NATIONAL PREVENTION OF BLINDNESS PROGRAM A.

BACKGROUND Vision 2020: The RIGHT TO SIGHT Is a global initiative to eliminate avoidable blindness by the year 2020. Aim: To develop a sustainable comprehensive health care system to ensure the best possible vision for all people and thereby improve quality of life. Latest National Survey on Blindness and Low Vision (2002) a. prevalence of visual impairment ---- 4.62% b. prevalence of bilateral blindness ----0.58% c. monocular blindness--------------------1.07% d. bilateral low vision------------------------.64% e. monocular low vision-------------------1.33% Region 2 (7.75%)-The highest prevalence of visual impairment CARAGA (1.67%)-Lowest prevalence of visual impairment Age Group 60-74- Highest prevalence rate Age Group 0-20-Lowest prevalence rate 75% of blindness and visual impairment in the Philippines is the result of the preventable or treatable conditions: cataract, refractive errors and low vision and causes of childhood blindness. B. Vision /Mission/Goals/Objectives Vision All Filipinos enjoy the right to sight by the year 2020 Mission The Department of Health, Local Health Units, partners and stakeholders commit to; a. Strengthen partnership among and with stakeholders to eliminate avoidable blindness in the Philippines. b. Empower communities to take proactive roles in the promotion of eye health and prevention of blindness. c. Provide access to quality eye care services for all. d. Work towards poverty alleviation through preservation and restoration of sight to indigent Filipinos. Goal Reduce the prevalence of avoidable blindness in the Philippines through the provision of quality eye care. Objectives: a. General Objective No.1:Increase Cataract Surgical Rate from 730 to 2,500 by the year 2010 b. General Objective No.2: Reduce visual impairment due to refractive errors by 10% by the year 2010 c. General Objective No. 3: Reduce the prevalence of visual disability in children from 0.43% to 0.20% by the year 2010 Interventions by Eye Disorder: 1. Cataract The opacification of the normally clear lens of the eye. Most common cause of blindness worldwide. Causes 62% of all blindness I the Phil. and most found mostly among older are group. CURE: Surgery INTERVENTION: a. Increasing awareness about cataract and cataract surgery. b. Improving the delivery of cataract services. 2. Error of Refraction Most common cause of visual impairment(prevalence is 2.06%in the population) It is corrected either with spectacle glasses, contact lenses or surgery. It is provided mainly by optometrists.

3. Childhood Blindness Prevalence of blindness among children(up to age 19) is 0.06% Prevalence of visual impairment in the same age is 0.43% Screening of children of any sign of visual impairment can be done by paediatricians, school clinics and health workers. Vision 2020 Philippines envisions to eliminate avoidance blindness though three strategies: a. Ensuring that cataract surgery is available, accessible, and affordable to everyone b. Reduction of the prevalence of cataract blinding error of refraction and vitamin A deficiency through services c. Pooling of resources of government and non-government agencies to address the problem of cataract blinding error of refraction, and vitamin A deficiency. MENTAL HEALTH AND MENTAL DISORDERS World health Organization (WHO) defines mental health as: o State of well-being where a person can realize his or her own abilities to cope with normal stresses of life and work productively. 4 Facets as a public health burden of Mental Health problems 1. Defined Burden Refers to the burden currently affecting persons with mental disorder. Measured in terms of prevalence and other indicators such as the quality of life indicators and disability adjusted life years (DALY). 2. Undefined Burden Is the portion of the burden relating to the impact of mental health problems to persons and other than the individual directly affected. Repercussions are felt heavily by families and communities both in human and economic loss. 3. Hidden Burden Refers to the stigma and violations of human rights. Stigma is a mark of shame, disgrace or disapproval that results in a person being shunned or rejected by others. 4. Future Burden Refers to the burden in the future resulting from the aging of the population, increasing social problems and unrest inherited from the existing burden. The World Health Report of 2003 showed that mental, neurological, and substance use disorders cause a large burden of disease and disability: Globally-13%of overall disability-adjusted life years (DALYs) 33% of overall years lived with disability (YLDs) More than 150 M people suffer from depression at any point in time Nearly 1M commit suicide every year About 25M suffer from schizophrenia 38M from epilepsy More than 90Mfrom alcohol or drug use disorder Philippine most recent epidemiologic data on mental illness was the 1993-94 Baseline Survey conducted in Region VI. Prevalence of mental illness among adults of 25.6% are as follows: a. Psychosis-4.3% b. Depression-5.3% c. Panic disorder- 5.5% d. Anxiety disorder-10.5% Among Children a. Enuresis-9.3% b. Speech and language disorder-3.9% c. Mental subnormality-3.7%

d. Adaptation reaction-2.4% e. Neurotic disorder-1.1% Mental Health Sub- Programs A. Wellness of Daily Living The process of attaining and maintaining mental well-being across the life cycle through the promotion of healthy life style with emphasis on coping with psychosocial Issues. Objectives: 1. To increase awareness among the population on mental health and psychosocial issues. 2. To ensure access of preventive and promotive mental health services. B. Extreme Life Experiences An extreme life experience in one that is out of the ordinary and which threatens personal equilibrium. Objectives: 1. To differentiate between critical incident and extreme life experiences. 2. To identify situations which may be extreme life experiences. 3. To categories/prioritize the extreme life experience which may be the concern of mental health. 4. To identify programs that could address psychosocial consequences and mental health issues of persons with extreme life experiences. C. Mental Disorder Objective: Promotion of mental health and prevention of mental illness across the lifespan and across sectors (children and adolescents, adult, elderly, and special population such as military, OFWs, refugees, persons with disabilities). D. Substance Abuse & Other Forms of Addiction Objectives: 1. To provide implementers for advocacy accurate, technical information about the psychosocial effects of drugs. 2. To promote protective factors against the development of substance abuse/addiction in the following key settings (Family, School, Workplace, Community, Health care Setting, Industry) through existing DOH programs and responsible agencies 3. To rationalize and enhance the drug program to different key settings as a form of deterring factor. Nursing Responsibilities and Function 1. In Mental health Promotion Participate in the promotion of mental health among families and the community. Utilize opportunities in his/her everyday contacts with other members of the community to extend the general knowledge on mental hygiene. Help people in the community understand basic emotional needs and the factors that promote mental well- being. Teach parents the importance of providing emotional support to their children during critical periods in their lives as first day in school graduation. 2. In prevention and Control Recognize mental health hazards and stress situations as unemployment, divorce or abandonment of children, vices , long standing physical illness, all of which may make demands on the emotional resources of the persons concerned. Recognize pathological deviations from normal in terms of acting, thinking, and feeling and make early referral so that diagnosis and treatment could be done early. BE aware of the potential causes of breakdown and when necessary take some possible preventive action. Help the family to understand and accept the patients health status and behaviour so that all its members may offer as much support in the readjustments to home and community.

3. Rehabilitation Initiate patient participation in occupational activities best suited to patients capabilities, education, experience and training, capabilities and interest. Encourage and initiate patients to partake in activities of CIVIC organization in the community through the cooperation of patients family. Advise the family about the importance of regular follow-up at the clinic. Make regular home visits to observe patients conditions during conversation and follow-up of medication. 4. In Research and Epidemiology Participate actively in epidemiological survey to be aware of the size and extent of mental health problems of the community and organize a program for better preventive, curative and rehabilitative measures. Pointers for Having Mental Health Maintain Good Physical health Undergo annual medical examination or more often as needed. Develop and maintain a wholesome lifestyle.. Avoid smoking, substance abuse and excessive alcohol. Have a realistic goal in life. Have a friend in whom you can confide and ventilate your problems. Dont live in the past and avoid worrying about the future. Live-one day at a time. Avoid excessive physical, mental and emotional stress. Develop and sustain solid spiritual values.