CHN 2

MATH
Philippine
SUBJECT
Health
FOR HIGH
Situation
SCHOOL
Anne Jo
Quadratic M. Ruiz, MSN, RN
Functions
Projected data 2021
Source: https://www.unfpa.org/data/demographic-dividend/PH
Source: https://www.unfpa.org/data/demographic-dividend/PH
 Universal Health Care
● February 2019- President Rodrigo Duterte signed the Universal
Health Care Bill into law.
● Republic Act 11223 (Universal Health Care Act)
Six Building Blocks of Philippine Health System

SERVICE
SERVICE DELIVERY
DELIVERY
ACCESS
HEALTH
HEALTH WORKFORCE
WORKFORCE COVERAGE
IMPROVED
IMPROVED HEALTH
HEALTH

INFORMATION
INFORMATION RESPONSIVENESS
RESPONSIVENESS

MEDICAL
MEDICAL PRODUCTS
PRODUCTS RISK
RISK PROTECTION
PROTECTION
QUALITY IMPROVED
IMPROVED EFFICIENCY
EFFICIENCY
FINANCING
FINANCING SAFETY

LEADERSHIP
LEADERSHIP
 Organization of Health Services
1.Public- Private Sector Imbalance
● Highly resourced private sector servicing 20%-30% of population
● Health promotion/ Disease prevention lag behind curative service
provision
2.Fragmentation of Services
● Overspecialization of curative services
● Devolution of health services
● National and local
● Weak regulatory mechanisms
 Philhealth

● Article 2 Section 2, RA 7875 as amended:

“Compulsory Coverage- All citizens of the Philippines shall
be required to enroll in the National Health Insurance
Program in order to avoid adverse selection and social
inequity
 Human Resources for Health
● Health Worker Migration
1. Overproduction
2. Maldistribution
3. High-out Migration
4. Nil-in Migration
5. Low return migration
 CHN 2

Epidemiology and the

Nurse
ROLE OF A NURSE IN EPIDEMIOLOGY

●Preventive role
●Promotive role
●Curative role
●Rehabilitative role
Natural Life History of
Disease
 Natural History
● Refers to the progress of a disease process in an individual over time, in the absence of
intervention
● The process begins with exposure to or accumulation of factors capable of causing
disease
● Without medical intervention, the process ends with
a. Recovery
b. Disability
c. Death
 Natural History of Disease

Recovery

Exposure Host Disease Disability

Death
 Iceberg Concept

The iceberg phenomenon describe a situation in which a large

percentage of a problem is subclinical, unreported, or otherwise
hidden from view. Thus, only the "tip of the iceberg" is apparent to
the epidemiologist.
Iceberg Concept

Clinical Disease

Sub-clinical Disease
Epidemiological Process &
Investigation
 TABLE OF CONTENTS

01 Standard Form 02 Factored Form 03 Vertex Form

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04 The Square I 05 The Square II 06 Modeling

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 Conducting a Field Investigation
● Step 1. Prepare for Field Work
a. Agree on purpose of the investigation
b. Required official approvals have been received
c. Roles and Responsibilities
 Conducting a Field Investigation
● Step 2. Confirm the Diagnosis
a. Interviewing the affected persons;
b. Clinical examination of the affected persons by health-care personnel when indicated and
possible;
c. Reviewing medical records and other pertinent clinical information (e.g., radiography and
other imaging studies); and
d. Confirming the results of laboratory testing; if the epidemiologist does not have the
expertise to assess the adequacy, accuracy, or meaning of the laboratory findings, laboratory
scientists and other personnel should be consulted.
 Conducting a Field Investigation
● Step 3. Determine the Existence of an Outbreak
a. Establishing a comparison timeframe in the suspected epidemic setting by considering, for
example, whether it should be the period (e.g., hours, days, weeks, or months) immediately
preceding the current problem or the corresponding period from the previous year;
b. Taking into account potential problems or limitations in determining comparison
timeframes (e.g., lack of data, varying or lack of case definitions, incomplete reporting, and
other reasons for inefficient surveillance); and
c. Calculating occurrence rates, when possible, between the period of the current problem and
a comparator period.
 Conducting a Field Investigation
● Step 4. Identify and Count Cases
a. Conditions consisting of

i. A set of symptoms

ii. Signs

iii.Laboratory findings
 Conducting a Field Investigation
● Step 4. Identify and Count Cases
b. With the condition occurring during a particular
period, usually referred to as the epidemic period
c. With the condition occurring after the person was in
one or more specific settings 
 Conducting a Field Investigation
● Step 5. Tabulate and Orient the Data in Terms of Time, Place, and
Person
a. Drawing epidemic curves,
b. Constructing spot maps or other special spatial projections, and
c. Comparing groups of persons

Key Actions:
d. Time
e. Place
f. Person
 Conducting a Field Investigation
● Step 6. Consider Whether Control Measures Can Be Implemented Now
a. Those that can be directed at the source(s) of most infectious and other disease-causing
agents
b. Those that can be directed at persons who are susceptible to such agents
 Conducting a Field Investigation
● Step 7. Develop and Test Hypotheses
a. Descriptive epidemiologic findings resulting from analysis of the line listing of
identified affected persons;
b. Information obtained from interviews of individuals or groups of affected
persons by using structured questionnaires or open-ended questioning;
c. Anecdotes, impressions, and ideas from affected persons or others in the affected
area; and
d. Consideration of outlier cases (i.e., cases with onset occurring at the beginning
or end of the outbreak period).
 Conducting a Field Investigation
● Step 8. Plan One or More Systematic Studies
a. improving the quality of information
b. refining the accuracy of the estimates of persons at risk and
examining other germane concerns
 Conducting a Field Investigation
● Step 9. Implement and Evaluate Control and Prevention Measures
a. implement scientifically rational and advisable control
measures for preventing additional outbreak-associated
morbidity or mortality.
b. evaluation efforts should be implemented concurrently
with control measures to assess their effectiveness in
attenuating and ultimately terminating the outbreak.
 Conducting a Field Investigation
● Step 10. Communicate Findings
a. Identify and designate a spokesperson or a consistent point of contact who will
serve as the primary communicator for the investigative team. 
b. Provide oral briefings and written communications, as might be indicated.
c. Written reports can be customized for multiple purposes
d. Preliminary written report and oral briefing to the requesting authority and local
stakeholders
e. Brief reports published rapidly in public health bulletins can help alert
colleagues about the problem.
Thanks!
annemendenueta@gmail.com