Community and Public Health Medical Model of Illness

[ Health and Development ]

Health- defined as a state of physical,
mental, and social well-being and not
merely the absence of disease or
infirmity
Philippine Constitution 1987
Section 2, Article 16- the state shall
protect and promote the right to health
of the people and instill health
consciousness among them
Development- refers to the progressive
improvements in the living conditions
and quality of life enjoyed by society and
shared by its members –WHO 1978
Disease  Impairment  Disability 
Handicap
o Impairments- disturbances at the
organ level
o Disability- disturbances at the
person level
o Handicap- interaction with and
adaptation to the individual’s
surroundings
Kofi Annan- said that “the biggest
enemy of health in the developing world
is poverty”

Public Health- refers to all organized

measures to prevent disease, promote
health, and prolong life among the
population as a whole

o Prevent- the assessment and

monitoring of the health of
communities and populations at
risk to identify health problems
and priorities
o Protect- the formulation of public
policies designed to solve
identified local and national
health problems and priorities
o Promote- to assure that all
populations have access to
appropriate and cost-effective
care, including health promotion
and disease prevention services

Multidimensionality of Health

Etiology  Pathology  Manifestations

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 today’s population and to
Low- and Middle-income Countries continue to meet the needs of
future generations
10

The Global Goals

54
o No Poverty- end poverty in all its
36
forms everywhere
o Zero hunger- end hunger,
achieve food security and
improved nutrition and promote
Non-Communicable Communicable Disease sustainable agriculture
Injuries o Good Health and Well-being-
ensure healthy lives and promote
well-being for all at all ages
High-income Countries o Quality Education- ensure
6 inclusive and equitable quality
7 education and promote life-long
learning opportunities for all
o Gender Equality- achieve gender
equality and empower women
and girls
o Clean Water and Sanitation-
87 ensure availability and
sustainable management of
Non-Communicable Communicable Disease
water and sanitation for all
Injuries
o Affordable and Clean Energy-
Evolution of Development
ensure access to affordable,
reliable, sustainable modern
Economic (c 1940)  Social (c 1960) 
energy for all
Sustainable (c 1980)
o Decent Work and Economic
Growth- promote sustained,
o Economic- related productivity,
inclusive, and sustainable
allocation of resources and their
economic growth, full and
effects on man
productive employment and
o Social- development of a social
decent work for all
environment that favors the o Industry, Innovation and
construction of satisfactory
Infrastructure- build resilient
individual identities
infrastructure, promote inclusive
o Sustainable- growth must be both
and sustainable industrialization
inclusive and environmentally and foster innovation
sound to reduce poverty and
build shared prosperity for

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 o Reduced Inequalities- reduced
inequality within and among
country
o Sustainable Cities and
Communities- make cities and
human settlements inclusive,
safe, resilient and sustainable
o Responsible Consumption and
Production- ensure sustainable
consumption and production
patterns
o Climate Action- take urgent
action to combat climate change
and its impacts
o Life Below Water- conserve and
sustainably use the oceans,
seas, and marine resources for
sustainable development
o Life On Land- protect, restore,
and promote sustainable use of
terrestrial ecosystems,
sustainably manage forests,
combat decertification and halt
and reverse land degradation and
halt biodiversity loss
o Peace, Justice and Strong
Institutions- promote peaceful
and inclusive societies for
sustainable development, provide
access to justice for all and build
effective, accountable, and
inclusive institutions at all levels
o Partnerships for the Goals-
strengthen the means of
implementation and revitalize the
global partnership for sustainable
development
Philippine Health Agenda (2016-2022)
“All For Health towards Health For All”
Goals
o Financial Protection- Filipinos,
especially the poor,
marginalized, and vulnerable
are protected from high cost of
health care
o Better Health Outcomes-
Filipinos attain the best possible
health outcomes with no
disparity
o Responsiveness- Filipinos feel
respected, valued, and
empowered in all of their
interaction with health system
Persistent Inequities in Health
Outcomes
o 2000- every year 2000 mothers
die due to pregnancy-related
complications
o A Filipino born to the poorest
family is 3 times more likely to not
reach his 5th birthday, compared
to one child born in richest family
o 3 out 10 children are stunted
Restrictive and Impoverishing
Healthcare Costs
o Every year 1.5 million families are
pushed to poverty due to
healthcare expenditures
o Filipinos forego or delay care due
to prohibitive and unpredictable
user fees or co-payments
o 4000 a month healthcare
expenses considered
catastrophic for single income
families
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Poor quality and undignified care Triple burden of Disease:
synonymous with public clinic and 1. Communicable- HIV/AIDS,
hospitals Malaria, TB, Disease for
Elimination, Dengue,
o Long wait times Leptospirosis, Ebola, Zika
o Limited autonomy to choose 2. Non-communicable- Cancer,
provider Diabetes, Heart Disease, and
o Less than hygienic restrooms, their Risk Factors- obesity,
lacking amenities smoking, diet, Sedentary lifestyle,
o Privacy and confidentiality taken Malnutrition
lightly 3. Disease of Rapid Urbanization
o Poor record-keeping and Industrialization- Injuries,
o Overcrowding and under Substance Abuse, Mental Illness,
Pandemics, Travel Medicine,
provision of care
Health Consequences of Climate
Change/ Disaster
Values
o Guarantee 2- Services are
o Sustainability
Delivered
o Transparency
o Resilience
Services:
o Accountability
1. Fully functional
o Quality 2. Compliant with Clinical Practice
o Efficiency Guidelines
o Equity 3. Available 24/7 & even during
Disasters
4. Practicing Gatekeeping
5. Located close to the People
6. Enhanced by Telemedicine

3 Guarantees o Guarantee 3- Services are

financed predominantly by
o Guarantee 1- All Life Stages and PhilHealth
Triple Burden of Disease
1. 100% of Filipinos are
Life Stages: members
1. Pregnant 2. Formal Sector premium paid
2. Newborn through payroll
3. Infant 3. Non-formal Sector premium
4. Child paid through tax subsidy
5. Adolescent 4. No balance billing the
6. Adults poor/basic accommodation
7. Elderly

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 and fixed co-payments for
non-basic accommodation
5. Expand benefits to cover
comprehensive range of
services
6. Contracting networks of
providers within SDNs

Strategy

o Advance quality, health

promotion, and primary care
o Cover all Filipinos against health-
related financial risk
o Harness the power of strategic
HRH development
o Invest in eHealth and data for
decision-making
o Enforce standards, accountability
and transparency
o Value all clients and patients,
especially the poor, marginalized
and vulnerable
o Elicit multi-sectoral and multi-
stakeholder support for health

Problem Tree Analysis- is a pictorial

representation of a problem, its causes
and its consequences

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