1. COMMUNITY ORGANIZING PARTICIPATORY ACTION
RESEARCH
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COMMUNITY ORGANIZING
PROCESS:
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Educating the people to let them understand and
develop their critical awareness of existing
conditions.
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STRUCTURE:
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Particular group of community members themselves
that work together for common health and health
related problems.
People organize themselves into a working team to
solve their own health problems.
PARTICIPATORY ACTION RESEARCH
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It an investigation on problems and issues concerning
life and environment of the underprivileged by way of
research collaboration.
PAR is a community-directed process of gathering and
analyzing information or an issue for the process of
taking actions and making changes.
The essential element of PAR is participation
The beneficiaries of the research are the people.
it enables the community to experience a collective
consciousness of their own situation.
PAR involves research, education and action to
empower the people to determine the cause of their
problems; analyze these problems and act by
themselves in responding to their own problems.
COMMUNITY ORGANIZING PARTICIPATORY ACTION
RESEARCH (COPAR) AS A TOOL FOR DEVELOPMENT
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A middle ground where the health care worker and
the people need to attain community organization.
A liberal freedom of the community where the people
are allowed to participate in the overall health care
status of their community.
A transformation force, that enables the individuals,
families and communities to be responsible for their
own health.
A phenomenon of interest's goals and objectives at
the health care worker and the people in their way to
health citizenry.
It is a social development approach that aims to
transform the apathetic, individualistic and voiceless
poor into dynamic, participatory and politically
responsive community.
Vital part of public health nursing.
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Collective, participatory, transformative, liberative,
sustained and systematic process of building people’s
organizations by mobilizing and enhancing the
capabilities and resources of the people for the
resolution of their issues and concerns towards
effecting change in their existing oppressive and
exploitative conditions (1994 National Rural
Conference).
Process by which a community identifies its needs
and objectives, develops confidence to take action in
respect to them and in doing so, extends and
develops cooperative and collaborative attitudes and
practices in the community (Ross 1967).
A continuous and sustained process of educating the
people to understand and develop their critical
awareness of their existing condition, working with
the people collectively and efficiently on their
immediate and long-term problems, and mobilizing
the people to develop their capability and readiness
to respond and take action on their immediate needs
towards solving their long-term problems (CO: A
manual of experience, PCPD).
IMPORTANCE OF COPAR:
 COPAR is
an important tool tor community
development and people empowernment as this
helps the community workers to generate
community participation in development activities.
 COPAR prepares people to eventually take over the
management of a deveiopment program in the
future.
 COPAR maximizes community participation and
involvement, community resources are mobilized for
health development services.
PRINCIPLES OF COPAR:
 People, especially the most oppressed, exploited and
deprived sectors are open to change, have the
capacity to change and are able to bring about
change.
 COPAR should be based on the interests of the
poorest sectors of society.
 COPAR should lead to a self-reliant community and
society.
METHODS USED IN COPAR:
1. Progressive cycle of action-reflection-action
 It begins with small, local and concrete issues
identified by the people and the evaluation and
retlection of and on the action taken by them.
2. Consciousness-raising
 Experiential learning is central to the COPAR process
because it places emphasis on learning that emerges
irom concrete action and which encircles succeeding
action.
power and confidence and the problems and issues
are discussed.
3. Participatory and mass-based
 it is primarily directed towards anc biased in favor of
the poor, the powerless and the oppressed.
6. Role Play
 It means acting out the meeting that will take place
between the leaders of the people and the
government representatives. It is a way of training
the people to anticipute what will happen and
prepare them for such eventuality
7. Mobilization or Action
 It is the actual experience of the people in confronting
the powertul and the actual exercise of people power
8. Evaluation
 To determine whether the objectives were attained.
4. Group-centered and not leader -centered
 Leaders are identitied, emerge und are tested
through action rather than appointed or selected by
some external force or entity.
ACTIVITIES IN COPAR:
1. Integration
 The health care worker becomes one with the people
in order to immerse hmself/herself in the community,
understand deeply the Culture, economy, leaders,
history and litestyle in the community.
Methods of integration
 participation in direct production activities of the
people
 conduct of house-to- house visits
 Participation in activities on specinl occasions
 conversing with the people where they usually gather
 helpng out in household ehores
2. Social investigation
 Known as community study
 a systematic process of collecting, collating, analyzing
data to draw a clear picture of the community.
 the health worker must remember the following:
 Use of survey questionnaire is discouraged.
 Community leaders can be trained to initially
assist the community worker.
 secondary data should be thoroughly
examined because much of the information
mighit already be available.
 Social investigation is tacilitated it he health
worker is properly integrated and has
acquired the trust of the people.
 -Confirmation and vulzdatron of community
should be done regularly.
3. Tentative Program Planning
 Community organizer to choose one issue to work on
in order to begin organizing the people.
9. Reflection
 It gives the people time to retlect reality of life
compared to the ideal one. Community organizer is
trying to build in the organization.
10. Organization
 The people's organization is the result of many
successive and similar actions of the people. A linal
organization structure is set up with elected officers
and supporting members.
PHASES OF COPAR PROCESS
1. PRE- ENTRY PHASE
 The initial phase of the organizing process where the
community organizer looks for communities to serve
or help. It is the most complex phase in terms of
actual outputs, activities and strategies and time
spent for it.
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4. Groundwork
 Going around and motivating the people on a one on
one basis to do something on community issue
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5. The Meeting
 The people collectively ratily what they have already
decided individualy. lt gives the people the collective
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Recommended Activities:
Statement of objectives, and realization of COPAR
guidelines
Laying out the site criteria.
Site selection
ACTIVITIES:
Develop criteria for site selection
ldentily potenttal munieipuliucs Catchment areas
through preliminary social investigation (to gather
information about the area)
Identify potential Barangay
Choose the final project Barangay
CRITERIA FOR SITE SELECTION:
Depressed, deprived and unserved rural communities
with majority of the people belong to poor sectors
Poor health status of the community
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No serious peace and order problem
No strong resistance from the community
Not currently served by similar agencies or program
Meeting and courtesy call to the local government
unit of the selected site.
Courtesy call to the barangay level.
Meeting with the "will be'" foster parents of the
health care students
Setting the target date immersion, exposure, and
departure.
2. ENTRY PHASE (Immersion)
 Sometimes called the immersion phase as it the
activities done here includes the sensitization of the
people on the critical events in their life, motivating
them to share their dreams and ideas on how to
manage their concerm and eventually mobilizing
them to make collective action on these. This phase
signals the actual entry of the community
worker/organizer into the community.
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Provision of basic health services
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PURPOSE:
Draw out the people's interest in the project
Enhances the team's integration into the community
Focus on health problems that may need immediate attention
3.ORGANIZATION BUILDING PHASE
 It is the formation of more formal structures and the
inclusion of more formal procedures of planning.
implementing, and evaluating community-wide
activities. It is at this phase where the organized
leaders or groups are being given trainings (formal,
informal) to develop their ASK (attitude knowledge
and skills) in managing their own concerns/programs.
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Recommended Activities:
Meeting with the officials.
Identitying problems
Spreading awareness and soliciting solution or suggestions.
Analysis of the presented solution.
Planning of the activities.
Organizing to build their own organization.
Registration of the organization. (Legality purposes.)
Implementation of the said activities.
Evaluation.
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Recommended Activities:
Meeting with organizational leaders.
Evaluation of the programs
Re-implementation of the programs. (For unmet goals).
Education and training
Networking and linking
Conduct of mobilization on health and development concerms
Implementation of livelihood projects.
Developing secondary leaders.
Recommended Activities:
Courtesy Call to mayo, or the local government leader of the
selected site
Courtesy call to the barangay level.
Meeting with the foster parents.
Appreciating the environment.
Meeting the community officials and residents.
4. SUSTENANCE AND STRENGTHENING PHASE
General assembly.
 It occur when the community organization has
already been established and the community wide
Preparation of survey torms.
undertakings. At this point, the different committee's
Actual survey.
set-up in the organization-building phase is already
Analysis of the data gathered.
expected to be fiunctioning by way of planning.
implementing and evaluating their own prograns,
ACTIVITIES:
with the overall guidance trom the community wide
Integration
organization.
Conduct information
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HOW TO CONDUCT INFORMATION CAMPAIGN
Discussion during home visit
Small group discussion
Purok meetings and assemblies
General meeting
Conduct deepening social investigation( is
systematically looking for issues arournd which to
organize the people)
Identificati on of potential leaders
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CHARACTERISTICS OF POTENTIAL LEADERS
5. PHASE OUT
They mast belong to the poor sector
 It is the phase when the health care workers leave the
Must be respected member
community to stand alone. This phase should be
Responsive and willing to work for change
stated during the entry phase so that the people will
Willing to learn
be ready for this phase. The organizations built should
Possess relatively good communication skill
be ready to sustain the test of the community itself
Identification of potential leaders is a NEVER ending process
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because the real evaluation will be done by the
residents of the community itself.
Recommended Activities:
 Leaving the immersion site.
 Documentation.
IDEAL COPAR AGAINST PRACTICED COPAR
1. TIME FRAME AND MODE OF EXPOSURE
Ideal COPAR:
 Three (3) to six (6) weeks immersion.
 Three to six weeks duty, cight hours a day. five to six
days a week
Practiced COPAR
 Sometimes eight to sixteen hours a week, for two to
four weeks depending on the time allotted by the
school or institution.
2. METHODOLOGY AND SURVEY FORM
Ideal COPAR:
 The survey torm will vary to the needs of the
community (custom made) and the methodology is
surveying the partipants.
Practiced COPAR
 Use of ready made survey form from the school,
books, or from the institution they are working for.
 Some use survey but others just collect data from
previous studies. E.g. health situation from the
barangay.
3. NUMBER OF RECIPIENTS
Ideal COPAR:
 30%, 60%, or 100% depending on the number of
population and situation of the community.
 With allotted 10-15 data or tally sheets for deadfiles.
Practiced cOPAR
 25-50 families or depending on the required number
of families by the school or institution.
4. ORGANIZATION BUILDING STAGE
Ideal COPAR:
 A primary and secondary organization should be built
and it should be strengthened by set ot officers,
bylaws; registrations to the proper institutions
(SECDT).
 he primary and secondary leaders are committed and
the members are all coming rom the community and
not from the healtheare workers.
Practiced cOPAR:
 No organizations built or sometimes the
organizations are not properly strengthened or
registered, no bylaws are present. Therelore the
functtons are not clear and the responsibilities are
not well stated.
5. PROBLEM STATEMENT
Ideal COPAR
 The problems will only the stated ater the survey has
been done, tallied andanalyzed.
 The problem will all be coming trom the survey torm
and not from the judgment of the healthcare worker,
because of the simple reason that any problem not
perceived is not a problem
 Any problem too big or too complicated to the health
worker to manage should not be prioritized. The
principle within is that we should not prioritize
something that we can do nothing about.
Practiced COPAR:
 Misjudging complex problems as simple ones.
 Not considering the result of the survey form but the
say of the few. Eg. barangay officials.
6. IMPLEMENTATION
Ideal COPAR:
 The "tishing rod effect" should be done "teach the
man to fish, and he will never be hungry, give the man
fish and he will ask for more". The programs that will
be implemented should stand or remain feasible even
after the Phase out or even after the healthcare
worker leave the community.
 The programs should not be one day afTair, (eg.
Medical mission, one-day mother's class, one day
feeding. or nutrition program) but should be program
that will last even after the phase out. It should be
something that you will leave with community.
Practice COPAR:
 The "fish effect" programs that are meant to last.
 One day programs are often done this programs also
diminishes after the health workers leave.
7. EVALUATION
Ideal COPAR:
 The health worker should learn to accept reality that
not all programs will prosper and not all their goals
will be met.
 After evaluation there should be a reimplementation.
Practiced COPAR:
 Some results are manipulated just to say that the
goals are met.
 No re-implementation
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COMMUNITY IMMERSION PROGRAM
Community immersion program (CIP) is the
community health nursing practicum of health care
students, an integral part of the Community Health
Nursing.
It isa third level experience designed to enable the
students to apply the concepts of primary healtlh care
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(PHC) and community organizing (CO) in a real
community set-up.
The Students will be living with selected foster
families and learn to integrate with the whole
community for four weeks.
This would be the actual application of the
knowledge, skills and attitudes in dealing with the
family and the community as a whole.
In the process, the student nurses arouse the
people's awareness about health and wellness.
Through CIP the people wil realize the importance of
seif-reliance making them more productive, thus
improving the quality of life in the community.
ENVIRONMENTAL HEALTH
All physical, chemical and biological factors external
to a person and all related behavior but excluding
those natural environments that cannot be
reasonably modified
“As a fundamental component of a comprehensive
public health system, environmental health woks to
advance policies and programs to reduce chemical
and other environmental exposures in air, water,
soil, and food to protect residents and provide
communities with healthier environments”
(National Environmental Health Association, 2016)
The purpose of environmental health is to assure the
conditions of human health and provide healthy
environments for people to live, work and play and
this can be accomplished through risl assessment,
prevention and intervention.
Concept related to this is Environmental sanitation
which is the promotion of hygiene and the
prevention of disease and other consequences of illhealth relating to environmental factors.(WHO,
2018)
PROPER EXCRETA DISPOSAL
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MAJOR LAWS REGULATING SANITATION IN THE
PHILIPPINES
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Presidential Decree 856 – Sanitation Code of the
Philippines
Presidential Decree 825 – Anti Littering Law
R. A. 9003 – Solid Waste Management Act
R. A. 8749 – Clean Air Act
R. A. 9275 – Clean Water Act
R. A. 9512 – National Environmental Awareness and
Education Act
Executive Order 26 – Nationwide Smoking Ban
R. A. 10611 – Food Safety Act
R. A. 11311 – Provision of Clean Toilets in Public
Transportation Terminals
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Safe disposal of excreta, so that it does not
contaminate the environment, water, food or hands,
is essential for ensuring a healthy environment and
for protecting personal health. This can be
accomplished in many ways, some requiring water,
others requiring little or none. Regardless of
method, the safe disposal of human faeces is one of
the principal ways of breaking the faecal–oral
disease transmission cycle.
The methods used for excreta disposal vary and
depend on community habits and practices (such as
wiping or washing the anal area), socio-economic
status of the individual, availability of water and the
method of water supply.
Excreta disposal varies from district to district.
Urban centres have more excreta disposal facilities.
This is with the exception of informal settlement
areas where latrine facilities are very few and those
available are in such condition that they can no
longer be used without risk of infection. In such slum
areas, “flying toilet syndrome” is common whereby
residents defecate into plastic bags in their rooms
then throw the contents on to an existing toilet
floor, compound or open drain channel.
Sanitation is therefore a critical barrier to disease
transmission. Plans for locating sanitation facilities,
and for treating and removing waste, must consider
cultural issues, particularly as sanitation is usually
focused on the household.
Excreta disposal may be a difficult subject for a
community to discuss: it may be taboo, or people
may not like to discuss issues they regard as personal
and unclean. In some cases, people may feel that
sanitation facilities are not appropriate for children,
or that children’s faeces are not harmful. In others,
separate facilities may be required for men and
women, and it may be necessary to locate the
facilities so that no one can be seen entering the
latrine building. If the disposal facilities smell and
are a breeding ground for flies, people may not use
them.
Health improvement comes from the proper use of
sanitation facilities, not simply their physical
presence, and they may be abandoned if the level of
service does not meet the social and cultural needs
of community members at an affordable cost.
Within a community, several different sanitation
options may be required, with varying levels of
convenience and cost (sometimes called a sanitation
ladder). The advantage of this approach is that it
allows households to progressively upgrade
sanitation facilities over time.
Role of Excreta in the Spread of Diseases
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Hygienic disposal of excreta is important because
the infective organisms may enter diseases leave
the human body in faeces and urine. The infective
organisms may enter the human body directly or
sometimes after an intermediate stage which may
be free living or in an intermediate host.
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The following infections mainly occur through
consumption of foods contaminated with the
disease organisms. They may be classified as
follows:
 Viral diseases: poliomyelitis, infectious
hepatitis and gastro-enteritis.
 Bacterial diseases: cholera, typhoid and
paratyphoid, bacillary dysentery
 Protozal diseases: amoebic dysentery
 Parasitism:
ascariasis
(roundworm),
trichuariasis
(whipworm),
pinworm,
tapeworm.
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Almost all the above viral, bacterial and protozal
infections may be transmitted through drinking
water contaminated with infected faecal matter. In
addition, the other infection of faecal origin is
schistosomiasis, both urinary (schist soma
haematobium) and intestinal (schist stoma
mansoni).
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Likewise, all the above bacterial diseases may be
spread through flies and other insects like
cockroaches. The mode of spread may be
mechanical, through insects’ hairs and feet, or by
regurgitation of organisms on to food. The
domestic housefly can also spread conjunctivitis.
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Most bacterial infections may be spread through
contamination of uncovered food or by soil and
dust blown by wind. Other forms of infection from
soil are ankylostomiasis (hookworm) where the
infective form of the worm in the soil penetrates
the skin and enters the body.
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Proper excreta disposal methods provide safe
disposal of excreta to stop it from contaminating
the environment. Any method selected for
disposal of excreta should be:
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● Simple, cheap and easy to use.
● Constructed of locally available materials.
● Easy to maintain.
● Fly-proof.
● Acceptable to users.
● As odourless as possible.
● Private.
● Non-polluting.
It is significant to note that there has been an
increase in the households having sanitary toilet
facilities number both in of the persons, urban and
which rural areas there is also an increase in the
absolute an access to sanitary toilet facilities.
Health surveys reveal that there is utilization of
sanitary toilet facilities in the sense that the mothers
still children to move their bowel elsewhere despite
of the presence of toilets in own homes. Again, the
EHS set policies on the approved types of toilet
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Approved types of toilet facilities
LEVEL 1
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Non-water carriage toilet facility - no water
is necessary to wash the waste into the receiving
space. Examples are pit latrines, reed odor, less
earth closet.
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Toilet facilities requiring small amount of
water to wash the waste into the receiving space.
Examples are pour flush toilet and aqua privies.
LEVEL Il
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On site toilet facilities of the water carriage
type with water-sealed and flush type with septic
vault/tank disposal facilities.
LEVEL IlI
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Water carriage types of toilet facilities
connected to septic tanks and/or to
sewerage system to treatment plant.
In rural areas, the "blind drainage" type of
wastewater collection and disposal facility shall
continue to be the emphasis until such time that
sewer facilities and off—site treatment facilities
shall be made available to clustered houses in rural
areas.
Conventional sewerage facilities are to be promoted
for construction in "Poblacions"' and cities in the
country as developmental objectives to attain
control and prevention of fecal-water-borne
diseases.
Other policies embodied in Code of Sanitation of the
Philippines shall be pursued and enforced by the
local government units.
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Sanitation Facilities:
Box and can privy (bucket latrine)
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Fecal matter is collected in a can or bucket, which is
periodically removed for emptying and cleaning.
Each day, the bucket is emptied into a larger
container and the contents disposed of.
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Bucket latrines should not be promoted because
they pose health risks to both users and collectors
and may spread disease.
unless water is piped into the home .The tank is
connected to a soak away to dispose of effluent.
Unlike a septic tank, the aqua privy tank is located
directly below the house, but it, too requires
periodic emptying and must be accessible to a
vacuum tanker A are expensive and do not offer any
real advantages over pour-flush latrines.
Pit latrine (pit privy)
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Fecal matter is eliminated into a hole in the ground
that leads to a dug pit. Generally, a latrine refers to
toilet facilities without a bowl. It can be equipped
with either a squatting plate or a riser with a seat.
Overhung latrine
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pit latrines do not require periodic emptying; once a
pit is full it is sealed and a new pit dug. If fecal matter
is left decompose in dry conditions for at least two
years, the contents can best emptied manually and
the pit reused. Indeed, some pit latrines are
designed to allow fecal matter to compost and be
reused in agriculture. Other designs use two
alternating pits, reducing the need for new pits.
Some designs are meant to be completely dry, while
some use small quantities of water. Ventilation to
remove odors and flies is incorporated into certain
designs, while others are very basic and use
traditional materials and approaches. As with all
sanitation designs, it is important to community
members want and can pay for before embarking on
construction.
Ventilated-improved pit (VIP) latrine
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A pit latrine with a screened air vent installed
directly over the pit. When air flows across the top
of the vent pipe, air is drawn up the pipe from the
pit and fresh air is drawn into the pit from the
building. Offensive odors from the pit thus pass
through the vent pipe and do not enter the building.
The location of VIP latrines is important: unless a
clear flow of air is maintained across the top of the
vent, the ventilations may not be effective. VIP
latrines should therefore be located away from trees
or high buildings that may limit airflow. A dark vent
pipe also helps the air to rise. The top of the pipe is
usually covered with mosquito meshing if the inside
of the building is kept partially dark, the flies will be
to light at the top of the pipe, where they will be
trapped and die.
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When the VIP latrine is constructed and used
properly, it provides great improvements in fly and
odour control, but may not eliminate either
completely. A VIP latrine is designed to work as a dry
system, with any liquid in the content infiltrating
into the surrounding soil. Although some liquid
inevitably will enter the pit, it should be minimized.
For example, it would not be appropriate to dispose
of household wastewater into the pit as this may
prevent decomposition of the contents. VIP latrines
are most appropriate where people do not use
water for cleaning themselves after defecating, but
use solid materials such as paper, corncobs or
leaves.
Antipolo toilet
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It is made up of an elevated pit privy that has a
covered latrine. This is a pit privy in which the
superstructure, constructed to provide the
necessary privacy and protection from the rain and
sun, elevated to the same level as the main building
of the house.
Septic Privy
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Fecal matter is collected in a build septic tank that is
not connected to a sewerage system.
Aqua privy
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Fecal matter is eliminated into a water-sealed drop
pipe that leads from the latrine to a small water
filled septic tank located directly below the
squatting plate. An aqua privy is similar to a septic
tank; it can be connected to flush toilets a take most
household wastewater. It consists of a large tank
with a water seal formed by a simple down pipe into
the tank to prevent odor and fly problems. Its
drawback is that water must be added each day to
maintain the seal, and this is often difficult to do
Fecal matter is directly eliminated into a body of
water such as a flowing river that is underneath the
facility
Concrete vault privy
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Fecal matter is collected in a pit privy lined either a
concrete in such a manner so as to make it water
tight.
Chemical privy
● Fecal matter is collected into a tank that contains a
caustic chemical solution, which in turn controls and
facilitates the waste decomposition
Compost Privy
● Fecal matter is collected into a pit with urine ad anal
cleansing materials with the addition of organic
garbage such as leaves and grass to allow biological
decomposition and production of agricultural or
fishpond compost.
Pour flush latrine
● It has a bowl with a water seal trap similar to the
conventional tank flush toilet expect that it
requires only a small volume of water for flushing.
Tank-flush toilet
● Feces are excreted into a bowl with a water sealed
trap. The water tank that receives a limited amount
of water empties into the bowl for flushing of fecal
materials through the water sealed trap and into the
sewerage system.
FOOD SAFETY
 Refers to handling, preparing and storing food in a
way to best reduce the risk of individuals becoming
sick from foodborne illnesses. Food safety is a
global concern that covers a variety of different
areas of everyday life.
 Access to sufficient amounts of safe and nutritious
food is key to sustaining life and promoting good
health. Unsafe food containing harmful bacteria,
viruses, parasites, or chemical substances can
cause more than 200 different diseases – ranging
from diarrhea to cancers.
 Food safety, nutrition, and food security are closely
linked. Unsafe food creates a vicious cycle of
disease and malnutrition, particularly affecting
infants, young children, elderly, and the sick.
 In addition to contributing to food and nutrition
security, a safe food supply also supports national
economies, trade, and tourism, stimulating
sustainable development.
 The globalization of food trade, a growing world
population, climate change and rapidly changing
food systems have an impact on the safety of food.
WHO aims to enhance at a global and country-level
the capacity to prevent, detect, and respond to
public health threats associated with unsafe food.
Why Is Food Safety Important?

Foodborne illnesses are a preventable and
underreported public health problem. These
illnesses are a burden on public health and
contribute significantly to the cost of health
care. They also present a major challenge to
certain groups of people. Although anyone can
get a foodborne illness, some people are at
greater risk.
 Safer food promises healthier and longer lives
and less costly health care, as well as a more
resilient food industry.
PRINCIPLES OF FOOD SAFETY

The principles of food safety aim to prevent food
from becoming contaminated and causing food
poisoning. This is achieved through a variety of
different avenues, some of which are:
 Properly cleaning and sanitizing all surfaces,
equipment and utensils
 Maintaining a high level of personal hygiene,
especially hand-washing
 Storing, chilling and heating food correctly
with regards to temperature, environment
and equipment
 Implementing effective pest control
 Comprehending
food
allergies,
food
poisoning and food intolerance

Regardless of why you are handling food, whether
as part of your job or cooking at home, it is
essential to always apply the proper food safety
principles. Any number of potential food hazards
exist in a food handling environment, many of
which carry with them serious consequences.
FIVE FOOD SAFETY RULES
The core messages of the Five Keys to Safer Food are:
1. Keep clean
2. Separate raw and cooked
3. Cook thoroughly.
4. Keep food at safe temperatures.
5. Use safe water and raw materials.
What is the greatest threat to food safety?
 Of all the microorganisms, bacteria are the greatest
threat to food safety. Bacteria are single-celled, living
organisms that can grow quickly at favorable
temperatures. Some bacteria are useful. We use them
to make foods like cheese, buttermilk, sauerkraut,
pickles, and yogurt.
 Other bacteria are infectious disease-causing agents
called pathogens that use the nutrients found in
potentially hazardous foods to multiply.
 Some bacteria are not infectious on their own, but
when they multiply in potentially hazardous food,
they eject toxins that poison humans when the food is
eaten.
 Food handling practices are risky when they allow
harmful bacteria to contaminate and grow in food. If
you touch a food during preparation, you may transfer
several thousand bacteria to its surface.
 Under the right conditions, bacteria can double
every 10 to 30 minutes. A single bacterium will double
with each division—two become four, four become
eight, and so on. A single cell can become billions in 10
to 12 hours.
THE IMPLEMENTING RULES AND REGULATIONS OF REPUBLIC
ACT NO. 10611, “AN ACT TO STRENGTHEN THE FOOD SAFETY
REGULATORY SYSTEM IN THE COUNTRY TO PROTECT
CONSUMER HEALTH AND FACILITATE MARKET ACCESS OF
LOCAL FOODS AND FOOD PRODUCTS, AND FOR OTHER
PURPOSES” OTHERWISE KNOWN AS THE “FOOD SAFETY ACT
OF 2013.”
Pursuant to the provisions of Section 39, Republic Act
10611, otherwise known as the “Food Safety Act of 2013”, the
Department of Agriculture (DA) and the Department of
Health (DOH) hereby jointly adopt and promulgate the
following Rules and Regulations:
Food safety standards refer to the formal documents
containing the requirements that foods or food processors
have to comply with to safeguard human health. They are
implemented by authorities and enforced by law; and are
usually developed and published under the auspices of a
national standards body.
WHO "Golden Rules" for Safe Food Preparation
WHO data indicate that only a small number of factors
related to food handling are responsible for a large
proportion of foodborne disease episodes everywhere.
Common errors include:




preparation of food several hours prior to
consumption, combined with its storage at
temperatures which favour growth of pathogenic
bacteria and/or formation of toxins;
insufficient cooking or reheating of food to reduce or
eliminate pathogens;
cross contamination; and
people with poor personal hygiene handling the
food.
The Ten Golden Rules respond to these errors, offering
advice that can reduce the risk that foodborne pathogens will
be able to contaminate, to survive or to multiply.
Despite the universality of these causes, the plurality of
cultural settings means that the rules should be seen as a
model for the development of culture-specific educational
remedies.
Users are therefore encouraged to adapt these rules to
bring home messages that are specific to food preparation
habits in a given cultural setting. Their power to change
habitual practices will be all the greater.
The World Health Organization regards illness due to
contaminated food as one of the most widespread health
problems in the contemporary world. For infants,
immunocompromised people, pregnant women and the
elderly, the consequences can be fatal. Protect your family by
following these basic rules. They will reduce the risk of
foodborne disease significantly.
These are the WHO "Golden Rules"
1. Choose foods processed for safety
While many foods, such as fruits and vegetables, are best in
their natural state, others simply are not safe unless they have
been processed. For example, always buy pasteurized as
opposed to raw milk and, if you have the choice, select fresh
or frozen poultry treated with ionizing radiation. When
shopping, keep in mind that food processing was invented to
improve safety as well as to prolong shelf-life. Certain foods
eaten raw, such as lettuce, need thorough washing.
2. Cook food thoroughly
Many raw foods, most notable poultry, meats, eggs and
unpasteurized milk, may be contaminated with diseasecausing organisms. Thorough cooking will kill the pathogens,
but remember that the temperature of all parts of the food
must reach at least 70 °C. If cooked chicken is still raw near the
bone, put it back in the oven until it's done - all the way
through. Frozen meat, fish, and poultry, must be thoroughly
thawed before cooking.
3. Eat cooked foods immediately
When cooked foods cool to room temperature, microbes begin
to proliferate. The longer the wait, the greater the risk. To be
on the safe side, eat cooked foods just as soon as they come
off the heat.
4. Store cooked foods carefully
If you must prepare foods in advance or want to keep leftovers,
be sure to store them under either hot (near or above 60 °C)
or cool (near or below 10 °C) conditions. This rule is of vital
importance if you plan to store foods for more than four or five
hours. Foods for infants should preferably not be stored at all.
A common error, responsible for countless cases of foodborne
disease, is putting too large a quantity of warm food in the
refrigerator. In an overburdened refrigerator, cooked foods
cannot cool to the core as quickly as they must. When the
center of food remains warm (above 10 °C) for too long,
microbes thrive, quickly proliferating to disease-causing levels.
5. Reheat cooked foods thoroughly
 Helps safely produce and prepare food.
 Facilitates trade and access to new markets
 Reduces food loss and waste.

SANITATION
This is your best protection against microbes that may have
developed during storage (proper storage slows down
microbial growth but does not kill the organisms). Once again,
thorough reheating means that all parts of the food must reach
at least 70 °C.
KEEPING OUR ENVIRONMENT CLEAN
Community sanitation means the work we
do to keep our environment clean. We must live in a
healthy, clean environment. There are some
activities we need to do in order to live in a clean
environment. As good citizens, we must not litter
the environment with dirty things. When we live in
a clean surroundings, we will be healthy and happy.
6. Avoid contact between raw foods and cooked foods
Safely cooked food can become contaminated through even
the slightest contact with raw food. This cross-contamination
can be direct, as when raw poultry meat comes into contact
with cooked foods. It can also be more subtle. For example,
don't prepare a raw chicken and then use the same unwashed
cutting board and knife to carve the cooked bird. Doing so can
reintroduce the disease-causing organisms.
7. Wash hands repeatedly
Wash hands thoroughly before you start preparing food and
after every interruption - especially if you have to change the
baby or have been to the toilet. After preparing raw foods such
as fish, meat, or poultry, wash again before you start handling
other foods. And if you have an infection on your hand, be sure
to bandage or cover it before preparing food. Remember, too,
that household pets - dogs, cats, birds, and especially turtles often harbor dangerous pathogens that can pass from your
hands into food.
8. Keep all kitchen surfaces meticulously clean
Since foods are so easily contaminated, any surface used for
food preparation must be kept absolutely clean. Think of every
food scrap, crumb or spot as a potential reservoir of germs.
Cloths that come into contact with dishes and utensils should
be changed frequently and boiled before re-use. Separate
cloths for cleaning the floors also require frequent washing.
9. Protect foods from insects, rodents, and other animal
Animals frequently carry pathogenic microorganisms which
cause foodborne disease. Storing foods in closed containers is
your best protection.
10. Use safe water
Safe water is just as important for food preparation as for
drinking. If you have any doubts about the water supply, boil
water before adding it to food or making ice for drinks. Be
especially careful with any water used to prepare an infant's
meal.
Benefits of Food Safety


Keeps foodborne illnesses away.
Sustains life enables healthy diets.
HOW TO CLEAN OUR SURROUNDINGS?
o By sweeping the compound and cleaning our
surroundings clean
o Proper use of the toilets and urinary: This places must
always with disinfectant to prevent bad odour from
coming out of them. And also shut the doors to prevent
flies from getting in.
o By disposing the refuses in the dustbin
Do not throw dirty things about. Wastes, especially those
that can infect or harm other people when touched, must
be taken to incinerator for burning. Some refuses can be
reused or recycled.
What can go in your rubbish bin or sack?
1.
2.
3.
4.
5.
6.
7.
8.
o
Dirty foil (clean foil can be reused or recycled)
Polystyrene
Pet waste and pet food pouches
Pyrex glass and ceramics
Nappies, tissues and sanitary products
Plastic film
Shredded paper
Single use masks and gloves.
By keeping the gutters clean regularly
Not leaving dirty water and things in the gutters and
dropping refuse in them which blocks from flowing
which may lead to flooding and it is dangerous to
health and properties. Cutting down bushes is also
important to avoid snakes and some dangerous
animals from entering the home
OUR ROLES IN COMMUNITY SANITATION
We have roles to play to make our surroundings
clean. As individuals, we must keep our surroundings clean. As
a community, we must work together to keep our environment
clean. We must cooperate with the government to keep our
surroundings clean. We must observe the clean-up exercise of
the government that comes up once a month in our different
states.
The Following Are Our Duties in Community Sanitation:
1. To take active part in community sanitation.
2. To encourage others to join in the community
sanitation.
3. To maintain good sanitation in our own houses.
4.
To educate people in the community on our need for
cleanliness.
BENEFITS OF IMPROVING SANITATION
Benefits of improved sanitation extend well beyond
reducing the risk of diarrhoea. These include:
1. Reducing the spread of intestinal worms,
schistosomiasis and trachoma, which are neglected
tropical diseases that cause suffering for millions;
2. Reducing the severity and impact of malnutrition;
3. Promoting dignity and boosting safety, particularly
among women and girls;
4. Promoting school attendance: girls’ school
attendance is particularly boosted by the provision of
separate sanitary facilities; and
5. Potential recovery of water, renewable energy and
nutrients from faecal waste.
PROGRAMS IMPLEMENTED IN THE PHILIPPINES FOR
COMMUNITY SANITATION
GoAL WaSH Philippines
Achieving the SDGs through the Integrated Safe
Water, Sanitation and Hygiene Approach – iWaSH Governance.
GOALS
A. Increase the number of households, schools and
health centers with access to safe water, sanitation
and hygiene.
B. Improve national and local policies on integrated safe
water, sanitation and hygiene.
CHALLENGES
Millennium Development Goals progress in terms of
water, sanitation and hygiene showed that use of improved
drinking water sources was at 84 percent in 1990 and rose to
92 percent in 2015. Use of improved sanitation facility was
measured at 57 percent in 1990 and by 2015 it was recorded
at 74 percent.
Despite steady progress, it is estimated that 7 million
Filipinos still defecate in the open. Additionally, there are 323
municipalities in the Philippines who continue to have no
sustained access to safe water, sanitation and hygiene. These
municipalities are difficult to access and are clearly left behind
in terms of achieving SDG 6.
Exacerbating the problem is the fragmentation of
structures, policies and programs on safe water, sanitation and
hygiene at the national and local levels resulting in
uncoordinated and ambiguous policies for the sector.
OPPORTUNITIES
The Philippines is a signatory of the 2030 Agenda and
the 17 SDGs. These are expressed in the Philippine
Development Plan 2017 – 2022, providing an opportunity to
effectively sustain the implementation of the integrated safe
water, sanitation and hygiene (iWaSH) approach.
Through GoAL WaSH, there is an opportunity to
institutionalize iWaSH in national policies specifically in the
water and sanitation roadmaps. The Regional Water and
Sanitation Hubs (RHubs), composed of partner state
universities, water districts, non-government organizations
and civil society organizations, are organized to assist the local
government units in mainstreaming iWaSH in local plans and
budgets. The RHubs are tasked to support the government in
preparing local government units and communities to develop
local projects in establishing, improving and expanding water
and sanitation systems and facilities.
STRATEGIES
The iWaSH approach ensures a complete package of
interventions consisting of social preparation and community
organizing, construction of water supply and sanitation
facilities and behavioral change campaigns. All these
interventions are implemented in an integrated manner. The
project focuses on 13 municipalities that are left behind in
terms of achieving SDG 6. GoAL WaSH will also support the
development of policies and governance instruments to
broadening access to safe water, sanitation and hygiene.
Local citizens groups are being established to monitor
the implementation of integrated safe water, sanitation and
hygiene at the community level. Furthermore, GoAL WaSH is
supporting coordination among WASH sector institutions at
the national level.
ACHIEVEMENTS
In total, 7,169 households in six regions received
improved access to water supply following the construction of
water supply systems. Moreover, the provision of the water
quality monitoring kits by the project has been valuable in the
identification of the contaminated drinking water sources in
the target municipalities. In one municipality, drinking water
sources tested revealed that majority, 87 out of the 110 water
sources, tested positive for E.Coli and Total Coliform. Local
government authorities had the opportunity to immediately
take action and communicate this to the community.
DEPED, DOH AND UNICEF UNITE TO BRING CLEAN HANDS
FOR ALL ON OCTOBER 15, 2020
Two of the most crucial government agencies in shaping the
future and well-being of a generation are coming together to
mark the beginning of a stronger partnership.
Manila, 15 October 2020 — As the COVID-19
pandemic continues, the world turns to a simple age-old
solution to reduce the risk of disease transmission – hand
washing with soap and water.
On October 15, 2020, this year’s celebration of Global
Hand washing Day will be its most significant yet. For the first
time, two of the most crucial government agencies in shaping
the future and well-being of a generation are coming together
to mark the beginning of a stronger partnership.
“DepEd has been celebrating Global Hand washing
Day in schools since 2008, in recognition of the importance of
building the habit of hand washing among children to ensure
their health. Through our WASH in Schools Program, DepEd
has institutionalized actions to improve hand washing facilities
and instill hand washing behaviour among learners. And now
under the new normal, our Basic Education-Learning
Continuity Plan also integrates hand washing practice as part
of the required health standards. With the children continuing
their learning at home because of the pandemic, we call on
families to make their homes a safe environment to live and
learn; and teach their children to make hand washing a habit.
And when we do return to school, hand washing will be key in
ensuring safety of our children,” says DepEd Secretary Leonor
Briones.
With the theme “Clean Hands for All”, the
Department of Education (DepEd) and the Department of
Health (DOH), with support from UNICEF, unite various
development partners, sector representatives and local chief
executives in an online symposium on October 15 and 16,
2020. The event aims to identify key directions for sustaining
the hand washing habit beyond the COVID-19 pandemic and
promote sustainable proper hand hygiene culture in the
Philippines.
DOH has been promoting hand washing practice as an
integrated part of their health programs and particularly
through the Zero Open Defecation Program (ZODP) that
utilizes approaches and strategies under the umbrella concept
of total sanitation to curb open defecation practices and
promoting frequent and proper hand washing among others.
Hand washing with soap is key in the fight against
COVID-19. It destroys the outer membrane of the virus and
thereby inactivates it. One study found that regular hand
washing with soap can reduce the likelihood of common
coronavirus infection by 36%. However, based on 2019 data,
over 7 million Filipinos are unable to wash their hands due to
lack of access to a hand washing facility, water, and/or soap.
This is found to be highest among poorest households and
those living in rural areas. From school year 2018-2019 data,
only half of schools have at least one group hand washing
facility with soap.
The lack of access to hand hygiene facilities is not just
in homes and schools but can also be found in workplaces,
healthcare facilities, and public spaces as well. Even when
awareness and knowledge around hand washing is high –
actual practice is often found to be much lower. In a study in
2018 by the Department of Education and UNICEF among
school children, observations demonstrated that less than 8%
did actually wash their hands after using the toilet even when
a handwashing facility with soap and water was available. The
issue is a detriment to public health and safety and requires
structural change from the whole of society and the
government, acting together.
VERMIN AND VECTOR CONTROL
 Vermin is used by some people as a term of abuse, either
individually or collectively. Vermin are pests or nuisance
animals that spread diseases or destroy crops or livestock.
 Vector is an organism, typically a biting insect or tick that
transmits a disease or parasite from one animal or plant to
another.
 Any method to limit or eradicate the mammals, birds,
insects or other arthropods (here collectively called
"vectors") which transmit disease pathogens. The most
frequent type of vector control is mosquito control using a
variety of strategies.
 Vector control focuses on utilizing preventive methods to
control or eliminate vector populations. Common
preventive measures are: Habitat and environmental
control, Reducing contact, Chemical control and Biological
control.
Methods of Vector Control
Environmental Management
 Environmental Management seeks to change the
environment in order to prevent or minimize vector
propagation and human contact with vector-pathogen by
destroying, altering, removing or recycling non-essential
containers that provide larval habitats. Such actions
should be the mainstay of dengue vector control. Three
types of environmental management are defined:
 Environmental modification - long-lasting physical
transformations to reduce vector larval habitats
 Environmental manipulation - temporary changes to
vector habitats involving the management of “essential”
containers.
 Changes to human habitation or behaviour - actions
to reduce human - vector contact.
Improvement of Water Supply and Water-Storage Systems
 Improving water supplies is a fundamental method of
controlling Aedes vectors, especially Ae.aegypti. Water
piped to households is preferable to water drawn from
wells, communal standpipes, rooftops catchments and
other water-storage systems.
 Potable water must be supplied reliably so that waterstorage containers that serve as larval habitats - such as
drums, overhead or ground tanks and concrete jars - are
not necessary. In urban areas the use of cost-recovery
mechanisms such as the introduction of metered water
may actually encourage household collection and storage
of roof catchment rainwater that can be harvested at no
cost, resulting in the continued use of storage containers.
Mosquito-Proofing of Water-Storage Containers
Water-storage containers can be designed to prevent access
by mosquitoes for oviposition. Containers can be fitted with
tight lids or, if rain-filled, tightly-fitted mesh screens can allow
for rainwater to be harvested from roofs while keeping
mosquitoes out. Removable covers should be replaced every
time water is removed and should be well maintained to
prevent damage that permits mosquitoes to get in and out.
Solid Waste Management
In the vector control, “solid waste” refers mainly to nonbiodegradable items of household, community and industrial
waste. The benefits of reducing the amount of solid waste in
urban environments extend beyond those of vector control,
and applying many of the basic principles can contribute
substantially to reducing the availability of Ae. aegypti larval
habitats.
Proper storage, collection and disposal of waste are
essential for protecting public health. The basic rule of
“reduce, reuse, recycle” is highly applicable. Efforts to reduce
solid waste should be directed against discarded or nonessential containers, particularly if they have been identified in
the community as important mosquito-producing containers.
Solid waste should be collected in plastic sacks and
disposed of regularly. The frequency of collection is important:
twice per week is recommended for housefly and rodent
control in warm climates. Integration of Ae. aegypti control
with waste management services is possible and should be
encouraged.
Street Cleansing
A reliable and regular street cleansing system that
removes discarded water-bearing containers and cleans drains
to ensure they do not become stagnant and breed mosquitoes
will both help to reduce larval habitat and remove the origin of
other urban pests
Building Structures
During the planning and construction of buildings and
other infrastructure, including urban renewal schemes, and
through legislation and regulation, opportunities arise to
modify or reduce potential larval habitats of urban disease
vector.
Chemical Control: Larvicides
Although chemicals are widely used to treat Ae.
aegypti larval habitats, larviciding should be considered as
complementary to environmental management and – except
in emergencies – should be restricted to containers that
cannot otherwise be eliminated or managed.
Larvicides may be impractical to apply in hard-toreach natural sites such as leaf axils and tree holes, which are
common habitats of Ae. albopictus, or in deep wells. The
difficulty of accessing indoor larval habitats of Ae. aegypti (e.g.
water-storage containers, plant vases, saucers) to apply
larvicides is a major limitation in many urban contexts.
Target Area
Productive larval habitats should be treated with
chemicals only if environmental management methods or
other non-chemical methods cannot be easily applied or are
too costly. Perifocal treatment involves the use of hand-held
or power-operated equipment to spray, for example, wettable
powder or emulsifiable-concentrate formulations of
insecticide on larval habitats and peripheral surfaces. This will
destroy existing and subsequent larval infestations in
containers of non-potable water, and will kill the adult
mosquitoes that frequent these sites.
Treatment Cycle
The treatment cycle will depend on the species of
mosquito, seasonality of transmission, patterns of rainfall,
duration of efficacy of the larvicide and types of larval habitat.
Two or three application rounds carried out annually in a
timely manner with proper monitoring of efficacy may suffice,
especially in areas where the main transmission season is
short.
Precautions
Extreme care must be taken when treating drinkingwater to avoid dosages that are toxic for humans. Label
instructions must always be followed when using insecticides.
Methods of Vermin Control
Hygiene
When houses and yards are kept clean, there is no
food for pests and nowhere for them to live and breed, and
this in turn means that there are few pests.
Pests can be controlled by practicing good hygiene in the
following ways:









Clean up after meals. Put foods scraps in the bin, and wash
and dry plates, cups, glasses, cutlery and cooking pots
after use.
Put all rubbish into the bin
Wrap all food scraps tightly in paper before putting them
in the bin
Keep all the benches, cupboards and floors clean and free
of foods scraps
Regularly clean behind stoves, refrigerators and other
household appliances
Keep food in containers with tight-fitting lids
Use the toilet properly. Make sure that all urine and faeces
goes into the pedestal pan and that the toilet is flushed
after use. Toilet paper is the only kind of paper that should
be flushed down the toilet.
Make sure the toilet is clean and the cistern works
correctly
Make sure that all septic tanks and leach drains are well
sealed
Biological Control Methods
Biological control methods can also be used to control
pests. These methods include using natural enemies of the
pest and biologically interfering with their ability to breed.
Pesticides are not used.
BUILT ENVIRONMENT
Refers to the human-made surroundings that provide
the setting for human activity, ranging in scale from buildings
and parks or green space to neighborhoods and cities that can
often include their supporting infrastructure, such as water
supply or energy networks.
Our built environment includes all the human-made physical
spaces where we live, recreate and work. These include our
buildings, furnishings, open and public spaces, roads, utilities
and other infrastructure. These structures and spaces affect
our health by bringing pollutants into our environments and by
allowing or restricting access to physical activity,
transportation and social interactions.
Indoor Environments and Health
Because close to 90 percent of time is spent indoors on
average in developed countries, and because indoor spaces in
developing nations are often greatly impacted by burning solid
fuels, indoor environments have a huge potential to influence
health worldwide.The features of our indoor environments
that can affect our health and well-being include noise,
temperature, humidity and mold, light, air quality, lead paint,
electromagnetic and radio frequency radiation and water
quality.
Air Quality

Indoor environments can concentrate some pollutants
such that indoor levels can be many times higher than
outdoor levels. Poor indoor air quality may increase rates
of asthma, allergies, and infectious and respiratory
diseases.
1.Radon
2.Carbon Monoxide
3.Particulate Pollution
Cooking
Burning of fuels, candles and other material
Smoking
Some electronics, such as laser printers
4.Chemicals
Water Quality
The built environment's plumbing infrastructure can
affect water quality, Lead pipes or solder either within
buildings or connecting buildings to water mains can
contaminate water coming into homes with enough lead to
cause permanent harm to children's brains and also affect
adult health.
Chlorine and other disinfectants added to water can
interact with other materials in water to create disinfectant byproducts, such as trihalomethanes and haloacetic acids. These
by-products
are
associated
with
some
forms
of cancer, reproductive health impacts and neural tube
defects in fetuses. Indoor chlorinated swimming pools can be
a significant source of exposures to chlorine and by-products.

Fluoride may be added to municipal water supplies, and
in some places occurs naturally in water. High levels can
have health impacts, including dental fluorosis, joint pain,
bone deformity, and adverse cognitive development in
children
Lead Paint
Small chips of flaking paint can adhere to hands or dusty
surfaces and then be transferred to food and ingested.
Crawling children and toddlers are especially likely to
encounter paint chips on floors, and they often put their hands
in their mouths.
Lead is toxic to people of any age but is especially
damaging to fetuses and young children. Very small amounts
of lead cause permanent brain and neurological damage to
children. Other health impacts include reproductive health
effects, anemia, renal disease, cataracts, coronary artery
disease, hearing
loss,
hypertension,
psychiatric
disturbances, seizures and more.
Pesticides
Pesticides are often used to control insects, rodents and
other pests within buildings, where residues on surfaces and in
the air can expose occupants. Various pesticides are associated
with cancer, neurodevelopmental
impacts, reproductive
impacts, asthma attacks, immune suppression, hearing loss,
psychiatric disturbance and other effects.
Humidity and Mold
Humidity levels in buildings affect our comfort levels, but
of much greater importance is the contribution of high
humidity to the growth of mold and some bacteria. All mold
needs to thrive is water and a food source, which is readily
available in buildings from wood, paper, tile glue, rugs and
other textiles, sheetrock and other building materials.

Symptoms and conditions associated with mold include
nasal stuffiness, eye irritation, wheezing or skin irritation.
People with serious allergies to molds may have more
severe reactions, and mold exposures have been found
to contribute to asthma incidence and episodes in
children.
Excess water or moisture in indoor environments can accrue
from these sources:




leaking plumbing
inadequately ventilated showers, laundry areas and
cooking areas; dishwashers can also create steam
seepage into basements and crawl spaces
overflow from heavy rain or floods
Noise
Noise levels indoors can sustained level at which hearing
loss occurs. Excessive indoor noise can come from appliances,
such as hair dryers and kitchen exhaust fans, or from music,
television or recreational electronics. Noise from outside
buildings can also intrude into indoor spaces: traffic, trains,
airplanes, heavy equipment, generators, lawn equipment,
fireworks and more.
Lower levels of noise can produce sleep
disturbance, cardiovascular effects including heart attacks and
stroke, learning impairment, psycho physiological effects,
psychiatric symptoms and impaired fetal development. Noise
also has widespread psycho-social effects including noise
annoyance, reduced performance and increased aggressive
behavior.
Light
Artificial light has changed many aspects of human
life, from allowing us to be productive long outside daylight
hours to reducing the risk of damage and injury from
uncontrolled fire. Light has its negative side, however, in
disrupting circadian rhythms of sleep and wakefulness. Early
research indicates that artificial light, and especially blue light
from electronic screens and some energy-efficient bulbs, may
contribute to the incidence of chronic disease and obesity.
Temperature
Our ability to heat and cool indoor environments has a huge
impact not only on comfort but on our health. Controlled
temperature environments bring these benefits.
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Reduce heat's exacerbation of many chronic diseases
and, at extreme levels, damage to the brain, heart, lungs,
kidneys and liver
Reduce heat stroke
Reduce hypothermia and its effects on cardiovascular
health
Reduce deaths from either heat or cold
At the same time, the built environment can create problems
by concentrating ambient heat and creating urban heat
islands. The annual mean air temperature of a city with one
million people or more can be 1.8–5.4°F (1–3°C) warmer than
its surroundings. In the evening, the difference can be as high
as 22°F (12°C). Indoor temperatures can be considerably
greater than in nearby rural areas. Dense urban areas without
indoor cooling can experience substantial health impacts
during heat episodes.
Outdoor Built Environments
Transportation
Beginning with the invention of the automobile, and
accelerating after World War II, environments from
neighborhoods to regions worldwide have been designed or
adapted to allow and promote automobile and other vehicle
use. These decisions and designs have had far-reaching
consequences for communities and societies:

Increased road construction and maintenance
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Promoted neighborhood sprawl
Increased traffic noise, pollution and congestion
Increased reliance on petroleum
Reduced opportunities for walking and other active
transportation
These consequences all have implications for our health.
Designing or altering transportation systems to focus on clean
community transit and walkability could have far-reaching
public health benefits.
Road Construction and Maintenance
More vehicle use generally means more paved roads and
parking lots. Building and maintaining roads release toxic
fumes and involve polluting and noisy heavy equipment. Rain
runoff from roads and parking lots impacts water quality and
can increase levels of heavy metals in water.
Increased Traffic
Traffic noise-can directly impact health. For example, a 2016
study found that the risk of myocardial infarction (heart attack)
rose with exposure to road noise or railroad noise. The
association was strongest, and extended to airplane noise,
among those whose heart attacks were fatal. Traffic noise is
also associated with impacts on respiratory and metabolic
health.
Air pollution -from vehicles includes several pollutant types:
fine particulate matter (PM), air toxicants, and volatile organic
compounds (VOCs), carbon monoxide and nitrogen oxides
which combine to form ground-level ozone (smog). Traffic
pollution contributes to poor respiratory and cardiovascular
health, and it is a factor in preterm birth, low birth weight,
miscarriage and stillbirth. Early research has connected air
pollution to poor cognitive performance, both in children and
in elders.
Traffic congestion-has both direct and indirect costs to
societies beyond the pollution it generates’
Longer driving times and more frequent commuting by car are
associated with these health effects:
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Weight gain, even among physically active adults
Higher cholesterol levels
Higher blood sugar
Lower cardiorespiratory fitness
Higher continuous metabolic score
A higher tendency toward depression, anxiety, and social
isolation
A greater risk of hypertension
More traffic accidents
Reliance on Petroleum
Although there has been some movement toward vehicles that
are not powered by fossil fuels, as yet the overwhelming
majority of vehicles rely on petroleum products.
The oil and gas industry is the largest industrial source of
emissions of volatile organic compounds (VOCs), which
contribute to the formation of ground-level ozone. Exposure
to ozone is linked to aggravated asthma, increased emergency
room visits and hospital admissions, and premature death.
Every stage of petroleum production and use impacts health:

Exploration, drilling and extraction- involve road building,
use of heavy equipment (often diesel-powered) and
increased vehicle traffic, with health effects. Studies
found moderate evidence that oil and natural gas
extraction increase risks of preterm birth, miscarriage,
birth defects, decreased semen quality and prostate
cancer.
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Refining petroleum releases hazardous toxicants
including particulates, sulfur oxides, carbon monoxide,
hydrocarbons, benzene, aldehydes and ammonia.

Transporting crude oil and refined petroleum products
produces pollution on shipping lanes, at ports, along
railways and on highways all along shipping routes.
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Oil and fuel spills can and often do happen at any stage of
extraction and transporting oil. Crude oil contains
hundreds of substances, many of which are known
carcinogens and have other health impacts
Consumption of the final products: Both the vapors from
gasoline and the substances produced when it is burned
(carbon monoxide, nitrogen oxides, particulate matter,
and unburned hydrocarbons) contribute to air pollution.
Burning petroleum products also releases carbon dioxide,
which contributes to climate change.
Energy and Heating
The introduction of electricity to buildings has had a huge
positive impact on quality of life and health worldwide. In fact,
lack of reliable electric power is a health concern: many parts
of the world do not have reliable access to electricity in their
health care facilities, impeding their ability to care for patients
during night time hours, to operate equipment, store
medications and vaccines, manage hazardous waste and even
pump water. The ways we heat our buildings and power our
electricity have widespread impacts on our outdoor
environments and health, with huge differences in impacts
depending on the sources of electricity.
Built Environment and Socioeconomic Status
The built environment interacts with socioeconomic
status: inequitable distributions of power, money and
resources create inequitable access to built environments that
support health. Poverty, age and mobility also make some
populations more vulnerable to built environment-related
disease than others. Youth, elderly, those with limited incomes
and people with disabilities disproportionately experience
poor built environments, such as those with high traffic
volumes, noise and crime rates, or neighborhoods close to
polluting industries. Indoor environments in low-income areas
are more likely to expose residents to lead paint and mold.
Exposure to more toxicants and fewer opportunities to engage
in physical activity are a double whammy against low-income
and disabled people.
Built Environment and Mental Health
Exposures like noise, air pollution, overcrowding and a lack of
access to nature can increase our physical and emotional
stress. Conversely, integrating opportunities to interact with
nature into the way we build our cities can have positive
effects on our health, including allowing us to think more
clearly and to reduce stress.
Built Environment Scale
Two scales of the built environment are typically considered:
the regional and the local.
The regional scale considers major areas of population and
how people get to and interact with places of employment and
housing. Considerations include transportation to and from
work, housing availability and cost, and school district and
neighborhood quality. Healthier regional built environments
focus on pedestrian-friendly design.
The local scale, or that of the neighborhood, also focuses on
transit but more on household travel needs. The distance to
frequent destinations, such as grocery stores, schools and
recreation areas, and the ease of traveling by foot or bike both
impact a person’s choices of active transportation. In
disconnected neighborhoods, families often have to drive to
access schools or recreational areas
A.
MONITORING AND EVALUATING COMMUNITY HEALTH
PROGRAMS IMPLEMENTED
Having a Healthy Communities Program evaluation
strategy ensures that national program objectives are
described and measured. Evaluation results will be used to
document funded community and partner challenges and
successes, as well as to inform similar programs working to
promote and replicate Healthy Communities Program
environmental change strategies. Assessment activities will
address process, outcome, and impact measures. Local
communities, national partners, and CDC will be responsible
for various aspects of program monitoring and evaluation.
Monitoring a process of measuring, recording, collecting and
analyzing data on actual implementation of the programme
and communicating it to the programme managers so that any
deviation from the planned operations are detected, diagnosis
for causes of deviation is carried out and suitable corrective
actions are taken.
Evaluation It is a systematic way of learning from experience
and using the lessons learnt to improve current activities and
promote better planning by careful selection of alternatives for
future action.
Used to assess the performance of projects, institutions and
programs set up by governments, international organizations
and NGOs. Its goal is to improve current and future
management of outputs, outcomes and impact.
Monitoring is a continuous assessment of programs based on
early detailed information on the progress or delay of the
ongoing assessed activities.
An evaluation is an examination concerning the relevance,
effectiveness, efficiency and impact of activities in the light of
specified objectives.
Monitoring and evaluation processes can be managed by the
donors financing the assessed activities, by an independent
branch of the implementing organization, by the project
managers or implementing team themselves and/or by a
private company. The credibility and objectivity of monitoring
and evaluation reports depend very much on the
independence of the evaluators. Their expertise and
independence is of major importance for the process to be
successful.
1.
DESIGNING AND IMPLEMENTING EVALUATION PLAN

Evaluation plan is an integral part of a grant
proposal that provides information to improve a
project during development and implementation.

To generate a good plan means logically working through a
series of issues.
 stakeholders and their concerns
 constraints
 translate concerns into key evaluation questions
 selection of data gathering methods to address key
questions that are to be the focus

Steps on designing and impleting evaluation plan:
When do you make a plan:
 Planning for evaluation should occur as part of the
other planning activities associated with project start
up.
Form a team:
 An evaluation group should be established and basic
management issues need to be addressed
Identifying stakeholder:
 Understanding the stakeholders and the audience of
the evaluation report(s) will shape:
 the goals/objectives of the evaluation
 the questions to be asked and when
 the methods of data collection, analysis and
reporting
Identifying concerns:
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takeholders will likely differ in their concerns and
what they want to find out, but these are not
necessary mutually exclusive.
Concerns will vary from project to project.
Concerns will change over the life of the project.
Stages:

Pre-implementation
Which concerns need to be addressed during the
design and development of the project?

Post-implementation

Short term

Medium term

Long term
Constraints:
 These factors will determine the size and scale of the
evaluation and what the evaluation team can do
practically.

Budget and resources

Time

Availability of competent staff

Pre-specified evaluation objectives,
methodologies and/or reporting procedures

Legal or ethical issues

Availability of data

Political’ considerations
The questions:

You must spend time on getting the evaluation
questions right.

OR, you may get the wrong answers, or answers to
questions you didn't ask or want to know about.

Action Questions

High Value Questions
Data gathering:
 MONITORING
 It is best to use a number of data gathering techniques
and/or sources of data to substantiate findings.
Continuous assessment that aims at providing all stakeholders
 This is known as a process of triangulation — the use with early detailed information on the progress or delay of the
ongoing assessed activities. It is an oversight of the activity's
of multiple investigative methods or information
implementation stage. Its purpose is to determine if the
sources to get the answer to the question at hand.
outputs, deliveries and schedules planned have been reached
Data sources:
so that action can be taken to correct the deficiencies as

Students — prospective, current, past, withdrawn quickly as possible.

Colleagues — teaching partners, tutors, teachers
external to the project

Discipline/instructional design experts

Professional development staff

Graduates and employers

Documents and records — teaching materials,
assessment records, past SETLs, assessment
statements and tasks
Good planning, combined with effective monitoring and
evaluation, can play a major role in enhancing the
effectiveness of development programs and projects. Good
planning helps focus on the results that matter, while
monitoring and evaluation help us learn from past successes
and challenges and inform decision making so that current and
future initiatives are better able to improve people's lives and
expand their choices.
Selecting methods:
Monitoring and Evaluation is used to assess the performance
of projects, institutions and programmes set up by
 Paradigm for the study (empirical, interpretive, critical
governments, international organisations and NGOs. Its goal is
theory-based, pragmatic)
to improve current and future management of outputs,
 Time involved in preparing to use the particular
outcomes and impact.
method/tool (e.g. preparation of a bank of questions
for a questionnaire)
EVALUATION
 Time involved in gathering or recording the data — on
Process that critically examines a program. It involves
the part of the data collector; on the part of the
collecting and analyzing information about a program's
'evaluee/s'
activities, characteristics, and outcomes. Its purpose is to make
 the time needed to analyse and report the data
judgments about a program, to improve its effectiveness,
 the scale involved — the number of students, staff
and/or to inform programming decisions.
required for valid/authentic data.
Evaluation is a systematic determination of a subject's
Method:
merit, worth and significance, using criteria governed by a set
of standards. ... The primary purpose of evaluation, in addition

The skill/expertise required to use the method

The expertise, personnel and/or resources required to gaining insight into prior or existing initiatives, is to enable
reflection and assist in the identification of future change.
to analyze and/or report the data.
Storing the data:
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Making sure that data is safe and not lost
Thinking through filing categories; e.g. by question
type; data source; data method
Considering confidentiality requirements & other
safeguards arrangements to access data
Ethical consideration:
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2. TYPES OF EVALUATION
PLANNING
Process of deciding in advance where we want to get to (our
goal) and how we will get there.
helps us to decide what that contribution should be and how
to achieve it.
evaluation plan is a written document that describes how you will
In any evaluation, the rights and welfare of 'subjects' monitor and evaluate your program, as well as how you intend to use
need to be respected and protected.
evaluation results for program improvement and decision making. The
Privacy: Some data gathering techniques may be
evaluation plan clarifies how you will describe the “What,” the “How,”
perceived as an invasion of privacy if prior consent and the “Why It Matters” for your program.
on the part of the subject(s) has not been gained.
FORMATIVE
Confidentiality: Much information that subjects
provide is given in confidence unless specific
permission to use 'private' information.
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3.
Method for judging the worth of a program
while the program activities are forming (in
progress).
Ongoing, flexible, and more informal
diagnostic tool.
A formative evaluation (sometimes referred to as
internal) is a method for judging the worth of a
program while the program activities are forming (in
progress). They can be conducted during any phase of
the process. This part of the evaluation focuses on the
process.
SUMMATIVE

Evaluation of the sum product of the lesson.

More formal, structured, and often used to
normalize performance so they can be
measured and compared.

Summative assessment, summative evaluation, or
assessment of learning is the assessment of
participants where the focus is on the outcome of a
program. This contrasts with formative assessment,
which summarizes the participants' development at a
particular time.
STEPS OF PROGRAM EVALUATION
 The program evaluation process goes through four
phases — planning, implementation, completion,
and dissemination and reporting — that
complement the phases of program development
and implementation. Each phase has unique
issues, methods, and procedure
 Six connected steps together can be used as a
starting point to tailor an evaluation for a
particular public health effort, at a particular point
in time. An order exists for fulfilling each step – in
general, the earlier steps provide the foundation
for subsequent progress.
 Engage stakeholders, including those
involved in program operations; those
served or affected by the program; and
primary users of the evaluation.
 Describe the program, including the
need, expected effects, activities,
resources, stage, and context and logic
model.
 Focus the evaluation design to assess the
issues of greatest concern to
stakeholders while using time and
resources as efficiently as possible.
Consider
the purpose, users, uses,
questions, methods and agreements.
 Gather credible evidence to strengthen
evaluation
judgments
and
the
recommendations that follow. These
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aspects of evidence gathering typically
affect perceptions of credibility:
indicators, sources, quality, quantity and
logistics.
Justify conclusions by linking them to the
evidence gathered and judging them
against agreed-upon values or standards
set by the stakeholders. Justify
conclusions on the basis of evidence
using these five elements: standards,
analysis/synthesis,
interpretation,
judgment and recommendations.
Ensure use and share lessons learned
with these steps: design, preparation,
feedback, follow-up and dissemination.