COMMUNITY

HEALTH

NURSING
Community
- a group of people with common characteristics
or interest living together within a territory or
geographical boundary.
Classifications of Communities:
1.URBAN
- increased in population; industrial-type of
work 2. RURAL
- decreased in population; agricultural-type of
work 3. RURBAN
- combination of rural and urban
4. SUBURBAN
- periphery around the urban areas
5. METROPOLITAN
- expanding urban areas
4 Aspects of Community:

1.Social
- communication and interaction of the
people. 2. Cultural
- norms, values and beliefs of the
people. 3. Political
- governance and leadership of the
people. 4. Geographical
- boundaries of the community.
Components of a Community:
A. PEOPLE
B. 8 SUBSYSTEMS
1. Housing
2. Education
3. Fire and Safety
4. Politics and Environment
5. Health
 6. Communication
7. Economics
8. Recreation
Health
- is the state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity. (World Health Organization)
Determinants of health
- factors or things that make people healthy or not.
1. Income and social status
2. Education
3. Physical environment
4. Employment and working conditions
5. Social support network
 6. Culture
7. Genetics
8. Personal behavior and coping skills
9. Health services
10. Gender
New concept in determinants of health
- OLOF (Optimum Level Of Functioning)
Factors that affects OLOF:
- Ecosystem
Composition of Ecosystem:
1. Political – power, authority, empowerment,
safety 2. Behavior – lifestyle related such as diet,
exercise 3. Heredity – genes, familial history
4. Environment – air, water, garbage, food, noise 5.
Socio-Economic – education, employment, housing 6.
 Health Care Delivery System – availability, accessibility
and affordability of services and facilities
Nursing
- an art and science of rendering care to
individual, families and community.

- assisting an individual, sick or well, in the

performance of those activities contributing to health
or its recovery in such a way as to help gain
independence. (OLOF)
Community Health Nursing
- a direct goal oriented and adaptable to the needs of
the individual, the family and community during health
and illness.
- (ANA, 1973)
- an area of human services directed toward
developing and enhancing the health capabilities of people
– either singly, as an individual or collectively as groups
and communities.
- (John Henrich, 1981)
- the utilization of the nursing process in different level of
clientele concerned with the promotion of health,
prevention of disease and disability and rehabilitation. -
(Aracelli Maglaya)

*** a service rendered by a professional nurse

with the community, groups, families and individuals
at home, in health centers, in clinics, in schools, in
 places of work for the promotion of health,
prevention of illness, care of the sick at home and
rehabilitation.
PRIMARY GOAL OF CHN:
- Enhance people’s capability.

ULTIMATE GOAL OF CHN:

- “ To raise the level of health of the citizenry.”

PHILOSOPHY OF CHN:
- CHN is based on the worth and dignity of man.
- (Margaret Shetland)
EMPHASIS/FOCUS:
- Health promotion and Disease prevention.
Important Concepts of CHN:
1. The primary focus of CHN is on health promotion. 2.
Recognized needs of individuals, families and communities
provide the basis for CHN.
3. The family is the unit of service.
4. Contact with the client may continue over a long period of
time which include all ages and all types of health care. 5. CH
nurses are generalists in terms of their practice throughout
life’s continuum –its full range of health problems and
needs.
6. CHN practice is extended to benefit not only the individual
but the whole family and community
Roles and Functions of CH Nurse:
1. Advocate
 - defends the rights of the client for self-determination
- intercedes, supports, pleads or acts as guardian of the
client’s rights to autonomy and free choice for self-care 2.
Supervisor
- provides administrative support
- oversees, monitors and evaluates the function of the
subordinates
3. Counselor
- encourages client to verbalize and express feelings and
concerns
- key task is active listening
4. Educator
- teaches the client to provide skills, knowledge and
attitude
- primary task is to assess readiness to learn
 5. Trainer
- provides technical support
- identifies training needs, formulates training program
designs
- arranges and conducts training to provide learning
experiences to subordinates and clients
Levels of Clientele:
1. Individual
- “point entry”
2. Family
- center of delivery of care.
3. Group
- point of specific care.
4. Community
 - point of entire care
PLACES IN CHN:

A. Public Health Nursing

- is a special field of nursing that combines the skills of
nursing, public health and some phases of social assistance
and functions as part of the total health program.

Public Health
- the science and art of preventing disease, prolonging
life and promoting life and efficiency. (C. E. Winslow) - is the
art of applying science in the context of politics to reduce
inequalities while ensuring the best health for the greatest
number. (WHO)
B. School Health Nursing
 > Home Visitation – effective implementation of total school
program
> RA 124 – it mandates the school to provide clinics for the
minor treatment and attendance to emergency cases >
Assessment:
1. Arms 5. Ears
2. Eyes and Visual Acuity 6. Neck and Chest 3. Nose
7. Hair
4. Mouth and Teeth 8. Lower extremities > Feeding
Program
- Should run for 120 days
- Deworming with consent
C. Occupational Health Nursing

> RA 1054
 – Occupational Health Act

> Business Firm must employ an occupational health nurse

when it has at least _____________?
101 employees
FAMILY – NURSE CONTACT:
I. HOME VISIT
- professional face to face contact done by a nurse to
the family.
Purposes:
1. Give nursing to the sick, post partum mother & newborn.
2. Assess living condition of client and their health
practices.
3. Give health teachings.
4. Establish relationship with health agency and public. 5.
Make use of inter-referral system and promote utilization of
community services.
Principles:
1. Must have a purpose and objective.
2. Make use available information about the patient and his
family.
3. Consider and prioritize essential needs of the individual
and family.
4. Should involve the individual and family in planning and
delivery of care.
5. Plan should be flexible.
Important Steps of Home Visit:
1. Greet client and family then introduce yourself.
2. Explain the purpose of the visit.
3. Observe the patient and determine the health needs.
4. Put the bag in a convenient place then perform bag
technique
5. Perform nursing care and give health teachings.
6. Record all important data, observation and care
rendered.
7. Make appointment for a return visit.
Phases:
1. Preparatory Phase
a. review existing records of referral data of the
family
b. notifies the family of the intention to make a
home visit
2. Home Visit Phase
a. actual visits of the family
 b. makes plans, interventions, evaluation with the
family and set schedule for the next visit
3. Post Visit Phase
a. records data and plans for the next visit and
referrals
Priorities During Home Visit:
1. Newborn
2. Post partum
3. Pregnant women
4. Morbid individuals

Factors affecting Frequency of Home Visit:

1. Physical, psychological and educational
2. Acceptance of family
 3. Policies given by the agency
Bag Technique:
- a tool making use of a public health bag and which
the public health nurse can perform procedures during
home visits.

Rationale :
- Helps render effective nursing care to clients.

Principles:
1. Minimize if not totally prevent the spread of infection.
2. Save time and effort.
*** Open bag TWICE during home visit.
Special Consideration:
 B
- bag and its contents must be free from any
contamination.
A
- always perform handwashing.
G
- gather necessary equipments to render effective
nursing care.
Steps in Performing The Bag Technique Actions:

1. Upon arrival, place the bag on the table lined with a clean
paper. (the clean side must be out and folded part, touching
the table)
2. Ask for a basin of water.
3. Open the bag and take out the towel and
soap. 4. Wash hands.
5. Take out the apron and put it on with the right side. 6.
Put out all the necessary articles needed for the specific
care.
7. Close the bag and put it in one corner of the working
area. 8. Perform nursing care and treatment.
9. After giving the treatment, clean all things that were used
and perform handwashing.
10. Open the bag and return all things that were used in their
proper place
11. Remove apron, folding it away fro the person, the
soiled side in and the clean side out. Place it in the bag. 12.
Fold the lining, place it inside the bag. Close the bag. 13.
Take the record and have a talk with the mother. 14. Make
an appointment for the next visit.
II. CLINIC VISIT
Advantage:
- it is inexpensive in time and usually in cost both for the
service and for the family.
Standard Procedure in Conducting Clinic Visit:
I. Registration/Admission
1. Greet the client and establish rapport
2. Prepare records
3. Elicit client’s chief complaint and clinical
history 4. Perform PE
II. Waiting Time
* Implement the “first come”, “first served” except
for emergency and urgent cases
III. Triaging
* Manage program-based cases
 * Refer all non-program based cases
IV. Clinical Evaluation
* Validate clinical history and PE
* Inform client of the nature of the illness, treatment,
prevention and control measures
V. Laboratory and other diagnostic examinations * Identify
a designated referral laboratory when needed
VI. Referral System
1. Refer if needs further management (BHS to RHU, RHU
to RHU, RHU to Hospital)
2. Accompany patient if it is an emergency
referral VII. Prescription/ Dispensing
* Give proper instructions on drug intake
VIII. Health Education
1. Conduct one-on-one counseling with the patient 2.
 Reinforce health education and counseling messages
3. Give appointments for the next visit
Phases:
1. Pre-consultation
a. establish relationship
b. assessment on chief complaint, VS, PE
2. Consultation
A. Medical Consultation
B. Nursing Intervention
3. Post-consultation
a. explaining intervention to be done at home
b. follow-up care
c. referral (if possible)
PRIMARY HEALTH CARE
 - is an essential health care made universally
accessible to individuals and families in the community by
means acceptable to them.
*** in Sept. 6-12, 1978 : UNICEF and WHO held the First
International Conference on Primary Health Care in Alma
Ata, USSR

Legal Basis:
LOI 949 : was signed by Pres Marcos on Oct 19, 1979
making Primary Health Care the thrust of the
Department of Health.
Vision :
Health for All Filipinos

Goal :
 Health for All Filipinos and Health in the Hands of the
people by the Year 2020

Mission :
In partnership with the people, provide equity, access
and quality health care especially to the marginalized
Principles:
1. 4 A’s; Accessibility, Availability, Affordability and
Acceptability of health services
2. Community Participation
- is the heart and soul of PHC
3. People are the center, object and subject of development
4. Self – reliance
5. Partnership between the community and the health
agencies in provision of quality life
6. Recognition of interrelationship between the health and
development
7. Social mobilization
8. Decentralization
RA 7160 :
The Local government Code of 1991 which
resulted in devolution, which transferred the
power and authority from the national to the
local government units, aimed to build their
capabilities for self-government and develop
them fully as self-reliant communities.

- Devolution Code (Mandate of Devolution)

Local Government Code
Primary Health Care Team: 1.
 Local Chief Executive
2. Physician
3. Nurse
4. Medical technologist
5. Midwife
6. Sanitary Inspector
7. Auxiliaries
- BHW
- PHW
4 Pillars/Cornerstones:
1. Active community participation
2. Intra and inter- sectoral linkages
3. Use of appropriate technology
4. Support mechanisms made available
Levels of PHC Workers:
1. Village or Brgy. Health Workers
- health auxiliary or volunteers
2. Intermediate Level Health Workers -
Physician - Sanitary Inspector - Nurse -
Midwife
Ratios to catchment population:
Public Health Worker = 1:50,000 Public
Health Physician = 1:20,000 Public Health
Nurse = 1:20,000 Public Health Midwife =
1: 5,000
Dentist = 1:20,000
LEVELS OF PREVENTION
1.Primary Prevention
 - health promotion
- specific protection
Behaviors:
1. Quit smoking
2. Avoid/limit alcohol intake
3. Exercise regularly
4. Eat well-balance diet
5. Reduce fat and increase fiber in the
diet 6. Complete immunization program
7. Wear hazard devices in work site
2. Secondary Prevention
- early diagnosis/detection/screening
- prompt treatment
Behaviors:
1. Have annual physical examination
2. Regular Pap smear for women
3. Monthly BSE for women who are 20 yrs old and
above
4. Sputum examination for Tuberculosis
5. Annual stool Guaiac test and rectal exam for clients
over age 50 yrs old
3. Tertiary Prevention
- prevention of complication
- optimal health status after a disease or
disability
Behaviors:
 1. Self-monitoring of blood glucose among
diabetics 2. Physical therapy after CVA
3. Attending self-management education for
diabetes 4. Undergoing speech therapy after
laryngectomy
Levels of Health Care and Referral System

1. Primary Level of Care

1. Rural Health Units
2. Community Hospitals and Health Center 3.
Private Practitioners (Puericulture Centers) 4.
Brgy. Health Stations
- is usually the first contact between the community
 members and the others levels of health facility. -
provided by center physicians, public health nurses,
rural health midwives, barangay health workers,
traditional healers
2. Secondary Level of Facilities
1. Provincial/City Health Services and Hospitals
2. Emergency and District Hospitals
- serves as a referral center for the primary health
facilities
- are capable of performing minor surgeries and perform
some simple laboratory examinations

3. Tertiary Level of Facilities

1. National and Regional Health Services
 2. Teaching and Training Hospitals
- serves complicated cases and intensive care
ALTERNATIVE HEALTH CARE

Legal Basis:
RA 8423 – Traditional and Alternative Medicine Act

* created the Philippine Institute of Traditional and

Alternative Health Care

** S A N T A L U B B Y **
S - Sambong
* anti-edema, diuretic, anti-urolithiasis
A - Ampalaya
* DM
N - Niyog-niyogan
* anti-helmintic
T- Tsaang Gubat
* diarrhea, stomachache, mouth wash
A - Akapulko (Bayabas-bayabasan)
* anti-fungal
L - Lagundi
* asthma, cough, fever, dysentery, skin diseases
U - Ulasimang Bato (Pansit-pansitan)
* lowers uric acid
B - Bawang
 * lowers cholesterol levels, hypertension, toothache
B - Bayabas
* washing of wounds, diarrhea, gargle for toothache
Y - Yerba Buena
* pain, rheumatism, arthritis, headache, cough and
colds, swollen gums, toothache, menstrual and gas
pain, nausea, fainting, insects bites and pruritus
Reminders on the Use of Herbal Medicine
1. Avoid the use of insecticides.
2. Use a clay pot and remove cover while boiling at low
heat.
3. Use only the part of the plant being advocated. 4.
Follow accurate dose of suggested preparation. 5. Use
only one kind of herbal plant for each sickness. 6. Stop
 giving in case with untoward reaction. 7. If signs and
symptoms are not relieved after 2 or 3 doses, consult
a doctor.
DOH
(Department of Health)
Vision:
- A leader, staunch advocate and model in promoting
health for all in the Philippines.

Mission:
- Guarantee equitable, sustainable and quality health for
all Filipinos, especially the poor and shall lead the quest for
excellence in health.
3 Roles and Functions of DOH:
 - Executive Order 102
1. Leadership in health
- serves as an advocate in the adoption of health
policies, plans and programs to address national and sectoral
concerns.
2. Administrator of Specific Service
- administer health emergency responsive services
including referral and networking system.
3. Enabler and Capacity Builder
- innovates new strategies in health to improve the
effectiveness of health programs.
Overriding Goal of DOH:
- Health Sector Reform Agenda (HSRA)
Framework for its Implementation:
- FOURmula One for Health --- *Arroyo
- Universal HealthCare (Kalusugan Pangkalahatan) ---
*Aquino ( Executive Order 36)

---Phil. Health Agenda (Pres. Duterte)

ALL FOR HEALTH TOWARDS HEALTH FOR ALL

Goals:
1. Financial Protection
2. Better Health Outcomes
3. Responsiveness
Values:
1. Equitable and inclusive to all
2. Transparent and accountable
3. Uses resources efficiently
4. Provides high quality services
Strategies:
1. Advance quality, health promotion and primary care. 2. Cover
all Filipinos against health-related financial risk. 3. Harness the
power of strategic HRH development. 4. Invest in eHealth and
data for decision-making. 5. Enforce standards, accountability
and transparency. 6. Value all clients and patients, especially the
poor, marginalized and vulnerable.
7. Elicit multi-sectoral and multi-stakeholder support for health.
8 MILLENIUM DEVELOPMENT GOALS
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower
women 4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
 7. Ensure environmental sustainability
8. Develop a global partnership for development

- based on the fundamental values of freedom, equality,

solidarity, tolerance, health, respect for nature and shared
responsibility.
PHILIPPINE REPRODUCTIVE HEALTH

Goal:
- To achieve “Better Quality Life among Filipinos”

*Responsible Parenthood and Reproductive Health Act of 2012

- RA 10354

Local Framework Focuses on:

 - Health needs of women, men, adolescents, children
and underserved groups.
Main objectives:

1. Reducing maternal mortality rate.

2. Reducing child mortality.
3. Halting and reversing spread of HIV/AIDS.
4. Increasing access to reproductive health information and
services.
10 Elements:
1. Family Planning
2. Maternal and Child Health and Nutrition
3. Adolescent Reproductive Health
4. Prevention and Management of Reproductive Tract Infections
including STIs and HIV/AIDS
 5. Prevention and Management of Abortion and its Complication
6. Education and Counseling on Sexuality and Sexual Health 7.
Prevention and Management of Breast and Reproductive Tract
Cancers and other Gynecological Conditions.
8. Men’s Reproductive Health
9. Violence Against Women and Children
10. Prevention and Management of Infertility and Sexual
Dysfunctions
PHILIPPINE FAMILY PLANNING PROGRAM

*** Principal recipients of information, education, communication and

motivation in family planning:
- married couples of reproductive age
*** It requires all couples who want to receive a marriage license to
first undergo a seminar in family planning and responsible parenthood
- PD 965
Advantages:
1. FP helps families improve their standard of living
2. FP reduces/eliminates fears of unwanted pregnancy 3. FP affords
family members time to study or pursue occupational interest
Major target (High Risk Women):
1. Women under 20 years old
2. Women over 35 years old
3. Women suffering from certain medical conditions that contradict
pregnancy
4. Women who have had at least 4 deliveries

*** The Family Code of the Philippines?

- Executive Order No. 209
The Family Planning Methods:
1. Female Sterilization
- safe and simple surgical procedure which provides
permanent contraception for women who do not want more children.
Also known as BTL that involves cutting or blocking the two fallopian
tubes.
- performed during first 2 weeks of her menstrual cycle or within the
first 3 days after delivery.
2. Male Sterilization
- permanent method wherein the vas deferens (passage of sperm) is
tied and cut or block through a small opening on the scrotal skin. It is
also known as Vasectomy.
3. Pill
- contains hormones estrogen and progesteron taken daily to prevent
contraceptions. Advised for women who are anemic because of the
reduced menstrual flow.
- taken some time everyday preferably at night.
Common side effects:
- dizziness, headache, nausea, spotting, weight gain, breast fullness.
Adverse effects: Contraindications:
1. Abdominal pain 1. pregnancy or suspected
2. Chest pain 2. history of diabetes
3. Headache 3. high blood pressure
4. Eyes blurred 4. weak heart
5. Severe leg pain 5. CA of the breast
6. over 50 years old
Important facts to remember about a Pill
1. Pill are advised for women who are anemic because of the
reduced menstrual flow
2. Take pill same time everyday
3. A packet of pills contain 28 tablets; 21 pills are “active pills”,
7 contain no hormones, only iron
4. Follow the direction of the arrows of the pill. When empty, start
a new pack on the next day without missing a day
 5. For 1 missed pill: take the pill as soon as possible; take regular pill
at night
6. For 2 missed pill: take 2 pills next day, then take 2 pills the
next day again
7. For 3 missed pill: discard and substitute method, start on next
pack on next menstrual period.
4. Male Condom
- thin sheath of latex rubber made to fit on a man’s erect penis to
prevent the passage of sperm cell and sexually transmitted disease
organism into the vagina.
- the shelf life is 3 years in the Phils., if stored in a cool dry place.
5. Injectables
- contain synthetic hormones, progestin which suppresses ovulation,
thickens cervical mucus, making it difficult for sperm to pass through
and changes uterine lining.
6. Basal Body Temperature
- used to measure changes of temperature during ovulation. Temp.
slightly decreases before ovulation and increases during ovulation day.
It must be measured on the same time of the day, before rising, with
the same thermometer.
7. Lactating Amenorhea Method or LAM
- temporary introductory postpartum method of postponing
pregnancy based on physiological infertility experienced by Breast
Feeding women.
Criteria:
1. Amenorrhea
2. Fully or nearly fully breastfeeding
3. Infant is less than 6 months
8. Mucus/Billings/Ovulation
- abstaining from sexual intercourse during fertile (wet) days prevent s
pregnancy.
9. Abstinence
- best way to prevent pregnancy and STI’s
10. Sympto-Thermal Method
- method in identifying the fertile and infertile days of the menstrual
cycle as determined through a combination of observations made on
the cervical mucus, basal body temp recording and other sign of
ovulation.
11. IUD
- changes the nature of internal secretions of woman’s body., disturbs
transport and decreases number of viable sperms Contraindications:
1. PID
2. Septic Abortion
3. Endometritis
4. Anemia
5. Suspected pregnancy
Adverse effects:
1. Period that is late
2. Abdominal pain
3. Increase in temperature
4. Noticeable discharge – foul smelling
5. Severe bleeding
> an outpatient procedure; examined 1 month after insertion, then
after 6 months then after 1 year.
12. Standard Days Method
- A new method of natural family planning in which all users with
menstrual cycles between 26 and 32 days are counseled to abstain
from sexual intercourse on days 8-19 to avoid pregnancy.
-The couples use color coded cycle beads to mark the fertile and
infertile days of the menstrual cycle.
NUTRITION PROGRAMS

Goal:
- To improve the quality life of Filipinos through better
nutrition, increased productivity and improved health.
3 Most Common Deficiencies:
1. Iron
2. Vitamin A
3. Iodine
Programs and Projects:
1. Micronutrient Supplementation
- is one of the interventions to address the health and nutritional
needs of infants and children and improve their growth and
survival.
* Araw ng Sangkap Pinoy (ASAP), Garantisadong Pambata -
addresses health and nutritional needs of 6-71 months old 2. Food
Fortification
- to improve the nutritional status of the populace including
children.
- legal basis: RA 8976
 4 Food Staples that require Mandatory
Fortification: 1. Rice with Iron 3. Oil with Vitamin A
2. Sugar with Vitamin A 4. Flour with Iron and Vitamin A
3. Essential Maternal and Child Health Services
- this ensures the right of the child to survival, development,
protection and participation.
4. Nutrition, information, communication and
education - promotion of 10 Nutritional Guidelines for
Filipinos.

1. Eat variety of foods everyday.

2. Promoting exclusive breastfeeding from birth up to 4-6 months.
3. Giving proper advice on proper feeding of children. 4. Consume
fish, lean meat, poultry or dried beans. 5. Eat more vegetables.
6. Eat foods cooked in edible/cooking oil daily.
7. Consume milk, milk products and other calcium-rich
foods. 8. Use iodized salt, but avoid excessive intake of salty
foods. 9. Eat clean and safe foods to prevent food-borne
diseases. 10. Promoting healthy lifestyles.
5. Home, School and Community Food Production -
establishment of kitchens, gardens in home, schools and in
communities in urban and rural areas.
6. Food Assistance
- it involves complementary feeding for wasted/stunted
children and pregnant women with delivering low birthweight. 7.
Livelihood Assistance
- provision of credit and livelihood opportunities to poor
households especially those with malnourished children through
linkage with lending and financial institutions.
Control of Acute Respiratory Infection (CARI)
Objective:
Reduce mortality through early detection.

Contributing Factors to Pneumonia:

1. Mothers failure to recognize signs and symptoms
of Pneumonia.
2. Indiscriminate use of antibiotics.
3. Not standardized management to Pneumonia
Sign of Severe Pneumonia:
- Chest Indrawing
Important Responsibility of the Nurse in preventing unnecessary
death from Pneumonia:
- Provision of careful assessment
National Cancer Control Program
9 Warning Signs:
 C – change in blood, bowel/bladder habits A – a
sore that does not heal
U – unusual bleeding/discharge T – thickening or
lump in breast I – indigestion or difficulty in
swallowing O – obvious change in wart or mole N
– nagging cough or hoarseness

U – unexplained anemia
S – sudden unexplained weight loss
Specific Guidelines for Early Detection of Common
Cancers 1. Breast Cancer
A. BSE - cheapest and most affordable
- done 1 week after menstrual period while
 taking a shower
B. Mammography
- if a mass detected and confirmed
2. Cervical Cancer
A. Pap Smear
- primary screening tool for women over age
18
3. Colon Rectal Cancer
A. Annual digital rectal exam starting at age
40 B. Annual stool blood test starting at age
50 C. Annual inspection of colon
4. Prostate Cancer
A. Digital rectal exam
 B. PSA (prostate Specific Antigen) – confirms
diagnosis
5. Lung Cancer
A. Chest X-ray
B. Sputum Cytology
LEVELS OF PREVENTION:

Primary Prevention:
- elimination of conditions causing cancer
Secondary Prevention:
- Definitive Treatment and Management (a.)
Chemotherapy, (b.) Radiation, (c. )Surgery Tertiary
Prevention:
- Supportive or Palliative Care
 a. Physical
b. Psychological, Social, Spiritual
National Voluntary Blood Services Program
- promotes voluntary blood donation to provide
sufficient supply of safe blood and to regulate blood
banks.
Legal basis:
RA 7719 “Blood Services Act of 1994”
Criteria for Eligible donor:
B = BP 90/60 – 160/100mmHg
A = 16 – 65 years old
W = 45 – 50 kgs minimum
A = At least 12.5 hemoglobin
S = Status in good condition
Main Objectives:
1. to promote and encourage voluntary blood donation
by the citizenry and to instill public consciousness of the
principle that blood donation is a humanitarian act

2. to provide adequate, safe, affordable and equitable

distribution of supply of blood and blood products

3. to mobilize all sectors of the community to participate

in mechanisms for voluntary and non-profit collection of
blood
Steps to donate:
1. Go to the nearest center
2. Register a s a donor
3. History taking
 4. Vital signs, PE taking
5. Blood test with blood type
Must do after donated blood:
1. Eye on dressing at least 8 hours but not more than 12
hours
2. No lifting heavy objects
3. No smoke for 2 hours, no alcohol for 12 hours
4. Eat regular meals and increase fluids
National TB Control Program
Vision:
- A country where TB is no longer a public health problems.

Mission:
 - Ensure that TB DOTS services are available, accessible and
affordable to the communities.

Treatment:
- Quality of SDF (Single Dose Formulation) & FDC (Fixed
Dose Combination)
Case Finding:
1. DSSM ( Direct Sputum Smear Microscopy)
- 3X collection
1st specimen – SPOT specimen collected on the day of
consultation
2nd specimen – early morning specimen on the next day 3 rd
specimen – SPOT specimen collected on the 2 nd day after
submission of early morning specimen
2. Chest X-ray
- to identify the extent of the disease

3. Tuberculin Testing/Mantoux Test/PPD Testing

TB Treatment:
TB Abbreviation
SDF OLD NEW Rifampicin R R Isoniazid INH H
Pyrazinamide PZA Z Ethambutol E E Streptomycin
SS