption acc to Expanded Senior Citizen Act
on the purchase of medicines, on the PFs of doctors,
3 Strategies or priority
directions
MEMORIZE SENIOR CITIZENS AND  Mainstreaming ageing into development policy and
DEVELOPMENT promoting full integration and participation of senior
citizens.
 Provision of social protection and security.
 Alleviation of poverty in old age.
 Senior Citizens and emergencies
 Promoting positive attitudes towards ageing and senior
citizens.


Employment of Senior Citizens.

Recognizing gender – specific issues in ageing.
ADVANCING HEALTH AND 
Ensuring the quality of life at all ages, including
WELL BEING INTO OLD AGE independent living, health and well being
 Providing quality health and long term care.
ENSURE ENABLING AND  Senior citizens and the family
SUPPORTIVE  Social Service and community support.
ENVIRONMENTS  Housing and enabling environments
 Care and support for caregivers
 Protection of the rights of senior citizen
ADOLESCENT and YOUTH HEALTH DEV’T PROGRAM
Age group definitions
11% % drug use among students

Essential Healthcare
Package
NON-COMMUNICABLE DSEs PCP

Philippine Statistics
<3.3 g Target salt-intake per day (NOH Objective 4)

50.8 Target % prevalence with high physical activity (NOH Objective 4)
Guiding principles of NCD
Risk factor assessment Key in the process of screening for NCDs

PHILIPPINE CANCER COMTROL PROGRAM
15% higher Prevalence in developed regions
25% higher in men Higher in men or women?
Lung Ca MC diagnosed cancer, MC for both sexes
Summary

Interventions by DOH
3rd SHIFTING
PHILHEALTH
3B 3A
LEADING CAUSES OF 1. diabetes (41%), 1. diabetes (41%),
KIDNEY FAILURE 2. inflammation of the kidney (24%) 2. Hypertension
3. and high blood pressure (22%) 3. Chronic Glomerulonephritis
 2003: 7th
RANK OF CKD ON
 2009-2012: 9
th
TOP 10 MORTALITY
 2014: 7
th
DIALYSIS AND
KIDNEY Patients developing kidney failure can choose these as treatment for their illness.
TRANSPLANTATION
Region with the highest % of Dialysis centers (both hemodialysis and peritoneal dialysis)
NCR
Region with highest number of new dialysis patients in 2013
FREE-STANDING
HEMODIALSIS outnumber that of hospital-owned or hospital-based centers
CENTERS
COMORBIDITIES OF  Top 1 comorbidity: HPN (56.59%)
HEMODIALYSIS  Top 2 comorbidity: DM (49.9%)
PATIENTS  Top 3 comorbidity: Ischemic Heart Disease (7.71%)
51-60 Age group with the highest number of new dialysis (HD and PD) patients in 2013
 organizes and implements projects to promote renal health and to raise awareness about the
consequences of renal diseases.
 office in-charge of implementing the NKTI's public health projects on the prevention and control of renal
and other related diseases.
REDCOP
 This program plans, implements and monitors projects for research, advocacy, training, service and
quality assurance.
 administers and manages the Philippine Renal Disease Registry (PRDR)
 has been tasked to operate the Philippine Organ Donation Program (PODP)
1. To conduct research studies related to renal diseases;
2. To assist the existing health facilities, both local and national through:
3. To formulate guidelines and protocols on the proper implementation of different levels of
prevention and care of renal diseases, for use of medical practitioners and other related professions
REDCOP GOALS 4. To give recommendations to law and policy-makers on renal health
5. To assist in the development of dialysis and transplant centers/units in strategic locations all
over the Philippines;
6. To establish an efficient and effective networking system with other programs and agencies,
both GOs and NGOs
1. Research - PNDR
2. Training – to help local health workers develop the capability and expertise in early recognition and
treatment of Renal and Urinary Tract diseases; to develop advocates on kidney and Urinary Tract
REDCOP PROGRAM disease prevention & control nationwide
COMPONENTS 3. Advocacy - to increase the level of awareness of the people on health promotion and the different
levels of kidney disease prevention, including prevention of death due to end-stage renal disease
(ESRD)
4. Quality Assurance - to ensure the efficiency and reliability of the component projects of the Program
 responsible for formulating policies and program standards towards the development of a rational,
ethical, accessible and equitable renal health program in the country
 shall undertake activities which shall increase public awareness on organ transplantation and renal
PHIL. ORGAN diseases.
DONATION  shall put in place a system for screening and matching of donors and recipients
PROGRAM  shall support researches about organ donation and transplantation.
 program shall actively promote, enjoin the participation of other stakeholders, government
organizations, academe, private institutions and civil society
 built-in monitoring and evaluation system shall be part of the program
LIVING RELATED related to the recipient by blood within the fourth-degree of consanguinity (e.g. parents, child, siblings,
DONORS nephews/nieces, first cousins).
 the difficulty of families of the deceased to give their consent while the heart is still beating,
Barriers in deceased
 guilt when the potential donor’s wishes were not known
organ donation
 the fear of organs being removed from a loved one

GUIDING DEFINITION
PRINCIPLE
Equity  Non-directed donated organs belong to the community. Such organs must be allocated fairly among
transplant centers and among recipients.
 Determination of priority shall be based on medical need and probability of success.
Justice  The criteria to be adopted in determining allocation of organs must be objective and independent of
gender, race, creed, culture and socio-economic status.
Benevolence  Only organs that are voluntary donated with full informed consent by a competent adult shall be subject
for transplantation.
 All health and health related facilities shall not allow the trade or commerce of kidneys/organs.
Non-maleficence  No harm should occur to the donor or recipient in the process of transplantation whether immediate or
PODP GUIDING
post transplantation.
PRINCIPLES
Solidarity  All stakeholders shall have a common and shared objective of safeguarding the health of both recipient
and the donor.
Altruism  Organ donation must be done first and foremost out of selflessness and philanthropy to save and
ensure the quality of life of the beneficiary.
Volunteerism  Organ donation must be done out of the donor’s:
o Competence(decision-making capacity)
o Willingness to donate
o Freedom from coercion
o Medical and psychosocial suitability
o Full information of the risks and benefits as a donor
o Full information of the risks, benefits and other alternative treatment available to the recipient
KIDNEY  near-ESRD (calculated creatinine clearance <20/min for diabetic nephropathy/pre-emptive

TRANSPLANT transplants)
CANDIDATE  with ESRD (calculated creatinine clearance < 15ml/min for non-diabetic chronic kidney disease)
 Only Filipino KTC will be allowed to enlist in a Hospital Transplant Candidate Waiting List of any
accredited TxC in the Philippines
 KTCs shall initially be listed as INACTIVE until approved by PHILNOS.
 After review and approval of the case, the status shall be changed to ACTIVE.
 All KTC will be allowed to enlist in only (1) Hospital Transplant Candidate Waiting List which
GUIDELINES should be in their TxC of choice.
 Only ACTIVE patients in the National Transplant Candidate Waiting List are eligible to receive offers
of deceased organs
 If at the time a graft is offered, the KTC is found medically unsuitable or financially incapable, he will
be temporarily considered INACTIVE.
 status may be changed to INACTIVE during the period of physical absence of the country
Consent for organ
donation must be 1. Legal spouse
obtained from the 2. Son or daughter of legal age
legal next-of-kin of 3. Either parent
the PMOD in the 4. Brother or sister or legal age
following order of 5. Guardian over the deceased person at the time of death.
priority
1. Geographical location
2. ABO compatibility
3. DASS for kidney transplantation
CRITERIA POINTS
Number of HLA Mismatches
0 DR Mismatch, Any B 4
1 DR Mismatch, Any B 2
DONOR ALLOCATION Panel Reactive Antibodies
PROCESS IS ≥ 50% 4
GOVERNED BY THE <50% 2
FOLLOWING Date of Enrollment
>3 years 4
>2 and ≤ 3 years 3
>1 and ≤ 2 years 2
≤ 1 year 1
Recipient Age
<18 years 2
19-65 years 1
Previous Kidney Donor 15
PREVIOUS KIDNEY
Highest number of points in Donor Allocation Scoring System
DONOR
NATIONAL POLICY ON VIOLENCE and INJURY
 MALES
 Age group: 20-59
 Mean Age: 27.8
GENERAL DATA  Median Age: 24
MAJORITY/MOST  Region: NCR (injuries), Region 3 (Transport/vehicular crash)
 Month: January
 Time: 12:01PM to 7:59 PM (injuries), 8:00AM to 7:59 PM (transport/vehicular crash) [highest in
4:00PM to 7:59PM]

 Injury type in general: open wound/laceration

 External cause: transport/vehicular crash
 Type of crash: non-collision
 Risk factor: alcohol/liquor
 Type of Vehicle: motorcycle
 Type of injury in vehicular crash: abrasion
 Mode of transport going to hospital: private vehicle
CULTURE OF
Essence of VIPP
SAFETY
1. Increase the use of safety belts among motor vehicle occupants by at least 75%
2. Increase the use of helmets among motorcyclists by at least 50%
RISK REDUCTION 3. Encourage the use of protective gears among cyclists and skaters by at least 50%
OBJECTIVES 4. Reduce the use of firecrackers during festivities by at least 50%
5. Increase the level of awareness on common causes and preventive measures of accidents and
suffocation or foreign bodies
1. Increase the number of regional hospitals and medical centers with Burn and Trauma Unit.
2. Develop and institutionalize the Injury Prevention and Control program and surveillance network in
all regional and provincial health facilities.
SERVICES AND
3. Develop and disseminate information campaign materials on injury prevention and control.
PROTECTION
OBJECTIVES 4. Increase the number of surgeons in regional hospitals and medical centers trained on burn and
trauma management
5. Increase the number of regional health personnel trained on the epidemiology, prevention and
control of accidents and injuries
 Education
 Enactment/Enforcement of laws and policies
 Empowerment of all stakeholders
SIX E’s
 Engineering control (most effective)
 Emergency Medical Services
 Engagement in surveillance and research
 focal agency responsible for designing, coordinating and integrating plans, programs, strategies
and activities of various stakeholders into an effective and efficient system geared towards violence
DOH and injury prevention
 VIPP is hereby institutionalized as one of the core programs of the National Center for Disease
Prevention and Control (NCDPC).
 oversee the implementation, monitoring and evaluation of the program and to ensure its
PROGRAM sustainability.
MANAGEMENT  Provide direction and technical support on policies and plans pertaining to the prevention of
COMMITTEE (PMC) violence and injury
 Provide the forum for coordinating all aspects of the implementation of the program.
NUTRITION PROGRAM
 Reflects chronic undernutrition in early life.
STUNTING  % of children aged 0 to 59 months whose height for age is below -2 SD (moderate and severe
stunting) and -3 SD (severe stunting)
 State of nutrition in which a deficiency, excess or imbalance of energy, protein, and other nutrients
 imbalance between the supply of nutrients and energy and the body’s demand for them to
MALNUTRITION
ensure growth, maintenance, and specific functions
 encompasses both ends of the nutrition spectrum, from undernutrition to overnutrition
 Reflects acute undernutri¬tion
WASTING  % of children aged 0 to 59 months whose weight for height is below -2 SD (mod¬erate and severe
wasting) and -3 SD (severe wasting)
 Philippines ranked 9th in stunting prevalence
 prevalence of underweight children is an indicator to measure progress towards MDG1, where Phils
have insufficient progress
 Wasting prevalence: top ranking country is India, Phils is ranked 10th
 Overweight prevalence: Phils NOT included in the top 10
POINTS ON  Low birth weight prevalence: India accounts for 1/3, The incidence of low birthweight exceeds 20% in
PREVALENCE OF India, Mauritania, Nauru, Pakistan, and the Philippines
MALNUTRITION  The percent of Filipino households with inadequate calorie intake decreased between 1990 (74.2%)
and 2008 (66.9%).
 The prevalence of Iodine Deficiency Disorder (IDD) increased but still with levels below that
considered of public health significance
 There was a decrease in the prevalence of Vitamin A Deficiency Disorder (VADD) in the country and
is below the cut-off point for a public health problem (15%) except for children 6 months to 5 years.
used in calamities or conditions wherein height and weight cannot be measured, making it a feasible
KANAWATI INDEX
method for peripheral health workers
GOMEZ  classifies malnutrition based on the child's percentage of standard or reference weight-for-age
CLASSIFICATION  used in population screening and public health evaluations
HEIGHT FOR AGE considered an indicator of long-term nutritional adequacy
WEIGHT FOR
generally interpreted as an indicator of present nutritional status
HEIGHT
access by all people at all times to sufficient food in terms of quality, quantity, and diversity for an active and
FOOD SECURITY
healthy life without risk of loss of such access
 due to the lack of knowledge about the benefits of exclusive breastfeeding and complementary
MOST LIMITING
feeding practices, the role of micronutrients
FACTORS IN FOOD
 women do not have enough time and proper practices to take care of themselves and their infants
SECURITY
during and after pregnancy
Specific situations  Pregnant and nursing women eat too few calories and too little protein, have untreated infections,

wherein a family is such as sexually transmitted diseases that lead to low birthweight, or do not get enough rest.
able to afford food on  Mothers have too little time to take care of their young children or themselves during pregnancy.
the table, but still the  Mothers of newborns discard colostrum, the first milk, which strengthens the child’s immune system.
children suffer from  Mothers often feed children < 6 mo of age foods other than breast milk even though exclusive
malnutrition: breast-feeding is the best source of nutrients and the best protection against many infectious and
chronic diseases.
 Caregivers start introducing complementary solid foods too late.
 Caregivers feed children <2 yr of age too little food or foods that are not energy dense.
 Though food is available, because of inappropriate household food allocation, women and young
children’s needs are not met and their diets often do not contain enough of the right micronutrients or
protein.
 Caregivers do not know how to feed children during and following diarrhea or fever.
 Caregivers’ poor hygiene contaminates food with bacteria or parasites.
DIRECT METHODS INDIRECT METHODS
 deal with the individual and measure objective  use community indices that reflect the community
DIRECT vs INDIRECT
criteria nutritional status or needs
METHOD of
 Anthropometry  Dietary assessment
MALNUTRITION
 Clinical examination  Vital health statistics
ASSESSMENT
 Biophysical and radiological assessment
 Laboratory or biochemical estimation
 Severe deprivation, or impaired absorption of protein, energy, vitamins, and minerals
 Severe muscle wasting, with no body fat
MARASMUS  No detectable edema and fatty liver
 Good appetite
 Skin is dry and easily wriknles
 Inadequate protein intake
 Some muscle wasting, with retention of some body fat
KWASHIORKOR  Edema and fatty liver
 Loss of appetite
 Skin lesions develop
INDICATOR AGE GROUP TREND
Exclusively Breast-fed 0-6 months old Decreased

Receiving 2 doses of Vitamin A in a 6-59 mos. Increased (2003-2008)
full calendar year Same
(2009-2011)
SUMMARY OF Underweight 0-5 years old Increased
TRENDS OF Underheight 0-5 years old Increased
INDICATORS Significant Thinness 0-5 years old Increased
FROM 2005 TO Overweight 0-5 years old Same
2008 (FOR MDG’s Underweight 6-10 years old Increased
1 & 4) Underheight 6-10 years old Increased
Overweight 11-19 years old Increased
Overweight 20 years above Increased
Nutritionally- Pregnant Decreased
at-risk
Underweight Pregnant Decreased
Overweight Pregnant Decreased
Indicators Baseline 2016 Targets
% Households with per capita intake below 66.9
32.8
100% dietary energy requirement (2008)
19.6
% Low birth weight infants <19.6
(2008)
20.6
NOH NUTRTION % Underweight children under five years old 12.7
(2008)
INDICATORS
% of Iron Deficiency Infants: 55.7 (2008) <40
Anemia (IDA) Pregnant: 42.5 (2008) <40
% Under-five children with Vitamin A Deficiency 15.2
<15
(VAD) (2008)
% Children exclusively 34
54.75*
breastfed until 6 months (2008)
PHIL PLAN OF
ACTION FOR provides the framework for improving the nutritional status of Filipinos
NUTRTION (PPAN)
BENEFITS OF  Micronutrient supplementation is a crucial for child survival, it significantly reduces:

MICRONUTRIENT o The risk from mortality by 23-34%
SUPPLEMENTATION o Deaths due to measles by about 50%
OF VIT A o Deaths due to diarrhea by about 40%
POPULATION Micronutrient supplementation is recommended on the following:
COVERED BY  0-59 months old children
MICRONUTRIENT  Pregnant and lactating women
SUPPLEMENTATION  Non-pregnant and non-lactating women of reproductive age (15- 49 years old)
1. Attainment of nutritional well-being is a main responsibility of families
GUIDING 2. It is the duty and obligation of government to assist those who are unable to enjoy the right to good
PRINCIPLES OF nutrition in the spirit of inclusive development
PPAN 3. Priority given to those with less access and most nutritionally at-risk
4. Evidence-based interventions and strategies, with bias to local research

5. Good governance is at the center of efforts for nutrition improvement

FOOD VEHICLE FORTIFI-CANTS MIN. LEVEL OF FORTIFICATION
Flour Vitamin A 490 RE / 100 grams 45ppm
Iron
FORTIFIED FOOD Sugar Vitamin A 175 RE / 15 grams
VEHICLES Edible Oil Vitamin A 300 RE / 15 grams
Rice Iron 6 mg / 100 grams Raw Rice
Salt Iodine 60 ppm (retail pack) 70 ppm (bulk pack)
Condiments Iron Level will be in accordance with Food Fortification Guidelines
GMP OPT PLUS
DEFINITION  Involves serial monitoring of a child’s weight in the  An annual mass weighing of all preschoolers 0-71
Barangay Health Center (BHC) or Rural Health months old in a community to identify and locate
Unit (RHU) aided by the Early Childhood Care and the malnourished children
Development (ECCD) card
GEN. OBJ.  To detect any early deterioration in the nutritional  To generate data for nutritional assessment,
status of a child for immediate counseling and planning, management, and evaluation of local
intervention nutrition programs
SCHEDULE  Performed every month for 0-23 months old  Performed on the first quarter of every year
preschoolers and malnourished 0-71 months old
 Done quarterly for children 24-71 months old
GMP VS OPT PLUS S. D.  All children participating in health center activities,  Involves complete enumeration
specifically well child, IMCI, and Garantisadong
Pambata
S. C.  All preschool children 0-71 months old in the  All households w/ 0-71 months old preschool
barangay children in the barangay
USES  To detect deterioration in the health and nutritional  For local nutrition action planning, particularly in
status of the child quantifying the number of malnourished in the
 Basis for counseling of parent community
 To help identify intervention needed by the child  For providing information on the effectiveness of
nutrition programs
 For prioritization of assistance by provinces,
regions, national-based NGOs, and other partners
FOOD SANITATION PROGRAM
refers to the assurance that food will not cause harm to the consumer when it is prepared or eaten
FOOD SAFETY
according to its intended use
 Develop environmental health indicators, appropriate information system and operational guidelines
 Develop technical assistance packages for stakeholders.
 Develop a comprehensive communication package for environmental and occupational health
STRATEGIC
concerns.
THRUSTS
 Strengthen capacity building
 Support environment-friendly infrastructure development projects.
 Manage health care waste
 an inter-agency plan to achieve long-term policy objectives.
National
o It is the framework for actions on priority Environmental Health issues.
Environmental Health
o It recognizes the need to coordinate the Environmental Health activities of all stakeholders to give it
Action Plan (NEHAP)
direction, support its implementation and avoid duplication of efforts.
Issue: Lack of an integrated system for food safety.
Goal 1: To establish an integrated system for food safety and quality in the Philippines aligned with international
standards
Strategies  Organize an inter-agency National Food Safety Body
 Upgrade, strengthen and establish support systems, infrastructure and logistics on food safety
 Collaborate and establish linkages with international organizations
Outputs  National Food Safety Coordinating Council (NFSCC) established through joint AO.
 Effective food safety mechanism
 Closer coordination with international organization
Lead Agency  DOH-FDA
Support Agency  DOH agencies (NCDC, HEMS, BOQ, NCHP, NEC, RITM)
 DA attached agencies (BFAR, BPI, BAI, NMIS, PCA, SRA, NDA, BAFPS, NFA, FDC, FPA)
 DTI, DILG-LGUs, DOST, DepEd, BOC
Goal 2: Prevent and reduce the incidence of foodborne diseases
ACTION PLAN Strategies  Participate actively in the CAC’s standard setting process and to adopt Codex standards, whenever
appropriate
 Continue to develop and maintain sustainable preventive measures, including food safety education
programs aimed at reducing the burden of foodborne diseases through a systems approach
encompassing the complete food production chain from farm to consumption
Outputs  Adoption of the Codex standard
 Decreased incidence of foodborne diseases
 IEC materials developed
Lead Agency  BFAPS
Support Agency  NCDC, NECM HEMS, BFAR, BPI, BAI, NMIS, PCA, SRA, NDA, FPA
Goal 3: To update existing rules and regulations of food safety responsive to the current situation
Strategies  Strengthen and enhance the capability of the food safety key players to properly address new and
emerging issues
 Review and update all food and safety standards and regulations including the proper disposal of
“condemned” food products without affecting human health and environment.
 Collegial review of the food safety bill to harmonize all existing food safety rules and regulations

Outputs  Efficient response to food safety problems

 Food safety standards and regulations updated
 Passage of the food safety bill into law
Lead Agency  NCHP (Output #1)
 FDA and BAFPS (Output #2 and 3)
Support Agency  All DOH and DA Agencies, LGUs, DepEd (Output #1 and 2)
 DepEd, DOST, DTI, BOC, Academe, DENR-EMB (Output #3)
VALIDITY OF
valid for one (1) year, ending on the last day of December of each year, and shall be renewed every year
SANITARY PERMITS
CITY/MUNICIPAL
Issues the health certificate to the employees
HEALTH OFFICE
TEMPERATURE OF
In the transport of food, all food shall be in covered containers, wrapped, or packed, so as to be protected
FOOD FOR
from contamination.
TRANSPORT/
All readily perishable food shall be kept at 7°C (45°F) or below; or 60°C (140°F) or above
STORAGE
a. Recyclables – include dry papers/ cardboards, plastics/ rubbers, glasses, broken bottles, metals and
minerals.
SEGRAGATION OF
b. Trashes – ashes, rice hulls, chaffs, husks, shells, cobs, papers, cardboards.
FOOD WASTE
c. Food materials – food leftovers, kitchen/ cooking wastes, food washings, vegetable trimmings, fruit
peelings, egg shells, bones, entrails and gills.
DEPARTMENT OF Food safety in the primary production and post-harvest stages of food supply chain and foods locally
AGRICULTURE produced or imported
DEPARTMENT OF  Safety of processed and prepackaged foods, foods locally produced or imported
HEALTH  Conduct of monitoring and epidemiological studies on food-borne illnesses.
 Food safety in food businesses such as, but not limited to, activities in slaughterhouses, dressing
plants, fish ports, wet markets, supermarkets, school canteens, restaurants, catering establishments
LGU
and water refilling stations
 Responsible for street food sale, including ambulant vending.
FOOD SAFETY
 Monitor and coordinate the performance and implementation of the mandates of the DA, the DOH, the
REGULATION
DILG and the LGUs in food safety regulation
COORDINATING
 Establish the policies and procedures for coordination among agencies involved in food safety
BOARD (FSRCB)
WATER SANITATION PROGRAM
MWSS  Agency responsible for water supply in Metro Manila
Local Water Utilities
 Agency responsible for water supply outside Metro Manila (those not served by MWSS)
Agency (LWUA)
OVERALL GOALS OF
1. Environmental health conditions in the country areimproved
THE NOH FOR
WATER SANITATION 2. Morbidity and mortality from environmental healthhazards are reduced
WATER RESOURCES
POTENTIAL
WATER SUPPLY
LEVELS
TREATMENT BASED
ON
BACTERIOLOGICAL
QUALITY
 part of the coagulation and flocullation process

 The reasoning behind this is the improvement of coagulation by hypochlorite and it also oxidizes
PRECHLORINATION certain materials such as iron and manganese that cannot be removed by usual chemicals used in
the first step.
 This also helps in removing the amount of taste, odor and color of the treated water.
 free residual chlorine level that should be maintained until the water reaches the consumer at the
0.2 – 0.5 ppm
farthest point to say that it is clean

1.5 ppm  a measurement in any part of the system is a sign of excess water chlorination
SOLD WASTE, HEALTHCARE WASTE, HUMAN WASTE MANAGEMENT
 Ignitability – Solvent, paint
HAZARDOUS WASTE  Corrosivity – highly acidic (pH<2), alkaline (pH>12.5)
CHARACTERISTICS  Reactivity – may cause explosion
 Toxicity – heavy metals, mercury
WASTE AVOIDANCE  most desired step to reduce the amount of waste produced in waste hierarchy
LEACHATE
COLLECTION &
pipes at the low areas of the liner to collect leachate for storage & eventual treatment & discharge
TREATMENT
SYSMTE
GAS CONTROL Series of vertical pipes or horizontal trenches containing permeable materials and perforated piping to
RECOVERY SYSTEM collect gas for treatment of use as an energy source
 General Waste – comparable to domestic waste
 Infectious – suspected to contain pathogens
 Pathological Waste - tissues, organs, body parts, human fetus and animal carcasses, blood & body
fluids
 Sharps - items that can cause a cut or puncture wounds
 Pharmaceutical Waste - Includes expired, unused, spilt, and contaminated pharmaceutical products,
drugs, vaccines and sera that are no longer required and need to be disposed of appropriately; Also
includes discarded items used in handling of pharmaceuticals
CLASSIFICATION OF
 Genotoxic Waste - Includes cytostatic drugs, vomit, urine or feces from patients treated with cytostatic
HEALTHCARE
drugs, chemicals and radioactive materials; mutagens, carcinogens, teratogens
WASTE
 Chemical Waste - solid, liquid and gaseous chemicals from diagnostic, experimental work, cleaning &
housekeeping and disinfecting procedures
 Heavy Metals – mercury, cadmium, lead
 Pressurized containers - Includes gases which are stored in pressurized cylinders, cartridges and
aerosol cans
 Radioactive Waste - Includes disused sealed radiation sources, liquid & gaseous materials
contaminated with radioactivity, excreta of patients who underwent radionuclide diagnostic and
therapeutic applications
COLOR CODING
 Chemical Disinfection – aldehydes, chloride compounds, phnolic compounds are added; Most suitable
in treating blood, urine, stools and sewage or in treating infectious wastes containing pathogens
 Biological Processes - Composting & vermiculture for treating and disposing of placental waste, food
HEALTHCARE
waste, yard trimmings & other organic wastes
WASTE TREATMENT
 Radiation technology – for wastes containing potentially infectious organisms
 Encapsulation – for disposal of sharps & chemical and pharmaceutical residues
 Intertization – suitable for pharmaceutical waste (mix with cement)
 Burial site should be lined with a material of low permeability like clay
 Only hazardous health care wastes should be buried
BURIAL ON  Large quantities (>1kg) of chemical & pharmaceutical wastes should not be buried
HOSPITAL  Burial site should be managed as a landfill
PRESMISES  Burial pit should be downhill & about 50 meters away from any body of water
 The bottom of the pit should be at least 1.5 meters higher than the ground water level
 On-site burial is for limited period of 1-2 years only & for small amounts of wastes ( 5-10 tons in total)
METHODS OF
EXCRETA DISPOSAL
(MEMORIZE!!!)
CISTERN FLUSH water seal squatting or pedestal unit from which excreta are flushed away by 10-20 liters of water which
TOILET have been stored in an automatically refilling cistern connected to the household water supply
AQUA PRIVY/ Consist of a squatting plate above a small septic tank which discharges its effluent to an adjacent soak-
SPETIC PRIVY away
BUCKET LATRINES Consist of a squatting plate & a metal bucket which is located in a small vault immediatelybelow the

squatting plate
 most commonly observed technology around the world especially in rural areas
PIT LATRINE
 Should not be placed within 30 meters of any drinking water source
OVERHUNG Consist of a superstructure provided w/ a latrine floor built on top of wooden piles above the water &
LATRINE connected to the main house by a bridge or cat-walk
WRAP AND THROW
Discarding newspaper or plastic wrapped feces at the nearest garbage heap , street or ditch
METHOD
SCHOOL HEALTH PROGRAM
 Mental deviates – highly gifted & retardates
EXCEPTIONAL  Physical deviates – deaf, blind, mute
CHILDREN  Emotional & Social deviates – delinquents, truant
 The program aims to enhance the oral health education component of school dental health program
through the four (4) basic dental concepts in the elementary school curriculum:
BRIGHT SMILES
o limit snacking sweet and sticky foods
BRIGHT FUTURES
o use of toothpaste with fluoride
PROGRAM
o proper toothbrushing
o regular visit to the dentist
 It focuses on the promotion of health and wellness.
SCHOOL NURSING
 They also assist in making choices for a healthy lifestyle, reduce risk-taking behavior and focus on
PROGRAM
issues for the prevention of communicable and non-communicable diseases through advocacy
MENTAL HEALTH  designed to equip health personnel in school with the knowledge and skills to conduct psycho-social
AND intervention activities.
PSYCHOSOCIAL  Obejctive is To train facilitators on psycho-social and other interventions strategies to ensure the
SUPPORT availability of service providers in times of crisis or disasters.
TB and AIDS  two communicable diseases which have dedicated programs in the school
 previously known as the Breakfast Feeding Program (BFP) to address the “short-term-hunger
SCHOOL-BASED syndrome” among public elementary school children.
FEEDING PROGRAM  Provide hot meals to severely wasted kinder and grades I to VI pupils in identified schools for 120
feeding days.
 provides daily lunch to undernourished Grades I and 2 pupils for 136 days or about eight (8) months
during the school year. The budget is Php 11.00 per child per meal or about Php1,500.00 for the
whole year, a child can be fed for the entire feeding period.
BUSOG-LUSOG-
 The meals are prepared by the parents following the low cost and nutritious meals developed by the
TALINO PROGRAM
foundation.
 The parents also attend seminars on food safety, health and nutrition organized by our local partners
and JF employees, Barangay and DepED Health personnel.
 self-aided supplementary feeding endeavor sustained and managed by the school, the parents and
APPLIED NUTRTION the community.
PROGRAM  The school garden serves as the main source of commodities to be prepared for feeding of target
beneficiaries.
 ensures that the concepts learned by the child are relayed to the parents.
 Learning is reinforced by activities in school and at home, thus promoting congruency in the values
TEACHER-CHILD-
learned by the child in the school and what is practiced by parents at home
PARENT APPROACH
 utilizes a relay system to strengthen the carry-over of learnings the child has mastered in school to
the home, promoting the sharing of messages and skills with the other members of the family.
SCHOOL-MANAGED
 School-managed Canteen refers to a school canteen that is operated and managed by the school
CANTEEN VS
under the general teachers’ cooperative.
TEACHER’S
COOPERATIVE  While Teacher’s Cooperative-managed Canteen refers to a school canteen that is operated and
managed by a duly registered teacher’s cooperative.
CANTEEN
OCCUPATIONAL HEALTH PROGRAM
MANUFACTURING  industry with the Highest number of occupational diseases
WORKPLACE-
ACQUIRED  Most common occupational disease
MUSKULOSKELETAL  MOST COMMON AMONG THESE IS BACKPAIN
DISEASE
SUPERFICIAL
INJURIES AND OPEN  most common occupational injury
WOUNDS
90 dB for 8 hours
every day for 20  at this exposure SENSORY HEARING LOSS MANIFESTS
years
HAND-ARM
 disease caused by vibration
VIBRATION
 Vibration-induced white finger
SYNDROME
HEAT STROKE  most serious concern upon exposure to heat
FROSTBITE  most serious concern upon exposure to cold
CATARACTS,
CORNEAL ULCERS,  injuries from prolonged Infrared exposure
RETINAL BURNS
1 mSv/year  maximum exposure of radiation for general public
BENZENE Leukemia
ASBESTOS Lung Cancer
CARCINOGENS
2-naphthylamine bladder cancer
vinyl chloride liver angiosarcoma

≥ 40 µg/dL blood lead level which requires medical intervention

single ≥ 60 µg/dL or 3
consecutive
indicates the necessity for removal of the employee from the site
measurements
averaging 50 µg/dL
ELIMINATION AND
most effective at reducing hazards but tend to be the most difficult to implement
SUBSTITUTION
 ventilation systems such as a fume hood
 sound dampening materials to reduce noise levels
 safety interlocks
Examples of
 radiation shielding
engineering control
 machine guards
 isolation or enclosure of hazards
 eliminating hazardous and substituting non-toxic chemicals
PROVIDING
ERGONOMICALLY
DESIGNED  control of ergonomic hazards among those working with computers
EQUIPMENT AND
FURNITURE
4th SHIFTING
PHILHEALTH
CHOICES:
A. Employed
B. Overseas Filipino worker
C. Individually Paying
D. Lifetime
PHILHEALTH E. Sponsored
MEMBERSHIP
CATEGORIZATION Filipino migrant worker employed in a cruise OFW
ship
Retired Judge Lifetime
Retiree who failed to meet minimum 120 Lifetime (RA 10645: Mandatory PhilHealth
monthly contributions Coverage for All Senior Citizens)
RHU Physician who holds clinic at night Individually Paying
Questions:
1. G5P4 = Not covered
2. Testing for Visual Acuity = not covered
3. Patient with acute MI who was confined and died 12 hours later = not covered
“PhilHealth provides subsidy for room and board, drugs and medicines, laboratories, operating
room and professional fees for confinements of not less than 24 hours.”
4. Payment for Alcoholics Anonymous = Not Covered
EXCLUSIONS (ITEMS
NOT PAID BY
 The following health services cannot be paid for through PhilHealth:
PHILHEALTH)
o Fifth and subsequent normal obstetrical deliveries
o Drugs and devices which are not prescribed by a doctor
o Treatment for alcohol abuse or dependency
o Cosmetic surgery
o Optometric services
o Other cost-ineffective procedures as defined by PhilHealth
Who among the following is a dependent?

A. Spouse employed in the LGU
B. 18 year old acknowledged illegitimate child employed by his father
C. 21 year old son with Down’s Syndrome
CRITERIA FOR
BEING A
 The legitimate, legitimated, legally adopted or acknowledged natural child who is:
DEPENDENT OF A
○ Unmarried
PHILHEALTH ○ Not gainfully employed
MEMBER
○ Not over 21 years of age or over 21 years of age provided he is incapacitated and incapable of
self-support due to a physical or mental defect which is congenital or acquired during
minority
 Legitimate spouse living with the employee
 Parents of said employee wholly dependent upon him for regular support.
A. The primary illness is the diagnosis (made upon discharge) that is deemed to be the cause of
hospitalization/confinement
B. For cases wherein there is a discrepancy between the final diagnosis and the management, PhilHealth
Which of the may return the claim to the hospital with request for a properly accomplished PhilHealth Claim
following is true C. Open heart surgery is a catastrophic case
D. Neurosurgery is an intensive case
Ang answer ata ay A, B, C. Since ang neurosurgery daw ay isang catastrophic case din.
EMPLOYEES COMPENSATION PROGRAM
DISABILITY Loss or impairment of a physical or mental function resulting from injury or sickness.
Injuries with NO 1. Due to intoxication
compensation 2. The employee’s willful intention to injure or kill himself (suicide) or another

3. Due to exhibited notorious negligence

 if that sickness is listed by the ECC as an “occupational disease”
CONDITIONS FOR
 An illness not listed as “occupational disease” may be compensable if an employee can show an
SICKNESS TO BE
evidence/proof that the risk of contracting such sickness was increased by the working conditions or the
COMPENSABLE
so called “increase risk theory”
PRESCRIPTION
PERIOD FOR No claim for compensation shall be given due course unless said claim is filed with the System within
COMPENSATION three years (36 months) from the time the cause of action accrued.
CLAIMS
Any employee who sustains an injury or contracts sickness which prevents him/her for continuing his
TEMPORARY TOTAL
work for a period not exceeding 120 days except where such injuries or sickness still requires medical
DISABILITY
attendance beyond 120 days but not to exceed 240 days.
PH ADMINISTRATION & MANAGEMENT
COMMERCIAL
Ability to identify the health problems of the community and solve those problems through health services
FUNCTION
Particular function area which is peculiar to or identifies an agency from others (Doctors providing
TECHNICAL healthcare)
FUNCTION  The SKILLS particular to this sector include: diagnosis, treatment, health promotion, disease
prevention, epidemiologic skills & knowledge
Formulation of the steps to be taken by an agency at some future period to achieve a desired state which
PLANNING
the process itself specifies as its objective/s
Assessment of the work to be done and allocating needed labor, resources, manpower
ORGANIZING
Assessment of how divisions are related to one another
DIRECTING Effective directing requires delegation, communication, training and motivation
COORDINATING Synchronization of activities towards well-established goals
MANAGER
Important skill among top-level managers
CONCEPTUAL
TECHNICAL SKILL Ability to use the procedures, techniques and knowledge of a specialized field
1. Authority and responsibility 9. Discipline
2. Delegation of authority and responsibility 10. Order
3. Unity of command 11. Equity
GENERAL
4. Unity of direction 12. Stability of staff or stability of tenure
PRINCIPLES OF
5. Span of control 13. Initiative
MANAGEMENT
6. Specification of objectives 14. Esprit de corps
7. Division of work 15. Absoluteness of responsibility
8. Renumeration 16. Scalar chain
UNITY OF The purpose of having unity of command in an organization is to help establish well-defined channels of
COMMAND authority
UNITY OF
Requires that there should be one head and one plan for a group of activities having the same objective
DIRECTION
The number of individuals reporting to a supervisor, should not be more than can be effectively
SPAN OF CONTROL
coordinated and directed
DOTTED LINES IN
ORGANIZATIONAL indicate close relationships but not official/responsibility relationships
CHART
SITUATIONAL ANAYLSIS
TRUE ABOUT AGE & Grouped variably depending on the specific needs of each subgroup
SEX STRUCTURE FALSE: should be group by 1s and 5s to facilitate uniformity
Crude as they maybe these are the first basis of making a judgment of inequality in health status among
geographical area.
CRUDE BIRTH RATE
NOTE: Ang isa pang choice ay percentage deaths, dapat ang index ay % death WITHOUT MEDICAL
ATTENDANCE
Endemic diseases which are very important causes in certain areas but do not reach the number big
ENDEMIC DISEASES
enough to be leading in the aggregate should be included.
 SAFE WATER SUPPLY
ENVIRONMENTAL  HUMAN WASTE DISPOSAL
INDICES  INDUSTRIAL WASTE DISPOSAL
 FOOD ESTABLISHMENTS
In a situational analysis, it is the one that is often subjected to change to effect improvement in the health
HEALTH SECTOR
status
Total number and distribution
 Based on:
COMPONENTS OF  Geographical areas
ANALYSIS OF  Components of the health sector (public, private, mix)
CURRENT STOCK  Technical areas of expertise
OF MANPOWER  Facilities to show at least how many are working in hospitals, in rural health units, special units
etc
 Nationality (if there are sizeable number from other countries)
a. Breakdown by regions and provinces
TOTAL POPULATION
b. Percentage of urban/rural areas
&
c. List of areas where accessibility is difficult
GEOGRAPHICAL
d. Percentage of population living in slum areas
DISTRIBUTION
e. Size of Indigenous population
PROJECT PLANNING
 strengthening of basic health services
PROGRAMS &
 integration of MCH & family planning
SERVICES
 development of a national pharmaceutical store

 training
MAJOR ACTIVITES  construction/infrastructure
 design of administrative subsystems
 Prevailing policies (of the government)
WHAT INFLUENCE
 Existing administrative expertise for carrying out the proposed changes
THE CHOICE
 Extent of the interrelationship of the projects
 Projects related to high priority program
HIGH PRIORITY  Projects which relate to urgent problems and which have significant political complications
PROJECTS  Projects which will give accent to better effectiveness and efficiency in the utilization of
resources and hence maximization of their impact
POLICY AS AN AREA  Formulation of
OF CHANGE -  hospital guidelines on generic use
ACTIVITIES  Implementation of executive order on integration
 A continuous process of critically analyzing a plan/project/program based on careful assessment of a
EVALUATION given situation leading to drawing of sensible conclusion and making proposals for future action.
 Takes place at different stages of planning:
WHAT IS  Formulation Stage (relevance and adequacy of the project)
EVALUATED AT  Implementation Stage (progress and efficiency of the project)
EACH STAGE  Summative Evaluation at the end of implementation (effectiveness and impact)
TECHNICAL  Efficacy to deliver change and the duration of said change
EFFECTIVENESS  Coverage of technology
OPERATION OR  The institutional capacity to effect change
ADMINISTRATIVE  Conformity or non-conformity to existing laws is an important consideration
FEASIBILITY  How much change the alternative requires and the amount of development efforts needed
ULTIMATE PURPOSE  include desired changes / development into the health system to increase the health program’s
OF A PROJECT capability in providing health services
COMMUNITY ORGANIZING
MOST IMPORTANT  People
FACTOR IN  Problem
COMMUNITY  Participation
ORGANIZING  Process and Power
EFFECT/GOAL OF
COMMUNITY  CREATING SOCIAL CHANGE
ORGANIZING
PROCESS POWER
 People are organized to facilitate:  People are organized to acquire and
o Communication demonstrate power.
o Education  The threat or use of power helps to influence
o Hope specific individuals to:
o Awareness o Correct specific problems
PROCESS VS.
o Sense of Community o Create systems change
POWER APPROACH
 By working together, the group learns how o Resolve conflicts
to address common health problems and  Example sa exam: yung new director ng
achieve specific objectives. hospital ay nagorganize/appoint ng bagong
 Example sa exam: yung increasing staff – this is to create a systems change
prevalence of TB/CAP, what process will you
use
QUESTION The most powerful tool of the presenter
 Prestige
FACTORS THAT  Attractiveness
ENHANCE THE  Role
ABILITY OF THE  Likeness to audience
*these first 4 were the choices in the question, “which is the most important?”, for me it would be the likenss to
COMMUNICATOR
audience
 Credibility
TRUE ABOUT USING
If you use fear, follow with specific actions that the audience can to do reduce the threat
FEAR
With the assistance of the Organizer and core group of community members , the host community must:
TRUE ABOUT
 Identify important issues and commonly held problems
TARGETING ISSUES
 Define desired changes (LUMABAS NA CHOICE)
AND SETTING
 Rank problems and set priorities
PRIORITIES
 Develop shred vision for problem solution
 Comes from the poor sector of the community and is directly engaged in economic production.
TRUE ABOUT  Must possess credibility and integrity
SPOTTING
 Is receptive to change
POTENTIAL
 Must have an analytical and critical mind (LUMABAS NA CHOICE)
INDIGENOUS
LEADERS  Must be able to communicate effectively
 Must be interested in the upliftment of his community
 Build people’s self-confidence and develop their collective spirit .
MOBILIZATION
 These activities must include assessment & reflection sessions including team building.
 Conduct regular social activities.
CONTINUING THE  Inter-visitation
PROCESS & KEEPING  Contests
THE ORG ALIVE  Health fairs and / exhibits
 Give recognition for those who have done well
PROBLEM IDENTIFICATION & PRIORITIZATION
STRATEGY GRID May assist in transitioning from brainstorming with a large number of options to a more focused plan of

action
HIGH NEED/LOW FEASIBILITY HIGH NEED/ HIGH FEASIBILITY
 These are long term projects which  With high demand and high return on
have great deal of potential but will investment, these are the highest priority
require significant investment. Focusing items and should be given sufficient
LOW on too many of these items can resources to maintain and continuously
NEED overwhelm an agency improve
STRATEGY GRID
HIGH LOW NEED/LOW FEASIBILITY
CATEGORIZATION LOW NEED/ HIGH FEASIBILITY
NEED  With minimal return on investment,
 Often politically important and difficult to
these are the lowest priority items and
eliminate, these items may need to be
should be phased out allowing for
redesigned to reduce investment while
resources to be reallocated to higher
maintaining impact
priority items
LOW FEASIBILITY ------> HIGH FEASIBILITY
 Useful in the early phases of prioritization when there exists a need to generate a lot
NOMINAL GROUP of ideas in a short amount of time and when input from multiple individuals must be
TECHNIQUE taken into consideration
 Opinions of community point persons are important
GUIDING  Size of the problem
CONSIDERATIONS IN  Seriousness of the problem
HANLON RANKING  Effectiveness of intervention
Propriety
Economics
PEARL Acceptability
Resources
Legality
PRECEDE-PROCEED MODEL
 Object of interest are those health status and quality of life indicators (mortality, morbidity,
unemployment, homelessness)
OUTCOME
PROCESS Implementation
EVALUATION
IMPACT Behaviors
OUTCOME Health status and QOL
 Absenteeism
 Comfort
SOCIAL INDICATORS
 Crime
 Unemployment
 Compliance  Preventive actions
BEHAVIORAL
 Consumption patterns  Self-care
INDICATORS
 Coping  Utilization
FACTOR DEFINITION EXAMPLES
 Antecedents to behavior that provide the  Knowledge
motivation for the behavior; factors within  Beliefs
Predisposing the target group;  Attitudes
Factors  Impact motivation  Confidence
 Percieved needs and abilities
 Antecedents to behavior that allow a Environmental & Personal Resources
motivation to be realized; characteristics of that impact:
the env’t or skills or resource required to  Accessibility
attain specific behaviour  Availability
PREDISPOSING, Enabling  Antecedent barriers & vehicles  Affordability
ENABLING, Factors
 Programs and Services
REINFORCING
 Skills
FACTORS
 Money and Time
 Facilities
 Laws
 Factors following a behavior that provide the Positive or Negative Feedback from:
continuing reward or incentive for the  Peers
persistence or repetition of the behaviour  Family
Reinforcing  Subsequent; feedback and rewards
 Healthcare workers
Factors
 Law enforcement
 Media
 others
HEALTH EDUCATION
MOTHER AND  Antenatal registration – in health center
THE UNBORN  Tetanus toxoid immunization – 3 doses during entire pregnancy
 Nutrition ( Vitamin A, folate, iron ) – folate prevents neural tube defects (1st
trimester)
 Dental care
ESSENTIAL
 STD/AIDS prevention and Management
HEALTHCARE
** (e.g Mrs.X on her 5th month of pregnancy, what health promotion activity will you
PACKAGES AT
recommend? ANS = AOTA)
VARIOUS STAGES
 Family planning – as early as prenatal
OF LIFE
 Comprehensive Evaluation
NEWBORN  Resuscitation
AND INFANTS  Routine eye prophylaxis – erythromycin eye ointment
 Prevention and management of hypothermia
 Newborn screening

 Breastfeeding immediate and exclusive

 Complementary feeding at six months
 Prevention and management of infection
 Birth registration
 Birth weight and growth monitoring
 Full immunization
 Micronutrient supplementation
 Dental care
 Developmental milestone screening
 Advice on psychosocial stimulation
EARLY  Growth monitoring and promotion
CHILDHOOD  Nutritional screening
 Micronutrient supplementation
 Developmental milestone screening
 Disability detection
 Management of common childhood diseases
 Dental care
 Counseling on accident prevention and use of safe toys, and psychosocial
stimulation
 First Aid
MIDDLE  Integrated management of childhood diseases
CHILDHOOD  Accident prevention
 Nutrition and diet counseling
 Dental Care
ADOLESCENT  Management of Illness
AND YOUTH  Counseling on substance abuse, sexuality, and reproductive tract infection
 Nutrition and diet counseling
 Mental health
 Family planning and responsible sexual behaviour
SHORT IMPRESSIVE,
INTENSIVE  What health promotion technique will you do for a person who is ignorant?
MESSAGES
PROVIDE MORAL
SUPPORT TO  Man wants to stop smoking. He tried using e-cigarettes as an alternative but claimed that he keeps on
CONTINUE THE smoking parin. What will you advise.
SOLUTION
PROVIDE MORAL
 Girl wants to shift to Natural Family Planning from OCP but was told by neighbour that they are not
SUPPORT TO TRY
effective. What will you advise?
THE SOLUTION
HEALTH PROMOTION
 General health promotion (nutrition, Exercise, Personal Hygiene)
 Immunization,
 Prophylaxis,
PRIMARY
 Ergonomics,
 Mosquito Repellants,
 ISOLATION AND QUARANTINE (According sa Community Health Nursing Book by
LEVELS OF Lundy, 2014)
PREVENTION
 Screening (FBS, Self-breast exam)
SECONDARY  Post-exposure Prophylaxis (?)
 Early Treatment
 Disability limitation
TERTIARY  Rehabilitation (physical therapy)
 Intensive follow-up and treatment of cases (DM, infectious)
FIVE KEY 1. It involves the population as a whole (not only groups at risk)

PRINCIPLES OF 2. It is directed towards action on the causes or determinants of health (holistic approach)
HEALTH PROMOTION 3. It combines diverse but complimentary methods or approaches
4. It aims at effective public participation supporting the principles of self-help movements (community
managed)
5. Health professionals have an important role in nurturing and enabling health promotion (ex. 5-star
doctor)
DIFFERENCE OF
 Has a broader concept than health education
HEALTH PROMOTION
 It involves environmental and political action
AND HEALTH
EDUCATION  Involves public policy change and community action to enable people to make changes in their lives
 Support or argument for a cause, policy etc. and convince others to act the same way
ADVOCACY
 Example: A doctor who is a member of a foundation that aims to promote breastfeeding in public
APPROACH AIM METHODS EVALUATION

 To reduce morbidity and premature  Preventive services like  Long term: reduction in
mortality Immunization and Screening disease rates and mortality
 Target: whole populations or high  Short term: increase in the
risk groups percentage of being screened
Medical or
 Seeks to increase medical or immunized
Preventive
intervention which will prevent ill
health and premature death
 Has 3 levels of intervention:
Primary, Secondary and Tertiary
1. Encourage individuals to adopt  Campaigns, Provision of  Has the behavior changed after
healthy behaviors which are seen information, One on one the intervention?
Behavior Change as the key to improved health counseling
2. It views health as a property of
individuals
 Provide knowledge & information  Learning which involves cognitive  Increase in knowledge and
 Develop the necessary skills so (pamphlets, film showing), skills
that people can make an informed affective (group activities, 1 on 1
choice about their health behavior counselling) and behavioural (role
Educational
 Based on the assumption that play, return demo) aspects
an increase in knowledge will
lead to a change in attitudes and
behavior
 To help people identify their own 1. Client-centered approach in 1. Outcome evaluation: includes
concerns & gain the skills & which the health promoter help the extent to which specific
confidence to act upon them clients to identify their health aims have been met
Empowerment  based on a bottom-up strategy & concerns & areas for change 2. Process evaluation: includes
calls for different skills from the 2. Community development – the degree to which the group
health promoter work with groups of people to has gelled or been empowered
plan programs of action to as a result of the intervention
address their health concerns
 Radical Health Promotion –  Necessary skills- lobbying, policy  Includes outcomes like
focus is at the policy or planning, negotiating legislative, organizational or
environmental level implementation regulatory changes which
promote health
Social Change 1. To bring about changes in the
physical, social and economic
environment
2. To make the healthy choice the
easier choice

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Multi-sectoral coordination or linkages

4,5,6 – directly related to health; 7 – indirectly related to health

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 Birth order of 7 and above

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Central Visayas/Region 7  Highest recorded cases

4S strategy  Search and destroy all breeding containers

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 To establish the vectors of the disease in the endemic areas

Schistosoma mansoni, S. haematobium,

CARAGA Highest number of schisto cases

Mia. Guian. Ivy. Vim. Jeph Page 5 of 24

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(top 3: Cebu, M.oriental,

Skilled birth attendance

Hospital based BEmONC Offers blood transfusion services

Six signal fxns of

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Safe motherhood initiative

Axillary T>37.5, rectal Guideline for fever

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CLASSIFICATION FOR CLASSIFY AS SIGNS IDENTIFY TREATMENT

 Lethargic or unconscious  Give fluid for severe dehydration (Plan C)

 Restless, irritable If child also has a severe classification:

VERY SEVRE MALARIA

Mia. Guian. Ivy. Vim. Jeph Page 9 of 24

11% % drug use among students

NON-COMMUNICABLE DSEs PCP

<3.3 g Target salt-intake per day (NOH Objective 4)

Risk factor assessment Key in the process of screening for NCDs

Mia. Guian. Ivy. Vim. Jeph Page 10 of 24

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KIDNEY  near-ESRD (calculated creatinine clearance <20/min for diabetic nephropathy/pre-emptive

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 Injury type in general: open wound/laceration

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Exclusively Breast-fed 0-6 months old Decreased

BENEFITS OF  Micronutrient supplementation is a crucial for child survival, it significantly reduces:

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5. Good governance is at the center of efforts for nutrition improvement

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Outputs  Efficient response to food safety problems

 part of the coagulation and flocullation process

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≥ 40 µg/dL blood lead level which requires medical intervention

Who among the following is a dependent?

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3. Due to exhibited notorious negligence

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 Breastfeeding immediate and exclusive

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APPROACH AIM METHODS EVALUATION

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