Community

Health Nursing

Community
A group if species who reside in a
designated geographic are and
who share common interests and
bonds.
A group of persons united by
some common feature or shared
interest.

Health
A state of complete physical,
mental, and social well-being, not
merely the absence of disease or
infirmity.

Public Health

The art of applying science in the

context of politics so as to reduce
inequalities in health while
ensuring the best health for the
greatest number.

Community Health

part of paramedical or medical

intervention/ approach which is
concerned on the health of the
whole or population

Aims:
health promotion
disease prevention
management of factors affecting
health

Public Health Nursing

A special field of nursing that
combines the skills of nursing,
public health and some phases of
social assistance for the
promotion o health, the
improvement of conditions in the
social and physical environment,
rehabilitation, prevention of
illness and disability.

Community Health Nursing

The utilization of the nursing
process in the different levels of
clientele-individuals, families,
population groups and
communities, concerned with the
promotion of health, prevention
of disease and disability and
rehabilitation.

Community Health Nursing

Goal: To raise the level of citizenry
by helping communities and
families to cope with the
discontinuities in and threats to
health in such a way as to maximize
their potential for high-level
wellness.

THE PHILIPPINE HEALTHCARE

DELIVERY SYSTEM

Department Of Health
Mandated as the lead agency in
health at the national level
Local Government Units
Runs the local health system
Provincial and district hospitals
RHUs and BHSs

Department Of Health
R.A. 7160 (1991) Local
Government Code

Decentralization
LGU (implementation)
DOH (governance)

E.O. 102 (1999)

The Department of Health is the national

authority on health, providing technical and
other resource assistance to local
government units, peoples organization, and
other members of the civic society in
effectively implementing programs, projects,

(a) Promote the health and well-being of every

Filipino.
(b) Prevent and control diseases among
population at risks.
(c) Protect individuals, families, and
communities exposed. to hazards and risks that
could affect their health, and
(d)Treat, manage, and rehabilitate individuals
affected by diseases and disability.
Roles and Functions: DOH EO 102
1. Leadership in Health
-national policy and regulatory institution where
LGUs and NGOs will base their direction for
health

2.Enabler and Capacity Builder

-innovates new strategies in health to improve
effectiveness of health programs
- ensures highest achievable standards of
quality health care

3. Administrator of Specific Services

-manage selected national health facilities that
shall serve as national referral centers
-administers health emergency response
services

Department Of Health
Vision by 2030: A global leader for
attaining better health outcomes,
competitive and responsive health
care system, and equitable health
financing.
Mission: To guarantee equitable,
sustainable, and quality health for all
Filipinos, especially the poor, and to
lead the quest for excellence in health.

Department Of Health
Goal: Health Sector Reform Agenda
(HSRA)

Overriding goal of the DOH

Conceptualized because although there has
been a significant improvement in the health
status of Filipinos for the fast 50 years some
the following conditions were still seen in the
population:

slowing down in the reduction of Infant Mortality Rare

(IMR)
persistence of large variations in health status across
population groups
high burden from infectious diseases
rising burden from chronic and degenerative diseases
unattended emerging health risks

Support mechanisms of HSRA:

Sound organizational development
Strong Policies, Systems, and procedures
Capable Human Resources
Adequate Financial Resources

Framework for Implementation:

FOURmula One for Health
Goals
Better health outcomes
More responsive health systems
Equitable health care financing

The Four Elements:

Health financing investment
Health regulationensure quality and
affordability of health goods
Health Service Delivery improve and
ensure the accessibility and availability of
basic and essential care
Good governance enhance health system
performance at national and local levels

Primary Health Care

Essential Health made universally
accessible to individuals and
families in the community by
means acceptable to them thru
their full participation and at cost
that the community and country
can afford at every stage of
development.
Mission: To strengthen the health
care system by increase
opportunities and supporting the

Primary Health Care

Was declared during the First
conference on Primary Health
Care was held in Alma Ata, USSR
on Sept. 6-12, 1978 by the WHO
as a strategy for community
health.
Goal: Health for All by the year
2000
Letter of Instruction 949 signed
on October 19, 1979 by Pres.
Marcos with a theme: Health in

Primary Health Care

It is a strategy aimed to provide
essential health care that is
(concept): (CAPAS)
Community-based
Accessible
Part and parcel of the total socioeconomic development effort of
the nation
Acceptable
Sustainable at an affordable cost

Primary Health Care

Elements of Primary Health
Care

Education of prevailing Health Problems

Locally-endemic Disease Prevention and Control
Expanded Program of Immunization
Maternal and Child Health and Family Planning
Environmental Sanitation and Safe Water Supply
Nutrition and Food Supply
Treatment of Communicable & Noncommunicable Diseases/ Conditions
Supply and Proper use of Essential Drugs and
Herbal Medicine
Dental Health Promotion
Access to and use of hospitals as Centers of
Wellness

Primary Health Care

The Four Cornerstones/Pillars of
Primary Health Care
1. Active Community Participation
2. Intra and Inter-sectoral Linkages
3. Use of Appropriate Technology
4. Support Mechanism Made
Available

Primary Health Care

8 Millennium Development
Goals
1. Eradicate extreme hunger and poverty
2. Achieve universal primary education
3. Promote gender equality and empower
women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other
diseases
7. Ensure environmental sustainability
8. Develop a global partnership for
development

Vital Statistics
The systematic study of vital events such as
births, deaths, illness, marriages and divorce.
SOURCES OF DATA:
Population Census once every 10 years
Registration of vital data birth, death,
divorce
Individual Health records and family records
Weekly Reports from Field health Personnel
Categories of Data according to Sources:
Primary data- those obtained first hand by
the investigator for the purpose of the study
Secondary data- those which are existing and
obtained by other people for purposes not
necessarily those of the investigator

Vital Statistics
Methods of data Collection:
Documented Sources
Ocular Inspection
Participant Observation
Interview
Group Interview
Sample Survey
Focus Group Discussion

Vital Statistics
Crude Birth Rate
The measure of one characteristic of the natural
growth or increase of a population.
Number of live births during a given year
x 1000
population estimated at mid
year
General Fertility Rate
Number of live births during a given year x
1000 female pop (15-44 y.o.)
population estimated at mid-year for
females age 15-44 during the same year

Vital Statistics
Crude Death Rate
The measure of one mortality from all causes which may
result in a decrease of population.
number of deaths from all causes during a given year x
1000
population estimated at mid year
Specific Death rate
Describes the risk of certain classes or groups to
particular disease.
Cause specific
Number of deaths from a specific condition during a given
year population estimated at mid year x 100,000
Age Specific
Number of deaths for a specified age group during a
given year x 1000
population estimated at mid year for the specific age

Vital Statistics
Infant Mortality Rate
Measures the risk of dying during the first year of life. It
is a good index of the general health condition of the
community.
Number of deaths under 1 year of age during the given
year x 1000 LBs
Number of live births during the same year

Maternal Mortality Rate

Measures the risk of dying from causes related to
pregnancy, childbirth and puerperium.
Number of deaths from the puerperal complications
during a given year
number of live births during the same year
x 100,000

Vital Statistics
Fetal Death Rate
Measures pregnancy wastage. Death of the product of
conception occurs prior to its complete expulsion,
irrespective of duration of pregnancy.
Number of fetal deaths at 20 weeks of gestation (or more) during a
given year x 1000
number of live births and fetal deaths during the same year

Neonatal Death Rate

Measures the risk of dying the 1st month of life.
serves as an index of the effects of prenatal care and
obstetrical management of the newborn.
Number of deaths under 28 days of age during a given year x 1000
Number of live births during the same year

Vital Statistics
Birth Death Ratio

Number of live births in a specified

population x 1000
Number of deaths in the same
population

Case Fatality Ratio

Number of deaths from a specified disease or

condition
Number of reported cases of the
specified disease or condition
x 100,000

Vital Statistics
General Morbidity Rate
Total number of sick persons
x 1000
population estimated at mid year
Prevalence Rate
-measures the proportion of the population which exhibits
a particular disease at a particular time; deals with NEW
and OLD CASES
Number of old and new cases of a specific disease or
condition
existing at a point in time
x 100,000
total population at the same point in time

Vital Statistics
Incidence Rate
Measures the frequency of occurrence of the
phenomenon; deals with NEW CASES.

number of new cases of a specific disease or

condition occurring during a given period of
time
population at risk during the same time period
x 100,000

Vital Statistics
Attack rate
Accurate measure of the risk of exposure.
Number of new cases of a disease in a time period
100
population at risk during that time
Rate
The relationship between a vital event and those
persons exposed to the occurrence of said event,
within a given area and during a specified time.

Ratio
Describes the relationship between 2 numerical
quantities or measures of events without taking
particular considerations to the time or place.

Expanded Program of
Immunization
Goal: morbidity and mortality
reduction of immunizable
diseases

Expanded Program of
Immunization
PD 996

Compulsory Basic Immunization to all children

before reaching 8 years old
Started in 1976 by MOH
Target Population:
A. Infants (0-12 months):
BCG, DPT, OPV& Measles
HBV (1996)
B. School Entrants:
MECS: Grade 1=7 years old
DECS: Grade 1=6 yrs. old (1993)
Booster of BCG

RA 7846 Compulsory HBV before 8 years old:1996

PP 4
Measles Elimination Program (September &
October)
1994 1997 Ligtas Tigdas (6 months-8 years)

Expanded Program of
Immunization
PP 6

PP 147

Universal Mother & Child Immunization Law advocated by

WHO from 1996 and onwards: 5 vaccines + Tetanus Toxoid
Strengthens the EPI Program
1. Pregnant mothers-Tetanus Toxoid
2. Children:
Infants-5 vaccines
School entrants-BCG booster dose
3. Before EPI total immunization-5
After EPI total immunization-6 (Tetanus
toxoid was included)
4. OPV was given to all children under 5 years old
irregardless of the # of doses & the time OPV was given

Declaring the National Immunization Day Plus (NIDs Plus)

initiated by former Sec. Flavier in 1993-1995
Initially every 3rd Wednesday of January & February (19931995)
1996 to present: Still being practiced but not every 3 rd
Wednesday of January & February
2002: 2nd Tuesday of March & April
At present: depends on the Secretary

Expanded Program of
Immunization
PP 773

Launched the Polio Elimination Program (PEP)

1995-2000: Zero Polio Philippines, 1. Knock
Out Polio (KOP)
2. Zero Polio Philippines (1996-2000)
3. Patak Polio (< 5 years old)

PP 1064

AFP (Acute Flaccid Paralysis) Elimination

Program-an adverse effect of Polio

PP 1066

Neonatal Tetanus Elimination

Morbidity
Mortality

Expanded Program of
Immunization
Vaccine (# of
Doses)
BCG-1 dose

Schedule

Site and Dose

At Birth
School Entrants (6
years old)

0.05ml ID (Deltoid)
0.10ml ID (Deltoid)

DPT-3 doses
HBV-3 doses

1st
6 wks or 1 mos 0.5ml IM (Upper
nd
2 10 wks or 2 mos Outer Thigh)
3rd 14 wks or 3 mos

OPV-3 doses
2 drops oral

MV-1 dose

9-12 months

0.05ml SC (Outer
Part Upper Arm)

Expanded Program of
Immunization
Tetanus Toxoid Immunization Schedule
Route: 0.05ml IM (Deltoid)
Primary Dose

TT1

Primary Dose

TT2

1st Booster

TT3

2nd Booster

TT4

3rd Booster

TT5

Anytime
during
Pregnancy
(5th-6th
months)
4 weeks after
TT1
6 months after
TT2
1 year after TT3
1 year after
TT4

3 years
immunity
5 years
immunity
10 years
immunity
Lifetime
immunity

Expanded Program of
Immunization
Side Effects
BCG:
Inflammation at the site (Kochs phenomenon) - warm
compress
Glandular enlargement, deep abscess, indolent
ulceration - incision and drainage and powdered INH
DPT:
Inflammation at site: warm compress
Fever for a day
Abscess - incision and drainage and antiseptic
(betadine)
Measles:
Fever 3-5 days within a week after injection
Mild rashes

Expanded Program of
Immunization
COLD CHAIN Logistics
A system used to maintain the potency of a vaccine from that of
manufacture to the time it is given to child or pregnant woman.
Storage of vaccine should not exceed:
6 mos. @ the Regional Level
3 mos. @ the Provincial Level
1 mo. @ main Health Centers (with refrigerators)
not more than 5 days @ Health Centers (using transport
boxes)
Important points to remember:
Arranging of stored vaccine according to:
Type
Expiration date
Duration of Storage
Number of times they have been brought out to the field
The vaccine stored the LONGEST AND THOSE THAT WILL
EXPIRE FIRST should be distributed or used 1st

Expanded Program of
Immunization
Vaccines which are opened, though not
consumed, should be discarded.
Reasons: They cannot be used for future
program because of vaccine half life
(duration of potency).
BCG and MV - 4 hours half life
Other vaccine - 8 hours half life
Use Cold Dogs for transport.

Expanded Program of
Immunization

Most
Sensitive
to Heat

Storag Vaccine
e
Temper
ature
OPV

Form

Liquid

Dose/ Container

Conditions when
exposed to HEAT/
FREEZING

20 dose/ special Easily damaged by

bottle or
heat: not
-25C
25 dose/special
destroyed by
to
bottle
freezing
-15C Measles Freeze dried
10 dose/vial
Easily damaged by
FREEZER
heat: not

destroyed by

freezing

BCG Freeze dried

20 dose/amp
Destroyed by heat,
BODY OF
50 dose/amp
sunlight; not
THE
destroyed by
REFRIGERA
freezing
TOR
DPT
LIQUID
20 dose/vial
Destroyed by
+ 2C
freezing
TO

+ 18C
Damaged by heat
Least
and freezing
Sensitive
Hepa-B
Liqiud
20 dose/vial
Damaged by heat
to heat

or freezing
Tetanus
Liquid

Expanded Program of
Immunization

Frequently Asked Questions (FAQs)

Q: What if the child failed to return after the first dose of the vaccine
(D.O.H.), can we still give it?
A: YES. It is a MUST to complete the doses .
Q: Is it necessary to repeat the 1st dose?
A: NO. just give the REMAINING doses not given.
Remember the principle: Even if the interval exceeded that of the
expected interval, continue to give the doses of the vaccine.
Q: What is the eligible age for giving immunization (up to what age can
we give the immunization)?
A: Before the child reaches 6 years old
Q: If there has been a reported epidemic of measles, is it okay to give
measles vaccine at an earlier age?
A: In case of measles epidemic, we can give MEASLES as early as 6
months of age .
* A booster dose of BCG shall also be given to all school entrants both in
private and public schools REGARDLESS of presence of BCG scar.

Expanded Program of
Immunization

Q: What if the 2nd dose of Tetanus Toxoid was not given to the mother,
when is the best time to give the dose?
A: It has to be given after birth in order to protect the mother and the
succeeding pregnancies.
Q: Is there any contraindication to giving DPT, OPV, Hepa-B?
A: There is none, EXCEPT when the child had convulsions upon giving the
1st dose of DPT. Mothers must be warned that the incident of
CONVULSION upon giving the 1st dose of DPT, MUST BE REPORTED.
Q: What if the child has fever of <38.5 C, mild respiratory infections and
diarrhea, should the child be given the vaccine? A: The abovementioned
conditions are not to be considered as a contraindication to
immunization. Thus, vaccine can still be given.
Q: What if the child Is malnourished?
A: MALNUTRITION is not a contraindication, but RATHER an INDICATION
for immunization since common childhood diseases are often severe to
malnourished children

BreastFeeding Program
Two (2) Beneficiaries of BF Program:
1. Mother-regulated by R.A. 7600: Breastfeeding
and Rooming-In Act

. Breastfeeding is an effective contraceptive method because it

stimulates the anterior pituitary gland to produce prolactin
hormone putting the female in an anovulatory stage
theres amenorrhea for 6 months from the time she gave
birth
. Rooming-in (RI) is putting together of mother and the
newborn and it stimulates the posterior pituitary gland to
release oxytocin hormone stimulates the uterine muscle
contraction that inhibits the implantation of fertilized zygote
in the endometrium no pregnancy occurs

Children-regulated by EO 51: Milk Code of the

Philippines
2.

. Dictum of Milk Code: Never commercialized a brand name of

BreastFeeding Program
3 Principles to make breastfeeding
effective: 3 Es
Early: start BF as early as possible NSD: after 30
minutes;
CS: after 3-4 hours
Exclusive: for the 1st six months; never alternate BF
with any supplementary feeding
Extensive: BF can be extended to 2 years

Unique Characteristics of BF:

Breast milk: EO 51-best for babies
Reduced allergy
Easily established
Always available
Safe makes/maintains soft stool
Temperature: right temperature 24C body reference if
to be frozen, preservation is minimum of 3 months &

BreastFeeding Program
Fresh always
Emotional bonding
Economical
Digestible: It contains lactalbumin, a protein
substance.
Immunity: Colostrum contains Ig A that protects
baby for the 1st 3 months.
Nutritious (optional)
GIT diseases such as diarrhea is
minimized/lessened because it is sterile.

Epidemiology
The study of occurrences and distribution of
diseases as well as the distribution and
determinants of health states or events on
specified population, and application of this
study to the control of health problems.
Concerned not only with deaths and illnesses,
but with positive health states and means to
improve health
Is considered as the backbone of preventing
disease
2 Main Areas of Investigation:
distribution of disease
search for determinants (causes) of disease
and its observed distributions

Epidemiology
Uses of Epidemiology (Morris):
Study the history of the health population and rise and
fall of diseases
Diagnose health of the community and condition of
people to measure distribution and dimension of illness
in terms of:
-incidence
-prevalence
-disability
-mortality
Study the work of health services with a view of
improving them
Estimate risk of disease, accident, defects, and
chances of avoiding them
Identify syndromes by describing the distribution and
association of clinical phenomena
Complete the clinical picture of chronic disease
Search for causes of health and disease by comparing
the experience of groups

Epidemiology
The Epidemiologic Triangle
A change in any of the components will alter
an existing equilibrium to increase or
decrease the frequency of the disease.
Classifications of Agents, Hosts, and
Environmental Factors which determine
the occurrence Disease in Human
Population
1. Agents of Disease
2. Host Factors (Intrinsic Factors)
3. Environmental Factors

Epidemiology
Patterns of Occurrence and Distribution
ENDEMIC
The habitual presence of a disease in a given
geographic location accounting for the low number of
immunes and susceptible.
causative factor of the disease is constantly available
or present in the area
EPIDEMIC
A situation when there is a high incidence of new cases
of a specific disease in excess of the expected.
when the proportion of the susceptible are high
compared to the proportion of the immune
PANDEMIC
global occurrence of a disease
SPORADIC
A disease occurs every now and then affecting only a
small number of people relative to the total population.

Epidemiology
Outline of Plan for Epidemiological Investigation
1. Establish fact of presence of epidemic
2. Establish time and space relationship of the disease
3. Relations to characteristic of the group of community
4. Correlation of all data obtained

Epidemiology and Surveillance Units

established in regional and some local office as support
to the public health system
responsible for providing timely and accurate
information on diseases in the locality
responsibilities include:
1. surveillance of infectious diseases
2. assisting LGUs in investigation of outbreaks
3. developing information package
4. providing technical assistance

Epidemiology
Public Health Surveillance
An ongoing systemic collection, analysis, interpretation, and
dissemination of health data.
considered information loops or cycles involving health care
providers, public health agencies, and the public
Information Loop:
1. Cases of disease occur
2. Cases are reported by health care providers to health agencies
3. Information about cases is relayed to those responsible for disease
prevention
4. Feedback of surveillance information is received by health providers,
health agencies, and the public
Surveillance
an continuous collection and analysis of data of cases and death
public health nurse function as a researcher in disease surveillance

Objectives:
measures magnitude of the problem
measures effect of the control program

Epidemiology
National Epidemic Sentinel Surveillance System (NESSS)
hospital based information system that monitors the
occurrence of infectious disease with outbreak potential
supplemental information system of the DOH

Objectives:
Provide early warning on occurrence of outbreaks
Provide program managers, policy makers, and public
administrators, rapid, accurate and timely information do that
inventive control measures can be instituted
NESSS shows:
Trends of cases across time
Demographic characteristics of cases
Estimates case fatality ratio
Clustering of cases in a geographical area
Formulate hypothesis for disease causation

Epidemiology
National Epidemic Sentinel Surveillance System (NESSS)
hospital based information system that monitors the
occurrence of infectious disease with outbreak potential
supplemental information system of the DOH

Objectives:
Provide early warning on occurrence of outbreaks
Provide program managers, policy makers, and public
administrators, rapid, accurate and timely information do that
inventive control measures can be instituted
NESSS shows:
Trends of cases across time
Demographic characteristics of cases
Estimates case fatality ratio
Clustering of cases in a geographical area
Formulate hypothesis for disease causation

Environmental Sanitation
It is defined as the study of all factors in mans physical
environment, which may exercise a deleterious effect on
his health, well-being and survival.
Goal:
To eradicate and control environmental factors in disease
transmission through the provision of basic services and
facilities to all households.
Components
Water Supply Sanitation Program
Proper Excreta and Sewage Disposal Program
Insect and Rodent Control
Food and Sanitation Program
Hospital Waste Management Program
Strategies on Health Risk Minimization
Environmental and Occupational Health Office (EOHO)

Water Supply Sanitation Program

3 Types of Approved Water Supply and Facilities

Level I
Point Source

Level II
Level III
Communal faucet system or Waterworks system or
stand posts
individual house
connections Level III
Protected well or developed Source of reservoir, A piped source, reservoir, a piped
spring with an outlet but
distribution network,
distributor network and
with out a distribution
communal faucets
households tap
system
Rural areas that are
urban areas where
Rural areas
clustered densely
population is dense
Serves around 15 to 25
not more than 25 meters

households
from the farthest user

Outreach: not more than

deliver 40 to 80 liters per

250 meters from the

day to 100 households
farthest user
one faucet per 4 to 6
Yield or discharge: 40 to
households
140 liters per minute

A system with a source, a

A system composed of a
reservoir, a piped
source, a reservoir, a piped distributor network and
A protected well or a
distribution network and
household taps that is
developed spring with an
communal faucets located suited for densely
outlet but without a
at not more than 25 meters populated urban areas.
distribution system for rural from the farthest house in
areas where houses are
rural areas where houses
thinly scattered.
are clustered densely.

Environmental Sanitation
Unapproved type of water facility:
Open dug wells
Unimproved springs
Wells that need priming

Disinfection of water supply sources is required

on the following:
Newly constructed water supply facilities
Water supply facility that has been repaired
or improved
Found to be positive bacteriologically by lab
analysis
Open dug wells
Unimproved springs
Surface water

Proper Excreta and Sewage Disposal

System
Level 1

Level 2

Level 3

Non-water carriage
toilet facility:
- Pit latrines
- Reed Odorless
Earth Closet
- Bored-hole
- Compost
- Ventilated
improved pit

Toilets requiring small

amount of water to
wash waste into
receiving space:
- Pour flush
- Aqua-privies

On site toilet
Water carriage types of toilet
facilities of the
facilities connected to septic
water carriage type tanks and/or to sewerage
with water sealed system to treatment plant.
and flushed type
with septic
vault/tank disposal
facilities.

Environmental Sanitation
Proper Solid Waste Management
- refers to satisfactory methods of storage collection and
final disposal of solid wastes.

Household
Burial

Community
Sanitary landfill or controlled
-Deposited in tipping
1m x 1m deep pits

covered with soil, located Excavation of soil deposition of

25m away from water
refuse and compacting with a
supply.
solid cover of 2 feet.

Open Burning
Incineration
Animal feeding
Composting
Grinding and disposal
sewer

Environmental Sanitation
Food Sanitation Program
Policies:
Food establishment are subject to inspection
(approved of all food sources containers and
transport vehicles).
Comply with sanitary permit requirement
Comply with updated health certificates for food
handlers, helpers, cooks
All ambulant vendors must submit a health certificate
to determine present of intestinal parasite and
bacterial infection.
DOH AO #1
Requires all laboratories to use Formalin Ether Concentration
Technique
( FECT ) instead of the direct fecal smear in
the analysis of stools of foodhandlers.
This will enable laboratories to identify food handlers with
parasitic infection and treat them before they are allowed to
work in food establishment.
All ambulant vendors must submit a health certificate to
determine present of intestinal parasite and bacterial
infection.

Environmental Sanitation
Food establishment shall be rated and
classified as:
Class A- Excellent
Class B- Very Satisfactory
Class C- Satisfactory

3 Points of Contamination
Place of production processing and
source of supply
Transportation and storage
Retail and distribution points

Environmental Sanitation
Four Rights in Food Safety

Right Source:
Always buy fresh meat, fish, fruits & vegetables.
Always look for the expiry dates of processed foods and avoid
buying the
expired ones.
Avoid buying canned foods with dents, bulges, deformation ,
broken seals
and improperly seams.
Use water only from clean and safe sources.
When in doubt of the water source, boil water for 2 minutes.

Right Preparation:
Avoid contact between raw foods and cooked foods.
Always buy pasteurized milk and fruit juices.
Wash vegetables well if to be eaten raw such as lettuce,
cucumber,
tomatoes & carrots.
Always wash hands and kitchen utensils before and after
preparing food.
Sweep kitchen floors to remove food droppings and prevent the
harbor of

Environmental Sanitation
Right Cooking:
Cook food thoroughly. Temperature on all parts of the food should
reach 70 degrees centigrade.
Eat cooked food immediately.
Wash hands thoroughly before and after eating.

Right Storage:
All cooked foods should be left at room temperature for NOT more
than two hours to prevent multiplication of bacteria.
Store cooked foods carefully. Be sure to use tightly sealed
containers for storing food.
Be sure to store food under hot conditions (at least or above 60
degrees centigrade) or in cold conditions (below or equal to 10
degrees centigrade). This is vital if you plan to store food for more
than four to five hours.
Foods for infants should not be stored at all. It should always be
freshly prepared.
Do not overburden the refrigerator by filling it with too large
quantities of warm food.
Reheat stored food before eating. Food should be reheated to at
least 70 degrees centigrade.

Rule in Food Safety: When in doubt, throw it out!

Environmental Sanitation
Hospital Waste Management
Goal:
To prevent the risk of contraction nosocomial infection from type
disposal of infectious; pathological and other wastes from
hospital.
Policies:
All newly constructed/ authorized and existing
government and private hospitals shall prepare and
implement a Hospital Waste Management ( HMW ) as a
requirement for registration and renewal of licenses.
Use of appropriate technology and indigenous resources
Training of all hospital personnel
Public information campaign on health and environmental
hazard shall be the responsibility of the hospital
administration.

Environmental Sanitation
HEALTH RISK MINIMIZATION
Anti- smoking Belching Campaign and Air
Pollution Campaign
Zero Solid Waste Management
Toxic, chemical, and Hazardous Waste
Management
Red Tide Control and Monitoring
Integrated Post Management and
Sustainable Agriculture
Pasig River Rehabilitation Management

Environmental Sanitation
Hospital Waste Management
Goal:
To prevent the risk of contraction nosocomial infection from type
disposal of infectious; pathological and other wastes from
hospital.
Policies:
All newly constructed/ authorized and existing
government and private hospitals shall prepare and
implement a Hospital Waste Management ( HMW ) as a
requirement for registration and renewal of licenses.
Use of appropriate technology and indigenous resources
Training of all hospital personnel
Public information campaign on health and environmental
hazard shall be the responsibility of the hospital
administration.

Non-Communicable Diseases
Integrated Community Based NonCommunicable Disease Prevention and
Control Program
Goal:
To reduce the toll of morbidity, disability, and
premature deaths due to chronic, noncommunicable lifestyle- related diseases.
Leading Lifestyle- Related Causes of Morbidity
1.Cardiovascular Diseases
2.Cancer
3.COPD
4.Diabetes Mellitus

Non-Communicable Diseases
Leading Lifestyle Related Causes of Mortality
1. Heart and Vascular System Disease
2. Cancers
3. COPD
4. Accidents
5. Diabetes
6. Kidney Problems
Health Promotion
Major strategy for the prevention of the emergence of
risk factors

Healthy Lifestyle
a way of life that promotes and protects well-being
includes practices that promote health such as:
healthy diet and nutrition, regular and adequate
physical activity and leisure, avoidance of
substances that can be abused, adequate stress
management and relaxation, safe sex,
immunization

Non-Communicable Diseases
Objectives:
1. Analyze the social, economic, political, and
behavioral determinants of NCD
2. Reduce exposure of individuals and population to
major determinants of NCD while preventing
emergence of preventable common risk factors.
3. Strengthen health care for people with NCD through
health sector reforms and cost- effective interventions

Approaches Used in Non-Communicable Disease

Prevention and Control:
1. Comprehensive Approach Focused on Primary
Prevention
2. Community-Based Approach
3. Integrated Approach

Non-Communicable Diseases
Key Intervention Strategies
1. Establishing program direction and
infrastructure
2. Changing environments
3. Changing lifestyle
4. Reorienting health services
Role of the Public Health Nurse in NCD
Prevention and Control
1. Health advocate
2. Health educator
3. Health care provider
4. Community Organizer
5. Health Trainer
6. Researcher

Non-Communicable Diseases
Role of the Public Health Nurse in Risk Assessment and
Screening:
1. Educate as many people and in every opportunity
2. Educate people on how to prevent the NCD risk
factors
3. Every client, not only the patient seeking
consultation, should be assessed for the presence of
risk factors
4. Train other health workers on performing risk factor
assessment

When risk factors are present:

1. Advise retesting if needed
2. Explain the significance of the finding
3. Educate on how to modify risk factors and promote
positive lifestyle change
4. Monitor and follow up
5. Refer for confirmation of diagnosis

Herbal Medicine
RA 8423: Alternative Traditional
Medicine Law
A program where patient may opt to
use herbal plants especially for drugs
that are not available in dosage form
or patients has no financial means to
buy the drug.

10 Advocated Herbal Plants by DOH: LUBBY SANTA

Plant
Name
Lagundi

Ulasiman
g Bato
Bayabas

Bawang
Yerta
Buena

Scientific Indication
Name
s
Vitex
Asthma,
negundo
cough,
colds &
fever
(ASCOF)
Pain and
inflammati
on
Peperonia
Gout
pellucida
Arthritis
Rheumatis
m
Psidium
Diarrhea
quajava
Toothache
Mouth and
wound
wash
Allium
HPN
sativum
Toothache
Mentha
Same as
cordifelia Lagundi
except

Plant Part
Preparation
Used
Leaves
Decoction
Poultice

Leaves

Decoction
Poultice

Leaves

Decoction

Clove/Bulb

Poultice

Leaves

Decoction
Poultice

Sambong
Akapulko

Blumea
balsanifer
a
Cassia
alata

Niyog
niyogan

Quisqualis
indica

Tsaang
Gubat

Carmona
resuta

Ampalaya

Mamordic
a
charantia

Edema
Diuretic

Leaves

Decoction

All forms of
skin
diseases
Intestinal
Parasitism
(Nematode
s)
Diarrhea
Infantile
colic
(Kabag)
Dental
caries
Type II
Diabetes
(NIDDM)

Leaves

Decoction
Poultice
Cream
Decoction
Poultice
Juice

Seeds

Leaves

Decoction
Poultice

Leaves

Decoction