COMMUNITY HEALTH LEC number of diphtheria cases were reported in the

National Capital Region, Region IV-A and

NCM 104
Cordillera Autonomous Region.
• MEASLES
In February 2019, the Department of Health
TOPIC 1: Overview of Public Health declared a measles outbreak in five regions in the
Nursing in the Philippines country, including Metro Manila. From 1 January
to 12 October 2019, over 42,400 cases were
Current Issues in Public Health Care
reported by DOH. Severe complications from
• The Philippines in midst of 'health care crisis'
measles have also claimed the lives of over 560
(Yee, 2019) , Health workers' groups warned that
people. As of 25 October, the reported cases of
the government's health programs are bound to
measles are declining as well as the case fatality
falter if it fails to address the "health crisis"
rate.
besetting the country. In addition to outbreaks of
• POLIO
infectious diseases, the groups said the health
On 19 September, the Department of Health
sector remains grossly underfunded with hospitals
confirmed the re-emergence of polio in the
still understaffed and personnel still underpaid.
Philippines and declared a national polio outbreak.
• One of the culprits is the onerous practice of
As of 25 October, thirteen environmental samples
contractualization, especially in government
and three human samples of vaccine-derived polio
hospitals. Nurses are no longer willing to work in
virus have been confirmed. Between October 2019
the country's hospitals because, aside from being
and January 2020, 4.4 million children under 5
unprotected by law, they are also overworked and
years of age will be vaccinated through vaccination
underpaid, Abenojar (2019)
campaigns.
• "Health workers have been unhealthy and
• CORONAVIRUS DISEASE (COVID-19) IN
uncared for despite [sometimes] enduring 16 hours
THE PHILIPPINES
of duty. We have seen a historical increase in the
- On 30 January 2020, the Philippine The
number of contractual health workers receiving
Department of Health
floor wages without security of tenure, few or
reported the first case of COVID-19 in the country
absent benefits but with huge workloads,
with a 38-year-old female Chinese national. On 7
(Mendoza) 2019
March, the first local transmission of COVID-19
• "There are a lot of DOH programs that will not be
was confirmed. WHO is working closely with the
implemented properly if there's not enough
Department of Health in responding to the
personnel. That alone should already make the
COVID-19 outbreak.
government think about its priorities, that this is an
- The coronavirus disease (COVID-19) is an
urgent and vital matter that should be addressed,
infectious disease
(Mendoza) 2019
caused by a new strain of coronavirus. This new
virus and disease were unknown before the
Global and National Health Situations
outbreak began in Wuhan, China, in December
• DENGUE (AEDES AEGYPTI)
2019.
On 6 August, the Department of Health declared a
dengue epidemic. With nearly 361,000 dengue
PUBLIC HEALTH
cases recorded and 1,373 deaths, the current
Is a science and art of preventing disease,
dengue epidemic is the largest in the last ten years,
prolonging life, promoting health and
or since the disease has been monitored in the
efficiency thru' organized community effort
Philippines.
for
• DIPHTHERIA
1. Sanitation of the environment
Almost 200 cases of diphtheria were reported by
2. Control of communicable diseases
the Department of Health for the period from 1
3. Education of individuals in personal
January to 5 October 2019, an increase of 47%
hygiene
compared to the same period in 2018. A significant
4. Organization of medical and nursing
services for the early diagnosis and preventive collaboration with others to the promotion of the
treatment of diseases client's optimum level of functioning thru' teaching
5. Development of social machinery to ensure and delivery of care (Johnson)
everyone a standard of living adequate for the • A service rendered by a professional nurse to
maintenance of health, so organizing the benefits as IFCs, population groups in health centers,
to enable every citizen to realize his birthright of clinics,schools, and the workplace for the
birth and longevity” (DR. C.E. Winslow) promotion of health, prevention of illness,care of
the sick at home and rehabilitation (DR. Ruth B.
PUBLIC HEALTH NURSING Freeman)
• Is the practice of promoting and protecting the • Philosophy of CHN "The philosophy of CHN is
health of populations using knowledge from based on the worth and dignity of the worth and
nursing, social, and public health sciences. dignity of man." (Dr. M. Shetland)
• Evaluations are conducted to determine the extent
to which the intervention has an impact on the Basic Principle of CHN
health status of individuals and the population. 1. The community is the patient in CHN, the
• Public health nurses are trained and educated to family is the unit of care and there are four levels of
assess the population overall of the world. Whereas clientele: individual, family, population group
the community of health nurse's knowledge lies (those who share common characteristics,
within assessing the needs of individuals and developmental stages and common exposure to
families within the population that they work. health problems - e.g. children, elderly), and
• Public Health includes community health. the community.
2. In CHN, the client is considered as an
COMMUNITY HEALTH ACTIVE partner NOT PASSIVE recipient of care
• Part of paramedical and medical 3. CHN practice is affected by developments in
intervention/approach which is concerned on the health technology, in particular, changes in society,
health of the whole population. in general
• Aims: 4. The goal of CHN is achieved through
1. Health promotion multi-sectoral efforts
2. Disease prevention 5. CHN is a part of health care system and the
3. Management of factors affecting health larger human services system.
Definition of Community Health Nursing
• "The utilization of the nursing process in the EVOLUTION of Public Health Nursing in the
different levels of clientele-individuals, families, Philippines
population groups and communities, concerned • Date Event
with the promotion of health, prevention of disease 1901- Act # 157 ( Board of Health of the
and disability and rehabilitation." (Maglaya, et al) Philippines) ; Act # 309 ( Provincial and Municipal
• Goal: "To raise the level of citizenry by helping Boards of Health) were created.
communities and families to cope with the 1905- Board of Health was abolished; functions
discontinuities in and threats to health in such a were transferred to the Bureau of Health.
way as to maximize their potential for high-level 1912- Act # 2156 or Fajardo Act created the
wellness" (Nisce, et al) Sanitary Divisions, the forerunners of present MOs;
• Special field of nursing that combines the skills of male nurses performs the functions of doctors
nursing, public health and some phases of social 1919- Act # 2808 (Nurses Law was created)
assistance and functions as part of the total public - Carmen del Rosario, 1st Fil. Nurse
health program for the promotion of health, the supervisor under Bureau of
improvement of the conditions in the social and Health
physical environment, rehabilitation of illness and Oct. 22, 1922- Filipino Nurses Organization
disability ( WHO Expert Committee of Nursing) (Philippine Nurses' Organization) was organized.
• A learned practice discipline with the ultimate 1923 - Zamboanga General Hospital School of
goal of contributing as individuals and in Nursing & Baguio General Hospital were
established; other government schools of nursing Jan. 1999 - Nelia Hizon was positioned as the
were organized several years after. nursing adviser at the Office of Public Health
1928-1st Nursing convention was held Services through Department Order # 29.
1940 - Manila Health Department was created. May 24, 1999 - EO # 102, which redirects the
1941 -Dr. Mariano Icasiano became the first city functions and operations of DOH, was signed by
health officer; Office of Nursing was created former President Joseph Estrada.
through the effort of Vicenta Ponce (chief nurse)
and Rosario Ordiz (assistant chief nurse)
Dec. 8, 1941 - Victims of World War II were Roles of the PUBLIC HEALTH NURSE
treated by the nurses of Manila. • Clinician, who is a health care provider, taking
July 1942 - Nursing Office was created; Dr. care of the sick people at home or in the RHU
Eusebio Aguilar helped in the release of 31 Filipino • Health Educator, who aims towards health
nurses in Bilibid Prison as prisoners of war by the promotion and illness prevention through
Japanese. dissemination of correct information; educating
Feb. 1946 - Number of nurses decreased from 556 people
- 308. • Facilitator, who establishes multi-sectoral
1948 - First training center of the Bureau of Health linkages by referral system
was organized by the Pasay City Health • Supervisor, who monitors and supervises the
Department. Trinidad Gomez, Marcela Gabatin, performance of midwives
Costancia Tuazon, Ms. Bugarin, Ms. Ramos, and • Health Advocator, who speaks on behalf of the
Zenaida Nisce composed the training staff. client
1950 - Rural Health Demonstration and Training • Advocator, who act on behalf of the client
Center was created. • Collaborator, who working with other health
1953 - The first 81 rural health units were team member
organized.
1957 - RA 1891 amended some sections of RA 1082 • In the event that the Municipal Health Officer
and created the eight categories of rural health unit (MHO) is unable to perform his duties/functions or
causing an increase in the demand for the is not available, the Public Health Nurse will take
community health personnel. charge of the MO's responsibilities.
1958-1965 - Division of Nursing was abolished
(RA 977) and Reorganization Act (E0 288) Responsibilities of CHN
1961 - Annie Sand organized the National League 1. Be a part in developing an overall health
of Nurses of DOH. plan, its implementation and evaluation for
1967 - Zenaida Nice became the nursing program communities
supervisor and consultant on the six special 2. Provide quality nursing services to the three
diseases (TB, leprosy, V.D., cancer, filariasis, and levels of clientele
mental health illness). 3. Maintain coordination/linkages with other
1975 - Scope of responsibility of nurses and health team members, NGO/government agencies
midwives became wider due to restructuring of the in the provision of public health services
health care delivery system. 4. Conduct researches relevant to CHN
1976-1986 - The need for a Rural Health Practice services to improve provision of health care
Program was implemented. 5. Provide opportunities for professional
1990- 1992- Local Government Code of 1991(RA growth and continuing education for staff
7160) development
1993-1998 - Office of Nursing did not materialize
in spite of persistent recommendation of the
officers, board members, and advisers of the
National League of Nurses Inc. TOPIC 2: The Health Care Delivery System
“ONE for ALL, ALL for ONE”
 Global and National Health System • The 17 Goals are all interconnected, and in order
Approach to leave no one behind, it is important that we
THE HEALTH CARE DELIVERY SYSTEM achieve them all by 2030
> Health care system is an organized plan of health
services. The rendering of health care services to The Sustainable Development Goals Action
the people is called the Health Care Delivery Towards 2030
System. • The SDGs follow the Millennium Development
> Thus, the health care delivery system is the Goals - or MDGs -agreed in 2000 in a global
network of health facilities and personnel which coordinated attempt to tackle development issues.
carries out the task of rendering health care to the • There are four underlying principles that come
people. with the SDGs and that are transformational in the
> In the Philippines health care system is a complex way we work on development in the future:
set of organizations interacting to provide an array 1. Firstly they are universal and apply to every
of health services. country, rich and poor, north and south, developed
and developing.
World Health Organization 2. Secondly, they integrate all dimensions of
•The World Health Organization is a specialized sustainability: economic development, social
agency of the United Nations responsible for progress and environmental protection.
international public health. 3. Thirdly, the SDGs tell us we should leave no
•The WHO Constitution, which establishes the one behind.
agency's governing structure and principles, states 4. And finally, the SDGs require the
its main objective as "the attainment by all peoples participation of all.
of the highest possible level of health.”
The 17 Sustainable Development Goals
Millenium Development Goals (SDGs) to transform our world:
1. Eradicate Extreme Poverty and Hunger 1. GOAL 1: NO POVERTY
2. Achieve Universal Primary Education By 2030, ensure that all men and women, in
3. Promote Gender Equality and Empower particular the poor and the vulnerable, have equal
Women rights to economic resources, as well as access to
4. Reduce Child Mortality basic services, ownership and control over land and
5. Improve Maternal Health other forms of 13 property, inheritance, natural
6. Combat HIV/AIDS and other Diseases resources, appropriate new technology and
7. Ensure Environmental Sustainability financial services, including micro-finance.
8. A Global Partnership for Development 2. GOAL 2: ZERO HUNGER
KEY FACTS By 2030, end all forms of malnutrition, including
- Globally, the number of deaths of children under 5 achieving, by 2025, the internationally agreed
years of age fell from 12.7 million in 1990 to 6.3 targets on stunting and wasting in children under 5
million in 2013. years of age, and address the nutritional needs of
- In developing countries, the percentage of adolescent girls, pregnant and lactating women and
underweight children under 5 years old dropped older persons.
from 28% in 1990 to 17% in 2013. 3. GOOD HEALTH AND WELL-BEING
4. QUALITY EDUCATION
SUSTAINABLE DEVELOPMENT GOALS 5. GENDER EQUALITY
• The Sustainable Development Goals are the 6. CLEAN WATER AND SANITATION
blueprint to achieve a better and more sustainable 7. AFFORDABLE AND CLEAN ENERGY
future for all. 8. DECENT WORK AND ECONOMIC
• They address the global challenges we face, GROWTH
including those related to poverty, inequality, 9. INDUSTRY, INNOVATION AND
climate change, environmental degradation, peace INFRASTRUCTURE
and justice. 10. REDUCED INEQUALITIES
 11. SUSTAINABLE CITIES AND • 1905- The Americans, led by Dean Worcester,
COMMUNITIES built the UP College of Medicine and Surgery.
12. RESPONSIBLE CONSUMPTION AND • 1909- nursing instruction was also begun at the
PRODUCTION Philippine Normal School. In terms of public
13. CLIMATE ACTION health, the Americans improved on the sewer
14. LIFE BELOW WATER system and provided a safer water supply.
15. LIFE ON LAND • In 1915- the Bureau of Health was reorganized
16. PEACE, JUSTICE AND STRONG and renamed into the Philippine Health Service.
INSTITUTIONS • On January 1, 1919, Dr. Vicente De Jesus
17. PARTNERSHIPS FOR THE GOALS became the first Filipino to head the Health
portfolio.
THE DEPARTMENT OF HEALTH • In 1933, after a reorganization, the Philippine
VISION: Health for all Filipinos Health Service reverted to being known as the
MISSION: Ensure accessibility & quality of health Bureau of Health.
care to improve the quality of life of all Filipinos, • By 1936, as Governor-General Frank Murphy was
especially the poor. assuming the post of United States High
Commissioner, he remarked that the Philippines
HISTORICAL BACKGROUND OF DOH led all oriental countries in terms of health status.
• The Department of Health (abbreviated as DOH; • In 1936- Dr. Jose Fabella was named chief of the
Filipino: Kagawaran ng Kalusugan) is the executive Bureau of Health.
department of the Government of the Philippines • When the Japanese occupied the Philippines, they
responsible for ensuring access to basic public dissolved the National Government and replaced it
health services by all Filipinos through the with the Central Administrative Organization of
provision of quality health care and the regulation the Japanese Army. Health was relegated to the
of all health services and products. Department of Education, Health and Public
• It is the government's overall technical authority Welfare under Commissioner Claro M. Recto.
on health. • In 1944- Dr. Antonio C. Villarama was appointed
• It has its headquarters at the San Lazaro Secretary of the Department of Health. First
Compound, along Rizal Avenue in Manila. secretary of health under Philippine Republic
AGENCIES attached to DOH SPECIALIZED HEALTH INSTITUTIONS
• Philippine Institute of Traditional and Alternative • June 2, 1978- the Department of Health was
Health Care transformed into the Ministry of Health with Dr.
• Philippine Health Insurance Corporation Clemente S. Gatmaitan as the first health minister.
• Philippine National AIDS Council • April 13, 1987, the Department of Health was
• Commission on Population created from the previous Ministry of Health with
• National Nutrition Council Dr. Alfredo R. A. Bengzon as secretary of health.
Usec David (2022) stated that the DOH eagerly • December 17, 2016 Health Secretary Paulyn
awaits the announcement of the name of the new Jean Rossel-Ubial announced that in 2017 the
Secretary of Health. government will start paying the hospital bills and
Usec. Maria Rosario Singh-Vergeire (OIC) medicines of poor Filipinos.
leads the DOH and Public Health Services Team
(PHST) LOCAL HEALTH SYSTEMS and Devolution
• September 10, 1898- Americans assembled a of Health Services
military Board of Health. To care for injured “First Wave of Health Sector Reform”
American troops.
• 1900- Bureau of Governmental Laboratories, Local Government code of 1991
which was built in 1901 for medical research and • The implementation of the Local Government
vaccine production to respond in an epidemic Code of 1991 resulted in the devolution of health
(200,222 lives including 66,000 children were lost) services to local government units (LGUs) which
included among others the provision, management
and maintenance of health services at different in order to raise the health conditions of barrio
levels of LGUs. people hence help decrease the high incidence of
• In 1991 the Philippines Government introduced a preventable diseases.
major devolution of national government services, R.A. 6425 - Dangerous Drugs Act. It stipulates
which included the first wave of health sector that the sale, administration, delivery, distribution
reform, through the introduction of the Local and transportation of prohibited drugs is
Government Code of 1991. punishable by law.
•The Code devolved basic services for agriculture R.A. 9165 - the new Dangerous Drug Act of 2002
extension, forest management, health services, P.D. No. 651 - requires that all health workers
barangay (township) roads and social welfare to shall identify and encourage the registration of all
Local Government Units. births within 30 days following delivery.
• In 1992, the Philippines Government devolved the P.D. No. 996 - requires the compulsory
management and delivery of health services from immunization of all children below 8 yrs. of age
the National Department of Health to locally against the 6 childhood immunizable diseases.
elected provincial, city and municipal governments. P.D. No. 825 - provides penalty for improper
(Grundy 2003) disposal of garbage.
R.A. 8749 - Clean Air Act of 2000
R.A. 7160: The Local Government Code P.D. No. 856 - Code on Sanitation. It provides for
- This involves the devolution of powers, the control of all factors in man's environment that
functions and responsibilities to the local affect health including the quality of water, food,
government both rural & urban. milk, insects, animal carriers, transmitters of
- Hence, each province, city and municipality disease, sanitary and recreation facilities, noise,
has a LOCAL HEALTH BOARD ( LHB ) which is pollution and control of nuisance.
mandated to propose annual budgetary allocations R.A. 6675 - Generics Act of 1988 which promotes,
for the operation and maintenance of their own requires and ensures the production of an adequate
health facilities. supply, distribution, use and acceptance of drugs
and medicines identified by their generic name
Composition of Local Health Board RA 4073 - advocates home treatment for leprosy
● Provincial Level RA 3573 - requires reporting of all cases of
1.Governor- Chair communicable diseases and administration of
2. Provincial Health Officer - Vice Chair prophylaxis
3. Chair, Committee on Health of Sangguniang Ministry Circular No. 2 of 1986 - includes
Panlalawigan AIDS as notifiable disease
4. DOH representative R.A. 8172 - Salt iodization Act (ASIN LAW)
5. NGO representative
● City and Municipal Level Philippine Health Care Delivery System
1. Mayor - Chair 1. PRIMARY LEVEL FACILITIES
2. MHO/CHO - Vice Chair 2. SECONDARY LEVEL FACILITIES
3. Chair, Committee on Health of Sangguniang 3. TERTIARY LEVEL FACILITIES
Bayan
4. DOH representative Classify as to what level the ff. belong
5. NGO representative 1. Teaching and Training Hospitals
2. City Health Services
LAWS AFFECTING PUBLIC HEALTH AND 3. Emergency and District Hospitals
PRACTICE 4. Private Practitioners
R.A. 1082 - Rural Health Act. It created the first 5. Heart Institutes
81 Rural Health Units. 6. Puericulture Centers
- amended by RA 1891 ; more physicians, 7. RHU
Dentists, nurses, midwives and sanitary inspectors
will live in the rural areas where they are assigned
 PHC Defined
TOPIC 3: PRIMARY HEALTH CARE Alma Ata Declaration:
PHC "is essential health care based on practical,
“GARANTISADONG PANG MASA”
scientifically sound and socially acceptable methods
Current issue of health and health care -
and technology made universally accessible to

✔️
Philippines 2020
individuals and families in the community through

✔️
Health quality of the population is challenging.
their full participation and at a cost that the
Vast majority of the population barely meet
community and country can afford to maintain at

✔️
health care.
every stage of their development in the spirit of
Health needs are not able to cope with the needs
self-reliance and self-determination".

✔️
of the citizens.
Continuous upward trend of communicable and
Health for All: Universal Goal of PHC

✔️
non-communicable diseases.
• "Health for All" means an acceptable level of
Hence, an approach in health services is
health for all the people of the world through
necessary - a strategy that is affordable to the
community and individual self-reliance.
government yet effective to the communities.
This policy agenda of "health for all by the
year 2000" technically, was a global strategy
Brief History of PHC
employed in achieving three main objectives:
September 6 to 12, 1978- health leaders (200
(1) promotion of healthy lifestyles,
countries) attended the Internationals Conference
(2) prevention of diseases, and
for PHC held at Alma Ata.
(3) therapy for existing conditions.
-Major concern- promotion and protection of the
health of the people.
"Health in the Hands of the People by 2020"
DECLARATION
• FIVE KEY ELEMENTS TO ACHIEVE THE
1. Health is a basic fundamental right.
GOAL
2. There exists global burden of health
1. Reducing exclusion and social disparities in
inequalities among the population.
health.
3. Economic and social development
2. Organizing health services around people's
4. Participation of government for the health
needs and expectations.
of the people.
3. Integrating health into all sectors.
October 19, 1979
4. Pursuing collaborative models of policy
Letter of Instruction 949 of 1979 or (LOI) 949 -
dialogue .
adaptation of the strategy, Philippines as the 1st to
5. Increasing stakeholder participation.
embark the challenge of PHC (Bautista 2011)
- Health care during that time was supported
EIGHT ESSENTIAL HEALTH SERVICES
by several non- government agencies and religious
E - Education for all
organizations, offering community health service in
L - Locally endemic disease control
rural areas of Visayas and Mindanao before the
E - Expanded program for Immunization
adoptionaga of PHC.
M -Maternal and child health including responsible
parenthood
DECLARATION of PHC
E - Essential drugs
• "HEALTH Is a state of complete physical, mental,
N -Nutrition
and social well being and not merely the absence of
T -Treatment of communicable and
the disease or infirmity" (WHO, 1978)
non-communicable disease
• WHO put emphasis on the social dimension of
S - Safe water and sanitation
health, that wellness can be achieved by
considering different factors that are
ELEMENTS OF PRIMARY HEALTH CARE
interdependently influencing the health of the
population. 1 Education for Health
 Is one of the potent methodologies for
Vaccine) 1 weeks
information dissemination. It promotes the IPV 14
partnership of both the family members and health (Inactivate weeks
workers in the promotion of health as well as d Polio
prevention of illness. Vaccine)

PCV Pneumococcal 3 (0.5ml) 6, 10,

2 Locally Endemic Disease Control (Pneumoco infections 14
ccal (e.g. weeks
The control of endemic disease focuses on Conjugate meningitis)
the prevention of its occurrence to reduce Vaccine)
morbidity rate.
Example: MCV Measles, 2 (0.5ml) 9-12
● Malaria Control (Measles Mumps, month
Containing Rubella s, 12-15
● Schistosomiasis Control
Vaccine) month
and MMR s
3 Expanded Program on Immunization (Measles,
Mumps,
This program exists to control the Rubella)
occurrence of preventable illnesses especially of
children below 6 years old. Immunizations on Rotavirus 2 (1.5ml) 6
Vaccine weeks,
poliomyelitis, measles, tetanus, diphtheria and
10
other preventable disease are given for free the weeks
government and ongoing program of the DOH.
age of a person should be fully vaccinated: 8
years old (include in prelim exam) 4 Maternal and Child Health and Family
Planning
Table 1: Philippine National Immunization
The mother and child are the most delicate
Schedule for Children 0 to 12 months of age
members of the community. So the protection of
(include in prelim exam)
the mother and child to illness and other risks
Vaccine/ Disease Doses Sched would ensure good health for the community. The
Antigen ule goal of Family Planning includes spacing of
children and responsible parenthood.
BCG Tuberculosis 1 Birth
(Bacillus (0.05ml) (within
Calmette-
Guerin)
24
hours)
5 Supply of Essential Drugs
- This focuses on the information campaign
HepB Hepatitis B 1 (0.5ml) Birth on the utilization and acquisition of drugs.
(monovale (within - In response to this campaign, the GENERIC
nt) 24 ACT of the Philippines is enacted .
hours)
- It includes the following drugs:
Pentavalen Diphtheria, 3 (0.5ml) 6, 10, Cotrimoxazole, Paracetamol, Amoxycillin, Oresol,
t vaccine tetanus and 14 Nifedipine, Rifampicin, INH(isoniazid) and
(DPT-Hep pertussis weeks Pyrazinamide, Ethambutol, Streptomycin,
B-HiB) Hepatitis B Albendazole, Quinine
Hemophilus
influenza type
B 6 Nutrition and Promotion of Adequate
Meningitis
Food Supply
OPV (Oral Poliomyelitis 3 (2 6, 10 - One basic need of the family is food.
Polio drops) ,14 - And if food is properly prepared then one
may be assured healthy family. 1. 4 A's- Accessibility. Affordability,
- There are many food resources found in the acceptability, availability.
communities but because of faulty preparation and 2. Support mechanisms
lack of knowledge regarding proper food planning 3. Multisectoral approach
- Malnutrition is one of the problems that we 4. Community participation
have in the country. 5. Equitable distribution of health resources
6. Appropriate technology

1 4 A's = Accessibility, Availability,

Affordability & Acceptability,
Appropriateness of health services.
•The health services should be present where the
supposed recipients are.
• They should make use of the available resources
within the community, wherein the focus would be
more on health promotion and prevention of
This reflects the principles of MOderation, VAriety illness.
and BAlance (MOVABA) to promote healthier AVAILABILITY
eating habits. ● Government-run drugstore
● “Ligtas Tigdas ang Pinas”
7 Treatment of Communicable Diseases
and Common Illness 2 SUPPORT MECHANISM
- The diseases spread through direct contact ● People
pose a great risk to those who can be infected. ● Government
- Tuberculosis is one of the communicable ● NGO (socio-civic groups and faith groups
diseases continuously occupies the top ten causes of
death.
- Most communicable diseases are also 3 Multisectoral approach
preventable. The Government focuses on the ● Intersectoral approach
prevention, control and treatment of these illnesses. ● Intrasectoral approach
Integrated Management of Childhood Illness
(IMCI) - STUDY THIS AND INCLUDE HERE!!!
4 COMMUNITY PARTICIPATION
- The heart and soul of PHC
8 Environmental Sanitation and - An educational and empowering process in
Promotion of Safe Water Supply which people, in partnership with those who are
- Environmental Sanitation is defined as the able to assist them, identify the problems and the
study of all factors in the man's environment, which needs and increasingly assume responsibilities
exercise or may exercise deleterious effect on his themselves to plan, manage, control and assess.
well-being and survival.
- Water is a basic need for life and one factor
in man's environment. Water is necessary for the 5 EQUITABLE DISTRIBUTION OF
maintenance of healthy lifestyle. HEALTH RESOURCES
- Safe Water and Sanitation is necessary for - Among health professionals employees by
basic promotion of health. the Philippine government, around 29% and 26% of
doctors and nurses respectively practice in the NCR
KEY PRINCIPLES OF PRIMARY HEALTH and Calabarzon (FgD 2020)
CARE - Doctor's to the Barrios (DTTB) Program-
deployment of doctors to municipalities that are
services Treatment
without doctors in 5th to 6th class municipalities by
for 2 years. Specialists
- Registered Nurses Health Enhancement and
Local Service (RN HEALS)- training and Tertiary Advanced, Rehabilita PT/OT
deployment program for unemployed nurses. They specialize tion
d,
served the unserved municipalities for 1 year to
diagnostic
address the inadequate nursing workforce. ,
therapeuti
6 APPROPRIATE TECHNOLOGY c, &
rehabilitat
- "Applied science" ive care
- Health technology- tools, drugs, methods,
procedures and techniques.
- Appropriate technology suitable for the PRIMARY SECONDAR TERTIARY
LEVEL Y LEVEL LEVEL
community.
- CRITERIA ( safe, effective, simple, Health Prevention of Prevention of
acceptable, feasible and reliable, ecological effect, Promotion and Compilations Disability
potential to contribute to individual and Illness thru Early
community development) Prevention Diagnosis and
Treatment
Levels of PREVENTION Provided at: When When
3 LEVELS OF HEALTH CARE 1. Health hospitalization highly-speciali
1. Primary Prevention care is deemed zed medical
2. Secondary Prevention (RHU) necessary and care is
3. Tertiary Prevention 2. Barang referral is necessary
ay made to referrals are
According to According to the health emergency made to
Increasing Type of Service Station (now district) hospitals and
Complexity of the s provincial or medical center
Services Provided 3. Main regional or such as POC,
health private PGH, NCMH,
Type Service Type Example center hospitals and other
4. Private government
Primary Health Health Informati and private
Promotion promotion on semi-p hospitals at
, and illness Dissemina rivate the municipal
Preventive Preventio tion agencie level
Care n s
Continuin
g Care for
common Referral System in Levels of the Health

✔️
health Care:
problems, Barangay Health Station (BHS) is under the
attention
✔️
management of Rural Health Midwife (RHM)
to
Rural Health Unit (RHU) is under the
psychologi

✔️
cal and management or supervision of PHN
social Public Health Nurse (PHN) caters to 1:10,000
care, population, acts as managers in the implementation
referrals of the policies and activities of RHU, directly under
the supervision of MH (who acts as administrator)
Secondary Surgery, Diagnosis Screening
Medical and
 8. Children not only have to respect their
TOPIC 4: The Family as Basic Unit of the parents and obey them, but also have to learn to
Society repress their repressive tendencies.
“The Strand of Community”
9. The older siblings have something of
FAMILY authority of their parents.
• A small social system and primary reference group
made up of two or more persons living together ⚫️ Nuclear family - a family unit consisting of
who are related by blood, marriage or adoption or two adults and any number of children living
who are living together by arrangement over a together. The children might be biological, step or

⚫️
period of time (Murray 1997) adopted.
• An open and developing system of interacting Single-parent family a lone parent and

⚫️
personalities with structure and process enacted in offspring living together as a family unit.
relationships among the individual members Extended family - grandparents, aunts,
regulated by resources and stressors and existing uncles, and cousins, either all living nearby or
within the larger community (Smith & Maurer, within the same household. For example, if a
1995) married couple lives with either the husband or
• A group of people related by blood or marriage or wife's parents the family changes from a nuclear to

⚫️
a strong common bond, such as those descended extended household.
from a common ancestor, or a husband, wife, and Multi-generational extended
their children ( Farlex 2012) o Three-generation: The most common
• Two or more people who live in the same multigenerational household arrangement consists
household (usually), share a common emotional of three generations - typically one or more
bond, and perform certain interrelated social tasks working-age adults, one or more of their children
(Spradley & Allender, 1996) (who may also be adults), and either aging
• Is a unit of interacting persons bound by ties of parent(s) or grandchildren.
blood, marriage or adoption. Constitute a single o Four-generation: Once a rarity except in
household, interact with each other in their some lower-income ethnic communities, the four-
respective familial roles and create and maintain a or even five-generation household - parents,
common culture. grandparents, great-grandparents, adult children,

⚫️
their children.
The Filipino Family and its Characteristics Nuclear Dyad Family -a family composed of

⚫️
The basic social units of Philippine society husband and wife only (childless couple)
are the nuclear family Blended Family or Reconstituted family -
1. Although the basic unit is the nuclear also known as a step family. A family where one or
family, the influence of kinship is felt in all both adults have children from previous
segments of social organizations. relationships living with them combined to form a
2. Extensions of relationships and descent new family EX widow married another widow &

⚫️
patterns are bilateral. have children.
3. Kinship circles are considerably greater Same-sex family - since civil partnerships
because effective range often includes the third were legalized in 2005 (US), the number of same
cousin. sex families has been growing (same-sex marriage
4. Kin group is further enlarged by a finial, was legalized in 2014 US ).
spiritual or ceremonial ties. Filipino marriage is not o Same-sex couples cannot conceive
an individual but a family affair. together, so their children may be adopted or be the
5. Obligation goes with this kinship system. biological children of one member of the couple.
6. Extended family has a profound effect on o They may also be from a sperm donor or a

⚫️
daily decisions. surrogate birth mother.
7. There is a great degree of equality between Communal - different families forming a
husband and wife. community
 o The word commune has various meanings orientation.
to different people. - If applicable, engage in reproductive life
o The term communal family refers to two planning.
or more groups of families that live together and
share facilities in some form of society. Stage 2: EARLY CHILDBEARING FAMILY
o It is actually a form of communal living • Birth or adoption of a first child which requires
forum. economic and social role changes
• Oldest child: 2-1/2 years
DECISION MAKING IN THE FAMILY
• Matriarchy or Matriarchal is essentially a Stage 3: FAMILY WITH PRESCHOOL
woman-oriented family, wherein all the leadership CHILDREN
and authority rest in the hands of women. • This is a busy family because children at this stage
• Patriarchy or Patriarchal on the other hand, demand a great deal of time related to growth and
is a social and familial system, wherein males enjoy development needs and safety considerations.
all the powers, control, and authority, and women • Oldest child: 2-1/2 to 6 years old
are given subordinate roles.
Stage 4: FAMILY WITH SCHOOL AGE
FAMILIAL CONFLICTS CHILDREN
• Misunderstanding and jumping to the wrong • Parents at this stage have the important
conclusion. responsibility of preparing their children to be able
• Role conflicts " Who will do the household to function in a complex world while at the same
chores?" " a young person become an adult" time maintaining their own satisfying marriage
• Changes in the family situation can also take a toll relationship.
on the family and contribute to conflict. • Oldest child: 6-12 years old
Example: Separation or divorce, Change in
financial circumstances. Stage 5: FAMILY WITH ADOLESCENT
• "Super-extended" family. CHILDREN
• A family allows the adolescents more freedom and
The Family as the Client prepare them for their own life as technology
Characteristics of a Family as a Client advances-gap between generations increases
- The family is a product of time and place. • Oldest child: 12-20 years old
- The family develops its own lifestyle.
- The family operates as a group. Stage 6: THE LAUNCHING CENTER
- The family accommodates the needs of the FAMILY
individual members. • Stage when children leave to set their own
- The family relates to the community household-appears to represent the breaking of the
- The family has a growth cycle. (Duvall & family
Miller, 1990) • Empty nests

Stages of Family Life Cycle Stage 7: FAMILY OF MIDDLE YEARS

Stage 1: MARRIAGE & THE FAMILY • Family returns to two partners nuclear unit
Involves merging of values brought into the • Period from empty nest to retirement

⚫️
relationship from the families of orientation.
Includes adjustments to each other's routines Stage 8: FAMILY IN RETIREMENT/OLDER
(sleeping, eating, chores, etc.), sexual and economic AGE

⚫️
aspects.
Members work to achieve 3 separate identifiable Stage 9: PERIOD FROM RETIREMENT TO
tasks: DEATH OF BOTH SPOUSES
- Establish a mutually satisfying relationship.
- Learn to relate well to their families of
HEALTH TASKS OF THE FAMILY (Duvall 12. Demonstrate concern of family unity, loyalty
2015) and interfamily
• Physical maintenance - provides food, shelter, cooperation.
clothing, and health care to its members being
certain that a family has ample resources to 5 Family Health Tasks (Maglaya, A., 2004)
provide. 1. Recognizing interruptions of health
• Socialization of Family - involves preparation development
of children to live in the community and interact 2. Making decisions about seeking health
with people outside the family. care/to take action
• Allocation of Resources - determines which 3. Dealing effectively health and non-health
family needs will be met and their order of priority. situations
• Maintenance of Order - task includes opening 4. Providing care to all members of the family
an effective means of communication between 5. Maintaining a home environment conducive
family members, integrating family values and to health
enforcing common regulations for all family maintenance
members.
• Division of Labor - who will fulfill certain roles Health as a Goal of Family Health Care
e.g., family provider, home manager, children's HEALTH DEFICIT - this refers to conditions of
caregiver health breakdowns or advent of illness in the family
• Reproduction, Recruitment, and Release of HEALTH THREAT - these are the conditions that
family member make it more likely for accidents, disease or failure
• Placement of members into larger society - to thrive or develop to occur.
consists of selecting community activities such as FORESEEABLE CRISIS - these are anticipated
church, school, politics that correlate with the periods of unusual demand on the family in terms
family beliefs and values of time or resources.
• Maintenance of motivation and morale - WELLNESS POTENTIAL - this refers to states
created when members serve as support people to of wellness and the likelihood for health
each other maintenance or improvement to occur depending
on the desire of the family.
12 Behaviors Indicating a Well Family
1. Able to provide for physical, emotional and NOTES: QUIZ SEP 12 8PM!!
spiritual needs of family members. UNIT EXAM & PRELIM EXAM
2. Able to be sensitive to the needs of the
family members.
3. Able to communicate thoughts and feelings
effectively.
4. Able to provide support, security and
encouragement.
5. Able to initiate and maintain growth
producing relationships.
6. Maintain and create constructive and
responsible community relationships.
7. Able to grow with and through children
8. Ability to perform family roles flexibly
9. Able to help oneself and to accept help when
appropriate
10. Demonstrate mutual respect for the
individuality of family members
11. Ability to use a crisis experience as a means
of growth