Gilbert T. Salacup RN, MSN

TYPES OF PRIMARY HEALTH WORKERS AUXILLARY INTERMEDIATE LEVEL ANCILLARY

CHARACTERISTICS

VILLAGE/GRASSROOTS HEALTH WORKERSTrained community Health worker; health auxiliary volunteer; Traditional birth attendant

General Medical PractitionersPublic Health nursesMidwives

HEALTH PERSONNEL OF 1st LINE HOSPITALSPhysicians with specialty NursesDentists

Initial link, 1st contact of the community

Work in liaison w/ the local health service workers

Provide elementary curative preventive health care measures

1st source of professional Health care Attend to health problems beyond the

competence of village health workers Provide support to the frontline health

workers in terms of supervision, training, referral services & supplies thru linkages with other sectors

Establish close contact with the village & intermediate level health workers to promote the continuity of acre from hospital to community to home.

Provide back-up health services for cases requiring hosp or dx facilities not available in HC

VILLAGE/GRASSROOTS HEALTH WORKERSTrained community Health worker; health auxiliary volunteer; Traditional birth attendant

General Medical PractitionersPublic Health nursesMidwives

HEALTH PERSONNEL OF 1st LINE HOSPITALSPhysicians with specialty NursesDentists

1. WHO ! Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

2.Claude Bernard !Health is the ability to maintain INTERNAL MILIEU. Illness is the result of failure to maintain.

3.Walter Cannon !Ability to maintain HOMEOSTASIS or dynamic equilibrium.

WHO Definition Healtha state of complete physical, mental, & social well-being and not merely the absence of a disease, illness or infirmity WHO: Health is a social phenomenonHealth as a result of interplay of diff. societal factors:-Biological, Physical- heat, temp, Ecological- adaptation to env't.- Political, Economic, Social culturalIt is an outcome of many theories : Multi-Causal Theory of Health, Disease & Death Multi Casual theory- holistic- General systems theory

CONCEPTS OF HEALTH:

1. Nightingale !Health is being well and using one’s power to the fullest extent. Health is maintained through prevention of disease via ENVIRONMENTAL HEALTH FACTORS.

2. Virginia Henderson !Individual’s ability to perform 14 components of nursing unaided.

3. Martha Rogers !Positive health symbolizes WELLNESS.

4. Sis. Callista Roy !State and process of being and becoming an integrated and whole person.

5. Dorothea Orem !State that is characterized by soundness or wholeness human structures and of bodily and mental functioning.

6. Imogene King !Dynamic state in the life cycle. Illness is an interference in the life cycle.

7. Betty Neuman !Wellness is the condition in which all parts and subparts of an individual are in harmony with the whole system.

8. Dorothy Johnson !elusive, dynamic state influenced by BIOLOGIC, PSYCHOLOGIC and SOCIAL FACTORS.

Diseases Vaccine

Minimum Age

Dose No. of Dose

Site Route Interval Reasons

1. Tuber- culosis

BCG At birth / anytime

School entrance

0.05 ml

0.10 ml

1 RDeltioid

L Deltoid

ID Given at earliest possible age protects against the possibility of infection from other family members.

2. Measles Measles

9 mons. 0.5 ml 1 Outer part of the artm

Subcu At least 80% of measles can be prevented by immunization at this age.

3.Diptheria

Pertusis

Tetanus

DPT1

DPT2

DPT3

1 ½ mos.

2 ½ mos.

2 ½ mos.

0.5 ml 3

Upper outer portion of the thigh

IM Z techniq

ue

4 wks. An early start with DPT reduces the chance of severe pertusis.

4.Hepatitis

B

Hepa B1

Hepa B2

Hepa B3

1 ½ mos.

2 ½ mos.

2 ½ mos.

0.5 ml 3 Upper outer portion of the thigh / anterior thigh

Intramus-cular

4 wks. An early start of Hepatitis B reduces the chance of being infected and becoming a carrier.

5. Polio-

Myelitis

OPV1

OPV2

OPV3

1 ½ mos.

2 ½ mos.

2 ½ mos.

2 drps or gtts.

3 Mouth Orally 4 wks. The extent of protection against polio is increased the earlier the OPV is given.

Most sensitive 1

-15to – 25 C OPV LIQUID

2 -15to – 25 C MV FREEZE DRIED

3 2-8 C BCG FREEZE DRIED

4 2-8 C DPT LIQUID

5 2-8 C HBV LIQUID

6 least sensitive 2-8 C TT LIQUID

Disease Vaccine Minimum Age Interval

Dose Route Site Percent Protected

Duration of Protection

Tetanus TT1 At 5th – 6th month of pregnancy

0.5 ml Deep intra – muscular

Deltoid region of the arm

80%

Varies 1 yr

TT2 At least 4 wks after TT1

0.5 ml Deep intra – muscular

Deltoid region of the arm

80% - Infants born will be protected from neonatal tetanus.

- 3 yrs protection for the mother.

TT3 At least 5-6 mons. later of 2nd pregnancy regardless of interval

0.5 ml Deep intra – muscular

Deltoid region of the arm

90% - Infants born will be protected from neonatal tetanus.

- 5 yrs. Protection for the mother.

TT4 At least 5-6 mons. Of 3rd pregnancy. Regardless of interval`

0.5 ml Deep intra – muscular

Deltoid region of the arm

99% - Infants protected from Neonatal Tetanus.

- 10 yrs. Protection for the mother.

TT5 At least 5-6 mons. Of 4th pregnancy. Regardless of interval`

0.5 ml Deep intra – muscular

Deltoid region of the arm

99% -lifetime protection.

- All infants born to that mother will be protected.

Retrospective (Past)

Case Control study

-Show an association bet. the risk factor & disease

Cross- Sectional (Present)

Prevalence study- old & new cases

-Get prevalence of disease (Lung CA)

- Get prevalence of risk factor (smoking) 

Prospective Cohort (future)

- Incidence or new cases

10 Leading Causes of Morbidity 10 Leading Causes of Mortality

1.P - neumonia --bacterial2.Di -arrhea3.Bro - nchitis4.In - fluenza -respiratory5.H - ypertension6.Tu - berculosis respiratory7.Di -seases of the heart8.Ma - laria9.Chick -enpox10.Me -asles

1. Di -sease of the heart2. Di -seases of the vascular system3. Ma -lignant neoplasm4. P -neumonia5. A- ccidents6. TB –all forms7. CO -PD8. Con -ditions originating in perinatal period9. DM 10. N - ephritis, nephritic syndrome

Fluids Frequent feeding Fast Referral

Oresol Rehydration

Therapy

Encourage/ensure intake of any fruit juices, “am”, “lugaw”, homemade soup

Continue breastfeeding/SF

With children over 6 mos; cereals/ starchy foods mixed with meat or fish & vegetables

Mashed banana or any fresh fruit

Feed the child at least 6x/day

After diarrhea episode, feed 1 extra meal/day for 2 weeks

If child doesn’t get better in 3 days, or if danger signs develop-refer patient

Danger signs:

FeverSunken fontanelSunken eyeballFrequent watery stoolsRepeated vomitingBlood in stoolPoor intake of mealsWeakness

Breastmilk Formula

CHO Increase decrease

CHON (LACTALBUMIN) (CASEIN)

Fats = =

Linoleic acid content (3x) Decrease

Minerals decrease Increase

SCHISTOSOMIASIS

CONTROL PROGRAM

H-FEVER

(DENGUE)

FILARIASIS

CONTROL PROGRAMSchistosomiasis-

A parasitic infection caused by blood flukes inhabiting the veins of their vertebral victims transmitted thru skin penetration causing diarrhea, ascites, hepatosplenomegaly

Dengue-

Acute febrile infection of sudden onset, caused by Aedes Aegypti, vector mosquito

> A mosquito borne disease caused by a tissue nematode attacking the lymphatic system of humans thereby causing elephantiasis, lymphedema & hydrocele

> Started in 1957 as an operational research of malaria. Eradication Service Three Filaria Control were established & later on integrated with the Regional Health Officers

Activities:

> C -ase Finding

> S - urveillance of the disease

> H - ealth education- encourage use of rubber boots for protection

> E - nvironmental Sanitation-proper disposal of feces

> S - nail Eradication- use of moluscides

Activities:

>Case Finding

Early reporting of any known case or outbreak

D

L

S -Stagnant

U - rban

Activities:

>Case Finding

>Early reporting of any known case of outbreak

H – ealth education

N – et mosquito

Targeted Food Task Force Assistance

Program

Nutrition Rehabilitation Ward

Akbayan sa Kalusugan (ASK Project)

Provision of food rations of bulgur wheat & green peas

Target population:

Pre-schoolers

Pregnant women

Lactating mothers

Every hospital must have a Nurse ward, where an adequately trained nutritionist were assigned (RA 422)

Aimed to provide rice & corn soya blend supplemented with local foods.

Target pop:

6 mos- 2 years

Moderately & severely underweight

Pre-schoolers not served by the DSWD and DA in Regions 2,8,9,10,11,12

Generics Act of 1988

R.A. # 6675

Dangerous Drugs Act

R.A. 6425

“Formally proclaims the state of promoting the use of generic terminology in the importation, manufacture, distribution, marketing, promotion & advertising, labeling, prescribing & dispensing of drugs.”

“Reinforces the NDP with regards to the assurance of the high-quality & rational drug use.”

“ The safe administration & transportation of prohibited drugs is punishable by law.”

2 Types of Drugs:

Prohibited Regulated

LSD Benzodiazepines

Eucaine Barbiturates

Cocaine/ codeine, Opiates

Level 1

Point Source

Level II

Communal Faucet System/ Stand Posts

Level III

Waterworks System/ Individual House

ConnectionsA protected well of a developed sprung with an outlet but w/o a distribution system for rural areas where houses are thinly scattered.

A system composed of a source, a reservoir, a piped distribution network & communal faucets, located at not more than 25 meters from the farthest house in rural areas where houses are clustered densely.

A system with a source, a reservoir, a piped distributor network & household tap that is suited for densely populated urban areas.

Level 1 Level 2 Level 3Non- water carriage

toilet facility:

-P-it Latrines-R-eed Odorless Earth Closet

- Compost-Bored-Hole-Ventilated improved pitToilets requiring small amount of water to wash waste into receiving space

-Pour flush, Aqua Privies

On site toilet facilities of the water carriage type with water sealed & flushed type with septic vault/tank disposal facilities.

Water carriage types of toilet facilities connected to septic tanks & /or to sewerage system to treatment plant.

Household Community

Burial

Deposited in 1m x 1m deep pits covered with soil, located 25m away from water supply

-Grinding and disposal sewer

-Animal feeding

-Composting

-- Open burning

Sanitary Landfill or Controlled Tipping

> Excavation of soil deposition of refuse & compacting with a solid cover of 2 feet

- Incineration