4. Community
> is defined as a sociological
group in a large place sharing
one environment. It includes
the individual and the family.
5.
6. Community health > is the art
and science of maintaining,
protecting and improving the
health of all the members of the
community through organized
and sustained community
efforts.
7.
8. Environmental Health >
comprises those aspects of
human health that are
determined by physical,
chemical, biological, social and
psychosocial factors in the
surrounding environment.
9. Characteristics of a Healthy Community
1. A clean and safe physical environment.
2. An environment that meets everyone’s basic
needs.
3. An environment that promotes social harmony
and actively involves everyone.
4. An understanding of local health and
environment issues.
5. A community that participates in identifying
local solutions to local problems.
10. Characteristics of a Healthy Community
6. A community whose members have access to
varied experiences, means of interaction and
communication.
7. Accessible and appropriate health services and
facilities.
8. The promotion and celebration of historical and
cultural heritage.
9. A diverse and innovative economy.
10.A sustainable use of available resources for all.
11. PRIMARY HEALTH CARE PROGRAMS
HEALTH CARE SERVICES FUNCTIONS
Maternal Health Care Pre-natal, Natal, Post-natal
Child Health Care Immunizations, Control of Diarrheal
diseases
Nutrition Program Operation Timbang, Food
Supplementation
Population and Family Planning Program Free Family Planning
Control of Communicable Diseases Tuberculosis control program
Environmental Sanitation Program Inspection of food establishments
Control on non-communicable diseases Blood pressure screening
12. HEALTH CARE SERVICES FUNCTIONS
Dental Health Program Tooth Extraction
Reproductive Health Care Counseling on Family Planning and RH
Medical Morbidity Clinic Provision of free medicines
National Voluntary Blood Services Blood-letting activities at barangay level
Epidemiology and Surveillance Program Controlling outbreaks
Disaster Management Preparedness
Program
Medical services/assistance during disaster
Mental Hygiene Adolescent counseling centers
Pharmacy Services Distribution of medicines to all health
centers
13. PERENNIAL COMMUNITY HEALTH PROBLEMS
Peace and
Order
Water
supply
Human
Disposal Food
Sanitation
Drug
Abuse
prevention
& control
in the
community
Disease
control
Human
Excreta
and
Sewage
Community health
problems
14. REFUSE > are the dump, food waste
or discarded materials.Garbage Ashes
18. Proper Waste Management
1. Storage > involves putting of waste in a
container with a cover.
2. Collection > is the procedure of gathering
wastes for disposal.
3. Disposal of wastes > another important
procedure in proper waste management.
19. Different Agencies:
DepEd Department of Education
PopCom Population Commission
DA Department of Agriculture
PMA Philippine of Medical Association
PNRC Philippine National Red Cross
DILG Department of Interior and Local
Government
NNC National Nutrition Council
NEDA National Economic and Development
Authority
DOH Department of Health
DBM Department of Budget and Management
20. Thoughts to Ponder:
As a student, what can you do to help your
community to become an ideal one?
If you were a brgy. chairman in your place, what
ordinance will you promote to help your
community lessen at least one or two of its
perennial problems?
21.
22.
23. A community is commonly considered a social
unit (a group of people) who have something in
common, such as norms, values, identity, and
often a sense of place that is situated in a given
geographical area (e.g. a village, town, or
neighborhood). Durable relations that extend
beyond immediate genealogical ties also define a
sense of community. People tend to define those
social ties as important to their identity,
practice, and roles in social institutions like
family, home, work, government, society, or
humanity, at large. Although communities are
usually small relative to personal social ties
(micro-level), "community" may also refer to
large group affiliations (or macro-level), such as
24. What is meant by
Health?Health is the level of functional and metabolic efficiency
of a living organism. In humans it is the ability of
individuals or communities to adapt and self-manage
when facing physical, mental or social changes. The
World Health Organization (WHO) defined health in its
broader sense in its 1948 constitution as "a state of
complete physical, mental, and social well-being and
not merely the absence of disease or infirmity." This
definition has been subject to controversy, in particular
as lacking operational value, the ambiguity in
developing cohesive health strategies, and because of
the problem created by use of the word "complete".
25. Other definitions have been proposed, among which a
recent definition that correlates health and personal
satisfaction.Classification systems such as the
WHO Family of International Classifications, including
the
International Classification of Functioning, Disability and
(ICF) and the International Classification of Diseases
(ICD), are commonly used to define and measure the
components of health
26.
27. So Community Health
means……..Community health is a subject of study within the medical and clinical
sciences which focuses on population groups and communities as
opposed to individual patients. It is a distinct field of study that may be
taught within a separate school of public health or environmental health.
It is a discipline which concerns itself with the study and improvement of
the health characteristics of biological communities. While the term
community can be broadly defined, community health tends to focus on
geographical areas rather than people with shared characteristics. The
health characteristics of a community are often examined using
geographic information system (GIS) software and public health datasets.
Some projects, such as InfoShare or GEOPROJ combine GIS with existing
datasets, allowing the general public to examine the characteristics of any
given community in participating countries.
28. take place in a hospital setting, such as intravenous rehydration or
surgery.
The success of community health programmes relies upon the transfer of
information from health professionals to the general public using one-to-
one or one to many communication (mass communication). The latest shift
is towards health marketing.Because 'health III' (broadly defined as well-
being) is influenced by a wide array of socio-demographic characteristics,
relevant variables range from the proportion of residents of a given age
group to the overall life expectancy of the neighborhood/community.
Medical interventions aimed at improving the health of a community range
from improving access to medical care to public health communications
campaigns. Recent research efforts have focused on how the built
environment and socio-economic status affect health.
29. Community health may be studied within three broad categories:
Primary healthcare which refers to interventions that focus on the
individual or family such as hand-washing, immunization, circumcision,
personal dietary choices, and lifestyle improvement.
Secondary healthcare refers to those activities which focus on the
environment such as draining puddles of water near the house, clearing
bushes, and spraying insecticides to control vectors like mosquitoes.
Tertiary healthcare on the other hand refers to those interventions that
30. Is it hard to maintain a
Healthy Community ?
PROPOSING A PROCESS FOR COMMUNITY HEALTH IMPROVEMENT
The committee proposes a community health improvement process (CHIP)
1 as a basis for accountable community collaboration in monitoring
overall health matters and in addressing specific health issues. This
process can support the development of shared community goals for
health improvement and the implementation of a planned and integrated
approach for achieving those goals.
31. A CHIP would operate through two primary interacting cycles, both of
which rely on analysis, action, and measurement. The elements of a CHIP
are illustrated in Figure 4-1. Briefly, an overarching problem identification
and prioritization cycle focuses on bringing community stakeholders
together in a coalition, monitoring community-level health indicators, and
identifying specific health issues as community priorities. A community
addresses its priority health issues in the second kind of CHIP cycle—an
analysis and implementation cycle. The basic components of this cycle are
analyzing a health issue, assessing resources, determining how to respond
and who should respond, and selecting and using stakeholder-level
performance measures together with community-level indicators to assess
whether desired outcomes are being achieved. More than one analysis and
implementation cycle may be operating at once if a community is
responding to multiple health issues. The components of both cycles are
discussed in greater detail below.
The actions undertaken for a CHIP should reflect a broad view of health
and its determinants. The committee believes that the field model (Evans
and Stoddart, 1994), discussed in Chapter 2, provides a good conceptual
basis from which to trace the multifactorial influences on health in a
community.
32. Community Diagnosis
Programme
The community diagnosis
is based on collection and
interpretation of the
relevant data:
The focus should be the
identification of the basic
health needs and health
problems of the
community.
(felt need, observed need
and real need)
33. Community Diagnosis
●
“Community diagnosis is a comprehensive
assessment of health status of the community in
relation to it’s social, physical and biological
environment.”
- Dr. Cynthia Hale et al
34. Comparing individual diagnosis
with community diagnosis
clinical diagnosis
●
Obtain a history of the patients’
symptoms.
●
Examine the patient and observe
sign.
●
Perform laboratory test , x-ray and
others.
●
To infer causation from the history
and test result to make the
diagnosis.
●
Provide treatment.
●
Follow-up and assess effectiveness
of the treatment.
Community diagnosis
●
Obtain health awareness of the community by
informal meeting and discussions.
●
Obtain measurable facts of causes through basic
demographic survey. (indicator)
●
Conduct specific survey based on finding of basic
demographic survey.
●
Make inference from the data (indicator) to make
the community diagnosis.
●
Prescribe community treatment or community
health action as part of community health
programme.
●
Evaluate (follow-up) the effect of community health
action
(Similarities)
35. Comparing individual diagnosis
with community diagnosis
Individual (clinical)
diagnosis
●
Patient aware of the
problem.
●
Patient take initiative
for problem solving.
●
Pathological condition
affects patient
alone.
●
It may or may not be
related to
environment.
Community diagnosis
●
Community may or may not be
aware of the problem.
●
Community rarely takes
initiative.
●
Can not be treated as isolated
occurrences.
●
Each condition is linked to the
inter-related factors in the
environment.
Differences:
36. Purposes of Community
Diagnosis
●
It helps to identify community needs and
problems.
●
It is pre-requisite for planning, implementing
and evaluation of health and development
programme.
●
It helps to match project organization and
services with community needs.
●
It can be used to help the community become
conscious of its existing problems and find
solution.
37. Methodology of CDP
Systematic activities of CDP (Chronology)
●
Determination of objectives
– General
– Specific
●
Selection of community
Criteria:
●
Convenient accessibility
●
Diversity of population based on socio-economic, cultural and
religious behavior.
●
Administrative and operational feasibility.
38. Nutritional assessment
●
Evaluation and measurement of
nutritional variables in order to assess the level
of nutrition or the nutritional status of the individual or
community as a whole.
39. Purposes of Nutritional
assessment
1. Identify individuals or population groups who
are malnourished or at risk of becoming
malnourished.
2. To develop health care programs that meet
the community needs which are defined by
the assessment.
3. To measure the effectiveness of the
nutritional programs & intervention once
initiated
41. Direct Methods of
Nutritional Assessment
These are summarized as ABCD
●
Anthropometric methods
●
Biochemical, laboratory methods
●
Clinical methods
●
Dietary evaluation methods
42. Indirect Methods of
Nutritional Assessment
These include three categories:
●
Ecological variables including crop production
●
Economic factors e.g. per capita income,
population density & social habits
●
Vital health statistics particularly infant &
under 5 mortality & fertility index
43. 2. Assessment of Dietary
intake
A. Qualitative aspect of food.
B. Quantitative aspect of food.
C. Social aspect of food
44. A. Qualitative aspect of
food●
Vegetarian and non-vegetarian food
●
Use of cooking oil: refined or non refined
●
Type of salt used: iodized or non-iodized.
●
Habit of Balanced diet
●
Knowledge about balanced diet
45. B. Quantitative aspect of
food intake
●
Total calorie requirement and daily
consumption of calorie in the family on
the basis of:
– Total family members by age and sex.
– Physical activities.
– Number of vulnerable groups
46. C. Social aspect of
nutrition
●
Knowledge and importance of nutrition.
●
Food cooking habit.
●
Storage and distribution of food.
●
Washing of vegetable.
●
Cutting of vegetable.
47. 3. Anthropometric measurement
Among all children below 5 years:
●
Mid upper arm circumference (MUAC) 6+ months
●
Weight
●
Height
●
Weight for age (GOMEZ classification)
●
Water low's classification
●
Chest and head circumference
BMI
for adult population
48. GOMEZ classification of PEM
Wt. of the child
●
Weight for age = X 100
Wt. of a normal child of same age
Between 90 and 110% = Normal nutritional status
Between 75 and 89% = 1st degree malnutrition
Between 60 and 74% = 2nd degree malnutrition
Under 60% = 3rd degree malnutrition
50. Waterlow’s classification
●
Wight/Height (%) = Weight of the child X 1oo
weight of a normal child at same
height
Height/Age = Height of the child X 1oo
Ht. of a normal child at same age
Nutritional status Stunting (Ht/Ag%) Wasting (wt/Ht%)
Normal >95 >90
Mildly impaired 87.5 - 95 80 – 90
Moderately impaired 80 – 87.5 70 – 80
Severely impaired <80 <70
