CPHM INTRO TO PUBLIC HEALTH

• Public Health:

  • The science of protecting and improving the health of people and their communities
  • Involves preventing disease, prolonging life, and promoting health through organized efforts and informed choices
  • Includes sanitation of the environment, control of community infections, education on personal hygiene, early diagnosis and preventive treatment of disease, and ensuring a standard of living adequate for health maintenance
• Public health is concerned with battling threats to the overall health of a community based on population health analysis
• Public health is ecological in perspective, multi-sectoral in scope, and collaborative in strategy
• Public Health aims to improve community health through an organized effort
• Public Health is preventive in nature and focuses on the population level rather than individual health issues
• Core Functions of Public Health or 10 Essential Public Health Services:

  1. Assessment:

  • Monitor health status to identify community health problems
  • Diagnose and investigate health problems and health hazards in the community

  2. Policy Development:

  • Inform, educate, and empower people about health issues
  • Mobilize community partnerships to identify and solve health problems
  • Develop policies and plans that support individual and community health efforts

  3. Assurance:

  • Enforce laws and regulations that protect health and ensure safety
  • Link people to needed personal health services and assure the provision of health care
  • Assure a competent public health and personal healthcare workforce
  • Evaluate effectiveness, accessibility, and quality of health services
• 5 Steps of Public Health Approach in Addressing Health Problems in Community:

  1. Define the health problem

  2. Identify the risk factors associated with the problem

  3. Develop and test community-level interventions to control or prevent the cause of the problem

  4. Implement interventions to improve the health of the population

  5. Monitor those interventions to assess their effectiveness
• Levels of Prevention:

  1. Primordial Level of Prevention

  2. Primary Prevention

  3. Secondary Prevention

  4. Tertiary Prevention
• Aspects of Health:

  • Physical Health
  • Mental Health
  • Social Health
• Determinants of Health:

  1. Income and Social Status

  2. Education

  3. Physical environment

  4. Employment and working conditions

  5. Social support networks

  6. Culture

  7. Genetics

  8. Personal behavior and coping skills

  9. Health services

  10. Gender
• Stages of Disease:

  1. Pre-disease stage

  2. Latent stage (asymptomatic)

  3. Symptomatic stage
• Risk Factors for Disease:

  1. Biologic and Behavioral Factors

  2. Environmental Factors

  3. Immunologic Factors

  4. Nutritional Factors

  5. Genetic Factors

  6. Services, Social Factors, and Spiritual Factors
• History of Public Health in the Philippines based on socio-political periods:

  • Pre-American Occupation
  • American Military Government
  • Philippine Assembly
  • The Jones Law
  • The Commonwealth
  • Japanese Occupation
  • Post World War II
  • Post EDSA Revolution
• Before the Americans came to the Philippines, hospitals included General Hospitals like San Juan de Dios Hospital, Chinese General Hospital, and others
• There were Contagious Hospitals such as San Lazaro Hospital and Hospital de Palestina in Camarines Sur
• Military and Naval Hospitals were also present, like Hospital Militar de Manila and Hospital dela Marie in Cebu
• Other hospitals and asylums included Hospicio de San Pascual Baylon in Manila and Hospital of San Jose for orphaned children and mentally ill
• During the American Military Government, control of epidemics like cholera and smallpox was emphasized
• Projects and activities during the American Military Government included establishing a garbage crematory and approving the first sanitary ordinance and rat control
• Cholera vaccine was first tried during the American Military Government
• The Jones Law years saw an increase in Crude Death Rate (CDR), Infant Mortality Rate (IMR), and morbidity in the Philippines
• During the Jones Law years, there was a campaign against Hookworm and the first training course for sanitary inspectors was given
• The Commonwealth Period saw the inauguration of new waterworks in Manila to control cholera and the opening of the Philippine General Hospital (PGH)
• The Japanese Occupation practically paralyzed all public health activities in the Philippines
• After World War II, the Philippines saw the creation of the National Chest Center and the introduction of the one-infection method for gonorrhea with penicillin
• Post-World War II, during the Philippine Independence, saw the construction of the National Chest Center and the creation of the Institute of Nutrition, later renamed as FNRI
• During Martial Law years, the Department of Health was renamed as the Ministry of Health (MOH) and the National Health Plan was formulated
• During the EDSA Revolution:

  • Ministry of Health was renamed Department of Health
  • Life expectancy increase slowed down
  • Morbidity and Mortality rates from preventable causes stabilized at high rates
  • Decline in infant and child mortality decelerated
  • Increased incidence of malnutrition
  • Declined practice of family planning
• Corazon Aquino Administration:

  • 1987 Constitution had more provisions on health for comprehensive healthcare availability
  • Active participation of private sector and NGOs
  • Major activities influencing public health:

  1. Milk Code required the marketing of breast milk substitute

  2. Universal child and mother immunization

  3. International safe motherhood initiative to reduce maternal mortality rate

  4. Act prohibiting discrimination against women (RA 6725)

  5. National Epidemic Surveillance System (NESS) to track down diseases causing outbreaks

  6. National Drug Policy and Genetics Act to ensure availability of safe, effective, and affordable quality drugs (RA 6675)

  7. Local Government Code devolution to governors and mayors (RA 7160)

  8. Organ Donation Act of 1991 legalizing donation of body parts after death for specified purpose
• Public Health is the science of protecting and improving the health of people and their communities
• It involves preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, and individuals
• Public Health is concerned with battling threats to the overall health of a community based on population health analysis
• It is ecological in perspective, multi-sectoral in scope, and collaborative in strategy
• Public Health aims to improve community health through an organized effort
• Ramos Administration:

  • Continued adoption of Primary Health Care (PHC) as a strategy
  • Memorable initiatives:

  1. National Immunization Day

  2. Mother and Baby-Friendly Hospital Initiative

  3. Promotion of Philippine Traditional Medicine

  4. Hospitals as Centers of Wellness

  5. Anti-smoking campaign

  6. Araw ng Sangkap Pinoy to prevent vitamin A, iron, and iodine deficiency

  7. Voluntary Blood Donation Program

  8. Family planning program

  9. Doctors to the Barrio

  • Laws passed during this time
• Public Health is preventive rather than curative, focusing on population-level health issues
• The 3 core functions of Public Health are Assessment, Policy Development, and Assurance
• Research is an essential part of Public Health for new insights and solutions to health problems
• Changes in the Health Scenario:

  • Rapid decline in mortality and morbidity
  • Steady progress in controlling infectious diseases
  • Major causes of illness and death included pneumonia, TB, diarrhea, nutrition-related diseases, measles, heart diseases, and malignant neoplasms
  • Challenges in service delivery infrastructure
• The 5 steps of the Public Health approach in addressing health problems in a community involve defining the problem, identifying risk factors, developing interventions, implementing interventions, and monitoring effectiveness