the philippine health care delivery system & primary health care
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The Philippine healthcare delivery system& primary health car
Mr. John Frederick C. Udtujan, M
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PROGRAMS OF DOHD ental Health
O steoporosis Prevention
H ealth Education and Community OrganizingP revention and Control of Communicable Diseases
R eproductive Health (RH)
O lder Persons Health Services
G uidelines for Nutrition
R ehabilitation and Management of Non-CommunicableDiseases.
A lternative Health Care Practices (Herbal Meds/Acupressure
M aternal and Child Health and Integrated Management of
Childhood Illness (IMCI)
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Primary Health Care
An essential health care made universally accessibleindividuals and families in the community by means acceptto them through their full participation and at a cost thatcommunity and country can afford every stage of developm(WHO). CONCEPT: PHC is characterized by PARTNERSHIPEMPOWERMENT of the people towards SELF-RELIANaccessible, acceptable and sustainable It is a strategy, which focuses responsibility for health on
individual, families and the communities. full participatand active involvement of the community
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Primary Health Care
PHC
Community-Based
AccessibleAffordable
Acceptable Sustainable
10/16/2013
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FUNCTIONS OF PHC1. Community-Based Within the community, health services should be delivered to w
people are
2. Accessible Within the reach of the people and those in far-flung areas sho
be deprived of these health services by regular periodic visits byhealth personnel and training of indigenous resident volunteersarea
3. Acceptable Serves for the people; the willingness of the people to identify a
their problems The people agree and are satisfied with the health care services
meet the requirements and needs of the area Families from lower income groups are the ones mostly served
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FUNCTIONS OF PHC
5. Sustainable For these health services to be successfully utilized, mainta
continue needs the active participation and involvement ofcommunity members.
The residents, once they have developed awareness buildinknowledge on health and health-related issues, will conseqdevelop self-confidence and self-efficacy which are the drivfor empowerment and self-reliance
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FUNCTIONS OF PHC
6. Affordable At a cost the people & the government can afford
Traditional herbal medicines and other alternative formhealing must be used together with the essential drugsare generic and are more affordable
7. Self-reliance People could provide for their own needs
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OBSTACLES TO PRIMARY HEACARE
Role Complexity the CHNurse is mandated to perform a lofunctions with its inherent responsibilities which requires thprovision of a high level of nursing care. He/she needs to beboth technical and communication skills.
Special
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PRIMARY HEALTH CARE
GOAL: Health for all Filipinos and Healtin the Hands of the People by the year2020
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Framework of PHC
PeopleEmpowerment
Partnership
Health for All
Filipinos by theYear 2000 andHealth in the
Hands of thePeople by 2020
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PRINCIPLES OF PRIMARY HEACARE
1. Accessibility, Acceptability, Availability, and AffordabilityServices
2. Partnership between the community and health agencieprovision of quality basic and essential health services
3. Community participation
4. Self-Reliance5. Social Mobilization
6. Decentralization
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PRINCIPLES OF PRIMARY HEACARE
1. Accessibility, Acceptability, Availability, and AffordabilityServices
Health services are delivered where the people live and work.
Indigenous residents and volunteer health workers should be givedevelop their capabilities for them to provide health care in their owith an ideal ration of1 health worker for 10-20 households depe
the distance between these households.Low cost appropriate technologies should be utilized for the comm
sustain combining it with traditional medicines.
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PRINCIPLES OF PRIMARY HEACARE
2. Partnership between the community and health agencieprovision of quality basic and essential health services
People should be the center of development not as objects.
Participation is always encouraged and that community needs andshould be the basis for planning health services and activities.
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PRINCIPLES OF PRIMARY HEACARE
3. Community Participation
Participation is considered the core of community organization.
Community should be aware and conscious about health and deveissues.
Planning, implementation, monitoring, and evaluation should be dpeople, even in the selection of Community Health Workers and fohealth committees.
Community Participation assumes that people have the capacity ttheir own welfare.
Having a sense of ownership for ones action ensure a sustainabledevelopment effort rather than depending on services through exdole out activities.
Partnership within the community ensures a more responsible devinitiative.
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PRINCIPLES OF PRIMARY HEACARE
4. Self-RelianceThrough community participation and cohesiveness of peoples orpeople can generate support for health care through social mobilinetworking, and mobilization of local resources.
Leadership and management skills should be developed among th
Existence of sustained and progressive income generating projects
cooperatives, family production, and sustained health care facilitieby the people are some of the major indicators that the communitinto self-reliance.
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PRINCIPLES OF PRIMARY HEACARE
6. DecentralizationThis ensures empowerment and that empowerment can only be fthe administrative structure provides local level political structuresubstantive responsibilities for development initiators.
This also facilitates proper allocation of budgetary resources.
STRATEGIES
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STRATEGIES Reorientation and reorganization of the national healt
care system (RA 7160/Local Government Code of 1991 Effective preparation and enabling process for health
action at all levels Mobilization of the people with the end view of providappropriate solutions leading to self-reliance and selfdetermination
Development and utilization of appropriate technologfocusing on local indigenous resources available in and
acceptable to the community Organization of communities arising from their expres
needs increase opportunities for community participa Development of intra-sectoral linkages with other
government and private agencies
Emphasizing partnership
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Primary Health Care
May 1977 - 30th World Health Assembly
decided that the main health target of thegovernment and WHO is the attainment oa level of health that would permit themto lead a socially and economicallyproductive life by the year 2000.
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Primary Health Care
September 6-12, 1978 - First Internationa
Conference on PHC held in Alma Ata, Russ(USSR). The Alma Ata Declaration statedthat PHC was the key to attain the Healthfor All by the year 2000 goal
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Primary Health Care
October 19, 1979 - Letter of Instruction (LOI) 949,the legal basis of PHC was signed by then Pres.Ferdinand E. Marcos, which adopted PHC as anapproach towards the design, development andimplementation of programs focusing on healthdevelopment at community level.
LOI 949 mandated the DOH to use PHC as anapproach in planning and implementing healthprograms
LOI 949 is the legal basis of PHC in the country has an underlying theme Health in the Hands of thPeople by 2020
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Board Question
What is the legal basis of Primary Health Care
approach in the Philippines?
A. Alma Ata Declaration of PHCB. Letter of Instruction No 949C. Presidential Decree No. 147D. Presidential Decree 996
Primary Health Care
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Primary Health Care
How can PHC be POSSIBLE?
Control of Communicable DiseasesOffers Health EducationMaternal and Child CareProvision of Medical Care and Emergency TreatmentOffersImmunizationNutrition and Food SupplyEnvironmental SanitationNFamily PlanningTreatment of Locally Endemic DiseasesSupply and Proper Use of Essential Drugs
Primary Health Care
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Primary Health CareE Education for Health (priority)
L Locally endemic disease prevention and control
E Essential drug provision
M Maternal and child health and family planning
E Expanded program on immunization (PD 996)
N Nutrition (adequate food and proper nutrition)
T Treatment of communicable disease
S Safe water and environmental sanitation
H Hospital as a center of wellness
O Oral and dental health
M Mental health
E Elderly care
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EDUCATION FOR HEALTH
Involves human development and is people-oriented.
It is a dynamic process of giving information and is the 1st stimprove knowledge, skills, and attitude of the people in ordthem to voluntarily adopt these teachings as an entry point development.
As health educators, we are not here to change the behavioindividual but rather to motivate him through information cfor him to voluntarily adapt to these changes as he interactsenvironment.
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LOCALLY ENDEMIC DISEASECONTROL Focuses on the prevention of the occurrence of endemic dis
because it is continuously present in the community
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EXPANDED PROGRAM ONIMMUNIZATION Exists to control the occurrence of preventable illnesses esp
children.
Immunizations on poliomyelitis, measles, tetanus, diphtheriother deadly but preventable diseases are given for free by government and is an on-going program of the DOH.
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MATERNAL AND CHILD HEALTH
The mother and child are the most delicate members of thecommunity.
Therefore, the maternal and infant mortality and morbidity among the indicators of health of a particular community.
The protection of the mother and child to illness and other would ensure a good health for the community.
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ESSENTIAL DRUG PROVISION
C otrixomazole
C arboceistine
A moxicillin
A mpicillin
R ifampicin
I soniazid (INH)
P yrazinamide (PZA)
P aracetamol
O resol
N ifedipine
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NUTRITION
Food is one of the basic needs of the individual.
Appropriate kind of food and food preparation can contribuhealthy state.
There are a lot of resources available in our setting but becalack of knowledge as well as faulty preparation, it leads tomalnutrition, which is one of the major health problems weour country.
TREATMENT OF COMMUNICABL
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TREATMENT OF COMMUNICABLDISEASES Tuberculosis, malaria, schistosomiasis, and other communic
diseases associated with poverty continue to be a serious pwith economic implications.
75,000 Filipino babies die of preventable causes every year most of these preventable diseases are communicable in na
The government then has to focus on the prevention, contrtreatment of these diseases.
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SAFE WATER & SANITATION
Access to potable water within 250 meters or 10-minute wasanitary toilet is a must for every family.
The government then has to see to it that policies, rules, anregulations related to this must be implemented and follow
Because this is also one of the basic needs of human beingssurvival, a clean environment is necessary to promote good
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Four Cornerstone of PHC (MAUS)
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Four Cornerstone of PHC ( US)
1. Multisectoral Linkages - Intra and intersectoral linkages
*Intra sectoral - within the health systemfacilities:
Primary RHU, LGU, HC, BHS
Secondary - regional health sectorTertiary - national level headed by the DO
Four Cornerstone of PHC
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2. Active community participation and involvement Participation is considered the core of community
organization. Community should be aware and be conscious abou
health and development issues. Planning, implementation, monitoring, andevaluation should be done by the people, even in thselection of Community Health Workers andformation of health committees.
Assumes that people have the capacity to care fortheir own welfare.
Having a sense of ownership for ones action ensuresustainable development effort rather thandepending on services through external or dole outactivities.
Partnership with the community ensures a moreresponsible development initiative.
Four Cornerstone of PHC
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3. Use of appropriate technology Provide social and environmental service that is
acceptable to all level and has a quality of product with
the least cost. Criteria for Selection of Technology1. Efficacy and safety2. Complexity and simplicity3. The cost4. Acceptability
5. Scope of technology6. Visibility
Four Cornerstone of PHC
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4. Support mechanism made available
*The primary health care, as a nurse one must trydetermine the needs of the community (ex. tea
income generating program (IGP) such as basweaving, candle making, soap making etc.)
REPUBLIC ACT NO 8423Traditional and Alternative MediA t (TAMA) f 1997
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Act (TAMA) of 1997.
REPUBLIC ACT NO. 8423 - AN ACT CREATING THE PHILIPPINE INSTITUTETRADITIONAL AND ALTERNATIVE HEALTH CARE (PITAHC) TO ACCELERATE DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN PHILIPPINES, PROVIDING FOR A TRADITIONAL AND ALTERNATIVE HEALTH CDEVELOPMENT FUND AND FOR OTHER PURPOSES
Section 1. Short Title This Act shall be known as the Traditional Alternative Medicine Act (TAMA) of 1997.
Section 2. Declaration of Policy It is hereby declared the policy of the Statimprove the quality and delivery of health care services to the Filipino pethrough the development of traditional and alternative health care andintegration into the national health care delivery system.
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REPUBLIC ACT NO 8423Traditional and Alternative MediAct (TAMA) of 1997
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Act (TAMA) of 1997.
Calls for the effective utilization of medicinal plants as an alternative for
cost medications
The law forwards the following policies
1. The indications and/or uses of plants2. The part of the plant to be used
3. Preparation of
a. Decoction laga/boil
b. Poultice tapal (may add oil)
c. Infusion an example is tea where hot water is added and steeped f
at least 24 hours
d. Syrup add sugar and for storage lasts 3-5 dayse. Oils bawang, luya, mansanilya extract
f. Ointment with wax
g. Tincture preparation composed of water and alcohol
h. Elixir based
REPUBLIC ACT NO 8423Traditional and Alternative MedA t (TAMA) f 1997
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Act (TAMA) of 1997.
It shall also be the policy of the State to seek a legally workable basiwhich indigenous societies would own their knowledge of traditimedicine. When such knowledge is used by outsiders, the indigensocieties can require the permitted users to acknowledge its source anddemand a share of any financial return that may come from its authorcommercial use.
In promoting herbal medicines:
Encourage client to backyard gardening.
When using herbal medicines, advise the client never to use insecticide
pesticides Use one herbal medicine at a time
When cooking the herb, use clay pot and remove the cover to prevent cook.
If there is a reaction to the herbal medicine, advice client to go to the neahealth center.
10 HERBAL PLANTS ADVOCATED BY THE DOH
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10 HERBAL PLANTS ADVOCATED BY THE DOH
1) Lagundi-cough, asthma, andcolds
2) Ulasimang-Bato-lowers uricacid
3) Bawang-anti cholesterol
4) Bayabas- antiseptic; diarrhea
5) Yerba Buena- toothache, pain,and arthritis
6) Sambong- renal calculi
7) Ampalaya- diabetes mellitus
8) Niyog-niyogan- anti-helminthic
9) Tsaang-Gubat- diarrhea
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1. Lagundi (Vitex negundo)Other Names:5 leavechaste tree (Eng.) Kamalan (Tag.)Limo-limo (Ilk.) Dabtan (If.)Tugas (Ceb) Molave aso (Su
A shrub known in English as the 5-leaved chastree which grows wild in vacant lots and wasteland. The flowers are blue and bell-shaped and
small fruits turn black when ripe. It is better to cthe leaves where are in bloom. Matured branchare planted.
Parts utilized: Leaves, flower.
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1. Lagundi (Vitex negundo) available as Asctablet
Benefits: Skin diseases (dermatitis, scabies, ulcer) a
wounds Headache Asthma, pharyngitis, cough, fever Aromatic bath for sick patients
Rheumatism, sprain, contusions, insect bit Eczema Dysentery (blood in the stool), colds and p
in any part of the body (influenza)
LAGUNDI
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Asthma, cough and fever- boil the chopped rawfruits or leaves in 2 glasses of water left for 15minutes until the water left in only one glass. StrThe following dosages of the decoction are give
age group.DRIED LEAVES FRESH
LEAVESAdult 4 tbsp 6 tbsp2-6 years old 1 tbsp 1 tbsp
7-12 years old 2 tbsp 3 tbs
Dysentery, colds and pain in any part of the bodinfluenza boil a handful of leaves and flowers water to produce a glass full of decoction 3 time
day
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Headache- crushed leaves may be appliedthe forehead.
Rheumatism, sprain, contusion insect bite
pound the leaves and apply on affected pa Aromatic bath for sick patients - prepare ledecoction for use in sick and newly deliverpatients.
G
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LAGUNDI
2. Ulasimang bato/Pansit-pansitan (Peperomiapellucida)
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pellucida)Other Names:Pansit-pansitan (Tag.)
A weed, with heart-shaped leaves also known a
"pansit-pansitan", grows in shady parts of thegarden and yard. It is effective in fighting arthritiand gout. The leaves can be eaten fresh (aboutcupful) as salad or like tea.
Parts utilized: leaves
2. Ulasimang bato / pansit-pansitan (Peperomiapellucida)
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pellucida)Uses:
Uric acid excretion (rheumatism & gout)
Preparation: Wash leaves well. One and a half cup leaves are
boiled in two glassfuls of water over lower fire. Dnot cover pot. Cool and strain. Divide into threeparts and drink each part three times a day aftermeals.
May also be eaten as salad. Wash the leaves wPrepare one and a half cups of leaves. Divide in3 parts and take as salad three times a day.
ULASIMANG BATO
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ULASIMANG-BATO
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3. Bawang (Allium sativum)
Benefits:
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Benefits:
BawHat: Bawang for HYPERTENSION &TOOTHACHE
Helps lower bad cholesterol levels (LDL)
Good for the heart
Remedy for arteriosclerosis
May help prevent certain types of cancer
Boosts immune system to fight infection
With anti oxidant properties
Cough and cold remedy
Relieves sore throat
Aids in treatment of tuberculosis
With anticoagulant properties
BAWANG
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BAWANG
4. Bayabas/Guava (Psidium guajava)
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A tree about 4- 5 meters high with tiny flowers wround or
oval fruits that are eaten raw. Propagated throu
seeds. Parts utilized: leaves Preparation:1. For washing wounds- may be used twice a day.2. For diarrhea- may be taken 3-4 twice a day.3. As gargle and to relieve toothache. Warm decoc
is used for gargle.Freshly pounded leaves are used for toothache
Guava leaves are to bewashed well and chopped. Boil for 15 minutes
low fire. Do not cover
pot Cool and strain before use
4. Bayabas/Guava (Psidium guajava)
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Uses of Bayabas: Diarrhea Washing of wounds antiseptic, astringent
(kills bacteria, fungi, and ameba) Gargle to relieve toothache For hypertension, diabetes and asthma Promotes menstruation
BAYABAS
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BAYABAS
5. Yerba Buena (Clinopodium dougla Other Names:
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Other Names:Peppermint mint (Eng.) Herba
Buena (most dialects)
A small multi- branching aromatic hercommonly known
as Peppermint. The leaves are smalelliptical ands with
soothed margin. The stem creeps toground, anddevelops roots. May also be
propagated throughcuttings.
5. Yerba Buena (Clinopodium douglasii)Preparation:
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Preparation:1) For pain in different parts of the body as headacstomach ache boil chopped leaves in two glasseof water for 15 minutes. Cool and strain. Divide
decoction into two parts and drink one part everythree hours.
2) Rheumatism, arthritis and headache crush thefresh leaves squeeze sap. Massage sap on painfuparts with eucalyptus.
3) Cough and colds get about 10 fresh leaves ansoak in a glass of hot water. Drink as tea. Acts as expectorant.
4) Swollen Gums (Gingivitis) steep 6 grams of frplant in a glass of boiling water for 30 minutes. Ussolution as gargle.
5. Yerba Buena (Clinopodium douglasii)Clinopodium douglasii)
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Clinopodium douglasii)Preparation:.6) Menstrual and gas pain soak a handful of leavin a glass of boiling water. Drink infusion. It induces
menstrual flow and sweating.7) Nausea and fainting crush leaves and apply atnostrils of patients.8) Insect bites crush leaves and apply juice onaffected part or pound leaves until paste-like. Then
this on affected part.9) Pruritis- boil plant alone or with eucalyptus in waUse decoction as wash on affected area.
5. Yerba Buena (Clinopodium douglasii Benefits & Treatment of:
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Benefits & Treatment of: S wollen gums P ain
I nsect bites T oothache M enstrual and gas pain A rthritis Nausea and fainting
D iarrhea
DIARRHEA
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DIARRHEA
B anana rich in Potassium
R ice carbohydrates
A pple balat rich in pectin; adsorbent and astringent effe
T oast
A pple - balat (peel) B anana - flesh
K aimito - flesh
D uhat - balat (peel) 100% pectin
CONSTIPATION
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CONSTIPATION
High fiber diet
Ripened Papaya
YERBA (HIERBA) BUENA
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YERBA (HIERBA) BUENA
6. Sambong (Blumea balsamiferaanti-edema
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diuretic, anti-lithiasis (stone)Other Names:
Haliban/Camphor, Blumeacamphora (Eng.)
Aliminon, Alibhon, Kambihon.Lakdanbulan (Vis.)
A plant that reaches 1.5 to 3 metehigh with
rough hairy leaves. Young plantsaround mother
6. Sambong (Blumea balsamifera)
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Benefits: A nti-edema
D iuretic A nt-urolithiasis (effective in
dissolving kidney stones)Anti diarrheic & Anti gastra
properties Helps remove worms, boils Treats dysentery, sore throat
SAMBONG
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SAMBONG
7. Ampalaya (Mamordica charantia) - forthose with non-insulindiabetes mellitus non ketosis prone diabete
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diabetes mellitus, non-ketosis prone diabetematurity onset orjuvenile diabetes.
Other Names:
Balsam Apple, Balsam Pear, Bitter Gourd(Eng.)
Palia (Bis.)
Known as "bitter gourd" or "bitter melon" inEnglish, it most known as a treatment ofdiabetes (diabetes mellitus), for the non-insdependent patients.
P t tili d l
7. Ampalaya (Momordica charantia)
Herbal Benefits of Ampalaya:
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Herbal Benefits of Ampalaya: Good for rheumatism and gout And diseases of the spleen and liver
Aids in lowering blood sugar levels Helps in lowering blood pressure Relieves headaches Disinfects and heals wounds and
burns Can be used as a cough & fever
remedy Treatment of intestinal worms, diarrh Helps prevent some type of cancer Enhance immune system to fight
infection
AMPALAYA
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AMPALAYA
8 Niyug niyogan (Quisqualis indica L )
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8. Niyug-niyogan (Quisqualis indica L.)
Anti-helminthic: ASCARIASIS
Other Names:
Balitadham, Pnones, Pinio, Bonor (Bis.)
Bawe-bawe (Pamp.)
Kasumbal, Talolong (Bik.)
Tagrau, Tagulo Totoraok (Tag.)
Tartarau (Ilk.) Burma creeper Chinese honey suckle
(English)
Parts utilized: Seeds
8. Niyug-niyogan (Quisqualis indica L.)
A vine which bears tiny fruits and grows wild in backy
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A vine which bears tiny fruits and grows wild in backyThe seeds must come from mature, dried but newlyopened fruits.
Propagated through stem cuttings about 20 cm. in he
Parts utilized: Seeds Use: Anti-helminthic used to expel roundworms
(ascariasis)
The seeds are taken 2 hours after supper.
If no worms are expelled, the dose may be repeated one week.
Adult 8-10 seeds
7-12 years old 6-7 seeds
6-8 years old 5-6 seeds
4-5 years old 4-5 seeds
CAUTION:
NIYOG-NIYOGAN
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9. Tsaang Gubat (Carmona retusa) - for those
diarrhea, stomach ache, can be used as moub it i i h i fl id
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because it is rich in fluoride.Other Names: Alibungog (Vis.)
Kalabonog, Maragued (Ilk) Kalimunog, Taglokot, Talibunog, Tsa (Tag.).Malatadian (Gad.)
Parts utilized: LeavesBenefits and Treatment of: Stomach pains
Gastroenteritis Intestinal motility Dysentery Diarrhea or Loose Bowel Movement (LBM) Mouth gargle Body cleanser/wash
9. Tsaang Gubat (Carmona retusa)
Uses:
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Uses:
Diarrhea Boil the following amount of chleaves in 2 glasses of water for 15 minutes
amount of water goes down to 1 glass. Costrain.
Dried Leaves Fresh Leaves
Adult 10 tbsp. 12 tbsp.
7-12 y.o. 5 tbsp. 6 tbsp.
2-6 y.o. 2 tbsp. 3 tbsp.
Divide decoction into 4 parts. Let patientpart every 3 hours.
Stomachache
9. Tsaang Gubat (Carmona retusa)
Uses:
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Uses:
Stomachace Wash leaves and chop. Bochopped leaves in 1 glass of water for 15
Cool and filter/strain and drink.Adult Dried Leaves Fresh Leaves
Adult 2 tbsp. 3 tbsp.
7-12 y.o. 1/2 tbsp. 1 tbsp.
TSAANG GUBAT
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10. Akapulko (Cassia alata) anti-fungal: tinea flava, ringscabies Athletes foot
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scabies,Athlete s foot.Other Names:Bayabas-bayabasan, Kapurko, Kantada, Katandang
Pakagonkin, Sonting (Tag.)Sunting, Palo china (Bis.)Ringworm bush or shrub (English)Parts utilized: LeavesUses of Akapulko: Treatment of skin diseases: Tinea infection, insects b
ringworms, eczema, scabies and itchiness. Internal:Expectorant for bronchitis and dyspnoea, mouthwashstomatitis, alleviation of asthma symptoms, used as dand purgative, for cough and fever, as a laxative to eintestinal parasites and other stomach problems. A stdecoction of the leaves is an abortifacient.
10. Akapulko (Cassia alata) anti-
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10. Akapulko (Cassia alata) antifungal: tinea flava, ringworm, scabi
Athletes foot.Preparation:
Fresh matured leaves are poundApply as soap to the affected par
times a day.
AKAPULKO
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HERBALISM
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A traditional medicinal or folk medicine practice based on th
plants and plant extracts Also known as botanical medicine, medical herbalism, herba
medicine, herbology, and phythotherapy
HERBAL MEDICINE PREPARATIO
1 A ti P ti
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1. Aromatic Preparations
Have volatile oil for treatment of fever, cough, colds, itchiness, and ga
Include luya, bawang, sibuyas, yerba buena, oregano, manzanilla, tanggrass), sambong, lagundi, petals of sampaguita, jasmine, and rosal.
Luya or ginger should not be taken on an empty stomach.
Tincture of bawang 1:5
Add 5 Tbsp. of gin; 1 Tbsp. chopped bawang
Shake 10 minutes for 1 week good for superficial wounds
Tanglad/lemon grass for feverSambong stomachache
Suha/kalamansi for fever, TSB
HERBAL MEDICINE PREPARATIO
2 A t i t
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2. Astringents
Bitter-tasting because they contain tannin and pectin
Generally effective for diarrhea and wounds
Examples:
Avocado leaves
Guava leaves
Kamilo leaves
Duhat leaves
Banana leaves
HERBAL MEDICINE PREPARATIO
3 Bitter Tasting Preparations
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3. Bitter-Tasting Preparations
Skin problems akapulko, kalachuchi, malunggay, kakawati, maka
Depressants (to put hyperactive people to sleep) dapdap, dita, m
makahiyaAnti-cancer drug tsitsirika
Aches and pains sambong, damong maria
Asthma talampugay can cause psychosis
HERBAL MEDICINE PREPARATIO
4 Seeds
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4. Seeds
Have fixed oils and are good anti-helminthicsNiyug-niyogan
Patola Ipil-ipil
Betel nut or bunga
Balanyog
Squash seeds
Lanzones do not throw peelings, instead burn it for it is a good insect rep
HERBAL MEDICINE PREPARATIO
5 Grass Family
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5. Grass Family
Good diuretics
Kugon
Tubo
Tanglad
Pandan
Pugo-pugo
Buton-butones
Gatas-gatasUlasimang bato
Corn hair good for kidney stones
Palay used for hypertension
MALUNGGAY
Known as horseradish
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Known as horseradish
A backyard pharmacy because all parts of the tree have medicinal otherapeutic valuemiracle vegetable
Propagation is through stem cuttings and seeds and is a low maintena
Contains the following:
4 times the calcium in milk
7 times the vitamin C in orange
4 times the vitamin A in carrots which is good for the eyes and effe
against cancer3 times the potassium in banana
2 times the protein in milk
MALUNGGAY
A multi-use plant its various parts are used in a variety of ways:
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A multi use plant, its various parts are used in a variety of ways:
Leaves food, medicine (for stomach, it is applied as a poultice) afeed; converted to powder and used as food supplement
Trees used as backyard hedges, alley cropping, and erosion contFlowers food or medicine
Pods food or medicine
Roots medicine (has abortive effect)
Dry and mature seeds water purification and used as oil (has moimpressive attributes/properties than olive oil)
Bark/stem medicine (laxative) and tenderizer
Fruit or seed arthritis
MALUNGGAY
Other uses:
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Other uses:
Promotes good eyesight
Good for digestion
Natural source of energy supplementFacilitates bowel movement
Local cure for stomachache
Prevents arthritis, cancer, heart, and kidney diseases
Known to increase milk production
GUIDELINES ON HERBAL PLAPREPARATION
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1. Use only half the dosage prescribed for fresh parts like leaves
when using dried parts.
2. Do not use stainless steel utensils when boiling decoctions. Ouse earthen, enameled, glass or like utensils.
3. Decoctions lose potency after some time. Dispose of decoctio
after one day. To keep fresh during the day, keep lukewarm in
flask or thermos.
GUIDELINES IN HANDLING OMEDICINAL PLANTS
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1. If possible, buy herbs that are grown organically without pesticid
2. Medicinal parts of plants are best harvested on sunny mornings. A
leaves, fruits, or nuts during and after heavy rainfall.3. Leaves, fruits, flowers, or nuts must be mature before harvesting.
medicinal substances are found on young parts.
4. After harvesting, if drying is required, it is advisable to dry the plan
either in the oven or air-dried on screens above ground and never
floors.
5. Store plant parts in sealed plastic bags or brown bottles in a cool dwithout sunlight preferably with a moisture absorbent material lik
Leaves and other plant parts that are prepared properly, well-dried
stored can be used up to 6 months.
REMINDERS ON THE USE OF HEPLANTS (ABONUS)
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( ) Accurate dosage of medication follow
Boiling at low heat: remove cover
One kind of plant for each type of sign/symptom
No insecticides may leave poison on plants
Use clay pot and plant part being advocated
Stop in case of untoward reaction such as allergy occurs; seek
consultation if s/sx not relieved after 2-3 doses of herbal med
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Decoctions loose potency after some time. Dispose of decocafter one day. To keep fresh during the day, keep lukewarm or thermos.
Tips on Handling Medical Plants / Her
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If possible, buy herbs that are grown organica
without pesticides. Medicinal parts of plants are best harvested osunny mornings. Avoid picking leaves, fruits onuts during and after heavy rainfall.
Leaves, fruits, flowers or nuts must be maturebefore harvesting. Less medicinal substances
found on young parts. After harvesting, if drying is required, it isadvisable to dry the plant parts either in the ovor air-dried on screens above ground and nevon concrete floors.
Store plant parts in sealed plastic bags or bro
Maternal & Child Care
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GOALS
Qualified for Home Deliveries
POINTERS 3 CLEANS
HANDS
SURFACE
CORD
Maternal & Child Care GOALS:1. To ensure that every expectant & nursing mother:
a Maintains good health
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a. Maintains good health
b. Learns the art of child care
c. Achieve normal delivery
d. Bears healthy children
2. That every child:
a. Grows up in a family with LOVE & SECURITY
b. Live in HEALTHY surroundings
c. Receives: adequate NOURISHMENTHealth supervision & MEDICAL attenti
d. Taught elements of healthy living
Maternal & Child Care
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Qualified for Home Deliveries1. Full term
2. Adequate pelvis3. CEPHALIC presentation4. Imminent deliveries5. Abdominal enlargement appropriate for AOG
POINTERS 3 CLEANSCLEAN HANDSCLEAN SURFACECLEAN CORD
Maternal & Child Care
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Postpartum Visits
1. FIRST: within 24 hours2. 2ND: at least one week after delive3. 3RD: two to four weeks later
LIGTAS BUNTIS CAMPAIGN
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A strategy to increase the visibility of family planning as an epublic health service
To improve access of men, women, and couples to family pland safe motherhood services
EXPANDED PROGRAM ON IMMUNIZATION (
OBJECTIVE: To reduce the morbidity and mortality among infants and chcaused by the 7 childhood immunizable diseases (TB Diphtheria Pertus
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caused by the 7 childhood immunizable diseases (TB, Diphtheria, PertusHepatitis B, Poliomyelitis, & Measles)
ELEMENTS OF EPI:
1) T ARGET SETTINGmain element
Infants 0-12 months
Pregnant and Post Partum Women
School Entrants/ Grade 1 / 7 years old
2) IE C (information, education, communication)
3) C old chain logistics management - vaccine distribution through codesigned to ensure that the vaccines were maintained under propeenvironmental condition until the time of administration.A ssessmeevaluation of overall performance
4) S urveillance, studies, and research
EXPANDED PROGRAM ONIMMUNIZATION
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MAIN PRINCIPLE: Based on EPIDEMIOLOGICAL SITUATION
PRESIDENTIAL DECREE (PD) 996: Providing for compulsory bimmunization for infants and children below 8 years old
IMMUNIZATION SCHEDULE: Provide maximal immunity to tEPI diseases BEFORE THE CHILDS FIRST BIRTHDAY
EXPANDED PROGRAM ONIMMUNIZATION
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VACCINE FIRST DOSE NO. OF DOSES INTERVAL
BCG (Bacillus Calmette-
Guerin)
AT BIRTH 1
DPT 3 DOSES GIVEN AS EARLY
AS 6 WEEKS AFTER BIRTH
3 4 WEEKS I
DOSES
HEPA B SIX WEEKS 3 4 WEEKS/
OPV (Sabin)
MEASLES 9 MONTHS 1
MMR 15-18 MONTHS 1
ADMINISTRATION OF VACCINESVACCINE DOSE ROUTE SITEBCG (Bacillus Calmette-
Guerin)
Initial dose AT BIRTH or anytime
after birth (0-1 year): 0.05 ml
Booster dose at SCHOOL ENTRY
Intradermal Right de
Left delt
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Booster dose at SCHOOL ENTRY
(Grade 1): 0.10 ml given to all grade
school pupils
regardless of the presence orabsence of a BCG scar
DPT 0.5 ml Intramuscular Deltoid
HEPA B 0.5 ml Intramuscular Upper o
thigh
OPV (Sabin) 2-3 drops Oral Mouth
MEASLES 0.5 ml Subcutaneous Upper p
upper ar
MMR 0.5 ml Subcutaneous Upper p
upper ar
Childhood Immunizations1. BCG
BCG i i t th li t ibl t t i t th ibilit f TB i f
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BCG is given at the earliest possible age protects against the possibility of TB inf
the other family members
2. Measles6 months earliest dose of measles given in case of outbreak
9months-11months- regular schedule of measles vaccine
15 months- latest dose of measles given
4-5 years old- catch up dose
At least 80%-85% of measles may be prevented
3. DPTEarly start with DPT vaccine reduces chances of severe pertussis
4. OPVExtent of protection is increased the earlier the OPV is given
5. Hepatitis BEarly start with Hep B vaccine reduces chances of being infected and becoming
TETANUS TOXOID IMMUNIZATIOSCHEDULE FOR WOMEN
Vaccine Minimum Age interval % protected Duration of Protectio
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TT1 As early as possible 0% 0
TT2 4 weeks later 80% 3 years
TT3 6 months later 95% 5 years
TT4 1year later/during next
pregnancy
99% 10 years
TT5 1 year later/third pregnancy 99% Lifetime
Immunization Guidelines1. BCG vaccine shall be given to all school entrants regardless of the pr
b f BCG
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absence of BCG scar.
2. Fever, local soreness, and rash are common side effects.
3. A fully immunized child (FIC) should have received 1 dose of BCG, 3OPV, 3 doses of DPT, 3 doses of Hepa B, and 1 dose of AMV
4. Contraindications include:
a. BCG vaccine: if child has clinical AIDS
b. DPT2 and DPT3 if child has convulsion or shock within 3 days of th
dose unless the pertussis component of DPT vaccine is removed
c. All serious conditions that need hospitalization
Immunization Guidelines5. The following are not contraindications:
a Moderate fever up to 38 5 degrees Celsius malnutrition mild acute
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a. Moderate fever up to 38.5 degrees Celsius, malnutrition, mild acute
respiratory infection (colds/cough), simple diarrhea, and vomiting
(1) Do not expose to sunlight(2) Do not apply alcohol on site of injection
(3) Side effects include local inflammatory reaction, superficial absc
with pus at times
(4) If no side effects, repeat BCG after 2 months
(5) Kochs phenomenon: begins after 2-4 days like a normal reactio
treatment neededb. Permanent scar formation: 2-12 weeks after
c. Indolent ulceration: does not heal within 12 weeks indicates the p
secondary infection and can be treated with local isoniazide (INH)
Immunization Guidelines5. The following are not contraindications:
d Deep (subcutaneous) abscess indicates wrong technique SC rout
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d. Deep (subcutaneous) abscess indicates wrong technique, SC rout
ID route. Treatment includes incision and drainage and local INH.
(1) Do not expose to sunlight(2) Do not apply alcohol on site of injection
(3) Side effects include local inflammatory reaction, superficial absc
with pus at times
(4) If no side effects, repeat BCG after 2 months
(5) Kochs phenomenon: begins after 2-4 days like a normal reactio
treatment neededb. Permanent scar formation: 2-12 weeks after
c. Indolent ulceration: does not heal within 12 weeks indicates the p
secondary infection and can be treated with local isoniazide (INH)
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Malnutrition is not a contraindication for immunizing childrit is an indication for immunization since common childhoo
are often severe to malnourished children.
COLD CHAIN UNDER EPI Cold Chain is a system used to maintain potency of a vaccine from that of manufact
time it is given to child or pregnant woman.
Th ll bl ti f f th t f i t diff t l l
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The allowable timeframes for the storage of vaccines at different levels are:
6months- Regional Level
3months- Provincial Level/District Level
1 month-main health centers-with ref.
Not more than 5days- Health centers using transport boxes.
Most sensitive to heat: Freezer (-15 to -25 degrees C)
OPV
Measles
Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celsius)
BCG
DPT
Hepa B
TT
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COLD CHAIN UNDER EPI Cold Chain is a system used to maintain potency of a vaccine from tha
manufacture to the time it is given to child or pregnant woman.
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The allowable timeframes for the storage of vaccines at different leve
6months- Regional Level
3months- Provincial Level/District Level
1month-main health centers-with ref.
Not more than 5days- Health centers using transport boxes.
Most sensitive to heat: Freezer (-15 to -25 degrees C)
OPV Measles
Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celsius)
BCG
DPT
Cold Chain Considerations
d h h
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OPV and AMV are the most sensitive to HEAT with storagetemperature of -15 degrees C to -25 degrees C
BCG, DPT, HBV, TT are sensitive to heat and freezing with stotemp of 2 degrees C to 8 degrees C; use of cold packs duringtransport
Maximum Storage and TransportConsiderations1 RHO PHO DHO 3 h
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1. RHO PHO DHO 3 months
2. RHU 1 month
3. Maximum transport period if with cold packs 5 days
UNDER FIVE CLINIC PROGRA
O i
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Overview
The first five years of life form the foundations of the childs physical a
growth and development. Studies have shown the mortality and morbhigh among this age group. The Department of Health established theClinic Program to address this problem.
Program Objectives and Goals
Monitor growth and development of the child until 5 years of age. Identify factors that may hinder the growth and development of the c
UNDER FIVE CLINIC PROGRA
Activities and Strategies
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Activities and Strategies
Regular height and weight determination/ monitoring until 5 years old
old=monthly 1 year old and above =quarterly
Recording of immunization, vitamins supplementation, deworming an
Provision of IEC materials (ex. Posters, charts, and toys) that promote enhance childs proper growth and development.
Provision of a safe and learning oriented environment for the child.
Monitoring and Evaluation.
ENVIRONMENTAL HEALTH &SANITATION
Environmental Health
I t A C itt E i t l H lth
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Inter-Agency Committee on Environmental Health
Laws & Policies that Affect Environmental Health & Sanitation
Water Supply Sanitation ProgramProper Excreta Disposal Program
Solid Waste Management/Garbage Disposal
Vector Control Program
Food Sanitation Program
Environmental QualityProper Housing
Other Environmental Health Services
Climate Change
ENVIRONMENTAL HEALTH &SANITATION
OVERVIEW
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OVERVIEW
Environmental Sanitation is still a health problem in the count
Diarrheal diseases ranked second in the leading causes of moramong the general population.
Other sanitation related diseases : tuberculosis, intestinal paraschistossomiasis, malaria, infectious hepatitis, filariasis and dehemorrhagic fever.
The DOH through the Environmental Health Services (EHS) uauthorized to act on all issues and concerns in environment anincluding the very comprehensive Sanitation Code of the Philip856, 1978).
ENVIRONMENTAL HEALTH &SANITATIONEnvironmental Health
A branch of public health that deals with the study of preve
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A branch of public health that deals with the study of preveillnesses by managing the environment and changing people
behavior to reduce exposure to biological and non-biologicaof disease and injury.
Environmental Sanitation
Study of all factors in mans physical environment, which maa deleterious effect on his health, well-being, and survival
ENVIRONMENTAL HEALTH &SANITATIONEnvironmental Sanitation
Study of all factors in mans physical environment, which may exercise
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deleterious effect on his health, well-being, and survival
Environmental factors:
1. Water supply sanitation 11. Stream pollution
2. Proper excreta disposal
3. Solid waste management (refuse and garbage disposal)
4. Insect vector and rodent control
5. Food sanitation
6. Air pollution
7. Proper housing
8. Noise
9. Radiological protection
10. Institutional sanitation
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
EO 489
l l h ( ) f d
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Inter-Agency Committee on Environmental Health (IACEH) was formed
composed of 11 members chaired by the secretary of DOH, with secreta
vice-chair. Committee members come from DPWH, DILG, DA, DTI, DOTC,
NEDA, and Public Information Agency.
Functions of IACEH:
1. Formulate policies and guidelines and develop programs for environm
health protection
2. Coordinate, monitor, and evaluate EH program and development proje
3. Undertake information dissemination and education campaigns on EH
programs
4. Coordinate, assist, and/or support the conduct of research and relevan
activities for environmental maintenance and protection
ENVIRONMENTAL HEALTH &SANITATION
Laws & Policies Affecting Environmental Health & Sanitation
1. Senate Resolution 676
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1. Senate Resolution 676
2. RA 6969
3. RA 8749
4. RA 9003
5. RA 9275
6. PD 856
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
Senate Resolution 676
St kh l C ti P i t t O i P ll t t (POP ) i M
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Stockholm Convention on Persistent Organic Pollutants (POPs) in May
the Phils. was a signatory was ratified by the Senate on Feb. 2, 2004
Bans the use of POPs in households and industries. POPs consists of the so-called Dirty Dozen of pesticides, industrial chem
unintentional products of burning which are:
1. Pesticides aldrin and dieldrin, endrin, chlordane, heptachlor, DDT,
hexachlorobenzene, mirex, and toxaphene
2. Industrial chemicals polychlorinated biphenyls and hexachlorobenze
3. Unintentional by-products of burning dioxins and furans (caused by
plastics)
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
RA 6969
T i S b t & N l W t C t l A t f 1990
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Toxic Substances & Nuclear Waste Control Act of 1990
Regulates the importation, use, movement, treatment, and disposal of to
and hazardous and nuclear wastes in the Philippines
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
RA 8749
Clean Air act of 1999
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Clean Air act of 1999
Provides a comprehensive air pollution management and control program
and maintain healthy air.1. Section 20 bans the use of incineration for municipal, bio-medical and
wastes but allows the traditional method of small-scale community bu
2. All motor vehicles are required to pass the smoke emission test prior to
3. Phasing out leaded gasoline by the end of the year 2000.
4. Lowering of the sulfur content of all automotive diesel fuels.
5. Decreasing the aromatic and benzene levels in unleaded gasoline.
6. Banning of smoking in public places including public transport in order
indoor pollution due to second-hand smoke
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
RA 9003
Ecological Solid Waste Management Act of 2000
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Ecological Solid Waste Management Act of 2000
Declares the adoption of a systematic, comprehensive, and ecological so
management program as a policy of the state using the community-baseand mandating waste diversion through composting and recycling.
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
RA 9275
Clean Water Act of 2004
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Clean Water Act of 2004
Aims to establish wastewater treatment facilities that will clean waste w
is released into the bodies of water like rivers and seas. Requires LGUs to form Water Management Areas that will manage waste
their respective areas
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
Supplemental Implementing Rules & Regulations (IRR) of Chapter II of Sa
Code of the Philippines
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Code of the Philippines
Water refilling stations should regularly monitor their drinking water qu
following schedules:1. Monthly for bacteriological quality
2. Every 6 months for physical and chemical properties
3. Annually for biological quality and radiologic properties when the nee
All water analysis procedures done only in DOH-accredited laboratories
The water quality should follow the Philippine National Standards for D
(PNSDW).
INTER-AGENCY COMMITTEE ON ENVIRONMHEALTH
PD 856
Supplemental IRR on Chapter XVII on Sewage Collection and Disposal a
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Supplemental IRR on Chapter XVII on Sewage Collection and Disposal a
Disposal and Drainage of the Sanitation Code of the Philippines regulat
provides proper guidelines for LGUs and establishments involved in the dcollection, handling, and transport and disposal of domestic sludge from
communal septic tanks, domestic sewage treatments plantas/facilities a
from household septic tanks
SANITATIONEnvironmental & Occupational Health Office (EOHO) This is under the National Center for Disease Prevention & Contr
of the DOH
Responsible for:
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Responsible for:
a. Promotion of healthy environmental conditions
b. Prevention of environmental related diseases through appropsanitation strategies like:
(1) Water quality surveillance
(2) Evaluation of food establishments
(3) Proper solid and liquid waste management
(4) Sanitation of public places(5) Sanitation management of disaster areas
(6) Impact assessment of environmentally critical projects
(7) Enforcement of sanitation laws, rules, regulations, & stand
SANITATIONEnvironmental & Occupational Health Office (EOHO) Has 2 divisions:
1. Water & Sanitation Division
2. Health Care Waste & Toxic/Hazardous Division
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2. Health Care Waste & Toxic/Hazardous Division
Programs/projects:
1. Water for Life2. Hospital Waste Management
3. Urban Health and National Projects
4. Pasig River Rehabilitation Program
ENVIRONMENTAL HEALTH &SANITATION
Presidential Proclamation 856
Sanitation Code of the Philippines
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Sanitation Code of the Philippines
WATER SUPPLY SANITATION PROGRAM
Approved Types of Water Supply
Level I: Point Source
Level II: Communal Faucet System/Stand-Post
Level III: Waterworks System/Individual House Connection
ENVIRONMENTAL HEALTH &SANITATION
Level I: Point Source Type
Protected well or developed spring with an outlet
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p p g
Without distribution system
Adaptable for rural areas where the houses are thinly scat
15-25 households
Must not be more than 250 meters from the farthest user
Yield/discharge: 40-140 liters per minute
ENVIRONMENTAL HEALTH &SANITATION
Level II: Communal Faucet System/Stand-Post Type
1. Source
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2. Reservoir
3. Piped distribution network
4. Communal faucet
Not more than 25 m away: farthest
40-80 liters/capital/day
Average: 100 households
4-6 households/faucet
For rural areas where houses are clustered densely to justify piped system
ENVIRONMENTAL HEALTH &SANITATION
Level III: Waterworks System/Individual House Connections
1. Source
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2. Reservoir
3. Piped distribution network
4. Household taps
Requires minimum disinfection
For densely populated urban areas
ENVIRONMENTAL HEALTH &SANITATION
Access to Safe & Potable Drinking Water
Certification of potability of an existing water source is issued by the S
the DOH or his duly authorized representative.
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the DOH or his duly authorized representative.
ENVIRONMENTAL HEALTH &SANITATION
Water Supply & Sanitation-related Diseases
Food- and water-borne diseases such as cholera and typhoid
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are some of the leading causes of morbidity and mortality in
Cholera manifests 1st as diarrhea but can lead to dehydrateven death if not treated swiftly
Typhoid accompanied by sustained high fever, headaches,
and constipation or abdominal discomfort
ENVIRONMENTAL HEALTH &SANITATION
Water Purification
FILTRATION eliminates sediments
CHLORINATION kills microorganisms
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g
FLUORIDATION fortification BOILING 5-10 minutes from boiling point
*Drinking water should be replaced every
Unapproved Types of Water Supply: doubtful sources like
OPEN DUG WELL
UNIMPROVED SPRING WELLS that need priming
The community must exert effort to convert approved type of water
supply
ENVIRONMENTAL HEALTH &SANITATION
Water Quality Monitoring Surveillance
Disinfection of Water Supply
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Newly constructed water facility
Repaired/improved water facility Water sources found to be (+) bacteriologically by lab analys
Container disinfection of drinking water collected from wate
subject to contamination like:
a. Open dug wells
b. Unimproved springs
c. Surface water
ENVIRONMENTAL HEALTH &SANITATION
Household Water Treatment
1. Boiling
Heating water to boiling point to destroy pathogens
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Heating water to boiling point to destroy pathogens
2. Chemical coagulation
Use of aluminum sulfate (tawas) to coagulate suspended materials in
3. Filtration
Use of sand, piece of cloth, or any other material for filter to remove
materials from water
ENVIRONMENTAL HEALTH &SANITATION
Household Water Treatment
4. Chlorination
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4. Chlorination
Adding chlorine to water to kill pathogens
a. Buy commercial chlorine solution (6%-10% sodium hypochlorite)
b. Prepare Chlorine Stock Solution by adding 1 tsp. of commercial chlo
solution to 1 L of water
c. Disinfect drinking water by adding 3 teaspoonfuls of chlorine stock s
liters of water
5. Softening boiling or adding certain chemicals to reduce calcium and
magnesium salts which cause water to be hard
ENVIRONMENTAL HEALTH &SANITATION
Waterworks/Water System
Well sites: approval
C l t it i t
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Comply to sanitary requirements
Supply of safe and potable water Adequate pressure and volume in the water system distribu
ENVIRONMENTAL HEALTH &SANITATION
Proper Excreta & Sewage Disposal Program
Approved Types: Toilet Facilities
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LEVEL 1
1. Non-water carriage toilet facility Water is not needed to wash the waste into the receiving sp
Pit latrines
Reed odorless earth closet
2. Toilets requiring small amount of water Pour flush toilets
Aqua privies
ENVIRONMENTAL HEALTH &SANITATION
Approved Types: Toilet Facilities
LEVEL 2
1 Water sealed
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1. Water-sealed
2. Flush type with septic vault/tank disposal facilities
LEVEL 3
1. Water-carriage type of facilities connected to septic tanks
sewerage system connected to treatment plants
ENVIRONMENTAL HEALTH &SANITATION
Terminologies related to Excreta Disposal Management:
Pail system a pail or a box is used; balot system included
Open Pit Privy a pit covered by a platform with an uncovered hol
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Open Pit Privy a pit covered by a platform with an uncovered hol
Closed Pit Privy a pit covered by a platform with a covered hole Bored-hole Latrine a deep but relatively narrow hole made with
equipment
Overhung Latrine the toilet house is constructed over a body of w
Antipolo-type elevated toilet house; the shallow pit is extended u
Water-sealed latrine a water-sealed toilet bowl is placed over a p
Flushed-type waste is disposed by flushing water through pipes (a sewerage system or septic tank
ENVIRONMENTAL HEALTH &SANITATION
Terminologies related to Solid Waste Management/Garbage D
Hog feeding left-over food/waste is used as hog feed
Open dumping garbage is piled in a dumping place with no s
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Open dumping garbage is piled in a dumping place with no s
covering Open burning garbage is piled then later burned in the open
Burial in pit garbage is placed in a pit and covered when fille
no intention to use as fertilizer
Composting biodegradable materials or garbage are convert
compost or soil conditioner Collection garbage is collected regularly by a facility for prop
disposal
ENVIRONMENTAL HEALTH &SANITATION
Vector Control Program
Focuses on sustainable preventive and vector control measure
the malaria parasite and mosquito vector
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the malaria parasite and mosquito vector.
Objective: to reduce the source of infection in the human popreducing/eliminating man-vector contact and reducing the de
mosquito vector population.
Vector-borne diseases include malaria, dengue fever, and deng
hemorrhagic fever.
ENVIRONMENTAL HEALTH &SANITATION
Vector Control Measures
1. Insecticide treatment of mosquito nets - where the mosqui
soaked in insecticide and allowed to dry and used as a prote
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soaked in insecticide and allowed to dry and used as a prote
measure against mosquitoes when a person sleeps whethereven when he takes a nap during the day.
2. House spraying of insecticide on surfaces whether indoor o
3. On-stream seeding involves the construction of bio-ponds
larvivorous fish propagated by the LGUs and their correspon
communities especially in malaria-endemic areas4. On-stream clearing involves removing vegetation overhan
to expose the stream to sunlight rendering it unsuitable for
propagation
ENVIRONMENTAL HEALTH &
SANITATIONPolicies of the Food Sanitation Program1. Inspection/approval of food sources, containers, & transport veh
2. Sanitary permit for all food establishments
3. Health Certificate for food handlers, cooks, and cook-helpers wh
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monitoring for the presence of intestinal parasites (ascaris, amoe
and bacterial infection (typhoid, cholera, dysentery, salmonella i
4. Banning of food unfit for human consumption like double-dead
botcha which are being dumped/sold in some markets
5. DOH Administrative Order No. 1-2006 requires all laboratories t
Formalin Ether Concentration Technique (FECT) instead of the d
smear in the stool analysis of food handlers. This will enable the identify infected food handlers and treat them before they are al
work in food establishments
ENVIRONMENTAL HEALTH &SANITATION
Policies of the Food Sanitation Program
Training of food handlers and operators on food sanitation
Rating and classification of food establishments
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g
Class A - ExcellentClass B - Very Satisfactory
Class C - Satisfactory
Compliance of requirements as to the issuance of health certifica
ambulant food vendors
Promotion & monitoring of household food sanitation and food
education
ENVIRONMENTAL HEALTH &SANITATION
Hospital Waste Management Program
Disposal of infectious, pathological and other wastes from hospital whcombine them with the municipal or domestic wastes pose health haz
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p p
people. Hospitals shall dispose their hazardous wastes thru incinerators or dis
to prevent transmission of nosocomial diseases
ENVIRONMENTAL HEALTH &SANITATION
Program on Health Risk Minimization due to Environmental
Prevention of serious environmental hazards resulting from
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Prevention of serious environmental hazards resulting from
growth and industrialization Policies on health protection measures
Researches on effects of GLOBAL WARMING to health (deplthe stratosphere ozone layer which increases ultraviolet radclimate change and other conditions)
ENVIRONMENTAL HEALTH &SANITATION
Nursing Responsibilities and Activities:
Health Education IEC by conducting community assemblies and ben
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y g y
conferences. The Occupational Health Nurse, School Health Nurse and other Nursin
impart the need for an effective and efficient environmental sanitatioplaces of work and in school.
Actively participate in the training component of the service like in FoHandlers Class, and attend training/workshops related to environmen
Assist in the deworming activities for the school children and targeted
ENVIRONMENTAL HEALTH &SANITATION
Nursing Responsibilities and Activities:
Effectively and efficiently coordinate programs/projects/activities with
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government and non-government agencies.
Act as an advocate or facilitator to families in the community in matteprogram/projects/activities on environmental health in coordination wmembers of Rural Health Unit (RHU) especially the Rural Sanitary Insp
Actively participate in environmental sanitation campaigns and projeccommunity. Ex. Sanitary toilet campaign drive for proper garbage disp
beautification of home garden, parks drainage and other projects. Be a role model for others in the community to emulate terms of clea
the home and surrounding.
ENVIRONMENTAL HEALTH &SANITATION
Policies of the Food Sanitation Program
Inspection/approval of all food sources, containers, & transp
vehicles
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Sanitary permit Health Certificate for food handlers, cooks, and cook-helper
include monitoring as to the presence of intestinal parasites
amoeba, E. coli, among others) and bacterial infection
Banning of food unfit for human consumption
Household sanitation
ENVIRONMENTAL HEALTH &SANITATION
Hospital Waste Management Program
Prepare and implement Hospital Waste Management Progr
(HWM)
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( )
Use of appropriate technology & indigenous materials Training of personnel
Admin: PUBLIC INFORMATION CAMPAIGN
SENTRONG SIGLA MOVEMENT (
1998 DOH embarked in a Quality Assurance Program (QAP) witof making DOH and LGU as active partners in providing quality hservices
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1999 QAP was renamed to Sentrong Sigla Movement (SSM) or Vitality Movement (SS Phase 1)
2001 Effort to raise quality of health was intensified, leading to2
SS PHASE 1 Sentrong Sigla Movement (SSM)
SS PHASE 2 Expansion of the concern for quality beyond DOH-
interaction level into the entire health sector Sentrong Sigla Certification the certification strategy of SSM thremained an important strategy in the accreditation approach ofbroader Philippine Quality in Health Program (QIP)
SENTRONG SIGLA MOVEMENT (
GOAL: Improvement of the Quality of Services provided by HEALCENTERS
AIM T t il bilit f lit i i h lth t
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AIM: To promote availability of quality services in health centershospitals and to make these services accessible to every Filipino
MAIN COMPONENT: CERTIFICATION RECOGNITION PROGRAM
FOUR PILLARS:
1. QUALITY ASSURANCE PILLAR
2. GRANTS & TECHNICAL ASSISTANCE
3. HEALTH PROMOTION
4. AWARDS
SENTRONG SIGLA MOVEMENT ( LEVEL & SCOPE OF CERTIFICATION:
1. Basic SS Certification minimum input, process, & outpu
standards for integrated public health services for 4 core
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health programs, facility systems, regulatory functions, ancurative services
2. Specialty Awards 2nd level quality standards for selecte
public health programs
3. Awards for Excellence highest level quality standards fo
maintaining Level 2 standards for the 4 core public healthand level 2 facility systems for at least 3 consecutive years
SENTRONG SIGLA MOVEMENT ( SS Certification validity of certification is every 2 years.
1. Facilities which did not progress to a higher level of cert
but maintained current certification are:
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but maintained current certification are:
a. given stickers to confirm the renewal of the validity of
b. no other incentives given for mere renewal of SS statu
2. Facilities that slide back; seal will not be removed but no
an SS sticker
INTEGRATED MANAGEMENT OFCHILDHOOD ILLNESS (IMCI) Respiratory Infection Control
Control of Diarrheal Diseases
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Ear Problems
Malnutrition & Anemia
INTEGRATED MANAGEMENT OFCHILDHOOD ILLNESS (IMCI)1. Respiratory Infection Control COLOR SYSTEM
PINK ROW: Severe classification; needs immediate attention
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referral YELLOW ROW: needs appropriate antibiotic/other treatmen
GREEN ROW: no need for specific medical treatment such aantibiotics
INTEGRATED MANAGEMENT OFCHILDHOOD ILLNESS (IMCI)3. EAR PROBLEMS COLOR SYSTEM
PINK ROW: Mastoiditis
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YELLOW ROW: Acute ear infection, Chronic ear infection
GREEN ROW: No ear infection
FIELD HEALTH SERVICES &INFORMATION SYSTEM (FHSIS) TREATMENT RECORD: fundamental building block or found
the Field Health Services and Information System
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TARGET/CLIENT LIST: second building block The FHSIS Report Forms are to be submitted by the reportin
identified in the upper portion of the page
REPORTING UNIT: defined as any DOH health care facility threnders public care-related health services
BARANGAY HEALTH STATION: lowest level of reporting unit
VITAL STATISTICS
Vital Statistics is the systematic study of vital events such asillnesses, marriages, divorce, and deaths
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Births and deaths are registered in the Office of the Local CiRegistrar
RATE: shows the relationship between a vital event and thoexposed to the occurrence of the said event, within a given during a specified unit of time
RATIO: relationship between 2 numerical quantities or meaevents without taking particular considerations to time and
VITAL STATISTICS
CRUDE/GENERAL RATES: rates referred to the total living po
SPECIFIC RATE: limits the occurrence of event to the portion
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population definitely exposed to it INFANT MORTALITY RATE: a good index of the general healt
condition of the community
VITAL STATISTICS
PRESENTATION OF DATA:
Line or Curve Graphs: show peaks, valleys, and seasonal tre
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period of time, e.g. births, deaths Bar Graphs: each bar represents or expresses a quantity in t
rates or percentages of a particular observation, e.g. causesand deaths
Area Diagrams: (Pie chart) show the relative importance of
the whole
VITAL STATISTICSEPIDEMIOLOGY: Epidemiology: concerned with the study of the factors that
the occurrence and distribution of diseases, defects, disabil
death
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It concerns the factors of causation It is the backbone of disease prevention
Nurses Roles:
1. Maintains surveillance of the occurrence of notifiable dis
2. Casefinding and collection of laboratory specimens
3. Isolation precautions4. Organize, coordinate, and conduct community health edu
campaign
VITAL STATISTICSDEMOGRAPHY:
Demography is the study of the populatio
Statistics on population and the character
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such as age and sex, distribution are obtai
from NSO
Thats all for ThisMorning..
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Thank YOU!
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