Overview of Session
The students are introduced to the
concept of community health and
the scope and focus of a community
health program. The students are
likewise introduced to the different
health programs in the Philippines
that are being implemented by the
Department of Health.
Objectives
At the end of the session, the students
shall be able to understand the
importance of the availability and
institutionalization of health programs
in the reduction of mortality and
morbidity rates of common public
health programs in the country.
COMMUNITY HEALTH/PUBLIC HEALTH
A. Environmental sanitation
B. Control of Community infection
(communicable disease)
C. Education of the individual in
principles of personal hygiene
D. Organization of Medical and nursing
services for early diagnosis and
preventive treatment of diseases
E. Development of social machinery which
will ensure everyone as standard living
adequate for maintenance of life
COMMUNITY HEALTH/PUBLIC HEALTH
a. Environmental sanitation
b. Control of Community infection (communicable
disease)
c. Education of the individual in principles of
personal hygiene
d. Organization of Medical and nursing services for
early diagnosis and preventive treatment of
diseases
e. Development of social machinery which will
ensure everyone as standard living adequate for
maintenance of life
Two broad areas of preventive medicine
1. Public Health- includes programs and activities
directed at community level and will benefit
everyone or individuals who are not currently
under the care of physician.
2. Risk Factor Evaluation- includes programs and
activities directed at individuals who are currently
under the care of physician who evaluates them
for high-risk factors that can cause disease,
educate them about good habits and screens them
for appropriate conditions.
Two broad areas of preventive
medicine
HEALTH
• A status of complete physical, mental
and social well being and not merely
the absence of disease or infirmity
regarded as person’s physical and
psychological capacity to establish
and maintain balance.
Aspects of Health
1. Physical Health- refers to condition which
enables a person to maintain a strong and
healthy body.
2. Mental Health- refers to how a person
thinks of himself, control his emotions and
adjust to environment.
3. Social Health- refers to ways a person feels,
think and acts towards everybody around
him
• Physical health
• Mental health
• Social health
Health or disease is expressions of the
success or failure of a person to respond
adaptively to environmental challenges.
• HEALTH- successful defense of the host
against forces landing to disturb body
equilibrium
• DISEASE- failure of the body defense
mechanism to cope with forces tending to
disturb body equilibrium
Determinants of Health
1. Income and social status- higher income
and social status are linked to better
health
2. Education- low education levels are linked
with poor health, more stress and lower
self confidence
3. Physical environment- safe water and
clean air, healthy workplace, safe houses,
communities and roads all contribute to
good health.
4. Employment and working conditionspeople in employment are healthier,
particularly those who have more
control over their working conditions.
5. Social support networks- greater
support from families, friends and
communities is linked to a better health
6. Culture- customs, traditions and the beliefs of
the family and community all affect the health
7. Genetics- inheritance plays a part in determining
lifespan, healthiness and the likelihood of
developing certain illness.
8. Personal behavior and coping skills- balanced
eating, keeping active, smoking, drinking and
how to deal with life’s stresses and challenges all
affect health
9. Health services- access and use of services that
prevent and treat disease influence health
10.Gender- men and women suffer from different
types of diseases at different ages.
Primary Health Care (PHC) as an approach
to delivery of health care services
WHO defines PHC as essential health care
made universally accessible to
individuals and families in the
community by means acceptable to
them through their full participation
and at a cost that the community and
country can afford at every stage of
development
Elements/Components of PHC
1. Environmental sanitation
2. Control of communicable disease
3. Immunization
4. Health Education
5. MCH and Family Planning
6. Adequate Food and Proper Nutrition
7. Provision of Medical Care and Emergency
Treatment
8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs
Four Cornerstones
or Pillars in PHC
1. Active community participation
2. Intra and inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made
available
Levels of Health Care
Referral System
1. Primary Level of Care
• It is health care provided by center
physicians, public health nurse, rural
midwives, barangay health workers,
traditional healers and others at the
barangay health stations and rural
health units. First contact between
the community members and the
other levels of health facility
2. Secondary level of care
• Given by physicians with basic health
training. It is usually given in health facilities
privately owned or government operated
such as infirmaries, municipal and district
hospital and out-patient departments of
provincial hospitals. This serves as the
referral center for the primary health
facilities. Secondary facilities are capable of
performing minor surgeries and perform
some simple laboratory examinations
3. Tertiary level of care
• Tertiary care is rendered by specialist
in health facilities including medical
centers as well as regional and
provincial hospitals and specialized
hospitals. Complicated cases and
intensive care requires tertiary care
and all these can be provided by the
tertiary care facility
Concept of Community Health
• Working together to help people
help themselves, not merely to
survive but also achieve the
maximum potential
Four priorities in Public Health
1. Survival of man
2. Prevention of condition which lead to
destruction or retardation of human
function and potential in the years of life
3. Achievement of human potential and
prevention of the loss of productivity of
young adults and those on the middle
period of life
4. Improvement of the quality of life,
especially in the later years
STRUCTURE OF THE PHILIPPINE
HEALTH CARE DELIVERY SYSTEM
Health Resources
• Rural Health Unit (RHU) and their sub-centers
• Chest clinics, Malaria Eradication Units and
Schistosomiasis Control Unit
• Tuberculosis clinics and Hospitals of the PTBs
• Private Clinics
• Clinics run by PMA
• Community Hospitals and Health services
Centers run by Philippine Medical Care
Commission (PMCC)
• Voluntary Health Facilities run by religious and
civic groups.
Three divisions of Health Care
Delivery System
1. Government
2. Mixed Sectors
3. Private Sectors
GOVERNMENT
The primary government agency in
the field of health runs the bulk
of the government health
facilities is the Department of
Health
Responsibilities if the DOH
• Ensuring access to basic health services to all
Filipinos through the provision of quality health
care
• Formulation and development of national health
policies, guidelines, standards and manual
operation for health services and programs
• Issuance of rules and regulations, licenses and
accreditation
• Promulgation of the national standards, goals,
priorities and indicators
• Development of special health programs and
projects
HEALTH PROGRAMS
1. Adolescent and Youth Health and
Development Program (AYHDP)
• Reproductive health Sexuality , Reproductive
Tract infection (STD, HIV/AIDS)
• Responsible parenthood, Maternal and Child
health,
• Communicable diseases, Diarrhea, DHF,
Measles, Malaria
• Mental Health Substance use and abuse
2. Botika ng Barangay
• Refers to a drug outlet manage by a
legitimate community organization
(CO/non-government Organization (NGO)
and/or Local Government Unit (LGU), with
a trained operator and a supervising
pharmacist specifically established in
accordance with Administrative Order No.
144 s. 2004.
3. Promotion of Breast feeding program/
Mother and Baby Friendly Hospital
Initiative (MBFHI)
• The Mother and Baby Friendly Hospital
Initiative is the main strategy to transform
all hospitals with maternity and new born
services into facilities which fully protect,
promote, support breast feeding and
rooming-in practices
4. Cancer Control Program
• The Philippines Cancer Control Program,
begun in 1988, is an integrated approach
utilizing primary, secondary and tertiary
prevention in different regions of the
country at both hospital and community
levels.
• Six lead Cancers (lung, breast, liver, cervix,
oral cavity, colon and rectum) are discussed.
5. Diabetes Control Program
• Diabetes is a serious chronic metabolic disease
characterized by an increase in blood sugar levels
associated with long term damage and failure or
organs functions, especially the eyes, the kidneys,
the nerves, the heart and blood vessels.
In diabetic, blood sugar reaches a dangerously high
level which leads to complications
• Blindness
• Kidney failure
• Stroke
• Heart attack
• Wounds that would not heal
• Impotence
What can you do to control your blood sugar?
• 1. Diet therapy
• 2. Exercise
• 3. Control your weight
• 4. Quit smoking
6. Dengue Control Program
• The thrust of the Dengue Control Program is
directed towards community-based prevention
and control in endemic areas
• Major strategy is advocacy and promotion,
particularly the Four O’clock Habit which was
adopted by most LGUs. This is a nationwide,
continuous and concerted effort to eliminate the
breeding places of Aedes aegypti.
7. Dental Health Program
• Comprehensive Dental Health program aims
to improve the quality of life of the people
through the attainment of the highest
possible oral health. Its objective is to
prevent and control dental diseases and
conditions like dental carries and
periodontal diseases thus reducing their
prevalence.
8. Emerging Disease Control Program
• Emerging infectious disease are newly
identified and previously unknown infection
which cause public health problems either
locally or internationally. These include
diseases whose incidence in humans have
increased within the past two decades or
threaten to increase in the near future.
9. Environmental Health
• Environmental health is concerned with
preventing illness through managing the
environment and by changing people’s
behavior to reduce exposure to biological
and non-biological agents of disease and
injury. It is concerned primarily with effects
of the environment to the health of the
people.
10. Expanded program on Immunization
• The expanded program on immunization is
one of the DOH programs that has already
been institutionalized and adopted by all
LGUs in the region. Its objective is to reduce
infant mortality and morbidity through
decreasing the prevalence of six (6)
immunizable diseases (TB, diphtheria,
pertussis, tetanus, polio and measles.
11. Family Planning
1. Responsible Parenthood which means that
each family has the right and duty to
determine the desired number of children
they might have and when they might have
them
2. Respect for life
3. Birth spacing refers to interval between
pregnancies ( which is ideally 3-5 years)
12. Food and Waterborne Diseases Prevention and
Control Program(FWBDPCP)
• Established in 1997 but became fully operational
in 1997 but became fully operational in year 2000
with the provision of a budget amounting to PHP
551,000.00 The program focuses on Cholera,
typhoid fever, hepatitis A and other food borne
emerging diseases (e.g. Paragonimus)
13. Knock out Tigdas
• The Knock-out tigdas is s strategy to reduce
the number or pool of children at risk of
getting measles, or being susceptible to
measles and achieve 95% measles
circulation in all communities in 2008.
14. Leprosy Control program
• Leprosy Control program envisions eliminating
Leprosy as a human disease by 2020 and is
committed to eliminate leprosy as a public
health problem by attaining a national
prevalence rate (PR) of less than 1 per 10,000
populations by year 2000
15. Malaria Control Program
• 58 of 80 provinces: malaria endemic
• Population at risk: 12 M
• 22 provinces: maintain malaria-free*
status
• 2– 4 outbreaks per year
• malaria-free:
absence of indigenous malaria case
16. National Filariasis Elimination Program
General Objectives:
To reduce the Prevalence Rate to <1/1000
population
17. National Mental Health Program
• It aims at integrating mental health within the total
health system, initially within the DOH system, and
local health system. Within the DOH, it has initiated
and sustained the integration process within the
hospital and public health systems, both at the
central and regional level. Furthermore, it aims at
ensuring equity in the availability, accessibility,
appropriateness and affordability of mental health
and psychiatric services in the country.
18. Newborn screening
• Newborn Screening (NBS) is a simple
procedure to find out if your baby has a
congenital metabolic disorder that may
lead to mental retardation and even death
if left untreated
19. Occupational Health Program
Vision/Mission Statement
• Health for all occupations in partnership with the
workers, employers, local government authorities
and other sectors in promoting self-sustaining
programs and improvement of workers’ health and
working environment.
• Program Objective and Targets: To promote and
protect the health and well being of the working
population thru improved health, better working
conditions and workers’ environment
20. Health development Program for Older Persons
• The Program intends to promote and improve
the quality of life of older persons through the
establishments and provision of basic health
services for older persons, formulation of policies
and guidelines pertaining to older persons,
provision of information and health education to
the public, dedicated to older person and, the
conduct of basic and applied researches.
21. Pinoy MD Program “Gusto Kong Maging Doktor”
• A Medical scholarship Grant for Indigenous People,
Local Health Workers, Barangay Health workers,
Department of Health employees or their children.
This is a joint program of the Department of Health
(DOH), Philippine Charity Sweepstakes Office
(PCSO), and several State Universities and Medical
Schools
22. Prevention of Blindness Program
• To eliminate all avoidable blindness by
preventing and controlling diseases
through the development of human
resource, infrastructure, and appropriate
technology
23. Schistosomiasis Control Program
• Goal of the National Schistosomiasis
control program is to eliminate
Schistosomiasis as a public health problem
(Prevalence of 1% and below)
24. National TB Control Program
• In 1196, WHO introduced the Directly Observed
Treatment Short Course (DOTS) to ensure completion
of treatment
• The DOTS strategy depends on five elements for its
success:
• Microscope, Medicines, Monitoring, DOT and
Political Commitment.
• If any of these elements are missing, our ability to
consistency cure TB patients slips through our
fingers.
25. Republic Act 7719 is otherwise known as “Blood
Services Act of 1994”
The main Objectives are:
• To promote and encourage voluntary blood
donation by the citizenry and to instill public
consciousness of the principle that blood
donation is a humanitarian act
• To provide, adequate, safe, affordable and
equitable distribution of supply of blood and
blood products
A
• Adolescent and Youth Health Program (AYHP)
B
• Botika Ng Barangay (BnB)
• Breastfeeding TSEK
• Blood Donation Program
C
• Child Health and Development Strategic Plan Year
2001-2004
• CHD Scorecard
• Committee of Examiners for Undertakers and
Embalmers
• Committee of Examiners for Massage Therapy
(CEMT)
D
• Dental Health Program
E
• Emerging and Re-emerging Infectious Disease
Program
• Environmental Health
• Expanded Program on Immunization
• Essential Newborn Care
F
• Family Planning
• Food and Waterborne Diseases Prevention and
Control Program
• Food Fortification Program
G
• Garantisadong Pambata
H
• Human Resource for Health Network
• Health Development Program for Older Persons - (Bureau
or Office: National Center for Disease Prevention and
Control )
• Health Development Program for Older Persons - R.A.
7876 (Senior Citizens Center Act of the Philippines)
• Health Development Program for Older Persons (Global
Movement for Active Ageing (Global Embrace 1999)
• Health Development Program for Older Persons - R.A.
7432 (An Act to Maximize the Contribution of Senior
Citizens to Nation Building, Grant Benefits and Special
Privileges)
• Health and Well-being of Older Persons
I
•
•
•
•
Infant and Young Child Feeding (IYCF)
Iligtas sa Tigdas ang Pinas
Inter Local Health Zone
Integrated Management of Childhood Illness (IMCI)
K
• Knock Out Tigdas 2007
L
• Leprosy Control Program
• LGU Scorecard
• Licensure Examinations for Paraprofessionals
Undertaken by the Department of Health
M
• Malaria Control Program
• Measles Elimination Campaign (Ligtas Tigdas)
N
•
•
•
•
•
•
•
•
•
National Tuberculosis Control Program
Natural Family Planning
National Filariasis Elimination Program
National Rabies Prevention and Control Program
Newborn Screening
National HIV/STI Prevention Program
National Mental Health Program
National Dengue Prevention and Control Program
National Prevention of Blindness Program
O
• Occupational Health Program
P
•
•
•
•
•
Persons with Disabilities
Pinoy MD Program
Province-wide Investment Plan for Health (PIPH)
Philippine Medical Tourism Program
Provision of Potable Water Program (SALINTUBIG
Program - Sagana at Ligtas na Tubig Para sa Lahat)
R
• Rural Health Midwives Placement Program (RHMPP) /
Midwifery Scholarship Program of the Philippines
(MSPP)
S
• Schistosomiasis Control Program
• Soil Transmitted Helminth Control Program
• Smoking Cessation Program
U
• Urban Health System Development (UHSD) Program
• Unang Yakap (Essential Newborn Care: Protocol for
New Life)
V
• Violence and Injury Prevention Program
W
• Women's Health and Safe Motherhood Project
• Women and Children Protection Program
MIXED SECTORS
•
•
•
•
PTS- Philippine Tuberculosis society
PCS- Philippine Cancer Society
PNRC- Philippine National Red Cross
PMHA- Philippine Mental Health
Association
• PHA- Philippine Heart Association
PRIVATE SECTORS
1. Socialized Medicine- funded b general taxation,
emphasis on prevention
2. Compulsory Health insurance- law requires people
to subscribe to health insurance plan, usually
government sponsored; covers only curative and
rehabilitative medicine; preventive services
provided by government agencies
3. Voluntary Health insurance- government only
encourages people to subscribe to health insurance
4. Free Enterprise- people have to take care of their
medical needs.