CHN2-Prelim-lecture.pptx

CARE (PHC) AS AN APPROACH TOWARDS HEALTHY FILIPINOS Community Health Nursing 2 (Population Groups and the Community as Clients) Introduction to PRIMARY HEALTH CARE  PRIMARY HEALTH CARE  isa comprehensive approach to health that focuses on prov...

CARE (PHC) AS AN APPROACH TOWARDS HEALTHY FILIPINOS Community Health Nursing 2 (Population Groups and the Community as Clients) Introduction to PRIMARY HEALTH CARE  PRIMARY HEALTH CARE  isa comprehensive approach to health that focuses on providing accessible, affordable, and quality health services to individuals and communities.  Itemphasizes prevention, health promotion, treatment, rehabilitation, and palliative care, aiming to address the majority of a person’s health needs throughout their life.  PHC is rooted in principles of equity, social justice, and community participation, and it is designed to meet the needs of the population as a whole.  PRIMARY HEALTH CARE  is an essential health care approach that is universally accessible to individuals and families in the community, using means that are acceptable to them, through their full participation, and at a cost that the community and country can afford. It focuses on overall health system strengthening by integrating various levels of care (from community health workers to specialized services) and emphasizing the prevention of illnesses, the promotion of health, and the treatment of diseases. History of PRIMARY HEALTH CARE ALMA ATA DECLARATION  First International Conference on PHC  ALMA-ATA, Almaty Kazakhstan, RUSSIA (USSR)  September 6-12, 1978  PHC goal: HEALTH FOR ALL BY THE YEAR 2000  Sponsored by WHO and UNICEF ASTANA DECLARATION  It was adopted during the Global Conference on Primary Health Care  Marks by 40 years since the first Global Conference on PHC  Declaration of Astana took place in Astana, Kazakhstan  October 25-26, 2018  Hosted by WHO, UNICEF and the Government of Kazakhstan LETTER OF INSTRUCTION (LOI) 949  Philippines- First Asian country to have adopted PHC as a national strategy  The legal basis of PHC was signed by Pres. Ferdinand Marcos  Signed by October 19, 1979  HEALTHFOR ALL FILIPINOS (by the year 2000) AND HEALTH IN THE HANDS OF THE PEOPLE (by the year 2020)  ENDGOAL of PHC approach is for people to be SELF-RELIANT PRINCIPLES OF PRIMARY HEALTH CARE PRINCIPLES OF PHC: 4 A’s of PHC 1)ACCESSIBILITY 2)AVAILABILITY 3)AFFORDABILITY 4)ACCEPTABILITY ACCESSIBILITY  Essential and appropriate health services are available to citizens within a reasonable geographical distance by an appropriate provider and within a time frame that is appropriate (Not more than 5 km away and 30 minutes to travel) AVAILABILITY  Carecan be obtained whenever people need it (24/7) 3)AFFORDABILITY  The cost should be within the means and resources of the individual and the country (not totally free SERVICES)  Services are free or low-cost, with government subsidies in place to ensure that even the poorest families can receive care without financial burden. 4)ACCEPTABILITY  Healthservices offered area to be in accordance to the prevailing beliefs and practices of the intended clients of care COMPONENTS OF PHC: “MAD ELEMENTS” OF 1)Mental Health 2)Access to Sentrong Sigla 3)Dental Health 4)Education In Concerning Prevailing Health Problems 5)Locally Endemic Disease Preventions And Control 6)Expanded Program Of Immunization Against Major Infectious Diseases (RA 10152) 7)Maternal And Child Healthcare Including Family Planning 8)Essential Drugs Arrangement 9)Nutritional Food Supplement, And Adequate Supply Of Safe And Basic Nutrition 10)Treatment Of Communicable And Non-Communicable Diseases And Promotion Of Mental Health 11)Safe Water And Sanitation 1) Mental Health Services  Integratingmental health care into primary health services to address the growing burden of mental health issues in the population.  Example: Community-based mental health programs that provide counseling, support, and basic treatment for mental health conditions. 2) Access to Sentrong Sigla  "Sentrong Sigla" (Centers of Vitality) was a certification program initiated by the Department of Health (DOH) in the Philippines to improve the quality of primary health care services provided by government health centers and rural health units (RHUs).  Access to Sentrong Sigla means that the health facilities have met certain standards of service quality and are certified as capable of delivering essential health services effectively. 3) Dental Health  refersto the integration of dental and oral health services within the broader framework of primary health care.  Itinvolves the provision of essential dental care services that are accessible, affordable, and focused on prevention, early detection, and treatment of oral health issues.  GOAL: is to promote good oral hygiene, prevent dental diseases such as cavities and gum disease, and ensure that dental health is considered a fundamental aspect of overall health and well- being. 4) Education In Concerning Prevailing Health Problems  Providing health education to individuals and communities about the most common health issues and how to prevent or manage them..  Example: Campaigns on hygiene practices, nutrition, family planning, and the importance of vaccinations. 5) Locally Endemic Disease Preventions And Control  Control and management of diseases that are prevalent in specific regions of the Philippines.  Example: Programs to control malaria, schistosomiasis, and other locally endemic diseases through vector control, mass drug administration, and community health education. 6) Expanded Program Of Immunization Against Major Infectious Diseases (RA 10152)  Providingimmunization services to protect children and other vulnerable populations from vaccine-preventable diseases.  Example:Routine immunizations for diseases such as measles, polio, hepatitis B, and BCG for tuberculosis.  7)Maternal And Child Healthcare Including Family Planning  Ensuring the health and well-being of mothers and children through prenatal, perinatal, and postnatal care, as well as child health services.  Example: The implementation of the "Unang Yakap" (First Embrace) program, which promotes essential newborn care, and the provision of free maternal care services in public health facilities. 8)Essential Drugs Availability  Ensuring the availability and accessibility of essential drugs and medicines, particularly in remote and underserved areas.  Example: The "Botika ng Barangay" program, which aims to make essential medicines affordable and accessible in rural areas through community-based pharmacies. 9)Nutritional Food Supplement, And Adequate Supply Of Safe And Basic Nutrition  Focus: Addressing malnutrition and promoting adequate nutrition through food security programs and nutritional education.  Example: The "Pantawid Pamilyang Pilipino Program" (4Ps), which includes conditional cash transfers linked to health and nutrition, and the promotion of breastfeeding and complementary feeding. 10)Treatment Of Communicable And Non- Communicable Diseases and Promotion Of Mental Health  Treatment of Communicable and Non-Communicable Diseases refers to the management and care provided for illnesses that can be transmitted from person to person (communicable) and for chronic diseases that are not infectious (non-communicable).  Communicable diseases require interventions such as medication, vaccination, isolation, and public health measures to prevent their spread and to treat those infected. 10)Treatment Of Communicable And Non-Communicable Diseases  Non-communicable diseases (NCDs) involve long-term management strategies, including lifestyle modifications, medications, and regular monitoring, to control and prevent the progression of these chronic conditions. 11)Safe Water And Basic Sanitation  Ensuringaccess to safe drinking water and proper sanitation to prevent waterborne diseases and improve public health.  Example: The construction of communal water supply systems and sanitation facilities in rural areas, and the promotion of proper waste disposal and hygiene practices.  DOH STANDARD RATIO OF HEALTHCARE WORKERS BARANGAY HEALTH 1:20 HOUSEHOLDS WORKERS MIDWIFE 1:5,000 NURSE 1:20,000 MD/PHYSICIAN 1:20,000 SANITARY INSPECTOR 1:20,000 DENTIST 1:50,000 CONTACT TRACERS 1:800 LEVELS OF HEALTHCARE DELIVERY SYSTEM PRIMARY LEVEL SECONDARY LEVEL TERTIARY LEVEL PRIMARY LEVEL  Basic health procedures  25-75 beds capacity  Puericulture centers/Birthing in or Lying in  Rural Health Unit (RHU) (RA 1082)  Community Health Centers Or Barangay Health Station (BHS) SECONDARY LEVEL  Referral system of primary level  Minoroperations and laboratory examinations  100-200 beds capacity  Outpatient Department Hospitals  Provincial Hospitals  District Hospitals/Emergency District Hospital TERTIARY LEVEL  Referral system of secondary level  Highly specialized staff and technical equipment  Complex medical and surgical interventions  Major operations and invasive procedures  Medical Centers & National Hospitals  Regional Hospitals  Training and Teaching Hospitals  3 LEVELS OF PREVENTION  PRIMARY LEVEL OF PREVENTION  SECONDARY LEVEL OF PREVENTION  TERTIARY LEVEL PREVENTION PRIMARY LEVEL OF PREVENTION  Target: HEALTHY individuals  GOAL: To prevent/delay the actual occurrence of disease  INTERVENTION: Health Promotion and Disease Prevention  HEALTH EDUCATION  Basic health service that aims to modify harmful practices of people and their unscientific knowledge and attitude PRIMARY LEVEL OF PREVENTION ACTIVITIES: a)Health Education 1.Family Planning 2.Genetic Counseling b)Healthy Lifestyle Habits 1.Health Diet 2.Rest 3.Exercise PRIMARY HEALTH CARE 4.Not Smoking c)Hygiene (HANDWASHING) d)Immunization/Inoculation e)Isolation of the diagnosed sick child to pregnant mother  PRIMARY HEALTH CARE f)Intake or use of Prophylactic drugs 1.Antiretroviral drugs 2.Chloroquine tablets (Prophylaxis of malaria) 3.Doxycycline (Prophylaxis of leptospirosis) 4.Crede’s Prophylaxis (prevent gonorrheal/chlamydial eye infection) g)Vector Control 1.Destroy breeding sites (for Dengue, Zika prevention) 2.Clear hanging trees in the riverbanks (for Malaria prevention) SECONDARY LEVEL OF PREVENTION  Target: Sick or at risk individuals  GOAL: SCREENS clients for early detection and prompt treatment of the disease  INTERVENTION: Early diagnosis and treatment ACTIVITIES: a)Case finding tools 1.Skin Slit Smears for leprosy 2.Sputum smear for TB 3.Swab Test for COVID-19 SECONDARY LEVEL OF PREVENTION b)Blood tests 1.CBC for blood disorders (Pancytopenia) 2.ELISA (Confirmatory for Dengue) 3.Western Blot for HIV (Confirmatory) CD4 T cell Count (Confirmatory for AIDS)  SECONDARY LEVEL OF PREVENTION c)Contact tracing d)Quarantine (separation of contact to well individuals) e)Disease surveillance f)Diagnostic Tests 1.Ultrasound 2.CXR 3.M 4.CT Scan 5.Mammography SECONDARY LEVEL OF PREVENTION g)Treatment/Cure of disease h)Examination of breast (BSE) i)Examination of Testes (TSE) j)OPLAN Timbang SECONDARY LEVEL OF PREVENTION k)Screening Test & Selective Examinations 1.Newborn Screening 2.Screening for hypertension l)Trauma & CRISIS PREVENTION (stress debriefing) TERTIARY LEVEL OF PREVENTION  Target: Individuals with diagnosed illness and advance disease  GOAL: Reduce impact/limit disability, prevent sequelae and prevent death  INTERVENTION: Rehabilitation TERTIARY LEVEL OF PREVENTION ACTIVITIES: a)Therapies 1.Physical therapy 2.Occupation therapy (Prostheses use) b)Health care and treatment for those infected by COVID-19 c)Use of assistive devices d)Maintenance drugs among patient with hypertension e)Blood pressure and Blood sugar monitoring TERTIARY LEVEL PREVENTION f)Self-Management Education for patient with diabetes g)Use of chemotherapeutic drugs and radiation for cancer h)Provide family therapy for abusive families; remove children from home TRADITIONAL AND ALTERNATIVE MEDICINE TRADITIONAL AND ALTERNATIVE MEDICINES By Juan Flavier  RA 8423 – TRADITIONAL AND ALTERNATIVE MEDICINAL ACT (TAMA) of 1997 TRADITIONAL AND ALTERNATIVE MEDICINES By Juan Flavier  Thislaw created the Philippine Institute of Traditional and Alternative Health Care (PITAHC), which is responsible for the research, development, and promotion of traditional and alternative health care modalities.  The law acknowledges the importance of traditional and alternative medicine as part of the country’s health care system.  10 HERBAL MEDICINES APPROVED BY THE DEPARTMENT OF HEALTH  S = Sambong  A = Akapulko  N = Niyog- niyogan  T = Tsaang Gubat  A = Ampalaya  L = Lagundi  u = Ulasimang Bato  B = Bawang  B = Bayabag  Y = Yerba Buena REMINDERS ON THE USE OF HERBAL MEDICINE 1)Boil using a clay pot and remove cover while boiling at low heat 2)Only one kind of herbal plant for each type of symptoms 3)No use of insecticides as these may leave poison on plants 4)Use only part of the plant being advocated REMINDERS ON THE USE OF HERBAL MEDICINE 5)Symptoms persist after 2-3 doses – CONSULT physician 6) Decoction loose potency after some time. Dispose decoctions after one day. To keep fresh during the day, keep lukewarm in a flask or thermos 1)LAGUNDI (Vitex Negundo) a)Sprain and Skin Diseases b)Headache & Fever c)Rheumatism d)Eczema e)Dysentery PREPARATION: a)Decoction: Boil ½ cup of chopped fresh or dried leaves in 2 cups of water for 10-15 minutes b)Drink half cup 3 times a day c)Pounded leaves for headache and rheumatism 2)ULASIMANG BATO/PANSIT- PANSITAN (Peperonia Pellucida) a)Gouty arthritis (Great Toe pain) b)Others: Boils and abscesses c)Uric Acid lowering Agent d)Tophi prevention e)YES you can boil it or eat like a salad PREPARATION: a)½ cup of leaves boiled in a glasses for water b)Divide into 3 parts and drink one part 3x a day 3)BAWANG (Allium Sativum) a)Hypertension b)Toothache c)Neutralize free radicals & lowers cholesterol level PREPARATION: a)Fried, roasted soaked in vinegar for 30 minutes b)Blanched in boiled water for 15 minutes c)Take 2 pieces 3x a day AFTER MEALS BAYABAS (Psidium Guajava) a)Stomach Flu/Diarrhea b)Use for Wound Washing c)Gets rid of fungi, amoeba, and bacteria d)Antiseptic activity e)Toothache PREPARATION:  a)Young leaves can be boiled taken 3-4x a day for diarrhea  b)Warm decoction for gargle in toothache 5)YERBA BUENA (Mentha Cordifolia) a)ANALGESIC b)Pruritus or itchiness c)Arthritis/Rheumatism d)Insect bites and swollen gums e)Nausea & Vomiting f)Flatulence or Gas pain g)Loss of consciousness temporarily (syncope) – alternative of spirit of ammonia h)Menstrual pain 5)YERBA BUENA (Mentha Cordifolia) PREPARATION: a)For PAIN: boil leaves in 2 glasses for 15 minutes b)Divide c)Decoction in 2 parts and drink one 6)SAMBONG (Blumea Balsamifera) a)Antiurolithiasis b)Diuretic c)Anti-edema d)NOT used for kidney infections PREPARATION: a)Decoction of leaves – boil chopped leaves in a glass of water b)Divide into 3 parts c)Drink one part every 3 hours 7)AKAPULKO (Cassia Alata L.) a)Antifungal parasites herb b)Ringworm (Fungal) c)Athlete’s Foot d)Tinea flava e)Scabies (Parasite) PREPARATION: a)Pounded fresh matured leaves b)Can be made into a soap, cream or paste applied to affected area 1-2x a day c)Apply cream all over the body for scabies 8)NIYOG NIYOGAN (Quisqualis Indica) a)Anti-helminthic b)Expel worms or parasite like roundworms, tapeworms, hookworms. PREPARATION: a)Take seeds 2 hours AFTER dinner b)CHILDREN: at least 4-7 seeds c)ADULTS: at least 8-10 seeds d)CONTRAINDICATED to less than 4 years old 9)TSAANG GUBAT (Carmona Retusa)= Wild Tea a)Antispasmodic (Cramps) b)Body cleanser/wash c)Diarrhea d)Oral Hygiene or canker sores e)Mouth wash used in “SAGIPIN: UNANG NGIPIN” (fluoridation of teeth) f)Eczema g)Natural remedy for biliary colic 10)AMPALAYA (Momordica Charantia) a)DM Type 2 PREPARATION: a)Chopped leaves b)Boil in a glass of water for 15 minutes c)Take 1/3 cup 3x a day AFTER MEALS Miss Jaja