Community (Client) : Core Determinants

BASIC CONCEPTS OF COMMUNITY HEALTH ○ Multidimensional
NURSING ● Health is a basic human right

○ Phil. Constitution
COMMUNITY (CLIENT) ● Health is not only to be well, but to be able to use
● People that don’t look like they are at risk well, every power we have
● Goal is to promote health, prolong life, and prevent ○ Nightingale
disease ● Health necessitates developing human potential.
● Group of people that live in a certain area, sharing Health therefore is development.
common beliefs, values, traditions, and customs ● It is a shared reality because each and everyone of
○ made up of: us is connected
■ Person/People ● Implication: Holistic Care and foster self-reliance
■ Place
■ Interaction CORE DETERMINANTS
■ Common interests, beliefs, and ● Gender
culture ● Health Services
○ Defined by geographic boundaries ● Employment Conditions
○ Able to interact so they develop something ○ Income loss
in common ● Education and Literacy
■ Culture ● Physical Environment
○ To be in a community, you must be living ● Social Support Networks
together in a particular area and interact ● Personal Health Practices and Coping Skills
with each other, therefore may share ● Social Environment
something in common ● Healthy Child Development
● Biology and Genetic Endorsements
C’s of Dealing with the Community ● Culture
● CULTURE ● Financial and Social Status
○ Should be able to understand their culture ● Implication:
○ This helps shape their view on health and ○ Highlights that health is not independent
why they get sick from social realities
● COMMUNICATION
○ Share information FACTORS AFFECTING HEALTH
○ Introduce change through communication POLITICAL
○ Deliver information to liberate people from ● Related to the core determinants
dark ignorance ● With power comes better access to health
● CHANGE ● Government budgeting; funding
○ Starts with awareness BEHAVIORAL
● Implication: Culture-specific care and use of ● Culture, attitude, mindset
effective communication to promote behavioral ● Views about health affect the behavior of people
change HEREDITY
○ Bound to achieve a common goal at any ● Diseases that can be gotten from your parents
circumstances despite any differences (GENES)
○ Breast Cancer
ENVIRONMENT
● Cleanliness
HEALTH (GOAL) ● Ventilation
● State of complete physical, mentual, social ● Sanitation
well-being and not merely the absence of disease. SOCIOECONOMIC INFLUENCE
○ Holistic ●
■ acknowledge that you need others HEALTH CARE DELIVERY SYSTEM
AMPATUAN | ANURAN | COLCOL | CONCIO

● Availability of resources and facilities ■ Training
● Availability of health services ● Capacity building
● This means that Community Health and Public
THE ONE HEALTH CONCEPT Health are the same
● Recognizes the interrelationship between animal, ● CHN is about capacity building
human, and environmental health. ● An area of human services directed toward
developing and enhancing the health capacities of
people — either singly, as individuals, or
collectively as groups and communities
○ Capacity building = Enhancing health
capabilities
○ Want people to acquire skills on their own
to maintain wellness
Community Health Public Health
communitare - French populus/populi - Latin

● derived from ● meaning people
“communitas”
○ meaning
people
HEALTH
● Article 2 Sec. 15 All but one are diseases transmitted by animals to humans
○ The state recognizes the right to healthcare except —
and shall instill health consciousness ● Leptospirosis
● Health is a basic human right ● Tuberculosis
● Is not only to be well, but to be able to use every ● Rabies
power we have (Nightingale) ● Lyme Disease
○ Role of the Nurse is to empower people -Tuberculosis
● Necessitates developing human potential
The CHN has which of the following concerns? Select all
NURSING (MEANS) that applies
● Putting people in the best possible condition for 1. Maternal and child welfare
nature to restore or tot preserve health (Nightingale) 2. Sanitation
● The unique function of the nurse is to assist the 3. Workplace hazard - threat to workmates
individual, sick or well, in the performance of those 4. Road safety
activities contributing to health or its recovery (or to 5. Healthcare delivery system
a peaceful death) that he would perform unaided if -All
he had the necessary strength, will, or knowledge.
And to do this in such a way as to help gain Which of the following statements about health are
independence as rapidly as possible (Henderson) applicable in the context of nursing?
1. Health is a human right and all should be given
COMMUNITY HEALTH NURSING equal access to healthcare
● Field of nursing practice that renders care to 2. Global warming and climate change results to
individuals, families, groups, and communities disasters that cause loss of lives and disrupts
focusing on health promotion and disease healthcare systems
prevention through people empowerment 3. Employment and education impacts health literacy
● Equipping them with knowledge and skills and decreases sensitivity of people to information
○ Empowerment = enabling 4. Animal and human health depends on
■ Teaching environmental health
-all except 3 The basic principle in CHN is to promote a self reliant
community
Which of the following accurately describes a healthy
community? FEATURES OF CHN
1. Absence of all forms of illness across all age groups ● Developmental in approach
2. People are actively involved in various health ○ You have to educate
forums and programs ○ Each has a capacity to take of his/her own
3. Children are provided routine immunization so you teach the individual so he/she can
a. 80% must be vaccinated to promoted Herd independently do it
immunity according to the WHO ○ Equipping people with knowledge and
4. Sanitation policies are well placed at the barangay skills
-all except 1 ○ Care is coupled with teaching
Which of the following factors is related to an increasing ● Population-focused

number of cases of HIV/AIDS in the country ○ We don’t talk of individual patients only,
1. Physical environment we talk about population groups.
2. HCDS ○ Make sure services are not just for one,
3. Genetics but for the group.
4. Politics ○ If a particular need isn’t given to a
5. Behavior particular population, problems arise.
6. Socioeconomic influence ○ Example:
-2,5,6 ■ If sex education isn’t given,
teenage pregnancy may arise
What organized framework does a nurse use follow in among adolescents
hospitals and in the comm ○ Talk to lawmakers to make these policies
● Scientific method implemented and to protect the people from
● Review of health systems the health risks
● Cephalocaudal assessment ○ Thinking of needs of specific groups
● The nursing process ■ Workers
- Nursing process ■ Adolescents
○ Assess based on needs
Assistance in physical therapy of a trauma patient is a ○ Come up with strategies to promote
● Primary people’s health
● Secondary ○ Think of them as a group
● Tertiary ■ Ex. Women need to be screened for
● Specialized breast cancer and need health
-Tertiary teachings for when they reach
menopause
The emphasis of CHN is empowerment of the community ● Driven by Social Justice
by education. ○ Greatest good for the greatest number
○ Which of the following can I do that can
Multisectoral approach encourages collaboration in the impact more people?
implementation of health programs. ○ Common good
● work with everybody because all of them and their ■ Allocating supplies to the barangay
jobs will influence health. with the highest number of people
(vs barangay with few population)
The main responsibility of the CHN is to educate the public. ■ Conducting immunization in
schools (vs house to house which
will take more time)
■ MMR vaccine that goes bad after 4 for dehydration and electrolyte imbalance
hours — tell patient to come back — Contact sanitary inspector because of
on another day suspected coliform contamination —
● Reason for immunization Assemble the people and inform them with
days the current health risk and teach to boil
● Reduce wastage of medical water
products to benefit more ○ Epidemiologic nursing
people ○ Preventing what’s about to happen
○ Aim for equity ■ Think in advance
■ Give more to those who need more ● Comprehensive Care
○ You cannot choose who your patients are
so you need to be prepared
● Ecology-oriented ○ Everytime we are on the field, expect
○ Talks about how care is given in the natural everyone
environment ○ Care is general
■ Going where people are ○ Variety of cases
● Schools, workplaces, ○ Loads of experience since it’s not for
homes beginners
● Ex. At work - Occupational ● Consumer Involvement
Health Nursing ○ We value patients as PARTNERS
● Do home visits since ■ Give them a sense of responsibility
people would be at their so they don’t rely on us and we
homes make them involved
● In schools, perform School ■ For them to participate, they must
Health Nursing and teach know first
hygiene and disease ● Build on their awareness
transmission ○ We don’t see them as merely end users
● Multidisciplinary ○ TB DOTS
○ Collaborative ■ Instill in them that they need to be
■ Solution lies on everybody’s responsible for their own health
hands, not just on one person ● Pre-paid mechanism
■ Fostering partnerships and building ○ People in power are paid to do it
linkages ○ Sugar beverage tax
○ Dogs and rabies ■ To prevent people from buying it
■ Developmental ■ Protect people from diabetes,
● Teachings to dog owners, kidney disease
etc about how rabies worth ■ Gain money that the government
■ Multidisciplinary can use to fund UHC
● Veterinarians: ■ Everyone is entitled to UHC
immunization of pets ○ Health services we receive are coming from
● Barangays: ordinances on our own pockets due to our taxes
dogs
○ Working with others
○ Everyone needs to contribute to health
● Preventive Service 5 C’s IN COMMUNITY HEALTH
○ We are heavy on prevention (Three ● Clients as partners
Levels) ○ They have endowed faculties so they can
○ Children coming to the health center with improve and protect their health
chief complaint if diarrhea who are at risk ○ Giving them a sense of responsibility
● Collective in scope delivering the best health for the greatest
○ Health is a shared reality and number
responsibility ○ Politics is crucial to health because
○ Inclusive of the production of policies to
○ Everyone is covered make things happen
● Collaborative approach ○ Promote healthcare equality and
○ Work together equity
○ Everyone can contribute ● The collective effort of improving the
○ Multisectoral and multidisciplinary health of the population
○ The solution is in our hands ○ We need each other
○ Nurses don’t have the solution to all the ○ Any one can take the lead because
problems, they have to work with health is everybody’s business
everybody to solve the problem ○ Core is health education
● Capacity building ● A special field of nursing that combines
○ Empowerment the skills of public health, nursing and
○ Helping people acquire knowledge skills some phases of social assistance and
by giving them information functions as part of a total public health
○ Nurses are catalyst bc we facilitate people program for the promotion of health,
acquire knowledge improvement of the physical and social
○ Developmental environment rehabilitation, and prevention
■ Combine with teaching of illness and disability (WHO Expert
○ Justice is observed and adhered to Committee on Nursing)
● Common good ○ Speaks of how CHN is an
○ Always for the majority integration of multiple disciplines
○ Would this be of benefit for more? (since health is multidimensional)
○ Greatest good for greatest number ○ We’re not simply meant
○ Clinic visits would make you cover a lot ● May be defined as a field of professional
more people practice in nursing and in public health in
which technical nursing, interpersonal,
PUBLIC HEALTH analytical, and organizational skills are
● The art and science of preventing disease, applied to problems of health as they affect
prolonging life, and promoting health the community. These skills are applied in
and efficiency through organized concert with those if other persons engaged
community effort in healthcare, through comprehensive
○ The strategy is by organized nursing care of families and other groups
community efforts and through measures for evaluation or
■ Everything is systematic control of threats to health, for health
and structured education of the public, and for the
○ Everybody should exert effort mobilization of the public for health action
through collaborating ● The practice of promoting and protecting
○ People empowerment the health of populations using knowledge
○ Patients should be self-reliant from nursing, social, and public health
■ Able to perform things on issues
their own
○ There should be policies and laws BASIC CONCEPTS
to have an organized community ● Scope is collective because health connects us all
■ Add legislative efforts ● Our starting point of care is in the communities
● The application of science in the context of (Families tayo magsstart not sa individuals)
politics to remove inequalities in health in
Levels of Clientele ● Strengthen community action
● Individual - Family - Groups - Community ○ Work with communities
Unit of Service ○ Help them realize that everyone should
● Family participate to solve problems
● Place where we acquire concept of health and ● Develop personal skills
illness ○ An element of nursing is to teach people
● Health of community begins with the family how to do it so they can do it on their own
● It is through our families where we get our next time
knowledge of who gets sick and why they get sick ● Reorient health services
Philosophy ○ Focus on primary healthcare
● Worth and Dignity of Man
● All share the same worth and dignity 3 PILLARS OF HP
● For all, fair for all, respect 1. Good Governance
Principle: ○ Healthy public policy begins with good
● Greatest good for the greatest number governance
Primary Activity 2. Healthy Cities
● Health Education ○ Most people dwell in cities today
● People Empowerment 3. Health Literacy
● Equipping people with knowledge ○ After people acquire information, they
Primary Focus: utilize it
● Health Promotion/ Disease Prevention CORE FUNCTIONS OF PHN
ASSESSMENT
HEALTH PROMOTION AND DISEASE ● Gathering, processing, analyzing data
PREVENTION ○ Research: Major tool
● Health promotion is the process of enabling people ■ Generating evidence
to increase control over and improve their health ■ Help us create policies
○ WHO ○ Makes use of research to generate evidence
● Combination of educational and environmental that will convince decision makers that they
support for action and conditions conducive to need to make a policy to promote and
health protect health
○ Lawrence Green POLICIES
○ Knowledge is not enough ● Rooted in evidence
○ Include policies ● Think of benefit and burden, must be equal and not
■ Funding singling out a group
○ Healthy comprised of going to exercise and ● Train law (Sugar beverage tax) - Compels people
eating healthy diet to consume less sugary products
● Republic Act 9211
HEALTH PROMOTION STRATEGIES ○ Tobacco Regulation Act
● Build healthy public policy ○ Prohibits multimedia tobacco endorsements
○ Taxation is the single, most cost-effective ASSURANCE
measure to reduce tobacco and alcohol ○ Guarantee
consumption
○ RA 8980 LEVELS OF PREVENTION
■ Barangays should have
Level Focus Goal Activities
playgrounds for children
■ To promote physical activity Primary Well clients Promote Risk reduction
● Create supportive environments health
○ Infrastructures Specific
○ Facilities OLOF protection

● Initiated by the DOLE in collab with the BON of
Secondary Sick clients Prevent Early detection
complication the Ph, DOH, PNA, and other stakeholders to
First aid (Early stage / Prompt promote nurse entrepreneurship
Asymptomatic) treatment ● FCNC’s
● Hospice, domiciliary and healthcare facility
Acute Surveillance management
● Public health advocacy
Emergency ● Home healthcare services
services
● Outsourcing public health delivery for LGUs, and
Tertiary Sick clients Limit Supportive care other government institutions
Disability ● Medical transcription services
(Late stage / Symptomatic
symptomatic) Management Healthcare Training Management
Rehabilitation ● PD442: NEW LABOR CODE
Chronic ● RA 11058
● Law on Occupational Health and Safety
FIELDS OF CHN
School Health Nursing Roles and Functions of the Public Health Nurse
● Focus: Health Promotion and Health Screening ● Three Roles sa BON (?) basta once you are
○ Health Promotion and Health Screening licensed:
○ Disease Prevention and Early Detection ○ Healthcare provider
○ Referral ○ Manager/Leader
○ Emergency Care ○ Researcher
● Activities about good food habits, how to prepare
food ROLES AND FUNCTIONS OF THE PHN
1. HCP
Occupational Health Nursing ● Being able to deliver care to
● Focus patients/community
○ Health Promotion ● Nurse employing the NP
■ Health Risk Assessment ● ADPIE
○ Health Protection ● Annual Physical Examination
■ Health Risk Management ○ Early signs and symptoms
● Encourage the higher ups to provide gyms for free 2. MANAGER/LEADER
because at risk na ang workers for CVD and DM ● Leader
● Guarantee that everyone will be of lesser risk ○ Influencing and motivating people
● Supervisor
Faith Community/Parish Nursing ○ Staffing and scheduling other
● Dealing with a population in the same workers
denomination ● Trainor
● Nursing combined with spiritual care, ● Property Custodian
● They may work in either paid or unpaid positions in ○ Inventories, requisition if supplies
a variety of religious faiths ● Environmental Manager
○ Resources must be used efficiently
Correctional Nursing and effectively
● In jails and correctional facilities 3. RESEARCHER/EDIDEMIOLOGIST
● Provision to healthcare to prisoners and developing ● Participant in epidemiologic investigations
programs to ensure health ● Statisticians
○ Municipal stats thru tools such as
Entreprenurse/Independent Practice graphs and tables
● Prepares and submits report ● Government and NGOs
● Health monitor of the community ● Taxation
● Gather data to identify trends and diseases - Taxation
in the community to come up with
preventive solutions or protective measures Level of healthcare delivery that offers basic hospitalization
4. HEALTH EDUCATOR under LGU
● After providing care, it is a must that you ● Secondary
educate them
● Teaching and training to sharing Health services were devolved to the LGUs for the
information following reasons except
5. PROGRAM IMPLEMENTER ● To transform LGus into
● Being able to deliver policies to
patients/community All of the ff are true of CHN except
● Protect people’s health ● Care is comprehensive and general
6. COMMUNITY ORGANIZER ● Care is episodic and focuses on individuals
● Help people solve their own problems ● Care is geared toward self reliance
7. ADVOCATE
○ Ensure the patient’s rights - Care is episodic
PHC aims to strengthen the hcds by

RA 1132
● Aims to prevent epidemics through mandatory HEALTHCARE DELIVERY SYSTEM
reporting of notifiable diseases and health events of ● Refers to the sum of all agencies, personnel, and
public health concern services directed to provide health care to the
population
ACT 3573 - LAW ON NOTIFIABLE DISEASES ● Critical for the need of a system - the Nurse
Weekly monitoring Sectors: Public and Private

Neonatal tetanus ● Ideally, public sector should play a larger role in the
Severe acute diarrhea healthcare delivery system
Acute flaccid paralysis polio ● RA 11123: Universal Healthcare System
Measles
AIDS COMPONENTS OF THE HEALTHCARE DELIVERY
SYSTEM
Within 24 hrs
Acute flaccid paralysis polio AGENCIES
Measles Department of Health (National)
For eradication ● Lead agency for health in the country
Rabies ● Develops, initiates and monitors health programs at
ACP the national level
Measles ○ Duty is not limited to providing health care
Neonatal Tetanus alone
● HCDS ● Mandate from Constitution 1986 Article 2 Section
15: The state recognizes the health of all Filipinos
Quiz in CHN and shall instill health consciousness among them.
● Dimensions of Healthcare: Promotive, Preventive,
All but one are components of the HCDS Curative, and Rehabilitative
● Health professionals ○ Problem in our HCDS is that we are
● Facilities and services focusing on curative
● Vision: Filipinos are among the healthiest among ○ Health Disparity - Equal outcomes
people in Southeast Asia by 2022 and Asia by 2040 ■ To reduce disparity, push for
● Mission: To lead the country in the development to legislation, and make sure that
a productive, resilient, equitable, and health programs are funded by the
people-centered health system. law
○ Equity: Give more to those who have less ■ Universal health care - Everybody
● Given its mandate, it is necessary for DOH to be a receives the benefit
both a policy and regulatory body for health ■ Ordinance - Only for the
○ Issues license of hospitals to operate government
○ Sets standards for LGUs to follow 2. Financial risk protection for all especially the
● As a major player the DOH is a: poor, marginalized, and vulnerable
○ Technical resource ○ UHC is an answer to this goal
■ Conducts research, offer support 3. A responsive health system which makes Filipinos
and guidance feel respected, valued, and empowered
○ Catalyzer for health policy ○ Give opportunity to learn by sharing
■ Takes the first steps to lobby in information
congress to benefit public health F1 Plus for Health
■ Accessible cheaper medicine law ● Framework and game plan of the DOH to achieve
○ Political sponsor and advocate for health targets
issues in behalf of health sector ● Aims to attain the goals
Comprehensive Reforms in Health LOCAL GOVERNMENT UNITS

● FOURmula 1+ (2018-present)
● All for Health towards Health for All (Duterte
Agenda until 2017)
● Universal Health Care (2005-2016)
● FOURmula One for Health (2005-2010)
● Health Sector Reform Agenda (1999-2004)
● LALABAS SA EXAM
The direction of the DOH depends on the president in

power
● Sustainability should always be considered
NATIONAL OBJECTIVES FOR HEALTH

(2017-2022)
● Serves as the medium-term roadmap of the
Philippines towards achieving Universal
Healthcare
● It specifies the objectives, strategies, and targets of ● RA 7160: Local Government Code
the Department of Health FOURmula 1+ for Health ○ The local governement can lihis to the sht
of the national government and that they
NATIONAL OBJECTIVES FOR HEALTH GENERAL can start their own health care
GOALS 2022 ○ Giving local governments autonomy
1. Better health outcomes with no major disparity ○ Aim: To transform local government units
among population groups into:
○ Reduce mortality cases of hypertension, ■ Self-reliant communities
diabetes, cancer, etc. ■ Active partnership with the people

■ Responsive to the needs of the ■ TBA (
people ■ Traditional Healers
■ Accountable government - These people help immediate health
representatives workers
■ Decentralization system on health - Include lay persons = community
decision making participation
■ Bottomline: Provide access to - Educational attainment is not a priority
healthcare ○ Intermediate Health Workers
● Implements health programs at the community level ■ MDs - 50,000 (ideally 20,000)
■ PHNs - 20,000
■ Midwife - Primary health worker;
5000
● Teams
○ Basic PHC Team (3)
■ Midwife, nurse, physician
○ Basic RHU Team (6)
■ Midwife, nurse, physician, dentist,
sanitary inspector, BHW
Grass roots
SERVICE
- Exceptions to this would be cities ● Primary
○ Out-patient services
PRIMARY ● Secondary
● Midwife ○ In-patient services
○ 1 is to 5000 ■ Bed and space will be occupied
SECONDARY ■ Not all may be accommodated
● Nurse ● People must seek primary
○ 1 is to 20,000 health care services first
● And all other HCP ○ Basic hospitalization
TERTIARY ● Tertiary
● Physician ○ In-patient services
○ 1 is to 50,000 ○ Specialized care
○ Critical care
COMPOSITION OF LOCAL HEALTH BOARDS
● Chairperson: Mayor or Governor TWO WAY REFERRAL SYSTEM
● Vice-chairperson: Municipal/Provincial Health ● Communication among facilities
Officer ● Increased competency of specialized care
● Members
○ Chairman of the Health Committee of In secondary and tertiary, not all can be accommodated
Sangguniang Pambayan/Panlalawigan because of the number
○ NGO Representative
○ DOH Representative As you go up, the cost, competency, and care also rise
PERSONNEL PRIMARY HEALTH CARE

● Categories of Health Workers ● Focuses on delivering care to individuals and
○ Grass Roots population groups
■ BHW/VHW ● Overall strategy to address the social determinants
■ Volunteers of health
○ Require multidisciplinary efforts or ○ Primary Healthcare was officially launched
initiatives ○ STRATEGY
○ Valuing knowledge and opinions of other ● PHC identified as a key strategy in achieving the
professionals HFA by the year 2000 goal
○ Health in the hands of the people ● 1979 - PH adopting PHC through Letter of
○ Health within reach Instruction 949
● Total approach to healthcare ● 2018 Astana Declaration reaffirming commitment
● Has to begin with what’s basic to PHC globally and commit to UHC
● Gives importance to collaboration ○ Implement primary healthcare and
● Considers patients as partners universal health coverage
● Health is more than a right but also a responsibility ○ Brought UHC in the Mainstream
● We want people to acknowledge that health is in ○ Echoes the Alma Ata Declaration
their hands = health within reach ○ Promotive, Preventive, Curative,
● 3 Dimensions Rehabilitative, and Pallative
○ Goal ■ Rehabilitative, you expect them to
■ 17 Sustainable Development Goals still recover but in Pallative, you do
○ Strategy not expect them to recover; both
■ Active participation of the are
community ● 2000-2015 MDGs
■ Organized community efforts ○ Global health targets
○ Philosophy ● 2016- 2030 SDGs or Agenda 2030
■ Introduced in the country on 1978 ● Underlying concepts touch on health
■ Goal by 2000 which became 2020 ● The way to achieve all of the targets is through
then now at 2030 Primary Healthcare
Primary Care
○ More medical in context/approach PRIMARY HEALTH CARE DEFINITION
○ Point of contact care in which we expect ● Essential healthcare based on practical,
that scientifically sound and acceptable methods and
○ Provides basic healthcare services like technology made universally accessible to
consultation, simple lab test individuals in communities through full
○ Majority are private participation and at a cost the community and the
○ We refer them as clinics which are country can afford to maintain at every stage of
privately owned by physicians their development in the spirit of self-reliance and
○ Require Out of pocket expenses, deriving self-determination
people of access ○ Full participation - organizing communities
○ Use beyond primary care which is primary to empower the people, so that they are
health care aware of their responsibilities and rights
○ Self-reliance - we want them to be
PRIMARY HEALTH CARE: HISTORICAL independent; equip them with knowledge
PERSPECTIVE skills, and attitudes for capacity building
● 1977 - 20th World Assembly of WHO and the HFA ○ Self-determination - patients have
2000 Movement autonomy so let them but stop or intervene
○ Health for All the Year 2000 when it already affects other people
○ They weren’t able to talk about how nila ● Definition: Essential healthcare made universally
maachieve accessible to the people by means acceptable to
○ GOAL them
● 1978 - Alma Ata Conference and Declaration ○ Essential healthcare: basic
○ First ever conference on Primary ○ Everyone is entitled to it
Healthcare ○ Health for all by all
○ 5 A’s of the Characteristics of Primary ■ Protocol on treating children under
Health Care 5
■ Accessible - must be within 5 km ○ Best managed in primary care
or 30 mins ● E Essential Drugs
■ Available ○ These are medicines that are must haves,
■ Affordable - both for patient and life saving and good for the
government to maximize resources ○ Hyperetensive Drugs (Losartan,
for the greatest good and the Amlodipine)
greatest number ○ Mitformin for Diabetes
■ Acceptable - respect culture and ○ Oresol
social norms ○ Antibiotic (Amoxycillin)
■ Appropriate - criteria, has to be ○ Paracetamol (For febrile patients)
effective, safe, and sensitive; went ○ Contraceptives
through research ■ RPRH: RA 10354
● Mission: Strengthen the HCDS by providing and ● Responsible Parenthood
supporting conditions wherein the people will Reproductive Health Law
manage their own health ● M Maternal and Child Health
○ We want the people to manage their own ○ Safe Motherhood
health and gain independence and feel ■ Prenatal checkups for early
empowered detection (Secondary)
● Goal:Health in the hands of the people by the year ■ High-risk Pregnancy
2020 ● Too young, Too old, Too
○ Health for all, by all many (more than 5), Too
○ Give access to health close, Too sick
○ Achieved through Universal Health ○ Dealing with childhood conditions
Coverage to achieve the SDGs ● E Expanded Program of Immunization
● Strategy: Believes in working together - ○ Herd immunity - 80%
collaboration ● N Nutrition
● Philosophy: The spirit of PHC lives on, ○ Food fortification
acknowledging that people should be independent, ● T Treatment of Simple Ailments
self reliant and want to build their capacity ○ First Aid
○ As a guide, this is involves ppl, work with ○ Wound Care
other professionals/people ● S Sanitation
○ Food Safety
PHC SERVICES ELEMENTS ○ Water Sanitation - safe drinking water
Core is capacity building ○ Waste Management
● E Education on Health ○ All three can be vectors of disease
○ Risk reduction, health promotion like
smoking cessation PHC SERVICES CORNERSTONES (AIUS)
○ Should be applied on all settings ● Active Community Participation
■ School: Promote healthy eating ○ Forming groups who will start initiating
habits health programs
■ Occupational settings: Stress ○ Health in the hands of the people
management like gyms and going ○ Give them a sense of ownership, they must
on exercise to raise their be involved, take responsibility
consciousness ○ Most important
● L Local Disease/Endemic Disease Control ● Inter-Intra-Sectoral Linkages
○ IMCI - Integrated Management on ○ Working with others
Childhood Illness ○ Collaboration
● Use of Appropriate Technology ○ Remove cover and use clay pot to allow
○ Effective and safe oxidation of impurities
○ Use of Eastern from Western = Alternative ● One kind of plant for each type of symptoms to
○ Use of Eastern and Western = avoid possibility of drug
Complementary ● No pesticides
○ SANTA LUBBY ○ Avoid poisoning
○ Use of Herbal Medicines: RA 8423 ● Use only the part recommended
Traditional Alternative Medicine Act ● Stop in case of untoward reactions; seek
○ Sambong (Camphor) consultation if s/sx not relieved after 2-3 doses
■ Diuretic
■ Prevent edema AROMATHERAPY
○ Akapulko (Ringworm Bush) ● Alternative form of holistic therapy that uses
■ Anti-fungal essential oils to help improve and create an
■ Tinea infections emotional and physical balance in the individual
○ Niyog-niyugan ● Works on three main levels: through teh sense of
■ Anti-helminthic smell, through absorption, and through absorption
○ Tsaang-gubat (Wild tea) via the skin
■ Diarrhea
■ High in chlorine content AGENDA 2030 or SDGs
■ Stomachache ● Elaborated MDGs lang
■ Tooth decay ● Most important is #3
○ Ampalaya ○ Good health and well-being
■ Mild NIDDM ○
■ Diabetes ● SDG 3 has 9 targets
○ Lagundi ○ To ensure healthy lives and promote well
■ Fever, cough, cold, and asthma being for all ages
■ Can be used for pain except for ■ Reduce Maternal Mortality
dysmenorrhea bc it can worsen the ■ Newborn and Child Mortality
pain ■ Communicable Diseases
○ Ulasimang bato (Peperomia) ■ NCDs and Mental Health
■ Lowers uric acid ■ Substance Abuse
■ Gouty arthritis ■ Road Traffic Accidents
○ Bawang ■ Reproductive Health
■ Anti-lipidemic ■ Universal Health Coverage
■ Lowers cholesterol, reduces bp ■ Environmental Health
■ Used as an antiseptic ● 4 Means/Mechanisms of Implementation
○ Bayabas ○ Tobacco Control
■ Toothache ■ Syntaxes
■ Antiseptic wash ○ Vaccines and Medicines
○ Yerba buena ○ Health Financing and Workforce
■ Rye - pain ■ Syntaxes and pushing for UHC
■ Pain reliever ○ Global Health Security
■ Arthritis ○ What happens in the national level impacts
● Support System made available the global level
○ Primary to Secondary to Tertiary if di
mahandle sa lower UNIVERSAL HEALTH COVERAGE
● All people having access to quality HS without
NURSING CONSIDERATIONS (BONUS) suffering financial hardship association with paying
● Boiling for care
○ All people (population coverage)
○ Access to quality health service (service
coverage)
○ W/o suffering financial hardship (financial
risk protection)
Primary Health Care

● Is a critical foundation for UHC
RA 11223
UHC = PAGCOR/PCSO + PhilHealth + Sin Tax

SAFE MOTHERHOOD PROGRAM
PRENATAL SERVICES
ACTIVITIES UNDER ANTENATAL
MATERNAL DEATHS BY MAIN CAUSE ● Intensive Assessment
1. Complications related to pregnancy occuring in the ○ Serves both primary and secondary levels
course of labor, delivery, and puerperium of prevention
2. Hypertension complicating pregnancy, childbirth, ○ Profile of Patient
puerperium ■ Demographics
3. Postpartum hemorrhage ● Age - Identify if too young
4. Pregnancy with abortive outcomes or too old
○ Dystocia (?)
❖ Pregnancy is their common ground ○ Psychological
❖ We want all deliveries and unpreparedness
❖ Assessment - Women are dying because of labor ■ Anthropometric Measurement
and delivery ● Weight
❖ Policy - Evidence is translated into policy - EINC ○ Obese - Baby may
❖ Assurance - All pregnancies will be safe be too big
○ Uterus becomes
too stretched and
● WHO recommends a minimum of four antenatal uterus may become
visits atonic and flabby
○ Before delivery, during pregnancy ○ Leading to
○ Reduce risk of woman and baby hemorrhage
○ Helps screen if woman is going through a ○ Labor is prolonged
complicated pregnancy causing decreased
■ Too young tissue perfusion to
■ Too old the fetus
■ Too many ● Height
■ Too close ○ Woman under 5ft
■ Too sick ○ Might affect her
○ 1st visit: Before 4 months pelvic structure
○ 2nd visit: 6 months and ability to
○ 3rd visit: 8 months ○ Pelvic inlet and
○ 4th visit: 9 months outlet may be too
● Lying-in clinics - puericulture centers small making
○ 5Ps
■ Power
Number of WHO/UNICEF/DOH PHN 2007
■ Passageway
Visits CPG 2005/2006 Book
■ Passenger
First Before 4th month of 1st trimester ■ Psych11
pregnancy ■ Position
○ Obstetric History
Second Between 6th to 7th 2nd trimester ■ If more than 5 Pregnancies
month of pregnancy ● May lead to uterine
prolapse causing heavy
Third 8th month of pregnancy 3rd trimester bleeding - death
■ GPTPAL
Fourth 9th month of pregnancy After 8th month: ■ LMP (Last Menstrual Period)
every 2 weeks ■ AOG (Age of Gestation)
■ EDC (Expected Date of ○ Most Common:
Confinement) ○ Prevent anemia and neural defects
○ Comorbidity ○ Pallor-anemia:
■ Identifying underlying conditions ○ Normal 11g/dl
that may affect pregnancy Iron Supplementation
○ Physical Exam
TARGETS PREP DOSE AND
■ Objective Data DURATION
■ Inspection
● Edema Pregnant women Tab containing 1 tab 1x/day for
● Bleeding 60mg El w/ 400 6 months or 2
● Gaining weight is normal mcg Folic Acid tabs/day if 2nd or
mga 24lbs / 12kg for 3rd trimester
Filipinos Lactating women Tab containing 1 tab 1x/day for
● Rapid weight gain in 60mg El w/ 400 3 months or 90
pregnancy is expected at mcg Folic Acid days
the Third Trimester
■ Palpation
● For Vit. A Deficiency (VAD)
■ Percussion
● Vit A: Can cause congenital problems if given early
■ Auscultation
● Do not give Vit. A if woman is taking
○ Laboratory Tests
multivitamins
■ Urinalysis
● UTI: If left undetected may TARGETS PREP DOSE AND
cause pelvic inflammatory DURATION
disease - may result to Pregnant women 10,000 IU 1 cap/tab 2x/wk
premature labor (4th mo. until
● Proteinuria - Preeclampsia delivery)
● Glucosuria
■ CBC Lactating women 200,000 IU 1 cap 1x
● Hemoglobin (within 4 weeks
after delivery)
○ 12-14: Female
○ 14-16: Male ● Iodine Supplementation
○ Anemia - not a TARGETS PREP DOSE AND
disease condition DURATION
but a manifestation
that there is Children of Iodized oil 1 cap for 1 year
something wrong school age capsule w/ 200
in the body mg iodine
○ Pre-eclampsia: Women Iodized oil 1 cap for 1 year
Pregnancy Induced 15-45 years old capsule w/ 200
Hypertension mg iodine
○ Polycythemia
● Hematocrit Adult males Iodized oil 1 cap for 1 year
■ Venereal Disease Research capsule w/ 200
mg iodine
Laboratory
● Syphilis
■ HIV test ● Immunization
● Micronutrient Supplementation ○ Tetanus Diphtheria
○ Purpose: Risk reduction against ■ Protection against Tetanus
Micronutrient Deficiency
■ Preferably given at 4th month of ● Continuous maternal support, by a companion of
pregnancy her choice, during labor and delivery
■ Fully Immunized Mother (5 shots) Companion is needed to alleviate stress
● 3 at minimum - offer Stress – leads to higher blood pressure, which
immediate protection for leads to vasoconstriction, which affects
mother and baby perfusion at the level of the placenta
Mother – usual companion (assists during labor
and delivery)
DOSE WHEN LENGTH
● Mobility during labor - the mother is still mobile,
1st Anytime during within reason, during this stage
pregnancy Facilitates fetal descend
Form of diversion to minimize stress
2nd 1 month after 1st 3 yrs
● Position of choice during labor and delivery
dose
● Non-drug pain relief, before offering labor
3rd 6 months after 5 years anesthesia
2nd dose ● Spontaneous pushing in a semi-upright position
○ Encouraged but not done due to the lack of
4th 1 year after 3rd 10 years practice even with evidence/research
dose
● Episiotomy will not be done unless necessary
5th 1 year after 4th Lifetime Shaving is not routinely done
dose *Metargin – never administered during labor
Analgesic – may arrest the process of labor
Dose: 0.5ml
Labor too long – causes fetal distress (usually,
Route: IM
there is a need for CS)
Site: Deltoid Muscle
● Active management of third stage of labor
(AMTSL)
● If 2nd dose is given at least 2 weeks before delivery
● Monitoring the progress of labor with the use of
○ Assurance of full protection against
partograph
neonatal tetanus
● Look at the number of pregnancies
POSTNATAL VISITS
● 2nd dose is given if mother has already delivered,
● Minimum of 2
for the protection of future pregnancies
● 3 doses of Pentavalent in Infancy
○ 1st 2 doses of tetanus toxoid # OF WHO/DOH/UNIC PHN
● 2 shots para protected both baby and mother VISIT EF 2005/2006 2007
● No such thing as overdose S BOOK
Precautions: 1st 1st 24 hours to 48 Within

● Ask if they already ate because it causes GI upset hours after delivery 3-5
● Ask if right/left handed because it causes soreness days
2nd 6 weeks after 6

Health in SDG 3
delivery weeks
● To ensure healthy lives and promote wellbeing
after
● 4 Means of Implementation
deliver
○ Tobacco control
y
EINC PRACTICES DURING INTRAPARTUM First 24 hours check up: (mother) to identify if there is
PERIOD hemorrhage or uterine atony, (infant) to identify if the
infant is sucking well (may be a sign that the child is
suffering from a neurologic condition, causing change in ● Ask: about h im/herself
the level of consciousness ● h ealth center and the services provided
Tell:
● Help: make the decision that is best for him/her
RA 11148 - KALUSUGAN AT NUTRISYON NG ● Explain: relevant information about the
MAG-NANAY ACT symptoms, diagnosis, treatment.

● First 1000 days of life is the period of rapid ● Return: schedule a return visit.
growth where nutrient deficiencies can have
long-term consequences. RA 10354
● Good nutrition maximize the child’s ability to ● Responsible Parenthood and Reproductive Health
grow, learn, and develop that has profound Law
effect in his/her future health, well-being and Requires national budget to be allocated for
success alter on in adulthood. The quality of contraceptives
nutrition during the first 1000 days can have a Mandatory family planning
significant impact on the achievement of Introduced sex education in basic education
national and global development goals Implemented: 2014
Helps reduce maternal and child mortality, and Culture: where the gap lies
gives emphasis on nutrition
CHILD HEALTH PROGRAMS
FAMILY PLANNING ESSENTIAL NEWBORN CARE: UNANG YAKAP
Determines the number of pregnancies (December 1, 2009)
● AO 2009-0025: Adopting Policies and Guidelines
FOUR PILLARS on Essential Newborn Care
1. Responsible Parenthood Used to reduce child mortality (neonates die
Involves both husband and wife because of infection, hypothermia,
Begins with understanding that having kids is a hypoglycemia, etc.)
responsibility ● Focus: MDG 4 (out of 8)
2. Respect for Life ● Performed in the first 90 minutes of life.
3. Child Spacing This is a critical period where hypothermia and
Close interval pregnancies: hypoglycemia sets in
Will put the woman at high risk
May cause malnutrition: kwashiorkor (disease 4 TIME-BOUND INTERVENTIONS
of the 2nd child) ● Immediate drying
4. Informed Choice ○ Thorough drying for 30 seconds to one
Autonomy minute warms the newborn and stimulates
breathing
PRIORITIES Head to toe
● Couples in the reproductive age: 20 to 44 years Use two cloths
More capable of giving birth
● 3 or more children ● Skin to skin contact
Beyond 3 may be economically challenging ○ Early skin-to-skin contact between mother
● Close interval pregnancies and newborn and delayed washing for at least
More people means more tax payers which six hours prevents hypothermia, infection,
means more social services and hypoglycemia
● (+) chronic disease *Don’t dry palms of hands
Pregnancy will put their health at risk (for the Don’t remove vernix caseosa
reduction of maternal and child mortality) Delay bathing
3 benefits: prevents hypothermia
COUNSELING (poikilothermia),
● Greet: warmly and politely Tummy then in between breasts
Galactosemia Death or Alive and
● Proper cord clamping and cutting
Cataracts Normal
○ Properly timed cord clamping and cutting
prevents anemia and protects against brain Phenylketonuria Severe Normal
hemorrhage in premature newborns. It (PKU Mental
means waiting for the cord pulsations to stop Retardation
(between 1 to 3 minutes)
■ Clamp 2 cm and 5 cm from the base of the G6PD Deficiency Severe Normal
umbilicus Anemia,
Kernicterus
● Non-separation of baby from mother and
breastfeeding initiation Maple Syrup Death Normal
○ Protects infants from dying from infection. Disease
The first feed provides colostrum, a substance ● T
imeline:
equivalent to the babies’ first immunization ○ Ideal: 48-72 hrs or 2-3 days of life
in its protective properties Within 48 hours, there is still maternal
○ RA 7600 - Rooming In blood in the system (which may make the
1st ever breastfeeding law result inaccurate)
Basis for the MBF (mother-baby-friendly) The infant has to pass stool first (to check
hospital recognition for phenylketonuria)
○ RA 10028 -- Expanded Breastfeeding Law ○ Maybe: 24 hours
NEWBORN SCREENING PROGRAM 1. Using heel prick method, a few drops of blood are
● RA 9288 Newborn Screening Act of 2004 taken from the baby’s meal.
Mandatory, but the cost is out-of-pocket 2. Blotted on a special absorbent filter card.
Screens for metabolic condition (which may 3. Blood is dried for 4 hours and sent to the NBS
result to mental retardation or premature death; center.
aims to reduce child mortality) 4. After 7 working days, parents claim the results
● Detect congenital metabolic disorders that may from the physician, nurse, midwife, or health
lead to mental retardation or even death if left worker:
untreated ■ If positive (+) screen:
● Expanded NBS offers 2 packages, basic 6, and ● Released within 24 hours for
additional 22 for a total of 28 diseases. confirmatory testing
● Trained MD, RN, midwife. RMT ● Referred to a specialist for further
screening
6 DISORDERS IN THE NBS PACKAGE
Screened Effect if Effect if ROLES OF RHU STAFF IN NBS
NOT SCREENED 1. Adovcacy for NBS of every baby. This starts
SCREENED and during pregnancy. The family is advised to save
TREATED P600.
Best done at the first antenatal visit
Congenital Severe Normal 2. Collection of samples.
Hypothyroidism Mental 3. Assures Transport of specimen within 24 hours
(CH) Retardation following collection of the sample.
4. Advice and counsel parents upon receiving the
Congenital Death Alive and screening results.
Adrenal Normal
Hyperplasia RA 9709
(CAH) ● N
ewborn Hearing Screening Test

● Focus: Prevention and Detection of Hearing When they feed less frequently, the production
Defects Among Neonates begins to drop – mas madalas mag-padede, mas
● Otoacoustic Emission Test (OAE) one day after madami ang gatas
the infant is born ● Feed as long as the baby wants
Early detection and to limit disability (hearing ● At 6 months, start supplementary feeding but
loss) breastfeeding should be continued until 2 years of
age or beyond
BREASTFEEDING Food: encouraged to eat galactagogues
RA 10028 (malunggay oysters, clams, soups)
● Expanded Breastfeeding Law Fluid: 1.5 to 2.5 L (too much fluid can suppress
● Responsible for mandating lactation break and prolactin secretion)
breastfeeding stations in establishments *Hygiene: do not wash with soap and water
Entitled to additional break for expressing
breastmilk POSITIONS FOR BREASTFEEDING
Assessment: breastmilk is best for babies 2 ● Cradle Hold/Madonna/Cross-Chest Position
years of age and beyond (provides immunity) ● Football Hold/Clutch Position
● Side-lying Position
BREASTFEEDING TSEK Not recommended at night
● Breastfeeding Tama, Sapat, at EKslusibo HOW TO GET BABY TO LATCH ON
● Launched: February 23, 2011 Crucial in the first visit after delivery
● Target: new expectant mothers in urban areas 1. C-hold
● Encourages mothers to exclusively breastfeed their 2. Stimulate the baby’s rooting reflex
babies from birth up to 6 months. Place nipple at the side of the breast
Complete nutrients 3. When the baby’s mouth opens wide, ut the nipple
After six months, maternal stores of vitamin A and as much of the areola as possible into his
and others are depleted (which would require mouth
complementary feeding)
● Exclusive breastfeeding means that for the 1st six HOW TO MAKE BABY LET GO OF THE BREAST
months for birth, nothing except breastmilk will WITHOUT HURTING THE MOTHER
be given to babies. 1. Press down on the breast near his mouth
2. Pull down on his chin and insert a small finger and
BENEFITS in the corner of his mouth. This will break his seal
● Offers protection/immunity on the nipple
● Offers complete nourishment (1st 6 months) 3. Then remove him from the breast
● Promotes maternal-child bonding
The personality develops when the child SIGNS THAT BABY HAS PROPERLY LATCHED
breastfeeds (reality orientation: source of 1. Mouth wide open
breastmilk is not the child, but the mother) 2. The baby and the mother are in tummy to tummy
Autism – may develop due to position
maternal-child bonding 3. Much of areola is inside baby’s mouth
*Id – begins to develop in toddlerhood 4. Mother does not feel pain
● Cost-efficient 5. The baby is relaxed and happy
RECOMMENDATIONS EXPANDED PROGRAM ON IMMUNIZATION (EPI)

● Frequency: 8 x in 24 hours (minimum) ● RA 10152
Day – 6 times ○ Mandatory and Basic Immunization of
Night – 2 times Infants and Children
■ Under 5 years of age
■ Priority Target: Under 1
● Fully Immunized Child Strong immune system + Weakened antigen = Immunity
● 1 BCG, 1 IPV, 2 MMR, 3 Stimulates the production of antibodies
POLIO PENTA PN (6, 10, 14) You become immune in the process
○ PD 996 repealed already Weak immune system + Weakened antigen = Disease
○ Gave authority to DOH Secretary to add more
vaccines as necessary All types of acquired is natural (except for
■ Under 8 to under 5 immunization)
● Most vulnerable to infection are Vertical transmission (mother to baby): natural
children 5 below (Routine immunization via placental transfer or breastmilk
Immunization)
● Children who had vaccines Active: antigen is usually administered, which makes
above 5 (Supplemental the body produce its own antibodies
Immunization) Lasts long-term (mobilizes the memory cells of
○ At least 80 - 95% immune system)
Fever is invoked by vaccines that are highly potent
IMMUNIZATION (like pentavalent vaccine)
● Process of conferring artificial immunity When antigen is administered, the body is
alarmed so you get fever (good sign; not all
IMMUNITY vaccines cause fever, because it’s already
● Acquired specific resistance usually attributed to weakened)
the presence of antibodies Basta, natural = active (except vertical transmission)
○ Active immunity is better than the passive Passive: an a ntibody is introduced
type because it produces a secondary immune Lasts less than a year in the body
response which leads to the formation of Pass antibodies
memory cells which acts faster and stronger
and lasts for a lifetime OBJECTIVE OF THE EXPANDED PROGRAM ON
○ Biologicals IMMUNIZATION
■ Vaccine (antigen) ● To reduce morbidity and mortality rates
■ Immunoglobulin (usually designated among infants and children from six childhood
by the prefix –anti) immunizable disease
■ Toxoid ○ Tuberculosis, Poliomyelitis, Diphtheria
Tetanus, Pertussis, and Measles
Natural Artificial
PRINCIPLES
Active · Exposure Antigens ● It is based on epidemiological situation
· Carrier Attenuated – BCG, Schedule of routine immunization is depending
· Sick
of the OPV, AMV on the problems present in the area
disease Killed – DPT, HBV ● It is basic health service
Pertussis To make everyone protective
(pangingisay) Right of health and longevity
Weakend toxins ● It is mass in approach
Target is to build herd immunity (80% is the
Passive · Breastmilk Gammaglobulin (B target but ideal is 95%)
(IgA) and T cells) (6 months
· Placenta to 1 year) ELEMENTS: TICAS
(IgB) Antitoxin, antiserum, ● Target-setting
serum Identifying who is our priority population (under
1 year old)
Target: under 1
Covered: under 5 (children are eligble for CONTRAINDICATIONS
routine immunization until 5 years of age) ● Fever about 38C
As immunization goes up, the mortality goes Vaccines may cause febral seizure
down ● Conditions requiring hospitalization (severe)
Fully immunized child: child protected from Severe pneumonia
disease ● Immunosupression
Has received all routine immunizations by 1 If receiving steroids
year old Chemo
Completely immunized child HIV – results to disease rather than receiving
Has received all routine immunizations immunity
beyond 12 months Strong immunity + Weak antigen = Resistance
● Information, education, and communication Weak immunity + Weak antigens = Disease
4 things to teach the mother: (1) what it is for
(indication), (2) what to expect, (3) what to do Malnutrition is not a contraindication; it magnifies the
(warm compress, massage, etc.), (4) when to infection (he needs the protection)
return
● Cold chain logistic management STRATEGIES
Avoid vaccine wastage -> Deprived children -> ● Conduct of Routine Immunization for Infants/
Poor coverage Children/ Women through Reaching Every
FEFO rule: first expiry, first out Barangay (REB) strategy’
Check the VVM: vaccine vial monitoring House-to-house if they were not able to receive
● Assessment and evaluation immunization because the vaccines ran out: use
Check if the child is physically fit before Principle of Justice (those who missed
immunization immunization, must still be covered)
Check for contraindications ● Supplemental Immunization Activity (SIA)
● Surveillance and research ● Strengthening Vaccine-Preventable Disease
Surveillance
MAINTENANCE OF POTENCY OF BIOLOGICALS
OPV – offers protection in the GI tract
TYPE OF STORAGE
IPV – offers protection in the blood
VACCINE TEMP.
Pentavalent (heme) and pneumococcal – offers protection
Most OPV -15C TO 25C against meningitis
sensitive to AMV (freeze Freezer
heat dried) (traditional) Two topics:
Garantisadong pambata
Least DPT 2C to 8C IMCI
sensitive to Hepa B Refrigerator
heat
BCG
TT
DURATION OF STORAGE
● RHU - 1 month
In the event of a power failure, the wastage is
limited to one month (in RHU)
● Provincial Health Office - 1 month
● Regional Health Office - 3 months

Community (Client) : Core Determinants

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BASIC CONCEPTS OF COMMUNITY HEALTH ○ Multidimensional

NURSING ● Health is a basic human right

AMPATUAN | ANURAN | COLCOL | CONCIO

communitare - French populus/populi - Latin

Which of the following factors is related to an increasing ● Population-focused

AMPATUAN | ANURAN | COLCOL | CONCIO

PHC aims to strengthen the hcds by

Weekly monitoring Sectors: Public and Private

Comprehensive Reforms in Health LOCAL GOVERNMENT UNITS

The direction of the DOH depends on the president in

NATIONAL OBJECTIVES FOR HEALTH

AMPATUAN | ANURAN | COLCOL | CONCIO

PERSONNEL PRIMARY HEALTH CARE

Primary Health Care

AMPATUAN | ANURAN | COLCOL | CONCIO

Precautions: 1st 1st 24 hours to 48 Within

2nd 6 weeks after 6

●​ ​Help: ​make the​ decision​ that is best for him/her

RA 11148​ - KALUSUGAN AT NUTRISYON NG ●​ ​Explain: ​relevant ​information​ about the

MAG-NANAY ACT symptoms, diagnosis, treatment.

AMPATUAN | ANURAN | COLCOL | CONCIO

RECOMMENDATIONS EXPANDED PROGRAM ON IMMUNIZATION (EPI)

AMPATUAN | ANURAN | COLCOL | CONCIO

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● Help: make the decision that is best for him/her

RA 11148 - KALUSUGAN AT NUTRISYON NG ● Explain: relevant information about the