DOH PROGRAMS

COMMUNICABLE DISEASE PREVENTION AND CONTROL PROGRAM NATIONAL TUBERCULOSIS PREVENTION AND CONTROL PROGRAM Magnitude of the Problem Worldwide Morbidity and mortality rates are higher in developing countries 6th leading cause of morbidity at 170/100,000 New sputum positive 3380 in region 10 ( 83.4/100,000 pop.) Total TB cases 4817 ( 118.8 / 100,000 pop. ) Increasing incidence of TB resistant General Objectives: To reduce the prevalence of tuberculosis Risk Reduction Objectives: To put all new cases under DOTS treatment protocol 95 to 100% compliance to treatment Greater than 85% cure rate ( sputum conversion ) DOTS Treatment Center PHIC Package Health workers should be knowledgeable about the types of TB patients and the 3 treatment regimens The facility should have the equipment and supplies necessary for case finding and treatment of clients diagnosed with tuberculosis Once started on treatment, TB patients should complete duration of therapy All clients should be counseled on proper compliance, and adherence to treatment. Health education should also include some expected drug interactions and what clients should do upon experiencing them All clients should have sputum examination on scheduled time to be able to assess the individual patients response to treatment. This is also the way to determine cure for TB patients. MALARIA PREVENTION AND CONTROL PROGRAM Still endemic in the provinces of Misamis Oriental and Bukidnon Both fall under the category B means 100 to 1000 cases per year Groups who are commonly affected are farmers, indigenous cultural groups, forest product gatherers, agricultural workers, soldiers and miners. The disease is transmitted through a bite of an infected female Anopheles mosquito It usually bites during nighttime Signs and Symptoms: Chills, high grade fever Sweating, severe headache 9276 blood smears were examined Plasmodium falciparum :373 Plasmodium vivax: 129 Plasmodium malaria: 1 Mixed Infections: 10 Risk Reduction Objectives: In endemic areas, install screens and use bed nets. The effectiveness of bed nets is greatly enhanced by impregnation with a synthetic permithrin Prompt and effective treatment of acute and chronic cases is an important adjunct to malaria control Prophylaxis if you are visiting an endemic area Borderline operation Biological Environmental Measures like biopond construction, streams cleaning and streams seeding and reseeding with larvivorous fish to destroy the breeding places ( Vector Control )

DENGUE PREVENTION AND CONTROL Magnitude of the Problem: There were 1,126 dengue cases registered and reported in the surveillance unit There were 14 registered deaths The case fatality rate is 1% Endemic in all provinces Signs and Symptoms Sudden onset of high fever that may lasts 3 -5 days Joint and muscle pain and pain behind the eyes Skin rashes maculopapular rash or red tiny spots on the skin called petechiae Nosebleeding when fever starts to subside Abdominal pain Vomiting of coffee colored matter Dark colored stools

Transmission Aedes aegypti, the transmitter of the disease, is a day biting mosquito which lay eggs in clear and stagnant water found in flower vases, cans, rain barrels, old rubber tires , etc. The adult mosquitoes rest in dark places of the house Infectious Agent: The viruses of dengue fever include immunologic types 1,2,3 and 4 Risk Reduction Objectives Educate the public on personal measures for destroying breeding sites and protecting against day biting mosquitoes, including use of screening, protective clothing Community survey to determine density of vector mosquitoes , to identify breeding places and to promote and implement plans for their elimination Cover water drums and water pails at all times Replace water in flower vases at least once a week Clean all water containers Clean gutters of leaves and debris so that rain water will not collect as breeding places Old tires as roof support should be punctured or cut to avoid accumulation of water Collect and dispose all unusable cans, jars, bottles and other items that can collect and hold water MAG 4 S AGAINST DENGUE 1. Search and Destroy 2. Self Protection Measures 3. Seek Early Consultation 4. Say no to indiscriminate fogging FILARIA PREVENTION AND CONTROL PROGRAM Magnitude of the Problem Endemic in the provinces of Bukidnon, Misamis Occidental and Misamis Oriental Nocturnal Blood Examination smears collected and examined with 27 positive cases Morbidity rate is .1 per 100,000 population It is commonly known as elephantiasis It is a disease caused by a parasite called Wuchereria bancrofti Transmitted by a bite of a mosquito , the most important being Culex quinquefasciatus Signs and Symptoms Pain and swelling of the breast, vagina, scrotum, legs and arms Fever, cough, chills, wheezing Risk Reduction Educate the public on the mode of transmission and methods of mosquito control Wear long sleeve shirt and long pants when working in farms or areas endemic of filariasis Sleep under a mosquito net

Mass treatment of the people living in established areas Selective treatment with DEC ( Diethylcarbamazine citrate ) is given to people with clinical manifestations of the disease Medicines ( DEC and albendazole ) are given once a year for 5 years

LEPROSY PREVENTION AND CONTROL PROGRAM Goal: Elimination of Leprosy ( PR of less than 1 per 10,000 ) Magnitude of the Problem: In the Philippines, the morbidity rate is between 1 1.5 per 100,000 pop. In region 10 it is 1.4 per 100,000 pop. Most of the provinces and cities in region 10 has already reached the goal of leprosy elimination except in Cagayan de Oro and Iligan city Infectious agent: Mycobacterium leprae Mode of Transmission: Airborne: inhalation of droplet nuclei from coughing and sneezing of untreated leprosy patient Household and prolong close contact Signs and Symptoms: Long standing skin lesions that do not disappear with ordinary treatment Loss of feeling / numbness of the skin Loss of sweating and hair growth over the skin lesions Thickened and / or painful nerves in the neck, forearm, near elbow joint and the back of the knees RISK REDUCTION : Health education to stress the availability of effective multidrug therapy, the absence of infectivity of patients under continuous treatment, and the prevention of physical and social disabilities Detect cases, particularly multibacillary cases, early and administer multidrug therapy on a regular outpatient basis GO TO THE NEAREST HEALTH CENTER FOR FREE MULTI DRUG THERAPY ( MDT ) RABIES PREVENTION AND CONTROL PROGRAM Magnitude of the Problem: Mortality rate is 0.3 / 100,000 pop Dog bites is 10,000 ( 250 / 100,000 pop ) Signs and Symptoms Headache and fever Pain or numbness of bite site Delirium and paralysis; muscle spasm Hydrophobia and aerophobia Mode of Transmission Through bite of a rabid animal Contamination of any wound or scratch with saliva containing rabies virus Be a Responsible Pet Owner Have your pet dog immunized against rabies at 3 months old and every year thereafter Never allow your pet dog to roam the streets Take care of your pet dog: bathe, give clean food, and provide clean sleeping quarters When Bitten by a Dog Wash the wound immediately with soap and running water ( first aid ) Thorough wound cleansing under medical supervision Rabies immune globulin and / or vaccine as indicated Tetanus prophylaxis and antibacterial treatment when required No sutures or wound closure advised unless unavoidable Observe the dog for 14 days and consult your physician if any of the following occurs: Dog becomes wild and runs aimlessly

Drooling of saliva Bites any moving or non moving objects Does not eat or drink The dog dies within observation period If dog cannot be observed ( stray dog ), or if suspected to be rabid, consult your physician immediately or go to the nearest Animal Bite Treatment Center

AIDS / STD PREVENTION AND CONTROL PROGRAM Magnitude of the Problem: Sexually transmitted disease other than HIV / AIDS is not alarming in our region The prevalence is less than 1% among the most at risk and vulnerable populations within the region Activities Done in the Region Comprehensive STI Case Management Training conducted Regular examination of establishment base sex workers Risk Reduction Programs: General health promotion programs Protect the community by preventing and controlling STD among establishment base sex workers Discouraging sexual promiscuity Provide facilities for early diagnosis and treatment Preventive Measures for HIV: Avoid having multiple sexual partners and sharing drug paraphernalia Avoid having sex with someone you do not know Avoid sexual intercourse ( anal, vaginal and oral ) with persons known or suspected to be infected with HIV No blood should be transfused unless screen for syphilis and HIV. SCHISTOSOMIASIS PREVENTION AND CONTROL PROGRAM Magnitude of the Problem Endemic in the provinces of Bukidnon, Lanao Norte and Misamis Occidental At the end of 2006, the national morbidity rate is 4 / 100,000 pop. In region 10 it is 7.5 / 100,000 pop. There were 49,860 stool examinations with 2,749 positive. The positivity rate is 5.5% ( Infection rate ) Infection rate is highest in Lanao Norte at 5.07 The Disease caused by a blood fluke called Schistosoma japonicum transmitted through a tiny fresh water snail Oncomelania quadrasi It is transmitted to man or animal through skin penetration when they get in contact with schistosoma infested waters Signs and Symptoms A. Early Stage: - abdominal pain - low grade fever - loose bowel movement - bloody stool B. Late Advanced Stage - Inflammation of the liver - Bulging of the abdomen - Enlargement of the spleen - Sometimes the brain is affected that caused epilepsy Diagnostic Method Stool examination through Kato Katz method Prognosis

Curable in the early stage but fatal in the advanced stage Risk Reduction Educate the public in endemic areas regarding mode of transmission and methods of protection Sanitary disposal of feces and urine so that viable eggs will not reach bodies of fresh water containing intermediate snail hosts Treat snail breeding sites with molluscides Prevent exposure to contaminated water Treat patients in endemic areas to prevent disease progression and to reduce transmission by reducing egg passage

NON COMMUNICABLE DISEASE PREVENTION AND CONTROL PROGRAM Cardiovascular Disease Prevention and Control Program Magnitude of the Problem: It is now the leading cause of death in our country Every hour, 9 Filipinos die of CVD 1 out of 4 deaths in the country is due to CVD 1 out of 10 Filipinos aged 15 years old and above has hypertension / high blood pressure 80 85 % of all primary high blood pressure are mild and thus can be managed by lifestyle modification HIGH BLOOD PRESSURE A SILENT KILLER Most common among the diseases of the heart Most common cause of stroke Highly preventable Mostly Affected by High Blood Pressure: Smokers Overweight Older age group: above 40 years old for males; menopausal age for female With family history like heart diseases, diabetes and kidney disease Under chronic stress Heavy alcohol drinker High serum cholesterol level Risk Reduction: Dont smoke Maintain ideal body weight Exercise regularly ( at least 20 minutes, continuous 3x a week ) Drink moderately Have a regular blood pressure check up Avoid fatty and salty foods Have adequate relaxation TAKE GOOD CARE OF YOUR HEART, HAVE A HEALTHY LIFESTYLE

CANCER PREVENTION AND CONTROL PROGRAM Magnitude of the problem Cancer of all forms is now the 4th leading cause of mortality Tumors can be classified as a. Benign tumors which are not cancerous. They often can be removed, and in most cases, do not come back. b. malignant tumors which are cancerous. Cells in these tumors are abnormal and they divide without control and they can invade and damage nearby tissues and organs Risk Factors: a. Heredity

b. Cigarette Smoking Smoking accounts for more than 85% of lung cancer deaths. Smokers are more likely to develop lung cancer compared to non smokers. Overall, smoking has been linked to cancers of the mouth, larynx, pharynx, esophagus, pancreas and bladder. c. Excessive Alcohol Intake Heavy drinkers have an increased risk of cancers of the mouth, throat, esophagus, larynx and liver. d. Unhealthy diet Diet plays an important role in the development of many cancers, particularly in the digestive system and reproductive organs. Likewise, being seriously overweight has been linked to breast cancer e. Chemicals and Other Substances Exposure to substances such as chemicals, metals or pesticides can increase risk of cancer. Prevention There is no 100% guarantee that cancer can ever be prevented. However, being aware of the cancer risk factors will help in reducing the possibility of cancer. Early detection and proper treatment plays a big role in controlling cancer A. Breast Cancer: Causes: 1. Genetic Factor 2. Environmental Factors - a constant diet that is high in fat, salt and sugar - being overweight - womans age ( above 30 years old ) during first pregnancy or those who never had any children Symptoms lump, thickening or swelling of the breast unusual change in the size or shape of the breast one breast unusually lower than the other puckering / dimpling of the skin of the breast retraction of the nipple a sore in the nipple Early Detection a. Mammography -starting age 40 every two years. - women at the age of 35 with personal or family history of breast cancer must have mammography every year b. Breast Self Examination ( BSE ) - done once a month, a week after a womans monthly period Prevention: Generally, breast cancer cannot be prevented from happening, particularly if a woman has a family history of breast cancer Eat a healthy diet consisting of high fiber foods Get enough exercise. Be active to maintain body muscles flexibility Maintain ideal body weight B. LUNG CANCER - IS ONE OF THE LEADING CANCER DEATHS AMONG MEN AND WOMEN Lung Cancer Facts: Almost 100% of all lung cancer cases are caused by smoking Smokers reach the cancer age at least 15 years earlier than non smokers Non smokers who are continuously exposed to tobacco smoke in enclosed spaces also run the risk of getting lung cancer C. CERVICAL CANCER

Cervical cancer is the 2nd leading cancer site among women Generally all women who have had sexual intercourse are at risk of cervical cancer Cause An infectious agent particularly human papilloma virus ( HPV ) that is transmitted through sexual intercourse causes cancer of the cervix Risk Factors Have had multiple sexual partners Have had sexual partners who themselves had several sexual partners Have had sexual partner who is infected with HPV Had first sexual intercourse at a very early age possibly 15 or 16 years old Risk Reduction All women of reproductive age should receive a pelvic exam and pap smear annually for 3 years in a row. If all 3 are negative, clients need to go to the facility only every 3 years for a pap smear Each facility should give patients counseling as to the risk factors for contracting cervical malignancy

EXPANDED PROGRAM ON IMMUNIZATION ( EPI ) A Fully Immunized Child is a child who had received: One dose of BCG 3 doses of OPV 3 dose of DPT 3 doses of HEPA B 1 dose of measles Before the child reaches one year old. Strategy: Immunization sessions should be conducted in the facility as regularly as possible. Although Wednesday has been adopted as the national immunization day, immunization days may be held on other days. Outreach immunization services offered in hard to reach areas * MOTHER AND BABY FRIENDLY HOSPITAL INITIATIVES * CONTROL OF ACUTE RESPIRATORY INFECTIONS * CONTROL OF DIARRHEAL DISEASES * MICRONUTRIENTS SUPPLEMENTATION / NUTRITION * FAMILY PLANNING PROGRAM

HISTORY OF WHO - When diplomats met to form the United Nations in 1945, one of the things they discussed was setting up a global health organization - WHO Constitution came into force on 7 April 1948 a date we now celebrate every year as World Health Day - WHO is the directing and coordinating authority for health within the United Nations system. - It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence based policy options, providing technical support to countries and monitoring and assessing health trends - In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defense against transnational threats Role of WHO in Public Health - Providing leadership on matters critical to health and engaging in partnerships where joint action is needed - shaping the research agenda stimulating the generation, translation and dissemination of valuable knowledge - Setting norms and standards and promoting and monitoring their implementation - Articulating ethical and evidence based policy options

- Providing technical support, catalyzing change and building sustainable institutional capacity - Monitoring the health situation and assessing health trends THE WHO AGENDA 1. Promoting Development - During the past decade, health has achieved unprecedented prominence as a key driver of socioeconomic progress, and more resources than ever are being invested in health. Yet poverty continues to contribute to poor health, and poor health anchors large population in poverty - Access to life saving or health promoting interventions should not be denied for unfair reasons, including those with economic or social roots. - Commitment to this principle ensures the WHO activities aimed at health development give priority to health outcomes in poor, disadvantage or vulnerable groups - Attainment of the health related Millennium Development Goals, preventing and treating chronic diseases and addressing the neglected tropical diseases are the cornerstones of the health and development agenda 2 Fostering Health Security - One of the greatest threats to international health security arises from outbreaks of emerging and epidemic prone diseases. - Such outbreaks are occurring in increasing numbers. Fueled by such factors as rapid urbanization, environmental mismanagement, the way food is produced and traded, and the way antibiotics are used and misused. 3. Strengthening Health Systems - For health improvement to operate as a poverty reducing strategy, health services must reach poor and underserved populations. - Areas being address include the provision of adequate numbers of appropriately trained staff, sufficient financing and access to appropriate technology including essential drugs 4. Harnessing research, information and evidence - Evidence provides the foundation for setting priorities, defining strategies and measuring results - WHO generates authoritative health information, in consultation with leading experts, to set norms and standards, articulate evidence based policy options and monitor the evolving global health situation 5. Enhancing Partnerships - WHO carries out its work with the support and collaboration of many partners, including UN agencies and other International Organizations, donors, civil society and the private sector 6. Improving Performance - WHO participates in ongoing reforms aimed at improving the efficiency and effectiveness, both at the international level and within countries THE DEPARTMENT OF HEALTH ( DOH ) - The DOH holds the overall technical authority on health as it is a national health policy maker and regulatory institution. The DOH has 3 major roles in the health sector 1. Leadership in health 2. Enabler and capacity builder 3. Administrator of specific services , its mandate is to develop national plans, technical standards and guidelines on health The DOH is also the provider of special tertiary health care services and technical assistance to health providers and stakeholders The DOH adheres to the highest values of work, which are 1. Integrity 2. Excellence 3. Compassion and respect for human dignity 4. Commitment 5. Professionalism 6. Teamwork 7. Stewardship of the health of the people

1991 1993 The Republic Act 7160 or Local Government Code of 1991 was fully implemented. The office of Special concerns was formed from the branching out of the Office of Public Health Services. The Office of Hospital Facilities, Standards and regulation was created Millennium Development Goals: Philippines Goal 1. Eradicate extreme poverty and hunger Goal 2. Achieve universal primary education Goal 3. Promote gender equality and empower women Goal 4. Reduce child mortality Goal 5. Improve maternal health Goal 6. Combat HIV/AIDS, malaria and other diseases Goal 7. Ensure environmental sustainability Goal 8. Develop a global partnership for development