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3. Social Health- refers to ways a person feels, think and acts towards everybody around him.
HEALTH- successful defense of the host against forces landing to disturb body equilibrium
DISEASE-
failure of the body defense mechanism to cope with forces tending to disturb body equilibrium
1. Income and social status- higher income and social status are linked to better health
3. Physical environment-
safe water and clean air, healthy workplace, safe houses, communities and roads all contribu
te to good health.
5. Social support networks- greater support from families, friends and communities is linked
to a better health
6. Culture- customs, traditions and the beliefs of the family and community all affect the health
9. Health services- access and use of services that prevent and treat disease influence health
10. Gender- men and women suffer from different types of diseases at different ages.
1. Pre-American Occupation
1577- Public health began at the old Franciscan Convent in Intramuros where Fr. Juan
Clemente put up dispensary for treating indigents in Manila.
A few of these, such as the Hospital San Juan de Dios, remain to this day.
To show that the vaccines were not meant to harm, it was first administered to the Governor-
General’s very own children.
By May 29, 1805, around six to seven thousand adults and children were vaccinated in
Manila, Tondo, and Cavite.
Typhoons brought heavy rainfall which caused widespread flooding in low-lying areas. Water-
borne diseases like cholera were rampant during these periods.
School of Midwifery
Forensic Medicine
General Hospitals
San Juan de Dios Hospital
Contagious Hospitals
Here the facility became known as the Hospital de San Lazaro, in honor of the patron saint of
lepers.
The name was given after the hospital undertook the care of 150 lepers sent to the Philippines
by the Japanese emperor Iemitsu in 1632 at the time of Governor-General Juan Nino
de Tabora.
a.cholera,
b.small pox
c.and plague
common cold,
HepatitsA-D,
chickenpox,
SARS,
flu
mumps,
malaria,
herpes,
STD, and
measles
During the battle for liberation of Manila, the Philippine General Hospital could not handle the
casualties alone.
Thus, the US Army converted an old school building into a make shift civilian hospital the North
General Hospital. Following the name of its first director, it was later named Jose R. Reyes
Memorial Medical Center.
3. Philippine Assembly
Increase Morbidity
5. COMMONWEALTH PERIOD
5.1939– Creation of Dept. of Public Health and Welfare - Dr. Jose Fabella as the First secretary
6.1940- Bureau of Census and Statistics was created to gather vital statistics
7. In spite of development
Inequitable distribution of health services remained a problem
4. HEALTH PROMOTION
MODEL :
directed at increasing client’s well-
being.
* Goal : enhance level of
wellness.
VARIABLES influencing Health
Status, Beliefs & Practices
5. WHO DEFINITION (1978) : a state of
complete physical, mental, and social
well-being, not merely the absence of
disease or infirmity(sickness).
✓Health is a social phenomenon.
✓It is an outcome of multi-causal theories
of health and disease.
VARIABLES influencing Health
Status, Beliefs & Practices
AGENT HOST
AGENT
• VIRUS
• BACTERIA
• PROTOZOVA
• FUNGUS
CHARACTERISTICS:
- Infectivity
- Pathogenicity
- virulence
PHYSICALAGENTS
• Exposure to excessive
heat, cold, humidity,
pressure, radiation,
• Chromosomal factors
• Immunological factors
HOST
• Human being is
referred
disease agent as “
seed”
DEMOGRAPHIC FACTORS
BIOLOGICAL FACTORS
SOCIO ECONOMIC FACTORS
LIFE STYLE FACTORS
ENVIRONMENTAL FACTORS
1. PHYSICAL ENVIRONMENT
BIOLOGICAL ENVIRONMENT
PSYCHO SOCIAL
ENVIRONMENT
COMMUNITY
ORGANIZING
Community Organizing
To find methods and procedures to
help deal with social issues within the
community.
Example: Cancer from tobacco use is a
social health issue in Community A.
Therefore community organizing would
involve methods and procedures to deal
with the issue such as canvasing or an
awareness campaign.
Community Organizing
To find methods and procedures to
help deal with social issues within the
community.
Example: Cancer from tobacco use is a
social health issue in Community A.
Therefore community organizing would
involve methods and procedures to deal
with the issue such as canvasing or an
awareness campaign.
Community Organizing
Process
1. Recognize the Issue
2. Gain Community Entry
3. Organize People
4. Asses the Community
5. Set Goals and Priorities
6. Arriving at a Solution
Community Organizing
Process
7. Selecting Strategies
8. Implementing Plans
9. Evaluating outcomes
10.Maintaining outcomes
11. (Source: McKenzie, Pinger, Kotecki, 2012).
Primary Health Care (PHC) in the Philippines
Introduction
Primary Health Care (PHC) is an essential health care made universally acceptable to
individuals and families in the community by means acceptable to them through their full
participation and at a cost that the community and country and can afford at every stage of
development.
Definitions
The WHO defines Primary Health Care an essential health care made universally acceptable to
individuals and families in the community by means acceptable to them through their full
participation and at a cost that the community and country and afford at every stage of
development.
The Declaration of Alma-Ata was adopted at the International Conference on Primary Health
Care (PHC), Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic),
6-12 September 1978
Eight essential elements based on the Alma Ata on PHC: An essential health care based on
practical, scientifically sound and socially acceptable methods and technology made
universally, accessible to individuals and families in the community by means of acceptable to
them, through their full participation and at a cost that community and country can afford to
maintain at every stage of their development in the spirit of self-reliance and self-
determination.
Health Education
Treatment of Locally Endemic Diseases
Expanded Program on Immunization
Maternal and Child Health
Provision of Essential Drugs
Nutrition
Treatment of communicable and non-communicable diseases
Safe water and good waste disposal
Goals
The ultimate goal of primary health care is better health for all. WHO has identified five key
elements to achieving that goal:
May 1977.The 30th World Health Assembly adopted resolution which decided that the main
social target of governments and of WHO should be the attainment by all the people of the
world by the year 2000 a level of health that will permit them to lead a socially and
economically productive life.
September 6-12, 1978. International Conference in PHC was held in this year at Alma Ata, USSR
(Russia)
October 19, 1979.The President of the Philippines (Ferdinand Marcos) issued Letter of Instruction
(LOI) 949 which mandated the then Ministry of Health to adopt PHC as an approach towards
design, development, and implementation of programs which focus health development at
the community level.
Rationale
There are two types of primary health care workers in the Philippines:
Four Pillars
Attaining health for all Filipinos will require expanding participation in health and health-related
programs whether as service provider or beneficiary. Empowerment to parents, families and
communities to make decisions of their health is the desired outcome.
Advocacy must be directed to national and local policy making to elicit support and
commitment to major health concerns through legislations, budgetary and logistical
considerations.
The health in the hands of the people brings the government closest to the people. It
necessitates a process of capacity building of communities and organization to plan,
implement and evaluate health programs at their levels.
Using appropriate technology will make services and resources required for their delivery,
effective, affordable, accessible and culturally acceptable.
The development of human resources must correspond to the actual needs of the nation and
the policies it upholds such as PHC.
The Department of Health (DOH) continue to support and assist both public and private
institutions particularly in faculty development, enhancement of relevant curricula and
development of standard teaching materials.
Essential National Health Research (ENHR) is an integrated strategy for organizing and
managing research using intersectoral, multi-disciplinary and scientific approach to health
programming and delivery.
Elements of PHC
The following are the eight (8) essential elements of primary health care:
This is one of the potent methodologies for information dissemination. It promotes the
partnership of both the family members and health workers in the promotion of health as well
as prevention of illness.
This program exists to control the occurrence of preventable illnesses especially of children
below 6 years old. Immunizations on poliomyelitis, measles, tetanus, diphtheria and other
preventable disease are given for free by the government and ongoing program of the DOH
The mother and child are the most delicate members of the community. So the protection of
the mother and child to illness and other risks would ensure good health for the community. The
goal of Family Planning includes spacing of children and responsible parenthood.
Environmental Sanitation is defined as the study of all factors in the man’s environment, which
exercise or may exercise deleterious effect on his well-being and survival. Water is a basic need
for life and one factor in man’s environment. Water is necessary for the maintenance of healthy
lifestyle. Safe Water and Sanitation is necessary for basic promotion of health.
One basic need of the family is food. And if food is properly prepared then one may be
assured healthy family. There are many food resources found in the communities but because
of faulty preparation and lack of knowledge regarding proper food planning, Malnutrition is
one of the problems that we have in the country.
The diseases spread through direct contact pose a great risk to those who can be infected.
Tuberculosis is one of the communicable diseases continuously occupies the top ten causes of
death. Most communicable diseases are also preventable. The Government focuses on the
prevention, control and treatment of these illnesses.
This focuses on the information campaign on the utilization and acquisition of drugs. In response
to this campaign, the GENERIC ACT of the Philippines is enacted. It includes the following drugs:
Paracetamol is a common painkiller used to treat aches and pain. It can also be used to
reduce a high temperature;
Oresol or Oral Rehydration Salts to replace fluids and electrolytes or body salts lost to diarrhea
or vomiting;
Albendazole or anti-worm medication used to treat certain infections caused by worms such
as pork tapeworm; and
Principles
Lack of motivation
Attitude
Resistance to change
Dependence on the part of community people
Lack of managerial skills
4. Self-reliance Through community participation and cohesiveness of people’s organization
they can generate support for health care through social mobilization, networking and
mobilization of local resources. Leadership and management skills should be develop
among these people. Existence of sustained health care facilities managed by the
people is some of the major indicators that the community is leading to self-reliance.
5. Partnership between the community and the health agencies in the provision of quality of
life. Providing linkages between the government and the non-government organization
and people’s organization.
6. Recognition of interrelationship between the health and development
Health is defined as not merely the absence of disease. Neither is it only a state of physical
and mental well-being. Health being a social phenomenon, recognizes the interplay of
political, socio-cultural and economic factors as its determinant. Good Health therefore, is
manifested by the progressive improvements in the living conditions and quality of life
enjoyed by the community residents
Development is the quest for an improved quality of life for all. Development is
multidimensional. It has political, social, cultural, institutional and environmental
dimensions (Gonzales 1994). Therefore, it is measured by the ability of people to satisfy
their basic needs.
7. Social Mobilization It enhances people’s participation or governance, support system
provided by the government, networking and developing secondary leaders.
8. Decentralization This ensures empowerment and that empowerment can only be
facilitated if the administrative structure provides local level political structures with
more substantive responsibilities for development initiators. This also facilities proper
allocation of budgetary resources.
The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States
in 2015, provides a shared blueprint for peace and prosperity for people and the planet, now
and into the future. At its heart are the 17 Sustainable Development Goals (SDGs), which are an
urgent call for action by all countries - developed and developing - in a global partnership.
They recognize that ending poverty and other deprivations must go hand-in-hand with
strategies that improve health and education, reduce inequality, and spur economic growth –
all while tackling climate change and working to preserve our oceans and forests.
2012 United Nations Conference on Sustainable Development (Rio+20, Member States agreed
to launch a process to develop a set of sustainable development goals (SDGs) to succeed the
Millennium Development Goals (MDGs), whose achievement period concludes in 2015.
The SDGs are to address all three dimensions of sustainable development (environmental,
economic and social) and be coherent with and integrated into the United Nations global
development agenda beyond 2015. The envisaged SDGs have a time horizon of 2015 to 2030.
The Millennium Development Goals (MDGs) are part of the Millennium Declaration by 189
countries, including 147 Heads of State, in September 2000. The goals and targets are inter-
related and should be viewed as a whole. Built on the outcomes of the international
conferences of the 1990s, the Millennium Declaration marked a strong commitment to the right
to development, to the eradication of the many dimensions of poverty, and to gender equality
and the empowerment of women. The Declaration mainstreams into the global development
agenda eight mutually reinforcing goals, to be achieved by 2015, that are driving national
development and international cooperation.
Target 1. Halve, between 1990 and 2015, the proportion of people whose income is less than
one dollar a day
Target 2. Halve, between 1990 and 2015, the proportion of people who suffer from Hunger
Target 3. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to
complete a full course of primary schooling
Goal 3. Promote gender equality and empower women
Target 4. Eliminate gender disparity in primary and secondary education, preferably by 2005,
and to all levels of education no later than 2015
Target 5. Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
Target 6. Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major
diseases
Target 9. Integrate the principles of sustainable development into country policies and
programmes and reverse the loss of environmental resources
Target 10. Halve by 2015 the proportion of people without sustainable access to safe drinking
water
Target 11. By 2020 to have achieved a significant improvement in the lives of at least 100 million
slum dwellers
Target 15. Deal comprehensively with the debt problems of developing countries through
national and international measures in order to make debt sustainable in the long term
Target 16. In cooperation with developing countries, develop and implement strategies for
decent and productive work for youth
Target 18. In cooperation with the private sector, make available the benefits of new
technologies, especially information and communications
Primary
Health Care
(PHC) in the
Philippines
Introduction
Treatment of Expanded
Maternal and Child
Health Education Locally Endemic Program on
Health
Diseases Immunization
Treatment of
Safe water and
Provision of communicable and
Nutrition good waste
Essential Drugs non-communicable
disposal
diseases
GOAL OF PHC
October 19, 1979. The President of the Philippines (Ferdinand Marcos) issued
Letter of Instruction (LOI) 949 which mandated the then Ministry of Health to adopt PHC as an
approach towards design, development, and implementation of programs which focus health
development at the community level.
Adopting primary health care has
the following rationales:
4. Isolation
2.
of health
Inadequate
1. Magnitude 3. Increasing care
and unequal
of Health cost of activities
distribution
Problems medical care from other
of health
development
resources
activities
Objectives of PHC
1. Improvement in
2. Favorable
the level of health
population growth
care of the
structure
community
5. Extension of essential
health services with 6. Improvement in basic
priority given to the sanitation
underserved sectors.
8. Maximizing the
7. Development of the contribution of the other
capability of the sectors for the social
community aimed at and economic
self- reliance. development of the
community.
Types of PHC workers
Intra and
Active
Inter-
Community
sectoral
Participation
linkages
Support
Use of
mechanism
appropriate
made
technology
available
Major Strategies
6. Recognition of interrelationship
between the health and
development
7. Social Mobilization
8. Decentralization
INTER-LOCAL HEALTH SYSTEM
INTER-LOCAL
HEALTH SYSTEM
INTER-LOCAL HEALTH SYSTEM
➢Espoused by the DOH to ensure quality of
health care service at the local level
➢Individuals, communities and all other health
care providers in a well-defined geographical
area participate together in providing
equitable and accessible healthcare with
inter LGU partnership
INTER-LOCAL HEALTH ZONE (ILHZ)
Defined population
Central referral
hospital
Expected Achievement of the Inter
Local Health System
Universal Improved quality
Effective referral Integrated
coverage of the of Hospital and
system planning
Health Insurance. RHU service
Appropriate Effective
Improved drug
health Developed leadership
management
information human resources through Inter-
system
system LGU cooperation
Combat
Reduce child Improve HIV/AIDS,
mortality maternal health malaria and
other diseases
Develop a
Ensure
global
environmental
partnership for
sustainability
development
HEALTH SECTOR REFORM
AGENDA
FOURmula One:
the framework for health sector reform as a means to
achieving the Millennium Development Goals
Goals:
FOURmula ONE for Health as Overall Frame
Better Health
Outcomes
Equitable More
Health Responsive
Care Health
Financing Systems
FOURmula ONE for Health:
Elements of the Strategy
Good
Governance -
Improved health
Health Service system
Delivery- Improve performance at
accessibility and the national and
Health availability of basic
Regulation- and essential
local levels
ensure quality & health care for all,
Health affordability of especially the poor.
Financing- goods and
greater, better services
& sustained
investment in
health