PHC WHO define PHC as essential health care made universally accessible to individual and families in the community by means
Paradigm of PHC Essential Universally Individual/ Socialhealth care accessible families development e.g. Family health EPI Community Primary Family based health planning workersInfant breast feeding
Essential Health Care Program 1. Family Health 2. Prevention and control of non-communicable disease 3. prevention and control of communicable disease 4. Environmental Health and sanitation 5. Other priority health programs
Family Health program 1. Maternal health program 2. Family planning program 3. Child health program 4. Expanded program of immunization 5. Nutrition program 6. Oral health program 7. Other health program
Family health The DOH- Family health office- is responsible for the creation, implementation and evaluation of health family programs The summary of its objective is to improve the survival, health and well being of each members of the family as well as the reduction of morbidity and mortality rates in the family and community.
Maternal Health Program Philippine statistics reveal 25% maternal deaths due to hypertension 20.3% Postpartum hemorrhage 9% Pregnancy related diseases Objective: To improve the survival, health and well being of mothers and unborn child
Maternal Health Services 1. Antenatal Registration- pregnant women can avail the free prenatal services at their respective health center. 2. Tetanus Toxoid Immunization-A series of 2 doses of tetanus toxiod vaccination must be received by a pregnant women one month before delivery and 3 booster doses after childbirth 3. Micronutrient Supplementation- Vitamin A and Iron supplement for the prevention of anemia
4. treatment of diseases and other conditions- These is for the women who is diagnosed as under the high risk pregnancy 5. Clean and Safe delivery- ensuring an aseptic areas for labor and delivery
The Family Planning Program In 2003, there are about 84 million Filipinos to grow annually at 2.36 percent and expected to double in 29 years. The total fertility rate is at 3.5 children/ women The use of contraceptive increases gradually from 15.4% (1996) to 48.9% (2003) 44% of women got pregnant with their first child at the age of 20-24.
The objectives: To help couples and individuals achieve their desired family size within the context of responsible parenthood and to improve their reproductive health to attain sustainable growth.
Family planning Method Female Sterilization 1. Tubal Ligation- It involves the cutting or blocking the 2 fallopian tubes. Advantages: Permanent method of contraception No repeated clinic visits Does not interfere with sex- result to increase enjoyment No known side effects
Male Sterilization 1. Vasectomy- The vas deferens is blocked or cut, to prevent the passage of sperm Advantages: Very effective 3 month after the procedure Permanent, safe, simple and easy to perform Does not interfere with sex
Use of Pill- These pill contains hormone: estrogen and progesterone, this is taken daily to prevent conception. Advantages: Safe, convenient and easy to use Make menstrual cycle occur regularly Reduces gynecological symptoms like painful menstruation and reduce the risk of ovarian and endometrial cancers
Disadvantage: It has side effects like; nausea, dizziness, breast tenderness, blurring of vision It suppress lactation Requires regular supply
Use of Condom- It’s a thin sheath of latex rubber made to fit on a man’s erected penis, it prevent the passage of sperm into the internal vagina Advantages: Safe and no hormonal effects; 98% effective It protect individual in sexually transmitted diseases Disadvantages: Allergies to rubber latex Decrease in sensation, interrupts the sexual act
Injectibles- It contains synthetic hormone, progestin which suppresses ovulation, it thickens the cervical mucus thus making it difficult for sperm to pass through Advantages: Reversible and no daily intake No sexual inference
Lactating amenorrhea method or LAM- A temporary postpartum method of postponing pregnancy based on the physiological infertility experienced by breast feeding mothers. Advantages: Available to all postpartum lactating mothers
Mucus/Billing/Ovulation Method- Abstaining from sexual intercourse during fertile (wet) days Advantages: Can be use by healthy women, no known diseases Disadvantages: Not reliable
Basal Body temperature- BBT is use to identify the fertile and infertile period of a woman’s cycle by daily taking and recording the rise and fall in body temperature during and after ovulation Advantage: Very effective Disadvantage: Couples abstinence during fertile period
Sympto-Thermal Method- It’s the combination of BBT and Billings method. Combination of observation made on cervical mucus and BBT Effectiveness 80%
Child Health Program Which includes the newborn, infants and children Programs for children Infant and young child feeding Newborn screening Expanded program on Immunization Management of Childhood diseases Micronutrient supplementation Dental health
Early child development Child Health injuries Overall objective To reduce morbidity and mortality rate among children from 0-9 years old.
Infant & young child feeding Importance of breast feeding- Exclusive breast feeding is giving only breast milk to infants, This is recommended up to 6 months and can be extended up to 2 years. Benefits for the infants A complete food for the infants Strengthen immune system thus preventing infections Increases IQ points
Benefit for the mothers Reduces excessive blood loss after birth Natural method of delaying pregnancies Reduces the risk of ovarian and breast cancers
Laws that protects infant and young child feeding Milk code (EO 51) – products covered by milk code consist of breast milk substitute, e.g. infant formula, other milk products, bottlefed complementary foods Rooming-In Breastfeeding Act of 1992- requires both public and private institution to promote rooming-in, it encourage and support the practice of breastfeeding
Food fortification Law or An act establishing the Philippine Food fortification Program and for other purpose- Food fortification law- Republic Act 8976 Food fortification law is vital in the promotion of optimal health and to compensate for the loss of nutrients during processing and storage of food.
Infant screening tests or Neonatal screening tests Newborn screening is a process of testing newborn babies from treatable genetic, endocrinologic, metabolic and hematologic diseases The test is mandated in the RA 9288 otherwise known as Newborn screening program of 2004
How the test is performed: Blood tests: A health care professional will prick the babys heel to obtain a few drops of blood. The blood is sent to a lab for analysis. Hearing test: An audiologist will place a tiny earpiece or microphone in the infant� s ear or stick electrodes on the baby� s head.
How to prepare for the test: There is no preparation necessary for newborn screening tests. The tests are performed when the baby is between 24 hours and 7 days old, typically before the baby goes home from the hospital. How the test will feel: The baby will most likely cry when his or her heel is pricked to obtain the small blood sample. The hearing test should not cause the baby to feel pain, cry, or respond
EPI Our commitment to Universal Child Immunization has lead to the mandate of laws regarding EPI. Accelerated EPI coverage started in 1986 and in 1992 Hepatitis B immunization has been integrated into EPI manual of operation. In early 1990 there is a declined of numerous cases of the immunizable disease such as: Polio disease, Measles and neonatal tetanus
Routine schedule of Immunization Every Wednesday is designated as immunization day in all parts of the country. A fully immunized child- receives one dose of BCG, 3 doses of OPV, DPT, HB and one dose measles vaccine before the child’s 1st birthday
Schedule of immunization Vaccine Minimum age Number of Minimum Reason at 1st dose doses interval between doses BCG Birth or 1 BCG protects anytime after the infant from birth possibility of TB meningitis & other TB infections DPT 6 weeks 3 4 weeks Reduce the chance of pertussis OPV 6 weeks 3 4 weeks Protection against polio disease
Vaccine Minimum age Number of Minimum Reason at 1st dose doses interval between dosesHepatitis B At birth 3 6 weeks Reduces the interval from 1st chance of being dose to 2nd infected and dose; 8 weeks becoming a interval from carrier 2nd to 3rd dose Measles 9 months Prevents deaths, malnutrition and protection from measles
EPI vaccines and its characteristics Type/Form of vaccine Storage TemperatureMost Sensitive to heat Oral Polio (live attenuated ) -15°C to -25°C ( at the freezer) Measles ( Freeze dried) -15°C to -25°C ( at the freezer)
Type/Form of vaccine Storage TemperatureLeast sensitive to heat DPT/Hep B +2 °C to + 8°C ( in the body of refrigerator) “D” toxoid is a weakened toxin “P” killed bacteria “T” toxoid is a weakened toxin Hepatitis B +2 °C to + 8°C ( in the body of refrigerator) BCG (freeze dried) +2 °C to + 8°C ( in the body of refrigerator) Tetanus toxoid +2 °C to + 8°C ( in the body of refrigerator)
Administration of the vaccineVaccine Dose Route of Site of Administration Administration BCG 0.05 ml Intradermal Right deltoid region DPT 0.5 ml Intramuscular Upper outer portion of the thigh OPV 2 drops or depending on the Oral Mouth manufacturer instructionMeasles 0.5 ml Subcutaneous Outer part of the armHepa B 0.5 ml Intramuscular Upper outer portion of the thighTetanus 0.5 ml Intramuscular Deltoid region toxoid
Nutritional program Common nutritional deficiencies in the Philippines according to DOH Vitamin A Iron Iodine Goal of Nutrition program- is to improve quality of life of every Filipinos through better nutrition, improved health and increase productivity.
Programs and projects 1. Micronutrient supplementation- 2x a year distribution of vitamin A capsules through the “Araw ng Sangkap Pinoy”- (ASAP) also known as GP- garantisadong pambata
2. Food Fortification- 3. Essential Maternal and child health service package 4. Nutrition information 5. Home, school and community food production 6. Food assistance 7. Livelihood assistance