MLS 051: CPH

• 6 BUILDING BLOCKS OF THE HEALTH SYSTEM

  • Leadership & Governance
  • Health Human Resource
  • Access to Medicine and Technology
  • Health Service Delivery
  • Health Information
  • Health Financing
• Leadership & Governance


  Also called stewardship, the most complex but critical building block of any health system, about the role of the government in health and its relation to other actors whose activities impact on health, involves overseeing and guiding the whole health system (private & public), to protect the public interest, requires both political and technical action, it involves reconciling competing demands for limited resources, in changing circumstances
• There is no blueprint for effective health leadership and governance
• PHILIPPINE HEALTHCARE SYSTEM


  A devolved health system, also referred to as "decentralized", with at least 4 levels of administrative division (Province, City, Municipality, Barangay) and two special administrative divisions (Cordillera Autonomous Region (CAR) and Autonomous Region for Muslim Mindanao (ARMM))
• Local Health Board


  • Provincial Health Board
  • City Health Board
  • Municipal Health Board
• Provincial Health Board


  Shall be headed by the governor as chairman, the provincial health officer as vice-chairman of the committee on health of the Sangguniang Panlalawigan (Provincial Council), a representative from the private sector or NGO involved in health services, and a representative of the DOH in the province, as members
• City Health Board


  Shall be headed by the city mayor as chairman, the city health officer as vice-chairman of the committee on health of the Sangguniang Panlungsod (City Council), a representative from the private sector or NGO involved in health services, and a representative of the DOH in the city, as members
• Municipal Health Board


  Shall be headed by the municipal mayor as chairman, the municipal health officer as vice-chairman of the committee on health of the Sangguniang Bayan (Municipal Council), a representative from the private sector or NGO involved in health services, and a representative of the DOH in the municipality, as members
• Functions of Local Health Board

  • To propose to the council concerned, by standards and criteria set by the Department of Health, annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality, city, or province, as the case may be
  • To serve as an advisory committee to the council concerned on health matters such as, but not limited to, the necessity for, and application of local appropriations for public health purposes
  • Consistent with the technical and administrative standards of the DOH, create committees that shall advise local health agencies on matters such as, but not limited to, personnel selection and promotion, bids and awards, grievance and complaints, personnel discipline, budge review, operations review and similar functions
• A leader-driven change process

  1. The leader recognizes the problem

  2. The leader formulates a vision that is an antithesis to the recognized problem

  3. The leader consolidates his/her resources, both internal and external, that can help achieve the vision

  4. The leader takes the lead in the implementation of the action plan, constantly monitoring and tracking progress and outcomes

  5. The leader constantly communicates the vision with the community and regularly gets their feedback

  6. The leader ensures that the skills and knowledge are transferred to others to ensure the sustainability of interventions and bigger ownership of the programs by the people
• Environmental Health


  Study of how the environment affects human health; focuses on people's health, whether the environment you are part of is helping you stay healthy, or making you sick
• Hazards


  Things in the environment that are harmful; can be natural or human-made, such as chemicals, disease causing bacteria, loud noises and even stress
• 7 CORE CONCEPTS


  • Toxicity
  • Exposure
  • Dose/Response
  • Individual Susceptibility
  • Risks & Benefits
  • Environmental Justice
  • Community Resources & Action
• Toxicity


  Toxic means poisonous or dangerous, toxicology is the study of poisons, toxicity is a measure of how dangerous a chemical is, the greater a chemical's toxicity, the less it takes to make a person sick or even kill them
• Exposure


  Everyday our bodies are exposed to all sorts of environmental hazards, such as bacteria, viruses, and the sun's ultra-violet (UV) rays, some of these hazards exist naturally and some of them are the result of human activities, hazards travels along an environmental pathway; air we breathe, the water we drink, the food we eat, and even the soil we work in, play in, and use to grow much of our food, total amount of a hazard that comes in direct contact with your body, three parts of exposure: the source of hazard, the environmental pathway, and the contact
• Routes of Exposure


  • Inhalation
  • Ingestion
  • Dermal Absorption
• Dose/Response


  Dose is the amount of the hazard that actually enters your body, the amount someone gets into their body (their dose) depends on many factors, including how long you are exposed, how often you are exposed, and how big or small you are
• Individual Susceptibility


  Some people are more likely than others to get sick when they are exposed to environmental hazards, this might be because of their genetics, body size, age, gender or general health
• Risks & Benefits


  We live in an industrial society that depends on the use of both natural and human-made chemicals to function, the use of these chemicals results in benefits to society as well as risks
• Environmental Justice


  Everyone has the right to live in an environment that doesn't make them sick, regardless of their race, culture, or income
• Community Resources & Action

  You can learn more about specific issues, understand environmental laws or seek environmental justice by using community resources like the library and city hall, you can also talk to environmental health scientists at local universities or health departments, and ask your teachers and family members what they know about the issue
• Water Pollution


  Occurs when harmful substances often chemicals or microorganisms contaminate a stream, river, lake, ocean, aquifer, or other body of water, degrading water quality and rendering it toxic to humans or the environment
• Categories of Water Pollution

  • Groundwater
  • Surface Water
  • Ocean Water
  • Point Source
  • Non-Point Source
  • Transboundary
• Groundwater


  When rain falls and seeps deep into the earth, filling the cracks, crevices, and porous spaces of an aquifer, it becomes groundwater—one of our least visible but most important natural resources, groundwater gets polluted when contaminants—from pesticides and fertilizers to waste leached from landfills and septic systems—make their way into an aquifer, rendering it unsafe for human use, groundwater can also spread contamination far from the original polluting source as it seeps into streams, lakes, and oceans
• Surface Water


  Covering 70% of the earth, surface water is what fills our oceans, lakes, rivers, and all those other blue bits on the world map, nearly half of our rivers and streams and more than one-third of our lakes are polluted and unfit for swimming, fishing, and drinking, the leading type of contamination in these freshwater sources is nitrates and phosphates
• Ocean Water


  80% of ocean pollution (also called marine pollution) originates on land—whether along the coast or far inland, contaminants such as chemicals, nutrients, and heavy metals are carried from farms, factories, and cities by streams and rivers into our bays and estuaries; from there they travel out to sea, marine debris—particularly plastic— is blown in by the wind or washed in via storm drains and sewers, seas are also sometimes spoiled by oil spills and leaks—big and small— and are consistently soaking up Carbon pollution from the air, the ocean absorbs as much as a quarter of man-made carbon emissions
• Point Source


  Contamination originates from a single source, such as wastewater (also called effluent) discharged legally or illegally by a manufacturer, oil refinery, or wastewater treatment facility, as well as contamination from leaking septic systems, chemical and oil spills, and illegal dumping
• Non-Point Source


  Contamination derived from diffuse sources, such as agricultural or stormwater runoff or debris blown into water ways from land, the leading cause of water pollution in the world waters, but it's difficult to regulate, since there's no single, identifiable culprit
• Transboundary


  The result of contaminated water from one country spilling into the waters of another, contamination can result from a disaster—like an oil spill—or the slow, downriver creep of industrial, agricultural, or municipal discharge
• Common Types of Water Contamination

  • Agriculture
  • Nutrient Pollution
  • Sewage and Wastewater
  • Oil Pollution
• Agriculture


  The leading cause of water degradation, a major contributor of contamination to estuaries and groundwater, every time it rains, fertilizers, pesticides, and animal waste from farms and livestock operations wash nutrients and pathogens—such bacteria and viruses—into our waterways
• Nutrient Pollution


  Caused by excess nitrogen and phosphorus in water or air, is the number-one threat to water quality worldwide and can cause algal blooms, a toxic soup of blue-green algae that can be harmful to people and wildlife
• Sewage and Wastewater


  Used water is wastewater; from our sinks, showers, and toilets (think sewage) and from commercial, industrial, and agricultural activities (think metals, solvents, and toxic sludge), include stormwater runoff, which occurs when rainfall carries road salts, oil, grease, chemicals, and debris from impermeable surfaces into our waterways, more than 80 percent of the world's wastewater flows back into the environment without being treated
• Oil Pollution


  Nearly half of the estimated 1 million tons of oil that makes its way into marine environments each year comes not from tanker spills but from land-based sources such as factories, farms, and cities, at sea, tanker spills account for about 10% of the oil in waters around the world, while regular operations of the shipping industry—through both legal and illegal discharges—account for the rest
• Sewage and wastewater are a threat to water quality worldwide and can cause algal blooms, a toxic soup of blue-green algae that can be harmful to people and wildlife
• Wastewater sources


  • Sinks
  • Showers
  • Toilets (sewage)
  • Commercial activities (metals, solvents, toxic sludge)
  • Industrial activities (metals, solvents, toxic sludge)
  • Agricultural activities (metals, solvents, toxic sludge)
  • Stormwater runoff (road salts, oil, grease, chemicals, debris)
• More than 80 percent of the world's wastewater flows back into the environment without being treated
• Sources of oil pollution

  • Tanker spills (10%)
  • Regular shipping operations (legal and illegal discharges) (33%)
  • Land-based sources (factories, farms, cities) (50%)
  • Natural ocean floor seeps
• Radioactive substances are generated by uranium mining, nuclear power plants, military weapons production and testing, and use in universities and hospitals
• Radioactive pollution can persist in the environment for thousands of years, making disposal a major challenge