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Health Care Programs


Published on

A powerpoint presentation about Health Care Programs in the Philippines

by Paolo Zabat, RN

Published in: Education

Health Care Programs

  2. 2. PARADIGM OF PHC Essential Health Care e.g. Family health EPI Family planning Infant breast feeding Community based Individuals/ Families Universally accessible Primary Health Workers Social Development
  3. 3. ESSENTIAL HEALTH CARE PROGRAMS 1. Family Health Program 2. Prevention and Control of Noncommunicable Diseases (NDCs) Prevention and control of Communicable disease Environmental Health and Sanitation Other priority health programs 3. 4. 5.
  4. 4. FAMILY HEALTH PROGRAMS   The DOH – Family Health Office is tasked to operationalized health programs geared towards the health of the family. It 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.
  5. 5. FAMILY HEALTH PROGRAMS The following are the family health programs: 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 
  7. 7.  WHO Philippines MCH Program works with local public health departments, community based organizations, statewide organizations and other providers to provide and/or assure quality health services are delivered to mothers, children, and families in the country. The primary areas of work focus are:  Increasing healthy birth outcomes;  Promoting and assuring comprehensive primary care for children, from birth to 21 year olds, including children with special health care needs;  Promoting healthy lifestyles among school-age youth, ages 6-21, including children with special health care needs;  Promoting access to safe, healthy child care, including children with special health care needs; and
  9. 9. MATERNAL HEALTH PROGRAM 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 toxoid 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 and Vit. A deficiency. 4. Treatment of diseases and other conditions - These is for the women who is diagnosed as under the high risk
  10. 10. MATERNAL HEALTH PROGRAM IDEAL FREQUENCY OF PRENATAL VISITS DURING THE DURATION OF PREGNANCY PRENATAL VISITS PERIOD OF PREGNANCY FIRST VISIT As early as possible before 4 months or during 1st trimester SECOND VISIT During the second trimester During the third trimester After 8 months until THIRD VISIT EVERY 2 WEEKS
  11. 11. TETANUS TOXOID Vaccine Minimum Age Interval Percent Protected Duration of Protection TT1 As early as possible during pregnancy 80% TT2 At least 4 weeks later 80% • Gives 3 years protection for the mothers TT3 Atleast 6 months later 90% • Gives 5 years protection for the mothers TT4 Atleast 1 year later 99% • Gives 10 years protection for the mothers TT5 Atleast 1 year later 99% • Gives lifetime protection for the mothers When given to women of childbearing age, vaccines that contain tetanus toxoid not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants.
  13. 13. FAMILY PLANNING PROGRAM Brief Description of Program  A national mandated priority public health program to attain the country's national health development: a health intervention program and an important tool for the improvement of the health and welfare of mothers, children and other members of the family. It also provides information and services for the couples of reproductive age to plan their family according to their beliefs and circumstances through legally and medically acceptable family planning methods.
  14. 14. FAMILY PLANNING PROGRAM The program is anchored on the following basic principles.  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. And beyond responsible parenthood is Responsible Parenting which is the proper upbringing and education of chidren so that they grow up to be upright, productive and civic-minded citizens.  Respect for Life. The 1987 Constitution states that the government protects the sanctity of life. Abortion is NOT a FP method.  Birth Spacing refers to interval between pregnancies (which is ideally 3 years). It enables women to recover their health improves women's potential to be more productive and to realize their personal aspirations and allows more time to care for children and spouse/husband,.  Informed Choice that is upholding and ensuring the rights of couples to determine the number and spacing of their children according to their life's aspirations and reminding couples that planning size of their families have a direct bearing on the quality of
  15. 15. 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. In 2003, among married women, 48.8% use any form of contraceptive method and 51.1% do not use any form of contraceptive method at all.
  16. 16. FAMILY PLANNING PROGRAM GOAL:  To provide universal access to family planning information and services wherever and whenever these are needed. It aims to contribute to Reduce neonatal, infant, under-five and maternal deaths. 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.  Ensure that quality FP services are available in DOH retained hospitals, LGU managed health facilities and private sector.
  17. 17. TYPES OF FAMILY PLANNING NATURAL • Standard Days Method • Lactational Amennorhea Method • Basal Body Temperature • Billings Ovulation/Cervical Mucus Method • Symptothermal Method ARTIFICIAL • • • • Condom Injectables Oral Contraceptive Pills Intrauterine Device PERMANENT • Vasectomy • Bilateral Tubal Ligation
  18. 18. STANDARD DAYS METHOD Is the most appropriate for women who usually have cycles between 26 and 32 days long.  95% effective  Uses cycle beads to determine fertile days.  N A T U R A L
  19. 19. STANDARD DAYS METHOD N A T U R A L Steps: 1. Count the first day of your menstrual bleeding as DAY 1. 2. On days 1 to 7, you can have unprotected intercourse. 3. On days 8 to 19, you should use a barrier method or avoid intercourse. 4. From day 20 through the end of the cycle, you can have unprotected intercourse.
  20. 20. CYCLE BEADS N A T U R A L
  21. 21. LACTATIONAL AMENORRHEA METHOD (LAM) A temporary postpartum method of postponing pregnancy based on the physiological infertility experienced by breast-feeding mothers.  The mother may ovulate but not menstruate while breast-feeding.  N A T U R A L  Advantage: Easily accomplished by all postpartum lactating mothers  99.5% effective
  22. 22. BASAL BODY TEMPERATURE It is used 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.  99% effective  Based on the fact that: ◦ Before the day of ovulation, a woman’s BBT falls about half a degree. ◦ At the time of ovulation, her BBT rises a full degree because of the influence of progesterone. This is maintained for the rest of her menstrual cycle.  N A T U R A L
  23. 23. BILLINGS OVULATION / CERVICAL MUCUS METHOD Abstaining from sexual intercourse during fertile (wet) days of spinnbarkeit mucus and 3 days after the peak day.  97% effective  Advantage: Can be used by healthy women with no known diseases  Disadvantage: Not so reliable  N A T U R A L
  24. 24. BILLINGS OVULATION / CERVICAL MUCUS METHOD  N A T U R A L  During ovulation, cervical mucus is copious, thin, watery, transparent, feels slippery and stretches at least 1 in before strand breaks. The stretchability of the mucus is described by its spinnbarkeit, having the raw egg white quality that is easier for sperm to penetrate. After ovulation, the character of cervical mucus changes, and under the influence of progesterone it becomes thick, scant, and tacky; mucus doesn’t stretch when pulled between the thumb and finger. Sperm typically cannot
  25. 25. SYMPTOTHERMAL METHOD It is the combination of Basal Body Temperature and Billings method.  98% effective  N A T U R A L
  26. 26. RHYTHM METHOD Calendar method  It is abstaining from coitus 3 or 4 days before ovulation until 3 or 4 days after ovulation.  The woman determines the number of days per menstrual cycle for 6 cycles. Calculation:  N A T U R A L Subtract 18 from the shortest cycle – first fertile day  Subtract 11 from the longest cycle – last fertile day Ex. Range from 25 to 29 days 25 29 - 18 - 11 7th to 18th day – fertile days (12) 1st to 6th day; 19th to 29th day – non-fertile days 
  27. 27. COITUS INTERRUPTUS Method of contraception where couple proceeds with coitus until moment of ejaculation and the man withdraws so that the spermatozoa are emitted outside the vagina.  Disadvantages:  N A T U R A L   Presence of few spermatozoa in preejaculation fluid Lack of control
  28. 28. CONDOM 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 DISADVANTAGES  98% effective ADVANTAGES  A R T I F I C I A L • Safe and has no hormonal effect • Protects against microorganims • Easily accessible • Used in managing premature ejaculation • May cause allergy to latex • May decrease sensation • Interrupts the sexual act • Requires man’s cooperation
  29. 29. INJECTABLES  A R T I F I C I A L  It contains synthetic hormone, progestin which suppresses ovulation; thickens the cervical mucus thus making it difficult for sperm to pass through Advantages:  Reversible and no daily intake  No sexual inference  No estrogen related effects  Doesn’t affect breastfeeding  99.95% effective
  30. 30. ORAL CONTRACEPTIVE PILLS   A R T I F I C I A L   Pill contains hormones: estrogen and progesterone, taken daily to prevent conception. 99.7% effective Advantages:  Safe, convenient and easy to use, 3% failure  Reduces gynecological symptoms like painful menstruation and reduce the risk of ovarian and endometrial cancers Disadvantages:  Has side effects like: nausea, dizziness, breast tenderness, blurring of vision  Suppresses lactation
  31. 31. INTRAUTERINE DEVICE A long term birth control method that is a small, Tshaped plastic device that is wrapped in copper or contains hormones.  A plastic string is tied to the end of the IUD hangs down through the cervix into the vagina.  99.4% effective and can last up to 10 years.  A R T I F I C I A L
  32. 32. VASECTOMY The vas deferens is blocked or cut, to prevent the passage of sperm.  99.9% effective  Birth control should be used until two negative sperm reports have been examined  P E R M A N E N T
  33. 33. BILATERAL TUBAL LIGATION (BTL)   P E R M A N E N T  Involves the cutting or blocking of the 2 fallopian tubes. 99.5% effective Advantages:  Permanent method of contraception  No repeated clinic visits  Does not interfere with sex – result to increase enjoyment  No known side effects
  35. 35. CHILD HEALTH PROGRAMS   Newborns, infants and children are vulnerable age group for common childhood diseases. To address problems, child health programs have been created and available in all health facilities which includes:  Infant and Young Child Feeding  Newborn Screening (NBS)  Expanded Program on Immunization (EPI)  Management of Childhood Illnesses  Micronutrient Supplementation  Dental Health  Early Child Development  Child Health Injuries  GOAL: Reduce morbidity and mortality rates for children 0 – 9 years with the strategies necessary for program
  36. 36. INFANT AND YOUNG CHILD FEEDING There is global evidence that good nutrition in the early months and years of life plays a very significant role, affecting not only the health and survival of infants and children but also their intellectual and social development, resulting in life-long impact on school performance and overall productivity.  Breastfeeding, especially exclusive breastfeeding during the first half-year of life is an important factor that can prevent infant and childhood morbidity and mortality.  Timely, adequate, safe and proper complementary feeding will prevent childhood malnutrition. 
  37. 37. INFANT AND YOUNG CHILD FEEDING BREASTFEEDING 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 BENEFITS FOR THE MOTHERS INFANT • Reduces excessive • A complete food for the blood loss after birth infants • Natural method of • Strengthen immune delaying pregnancies system thus preventing • Reduces the risk of infections ovarian and breast • Increases IQ points cancers
  38. 38. INFANT AND YOUNG CHILD FEEDING 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 (RA 7600)  Requires both public and private institution to promote rooming-in, it encourage and support the practice of breastfeeding  Food Fortification Law (RA 8976)  An act establishing the Philippine food fortification Program and for other purpose
  39. 39. FOOD FORTIFICATION 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.  The law requires a mandatory food fortification of staple foods – rice, flour, edible oil, and sugar and voluntary food fortification of processed food and food products. (Vitamin A, Iron, Iodine)  Fortification is “the addition of one or more essential nutrients to food, whether or not it is normally contained in the food, for the purpose of preventing or correcting a demonstrated deficiency of one or more nutrients in the population or specific population groups” 
  40. 40. NEWBORN SCREENING Newborn Screening Act of 2004 (RA 9288).  Newborn screening (NBS) is a public health program aimed at the early identification of infants who are affected by certain genetic/ metabolic/ infectious conditions.  Early identification and timely intervention can lead to significant reduction of morbidity, mortality, and associated disabilities in affected infants. 
  41. 41. NEWBORN SCREENING Newborn screening is ideally done on the 48th – 72nd hour of life. However, it may also be done after 24 hours from birth.  A few drops of blood are taken from the baby’s heel, blotted on a special absorbent filter card and then sent to Newborn Screening Center (NSC). 
  42. 42. DISORDERS TESTED FOR NEWBORN SCREENING      CH (Congenital Hypothyroidism) CAH (Congenital Adrenal Hyperplasia) GAL (Galactosemia) PKU (Phenylketonuria) G6PD (Glucose-6-Phosphate Dehydrogenase)
  43. 43. DISORDERS TESTED FOR NEWBORN SCREENING    CH – results from lack or absence of thyroid hormone which is essential for the physical and mental development of a child. CAH – is an endocrine disorder that causes severe salt loss, dehydration and abnormally high levels of male sex hormones in both boys and girls. If not detected and treated early, babies with CAH may die within 7-14 days. GAL – is a condition in which babies are unable to process galactose, the sugar present in milk. Accumulation of excessive galactose in the body can cause many problems, including liver damage, brain damage and cataracts.
  44. 44. DISORDERS TESTED FOR NEWBORN SCREENING   PKU – is a rare condition in which the baby cannot properly use one of the building blocks of protein called phenylalanine. Excessive accumulation of phenylalanine in the blood causes brain damage. G6PD – is a condition where the body lacks the enzyme called G6PD. Babies with this deficiency may have hemolytic anemia resulting from exposure to oxidative substances found in drugs, foods and chemicals.
  45. 45. NEWBORN SCREENING DISORDERS SCREENED Effect if NOT SCREENED Effect if SCREENED and Managed CH Severe Mental Retardation Normal CAH Death Alive and normal GAL Death or Cataracts Alive and normal PKU Severe Mental Retardation Normal G6PD Deficiency Severe anemia, Kernicterus Normal
  46. 46. EXPANDED PROGRAM ON IMMUNIZATION The EPI was launched in July 1976 by the DOH in cooperation with WHO and UNICEF.  The original objective was to reduce the morbidity and mortality among infants and children caused by the seven childhood diseases.  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  st
  47. 47. EXPANDED PROGRAM ON IMMUNIZATION Republic Act No. 10152  “Mandatory Infants and Children Health Immunization Act of 2011 signed by President Benigno Aquino III in July 26, 2010.  The mandatory includes basic immunization for children under 5 including other types that will be determined by the Secretary of Health.
  48. 48. EXPANDED PROGRAM ON IMMUNIZATION  Four major strategies: ◦ Sustaining high routine FIC coverage of atleast 90% ◦ Sustaining polio free country for global certification ◦ Eliminating measles by 2008 ◦ Eliminating neonatal tetanus by 2008   Immunization is the process by which vaccines are introduced into the body before injection sets in. Vaccines are administered to induce immunity thereby causing the recipient’s immune system
  49. 49. EXPANDED PROGRAM ON IMMUNIZATION GUIDELINES  It is safe and immunologically effective to administer all EPI vaccines on the same day at different sites of the body.  Moderate fever, malnutrition, mild respiratory infection, cough, diarrhea and vomiting are not contraindicated to vaccination.  DPT2 and DPT3 are contraindicated to a child who has had convulsion or shock within 3 days the previous dose.  Live vaccines like BCG must not be given to individuals who are immunosuppressed due to malignant disease, therapy with immunosuppressive agents or irradiation.  It is safe and effective with mild side effects after vaccination. (Ex: Local reaction, fever)  Repeat BCG vaccination if the child does not develop a scar after the first injection.  BCG immunization shall be given to all school entrants both in private and public schools regardless of the presence or absence of BCG scar.
  50. 50. EXPANDED PROGRAM ON IMMUNIZATION Vaccine Minimum Age at 1st Dose Number of Doses Minimum Interval Between Doses Reason BCG Birth or anytime after birth 1 DPT 6 weeks 3 4 weeks Reduces the chance of pertussis OPV 6 weeks 3 4 weeks Protection against Polio Disease BCG protects the infant from possibility of TB meningitis & other TB infections
  51. 51. EXPANDED PROGRAM ON IMMUNIZATION Vaccine Minimum Age at 1st Dose Number of Doses Minimum Interval Between Doses Reason Hepatitis B At birth 3 6 weeks interval from 1st dose to 2nd dose; 8 weeks interval from 2nd to 3rd dose Reduces the chance of being infected and becoming a carrier Measles 9 months 1 Prevents deaths, malnutrition and protection from measles
  52. 52. EXPANDED PROGRAM ON IMMUNIZATION Type/Form of vaccine Storage Temperature 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 Temperature Least 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) Most Sensitive to Heat
  53. 53. EXPANDED PROGRAM ON IMMUNIZATION Vaccine Dose Route of Administration Site of Administration BCG 0.05 ml Intradermal Right deltoid region DPT 0.5 ml Intramuscular Upper outer portion of the thigh OPV 2 drops Oral Mouth Measles 0.5 ml Subcutaneous Outer part of the arm Hepa B 0.5 ml Intramuscular Upper outer portion of the thigh Tetanus Toxoid 0.5 ml Intramuscular Deltoid region
  54. 54. NUTRITION PROGRAM     Malnutrition continues to be a public health concerns in the country. The common nutritional deficiencies are Vitamin A, Iron and Iodine. GOAL: To improve quality of life of Filipinos through better nutrition, improved health and increased productivity. Programs and projects are: Micronutrient supplementation, food fortification, nutrition information, communication and education, home, school and community food production and food assistance.
  55. 55. MICRONUTRIENT SUPPLEMENTATION   It is one of the interventions to address the health and nutritional need of infants and children and improve their growth and survival. The twice-a-year distribution of Vitamin A capsules through the “Araw ng Sangkap Pinoy” (ASAP), known as Garantisadong Pambata or Child Health Week is the approach adopted to provide micronutrient supplements to 6-71 months old preschoolers on a nationwide scale.
  56. 56. DENTAL HEALTH    Oral disease continues to be a serious public health problem in the Philippines. The prevalence of dental caries on permanent teeth has generally remained above 90% throughout the years. About 92.4% of Filipinos have tooth decay (dental caries) and 78% have gum diseases (periodontal diseases) Although preventable, these diseases affect almost every Filipino at one point or another in his or her lifetime. Goal: Attainment of improved quality of life through promotion of oral health and quality
  57. 57. DENTAL HEALTH Dental Health Objectives: The prevalence of dental caries is reduce  The prevalence of periodontal disease is reduced  Dental caries experience is reduced  The proportion of Orally Fit Children (OFC) 12-71 months old is increased 