Transcript of "Community and Public Health (Week 7)"
Ma. Jenna Paje-Andres RMT, MPH CPH Professor
COMMUNITY ORGANIZATION AND HEALTH HEALTH PROGRAMS IN THE PHILIPPINES
Overview of SessionThe 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.
ObjectivesAt 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 HEALTHA. 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 HEALTHa. Environmental sanitationb. Control of Community infection (communicable disease)c. Education of the individual in principles of personal hygiened. Organization of Medical and nursing services for early diagnosis and preventive treatment of diseasese. Development of social machinery which will ensure everyone as standard living adequate for maintenance of life
Two broad areas of preventive medicine1. 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.
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 Health1. 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
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 Health1. Income and social status- higher income and social status are linked to better health2. Education- low education levels are linked with poor health, more stress and lower self confidence3. Physical environment- safe water and clean air, healthy workplace, safe houses, communities and roads all contribute to good health.
4. Employment and working conditions- people 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 health7. 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 health9. Health services- access and use of services that prevent and treat disease influence health10.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 servicesWHO 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 PHC1. Environmental sanitation2. Control of communicable disease3. Immunization4. Health Education5. MCH and Family Planning6. Adequate Food and Proper Nutrition7. Provision of Medical Care and Emergency Treatment8. Treatment of Locally Endemic Diseases9. Provision of Essential Drugs
Four Cornerstones or Pillars in PHC1. Active community participation2. Intra and inter-sectoral linkages3. Use of appropriate technology4. Support mechanism made available
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 Health1. Survival of man2. Prevention of condition which lead to destruction or retardation of human function and potential in the years of life3. Achievement of human potential and prevention of the loss of productivity of young adults and those on the middle period of life4. Improvement of the quality of life, especially in the later years
STRUCTURE OF THE PHILIPPINEHEALTH 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 System1. Government2. Mixed Sectors3. Private Sectors
GOVERNMENTThe 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• ImpotenceWhat 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 Planning1. 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 them2. Respect for life3. 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 ProgramGeneral 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 ProgramVision/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• Womens 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 SECTORS1. Socialized Medicine- funded b general taxation, emphasis on prevention2. 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 agencies3. Voluntary Health insurance- government only encourages people to subscribe to health insurance4. Free Enterprise- people have to take care of their medical needs.
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