Community Health PDF

COMMUNITY high degree among its A social group of people interacting members with each other determined by: Geographic boundaries COMPONENTS OF COMMUNITY Common or sharing the same The Ten Key Components for inte...

COMMUNITY high degree among its A social group of people interacting members with each other determined by: Geographic boundaries COMPONENTS OF COMMUNITY Common or sharing the same The Ten Key Components for interest. creating healthy, equitable Social system communities build on the great Shared interest work of our partners and were Fluid boundaries identified through analyzing Population local health data and research and gathering extensive DIFFERENCE OF RURAL AND URBAN community feedback. COMMUNITY Within these 10 components, Physical environment four priority areas were Population size and density identified as key priorities for Economy healthy, equitable communities Culture that focus on the root causes of Political dynamics health, grouped as: Healthy Availability and adequacy or Housing, Healthy social services Neighborhoods, Healthy Availability and accessibility of Schools, and a Healthy health resources Economy. CHARACTERISTICS OF A HEALTHY DETERMINANTS OF HEALTH AND COMMUNITY DISEASE Awareness that "we are A. Characteristics of Population community" 1. Population Size and Density- A Conservation of natural densely populated or resources overpopulated community can Recognition of, and respect for, easily be attacked by the existence of subgroups communicable diseases Participation of subgroups in Total size is generally expressed community affair as the number of individuals in a Preparation to meet crises population. Ability to solve a problem Communication through an B. Location of the Community open channels Geographical location; Some Resource available to all communities are more prone.to Settings of disputes through a diseases due to the legitimate mechanisms geographical location. Participation of community in For example - Some decision making Wellness of a communities which are located  in swampy areas ARE MORE NURSE'S ROLES AND PRONE TO DISEASES especially RESPONSIBILITIES IN HEALTH during heavy rains where floods PROMOTION cause water stagnation causing organisms to proliferate. HEALTH PROMOTION AND DISEASE PREVENTION C. Social System Within the Health promotion activities Community enhance resources directed at 1. Government- since the improving well-being, whereas government involves planning, disease prevention activities implementing and provision of protect people from disease and community services such as the effects of disease. water supply, medical supplies and other needs which can LEVEL OF PREVENTION directly affect the community 1. Primary- general health health. promotion and specific 2. Educational factors; protection. - Poor education or illiteracy 2. Secondary- early detection and affects the health of a prompt intervention community when people don't 3. Tertiary- reduce the effects of have education on how they can disease and injury, and restore prevent themselves from individuals to their optimal level diseases. of functioning - CH nurse educate the people on: COMMUNITY HEALTH NURSE ROLES - Treated mosquito net - Malaria AND FUNCTIONS Environmental Hygiene- Cholera/ Trachoma Provider of Nursing Care 3. Individual behavior; Provides direct nursing care to - Community health is greatly sick or disabled in the home, influenced by individuals, their clinic, school, or workplace personal health, habits etc. And Develops the family's capability in order to achieve a healthy to take care of the sick, disabled, community, it takes teamwork. or dependent member - For example,proper disposal of waste products clearing all Community Organizer stagnant water active smokers v Motivates and enhances Self-medication community participation in terms of planning, organizing, implementing, and evaluating health services.  Initiates and participates in Reviews, validates, consolidates, community development analyzes, and interprets all activities records and report Prepares statistical data/chart Coordinator of Services and other data presentation Coordinates with individuals, families, and groups for Researcher health-related services provided Participates in the conduct of by various members of the survey studies and researches health team. on nursing and health-related Coordinates nursing program subjects. with other health programs like Coordinates with government environmental sanitation, health and non-government education, dental health, and organizations in the mental health. implementation of studies/research. Trainer/Health Educator Identifies and interprets training DEFINITION OF EPIDEMIOLOGY needs of the RHMs, Barangay HEALTH STATISTICS AND Health Workers (BHW), and EPIDEMIOLOGY hilots Etymology: from the Greek Conducts training for RHMs and words: epi "upon", demos hilots on promotion of health "people," and logos "study" and disease prevention Last's definition: Study of the Conducts pre and distribution and determinants of post-consultation conferences health-related states or events for clinic clients; acts as a in specified populations, and the resource speaker on health and application of this study to the health related services prevention and control of health Initiates the use of tri-media (radio/TV, problems cinema plugs, and print ads) for health Makes use of concepts and education purposes methods from biology, Conducts pre-marital counseling. sociology, demography, geography, environmental Recorder/Reporter/Statistician science, policy analysis and Prepares and submits required statistics reports and records Maintain adequate, accurate, and complete recording and reporting DEMOGRAPHY- THE STUDY OF HEALTH INDICATORS HUMAN POPULATIONS Quantitative measures, usually Demography is the study of expressed as rates, ratios, or human populations - their size, proportions, that describe & composition and distribution summarize various aspects of across space - and the process the health status of the through which populations population. change. Births, deaths and Used to describe the health migration are the 'big three' of status of the population (i.e., for demography, jointly producing situational analysis or population stability or change. community diagnosis). A population's composition may There are various types (e.g., be described in terms of basic morbidity indicators, mortality demographic features - age, sex, indicators, fertility indicators, family and household status - etc.) depending on the aspect of and by features of the health that is of interest population's social and economic context - language, education, occupation, ethnicity, EPIDEMIOLOGY AND THE NURSE religion, income and wealth. Nurse Epidemiologist What are the roles of Identifies people or populations Community Health Nurses at high risk; pertaining to: Monitors the progress of - Number of birth diseases; - Aging of population Specifies areas of health care - Migration need; determine priorities, size, - Gender distribution and scope of programs; evaluate - Households their impact. - Educational attainment They generally do not provide direct patient care but serve as a Demography - the study of human resource and plan educational populations programs. The distribution of populations can be defined at multiple levels DISEASE NOTIFICATION (local, regional, national, global) An integral part of disease and with different types of surveillance boundaries (political, economic, Republic Act 3573: Law on geographic). reporting of communicable Demography is a central diseases mandates health component of societal contexts workers to report notifiable and social change. diseases (e.g., dengue, rabies,  leptospirosis, and HIV/AIDS to outbreaks, and monitoring local and national health progress towards attainment of authorities targets for the control, Many people who need services elimination, or eradication of a do not have access to health specific disease. facilities. Minimal vigilance in reporting Active surveillance: cases of the notifiable diseases Public health staff members among health care providers, actively and regularly contact particularly private practitioners health care providers or the Leads to gross underreporting B population to obtain distorted picture of health information about the disease of problems in the community interest. Much more expensive but yields DISEASE REGISTRY more accurate and timely data. A compilation of information Allows both an early detection of about a particular disease. an impending epidemic and a Aim: to include all cases of the more valid evaluation of the disease in the registry without impact of public health duplication interventions. Attainment of this aim is A very active surveillance system dependent on: should be used to detect every - cooperation of agencies and case to monitor eradication and health facilities that feed the elimination programs. registry - having a unique patient The Philippine Integrated identifier that will allow record Disease Surveillance and linkage Response (PIDSR) integrates health statistics generated DISEASE SURVEILLANCE SYSTEM through the major disease Passive surveillance: surveillance systems in the Public health surveillance: The country. ongoing, systematic collection, - Notifiable Disease Reporting analysis and interpretation of System (NDRS) health-related data needed for - Field Health Service Information the planning, implementation, System (FHSIS) and evaluation of public health - National Epidemiology Sentinel practice. - Surveillance System (NESSS) Surveillance systems were - Expanded Program on initially developed for Immunization Surveillance monitoring high burden System (EP| Surveillance) diseases, detecting disease - HIV-AIDS Registry  In the Philippines, one may request tor data from the DETERMINATION OF DISEASE National Statistics Office fee; it CAUSATION takes a long time to avail of the Interventions that target the data causes of a public health In developed countries, several problem have greater chances data resources can be of having positive outcomes. downloaded from the Internet Answering the epidemiologic USAID founded Demographic questions "What factors and Health Survey that includes contribute to disease causation? many low end middle income Why does disease occur?" based countries that can be on valid evidence will contribute downloaded from the internet. to the success of health interventions. A review of literature and an CONSIDERATIONS IN THE ANALYSIS understanding of the natural AND INTERPRETATION OF HEALTH history of the disease will INDICATORS contribute to the development 1. Is the denominator of the rate of an epidemiologic disease the most appropriate one? model representing the factors Preferably, it should be the that influence disease causation. population which gave rise to the events in the numerator. MODELS OF DISEASE CAUSATION 2. Is the numerator an accurate Triad model count of the number of events? Suggests that the agent and the Inaccuracies can arise due to susceptible human host are under-registration, interacting freely in a common underreporting, or duplication. (physical, biologic, 3. There should be socioeconomic) environment. correspondence in time and Disease does not occur for as geographical location of the long as the balance is events in the numerator and the maintained or is tilted in favor of population in the denominator. the host (because of good 4. Time specifications are usually nutritional status and high levels on an annual basis. However of immunity). special indicators may have Disease eventually occurs when other period specifications and the balance is tilted in favor of these should be stated the agent (through increased 5. The factor used in the dosage, virulence, pathogenicity computation of the different of the agent). rates may be any number of the base 10.  Environmental elements (i.e. - elucidate the natural history of climate) can also tilt the balance the disease, in favor of the agent. - determine why the problem disease occurs, Wheel model - and identify the factors that Gives emphasis on the role of contribute to disease causation. the genetic makeup of the host that is presented as the inner OUTBREAK INVESTIGATION core of the wheel's hub. Disease outbreak: the The outer core of the hub occurrence of cases of disease in includes host characteristics excess of what would normally (sex, age, socioeconomic status, be expected in a defined behaviors). community, geographical area The rim or the outer edge or season represents the biologic, physical, Occurrence of a single case of a and chemical environment. communicable disease is considered an outbreak if the Web model: disease: became more applicable for 1. is a previously unknown disease non-communicable diseases to 2. has never occurred in the area capture the complex 3. has been absent from the interrelationships of numerous population for a long time factors that influence disease occurrence either by increasing An outbreak investigation the risk or protecting against should be conducted to: the disease. 1. Identify and eliminate the Under this model, disease can source of infection and prevent be prevented by breaking the the occurrence of more cases weakest strand of the causal 2. Assess the preventive strategies web as identified previously that are currently implemented through various types of 3. Devise strategies for preventing epidemiologic studies similar outbreaks in the future PREVENTION AND CONTROL OF Basic steps in an outbreak DISEASE investigation: Epidemiology can be used to 1. Operationally define what - identify the important public constitutes a case. health problems of the 2. Based on the operational community, definition, identify the cases. - determine the magnitude and 3. Based on the number of cases distribution of the health identified, verify the existence of problem, an outbreak.  4. Establish the descriptive Monitoring epidemiologic features of the An ongoing activity during cases. program implementation to 5. Record the clinical assess the current status of its manifestations of cases. implementation in terms of 6. Based on the clinical compliance to the design of the manifestations, incubation program, timelines, and period, available laboratory attainment of midterm goals findings, and other information As a result of monitoring, the gathered, formulate hypotheses project management team is regarding the probable etiologic able to: agent, the sources of infection, - Assess the progress of program the mode of transmission, and implementation, the best approach for - Identify problems, controlling the outbreak. - Take corrective action, 7. Test the hypotheses by - Have a tool for quality assurance collecting relevant specimens and management, from the patients and from the - Measure achievement of environment. midterm program objectives, 8. Based on the results of the - Lay the groundwork for investigation, implement program evaluation. prevention and control measures to prevent recurrence Evaluation of similar outbreak. A process that systematically 9. Disseminate the findings of the and objectively assesses investigation through medi and compliance to the d program, other forms to inform the public. the performance, relevance and success of a project, that is, the MONITORING AND EVALUATION OF which a project accomplishes its HEALTH INTERVENTIONS intended results (outcomes) and A health intervention plan achieve: measurable impacts. should include the plan for its Employs research techniques monitoring and evaluation. and applies the methods of Monitoring is done while the epidemiology and statistics. intervention is still being Its primary purpose is to provide implemented to provide feedback on the results feedback on its current status. (outcomes) and the project in Evaluation is done at the end of order to inform policymakers the project to assess whether or and planners about the efficacy not its objectives were achieved. intervention. It answers such questions as:  - Did the program work as example, avoiding certain food intended? items. - What results (outcomes) did the program accomplish? The NBS Act of 2004 - What measurable impacts did institutionalized the "National the program achieve? NBS System" which ensures - Is the program cost effective? that: 1. Every baby born in the Philippines is Guiding principles for evaluation: offered NBS; 1. Impartiality 2. A sustainable NBS System is 2. Independence established and integrated into the 3. Partnership public health delivery system; 4. communication and coordination 3. All health practitioners are aware of 5. Credibility the benefits of NBS and of their 6. transparency responsibilities in offering it to their patients; and PROVISION OF EVIDENCE FOR 4. All parents are aware of NBS and HEALTH POLICY FORMULATION their responsibility in protecting their Epidemiologic evidence is child from any of the disorders. necessary for the formulation of health policy. DEFINITION OF EPIDEMIOLOGY Example: the legislation of Etymology: from the Greek words: epi Republic Act 9288 (Newborn "upon", demos "people," and logos Screening (NBS) Act of 2004. "study" Passed due to the compelling Study of the distribution and evidence from a study done by a determinants of health-related states group of obstetricians and or events in specified populations, and pediatricians from 24 hospitals the application of this study to the in Metro Manila. prevention and control of health The Philippine Newborn problems (Last 1988) Screening Project (PNBSP) showed that the incidence of six EPIDEMIOLOGICAL TRIANGLE metabolic conditions is high The Triangle has three corners (called enough to be considered of vertices): public health importance. Agent, or microbe that causes Although the sequelae of these the disease (the "what" of the conditions can compromise the Triangle) functionality of cases as they Host, or organism harboring the mature, the secondary level of disease (the "who" of the prevention could be relatively Triangle) simple in some instances, for Environment, or those external factors that cause or allow  disease transmission (the 3. Indicating priorities for resource "where" of the Triangle) allocation' 4. Monitoring implementation of PRACTICAL APPLICATIONS OF health programs' EPIDEMIOLOGY 5. Evaluating outcomes of health Assessment of the health status programs of the community or community diagnosis MORBIDITY INDICATORS Elucidation of the natural history Morbidity indicators are generally of disease based on the disease-specific Determination of disease incidence or prevalence for the causation common and severe diseases Prevention and control of Can partly answer two disease epidemiologic questions: Monitoring and evaluation of - "What are the health problems health interventions in our area?" Provision of evidence for policy - "How many cases occur in the formulation area?" Two types: HEALTH INDICATORS - Prevalence Quantitative measures, usually - Incidence expressed as rates, ratios, or proportions, that describe & POPULATION PYRAMID summarize various aspects of Graphical representation of the the health status of the age-sex composition of the population. population. Should be examined during the Used to describe the health assessment of the health status status of the population (i.e., for of the community. situational analysis or Shape of the pyramid provides community diagnosis). insights into the fertility and There are various types (e.g., mortality patterns of the morbidity indicators, mortality community and the most indicators, fertility indicators, probable health problems that etc.) depending on the aspect of would likely need health health that is of interest. services. Health indicators are also used for SOURCES OF DATA FOR 1. Determining factors that may CALCULATION OF HEALTH contribute to causation of the disease INDICATORS and control of disease Census 2. Identifying public health problems Vital registration system and needs Disease notification  Disease registries monitoring high burden Surveillance system diseases, detecting disease Hospital data outbreaks, and monitoring Health insurance progress towards attainment of School health program targets for the control, Downloadable data sets elimination, or eradication of a Surveys (morbidity, specific disease. demographic and health) Active surveillance: DISEASE REGISTRY Public health staff members A compilation of information actively and regularly contact about a particular disease. health care providers or the Aim: to include all cases of the population to obtain disease in the registry without information about the disease of duplication interest. Attainment of this aim is Much more expensive but yields dependent on: more accurate and timely data. - cooperation of agencies and Allows both an early detection of health facilities that feed the an impending epidemic and a registry more valid evaluation of the - having a unique patient impact of public health identifier that will allow record interventions. linkage A very active surveillance system In the Philippines: should be used to detect every - A cancer registry covers Metro case to monitor eradication and Manila and Rizal Province elimination programs. - An HIV/AIDS registry intended to include all newly detected cases The Philippine Integrated of HIV infection and AIDS in the Disease Surveillance and Philippines Response (PIDSR) integrates health statistics generated DISEASE SURVEILLANCE SYSTEM through the major disease Passive surveillance: surveillance systems in the Public health surveillance: The country. ongoing, systematic collection, - Notifiable Disease Reporting analysis and interpretation of System (NDRS) health-related data needed for - Field Health Service Information the planning, implementation, System (FHSIS) and evaluation of public health - National Epidemiology Sentinel practice. - Surveillance System (NESSS) Surveillance systems were initially developed for  - Expanded Program on supervisory functions in facilities Immunization Surveillance and program areas. System (EP| Surveillance) It monitor health service - HIV-AIDS Registry delivery nationwide In the Philippines, one may request tor data from the PRIMARY COLLECTION OF DATA National Statistics Office fee; it Primary data are an important takes a long time to avail of the part of community health data assessment. In developed countries, several These data can fill in gaps in data resources can be secondary data sources, downloaded from the Internet highlight critical issues or USAID founded Demographic concerns, and provide and Health Survey that includes opportunities for community many low end middle income members to actively engage in countries that can be the community health downloaded from the internet. assessment process. When existing data are not available for a particular THE NURSING PROCESS IN THE CARE population, it may be necessary OF THE COMMUNITY to collect primary data. Records is an account of something, written to Observation perpetuate knowledge of - ocular survey, "windshield events. survey", vulnerable groups Records and reports and Survey indispensable aids to all who are - A survey is made up of series of responsible for giving best questions for systematic possible service to individuals, collection of information from families and community. sample of individuals or families Good reports are time savers. It in a community and may be prevents duplication of work, written or oral (Maurer & Smith decreases errors and shows the 2009) efficiency level of the NURSE. Information interview-" key FIELD HEALTH SERVICES person interview" INFORMATION SYSTEM - formal of informal community It is a network of information. leaders It is intended to address the - person of influence short term need of DH and LGU Community forum-" an open staff with managerial or meeting of the members of the  community" (Laundy & Janes, 2009) The need for the information - "Pulong-pulong sa barangay" is dissemination on registration, a good example of a community especially among the Muslim forum. population and indigenous cultural communities, has been noted. (Hufana The PH Nurse / CH Nurse observe the 2011). following People Birth Certificate Use of your community space In facility-based births, the Daily life facility administrator shall be The nature of debate responsible for the registration Hidden participants of the event. Other Social Media Community The physician, nurse, midwife or Managers anybody who attended the delivery has the responsibility SECONDARY COLLECTION OF DATA for registering births that occur outside a facility. REGISTRY OF VITAL EVENTS Acts 3753 (Civil Registration Law, DEATH CERTIFICATE Philippines Legislature). PD 856 or also known as Enacted 1930, established the Sanitation Code requires a civil registry system in the death certificate before burial of Philippines and requires the the deceased. registration of virtual events, The physician who last attended such as births, marriages and the deceased shall be deaths. responsible for preparing the RA 7160 (Local Government death certificate, certifying the Code) assigned the function of cause of death, and forwarding the civil registration to local the death certificate to the governments and mandated health officer within 48 hours. the appointment of Local (city/ municipal) Civil registrars. The HEALTH RECORDS AND REPORTS PSA serves as the central EO 352, the Field Health Service repository of civil registries and Information System (FHSIS) is PSA Administrators and Civil the official recording and Registrar General of the reporting system of the DOH Philippines and is used by the NSCB or National Statistical Coordination The birth and death registries are of Board to generate health importance to the nurse, since they are statistics. a source of fertility and mortality data.  The FHSIS is an essential tool in To have a visual image of trends in monitoring the health status of data over time or age. This is the population at different appropriate for time series. For levels. example, the trend of the total fertility rate or average number of children per DISEASE REGISTRIES woman in the Philippines from 1973 to A disease registry is a listing of 2011. persons diagnosed with a specific type of disease in a Pie Chart defined population. To show the percentage distribution or Data collected through disease composition of variables, such as registries serve as basis for population or households. A pie chart monitoring, decision making, is an effective tool in highlighting the and program management ( value of a group in relation to the DOH, 2011) whole population. But it can illustrate only a small number of categories, CENSUS DATA usually not more than six A census is a periodic governmental enumeration of HEALTH RECORDS AND REPORTS the population (Merriam-Webster Online IMMUNIZATION RECORD Dictionary, 2012) An immunization record is a Batas Pambansa Blg 72 provides comprehensive timeline of all for a national census of vaccinations a patient has population and other related received. data in the Philippines every 10 Good record-taking will ensure a years. patient can provide accurate De jure or de facto method immunization records required for certain jobs, travel, or school Graphs for Presenting Community enrollment. Data and Their Uses MEDICAL CERTIFICATION Bar Graphs: A medical certificate or doctor's To compare values across different certificate is a written statement categories of data. For example, a from a physician or another population pyramid is made up of two medically qualified health care horizontal bar graphs representing the provider which attests to the age structure of the male and female result of a medical examination population. of a patient. It can serve as a "sick note" or Line Graph: evidence of a health condition. Or use for insurance claims.  exposed to infections, diabetes, skin diseases, and illnesses resulting from high meat consumption. In 2020, over MEDICAL RECORDS 700,000 Filipinos contracted acute The medical record serves as the respiratory tract infections, followed by central repository for planning patient over 400,000 diagnosed with care and documenting hypertension. In areas with high communication among patient and exposure to rain, dengue infections health care providers and professionals and leptospirosis have also become contributing to the patient's care. prevalent. (Balita 2024) DISEASE REGISTRY CENSUS DATA MORBIDITY CASES Leading Cause of Death by Ischemic heart disease occurs 2023 when the heart does not get Ischemic heart disease was the leading enough supply of blood and cause of death in the Philippines. The oxygen due to narrowed number of people who died from this arteries. illness was estimated at 124,437. It is the top cause of death Following 5, cancer resulted in the among Filipino men with 74,134 deaths of about 71,000 people. cases and the second cause of death among Filipino women Eating habits with 29,662 cases in a year. Heart diseases have been linked to Quizon advised against high meat consumption, among cigarette smoking and alcohol others. In the Philippines, pork has intake, and recommended been the most consumed meat type, sugar and cholesterol control, as followed closely by chicken. While pork well as stress management. meat is typically produced (Montemayor 2023) domestically, the country also imports pork to supplement its supply. CANCER However, plant-based food has started Cancer, also known as gaining popularity among Filipinos. In neoplasms, is characterized by fact, a 2024 survey revealed that 69 the presence of a malignant percent surveyed Filipinos consumed growth or tumor which results plant-based products, including meat from abnormal cell division. The alternatives. most common types of neoplasms include uterine, LEADING CAUSE OF DISEASES urinary bladder, thyroid, soft tissue, prostate, ovarian, skin, Common diseases in the Philippines lymph node, lung, kidney, Aside from heart and cerebrovascular gastric, anal, blood, bone, breast, diseases, the Filipino population is also  cervical, esophageal and colorectal cancer. According to PSA's latest data, more Filipino women die from cancer compared to men, with 30,954 annual cases logged. (Montemayor 2023) PNEUMONIA Pneumonia is the infection of both lungs. In the past decade, it claims the lives of 57, 089 Filipinos every year. "It is mistaken by some as caused by lung cancer but pneumonia is not just due to lung cancer, anybody with a compromised immune system like elderlies, diabetics and patients undergoing dialysis they are considered at a high risk of contracting pneumonia," medical oncologist Denky Shoji dela Rosa told PNA. (Montemayor 2023)