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HEALTH
VISION: HEALTH FOR ALL FILIPINOS
MISSION: ENSURE ACCESSIBILITY &
QUALITY OF HEALTH CARE TO
IMPROVE THE QUALITY OF LIFE OF ALL
FILIPINOS, ESPECIALLY THE POOR.
NATIONAL OBJECTIVES
1. Improve the general health status of the population
(reduce infant mortality rate, reduce child morality
rate, reduce maternal mortality rate, reduce total
fertility rate, increase life expectancy & the quality
of life years).
2. Reduce morbidity, mortality, disability &
complications from Diarrheas, Pneumonias,
Tuberculosis, Dengue, Intestinal Parasitism, Sexually
Transmitted Diseases, Hepatitis B, Accident &
Injuries, Dental Caries & Periodontal Diseases,
Cardiovascular Diseases, Cancer, Diabetes, Asthma
& Chronic Obstructive Pulmonary Diseases, Nephritis
& Chronic Kidney Diseases, Mental Disorders, Protein
Energy Malnutrition, Iron Deficiency Anemia &
Obesity.
3.Eliminate the ff. diseases as public health problems:
Schistosomiasis
Malaria
Filariasis
Leprosy
Rabies
Measles
Tetanus
Diphtheria & Pertussis
Vitamin A Deficiency & Iodine Deficiency Disorders
4. Eradicate Poliomyelitis
5. Promote healthy lifestyle through healthy diet & nutrition, physical
activity & fitness, personal hygiene, mental health & less stressful life
& prevent violent & risk-taking behaviors.
6. Promote the health & nutrition of families & special populations
through child, adolescent & youth, adult health, womens health,
health of older persons, health of indigenous people, health of
migrant workers and health of different disabled persons and of the
rural & urban poor.
7. Promote environmental health and sustainable development
through the promotion and maintenance of healthy homes,
schools, workplaces, establishments and communities towns
and cities.
Basic Principles to Achieve
Improvement in Health
1. Universal access to basic health services must
be ensured.
2. The health and nutrition of vulnerable groups
must be prioritized.
3. The epidemiological shift from infection to
degenerative diseases must be managed.
4. The performance of the health sector must be
enhanced.
Primary Strategies to
Achieve Goals
1. Increasing investment for Primary Health Care.
2. Development of national standards and
objectives for health.
3. Assurance of health care.
4. Support to the local system development.
5. Support for frontline health workers.
PHC as a Strategy
PRIMARY HEALTH CARE (PHC)
May 1977 -30th World Health Assembly decided that the main health
target of the government and WHO is the attainment of a level of
health that would permit them to lead a socially and economically
productive life by the year 2000.
September 6-12, 1978 - First International Conference on PHC in Alma
Ata, Russia (USSR) The Alma Ata Declaration stated that PHC was the
key to attain the health for all goal
October 19, 1979 - Letter of Instruction (LOI) 949),
the legal basis of PHC was signed by Pres.
Ferdinand E. Marcos,
which adopted PHC as an approach towards
the design, development and implementation of
programs focusing on health development at
community level.
RATIONALE FOR ADOPTING PRIMARY HEALTH CARE:
An improved state of health and quality of life for all people attained
through SELF-RELIANCE.
2. COMMUNITY PARTICIPATION
=heart and soul of PHC
3. People are the center, object and subject of development.
Thus, the success of any undertaking that aims at
serving the people is dependent on peoples
participation at all levels of decision-making;
planning, implementing, monitoring and
evaluating. Any undertaking must also be based
on the peoples needs and problems (PCF, 1990)
Part of the peoples participation is the
partnership between the community and the
agencies found in the community; social
mobilization and decentralization.
In general, health work should start from where
the people are and building on what they have.
Example: Scheduling of Barangay Health Workers
in the health center
BARRIERS OF COMMUNITY INVOLVEMENT
Lack of motivation
Attitude
Resistance to change
Dependence on the part of
community people
Lack of managerial skills
4.SELF-RELIANCE
5.Partnership between the
community and the health
agencies in the provision of quality
of life.
Providing linkages between the
government and the non-
government organization and
peoples organization.
6. Recognition of interrelationship between
the health and development
HEALTH
is not merely the absence of disease. Neither it is
only a state of physical and mental well-being.
Health being a social phenomenon recognizes
the interplay of political, socio-cultural and
economic factors as its determinant. Good
Health therefore, is manifested by the progressive
improvements in the living conditions and quality
of life enjoyed by the community residents (PCF,
DEVELOPMENT is the quest for an improved quality
of life for all. Development is multi-dimensional. It
has a political, social, cultural, institutional and
environmental dimensions(Gonzales 1994).
Therefore, it is measured by the ability of people
to satisfy their basic needs.
7. SOCIAL MOBILIZATION
It enhances people participation or
governance, support system
provided by the Government,
networking and developing
secondary leaders.
8. DECENTRALIZATION
MAJOR STRATEGIES OF PRIMARY HEALTH
CARE
A. ELEVATING HEALTH TO A COMPREHENSIVE AND
SUSTAINED NATIONAL EFFORTS.
Attaining Health for all Filipino will require
expanding participation in health and health
related programs whether as service provider or
beneficiary. Empowerment to parents, families
and communities to make decisions of their
health is really the desired outcome.
Advocacy must be directed to National and
Local policy making to elicit support and
commitment to major health concerns through
legislations, budgetary and logistical
considerations.
B. PROMOTING AND SUPPORTING COMMUNITY
MANAGED HEALTH CARE
1. Nuclear
2. Extended
3. Three generational
4. Dyad
5. Single- Parent
6. Step- Parent
7. Blended or reconstituted
Types of Families
Qualifications
1. Bachelor of
Science in Nursing
2. Registered Nurse
of the Philippines
Planner/Programmer
1. Identifies needs, priorities, and problems of
individuals, families, and communities
2. Formulates municipal health plan in the
absence of a medical doctor
3. Interprets and implements nursing plan,
program policies, memoranda, and circular
for the concerned staff personnel
4. Provides technical assistance to rural health
midwives in health matters
Provider of Nursing
Care
1. Provides direct nursing care to sick
or disabled in the home, clinic,
school, or workplace
2. Develops the familys capability to
take care of the sick, disabled, or
dependent member
Manager/Supervisor
1. Formulates individual, family, group, and community-centered
plan
2. Interprets and implements programs, policies, memoranda, and
circulars
3. Organizes work force, resources, equipments, and supplies at
local level
4. Provides technical and administrative support to Rural Health
Midwives (RHM)
5. Conducts regular supervisory visits and meetings to different
RHMs and gives feedback on accomplishments
Community Organizer
1. Motivates and enhances
community participation in
terms of planning,
organizing, implementing,
and evaluating health
services
2. Initiates and participates in
community development
activities
Coordinator of Services
1. Coordinates with individuals,
families, and groups for health
related services provided by
various members of the health
team
2. Coordinates nursing program with
other health programs like
environmental sanitation, health
education, dental health, and
mental health
Trainer/Health Educator
1. Identifies and interprets training needs of the RHMs, Barangay
Health Workers (BHW), and hilots
2. Conducts training for RHMs and hilots on promotion and disease
prevention
3. Conducts pre and post-consultation conferences for clinic
clients; acts as a resource speaker on health and health-related
services
4. Initiates the use of tri-media (radio/TV, cinema plugs, and print
ads) for health education purposes
5. Conducts pre-marital counseling
Health Monitor
1. Detects deviation from
health of individuals,
families, groups, and
communities through
contacts/visits with them
Role Model
1. Provides good
example of
healthful living to
the members of
the community
Change Agent
1. Motivates changes in
health behavior in
individuals, families,
groups, and communities
that also include lifestyle in
order to promote and
maintain health
Recorder/Reporter/Statistician
1. Prepares and submits required
reports and records
2. Maintain adequate, accurate,
and complete recording and
reporting
3. Reviews, validates, consolidates,
analyzes, and interprets all records
and reports
4. Prepares statistical data/chart and
other data presentation
Researcher
1. Participates in the conduct of
survey studies and researches
on nursing and health-related
subjects
2. Coordinates with government
and non-government
organization in the
implementation of
studies/research
Community Organizing
Principles of CO:
1. People esp. the oppressed, exploited and
deprived sectors are most open to change, have
the capacity to change and are able to bring
about change. Hence , CO is based on the ff:
A. Power must reside in the people
B. Devt. is from the people to the people
C. People participation
Principles of CO
OBJECTIVES OF EPI:
TO REDUCE MORBIDITY AND MORTALITY RATES AMONG INFANTS AND
CHILDREN from SIX CHILDHOOD IMMUNIZABLE DISEASE
ELEMENTS OF EPI:
1. TARGET SETTING
2. COLDCHAIN LOGISTIC MANAGEMENT- Vaccine distribution through
cold chain is designed to ensure that the vaccine were maintained
under proper environmental condition until the time of
administration.
3. IEC
4. Assessment and evaluation of Over-all performance of the program
5. Surveillance and research studies
EXPANDED PROGRAM ON IMMUNIZATION
Vaccine Minimum Numbe Minimum Reason
Age of 1st r of Interval
Dose Doses Between
Doses
1. BCG Birth or 1 BCG is given
(Bacillus at the earliest
anytime possible age
Calmette after protects
Guerin) against the
birth
possibility of
School
TB infection
entrants from the other
family
members
2. DPT 6 weeks 4 weeks An early start with
(Diphtheria 3 DPT reduces the
Pertusis
Tetanus)
chance of severe
pertussis
15 YRS UP 30 UP 2200-4000
1. If the child wants more ORS than shown, give more
2. Continue breastfeeding
3. For infants below 6 mos. who are not breastfeed,
give 100-200 ml clean water during the period
4. For a child less than 2 years give a teaspoonful
every 1-2 min.
5. If the child vomits, wait for 10 min, then continue
giving ORS, 1 tbsp/2-3 min
6. If the childs eyelids become puffy, stop ORS , give
plain water or breast milk, Resume ORS when
puffiness is gone
7. If ( -) signs of DHN- shift to Plan A
Use of Drugs during Diarrhea
Antibiotics should only be used
for dysentery and suspected
cholera
Antiparasitic drugs should only be
used for amoebiasis and
giardiasis
C. SEVERE DEHYDRATION
Condition lethargic or unconscious; floppy
Eyes very sunken and dry
Tears absent
Mouth and tongue very dry
Thirst- drinks poorly or not able to drink
Skin pinch goes back very slowly
TTT PLAN C- ttt. quickly
1.Bring pt. to hospital
2. IVF Lactated Ringers Solution or Normal Saline
3.Re-assess pt. Every 1-2 hrs
4. Give ORS as soon as the pt. can drink
ROLE OF BREASTFEEDING IN THE CONTROL
OF DIARRHEAL DISEASES PROGRAM
Chest indrawing
Nasal flaring
Grunting ( short sounds made with the voice)
Cyanosis
TTT.
1. Refer urgently to hospital
2. Treat fever ( paracetamol), wheezing (
salbutamol)
D. Very Severe Disease
That every child lives and grows up in a family unit with love and
security, in healthy surroundings, receives adequate nourishment,
health supervision and efficient medical attention and is taught
the elements of healthy living
Classification of pregnant
women
Normal healthy pregnancy
With mild complications- frequent home visits
With serious or potentially serious cx referred to
most skilled source of medical and hospital care
Home Based Mothers
Record ( HBMR )