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CHN

History

Act No. 157- Creation of Board of Health of the Philippine (BON)

Act No. 147- A!olish BOH "#$%

1&1& 'rs. Caren "el osario * 1st+ilipino N,rse ,perisor

1&&-1&&/ * $ocal eol,tionary Code of 1&&10 A 71 eol,tion Code

National to local

"efinition

Health * (2HO) state of coplete physical0 ental and social 3ell !ein0 not erely

the a!sence of disease or infirity

P,!lic health * ("r. C.. 2inslo3) the science and art of preentin disease0

prolonin life0 prootin health and efficiency thro,h orani6ed

co,nity effeort.

Co,nity Health N,rsin (aco!son)- is a learned practice discipline 3ith the

,ltiate oal of contri!,tin as indiid,al and in colla!oration 3ith others to

the prootion of clients opti, leel of f,nction thro,h teachin and

deliery of care.

+actors affectin Opti, $eel of +,nction (O$O+)

1. Political

/. Behaioral

8. hereditary

4. Health Care "eliery yste

5. nironental #nfl,ences

. ocio econoic #nfl,ences

Concepts

1. 9he priary foc,s of co,nity health n,rsin practice is on health

prootion.

/. Co,nity health n,rses are eneralist in ter of their practice thro,h life

!,t the 3hole co,nity.

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8. Co,nity health n,rses are eneralist in ters of their practice thro,h

life contin,ity in its f,ll rane of health pro!les and needs.

4. 9he nat,re of CHN practice re:,ires that c,rrent ;no3lede deried fro

the !ioloical0 social science0 ecoloy0 clinical n,rsin and co,nity health

orani6ations !e ,tili6ed

5. Contact 3ith the client and or faily ay contin,e oer a lon period of tie3hich incl,des all aes and all types of health care.

. 9he dynaic process of assessin0 plannin0 ipleentin and interenin

proide eas,reents of proress0 eal,ation and a contin,, of the cycle

,ntil the terination of n,rsin is iplicit in the practice of co,nity

health n,rsin.

Principles

1. CHN is !ased on reconi6ed needs of co,nities0 failies0 ro,ps and

indiid,als./. 9he co,nity health n,rse ,st ,nderstand f,lly the o!s eal,ation of co,nity health tea.

?. Opport,nities for contin,ation staff ed,cation proras n,rses ,st !e

proided !y the CHN aency. 9he co,nity health n,rse also has a

responsi!ility for his@her o3n professional ro3th.

&. 9he co,nity health n,rse a;es ,se of aaila!le co,nity health

reso,rces.

1. 9he co,nity health n,rse ,tili6es the already eistin actie orani6ed

ro,ps in the co,nity.

11. 9here ,st !e proision for ed,catie s,perision CHN

1/. 9here sho,ld !e acc,rate recordin and reportin in CHN.

P,!lic Health N,rse

1. Planner@proraer

/. Proide of N,rsin Care@Careier

8. 'anaer@,perisor

4. Co,nity Orani6er

5. Coordinator of erice

. 9rainer@ Health d,cator@ Co,nselor

7. Health onitor

?. ole 'odel

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&. Chane Aent

1. ecorder@ eporter@ tatistician

11. esearcher

Co,nity Health Process

AssessentCollection of data0 collected fro faily0 ro,ps and co,nity.

aples "eoraphic "ata

ital Health tatistics

Co,nity "ynaics

Health tat,s

d,cation

'ethods Co,nity ,rey

#nterie3

tatistics pideioloical st,dies

Coon indicators of health stat,s

'or!idity

'ortality

Cateories of Health Pro!les

1. Health "eficit (H")- instances of fail,re in health aintenance ( dse0

disa!ility0 de>tl la) -e. "se@ illness- =9#0 aras,s0 sca!ies0 edea

disa!ilities- !lindness0 polio0 color!lindness0 deafness

de>tl pro!les li;e ental retardat0 iantis0 horonal0

d3arfis

Health 9reat (H9)- conditions cond,cie to dse0 accidents or fail,re to reali6e

one>s health potential

healthy people

e. +aily h of illness- hereditary li;e "'0 HPN

n,tritional pro!les- eatin salty foods

personal !ehaior- so;in0 self-edication0 se,al practices0dr,s0 ecessie drin;in

inherent personality char- short teperedness0 short attn span

short cross infect

poor hoe eni

lac;@inade:,ate i,ni6ation

ha6ards- fire0 falls0 or accidents

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faily si6e !eyond 3hat reso,rces can proide

+oreseea!le Crisis (+C)- anticipated periods of ,n,s,al deand on indi

or fa in ters of ad

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=tili6ed s,pport syste

al,ation

+rae 3or;s

a. tr,ct,ral eleents

!. Process eleents

c. O,tcoe eleents

N,rsin Proced,res

Clinic isit

1. Pre-cons,ltation conference

/. 'edical eaination

8. N,rsin interention4. Post cons,ltation conference

Hoe isit- face to face contact 3ith the client

Principles

1. A hoe isit sho,ld hae a p,rpose or o!

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/. Perforance of n,rsin care ,tilities s;ills that 3o,ld ie ai,

cofort and sec,rity.

8. N,rsin care at hoe sho,ld !e ,sed as a teachin opport,nity.

4. Perforance of n,rsin care sho,ld reconi6ed daners in the patients> oer-

proloned acceptance of s,pport and cofort.

5. N,rsin care is an opport,nity for detectin a!noral sins and syptos.

#solation 9echni:,es

All Articles ,sed !y the patient sho,ld not !e ied 3ith the articles ,sed !y

the rest of the e!ers of the ho,sehold.

+re:,ent 3ashin and airin of !eddins and other articles and disinfectants

of roo are iperatie

9he one carin for the sic; e!er sho,ld !e proided 3ith a protectie

o3n that sho,ld !e ,se 3ith in the roo of the sic;.

All dischares0 especially fro the nose and throat of a co,nica!le

disease patient sho,ld !e caref,lly dischared. Articles 3ith dischares sho,ld !e first !oiled for 8 in,tes !efore

la,nderin. 9hos co,ld !e !,rned0 sho,ld !e !,rned.

"OH

ision HA$9H +O A$$ B / I HA$9H #N 9H HAN" O+ 9H

POP$ B //

'ission ns,re accessi!ility and :,ality of health care to iproe the :,ality of

life of all +ilipinos0 especially the Poor.

National O!

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a. #ncrease inestent for priary health care

!. "eelopent of national standards and o!

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B aya!as- "iarrhea

er!a B,ena- arthritis0 toothache0 s3ollen ,s0 co,h I colds

a!on- co,h and colds0 renal stones

A palaya- "'

N iy,-nyoan- ascariasis

9 saan ,!at- diarrheaA cap,lco- f,nal infection0 sca!ies

A ?4/8- ,tili6ation of edicinal plants as alternatie for hih cost edications.

pideioloy- st,dy of distri!,tion and dynaic of disease occ,rrence in h,an

pop,lation

ndeic- constant presence of disease or infection aent 3ith in a ien eoraphic

area

pideic- occ,rrence in a co,nity or reion of cases of an illness clearly in

ecess of epectancy

Pandeic- epideic 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

,reillance- a contin,in scr,tiny of all aspects of occ,rrence and spread of a

disease that is pertinent to effectie control ( prootion0 preentie

patient and reha!ilitatie)

entinel sites- are health facilities 3hich are selectie as representaties of 3hat is

happenin in areas 3hose reports are acc,rate0 coplete and propt

(health center)

tatistics- that science inoled in the collection0 orani6ation0 analysis and

interpretation of n,erical data

Biostatistics- the scientific discipline concerned 3ith the application of statistical

ethods to pro!les in !ioloical and edicine.

+ertility ate

1. CB (Cr,de !irth rate)- relatie pop d,e to !irths

9otal n,!er of !irths in a calendar year

CBM Birth 1

Pop e. /5.?M CB

9here are / !irths in eery 1 pop

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/. %eneral +ertility ate (%+) - tr,e fertility rate * specific seents of pop that is

fertile

%+M JJJJJJJJBirthJJJJJJJJJJJ 1

Pop of 3oen (15 to 44 yo)

. %+M8/ 9here are 8/ !irths in eery 3oan in 15-44

'ortality ates

1.Cr,de "eath ate JJJJ 1

"ecrease in pop d,e to death

C"M death 1

Pop

. C"M there are in eery 1 pop

/. pecific 'ortality ate- can apply to any pop rp' M death fro or partic,lare rp 1

Pop of that rp

a. '(ales) M death (ales) 1

pop of ales

!. ' (feales) M death of feales 15-44

pop of feales 15-44

#nfant 'ortality ate #'M "eath -1 year 1

Births

Neonatal 'ortality ate N'M deaths -/? days 1

Births

Post Neonatal 'ortality ate PN' M deaths /? days to 1 year 1 Births

N' PN' M #'

Neonatal deaths Post neonatal deathsM #nfant deaths

. Birth /

N'M /

"eath * /? to 1

N' PN' M #'

/ 1 M 8 (AN)

/ J 1 M 1 M 1

/ 1

'aternal 'ortality ate ('')

''M death of 3oen r@t prenancy0 deliery0 I p,erperi, 1

Births

. #' M 8 9here are 8 infant deaths in eery 1 !irths

N' M / 9here are / neonatal deaths in eery 1 !irths

PN' M 1

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'' M .&/

Proportionate 'ortality ate M P' ( for any rp)

P'M death fro a partic,lar rp 1

total death

. 5/ P' of ales M deaths of ales 1total deaths

#n eery 1 death0 5/ are ales

P' M deaths -1 1

.1 total deaths

POPO9#ONA9 'O9A$#9 #N"#CA9O

A. 3aroop>s #nde M #

# M death of 5 yrs I ,p 1

total deaths

9he #0 the !etter the sit,ation is

B. elatie iportance of a ;iller ( 9B0 heart dse0 diarrhea)

"eath d,e to 9B 1

total deaths

P' M 8

9B

--#n eery 1 deaths0 8 are d,e to 9B

Case +atality ate (C+)

Ho3 is s,rial rate0 ho3 stron is ;illin po3er0 pronosisC+M death d,e to part ca,se 1

total cases

. C+ M &?

H#

JJJdeath H#JJJ 1

9otal cases of 9B

#n eery 1 cases of H#0 there are &? deaths

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

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an; as a ;iller

C of "M death d,e to partic,lar ca,se 10

total pop

. C of " M8/ 9B

#n eery 10 pop there are 8/ deaths d,e to 9B

Prealence ate M ('or!idity rate)

an; as a coon dise

P M old and ne3 case of 9B 10

9B total pop

. P M old I ne3 case of 9B 10

9B. P M 8/

9B

9here are 8/ cases of 9B o,t of 10 pop,lation.

#ncidence ate

#M JJJne3 casesJJJ 10

pop at ris;

3aroff>s #nde

9otal death of a person ain a!oe 5 Q 19otal n,!er of deaths of all aes

it,ation Baranay Q has a total pop,lation of 18/ for the year 1&&&-/ !ases

on the follo3in date0 sole for the s3aroff>s inde0 infant ortality rate0 cr,de

death rate and the aternal ortality rate

3arrof>s indeM 7@57 1M 1/.?

#'M 17@1/&4 10 M 18 #M @18/ 10M 4&

CBM 1/&4@18/ 10 M &5

C"M 57@18/ 10M 4/

''M 8@1/&4 10 M /.88

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ssential Health erices

($'N9) of PHC

- d,cation on ethods of preentin and controllin health pro!les

$- $ocal endeic disease preention and control

'- 'aternal and child care incl,din faily plannin- ssential dr,s

N- N,trition

9. 9reatent

- anitation and H/O s,pply

+o,r Corner stone@ Pillar in PHC

1. Actie co,nity participation

/. #ntra and inter sectoral lin;aes

8. =se of appropriate technoloy

4. ,pport echanis ade aaila!le

$eels Health Care

Priary- Branay D district id3ife@ trained health 3or;ersE

econdary- eional@"istrict DN=E

9ertiary- Hearth Center0 $,n Center etc. - doctor

eprod,ctie Health (H)

ision reprod,ctie health practices as a 3ay of life for eer an and 3oan

thro,ho,t life

Concept

a. arried co,ples has the capa!ility to reprod,ce

!. reprod,ctie health is eercise of reprod,ctie riht

c. p,rpose of enhanceent of life and personal relation

d. safe prenancy0 safe deliery

e. protection fro ,n3anted prenancy

f. protection fro harf,l reprod,ctie practice and iolence

. ass,res access to inforation on se,ality to achiee se,al

enironent

"eterinants of H

1. socio- econoic

/. stat,s of 3oen

8. social and ender iss,es

4. !ioloical0 c,lt,ral and psycho-social factors

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%OA$ 'CH AN" N=9#9#ON

R eery prenancy sho,ld !e intended

R eery !irth sho,ld !e healthy

R eery se act sho,ld !e free of co erection and infectionR achiee desired faily si6e

9en leents of H

1. 'aternal and child health n,trition

/. +aily plannin

8. Preention and anaeent of a!ortion coplication

4. Preention and treatent of reprod,ctie tract infection0 respiratory

infection and 9"0 H#@ A#"

5. d,cation and co,nselin on se,ality and se health

. Breast and reprod,ctie tract cancer7. Other ynecoloical condition

?. 'en>s H

&. Adolescent H

1. Preention and treatent of infertility

9etan,s 9oiod

91- anytie d,rin prenancy

9/- 4 3ee;s of prenancy

98- onths@ /44 3ee;s of prenancy

94- 1 year old

95- a!oe 1 year

SPP" && i,ni6ation prora

accine o,te "osae +re:,ency

BC% half life 4ho,rs

$ie atten,ated !acteria

Dstored T /-?deree Celsi,s

dorsal

"eltoid

$ "eltoid

.5@l

.1@l

At !irth

chool entrance

"P9 half life ? ho,rs

2ea;ened toin

;illed !acteria stored T/

2ea;ened toin to ? deree

Celsi,s

#'

iht@ $eft@

iht

.5@l "P9 1- th3ee;s

"P9 /- 1 3ee;s

"P9 8- 8 U onths

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OP Oral /-8 tts 3ee;sT 8 doses

Hepa B #' anterior

thih

left@riht@

left

.5@l 3ee;s/ 8 doses 4th

3ee;s

interal

'easles V o,terpart of the

ar

.5l & onths

ide effects

1. Foch>s phenoenon- /-4 days after accines

- ac,te inflaation

deep a!scess- deeper in

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$eprosy Control Prora

- ',lti "r, therapy 1&?? A 478

- Chronic disease of the s;in and peripheral neres ca,sed !y 'yco!acteri,

$eprea or Han>s Bacill,s

arly s@s

Chane in s;in color- reddish or 3hite

$oss of sensation

"ecrease hair ro3th- deris

$oss of s3eatin- eocrine

',scle 3ea;ness- neres

9hic;ened@ painf,l neres

=lcer that do not heal

$ate s@s

'adiacrosis

$aophthalos- ina!ility to close the eye lids

Cla3in of finers and toes

Contract,res

in;in of nose !ride

%ynecoastia

Chronic ,lcers

Pne,onia

ins

+ast !reathin

Chest in dra3in

Con,lsion

A!norally sleepy

eere ,nder n,trition

Not a!le to drin;

tridor ,pon inhalation- a,sc,ltation

2hee6in- ,pon ehalation

+eer or lo3 !ody tep.

'anaeent of pne,onia ost pne,onia deaths are preenta!le if treated

early

9 is !ased

early reconition of pne,onia

propt treatent of non seere cases at hoe 3ith standard

anti!iotics and ood s,pportie care

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:,ic; identification if seere cases and :,ic; referral to the

hospitals- preent death

9reatent ay incl,de

anti!iotics

adisin others to ie hoe care treatin feer and 3hee6in

Hoe Care (child 3ith co,h and colds)

no anti!iotics needed

feed the child

increase fl,id inta;e

clear nose

;eep child 3ar and coforta!le

@ that the child ,st !e !ro,ht to health care facility

fast !reathin

diffic,lty !reathin

,na!le to drin;

feedin pro!le

ole of "r,s in control of infection

children 3ith co,h and colds 3ith no pne,onia ,st not !e

ien anti!iotics

anti!iotics sho,ld only !e ien to cases pne,onia0 seere

pne,onia and ery seere disease

CO9#'OQAGO$

Aaila!ity of "r,s

1. Cotrioa6ole

/. in

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7. Practicin ood hyiene

Control of "iarrhea "isease

'anaeent of patient 3ith diarrhea

,se this chart for patients 3itha. loose 3atery stools

!. loose stools 3ith !lood

tep 1- Asses yo,r patient for dehydration

tep /- Asses for other pro!les

1. $oo; at condition 3ell alert

ye noral

9ears present

'o,th and ton,e oist

9hirst drin;s norally0 not thirsty

/. +eel- ;in Pinch oes !ac; :,ic;ly

8. "ecide No dehydration

4. 9reatent treatent A

9reatent Plan A

R to treat diarrhea at hoe

R ,se this plan to teach the other to

1. Contin,e to treat at hoe her child>s c,rrent episode of diarrhea

/. ie early treatent for f,t,re episode of diarrhea

9reatent Plan C

(eer dehydration)

Can yo, ie #+ ------------es-------tart #+ iediately DPN and .& NaCl

NO

#s # net aaila!le-----------es-------end patient 3ithin 8 in,tes

NO

Are yo, trained 9o------------es------tart 3ith O

=se N%9 for

ehydration

NO

Can the patient-----------------es------tart 3ith O per ore

"rin;

ehydration

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=%N9

end the patient for # or N%9

2ater "econtaination

Boilin /-8 in,tes

Chlorine 1 drop of 5 Na Hypo chloride in 1 $ H/O

tat for /-8 in,tes

Aerate

'"9

PB non infectio,s 'B- infectio,s

9,!erc,loid $praato,s@ Borderline

#ndeteridiate

-& onths /4-8 onths

"ay 1@ /-? "ay 1@ /-/?

ifapicin@"apsone ifapicin

Clofa6iine

"apsone

O'- ifapicin. Ofloacin0 'inocyclinc

Preention- BC%

Pne,oniaery eere eere Pne,onia No Pne,onia

=na!le to drin; +ast !reath +ast !reathin No fast !reathin

Con,lsion Chest indra3in No chest indra3in No chest indra3in

"iffic,lt to 3a;e

stridor

9! Net3or; N,rse

Physician

'id3iesarly case 'ed 9ech

+indins

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Cateory 1 Cateory / Cateory 8

Ne3 () cases P9B

erio,sly #$$

a. #ntensie PhaseAdance p,lonary 9B

!. tra p,lonary 9B

/ onths

ifapicin

# sonia6id

P yra6inaide

tha!,tol Dsho,ld

not ,sed years old

!elo3 !eca,se of is,al

dist,r!ance

4 onths

ifapicin

# sonia6id

/-? onths aintenance

9reatent replaces

+ail,re

/ onths 8 onths

# #

P P

- streptoycin D#'E

5 onths

#

P9B inial(-) 8

sp,t, sear

-ray P9B inialtra 9PB (not serio,s)

/onths / onths

# #

P

ENVIRONMENTAL SANITATION

Environmental Sanitationis 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 ofbasic services and facilities to all households.

1. Water upply anitation !rogram

1 types of "pproved Water upply #acilities

$evel 1!oint ource

$evel %%&ommunal #aucet system or standposts

$evel %%%Waterwor's system orindividual houseconnections

" protected well of adeveloped sprung with anoutlet but without a

distribution system for ruralareas where houses arethinly scattered.

" system composed of a source, areservoir, a piped distributionnetwor' and communal faucets,

located at not more than () metersfrom the farthest house in rural areaswhere houses are clustered densely.

" system with a source, areservoir, a piped distributornetwor' and household

taps that is suited fordensely populated urbanareas.

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 $evel ( $evel /

*on- water carriage toilet facility: n site toilet facilities of Water carriage types

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- !it $atrines

- eed dorless arth &loset

- 2ored-ole

- &ompost

- 3entilated improved pit

0oilets re4uiring small amount of water towash waste into receiving space-pour flush-a4ua privies

the water carriage typewith water sealed andflushed type with septicvault5tan' disposalfacilities.

of toilet facilitiesconnected to septictan's and5or tosewerage system totreatment plant.

ural "reas- 6blind drainage7 type of wastewater collection and disposal facilities shall beemphasi8ed 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 f inal disposal of solid wastes.

efuseGarbageubbish

( ways to efuse +isposal

ousehold &ommunity

-2urial deposited in 1m x 1m deep pits covered withsoil, located ()m away from water supply- open burning- animal feeding- composting- grinding and disposal sewer

-anitary landfill or controlled tipping excavation of soil deposition of refuse andcompacting with a solid cover of ( feet- %ncineration

;. #ood anitation !rogram!olicies:

#ood establishment are sub

&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 parasiteand bacterial infection.

/ points of contamination

!lace of production processing and source of supply

0ransportation and storage

etail and distribution points

). ospital Waste 9anagementGoal:

0o prevent the ris' of contraction contracting nosocomial infection from type disposal ofinfectious, pathological and other wastes from hospital

?. !rograms related to health-ris' minimi8ation secondary to environmental pollution0hese include the following:

"nti-smo'e 2elching campaign and "ir !ollution &ampaign

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@ero olid Waste 9anagement

0oxic, chemical and a8ardous Waste 9anagement

ed tide &ontrol and 9onitoring

%ntegrated !est 9anagement and ustainable "griculture

!asig iver ehabilitation 9anagement

A. ducation of prevailing health problems"ccepted activitiy at all levels of public health used as a means of improving the health ofthe people through techni4ues which may influence peoples thought motivation,

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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". tress2. +rugs and "lcohol "buse ehabilitation&. 0reatment and ehabilitation of 9entally-ill !atients+. pecial !ro