1.
CD control program
 Communicable diseases
National Tuberculosis Control
Program – key policies
 Case finding – direct Sputum
Microscopy and X-ray
examination of TB symptomatics
who are negative after 2 or more
sputum exams
 Treatment – shall be given free
and on an ambulatory
ambulatory basis,
except those with acute
complications and emergencies
 Direct Observed Treatment Short
Course – comprehensive strategy
to detect and cure TB patients.
 Category and Treatment Regimen
 Category 1- new TB patients whose sputum is
positive; seriously ill patients with severe forms
of smear-negative PTB with extensive
parenchymal involvement (moderately- or far-
advanced) and extra-pulmonary TB (meningitis,
pleurisy, etc.)
 Category 2-previously-treated patients with
relapses or failures.
 Category 3 – new TB patients whose sputum is
smear-negative for 3 times and chest x -ray
result of PTB minimal
Category 1-
 new TB patients whose sputum is positive;
seriously ill patients with severe forms of smear-
negative PTB with extensive parenchymal
involvement (moderately- or far- advanced) and
extra-pulmonary TB (meningitis, pleurisy, etc.)
Intensive Phase (given daily for the first 2 months)-
Rifampicin + Isioniazid + pyrazinamide + ethambutol.
If sputum result becomes negative after 2 months,
maintenance phase starts. But if sputum is still positive
in 2 months, all drugs are discontinued from 2-3 days
and a sputum specimen is examined for culture and drug
sensitivity. The patient resumes taking the 4 drugs for
another month and then another smear exam is done at
the end of the 3rd month.
Maintenance Phase (after 3rd month, regardless of the
result of the s putum exam)-INH + rifampicin daily
Category 2-previously-treated patients with relapses or
failures.
Intensive Phase (daily for 3 months, month 1,2 & 3)-
Isioniazid+ rifampicin+ pyrazinamide+ ethambutol+
streptomycin for the first 2 months Streptomycin+
rifampicin pyrazinamide+ ethambutol on the 3rd month.
If sputum is still positive after 3 months, the intensive
phase is continued for 1 more month and then another
sputum exam is done. If still positive after 4 months,
intensive phase is continued for the next 5 months.
Maintenance Phase (daily for 5 months, month 4,5,6,7,&
8)-Isionazid+ rifampicin+ ethambutol
Category 3 – new TB patients whose sputum is smear-
negative for 3 times and chest x-ray result of PTB
minimal
 Intensive Phase (daily for 2 months) – Isioniazid
+ rifampicin + pyrazinamide
 Maintenance Phase (daily for the next 2 months)
- Isioniazid + rifampicin
Stop TB ; Do it with DOTS
 Advocacy is a planned and continuo us effort to
inform people about issue and instigate change.
Advocacy usually takes place over an extended
period of time and includes a variety of  weeks before entering the endemic area.
strategies to communicate a specific message.
 TB is the number one infectious killer in the
world.
 One TB suspect can infect another 10 healthy
persons
Leprosy Control Program
 WHO Classification – basis of multi-drug therapy
▪ Paucibacillary/PB – non-
infectious types. 6-9 months of 
treatment.
▪ Multibacillary/MB – infectious
types. 24-30 months of 
treatment.
 Multi-drug therapy – use of 2 or more drugs
renders patients non-infectious a week after
starting treatment
▪ Patients w/ single skin lesion and
a negative slit skin smear are
treated w/ a single dose of ROM
regimen
▪ For PB leprosy cases-
Rifampicin+Dapsone on Day 1
then Dapsone from Day 2-28. 6
blister packs taken monthly
within a max. period of 9 mos.
 All patients who have complied w/ MDT are
considered cured and no longer regarded as a
case of leprosy, even if some sequelae of leprosy
remain.
 Responsibilities of the nurse
▪ Prevention – health education,
healthful living through proper
nutrition, adequate rest, sleep
and good personal hygiene;
▪ Casefinding
▪ Management and treatment –
prevention of secondary injuries,
handling of utensils; special
shoes w/ padded soles;
importance of sustained therapy,
correct dosage, effects of drugs
and the need for medical check-
up from time to time; mental &
emotional support
▪ Rehabilitation-makes patients
capable, active and self-
respecting member of society.
Control of Schistosomiasis – a tropical disease caused by
a blood fluke, Schistosoma Japonicum
Schistosoma  Japonicum ; transmitted by a
tiny snail Oncomelania quadrasi 
 Preventive measures – health education
regarding mode of transmission and methods of 
protection; proper disposal of feces and urine;
improvement of irrigation and agriculture
practices
 Control of patient, contacts and the immediate
environment
 Specific treatment- Praziquantel – drug of choice
Programs on Filariasis, Malaria and Dengue Hemorrhagic
Fever
 Filariasis- a chronic prasitic infection caused by
a nematode, Wuchereria bancrofti. Young
bancrofti. Young and
adult worms live in the lymphatic vessels and
nodes, while the micro filariae are in the blood;
transmitted through bites from an infected
female mosquito, Aedes poecilius,
Aedes poecilius, that bites at
night.
▪ Treatment: Diethylcarbamazine
citrate or Hetrazan
▪ Elephantiasis and Hydrocoele
are handled through surgery,
prevention and supportive care
Malaria – infection caused by the bite of the female
 Anopheles mosquito,
mosquito,
 Chemoprophylaxis – Chloroquine taken
at weekly intervals, starting from 1-2
Anti-malarial drugs – sulfadoxine,

quiinine sulfate, tetracycline, quinidine
 Insecticide treatment of mosquito nets,
house spraying, stream seeding and
clearing, sustainable preventive and
vector control meas
Dengue H-fever
4 o’clock habit  type of assessment responds to a
 Programs on Measles. Chickenpox, particular need
Mumps, Diphtheria, Pertusis, Tetanus – ELEMENTS OF
focused on health information COMPREHENSIVE
COMPREHENSIVE COMMUNITY DIAGNOSIS
campaigns and intensive immunization 1. DEMO
DEMOGR GRAPAPHIHIC
C VARI
VARIABABLELESS
of children in barangays. i. Tota
Totall popu
popula lati
tion
on & Geog
Geograraph
phic
ical
al
Prevention and Control Program on Parasitic distribution including Urban-Rural index
Infestations ( STH e.g. Ascaris, Trichuris, Hookworm) and & Population Density
Paragonimiasis in communities where eating of fresh or ii. Age & Sex composit iio on
inadequately cooked crab is a practice iii.
iii. Sele
Selectcted
ed vit
vital
al ind
indic
icat
ator
orss e.q.
e.q. Gro
Growt
wth
h
Management: rate, CBR, CDR & Life expectancy rate
1. Deworming iv. Patterns of migrat iio on
2. Health Education re: v. Population project iio on
▪ Good personal hygiene  Note:
▪ Use of footwear  Population groups that need special
▪ Washing fruits and vegetables attentions:
well ▪ Indigenous people
▪ Use of sanitary toilets ▪ Socially dislocated groups as a
▪ Sanitary disposal of garbage result of disasters, calamities &
▪ Boiling drinking water at least 2- development programs
3 min. from boiling point or 2. Socio-
Socio-eco
econom
nomic ic & Cultu
Cultural
ral vari
variabl
ables
es
chlorination i. Social inindicators
Prevention and Control on Leptospirosis/
Leptospirosis/ Weil’s Disease/  Communication network 
Mud fever/Flood fever/ Spirochetal Jaundice thru contact with  Transportation system
the skin/ open wound with water or moist soil contaminated  Educational level
with urine of infected rat
 Housing conditions
 And Rabies ii. Economic indicators
Mgt. of Rabies
 Poverty level income
 Wash wound with soap and water, betadine or
 Employment rate
alcohol may be applied
 Types of industry present in the
 If dog is healthy observe for 14 days. days. If nothing
community
happens- no need for ttt.If it dies or shows
rabies, kill then bring head for lab. Exam &  Occupation common in the community
iii.
iii. Env
Enviro
ironme
nmentalntal ind
indicat
icatoors
consult doctor.
Active immunization – body develops Ab against  Physical/geographical/topographical

characteristics
rabies up to 3 yrs.
 Water supply
 Passive I – giving Ab to persons with head and
neck bites, multiple single deep bites,  Waste disposal
contamination of mucous membranes or thin  Air, Water and Land pollution
covering of the eyes, lips or mouth to provide iv. Cultural fa factors
immediate protection  Variables that may break up people into
 RPO – immunization of pets at 3 mos. of age and groups within the community e.q.
yearly thereafter ▪ Ethnicity
Prevention and Control on STIs ▪ Social class
- Gonorrhea, Syphilis, HIV/AIDS, ▪ Language
Trichomoniasis,Chlamydia,
Trichomoniasis,Chlamyd ia, Hep B ( the most
most ▪ Religion
serious type ‘cause of severe cx. Eg. Massive ▪ Race
liver damage and hepatocarcinoma ▪ Political orientation
- 4 C’s in the Syndromic
Syndromic Mgt  Cultural beliefs and practices that affect
- 1. Compliance health
- 2. Counseling/ Education  Concepts about Health and Illness
- 3. Contact tracing to treat partner 3. Heal
Healthth & illn
illnes
esss patt
patter
erns
ns
- 4. Condom use  Leading cause of mortality
- Hep B vaccination  Leading cause of morbidity
- Universal precautions  Leading cause of infant mortality
- Safe sex  Leading cause of maternal mortality
2. Community Needs Assessment/ Community Diagnosis  Leading cause of hospital admission
 Community Diagnosis 4. Heal
Healthth reso
resoururce
ces s
 A process by which the nurse collects data about  Manpower resources
the community in order to identify factors which  Material resources
may influence the deaths and illnesses of the 5. Politi
Political
cal/Le
/Leade
adershi
rshipp patte
patterns
rns
population
 Reflects the action potential of the state
 to formulate a community health nursing and its people to address the health
diagnosis and develop and implement community needs and problems of the community
health nursing interventions and strategies Mirrors the sensitivity of the

 Done to come up with a profile of local health government to the people’s struggle for
situation better lives
 Will serve as a basis of health programs and PROCESS OF COMMUNITY DIAGNOSIS
services to be delivered to the community Consists of;
 Starts with determining the health status of the 1. Collec
Collectin
ting,
g, organi
organizin
zingg & synthesi
synthesizin
zing
g data
data
community  In order to identify the different factors
2 Types of Community Diagnosis that may directly or indirectly influence
1. Compre
Comprehenhensiv
sivee Commun
Community ity Diag
Diagnos
nosis
is the health of the population
 aims to obtain general information about 2. Analyz
Analyzinging & inter
interpre
preting
ting health
health data
data
the community  Seek explanations for the occurrence of 
2. Proble
Problem-O
m-Orie
riente
nted d Communi
Community ty Diagno
Diagnosis
sis health needs and problems of the
community
 3. Formul
Formulati
ation
on of Comm
Communi
unity
ty Healt
Health
h Nursing
Nursing  Perception of the population or the
Diagnoses community as they are affected by the
 Will become the bases for developing problem and their readiness to act on
and implementing community health the problem
nursing interventions and strategies  PLANNING
STEPS IN CONDUCTING COMMUNITY   WHAT IS PLANNING?
DIAGNOSIS
 is a process that entails formulation of 
1. DETERMINING THE OBJECTIVES – the nurse steps to be undertaken in the future in
decides on the depth and scope of the
of the data she order to achieve a desired end.
needs to gather. Concepts of Planning:
2. DEFINING THE STUDY POPULATION – the nurse  Planning is futuristic.
identifies the population group to be included in
the study.  Planning is change-oriented.
3. DETERMINING THE DATA TO BE COLLECTED – the  Planning is a continuous and dynamic
objectives will guide the nurse in identifying the process.
specific data she will collect, and will also decide  Planning is flexible.
on the sources of these data.
 Planning is a systematic process.
4. COLLECTING
COLLECTING THE DATA – the nurse decides on
 THE PLANNING CYCLE:
the specific methods depending on the type of 
data to be generated. 1. Situational Analysis
 Ocular survey,
survey, interview, and records
records  gather health data
review,
 tabulate, analyze and interpret data
5. DEVELOPING THE INSTRUMENT instruments/tools
facilitate the nurse’s data-gathering activities.  identify health problems
Most common instrume
in struments
nts :  set priority
 survey questionnaire 2. Goal and Objective Setting
 interview guide  define program goals and objectives
 observation checklist
 assign priorities among objectives
6. ACTUAL DATA GATHERING – the nurse supervises 3. Stra
Strate
tegy
gy/A
/Act
ctiv
ivit
ity
y Sett
Settin
ing
g
the data collectors by checking the filled-up  Design CHN Program
instruments in terms of completeness, accuracy  Ascertain resources
and reliability of the information collected.  Analyze constraints and limitations
7. DATA COLLATION – the nurse is now ready to put 4. Evaluation
together all the information.  determines outcomes
 Numerical data  specify criteria and standards
 Descriptive data Application of Public Health Tools (discuss
( discuss in separate
slide)
8. DATA PRESENTATION – will depend largely on Three important tools
the type of data obtained.  The health disciplines of 
 Descriptive- narrative reports
1. Demography
 numerical data- table or graphs
2. Vital statistics
9. DATA ANALYSIS – aims to establish trends and
patterns in terms of health needs and problems
3.
Epidemiology
3. COMMUNITY ORGANIZING
of the community.
10. Identifying Community Health Nursing Problems  A process whereby the community members
a. Heal
Health
th Stat
Statusus Prob
Proble
lemsms develop the capability to assess their health
Increased/decreased morbidity, needs and problems, plan and implement actions

to solve these problems, put up sustain
mortality fertility or reduced capability
for wellness organizational structures which will support and
monitor implementation of health initiatives by
b. Heal
Health
th Reso
Resour urce
ces
s Probl
Problememss
the people
 Lack of or absence of manpower, money,
materials or institutions necessary to  maglaya
solve health problems  COMMUNITY ORGANIZING
c. Heal
Health
th Rela
Relate ted
d Pro
Probl
blememss Purpose:
 Existence of social, economic,  Empowerment or building the capability
environmental and political factors that of people for future community action
aggravate the illness-inducing situations Approaches to community development
in the community a. Soci
Social
al chan
changges
11. Priority-se
Priority-setting
tting
 Building up social organizations
a. Nature
Nature of the the conditi
condition/on/pro
proble
blem
m present
presented
ed
(relationships, structure and resources)
 Classified as health status, health b. Chan
Changege in ide
ideol
olog
ogyy
resources or health related problems
 Knowledge, beliefs and attitude
b. Magn
Magnit itud
ude e of the
the pro
problblem
em
c. Chan
Chang ge agen
agentsts
 Severity of the problem which can be
 Capacity to influence others by setting a
measured in terms of the proportion of 
good example.
the population affected by the problem
Principles of CO:
c. Modi
Modififiab
abililit
ity
y of the
the prob
problelem
m
1. Welf
Welfar
aree app
appro
roac
achh
 Probability of reducing, controlling or
 People esp. the oppressed, exploited and
eradicating the problem
deprived sectors are most open to change, have
d. Prev
Preven
entitive
ve pote
potentntia
iall
the capacity to change and are able to bring
 Probability of controlling or reducing the about change. Hence , CO is based on the ff:
effects posed by the problem a. Power
Power must
must resi
reside
de in the
the peop
people
le
e. Soci
Sociaal con
concecernrn
 b.
Develo
Developmpment.
ent. is from
from the
the peopl
people
e to the
the b. Coalition-
Coaliti on- linking organizations
organiza tions and
people groups to work on community issues.
c. Peop
People
le part
partic
icip
ipat
atio
ion
n
2. Tech
Techno
nolo
logi
gica
call appr
approa
oachch c. “lead” or official agency- a single agency
 must be based on the poorest sectors of society. takes the primary responsibility of a
The solutions of problems commonly shared by liaison for health promotion activities in
these sectors must be focused on collective the community.
organizations, planning and action d. Grass-roots- informal structures in the
3. Tran
Transf
sfor
orma
matotory
ry app
appro
roahah community like the neighbourhood
 should lead to self-reliant communities residents.
Five stages e. Citizens panels- a group of citizens (5-
1. Community analysis 10) emerge to form a partnership with
2. Design and initiation the government agency.

3. Implementation f. Networks and consortia- network 

develop because of a certain concerns
4. Program maintenance – consolidation 3. Identi
Identify,
fy, selec
selectt and recruit
recruit orga
organiz
nizati
ationa
onall
5. Dissemination – reassessment members.
1.Community analysis  As much as possible different groups,
 The process of assessing and defining needs, organizations sectors should be
opportunities and resources involved in represented.
initiating community health action .  Chosen representative have power for
 Maybe referred to as community diagnosis, the group they represents
community needs assessment, health education 4. Define
Define the organi
organizat
zation
ion missio
missionn and
and goals
goals..
planning and mapping  This will specify the what, who, where,
5 components of community analysis when and extent of the organizational
1. Demograp
Demographic, hic, social and economic
economic profile
profile of the objectives.
community derived from secondary data. 5. Clarif
Clarify
y roles
roles and respo
responsib
nsibili
ilitie
ties
s of people
people
2. Health
Health risk
risk profi
profilele (socia
(social,l, behav
behaviou ioural
ral and
and involved in the organization.
environmental risks)  This is done to establish a smooth
 Behavioural- dietary habits and other life working relationship and avoid
style concerns like alcohol, tobacco and overlapping of responsibilities.
drugs 6. Provid
Provide e train
training
ing and recog
recogniti
nition.
on.
 Social indicators- exposure to long term  Active involvement in planning and
unemployment, low education and management of programs may require
isolation. skills development training.
3. Health
Health/we
/wellne
llness
ss out
out come
comes s profi
profile
le  Recognition of the programs
(morbidity/mortality data) accomplishment and individuals
4. Survey
Survey of curre
current nt health
health promot
promotion ion progr
programs
ams.. contribution to the success of the
5. Studie
Studies s conduct
conducted ed in certa
certain in targe
targett groups
groups program and boost morale of the
 Steps in community analysis members.
Steps in community analysis 3.Implementation
i. Defining the community -put the design plan into action.
1. Dete
Determrmin inin
ingg the
the geog
geogra raph
phicic bou
boundndar
arie
iess a. Genera
Generate
te broad
broad citi
citizen
zen part
partici
icipat
pation
ion
of the target community  How?
ii. Collecting data ▪ Organizing task force, who, with
iii.
iii. Asse
Assessssin
ingg comm
commun unitityy capa
capaci city
ty appropriate guidance can
1. Enta
Entailils
s an
an eva
evaluluat
atio
ionn of
of the
the driv
drivin
ing
g provide the necessary support.
forces which may facilitate or impede b. Develo
Developp a sequen
sequentia
tiall work
work plan
plan
the advocated change
 Activities should be planned
iv.
iv. Asses
ssessi
sing
ng com
comm munit
unity y bar
barrier
riers s
sequentially. Often, times has to be
v. Asses
ssessi
sing
ng read
eadines
iness s to
to cha
changnge e
modified as events unfold. Community
1. Community interest
members may have to constantly
2. Perc
Percepeptition
on on the the imp
impororta
tancncee of
of the
the
monitor implementation steps.
problem
c. Use compre
comprehen
hensiv
sive,
e, integr
integrate
ated d strateg
strategies
ies
vi.
vi. Synt
Synthehesi
sis
s dat
dataa and
and setset pri
prior
orititie
ies
s
 Generally the program utilize more than
1. Prov
Provididee a com
commu muninity
ty pro
profifile
le of
of the
the nee
needs
ds
one strategies that must complement
and resources and will become the Basis
each other.
for designing prospective community
d. Integrate
Integrate community
community values
values into
into the
the programs,
programs,
interventions for health promotion
materials and messages.
2.Design and initiation
STEPS:  The community language, values and
norms have to be incorporated into the
1. Establish a core planning group and select a program.
local organizer. 4.Program maintenance – consolidation
 Requirements:  The program a this point has experienced s ome
 Select 5-8 member in charge for core degree of success and has weathered through
planning and management of the implementation problems, the organization and
program program is gaining acceptance in the
 With management skills, good listener community.
and conflict resolution skills. Maintenance:
2. Choose
Choose an org
organi
anizat
zation
ional
al struc
structur
ture.
e. a. Integr
Integrate
ate interve
interventi
ntion
on activiti
activities
es into commun
community
ity
 This activate the community networks
participation.  This can be affected through
 Types: implementation problems.
a. Leadership
Leadersh ip board council-
council - existing local  The organization and program is gaining
leaders working for a common cause acceptance in the community.
b. Establish
Establish a positive
positive organizat
organizational
ional culture.
culture.
  A positive environment is a critical  Short-term service
element in maintaining cooperation and HISTORY OF HRDP
preventing fast turnover of members.  HRDP II
 This is a result of good group process  The 2nd cycle uses the same strategy but
based on trust, respect, and openness.
the program could not be sustained by
c. Establ
Establish
ish an
an ongoi
ongoing
ng recr
recruit
uitmen
mentt plan.
plan.
the schools or hospitals and the income-
 It should be expected that volunteers generating projects eventually become
may leave the organization. the hindrance to the goal of achieving
 This requires a built in mechanisms for the health program because the people
continuous recruitment and training of  tend to be more interested in the income
new members. generated by the projects
d. Disse
Dissemi
mina
nate
te resul
results
ts..  Both HRDP I and HRDP II have brought
 Continuous feedback to the community about some changes in the community
on results of activities enhances life of the people
visibility and acceptance of the  Established basic health infrastructure;
organization. basic health services were increased;
 Dissemination of information is vital to there were trained workers and
gain and maintain community support. organized health groups to take care of 
5.Dissemination-Reassessment
5.Dissemination-Reassessment the needs of the community
 Continuous assessment is part of the monitoring HISTORY OF HRDP
aspect in the management of the program  HRDP III
a. Update
Update the commun
community ity analys
analysis.
is.  PCPD refined the program and resulted
 Is there a change in leadership, to what is now called HRDP III, which has
resources and participation? these unique features:
 This may necessitate reorganization and ▪ Comprehensive training of the
new collaboration with other staff and faculty of the
organizations. participating agency in which the
b. Assess effectiven
effectiveness
ess of interventio
interventions/pr
ns/program
ograms.
s. community work was initiated
 Quantitative and qualitative methods of  ▪ Periodic training program and
evaluation can be used to determine regular assistance to the
participation, support and behavior participating agency were
change level of decision making and provided to strengthen the
other factors deemed important to the health outreach program to
program. become community oriented
c. Chart
Chart futur
futuree direct
directori
ories
es and mod
modific
ificati
ations
ons.. ▪ PHC as the approach with which
 This may mean revision of goals and all nursing/medical students,
objectives and development of new their CI’s and indigenous health
strategies. workers are trained for
 Revitalization of collaboration and community health work and
networking may be vital in support of  around which all other project
new ventures. inputs will revolve
d. Summar
Summarizeize and
and diss
dissemi
eminat
nate
e result
results.
s. HISTORY OF HRDP
 Some organization die because of the  Community organizing as the main
lack of visibility. strategy to be employed in preparing the
communities to develop their community
 Thus, a dissemination plan may be
health care systems and the
helpful in diffusion of information to
establishment of community health
further boost support to the
organization to manage the community
organization’s endeavour.
health programs
 The Health Resource Development Program
 Organizing work in the communities
 Community Health Organizing Utilizing COPAR were done in 3 phases
 HRDP PAR as fascinating strategy for

 Was developed and sponsored by the Philippine maximum community involvement
Center for Population and Development (PCPD) through collective identification and
 To make health services available and accessible analysis of community health problems
to depressed and underserved communities in and collective health action
the Philippines  Available funds to finance community
 PCPD is a non-stock, non-profit institution, which initiated projects
serves as a resource center assisting institutions COPAR?
and agencies through programs and projects  Since Management Leadership and
geared toward the social human development of   Jurisprudence are courses taught in the
rural and urban communities classroom members of this group of students
 Formerly known as The Population Center were trained to manage and acts as leaders of 
Foundation the different levels of the students who were
HISTORY OF HRDP involved in COPAR
 HRDP I  Principles of management were applied in
 Trained the faculty, medical/nursing carrying out primary health care
students to provide health care services  The community members,
members, CHW’s
CHW’s and leaders
to the far flung barrios because of lack  were empowered to manage their own health
of man power for health services at the projects
same time that similar activities fulfilled  Conducted seminars and trainings as well as
the curricular requirements of the health education and services needed by
students for public health community(exposure and immersion 6-8 weeks)
 The PCPD provides seed money
money for the THE HRDP-COPAR PROCESS
income generating projects 1. PRE-
PRE-ENENT
TRY PHAS
PHASE E
 The CO uses his/her own strategy or 2. ENTRY PH PHASE
method in developing the community
3. COMMU
COMMUNI NITY
TY STUDY/
STUDY/DIA
DIAGNO
GNOSIS
SIS
 § avoid gambling and drinking
PHASE/RESEARCH PHASE
 Deepening social investigation/community study
4. COMMUNIT
COMMUNITY Y ORGANIZAT
ORGANIZATION
ION AND CAPABILIT
CAPABILITY-
Y-
verification and enrichment of data collected
BUILDING PHASE
from initial survey
5. COMM
COMMUNUNITITY
Y ACTI
ACTION
ON PHA
PHASE
SE
6. SUSTEN
SUSTENANANCECE AND STRE
STRENG
NGTHE
THENIN
NING
G PHASE
PHASE  conduct baseline survey by students,
1. Pre-Entry Phase results relayed through community
assembly
 Preparation of the Institution
 Train faculty and students in COPAR. 
Leader Spotting Through Sociogram.
 Formulate plans for institutionalizing COPAR. Key persons - approached by most people

 Revise/enrich curriculum and immersion  Opinion leader - approach by key persons
program.  Isolates - never or hardly consulted
 Coordinate participants of other departments. 4.NCD prevention and control program
1. Preven
Preventio
tionn and Contr
Control
ol of Cardi
Cardiova
ovascul
scular
ar
 Site Selection
Diseases
 Initial networking with local government. 2. Cancer
Cancer Prev
Prevent
ention
ion and
and Earl
Early
y Detec
Detectio
tion
n
 Conduct preliminary special investigation. 3. Nat’l
Nat’l Diabete
Diabetes s Prevent
Prevention
ion and Control
Control Progra
Program
m
 Make long/short list of potential communities. 4. Preven
Preventio
tionn and Cont
Control
rol of
of Kidney
Kidney Dise
Disease
ase
 Do ocular survey of listed communities. 5. Progra
Programm on Mental
Mental Healt
Healthh and Mental
Mental Disor
Disorder
ders
s
 Criteria for Initial Site Selection 6. Prog
Progra
ram
m on Drug
Drug Depe
Dependnden
ence/
ce/
Substance Abuse
 o Must have a population of 100-200 families.
7. Commun
Communityity-Ba
-Based
sed Rehabi
Rehabilit
litati
ation
on Program
Program
 o Economically depressed.
8. Progra
Programm on the Elder
Elderly/
ly/Ger
Geriat
iatric
ric Nursi
Nursing
ng
 o No strong resistance from the community. Services
 o No serious peace and order problem. 9. Progra
Programs
ms onon Blindn
Blindness
ess,, Deafn
Deafness
ess and
and
 o No similar group or organization holding the Osteoporosis
same program. 1. Prevention and Control of Cardiovascular Diseases
 Identifying Potential Barangay   heart – 1st leading cause of death

 o Do the same process as in selecting

 blood vessels - 2nd
municipality. Types:
 o Consult key informants and residents. 1. Cong
Congen
enit
ital
al Hea
Heart
rt Dis
Disea
ease
se (CH
(CHD)
D)::
 o Coordinate with local government and NGOs 2. Rheu
Rheumat
matic
ic Fev
Fever
er or Rhe
Rheuma
umatic
tic Heart
Heart Dise
Disease
ase
for future activities. 3. Hyp
Hyperte
ertens
nsio
ionn
 Choosing Final Barangay  4. prim
primar
ary
y or esse
essentntia
iall
 o Conduct informal interviews with community 5. Ischem
Ischemicic Heart
Heart Diseas
Disease/e/ Athero
Atheroscl
sclero
erosis
sis
residents and key informants. 1.Congenital Heart Disease (CHD): Result of the
 o Determine the need of the program in the abnormal development of the heart that exhibits
community. septal defect, patent ductus arteriosus, aortic and
 o Take note of political development. pulmonary stenosis, and cyanosis; most prevalent in
 o Develop community profiles for secondary children
data. Causes: environmental factors, maternal diseases or
genetic aberrations
 o Develop survey tools.
2. Rheuma
Rheumatictic Fever
Fever or Rheu
Rheumat
matic
ic Heart
Heart Diseas
Disease:
e:
 o Pay courtesy call to community leaders.
Systematic inflammatory disease that may
 o Choose foster families based on guidelines. develop as a delayed reaction to repeated and
 Identifying Host Family  an inadequately treated infection of the upper
 o House is strategically located in the respiratory tract by group A beta-hemolytic
community. streptococci.
 o Should not belong to the rich segment. 3. Hypert
Hypertens
ension
ion:: Persist
Persistent
ent eleva
elevatio
tion
n of the
 o Respected by both formal and informal arterial blood pressure.
leaders. 4. primary
primary or essential)
essential) ;frequent
;frequent among
among females
females
but severe,malignant form is more common
 o Neighbours are not hesitant to enter the
among males
house.
5. Ischem
Ischemicic Heart
Heart Diseas
Disease/e/ Athero
Atheroscl
sclero
erosis:
sis:
 o No member of the host family s hould be
Condition usually caused by the occlusion of the
moving out in the community.
coronary arteries by thrombus or clot formation.
2. Entry Phase
 higher among males than females for the latter
 Guidelines for Entry  are protected by estrogen before menopause
 o Recognize the role of local authorities by  PF: HPN, DM, Smoking
paying them visits to inform their presence and  Minor RF: stress, strong family history, obesity
activities.  CVD
 o Her appearance, speech, behavior and lifestyle  CVD
should be in keeping with those of the  Primary Prevention: CVD
community residents without disregard of their
 Primary Prevention thru health education is the
being role model.
main focus of the program:
 o Avoid raising the consciousness of the 1. mainte
maintenan
nancece of ideal
ideal body
body wt.
community residents; adopt a low-key profile. 2. diet - low fat
  Activities in the Entry Phase 3. alcoho
alcohol/s
l/smok
moking
ing avoida
avoidance nce
 Integration - establishing rapport with the 4. Exercise
people in continuing effort to imbibe community 5. regu
regula
lar
r BP
BP che
checkck up
life. 2. Cancer
Cancer Prev
Prevent
ention
ion and
and Early
Early Detect
Detection
ion
 Any malignant tumor arising from the abnormal
 § living with the community
and uncontrolled division of cells causing the
 § seek out to converse with people destruction in the surrounding tissues.
where they usually congregate
 § lend a hand in household chores
  Common Cancer: Lung cancer, cervical cancer,  Goal: To improve the quality of life and increase
colon cancer, cancer of the mouth, breast productivity of disabled, handicapped persons.
cancer, skin cancer, prostate cancer.  Aim: To reduce the prevalence of disability
 3rd leading cause of illness and death ( Phil.) through prevention, early detection and
provision of rehabilitation services at the
 Incidence can only be reduced thru prevention
thru prevention community level.
and early detection 8. Progra
Program m on the Elder
Elderly/
ly/Ger
Geriat
iatric
ric Nursi
Nursing
ng
NINE WARNING SIGNS OF CANCER: Services
 Change in blood bowel or bladder habits  7 humanitarian issues: family, health, income,
 A sore that does not heal security, employment
employment and labor,
labor, social welfare,
 Unusual bleeding or discharge education, recreation, culltural activities and
 Thickening or lump in breast or elsewhere housing
 Indigestion or difficulty in swallowing Leading causes of illness:elderly
 Obvious change in wart or mole  Influenza, HPN, diarrhea,
 Nagging cough or hoarseness  bronchitis, TB, diseases. of the heart,
 Unexplained anemia  pneumonia, malaria,
 Sudden unexplained weight loss  malignant neoplasm, chickenpox
Prevention & Early Detection  Leading causes of death:elderly
PRINCIPLES OF TREATMENT OF MALIGNANT DISEASES  Diseases of heart and vascular system
 One third of all cancers are curable if   Pneumonia, TB, CCOPD
detected early and treated properly.  Malignant neoplasms
Three major forms of treatment of cancer:  Diabetes
 Surgery   Nephritis
 Radiation Therapy  Accidents
 Chemotherapy 9.Programs on Blindness, Deafness and Osteoporosis
3.Nat’l Diabetes Prevention and Control Program  Cataract- main causes of blindness
 Aim:  VAD- main cause of childhood blindness; most
 Controlling and assimilating healthy lifestyle in serious eye problem of Fil. children below 6 yrs.
the Filipino culture ( 2005-2010) thru IEC old
 Main Concern: modifiable risk factors( diet, body  Osteoporosis special problem in women,
wt., smoking, alcohol, stress, sedentary living, highest bet. 50—79 yrs. old, MENOPAUSE- main
birth wt. ,migration cause
4.Prevention and Control of Kidney Disease  Prevention of NCD/Role of Nursing in Health Promotion
 Acute or Rapidly Progressive Renal Failure : A And Advocacy
sudden decline in renal function resulting from the   Yosi Kadiri- anti smoking
failure of the renal circulation or by glomerular or  Edi Exercise/Hataw-regular physical activity
tubular damage causing the accumulation of   Tiya Kulit/ Iwas Sakit Diet-low salt, low fat, high
substances that is normally eliminated in the urine in fiber diet
the body fluids leading to disruption in homeostatic,  Mag HL – exercise, no smoking, avoidance of 
endocrine, and metabolic functions. alcohol, healthy diet, iwas stress, watch wt.
 Acute Nephritis: A severe inflammation of the kidney Sentrong Sigla Movement ( SSM)
caused by infection, degenerative disease, or disease -a certification recognition program which develops and
of the blood vessels. promotes standards for health facilities
-  Joint effort bet.:
 Chronic Renal Failure: A progressive deterioration of  1.DOH – provides technical and financial assistance
renal function that ends as uremia and its packages for health care
complications unless dialysis or kidney transplant is 2. LGUs – direct implementers of health programs &
performed. prime developers
developers of health centers and hospitals
 Neprolithiasis: A disorder characterized by the making services accessible to every Filipino
presence of calculi in the kidney.  Pillars of SSM
 Nephrotic Syndrome: A clinical disorder of  1. Qual
Qualit
ity
y Ass
Assur
uran
ance
ce
excessive leakage of plasma proteins into the 2. Grant
Grant and Techni
Technical
cal Assist
Assistanc
ance e
urine because of increased permeability of the 3. Heal
Health
th Prom
Promot
otio
ionn
glomerular capillary membrane 4. Awards
 Urinary Tract Infection: A disease caused by the  Expected Outcome: SSM
presence of pathogenic microorganisms in the  Empowered individuals adopting healthy
urinary tract with or without signs and lifestyle, improved
improved health-seeking behavior and
symptoms. well-being & increased demand for quality
 Renal Tubular Defects: An abnormal condition in health services
the reabsorption of selected materials back into  Institutions will develop policies, provide quality
the blood and secretion, collection, and services , institute system for surveillance/
conduction of urine. merits and advocate for laws
 Urinary Tract Obstruction: A condition wherein  Programs: SSM
the urine flow is blocked or clogged.  EPI
5. Program on Mental Health and Mental Disorders  Disease Surveillance
6. Program on Drug Dependence/  CARI
Substance Abuse
 CDD
7.Community-Based Rehabilitation Program
 Nutrition/ Micronutrient Supplementation-
 A creative application of the primary health care
*Food Fortification :
approach in rehabilitation services, which
Rice –iron; Oil and sugar – Vit. A;
involves measures taken at the community level
Flour-Vit. A & iron; Salt- iodine
to use and build on the resources of the
community with the community people,  Integrated Management of Childhood Illness
including impaired, disabled and handicapped ( IMCI)
persons as well.
  Integrates management of most common 5. Surv
Survei
eill
lla
ance
nce
childhood problems
problems ( diarrhea, pneumonia, 6. Reco
Record
rdin
ingg and
and rep
repor
orti
ting
ng
measles, malnutrition, DHF, malaria) 7. epid
epidem
emio iolo
log
gy
 Involves family members and community in the IV. SPECIAL FIELDS IN COMMUNITY HEALTH NURSING
health care process for physical growth and School nursing
mental development & disease prevention and
 IV. The Public Health Nurse occupational health nursing
Definition and terms: School nursing
Public Health Nursing  A type of public health nursing that focuses on
refers to the practice of nursing in local/national the promotion of health and wellness of the
health departments (which includes health pupils/students, teaching and non teaching
centers and rural health units) and schools. personnel of the schools.
It is a community health nursing practice in the  The primary role is to support the student
public sector learning and ensure that educational potential is
Public Health Nurses not hampered by unmet health needs
Refers to the nurses in the local/national health  Assist the students in making choices for a
departments or public schools whether their healthy life style, reduce risk taking behaviour
official position title is public health nurse or and focus on issues such as prevention of drug
nurse or school nurse and substance abuse, teenage pregnancy,
Leaders in providing quality health services to the STD,Malnutrition, CD and NCD
communities
First level of health workers to be  founded by: Lillian Wald (1902)
knowledgeable about new public health  a member of the professional educational 
technologies and methodologies employed to aid students in developing their full 
Usually the first ones to be trained to implement health potential in health and education
new programs and apply new technologies  HNC (health and Nutrition Center) of the DepEd
Qualifications
 Mandated to safeguard the health and
Must be professionally qualified and licensed to
nutritional well-being of the total school
practice in the arena of public health nursing
population.
Consistent with the nursing law of 2002 (RA
 2 division
9173)
1. health
7 Roles and Functions
1. Mana
Manage geme
ment nt func
functi
tion
on  4 sections
 Inherent in the practice of PHN  Medical
 Organizes the nursing service of the  Dental
local health agency  Nursing
 Applications of 5 management Functions  Health education
“POSDC” in organizing the nursing 2. nutr
nutrit
itio
ion
n divi
divisi
sion
on
service and the local health agency. Objectives of School Nursing
2. Supe
Superv rviso
isoryry func
functi
tion
on  General:
General: To promote
promote and maintain
maintain the health of 
 Supervisor of the midwives and other the school populace by proving comprehensive
health workers and quality nursing care.
3. Nurs
Nursiningg car
caree func
functi
tion
on
 6 Specif
Spe cific
ic :
 Inherent function of the nurse
1. Provid
Provide e quality
quality nursi
nursing
ng servic
service e to the school
school
 Based on the science of art and caring population
 Caring for all levels of clientele toward 2. Create
Create awaren
awareness ess among
among child
children
ren,, personn
personnelel
health promotion and disease prevention and administrators on the importance of the
4. Collab
Collabora
oratin
tingg and coordi
coordinat
nating
ing functi
function
on promotive and preventive aspects of health
 Care coordinators for communities and through health education.
their members 3. Encour
Encourageage thethe provisi
provisionon of standar
standard d functio
functional
nal
 Establishes linkages and collaborative facilities
relationships with other health 4. Providing
Providing nursing
nursing personnel
personnel with opportuniti
opportunities es
professionals, government agencies, for continuing education and training.
private sectors, NGO’s people’s 5. Conduc
Conductt and partic
participa
ipate
te in researc
researcheshes relate
relatedd to
organizations to address health nursing care.
problems 6. Establish/
Establish/ strengthen
strengthen linkages
linkages with governmen
governmentt
5. Health
Health prom
promotiotion
on and educ
educati
ation
on functi
function
on and non-government organization/agencies
 Activities goes beyond health teachings ▪ for school community health
and health information campaigns work.
6. Trai
Traini
ning
ng func
functition
on 9 Duties and responsibilities of the school nurses
 Initiates the formulation of staff  1. Heal
Healthth advo
advoca cacy
cy
development and training programs for 2. Health
Health and nutrinutritio
tion
n assessme
assessment nt includ
including
ing other
other
midwives and other auxiliary workers screening procedures such as vision and
7. Rese
Resear arch
ch func
functi
tion
on hearing.
 Participates in the conduct of research 3. Superv
Supervisiision
on of the
the healt
health h and safe
safetyty of the
and utilizes research findings in her school plant.
practice 4. Treatm
Treatmentent of comm
common on ailmen
ailmentsts and atten
attendin
dingg to
 Disease surveillance emergency cases.
▪ Measure the magnitude of the 5. Referrals
Referrals and follow-up
follow-up of pupils
pupils and personnel
personnel
problem 6. Home vi visits
▪ Measure the effect of the control 7. Comm
Commun unit
ity
y outre
outreac
achh
program  E.g.,:
Competencies and skills ▪ attending community assemblies
1. Commun
Community ity health
health nursin
nursingg proc
process
ess ▪ and organizing school
2. Nursing
Nursing proced
procedures
ures during
during clinic
clinic and home visits community health councils.
3. Comm
Commun unitity
y orga
organinizi
zing
ng 8. Record
Recordinging and repo
reporti
rting
ng of accompl
accomplishishmen
mentsts
4. Health
Health promot
promotionion and educa
educatio
tion
n
 9. Monito
Monitorin
ring
g and eval
evaluat
uation
ion of prog
program
rams s and  Encourage the importance of 
projects. immunization for prevention
Skills and competencies 13. Establishm
Establishmentent of Data Bank on School Health
Health
1. Assessm
Assessment
ent and screen
screeninging skills
skills and Nutrition Activities
2. Heal
Health
th cou
counse
nsell
llin
ing
g skil
skills
ls  Treatment in the school clinic
3. Soci
Social
al mobi
mobili
liza
zati
tion
on skil
skills
ls  Record of the school visit
4. Good
Good oral
oral and writt
written
en commun
communica icatio
tion
n skills
skills  Health assessment report of the school
5. Basi
Basic
c man
managagem
emen
entt skil
skills
ls health personnel
6. Life skills
 Health and nutritional status of 
16 function of the school nurse pupils/students
1. School health and nutritional survey (from 1 st  Form 86 of teaching and non teaching
visit and Qyr)- for data and planning purposes personnel
 Survey of the ff:  Teachers health profile
 current health situation  Records of attended emergency case
 and nutritional status  Inventory of clinic and equipment
 Facilities supplies
 Health education activities  Health and nutrition activities in school
2. Puttin
Puttingg up a school
school clinic
clinic (R.A
(R.A.. 124)
124)  Record of accomplishment of school
3. Health
Health asses
assessme
sment nt (ever
(everyy year
year or
or with
with health services
epidemics)  Records of officers/ officials of the
 Purpose: School-Community Health Council and
 detect the signs of illness and physical their accomplishment
defects for early correction.  Action plan
 Health habits 14. School
School plant inspection
inspection for healthy environment
environment
4. Standa
Standardrd vision
vision testi
testing
ng for schoo
schooll childre
children
n  Others concerns: school site, area,
(20/20) location, space and sanitation,
 a classroom and others rooms, school
Purpose: clinics, water supplies, sanitation, school
 Screen students with poor visual acuity canteen.
and indentify other ocular problems  Inspect for the size, lighting, ventilation,
 Refer students with eye disease and arrangement of seats.
errors of refraction for further 15. Rapid Classroom
Classroom Inspection(
Inspection( after holidays and
examination and management. epidemics but not to exceed more than a month
5. Ear
Ear exam
examininat
atio
ion
n except for cases of epidemics)
 Methods:  Procedure same as HA
 Observation Purpose:
 Examination by using penlight or  Detect cases of CD
otoscope  Note the correction that have been made
 Screening test (whisper test,  Note if the eyeglasses are correctly adjusted
conversation voice test, ball pen click.)  Note the general cleanliness of the students
6. Height
Height and
and weight
weight measure
measuremenmentt and nutriti
nutritiona
onall  Note new ailments.
status determination 16. Home visitation
 Height and weight measurement is a procedure Indication:
for evaluating the tallness or the shortness and   Pupils whose parents are afraid of some
the heaviness of a pupil. medical procedures
 DepEd  Pupils who get re-infected because of 
 <10 years old=weight for age and height home conditions
for age  Pupils suffering from CD
 >10 years old= BMI  Pupils who are absent frequently
 Appropriate school feeding programs with rice, because of sickness
milk or fortified noodles are given to children  Pupils who are malnourished.
with below normal nutritional status for 120 •Occupational health nursing
feeding days  By American Association of Occupational Health
 Deworming is a pre requite prior to feeding  • The special practice that provides for and 
 Consent from parent is pre requisite prior to de- delivers health care services to workers and 
worming worker populations.
7. Medi
Medicacall ref
refer
erra
rals
ls  The practice focuses on promotion, protection,
8. Attend
Attendanc
ance e to
to emerge
emergency
ncy cases
cases and restoration of workers’ health within the
9. Student health counselling( for student who context of a safe and health work environment.
manifest the physical and emotional symptoms)
symptoms)  Occupational health nursing is autonomous, and 
(parents, teacher, and student) occupational health nurses make independent 
10. Health
Health and nutrition
nutrition education
education activities
activities nursing judgments in providing occupational 
 Training programs, health services.
conferences/workshops for teachers,  The foundation of occupational
occupati onal health nursing
pupils and parents  practice is research-based with an emphasis on
11. Organization of school-Community
school-Community Health and optimizing health, preventing illness and injury,
Nutrition Councils and reducing health hazards.
 Membership shall come from both school  By PNA – ANSAP, 1982
and community
 This attend to the health related  •Is aimed at assisting workers in all occupations
problems and concerns to cope with actual and potential stresses in
12. Communicab
Communicable le disease control
control relation to their work and work environment.
 In participation of both the teachers,  It is primarily geared at helping workers attain
parents and students and maintain optimum level of physical and 
 psychological functioning.
mission ▪ disease trends including
 To ensure so far as possible every working man morbidity and mortality
in the country is safe and in healthful working statistics,
conditions ▪ and social environmental
Occupational Health Team conditions
1. Occu
Occupa
pati
tion
onalal Heal
Health
th Nurs
Nurseses ▪ that will provide
2. Occupa
Occupatio
tional
nal phys
physici
icians
ans-- focus
focus on the pertinent information for
prevention, detection, and treatment of work- the establishment of 
related diseases and injuries. priorities in planning and
3. Industrial
Industrial hygienists-
hygienists-recog
recognize,
nize, evaluate,
evaluate, and implementing
control toxic exposures and hazards in the work  occupational health
environment. programs
4. Safety Hazards engineers- focus on the B. Work
Workerer Asses
Assessmsmenent:
t:
prevention of occupational injuries and the maintenance  Assessment of the workforce to
or creation of safe workplaces and safe work practices. determine populations at risk for
5. epidemiologists- study and describe the natural occupationally related injury or illness.
history of occupational diseases and injuries in Types of Classification:
population groups.  Age, sex, race, type of work, the
6. toxicologists- study and describe the toxic presence or absence of disability.
properties of agents used in work application to which C. Applic
Applicatio
ationn of
of Epi
Epidem
demiol
iolog
ogy
y
workers may be exposed.  To determine relationship of work and
7. Indust
Industria
riall engine
engineers
ers-- desig
designn the tool
tools,
s, injury or illness
equipment, and machines used in manufacturing  Methods use:
and other work applications  Toxicology, pathology, ergonomics
8. Ergono
Ergonomis
mists-
ts- study
study desi
design,
gn, and
and promot
promote e the D. Team
Team Appr
Approaoach
ch
healthy interface of humans, their tools, and
 Collaboration with occupational health
their work.
team for the development of 
9. Enviro
Environme
nmentantall enginee
engineers-rs- conce
concentr
ntrate
ate on
comprehensive occupational health
environmental controls to limit environmental
program
pollution and achieve a healthy environment.
 Industrial hygienist, epidemiologist,
Function of Public Health Nurse as an Occupational
medical technologist, toxicologist, safety
Health Nurse
engineer, ergonomist, physician,
1. Work
Work with
with the occu
occupat
pation
ionalal healt
healthh team
team
occupational health nurse, occupational
 to lead the sanitary hygiene of all industrial
health therapist
establishment including hospitals to
E. Progra
Programm Planni
Planningng and
and Implem
Implement
entati
ation
on
determine their
Goal: promotion of wellness and prevention of 
 compliance with the sanitation code and its illness and injury among workers.
implementing rules and regulations Application:
2. Recommends to Local Health Authority the issuance Primary prevention
of license/ business permits and suspensions or  A program to ensure the health of 
revocation of the same for any violations of the prospective employees/ workers includes
conditions upon which said licenses or permits had been a history and physical examination to
issued, pursuant to existing rules and regulation. assess level of wellness. Maintenance of 
3. Coordinates with other governments agencies relative that level is provided through
to the implementation of the implementing rules and appropriate job placement.
regulations Secondary Prevention
4. Attends to complaints of all establishment in the area  Applied once the health problems is not
of assignment related to industrial hygiene and meet by primary prevention
recommends appropriate measures for immediate  methods:
compliance.  Early detection and treatment of both
5. Participate to provide, install and maintain in good work-and non-work related health
condition all control facilities and protective barriers for problems
potential and actual hazards. Tertiary prevention:
6. Informs all affected workers regarding the nature
 Rehabilitation toward workers disabled
hazards and the reasons for the control measures and by occupational and non occupational
protective equiptment. problems
7. Makes a periodic testing for physical examination of 
 Methods:
the workers and other health examination related to
workers exposure to potential or actual hazards in the  Evaluation of current status
work place  Enhancement of employability,
8. Provide control measures to reduce noise, dust,  and appropriate job placement of 
health and other hazards. employees
9. Ensure strict compliance on the regular use and  Services:
proper maintenance of Personal Protective Equipment  Physical occupational and speech
(PPE) therapy
10. Provide employees
employees an occupational
occupational health services  Vocational training
and facilities  Chronic pain clinics
11. Refers or elevate to higher authority all unresolved  Remedial reading
issues in relation to occupational and environmental;  Mathematics program
health problems F. Referr
Referral
al to
to Com
Commun
munity
ity Resour
Resources
ces
12. Prepare and submit yearly reports to the local and G. Prog
Progra
ram
m Eva
Evalu
luat
atio
ion
n
national Government  Assessment of program to determine
Application of Public Health Principles to Occupational benefits in terms of decreasing loss of 
Health Nursing productivity related to employee health
A. Community Assessment
Assess ment : problems is carried out.
 Identify the demographic data on Issues In Occupational Health Nursing
 A.
 A. Phys
Physic
ical
al Haz
Hazarard 
d 
  Are agents within the work environment autonomy, poorly defines expectations and work 
that may cause tissue damage or other instructions, and absent or limited reward.
physical harm.  Acute: increased HR, increased BP, sleep
 Radiation, extreme temperature, noise, disturbances, fatigue, depression,
electric and magnetic field, lasers, substance abuse, worksite violence.
microwaves, and vibration.  Chronic: HPN, alcoholism, CAD, mental
 Acute: acoustic trauma from excessive noise, illness, GI
heat stress or stroke, skin rashes, eye injuries f.Occupational injury - is any injury, such as cut, fracture,
from infrared radiation, skin burns, cuts or sprain, or amputation that results from a single incident
contusions. in the work environment.
 Chronic: NIHL, multiple myeloma and g.Occupational illness-
illness- is any abnormal condition or
leukaemia's from exposure to ionizing radiation, disorder, other than one resulting from a occupational
teratogenic or genetics effects induced by injury, caused by exposure to environmental factors
certain types of radiation. associated with employment.
B. Chem
Chemic ical
al Haza
Hazard
rds:
s:  School Nursing
 Various forms of either synthetic or naturally  Health assessment
occurring chemicals in the work environment METHODS USED:
may be potentially toxic or irritating to the body a. Interview
system through inhalation, skin absorption, b. Nutrit
Nutrition
ional al Assessm
Assessment ent – height
height andand weight
weight
ingestion, or accidental injection. measurements
 Mists, vapors, aerosols, gases, medications, c. Vision
Vision Acuity
Acuity Test/
Test/ Hearin
Hearing g Test
Test
particulate matters (dusts and fumes), solvents, d. IPPA
metals, oil synthetic textiles, pesticides, e. V/S
explosives, and pharmaceuticals. Specifically, f. Apprai
Appraisal
sal ofof the Gene
Generalral and
and Phys
Physica
icall and Ment
Mental al
health care workers are exposed to chemical Condition
hazards such as anaesthetic gases, g. Recording
chemotherapeutic and antineoplastic agents, PREPARATION:
tissue fixative reagents, disinfectant and a. Well,
Well, lighte
lighted, d, venti
ventilat
lated,
ed, scree
screened
ned room
room or a
detergents, sterilizing agents, solvents, latex corner of the classroom
and mercury. b. 2 or 3 chair
chairs s accor
accordin
dingg to need
need
 Acute: respiratory irritation due to smoke, c. Waste ba basket
poisoning from accidental ingestion, metal-fume d. Hand
Hand was
washi hing
ng faci
facili
liti
ties
es
fever, chemical burns, contact dermatitis and e. Tong
Tongueue dep.
dep.,, pen
penli
ligh
ghtt
other dermatoses f. Step/ s phphygmo
 Chronic: cancers (mesothelioma, bronchogenic g. Form
Forms/s/ rec
reco ords
rds
and GI carcinomas); pleural diseases; PROCEDURES OF HEALTH ASSESSMENT
occupational asthma; hypersensitivity 1. Nx condu
conduct ct a classr
classroom
oom lect
lecture
ure to educ
educate
ate the
the
pneumonitis, birth defects and neurological pupils on what to do during the Health
disorders. Assessment.
2. 3-5 chil
childre
dren n at a time
time should
should be
be waiting
waiting for
for the
the
 mesothelioma
assessment
C. Biological Hazards:
3. Wash
Wash hand
hand by the star startt of heal
health
th asses
assessme
sment
nt
 Biological agents such as viruses, bacteria,
4. Assess
Assess the childr
children
en one
one by one
fungi, mold, or parasites may cause infection
5. Ins pe
pection:
disease via direct contact with infected
a. FromFrom head
head to foot
foot
individuals/ animals, contaminated body fluids,
b. SkinSkin disea
isease
sess
or contaminated objects, surfaces
c. SignSigns s of abn
abnororma
mall cond
condititio
ion
n
 Workers in certain occupations ( health care, d. StetStet should
should be use use across
across the
the heart
heart// lung
lung
biological research and animal handling) have a assessment
high incidence of infectious diseases. e. Findin
Findingsgs shoul
should d be reco
recorde
rded d during
during the
the
 Acute: self limiting infections such as colds and assessment
influenzas, measles, skin and parasitic STEPS
infections. a. ARMS,
ARMS, HANDS,
HANDS, AND FINGER FINGER NAILS:
NAILS:
 Chronic: TB, chronic Hepa B, HIV and AIDS  Ask the child to roll their sleeves
D. Mechanical Hazards  Extend their arms
 Mechanical agents may cause stress on the  Show hands one side first, then the
musculoskeletal or other body systems other
 Hazards include inadequate work-station and  Spread their finger
tool design, frequent repetition of a limited b. EYES
movement, repeated awkward movements with
 Ask the child to pull his lower lid using
hand-held tools, local vibrations.
his index finger and ask him to look up
 Acute: neck strain and other muscular fatigue c. TEETH
from forceful exertion or awkward positioning,
 Ask the child to open is mouth and say
and visual; fatigue.
“ah” to show his throat
 Chronic: Raynaud's syndrome from use of  d. NOSE
vibrating power tools, carpal tunnel syndrome
 Raynaud's syndrome  Ask the child to place his 2nd finger on
E. Psychosocial Hazards:
Hazards: the tip of the nose and pull up his nose
 Often related to trauma to the nature of the job, and extend his head backward
the job content, the organizational structure and e. EARS
culture, insufficient training and education  Ask the child to push back his hair
regarding job requirements, and the physical behind his ear and pull the outer ear up,
condition in the work place, leadership and slightly backward/ and then forward.
management styles. f. NECK and CHEST
 Interpersonal conflict, unsafe working  Examine the neck 
conditions, overtime, sexual harassment, racial  Chest/ back should be auscultated
inequality, role conflict, shift work, limited g. HAIR
 Ask the pupil to run his fingers through o Pay courtesy call to community leaders.
his hair several times o Choose foster families based on guidelines.
 Ask to show the nape by the pulling the Identifying Host Family 
hair up. o House is strategically located in the
h. FEET/LEG community.
 Ask the girl to pull up her dress o Should not belong to the rich segment.
 The boy his trousers to their knees o Respected by both formal and informal
Or you can observe while they leaders.

o Neighbours are not hesitant to enter the
performed marching
i. GENE
GENERARALL APPE
APPEAR ARANANCE
CE house.
IMPORTANT REMINDERS IN HA: o No member of the host family should be
moving out in the community.
1. If the
the health
health perso
personne
nnell is of the
the opposi
opposite
te sex,
sex,
performed the procedure in the presence of the
2. Entry Phase
same sex.
2. The resu
result
lt shoul
should d be disc
discuss
uss to
to the teac
teacher
her Guidelines for Entry 
o Recognize the role of local authorities by
3. If  
4. Refer
Refer case
cases s that
that canno
cannott be handle
handle stat
stat paying them visits to inform their presence
and activities.
5. Inform
Inform parent
parents s if the findin
findings
gs
o Her appearance, speech, behavior and
lifestyle should be in keeping with those of 
COMMUNITY ORGANIZING PARTICIPATORY ACTION
RESEARCH (COPAR) the community residents without disregard of 
their being role model.
Importance of COPAR
o Avoid raising the consciousness of the
COPAR is an important tool for community development and
community residents; adopt a low-key profile.
people empowerment as this helps the community workers to
generate community participation in development activities.
 Activities
 Activities in the Entry Phase
COPAR prepares people/clients to eventually take over the
o Integration - establishing rapport with the
management of a development program(s) in the future. COPAR
people in continuing effort to imbibe
maximizes community participation and involvement;
community life.
community resources are mobilized for community services.
Principles of COPAR
 living with the community
 seek out to converse with people where
1. People, especially the most oppressed, exploited
and deprived sectors are open to change, have the capacity to they usually congregate
 lend a hand in household chores
change, and are able to bring about change.
 avoid gambling and drinking
2. COPAR should be based on the interest of the
o Deepening social investigation/community
poorest sector of society.
study verification and enrichment of data
3. COPAR should lead to a self-reliant community and
collected from initial survey
society.
 conduct baseline survey by students,
Phases of the COPAR Process results relayed through community assembly
1. Pre-Entry Phase
Preparation of the Institution Leader Spotting Through Sociogram.
Key persons - approached by most people
o Train faculty and students in COPAR.
o Formulate plans for institutionalizing Opinion leader - approach by key persons
Isolates - never or hardly consulted
COPAR.
3. Organization-building Phase
o Revise/enrich curriculum and immersion
Entails the formation of more formal structure and the inclusion
program.
of more formal procedure of planning, implementing, and
o Coordinate participants of other
evaluating community-wise activities. It is at this phase where
departments.
Site Selection the organized leaders or groups are being given training
(formal, informal, OJT) to develop their style in managing their
o Initial networking with local government.
own concerns/programs.
o Conduct preliminary special investigation.
Key Activities
o Make long/short list of potential
o Community Health Organization (CHO)
communities.
o Do ocular survey of listed communities.
 preparation of legal requirements
 guidelines in the organization of 
Criteria for Initial Site Selection
the CHO by the core group
o Must have a population of 100-200 families.
 election of officers
o Economically depressed.
o Research Team Committee
o No strong resistance from the community.
o Planning Committee
o No serious peace and order problem.
o No similar group or organization holding the o Health Committee Organization
o Others
same program.
o Formation of by-laws by the CHO
Identifying Potential Municipalities
4. Sustenance and Strengthening Phase
o Make long/short list.
Occurs when the community organization has already been
Identifying Potential Barangay 
established and the community members are already actively
o Do the same process as in selecting
participating in community-wide undertakings. At this point, the
municipality.
different committee’s setup in the organization-building phase
o Consult key informants and residents.
is already expected to be functioning by way of planning,
o Coordinate with local government and NGOs
implementing and evaluating their own programs, with the
for future activities.
overall guidance from the community-wide organization.
Choosing Final Barangay 
Key Activities
o Conduct informal interviews with
o Training of CHO for monitoring and
community residents and key informants.
o Determine the need of the program in the implementing of community health program.
o Identification of secondary leaders.
community.
o Linkaging and networking.
o Take note of political development.
o Conduct of mobilization on health and
o Develop community profiles for secondary
development concerns.
data.
o Implementation of livelihood projects.
o Develop survey tools.
 MATERNAL HEALTH PROGRAM  ORS for both unconscious or with
convulsions
 Tasked:
 IVF if not trained to do so.
 to reduce MMR by three quarters by 3. Post
Post part
partum
um blee
bleedi
ding
ng
2015 to achieve ( millennium What to do?:
Development Goal) MDG  Massage uterine and expel clots.
Maternal Mortality Rate (2003)  If bleeding persist:
CAUSE ▪ Place cupped palmed on uterine
Other Complications related to pregnancy occurring in fundus and feel for state of 
the course of labor, delivery and puerperium contraction
1. Hypertension complicating pregnancy, childbirth ▪ Massage fundus in a circular
and puerperium (25%) motion
2. Postpartum hemorrhage (20.3%) ▪ Apply bimanual uterine
compression if mem treatment
3. Pregnancy with abortive outcome (9%) done and postpartum bleeding
4. Hemorr
Hemorrhag
hage e relat
related
ed toto preg
pregnan
nancy
cy still persist.
Strategic thrusts for 2005-2010 ▪ Give ergometrine 0.2mg IM and
1. Launch
Launch and
and imple
implemen
mentt Basic
Basic Emerge
Emergency
ncy and
and another dose after 15’
Obstetric Care (BEMOC) strategy in coordination Do not give:
with DOH  Mem to woman with eclampsia, pre-
 Entails establishment of facilities that eclampsia or HPN
provide emergency obstetric care for  4. Intest
Intestina
inall para
parasit
site
e infect
infection
ion
every 125,000 population and which are What to do?
located strategically  Give mebendazole 500mg tab. Single
2. Improve
Improve quality
quality ofof prenata
prenatall and postnatal
postnatal care dose anytime from 4-9mos. Of pregnancy
 Pregnant women should have at least if none was given in the past 6 mos.
four (4) prenatal visit Do not give:
3. Reduce
Reduce wom
women’ en’s
s exposu
exposure re to health
health risk
risks
s
 Mebendazole in the 1st 1-3mos. Of 
 Institutionalization of responsible
parenthood pregnancy
4. Stakeh
Stakehold
olders
ers must
must adv
advocaocate
te for
for health
health ▪ This might cause congenital
problem in the baby
 Resource generation and allocation for
5. Malaria
health services
What to do?
Essential Health Service Packages
A. Ante
Antena
nata
tall Regis
Registr
trat
atio
ionn  Give sulfadoxin-pyrimethamine to
B. Tetanus Toxoid Immunization woman from malaria endemic areas who
are in 1st or 2nd pregnancy
C. Micronutrient Supplementation
D. Treatment
Treatment of Disease
Diseasess and Other Condition
Conditions
s  500mg-25mg tab., 3 tabs. At the
E. Clea
Cleann and
and Safe
Safe deli
delive
very
ry beginning of 2 nd to 3rd tri semesters not
F. Recomm
Recommendended
ed Schedu
Schedule
le for Post
Post Partu
Partum
m Care
Care less than one month interval.
Visits E. Clea
Clean
n and
and Saf
Safe
e del
deliv
iver
ery
y
 Presence of skilled birth attendant
G. Importance of BF
 Purpose
1. Antenatal Registration
2. Tetanus Toxoid Immunization  to ensure hygiene during labor and
delivery.
 Dose:0.5ml
 Provide non-traumatic delivery
Route: Intramuscularly
Site: Right or Left Deltoid/Buttocks  recognize complications
3. Micronutrient Supplementation  Referred those complicated deliveries to
4. Treatment of Diseases and Other Conditions high level of care
Types: Steps to follow during labor, childbirth and immediate
1. Diffic
Difficult
ultyy of breathi
breathing/
ng/ obstr
obstruct
uction
ion of airway
airway postpartum
2. Unco
Unconsnsci
ciou
ousn
snes
ess
s  Please refer accordingly
3. Post
Post part
partum
um blee
bleedi
ding
ng 1. Do a quick
quick check
check upon
upon admissi
admission
on for
for emergen
emergency 
cy 
4. Intest
Intestina
inall parasi
parasite
te infect
infection
ion signs:
5. malaria  Unconscious/convulsion
1.Difficulty of breathing/ obstruction of airway   Vaginal bleeding
What to do?  Severe abdominal pain
 Clear the airway  Looks very ill
 Place in her best position  Severe headache with visual disturbance
 Refer woman to hospital with EmOC  Severe breathing difficulty
capabilities.  Fever
Do not give anything PO  Sever vomiting
2. Unco
Unconsnsci
ciou
ousn
snes
ess
s 2. Make the woman comfortable
What to do?  Establish rapport with the client by greeting and
 Keep on her back arms at the side. interviewing to make her comfortable
 Tilt head backwards (unless trauma is 3. Assess the woman in labor 
suspected) - to determine the status during labor
 Lift chin to open airway  LMP
 Clear secretions from throat.  Number of pregnancy
 Give IVF to prevent or correct s hock.  Start of labor pains
 Monitor BP and SOB every 15’  Age/height
 Monitor fluid given. If DOB and puffiness  Danger signs of pregnancy
develops, stop the infusion.  Taking the history through interview will help
 Monitor UO determine the client’s condition during delivery
Do not give: of baby
 4. Determine the stage of labor 
  Uterine contractions What to do:
 Bulging vulva  Check Q 5’ for perineum thinning and
 Leaking amniotic fluid bulging, visible descend of the had
 Vaginal bleeding during contraction, emergency signs,
 IE FHR and mood and behavior
5. Decide if the woman can safely deliver   Continue recording in the partograph.
 By assessing the condition of the client Not to do:
 and not finding any indication that could  Do not apply fundal pressure to help
harm the delivery of the baby deliver the baby
6. Give supportive care throughout labor. Third stage:
Purpose:  Between birth of the baby and delivery
 To deliver clean, safe and free from of the placenta
fatigue What to do:
1. Encour
Encourage
age to
to take
take a bath
bath at the
the onset
onset of
of labor
labor  Deliver the placenta
2. Encour
Encourage
age to
to drink
drink but
but not
not eat as
as this
this may  Check the completeness of placenta and
interfere surgery in case needed membranes
3. Encour
Encourage
age to
to empty
empty bladd
bladder
er and bowe
bowelsls to Not to do:
facilitate delivery of the baby. Remind to empty  Do not squeeze or massage the abdomen
the bladder every 2 hours. to deliver the placenta
4. Encourage to do breathing technique to help 8. Monito
Monitorr close
closely
ly within
within 1hr.
1hr. After
After delive
delivery
ry and
and
give supportive care.
energy in pushing out the vagina. Panting can
9. Continue
Continue care
care after 1hr. Postpartum
Postpartum.. Keep
Keep watch
watch
be done by breathing with open mouth with 2
closely for at least 2hrs.
short breaths followed by long breaths. This
10. Educate
Educate and counsel
counsel on FP and provid
provide
e FP
prevent pushing at the end of the 1st stage
method if available and decision was made by a
7. Monitor and manage the different stage of labour 
woman.
-watch out for any danger signs
11. Informs,
Informs, teach
teach and counsel
counsel the woman on
1. First
First stag
stage:
e: not
not in acti
active
ve labo
labor 
r 
important MCH messages:
 Cervix: 3cms
 Birth registration
 Contraction: weak 
 Importance of BF
 Frequency: < 2 to 10’
 Newborn Screening for babies delivered
What to do?
in RHU or at home within 48hrs up to 2
 Check Q 1hr. for emergency signs,
weeks after birth.
frequency and duration of contractions
 Scheduled when to return for
and FHT.
consultation for postpartum visit
 Check Q 4hrs. For fever, pulse, BP and
cervical dilatation. F. Recommended Schedule for Post Partum Care
 Record time of ROM and color of  Visits
amniotic fluid G. Impo
Import
rtan
ance
ce of BF
 Assess progress of labor BREASTFEEDING
▪ Refer STAT to hospital with Breast milk is best for babies up to 2
complete facilities for the ff  years old. Exclusive breastfeeding is recommended for for
condition: the first six months of life. At about
about six months, give
▪ If after 8hrs, carefully selected nutritious foods as supplements.
contractions are Breastfeeding provides physical and
stronger and more psychological benefits for children and mothers as well
frequent but not as economic benefits for families and societies.
societies.
progress in cervical BENEFITS :
dilatation, with or For infants
without membranes a. Provid
Provides
es a nutrit
nutrition
ional
al comp
complete
lete food
food for the
the
ruptured young infant.
b. Streng
Strengthe
thens
ns the infan
infant’s
t’s immu
immune ne syste
system,
m,
 It is false labor if after 8hrs there is no
preventing many infections.
increase in contractions, membranes are
c. Safely
Safely rehyd
rehydrate
rates
s and prov
provide
idess essenti
essential
al
not ruptured and no progress in cervical
nutrients to a sick child, especially to those
dilatation.
suffering from diarrheal diseases.
Not to do:
d. Reduce
Reduces s the infant
infant’s
’s exposu
exposure re to infect
infection
ion..
 IE more frequently than Q 4hrs.
BREASTFEEDING/
BREASTFEEDING/ LACTATION MANAGEMENT EDUCATION
First stage: active labor 
TRAINING
 4cms cervical dilatation Breastfeeding practices has been proved to be very
What to do? beneficial to both mother and baby thus the creation of 
 Check Q30’ for emergency signs the following laws support the full implementation of 
 Check Q4hrs. For fever, pulse, BP and this program:
cervical dilatation A. Executive Order 51
 Record time of ROM and color of  B. Republic Act 7600
amniotic fluid C. The Rooming-In and Breastfeeding Act
 Record finding in partographs/patient of 1992
record. A. EO 51 THE MILK CODE – protection and promotion of 
Not to do: breastfeeding to ensure the safe and adequate nutrition
 Do not allow woman to push unless of infants through regulation of marketing of infant
delivery is imminent. It will just exhaust foods and related products. (e.g. breast milk 
the woman substitutes, infant formulas, feeding bottles, teats etc. )
 Do not give medication to speed of  B. RA 7600 THE ROOMING –IN and BREASTFEEDING ACT
labor. It may cause trauma to mother of 1992
and the baby =An act providing incentives to government and private
Second stage: health institutions promoting and practicing rooming-in
 Cervix: 10 cms. or bulging thin perineum and breast-feeding.
and head visible =Provision for human milk bank.
=Information, education and re-education drive  Approved types of water facilities
=Sanction and Regulation  Unapproved type of water facility
BABY   Access to safe and potable drinking water
 Provides Antibodies  Water quality and monitoring surveillance
 Contains Lactoferin (binds with Iron)  Waterworks/Water system and well construction
 Leukocytes  Approved type of water facilities
 Contains Bifidus factor-promotes growth of the Level 1 (Point Source)- a protected well or a developed
Lactobacillus-inhibits the growth of pathogenic spring with an outlet but without a distribution system
bacilli  indicated for rural areas;
 For the Mother  serves 15-25 households; its outreach is not
e. Reduce
Reduces s a woman’
woman’s s risk of
of excessi
excessiveve blood
blood loss
loss more than 250 m from the farthest user
after birth  yields 40-140 L/ min
f. Provid
Provideses a natura
naturall meth
methodod of delayi
delaying
ng
pregnancies.  Level II ( Communal Faucet or Stand Posts)
Posts )
g. Reduce
Reduces s the risk
risk of ovaria
ovariann and breas
breastt cancers
cancers  With a source, reservoir, piped distribution
and osteoporosis. network and communal faucets
 For the Family and Community  Located at not more than 25 m from the farthest
h. Conser
Conserves
ves funds
funds that
that other
otherwis
wise e would
would be spent
spent house
on breast milk substitute, supplies and fuel to  Delivers 40-80 L of water per capital per day to
prepare them. an average of 100 households
i. Save
Saves s medi
medica
call cost
costs
s to fami
famililies
es and
and  Fit for rural areas where houses are densely
governments by preventing illnesses and by clustered
providing immediate postpartum contraception. Level III ( Individual House Connections or Waterworks
System)
 POSITIONS IN BF THE BABY:
 With a source, reservoir, piped distributor
 1. Cradle Hold = head and neck are supported network and household taps
 2. Football Hold  Fit for densely
densely populated
populated urban communities
 Requires minimum
minimum treatment or disinfection
disinfection
 3. Side Lying Position
ENVIRONMENTAL SANITATION
BEST FOR BABIES - the study of all factors in man’s
REDUCE INCIDENCE OF ALLERGENS physical environment, which may exercise a deleterious
ECONOMICAL effect on his health, well-being and survival.
ANTIBODIES PRESENT Includes:
STOOL INOFFENSIVE (GOLDEN YELLOW) 1.1 Water sanitation
EMPERATURE ALWAYS IDEAL 1.2 Food sanitation
FRESH MILK NEVER GOES OFF 1.3 Refuse and garbage disposal
EMOTIONALLY BONDING 1.4 Excreta disposal
EASY ONCE ESTABLISHED 1.5 Insect vector and rodent control
DIGESTED EASILY  1.6 Housing
IMMEDIATELY AVAILABLE 1.7 Air pollution
NUTRITIONALLY
NUTRITIONALLY OPTIMAL 1.8 Noise
GASTROENTERITIS GREATLY REDUCED 1.9 Radiological Protection
 Environmental Health Program 1.10 Institutional sanitation
 Environmental Sanitation and Promotion of Safe 1.11 Stream pollution
Water Supply  PROPER EXCRETA AND SEWAGE DISPOSAL PROGRAM
Environmental Sanitation is defined as the study of all EHS sets policies on:
factors in the man’s environment, which exercise or may Approved types of toilet facilities :
exercise deleterious effect on his well-being and LEVEL II – on site toilet facilities of the water carriage
survival. type with water-sealed and flush type with septic
-Water is a basic need for life and one factor in vault/tank disposal.
man’s environment. Water is necessary for the LEVEL III – water carriage types of toilet facilities
maintenance of healthy lifestyle. connected to septic tanks and/or to sewerage system to
Safe Water and Sanitation is necessary for basic treatment plant.
promotion of health.
health. FOOD SANITATION PROGRAM
-One basic need of the family is food. And if  -sets policy and practical programs to prevent
food is properly prepared then one may be assured and control food-borne diseases to alleviate the living
healthy family. There are many food resources found in conditions of the population
the communities but because of faulty preparation and HOSPITAL WASTE MANAGEMENT PROGRAM
lack of knowledge regarding proper food planning, Disposal of infectious, pathological and other
Malnutrition is one of the problems that we have in the wastes from hospital which combine them with the
country. municipal or domestic wastes pose health hazards to the
HEALTH AND SANITATION people.
-Environmental Sanitation is still a health Hospitals shall dispose their hazardous wastes thru
problem in the country. incinerators or disinfectants to prevent transmission of 
-Diarrheal diseases ranked second in the nosocomial diseases
leading causes of morbidity among the general PROGRAM ON HEALTH RISK MINIMIZATION DUE TO
population. ENVIRONMENTAL POLLUTION
-Other sanitation related diseases : Foci:
tuberculosis, intestinal parasitism, schistossomiasis, 1. Prevention of serious environmental hazards
malaria, infectious hepatitis, filariasis and dengue resulting from urban growth and industrialization
hemorrhagic fever 2. policies on health protection measures
DOH thru’ Environmental Health Services (EHS)unit
(EHS)unit is 3. researches on effects of GLOBAL WARMING to health
authorized to act on all issues and concernsin (depletion of the stratosphere ozone layer which
environment and health including the increases ultraviolet radiation, climate change and other
verycomprehensive Sanitation Code of the Philippines conditions)
(PD 856, 1978). NURSING RESPONSIBILITIES AND ACTIVITIES
WATER SUPPLY SANITATION PROGRAM  Health Education – IEC by conducting community
EHS sets policies on: assemblies and bench conferences.
 The Occupational Health Nurse, School Health
Nurse and other Nursing staff shall impart the
need for an effective and efficient environmental
sanitation in their places of work and in school.
 Actively participate in the training component of 
the service like in Food Handler’s Class, and
attend training/workshops related to
environmental health.
 Assist in the deworming activities for the school
children and targeted groups.
 Effectively and efficiently coordinate
programs/projects/activities with other
government and non-government agencies.
 Act as an advocate or facilitator to families in
the community in matters of 
program/projects/activities
program/projects/ac tivities on environmental
health in coordination with other members of 
Rural Health Unit (RHU) especially the Rural
Sanitary Inspectors.
 Actively participate in environmental sanitation
campaigns and projects in the community.
community. Ex.
Sanitary toilet campaign drive for proper
garbage disposal, beautification of home
garden, parks drainage and other projects.
 Be a role model for others in the community to
emulate terms of cleanliness in the home and
surrounding.
 There was a man who saw a scorpion floundering
around in the water.
 He decided to save it by stretching out his finger
but the scorpion stung him.
 The man still tried to get the scorpion out of the
water but the scorpion stung him again.
 Another man nearby told him to stop s aving the
scorpion but the man said, “It’s the nature of 
the scorpion to sting. It’s my nature to love, why
should I give up my nature to love just because
it’s the nature of the scorpion to sting?”
 Don’t give up loving, don’t give up your
goodness even if people around you sting…
THE END
See u next sem.