PROGRAMSSERVICES

&ROWENA C. YUBY: HEPO DESIGNATE PIHES

VISION:VISION:

““Healthy,Empowered Healthy,Empowered and Productive and Productive Kagay-anons”.Kagay-anons”.

VISIONVISION ::

““Healthy, Empowered Healthy, Empowered and Productive and Productive Kagay-anons”Kagay-anons”

CityCity Health OfficeHealth Office – – Cagayan Cagayan de Oro Cityde Oro City

MISSIONMISSION : :

We, the Health Care Manager and We, the Health Care Manager and Providers pledge to provide Providers pledge to provide QUALITY HEALTH CARE through QUALITY HEALTH CARE through regulative preventive, curative and regulative preventive, curative and rehabilitative services. rehabilitative services.

To attain our MISSION, we To attain our MISSION, we subscribed to the following subscribed to the following values :values :

Equality/LiberationEquality/Liberation Knowledge/InsightKnowledge/Insight Self-ActualizationSelf-Actualization Human DignityHuman Dignity Service/VocationService/VocationPHILOSOPHY PHILOSOPHY :: “ “QUALITY SERVICE EVERYTIME”QUALITY SERVICE EVERYTIME”

MATERNAL & CHILD HEALTH SERVICES:MATERNAL & CHILD HEALTH SERVICES:Prenatal Care :Prenatal Care : assessment of pregnancyassessment of pregnancy Early detection of problemEarly detection of problem EducationEducation Advice on proper breastfeedinigAdvice on proper breastfeedinig Nutritional supplementation & couselingNutritional supplementation & couseling Tetanus toxoid immunizationTetanus toxoid immunizationPost Natal Care Post Natal Care

Child Health Care :Child Health Care :

Promotion of breasfeedingPromotion of breasfeedingExpanded program on Expanded program on

immunizationimmunization

NUTRITION PROGRAM NUTRITION PROGRAM SERVICES :SERVICES :1.1. Weighing of 0-71 mos. old childrenWeighing of 0-71 mos. old children2.2. Micronutrient SupplementationMicronutrient Supplementation

a. Vit. A - 9-11 mos. old – 100,000iua. Vit. A - 9-11 mos. old – 100,000iu - 12-59 mos. old – 200,000iu- 12-59 mos. old – 200,000iu - pregnant mothers – 10,000iu- pregnant mothers – 10,000iu - post partum mothers - post partum mothers

200,000iu (w/in 1 mo. After 200,000iu (w/in 1 mo. After delivery) delivery)

- children w/ chronic diarrhea- children w/ chronic diarrhea - children w/ measles - children w/ measles

b. Iron supplementationb. Iron supplementation- low birth weight babies (LBW)- low birth weight babies (LBW)- IDA cases- IDA cases

- severe & moderate malnourished- severe & moderate malnourished childrenchildren

- pregnant mothers- pregnant mothers- lactating mothers- lactating mothers

c. Iodine Supplementation :c. Iodine Supplementation :- Promotion of iodized salt- Promotion of iodized salt

3.3. Deworming - 3-7 yrs. old childrenDeworming - 3-7 yrs. old children4.4. Nutrition Education & Diet CounsellingNutrition Education & Diet Counselling5.5. Food Supplementation (if food Food Supplementation (if food

supplements are available – for supplements are available – for malnourished childrenmalnourished children))

Growth Monitoring AreaGrowth Monitoring Area- - 33rdrd important area for child health care. The important area for child health care. The child’growth is monitored and recorded using the child’growth is monitored and recorded using the Growth Monitoring Chart/Card which is given to Growth Monitoring Chart/Card which is given to the mother as soon as the newborn is registered. the mother as soon as the newborn is registered. The card shows the programs of the child’s The card shows the programs of the child’s growth and other information about the child growth and other information about the child such as illness, immunization, supplemental, such as illness, immunization, supplemental, feeding, vitamin supplementation etc.feeding, vitamin supplementation etc.

DIRECTLY OBSERVED TREATMENT DIRECTLY OBSERVED TREATMENT SHORT COURSE CHEMOTHERAPY SHORT COURSE CHEMOTHERAPY (D.O.T.S)(D.O.T.S) The Life span of a smear positive The Life span of a smear positive

case is about 2 years during which- case is about 2 years during which- time he can infect about twenty other time he can infect about twenty other people. On the other hand, during people. On the other hand, during the first 2 weeks of the D.O.T.S 6-the first 2 weeks of the D.O.T.S 6-month treatment, 6 out of 10 patients month treatment, 6 out of 10 patients are rendered non-infectiousare rendered non-infectious..

D.O.T.S strategy consists D.O.T.S strategy consists of 4 elements which of 4 elements which include :include : Adequate supply of drugsAdequate supply of drugs Treatment partners who see to it that TB Treatment partners who see to it that TB

clients are taking their medications dailyclients are taking their medications daily Training of all health implementorsTraining of all health implementors Political will of the Local Gov’t Executives Political will of the Local Gov’t Executives

as committed partners of this strategy.as committed partners of this strategy.

STEPS ON HOW TO IMPLEMENT STEPS ON HOW TO IMPLEMENT (D.O.T.S)(D.O.T.S)

Smear + TB patients are referred to Smear + TB patients are referred to physician who explains his disease & physician who explains his disease & determines his category of treatment.determines his category of treatment.

The patients then go to the nurse for The patients then go to the nurse for initiation of treatment, who gives initiation of treatment, who gives additional information about his additional information about his medications, possible side effects & medications, possible side effects & schedule of sputum follow-up schedule of sputum follow-up examination.examination.

A treatment partner (nurse, midwife, BHW) A treatment partner (nurse, midwife, BHW) assigned to each patient who will supervise assigned to each patient who will supervise him as he takes his medicaiton everyday once him as he takes his medicaiton everyday once treatment is started.treatment is started.

Each TB patient is allocated complete set of Each TB patient is allocated complete set of anti-TB drugs for the whole duration of anti-TB drugs for the whole duration of treatment.treatment.

Assessment of treatment is done for all Assessment of treatment is done for all patients to determine cure.patients to determine cure.

EXPANDED PROGRAM ON EXPANDED PROGRAM ON IMMUNIZATIONIMMUNIZATIONDiseaseDisease VaccineVaccine Minimum Minimum

Age at 1Age at 1stst DoseDose

No. of No. of DosesDoses

Minimum Minimum Interval Bet. Interval Bet. DosesDoses

TuberculosisTuberculosis BCGBCG Birth or Birth or anytime anytime after Birthafter Birth

11

Diptheria,Diptheria,Pertussis,Pertussis,TetanusTetanus

DPTDPT 6 weeks6 weeks 33 4 weeks4 weeks

PolioPolio Oral PolioOral Polio 6 weeks6 weeks 33 4 weeks4 weeks

Hepatitis BHepatitis B Hepatitis BHepatitis B 6 weeks6 weeks 33

MeaslesMeasles MeaslesMeasles 9 months9 months 11

FAMILY PLANNING FAMILY PLANNING SERVICES :SERVICES :

Family Planning is the voluntary and Family Planning is the voluntary and positive act of couples to plan and decide positive act of couples to plan and decide the number of children they want and the number of children they want and when they want to have them.when they want to have them.

It is deciding :It is deciding : The number of children a married couple The number of children a married couple

wantswants When to have the next babyWhen to have the next baby To use responsible means to achieve the To use responsible means to achieve the

couples desired number of childrencouples desired number of children

To seek help so the To seek help so the childless couple will have childless couple will have childrenchildrenProgram Methods :Program Methods :

A. Temporary Methods :A. Temporary Methods :

1.1. Natural Family Planning MethodsNatural Family Planning Methods1.a Cervical Mucus Method1.a Cervical Mucus Method1.b Basal Body Temperature1.b Basal Body Temperature1.c Symptothermal Method1.c Symptothermal Method

2.2. PillsPills3.3. Intra Uterine DeviseIntra Uterine Devise4.4. DMPADMPA5.5. CondomCondom6.6. Lactaional Amenorrhea Method (LAM)Lactaional Amenorrhea Method (LAM)

B. Permanent Methods :B. Permanent Methods :1.1. Bilateral Tubal LigationBilateral Tubal Ligation

(BTL- Femal Stelization)(BTL- Femal Stelization)2. Vasectomy2. Vasectomy

Other Services/Other Services/Reproductive Health Care :Reproductive Health Care :

Knowing & Treating Reproductive Tract Knowing & Treating Reproductive Tract InfectionsInfections

PAP SmearPAP Smear Breast ExaminationBreast Examination Counseling in Family PlanningCounseling in Family Planning

ENVIRONMENTAL ENVIRONMENTAL SANITATIONSANITATION

a)a) Water sanitation – assist in the Water sanitation – assist in the provision and maintenance of safe and provision and maintenance of safe and adequate water supply to the adequate water supply to the community.community.

b)b) Excreta and sewage disposal-Assists in Excreta and sewage disposal-Assists in the provision and maintenance of the provision and maintenance of sanitary disposal facilities for human sanitary disposal facilities for human excrement and sewage.excrement and sewage.

c.) Food sanitation – Assists in the c.) Food sanitation – Assists in the provision of safe and wholesome food to provision of safe and wholesome food to consumers through proper enforcement consumers through proper enforcement of sanitary rules and regulation and of sanitary rules and regulation and training of food operators and food training of food operators and food handlers.handlers.

d.) Solid waste management – Helps and d.) Solid waste management – Helps and promotes in the provision of sanitary promotes in the provision of sanitary storage facilities, and proper collection storage facilities, and proper collection and disposal of solid waste either by and disposal of solid waste either by individual, group or municipal system.individual, group or municipal system.

e.) Insect and vermin control – Assists in e.) Insect and vermin control – Assists in the elimination of breeding and the elimination of breeding and harborage places and conducts of guides harborage places and conducts of guides organized control program.organized control program.

f.) Public place sanitation - Assists in the f.) Public place sanitation - Assists in the provision of sanitary facilities and provision of sanitary facilities and maintenance of the sanitary condition in maintenance of the sanitary condition in public places such as schools, public public places such as schools, public buildings, parks, playground, public buildings, parks, playground, public transports, air and sea ports, swimming transports, air and sea ports, swimming pools, bars, hotels, amusement and pools, bars, hotels, amusement and recreational centers, etc.recreational centers, etc.

gg.) Environmental protection – Establishes .) Environmental protection – Establishes close working relation with the close working relation with the environmental protection agencies such as environmental protection agencies such as the National Air and Water Pollution the National Air and Water Pollution Control Commission, Industrial Hygiene Control Commission, Industrial Hygiene Division, Bureau of Health Services and Division, Bureau of Health Services and other related agencies.other related agencies.

h.) Routine inspection – Carries our routine h.) Routine inspection – Carries our routine inspection in accordance with the standard inspection in accordance with the standard frequency for the different fields of frequency for the different fields of environmental sanitation, using the environmental sanitation, using the prescribed non-routine inspection from prescribed non-routine inspection from time to time as the need arises.time to time as the need arises.

i.) Health Education – Assists in the i.) Health Education – Assists in the implementaiton of health education implementaiton of health education activities.activities.

j.) Referral – Gives technical advice and j.) Referral – Gives technical advice and guidance along environmental health to guidance along environmental health to midwives/public health nurses in their midwives/public health nurses in their assignment areas, when needed.assignment areas, when needed.

STD SERVICESSTD SERVICES1.1. Active Case Finding (Weekly Smearing)Active Case Finding (Weekly Smearing)2.2. Treatment of Positive CasesTreatment of Positive Cases3.3. Counselling/Contact Tracing/Partner Counselling/Contact Tracing/Partner

NotificationNotification4.4. Health Educatoin (Seminar-Orientation Health Educatoin (Seminar-Orientation

STD-HIV/AIDS Prevention and ControlSTD-HIV/AIDS Prevention and Control5.5. Weekly monitoring of females working in Weekly monitoring of females working in

establishmentsestablishments6.6. Special Surveillance activities Special Surveillance activities

a) HIV Serologic Surveillance (HSS)a) HIV Serologic Surveillance (HSS)b) HIV Behavioral Sentinel Surveillance b) HIV Behavioral Sentinel Surveillance (BSS)(BSS)

FILARIASISFILARIASIS

1.1. Active case finding (night blood Active case finding (night blood examination)examination)

2.2. Treatment of casesTreatment of cases3.3. Health Education on Filariasis Health Education on Filariasis

Transmission Prevention and ControlTransmission Prevention and Control

DENTAL HEALTH SERVICESDENTAL HEALTH SERVICES

A.) Preventive :A.) Preventive :a.1a.1 Oral Health ExaminationOral Health Examination(chairside instructions, proper (chairside instructions, proper `̀toothbrushing techniques)toothbrushing techniques)a.2a.2 Oral ProphylaxisOral Prophylaxis(periodic cleaning of teeth done(periodic cleaning of teeth doneusually every after 6 mos.)usually every after 6 mos.)

a.3.a.3.Pit & Fissure Sealant Pit & Fissure Sealant Application Application

(school children ages 6 & (school children ages 6 & above)above)

a.4a.4 FlouridizationFlouridization(mouth rinsing of flouride (mouth rinsing of flouride

to school to school children) children)B.) CurativeB.) Curative

b.1b.1 Dental Extraction/tooth Dental Extraction/tooth extraction extraction

b.2b.2 Restorative fillingRestorative filling(temporary & permanent (temporary & permanent

restoration of decayed teeth) restoration of decayed teeth)

Integrated Integrated Management of Management of Childhood Illness Childhood Illness (IMCI)(IMCI)Addressing the overall health of the Addressing the overall health of the

childchild

WHAT IS IMCI?WHAT IS IMCI? A Joint WHO/UNICEF initiative since A Joint WHO/UNICEF initiative since

19921992 Currently focused on first level health Currently focused on first level health

facilitiesfacilities Comes as a generic guidelines for Comes as a generic guidelines for

management which have been adapted management which have been adapted to each countryto each country

ObjectivesObjectives

To reduce death and the frequency To reduce death and the frequency and severity of illness and disabilityand severity of illness and disability

To contribute to improved growth To contribute to improved growth and development of childrenand development of children

IMCI components and intervention IMCI components and intervention areasareas

Improving family & Improving family & community practicescommunity practices

Improving Health Improving Health SystemsSystems

Improving health Improving health worker skillsworker skills

• Appropriate careseeking Appropriate careseeking •NutritionNutrition•Home case management Home case management and adherence to and adherence to recommended treatmentrecommended treatment• Community involvement in Community involvement in health services planning health services planning and monitoringand monitoring

• District planning and District planning and managementmanagement•Availability of IMCI Availability of IMCI drugs drugs •Organization of work at Organization of work at healht facilitieshealht facilities•Quality improvement Quality improvement and supervision at and supervision at health facilitieshealth facilities•Referral pathways and Referral pathways and servicesservices•Health information Health information Systems Systems •IMCI and health sector IMCI and health sector reformsreforms

• Case management Case management standards & guidelines standards & guidelines • Training of facility-based Training of facility-based public health care public health care providersproviders• IMCI roles for private IMCI roles for private providersproviders• Maintaining competence Maintaining competence among trained health among trained health workersworkers

14 KEY 14 KEY FAMILY/COMMUNITY FAMILY/COMMUNITY

IMCI PRATICESIMCI PRATICES1.1. Exclusively breastfeed infants up to Exclusively breastfeed infants up to

about six months. (Mothers found to be about six months. (Mothers found to be HIV positive require counseling about HIV positive require counseling about possible alternatives to breastfeeding.possible alternatives to breastfeeding.

2.2. Starting at about six months of age, Starting at about six months of age, feed children freshly prepared energy feed children freshly prepared energy and nutrient rich complementary foods, and nutrient rich complementary foods, while continuing to breastfeed up to two while continuing to breastfeed up to two years or longer.years or longer.

3. Ensure that children receive adequate 3. Ensure that children receive adequate amounts of micro-nutrients (Vitamin A amounts of micro-nutrients (Vitamin A and iodized salt) through and iodized salt) through supplementation.supplementation.

4.4. Dispose feces, including that of the Dispose feces, including that of the children, safely and properly.children, safely and properly.

5.5. Wash hands with soap and water : Wash hands with soap and water : before and after preparing meals; before and after preparing meals; before and after eating meals; before before and after eating meals; before and after feeding children; after and after feeding children; after defecation and disposal of feces.defecation and disposal of feces.

66. Prevent Dengue Fever by:. Prevent Dengue Fever by: Proper disposal of unwanted containersProper disposal of unwanted containers

which collect waterwhich collect water Regular emptying and cleaning of usable water containers in Regular emptying and cleaning of usable water containers in

the housethe house Cover all water containers with tight lids.Cover all water containers with tight lids.

7. Take children for immunization as scheduled to be fully 7. Take children for immunization as scheduled to be fully immunized (BCG, 3 doses of DPT and OPV and measles) immunized (BCG, 3 doses of DPT and OPV and measles) before the first birthday.before the first birthday.

8.8. Protect children in malaria-endemic areas by ensuring that Protect children in malaria-endemic areas by ensuring that they sleep under insecticide-treated mosquito nets.they sleep under insecticide-treated mosquito nets.

9.9. Promote mental and social development by responding to a Promote mental and social development by responding to a child’s needs for care through talking and providing a child’s needs for care through talking and providing a stimulating environment as early as the first trimester of stimulating environment as early as the first trimester of pregnancy.pregnancy.

10.10. Continue to feed complete complementary food and offer Continue to feed complete complementary food and offer more fluids including breastmilk to children when they are more fluids including breastmilk to children when they are sicksick

11. 11. Give children appropriate home treatment Give children appropriate home treatment for common illnesses.for common illnesses.

12. Recognize when to bring sick children for 12. Recognize when to bring sick children for treatment and care from appropriate treatment and care from appropriate health providers.health providers.

13.13. Follow the health worker’s advice about Follow the health worker’s advice about treatment, follow-up and referral.treatment, follow-up and referral.

14.14. Ensure that every pregnant woman ahs Ensure that every pregnant woman ahs adequate prenatal check-up at least once adequate prenatal check-up at least once in every trimester an once on the ninth in every trimester an once on the ninth month with an appropriate health care month with an appropriate health care provider and receiving the recommended provider and receiving the recommended doses of tetanus toxoid vaccination. The doses of tetanus toxoid vaccination. The mother also needs support form her mother also needs support form her family and community in seeking care at family and community in seeking care at the time of delivery and during the the time of delivery and during the postpartum and lactation periodpostpartum and lactation period..