LECTURE 12.

2: COMMUNITY HEALTH NURSING

MS. VIVIAN CEZAR

OUTLINE DISEASE PREVENTION & CONTROL BUREAU

A. Non-Communicable Disease (NCD)
B. Cardiovascular & Cerebrovascular Disease
C. Diabetes
D. Renal Disease
E. Chronic Obstructive Pulmonary Disease
(COPD)
F. Cancer
G. Senior Citizen
H. Disability
Link:

https://drive.google.com/drive/folders/1-
w8Xu_jjBc3UaCtYP6lYb7xJQHVzDAHz?usp=share_li
nk

NON-COMMUNICABLE DISEASE PROGRAMS &

FAMILY PLANNING IN THE PHILIPPINES
• *Pero an Family Planning gin discuss na ni
Ma'am Orpz so wa na gin discuss ni Ma'am V*

NON-COMMUNICABLE DISEASE
Description
• What do you remember about Non-
Communicable Diseases? They are CHRONIC
because they are life-style related diseases.

KEY TERMS & DEFINITIONS

• Non-Communicable Disease (NCD)
• Cardiovascular & Cerebrovascular Disease
Disease of the heart and blood vessels which
would eventually affect the brain.
• Diabetes
Insulin resistant and a metabolic disorder.
• Renal Disease
In morbidity and mortality, patients with renal
disease have already increased. The percentage
is going up.
• Chronic Obstructive Pulmonary Disease (COPD)
Due to smoking.
• Cancer
• Senior Citizen
Over the age of 60 years old.
• Disability
PWD, those who have impairments, activity
related disabilities, anyone who has difficulty,
physically, mental disabilities. • This is important for you to know. Before we
discuss further, you need to know the function of
These are included/part of your NCD because the Disease Prevention & Control Bureau. What
these diseases affect the whole population. the function of the Systems Integrator is, the
Unlike your communicable diseases, you can Office of the Director III as well as the Technical
prevent them from spreading. Your non- Integration, the Office of the Director III.
communicable disease, remember that it is a
lifestyle disease. This is more on the preventive The DPCB is divided into two main components,
side. That's why as a PHN, your role is health specifically the System Integration Divisions and the
promotion/health education, which is a primary Primary and Specialty Care Divisions.
level of care.
SYSTEMS INTEGRATION
*PS. The following that proceeds here are pictures that’s • The Director III for System Integration shall
why malaki at OC me so ganun HAHAHAHA have the following duties:
1. Oversee the Policy, Planning, Research and
Monitoring and Evaluation Divisions and sub-
units of DPCB, and report Systems
Integration work to the Director IV of the
Disease Prevention and Control Bureau.
2. Sign all policy, administrative and financial
documents related to COVID-19 and directly

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MS. VIVIAN CEZAR

report to the Public Health Services Team

(PHST) Undersecretary for COVID-19
related concerns.

During the COVID-19 protocol, the

implementation amo ito an ira gin himo. The
Systems Integration is the one who implemented
the Administrative Order Financial Documents
related to COVID-19. This appeared on the board
exam this year.

PRIMARY AND SPECIALTY CARE DIVISION

• The Director Ill for Technical Integration shall
have the following duties:
1. Operationalize the integrated primary care for
the following flagship programs:
Reproductive, Maternal, Newborn, Child
Health, and Nutrition (RMNCHN), Oral
Health, National Immunization Program and
the National Tuberculosis Program and
National AIDS, STI Prevention and Control
Program.
2. Lead the following Divisions in line with the
primary care integration: The National
Immunization Program (NIP), Oral Health,
Infectious Diseases and Family Health
Division and report directly to the Director IV
of the Disease Prevention and Control
Bureau. The rest of the Divisions under the
Primary and Specialty Care shall be directly
under the Director IV.
For your NCD such as your cancer and all the
These areas are your Non-Communicable other diseases that I've mentioned earlier, for this
Diseases Division. Your Environmental Health slide, this shows you the report which provides
and Safety, 2nd Division the National you with evidence. So, 3 analysis that NCD
Immunization Program, Mental Health & Cancer reduce economic output and discusses potential
Control Division will be directly reported to the options in response, outlining the details of their
Technical Integration Officer [kalalaksi ni ma'am relative returns on investment.
magyakan ambot kun nakuha ko tanan huhu]. Kay kun damo it nagkakasakit syempre na shell
The rest of these, all the data that will be out it gobyerno hin amount so it could be an
gathered, the survey results, will be directly economic burden. But this can be prevented
communicated to the office of the director. because it's a lifestyle disease unlike your
communicable disease na once matapnan ka,
infectious ka na. Makatapon ka na ghap ha iba.
Whereas in your NCDs, it can be controlled.
Dapat may alloted nira na budget imbes na it
budget pwede ngadto hit iba na programs,
nangangadto lugod ha NCD programs because
there are increasing patients kay wa na ka
prevent.

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• Stroke
• Cancer
• Chronic respiratory disease

MORTALITY: TEN (10) LEADING CAUSES

NUMBER AND RATE/100,000 POPULATION
Philippines
5-YEAR AVERAGE (2005-2009) & 2010
CAUSES 5-YEAR 2010
AVERAGE
(2005-2009)
NUMBE RAT NUMBE RAT
R E R E
Diseases of 88,299 99.4 102,936 109.5
the heart
Diseases of 58,761 66.2 68,553 72.9
the Vascular
System
Malignant 44,627 50.3 49,820 53.0
Neoplasms
Pneumonia 37,865 42.6 45,591 48.5
Accidents -- 35,005 39.5 36,329 38.6
Tuberculosis 25,296 28.6 24,714 26.3
, all forms
Chronic 21,586 24.4 22,877 24.3
Lower
Respiratory
Disease
Diabetes 20,964 23.6 21,512 22.9
mellitus
• High human and economic costs highlight the
Nephritis, 12,321 13.9 14,084 14.9
need to reduce the burden of NCDs in the
Nephrotic
Philippines. Syndrome
• WHO recognizes that the risk of NCDs can be and
reduced by modifying four types of behavior Nephrosis
(tobacco use, harmful use of alcohol, an Certain 12,257 13.8 12,086 12.9
unhealthy diet and physical inactivity) and conditions
metabolic risk factors such as high blood originating in
pressure and cholesterol (WHO, 2013). Fig. 1 the perinatal
illustrates the determinants and risk factors that period
drive the development of NCDs, many of which *Note: Excludes ill-defined and unknown causes of
are beyond the control of the health sector alone. mortality
Dire man kita pwede umasa ha health sector la - Reference year
- External causes of Mortality
kay sumiring ngani na lifestyle disease, an
This is from the DOH statistics. The WHO records
individual mismo an maka control ngan prevent.
NCD to be the leading cause of mortality. This is
the retest and updated one. Number one is the
In the Picture:
Diseases of the Heart (upod daw mga broken
Underlying Determinants
hearted yaks HAHAHAHA udog). Next is your
• Poverty and poor living conditions diseases of the vascular system, malignant
• Social exclusions neoplasm, pneumonia, tuberculosis (all forms),
• Design of cities and towns accidents, chronic lower respiratory disease,
• Availability and marketing of goods diabetes mellitus, nephritis, nephrotic syndrome
and nephrosis and last is your conditions
Behavioral Risk Factors originating from the perinatal period.
• Unhealthy diet
• Physical inactivity CARDIOVASCULAR & CEREBROVASCULAR
• Tobacco use DISEASE
• Harmful alcohol use 2 Most Common Causes
1. Atherosclerosis - Blockage in the heart
Intermediate Risk Factors particularly in the blood vessels, your aorta.
• Overweight/Obesity 2. Hypertension - Increase of your systolic blood
• Raised blood sugar pressure and diastolic blood pressure.
• High blood pressure
Kun uncontrolled ine na duha, it would lead to a
• Abnormal blood lipids
lot of complications such as stroke, kidney
damage and other complications.
Main NCDs
• Heart disease
• Diabetes

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 LECTURE 12.2: COMMUNITY HEALTH NURSING
MS. VIVIAN CEZAR

Screening • Kun ha atun basic nutrition, kun nagplaplano hin

• Monitoring of blood pressure and blood chemistry
which included LDL & HDL. (See chart below
chz).
• Reducing industrially-produced trans fatty acids
meal, pira la iton atun fats? How many servings
of fat would you recommend? Maximum of 3-
5. It would also depend on the type of oil that we
use. Ano dapat na oil tat gin use?
Unsaturated.
(itfa) in pre-packaged and processed foods are
prone to increase bad cholesterol, decrease good
cholesterol and increase blood sugar. So trans fat
is not good for us.

CANCER (MALIGNANT NEOPLASM)

Description
• Is cancer preventable? No. If you have a history,
if you are careful pero kay bisan careful ka ma-
iinherit man la ngani ghap nimo kay genetics
man. So what we usually door we usually
recommend in the healthcare setting as
healthcare providers, is to instruct the individual
for an early screening for early detection.
• It is the national health priority, because it is the
3rd leading cause of morbidity and mortality,
• It says in the survey, that among Filipino men, the
6 most common sites of cancer diagnosed in
2010 were lung, liver, colon, prostate, stomach,
and leukemia.
• For women, breast, cervix, lung, colon/rectum,
ovary and liver.

The Warning Signals of Cancer (Mnemonic: CAUTION

US)
• C - Change in bowel habits
• A - A sore throat that does not heal
• U - Unusual bleeding
• T - Thickening or lump in breast
• I - Indigestion or difficulty of swallowing
• O - Obvious change in wart/mole
• N - Nagging cough/hoarseness
• U - Unexplained anemia
• S - Sudden weight loss

NATIONAL CANCER CONTROL COMMITTEE (NCCC)

DEVELOPED THE NATIONAL CANCER PREVENTION
AND CONTROL ACTION PLAN (NCPCAP) 2015-2020
THE DEPARTMENT OF HEALTH — PHILIPPINE
CANCER CONTROL PROGRAM
Description
• A systematic, organized, integrated, approach to
the control of cancer that can significantly alter or
reduce mortality and morbidity utilizing primary
and secondary prevention at the community level
and tertiary prevention and rehabilitation at both
the community and hospital levels in all regions
of the country.
• Aims is to develop methods, plans or policy for
intervention that will benefit the population as well
as develop systems for monitoring and evaluating
these interventions in the future.

VISION Comprehensive Cancer

Care and Optimized
• DOH healthy policy check, they promote Filipino’s
Cancer Survival in 2025
heart health amidst pandemic, prohibits trans-fat
in pre-packaged and processed foods.

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b. Development and Operationalization of

MISSION To reduce the impact of
National Cancer Prevention and Control
cancer and improve the Website and Social Media Sites
c. Development of “Comprehensive National
wellbeing of Filipino
Policy on Cancer Prevention and Control”
people with cancer and d. Establishment of National Cancer Center and
their families Strategic Satellite Cancer Centers
e. Expansion of PhilHealth Z Benefit Package
Coverage to Other Cancers
OBJECTIVES / GOALS 1. To reduce premature ✓ PhilHealth Z-Benefit Package for
mortality from cancer by catastrophic diseases (breast, prostate,
cervical cancers and childhood acute
25% in 2025 lymphocytic leukemia) is an in-patient
package which includes mandatory
2. To ensure relative diagnostics, operating room expenses,
doctor/professional fees, room and
reduction of the following
board, and medicines.
risk factors for cancer: 2. Advocacy and Promotions
a. Cancer Awareness Campaigns
a) 10%
✓ National Cancer Consciousness Week
harmful use of ✓ Colon and Rectal Cancer Awareness
Month
alcohol
✓ Cancer in Children Awareness Month
b) 10% ✓ Cervical Cancer Awareness Month
✓ Prostate Cancer Awareness Month
physical
✓ Lung Cancer Awareness Month
inactivity ✓ Liver Cancer Awareness Month
✓ Breast Cancer Awareness Month
c) 30%
✓ Cancer Pain Awareness Month
tobacco use b. Partnership with DepEd, CHED, DOLE-
Bureau of Working Conditions, and Civil
3. To guarantee the Service Commission
3. Capacity Building and Resource Mobilization
availability of the following • The areas of concern locate(?) the Policy and
services for selected Standards Development. Kay ano may area
of concern when it comes to the policy and
population: standard development? Kun nasasakit ka
a) Selected ano it ginagamit na insurance?
PHILHEALTH.
cancer
• It atun PHILHEALTH medyo complicated it
screening ira pagrelease hin mga PHILHEALTH
package. So kun dire ka meticulous, dire ka
b) Human
maniningkamot mag avail. Dako tim
Papilloma babayaran.
• Another area of concern is the Advocacy and
Virus and
Promotions. Kun gaano kapursigido iton
Hepatitis B DOH to promote Cancer Awareness or to
vaccination have a campaign against cancer.
• Capacity Building and Resource Mobilization
c) Access to because you need the healthcare providers
palliative care to be trained for this.
• National Cancer Committee have the
d) Drug following roles and functions. You can check
therapy and it out ha ira website.
https://doh.gov.ph/philippine-cancer-control-
counseling program

Roles and Functions of National Cancer Control

Although waray po ine (text below) ha ppt ni ma’am gin Committee
include ko nala since asya man ine iya ginyayakan.
1. Set the roadmap of National Cancer Prevention
and Control Program (NCPCP)
THE NATIONAL CANCER PREVENTION AND
2. Plan, establish and implement policies,
CONTROL ACTION PLAN 2015-2020 SHALL COVER
guidelines and standards throughout the
THE FOLLOWING KEY AREAS OF CONCERN
continuum of holistic health care (preventive,
1. Policy and Standards Development
promotive, curative, rehabilitative and palliative)
a. Development of “National Policy on the
3. Advise / recommend upgrading of existing cancer
Integration of Palliative and Hospice Care
management facilities in the country
into the Philippine Health Care System”

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MS. VIVIAN CEZAR
4. Coordinating body for all cancer works in the
country
5. Ensure the implementation of NCPCP down to
the grassroots level
6. Establish and carry out an effective nationwide
cancer education program / dissemination
7. Provide technical and financial support on cancer
prevention, early detection, treatment and
palliative care
8. Establish and carry out effective training program
9. Ensure the collection and analysis of data from
registry and surveillance
10. Implement, monitor and evaluate the NCPCP
regularly through implementation review and
impact evaluation
11. Empower and engage all the stakeholders to
actively work on and participate in on various
areas of NCPCP
12. Endorse support for researchers in the clinical,
epidemiological, public health and knowledge
management areas and in collaboration with
international institutes
13. Others that may be identified and approved by
the Secretary of Health
*Nagdidilemma ako if igcocopy paste ko ba tanan na
aadto ha programs kay dadamo talaga hiya tas magiging
wordy kaduro tat reviewer T_T so if ever man visit nala
ada kita ha ira site.
COPD (CHRONIC PULMONARY OBSTRUCTIVE
DISEASE)
Would Result
• Chronic Bronchitis
• Chronic Asthma
• Emphysema
Risk Factors
• Smoking
• Second-hand smoke
• Pollution
DOH Program has a National Tobacco Control
Strategy from 2011-2016 but it is still being
practiced until now.
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NATIONAL TOBACCO CONTROL STRATEGY
Description
• The National Tobacco Control Strategy (NTCS) is
the country’s strategic plan on tobacco control,
which builds upon the gains of the previous years
and continues to address the challenges that
remain. Likewise, the NTCS situates and aligns
the country’s overall goals and actions in tobacco
control within the aspirations of the Fourmula
Plus 1 Framework.
• The NTCS 2017-2022 was developed by the
health department, in collaboration with other
partner government agencies and civil society
organizations, to improve the health of all
Filipinos by reducing the prevalence of smoking
and its associated health, social and economic
costs, and the inequalities it causes.
Goals
• Overall, the strategy plan aims to achieve these
goals:
• Goal 1: To reduce further the prevalence of
tobacco use based on the current baseline data
• Goal 2: To increase the protection of non-
smokers from secondhand smoke
Objectives
• Toward achieving this end, this strategy plan
aims to fulfil two objectives:
• Objective 1: To implement fully and effectively
tobacco control measures in accordance with the
World Health Organization Framework
Convention on Tobacco Control (WHO FCTC)
• Objective 2: To strengthen the institutional
capacity of the tobacco control agencies
Kada na change hin national Director the DOH would
come up with many various campaigns and programs (ex.
Non-communicable disease program)
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• Amo ito it complication hit Diabetes, either it

DIABETES would affect your EYES or your KIDNEYS
Description
• Metabolic Disorder CHRONIC-KIDNEY DISEASE PREVENTION AND
• Most common effect is hyperglycemia CONTROL
• Current Guidelines of WHO for diagnosis if FBS Description
(Fasting Blood Sugar) • Majority of the increases in total morbidity and
• Signs & Symptoms mortality in the Philippines have actually come
✓ Polyuria from Non-Communicable Diseases (NCDs),
✓ Polydipsia specifically Chronic Kidney Disease (CKD). If left
✓ Polyphagia untreated, CKD can progress to more severe
✓ Weight loss complications such as End-Stage Kidney
✓ Vision Changes Disease (ESKD) that now requires more
✓ Fatigue immediate and regular interventions. These
• Their goal here is to decrease the number of interventions include renal replacement therapies
people that have Diabetes by 2025 ranging from hemodialysis to renal transplant.
The increasing numbers of CKDs have become
RENAL DISEASE (CHRONIC KIDNEY DISEASE) an urgent national concern due to the burden of
the disease and high costs of care. Hence, this
program aims to reinforce strategies for the
prevention and control of CKDs such as lifestyle-
related disease prevention, facilitation of early
detection and evaluation, and proper disease
management for people with CKDs.

Vision
• Philippines free from the avoidable burden of
NCDs.

Mission
• Provision of accessible, affordable, quality health
care services to all

❖ Is this being implemented now? Diba damo

naman aton Dialysis Center
❖ Also, PHILHEALTH also offers Dialysis Program
wherein 1year, 1000.00 la it gin babayaran hit
pasyente pagpapa Dialysis, covered na ito han
PhilHealth
❖ What month do we celebrate or what month
makusog it era campaign for Renal Disease?
Kidney Awareness Month kada ano man? JUNE
❖ Breast Cancer awareness month kada
OCTOBER
❖ So we have the following policies, (everyone:
maam dre na babasahan.. Maam: KAY
REVIEW!) sorry waray na maintindihan an next
part
❖ Usually it na appear ha Board Exam AN LATEST
(alang mang hera mag ask parte 1949)

Goal
• To reduce premature mortality due to
cardiovascular diseases, diabetes mellitus,
chronic respiratory diseases, chronic kidney
diseases, and cancer* by 25% by 2025.

❖ Balik balik gad la ubog it era mga (goals?)

It Has 5 Stages
• Stage 1: your GFR na function pa at 90%
• Normal GFR: 90-120%
• With 100% na waray damage
• Kun End Stage, reversible or Irreversible?
IRREVERSIBLE
• Nag aano naman ito it pasyente? DIALYSIS
• Ma start it Dialysis at what stage? STAGE 4
depende hilton disease
❖ So kun mayda PT nga nag dialysis, it era Kidney
Disease Control Program mayda hito PhilHealth
Benefit Package na gin sisiring.
PhilHealth Benefit Package
• Implementing Guidelines for the Philhealth
Konsultasyong Sulit at Tama (Philhealth
Konsulta) Package

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• "PD FIRST" Z benefits: The Z benefits for End-
stage Renal Disease requiring Peritoneal Dialysis
• Philhealth Dialysis Database (PDD)
• Philhealth Dialysis Package
Partner Organizations
• National/Government
✓ National Kidney Transplant Institute
• Local/Youth/CSOs/NGOs
✓ Philippine Society of Nephrology
✓ Dialysis Ph
• International Partners
✓ None
RENAL DISEASE CONTROL PROGRAM (REDCOP)
Description
• The Renal Disease Control Program (REDCOP)
is the office in-charge of implementing the NKTI's
public health projects on the prevention and
control of renal and other related diseases. It
plans, implements and monitors projects for
research, advocacy, training, service and quality
assurance. REDCOP's activities are done mostly
on a national scale through its network of
Regional Coordinators throughout the country.
• The REDCOP also administers and manages the
Philippine Renal Disease Registry (PRDR),
which include the following: The End Stage Renal
Disease (ESRD) Registry composed of the
Hemodialysis, Peritoneal Dialysis & Transplant
Registries, and the Chronic Kidney Disease
Registry composed of Biopsy.
• The same Office has been tasked to operate the
Philippine Organ Donation Program (PODP) of
the Department of Health (DOH). PODP sets up
policies, guidelines and ethical principles
whereby the act of organ donation and conduct of
transplantation from living non-related organ
donors (LNRDs) shall be managed and
regulated. This Program supports a rational,
equitable, ethical, and accessible renal health
care program in the country.
• A huge database on completed and ongoing
researches on nephrology, urology & transplant
is being maintained by REDCOP and is utilized
for planning & policy making. This database is
open to other users upon request, using the
NKTI's guidelines & policies on data request.
❖ So Tanan na Dialysis Centers, may it be Hospital-
based or Satellite/Free standing clinics, na submit
ito hera hin report kun hinot mga pt nga bago
every quarter nga aadmit ha era center. So gin
hashtag ito ha Surveillance team hit DOH
❖ For example dinhin ha Tacloban, tanan na
Dialysis centers will submit the REDCOP form to
the City Health Office, then they will forward it to
the Regional office
❖ Also Kidney Donor Transplant, mga cadavers or
mga fresh bodies na nagkakamatay, and then
gusto nera igdonate it era mga organs would also
be reported hear under the REDCOP
SENIOR CITIZEN PROGRAM
Description
• The program intends to promote and improve the
quality of life of older persons through the
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establishment and provision of basic health
services for older persons, in combination of
policies and guidelines pertaining to older
persons (waray na maintindihan hi maam after
hini)
Vision
• A country where all Filipino senior citizens are
able to live an improved quality of life through
healthy and productive aging.
Mission
• Implementation of a well-designed program that
shall promote the health and wellness of senior
citizens and improve their quality of life in
partnership with other stakeholders and sectors.
Department of Social Welfare and Development
Policies, Programs/Services and other Initiatives for
Senior Citizens
I. Current Laws and Plan
1. Republic Act No. 10645 (July 28, 2014) -
An Act Providing for the Mandatory
Philhealth Coverage for All Senior
Citizens, Amending for the Purpose of the
Republic Act no. 7432, as Amended by
Republic Act No. 9994, otherwise Known
as “Expanded Senior Citizen Act of 2010”
a. Is an act guaranteeing all senior citizens
coverage of the national health insurance
program, including Philhealth. It
stipulates that funds necessary to ensure
the enrollment of all senior citizens that
are currently covered by any existing
category shall be sourced from the
National Health Insurance of Philhealth
proceeds of Republic Act No. 10351, in
accordance with pertinent laws and
regulations.
2. Republic Act No. 9994 (February 19, 2010)
- An Act Granting Additional Benefits and
Privileges to Senior Citizens, Further
Amending Republic Act No. 7432
➢ It augments benefits and services to all
elderly. These Benefits and Services
include:
a. The grant of twenty percent (20%)
discount and exemption from the
value -added tax (VAT), if applicable,
on the sale of the following goods
and services from all establishments,
for the exclusive use and enjoyment
or availment of the senior citizen
b. The grant of a minimum of five percent
(5%) discount relative to the monthly
utilization of water and electricity
supplied by the public utilities: Provided,
that the individual meters for the
foregoing utilities are registered in the
name of the senior citizen residing
therein: Provided, further, That the
monthly consumption does not exceed
one hundred kilowatt hours (100 kWh) of
electricity and thirty cubic meters (30 m3)
of water: The privilege is granted per
household regardless of the number of
senior citizens residing therein
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c. At least fifty percent (50%) discount shall
be granted on the consumption of
electricity, water, and telephone by the
senior citizens center and residential
care/group homes that are government-
run or non-stock, non-profit domestic
corporation organized and operated
primarily for the purpose of promoting the
well-being of abandoned, neglected,
unattached, or homeless senior citizens,
subject to the guidelines formulated by
the DSWD.
d. Indigent senior citizens shall be entitled
to a monthly stipend amounting to Five
hundred pesos (Php500.00) to augment
the daily subsistence and other medical
needs of senior citizens, subject to a
review every two (2) years by Congress,
in consultation with the DSWD
e. The head of the OSCA shall be entitled
to receive an honorarium of an amount at
least equivalent to Salary Grade 10 to be
approved by the LGU concerned
f. The inclusion of the Secretary of
Department of Trade and Industry (DTI)
as member of the National Conciliation
and Mediation Board.
3. Republic Act No. 9257 (February 26, 2012)
- An Act Granting Additional Benefits and
Privileges to Senior Citizens, Amending
for the Purpose Republic Act No. 7432.
a. This act guarantees full support to the
improvement of the total well-being of the
elderly and their full participation in
society considering the senior citizens as
integral part of Philippine society.
b. It expanded the coverage of the benefit
and due privileges to the senior citizens
to include all business establishments. It
made mandatory the provision of 20
percent discount in all establishments, as
well as installed due processes in the
organization of the OSCA and selection
of the OSCA Head. It also recognized the
important role of the private sector in the
improvement of the welfare of senior
citizens and to actively seek their
partnership.
Also, it provides a comprehensive health
care and rehabilitation system for the
disabled senior citizens to foster their
capacity and to attain a more meaningful
aging.
4. The General Appropriations Act FY 2015,
Section 33 - Programs and Projects
Related to Senior Citizen and Persons
with Disability
a. For the past years the GAA has included
a provision addressing the concerns of
senior citizens. This year, said provision
stipulates that all agencies of the
government shall formulate plans,
programs and projects intended to
address the concerns of senior citizens
and persons with disability. Moreover, it
provides that all government facilities,
including infrastructure, non-
infrastructure and civil works projects of
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the government, as well as office
buildings, streets and highways, shall
provide architectural facilities ar
structural features, designs ar facilities
that shall reasonably enhance the
mobility, safety and welfare of persons
with disability pursuant to B.P. Blg. 344
and R.A. No. 7277.
5. Implementation of the Philippine Plan of
Action for Senior Citizens (PPASC)
a. The PPASC 2012-2016 builds on the
achievements of the previous plans while
enhancing the strategies and
mechanisms for more responsive actions
given the emerging challenges the senior
citizens sector is facing.
b. The Plan focuses on strengthening the
collaboration of different stakeholders
and the senior citizens themselves to
ensure the effective implementation of
various programs and services for the
elderly.
c. With the Plan, the government and the
private sector would be able to firm up its
commitment to vigorously pursue
measures to address challenges of the
aging population such as combating
elderly poverty.
WHAT HAS BEEN DONE FOR SENIOR CITIZENS IN
THE PAST 5 AND A HALF YEARS?
A. PHILHEALTH COVERAGE BECAME
MANDATORY FOR ALL SENIOR CITIZENS
• As of June 2015, more than 4.8 million senior
citizens have been enlisted under the healthcare
program through amendments of the 2010
Expanded Senior Citizens Act, which were signed
into law in 2014.
B. INDIGENT SENIOR CITIZENS GOT AN
AUGMENTED SOCIAL PENSION
• The 2010 Expanded Senior Citizens Act was
signed in February 2010. It included a provision
to augment the medical needs of indigent senior
citizens with a-monthly pension. This was
implemented under the Aquino administration.
From 2011 to May 2015, social pon served
937,556 senior citizens.
C. THE AGE TO QUALIFY FOR INDIGENT SENIOR
CITIZENS PENSION WENT DOWN
• From 2011 to 2014, the DSWD prioritized senior
citizens aged 77 years and above. In 2015,
seniors 65 years old and above were allowed to
qualify for the program. In that year, 760,736
indigent senior citizens were served.
D. SSS PENSIONS INCREASED BY 5%
• On May 31, 2014, The Social Security Service
raised the monthly pensions of existing
pensioners 5%
DISABILITY
Description
• Persons with disabilities (PWDs), according to
the UN Convention on the Rights of Persons with
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Disabilities, include those who have long-term
physical, mental, intellectual or sensory
impairments which in interaction with various
barriers may hinder their full and effective
participation in society on an equal basis with
others.
• Globally, over 1 billion people, or approximately
15% of the world's population, have some form of
disability. In the Philippines, the results of the
2010 Census of Population and Housing (CPH,
2010) show that of the household population of
92.1 million, 1.443 million Filipinos or 1.57%,
have a disability.
• The mandate of the DOH to come up with a
national health program for PWD was based on
Republic Act No. 7277, "An Act Providing for the
Rehabilitation and Self- Reliance of Disabled
Persons and Their Integration into the
Mainstream of Society and for Other Purposes"
or otherwise known as "The Magna Carta for
Disabled Persons”.
The Revised Philippine Registry Form for People with
Disabilities now enumerates the following types of
disabilities
1. Deaf/Hard of hearing
2. Intellectual Disability
3. Learning Disability
4. Mental disability
5. Orthopedic Disability
6. Physical Disability
7. Psychosocial Disability
8. Speech and language Impairment
9. Visual Disability
GLOBAL DISABILITY ACTION PLAN
• Released by the WHO
Main Objectives
• Global Disability Action Plan 2014-2021
1. To remove barriers and improve access to
health services and programmes;
2. To strengthen strengthen and extend
rehabilitation, habilitation, assistive
technology, assistance and support services,
and community-based Rehabilitation;
3. To strengthen collection of relevant and
internationally comparable disability and
support research on disability and related
programs
HEALTH AND WELLNESS PROGRAM FOR PERSONS
WITH DISABILITIES
Vision
• A country where all persons with disability,
including children and their families, have full
access to inclusive health and rehabilitation
services.
Mission
• A program designed to promote the highest
attainable standards of health and wellness for
PWDS by fostering a multi-sectoral approach
towards a disability and health agenda.
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Objectives
1. To address barriers and improve access and
reasonable accommodations of PWDs to health
care services and programs.
2. To ensure the accessibility, availability,
appropriateness and affordability of habitation
and rehabilitation services for PWDs, including
children with disabilities.
3. To ensure the development and implementation
of policies and guidelines, health service
packages, including financing and provider
payment schemes for health services of PWDs.
4. To enhance capacity of health providers and
stakeholders in improving the health status of
PWDs.
5. To strengthen collaboration and synergy with and
among stakeholders and sectors of society to
improve response to a disability inclusive health
agenda through regular dialogues and
interactions.
6. To provide the mechanism in facilitating the
collection, analysis and dissemination of reliable,
timely and complete data and researches on
health-related issues of PWDs in order to develop
and implement evidence-based policies and
interventions.
Action Framework for the Health and Wellness
Program of Persons with Disabilities
• Action Area 1: Removal of barriers and improve
access to health services and programs.
(considered an booklets han PWD)
• Action Area 2: Strengthening and expansion of
rehabilitation, habilitation, assistive technology,
and community-based rehabilitation.
• Action Area 3: Strengthening collection of
relevant and internationally comparable disability
data and support disability researches.
DRUG ABUSE PREVENTION & CONTROL PROGRAM
• (Republic Act or R.A. 9165 is otherwise known as
Comprehensive Dangerous Drugs Act of 2002)
DANGEROUS DRUG ABUSE PREVENTION AND
TREATMENT PROGRAM (DDAPTP)
Description
• DDAPTP was created as a specialized program
of the Department of Health, under the Office for
Health Services Development, serving as the
directing, coordinating, and monitoring office for
national health matters and public health issues
related to drug abuse prevention, treatment and
rehabilitation in the country.
Roles of DDAPTP
1. Formulate & review policies, develop strategies,
and strengthen partnerships to ensure proper
implementation of the DOH mandates on drug
abuse prevention and control.
2. Lead in the development, implementation, and
evaluation of DOH plans, programs, and
procedures on drug abuse prevention, treatment
and rehabilitation.
5 Pillars of DDAPTP
• Drug Supply Reduction
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a. The object is to take away the drugs from the
person through market denial operations and
prevention of diversion from the licit to the
illicit market.
b. Examples: A. Law Enforcement B.
Regulatory Compliance C. Judicial &
Legislative Measures
• Drug Demand Reduction
a. The aim is to take away the person from
drugs and reduce his desire to abuse drugs.
b. Examples: A. Policy Formulation B.
Preventive Education Programs C.
Treatment and Rehabilitation Programs D.
Research
• Alternative Development
a. Aims to reduce the production of marijuana
and eventually eliminate its cultivation
through sustainable rural development &
alternative livelihood programs.
• Civic Awareness and Response
a. The concept is to promote public awareness
on the evils of dangerous drugs & social
response by advocating the non-use of
dangerous drugs. Production and Distribution
of Information, Education, Communication
(IEC) materials and collaterals.
• Regional and International Cooperation
a. The intent is to forge and foster cooperation
with regional and international agencies.
Adhering to treaties, formulating agreements,
conducting tie-up projects. Attending foreign
conferences, exchanging drug reports,
hosting study tours and field visits, sharing of
best practices.
Vision
• ”Drug-Free Philippines”
Mission
• Lead in the implementation of a unified and
rational health response in the country’s drug
abuse prevention and control, aligned with the
Duterte Health Agenda (Philippine Health
Agenda).
Objectives
• To develop a more effective leadership and
governance for drug abuse prevention, treatment
and rehabilitation;
• To implement strategies for advocacy, health
promotion and drug abuse prevention;
• To ensure provision of comprehensive &
integrated health care services in treatment and
rehabilitation centers, (TRCs) and community-
based settings
• To strengthen information systems, M&E,
research, networking and linkaging.
Risk Factors
• Physical inactivity
• Cigarette smoking
• Unhealthy eating
• (other risk factors inaudible in both recs huhuhu
i’m so sorry)
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PREVENTION OF NONCOMMUNICABLE DISEASES
Goal
• Reduce Morbidity, Disability & Premature Deaths
Due to Chronic, Noncommunicable Lifestyle-
related Diseases
Objectives
• Analyze the socio-economic, political &
behavioral determinants of NCD.
• Reduce exposure of individuals & population to
major determinants of NCD while preventing
emergence of preventing common risk factors
• Strengthen health care for people with NCD
through health sector reforms & cost-effective
interventions.
• Promote Physical Activity and Exercise
• Promote Healthy Diet and Nutrition
• Promote a Smoke Free Environment
• Stress Management
If you would go back to your FAMORCA, there
are 10 facts about the global burden of the
disease, just browse through it.
POLICIES AND TREATMENTS TO REDUCE THE NCD
BURDEN
Description
• A national multisectoral plan and a Department of
Health strategic action plan for NCD prevention
and control 2017–2025;
• A recently updated national tobacco control
strategy;
• Tobacco and alcohol taxation: 2012 Republic Act
10351 (also known as the Sin Tax Reform Law);
and 2017 Republic Act 10963 (Tax Reform for
Acceleration and Inclusion (TRAIN))
• Package of Essential NCD Interventions
(PhilPEN);
• Philhealth primary care benefit package for
NCDs;
• Provision of NCD maintenance medicines under
the Medicines Access Program of the
Department of Health;
• Policies on cancer prevention and control,
including palliative and hospice care;
• STOPSMOKE mobile health programme
together with a quit-line and smoking-cessation
clinics;
• Philippine Plan of Action for Nutrition 2017–2022,
which addresses stunting, overweight and
obesity; and
➢ The Philippine Plan of Action for Nutrition has
already been implemented, the nutritional
council are the ones who usually manage.
• Guidelines for front-of-pack labeling for
prepackaged food.
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PHILIPPINE PACKAGE OF ESSENTIAL
NONCOMMUNICABLE DISEASES INTERVENTIONS
(PhilPEN)
Description
• The Philippine Package of Essential Non-
Communicable Diseases Interventions (PhilPEN)
was adopted and implemented in 2012 in low
resource setting from the World Health
Organization and was included in Philhealth’s
Primary Care Benefit Package in 2013.
• The National Policy on Strengthening the
Prevention and Control of Chronic Lifestyle
Related Non-Communicable Diseases
(Administrative Order No. 2011-0003 dated April
14 2011)
PhilPEN Goal & Objectives:
• This policy and guide aims to ensure the
appropriate provision of quality clinical
interventions and services for lifestyle-related
NCDs in the country: Specifically, it aims to:
• Guide health workers and providers at primary
health care facilities in implementing the Phil PEN
to identified population groups and client needs
• Define the roles and responsibilities of the
different DOH offices, the Philippine Health
Insurance Corporation, the LGUs and other
agencies in the implementation of the Phil PEN,
including higher level referral facilities.
• Generate the support of various stakeholders in
implementing the Phil PEN policy and guidelines
in the country.
• Usually these are found in our RHUs and brgys.
When you go to the community, ask them if the
RHU or brgy if they had achieved the Phil PEN
goals and objectives.
PhilPEN Scope & Coverage
• This policy applies to all units and
instrumentalities including attached agencies of
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the DOH and local government units (LGUs). It
also applies to non-government organizations,
professional organizations, private sector, and
other relevant partners in the health sector.
General Guidelines
1. The Phil PEN Protocol on the Integrated
Management of Hypertension and Diabetes shall
be used in all primary health care facilities in the
country, i.e. barangay health stations, rural health
centers, community health centers, and the like.
2. All relevant health care providers shall undergo
training on the use of the protocol to be provided
by the DOH-NCDPC in coordination with NCPAM
and PhilHealth.
3. The National Center for Pharmaceutical Access
Management shall support the implementation of
the Phil PEN by providing the complete treatment
packs for lifestyle related diseases pursuant to
Administrative Order 2011-0013 dated
September 12, 2011 (Implementing Guidelines
on the DOH Complete Treatment Pack
(COMPACK) to Ensure Sustainable Access to
Essential Drugs and Medicines for the
Marginalized Sector) until such time that the
PhilHealth benefit packages shall have been fully
instituted.
4. The PhilHealth benefit packages shall be
provided for the long-term support of the
implementation of the Phil PEN Protocol on
Integrated Management of Hypertension and
Diabetes.
5. The referral system must be established and duly
guided, while higher referral centers must be
properly equipped to deal with referrals coming
from the primary care level facilities.
6. All primary health care facilities in the country
should be reorganized to address chronic long-
term care of patients taking into account patient
load, logistical requirements and recording and
reporting accountabilities.
Specific Guidelines & Procedures
These specific guidelines and procedures shall be
instituted at the primary health care level facilities all over
the country, i.e. barangay health stations, rural health
units, community health centers and the like, whatever is
appropriate. A manual of operation will be issued
containing more details.
1. Target Population
➢ All individuals aged 25 years old and above
with no established cardiovascular disease
(angina pectoris, coronary heart disease,
myocardial infarction and transient ischemic
attacks), cerebrovascular disease (CeVD) or
peripheral vascular disease (PVD) or have
not undergone coronary revascularization or
carotid endarterectomy will undergo Risk
Factor Assessment. (WHO 2007)
2. Flow of Activities or Service Pathway
➢ The flow of activities (service pathway) in
the assessment, screening and
management of potential clients at risk of
NCD shall follow the algorithm illustrated
in APPENDIX 2.
3. List of Essential Devices
➢ The following equipment, devices and
supplies are needed in the implementation of
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the Phil PEN protocol on the management of
hypertension and diabetes and should be
made available at the health care facility:
✓ Stethoscope
✓ Blood Pressure measurement device,
non-mercurial
✓ Measuring Tape, non-extensible
✓ Height Board
✓ Weighing Scale
✓ Glucometer with test strips*
✓ Cholesterol Meter with test strips
✓ Test tube or glass container for the urine
✓ Tests strips for checking urine ketones
and protein
4. List of Essential Drugs/Medicines
➢ The following drugs and medicines are
needed in the implementation of the Phil PEN
protocol on the management of hypertension
and diabetes and should be made available
at the health care facility:
✓ Thiazide diuretics
✓ Beta blockers
✓ Angiotensin converting enzyme inhibitors
✓ Calcium Channel blockers (sustained
release formulations)
✓ Aspirin
✓ Metformin
✓ Glibenclamide
✓ Gliclazide
✓ Simvastatin
5. Risk Assessment and Screening
➢ Risk Factor Assessment is the key process
of evaluating individuals for the presence or
absence of common risk factors that expose
them to increased likelihood of developing
NCDs.
➢ Risk factor assessment involves asking
specific questions to determine the
individual's age, sex, family history of
diseases associated with NCDs among first
degree relatives, the use of alcohol and
tobacco, physical inactivity and diet.
➢ Risk Screening is the presumptive
identification of unrecognized disease or the
presence of intermediate risk factors by the
application of tests and procedures which
can be applied rapidly.
6. Referral
➢ Conditions where you can refer to the facility.
➢ Coordination mechanisms with the next
referral level should be established for clients
who need specialist or hospital care.
➢ Individuals with any of the conditions below
will be referred to a higher-level facility:
✓ Blood Pressure of ~140 (systole) or ~90
mmHg (diastole) in people below 40
years old (to exclude secondary
hypertension)
✓ Known heart disease, stroke, TIA, DM,
kidney disease (for assessment as
necessary)
✓ Angina, claudication
✓ Worsening heart failure
✓ Raised Blood Pressure ~140/90 (in DM
above 130/80 mmHg) in spite of
treatment with 2 or 3 agents
✓ Any proteinuria
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✓ Newly diagnosed diabetes with urine
ketones 2+ or in lean person of below 30
years old
✓ DM with fasting blood glucose >14
mmol/1 despite maximal metformin with
or without sulphonylurea
✓ DM with severe infection and/or foot
ulcers
7. Risk Stratification
➢ Following risk assessment and screening,
the level of risks of individuals who are not
referred to a higher-level facility will be
estimated using the WHO/ISH Risk
Prediction Charts for the Western Pacific
Region.
8. Risk Management
➢ Management guidelines for risk reduction will
follow Action 5 of the WHO PEN Protocol for
the Integrated Management of Hypertension
and Diabetes (WHO 2010) and the Pocket
Guidelines for Assessment and Management
of Cardiovascular Risk (WHO 2007).
Implementation Arrangement
• The oversight in the implementation of the Phil
PEN lies with the National Center for Disease
Prevention and Control, Degenerative Disease
Office in collaboration with the National Center for
Pharmaceutical Access Management and the
Philippine Health Insurance Corporation.
Roles & Responsibilities
Catered towards the following agencies:
1. Department of Health
➢ Provides leadership
➢ More info on DOH site: The DOH shall
provide leadership in the adoption of Phil
PEN by (1) promoting Phil PEN for
nationwide adoption and formation of
partnership among several stakeholders; (2)
providing of technical support, logistics and
financial assistance to LGUs; and (3)
monitoring progress of nationwide
implementation of Phil PEN.
2. Philippine Health Insurance Corporation
(PHIC)
➢ Ensure the adaption of the Phil PEN
➢ More info on DOH site: In order to ensure
the adoption of Phil PEN, the PHIC shall:
✓ Develop and implement an insurance
package for individuals at risk and
afflicted with lifestyle related disease.
✓ Advocate the adoption of Phil PEN in the
health facilities nationwide by linking to
financial incentives.
3. Local Government Units (LGUs)
➢ Adapt and implement the Phil PEN
➢ More info on DOH site: The Local
Government Units shall adopt and implement
the PHIL PEN and provide services and
products in primary health care facilities and
hospitals in their localities as well as provide
the training needs for personnel at peripheral
health units, district hospitals and
laboratories.
4. Referral Centers
➢ Higher level facilities such as district,
provincial hospitals, medical centers,
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MS. VIVIAN CEZAR

regional hospitals and specialty hospitals

must be equipped to handle referral for lower
level facilities and provide the necessary
support to the implementation of the PHIL
PEN.

Who leads (?) the Phil PEN: Department of

Health

FUNDING
Description
• The Department of Health Central Office and
Centers for Health Development shall provide
funds for technical assistance, monitoring and
health promotion campaigns to ensure the
operationalization of this Order. Local
Government Units shall provide funds to provide
products and services in their respective
communities.
• Other government agencies, non- government
organizations and other stakeholders shall
provide counterpart funds and technical
assistance as appropriate to ensure the effective
implementation of the PHIL PEN Protocol in the
country.

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