COMMUNITY AND PUBLIC HEALTH LECTURE

- LECTURE 6: HEALTH COMMUNITY – o Distribution of facilities

 Fire and safety
HEALTH COMMUNITY o Availability and accessibility of fire protection and
 Community is a social group of people who have common safety services and facilities
characteristics whose members know and interact with each o Prevention activities
other. It functions within a particular social structure and  Politics and government
exhibits and creates norms, values and social institutions. o Existing political structure, decision
 This group of people work together to organize social life within o Leadership
a particular phrase or they may be bound by a sense of o Decision making process or pattern
belonging sustained across time  Health
o Health facilities and activities
CLASSIFICATION OF COMMUNITIES o Distribution and utilization of facilities
 Urban o Ratio of health providers to the clients
o socially heterogenous population and complex structure o Prioritization
o non-agricultural occupations  Communication
o characterized by complex interpersonal social relations o Forms of communication (Formal/Informal)
o more crowded than a rural place or a town o Their influence on health
 Rural  Economics
o Occupations are usually farming, fishing and food o There should be available occupations
gathering o There should be different types of economic activities
o People are simple fold characterized by primary group
 Recreation – must be for all ages
relations o Recreational activities and facilities
o Well-knit and having ahigh degree of group feeling
o Consumers
 Rurban o Appropriate awareness
o Resemble urban locality
o The way of living of the people is like an urban community FACTORS THAT AFFECT COMMUNITY HEALTH
although they are in the rural geographic space Physical Factors
 Geography – location itself e.g. weather
CHARACTERISTICS OF A HEALTHY COMMUNITY  Environment – e.g. coal mining power plant can affect the
 A healthy community prompts its members to have a high health
degree of awareness that we are a community. More people  Community size
are concerned for the lives of each other
 Industrial Development
 A healthy community uses its natural resources while taking
steps to conserve them for future generations. Social Factors – arises from the interaction of individuals or groups
 A healthy community openly recognizes the existence of sub- within the community
groups and welcomes their participation in community affairs.
Continuous to grow and accept new people in that place. Cultural factors
 A healthy community is prepared to meet crisis. E.g. allocating o Beliefs, Traditions, prejudices
budget o Economy
 A healthy community has open channels of communication that o Religion
allow information to be known to all.
o Social norms
 A healthy community seeks to makes its system’s resources
o Education
available to all members of the community.
 A healthy community has legitimate and effective ways to settle
Politics
disputes and meet needs that arise within the community.
o Nationally
 A healthy community encourages maximum citizen
o Locally
participation in decision making.
(can improve or jeopardize the health of the community)
 A healthy community promotes a high level wellness among all
Health care delivery system – the network of health facilities and
its members.
personnel which caries out the task of rendering health care to the
people
COMPONENTS OF COMMUNITY
Core: People
Subsystem:
 Housing
o Type and characteristics of houses
o Presence of housing laws and regulations
 Education
o Laws and regulations
o Ratio of educators to learners
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 COMMUNITY AND PUBLIC HEALTH LECTURE
Community organization - the process through which communities
are helped to identify common problems or goals, mobilize
resources and develop and implement strategies for reaching the
goals they have collectively set.
 1979
INDIVIDUAL BEHAVIORS
ELEMENTS OF A HEALTHY COMMUNITY
o People that work together to attain goals
(health)
o A physical environment that promotes safety,
health, order and cleanliness
o Safe water and nutritious food
o Families that provide members with basic needs
o Available and affordable health care
o Linkages in health care – there should be a wide
network of health care, there should be a
specializations
- LECTURE 7: PRIMARY HEALTH CARE -
PRIMARY HEALTH CARE
Is essential healthcare based on practical, scientifically sound and
acceptable methods and technology made universally accessible to
individuals and families in the community by means acceptable to
them, through their full participation and at a cost that community
and country can afford to maintain at every stage of their
development in the spirit of self-reliance and self-determination.
HISTORY OF PRIMARY HEALTH CARE
 May 1977
o The 30th World Health Assembly adopted resolution WHA
30:43. This resolution states that the main social target of
government and of the WHO should be the attainment of
a level of health that will permit all the people of the world
to lead a socially and economically productive life by year
2000.
o “Health for All”
 September 12, 1978
o International Conference of Primary Health Care was held
at Alma Ata, USSR
o Alma Ata Declaration
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o Represents a global idea, a new vision about how to
achieve world health.
o “Primary health care is the key to attaining the health for
all goal” (slogan)
o The World Health Assembly lunch the Global Strategy for
Health for All.
o October 19, 1979, Philippines
 Letter of instruction 949 mandated the then
Ministry of Health to adopt Primary Health Care
as an approach towards the design,
development and implementation of programs
which focuses on health development at the
community level.
THE MAIN REASONS THEY ADAPT HEALTHCARE
1. The magnitude of health problem
2. Inadequate and unequal distribution of health
resources
3. Increasing cause of medical care
4. Isolation of health care activities from other
health care activities
 2018
o Global Conference on PHC (Kazakhstan, October 2018)
o Declaration of Astana
 Renewed political commitment to PHC from
government and NGOs. Professional
organizations, academia and global health and
development organizations.
 Universal health coverage (UHC) and health
related Sustainable Development Goals
(SDGs)
4 PLEDGES THAT THE DECLARATION HIGHLETED
1. To make bold political choices for health across all sectors
2. To build sustainable primary health care
3. Empower individuals and communities
4. To align stakeholders, support to national policies, strategies
and plans
GLOBAL GOAL OF PRIMARY HEALTH CARE
“Health Services for all” – New slogan
PRIMARY HEALTH CARE PRINCIPLES AND STRATEGIES
1. Accessibility, availability, affordability and acceptability of
health services
o Strategies:
 Health services delivered where the people are
 Use of indigenous/resident volunteer health
worker as a health care provider with a ration of
one community health worker per 10-20
households
 Use of traditional (herbal) medicine with
essential drugs
2. Provision of quality, basic and essential health services
o Strategies:
 Attitudes, knowledge and skills developed are on
promotive, preventive, curative and
rehabilitative health care.
 Regular monitoring and periodic evaluation of
community health worker performance by the
community and health staff.
 COMMUNITY AND PUBLIC HEALTH LECTURE

3. Community participation  A health program to prevent the transmission of endemic

o Strategies:
 Awareness building and consciousness raising on
health and health related issues
 Planning, implementation, monitoring and
evaluation done through small group meetings
 Establishment of a community health
organization at the parish or municipal level
4. Self reliance
o Strategies:
 Community generates support for health
program
 Use of local resources
 Training of community in leadership and
management skills
 Incorporation of income generating projects,
cooperative and small scale industries
5. Recognition of the interrelationship of health and development
o Strategies:
 Convergence of health, food, nutrition, water,
sanitation and population services
 Establishment of an effective health referral
system
6. Social Mobilization
o Strategies:
 Multi-sectoral and interdisciplinary linkage
 Establishment of an effective health referral
system
 Collaboration between government and
NGOs
7. Decentralization
o Strategies:
 Relocation of budgetary resources
 Reorientation of health care professionals on
PHC
 Advocacy for political will and support from the
national leadership down to the barangay level
disease through vector control and detection and early
treatment to reduce cases and prevent deaths
o Programs:
 Malaria
 Leprosy
 Leptospirosis
 Dengue
EXPANDED PROGRAM ON IMMUNIZATION
 This program aims to control the occurrence of preventable
illnesses especially of children
o Immunizations:
 Measles, Mumps, Rubella (MMR)
 Tetanus
 Diptheria, Pertussis, Tetanus (DPT)
MATERNAL AND CHILD HEALTH
 Ensures protection of the mother and child against illness and
other risks.
ESSENTIAL DRUGS
 This program focuses on the information campaign on proper
utilization and acquisition of drugs.
 Generic Act of the Philippines
NUTRITION
 Knowledge on adequate nutrition, and the proper production,
purchase, preparation, storage and consumption of food is
essential to the client’s health
TREATMENT OF COMMUNICABLE DISEASE
 Prevention, control and affordable treatment of diseases like
tuberculosis, etc
SAFE WATER AND SANITATION
 The environment plays a very important role in the promotion
and maintenance of good health.

ESSENTIAL HEALTH SERVICES IN PHC – ALMA ATA

 Education for health - LECTURE 8: DEPARTMENT OF HEALTH -
 Local endemic diseases control
 Expanded program for immunization DEPARTMENT OF HEALTH
 Maternal and Child Health plus responsible parenthood The principal government agency mandated by the constitution for
 Essential drugs health promotion and protection
 Nutrition
 Treatment of diseases VISION
 Safe water and sanitation Filipinos are among the healthiest people in southeast Asia by 2022,
and Asia by 2040
EDUCATION FOR HEALTH
 Sum of all activities in which health agencies engage to MISSION
influence the thinking, motivation, judgment and action of the To lead the country in the development of a productive resilient,
people. equitable and people centered health system
 Consist of techniques that stimulate, rows, and guide people to
live healthfully. BROAD OBJECTIVES OF THE DOH
 Process whereby knowledge, attitude and practice of the  To promote equity in health among health status among all
people are changed to improve individual, family and segments of society
community.  To address specific health problems of the population
LOCAL ENDEMIC DISEASE CONTROL  To upgrade the status and transform the healthcare delivery
system into one that is responsive, dynamic, highly efficient and

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 COMMUNITY AND PUBLIC HEALTH LECTURE

effective in providing solutions to the changing health needs of  The main goal is to reduce cardiovascular diseases through
the population control and preventative measures thus lowering the risk
 To promote active and sustain people’s participation in factors in developing this.
healthcare  Emphasis:
o Anti-smoking campaign “Yosi Kadiri”
FUNCTIONS OF THE DOH o Cholesterol lowering diet and health lifestyle
1. Leadership in health directives
 Serves as the national policy and regulatory institution 5. Expanded Program on Immunization
from which members of the health sector anchor their  PD 996 “all children 8 years and below must have
trust and direction. compulsory basic immunization”
 Provide leadership in the formulation, monitoring and  Aims to protect children from the seven immunizable
evaluation of national health policies, plans and programs. diseases by providing specific vaccines
 Serves as the advocate in the adoption of health policies, 6. Mental Health Promotion
plans and programs to address national and sectoral  Aims to implement and expand outpatient services in all
concerns. mental health facilities
2. Enabler and capacity builder  Early diagnosis and treatment of mental problems through
 Innovative new strategies to improve the effectiveness of outreach programs
health programs  Training of mental health workers who could be dispersed
 Exercises monitoring and evaluation of national health in rural communities
plans, programs and policies 7. Nutrition Program
 Insurers the highest achievable standards of quality health  Aims to improve the nutritional status of preschoolers and
care, health promotion and health protection pregnant and lactating mothers
3. Administration of specified services  To prevent and relieve the prevalence of protein energy
 Manage selected national health facilities and hospitals malnutrition, vitamin a deficiency, nutrition education,
 Administers direct services for emergent health concerns food and nutrition supplementation and rehabilitation of
that require new complicated technology that is deemed malnourished children
necessary for public welfare 8. Others
 Initiate special programs for endemic diseases  Diabetes control program
 Administers health emergency response services including  Prevention and control of kidney diseases
referral and networking system for trauma, injuries and  Programs on blindness, and deafness and osteoporosis
catastrophic events.  Diarrheal disease control program
 Tuberculosis control program
PROGRAMS OF THE DOH  Integrated management of childhood diseases
1. Health Education and Communication Program
 Aims to improve the health behavior of the individual and
family by teaching the practice of good health habits and
personal hygiene
 Educates/informs the public on healthy issues and health
policies through multiple communication channels
 Provides training and seminars to health workers and
personnel
2. Maternal and Child Health Program
 Aims to reduce the perinatal, infant and young child (0-4)
morbidity and mortality by providing free basic prenatal,
postnatal delivery care to mothers
 Includes immediate newborn care and the early
introduction of breastfeeding
 Basic preventative and health promotion services are also
rendered
3. Family Planning Program
 Directed towards improving family well-being by providing
education programs and services on all legally permissible
and medically acceptable family planning programs
 Information and service are aimed towards helping Filipino
couples to arrive at a decision based on their moral,
religious beliefs and capabilities to raise a family
4. Cardiovascular Disease Program