Quizzes Midterms Merged

Flight range is 50-300 kilometers
MODULE 5 DENGUE PREVENTION
1. These are living organisms that transmit

infectious diseases between humans or from 4. The following are TRUE indications/
animal to human. * manifestations of the Febrile Phase of dengue
infection, EXCEPT *
Pathogen
A. Usually last 2-7 days

Vector
B. Result of 20,000 WBC per microliter

Reservoir
C. Positive of Herman’s Sign

Microorganisms
D. Presence of myalgia, diarrhea, and vomiting

None of the above
E. None of the above

2. The following are TRUE about dengue infection,
EXCEPT * 5. Hypervolemia is a usual clinical problem
during what phase of dengue infection? *
It is an acute viral infection with no definitive

anti-viral treatment. Febrile Phase
It has four serotypes (DENV1, DENV2, DENV3, Critical Phase

and DEV4).
Recovery Phase
Infection to one serotype will mean a lifetime
infection to that serotype. None of the above
It is possible for a human to get infected four All of the above

times with dengue.
None of the above. 6. The following are TRUE about the Critical
Phase of dengue infection, EXCEPT. *
.3. The following are TRUE about the Aedes
Mosquito, EXCEPT. *
Patients can either improve of deteriorate.
Life span of 20-30 days

Those who will improve after defervescence
can be categorized as Dengue with Warning
Flight range is 50-300 kilometers Signs.
It takes 7-10 days for an egg to develop into an Warning signs include: mucosal bleeding,
adult mosquito lethargy, and/or persistent vomiting.
It can also be a vector for zika virus and When warning signs occur, severe dengue may
chikungunya virus follow.
None of the above None of the above

7. In dengue, the fever pattern breaking and then
returning for 1 or 2 more days after is called as 10. In the case of #9, what management group
______. * and intervention he should be given? *
a. Saddleback fever Group A: Referred for in hospital care
b. Biphasic Fever Group B: Referred for in Hospital Care
c. Relapsing Fever Group C: Referred for in hospital care
Both a and b Group C: Require emergency treatment
Both a and c Group D: Require emergency treatment
8. Ambrocio is a 70 year-old dengue patient with 11. The following are home care management
no warning signs. What management intervention interventions of dengue, EXCEPT.
should he be given? *
Adequate bed rest
Refer for in-hospital care.
Increase and strict intake of plain water only
May be sent home.
Non-prescription of aspirin.
Require Emergency treatment.
Tepid sponge bath
Refer to barangay health station.
None of the above
None of the above.
12. Conrado is a 7 years old, 22 kg, dengue patient,

9. Gordon had the following clinical parameters: needing oral rehydration fluids. Per Barnes and
(+) history of travel from an endemic area of Young Method, how many ml per day is
dengue, with 3 days fever, rash, and myalgia. He recommended? *
also has abdominal pain and persistent vomiting.
To date, melena and hematuria also noted. What 2,200 ml per day
category of dengue infection he is in? *
1,650 ml per day
Dengue without warning signs

1,320 ml per day
Dengue with warning signs

880 ml per day
Severe dengue
None of the above
Dengue with critical signs

13. Alvin is a 29 years old, 54 kg, dengue patient,
None of the above needing oral rehydration fluids. Per Barnes and
Young Method, how many ml per day is 16. This is a molecular based confirmatory test
recommended? * for dengue, available in sub-national and national
reference laboratories. *
5400 ml per day
Polymerase Chain Reaction
4,050 ml per day
Plaque Reduction Neutralization Test
1,500 ml per day
Dengue IgM
2,430 ml per day
Dengue NS1 RDT
None of the above
None of the above
14. 3,000 ml per day is prescribed to Calvin, a 30
year old, 60 kg dengue patient. How many cups of 17. The following are TRUE about dengue
homemade ORS should be given in a day? * diagnostic modalities, EXCEPT. *
10 cups Dengue IgM may cross react with Zika Virus

Infection.
15 cups
Dengue NS1 RDT shall be requested after five
days.
20 cups
Plaque Reduction Neutralization Test is the

25 cups gold standard to characterize and quantify
circulating level of anti-DENV neutralizing
antibody.
30 cups
All of the above
None of the above

15. It is as a triage tool to differentiate dengue
patients and can be used as a marker of capillary 18. This is an enhanced surveillance system that
fragility. * monitors notifiable diseases and other health-
related events of public health importance in an
Mucosal Bleeding
integrated approach. *
Petechiae
Vaccine Preventable Diseases Surveillance
Torniquet Test
Philippine Integrated Disease Syndrome and
Response
Capillary Test
Events Based Surveillance

None of the above
Philippine Integrated Disease Surveillance and

Response
Entomological Based Surveillance None of the above
19. A PIDSR case classification, where there is a QUESTION 22-24 DATA: -Suspect cases: 3,200;
verification by a laboratory confirmation. * Suspect cases deaths: 50; Probable cases: 1,200;
Probable Cases deaths: 20; Confirmed Cases: 50;
Suspect Confirmed cases deaths: 10; Total Population:
245,000
Probable
Confirmed 22. Compute for Morbidity Rate *
Susceptible
1,816 cases per 10,000 population
None of the above

1,816 cases per 100,000 population
20. The following are TRUE about the PIDSR Case 510 cases per 10,000 population
Classifications and reporting, EXCEPT. *

510 cases per 100,000 population
Suspect cases are those indicative of clinical

picture without being probable or confirmed. 51 cases per 100 population
Probable classification is not applicable to all 23. Compute for Mortality Rate. *
diseases.
12 deaths per 100,000 population
This is the official reporting of dengue vector-
based surveillance.
Dengue is a Category 2 Notifiable Disease,

reported weekly. 12 deaths per 10,000 population
All of the above 33 deaths per 10,000 population

21. Harvey has a positive dengue NS1 result as
done in the rural health unit. What is the case
24. Compute for Case Fatality Rate. *
classification per PIDSR? *
2.4 deaths per 100 population
1/1
2.4 deaths per 1,000 population
Suspect
6.4 deaths per 100 population
Probable
6.4 deaths per 1,000 population
Confirmed
25. The following are FALSE about the objectives
Critical of the dengue program, EXCEPT. *
A dengue-free Philippines
28. Targeted indoor residual spraying should be
To reduce dengue morbidity by at least 25% by done at what frequency?

2024
1 cycle per year
To reduce dengue mortality by at least 50% by
2022
2 cycles per year
To maintain dengue case fatality rate to <2%

every year 3 cycles per year
Ensure healthy lives and promote well-being 4 cycles per year

for all at all ages.
5 cycles per year
26. This is the occurrence of 2 or more dengue

cases in a barangay for the past two morbidity 29. The following are TRUE about the HIV
weeks. * Program, EXCEPT. *
Clustering Republic Act 8504 is also known as National

HIV and AIDS Policy Act of 2018.
Hotspot
HIV Treatment is free nation-wide.
Outbreak
HIV can be transmitted through infected
mother to child transmission during pregnancy,
Epidemic labor, delivery, and breastfeeding.
None of the above HIV cannot be transmitted through the

following casual contacts: hugging, sharing of
utensils, and/or shaking hands.
27. The following are TRUE about the
interventions for ENHANCED 4S Strategy, None of the above.
EXCEPT. *
30. In the Philippines, anti-retroviral therapy is
Seek early consultation available for free in what type/s of facilities? *
Reactivation of the 4 o'clock habit HIV Treatment Facilities
Wearing of dark colored clothing and long HIV Treatment Hubs

sleeves.
Primary HIV Care Clinics

Fogging in areas where increase in cases is
registered for two consecutive weeks to
prevent impeding outbreak All of the above
Application of insect repellant on uncovered None of the above.

skin area.
MODULE 6 AND 7 MH GAP AND ORAL HEALTH

Dementia
1. The following are TRUE about Mental
Schizophrenia
Health Gap Action Program (MHGAP),
EXCEPT: * Epilepsy
Paraphilia
MHGAP Implementation was initiated by WHO None of the above
in 2008.
This programme is grounded on the best 5. This is a non-fatal, potentially injurious

available scientific and epidemiological
evidence on priority conditions. behavior directed against the self with an
intent to die as a result of the behavior. *
WHO’s action plan to scale up services for
mental, neurological and substance use
disorders for countries especially with high
Suicidal intent
income countries.
Suicidal attempt
The mhGAP package consists of interventions
for prevention and management for each of Suicide
these priority conditions.
Suicidal bereaved
All of the above
None of the above
None of the above
6. Nurse Anna knows that the term used for

2. The following are the priority conditions for
death caused by an intentional act of self harm
MHGAP, EXCEPT: *
designed to be lethal is called _______.
Depression
Suicidal intent
Schizophrenia and other psychotic disorders
Suicide
Suicide
Suicide attempt
Disorders due to use of alcohol
Suicidal loss survivor
None of the above
None of the above
3. Nurse Cora knows that the following are
7. Per MHGAP priority conditions, Nurse
true about the advocacy calendar for mental
Trisha catered for a 90-year old client with
health, EXCEPT: *
impaired ability to remember, think, or make
September 10 - World Suicide Prevention Day decisions. This is a possible case of ________. *
November 10 -World Mental Health Day

Epilepsy
2nd Week of October - National Mental Week
Amnesia
All of the above
Dementia
None of the above
Psychotic disorders
4. Nurse Albert knows that the referred None of the above
patient from the community after assessment
8. The following are considered as illicit drugs
as characterized by distortions in thinking,
in the Philippines, EXCEPT *
perception, language, sense of self, and
behavior is a possible case of _________. *
Alcohol None of the above
Heroin All of the above
Marijuana
13. The following are conditions to consider
Metamphetamine Hydrochloride
from agitated and/or aggressive behavior,
None of the above EXCEPT *
9. This is a common condition that affects the

Dementia
brain and causes frequent seizures. This is
Psychosis
called _____. *
Disorders due to substance abuse
Schizophrenia Epilepsy
Dementia None of the above
Disorders due to alcohol

14. The following are are about
Epilepsy
TUBERCULOSIS, EXCEPT: *
None of the above
Symptom screening using any of the four
10. Nurse Albert knows that the Mental Health cardinal signs and symptoms shall be the
primary screening tool for systematic
Act of 2018 is also known as ___________. *
screening in health facilities amongst all
consults.
RA 10136 Direct Sputum Smear Microscopy is a sensitive
and fully automated rapid test that detects
RA 11036
Mycobacterium tuberculosis and rifampicin
RA 31106 resistance. It also serves as the primary
diagnostic tool for TB.
RA 63110
TB is not hereditary.
None of the above
TB treatment is free.
11. The following are emergency None of the above
presentations of suicide, EXCEPT: *

15. The only contraindication to collecting
sputum for bacteriological diagnosis of TB is
Act of self harm with signs of poisoning or
intoxication _____. *
Bleeding from self-inflicted wound
Massive hemoptysis
Current thoughts, plan or act of suicide
Blood-streaked sputum
Aggressive behavior
Night sweats
None of the above
Coughing
12. Per MHGAP, the following are evidenced-
None of the above
based interventions for depression, EXCEPT *
16. Attainment of improved quality of life
Treatment with anti-depressants through the promotion of oral health and
Psychosocial interventions quality oral health care is the _________ of the
Treatment with antipsychotic program. *

Vision Oral hygiene
Mission Fluoride utilization program
Goal Drainage of localized oral abscess
Objective None of the above
None of the above

21. Nurse Bless conducted a toothbrushing
17. Republic Act 9484 is also called as demonstration for school-aged children
_________. * during the Oral Health Month Celebration in

the school she is working for. What month is
Philippine Dental Act of 1997 this celebrated? *
Philippine Dental Act of 2007
January
Philippine Dental Act of 2017
February
Philippine Policy on Dental Program of 2007
March
Philippine Policy on Dental Program of 2017
April
18. The most common oral health illnesses of
May
the Filipinos are ___________. *
22. This is the treatment of deep seated tooth
Dental caries and oral thrush decay with zinc oxide and eugenol. *
Gingivitis and dental caries
Permanent Feeling
Tooth decay and periodontal diseases
Flouridation
Gum disease and stomatitis
Gum treatment
None of the above
Temporary Filling
19. Nurse Bong knows that the non-invasive
None of the above
prevention and control measure against tooth
decay for children, where a protective plastic 23. The following are curative services of oral
coating is applied to the biting surfaces of the health interventions, EXCEPT: *
back teeth is called ___________. *

Gum treatment
Oral hygiene Pit and fissure sealant
Pit and fissure sealant Extraction
Flouride utilization program Atraumatic restorative treatment
Oral Hygiene All of the above
None of the above

24. This is one form of permanent filling for
20. The following are preventive services for priority target groups by manually cleaning
oral interventions, EXCEPT: * dental cavities using hand instruments and

filling the cavities with fluoride releasing
Oral examination glass ionomer restorative materials.
Temporary Filling 12-15 month
Permanent Filling 15-18 months
Extraction
27. The following are basic oral health
Atraumatic Restorative Treatment
packages for pregnant clients, EXCEPT: *
None of the above
Breastfeeding the client
25. The following are basic oral health
Temporary filling
packages for infants, EXCEPT *
Permanent filling
Oral examination Gum treatment
Topical flouride application None of the above
Dental consultation
This is the restoration of savable teeth with
Temporary filling
amalgam, composite or glass filling
26. How long is the treatment for a patient materials. *
infected with TB bacteria that is fully

Permanent filling
susceptible? *
Temporary filling
3-6 month Gum Treatment
6-12 months Root canal
6-9 months None of the above
MODULE 8 AND 9 AHD AND WCPP

Nurse Aldrin knew that adolescence Sexual and Reproductive Health
(according to the Philippine Pediatric Society)
is divided into the following periods,
EXCEPT: * None of the above
Early adolescence: 10-13 years old

The following are FALSE about the Adolescent
Middle adolescence: 14-16 years Health and Development Program, EXCEPT:
Late adolescence: 17-19 years

Goal: To improve the health status of the
adolescent and to enable them to fully enjoy
None of the above their right to health
Vision: To ensure that all adolescents have

The following are risk factor/s to health of access to quality comprehensive health care
and services in an adolescent-friendly facility
adolescents in the Philippines, EXCEPT: *
Mission: A country with well-informed,

Violence empowered, and responsible adolescent who
are leaders of society
Alcohol, Tobacco, and Illegal Substances
All of the above
Environmental Health
None of the above
Per the logical framework of AHDP, the following The following are FALSE about the program goal
are prevention services offered to the adolescent per sub-group of adolescent, EXCEPT *
population, EXCEPT: *
Not sexually active: prevent rapid repeat of
pregnancy
Health Promotion
Pregnant or with children: protect from HIV

Health Education and unplanned pregnancy
Case Management Sexually active: delay sexual activity
Vaccinations None of above
None of the above

The following are program components of the
AHDP, EXCEPT *
According to the AHDP Logical framework, the
following are behavioral outcomes for
Mental Health
prevention services, EXCEPT:
Tobacco Control
Increase knowledge
Violence and Injury Prevention
Avoid risky behaviors
HIV/STIs
Practice protective behaviors
Rabies
Adhere to rehabilitative services
Nurse Allen knew that the following are TRUE

None of the above
about public health laws related to
adolescents in the Philippines, EXCEPT: *
Compute the adolescent birthrate of LGU-
Marigonda with the ff data: a. total population of
RA 11166 allows 15 years old and above access
15-19 years old: 10,000, live births among 10-19 HIV Testing Services without parent's consent
live births: 30, live births among 15-19 : 20, Total

RA 10361 defines criminal age of liability at 16
population: 200,000 * years old and above
2 per 10,000 population RA 7658 prohibits employment of children

under 15 years old
2 per 1,000 population

None of the above

The following are TRUE about LINGGO ng
KABATAAN, EXCEPT: *
None of the above

It is promulgated per Proclamation 99 series of
1992
It is celebrated within the week where August Field Health Service Information System
12 falls
IHBSS
This is to coincide with the International
Adolescent Day
Philippine Health Statistics
None of the above

The following are TRUE about the National
This is a tool for psychosocial history and Nutrition Survey, EXCEPT *
assessment of adolescents. *
It is primarily spearheaded by National
Nutrition Council.
HEEADSSS Tool
It is the key data source for nutrition-related

Adolescent Suicide Tool information
MHGAP Adolescent Tool It is conducted every 5 years
Healthy Young Ones Psychosocial Tool None of the above
None of the above

An act defining violence against women and
their children, providing for protective
The following are true about ADOLESCENT
measures for victims, prescribing penalties
FRIENDLY FACILITIES, EXCEPT *
therefore, and for other purposes. This refers
to: *
There are four national standards for
adolescent friendly facilities
RA 9226
There are three levels of compliance to
standards (Level I-IV) RA 2692
Standards for level of compliance are per DM RA 9622

2017-0098.
RA 6229
None of the above
None of the above

This is the country's primary source of
information on sexual and non sexual risk Nini, a 35 year old businesswoman who got
behaviors and its determinants. * separated to her husband because of adultery.
She has 2 children who resides at her husband.
1/1 Nini plans to visit her children once a week

but her husband deprives to have an access to
Young Adult Fertility and Sexuality Survey her children. The husband exercises: *
System
YAFSS Physical violence

Psychological violence Lesbian girlfriends/partners or ex partners
Economic Abuse Any person with whom the woman has/had a

sexual or dating relationship
Sexual violence
Protection Order describes the following
Social violence
EXCEPT: *
Prostituting the child and woman is an Prevent further acts of violence against a
woman or her child
example of: *
Basis for woman and child for filing criminal

Physical Violence case
Economic Abuse Safeguard the victim from further harm,

minimizing disruption in victim’s daily life
Psychological violence
Give her the opportunity and ability to regain
control over her life.
Sexual Violence
None of the above

Social Violence
Rosie is asking her husband the reason why What kind of protection order is issued by the
she is not allowing or giving her opportunity court? *
to work in line with her chosen profession

A. BPO
without any valid reason. This is an example
of: * B. TPO
Physical violence C. PPO
Economic abuse D. A and B
Psychological violence E. B and C
Sexual violence
The following are TRUE about PROTECTION
Social Violence ORDERS, EXCEPT: *
Barangay Protection Order: Effective for 15

The following people can be liable on VAWC, days only
EXCEPT: *
Temporary Protection Order: Effective for 30
days; extendible
Husband
Permanent Protection Order: 30 years

Boyfriend
None of the above

Brother
Food Insecurity is the state of being without
Mutilation is an example of: * reliable access to a sufficient quantity of
affordable, nutritious food.
Physical violence All of the above
None of the above

Sexual violence
The following are TRUE about the concepts of

Economic violence
FOOD INSECURITY, EXCEPT: *
Psychological violence
Type of food insecurity based on time period
are as follows: mild, moderate, and severe
Social Violence
Transitory food insecurity is a short-term and
temporary condition.
In the absence of the Barangay Captain, a
Chronic food insecurity is long-term and
barangay kawagad can file a BPO. * persistent condition of food insecurity.
Seasonal food insecurity is a type of food

True insecurity that reoccurs predictably, following
the cyclical pattern of seasons
False None of the above
Other:
The following may file PROTECTION ORDERS,
EXCEPT: *
The following information are TRUE about the
At least 1 citizen of the city or municipality Presidential Decree 491, EXCEPT: *

who have personal knowledge of the offense
This is also known as Nutrition Act of the

Social worker Philippines.
This is an administrative issuance creating

Parent National Nutrition Council, which is the
country's highest direct service delivery
implementation unit on nutrition.
Ascendants
This declared nutrition as a priority of the
Police Officer government.
This designated July as a Nutrition Month.

MODULE 10 NUTRITION
None of the above
The following are TRUE about FOOD SECURITY, This is the law which mandates the scaling up
EXCEPT: * of interventions and services in the first 1000

days. *
Food Security Components: Food Availability,
Food Access, Food Utilization, and Food
RA 11148
Stability
RA 11184
Food Security is the state in which poor people
at all times has both physical and psychosocial RA 11149
access to sufficient food to meet their dietary
needs for a productive and healthy life. RA 11194
RA 11150 This is also known as the Adoption and
Implementation of the PPAN 2017-2022.
Nurse John knows that _____________ is the This designated Nutrition and Action Officer as
cellular imbalance between the supply of implementers of PPAN and LNAP.
nutrients and energy and the body's demand This organized Local Nutrition Committees.
for them to ensure growth, maintenance, and This includes provision of incentives to
members of local nutrition committees
specific functions. *
None of the above
Avitaminosis
This is an act institutionalizing a national
Malabsorption
feeding program for undernourished children
Malnutrition in public day care, kindergarten and
Overweight elementary schools to combat hunger and
All of the above undernutrition among Filipino children and
appropriate funds *
Nurse Albert knows that the following are
TRUE about the types/ broad groups of
a. RA 11307
malnutrition conditions, EXCEPT: *
b. Masustansyang Pagkain para sa Batang
Pilipino Act
overweight, obesity and diet-related
c. RA 11037
noncommunicable diseases
Either a or b
micronutrient-related malnutrition, which
includes micronutrient deficiencies (a lack of Either b or c
important vitamins and minerals) or
micronutrient excess
The following are TRUE about the components
undernutrition, which includes stunting (low
weight-for-height), wasting (low height-for-age) of the National Feeding Program, EXCEPT: *
and underweight (low weight-for-age)
All of the above Supplemental Feeding Program for Day Care

Children shall be under the DSWD covering
None of the above undernourished children aged 3-5 years old
School-Based Feeding Program shall be under

Nurse Joan reiterated that the term used when the DepEd, covering undernourished
a person is too heavy for his or her height kindergarten to grade 12
is/are called as __________. * This includes Gulayan sa Paaralan as the

strategy of cultivating vegetables and other
nutrient rich plants.
a. Overweight
All of the above
b. Obsesity
None of the aove
c. Reverse Wasting
The following are TRUE about DSWD
Both a and b
Supplementary Feeding Program per AO 3
Both a and c
series of 2017, EXCEPT: *
DILG Memorandum Circular 2018-42 has the
following stipulations, EXCEPT: * One of the target beneficiaries are 2-4 year old
children in Supervised Neighborhood Play
The feeding shall be implemented thrice a day
for a minimum of 7days for a period of pregnancy with 1st born reported to have
120days. The food allocation is P30 per child anencephaly, should have a recommended
per day.
folic acid regimen of __________. *
The food allocation is P30 per child per day.
None of the above 4 grams daily

All of the above 4 mg daily
The following are TRUE about the concepts 4 mcg daily
and utilization of the micronutrient powder in 4 cg daily
the Philippines, EXCEPT: * None of the above
The following are TRUE about food

Do not mix MNP with hot meals.
fortification, EXCEPT *
Prepare food the baby can consume.
Do not directly feed MNP to the baby.

R.A. 8976 is also known as Food Fortification
The MNP is a powder mix containing 12 Law
vitamins and minerals.
Mandatory Fortification: Rice with Iron
None of the above
Mandatory Fortification: Refined Sugar with
Iodine
Baby Albert is a 10-month old infant for
National Food Fortification Day is November 7
Vitamin A Supplementation, what dosage is
recommended? * This is a strategy to encourage food
manufacturer to fortify processed foods or
50,000 IU single dose food products with essential nutrients at a
100,000 IU single dose level approved by the DOH. *
150,000 IU single dose
Malusog na Bayan Program
Sangkap Pinoy Seal Program
Healthy Food Program
Nurse Elizabeth knows that her 25-year old
Pinggang Pinoy
pregnant client, currently at 4th month of
None of the above
pregnancy is for Vitamin A Supplementation
should have _____________________ as the As a CHN, the following are the important key
recommended regimen. * messages about nutrition, EXCEPT: *
1,000 IU twice a week until delivery Eat a variety of healthy food everyday.
10,000 IU twice a week until delivery Prepare nutrient and anti-oxidant rich
beverages.
100,000 IU twice a week until delivery
Encourage consumption of processed food.
200,000 IU twice a week until delivery
Exercise regularly.
Nurse Joana knows that her 29-year old None of the above
pregnant client, currently at 6th month of
The following are the qualifications for a This is a term used to describe xerophthalmia
BARANGAY NUTRITION SCHOLAR, EXCEPT: * and keratomalacia, or corneal necrosis,
caused by vitamin A deficiency. *
Bonafide resident of the barangay for at least
four years and can speak the local language
Nutritional Blindness
At least elementary graduate but preferably
has reached high school level Night Blindness
More than 18 years old, but younger than 60 Astigmatism

years old
Cretinocorneatitis
Physically and mentally fit
None of the above
None of the above
Case: As a recommended regimen, the
This is a severe form of protein-energy treatment (high dose Vitamin a Capsule) of
malnutrition that results when a person does xerophthalmia for a 16th month old client is
not consume enough protein and calories. * __________________ . *
Marasmus 50,000 IU: One capsule today, One capsule

tomorrow, One capsule after two weeks
Kwashiorkor
100,000 IU: One capsule today, One capsule
Stunting
tomorrow, One capsule after two weeks
Overweight
None of the above tomorrow, One capsule after two weeks

The following are manifestations of tomorrow, One capsule after two weeks
MARASMUS, EXCEPT: * None of the above
Alert and Irritable The following are the manifestations of Iron

Deficiency Anemia, EXCEPT: *
Ribs become very prominent
Voracious Feeder
Weakness
Severe muscle wasting
Shortness of Breath
None of the above
Pallor
The following are manifestations of Warm hands or feet

KWASHIORKOR, EXCEPT: * None of the above
Edema is Present The following concepts are TRUE about Iodine

Deficiency, EXCEPT: *
Subcutaneous fat is preserved
No fatty liver
Treatment of women 15 to 45 years old to take
Lethargic one iodized capsule with 200mg iodine every
year
None of the above
Treatment of school age children to take one
iodized capsule with 200mg iodine every year
Manifestations: dry skin, diarrhea, goiter, and
impaired memory
90% of iodine sources is coming from food and

10% from water
None of the above

Module No. 5:
National Dengue Prevention and Control Program-
Philippine Aedes Borne Viral Diseases
Prevention and Control Program
JOSEPH MICHAEL D. MANLUTAC, RN, MPH

Clinical Instructor
NCM 104
DESIRED LEARNING OUTCOMES
• Identified the associated concepts on dengue.
• Distinguished case classification, phases and level of severity

of dengue infection.
• Determine the overview of dengue management.
• Discuss the Dengue Prevention and Control Program (thrusts

and strategies).
Dengue
o An acute viral infection that affects mostly young children and adults
whole year-round.
o Transmitted through a bite of dengue infected female Aedes mosquitoes.
Source of Infection
o Aedes aegypti or the common household mosquito. Also transmitted by
Aedes Albopictus.
o Infected person in whose blood the virus stays during the acute phase of
the disease, thus, the infected act as a reservoir of the virus.
Characteristics of the Aedes Mosquito
• Peak biting time:
• 2 hours after sunrise and 2 hours before sunset
• Flight range: 50-300 meters from the breeding sites
• Lives for 20-30 days.
• If Aedes mosquito carries dengue virus, it will carry
the virus until lifetime.
• It takes 7-10 days for an egg to develop into an adult
mosquito.
• Aedes aegypti: has fine white spots at the base of the
wings and white bands on the legs, day biting.
• It also is the vector for Zika Virus and Chikungunya
Virus Infection.
Dengue is the fastest spreading vector-borne disease in the world
endemic in 100 countries·
• Dengue virus has four serotypes (DENV1, DENV2, DENV3 and
DENV4).
• First infection with one of the four serotypes usually is non-severe or
asymptomatic, while second
infection with one of other serotypes may cause severe dengue.
• Dengue has no definitive treatment, but the disease can be early
managed.
INCUBATION PERIOD
• Uncertain, probably 6 days to one week
COURSE OF DENGUE INFECTION
A. FEBRILE PHASE
• Usually last 2-7 days.
• Mild haemorrhagic manifestations like petechiae and mucosal
membrane bleeding (e.g nose and gums) may be seen.
• Monitoring of warning signs is crucial to recognize its progression to
critical phase.
• Clinical signs and symptoms: fever, headache, body malaise, myalgia,
arthralgia, retro-orbital pain, anorexia, nausea, vomiting, diarrhea,
flushed skin, rash (petechial, Hermann’s sign).
• Laboratory: CBC (leukopenia with or without thrombocytopenia),
and/or Dengue NS1 antigen test or dengue IgM antibody test
(optional)
HOW TO DO TOURNIQUET TEST?
• TT is a marker of capillary fragility and it can be
used as a triage tool to differentiate patients
1. Take the patient's blood pressure (i.e. BP 100/70)

2. Inflate the cuff to a point midway between SBP and DBP @ 85 mm
Hg maintain for 3-5 minutes. [(100 + 70) ÷ 2 = 85 mm Hg]
3. Slowly reduce the cuff and wait 2 minutes.
4. Count petechiae below antecubital fossa.
❖ A positive test is 10 or more petechiae per 1 square inch.
❖ TT is more likely to be positive near time of defervescence.
❖ Less likely to be positive in patients with shock
@talea211md10/04/18
B. CRITICAL PHASE
• Phase when patient can either improve or deteriorate.
• Defervescence occurs between 3 to 7 days of illness. Defervescence is known as the period in
which the body temperature (fever) drops to almost normal (between 37.5 to 38°C).
• Those who will improve after defervescence will be categorized as Dengue without Warning
Signs, while those who will deteriorate will manifest warning signs and will be categorized as
Dengue with Warning Signs or some may progress to Severe Dengue.
• When warning signs occurs, severe dengue may follow near the time of defervescence which
usually happens between 24 to 48 hours.
• Warning Signs: abdominal pain or tenderness, persistent vomiting, clinical signs of fluid
accumulation, mucosal bleeding, lethargy, restlessness, liver enlargement Laboratory: increase
hematocrit and/or decreasing platelet
• Severe Dengue: (1) plasma leakage that may lead to shock (dengue shock) and/or fluid
accumulation, with or without respiratory distress, and/or (2) severe bleeding, and/or (3) severe
organ impairment
C. RECOVERY PHASE
• Happens in the next 48 to 72 hours in which the body fluids
go back to normal. Patients’ general well-being improves.
• Some patients may have classical rash of “isles of white in
the sea of red”.
• The White Blood Cell (WBC) usually starts to rise soon after
defervescence, but the normalization of platelet counts
typically happens later than that of WBC.
Clinical Problems encountered during the different phases of
dengue are:
• Febrile phase: dehydration; high fever may cause febrile
seizures in young children; neurological disturbances
• Critical phase: shock form plasma leakage; severe hemorrhage;

organ impairment
• Recovery phase: hypervolemia (only if IV therapy has been

excessive and/or extended)
DISCHARGE CRITERIA
• No fever for 24 – 48 hours
• Improvement in clinical status (general well being, appetite,

hemodynamic status, urine output, no respiratory distress)
• Increasing trend of platelet count (usually preceded by

rising WBC)
• Stable hematocrit without intravenous fluids

HOME CARE MANAGEMENT FOR DENGUE
What should be done?

• Adequate bed rest
• Adequate fluid intake (> 5 glasses for average-sized adult & accordingly in children)
– Milk, fruit juice (caution with diabetes patient) and isotonic electrolyte solution (ORS) and barley/rice
water/clear soup
– Plain water alone may cause electrolyte imbalance
• Take Paracetamol
• Tepid sponging
• Look for mosquito breeding places in and around the home and eliminate them
• Do not take steroids or NSAIDS e.g. Acetyl-salicylic acid (aspirin), Mefenemic acid (Ponstan), Voltaren tablets,
injections or suppositories
Calculation of Oral Rehydration Fluids Using Weight (Barnes and Young Method)
Body Weight (kg) ORS to be given
> 3 – 10 100 ml/kg/day
> 10 – 20 75 ml/kg/day
> 20 – 30 50 – 60 ml/kg/day
> 30 – 60 40 – 50 ml/kg/day
Homemade ORS Recipe (WHO)
Ingredients:
• 1 Liter drinking water
• 1/2 tsp salt
• 6 tsp (white) sugar*
Procedure:
• Bring to boil 1 liter of drinking water.
• Mix the 1/2 tsp salt and 6 tsp sugar into the
water until completely
HOME CARE MANAGEMENT FOR DENGUE
If any of these are observed, seek medical attention immediately:

• Bleeding:
– Red spots or patches on the skin
– Bleeding from nose or gums
– Vomiting blood
– Black coloured stools
– Heavy menstruation / vaginal bleeding
• Frequent vomiting
• Severe abdominal pain
• Drowsiness, mental confusion or seizures
• Pale, cold or clammy hands and feet
• Difficulty in breathing
LABORATORY TESTS
Test Description
Requested between 1-5 days of illness. Not done after
five days of illness.
Use to detect dengue virus antigen during early phase
1. Dengue NS1 RDT ofacute dengue infection
Test is for free in all health centers and selected public

hospitals nationwide
Requested beyond five days of illness
Use to detect dengue antibodies during acute late
stage of dengue infection (IgM) and to determine
previous infection
(IgG)
2. Dengue IgM/IgG May give false positive result due to antibodies
induced by dengue vaccine
May cross react with other arboviral diseases such as

Chikungunya and Zika
DOH augmentation is limited to selected government

hospitals only
LABORATORY TESTS
One of the gold standard laboratory tests to confirm dengue
virus.
3. Polymerase Chain Reaction (PCR) Molecular based test confirmatory test
Available only in dengue sub-national and national reference
laboratories
A novel molecular-based confirmatory test used to detect
4. Nucleic Acid Amplification Test- Loop Mediated dengue virus.
Isothermal Amplification Assay (NAAT-
Work just like PCR but cheaper and simpler in nature.
LAMP)
In the pipeline to be introduced under the National Dengue
Prevention and Control Program in district and provincial
Hospitals
5. Plaque Reduction Neutralization Test (PRNT) Gold standard to characterize and quantify circulating level
of anti-DENV neutralizing antibody (NAb)
PHILIPPINE INTEGRATED DISEASE SURVEILLANCE AND RESPONSE
CASE CLASSIFICATION-official reporting system for human dengue data.
1. Suspect Dengue
Dengue Without Warning Signs: A previously well person with acute febrile illness of 2-7 days duration plus two of the
following: headache, body malaise, myalgia, arthralgia, retro-orbital pain, anorexia, nausea, vomiting, diarrhea, flushed
skin, rash (petechial, Herman’s sign)
Dengue with Warning Signs: A previously well person with acute febrile illness of 2-7 days duration plus any one of the
following: abdominal pain or tenderness, persistent vomiting, clinical signs of fluid accumulation, mucosal bleeding,
lethargy, restlessness, liver enlargement, laboratory: increase in HCT and/or decreasing platelet count.
Severe Dengue: A previously well person with acute febrile illness of 2-7 days duration and any of the clinical
manifestations for dengue with or without warning signs, plus any of the following:
a. Severe plasma leakage leading to
- Shock
- Fluid accumulation with respiratory distress
b. Severe bleeding
c. Severe organ impairment
- Liver: AST or ALT >1000
- CNS: e.g. seizures, impaired consciousness
- Heart: e.g. myocarditis
- Kidneys: e.g. renal failure
PHILIPPINE INTEGRATED DISEASE SURVEILLANCE AND
RESPONSE CASE CLASSIFICATION-official reporting system
for human dengue data.
2. Probable Case: A suspected case and with a Laboratory test result of a,

CBC with
leucopenia with or without thrombocytopenia and/or a positive Dengue
NS1, antigen test or dengue IgM antibody test or;
A suspected case and with leucopenia with or without thrombocytopenia
and/or positive Dengue NS1, antigen
test or positive dengue IgM antibody test.
3. Confirmed Case: A suspected case with positive results for: -Viral culture
isolation, and/or Polymerase Chain Reaction (PCR)
NATIONAL DENGUE PREVENTION AND CONTROL
PROGRAM
VISION MISSION GOAL OBJECTIVES
A Ensure healthy lives and To reduce the burden of To reduce dengue morbidity
promote well-being for all at dengue disease by at least 25% by 2022
Dengue-Free Philippines
all ages. To reduce dengue mortality
by at least 50% by 2022
To maintain case fatality
rate to <1% every year
NATIONAL DENGUE PREVENTION AND CONTROL
PROGRAM
Indicators:
Morbidity rate =
(No. of suspect, probable & confirmed cases/ total population) x 100,000
Mortality rate =
(No of dengue probable & confirmed deaths/ total population) x 100,000
Case Fatality Rate =

(No. of dengue probable & confirmed deaths/ no. of probable & confirmed cases ) x 100
PROGRAM COMPONENTS
1. Surveillance
• Case Surveillance through Philippine Integrated Disease Surveillance and Response (PIDSR)
• Laboratory-based surveillance/ virus surveillance through Research Institute for Tropical Medicine
(RITM) Department of Virology, as national reference laboratory, and sub-national reference
laboratories.
• Vector Surveillance through Centers for Health Development and RITM Department of Entomology
2. Case Management and Diagnosis

• Dengue Clinical Management Guidelines training for hospitals.
• Dengue NS1 RDT as forefont diagnosis at the health center/ RHU level.
• PCR as dengue confirmatory test available at the sub-national and national reference laboratories.
• NAAT-LAMP as one of confirmatory tests will be available at district hospitals, provincial hospitals
and DOH retained hospitals.
PROGRAM COMPONENTS
3. Integrated Vector Management (IVM)

• Is the rational decision- making process for the optimal use of
resources for vector control
• Training on Vector Management, Training on Basic
Entomology for Sanitary Inspector, Training on Integrated
Vector Management (IVM) for health workers.
Insecticide Treated Screens (ITS) as dengue control
strategy in schools.
PROGRAM COMPONENTS
4. Outbreak Response
• Continuous DOH augmentation of insecticides such as adulticides and larvicides to LGUs for outbreak
response.
Type of Dengue Occurrence
• Clustering: occurrence of 2 or more dengue cases in a barangay for the past two morbidity weeks
• Hotspot: clustering of dengue cases with increasing number in two consecutive weeks
• Outbreak: Cases exceeds the usual number reported in the area
• When to declare? Upon confirmation of an outbreak by the PESU/CESU/MESU. Person/s

responsible: Local Chief Executive, Local Health Office only if they have a functional surveillance
system. If none, the next higher level may provide the basis for outbreak declaration BUT declaring the
outbreak shall be the responsibility of the LGU. Inform the RESU of the outbreak declaration
PROGRAM COMPONENTS
5 . Research
What is Dengvaxia?
• CYD-TDV is the first dengue vaccine to be licensed. It was first licensed in Mexico in December 2015 followed
by Philippines thereafter for use in individuals 9-45 years of age living in endemic areas.
• CYD-TDV is a live recombinant tetravalent dengue vaccine developed by Sanofi Pasteur (CYD-TDV)
• Given as a 3-dose series on a 0-6-12 month schedule.
• Vaccine efficacy against confirmed dengue pooled across both trials was 59.2% in the year following the
primary series. During this initial data, pooled vaccine efficacy against severe dengue was 79.1%.
• Efficacy varied by serotype:
Serotype 1 (54.7%) Serotype 2 (43.0%)
Serotype 3 (71.6% ) Serotype 4 (76.9%)
PROGRAM COMPONENTS
▪ The new research suggests that the vaccine acts very much like a natural infection
but without making recipients sick.
▪ Those previously been infected with dengue (seropositive), the vaccine acts like a
silent second infection, stimulating the immune system without the more severe
symptoms that may accompany a natural second infection.
▪ Those not yet been infected with dengue (seronegative), the vaccine causes the
immune system to recognize that a first dengue infection has occurred and then when
exposed to dengue in a natural setting, the body reacts as if it is getting a second
infection that may be more severe.
▪ When limited to older age groups (ages included in the current licensure), pooled
vaccine efficacy amongst all participants aged 9 years or over was 65.6%, and in
participants aged <9 years it was only 44%.
6. Health Promotion and Advocacy
• Celebration of ASEAN Dengue Day every June 15
• Quad media advertisement IEC materials
ENHANCED 4S-STRATEGY
a. Search and destroy mosquito breeding sites (Suyurin at sirain ang pinamumugaran ng mga lamok)
• Vector control measures

• Regular clean-up drive and re-activation of “4 o’clock habit wherein daily at 4 o’clock in the afternoon of each and
every household will hav e to search for all water-holding containers and other breeding sites of mosquitoes to destroy.
• For any water holding container/area wherein it cannot be destroyed/ eliminated, the application of
biological/chemical larvicides shall be done.
b. Secure self-protection (Sarili ay protektahan laban sa mga lamok)
• Use of light colored clothing and long-sleeves top and long pants during daytime.
• Application of insect repellant on uncovered skin surface.
• Use of physical barrier such as window and door screens and/or insecticides treated curtains/screens.
c. Seek early consultation (Sumangguni agad sa pagamutan kapag may sintomas ng dengue)
ENHANCED 4S-STRATEGY
d. Support fogging/spraying only in hotspot areas where increase in cases is registered for two consecutive weeks to
prevent impending outbreak (Suportahan ang fogging/spraying operations kapag may banta ng outbreak)
• Objective of spraying is the massive, rapid destruction of the adult vector population.
• Spraying is recommended to prevent impending outbreak or to suppress an on-going epidemic.
• Targeted Indoor Residual Spraying (TIRS) – 3 cycles in a year
• Targeted Outdoor Residual Spraying (TORS) – 2-3 cycles in a year
HOME ACTIVITY
• Supplemental Program:
• National AIDS, STIs, and Viral Hepatitis Prevention and Control Program
• Watch the video (Basics of HIV and STIs) in this link:
https://tinyurl.com/HIVSTIBASICS
• After watching the video, answer the exam as home activity. You can take
the exam twice, whichever is higher will be your final score (15 points).
Note: screenshot your score.
• Do a minimum of 100-word reflection (prototype to be provided) about
the video (15 points), answering the question: As a future CHN, how can
I help with the HIV Program? Note: Attach the screenshot of your score
in the prototype to be shared.
QUESTIONS?
Module No. 6: Mental Health Gap
Action Program
• Define important terms related to the program.
• Discuss Mental Health Gap Action Program (mhGAP) all

about.
• Explain evidence-based interventions for each priority

conditions.
Mental Health
• “A state of well-being in which the individual realizes his or her own abilities, can
cope with the normal stresses of life, can work productively and fruitfully, and is
able to make a contribution to his or her community.” (World Health
Organization)
• Mental, neurological and substance use disorders are highly prevalent and
burdensome globally.
The gap between what is urgently needed and what is available to reduce the
burden is still very wide.
• World Health Organization recognizes the need for action to reduce the burden,
and to enhance the capacity of Member States to respond to this growing
challenges.
MENTAL HEALTH PROGRAM
•
Vision
• A society that promotes the well-being of all Filipinos, supported by transformative multi-sectoral partnerships,
comprehensive mental health policies and programs, and a responsive service delivery network
• Mission
• To promote over-all wellness of all Filipinos, prevent mental, psychosocial, and neurologic disorders,
substance abuse and other forms of addiction, and reduce burden of disease by improving access to quality
care and recovery in order to attain the highest possible level of health to participate fully in society.
• Objectives
1. To promote participatory governance and leadership in mental health
2. To strengthen coverage of mental health services through multi-sectoral partnership to provide high quality
service aiming at best patient experience in a responsive service delivery network
3. To harness capacities of LGUs and organized groups to implement promotive and preventive interventions on
mental health
4. To leverage quality data and research evidence for mental health
5. To set standards for compliance in different aspects of services
Enabling Law
Republic Act No. 11036 Mental Health Act (2018)
"An Act Establishing a National Mental Health Policy for the Purpose of
Enhancing the Delivery of Integrated Mental Health Services, Promoting and
Protecting the Rights of Persons Utilizing Psychiatric, Neurologic and
Psychosocial Health Services, Appropriating Funds Therefore and for Other
Purposes"
Program Components
1. Wellness of Daily Living
• All health/social/poverty reduction/safety and security programs and the like are protective factors in general for the entire
population
• Promotion of Healthy Lifestyle, Prevention and Control of Diseases, Family wellness programs, etc
• School and workplace health and wellness programs
2. Extreme Life Experience

• Provision of mental health and psychosocial support (MHPSS) during personal and community wide disasters
3. Mental Disorder
4. Neurologic Disorders
5. Substance Abuse and other Forms of Addiction

• Provision of services for mental, neurologic and substance use disorders at the primary level from assessment, treatment and
management to referral; and provision of psychotropic drugs which are provided for free.
• Enhancement of mental health facilities under HFEP
Calendar of Activities
•September 10 - World Suicide

Prevention Day
•October 10 -World Mental Health Day
•2nd Week of October - National

Mental Week
What is the Mental Health Treatment Gap?
• Mental, neurological, and substance use disorders are highly prevalent in all regions of the world,
• and they are major contributors to disease, premature death, and disability worldwide.
• Mental, neurological and substance use (MNS) conditions account for 13% of the global burden of
disease.
• Yet between 75–90% of individuals with MNS conditions do not receive the treatment they require
although effective treatment exists.
• They are also frequently associated with high levels of stigma and human rights violations,
particularly in low- and middle-income countries.
✓ About 1 person in every 10 worldwide is suffering from a mental health disorder
✓ About 1 person in 4 families has a member with mental health disorder
✓ Only 1% of the global health workforce provides mental health care
✓ Most low- and middle-income countries spend less than US$ 2 per person on the treatment and
prevention of mental health disorders
✓ 76-85% of people with a mental health disorder in low-and middle-income countries do not
receive treatment.
Mental Health Gap Action Program (mhGAP) - is WHO’s action plan to scale up
services for mental, neurological and substance use disorders for countries
especially with low and lower middle incomes.
• In 2008, WHO launched the mental health gap action programme (mhGAP) in
response to the wide gap between the resources available and the resources
urgently needed to address the large burden of mental, neurological, and
substance use disorders globally.
• The mhGAP package consists of interventions for prevention and management
for each of these priority conditions.
• Successful scaling up is the joint responsibility of governments, health
professionals, civil society, communities, and families, with support from the
international community.
The essence of mhGAP is building partnerships for collective action.
• A commitment is needed from all partners to respond to this urgent public health
need and the time to act is now!
• Through mhGAP, WHO aims to provide health planners, policy-makers, and donors
with a set of clear and coherent activities and programmes for scaling up care for
mental, neurological and substance use disorders.
“The essence of mhGAP is partnerships to reinforce and to accelerate

efforts and increase investments towards providing services to those who
do not have any”.
Intervention Package
Objectives of mhGAP
• To reinforce the commitment of governments, international organizations, and other
stakeholders
• To increase the allocation of financial and human resources for care of mental health and
substance use disorders.
• To achieve much higher coverage with key interventions in the countries with low and lower
middle incomes that have a large proportion of the global burden of mental health and
substance use disorders.
Strategies:
This programme is grounded on the best available scientific and epidemiological evidence on
priority conditions. It attempts to deliver an integrated package of interventions, and takes into
account existing and possible barriers to scaling up care.
Priority Conditions:
✓ Depression
✓ Schizophrenia and other psychotic disorders
✓ Suicide
✓ Epilepsy
✓ Dementia
✓ Disorders due to use of alcohol
✓ Disorders due to use of illicit drugs
✓ Mental disorders in children
EVIDENCE-BASED INTERVENTIONS TO
ADDRESS THE PRIORITY CONDITIONS
EVIDENCE-BASED INTERVENTIONS TO
ADDRESS THE PRIORITY CONDITIONS
SEVEN GOOD REASONS FOR INTEGRATING MENTAL HEALTH
INTO NON-SPECIALIZED HEALTH CARE
1. The burden of mental disorders is great.
2. Mental and physical health problems are interwoven.
3. The treatment gap for mental disorders is enormous.
4. Enhance access to mental health care.
5. Promote respect of human rights.
6. It is affordable and cost-effective.
7. Generates good health outcomes.
WHO MHGAP INTERVENTION GAP 2. WHO MHGAP INTERVENTION GAP 2.0
WHO MHGAP INTERVENTION GAP 2.0
Module No. 7
Oral Health Program
• Describe the importance of good oral health to the

individual.
• Identify oral health services that prevent, cure and

promote good oral health.
• Explain oral health as a public health program

ORAL HEALTH PROGRAM
• Oral Health is fundamental to overall health, well-being and quality of life.

• A healthy mouth enables people to eat, speak and socialize without pain, discomfort
or embarrassment.
• Tooth decay and gum diseases do not directly cause disability or death.
• These conditions can weaken bodily defenses and serve as portals of entry to other
more serious and potentially dangerous systemic diseases and infections.
• Serious conditions include arthritis, heart disease, endocarditis, gastro-intestinal
diseases, and ocular-skin-renal diseases.
ORAL HEALTH PROGRAM
• Pain from untreated dental diseases can lead to eating, sleeping, speaking, and learning problems in
children and adolescents, which affect child’s social interactions, school achievement, general health,
and quality of life.
• Rampant dental caries in children adversely affect the overall nutrition necessary for the growth of the
body specifically body weight and height. That begins with the first bite and chewing the food efficiently.
• Poor oral health poses detrimental effects on school performance and success in later life.
• Children who suffer from poor oral health are 12 times more likely to have restricted-activity days
• In the Philippines, toothache is a common ailment among schoolchildren, and is the primary cause of
absenteeism from school
• Oral health services are provided by the DOH and LGUs through the Rural Health Units, health
centers, districts and provincial / city hospitals.
Vision
✓ Empowered and responsible Filipino citizens taking care of their own
personal oral health for an enhanced quality of life.
Mission
✓ The state shall ensure quality, affordable, accessible and available oral
health care delivery.
Goal
✓ Attainment of improved quality of life through promotion of oral health and
quality oral health care.
OBJECTIVES
• GENERAL:
• Reduction on the prevalence rate of dental caries and periodontal
diseases from 92% in 1998 to 85% and from 78% in 1998 to 60%.
•
• SPECIFIC:
• To increase proportion of Orally Fit Children (OFC) under 6 years old
to 12% by 20% by 2020
• To control oral health risks among the young people
• To improve the oral health conditions of pregnant women by 20%
and older persons by 10% every year till 2016
Policies / Standards / Guidelines / Laws related to the Oral Health Program
• Republic Act 3814: An Act Creating the Bureau of Dental Health Services (As Amended by RA 5211)
• Republic Act 9484: The Philippine Dental Act of 2007
• AO. 101 s. 2003 dated Oct. 14, 2003 - National Policy on Oral Health
• AO 2007-0007 - Dated January 3, 2007 Guidelines In The Implementation Of Oral Health Program
For Public Health Services In The Philippines
• AO 4-s.1998 - Revised Rules and Regulations and Standard Requirements for Private School Dental
services in the Philippines
• AO 11-D s. 1998 - Revised Standard Requirements for Hospital Dental services in the Philippines
• AO 3 s. 1998 - Revised Rules and Regulations and Standard Requirements for Occupational Dental
services in the Philippines
• AO 4-A s. 1998 - Infection Control Measures for Dental Health Services
Most common oral health illnesses of the Filipinos

1. Dental Caries (tooth decay)
2. Periodontal Diseases (gum diseases)
Dental caries
• Occurs when foods containing carbohydrates (sugars and
starches) are left on the teeth.
• Bacteria that live in the mouth digest these foods, turning them
into acids.
• The bacteria, acid, food debris, and saliva combine to form
plaque, which clings to the teeth.
• The acids in plaque dissolve the enamel surface of the teeth,
creating holes in the teeth called cavities, or dental caries.
Prevention:
• regular visits to the dentist for early diagnosis
and preventive care
• professionally applied fluorides & sealants
• well balanced diet
• minimize eating sugary foods
• good plaque control through regular
toothbrushing and flossing
Gum diseases
• Gingivitis (gum inflammation) usually precedes

periodontitis (gum disease).
• In the early stage of gingivitis, bacteria in plaque
buildup cause the gums to become inflamed (red and
swollen) and often easily bleed during tooth brushing.
• Although the gums may be irritated, the teeth are still
firmly planted in their sockets.
Prevention:
• regular visits to the dentist for early detection and
treatment
• regular and proper toothbrushing
• healthy lifestyle such as avoidance of tobacco
smoking, drugs & excessive alcohol-intake Oral Health
Services
Classification of Oral Interventions
1. Preventive Services
Consists of the following measures which will promote oral health and provide specific protection from the
occurrence of dental caries and other oral diseases
a.) Oral examination - is the careful checking of the oral cavity by duly trained dentist to detect and diagnose
oral diseases and conditions, oral examinations, and detect signs and symptoms STD-AIDS and other non-
communicable diseases such as diabetes
b.) Oral hygiene - basic personal measure to prevent and control tooth decay and gum disease. It includes
among others oral prophylaxis, regular and proper way of tooth brushing, gum massage, eating detersive
foods and the use of mouthwashes.
c.) Pit and fissure sealant program - non-invasive prevention and control measure against tooth decay
for children. Flouride therapy is best for smooth surfaces but limited where grinding surfaces are
concerned owing to the presence of pit and fissures on the surface.
d.) Flouride utilization program - a non-invasive and control measures through multiple use of flourides in
areas where fluoride content is low. Flouridation can be done in systemic and local route.
2. Curative Services
Remedial measures applied to halt the progress of oral disease and restore the sound condition of the teeth
and supporting tissues
a) Permanent filling - restoration of savable teeth with amalgam, composite or glass filling materials
b) Gum treatment - deep scaling and root planning of affected tooth or teeth for pregnant mothers and
older person with periodontal disease
c) Atraumatic restorative treatment - one form of permanent filling for priority target groups by manually
cleaning dental cavities using hand instruments and filling the cavities with fluoride releasing glass ionomer
restorative materials
d) Temporary filling - treatment of deep seated tooth decay with zinc oxide and eugenol
e) Extraction - removal of unsavable teeth to control foci of infection
f) Treatment of post extraction complication such as dry sockets and bleeding
g) Drainage of localized oral abscesses - incision and drainage
y
3. Promotive Services
• Health education activities directed to the priority groups through individuals or
group approach using accepted tools and media.
• Oral Health Month: FebruarY
Gum diseases
1. 0-11 months (infants)
3. 5-9 years old (school-aged children)
• 0-8 months - Oral Examination, Instruction on Oral examination
infant’s oral health care, Advice on exclusive Supervised Toothbrushing
breastfeeding
Oral Health Education Pits and Fissure
• 9-11 months - Same as above
and topical fluoride application Sealant Temporary filling
• 6-12 months - Seeking dental Permanent filling
consultation
2. 1-4 years old (11-59 4. 10-19 years old (adolescents)
months old children) Oral examination Education and counselling on good oral
-Oral examination
hygiene, diet and adverse effects of tobacco/smoking and
-Topical Fluoride
Application alcohol and sweetened beverages & food
-Supervised Pit and fissure sealant application
Tooth Brushing Temporary filling
-Oral Health Permanent filling Oral
Education
prophylaxis/scaling
-Atraumatic
Restorative Treatment Oral Urgent
(ART) Treatment (OUT)
-Oral
prophylaxis/scaling
Gum diseases
5. 20-59 years old (adults) *
Oral Examination
• Education and counseling on good oral hygiene, diet and adverse effects of
tobacco/smoking and alcohol and sweetened beverages & food
• Gum Treatment
• Oral prophylaxis/scaling
• Permanent filling
• Atraumatic Restorative Treatment (ART)
6. 60 years old and above (senior citizens)
Oral Examination
Education and counselling on good oral hygiene, diet and adverse effects of
tobacco/smoking and alcohol and sweetened beverages & food
Oral Urgent Treatment (OUT): relief of pain, extraction of unsavable teeth and
referral of complicated cases to higher level
Gum diseases
7. Pregnant women
• Oral examination
• Education and counselling on good oral hygiene, diet and adverse
effects of tobacco/smoking and alcohol and sweetened beverages &
food
• Oral prophylaxis/scaling
• Gum treatment
• Temporary filling
• Permanent filling
COLLEGE OF NURSING AND PHARMACY
C-NCM 104 –COMMUNITY HEALTH NURSING 1 (INDIVIDUAL AND FAMILY)
First Semester | AY 2021-2022
Module No.8: ADOLESCENT HEALTH AND DEVELOPMENT PROGRAM
Schedule of Synchronous Classes: BSN 2A: Tuesday, 5:00PM-6:00PM

BSN 2B: Saturday, 3:00 PM-4:00PM
Time Frame: 1 hour
Mapped Learning Outcomes and Course Content for C-NCM 104 CHN, Module 8
Target Learning Content and Activities
Hour Outcomes Online Session Offline Session
(At the close of the period
allotted, students should
have :)
1 Hour • Explained the basic • Periods of Home Activity:
concepts of Adolescence
adolescent health. • Risk Factors Title: Analysis for Home Care
• Discussed the • Brief History of Management of COVID-19
program’s vision, Adolescent Health in
mission, goals, and the Philippines
objective • Overview of the • Watch the video in this
Adolescent Program link: Lecture: COVID-19
• Determine
in the Philippines Home Care (Lay) -
components of
• Program (psmid.org) (5 points)
adolescent health as
Components • Identify minimum of 10
a public health
important take-aways
program.
for home care
management (10
points).
• Essay (minimum of 50
words): As a CHN, what
is the importance of
knowing home care
management? (10
points)
Faculty: Aurora Valencia, RN, LPT, MAN and Joseph Michael D. Manlutac, RN, MPH
Page 1 of 8
1. Content / Discussion / Learning Resources / Link
ADOLESCENCE is the transitional phase of growth and development between childhood and
adulthood. World Health Organization (WHO) defines an adolescent as any person between
ages 10 and 19.
Department of Health (DOH) and the Philippine Pediatric Society (PPS) divides this period
into:
• Early adolescence: 10-13 years old
• Middle adolescence: 14-16 years
• Late adolescence: 17-19 years
• According to the World Health Organization, ADOLESCENTS are the greatest resource for a
society to thrive.
• Healthy Adolescence
• Academically engaged
• Emotionally and physically safe
• Positive sense of self and self-efficacy
• Life and decision-making skills
• Physically and mentally healthy
Adolescent by the numbers

• 22% of the Philippine population
• 47/1000 Prevalence of adolescent birth rate
• 9% of ages 15-19 have begun childbearing
• 1 in every 5 19 year-old girls is already a mother
• 2x Rate in Philippines compared to Southeast Asian Countries
• 40-45% are malnourished
• 3% have tried to commit suicide
• 4% use drugs, 19% smoke, 37% drink alcohol
• 17% experienced being physically hurt
• 18% of reported injury cases are among them
• 3% have HIV among adolescent MSM
• 0.8% have syphilis among adolescent MSM
• Overall, 9 percent of women aged 15-19 have begun childbearing (2017 NDHS)
Leading Risk Factors:

• Alcohol use
• Unsafe sex
• Drug use
• Intimate partner violence
Page 2 of 8
• Occupational hazards (exposure to toxins or work-related injuries)
Burden and Risk Factors Pertaining to Adolescents in the Philippines:

• Violence
• Alcohol, Tobacco, and Illegal Substances
• Malnutrition
• Sexual and Reproductive Health
• HIV and AIDS
For complete discussion for these burden and risk factors, refer to this link:
2082017_full.pdf
Brief History of Adolescent Health and Development Program in the Philippines

• In April 2000, DOH issued the Administrative Order 34- A s 2000, the Adolescent and
Youth Health (AYH) Policy, creating the Adolescent Youth Health Sub-program under the
Children’s Health Cluster of Family Health Office.
• In 2006, the department created the Technical Committee for Adolescent and Youth
Health Program, composed of both government and non-government organizations
dedicated to uplifting the welfare of adolescents and tasked to revitalize the program.
• Due to an increasing health risky behavior among our Filipino adolescents, DOH
embarked on revising the policy and to focus on the emerging issues of the adolescents
which are the 10 – 19 years old.
• In March 21, 2013, DOH with the support of the United Nations Population Fund (UNFPA)
Philippines, revised the policy and served the Administrative Order 0013 - 2013 National
Health Policy and Strategic Framework on Adolescent Health and Development (AHDP).
• In 2015, DOH AHDP Program revived the National External Technical Working Group
(TWG) on AHDP. This is composed of different stakeholders from the government, non-
government, academe, and youth – led organizations.
• In 2016, DOH recognized the need for harmonization of programs within the department
that caters 10 – 19 years old. The AHDP Program convened the first DOH – Internal
Technical Working Group.
Aims:
Ensure that all programs are working together for the betterment of the adolescents
in the country
It will be an avenue to discuss indicators, policies, strategies, and service delivery at
the national and local implementation levels.
• In 2017, both TWGs revised the strategic framework, and developed a logical
framework, and monitoring and evaluation framework of the program.
Page 3 of 8
AHDP’s GOAL, VISION and MISSION
Objectives
Improve the health status of adolescents and enable them to fully enjoy their rights to health.
Adolescent Health Development Program Framework (2017)
Program Components
1. Nutrition
2. National Safe Motherhood
3. Family Planning
4. Oral Health
Page 4 of 8
5. National Immunization Program

6. Dangerous Drugs Abuse Prevention and Treatment
7. Harmful Use of Alcohol
8. Tobacco Control
9. Mental Health
10. Violence & Injury Prevention
11. Women and Children Protection
12. HIV/STI
Partner Institutions
Local & International Development Partners:
• Department of Education
• National Youth Commission
• Commission on Higher Education
• Commission on Population
• Council for the Welfare of Children
• Department of Social Welfare and Development
• Department of Interior and Local Government
• Linangan ng Kababaihan (Likhaan)
• The Family Planning Organization of the Philippines
• Technical Education and Skills Development Authority
• Woman Health Philippines
• Save the Children
• ACT! 2015 Alliance
• Youth Peer Education Network
• Society of Adolescent Medicine in the Philippines Inc.
• Micronutrient Initiatives
• Child Protection Network
• National Nutrition Council
• Philippine National AIDS Council
• Philippine Society of Adolescent Medicine Specialist
• United Nations for Children’s Fund
• United Nations Population Fund
• United Nations Programme for HIV and AIDS
• United States Agency for International Development
• World Health Organization
Policies and Laws

• Republic Act 10360 (Juvenile Justice Act) defines age of criminal liability at 16 years
Page 5 of 8
old above.
• Republic 7658 (Prohibiting the Employment of Children below 15 years of age in

Public and Private Undertaking) prohibits employment of children under 15 years old.
• Republic Act 11166 (National HIV and AIDS Policy Act of 2018) allows individuals
15 years old and above to access HIV testing without needing parent’s consent.
• Republic Act 10354 (The Responsible and Reproductive Health Act of 2012)
emphasizes the need for age and development appropriate reproductive health
education to adolescent and requires the need for consent for the access of modern
family planning services for minors, except for those minors who are parents and/or
with experience of miscarriage.
• Administrative Order No. 2013-0013 (National Policy and Strategic Framework

on Adolescent Health and Development)
• Administrative Order No. 2017-0012 (Guidelines on the Adoption of Baseline

Primary Health Care Guarantees for All Filipinos)
• Proclamation 99 s.1992 (Linggo ng Kabataan)
Strategies, Action Points and Timeline

• Health promotion and behavior change for adolescents
• Adolescent participation in governance and policy decisions
• Developing/transforming health care centers to become adolescent-friendly facilities
• Expanding health insurance to young people
• Enhancing skills of service providers, families and adolescents
• Strengthening partnerships among adolescent groups, government agencies,
private sectors, Civil Society organizations, families and communities
• Resource mobilization
• Regular assessment and evaluation
Program Accomplishments/ Status
A. Health Education and Promotion

o Advocacy and awareness raising activities such as Adolescent Health TV
segment and Healthy Young Ones
o Youth development sessions
Page 6 of 8
B. Provision of Health Services

o Establishment of Adolescent-Friendly Health Facilities (Level I to Level III)
Nationwide includes:
a. Core package of adolescent health services (AO 2017-0012) available at
the different levels of the health care system and in settings outside the
health care system.
b. Institutionalize linkage between school, community, civil society
organizations and health facilities in a service delivery network (SDN).
c. Trained health and non-health personnel nationwide with the following:
o Competency Training on Adolescent Health
o Adolescent Job Aid (AJA) Training
o Adolescent Health Education and Practical Training (ADEPT)
o Healthy Young Ones (HYO) Training
o Adolescent Health and Development Program Manual of Operations
(MOP) Training
o HEEADDSSS Orientation (Home, Education, Eating Habits, Activities,
Drugs, Sexuality, Safety, Suicide) Tool- This is a tool for psychosocial
history and assessment for adolescents.
Calendar of Activities
The celebration of Linggo ng Kabataan every second week of December
Program Data Sources
• Philippine Health Statistics (PHA)

• Young Adult Fertility and Sexual Survey (YAFSS)
Page 7 of 8
• National Demographic Health Survey (NDHS)

• Field Health Service Information System (FHSIS)
• National Nutrition Survey (NNS)
• Integration HIV Behavioral and Serologic Surveillance (IHBSS)
• HIV, AIDS, and ART Registry of the Philippines (HARP)
• Global Youth Tobacco Survey (GYTS)
• National Baseline Study on Violence Against Children (NBS-VAC)
2. Assessment of Learning
Search form one program component of AHDP and identify current status, gaps, and recommended
solutions.
3. Evaluation of Learning
For the evaluation of learning, a scheduled quiz will be assigned in the Google Classroom and will be
taken before the start of the next Module during the Synchronous Class.
4. References
• Manual of Procedures for Adolescent Health and Development Program

• https://www.doh.gov.ph/Adolescent-Health-and-Development-Program
• https://www.doh.gov.ph/sites/default/files/publications/WHO_DOH_2017_12082017_full.pdf
5. FOOD FOR THE SOUL
Galatians 6:9: Let us not become weary in doing good, for at the proper time we will reap a harvest if we will not give up.
Take a moment of silence in gratitude and prayer!
Congratulations on finishing this Module! You are Amazing!
Page 8 of 8
Module No. 9: WOMEN AND CHILDREN PROTECTION PROGRAM

Schedule of Synchronous Classes: BSN 2A: Tuesday, 6:00PM-7:00PM
BSN 2B: Saturday, 4:00 PM-5:00PM
Time Frame: 1 hour
Mapped Learning Outcomes and Course Content for C-NCM 104 CHN, Module 9
Target Learning Content and Activities
Hour Outcomes Online Session Offline Session
(At the close of the period
allotted, students should
have :)
1 Hour 1. Discussed the • Overview of Women Home Activity:
programs of the and Child Protection
government Program Title: Analysis for Home Care
related to
• RA 9262 Management of COVID-19
women and child
protection • Types of Violence
program. • Community • Watch the video in this
2. Identified the interventions for link: Lecture: COVID-19
mission, vision violence against Home Care (Lay) -
and objectives of women and children (psmid.org) (5 points)
the program to • Identify minimum of 10
the national important take-aways
development. for home care
3. Described the management (10
pertinent points).
information of
• Essay (minimum of 50
RA 9262.
4. Enumerated the words): As a CHN, what
different types of is the importance of
violence against knowing home care
women and their management? (10
children. points)
5. Enumerated the
different
interventions
and support for
women and
children who are
at risk of
violence.
Faculty: Faculty: Aurora Valencia, RN, LPT, MAN and Joseph Michael D. Manlutac, RN, MPH
Page 1 of 7
1. Content / Discussion / Learning Resources / Link

The Anti-Violence against Women & Their Children Act of 2004 (RA 9262)
• An act defining violence against women and their children, providing for protective
measures for victims, prescribing penalties therefor, and for other purposes.
Declaration of Policy
• It is hereby declared that the State values the dignity of women and children and
guarantees full respect for human rights. The State also recognizes the need to protect
the family and its members particularly women and children, from violence and threats
to their personal safety and security.
Violence against Women & their children (VAWC)

❖ any act or series of acts committed by any PERSON (male or female)
❖ against a WOMAN who is his wife, former wife, or with whom the person has or had a
sexual or dating relationships, or
❖ with whom he has a common child, or against her child within or outside the residence
❖ Which result or likely to result in physical, sexual, psychological harm or suffering or
economic abuse including threats of such acts,
❖ Battery, assault, coercion, harassment or arbitrary deprivation of liberty
Types of Violence Punishable under this Law

1. PHYSICAL VIOLENCE
refers to acts that include bodily or physical harm, physical injuries and mutilation
2. PSYCHOLOGICAL VIOLENCE
acts or omissions causing or likely to cause mental or emotional suffering,
including:
a. Stalking
b. Damage or property
c. Ridicule
d. Repeated verbal abuse
e. Depriving the woman of access to her family
f. Marital infidelity
3. SEXUAL VIOLENCE
Refers to an act which is sexual in nature, committed against a woman or child.
forcing the woman to watch obscene movies
Forcing the woman to engage in any sexual act
Prostituting the woman or child
Page 2 of 7
4. ECONOMIC ABUSE
acts that make or attempt to make a woman financially dependent, including:
a. withdrawal of financial support
b. preventing her from engaging in a legitimate profession, business or activity –
c. deprivation or threat of deprivation of financial resources and the right to use
conjugal or community property
CENTRE OF APPROACH
1. Relationship, past or present;
2. Married or not;
3. living in or not
4. Sexual or dating relationship
5. Including lesbian relationships with common child
Who are protected?

❖ Women
❖ Children of the abused woman
LIABLE PERSONS ON VAWC

1. Husband, ex-husband
2. Boyfriend or ex-boyfriend
3. Father of the woman’s child
4. Lesbian girlfriends/partners or ex partners
5. Any person with whom the woman has/had a sexual or dating relationship
ACTS OF VIOLENCE AGAINST WOMEN AND THEIR CHILDREN

The crime of violence against women and their children is committed through
any of the following acts:
a. Causing physical harm to the woman or her child
b. Threatening to cause the woman or her child physical harm
c. Attempting to cause the woman or her child physical harm
d. Placing the woman or her child in fear of imminent physical harm
e. Desist from conduct which they have a right to engage in or attempting
to restrict or restricting the woman’s or her child’s freedom of movement
or conduct by force or threat
f. Inflicting or threatening to inflict physical harm on oneself for the
purpose of controlling her actions or decisions
g. Causing or attempting to cause the woman or her child to engage in any
sexual activity which does not constitute rape, by force or threat of force,
physical harm, or through intimidation directed against the woman or
her child or her/his immediate family
Page 3 of 7
h. Engaging in purposeful, knowing, or reckless conduct, personally or

through another that alarms or causes substantial emotional or
psychological distress to the woman or her child. This shall include, but
not be limited to, the following acts:
- Stalking or following the woman or her child in public or private
places-
- Peering in the window or lingering outside the residence of the
woman or her child
- Entering or remaining in the dwelling or on the property of the
woman or her child against her/his will
- Destroying the property and personal belongings or inflicting harm
to animals or pets of the woman or her child
- Engaging in any form of harassment or violence
- Causing mental or emotional anguish, public ridicule or humiliation
to the woman or her child, including, but not limited to, repeated
verbal and emotional abuse, and denial of financial support or
custody of minor children of access to the woman's child/children
VENUE
The Regional Trial Court designated as a Family Court shall have original and
exclusive jurisdiction over cases of violence against women and their children
under this law.
In the absence of such court in the place where the offense was committed, the
case shall be filed in the Regional Trial Court where the crime or any of its
elements was committed at the option of the compliant.
PROTECTION ORDERS
to prevent further acts of violence against a woman or her child.
To safeguard the victim from further harm, minimizing disruption in victim’s daily
life, and give her the opportunity and ability to regain control over her life.
Kind of Protection Order.

1. Barangay Protection Order
❖ Issued by Punong Barangay
❖ Effective for 15 days only
❖ Ordering perpetrator to desist from committing physical harm or
threatening
❖ Ex parte proceedings
❖ Kagawad can issue if Punong Barangay is not available
2. Temporary Protection Order
❖ Issued by the court on the day of filing
❖ Ex parte
❖ Priority over all other cases
❖ Effective for 30 days; extendible
Page 4 of 7
3. Permanent Protection Order- lifetime

❖ Issued after notice and hearing  Priority over all other proceedings such
as election cases, habeas corpus, cases of children
Protection Orders:
o Prohibition from threatening or committing, personally or through another, any of
acts in Sec. 5
o Prohibition from harassing, telephoning, contracting the petitioner
o Removal and exclusion from the residence regardless of ownership, temporarily
or permanently where no property rights are violated
o Stay away from petitioner, any designated family or household member, from
residence, school, workplace, or specified place Protection Orders
o Directing law enforcer to accompany petitioner to the residence, ensure
possession of automobile and other personal effects; supervise respondent’s
removal of belongings
o Temporary or permanent custody of child
o Support: automatic remittance of salary or income by employer
o Directing DSWD or appropriate agency to provide shelter and social services
Who may file for Protection Orders (P.O.)

❖ Offended party
❖ Parents or guardians
❖ Ascendants, descendants, collateral relatives within 4th degree of consanguinity or
affinity
❖ Social workers of DSWD or LGUs
❖ Police officers, Punong Barangay or kagawad
❖ Lawyer, counselor, therapist, healthcare provider
❖ At least 2 citizens of the city or municipality who have personal knowledge of the
offense
Public crime
❖ Any citizen having personal knowledge or the circumstances of the offense may file a
case.
Battered Woman Syndrome (BWS)

❖ scientifically defined pattern of psychological and behavioral symptoms found in
women living in battering relationships as a result of cumulative abuse.
❖ A defense; justifying circumstance;
❖ A victim with BWS is not disqualified from having custody of her children 
Perpetrator of woman with BWS shall not have custody
Duties of Barangay Officials & Law Enforcers

❖ Enter the dwelling whether or not a P.O. has been issued
❖ Confiscate deadly weapon in possession or in plain view
Page 5 of 7
❖ Transport or escort the victim to safe place or clinic, hospital

❖ Assist victim in removing personal belongings from the house Duties
❖ Ensure enforcement of BPO, TPO, PPO
❖ Arrest without a warrant  when the acts of violence is occurring, or
❖ When s/he has personal knowledge that abuse has just been committed, and
there is imminent danger to life and limb of victim
❖ Immediately report the call for assistance of DSWD, LGU social workers or
accredited NGOs
Penalties for failure to report

Barangay official or law enforcer who fails to report the incident shall be liable
for fine not exceeding P10,000 or civil, criminal or administrative liability
Prohibited Acts
Barangay official or the court hearing the application for a P.O. shall not order,
direct, force or in any way influence the applicant to compromise or abandon
any of the relief sought.
No mediation or conciliation of acts of VAWC in the barangay
Exemption from liability

NO CRIMINAL, CIVIL, ADMINISTRATIVE LIABILITY
Any person, private individual, police authority, barangay official acting in
accordance with law, who
responds or intervenes without using violence or restraint greater than
necessary to ensure safety of the victim
Rights of victims
Right to be treated with respect & dignity;
Legal assistance; support services from DSWD, LGUs
To be informed of their rights and services available
Additional 10 day paid leave from work aside from present paid leave benefits
MANDATORY PROGRAMS AND SERVICES FOR VICTIMS

The DSWD, and LGU's shall provide the victims temporary shelters, provide
counseling, psycho-social services and /or, recovery, rehabilitation programs
and livelihood assistance.
The DOH shall provide medical assistance to victims.
Counseling & Treatment of Offenders

DSWD shall provide rehabilitative counseling and treatment of perpetrators
Constructive ways of coping with anger and reforming their ways.
When necessary, the Court shall order offender to submit to psychiatric
treatment or confinement
Page 6 of 7
Confidentiality of records
Court records and barangay records
Right to privacy of victim
Violation: 1 year imprisonment & fine of not more than P500,000
FUNDING
The amount necessary to implement the provisions of this Act shall be
included in the annual General Appropriations Act (GAA).
The Gender and Development (GAD) Budget of the mandated agencies and
LGU's shall be used to implement services for victim of violence against
women and their children.
2. Assessment of Learning
1. Discuss the programs of the government related to women and child protection program.
2. Identify the mission, vision and objectives of the program to the national development.
3. Describe the pertinent information of RA 9262.
4. Enumerate the different types of violence against women and their children.
5. Enumerate the different interventions and support for women and children who are at
risk of violence.
3. Evaluation of Learning
For the evaluation of learning, a scheduled quiz will be assigned in the Google Classroom and will be
taken before the start of the next Module during the Synchronous Class.
4. References
https://cdn.slidesharecdn.com/ss_thumbnails/ra9262-160902051321-thumbnail-4.jpg?cb=1472793257
https://cdn.slidesharecdn.com/ss_thumbnails/ra9262-vawc-140331023914-phpapp02-thumbnail-
4.jpg?cb=1396246601
https://cdn.slidesharecdn.com/ss_thumbnails/avawca-120511230600-phpapp01-thumbnail-
4.jpg?cb=1336777813
5. FOOD FOR THE SOUL
Psalm 28:7: The LORD is my strength and my shield; my heart trusted in him, and I am helped: therefore my
heart greatly rejoices; and with my song will I praise him.
Take a Faculty:
moment of silence
Faculty: AurorainValencia,
gratitudeRN, and prayer!
LPT, MAN and Joseph Michael D. Manlutac, RN, MPH
Page 7 of 7
Congratulations on finishing this Module! You are Amazing!
REMINDERS
• Group 4 BSN 2A to lead us in prayer and take-aways.
• 25 minutes will be given for the exam. OPEN YOUR

CAMERA, WHILE TAKING THE EXAM.
• TYPE IN YOUR NAME AND TEMPERATURE.
• Share your thoughts using this link:

https://tinyurl.com/KAMUSTAKAKAPATID.
• RLE GROUP LEADERS, PLEASE CHECK YOUR MEMBERS

AND NOTE WHO ARE ABSENT at 5:05 PM.
MODULE 10: NUTRITION
PROGRAM
Joseph Michael D. Manlutac, RN, MPH

Clinical Instructor, NCM 104
At the end of this module, you should be able
to:
•Discuss the programs of the government related
to nutrition.
•Describe the role of the Barangay Nutrition

Scholar in promoting good nutrition in the
community.
•Identify salient information about diseases

related to nutrition.
•Nutrition is the study of nutrients in food, how the body
uses them, and the relationship between diet, health, and disease
According to WHO…..
• Nutrition is a critical part of health and development. Better
nutrition is related to improved infant, child and maternal health,
stronger immune systems, safer pregnancy and childbirth, lower
risk of non-communicable diseases (such as diabetes and
cardiovascular disease), and longevity.
• Healthy children learn better. People with adequate nutrition are

more productive and can create opportunities to gradually break
the cycles of poverty and hunger.
MDG#1 was addressed by
the Nutrition Program -
Eradicate Extreme
Poverty and hunger
Sustainable Development Goals
#1 - No Poverty
#2 - Zero Hunger
#3 - Good Health and Well- being

#2 - Zero Hunger
2.1 By 2030, end hunger and ensure access by all
people, in particular the poor and people in vulnerable
situations, including infants, to safe, nutritious and
sufficient food all year round
2.2 By 2030, end all forms of malnutrition, including

achieving, by 2025, the internationally agreed targets on
stunting and wasting in children under 5 years of age,
and address the nutritional needs of adolescent girls,
pregnant and lactating women and older persons
2.3 By 2030, double the agricultural productivity and incomes of
small-scale food producers, in particular women, indigenous
peoples, family farmers, pastoralists and fishers, including through
secure and equal access to land, other productive resources and
inputs, knowledge, financial services, markets and opportunities
for value addition and non-farm employment
2.4 By 2030, ensure sustainable food production systems and

implement resilient agricultural practices that increase productivity
and production, that help maintain ecosystems, that strengthen
capacity for adaptation to climate change, extreme weather,
drought, flooding and other disasters and that progressively
improve land and soil quality
2.5 By 2020, maintain the genetic diversity of seeds, cultivated
plants and farmed and domesticated animals and their related
wild species, including through soundly managed and diversified
seed and plant banks at the national, regional and international
levels, and promote access to and fair and equitable sharing of
benefits arising from the utilization of genetic resources and
associated traditional knowledge, as internationally agreed
2.a Increase investment, including through enhanced international

cooperation, in rural infrastructure, agricultural research and
extension services, technology development and plant and
livestock gene banks in order to enhance agricultural productive
capacity in developing countries, in particular least developed
countries
2.b Correct and prevent trade restrictions and distortions
in world agricultural markets, including through the
parallel elimination of all forms of agricultural export
subsidies and all export measures with equivalent effect,
in accordance with the mandate of the Doha Development
Round
2.c Adopt measures to ensure the proper functioning of

food commodity markets and their derivatives and
facilitate timely access to market information, including
on food reserves, in order to help limit extreme food price
volatility
FOOD SECURITY
all people
• Food Security ➔ a state in which
at all times has both physical

and economic access to sufficient
food to meet their dietary needs for a productive and
healthy life (USAID, 1992)
FOOD SECURITY
COMPONENTS
Affected by:
Production
Distribution
FOOD AVAILABILITY Exchange
Affected by:
Affordability
FOOD ACCESS Allocation
Preference Affected by:
Nutrition value
Health status
FOOD UTILIZATION Food safety
Preparation and
consumption
STABILITY
FOOD INSECURITY
•State of being without

reliable access to a
sufficient quantity of
affordable, nutritious
food.
Types of food insecurity
Chronic food insecurity ➔long-term and persistent
condition of food insecurity. (approximately six months
of the year or longer).
Transitory food insecurity ➔ short-term and

temporary condition (sudden drop in the ability to
produce or access sufficient food for a healthy
nutritional status)
Seasonal food insecurity ➔ food insecurity that

reoccurs predictably, following the cyclical pattern of
seasons.
According to the Philippine Health Agenda 2016-2022
• Three out of ten children are stunted
National Nutrition Council -It is the country’s
highest policy making and coordinating body on
nutrition
PD 491 - Nutrition Act of the Philippines

• Declares nutrition as a priority
of the government
• Creates national Nutritional
Council
• Designated July as the Nutrition Month
Theme for the 47th Nutrition Month
2020:
• There is low awareness of the first 1000 days strategy based on a
recent message recall survey conducted by the NNC that showed
only 11% of respondents had awareness.
• As such, this theme centered in boosting limited implementation

of Republic Act 11148 or the Kalusugan at Nutrisyon ng Mag-
Nanay Act of 2018, which mandates the scaling up of
interventions and services in the first 1000 days. The focus on the
first 1000 days was also the recommendation of the regional
nutrition program coordinators of NNC who saw the need to
further advocate for the first 1000 days especially among local
government units.
• Why focus on 1st 1,000 days?
It’s called the "golden window of opportunity" during which the

delivery of key health, nutrition, and early learning interventions
could result to optimum physical and brain development.
This strategic intervention calls for a "holistic approach to the

provision of health, nutrition, education, and social welfare
services to children 0-8 years of age", but with an even more
refined focus on the first 1000 days of life. The first 1000 days of
life covers pregnancy and the first two years of life.
Nutrition Program in the
Philippines
Goal
The improvement of nutritional
productivity and quality of life of the
population through the adoption of
desirable dietary practices and
healthy lifestyle.
• Reduction in the proportion of Filipino households with intake below 100%
of dietary energy requirement from 53.2% to 44.0%
• Reduction in:
a. Underweight among preschool children
b. Stunting among preschool children
c. Chronic energy deficiency among pregnant women
d. Iron deficiency among children 6months to five years old, pregnant and
lactating mothers
e. Prevalence of overweight, obesity and non-communicable diseases
f. Reduction in the prevalence of iron deficiency disorders among lactating
mothers
g. Elimination of moderate and severe IDD among school children and
pregnant women
h. Reduction in the prevalence of low birth weight
Philippine Food and Nutrition
Programs
• Directed towards the provision of nutrition services to the

DOH’s identified priority vulnerable groups: infants,
preschoolers, schoolers, women of child-bearing age (pregnant
and lactating mothers) and the elderly.
• Objectives: To decrease the morbidity and mortality rates

secondary to avitaminoses and other nutritional deficiencies
among the population mostly composed of infants and children.
• Coverage: a) Protein Energy Malnutrition, b) Vitamin A Deficiency

, c) Iron Deficiency Anemia, and d) Iodine Deficiency Disorders
• The World Health Organization (WHO) defines
malnutrition as "the cellular imbalance between
the supply of nutrients and energy and the
body's demand for them to ensure growth,
maintenance, and specific functions."
• The term protein-energy malnutrition (PEM)

applies to a group of related disorders that
include marasmus, kwashiorkor (see the images
below), and intermediate states of marasmus-
kwashiorkor.
•Malnutrition refers to deficiencies, excesses, or imbalances
in a person’s intake of energy and/or nutrients. The term malnutrition
addresses 3 broad groups of conditions:
• undernutrition, which includes wasting (low weight-for-height),

stunting (low height-for-age) and underweight (low weight-for-age);
• micronutrient-related malnutrition, which includes micronutrient

deficiencies (a lack of important vitamins and minerals) or
micronutrient excess; and
• overweight, obesity and diet-related noncommunicable diseases

(such as heart disease, stroke, diabetes and some cancers).
UNDERNUTRITION
• Low weight-for-height is known as wasting. It usually indicates
recent and severe weight loss, because a person has not had enough
food to eat and/or they have had an infectious disease, such as
diarrhoea, which has caused them to lose weight. A young child who is
moderately or severely wasted has an increased risk of death, but
treatment is possible.
• Low height-for-age is known as stunting. It is the result of chronic

or recurrent undernutrition, usually associated with poor
socioeconomic conditions, poor maternal health and nutrition, frequent
illness, and/or inappropriate infant and young child feeding and care in
early life. Stunting holds children back from reaching their physical and
cognitive potential.
• Children with low weight-for-age are known as underweight. A

child who is underweight may be stunted, wasted, or both.
Micronutrient-related
malnutrition
• Inadequacies in intake of vitamins and

minerals often referred to as micronutrients,
can also be grouped together. Micronutrients
enable the body to produce enzymes, hormones,
and other substances that are essential for
proper growth and development.
• Iodine, vitamin A, and iron are the most

important in global public health terms; their
deficiency represents a major threat to the health
and development of populations worldwide,
particularly children and pregnant women in low-
income countries.
Overweight and obesity
• Overweight and obesity is when a person is too

heavy for his or her height. Abnormal or
excessive fat accumulation can impair health.
• Overweight and obesity result from an imbalance

between energy consumed (too much) and
energy expended (too little). Globally, people are
consuming foods and drinks that are more
energy-dense (high in sugars and fats), and
engaging in less physical activity.
Diet-related
noncommunicable diseases
•Diet-related noncommunicable diseases

(NCDs) include cardiovascular diseases
(such as heart attacks and stroke, and
often linked with high blood pressure),
certain cancers, and diabetes. Unhealthy
diets and poor nutrition are among the top
risk factors for these diseases globally.
PHILIPPINE PLAN OF ACTION FOR NUTRITION
2017-2022
The Philippine Plan of Action for Nutrition

(PPAN) 2017-2022 is an integral part of
the Philippine Development Plan 2017-
2022. It is consistent with the Duterte
Administration 10-point Economic Agenda,
the Philippine Health Agenda, and the
development pillars of malasakit
(protective concern), pagbabago (change
or transformation), and kaunlaran
(development), and the vision of
Ambisyon 2040.
It factors in and considers country

commitments to the global community as
embodied in the 2030 Sustainable
Development Goals, the 2025 Global
Targets for Maternal, Infant and Young
Child Nutrition, and the 2014 International
Conference on Nutrition.
DILG
MEMORANDUM
CIRCULAR
2018-042
DILG
MEMORANDUM
CIRCULAR
2018-042
PHILIPPINE PLAN OF ACTION FOR
NUTRITION 2017-2022
1. Infant and Young Child Feeding

• Enforcement of Milk Code (EO 51)
• Establishment of breastfeeding places in non-
health establishment
• Maternity protection and capacities of
workplaces on breastfeeding
• Community-based health and nutrition
support
• Health systems support
2. Integrated Management of Acute
Malnutrition
• Enhancement of facilities and
provision of services
• Building of capacity of local

implementers
3.National Dietary Supplementation Program
• Supplementary feeding of pregnant women
• Supplementary feeding of children 6 to 23
months old
• Supplementary feeding of children 24 to 59
months old
• Supplementary feeding of school children
• Food plants for producing supplementary
foods
RA 11037 - “Masustansyang Pagkain para sa
Batang Pilipino Act”
An act institutionalizing a national feeding program

for undernourished children in public day care,
kindergarten and elementary schools to combat
hunger and undernutrition among Filipino children
and appropriate funds
National Feeding Program
Components:
a.) Supplemental Feeding Program for Day Care Children - c/o
DSWD; target: undernourished aged 3 - 5
b.) School-Based Feeding Program - c/o DepEd; target:

undernourished kindergarten to grade 6
c.) Milk Feeding Program - National Government Agencies

coordinate with Department of Agriculture,
National Dairy Authority, Philippine Carabao Center and
Cooperative Development Authority for the incorporation of fresh
milk and fresh milk based food products in the fortified meals and
cycle menu
d.) Micronutrient Supplements - used of iodized salt (RA
8172 - “Salt Iodization or ASIN” law)
e.) Health Examination, Vaccination and Deworming
f.) Gulayan sa Paaralan - cultivation of vegetables and other

nutrient rich plants
g.) Water, Sanitation and Hygiene (WASH)
h.) Integrated Nutrition Education, Behavioral

Transformation and Social Mobilization
DSWD - AO 03 series of 2017
Supplemental guidelines to AO 04 series of

2016 otherwise known as Amended
Omnibus Guidelines in the Implementation
of the Supplementary Feeding Program
Target Beneficiaries:
a.) 2-4 year old children in Supervised Neighborhood
Play
b.) 3-4 year old children enrolled in Child

Development Centers
c.) 5 year old children not enrolled in the DepEd

preschool but enrolled in Child Development Centers
Conduct of Feeding:
The feeding shall be implemented twice a day for a minimum of 5days and
maximum of 7days a week for a period of 120days. The food allocation is P30
per child per day.
It consists of the following:
a.) Hot meals and alternative meals shall be served during the day
Alternative meals: heavy snacks - milk and bread / pasta / noodles or root
crops
Time Morning Session Afternoon Session
9AM Alternative meal
12NN Hot meal Hot meal
3PM Alternative meal

FEEDING PROGRAM
b.) Micronutrient Powder may be added once to
either hot meal or alternative meal per day
c.) Hot meals and alternative meals shall be

based on the Cycle Menu as recommended by
Food and Nutrition Research Institute and
prepared by DSWD Regional Nutritionists
Dietitians of SFP.
4. National Nutrition Promotion Program for
Behavior Change (In schools, In communities, In
workplace, and Resource center)
a.) Improving diet/ dietary diversification
Adoption of proper food and nutrition practices thru nutrition
education food production & consumption.
b.) Growth monitoring and promotion

Educational strategy for promoting child health, human
development and quality of life through sequential
measurement of physical growth and development of
individuals in the community.
The Pinggang Pinoy is a nutrition tool for preparing healthy food
on a per meal basis. It was developed by the Department of Science
and Technology’s Food and Nutrition Research Institute (DOST-
FNRI).
The Pinggang Pinoy is intended to guide meal planners in

preparing food that is proportional according to current nutritional
guidelines for different age groups.
For age specific instructions, please visit: https://www.fnri.dost.gov.ph/index.php/tools-and-

standard/pinggang-pinoy
5. Micronutrient Supplementation (vitamin A,
iron-folic acid, multiple micronutrient
powder, zinc)
• In health unit
• In schools
• Communication support
TARGET CLIENTS MICRONUTRIENT PREPARATION DOSAGE/FREQUENCY/DURATION
6-11 months old Iron Drops, 15mg elemental iron 0.6 ml Give 0.6 ml once a day for 3 mos.
MNP
Once the MNP is Single served sachet 15 Give 60 sachets to consume in 6
locally available, micronutrient formulation mos.
iron req’t will be in
the form of MNP
instead of iron
drops
Vitamin A Capsule 100,000 IU Give 1 Cap once (single dose)
12 – 23 months Iron Syrup containing 30 mg elemental Give 1 tsp once a day for 3 mos or
old iron/5 ml 30 mg once a week for 6 mos with
supervised administration.
Give 120 sachets in a year

Single served sachet 15
MNP
micronutrient formulation
Note: Once MNP
becomes locally
available, iron req’t
will be in the form
of MNP instead of
iron syrup
12 – 59 months Vitamin A Capsule, 200,000 IU Give 1 cap every 6 months
Vitamin A Supplementation in Pregnancy
Pregnant Women Postpartum Mothers
10,000 IU twice a week starting at the 4th 200,000 IU within four
month
weeks after delivery
of pregnancy until delivery
Not given in the 1st trimester to prevent

congenital problems and to women who are
already taking multivitamins with Vitamin A
What are the recommended levels of folic acid?
• All women in reproductive age should receive 400 micrograms (0.4 mg) of
folic acid daily
• Women who have had a previous child with neural tube defect should
receive 4000 micrograms (4 mg) of folic acid daily
6. Mandatory Food Fortification (technology
development, capacity building, regulation and
monitoring promotion
▪ Rice fortification with iron
▪ Flour fortification with iron and Vitamin A
▪ Cooking oil fortification with Vitamin A
▪ Sugar fortification with Vitamin A
▪ Salt iodization
Policies Description
AO No. 2010-0010 Revised Policy on Micronutrient Supplementation to support achievement of
2015 MDG Targets to reduce under-five and maternal deaths and micronutrient
needs of other population groups
AO No. 2007-0045 Zinc Supplementation and reformulated Oral rehydration salt in the
Management of diarrhea among children
R.A. 8172 An act promoting salt iodization nationwide and for other purposes
ASIN Law / FIDEL salt
RA 832 All milled rice will have to be enriched with pre-mixed rice
Rice Enrichment Law
R.A. 8976 • An act establishing the Philippine Food Fortification Program and for other
purposes”
Food fortification law
• mandating fortification of flour, oil and sugar with Vitamin A and flour and rice
with iron by November 7, 2004
• promoting voluntary fortification through the SPSP, signed into law on
November 7, 2000
• Department Memorandum No. 2011-0303 “Micronutrient powder
supplementation for children 6-23 months”
Food Fortification Program
Objectives:
• To provide the basis for the need for a food
fortification program in the Philippines: The
Micronutrient Malnutrition Problem
• To discuss various types of food fortification

strategies
• To provide an update on the current situation of

food fortification in the Philippine
Fortification
Addition of essential micronutrients to widely
consumed food products at levels above its normal state
Micronutrients
• Vitamins and minerals required by the body in
very small quantities.
• These are essential for maintaining a strong,
healthy and active body; sharp mind; Ans for
women to bear healthy children.
National Food Fortification
Day
• Every 7th of November
• Mandatory fortification of the following staple food:

a.) Rice with iron
b.) Wheat flour with Vitamin A and Iron
c.) Refined sugar with Vitamin A
d.) Cooking Oil with Vitamin A
e.) Salt – iodine
• Voluntary Fortification- Iron and B complex vitamins

 Fortification is highly encouraged for foods that are highly widely consumed particularly by
at risk population:
a.) Cereals (e.g. wheat flour, mil ed rice, corn grits)
Iron and B complex vitamins
b.) Cereal products (e.g. food snacks, instant noodles)
c.) Juice, flavored drinks, food gels – Vitamin C
d.) Fil ed milk, cooking oil, margarine – Vitamin A
e.) Salt – iodine
• Sangkap Pinoy Seal Program - strategy to encourage food
manufacturer to fortify processed foods or food products
with essential nutrients at a level approved by the DOH.
• The DOH seal of acceptance for processed foods or food

products can be used by food manufacturers provided
they passed the criteria set by the DOH Use of FIDEL salt
in lieu of the National Salt Iodization Program
(Fortification for Iodine Deficiency Elimination)
7. Nutrition in Emergencies
• Capacity building for mainstreaming nutrition protection
in emergencies
•NNC Governing Board Resolution No.1, Series of 2009

Adopting the National Policy on Nutrition Management in
Emergencies and Disasters
8. Overweight and Obesity Management and
Prevention Program
• Healthy food environment

• Promotion of healthy lifestyle
• Weight management intervention (for overweight
and obese individuals)
Belly Gud for Health

• Hataw Activities
• Jogging and Walking
• Ala Stress
• Fee Use of Gym
Nutrition Tips
1. Eat a variety of healthy food everyday
2. Consume fresh and unprocessed food
3. Enhanced the nutrient contents of simple dishes and
processed foods by adding a variety of fruits
and vegetables
4. Prepare nutrient and anti-oxidant rich beverages
5. Take supplements if needed
6. Exercise regularly
Nutrition Surveillance System
• It involves keeping a close watch on the

state of nutrition and the causes of
malnutrition within a locality. This
involves periodic collection of data and
analysis and dissemination of analyzed
information.
Tools used are anthropometric measurements:
• Weight for age - measures the degree and presence of
wasting and stunting
• Height for age - measures the presence of stunting; if

height is <90% of standard = stunting or past chronic
malnutrition
• Weight for height - determines the presence of muscle

wasting
BARANGAY NUTRITION
SCHOLAR (BNS)
• It is a human resource development strategy of the Philippine
Plan of Action for Nutrition, which involves the recruitment,
training, deployment and supervision of volunteer workers
called the
• Barangay Nutrition Scholars (BNS).
• Presidential Decree No. 1569 (1979)
• Deployment of at least one (1) BNS in every barangay in the
country to monitor the nutritional status of children and
other nutritionally at-risk groups and link them with
nutrition and nutrition-related service providers.
• Mandated the NNC to administer the program in cooperation
with local government units.
Qualifications of a Barangay Nutrition Scholar
1. Bonafide resident of the barangay for at least four years and can
speak the local language;
2. Possess leadership potentials as evidenced by
membership and leadership in community
organizations;
3. Willing to serve the barangay, part-time or full-time for at least
one year;
4. At least elementary graduate but preferably has reached high
school level;
5. Physically and mentally fit;
6. More than 18 years old, but younger than 60 years old.
Training
• Training under the supervision of the
District/City Nutrition Program Coordinator or
the designated BNS trainer-supervisor. The
training combines didactic training and twenty
(20) days practicum.
• It includes acquisition of knowledge, attitudes,

and skills needed for effective performance of the
tasks of identifying the malnourished,
monitoring the malnourished, and referring
them to appropriate service providers.
Basic Tasks of the BNS
1. Caring for the malnourished
• Locates and identifies malnourished children (Operation
Timbang)
• Weighs monthly all undernourished preschoolers.
Monitoring of:
a.) 0-23 month-old children to monitor if the children are
reaching their growth targets
according to the accepted child growth standard.
b.) Quarterly follow-up weighing of children, 24-59 months
old, to monitor any growth
faltering and determine any need for counselling of parents
and/or care givers or referral to appropriate service
providers.
2. Mobilizing the community
• Engages the community to action by organizing families
into clusters of 20-25 households, or into community-
based organizations working and helping the barangay
to improve the nutrition situation among the
vulnerable.
3. Linkage-building
• With the barangay masterlist of wasted, stunted,
under- and overweight children, pregnant and lactating
mothers, the BNS links the people needing nutrition
intervention and the barangay service providers.
4. Other forms of BNS assistance
• Organizing mothers’ class or community nutrition education classes;
• Providing nutrition counseling services (e.g. exclusive breastfeeding and appropriate
complementary feeding)
• Managing community-based feeding programs under the supervision of a nutritionist-
dietitian or a trained personnel;
• Distributing seeds, seedlings, and small animals from the local agriculture office and
other government organizations and nongovernment organizations (e.g. community
food gardens)
• Information dissemination on scheduled immunization, deworming and other health
activities under the instruction of the local midwife, agriculture officer, social welfare
officer, and other workers.
• Keeping records
• Formulates a BNS Action Plan as guide in managing her/his different tasks to support
implementation of the Barangay Nutrition Action Plan.
Malnutrition
1.Oxidative Stress
phenomenon caused by an imbalance between
production and accumulation of oxygen reactive species
(ROS) in cells and tissues and the ability of a biological
system to detoxify these reactive products.
➢“kulang sa timbang”, “kulang sa taas”

➢Causes: starvation / lack of food, diseases
➢Undernutrition
➢energy needs, risk of disease, immunity
Scarcity of principal
nutrients (protein, serum
albumin, Vitamin E) which
are part of antioxidant
defense were decreased,
resulting in oxidative stress.
Malnutrition
2. Inflammation
➢Causes: overeating, oversitting, metabolic
disorders
➢Obesity is the accumulation of abnormal or excessive

fat that may interfere with the maintenance of an
optimal state of health. The excess of macronutrients
in the adipose tissues stimulates them to release
inflammatory mediators
Malnutrition
3. Immunocompromised
➢Micronutrient deficiency
➢Hidden hunger ➔ lack of vitamins and minerals.
➢Hidden hunger occurs when the quality of food people eat

does not meet their nutrient requirements, so the food is
deficient in micronutrients such as the vitamins and
minerals that they need for their growth and development.
Types of Nutritional
Deficiencies
A. Protein Energy Malnutrition (PEM)
1. Marasmus
o Total caloric deficiency; the child lacks food rich in protein
and energy
o Child is usually less than one year old when malnutrition
started
o Signs:
• Very thin (no fat, there is muscle wasting)
• Very poor weight gain
• Old man’s face
• Enlarged abdomen
• Prominent ribs
• Loose and wrinkled skin
• Anxious
• Always hungry
2. Kwashiorkor
O Protein deficiency
O Disease of the older child when the next child is born
O Usually occurs when the child is 1 to 3 years old
O Signs:
• Very thin, fails to grow
• Light colored, weak hair (flag sign)
• Moon shaped, unhappy face
• Enlarged abdomen
• Muscle wasting
• Swollen or edematous legs, feet, arms and hands
• Apathetic
• Skin sores and skin peeling
• Dark spots on the skin
• Does not want to eat
TREATMENT:
FOOD is the only CURE!
1.Increase the protein and energy concentration of the food prepared

2.Increase frequency of feeding
3.Increase variety of food offered.
B. Vitamin A Deficiency
O A condition in which blood levels of Vitamin A are low and
stores in the liver are depleted
O Causes:
• Low intake of Vitamin A rich foods
• Low intake of oil and protein
• Illnesses like measles, diarrhea, and pneumonia
O Consequences:
• Blindness
1. Night Blindness - due to decrease rhodopsin (visual purple)
2. Nutritional Blindness - destruction of cells of the cornea
• Low resistance to infection
Source of Vitamin A
• Breastmilk
• Best animal sources: whole milk, eggs,
liver, meat
• Best plant sources: yellow / orange fruits
(papaya, mango), green leafy vegetable
(kangkong, malunggay)
Provision of high dose of Vitamin A capsule for the treatment of
xerophthalmia
Infants (6 to 11 months) with signs and symptoms of VAD, give 100,000
IU VAC
• One capsule tomorrow
• One capsule after two weeks
• One capsule today
Preschoolers (12 to 83months) with signs and symptoms of VAD,

give 200,000 IU VAC
One capsule today
• One capsule tomorrow
• One capsule after two weeks
• Undernourished preschoolers and school age children
with persistent diarrhea, measles and severe
pneumonia, give 200,000 IU, VAC upon diagnosis
• Undernourished infants with persistent diarrhea,

measles and severe pneumonia give 100,000 IU VAC
upon diagnosis
• 15 to 59 months old children - during NID or araw ng

Sangkap Pinoy
C. Iron Deficiency Anemia (IDA)
o A condition in which there is not enough hemoglobin in the
red blood cells because of lack of iron, which is necessary for RBC
formation
o Causes:
• Low intake of iron-rich foods, especially the more
absorbable iron from foods of animal origin
• Blood loss which may be due to hookworm infestation,
menstruation and childbirth
• Poor absorption of iron due to lack of iron absorption
enhancers or the presence of inhibitors
• Increased demands during certain stages in life such as
during infancy, preschool and adolescence, pregnancy
and lactation.
Sources of Iron
• Best animal sources (Heme - iron): liver,
internal organs, meat (pork and chicken),
blood,
fish and shellfish
• Best plant sources (Non-heme - iron):
green leafy vegetables (alugbati, kangkong,
saluyot, pechay, kamote tops, mustasa),
dried beans (bitsuelas, kadyos, mongo)
Treatment and Prevention:
Iron Supplementation
• Provision of iron (ferrous sulfate) with folic acid

for the treatment and prevention of IDA.
• Pregnant women to take 60mg elemental iron
with 400 mcg of folic acid once a day for 90 days.
• Low birth weight infants and those 6-11 months
to be given ferrous sulfate drops with 15mg
elemental iron/0.6 ml
TREATMENT and PREVENTION:
IRON SUPPLEMENTATION
1.Provision of iron (ferrous sulphate) with folic acid for the treatment and
prevention of iron deficiency anemia
2.Pregnant woman to take 60mg elemental iron with 400mcg of folic acid
once a day for 180days
3.Lactating women to take 60mg elemental iron with 400mcg of folic acid
once a day for 90 days
4.Low birth weight infants and those 6 to 11 months to be given ferrous
sulphate drops with 15mg elemental iron / 0.6ml
D. Iodine Deficiency Disorders (IDD)
o Abnormalities that result when the body does not get enough
iodine.
o This abnormalities range from mild such as goiter, to serious
such as stillbirths, congenital
anomalies, growth and mental retardation, and physical and
motor abnormalities
o Causes:
• Low intake of iodine rich foods or low content
of iodine in food
• Goitrogens and other environmental factors
Consequences
Fetus
• Abortion or miscarriage
• Congenital abnormalities
• Stillbirth
Infants and preschoolers
• Cretinism (mental retardation, squint, deafmutism and paralysis)
• Delayed walking and other motor activities
• Delayed speech and cognitive development
School age
• Poor scholastic performance
Adults
• Mental impairment
• Poor working capacity resulting to low productivity
Iodine Sources
90% from food (best sources are
seafoods and crops grown on iodine rich
soil)
• 10% from drinking water
TREATMENT and PREVENTION:
IODINE SUPPLEMENTATION
1.Women 15 to 45 years old to take one iodized capsule with 200mg iodine
every year
2.School age children to take one iodized capsule with 200mg iodine every
year
3.Adult males to take one iodized capsule with 200mg iodine every year.
HOME ACTIVITY
• Overview of Nurse Entrepreneurship (CHN Context)
1. Watch the video in this link: https://tinyurl.com/NURSEENTREP.

2. Do a 100-word reaction paper answering the question, “In the
context of CHN, what are your views about nurse entrepreneurship?
-Individual (20 points)
3. Do a project blueprint/ charter (prototype to be shared) of a
possible entrepreneurial project that will profit, will help the
community, and related to a public health issue. -Group Activity (30
points)
• Submission: 2 weeks from the delivery of this module.

REMINDERS
• Group 1 BSN 2B to lead us in prayer and take-
aways.
• TYPE IN YOUR NAME AND TEMPERATURE.
• RLE GROUP LEADERS, PLEASE CHECK YOUR

MEMBERS AND NOTE WHO ARE ABSENT at 3:05
PM.
Module 11: GARANTISADONG
PAMBATA

At the end of this module, you should be
able to:
•Reiterated the overview of GP as a public
health program.
•Identified the components of GP.
•Identified the roles of Community Health

Nurses (CHN) in the implementation of GP.
GARANTISADONG PAMBATA
•
National health service and communication initiative

that will help
children survive illnesses
and diseases and live long healthy
lives
• 25 babies in every 1,000 live births die before their first
birthday
• 16 babies in every 1,000 live births die before one month
old
• 34 children in every 1,000 live births die before the 5th
birthday
Mandate: A.O. 36, s2010 - Aquino Health Agenda
(AHA): Achieving Universal Health Care for All
Filipinos.
Goal Achievement of better health outcomes,

sustained health financing and responsive health
system by ensuring that all Filipinos, especially the
disadvantaged group (lowest 2 income quintiles)
have equitable access to affordable health care
EXPANDED GARANTISADONG PAMBATA-
This is a comprehensive and integrated
package of services and communication on
health, nutrition and environment for
children available everyday at various
settings such as home, school, health facilities
and communities by government and non-
government organizations, private sectors
and civic groups.
GIDA
Geographically Isolated and Disadvantaged Areas
• Communities with marginalized population

physically and socio-economically separated from
the mainstream society and characterized by:
1. Physical Factors - isolated due to distance,

weather conditions and transportation difficulties
(island, upland, lowland, landlocked, hard to
reach and unserved/underserved communities).
2. Socio-economic Factors (high poverty

incidence, presence of vulnerable sector,
communities in or recovering from situation of crisis
or armed conflict).
Objectives
• Contribute to the reduction of infant and child
morbidity and mortality towards the attainment
of MDG 1 and 4.
• Ensure that all Filipino children, especially the

disadvantaged group (GIDA), have equitable
access to affordable health, nutrition and
environment care.
Components of
Garantisadong
Pambata
https://data.unicef.org/country/phl/
Garantisadong Pambata Services
Age by Year Health Nutrition Environment
0 to 1 Maternal health care Maternal nutrition Water
Essential newborn care Iron supplementation Sanitation
Immunization Vitamin A Hygiene promotion
Early and exclusive Oral health
breastfeeding
Complementary feeding
1 to 5 Immunization Breastfeeding Child injury
Deworming Complementary feeding prevention
IMCI Vitamin A Treated bednets
Iron supplementation Smoke fee homes
Iodized salt at home
6 to 10 Deworming Proper nutrition
Booster immunization (Screening) Iodized salt at home
11 to 14 Deworming Proper nutrition

Booster immunization (screening) Iron supplementation
Physical activity (Healthy Lifestyle) Iodized salt at home
1. MAGPASUSO
(Newborn to 6 mos) Pasusuhin ng gatas ni Nanay lang
(6 mos to 2 years old) Magpasuso at bigyan ng (mga
masustansiyang ibat-ibang pagkain) ibang pagkain
(pampamilyang pagkain).
Bumili/ Gumamit ng mga produktong may SANGKAP PINOY seal
sa pagluluto.
Breastfeeding
• Unequalled way of providing ideal food for the healthy growth
and development of infants
• Integral part of the reproductive process with important
implications for the health of mothers.
Exclusive Breastfeeding
• Infant receives only breast milk.
• No other liquids or solids are given – not even water – with the
exception of oral rehydration solution, or drops/syrups of
vitamins, minerals or medicines.
Recommendation of WHO and UNICEF for mother to establish and
sustain breastfeeding for 6 months
• Initiation of breastfeeding within the first hour of life
• Exclusive breastfeeding
• Breastfeeding on demand – that is as often as the child wants, day and
night
•No use of bottles, teats or pacifiers

Colostrum
oYellowish fluid rich in proteins which is essential to
the development of a healthy immune system.
oProtein is easily digested and absorbed by the body
oProvides factors that can promote maturation of
the gut and good digestion.
oMost superior and well-designed nutrition for the
baby in the first few days of life.
Components of Breast
milk
1. Saturated and unsaturated fats, cholesterol- important
constituent of brain and nerve tissue
2. Fats- easily digester
3. Full range of vitamins and minerals in an easily digestible
combination
4. Lactoferrin- binds to iron, thus rendering it unavailable to viruses
and bacteria.
5. Lysozymes and milk leucocytes -destroy viruses and bacteria
6. Secretory IgA-immunoglobulin that destroys viruses and bacteria
7. Bifidus factor-promotes the growth of beneficial bacteria in the
gut and limits the growth of disease-causing bacteria.
Advantages of breastfeeding for the baby
1.Superior nutrition
2. resistance to infections, and therefore fewer incidents of illness and
hospitalization
3. risk of allergies and lactose intolerance
4.Breast milk is sterile
5.Experiences less nappy rash and thrush
6.Less likely to develop allergies
7.Fewer stomach upsets and constipation
8.Breastfed infants tend to have fewer cavities
9.Promotes the proper development of baby’s jaw and teeth.
10.Higher IQs due to good brain development early in life
11.Babies benefit emotionally, because they are held more
12.Promotes mother-baby bonding
13.Breastfed babies have a  risk of malnutrition, obesity and heart disease
compared to formula fed babies.
Advantages of breastfeeding
for the mother
1.Contraction of the uterus when the baby sucks
2.During lactation, menstruation ceases, offering a form of contraception
(LAM)
3.Lose weight and achieve their pre-pregnancy figure more easily than
mothers who bottle feed
4.Less likely to develop breast cancer later in life
5.More economical than formula feeding
6.Less money spent for consultation and medication if the baby gets sick
7.Promotes mother-baby bonding
8.Hormones released during breast-feeding create feelings of warmth and
calm in the mother
Complementary Feeding
• Period of transition from exclusive breastfeeding to family foods
which covers a child from 6-23 months of age, and is a very
vulnerable period.
• Foods introduced to the child at the age 6months to

supplement breastmilk
• Given progressively until the child is used to three meals and in-
between feedings at the age of one year
• It is the time when malnutrition starts in many infants, contributing
to the high prevalence of malnutrition in children less than two years
of age.
Importance of
1.Breastmilk can be a single source of nourishment from birth up to six
months of life.
2.The child’s demands for food increases as he grows older and
breastmilk alone is not enough to meet his increased nutritional needs
for rapid growth and development
3.Breastmilk should be supplemented with other foods so that the child
can get additional nutrients
4.Introduction of complementary foods will accustom him to new foods
that will also provide additional nutrients to make him grow well
5.Breastfeeding, however, should continue for as long as the mother is
able and has milk which could be as long as two years
Process of
1.Prepare mixture of thick lugao/ cooked rice, soft

cooked vegetables. Egg yolk, mashed beans, flaked
fish/chicken/ground meat and oil.
2.Give mixture by teaspoons 2-4 times daily, increasing
the amount of teaspoons and number of feeding until
the full recommended amount is consume
3.Give bite-sized fruit separately
4.Give egg alone or combine with above food mixture
2. MAGPABAKUNA
• MAGPABAKUNA 
Siguraduhing
kumpletoang bakuna
ni baby sa buwan ng
unang kaarawan. 
• Pabakunahan ng
MMR ang mga
batang 1 taon. Ito ay
laban sa tigdas, beke
at rubella (German
Measles) Fully
Immunized Child
• (FIC) completed BCG

1, penta 1, penta 2,
penta 3, opv 1, OPV 2,
OPV 3, and 2 doses
measles mumps
rubella vaccines at 12
months of age
3. MAGBITAMINA A
Siguraduhing mabigyan
(mapatakan) ng Bitamina A kada
anim (6) na buwan ang inyong
mga anak na edad 6 na buwan
hanggang 5 taon
•ROUTINE ➔
Every 6 months for 6-59 months
preschoolers
•THERAPEUTIC
o1 capsule upon diagnosis regardless of when the last dose of VAC for
preschoolers with measles
o1 capsule upon diagnosis except when child was given Vitamin A was
given less than 4 weeks for preschoolers with severe
pneumonia, persistent diarrhea, severely underweight
o1 capsule immediately
upon diagnosis, 1
capsule the next day
and another capsule
after 2 weeks after for
preschoolers with
xerophthalmia
oAdverse effects within 48 hours of receiving
supplements containing 100 000–200 000 IU
vitamin A are usually mild and transient, with no
long term consequences.
oAdverse effects:
bulging of open fontanelles in younger infants,
nausea and/or vomiting and headache in older
children with closed fontanelles.
4. MAGPURGA
Siguraduhing mapurga ang

inyong mga anak na edad 1
hanggang 12 na taong
gulang kada anim na buwan.
Soil-transmitted helminth
infections
oOne of the most common infections in humans, caused by a

group of parasites – worms (e.g. roundworms, whipworms
and hookworms)
oMost vulnerable: low socio economic status
oEffects:
a)internal bleeding which can lead to loss of iron and anemia
b)intestinal inflammation and obstruction
c)diarrhea
d)impairment of nutrient intake, digestion and absorption
• Preventive chemotherapy (deworming)
oUsing annual or biannual single-dose albendazole (400 mg) or
mebendazole (500 mg)
a)all young children 12–23 months of age
b)preschool children 1–6 years of age (April and October)
c)school-age children 6–12 years of age (in some settings up to
14 years of age) (January and June)
oBiannual administration is recommended
✓1 to 2 years old = Albendazole 400mg ½ tablet single dose
✓2 to 14 years old = Albendazole 400mg 1 tablet single dose
National Deworming Months
January and July

5. GUMAMIT NG PALIKURAN
Gumamit ng kubeta o palikuran

sa pagdumi at pagihi.
oProper use of toilets
World Toilet Day
November 19
6. MAGSIPILYO
Wastong pagsisipilyo ng ngipin ng dalawang beses sa

isang araw, lalo na bago matulog.
oTooth brushing at least twice a day
oGum problems or cavities usually develop to kids aged
six and below due to poor eating habits.
oThis could lead to malnutrition and could lose
socialization with other kids and even other people.
oA toothache is also one of the reasons why kids do not
want to go school leads to several absences.
oThe moment babies are having their first tooth, parents should
seek an orthodontist or dentist to ensure that the teeth
development of the child will be monitored and that parents are
guided
oDental check up every 6 months

Oral Health Month
February
7. MAGHUGAS NG KAMAY
Maghugas ng kamay bago kumain at

matapos gumamit ng kasilyas.
Ugaliin din ang paghuhugas ng kamay
matapos maglaro o humawak ng
maduduming bagay.
oWashing hands with soap and water
Global Handwashing Day
October 15
8. HUWAG MANIGARILYO
Huwag manigarilyo, lalo na habang nagbubuntis

Huwag manigarilyo sa loob ng bahay at sasakyan o habang
karga o kaharap ang sanggol o maliliit na bata
Itago o ilayo sa bata ang sigarilyo, ashtray, posporo, lighter o
anumang bagay na gamit sa paninigarilyo.
Iwasan ang mga pampublikong lugar kung saan maaaring
makalanghap ng usok ng sigarilyo ang mga bata.
Huwag utusang bumili o magsindi ng sigarilyo ang bata.
World No Tobacco Day
MAY 31
Additional Components included in
Garantisadong Pambata
1.Pag-aalaga ng midwife, nurse, doctor sa inang buntis hanggang siya ay

manganak
Prenatal check up
Giving birth in the hospital, lying in, birthing homes is recommended
Bring the pregnant woman in the hospital when
a)Bleeding
b)Convulsion
c)Elevated body temperature
d)Frequent uterine contractions
e)Difficulty or fast breathing
2. Unang Yakap – Yakap ng Ina,
Yakap ng Buhay
3. Responsableng Pagpaplano
ng Pamilya
Birth Spacing – 3 years interval
4. Ingat Bata – Pag-iwas sa Sakuna
Constant monitoring of children to avoid accidents like fall,
drowning, burning, accidents (electricity), wound
Provide toys safe and appropriate for age
Place grills on windows and stairs
Do not allow children to play in streets
Be with the child when crossing the street
Keep chemicals, poisons, match sticks out of reach of children
Cover water containers to avoid drowning
5. Bantay Sakit – Wastong Alaga sa Batang Maysakit
Know the signs and symptoms of common diseases: pneumonia,
dehydration, measles, malnutrition
Bring the child to the nearest health center once signs and symptoms
were observed
Ensure that the child received Vitamin A
Give zinc and oral rehydration solution to a child with diarrhea
Know basic home management for common diseases
Follow recommendations given by the health care personnels
EXCITED FOR THE
NEXT MODULE???
Module 12
INFANT AND YOUNG CHILD FEEDING

At the end of this module, you should be able to:
• Explained the guiding principles in the infant
and child feeding (IYCF)
• Described how feeding should be intervened

during exceptionally difficult situations
• Related the role of CHN in the promotion of

healthy feeding practices
INFANT AND YOUNG CHILD FEEDING (IYCF)
A global strategy for Infant and Young Child
Feeding (IYCF) was issued jointly by the
World Health Organization (WHO) and the
United Nations Children’s Fund (UNICEF)
To reverse the disturbing trends in infant

and young child feeding practices.
Guiding Principles
1.Children have the right to adequate nutrition and access to
safe and nutritious food, and both are essential for
fulfilling their right to the highest attainable standard of
health.
2.Mothers and Infants form a biological and social unit and
improved IYCF begins with ensuring the health and
nutritional status of women.
3.Almost every woman can breastfeed provided they have
accurate information and support from their families,
communities and responsible health and non-health
related institutions during critical settings and various
circumstances including special and emergency situations.
Guiding Principles
4. The national and local government,
development partners, non-government
organizations, business sectors, professional
groups, academe and other stakeholders
acknowledges their responsibilities and form
alliances and partnerships for improving
IYCF with no conflict of interest.
5. Strengthened communication approaches
focusing on behavioral and social change is
essential for demand generation and
community empowerment.
Goal
•Reduction of child mortality and
morbidity through optimal feeding of
infants and young children
Objective
•To ensure and accelerate the promotion,
protection and support of good IYCF
practice
Key Facts
• Every infant and child has the right to good nutrition according to
the "Convention on the Rights of the Child".
• Undernutrition is associated with 45% of child deaths.
• Globally in 2019, 144 million children under 5 were estimated to

be stunted (too short for age), 47 million were estimated to be
wasted (too thin for height), and 38.3 million were overweight or
obese.
• About 40% of infants 0–6 months old are exclusively breastfed.

Key Facts
•Few children receive nutritionally adequate and
safe complementary foods; in many countries less
than a fourth of infants 6–23 months of age meet
the criteria of dietary diversity and feeding
frequency that are appropriate for their age.
• Over 820 000 children's lives could be saved every

year among children under 5 years, if all children 0–
23 months were optimally breastfed. Breastfeeding
improves IQ, school attendance, and is associated
with higher income in adult life
Key Facts
•Improving child development and reducing health
costs through breastfeeding results in economic
gains for individual families as well as at the
national level.
•Undernutrition is estimated to be associated with
2.7 million child deaths annually or 45% of all child
deaths. Infant and young child feeding is a key area
to improve child survival and promote healthy
growth and development.
Key Facts
•The first 2 years of a child’s life are
particularly important, as optimal nutrition
during this period lowers morbidity and
mortality, reduces the risk of chronic disease,
and fosters better development overall.
•Optimal breastfeeding is so critical that it
could save the lives of over 820 000 children
under the age of 5 years each year.
Recommendation of
WHO and UNICEF
1.Early initiation of breastfeeding within 1 hour of
birth;
2.Exclusive breastfeeding for the first 6 months of
life
3.Introduction of nutritionally-adequate and safe
complementary (solid) foods at 6 months together
with continued breastfeeding up to 2 years of age or
beyond.
Recommendation of
WHO and UNICEF
•Recommendations have been refined to also
address the needs for infants born to HIV-
infected mothers.
•Antiretroviral drugs now allow these
children to exclusively breastfeed until they
are 6 months old and continue breastfeeding
until at least 12 months of age with a
significantly reduced risk of HIV
transmission.
A. BREASTFEEDING
Three E’s of Breastfeeding
•Early
•Exclusive
•Extended
Benefits of exclusive
breastfeeding to the infant
and mother
1.Protection against gastrointestinal infections which is observed not
only in developing but also industrialized countries.
2.Early initiation of breastfeeding, within 1 hour of birth, protects the
newborn from acquiring infections and reduces newborn mortality.
3.Risk of mortality due to diarrhea and other infections can increase in
infants who are either partially breastfed or not breastfed at all.
4.Important source of energy and nutrients in children aged 6–23
months. It can provide half or more of a child’s energy needs between
the ages of 6 and 12 months, and one third of energy needs between 12
and 24 months. Breast-milk is also a critical source of energy and
nutrients during illness, and reduces mortality among children who
are malnourished.
Benefits of exclusive
breastfeeding to the infant
and mother
5. Children and adolescents who were breastfed as babies are less
likely to be overweight or obese.
6. Perform better on intelligence tests and have higher school
attendance.
7. Associated with higher income in adult life.
8. Improving child development and reducing health costs results in
economic gains for individual families as well as at the national
level.
9. Longer durations of breastfeeding also contribute to the health and
well-being of mothers: it reduces the risk of ovarian and breast
cancer and helps space pregnancies–exclusive breastfeeding of
babies under 6 months has a hormonal effect which often induces a
lack of menstruation.
Actions that help protect,
promote and support
breastfeeding
1.RA 11210 – Expanded Maternity

Leave
• An act increasing the maternity leave period to one hundred five
(105) days for female workers with an option to extend for an
additional thirty (30) days without pay, and granting an
additional fifteen (15) days for solo mothers
promote and support
breastfeeding
2. EO 51 – Milk Code
• National Code of Marketing of Breastmilk Substitutes, Breastmilk
Supplements and Other Related Products
• Scope of EO 51
a)Specific products and other products when marketed as partial or
total replacement of breastmilk
b)The quality and availability and information concerning the use of
these products
promote and support
breastfeeding
3. RA 10028 – Expanded
Breastfeeding Promotion Act of
2009
• Mandates workplace compliance with EO 51, prohibiting any direct
or indirect promotion, marketing and / or sales of products within
the scope of the law inside lactation stations or in any event involving
women and children whether related to breastfeeding promotion or
not.
Ten steps to successful
breastfeeding
1.Have a written breastfeeding policy that is routinely

communicated to all health care staff.
2.Train all health care staff in skills necessary to implement this
policy.
3.Inform all pregnant women about the benefits and management
of breastfeeding.
4.Help mothers initiate breastfeeding within one half-hour of birth.
5.Show mothers how to breastfeed and maintain lactation, even if
they should be separated from their infants.
6.Give newborn infants no food or drink other than breastmilk,
unless medically indicated.
7. Practice rooming in – that is, allow mothers and infants to remain
together 24 hours a day.
• RA 7600 – Rooming in as a national policy to encourage, protect
and support breastfeeding
• Exemptions – mothers who are:
➢Seriously ill, taking medications contraindicated to breastfeeding,
violent /psychotic or those whose conditions do not permit
breastfeeding or rooming-in
• Provide facilities for breastfeeding collection and storage
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants.
10.Foster the establishment of breastfeeding
support groups and refer mothers to them
on discharge from the hospital or clinic.
Provision of supportive health services
with infant and young child feeding
counseling during all contacts with
caregivers and young children, such as
during antenatal and postnatal care,
well-child and sick child visits, and
immunization
• Breastfeeding in the workplace
• Breastfeeding lactation station – OPD-Adolescent and Youth Wellness
Clinic, NICU, Private Ward
• HIV and Infant feeding
a)Evidence has been reported that Antiretroviral drugs regimens given
to women can reduce the risk of mother-to-child transmission during
pregnancy, labor, and delivery as well as during breastfeeding, all of
which increases the chance of HIV-free survival of the baby
b)Risk of illness and death from NOT exclusively breastfeeding is
higher than the risk of HIV transmission form Breastfeeding
c)About 5-15% of babies born to infected mother will become HIV+
through Breastfeeding (1 in 20 or 1 in 7).
d)Breastfeeding is recommended for women who do not know their
status and who are HIV negative
Community support, including mother support groups and
community-based health promotion and education activities.
• Breastfeeding Management – Mother’s Class emphasis on:
a)Significance of breastfeeding
b)Exclusive breastfeeding and its benefits
c)Proper Positioning and Attachment during breastfeeding
d)Introduction and proper timing of Supplementary foods
e)Demonstration on Proper Hand Milk Expression
f)Significance of Demand Feeding or baby-led feeding
• Breastfeeding capacity building activities
At age 6 months, infant’s need for energy and nutrients

starts to exceed what is provided by breastmilk – need for
complementary feeding
At this age the infant is developmentally ready to take in

other foods
If complementary feeding is not introduced at around

the age of 6 months, infant’s growth may be retarded.
Characteristics of Complementary
Feeding
•Safe
•Adequate
•Timely Introduced
•Suitable
•Fed Properly
Guiding principles for appropriate
1.Continue frequent, on-demand breastfeeding until 2 years of age

or beyond
2.Practice responsive feeding

• e.g. Feed infants directly and assists older children
• Feed slowly and patiently
• Encourage them to eat but do not force them
• Talk to the child and maintain eye contact
Guiding principles for appropriate
3. Practice good hygiene and proper food handling

4. Start at 6 months with small amounts of food and increase gradually
as the child gets older
5. Gradually increase food consistency and variety
6. Increase the number of times that the child is fed:
• 2–3 meals per day for infants 6–8 months of age
• 3–4 meals per day for infants 9–23 months of age, with 1–2
additional snacks as required
7. Use fortified complementary foods or vitamin-mineral supplements
as needed
8. During illness, increase fluid intake including more breastfeeding,
and offer soft, favorite foods
Fluid Needs of the
Young Child
Water is good for thirst. Pure juices can also be used, however, too
much can cause diarrhea and may reduce the child’s appetite to food
Drinks that contain a lot of sugar may actually make the child
thirstier. Fizzy drinks are not suitable
Teas and coffee reduce the iron that is absorbed from foods. If to be
given, not at the same time as food or 2 hours before and after food.
Drinks should not replace foods or breastfeeding
A non-breastfed child aged 6 to 24 months needs approximately 2 to
3 cups of water per day in temperate climate and 4 to 6 cups in a hot
climate
During meal the child maybe thirsty offer small amount of drink to
satisfy the thirst then the child may continue to eat.
Feeing the Child who is Ill
Encourage the child to drink and to eat with lots

of patience
Feed small amounts frequently
Give foods that the child likes
Give a variety of nutrient rich foods
• Continue to breastfeed – often ill children
breastfeed more frequently
Feeding during recovery
•To allow “catch up” growth:

Give extra breastfeeds
Feed an extra meal
Give an extra amount
Use extra rich foods
Feed with extra patience
Feeding in Exceptionally
Difficult Circumstances
Families and children in difficult circumstances
require special attention and practical support.
Wherever possible, mothers and babies should
remain together and get the support they need to
exercise the most appropriate feeding option
available.
Breastfeeding remains the preferred mode of
infant feeding in almost all difficult situations
Difficult circumstances – refers to situations faced by vulnerable
groups
• HIV-infected mothers and their infants
• People suffering the consequences of complex emergencies,
including natural or human-induced disasters such as floods,
drought, earthquakes, war, civil unrest and severe political and
economic living conditions.
• Low birth-weight or premature infants
• Infants and young children who are malnourished
• Adolescent mothers and their infants
• Children living in special circumstances such as foster care, or with
mothers who have physical or mental disabilities, or children whose
mothers are in prison or are affected by drug or alcohol abuse.
• NOTE: The most suitable food for the infant is breast milk
• Alternatives to breastmilk in cases wherein the infant is
separated from the mother or mother is unable to
breastfeed:
• Breastmilk from others (wet nurses, milk bank)
• Artificial feeding (use of non-human milk)
• If artificial feeding is given, use of feeding bottles should be
avoided.
• Cup feeding is possible from birth and a safer option
HIV and Infant Feeding
Breastfeeding, and especially early and exclusive breastfeeding, is one of the
most significant ways to improve infant survival rates.
While HIV can pass from a mother to her child during pregnancy, labor or
delivery, and also through breast-milk, the evidence on HIV and infant
feeding shows that giving antiretroviral treatment (ART) to mothers living
with HIV significantly reduces the risk of transmission through
breastfeeding and also improves her health.
WHO now recommends that all people living with HIV, including pregnant
women and lactating mothers living with HIV, take ART for life from when
they first learn their infection status.
Mothers living in settings where morbidity and mortality due to diarrhea,
pneumonia and malnutrition are prevalent and national health authorities
endorse breastfeeding should exclusively breastfeed their babies for 6
months, then introduce appropriate complementary foods and continue
breastfeeding up to at least the child’s first birthday.
Frequently asked Questions
about Breastfeeding and HIV
1. Can mothers living with HIV breastfeed their children in the same
way as mothers without HIV?
• WHO recommends that all mothers living with HIV should receive life-
long antiretroviral therapy (ART) to support their health and to
ensure the wellbeing of their infants.
• Mothers living with HIV who are on ART and adherent to therapy
should breastfeed exclusively for the first 6 months, and then add
complementary feeding until 12 months of age.
• Breastfeeding with complementary feeding may continue until 24
months of age or beyond
2. Is mixed feeding better than no breastfeeding at all, if the mother
is on HIV treatment?
• Yes. Mothers living with HIV can be reassured that AFT reduces
the risk of post-natal HIV transmission even when the baby is on
mixed feeding. Although exclusive breastfeeding is recommended
for the first 6 months, mixed feeding is better than no feeding.
3. If a mother on HIV treatment plans to return to work or school is
a shorter duration of breastfeeding better than no breastfeeding at
all?
• Yes. Mothers and health care workers can be reassured that
shorter durations of breastfeeding of less than 12 months are
better than never initiating breastfeeding
4. What can be done to support breastfeeding among mothers
living with HIV?
• Government and local authorities should actively promote and
implement services to create a supportive environment for
mothers living with HIV to remain adherent to treatment and to
breastfeed the infant in all settings.
NCOVID 19 & BREASTFEEDING
EXCITED FOR THE
NEXT MODULE???

Quizzes Midterms Merged

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Quizzes Midterms Merged

Uploaded by

Copyright:

Available Formats

Flight range is 50-300 kilometers

MODULE 5 DENGUE PREVENTION

1. These are living organisms that transmit

A. Usually last 2-7 days

B. Result of 20,000 WBC per microliter

C. Positive of Herman’s Sign

D. Presence of myalgia, diarrhea, and vomiting

E. None of the above

It is an acute viral infection with no definitive

It has four serotypes (DENV1, DENV2, DENV3, Critical Phase

It is possible for a human to get infected four All of the above

Life span of 20-30 days

None of the above None of the above

a. Saddleback fever Group A: Referred for in hospital care

b. Biphasic Fever Group B: Referred for in Hospital Care

c. Relapsing Fever Group C: Referred for in hospital care

Both a and b Group C: Require emergency treatment

Both a and c Group D: Require emergency treatment

12. Conrado is a 7 years old, 22 kg, dengue patient,

Dengue without warning signs

Dengue with warning signs

Dengue with critical signs

10 cups Dengue IgM may cross react with Zika Virus

Plaque Reduction Neutralization Test is the

All of the above

None of the above

Events Based Surveillance

Philippine Integrated Disease Surveillance and

Confirmed 22. Compute for Morbidity Rate *

None of the above

Classifications and reporting, EXCEPT. *

Suspect cases are those indicative of clinical

Dengue is a Category 2 Notifiable Disease,

All of the above 33 deaths per 10,000 population

33 deaths per 20,000 population

2.4 deaths per 100 population

To reduce dengue morbidity by at least 25% by done at what frequency?

To maintain dengue case fatality rate to <2%

Ensure healthy lives and promote well-being 4 cycles per year

26. This is the occurrence of 2 or more dengue

weeks. * Program, EXCEPT. *

Clustering Republic Act 8504 is also known as National

None of the above HIV cannot be transmitted through the

Reactivation of the 4 o'clock habit HIV Treatment Facilities

Wearing of dark colored clothing and long HIV Treatment Hubs

Primary HIV Care Clinics

Application of insect repellant on uncovered None of the above.

MODULE 6 AND 7 MH GAP AND ORAL HEALTH

This programme is grounded on the best 5. This is a non-fatal, potentially injurious

6. Nurse Anna knows that the term used for

November 10 -World Mental Health Day

Heroin All of the above

9. This is a common condition that affects the

Dementia None of the above

Disorders due to alcohol

11. The following are emergency None of the above

presentations of suicide, EXCEPT: *

Treatment with antipsychotic program. *

Mission Fluoride utilization program

Goal Drainage of localized oral abscess

Objective None of the above

None of the above

_________. * during the Oral Health Month Celebration in