Community Health Nursing - Enhancement

Community
Health
Nursing -
Introduction
MARYJAN B. GUTIERREZ, RN
PUBLIC HEALTH NURSING
Public health systems are operating within a context of ongoing

changes, which exert several pressures on the public health systems.
1. Health Reforms
2. Existing and emerging environmental hazards some associated
with globalization
3. New technologies for health care, communication and information
4. Shifts in demographic and epidemiologic trends in diseases,
including the emergence and re-emergence of new diseases and
in the prevalence of risk and protective factors.
Millennium
Development Goals
• Based on the fundamental values
of freedom, equality, solidarity,
tolerance, health, respect for
nature and shared responsibility.
• Target date: 2015

Sustainable
Development
Goals
• According to
United Nations,
“SDG’s are the
blueprint to
achieve a better
and more
sustainable future
for all”
• Target date: 2030

The Public
Health
Nurse
ROLES AND RESPONSIBILITY
Management Function
Execution of the five management functions: Planning,
Organizing, Staffing, Directing and Controlling. This function is
performed when she organizes the “nursing service” of the local
health agency.
Program management: She is responsible for the delivery of the

package of services provided by the program to the target
clientele.
Supervisory Function
The public health nurse is the supervisor of the midwives and

other auxiliary health workers in the catchment area. As a
supervisor, she formulates a supervisory plans and conducts
supervisory visits to implement the plan.
Nursing Care Function
Nursing care provision is an inherent function of the nurse. Her

practice is based on the science and art of caring, in whatever
setting she maybe or role she may have, providing nursing
care is the heart of it. Home visits are must activities of the
PHN.
Collaborating and Coordinating Function
PHN are the care coordinators for communities and their

members. They are actively involved both socially and politically
to empower individuals, families and communities as an entity to
initiate and maintain health promoting environments.
She establishes linkages and collaborative relationships with

other health professionals, government agencies, the private
sector, NGO, people’s organizations to address the health
problems.
Health Promotion and Education
Function
PHN activities go beyond health teachings and health information
campaigns. As an educator, the nurse provides clients with
information that allows them to make healthier choices and
practices. Giving health education is very important function and
a major component of any public health program.
Training Function
PHN initiates the formulation of staff development and training

programs for midwives and other auxiliary workers. She does
training needs assessment for these health workers, designs the
training program and conducts them in collaboration with other
resource persons. She also does evaluation of training
outcomes.
Research Function
PHN participates in the conduct of research and utilizes research

findings in her practice. One of the areas of PHN is disease
surveillance.
Leader and Change Agent Function
Influence, change and inspire

CONCEPTS
What is health?
❑ According to WHO, “State of complete physical, mental and

social well-being, not merely the absence of disease or
infirmity”
❑ According to the Modern Concept, “it is the optimum level

of functioning”
COMMUNITY HEALTH
NURSING
PHN Field
Clientele:
1. Family
2. Community
3. Individual
4. Subpopulation
HISTORICAL BACKGROUND OF
PUBLIC HEALTH
1st INTERNATIONAL MEETING LOCAL MEETING
When: September 6-12 1978 Who: Pres. Ferdinand Marcos Sr.

Where: Alma Atta, USSR When: October 19, 1979
Target: 2000 Where: Alma Atta, USSR
Theme: Health for All Target: 2020
Theme: Health in the Hands of the
Filipino People
Levels of Primary Health Care Workers
1. Village/Barangay Health Workers/Grassroots

2. Intermediate Level of Health Workers
PHILIPPINE
HEALTH
CARE
DELIVERY
SYSTEM
2 MAJOR PLAYERS
Composed of two sectors:
1. Public sector
- largely financed through a tax-based budgeting system at both

national and local levels and where health care is generally given free
at the point of service
2 MAJOR PLAYERS
2. Private sector
- largely market-oriented and where health care us paid through

user fees at the point of service
DOH History
Late President Corazon Aquino passed Republic Act 7160 known

as the Local Government Code on October 10, 1991, allowing the
decentralization of the entire government. This brought about a major
shift in the role and functions of the Department of Health. Under this
law, all transactions from the provincial health level down to the
barangays were DEVOLVED to the Local Government Unit (LGUs) to
facilitate health service delivery.
DOH History
DOH mandated as the lead agency of health for the national level.
Through this, EO 102 by President Joseph E. Estrada granted the DOH
to proceed with its Rationalization and Streamlining Plan which
prescribed the current organizational, staffing and resource structure
consistent with its new mandate, roles and functions post devolution
New Roles and Functions of DOH
Leadership in Health
• Serves as the national policy and regulatory institution from which
the local government units, NGOS and other members of the
health sector involved in social welfare and development will
anchor their thrusts and directions for health
• Provides leadership in the formulation, monitoring and evaluation
of national health policies, plans and programs. The DOH shall
spearhead sectoral planning and policy formulation and
assessment at the national and regional levels.
• Serve as advocate in the adoption of health policies, plans and
programs to address national and sectoral concerns
Enabler and Capacity Builder
• Innovate new strategies in health to improve the effectiveness
of health programs, initiate public discussion on health issues
and undertaking and disseminate policy research outputs to
ensure informed public participation in policy decision-making
• Exercise oversight functions and monitoring and evaluation of
national health plans, programs and policies
• Ensure the highest achievable standards of quality health care,
health promotion and health protection
Administrator of Specific Services
• Manage selected national health facilities and hospitals with modern
and advanced facilities that shall serve as national referral centers
and selected health facilities at sub-national levels that are referral
centers for local health systems
• Administer direct services for emergent health concerns that require

new complicated technologies that it deems necessary for public
welfare; administer special components of specific programs like
tuberculosis, schistosomiasis, HIV-AIDS, in as much as it will benefit
and affect large segments of the population
Administrator of Specific Services
• Administer health emergency response services, including
referral and networking systems for trauma, injuries and
catastrophic events, in cases of epidemic and other widespread
public danger, upon direction of the President and in
consultation with concerned LGU
DOH Vision
OLD:
To guarantee Equitable, Sustainable and Quality health for all
especially for the poor (ESQ)
NEW:
Productive, Resilient, Equitable and People Centered health
system for universal health care (PREP)
DOH Mission
OLD:
Health For All
NEW:
Leader, Advocate, Promoter of Health for All
NEWER:
Goals by 2030
1. Better Health Outcomes
2. More Responsive Health System
3. Equitable Health Financing
DOH Mission
NEWEST:
That the Filipino people is the healthiest people in Southeast Asia

by 2022 and in Asia by 2040
DOH Goal: Health Sector Reform Agenda
Health sector reform is the overriding goal of the DOH.
Rationale:
- Slowing down IMR and MMR
- Persistent large variations in health status across population
groups and geographic areas
- High burden from infectious, chronic and degenerative disease
and is heaviest on the poor.
- Unattended emerging health risks from environmental and work-
related factors
Framework for Implementation of HSRA:
FOURmula One for Health
This is adopted as the implementation framework for health
sector reforms under the current administration. It intends to
implement critical interventions as a single package backed by
effective management infrastructure and financing arrangements
following a sector wide approach
Goals of FOURmula ONE for Health
1. Better health outcomes

2. More responsive health systems
3. Equitable health care financing
Elements of FOURmula ONE
1. Health financing – the goal of this health reform area is to

foster greater, better and sustained investments in health.
The Philippine Health Insurance Corporation, through the
National Health Insurance Program and the DOH through
sector wide policy support will lead this component jointly
2. Health regulation – the goal is to ensure the quality and

affordability of health goods and services
Elements of FOURmula ONE
3. Health service delivery – the goal is to improve and ensure

the accessibility and availability of basic and essential
health care in both public and private facilities and services
4. Good governance – the goal is to enhance health system

performance at the national and local levels
Levels of Prevention
PRIMARY -P
SECONDARY -S
TREATMENT -T
Levels of Health Care and Referral
System
TERTIARY
SECONDARY
PRIMARY
Nursing
procedures
Clinic visit
Process of checking the clients’ health condition in a medical

clinic where the nurse assists the client as well as the physician
in the whole course of examination.
Pre-consultation conference
- a pre-clinic lecture is usually conducted prior to the admission
of patients, which is one way of providing health education.
Home Visit
This is a family-nurse contact which allows the health worker to
assess the home and family situations in order to provide the
necessary nursing care and health related activities.
SCHOOL
HEALTH
NURSING
INTRODUCTION
The Health and Nutrition (HNC) of the Department of Health
(DepEd) is mandated to safeguard the health and nutritional well-
being of the total school population.
Two Divisions:
1. Health Division: Sections are Medical, Dental, Nursing and
Health Education Sections
2. Nutrition Division
INTRODUCTION
Every child deserves to be as fit and as healthy as possible to
gain maximum benefits from his education. The primary role of
the school nurse is to support student learning and ensure that
educational potential is not hampered by unmet health needs.
WHAT IS SCHOOL NURSING?
School nursing is a type of public health nursing that focuses on
the promotion of health and wellness of the pupils/students,
teaching and non-teaching personnel of the schools.
GENERAL OBJECTIVE
To promote and maintain the health of the school populace by
providing comprehensive and quality nursing care
DUTIES AND RESPONSIBILITIES
1. Health advocacy
2. Health and nutrition assessment including other screening
procedures such as vision and hearing
3. Supervision of the health and safety of the school plant
4. Treatment of common ailments and attending to emergency
cases
5. Referrals and follow-up of pupils and personnel
DUTIES AND RESPONSIBILITIES
6. Home visits
7. Community outreach like attending community assemblies
and organizing school community health councils
8. Recording and reporting of accomplishments
9. Monitoring and evaluation of programs and projects
SKILLS NEEDED
1. Assessment and Screening Skills
2. Health and counselling skills
3. Social Mobilization Skills
4. Good Oral and Written Communication Skills
5. Basic Management Skills
6. Life Skills
DOH
PROGRAMS
Maryjan B. Gutierrez, RN
PUBLIC HEALTH PROGRAMS
Public health programs are sets of interventions put together to

operationalize policies and standards directed towards the prevention
of certain public health problems. Strategies and activities used are
based on scientific evidences and has shown to be effective.
What are the DOH Programs?
D Dental Health
O Operations for Environmental Sanitation
H Health Education and Community Organizing
P Prevention and Control of Communicable Diseases
R Reproductive Health
O Older Persons Health Services
G Guidelines for Nutrition
R Rehabilitation and Management of Non-Communicable Diseases
A Alternative Health Care Practices
M Maternal and Child and IMCI
S Sentrong Sigla Movement
DENTAL HEALTH/ORAL HEALTH
PROGRAM
Goal:
Reduce the prevalence rate of dental caries and
periodontal diseases among general population
OPERATIONS FOR ENVIRONMENTAL
SANITATION
Environmental Health
“Branch of public health that deals with the study of
preventing illnesses by managing the environment and changing
people’s behavior to reduce exposure to biological and non-
biological agents of disease and injury” – John Tomarro (USAID)
It also focuses on preventing diseases.

SANITATION
SANITATION
Environmental Sanitation:
is defined as the study of all factor in man’s physical
environment, which may exercise a deleterious effect on his
health well-being and survival
SANITATION
Environmental and Occupational Health Office (EOHO) is
responsible for the promotion of healthy environmental
conditions, give technical assistance, conceptualize new
programs and prevention of environmental related diseases
through appropriate sanitation strategies.
SANITATION
Water Supply Sanitation Program
Level Distance Production Household
I No distribution system 250 m away 40-140 L/min 15-25
II Distribution system 25 m away 40-80 L/capita 100 (4-6 per
only to those using the (day) facility)
facility
III With source, reservoir,
piped distributor
network and
household taps
SANITATION
Unapproved type of water facility

1. Open dug wells
2. Unimproved springs
3. Well that need priming
Monitoring surveillance – once a year

SANITATION
The examination of drinking water shall be performed ONLY in

private or government laboratories duly accredited by the
Department of Health
Certification of potability of an existing water source is issued

by the Secretary of Health or his duly authorized representative
(local health authority)
SANITATION
Disinfection is required on the following:

1. Newly constructed water supply facilities
2. Water supply facility that has been repaired/improved
3. Water supply sources found to be positive bacteriologically by
laboratory analysis
4. Container disinfection of drinking water collected from a water
facility that is subject to recontamination like open dug wells,
unimproved springs and surface water
SANITATION
Proper Excreta and Sewage Disposal Program
Level Type Examples
I Non-water Aqua privy, pit-latrine
carriage
Small water Pour-flush
II Water Septic tank
carriage/Sealed
III Water Septic tank with sewerage system and
carriage/Sealed treatment plant
SANITATION
Recent Laws and DOH Policies affecting Environmental
Health
1. RA 6969
2. RA 8749
3. RA 9003
4. RA 9275
5. PD 856
6. PD 825
GUIDELINES FOR NUTRITION
Malnutrition continues to be the public health concerns in the
country. These common nutritional deficiencies are:
1. Vitamin A
2. Iron
3. Iodine
Goal: Improve quality of life of Filipinos through better nutrition,

improved health and increased productivity.
Program and Projects
1. Micronutrient Supplementation
The twice a year distribution of Vitamin A capsules through
the “Araw ng Sangkap Pinoy” seal known as the Garantisadong
Pambata or Child Health Week is the approach given to provide
micronutrient supplementation.
c
1. Micronutrient Supplementation – Vitamin A
Target/Illness Age Preparation Dose/Duration
Infants Less than 6 months 50, 000 IU One Dose
Infant/Infant with 6-11 months 100, 000 IU One Dose

measles/SP/PD/MLNTRN
Children/Children with 12-71 months 200, 000 IU One every 6 months
Pregnant 10, 000 IU Twice a week
Post-partum women 200, 000 IU One dose
Infant with xeropthalmia 6-11 months 100, 000 IU TTT
Child with xeropthalmia 12-59 months 200, 000 IU TTT
Pregnant women with 10, 000 IU Regardless of month

nightblindness
Infants Less than 6 months 50, 000 IU One Dose
Infant/Infant with 6-11 months 100, 000 IU One Dose

Children/Children with 12-71 months 200, 000 IU One every 6 months

Pregnant 10, 000 IU Twice a week
Post-partum women 200, 000 IU One dose
Infant with xeropthalmia 6-11 months 100, 000 IU TTT
Child with xeropthalmia 12-59 months 200, 000 IU TTT
Pregnant women with nightblindness 10, 000 IU Regardless of month

1. Micronutrient Supplementation – Iron
Pregnant women 60 mg of iron with 400 mg or 800 1 tablet for 6 months or…
mcg of folic acid
Lactating women 60 mg of iron with 400 mg of folic 1 tab for 3 months
acid
Low birth weight Drops: 15 mg. elemental iron/0.6 .3 mL Once a day until 6
mL months
Infants 6-11 months Drops: 15 mg. elemental iron/0.6 .6 mL once a day for 3 months
mL
Children 1-5 years old 30 mg iron/5 mL 1 tbsp for 3 months or 30 mg
once a week for 6 months
Children (Anemic and 6-11 years old 30 mg/5mL 2 tbsp once a day for 6
underweight) months
Adolescent Girls 10-19 years old 60 mg iron with 400 mcg folic acid Once a day
Older Persons 60 mg iron with 400 mcg folic acid Once a day
Pregnant women 60 mg of iron with 400 mg or 800 1 tablet for 6 months or…
mcg of folic acid
Lactating women 60 mg of iron with 400 mg of folic 1 tab for 3 months

acid
Low birth weight Drops: 15 mg. elemental iron/0.6 .3 mL Once a day until 6 months
mL
Infants 6-11 months Drops: 15 mg. elemental iron/0.6 .6 mL once a day for 3 months
mL
Children 1-5 years old 30 mg iron/5 mL 1 tbsp for 3 months or 30 mg

once a week for 6 months
Children (Anemic and 6-11 years old 30 mg/5mL 2 tbsp once a day for 6 months
underweight)
Adolescent Girls 10-19 years old 60 mg iron with 400 mcg folic Once a day
acid
Older Persons 60 mg iron with 400 mcg folic Once a day

acid
1. Micronutrient Supplementation – Iodine
Women 15-45 years old Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
Children or school age Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
Adult Males Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
Women 15-45 years old Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
Children or school age Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
Adult Males Iodized oil capsule with 200 mg 1 capsule for 1 year
of iodine
2. Food Fortification
The Food Fortification Act of 2000 provides for the
mandatory fortification of staple foods namely: flour with iron and
vitamin A, cooking oil and refined sugar with Vitamin A and rice
with iron and the voluntary fortification of processed foods
through the Sangkap Pinoy Seal
2. Food Fortification
ASIN Law RA 8172
3. Essential Maternal and Child Health Service Package

❑ Breastfeeding
❑Complementary Feeding
❑Micronutrient supplementation
4. Nutrition information, communication and education

5. Home, School and Community Food Production
6. Food Assistance
7. Livelihood assistance
REHABILITATION AND MANAGEMENT
OF NON-COMMUNICABLE DISEASES
There are four major non-communicable diseases (also known

as chronic diseases or lifestyle-related diseases):
a. Cardiovascular Disease
b. Cancer
c. COPD
d. Diabetes Mellitus
INTRODUCTION
The most widely used summary measure of the burden of
disease is the disability adjusted life year or DALY, which
combines the number of years of healthy life lost to premature
death with time spent in less than full health.
One DALY can be thought of as one lost healthy year of life.

INTRODUCTION
These four major NCDs are linked by three major risk factors:
tobacco smoking, physical inactivity and an unhealthy diet
INTRODUCTION
A major strategy is health promotion across the life course and
prevention of the emergence of the risk factors in the first place.
Healthy lifestyle is operationally defined as a way of life that

promotes and protects health and well-being.
INTRODUCTION
Goal:
Reduce the toll of morbidity, disability and premature deaths due
to chronic, non-communicable lifestyle related diseases.
THE ROLE OF PHN IN NCD
PREVENTION AND CONTROL
Health Advocate:
Promotes active community participation in NCD prevention
and control through advocacy work.
Health Educator:
Is an essential tool to achieve community health. They are
concerned with promoting health as well as reducing behavior-
induced disease. In NCD, it focuses on establishing or inducing
changes in personal and group attitudes and behavior that
promote healthier living.
Health Care Provider:
Provider to IFC, rendering services in any setting.
Emphasis of care is on health promotion and disease prevention.
Community Organizer:
The ultimate goal of the PHN is community health
development and empowerment of the people.
Health Trainer:
Provides technical assistance in the assessment of the
skills of auxiliary health workers in NCD prevention and control;
teaching and supervision on clinical management of NCD and
other community-based services and recording, reporting and
utilization of health information related to NCDs
Researcher:
Research provides valuable information and prevents
health workers from implementing irrelevant interventions.
KEY PREVENTION
1. Elevated blood lipid (Hyperlipidemia)/High intake of fatty
foods/Inadequate intake of dietary fiber
Promote Proper Nutrition

a. Limit intake of fatty, salty and preserved foods
b. Increase intake of vegetables and fruits
c. Avoid high caloric low-nutrient value food
d. Start developing healthy habits in children
KEY PREVENTION
1. Elevated blood lipid (Hyperlipidemia)/High intake of fatty
foods/Inadequate intake of dietary fiber
Comprehensive nutritional assessment involves detailed recall

methods or extensive food frequency.
KEY PREVENTION
2. Overweight and Obesity/Sedentary Lifestyle
Encourage more physical activity and exercise

a. Moderate physical activity of at least 30 minutes for most
days
b. Integrate physical activity and exercise into regular day-
to-day activities
c. Walking is one form of exercise that is possible for all
including older persons and persons with cardiovascular disease
KEY PREVENTION
Weight: regular weighing is the simplest way of knowing if energy

balance is being achieved.
BMI: calculated using the formula of
Waist Circumference: This is an accurate measure of the amount

of visceral fat
KEY PREVENTION
Minimum recommended amount of physical activity needed to

achieve health benefit:
Regular : Min 30 minutes/day most days of the week

Moderate : 5 or more days of the week
Vigorous : 3 or more days of the week
KEY PREVENTION
Guideline:
At least 30 minutes of cumulative physical activity moderate in
intensity for most of the days of the week.
KEY PREVENTION
3. Smoking, both active or passive/Second hand
Smoking status should be recorded and updated at regular

intervals
KEY PREVENTION
Promote smoke-free environment

a. Smoking cessation for active smokers to reduce risk
b. Prohibit smoking inside living areas, houses and closed areas
c. Avoid smoke-filled places
d. Advocate for implementation of policies and Clean Air Act that
support smoke-free environment
e. Support policies/ordinances/laws that limit access of cigarettes
to children and youth
KEY PREVENTION
What to assess?
a. Number of cigarettes smoked
b. Duration of smoking
c. Age started smoking
d. Pattern of inhaling
KEY PREVENTION
Harmful Substances in Tobacco

a. TAR
b. NICOTINE
c. CARBON MONOXIDE
KEY PREVENTION
4A’s in helping the smoker quit:

ASK
ADVISE TO STOP SMOKING AND THAT SMOKING CAN
CAUSE DISEASE, EVEN DEATH
ASSIST
ARRANGE FOLLOW-UP
KEY PREVENTION
4. Excessive use of alcohol
Discourage excessive drinking of alcoholic beverages

KEY PREVENTION
5. Hyperlipidemia, Hypertension and Diabetes Mellitus
Early diagnosis and prompt treatment

12 STRESS MANAGEMENT
TECHNIQUES
1. Spirituality
2. Self-Awareness
3. Scheduling: Time management
4. Siesta
5. Stretching
6. Sensation Techniques
7. Sports
8. Socials
12 STRESS MANAGEMENT
TECHNIQUES
9. Sounds and songs
10.Speak to me
11. Stress debriefing
12.Smile
MENTAL HEALTH AND PROGRAMS
WHO definition of mental health
“state of well-being where a person can realize his or her own
abilities to cope with normal stresses of life and work
productively.
Four facets:
1. Defined burden: currently affecting persons with mental
disorder
2. Undefined burden: Impact of mental health problem to
persons other than the individual directly affected
3. Hidden burden: refers to the stigma and violations of human
rights
4. Future burden: From aging of the population, increasing social
problems and unrest inherited from the existing burden
Mental Health Sub-Programs
1. Wellness of Daily Living
2. Extreme Life Experiences
3. Mental Disorder
4. Substances Abuse and Other Forms of Addiction
Pointers of having Mental Health
1. Maintain good physical health
2. Undergo annual medical examination or more often as
needed
3. Develop and maintain a wholesome lifestyle
4. Avoid smoking, substance abuse and excessive alcohol
5. Having a realistic goal in life
6. Have a friend in whom you can confide and ventilate your
problems
Pointers of having Mental Health
7. Don’t live in the past and avoid worrying about the future
8. Live-one day at a time
9. Avoid excessive physical, mental and emotional status
10.Develop and sustain solid spiritual values
ALTERNATIVE HEALTH CARE
PRACTICES
Herbal Medicine
1. Lagundi
Skin disease
Headache
Asthma, cough and fever
Rheumatism, sprain and insect bites
Eczema
Dysentery
PRACTICES
Herbal Medicine
2. Ulasimang Bato
Decrease uric acid
3. Bayabas – cleansing wounds, diarrhea and toothache
Diarrhea
Washing wounds
Gargle to relieve toothache
PRACTICES
Herbal Medicine
4. Bawang – lowers cholesterol, HTN and toothache
Hypertension
Toothache
PRACTICES
Herbal Medicine
5. Yerba Buena – joint pains
Swollen gums
Pain
Insect bites
Toothache
Menstrual & Gas pain
Arthritis
Nausea & Fainting
Diarrhea
PRACTICES
Herbal Medicine
6. Sambong
Edema
Diuretic
Urolithiasis
PRACTICES
Herbal Medicine
7. Akapulko – fungal infection
8. Niyug-niyugan – anti-helminthic
9. Tsaang Gubat
Stomach ache
Tsaang Gubat
Diarrhea
10. Ampalaya – DM mild; Non-insulin dependent
PRACTICES
Herbal Medicine
Reminders on the use of herbal medicine

• Boiling: remove cover
• One kind of plant for each type of symptoms
• No insecticides
• Use clay pot and plant part advocated
• Stop in case of untoward reactions; Seek consultation if s/sx not
relieved after 2-3 doses
What are the DOH Programs?
D Dental Health
O Operations for Environmental Sanitation
H Health Education and Community Organizing
P Prevention and Control of Communicable Diseases
R Reproductive Health
O Older Persons Health Services
G Guidelines for Nutrition
R Rehabilitation and Management of Non-Communicable Diseases
A Alternative Health Care Practices
M Maternal and Child and IMCI
S Sentrong Sigla Movement
EXPANDED PROGRAM ON
IMMUNIZATION
Priority DOH program with PD 996 as its law
Mandatory Immunization for Children less than 8 years old.

6 preventable diseases:
1. BCG
2. OPV
3. Measles
4. Diptheria
5. Pertussis
6. Tetanus
EXPANDED PROGRAM ON
IMMUNIZATION
RA 7846
Mandatory Immunization for Children less than 8 years old

against Hepatitis B
EXPANDED PROGRAM ON
IMMUNIZATION
Vaccine Dose Number of Route Minimum Age Site
Doses
BCG Infants 0.05 mL 1 Intradermal Birth or anytime Right deltoid
after birth region of the arm
DPT 0.5 mL 3 Intramuscular 6 weeks Upper outer
portion of the
thigh
OPV 2 drops or 3 Oral 6 weeks Mouth
depending on the
manufacturer’s
instructions
Measles 0.5 mL 3 Subcutaneous At birth Outer part of the
upper arm
Hepa B 0.5 mL Intramuscular 9 months Upper outer
portion of the
thigh

Community Health Nursing - Enhancement

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Community Health Nursing - Enhancement

Uploaded by

Copyright:

Available Formats

Community

Public health systems are operating within a context of ongoing

• Target date: 2015

• Target date: 2030

Program management: She is responsible for the delivery of the

The public health nurse is the supervisor of the midwives and

Nursing care provision is an inherent function of the nurse. Her

PHN are the care coordinators for communities and their

She establishes linkages and collaborative relationships with

PHN initiates the formulation of staff development and training

PHN participates in the conduct of research and utilizes research

Influence, change and inspire

❑ According to WHO, “State of complete physical, mental and

❑ According to the Modern Concept, “it is the optimum level

When: September 6-12 1978 Who: Pres. Ferdinand Marcos Sr.

1. Village/Barangay Health Workers/Grassroots

Composed of two sectors:

- largely financed through a tax-based budgeting system at both

- largely market-oriented and where health care us paid through

Late President Corazon Aquino passed Republic Act 7160 known

• Administer direct services for emergent health concerns that require

That the Filipino people is the healthiest people in Southeast Asia

Health sector reform is the overriding goal of the DOH.

1. Better health outcomes

1. Health financing – the goal of this health reform area is to

2. Health regulation – the goal is to ensure the quality and

3. Health service delivery – the goal is to improve and ensure

4. Good governance – the goal is to enhance health system

Process of checking the clients’ health condition in a medical

Public health programs are sets of interventions put together to

It also focuses on preventing diseases.

Unapproved type of water facility

Monitoring surveillance – once a year

The examination of drinking water shall be performed ONLY in

Certification of potability of an existing water source is issued

Disinfection is required on the following:

Goal: Improve quality of life of Filipinos through better nutrition,

Infants Less than 6 months 50, 000 IU One Dose

Infant/Infant with 6-11 months 100, 000 IU One Dose

Post-partum women 200, 000 IU One dose

Infant with xeropthalmia 6-11 months 100, 000 IU TTT

Child with xeropthalmia 12-59 months 200, 000 IU TTT

Pregnant women with 10, 000 IU Regardless of month

Infants Less than 6 months 50, 000 IU One Dose

Infant/Infant with 6-11 months 100, 000 IU One Dose

Children/Children with 12-71 months 200, 000 IU One every 6 months

Pregnant 10, 000 IU Twice a week

Post-partum women 200, 000 IU One dose

Infant with xeropthalmia 6-11 months 100, 000 IU TTT

Child with xeropthalmia 12-59 months 200, 000 IU TTT

Pregnant women with nightblindness 10, 000 IU Regardless of month

Lactating women 60 mg of iron with 400 mg of folic 1 tab for 3 months

Children 1-5 years old 30 mg iron/5 mL 1 tbsp for 3 months or 30 mg

Older Persons 60 mg iron with 400 mcg folic Once a day

3. Essential Maternal and Child Health Service Package

4. Nutrition information, communication and education

There are four major non-communicable diseases (also known

One DALY can be thought of as one lost healthy year of life.

Healthy lifestyle is operationally defined as a way of life that

Promote Proper Nutrition

Comprehensive nutritional assessment involves detailed recall

Encourage more physical activity and exercise

Weight: regular weighing is the simplest way of knowing if energy

BMI: calculated using the formula of