COMMUNITY HEALTH NURSING - The community directly influences

(November 7, 2022) the health of individuals, families,

groups, subpopulations, and
populations who are a part of it.
COMMUNITY - Provision of most health services
 A social group determined by occurs at the community level.
geographic boundaries and/or
common values or interests. TYPES OF COMMUNITY
 Its members know and interact with
one another Urban Vs. Rural
 It functions within a particular social Criteria Rural Urban
structure Size Usually small Generally big
 It exhibits and creates norms, values
and social institutions
 Community is a number of families
residing in a relatively small area Population Less Thickly
within which they have developed a density dense/sometimes populated
sparsely
ore or less complete socio-cultural
populated
definitions imbued with collective
identifications and by means of which
they resolve problems arising from
Social Number of Frequent face-
the sharing of an areas. contacts few;
relationship to-face contact,
 Community is a social group with a primary relational but casual &
common territorial base; those in groups prevail superficial.
the group share interests and have a
sense of belonging to the group Less intimate
 Community refers to a structure of relationships
relationships through which a
localized population provides its daily
requirements

Characteristics of Community Criteria Rural Urban

- Defined by its geographical Social Mobility Lesser Greater
boundaries with certain identifiable
characteristics.
- Social structure is the organized set of Social Structure No significant Wide range of
social institutions and patterns of disparity in wealth income
institutionalized relationships that distribution
together compose society
- It has a population aggregate concept
Social Small-scale, not Large, highly
POPULATION – the general public or society Institutions very specialized, specialized,
or a collection of communities less in more in
membership membership
AGGREGATES – population with some
common characteristics who frequently have
common, but may not interact with each other
to address those concerns

Community as Client
 A community-wide group of people
as the focus of nursing service
 Working with communities is a primary
mission of CHN for two important
reasons:
 - Presence of housing laws/regulations
governing people
Criteria Rural Urban
Shared activties Common, Seldom
“bayanihan” spirit
prevails
o FIRE AND SAFETY – availability and
accessibility of fire protection and
Cultural centers Few Many safety services and facilities
o EDUCATION – Includes laws,
regulations, facilities, activities
affecting education.
- Ratio of health educators to learners
Nature of Mostly Prevalence of - Distribution of educational facilities
occupation agricultural, non- white-collar - Presence of informal education
professional jobs, facilities and activities existing
professionals, o HEALTH – health facilities and
services/activities
- Availability and accessibility of health
facilities
Criteria Rural Urban - Ration pf health providers and clients
Domestic Many Few availing the services
animals o RECREATION – types of recreational
activities and facilities present
- Types of consumers
Choice of Based on Based on - Appropriateness of recreational
leaders personal popularity, activities to consumers
attachments credentials,
o COMMUNICATION – kind of
education
attainment, communication system present
achievements

Components of Community
- The PEOPLE
- Subsystems
FUNCTION OF A COMMUNITY - Housing
1. To determine the use of space for - Fire and safety
living and other purposes - Education
2. To make available the means for - Health Politics and Gov’t
production and distribution of - Economics
necessary goods and services - Recreation
3. To protect and conserve the health, - Communication
life, resources, and property of
individuals
4. To educate and acculturate CHARACTERISTICS OF THE POPULATION
newcomers (Community conditions affecting health)
5. To transmit information, ideas, and 1. Demography: population size,
beliefs composition and distribution in space
6. To provide opportunities for interaction 2. Vital statistics: fertility, morbidity and
between individuals and groups mortality
3. Patterns f migration
Community’s Subsystem 4. Psychological characteristics:
o HOUSING – includes type of sense of belonging, responsiveness to
characteristics of housing facilities health efforts
- Availability of housing facilities 5. Quality of families that make up the
community
 - Ms. Magdalena Valenzuela founded
the industrial nursing unit (INU) of the
Philippine Nurses Association
(August 19, 1964)
- Ms. Anita Santos of Jardine Davies
was elected as first President of INU
- She organized several continuing
ENVIRONMENTAL CONDITIONS education programs
1. Geographic characteristics: location of (November 12, 1966)
the community quality of the soil, - Constitution & by-laws was passed
topography, climate and seasonal and approved
changes - IINU was renamed into Occupational
2. Rural, Urban, or semi-rural Health Nurses Association of the
3. Housing conditions Philippines (ONHAP), Inc.
4. Water supply (June 5-6, 1970)
5. Waste disposal - First annual convention on ONHAP
was held
Social systems (September 25, 1979)
- Economy - ONHAP, Inc was registered with the
- Education securities & exchange commission
- Religion (September 02, 2000)
- Politics - ONHAP signed a sisterhood alliance
- Transportation system with the Okayama (Japan)
- Communication system Occupational Health Nursing
- Health care system Association
(June 5-6, 1970)
OCCUPATIONAL SAFETY AND HEALTH - First annual convention on ONHAP
- Is the discipline involved in the was held
PROMOTION and MAINTENANCE of (1978)
the highest degree of physical, - ONHAP, Inc Constitution & by laws
mental, and social well-being of was amended
workers in all occupations - Article to organize a specialty board
- The specialty practice that focuses on for Certified Occupational Health
the promotion, prevention and Nurses title.
restoration of health within the context (September 2-4, 2004)
of a safe and healthy environment - ONHAP hosted the FIRST
- It includes the prevention of adverse INTERNATIONAL CONFERENCE
health effects from occupational & HEALTH NURSING at the Manila
environmental hazard Hotel

Article 23 of UN Universal Declaration of Health Corridor – Official newsletter of the

human rights Association
Journal of Occupational Health Nursing –
“Everyone has the right to work, to free choice Official journals of ONHAP
of employment, to just and favorable
conditions of work” ONHAP – DOLE – BWC Post-Graduate
Course on Basic Occupational Safety and
DEPARTMENT OF LABOR & EMPLOYMENT Health (BOSH) Training for Nurses
(DOLE) (Post0graduate course – 6 days)
- Lead government agency on
occupational safety & health ONHAP, INC
- Occupational Health Nurses
EVOLUTION OF OCCUPATIONAL HEALTH Association of the Philippines
NURSING IN THE PHILIPPINES (ONHAP), Inc. is a non-stock, non-
profit professional organization of
(November 11, 1950) nurses working in industrial,
 agricultural, commercial, educational,
service (hotel & restaurant),
government and non-government
institutions
FUNCTIONS OF OCCUPATIONAL HEALTH
NURSES
1. Organizing and administering a health
service program integrating
occupational safety in the absence of
the physician
2. Providing nursing care to injured or ill
workers
3. Participating in health maintenance
examination
4. Participating in the maintenance of
occupational health and safety
5. Maintaining a reporting and records
system, if physician is not available,
preparing & submitting an annual
medical report.
C. Tertiary Prevention
- This aim to play a key role in the
rehabilitation and restoration of the
worker to an optimal level of
functioning based on the limitation
imposed by the disability or illness.
DIFFERENT PROFESSIONS WHOM OHN
ARE WORKING WITH
1. SAFETY SPECIALIST – prevents
occupational injuries and evaluates
safety practices and protocols in
workplace
2. ERGONOMIST – design specialist
who helps promote healthy interface of
humans and their tools
3. EPIDEMIOLOGIST – conduct
research studies on the patterns of
diseases and history of occupational
disease and injuries in the workplace

LEVELS OF PREVENTIVE CARE AND CATEGORIES OF WORKPLACE HAZARD

OCCUPATIONAL HEALTH NURSING 1. HEALTH HAZARDS – are the
A. Primary Prevention elements in the work environment that
- OHN is involved in both health can cause work-related disease to the
promotion and disease prevention workers
 Types of non-occupational 2. SAFETY HAZARD – are the u safe
programs are: conditions or unsafe acts that
 Cardiovascular health significantly increase the risk of a
 Cancer Awareness worker to be injured
 Personal safety 3. BIOLOGICAL-INFECTIOUS
 Prenatal and postpartum HAZARDS – are the infectious-
health biological agents such as bacteria,
 Accident prevention viruses, fungi, or parasites that may be
 Retirement health transmitted via contact with infected
 Stress management and clients or co-workers and
relaxation techniques contaminated material
 Types of occupational programs 4. CHEMICAL HAZARD – are various
are form of chemical agents including
 Emergency response medications, solutions and gases that
 First aid and CPR training interact with body tissues and cells
 Right to know – training and are potentially toxic or irritating to
 Prevention of ack injury such body systems
as proper lifting, ergonomics, 5. ENVIROMECHANICAL HAZARD –
etc. are factors encountered in work
environments that cause accidents,
B. Secondary prevention injuries, strain, or discomfort
- They are aimed at early diagnosis, 6. PHYSICAL HAZARD – are agents
early treatment interventions and within work environment such as
attempts to limit disability radiation, electricity, extreme
 Vision temperature and noise that can cause
 Cancer trauma through transfer of energy from
 Cholesterol these sources
 Hypertension 7. PSYCHOSOCIAL HAZARD – are
 Diabetes mellitus factors and situation encountered or
 associated with the job or work
environment that create stress,
emotional strain or interpersonal
problem

TYPES OF CONTROL MEASURES FOR

OCCUPATIONAL HAZARDS
1. ADMINISTRATIVE CONTROL – is
the development of policies and
implantation of policies, standards,
trainings, job design and the like
2. ENGINEERING – is the adoption of
physical, chemical or technological
improvements to limit the exposure of
workers to the hazard of workplace
3. MATERIAL PROVISION – refers to
providing the workers with supplies or
supplements that can decrease their
exposure or susceptibility to
occupational hazard

LEGISLATION AFFECTING
OCCUPATIONAL HEALTH
- PD 442 – Philippine Labor Code
- Administrative Code on Enforcement
of Safety & Health Standards
- Occupational Safety and Health
Standards
- RA 9165 – Comprehensive Drugs Act
1992
- DOH -Sanitation Code

(NOVEMBER 8, 2022)
THEORETICAL APPROACHES THEORY
General Systems Theory
- The clients are viewed as “interacting
elements that exchange matter,
energy or information with the external
environment to exists; useful when
analyzing interrelationship of the
elements within the client, as well as
those of the client and environment.
Social Learning Theory
- Learning takes place in social context
people learn from one another and
that learning is promoted by modeling
or observing other people.
- Persons are thinking beings with self-
regulatory capacities, capable of
making decisions and acting according
to expected consequences of their
behavior. Environment affects
learning, but outcomes depends on
learner’s characteristics.
Pender’s Health Promotion Model
- It explores many biopsychosocial
factors that influence individuals to
pursue health promotion activities.
This contains variables related to
health behavior as well as individual
characteristics that may influence a
behavior outcome
Health Belief Model
- The model that is use to explain
behavior change and maintenance of
behavior change and to guide health
promotion intervention
Transtheoretical Model
- It combines several choices of
intervention and is based on the
assumption that behavior changes
tales places over time, progressing
thru a sequence of stages; has
assumed that each of the stages is
both stable and open to change
Milio’s Framework of Prevention
- It provides completeness to the HB<
and provides mechanism for directing
attention upstream and examining
opportunities for nursing intervention.
“Health deficits often results from an
imbalance between a population’s
health needs and it’s sustaining
resources.
Percede-Proceed Model
- It is a model for implementing and
evaluating health program based on
PRECEDE; predisposing factors,
enabling factors, and reinforcing
factors are considered.
STATISTICS
- In 2013, 1.2 million children go to
Pre-Schools
- 13.7 million to elementary school
- 6.8 million to high school
This created a unique opportunity for the
school nurse to make a positive impact on the
nation’s youth.
HISTORICAL DEVELOPMENT OF SCHOOL
HEALTH PROGRAM
 Traditional components of school
health programs
 School Health Services
 School Health Education
 Healthy School environment
-Physical
-Psychological
LEGAL BASIS
- Republic Act 124 in 1947
“An act to Provide for Medical
Inspection of Children Enrolled in
Private Schools, Colleges, and
Universities in the Philippines.”
Components of School Health Program
 Health Education – Oral
hygiene (Oral Health Care
Program-7 o’clock Tooth
brushing Habit Activity)
-Injury Prevention &
developing safety conscious
behavior
-Tobacco use
-Substance Abuse
NATIONAL DRUG EDUCATION PROGRAM
- This is to raise the consciousness of -Recognized and refer at risk
primary and secondary students adolescents
regarding the perils of the use of illicit -allows training of other school
drugs. personnel on crisis
- RANDOM DRUG TESTING is also management
carried out as part of this program
-
 Physical education – IS
should focus on activities that
they can continue into their  Healthy School
adult year such as; walking, Environment – should consist
swimming, jogging, biking in physical, psychological, and
social environment that is
 Health Services – It includes developmentally oriented and
PREVENTIVE Services culturally appropriate
-Health screening -Healthy organizational culture
(Completeness of within the school
immunization) -Productive interaction
-Annual Individual Health between school and the
Assessment such as; community.
Physical Examination,
Visual Activity Test (use of  Health Promotion for staff –
snellen’s, symbol chart, e- School nurse can assist
Chart), Auditory Screening faculty and staff by: giving
Test (Ballpen Click Test), workshop on exercise and
Height and weight nutrition, screening for
measurement, rapid increased blood pressure,
classroom inspections establishing weight
-Emergency Care (Basic management program
FIRST AID equipment must
be available, knowledgeable  Family/Community
about CPR involvement – School nurse
can conduct HEALTH
 Nutrition Services – it can be EDUCATION that are
realized thru SCHOOL designed to positively
BASED FEEDING PROGRAM influence parents, staff, and
(SBFP) other in matters related to
-DepEd aims to: Rehabilitate health
at least 70% of more than
570,000 severely wasted
school children at the end OTHER POLICY ISSUED IN THE
of 100-120 feeding days PHILLIPINES
-SBFP hot meals following - Adoption of the REDESIGNED
developed recipes using APPROACH IN SCHOOL HEALTH
malunggay and 20 days cycle NURSING (RASHN)
menu utilizing locally - DECS Memorandum Order #37, s.
produced/grown foods. 1991
- “Academic Performance of the Pupils
 Counseling, Psychological, and the instructional outcomes are
& Society Services – School determined by the quality of health of
nurse acts as counselor and the school population and the
confidante, therefore community where they come from.”
knowledge of the following is
necessary: (warning signs of DepEd Order #43, s. 2011
stress, warnng signs - Strengthening the Social Health and
associated with suicide Nutrition Programs (SHNP)
 - Directs the integration of SHNP with of population changes and planning programs
the annual and medium term and services.
development plans of the
region/division and with school Purpose of Census
improvement plans, ensuring - To determine and explain:
administrative and financial support.  Trends in terms of population
changes
 PLAN of programs and
services

DepEd Order No. 40 s. 2012 Two ways of assigning people in census:

- DepEd Child Protection Policy 1. DE JURE Method – done when people are
- It promotes a zero-tolerance policy for assigned to the place where they usually live
any form of child abuse, violence, regardless of where they are at tthat time of
discrimination, bullying and other form the census.
of child abuse. 2. DE FACTO Method – used the people are
assigned to the place where they are
physically present at that time of the census
regardless of their usual place of residence.
(November 9, 2022)
SAMPLE SURVEY
DEMOGRAPHY - When demographic data are obtained
- Science of populations. from a small number of people
Demographers seek to understand proportionate to the whole population.
population dynamics by investigating
three main demographic processes: REGISTRATION SYSTEM
birth, migration and aging - Done through the recording of vital
(including death) events in the community including
- Is the science which deals with the births, deaths, marriages, and others
study of the human: - CIVIL REGISTRAR’S Office –
1. Population’s size – simply refers to municipal level
the number of people in a given place - NATIONAL STATISTICS OFFICE –
or area at a given time. national level
2. Population Composition –
characterized in relation to certain
variables such as age, sex, BATAS PAMBANSA #72
occupations or education level. “Provides for a NATIONAL CENSUS of
3. Population Distribution – how population and other related data in the
people are distributed in specific Philippines every 10 years”
geographic location
- Measures helps the nurse decide ACT 3753 known as “CIVIL REGISTRATION
how meager resources can be LAW” – requires the registration of vital events
justifiably allocated based on such as births, marriages, and deaths.
concentration of population in certain
place - The BIRTH of the child should be
registered within 30 DAYS from the
SOURCES OF DEMOGRAPHIC DATA occurrence of the birth at the Local
1. CENSUS Civil Registry Office of the city or the
- is an official and periodic enumeration of municipality
population
- During the census, demographic, economic PRESIDENTIAL DECREE 856 known as
and social data are collected form specified SANTATION CODE – requires the DEATH
population group certificate before burial of the deceased
- These data are later collated, synthesized
and make known to the public for the purpose - The death certificate that specify the
of determining and explaining trends in terms cause of the death shall be signed by
 the doctor who last attended the
deceased
- Such DEATH certificate shall be
forwarded to the municipal health
officer with 48 hours
- Registration of death shall be made
within 30 days from the occurrence of
death at the local civil registry office
MEASUREMENT OF POPULATION SIZE
1. NATURAL INCREASES
Number of births – Number of births
FORMULA:
Natural increase = # of births (in specified yrs)
minus # of deaths (specified years)
2. RATE OF NATURAL INCREASES
Crude Birth Rate – Crude Death Rate
FORMULA:
CBR (specified years) minus CDR (specified
years)
DEFINITION OF RATE
- Shows the relationship between a vital
event and those person exposed to
the occurrence of the said event,
within a given area and during a
specified unit of time
MEASURES OF FERTILITY
1. Crude Birth Rate
CBR = # of live births
______________ x 100
Midyear population of women 15-44 y/o
MID YEAR POPULATION
- Refers to the estimated number of
people as of July 1 every year
MEASUREMENT OF POPULATION SIZE
1. Absolute Increase per year
- measures the number of people that are
added to the population per year
FORMULA:
Population size at a later time minus
Population size at an earlier time divide to the
number of years between time 0 and time t
Pt – Po
T
RELATIVE INCREASE
- Is the actual difference between two
census counts expressed in percent
relative to the population size made
during an earlier cencus.
FORMULA:
Pt – Po
Po
Take note: you should multiply to 100 kung
ano makuha mong sagot if and hinahanap is
percentage
MEASUREMENT OF SEX COMPOSITION
1. Sex Ratio
- compres the number of males to the number
of females
FORMULA:
Number of males x 100
Number of females
- It present the number of males for
every 100 females
RATIO
- Used to describe the relationship two
(2) numerical quantities or measures
of events without taking particular
consideration to the time or place
MEASUREMENT OF AGE COMPOSITION
1. Median age
- divides population into to equal parts
FORMULA:
Median age + (n+1)/2
- Need to list down the individual ages
of the population in chronological
order in a particular group
EXAMPLE:
Under the Population Distribution are the:
1. URBAN –RURAL Distribution
> Illustrate the proportion of the people
living in the urban compared to rural areas.
2. CROWDING INDEX
> dividing the number of persons in a
household with the number of rooms used by
the family for sleeping
3. POPULATION DENSITY
> can be computed by dividing the number
of people living in a given land area.
FORMULA:
Number of people/total population
Total land area in hectares
November 11, 2022
HEALTH INDICATORS
- List of information which would
determine the health of a particular
community like population, CBR, CDR,
IMR, MMR or NMR
Importance of VITA/HEALTH STATISTICS
- The nurse will be able to describe the
health status of the people
- It is a tool in estimating the extent or
magnitude of health needs and
problem in the community
MID-YEAR POPULATION
- Refers to the estimated number of
people as of July 1 every year
POPULATION AT RISK
- This are group of people which may or
may not develop certain disease or
illnesses
POPULATION
- Number of persons occupying a
certain geographic area, drawing
subsistence from their habitat and
interacting with one another
GENERAL RATE
- These rates referred to the total living
population
- It must be presumed that the total
population was exposed to the risk of
the occurrence of the event
SPECIFIC RATE
- These rates refer to a specific
population class or group
 - It must be occurrence of the event to SMR= Number of death in specified x 1000
the portion of the population definitely SDR = midyear pop. of same specified group
exposed to it.

RATE
- Show the relationship between a vital
event and those persons exposed to
the occurrence of the said event,
within a given area and during a
specified unit of time.

FERTILITY
- Refers to the actual number of
children born to a woman or a group of
women
-
- It also refers to measure of one
characteristics of the natural growth or
increase in the population

Measures of FERTILITY
1. Crude Birth Rate

Number of live births

CBR = __________________ x 1000
Midyear population

2. General Fertility Rate

Number of live births

GFR= ________________________ x 1,000
Midyear pop. of women 15-44 y/o

MORTALITY
-
- Refers to the actual number of deaths
in a given place from all causes and
may result in a decrease in population

Measure of MORTALITY
1. Crude Death Rate

Number of deaths
CDR= ____________________ x 1000
Midyear population

2. Specific Death/Mortality Rate

Main Reasons why People migrate A. Assessment of health status of the
- Keen competition for economic community
security in one’s locality  Epidemiology is used to descrube the
- The desire to improve one’s standard health status of the population
of living through estimation of Health
- The attraction of job opportunities in Indicators.
other places
MORBIDITY INDICATORS
EPIDEMIOLOGY  Any departure, subjective, or
- Comes from the greek word “epi” objective, from a state of
meaning upon, and “demos” meaning physiological or psychological well
people, and “logos” meaning study being
- Study of occurrence and distribution of  Are based on the disease-specific
health conditions such as disease, incidence or prevalence
death, deformities or disabilities on
human population INCIDENCE RATE
- Study of distribution and determinants  Measure the number of NEW cases,
of health-related states or events in episodes, events occuring over a
specified populations and the specified period of time within a
application of this study to the specified population at risk
prevention and control of health
problems AT RISK GROUP
- Study of probable factors that  If the members are free of the
influence the development of these disease but have the potential for
health condition developing a particular disease within
- Study of how often disease occur in a specified period of time
different groups of people and why
- Epidemiological information is used to COHORT
plan and evaluate strategies to  A group of people who share
prevent illness and as a guide to common defining characteristics
management of patients in whom
disease has already developed. Measurement of MORBIDITY
 Incidence Rate (Cumulative
Incidence and Incidence Density

Rate)

INCIDENCE RATE – the proportion of INITIAL
cases of disease
PREVELANCE RATE – the proportion of
INITIAL and EXISTING cases of disease
PUBLIC HEALTH SURVEILLANCE
 The ongoing, systematic collection,
analysis and interpretation of health
related data needed for planning,
implementation and devaluation of
public health practice
DISEASE NOTIFICATION
 Involves the official and timely
reporting of the occurrence of specific
diseases and conditions
designated public health authorities
by clinicians and other health
personnel for action using designated
PIDSR
 Enhance surveillance system that
monitors notifiable diseases and
other health-related events of public
health importance utilizing an
integrated approach
VPD SURVEILLANCE
 Focuses on the monitoring of priority
vaccine-preventable diseases
targeted for eradication and
elimination, namely: poliomyelitis,
measles and neonatal tetanus.
HIV-AIDS REAGISTRY
 Keeps tract of the number of HIV-
AIDS cases through a voluntary
testing program
THREE COMPONENTS OF ENVIRONMENT
- Physical
- Biological
- Socio-economic
PREVENTION and CONTROL disease
OUTBREAK Investigation
 Occurrence of cases of disease in
excess of what would the community
would normally be expected in a
defined geographical are or season
Levels of Disease Occurrence
1. SPORADIC LEVEL – occasional cases at
irregular intervals
2. ENDEMIC LEVEL – persistent occurrence
with a low to moderate
3. HYPERENDEMIC LEVEL – persistently
high level of occurrence
4. EPIDEMIC or OUTBREAK – occurrence
clearly in excess of the expected level for a
given time period
5. PANDEMIC – epidemic spread over several
countries or continents, affecting a large
number of people
Steps of Outbreak Investigation
1. Prepare the field work
- Through having communication plan
as well as operational plan and
logistical details which will allow better
investigation and avoid unnecessary
to
delays.
2. Verify the diagnosis
- To ensure that disease has been
properly identified since control
measures are often disease specific
3. Construct a working case definition
- Case definition is a tool for classifying
someone as having or not having the
disease of interest
- Includes criteria and restriction by
time, place and person
4. Find cases systematically and
record information
- Through passive or active surveillance
5. Perform descriptive epidemiology
- After finding cases, the outbreak is
now characterized by time, place, and
person
- It provides the comprehensive
characterization of the outbreak such
as TRENDS over time, geographic
distribution and population affected by
the disease.
6. Develop Hypotheses
- May address the source of agents,
mode of transmission or the exposure
that caused the disease, depending on
 what is already known about the
disease
7. Evaluate hypotheses epidemiology
- Compare hypotheses with established
facts
- Use of analytical epidemiology to
quantify relationship and assess the
role of chance
8. As necessary, reconsider, refine,
and re-evaluate hypotheses
- There is a need to re-think the
hypothesis by considering new modes
of transmission, getting a more
specific control group or
characteristics of host factors and
agents
9. Implement control and prevention
measures
- Appropriate public health control
measures are usually initiated even
before outbreak investigation is started
10. Initiate or maintain surveillance
- This is mainly to determine whether
the prevention and control measures
are working in terms declining number
of cases as well as checking whether
the outbreak has spread to other
areas.
11. Communicate findings
- Through the oral briefing to local
authorities and as a written report with
scientific format which can also be
published in public health literatures.