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Primary health care


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Primary health care

  1. 1. Gilbert T. Salacup RN, MSN
  2. 2. TYPES OF PRIMARY HEALTH WORKERS AUXILLARY INTERMEDIATE LEVEL ANCILLARY VILLAGE/GRASSROOTS HEALTH General Medical Practitioners HEALTH PERSONNEL OFC WORKERS Public Health nurses 1st LINE HOSPITALSH Trained community Midwives Physicians with specialty Health worker; health auxiliary NursesA volunteer; Traditional birth attendant DentistsR    Initial link, 1st contact of the 1st source of professional Establish closeA community Health care contact with the village  Work in liaison w/ the local  Attend to health problems beyond the & intermediate levelC health service workers competence of village health workers health workers toT  Provide elementary curative  Provide support to the frontline health promote the continuity of preventive health care workers in terms of supervision, acre from hospital toE measures training, referral services & supplies community to home.R thru linkages with other sectors  Provide back-up health services for casesI requiring hosp or dxS facilities not available in HCT VILLAGE/GRASSROOTS HEALTH General Medical Practitioners HEALTH PERSONNEL OFI WORKERS Public Health nurses 1st LINE HOSPITALS Trained community Midwives Physicians with specialtyC Health worker; health auxiliary NursesS volunteer; Traditional birth attendant Dentists
  3. 3. WHO Definition Healtha state of complete physical, mental, & social well-being and not merely the absence of adisease, illness or infirmity WHO: Health is a social phenomenonHealth as a result of interplay of diff. societal factors:-Biological, Physical- heat, temp, Ecological- adaptation to envt.- Political, Economic, Social culturalIt is an outcome of many theories : Multi-Causal Theory of Health, Disease & Death Multi Casual theory- holistic- General systems theoryCONCEPTS OF HEALTH:1. WHO !Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.2.Claude Bernard !Health is the ability to maintain INTERNAL MILIEU. Illness is the result of failure to maintain.3.Walter Cannon !Ability to maintain HOMEOSTASIS or dynamic equilibrium.
  4. 4. !Health is being well and using one’s power to the fullest1. Nightingale extent. Health is maintained through prevention of disease via ENVIRONMENTAL HEALTH FACTORS. !Individual’s ability to perform 14 components of nursing2. Virginia Henderson unaided. !Positive health symbolizes WELLNESS.3. Martha Rogers !State and process of being and becoming an integrated4. Sis. Callista Roy and whole person. !State that is characterized by soundness or wholeness5. Dorothea Orem human structures and of bodily and mental functioning. !Dynamic state in the life cycle. Illness is an interference6. Imogene King in the life cycle. !Wellness is the condition in which all parts and subparts7. Betty Neuman of an individual are in harmony with the whole system. !elusive, dynamic state influenced by BIOLOGIC,8. Dorothy Johnson PSYCHOLOGIC and SOCIAL FACTORS.
  5. 5. Diseases Vaccin Minimum Dose No. of Site Route Interval Reasons e Age Dose1. Tuber- BCG At birth / 0.05 ml 1 RDeltioid ID Given at earliest possibleculosis anytime age protects against the 0.10 ml L Deltoid possibility of infection from School other family members. entrance2. Measles Measl 9 mons. 0.5 ml 1 Outer part Subcu At least 80% of measles can es of the artm be prevented by immunization at this age.3.Diptheria Upper outer Pertusis DPT1 1 ½ mos. 0.5 ml 3 IM Z 4 wks. An early start with DPT portion of techniq reduces the chance of Tetanus DPT2 2 ½ mos. the thigh ue severe pertusis. DPT3 2 ½ mos.4.Hepatitis Hepa 1 ½ mos. 0.5 ml 3 Upper Intramu 4 wks. An early start of Hepatitis B B1 outer s-cular reduces the chance of B 2 ½ mos. portion of being infected and Hepa the thigh / becoming a carrier. 2 ½ mos. B2 anterior Hepa thigh B35. Polio- OPV1 1 ½ mos. 2 drps 3 Mouth Orally 4 wks. The extent of protection or gtts. against polio is increased Myelitis OPV2 2 ½ mos. the earlier the OPV is given.
  6. 6. Most sensitive -15to – 25 C OPV LIQUID12 -15to – 25 C MV FREEZE DRIED3 2-8 C BCG FREEZE DRIED4 2-8 C DPT LIQUID5 2-8 C HBV LIQUID6 least sensitive 2-8 C TT LIQUID
  7. 7. Disease Vaccine Minimum Age Dose Route Site Percent Duration of Protection Interval ProtectedTetanus TT1 At 5th – 6th month of 0.5 ml Deep intra – Deltoid region 80% pregnancy muscular of the arm Varies 1 yr TT2 At least 4 wks after 0.5 ml Deep intra – Deltoid region 80% - Infants born will TT1 muscular of the arm be protected from neonatal tetanus. - 3 yrs protection for the mother. TT3 At least 5-6 mons. 0.5 ml Deep intra – Deltoid region 90% - Infants born will later of 2nd muscular of the arm be protected from neonatal tetanus. pregnancy regardless of - 5 yrs. Protection interval for the mother. TT4 At least 5-6 mons. 0.5 ml Deep intra – Deltoid region 99% - Infants protected Of 3rd pregnancy. muscular of the arm from Neonatal Tetanus. Regardless of interval` - 10 yrs. Protection for the mother. TT5 At least 5-6 mons. 0.5 ml Deep intra – Deltoid region 99% -lifetime Of 4th pregnancy. muscular of the arm protection. Regardless of - All infants born interval` to that mother will be protected.
  8. 8. Cross- Sectional (Present) Prospective Cohort (future)Retrospective (Past)Case Control study Prevalence study- old - Incidence or new & new cases cases-Show an association -Get prevalence ofbet. the risk factor & disease (Lung CA)disease - Get prevalence of risk factor (smoking)  
  9. 9. 10 Leading Causes of Morbidity 10 Leading Causes of Mortality•P - neumonia --bacterial 1. Di -sease of the heart•Di -arrhea 2. Di -seases of the vascular system•Bro - nchitis 3. Ma -lignant neoplasm•In - fluenza -respiratory 4. P -neumonia•H - ypertension 5. A- ccidents•Tu - berculosis respiratory 6. TB –all forms•Di -seases of the heart 7. CO -PD•Ma - laria 8. Con -ditions originating in perinatal period•Chick -enpox 9. DM•Me -asles 10. N - ephritis, nephritic syndrome
  10. 10. Fluids Frequent feeding Fast Referral◊ Oresol Rehydration ◊ Continue breastfeeding/ If child doesn’t get better in 3Therapy SF days, or if danger signs ◊ With children over 6 develop-refer patient◊ Encourage/ensure intake mos; cereals/ starchy of any fruit juices, “am”, Danger signs: foods mixed with meat or “lugaw”, homemade fish & vegetables ◊Fever soup ◊ Mashed banana or any ◊Sunken fontanel fresh fruit ◊Sunken eyeball ◊ Feed the child at least ◊Frequent watery stools 6x/day ◊Repeated vomiting ◊ After diarrhea episode, ◊Blood in stool feed 1 extra meal/day for ◊Poor intake of meals 2 weeks ◊Weakness
  11. 11. Breastmilk FormulaCHO Increase decreaseCHON (LACTALBUMIN) (CASEIN)Fats = =Linoleic acid content (3x) DecreaseMinerals decrease Increase
  12. 12. SCHISTOSOMIASIS H-FEVER FILARIASIS CONTROL PROGRAM (DENGUE) CONTROL PROGRAMSchistosomiasis- Dengue- > A mosquito borne disease caused by a tissue nematode A parasitic infection caused Acute febrile infection of attacking the lymphaticby blood flukes inhabiting sudden onset, caused by system of humans therebythe veins of their vertebral Aedes Aegypti, vector causing elephantiasis,victims transmitted thru skin mosquito lymphedema & hydrocelepenetration causing diarrhea,ascites, hepatosplenomegaly > Started in 1957 as an operational research of malaria. Eradication Service Three Filaria Control were established & later on integrated with the Regional Health OfficersActivities: Activities: Activities:> C -ase Finding >Case Finding >Case Finding> S - urveillance of the Early reporting of any >Early reporting of anydisease known case or outbreak known case of outbreak> H - ealth education- D H – ealth educationencourage use of rubber L N – et mosquitoboots for protection S -Stagnant> E - nvironmentalSanitation-proper disposal of U - rbanfeces> S - nail Eradication- use ofmoluscides
  13. 13. Targeted Food Task Nutrition Rehabilitation Akbayan sa Kalusugan Force Assistance Ward (ASK Project) ProgramProvision of food Every hospital must Aimed to provide rice &rations of bulgur wheat have a Nurse ward, corn soya blend& green peas where an adequately supplemented with trained nutritionist local foods.Target population: were assigned (RA 422) Target pop: Pre-schoolers 6 mos- 2 years Pregnant women Moderately & severely Lactating mothers underweight Pre-schoolers not served by the DSWD and DA in Regions 2,8,9,10,11,12
  14. 14. Generics Act of 1988 Dangerous Drugs Act R.A. # 6675 R.A. 6425“Formally proclaims the state of promoting the use “ The safe administration & transportation ofof generic terminology in the importation, prohibited drugs is punishable by law.”manufacture, distribution, marketing, promotion & 2 Types of Drugs:advertising, labeling, prescribing & dispensing ofdrugs.” Prohibited Regulated“Reinforces the NDP with regards to the assurance LSD Benzodiazepinesof the high-quality & rational drug use.” Eucaine Barbiturates Cocaine/ codeine, Opiates
  15. 15. Level 1 Level II Level III Point Source Communal Faucet Waterworks System/ System/ Stand Posts Individual House ConnectionsA protected well of a A system composed of a A system with a source, adeveloped sprung with an source, a reservoir, a reservoir, a pipedoutlet but w/o a piped distribution network distributor network &distribution system for & communal faucets, household tap that isrural areas where houses located at not more than suited for denselyare thinly scattered. 25 meters from the populated urban areas. farthest house in rural areas where houses are clustered densely.
  16. 16. Level 1 Level 2 Level 3 Non- water carriage On site toilet facilities Water carriage types toilet facility: of the water carriage of toilet facilities-P-it Latrines type with water sealed connected to septic-R-eed Odorless Earth & flushed type with tanks & /or to septic vault/tank sewerage system to disposal facilities. treatment plant.Closet- Compost-Bored-Hole-Ventilated improvedpitToilets requiringsmall amount of waterto wash waste intoreceiving space-Pour flush, Aqua
  17. 17. Household CommunityBurial Sanitary Landfill orDeposited in 1m x 1m deep pits Controlled Tippingcovered with soil, located 25m away from > Excavation of soilwater supply deposition of refuse &-Grinding and disposal sewer compacting with a solid cover of 2 feet-Animal feeding - Incineration-Composting-- Open burning