CPH

SALON, GERALDINE KETH

LESSON 7 9 10
9
LESSON 9 exposed to measles, mumps,
Communicable Diseases Control whooping cough, poliomyelitis
REVIEW OF CONCEPTS with o the individual’s own immune
emphasis on the COVID- 19 system is stimulated to produce
PANDEMIC antibodies and lymphocytes.
Passive Immunization
PREVENTION AND CONTROL Active Immunization
Individual Level 1. HERD IMMUNITY
 Breaking the Infection Chain o also known as 'population
 Healthy/Positive Lifestyle immunity’
Behavior o indirect protection from an
 Primary Prevention: Health infectious disease that happens
Maintenance, Health Protection when a population is immuneither
Public Health/Population Level through vaccination or immunity
 Health Education developed through previous
 Advocacy of relevant health infection.
programs o WHO supports achieving 'herd
 Isolation, Segregation, Quarantine immunity' through vaccination, not
 Monitoring and Surveillance by allowing a disease to spread
 Expanded Program of through any segment of the
Immunization population, as this would result in
unnecessary cases and deaths.
Expanded Program Of Immunization
IMMUNIZATION
o The procedure of administering a
vaccine to a person in order to
protect them from disease is known
as immunization. Immunity
(protection) from immunization is
similar to disease immunity,
however instead of receiving the
disease, you get a vaccine. This is 1. VACCINE
why vaccines are such effective o a substance used to stimulate the
medicines. production of antibodies and
o Majority of vaccines are provide immunity against one or
administered via needle (injection), several diseases, prepared from the
although others are administered causative agent of a disease, its
via mouth (orally) or nasal spray products, or a synthetic substitute,
(nasally). Immunizations, needles, treated to act as an antigen without
shots, and jabs are all terms used to inducing the disease.
describe vaccinations. Types of vaccine
Two types of Immunization 1. Live-attenuated Vaccines - Live-
o administration of antibodies to an attenuated vaccines inject a live
version of the germ or virus that
unimmunized person from an
causes a disease into the body.
immune subject to provide
2. Inactivated Vaccine - uses a strain
temporary protection against a
of a bacteria or virus that has been
microbial agent or toxin.
killed with heat or chemicals. This
o this type of immunity can be
dead version of the virus or
conferred on persons who are

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SALON, GERALDINE KETH
LESSON 7 9 10
9
bacteria is then injected into the Millennium Development Goal 4:
body. Reduce Child Mortality
3. Subunit, Recombinant, Target : Reduce by two-thirds, between
Conjugate, and Polysaccharide 1990 and 2015, the under-five mortality
Vaccines - use particular parts of rate
the germ or virus. They can trigger o In 2013, 6.3 million children under
very strong immune responses in 5 died, compared with 12.7 million
the body because they use a in 1990. Between 1990 and 2013,
specific part of the germ. under-5 mortality declined by 49%,
from an estimated 90 deaths per
1000 live births to 46. Despite this
What is Expanded Program on improvement, the world is unlikely
Immunization (EPI)? to achieve the MDG target of a
The Expanded Program on two-thirds reduction in 1990
Immunization (EPI) was established in mortality levels by 2015.
1976 to ensure that infants/children and o More countries are now achieving
mothers have access to routinely high levels of immunization
recommended infant/childhood vaccines. coverage; in 2013, 66% of Member
In 1986, 21.3% “fully immunized” States reached at least 90%
children less than fourteen months of age coverage. In 2013, global measles
based on the EPI Comprehensive Program immunization coverage was 84%
review among children aged 12–23
Immunization is a global health and months. During 2000–2013,
development success story, saving estimated measles deaths decreased
millions of lives every year. Vaccines by 74% from 481 000 to 124 000.
reduce risks of getting a disease by 1. EPI to MDG
working with your body’s natural 2. Over-all Goal:
defences to build protection. When you o To reduce the morbidity and
get a vaccine, your immune system mortality among children against
responds. the most common vaccine-
We now have vaccines to prevent more preventable diseases.
than 20 life-threatening diseases, 1.
helping people of all ages live longer, 2. Specific Goals:
healthier lives. Immunization currently 3. 1. To immunize all
prevents 2-3 million deaths every year infants/children against the most
from diseases like diphtheria, tetanus, common vaccine-preventable
pertussis, influenza and measles. diseases.
Immunization is a key component of 4. 2. To sustain the polio-free status
primary health care and an indisputable of the Philippines.
human right. It’s also one of the best 5. 3. To eliminate measles infection.
health investments money can buy. 6. 4. To eliminate maternal and
Vaccines are also critical to the neonatal tetanus
prevention and control of infectious- 7. 5. To control diphtheria, pertussis,
disease outbreaks. They underpin global hepatitis b and German measles.
health security and will be a vital tool in 8. 6. To prevent extra pulmonary
the battle against antimicrobial tuberculosis among children.
resistance. Mandates:
1. Significance of EPI to Public Republic Act No. 10152 “Mandatory
Health Infants and Children Health

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SALON, GERALDINE KETH
LESSON 7 9 10
9
Immunization” Act of 2011 Signed by polio and may experience
President Benigno Aquino III in July 26, resurgence of polio cases
2010. The mandatory includes basic DIPHTHERIA
immunization for children under 5 TETANUS
including other types that will be 1. Maternal and Neonatal Tetanus
determined by the Secretary of Health. Elimination
1. What are the vaccines included in o 10 areas were classified as highest
EPI? risk for neonatal tetanus (NT).
Vaccine-preventable diseases that are Figure 3 shows the areas
included in the Expanded Program of categorized as low risk, at risk and
Immunization: highest risk based on the NT
o Tuberculosis surveillance, skilled birth
o Poliomyelitis attendants and facility based
o Diphtheria delivery and the tetanus toxoid 2+
o Tetanus (TT 2+) vaccination.
o Pertussis o Three (3) rounds of TT vaccination
o Measles are currently on-going in the 10
o Hepatitis B highest risk areas. An estimated
TUBERCULOSIS 1,010,751 women age 15 - 40 year
POLIOMYELITIS old women regardless of their TT
1. Polio Eradication immunization will receive the
o The Philippines has sustained its vaccine during these rounds. This
is funded by the Kiwanis
polio-free status since October
International through UNICEF and
2000.
World Health Organization.
o Declining Oral Polio Vaccine
PERTUSSIS
(OPV) third dose coverage since
MEASLES
2008 from 91% to 83%. A least
HEPATITIS B
95% OPV3 coverage need to be
1. Measles Elimination
achieved to produce the required
o Conducted 4 rounds of mass
herd immunity for protection.
measles campaign: 1998, 2004,
o There is an on-going polio mass
2007 and 2011.
immunization to all children ages 6
o Implemented the 2-dose measles-
weeks up to 59 months old in the
containing vaccine (MCV) in 2009
10 highest risk areas for neonatal
MCV1
tetanus. These areas are the
(monovalent measles) at 9-11 months
following: Abra, Banguet, Isabela
old
City and Basilan, Lanao Norte,
MCV2 (MMR) at 12-15
Cotabato City, Maguindanao,
months old.
Lanao Sur, Marawi City and Sulu.
o Implemented and strengthened the
o Acute Flaccid Paralysis (AFP)
laboratory surveillance for
reporting rate has decreased from
confirmation of measles. Blood
1.44 in 2010 to 1.38 in 2011. Only
samples are withdrawn from all
regions III, V and VIII have
measles suspect to confirm the case
achieved the AFP rate of 2/100,000
as measles infection.
children below 15 years old.
o A supplemental immunization
(Source: NEC, DOH). A
decreasing AFP rate means we may campaign for measles and rubella
not be able to find true cases of (German measles) was done in
2011. This was dubbed as “Iligtas

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SALON, GERALDINE KETH
LESSON 7 9 10
9
sa Tigdas ang Pinas” 15.6 million o Cold chain is a system of storing,
(84%) out of the 18.5 million transporting and distributing of
children ages 9 months to 8 years vaccines in the correct temperature
old were given 1 dose of the and way from the factory to the
measles-rubella (MR) vaccine vaccinated child.
between April and June 2011. o Cold chain is a corner stone of the
1. IMMUNIZATION SCHEDULE EPI, because the vaccine loses the
FOR INFANTS efficacy if incorrectly kept.
Strategies o Vaccines are sensitive to heat and
1. Conduct of Routine freezing and Vaccines are sensitive
Immunization for to heat and freezing and must be
Infants/Children/Women kept at the correct temperature
through the Reaching Every from must be kept at the correct
Barangay (REB) strategy temperature from the time they are
manufactured until they are the
The Reaching Every District (RED) plan, time they are manufactured until
which was adapted from the WHO- they are used.
UNICEF Reaching Every District (RED)
strategy, was adopted in 2004 with the
goal of improving access to routine
immunization and reducing dropouts. Data
analysis for action, re-establish outreach
services, enhance ties between the
community and service, supportive
supervision, and resource maximization
are the five components of the plan.
1. 2. Supplemental Immunization
Activity (SIA)
Supplementary immunization activities are
used to reach children who have not been
vaccinated or have not developed
sufficient immunity after previous
vaccinations. It can be conducted either
national or sub-national –in selected areas.
3. Strengthening Vaccine-
Preventable Diseases
Surveillance
1. This is critical for the
eradication/elimination efforts,
especially in identifying
2. true cases of measles and
indigenous wild polio virus. LESSON 7
3. 4. Procurement of adequate ENVIRONMENTAL SANITATION
and potent vaccines and needles • Definition (WHO)
and syringes to • Control of all factors in man’s
4. all health facilities nationwide physical environment which
5. COLD exercise or may exercise a
CHAIN deleterious effect on his physical
development, health and survival.

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SALON, GERALDINE KETH
LESSON 7 9 10
9
• • Water
Factors – Prime necessity for
• Water sanitation existence of life
• Food sanitation – Quality of water is one
• Refuse and garbage disposal most impt factor in public
• Excreta disposal health
• Insect and vector control • Maybe a vehicle of
• Housing water-related
• Factors disease
• Air pollution transmission
• Noise • Impurities of Water
• Radiological protection (Water is a universal Solvent)
• Institutional sanitation • Bacteriological – bacteria maybe
• Stream pollution parasitic, pathogenic or both
• Environmental Health Service • Physical –suspension of floating
(DOH) substances; responsible for
turbidity or cloudiness
• Legal basis – PD 856 Sanitation
• Chemical – dissolved or colloidal
Code of the Phils, 1978 constituent; account mostly for
• Functions of EHS: color and palatability
• Promotion of healthy • Impurities
environmental conditions & • Biological – microscopic &
prevention of related diseases macroscopic plants and animal life
through appropriate sanitation • Radiological – may result from
strategies nuclear weapon testing and
• Conceptualization of new discharge of radio-isotopes into
programs/projects to contend with water courses
emerging problems • Water-related diseases:
• Implementors: • Poor sanitation contributes to
• DOH field units thru programs & water-borne diseases which
projects (basic services & facilities) include cholera, typhoid &
– Elimination & control of infectious hepatitis
environmental factors in – Polluted water acts as a
disease transmission passive vehicle for an
– Strategies infecting agent
• Water quality surveillance • Lack of water, poor personal
• Evaluation of food establishments hygiene and lack of proper waste
• Proper solid & liquid waste disposal contribute to a large
management group of water-washed diseases
• Sanitation of public places including scabies, leprosy and
• Strategies conjunctivitis
• Sanitation management of disaster • Aquatic animals in drinking water
areas can cause water-based diseases
• Impact assessment of like guinea worms, urinary and
environmentally critical projects rectal infections
and enforcement of sanitation • Diseases with water-related insect
laws, rules and regulations vectors such as malaria,
• Water supply sanitation

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SALON, GERALDINE KETH
LESSON 7 9 10
9
schistosomiasis, infectious viral – Level III (Waterworks or
fevers (dengue) are spread by individual house
mosquitoes and other insects that connections)
breed in water • System with a
• Diseases related to fecal disposal source, reservoir,
likely to be acquired by eating raw piped distribution
fish and fresh-water shrimps, crabs network and
and other large aquatic organisms; household taps
ex: Paragonimiasis – endemic in • Unapproved types – not to be
Jaro, Leyte used for drinking such as open dug
• Water Supply Sanitation Program: wells, unimproved springs
• Approved types of water supply • All households shall be provided
facilities: with safe and adequate water
– Level I (Point Source) supply
• Protected well or a • Yearly monitoring/surveillance
– Water analysis by DOH
developed spring accredited labs
with an outlet but – Disinfection of water
without a supply sources: required
distribution system for new construction,
– 15-25 repaired or improved and
households those found (+)
– Farthest bacteriologically
user not – Container disinfection if
more than subject to recontamination
(from unapproved water
250 meters types)
– Yield/ • Sampling for water analysis:
discharge of • All water samples should be
40-140 L per submitted to the lab after
minute collection and not later than the
– Level II (Communal faucet max allow time below
system or stand-posts – Bacteriological
• Concrete reservoir, • Use sterile
piped distribution containers; within
network and 24 hours; maintain
communal faucets same temperature
– 100 as its source
households • If more than 24 hrs,
– Farthest keep sample in a
user not box with ice
more than – Physical & chemical
25 m • Submit within 72
– Delivers 40- hrs
80 L per • Keep cool
capita per • Use ice if needed
day • Disinfection and Treatment

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SALON, GERALDINE KETH
LESSON 7 9 10
9
• Use of chlorine – powerful – Health certificate
germicide, readily available, cheap requirements for ambulant
and easy to apply food vendors
– Safe level: 1 ppm available – Promotion of household
food sanitation and food
chlorine hygiene education
– Use clean container • Excreta Disposal
– Let treated water stand for • Collection and disposal of human
at least 30 minutes before wastes are among the most
using important problems of
• Boiling – simple and effective environmental health
emergency measure for water • Diseases closely associated with
sterilization improper human excreta disposal
– At least 20 minutes, have are among the leading causes of
water over the fire for at illness and deaths in the country
least 3 minutes after • Approved types of toilet facilities
reaching boiling point • Level I
• Food Sanitation – Non-water carriage toilet
• Application of measures that will facility as pit latrines
make the physical environment – Toilet facilities requiring
healthful (clean and orderly) small amount of water as
• Proper food handling pour-flush type
• Efficient supply of clean, potable • Pit latrines or sanitary pit privy
water – Dug pit cased by bamboo,
• Proper preparation/cooking wood, brick, hollow blocks
• Protection of food from insect or empty drums on the
vectors and rodents sides measuring 1-2 m
• DOH programs: deepx1 cu. m. with floor
• Appraisal of food establishments- cover at top of pit, riser,
– Inspection and approval of seal and self-closing lid, all
food sources, containers made as “fly-tight” as
and transport vehicles possible; screened vent
– Sanitary permit maybe provided; with a
requirements compliance superstructure/shed for
– Updated health certificates privacy
for food handlers, cooks • Level II – on site water carriages
and cook helpers with water sealed and flush type
• Classification of food with septic tank
establishments • Pour-flush or water-seal latrine
– Class A (excellent) – Modified pit privy with a
– Class B (very satisfactory) relatively simple concrete
– Class C (satisfactory) bowl the lower portion is
– Destruction or banning of
food unfit for human either “P” or “S” shaped
consumption trap which form a “water-
– Training of food handlers seal” when water is added;
and operators on food fitted with an ordinary
sanitation concrete slab and the bowl

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SALON, GERALDINE KETH
LESSON 7 9 10
9
is placed directly over the – Biological vector is one in
pit whichthe disease agent
• Level III – water carriage types completes part of its life
connected to septic tanks and/or cycle in the insect host e.g.
sewerage system to treatment mosquito
plant – Mechanical vector is one
• Flush type which transmits the disease
– Waste is disposed by agent physically e.g.
flushing water through housefly
sewer pipes into a public • Control strategies:
sewerage system or into • Physical – use physical force and
individual disposal system devices
(individual septic tank) • Chemical – use of rodenticides and
• Other types of toilet/unapproved insecticides
types • Biological – limiting the growth
• Cat-hole and reproduction of vectors by
• Pail method limiting availability of food sources
• Chemical toilet – liquefaction of and harborages e.g. effect of
organic matter with the use of predators
caustic chemicals • Environmental measures –
• Cesspool – reverse of a well; maintaining the cleanliness of
untreated liquid wastes are run immediate premises and observing
into a hole in the ground proper building construction and
• Sewerage Systems maintenance to prevent access of
• Urban places – collected and pests into human dwellings
carried by sewer pipes and are • Health education – e.g.
disposed of by land or into bodies importance of control measures
of water; some undergo treatment • Considerations:
processes before its discharge to • Construction materials used
bodies of water – Lead based paints
• Rural places – Asbestos
– Domestic sewage • Water supply (private water wells)
commonly discharged into • Domestic sewage
backyards, canals without • Minimum standards for
treatment;
accomodation
– Open drainage
– Blind drainage • Accomodation Stds
• Waste water flows 1. Physiological Requirements
thru a system of Thermal conditions
closed pipes to an • Dampness/molds
underground pit or • Excessive heat/cold
covered canal Presence of pollutants
• Insect & Rodent Control • Asbestos,lead
• Vectors are arthropods or other • Carbon monoxide
• Radiation
invertebrates which transmit
infection thru biological or
mechanical means 2. Psychological Requirements
• Space (crowding)

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SALON, GERALDINE KETH
LESSON 7 9 10
9
• Security/access by intruders • International
• Light and noise Atomic Energy
Authority
• Local health
3. Protection against infection authorities
• Hygiene and sanitation • Response is divided into
– Water supply and drainage – Early phase
– National and local level
– Refuse priorities
– Pests Medical care
4. Protection against accidents/falls to radiation
• Electrical hazards victims
– Provision of
• Fires, burns & scalding info on food
• Collisions and falls (stairs) and drinking
• Air Pollution water
• Noise contaminati
on
• Effect of environmental noise – Implement
– Sleep related problems countermea
– Noise induced hearing sures, if
impairment/loss necessary
– Children are more » Shelt
vulnerable ering
» Radio
* For good sleep, sound level prote
should not exceed 30 dB(A) ctive
for continuous background prop
noise & 45 dB(A) for individual hylax
noise events is,
iodin
• Main health risks of noise e
interference (WHO) prop
• Pain and hearing fatigue hylax
• Hearing impairment incldg tinnitus is,
body
• Annoyance prote
• Interference with social behavior ction,
(aggressiveness, protest, evac
helplessness) uatio
n,
• Interference with speech perso
communication nal
• Sleep disturbance and all its deco
consequences on a shot-term and ntam
inati
long-term basis on
• Cardiovascular effect – If necessary,
• Performance at work and school request
• Normal responses, stress follows assistance of
international
• Radiological Protection community
• Response to a nuclear accident – Intermediate phase
– Networking/cooperation/ • Applicable
coordination countermeasures
• WHO – Sheltering

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SALON, GERALDINE KETH
LESSON 7 9 10
9
– Radioprotec • Participate/conduct ES researches
tive • Be a role model of cleanliness in
prophylaxis the homes and surroundings
– Body including observance/practice of
protection proper waste disposal in both
– Decontamin public and private places
ation of • 9.1 DOH
areas • Republic Act No.4226
– Evacuation • “Hospital Licensure Act”
– Recovery requires of all the hospitals in the
phase country and mandates DOH to
– Applicable or essential provide the guidelines for
countermeasures hospital technical standards as to
personnel , equipment and
• Personal
physical facilities.
decontamination
• PRESIDENTIAL DECREE No.
• Relocation 856
• Control of access • “
• Food control • The Code on Sanitation of the
• Decontamination of PHILIPPINES ” mandates the
areas DOH to promote and preserve
• Institutional Sanitation public health and upgrade the
• Healthcare Waste Management standard of medical practice . In
• AO No. 341 – Implementing the line with the DOH mandate , a
Phil Health Promotion Program Manual on Hospital
through Healthy Places Management was published in
– Water supply 1997 and the Implementing
– Sanitary toilets Rules and Regulations of
– Waste collection and Chapter XVII , fuse Disposal of
disposal PD 856 was promulgated.
• IMPACT OF HEALTH CARE
– Non pollution of the
WASTE
environment
A framework for health care waste
– Insect and vermin control management should always
measures consider health and occupational
• safety . There are many potential
Stream Pollution hazards associated when dealing or
• Waste collection and disposal handling health care waste such as
• Disposal of human and animal physical , chemical and biological
excreta hazards as well as ergonomic
• Responsibilities of Health Workers factors.
• Health education Minimizing these hazards may
• Participation in the training entail the institution of
component administrative , engineering and
• Assistance in projects like medical controls including the
deworming of target groups provision of personal protective
• Participation in ES campaigns e.g. equipment.
Administrative control includes:
use of sanitary toilets, proper
 Proper and regular training
garbage disposal, “green” projects

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SALON, GERALDINE KETH
LESSON 7 9 10
9
 Change of job schedule • Patients in the health care
 Rotation of workers establishment or receiving home
Engineering control includes the care
substitution of equipment/devices , • Visitors , comforters ,and
change of process to a much safer caregivers to health care
method , the mechanization or establishment
computerization , proper upkeep • Personnel and workers providing
and regular maintenance of support services and allied to
equipment/machine and imposition health care establishment , such as
of warning devices . Medical laundries , waste handling and
control includes : transportations.
 Written occupational health and • Persons transporting hazardous
safety program health care waste.
 Physical examination(pre- • Workers and operators of waste
employment and annual treatment and disposal facilities ;
 Regular immunization sanitary landfill.
 Health education • Hazards from Infectious Waste and
 Regular exercise Sharps :
 Healthy diet and continuous Infectious waste may contain any
medical monitoring and periodic of a great variety of pathogenic
examination organisms .Pathogens in infectious
 Adequate and good designed waste may enter the human body
personal protective equipment by a number of routes :
should be provided  Through a puncture
this include protection for the  Abrasion
head , face , body, arms ,legs and  Cut in the skin
feet.  Through in the mucous membrane
Exposure to hazardous health care  Inhalation
waste can result to disease or injury  ingestion
. The hazardous nature of health Infectious waste may contain any
care waste maybe due to one or of a great variety of pathogenic
more of the following organisms .Pathogens in infectious
characteristics : waste may enter the human body
 Contains infectious agents by a number of routes :
 Geno-toxic  Through a puncture
 Contains toxic or hazardous  Abrasion
chemicals or pharmaceuticals  Cut in the skin
 Radioactive  Through in the mucous membrane
 Contains sharps  Inhalation
 PERSONS AT RISK  ingestion
The main groups of people who are  GENERAL WASTE : comparable
at risk of exposure to health to domestic waste , this type of
hazards associated with health care waste does not posed special
waste are the following: handling problem or hazard to
• Staff of the health care human health or to environment . It
establishments such as physician , comes mostly from the
nurses , health care auxiliaries , and administrative and housekeeping
hospital maintenance personnel functions of health care
establishment and may also include

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SALON, GERALDINE KETH
LESSON 7 9 10
9
waste generated during 1. Hospitals
maintenance of health care 2. Clinics
premises. • Medical
 INFECTIOUS WASTE : this type • Veterinary
of waste is suspected to contain • Health care centers and
pathogens dispensaries
 PATHOLOGICAL WASTE : • Alternative medicine
consist of body parts , human fetus • Dental
and animal carcasses , blood and • Maternity and lying-in
body fluids. • Dialysis center
 SHARPS : include needles , • Physician offices
syringes , scalpels , saws , blades , 3.Laboratories and research center
broken glass , infusion sets , knives 4.Drug Manufacturers
any other items can cause cut or 5.Institution
puncture  Medical
 PHARMACEUTICAL WASTE :  Nursing homes
includes expired , unused spilt and  Dental
contaminated pharmaceutical  Paramedics
products.  Nursing
 GENOTOXIC WASTE : include  Drug rehabilatation center
certain cytostatic drugs , vomit ,  Veterinary
urine , feces from patients treated  6.Motuary and Autopsy center
with cytostatic drugs.  7.Ambulances and Emergency care
 CHEMICAL WASTE : consist of  8.Home treatment
discarded solid , liquid and gaseous  9.Cosmetic ear peircing and tattoo
chemicals , for example from parlors.
diagnostic and experimental work.
Chemical waste is considered
hazardous if it has at least one of
the following properties:
 Toxic
 Corrosive
 Flammable
 Reactive(explosive ,water-
reactive , shock sensitive)
 Genotoxic (e.g cytostatic drugs)
 8.WASTE WITH HIGH
CONTENT HEAVY METALS 4. SEGREGATION OF WASTE
 -consist of broken mercury and Is the important step to waste
blood pressure gauges management . There are several
 9.PRESSURIZED CONTAINERS reasons to undertake waste
 includes pressurized cylinders , segregation :
cartridges and aerosols cans.  Segregation minimizes the amount
 10.RADIOACTIVE WASTE of waste that needs to be managed
 include disused sealed radiation as bio-hazardous or hazardous
sources , liquid and gaseous waste.
materials  Facilitates waste minimization by
 contaminated with radioactivity. generating a solid waste steam
 SOURCES AND COMPOSITION which can be easily , safely , and
OF HEALTH CARE WASTE

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LESSON 7 9 10
9
cost-effectively managed through  “ENVIROMENTAL IMPACT
recycling or composting. STATEMENT(EIS) SYSTEM
 Reduces the amount of toxic  requires projects like construction
substances release to the of new hospital buildings or
environment through disposal of expansion of existing hospitals to
general waste. secure an Environmental
 Makes it easier to conduct Compliance Certificate(ECC)prior
assessments of the quantity and to construction and operation of the
composition of different waste facility.
streams thereby allowing health  REPUBLIC ACT No. 8749
care facilities to obtain baseline  “CLEAN AIR ACT”
data , identify options , determine  Prohibits the incineration of
waste management cost , and biomedical waste effective JULY
assess the effectiveness of waste 17, 2003.It promotes the state-of-
minimization strategies. the-art , environmentally sound and
 6. COMPOSTING safe-burn technologies for the
 Composting is another important handling , treatment , thermal
strategy to minimize waste such as destruction , utilization , disposal
food discards , kitchen waste , of sorted , un recycled and
cardboard , and yard waste . Some hazardous waste.
hospitals in other countries have  ADMINISTRATIVE
also successfully composted REQUIREMENTS
placenta waste. Sufficient land  OGANIZATION AND
space for on-site composting far FUNCTIONS : appropriate health
enough from patient care and care waste management practices
public access area would be depend largely on the
needed. administration and organization
 OTHER DOH and require adequate legislative
REQUIREMENTS: and financial support as well as the
 DOH Department Circular No. active participation by trained and
156-C,series of 1993 informed staff.
 “PROVIDES GUIDELINES ON  HEALTH CARE WASTE
HOSPITAL WASTE MANAGEMENT
MANAGEMENT COMMITTEE(HCWMC)promulg
 All undevolved government ate a policy formalizing the
hospitals , clinics , laboratories , commitment of the health care
and research offices , shall institution to proper management
incorporate satisfactory segregation of its waste with the goal of
, treatment , collection , and protecting health and environment.
disposal system”.  HEALTH CARE WASTE
 DOH MEMORANDOM No. 1- MANAGEMENT PLAN : a
A,series of 2001 comprehensive health care waste
 “Requiring the Department of management plan is the key
Health Central Office , Centers for ingredient s to a successful waste
Health development and all management within a health care
concerned hospitals to practice facility.
proper solid waste management.
 DENR • HEALTH AND SAFETY
 PRESIDENTIAL DECREE N. • PRACTICES
1586 • Proper training of Health workers

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SALON, GERALDINE KETH
LESSON 7 9 10
9
• No training/no hiring policy should pollution control should be allowed
be instituted in the area.
• Immunization at the first day of • IMMUNIZATION
work • -health care personnel should be
• Provision of personal protective given immunization against
equipment(from head to toe) infection from virus causing
• Establishment of an effective hepatitis B and tetanus infection.
occupational health program that • RESPONSE TO INJURY AND
includes immunization , post EXPOSURE
exposure prophylactic treatment , • -all staff that handles health care
and continuous medical waste must be trained to deal with
surveillance. injuries and exposures . Health care
• WORKER PROTECTION : establishment should develop a
• program that would prescribe the
• -all personnel who are directly actions taken in the event of injury
involved in the handling of or exposure to a hazardous
potentially hazardous health care subtance.
waste must be provided with • SAFE USE OF CYTOTOXIC
adequate protection from the DRUGS
hazards associated with it. • -in order to ensure safe use of
• PERSONAL PROTECTIVE cytotoxic drugs , the senior
EQUIPMENT pharmacist of the health care
• -health care waste management establishment , should be appointed
program requires that the following to supervised the safe management
personnel protective equipment be of cytotoxic waste . To minimize
made available to all health care exposures , the following measures
personnel who collect and handle should be observed
health care waste. • Written procedures that specify
• Hard hats with or without visor- safe working methods for each
depending on the nature of process
operation • Data sheets , based on the suppliers
• Facemask-depending on the nature specification , to provide
of operation information on potential hazards.
• Eye protector/safety goggles- • Established procedures for
depending on the nature of emergency response in case of
operation spillage or other occupational
• Overalls(coveralls)-obligatory accident
• PERONAL HYGIENE • Appropriate education and training
• -provision for washing for all personnel involved in the
facilities(with soap and warm handling of cytotoxic drugs.
water)should be made available to •
personnel. • Global Warming
• SPECIAL PRECAUTIONS FOR • El Nino phenomenon
CLEARING UP SPILLAGE OF – Characterized by extreme
POTENTIALLY HAZARDOUS climatic conditions,
SUBTANCES extreme temperature with
• -the place to be cleared must be little rainfall and, at the
secured or cordoned .Only opposite extreme, there is
authorized personnel or the
unusually heavy rainfall

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SALON, GERALDINE KETH
LESSON 7 9 10
9
• La nina phenomenon possible to fashion events
– Characterized by unusually that have never been seen
cold ocean temperature in before in the history of the
the equatorial pacific which world. As such, they
causes increased number embody the principle of
of tropical storms in the innovation and
pacific oceaN’ transformation that
underlies every single
LESSON 10
creative act that has
• Public Health Programs
occurred in the course of
From Womb to Tomb
civilization.
• The Twelve Stages of the Human
5. Middle Childhood
Life Cycle
(Ages 6-8): Imagination –
1. Pre birth: Potential –
In middle childhood, the
The child who has not yet
sense of an inner subjective
been born could become
self develops for the first
anything – a Michelangelo,
time, and this self is alive
a Shakespeare, a Martin
with images taken in from
Luther King – and thus
the outer world, and
holds for all of humanity
brought up from the depths
the principle of what we all
of the unconscious. This
may yet become in our
imagination serves as a
lives.
source of creative
2. Birth: Hope – When a
inspiration in later life for
child is born, it instills in its
artists, writers, scientists,
parents and other caregivers
and anyone else who finds
a sense of optimism; a
their days and nights
sense that this new life may
enriched for having
bring something new and
nurtured a deep inner life.
special into the world.
6. Late Childhood (Ages
Hence, the newborn
9-11): Ingenuity – Older
represents the sense of hope
children have acquired a
that we all nourish inside of
wide range of social and
ourselves to make the world
technical skills that enable
a better place.
them to come up with
3. Infancy (Ages 0-3):
marvelous strategies and
Vitality – The infant is a
inventive solutions for
vibrant and seemingly
dealing with the increasing
unlimited source of energy.
pressures that society places
Babies thus represent the
on them. This principle of
inner dynamo of humanity,
ingenuity lives on in that
ever fueling the fires of the
part of ourselves that ever
human life cycle with new
seeks new ways to solve
channels of psychic power.
practical problems and cope
4. Early Childhood (Ages
with everyday
3-6): Playfulness – When
responsibilities.
young children play, they
7. Adolescence (Ages 12-
recreate the world anew.
20): Passion – The
They take what is and
biological event of puberty
combine it with the what is
unleashes a powerful set of

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
changes in the adolescent betterment of society
body that reflect themselves through volunteerism,
in a teenager’s sexual, mentorships, and other
emotional, cultural, and/or forms of philanthropy. All
spiritual passion. of humanity benefits from
Adolescence passion thus their benevolence.
represents a significant Moreover, we all can learn
touchstone for anyone who from their example to give
is seeking to reconnect with more of ourselves to others.
their deepest inner zeal for 11. Late Adulthood (Age
life. 80+): Wisdom – Those
8. Early Adulthood (Ages with long lives have
20-35): Enterprise – It acquired a rich repository
takes enterprise for young of experiences that they can
adults to accomplish their use to help guide others.
many responsibilities, Elders thus represent the
including finding a home source of wisdom that
and mate, establishing a exists in each of us, helping
family or circle of friends, us to avoid the mistakes of
and/or getting a good job. the past while reaping the
This principle of enterprise benefits of life’s lessons.
thus serves us at any stage 12. Death & Dying: Life –
of life when we need to go Those in our lives who are
out into the world and make dying, or who have died,
our mark. teach us about the value of
9. Midlife (Ages 35-50): living. They remind us not
Contemplation – After to take our lives for
many years in young granted, but to live each
adulthood of following moment of life to its fullest,
society’s scripts for creating and to remember that our
a life, people in midlife own small lives form of a
often take a break from part of a greater whole.
worldly responsibilities to • Family Health Office
reflect upon the deeper • Purpose - tasked to operationalize
meaning of their lives, the family health programs which
better to forge ahead with focus on the health of the mother
new understanding. This and the unborn child, infant, child,
element of contemplation adolescent and youth, adult men
represents an important and women and older persons
resource that we can all • Aims.
draw upon to deepen and – Improvement of the
enrich our lives at any age. survival, health and well
10. Mature Adulthood being of mothers and the
(Ages 50-80): unborn through packages of
Benevolence – Those in health services covering
mature adulthood have pre-pregnancy, prenatal,
raised families, established natal and post natal stages
themselves in their work – Reduction of morbidity and
life, and become mortality and
contributors to the

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
Improvement of quality of lives in healthy surroundings,
life receives adequate nourishment,
Functions health supervision and medical
Formulates or develops attention, and is taught the
policies, standards abd elements of healthy living.
guidelines for public health • Objectives – to reduce significantly
services global mortality and morbidity
Provides technical associated with the major causes of
assistance in public health deaths in children and to contribute
programs or project to healthy growth and development
planning, implementation of children.
and evaluation. • Child 21 as Strategic Framework –
• Programs quality of life of Filipino Children
1. Maternal and Child Health in 2025 wherein a healthy Filipino
a. Infant and Young Child child is-
Feeding (IYCF) – Wanted, planned and
b. EPI conceived by healthy
c. PEM Prevention and parents
Control – Carried to term by a healthy
d. Micronutrient mother
Supplementation – Born into a loving, caring,
e. Food Fortification stable family capable of
f. Soil- Transmitted providing for his/her basic
Helminthiasis (STH) needs
g. NBS – Delivered safely by a
h. Growth Monitoring and trained attendant
Promotion – Screened for congenital
i. Oral Health defects shortly after birth; if
j. IMCI defects are found,
k. Safe Motherhood/Maternal interventions to correct
Care (First 1000 Days) these defects are
l. Adolescent Health implemented at the
m. Early Childhood Care and appropriate time
Development – Exclusively breastfed fr at
n. Child Injury Prevention and least 6 months, and
Control continued breastfeeding up
2. Women’s and Men’s to two years
Health – Introduced to
includes Family complementary foods at
Planning, Reproductive about 6 months of age, and
Health; Men’s Health; gradually to a balanced,
Women and Children in nutritious diet;
Special Need for – Protected from the
Protection; and Health and consequences of protein-
Development of Older calorie and micronutrient
Persons deficiencies through good
• Child Health Programs nutrition and access to
• Goal – That every child grows up fortified foods and iodized
in a family with love and security, salt

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
– Provided with safe, clean AND ESSENTIAL DRUGS AND
and hygienic surroundings MICRONUTRIENTS DUE TO
free from accidents WEAKNESS IN
– Properly cared for at home PROCUREMENT,
when sick and brought to a ALLOCATION AND
health facility for DISTRIBUTION
appropriate management – Pockets of low
when needed immunization coverage
– Offered equal access to attributed to irregular
good quality curative, supply of vaccines as a
preventive and promotive result of inadequate funds
health care services as a • Specific Objectives
member of the Filipino • Reduce mortality
society • Infants 0-1 year---
– Regularly monitored for to 17 deaths per
proper growth and 1,000 live births
development, and provided • Children 1-4
with adequate psychosocial years--- to 33.6%
and mental stimulation per 1,000 live births
– Screened for disabilities • Adolescents and
and developmental delays youths by 50%
in early childhood; if • Risk Reduction Objectives
disabilities are found, – Increase
interventions are • Percentage of fully
implemented to enable the immunized children
child to enjoy a life of to 90%
dignity at the highest level • Percentage of
of function available infants given timely
– Protected from and proper
discrimination, exploitation complementary
and abuse feeding at 6 months
– Afforded the opportunity to to 70%
reach his/her full potential • Percentage of
as adult mothers and
• Gaps and challenges in Children’s caregivers who
Health know and practice
• Local health units not adequately home management f
informed about the frameworks childhood illnesses
(Child 21 and Children’s Health to 80%
2025; need to disseminate for it to • Health care-seeking
serve as template for local planning behavior of
on children’s health adolescents to 50%
• Need to update and reiterate – Reduce the prevalence of
policies on children’s health protein-energy malnutrition
particularly: immunization, among school-age children
micronutrient supplementation and • Services and Protection Objectives
IMCI – Ensure 90% of infants and
• PROBLEMS WITH children are provided with
AVAILABILITY OF VACCINES

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
essential health care method of blood collection from
package baby’s heel
– Increase the percentage of • Babies with positive NBS results
health facilities with should be referred at once to
available stocks of vaccines nearest hospital/specialist for
and essential drugs and confirmatory testing and further
micronutrients to 80% management
– Increase the percentage of • Metabolic Disorders targeted by
schools implementing NB Screening; causes and
school-based health and consequence if left untreated
nutrition programs to 80% – Congenital Hypothyroidism
– Increase the percentage of (CH) – stunted growth and
health facilities providing mental retardation
basic health services – Congenital Adrenal
including counseling for Hyperplasia (CA) – may
adolescents and youths to die within 7-14 days
70% – Galactosemia (GAL) –
• Programs: Garantisadong Pambata accumulation of excessive
• Started in 1999 to address low galactose which may result
coverage on immunization and in liver damage, brain
micronutrient supplementation damage and cataracts
• Package of health services to – Phenylketonuria (PKU) –
children below 6 years old and accumulation of excess
even school-aged children now phenylalanine causes brain
offered whole year round damage
(previously in April and October – Glucose-6-Phosphate
only) Dehydrogenase Deficiency
• Highlights health-promoting (G6PG Def) – hemolytic
behaviors that parents, caregivers, anemia resulting from
teachers, leaders and children exposure to certain drugs,
themselves can do in their foods and chemicals
respective spheres of influence • Infant and Young Child Feeding
• Services include immunization for Situationer:
measles, tetanus, polio, hepatitis Malnutrition
and TB; Vitamin A common in children with
supplementation; deworming – 4 out of 10 children 0-10
• Newborn Screening Program years old are underweight
• To find out if the newborn has a – Low vitamin A serum
congenital metabolic disorder that levels with increasing
may lead to mental retardation and vitamin A deficiency due to
even death if left untreated; signs decreasing Vitamin A
and symptoms of which are supplementation coverage
manifested when the ill effects are from 97% in 1993 to 78%
already irreversible in 1997
• Ideally done on the 48th hour or at – Breastfeeding rate is 78%
least 24 hors from birth; if done (rural- 92%, urban – 84%);
earlier than 24 hours, baby must be exclusive breastfeeding
screened again after 2 weeks for increased from 13.2% to
more accurate results; prick

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
20% among children 4-5 through improved caring
months of age and seeking behaviors. It
• 0-2 years old operates through health and
• Conduct child growth and nutrition posts established
development monitoring through out the country
• Identify and manage cases • Mother and Baby-Friendly
– Severe acute malnutrition Hospital Initiative (MBFHI)
– Common childhood – Main strategy to transform
illnesses all hospitals with maternity
• Provide oral health services to and newborn services into
pregnant mothers and childhood. facilities which fully
• Lactating mothers protect, promote and
• Counselling and lactation support breastfeeding and
management support rooming-in practices
– Exclusive breast feeding: 6 – Field health personnel has
months to 2 years to provide antenatal
– Dietary supplementation for assistance and
nutritionally-at-risk breastfeeding counseling to
lactating mothers pregnant and lactating
– Community-based mother mothers as well as to the
support groups and peer breastfeeding support
counsellors groups in the community
– Lactation support in the • MBFHI Guidelines
workplace 1. Counsel pregnant women on the
• BF/Lactation merits of breastfeeding starting at
Stations the first encounter, and reinforced
• Lactation breaks with every subsequent visit
• Access to safe drinking water and 2. Prescribe non-human milk only
sanitary toilet facilities when there are valid medical
• Counselling on handwashing, ES, reasons and with information on
and personal hygiene the inherent hazards and risks of
• Counsel/encourage utilization of non-human milk
reproductive health and FP services 3. Strongly advocate for the adoption
• Provide social welfare support to of essential newborn care,
families esp nutritionally rooming-in and breastfeeding
vulnerable households to improve standards as mandated by law
access to health and nutrition • MBFHI guidelines also prohibit
services physicians from:
• Scale up stunting-prevention 1. Accepting gifts or any sort of
activities. material/financial inducements
• Improve nutrition of women of from manufacturers of breastmilk
reproductive age and support substitutes and other products
optimal breastfeeding and covered by the Milk Code
complementary feeding practices. 2. Accepting samples of non-human
• Enhanced Child Growth Strategy milk or similar products unless
– Community based approved by DOH, nor giving out
intervention that aims to samples or gifts of any sort from
improve the health and milk companies to pregnant
nutritional status of children

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
women, mothers, and members of supplementation and
their families counseling of mothers
3. Displaying, promoting or IMCI Strategy include
distributing non-human milk and 1. Focused Assessment of
other breastmilk substitutes in their danger signs, major
offices or clinics symptoms, nutritional
• Legal Basis status, immunization status
– Milk Code of the Phils (EO. 2. Classification of diseases
No. 51) into urgent referral, specific
– Rooming-in and treatment and home
Breastfeeding Act of 1992 management
(RA 7600) 3. Treatment includes
– National Policies on Young identifying the treatment,
Feeding (AO No. 2005- treating, counseling and
0014) follow-up, and counseling
– New Policies and Protocol the care takers and follow-
on Essential Newborn Care up
(AO No. 2009-0025) • Methods in Managing Childhood
• Immunization Guidelines Illnesses through the IMCI Color
1.BCG vaccine shall be Coded System
given to all school entrants • IMCI strategy – focuses on the
regardless of the presence well-being of the whole child; aims
or absence of BCG scar to reduce death, illness and
2. Fever, local soreness and disability and to promote improved
rash are common side growth and development among
effects children under 5 years old using
3. A fully immunized child the preventive and curative aspects
(FIC) should have received of care that are implemented by
1 dose of BCG, 3 doses of families, communities and health
OPV, 3 doses of DPT, 3 facilities
doses of Hepa B, and 1 • Nutrition Program
dose of AMV (for chicken • Common nutritional deficiencies
pox) are deficiencies in Vitamin A, Iron,
• Integrated Management of Iodine
Childhood Illnesses Phil Nutrition Program
• Approach to strengthen the Goal– Improve quality of
provision of essential and life among Filipinos
comprehensive health package to through better nutrition,
children improved health and
• Components increased productivity
– Improving health workers’ Objectives
skills a. Reduction in the proportion of
– Improving the health Filipino households with intake
system below 100% of the dietary energy
– Improving family and requirement from 53.2% to 44%
community practices b. Reduction of the
Even integrates nutrition, following –
immunization, vitamin -Underweight
among schoolchildren

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
-Stunting among Hepatitis B – first dose
pre-school children within 24 hours to 48 hours
-Chronic energy after birth; booster of 3
deficiency among pregnant doses given as early as 6
women weeks after birth with at
-Iron deficiency least 4 weeks interval
among children 6 moths to between doses
5 years old and pregnant Diptheria, Pertussis and
and lactating mothers Tetanus; Poliomyelitis
- Prevalence of DPT -3 doses given
overweight, obesity and as early as 6 weeks after
non-communicable diseases birth with at least 4 weeks
- Prevalence of iron interval between doses
deficiency disorder among Oral Polio - 3 doses
lactating mothers given as early as 6 weeks
- Prevalence of low after birth with at least 4
birth weight babies weeks interval between
Elimination of moderate to doses
severe iron deficiency – Nutrition programs and
disorder among school projects
children and pregnant • Micronutrient Supplementation
women through
Strategies include food- 1. Twice -a- year distribution of Vit A
based interventions for capsules during Araw ng Sangkap
sustained improvements in Pinoy, GP or Child Health Week to
the nutritional status, life 6-71 nonth-old pre-schoolers on a
cycle approach with nation-wide basis
strategic attention to 0-3 2. Iron def prevention and treatment
years old children, thru iron supplements to specific
adolescent females and target groups
pregnant/lactating mothers; Food Fortification Act of
effective complementation 2000 on the following
of nutrition interventions staples: flour, cooking oil,
with other services; and rice, salt; processed foods
geographical focus to (voluntary)
needier areas Refer also to “Ten
• Expanded Program on Nutritional Guidelines for
Immunization Filipinos”
• Immunizable Childhood Illnesses Desirable contribution of
and schedule major macronutrients to
Tuberculosis total energy intake should
BCG – initial dose be”
at birth or 0-1 year; booster Carbohydrates ---
dose upon school entry 55-70%
regardless of the Fat
presence/absence of scar ------------------ 20-
Measles, Mumps – single 30%
dose at 9-12 months; at Protein -------------
least 80% of measles can be 10-15%
prevented

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CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
• Home, School and Community curative program; oral habilitation
Food Production and rehabilitation program
1. Establishment of kitchens and • Support services include dental
gardens in homes, schools and health planning, training program,
communities as additional sources dental research program,
of food monitoring and evaluation
2. Establishment of demonstration • Prevention of dental problems:
centers and plant nurseries – Regular visits to the dentist
3. Distribution of planting materials (as soon as the first tooth
• Food Assistance erupts) for early diagnosis
1. Center-based feeding for and preventive care
wasted or children with – Eating a well-balanced diet
stunted growth and and minimizing eating
pregnant women with sugary foods
history of giving birth to – Use of fluorides and
low birth weight babies sealants and good plaque
2. Rice distribution is done control thru regular tooth
in schools thru LGUs brushing and flossing
• Livelihood Assistance • Gum diseases can be prevented by:
– provision of credit and – Regular visits to the dentist
livelihood opportunities to for early detection and
poor households with treatment
malnourished children – Regular and proper tooth-
• Oral Health brushing and healthy
Vision – A lifetime of oral lifestyle such as avoidance
health and no tooth decay of tobacco smoking, drugs
for the next generation. and alcohol
Strategies include – Orally Fit Child program
social mobilization for under-six Filipinos with
(“Sang Milyong Sepilyo”; following package of
coordination and activities:
partnership with sectoral 1. Oral examination and prophylaxis
groups; networking; 2. Sodium fluoride mouth rinsing
capacity building and work 3. Supervised tooth brushing drill
value formation; and 4. Pit and fissure sealant application;
• Aims of dental health program atraumatic restorative treatment
1. Emphasize the importance of oral and IEC
health in relation to total body -the program integrates its
health activities with the Maternal
2. Increase pubic awareness on the and Child Health Program.
prevention of common dental Nutrition Program and
diseases: tooth decay or dental Garantisadong Pambata
caries and periodontal diseases (GP)
(gum diseases) • Essential Youth and Adolescent
3. Solicit 1M new toothbrushes Health Program
• Direct services include dental • Addresses these concerns-
health promotion and advocacy; – Management of illness
dental preventive program, dental – Counseling on substance
abuse, sexuality and

Page 23 of 26
CPH
SALON, GERALDINE KETH
LESSON 7 9 10
9
reproductive tract infections 2. Traditions, beliefs an values as
including HIV/AIDS well as health practices
– Nutrition and diet 3. Holistic care – focus on
counseling developmental tasks
– Mental health 4. Care for older persons is multi-
– Family Planning and disciplinary
responsible sexual behavior • UN principles for older persons
– Dental care 1. Independence – be able to reside at
– Health of Adult Men and home for as lng as possible
Women 2. Participation – be able to remain
• Essential Health Care Package for integrated in society
Adult Men and Women 3. Care – be able to enjoy human
1. Management of illness rights and fundamental freedom
2. Counseling on substance 4. Self-fulfillment – be able to pursue
abuse, sexuality and opportunities for full development
reproductive tract infection of potential
3. Nutrition and diet 5. Dignity – be free from exploitation
counseling and physical and mental abuse; be
4. Mental health treated fairly regardless of age,
5. Dental care gender, racial or ethnic
6. Screening and background, disability or other
management of lifestyle status
related and other • Privileges of Senior Citizens
degenerative diseases 1. 20% discount and
Current Strategies: exemption of value-added
Phil PEN – tax on sale of goods and
provision of medicines for services (medicines,
non-communicable diseases medical and dental fees,
of hypertension and transport fare, services in
diabetes mellitus hotels/restaurants,
Establishment admission fees in theaters
Diabetes and Hypertensive and other places of leisure
support groups or Clubs at (Note;: also applies to
the community level Persons with Disabilities)
Violence against Women 2. Mandatory PhilHealth
(VAW) program include coverage – free medical and
Gender and Development dental service and
activities laboratory fees in govt
• Care of Older Persons facilities
• Elderly population – 60 years old 3. Monthly stipend of
and above Php500.00 , Php1,500 for
Goal: A longer disability indigents; free vaccination
free life against influenza virus and
Guidelines in providing pneumococcal disease
health care services for 4. 5% discount on water
older persons consider the bills (consumption of less
following than 30 cu.meters)and
1. Rights of older persons electric bills ( consumption
of less than 100 kw)

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SALON, GERALDINE KETH
LESSON 7 9 10
9
5. Educational assistance
for those who shall meet
school admission
requirements
Valid IDs to be issued by
the Office of Senior
Citizens Affairs (OSCA) of
respective LGUs

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SALON, GERALDINE KETH
LESSON 7 9 10
9

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