CHN History Act No. 157- Creation of Board of Health of the Philippine (BON) Act No. 14 7- A!

olish BOH "#$%

1&1& 'rs. Car(en "el )osario * 1st +ilipino N,rse -,per.isor 1&& -1&&/ * $ocal )e.ol,tionary Code of 1&&10 )A 711 )e.ol,tion Code National to local "efinition Health * (2HO) state of co(plete physical0 (ental and social 3ell !ein40 not (erely the a!sence of disease or infir(ity P,!lic health * ("r. C.5. 2inslo3) the science and art of pre.entin4 disease0 prolon4in4 life0 pro(otin4 health and efficiency thro,4h or4ani6ed co((,nity effeort. Co((,nity Health N,rsin4 (7aco!son)- is a learned practice discipline 3ith the ,lti(ate 4oal of contri!,tin4 as indi.id,al and in colla!oration 3ith others to the pro(otion of clients opti(,( le.el of f,nction thro,4h teachin4 and deli.ery of care. +actors affectin4 Opti(,( $e.el of +,nction (O$O+) 1. /. 8. 4. 5. 1. Political Beha.ioral hereditary Health Care "eli.ery -yste( 5n.iron(ental #nfl,ences -ocio econo(ic #nfl,ences

Concepts 1. 9he pri(ary foc,s of co((,nity health n,rsin4 practice is on health pro(otion. /. Co((,nity health n,rses are 4eneralist in ter( of their practice thro,4h life !,t the 3hole co((,nity.

8. Co((,nity health n,rses are 4eneralist in ter(s of their practice thro,4h life contin,ity in its f,ll ran4e of health pro!le(s and needs. 4. 9he nat,re of CHN practice re:,ires that c,rrent ;no3led4e deri.ed fro( the !iolo4ical0 social science0 ecolo4y0 clinical n,rsin4 and co((,nity health or4ani6ations !e ,tili6ed 5. Contact 3ith the client and or fa(ily (ay contin,e o.er a lon4 period of ti(e 3hich incl,des all a4es and all types of health care. 1. 9he dyna(ic process of assessin40 plannin40 i(ple(entin4 and inter.enin4 pro.ide (eas,re(ents of pro4ress0 e.al,ation and a contin,,( of the cycle ,ntil the ter(ination of n,rsin4 is i(plicit in the practice of co((,nity health n,rsin4. Principles 1. CHN is !ased on reco4ni6ed needs of co((,nities0 fa(ilies0 4ro,ps and indi.id,als. /. 9he co((,nity health n,rse (,st ,nderstand f,lly the o!<ecti.es and policies of the a4ency she represents. 8. #n CHN0 the fa(ily is the =nit of ser.ices. 4. CHN (,st !e a.aila!le to all re4ardless of race0 creed and socioecono(ic stat,s 5. Health teachin4 is a pri(ary responsi!ility of the CHN. 1. 9he co((,nity health n,rse 3or;s as a (e(!er of the health tea(. 7. 9here (,st !e a pro.ision for period>s e.al,ation of co((,nity health tea(. ?. Opport,nities for contin,ation staff ed,cation pro4ra(s n,rses (,st !e pro.ided !y the CHN a4ency. 9he co((,nity health n,rse also has a responsi!ility for his@her o3n professional 4ro3th. &. 9he co((,nity health n,rse (a;es ,se of a.aila!le co((,nity health reso,rces. 1 . 9he co((,nity health n,rse ,tili6es the already eAistin4 acti.e or4ani6ed 4ro,ps in the co((,nity. 11. 9here (,st !e pro.ision for ed,cati.e s,per.ision CHN 1/. 9here sho,ld !e acc,rate recordin4 and reportin4 in CHN. P,!lic Health N,rse 1. /. 8. 4. 5. 1. 7. ?. Planner@pro4ra((er Pro.ide of N,rsin4 Care@Care4i.er 'ana4er@-,per.isor Co((,nity Or4ani6er Coordinator of -er.ice 9rainer@ Health 5d,cator@ Co,nselor Health (onitor )ole 'odel

&. Chan4e A4ent 1 . )ecorder@ )eporter@ -tatistician 11. )esearcher Co((,nity Health Process Assess(ent Collection of data0 collected fro( fa(ily0 4ro,ps and co((,nity. 5Aa(plesB "e(o4raphic "ata Cital Health -tatistics Co((,nity "yna(ics Health -tat,s 5d,cation 'ethodsB Co((,nity -,r.ey #nter.ie3 -tatistics 5pide(iolo4ical st,dies Co((on indicators of health stat,s 'or!idity 'ortality Cate4ories of Health Pro!le(s 1. Health "eficit (H")- instances of fail,re in health (aintenance ( dse0 disa!ility0 de.>tl la4) -eA. "se@ illness- =)9#0 (aras(,s0 sca!ies0 ede(a disa!ilities- !lindness0 polio0 color!lindness0 deafness de.>tl pro!le(s li;e (ental retardatA0 4i4antis(0 hor(onal0 d3arfis( Health 9reat (H9)- conditions cond,ci.e to dse0 accidents or fail,re to reali6e one>s health potential healthy people eA. +a(ily hA of illness- hereditary li;e "'0 HPN n,tritional pro!le(s- eatin4 salty foods personal !eha.ior- s(o;in40 self-(edication0 seA,al practices0 dr,4s0 eAcessi.e drin;in4 inherent personality char- short te(peredness0 short attn span short cross infectA poor ho(e en.i lac;@inade:,ate i((,ni6ation ha6ards- fire0 falls0 or accidents

 fa(ily si6e !eyond 3hat reso,rces can pro.ide +oreseea!le Crisis (+C)- anticipated periods of ,n,s,al de(and on indi. or fa( in ter(s of ad<,st(ent or fa(ily reso,rces ( nat,re sit,atAs) eA. 5ntrance in school adolescents (circ,(cision0 (enarchs0 p,!arche co,rtship (fallin4 in lo.e0 !rea;in4 ,p) (arria4e0 pre4nancy0 a!ortion0 p,erperi,( death ,ne(ploy(ent0 transfer or relocation 4rad,ation0 !oard eAa( #dentify the ffB 5AB Acti.e 9B- H" 45 yr0 old (ale s(o;e- H9 -edi(entary health style- Ht 5arly pre4nancy- +C +ather of fa(ily losses his <o! +C "eath in the fa(ily- +C Patient is sic; d,e to pne,(onia- H" Children 3ho are not i((,ni6ed- H9 $ac; of prenatal chec; * ,p- H9 5cla(psia- H" 2or;in4 ha6ard- H9 Hypertensi.e- H" 2ith (easles DchildE- H" +a(ily (e(!ers has liprosy ((icro!actria liporea)- H" 'arria4e- +C Co((,nity dia4nosis A. B. C. ". 5. Physical Characteristics Pop,lation Characteristics 5n.iron(ental factors Fno3led4e0 attit,de0 practices of the people Co((,nity reso,rces and facilities

Plannin4B Based on the act,al and potential pro!le(s that 3ere identified and prioriti6ed %oalB "eclaration of p,rpose or intent0 4i.es essential direction to action -pecific o!<ecti.esB 'ade in ter(s of acti.ities of daily li.in4 #(ple(entationB Carries o,t n,rsin4 proced,res 3hich are consistent 3ith n,rsin4 3ith n,rsin4 care plans. #n.ol.e the patient 3ith his@her fa(ily

 =tili6ed s,pport syste( 5.al,ation +ra(e 3or;s a. -tr,ct,ral ele(ents !. Process ele(ents c. O,tco(e ele(ents N,rsin4 Proced,res Clinic Cisit 1. /. 8. 4. Pre-cons,ltation conference 'edical eAa(ination N,rsin4 inter.ention Post cons,ltation conference

Ho(e Cisit- face to face contact 3ith the client Principles 1. A ho(e .isit sho,ld ha.e a p,rpose or o!<ecti.e /. Plannin4 for a ho(e .isit sho,ld ,se e.ery a.aila!le infor(ation a!o,t the fa(ily0 and indi.id,al 8. Plannin4 sho,ld re.ol.e aro,nd the essential needs of the indi.id,al 4. Plannin4 of a contin,in4 care in.ol.e the indi.id,al or fa(ily 5. Plannin4 sho,ld !e fleAi!le and practical Ba4 techni:,e- 9ool P,!lic health !a4- is an indispensa!le e:,ip(ent of the p,!lic health n,rse Principles 1. /. 8. 4. Pre.ent the spread of infection -a.e ti(e and effort sho,ld not shado3 the concern for the patient Can !e perfor(er in a .ariety of 3ays Gippira( sol,tion- disinfectant

N,rsin4 Care in the Ho,se Principles 1. N,rsin4 care ,tili6es a (edical plan of care and treat(ent.

/. Perfor(ance of n,rsin4 care ,tilities s;ills that 3o,ld 4i.e (aAi(,( co(fort and sec,rity. 8. N,rsin4 care at ho(e sho,ld !e ,sed as a teachin4 opport,nity. 4. Perfor(ance of n,rsin4 care sho,ld reco4ni6ed dan4ers in the patients> o.erprolon4ed acceptance of s,pport and co(fort. 5. N,rsin4 care is an opport,nity for detectin4 a!nor(al si4ns and sy(pto(s. #solation 9echni:,es All Articles ,sed !y the patient sho,ld not !e (iAed 3ith the articles ,sed !y the rest of the (e(!ers of the ho,sehold. +re:,ent 3ashin4 and airin4 of !eddin4s and other articles and disinfectants of roo( are i(perati.e 9he one carin4 for the sic; (e(!er sho,ld !e pro.ided 3ith a protecti.e 4o3n that sho,ld !e ,se 3ith in the roo( of the sic;. All dischar4es0 especially fro( the nose and throat of a co((,nica!le disease patient sho,ld !e caref,lly dischar4ed. Articles 3ith dischar4es sho,ld !e first !oiled for 8 (in,tes !efore la,nderin4. 9hos co,ld !e !,rned0 sho,ld !e !,rned. "OH CisionB H5A$9H +O) A$$ BH / P5OP$5 BH / /

I H5A$9H #N 9H5 HAN"- O+ 9H5

'issionB 5ns,re accessi!ility and :,ality of health care to i(pro.e the :,ality of life of all +ilipinos0 especially the Poor. National O!<ecti.es 1. /. 8. 4. 5. 1. 7. #(pro.e 4eneral health stat,s )ed,ce (or!idity0 (ortality and disa!ility rates 5li(inate p,!lic health pro!le(s 5radicate polio(yelitis Pro(ote healthy lifestyle Pro(ote health and n,trition Pro(ote en.iron(ental health

Basic Principles 1. /. 8. 4. =ni.ersal access to !asic health ser.ices Health and n,trition of .,lnera!le 4ro,ps 5pide(iolo4ical shift fro( infectio,s to de4enerati.e Perfor(ance of the health sector (,st !e enhanced

Pri(ary strate4ies to achie.e health 4oals

a. #ncrease in.est(ent for pri(ary health care !. "e.elop(ent of national standards and o!<ecti.es for health Her!al 'edicine 1. aro(atic- has .olatile oil for tA of fe.er0 co,4h0 colds0 itchiness and 4as pain. $,ya0 !a3an40 si!,yas0 yer!a B,ena0 ore4ano0 (an6anilla0 tan4lad0 sa(!on40 la4,ndi0 JJJ or petals of sa(pa4,ita0 <as(ine I rosal $,ya- shd not !e ta;en on an e(pty sto(ach 5liAir- JJJJJJ -ha;e 3ee; after 3ee;KtA for 9B Ba3an4 cr,sh 1 ear I drin; it 9inct,re of !a3an4 1B5 Add 5 t!sp. of 4inL 1 t!sp chopped !a3an4 -ha;e 1 (ins for 1 3ee; * 4ood for s,perficial 3o,nds 9an4lad- le(on 4rassKfor fe.er -a(!on4Ksto(achache -,ha@;ala(ansi- for fe.er0 9-B /. astrin4ent-tastin4- !itter- has tannin I pectin for diarrhea I 3o,nd A .ocado lea.es B aya!as lea.es F a(ilo lea.es " ,hat lea.es - a4in4 lea.es (sa!a c,t into chips0 let dry0 p,l.eri6e then add to JJJJJ) 8. !itter-tastin4 a. s;in pro!le(s--Acap,lco0 ;alach,chi0 (al,n44ay0 ;a;a3ati0 ina;a!,hay !. depressants- to p,t hyper people to sleep--dapdap0 dita0 (a;a!,hay0 (a;ahiya c. anti-cancer dr,4-- tsitsiri;a d. aches I pains-- sa(!on40 da(on4 arya e. asth(a- tala(p,4ay- can ca,se psychosis 4. seeds- fiAed oils0 anti-hel(entics- niy,4-niyo4an (,rine)0 patola0 ipil-ipil0 !etel n,t or !,n4a0 !alanyo40 s:,ash seeds0 lan6ones- do not thro3 peelin4s instead0 !,rn itK 4ood insect repellant 5. 4rass fa(ily- di,reticsK;a4on0 t,!o0 tan4lad0 pandan0 p,4o-p,4o0 !,to-!,tones0 4atas-4atas0 ata<,o ;ahol0 pansit-pansitan or ,lasi(an4 !ato0 stones- (eis hair(0 HPN- palay 1 'edicinal PlantsB $ a4,ndi- asth(a0 co,4h0 colds = lasi(an4 !ato- ,ric acid0 HPN B a3an4- HPN

B aya!as- "iarrhea H er!a B,ena- arthritis0 toothache0 s3ollen 4,(s0 co,4h I colds - a(!on4- co,4h and colds0 renal stones A (palaya- "' N iy,4-nyo4an- ascariasis 9 saan4 4,!at- diarrhea A cap,lco- f,n4al infection0 sca!ies )A ?4/8- ,tili6ation of (edicinal plants as alternati.e for hi4h cost (edications. 5pide(iolo4y- st,dy of distri!,tion and dyna(ic of disease occ,rrence in h,(an pop,lation 5nde(ic- constant presence of disease or infection a4ent 3ith in a 4i.en 4eo4raphic area 5pide(ic- occ,rrence in a co((,nity or re4ion of cases of an illness clearly in eAcess of eApectancy Pande(ic- epide(ic so 3idely spread that .ast n,(!ers of people in different co,ntries are affected -poradic- disease that occ,rs only occasionally or in a fe3 isolated places -,r.eillance- a contin,in4 scr,tiny of all aspects of occ,rrence and spread of a disease that is pertinent to effecti.e control ( pro(otion0 pre.enti.e patient and reha!ilitati.e) -entinel sites- are health facilities 3hich are selecti.e as representati.es of 3hat is happenin4 in areas 3hose reports are acc,rate0 co(plete and pro(pt (health center) -tatistics- that science in.ol.ed in the collection0 or4ani6ation0 analysis and interpretation of n,(erical data Biostatistics- the scientific discipline concerned 3ith the application of statistical (ethods to pro!le(s in !iolo4ical and (edicine. +ertility )ate 1. CB) (Cr,de !irth rate)- relati.e pop d,e to !irths 9otal n,(!er of !irths in a calendar year CB)M Birth A 1 Pop eA. /5.?M CB) 9here are /1 !irths in e.ery 1

pop

/. %eneral +ertility )ate (%+)) - tr,e fertility rate * specific se4(ents of pop that is fertile %+)M JJJJJJJJBirthJJJJJJJJJJJ A 1 Pop of 3o(en (15 to 44 yo) 5A. %)+M8/ 9here are 8/ !irths in e.ery 3o(an in 15-44 'ortality )ates 1.Cr,de "eath )ate JJJJ A 1 "ecrease in pop d,e to death C")M death A 1 Pop 5A. C")M 1 there are 1 in e.ery 1

pop

/. -pecific 'ortality )ate- can apply to any pop 4rp -') M death fro( or partic,lare 4rp A 1 Pop of that 4rp a. -') ((ales) M death ((ales) A 1 pop of (ales !. -') (fe(ales) M death of fe(ales 15-44 pop of fe(ales 15-44 #nfant 'ortality )ateB #')M "eath -1 year A 1 Births Neonatal 'ortality )ateB N')M deaths -/? days A 1 Births Post Neonatal 'ortality )ateB PN') M deaths /? days to 1 year A 1 Births N') N PN') M #') Neonatal deaths N Post neonatal deathsM #nfant deaths 5A. Birth / N')M / "eath * /? to 1 N') N PN') M #') / N 1 M 8 (AN-) /J A 1 M1 M1 / 1 'aternal 'ortality )ate ('')) '')M death of 3o(en r@t pre4nancy0 deli.ery0 I p,erperi,( A 1 Births 5A. #') M 8 9here are 8 infant deaths in e.ery 1 !irths N') M / 9here are / neonatal deaths in e.ery 1 PN') M 1 !irths

'') M .&/ Proportionate 'ortality )ate M P') ( for any 4rp) P')M death fro( a partic,lar 4rp A 1 total death 5A. 5/O P') of (ales M deaths of (ales A 1 total deaths #n e.ery 1 death0 5/ are (ales

P') M deaths -1 A1 .1 total deaths P)OPO)9#ONA95 'O)9A$#9H #N"#CA9O) A. -3aroop>s #ndeA M -# -# M death of 5 yrs I ,p A 1 total deaths 9he -#0 the !etter the sit,ation isP B. )elati.e i(portance of a ;iller ( 9B0 heart dse0 diarrhea) "eath d,e to 9B A 1 total deaths P') M8 O 9B --#n e.ery 1 deaths0 8 are d,e to 9B Case +atality )ate (C+)) Ho3 is s,r.i.al rate0 ho3 stron4 is ;illin4 po3er0 pro4nosis C+)M death d,e to part ca,se A 1 total cases 5A. C+) M &? H#C JJJdeath H#CJJJ A 1 9otal cases of 9B #n e.ery 1 cases of H#C0 there are &? deaths

Ca,se-of-death )ate ((ortality rate)

)an; as a ;iller 0

C of ")M death d,e to partic,lar ca,se A 1 total pop 5A. C of ") M8/ 9B #n e.ery 1 0

pop there are 8/ deaths d,e to 9B

Pre.alence )ate M ('or!idity rate) )an; as a co((on dise P) M old and ne3 case of 9B A 1 9B total pop 5A. P) M old I ne3 case of 9B A 1 9B 5A. P) M 8/1 9B 9here are 8/1 cases of 9B o,t of 1 0

0 0

pop,lation.

#ncidence )ate #)M JJJne3 casesJJJ A 1 pop at ris;

-3aroff>s #ndeA 9otal death of a person a4in4 a!o.e 5 9otal n,(!er of deaths of all a4es

Q1

-it,ationB Baran4ay Q has a total pop,lation of 181/ for the year 1&&&-/ !ases on the follo3in4 date0 sol.e for the s3aroff>s indeA0 infant (ortality rate0 cr,de death rate and the (aternal (ortality rate -3arrof>s indeAM 7@57 A 1 #')M 17@1/&4 A 10 CB)M 1/&4@181/ A 10 C")M 57@181/ A 10 '')M 8@1/&4 A 10 M 18 M &5 M 4/ M /.88 M 1/.? #)M 1@181/ A 10 M4 &

5ssential Health -er.ices (5$5'5N9-) of PHC 5- 5d,cation on (ethods of pre.entin4 and controllin4 health pro!le(s $- $ocal ende(ic disease pre.ention and control '- 'aternal and child care incl,din4 fa(ily plannin4 5- 5ssential dr,4s N- N,trition 9. 9reat(ent -- -anitation and H/O s,pply +o,r Corner stone@ Pillar in PHC 1. /. 8. 4. Acti.e co((,nity participation #ntra and inter sectoral lin;a4es =se of appropriate technolo4y -,pport (echanis( (ade a.aila!le

$e.els Health Care Pri(ary- Bran4ay D district (id3ife@ trained health 3or;ersE -econdary- )e4ional@"istrict DN=)-5E 9ertiary- Hearth Center0 $,n4 Center etc. - doctor )eprod,cti.e Health ()H) CisionB reprod,cti.e health practices as a 3ay of life for e.er (an and 3o(an thro,4ho,t life ConceptB a. !. c. d. e. f. 4. (arried co,ples has the capa!ility to reprod,ce reprod,cti.e health is eAercise of reprod,cti.e ri4ht p,rpose of enhance(ent of life and personal relation safe pre4nancy0 safe deli.ery protection fro( ,n3anted pre4nancy protection fro( har(f,l reprod,cti.e practice and .iolence ass,res access to infor(ation on seA,ality to achie.e seA,al en.iron(ent

"eter(inants of )HB 1. socio- econo(ic /. stat,s of 3o(en 8. social and 4ender iss,es 4. !iolo4ical0 c,lt,ral and psycho-social factors

%OA$-B 'CH AN" N=9)#9#ON R e.ery pre4nancy sho,ld !e intended R e.ery !irth sho,ld !e healthy R e.ery seA act sho,ld !e free of co erection and infection R achie.e desired fa(ily si6e 9en 5le(ents of )H 1. /. 8. 4. 'aternal and child health n,trition +a(ily plannin4 Pre.ention and (ana4e(ent of a!ortion co(plication Pre.ention and treat(ent of reprod,cti.e tract infection0 respiratory infection and -9"0 H#C@ A#"5. 5d,cation and co,nselin4 on seA,ality and seA health 1. Breast and reprod,cti.e tract cancer 7. Other 4ynecolo4ical condition ?. 'en>s )H &. Adolescent )H 1 . Pre.ention and treat(ent of infertility 9etan,s 9oAiod 91- anyti(e d,rin4 pre4nancy 9/- 4 3ee;s of pre4nancy 98- 1(onths@ /44 3ee;s of pre4nancy 94- 1 year old 95- a!o.e 1 year SPP" &&1 i((,ni6ation pro4ra( Caccine BC% half life 4ho,rs $i.e atten,ated !acteria Dstored T /-?de4ree Celsi,s "P9 half life ? ho,rs 2ea;ened toAin ;illed !acteria stored T/ 2ea;ened toAin to ? de4ree Celsi,s $ "eltoid #' )i4ht@ $eft@ )i4ht )o,te ) dorsal "eltoid "osa4e . 5@(l .1@(l .5@(l +re:,ency At !irth -chool entrance "P9 1- 1th 3ee;s "P9 /- 1 3ee;s "P9 8- 8 U (onths

OPC Hepa B

'easles

Oral /-8 4tts #' anterior . 5@(l thi4h left@ri4ht@ left -V o,ter .5(l part of the ar(

1 3ee;sT 8 doses 1 3ee;s/ 8 doses

4th 3ee;s inter.al

& (onths

-ide effects 1. Foch>s pheno(enon- /-4 days after .accines - ac,te infla((ation deep a!scess- deeper in<ection tAB incession @ draina4e@ #NH po3der

/. +e.er- after and last for 1 day - 9AB antipyretics - (ore that /4 ho,rs after dose D local soreness at the siteE SA!scess- 3ron4 in<ection techni:,e 9AB incision and draina4e SCon.,lsion- rare and occ,rs 8 (onths d,e to pirtosis of .accine(don>t contin,e) 8. -al; * #' NO -#"5 5++5C9-a!in * Oral 4. +5C5) and )ash * 5 * 7 days D.accinationE - last 1-8 days - 'ana4e(entB antipyretic

$eprosy Control Pro4ra( ',lti "r,4 therapy 1&?? )A 4 78 Chronic disease of the s;in and peripheral ner.es ca,sed !y 'yco!acteri,( $eprea or Han>s Bacill,s

5arly s@sB Chan4e in s;in color- reddish or 3hite $oss of sensation "ecrease hair 4ro3th- der(is $oss of s3eatin4- eAocrine ',scle 3ea;ness- ner.es 9hic;ened@ painf,l ner.es =lcer that do not heal $ate s@s 'adiacrosis $a4ophthal(os- ina!ility to close the eye lids Cla3in4 of fin4ers and toes Contract,res -in;in4 of nose !rid4e %yneco(astia Chronic ,lcers Pne,(onia -i4ns +ast !reathin4 Chest in dra3in4 Con.,lsion A!nor(ally sleepy -e.ere ,nder n,trition Not a!le to drin; -tridor ,pon inhalation- a,sc,ltation 2hee6in4- ,pon eAhalation +e.er or lo3 !ody te(p. 'ana4e(ent of pne,(oniaB (ost pne,(onia deaths are pre.enta!le if treated early 9A is !ased B early reco4nition of pne,(onia pro(pt treat(ent of non se.ere cases at ho(e 3ith standard anti!iotics and 4ood s,pporti.e care

 :,ic; identification if se.ere cases and :,ic; referral to the hospitals- pre.ent death 9reatent (ay incl,de anti!iotics ad.isin4 (others to 4i.e ho(e care treatin4 fe.er and 3hee6in4 Ho(e CareB (child 3ith co,4h and colds) no anti!iotics needed feed the child increase fl,id inta;e clear nose ;eep child 3ar( and co(forta!le

-@- that the child (,st !e !ro,4ht to health care facilityB fast !reathin4 diffic,lty !reathin4 ,na!le to drin; feedin4 pro!le( )ole of "r,4s in control of infection children 3ith co,4h and colds 3ith no pne,(onia (,st not !e 4i.en anti!iotics anti!iotics sho,ld only !e 4i.en to cases pne,(onia0 se.ere pne,(onia and .ery se.ere disease CO9)#'OQAGO$5 A.aila!ity of "r,4s 1. Cotri(oAa6ole /. in<ecta!le penicillin 8. othersB O/ (ay !e deli.ered as a life sa.in4 (eas,re co,4h s,ppressant- antit,ssi.e antihista(ine- !ronchodilator Pre.ention of Pne,(onia 1. 9i(ely i((,ni6ation a4ainst (easles and pert,ssis /. 5Acl,si.e B+ for the 1st 4-1 (onths of life 8. %ood n,trition 4. Cit. A s,pple(entation 5. )ed,ce eApos,re to ho,se s(o;e fro( coo;in4@to!acco 1. Feepin4 yo,n4 infants 3ar(- pre.ent O/ loss

7. Practicin4 4ood hy4iene Control of "iarrhea "isease 'ana4e(ent of patient 3ith diarrheaB ,se this chart for patients 3ith a. loose 3atery stools !. loose stools 3ith !lood -tep 1- Asses yo,r patient for dehydration -tep /- Asses for other pro!le(s 1. $oo; at conditionB 3ell alert 5yeB nor(al 9earsB present 'o,th and ton4,eB (oist 9hirstB drin;s nor(ally0 not thirsty /. +eel- -;in PinchB 4oes !ac; :,ic;ly 8. "ecideB No dehydration 4. 9reat(entB treat(ent A 9reat(ent Plan A R to treat diarrhea at ho(e R ,se this plan to teach the (other to 1. Contin,e to treat at ho(e her child>s c,rrent episode of diarrhea /. 4i.e early treat(ent for f,t,re episode of diarrhea 9reat(ent Plan C (-e.er dehydration) Can yo, 4i.e #C+ ------------Hes--------tart #C+ i((ediately DPN-- and .& O NaCl NO #s #C neAt a.aila!le-----------Hes--------end patient 3ithin 8 (in,tes NO Are yo, trained 9o------------Hes-------tart 3ith O)=se N%9 for )ehydration NO Can the patient-----------------Hes-------tart 3ith O)- per ore( "rin; )ehydration

=)%5N9P -end the patient for #C or N%9 2ater "econta(ination Boilin4 /-8 (in,tes Chlorine 1 drop of 5O Na Hypo chloride in 1 $ H/O -tat for / -8 (in,tes Aerate '"9 PB non infectio,s 9,!erc,loid #ndeter(idiate 1-& (onths "ay 1@ /-? )ifa(picin@"apsone

'B- infectio,s $5pra(ato,s@ Borderline

/4-8 (onths "ay 1@ /-/? )ifa(picin Clofa6i(ine "apsone

)O'- )ifa(picin. OfloAacin0 'inocyclinc Pre.ention- BC% Pne,(onia Cery -e.ere =na!le to drin; Con.,lsion "iffic,lt to 3a;e stridor

-e.ere +ast !reath Chest indra3in4

Pne,(onia No Pne,(onia +ast !reathin4 No fast !reathin4 No chest indra3in4 No chest indra3in4

9! Net3or;B N,rse Physician 'id3i.es 5arly case 'ed 9ech +indin4s

Cate4ory 1 Ne3 (N) cases P9B -erio,sly #$$ a. #ntensi.e Phase Ad.ance p,l(onary 9B !. 5Atra p,l(onary 9B / (onths ) ifa(picin # sonia6id P yra6ina(ide 5 tha(!,tol Dsho,ld not ,sed 1 years old !elo3 !eca,se of .is,al dist,r!ance 4 (onths ) ifa(picin # sonia6id

Cate4ory / /-? (onths (aintenance 9reat(ent replaces +ail,re / (onths 8 (onths ) ) # # P P 5 5 -- strepto(ycin D#'E 5 (onths ) # 5

Cate4ory 8 P9B (ini(al(-) 8A sp,t,( s(ear A-ray P9B (ini(al 5Atra 9PB (not serio,s) /(onths ) # P / (onths ) #

ENVIRONMENTAL SANITATION Environmental Sanitation 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 dse transmission through the provision of basic services and facilities to all households. 1. Water upply anitation !rogram 1 types of "pproved Water upply #acilities $evel 1 $evel %% !oint ource &ommunal #aucet system or stand posts $evel %%% Waterwor's system or individual house connections " protected well of a " system composed of a source, a " system with a source, a developed sprung with an reservoir, a piped distribution reservoir, a piped distributor outlet but without a networ' and communal faucets, networ' and household distribution system for rural located at not more than () meters taps that is suited for areas where houses are from the farthest house in rural areas densely populated urban thinly scattered. where houses are clustered densely. areas. Water must pass the *ational tandards for +rin'ing Water set by the +,-. (. !roper .xcreta and ewage +isposal ystem / types of "pproved 0oilet #acilities $evel 1 *on- water carriage toilet facility: $evel ( ,n site toilet facilities of $evel / Water carriage types

the water carriage type of toilet facilities - !it $atrines with water sealed and connected to septic - 1eed ,dorless .arth &loset flushed type with septic tan's and5or to - 2ored--ole vault5tan' disposal sewerage system to - &ompost facilities. treatment plant. - 3entilated improved pit 0oilets re4uiring small amount of water to wash waste into receiving space -pour flush -a4ua privies 1ural "reas- 6blind drainage7 type of wastewater collection and disposal facilities shall be emphasi8ed until such time that sewer facilities and off-site treatment facilities are available. /. !roper olid Waste 9anagement - refers to satisfactory methods of storage, collection and final disposal of solid wastes. 1efuse Garbage 1ubbish

( ways to 1efuse +isposal -ousehold -2urial : deposited in 1m x 1m deep pits covered with soil, located ()m away from water supply - open burning - animal feeding - composting - grinding and disposal sewer &ommunity - anitary landfill or controlled tipping : excavation of soil deposition of refuse and compacting with a solid cover of ( feet - %ncineration

;. #ood anitation !rogram !olicies: #ood establishment are sub<ect to inspection =approved of all food sources containers and transport vehicles> &omply with sanitary permit re4uirement &omply with updated health certificates for food handlers, helpers, coo's "ll ambulant vendors must submit a health cert to det presence of intestinal parasite and bacterial infection. / points of contamination !lace of production processing and source of supply 0ransportation and storage 1etail and distribution points ). -ospital Waste 9anagement Goal: 0o prevent the ris' of contraction contracting nosocomial infection from type disposal of infectious, pathological and other wastes from hospital ?. !rograms related to health-ris' minimi8ation secondary to environmental pollution 0hese include the following: "nti-smo'e 2elching campaign and "ir !ollution &ampaign

@ero olid Waste 9anagement 0oxic, chemical and -a8ardous Waste 9anagement 1ed tide &ontrol and 9onitoring %ntegrated !est 9anagement and ustainable "griculture !asig 1iver 1ehabilitation 9anagement

A. .ducation of prevailing health problems "ccepted activitiy at all levels of public health used as a means of improving the health of the people through techni4ues which may influence peoples thought motivation, <udgement and action. 0hree aspects of -ealth education: %nformation- provision of 'nowledge &ommunication- exchange of information .ducation- change in 'nowledge, attitudes, and s'ills e4uence of teps in -ealth .ducation &reating awareness &reating motivation +ecision ma'ing action

HIV/ STI PREVENTION AND CONTROL ,perational trategies: !romotion of health5 health education +isease detection 0reatment program &ontact tracing &linical services !rogram components: &ase-finding &ase management 0raining 9onitoring 1eporting system ,perations research MENTAL HEALTH - " state of well-being where a person can reali8e his or her own abilities, to cope with the normal stresses of life and wor' productively - 0he emotional ad<ustment the person achieve in which he can live with reasonable comfort, functioning, acceptably in the community where he5she lives - %nvolves the promotion of a healthy state of mind amont the whole pop through +eveloping positive outloo' in life trengthening coping mechanisms

3ulnerable group to the dev of 9ental %llness: Women treet children 3ictims of torture or violence %nternal refugees 3ictims of armed conflicts 3ictims of natural and man-made disasters &omponents of 9ental -ealth !rogram ". tress 2. +rugs and "lcohol "buse 1ehabilitation &. 0reatment and 1ehabilitation of 9entally-ill !atients +. pecial !ro<ect for 3ulnerable Groups tresses in the environment of children such as times of disasters and natural calamities, disintegration of the values, structure and functions of the family and urbani8ation, migration, drugs, and physical and sexual abuse and poverty have direct effects on physical and mental health. G,,+ $B&CD