CPHM

• Community organization and health

  The science of preventing disease, prolonging life and promoting health and efficiency through organized community effort
• Areas of community organization and health

  • Environmental sanitation
  • Control of community infection
  • Education of the individual in principles of personal hygiene
  • Organization of medical and nursing services for early diagnosis and preventive treatment of diseases
  • Development of social machinery which will ensure everyone a standard living adequate for maintenance of life
• Two broad areas of preventive medicine

  • Public health
  • Risk factor evaluation
• Public health


  Includes programs and activities directed at community level and will benefit everyone or individuals who are not currently under the care of a physician
• Risk factor evaluation


  Includes programs and activities directed at individuals who are currently under the care of a physician who evaluates them for high risk factors that can cause disease, educate them about good habits and screens them for appropriate conditions
• Health


  A status of complete physical, mental and social well-being and not merely the absence of disease or infirmity, regarded as a person's physical and psychological capacity to establish and maintain balance
• Aspects of health


  • Physical health
  • Mental health
  • Social health
• Health


  Successful defense of the host against forces tending to disturb body equilibrium
• Disease


  Failure of the body's defense mechanism to cope with forces tending to disturb body equilibrium
• Determinants of health


  • Income and social status
  • Education
  • Physical environment
  • Employment and working conditions
  • Social support networks
  • Culture
  • Genetics
  • Personal behavior and coping skills
  • Health services
  • Gender
• Primary health care (PHC)

  Essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development
• Elements/components of PHC


  • Environmental sanitation
  • Control of communicable disease
  • Immunization
  • Health education
  • Family planning
  • Adequate food and proper nutrition
  • Provision of medical care and emergency treatment
  • Treatment of locally endemic diseases
  • Provision of essential drugs
• Four cornerstones/pillars in PHC

  • Active community participation
  • Intra and inter-sectoral linkages
  • Use of appropriate technology
  • Support mechanism made available
• Levels of health care referral system

  • Primary level of care
  • Secondary level of care
  • Tertiary level of care
• Community health


  Working together to help people help themselves, not merely to survive but also achieve the maximum potential
• Four priorities in public health

  • Survival of man
  • Prevention of conditions which lead to destruction or retardation of human function and potential in the years of life
  • Achievement of human potential and prevention of the loss of productivity of young adults and those on the middle period of life
  • Improvement of the quality of life, especially in the later years
• Structure of the Philippine health care delivery system

  • Rural health unit (RHU) and their subcenters
  • Chest clinics, malaria eradication units and schistosomiasis control unit
  • Tuberculosis clinics and hospitals of the PTBs
  • Private clinics
  • Clinics run by PMA
  • Community hospitals and health services centers run by Philippine Medical Care Commission (PMCC)
  • Voluntary health facilities run by religious and civic groups
• Three divisions of health care delivery system

  • Government
  • Mixed sectors
  • Private sectors
• Government health agency


  The Department of Health runs the bulk of the government health facilities
• Health programs


  • Adolescent and youth health and development program (AYHDP)
  • Botika ng barangay
  • Promotion of breast-feeding program / mother and baby friendly hospital initiative (MBFHI)
  • Cancer control program
  • Diabetes control program
  • Dengue control program
  • Dental health program
  • Emerging disease control program
  • Environmental health
  • Expanded program on immunization
  • Family planning
  • Food and waterborne diseases prevention and control program
  • Knock out tigdas
  • Leprosy control program
  • Malaria control program
  • National filariasis elimination program
  • National mental health program
  • Newborn screening
  • Occupational health program
  • Health development program for older persons
  • Pinoy MD program "gusto kong maging doktor"
  • Prevention of blindness program
• PINOY MD Program "Gusto Kong Maging Doktor"


  A Medical scholarship Grant for Indigenous People, Local Health Workers, Barangay Health workers, Department of Health employees or their children
• PINOY MD Program


  A joint program of the Department of Health (DOH), Philippine Charity Sweepstakes Office (PCSO), and several State Universities and Medical Schools
• Republic Act 7719 "Blood Services Act of 1994"


  • To promote and encourage voluntary blood donation by the citizenry and to instill public consciousness of the principle that blood donation is a humanitarian act
  • To provide, adequate, safe, affordable and equitable distribution of supply of blood and blood products
• Mixed Sectors


  • PTS - Philippine Tuberculosis society
  • PCS - Philippine Cancer Society
  • PNRC - Philippine National Red Cross
  • PMHA - Philippine Mental Health Association
  • PHA - Philippine Heart Association
• Private Sectors

  • Socialized Medicine - funded by general taxation, emphasis on prevention
  • Compulsory Health Insurance - law requires people to subscribe to health insurance plan, usually government sponsored; covers only curative and rehabilitative medicine; preventive services provided by government agencies
  • Voluntary Health Insurance - government only encourages people to subscribe to health insurance
  • Free Enterprise - people have to take care of their medical needs
• Communicable diseases are often the leading causes of all illness in the country today
• Communicable diseases most often afflict the most vulnerable, the young and the elderly
• Communicable diseases have numerous economic, psychological, disabling and distinguishing effects to the emergence of newly discovered diseases and the re-emergence of old ones
• Communicable diseases


  Readily transferred from one infected person to a susceptible and uninfected person and maybe caused by microorganisms
• Types of microorganism causing infections

  • Bacteria
  • Viruses
  • Fungi
  • Parasites
• Chain of Infection


  • Etiologic agent (microorganism)
  • Reservoir (host)
  • Portal of exit from reservoir
  • Mode of Transmission
  • Portal of entry to the susceptible host
  • Susceptible host
• Etiologic Agent


  • The extent to which any microorganisms is capable of producing an infectious process depends on the number of microorganism (pathogenicity)
  • The ability of the microorganisms to enter the body, the susceptibility of the host, and the ability of microorganisms to live in the host's body
• Reservoir


  • There are many reservoirs, or source of microorganisms
  • Common sources are the other humans, the client's own microorganism, plants, animals, or the general environment
  • People are the most common source of infection for others and for themselves
• Portal of exit from the Reservoir

  Before an infection can establish itself in a host, the microorganism must leave the reservoir
• Method of Transmission


  • Direct Transmission - Touching, Biting, Kissing, Sexual intercourse, Droplet spread
  • Indirect Transmission - Vehicle Borne, Vector Borne
• Portal of entry to the susceptible host

  • Before a person can became infected, microorganisms must enter the body
  • The skin is a barrier to infectious agents; however, any break in the skin can readily serve as portal of entry
  • Often, microorganisms enter the body of the host by the same route they used to leave the source
• Susceptible Host


  • A susceptible host is any person who is at risk for infection
  • A compromised host is a person "at increased risk", an individual who for one or more reasons is more likely than others to acquire an infection
  • Impairment of the body's natural defenses and a number of other factors can affect susceptibility to infection
• Handwashing


  • The most important procedure for preventing the transfer of microorganisms and the therefore nosocomial infection is correct and frequent handwashing
  • Proper handwashing should be done at the beginning of the work shift, before and after prolonged contact with the patient, before invasive procedure, before contact with especially susceptible patients, before and after touching wounds, after contact with the body substances, even when glove was worn, anytime you are in doubt the necessity for doing so, at the end of every shift before leaving the health care facility
• Gloves


  • Gloves are worn to protect the hands when health worker is likely to handle any substances, e.g. blood, urine, feces, sputum, mucous, transmitting their own endogenous microorganisms to individuals receiving care, and reduce the chance that the health worker's hands will transmit microorganisms from one client or to another client
  • In all situations, gloves are changed between client's contacts
• Specific Protection Against Disease

  • Immunization
  • Chemoprophylaxis
  • Mechanical Prophylaxis