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COMMUNITY HEALTH
NURSING
Mrs. Laarne Estenzo-Pontillas
BSN , R.N., MSN
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Mar! "#$%&'
(is)i*les+i* is a liestle
Not /st a 0i0li)al tr/t+
Nor a C+ristian i1eal 0/t a 2a o lie3or t+e Son o Man also )a4e not to 0e
ser5e1
B/t to ser5e an1 to 6i5e His lie as aranso4 or 4an.
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CO7ERAGE 3OR LOCAL
BOAR( E8AM $ CHN
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I. Sae an1 9/alit Care, Healt+
E1/)ation, an1 Co44/ni)ation,Colla0oration an1 Tea42or!
". Prin)i*les an1 Stan1ar1 o CHN
:. Le5els o )are
;. T*es o Clientele
%. Healt+ Care (eli5er Sste4
&. PHC as a Strate6
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II. Resear)+ an1 9/alit
I4*ro5e4ent
". Resear)+ in t+e Co44/nit:. National Healt+ Sit/ation
;. 7ital Statisti)s
%. E*i1e4iolo6
&. (e4o6ra*+
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I7. Et+i)o-Moral-Le6al Res*onsi0ilit
". So)io-)/lt/ral 5al/es, 0elies, an1*ra)ti)es o in1i5i1/als, a4ilies,
6ro/*s an1 )o44/nities
:. Co1e o Et+i)s or Go5ern4entor!ers
;. HO, (OH, LGU *oli)ies on +ealt+%. Lo)al Go5ern4ent Co1e
&. Iss/es
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7. Personal An1 Proessional
(e5elo*4ent". Sel-assess4ent o CHN
)o4*eten)ies, i4*ortan)e,
4et+o1s an1 tools:. Strate6ies an1 4et+o1s o
/*1atin6 ones sel, en+an)in6
)o4*eten)e in )o44/nit +ealt+
n/rsin6 an1 relate1 areas.
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HISTORY OF CHN
DateEvent1901 - Act # 157 ( Boar o! Hea"t o! te$%"%&&%ne' ) Act # *09 ( $rov%nc%a" an +,n%c%&a"Boar' o! Hea"t ere create.
1905 - Boar o! Hea"t a' a/o"%'e) !,nct%on'ere tran'!erre to te B,rea, o! Hea"t.
191 Act # 152 or Fa3aro Act create te San%tar4D%v%'%on' te !orer,nner' o! &re'ent +HO') 6a"en,r'e' &er!or6' te !,nct%on' o! octor'
1919 Act # 0 (N,r'e' 8a a' create- Car6en e" Ro'ar%o 1't F%". N,r'e ',&erv%'or,ner B,rea, o! Hea"t
Oct. 19 F%"%&%no N,r'e' Oran%:at%on
($%"%&&%ne N,r'e'; Oran%:at%on a' oran%:e.
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D 19*
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D Dec. 19?1 @%ct%6' o! or" ar II ere
treate /4 te n,r'e' o! +an%"a.
D ,"4 19? N,r'%n O!!%ce a' create) Dr.E,'e/%o A,%"ar e"&e %n te re"ea'e o! *1
F%"%&%no n,r'e' %n B%"%/% $r%'on a' &r%'oner' o!
ar /4 te a&ane'e.
D Fe/. 19?2 N,6/er o! n,r'e' ecrea'e !ro6 552 *0.
D 19? F%r't tra%n%n center o! te B,rea, o! Hea"t
a' oran%:e /4 te $a'a4 C%t4 Hea"tDe&art6ent. Tr%n%a =o6e: +arce"a =a/at%n
Co'tanc%a T,a:on +'. B,ar%n +'. Ra6o' an
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D 1950 R,ra" Hea"t De6on'trat%on an
Tra%n%n Center a' create.
D 195* Te !%r't 1 r,ra" ea"t ,n%t' ereoran%:e.
D 1957 RA 191 a6ene 'o6e 'ect%on' o!
RA 10 an create te e%t cateor%e'o! r,ra" ea"t ,n%t ca,'%n an %ncrea'e %n
te e6an !or te co66,n%t4 ea"t
&er'onne".D 195-1925 D%v%'%on o! N,r'%n a'
a/o"%'e (RA 977 an Reoran%:at%on Act
(EO
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D 199*-199 O!!%ce o! N,r'%n % not6ater%a"%:e %n '&%te o! &er'%'tent
reco66enat%on o! te o!!%cer' /oar6e6/er' an av%'er' o! te Nat%ona"8ea,e o! N,r'e' Inc.
D an. 1999 Ne"%a H%:on a' &o'%t%one a'te n,r'%n av%'er at te O!!%ce o!$,/"%c Hea"t Serv%ce' tro, De&art6entOrer # 9.
D +a4 ? 1999 EO # 10 %c re%rect' te!,nct%on' an o&erat%on' o! DOH a''%ne /4 !or6er $re'%ent o'e& E'traa.
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LAS A33ECTING
PUBLIC HEALTH AN(PRACTICE O3
COMMUNITY HEALTHNURSING
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R.A. ="
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Co4*osition o LHB
Pro5in)ial Le5el
".Go5ernor- )+air
:. Pro5in)ial Healt+ Oi)er 5i)e )+air;. C+air , Co44ittee on Healt+ o
San66/nian6
Panlala2i6an%. (OH re*.
&. NGO re*.
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Co4*osition o LHB
Cit an1 M/ni)i*al Le5el
". Maor )+air
:. MHO 5i)e )+air;. C+air, Co44ittee on Healt+ o
San66/nian6
Baan%. (OH re*
&. NGO re*
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E33ECTI7E LHS (EPEN(S
ON$
". t+e LGUs inan)ial )a*a0ilit:. a 1na4i) an1 res*onsi5e *oliti)al
lea1ers+i*
;. )o44/nit e4*o2er4ent
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R.A. :;>: P+ili**ine Me1i)al A)t. T+is a)t 1eines t+e*ra)ti)e o 4e1i)ine in t+e )o/ntr.
R.A. "#>: R/ral Healt+ A)t. It )reate1 t+e "st>" R/ralHealt+ Units.
-a4en1e1 0 RA ">@" F 4ore *+si)ians,
1entists, n/rses, 4i12i5es an1 sanitar ins*e)tors 2illli5e in t+e r/ral areas 2+ere t+e are assi6ne1 in or1erto raise t+e +ealt+ )on1itions o 0arrio *eo*le ,+en)e+el* 1e)rease t+e +i6+ in)i1en)e o *re5enta0le
1iseases
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R.A.
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P.(. No. @@< re/ires t+e )o4*/lsor
i44/nization o all )+il1ren 0elo2 > rs. o a6ea6ainst t+e < )+il1+oo1 i44/niza0le 1iseases.
P.(. No. >:& *ro5i1es *enalt or i4*ro*er1is*osal o 6ar0a6e.
R.A. >=%@ Clean Air A)t o :###
P.(. No. >&< Co1e on Sanitation. It *ro5i1es ort+e )ontrol o all a)tors in 4ans en5iron4ent
t+at ae)t +ealt+ in)l/1in6 t+e /alit o 2ater,oo1, 4il!, inse)ts, ani4al )arriers, trans4itterso 1isease, sanitar an1 re)reation a)ilities,noise, *oll/tion an1 )ontrol o n/isan)e.
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R.A. stan1ar1izes t+e salar o 6o5ern4ent
e4*loees in)l/1in6 t+e n/rsin6 *ersonnel.R.A.
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R.A. =;#& Ma6na Carta or P/0li) Healt+
or!ers. T+is a)t ai4s$ to *ro4ote an1 i4*ro5e
t+e so)ial an1 e)ono4i) 2ell-0ein6 o +ealt+2or!ers, t+eir li5in6 an1 2or!in6 )on1itions an1
ter4s o e4*lo4entF to 1e5elo* t+eir s!ills an1
)a*a0ilities in or1er t+at t+e 2ill 0e 4oreres*onsi5e an1 0etter e/i**e1 to 1eli5er +ealt+
*roe)ts an1 *ro6ra4sF an1 to en)o/ra6e t+ose
2it+ *ro*er /alii)ations an1 e)ellent a0ilities
to oin an1 re4ain in 6o5ern4ent ser5i)e.
R.A. >%:; )reate1 t+e P+ili**ine Instit/te o
Tra1itional an1 Alternati5e Healt+ Care.
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P.(. No. @
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D RA %#=; a15o)ates +o4e treat4ent or
le*ros
D Letter o Instr/)tion No. @%@ le6al 0asis
o PHC 1ate1 OCT. "@, "@=@
- *ro4otes 1e5elo*4ent o +ealt+ *ro6ra4s
on t+e )o44/nit le5el
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D RA ;&=; re/ires re*ortin6 o all )ases
o )o44/ni)a0le 1iseases an1
a14inistration o *ro*+lais
D Ministr Cir)/lar No. : o "@>< in)l/1es
AI(S as notiia0le 1isease
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R.A. =>=& National Healt+ Ins/ran)e A)t
R.A. =%;: Senior Citizens A)t
R. A. =="@ - National Bloo1 Ser5i)es A)tR.A. >"=: Salt Io1ization A)t ASIN LA'
R.A. =:==- Ma6na Carta or P(s,
*ro5i1es t+eir re+a0ilitation, sel-1e5elo*4ent an1 sel-relian)e an1
inte6ration into t+e 4ainstrea4 o so)iet
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D A. O. No. :##&-##"%- National Poli)ies onInant an1 Yo/n6 C+il1 3ee1in6$
".All ne20orns 0e 0reastee1 2it+in " +r ater
0irt+:. Inants 0e e)l/si5el 0reastee1 or < 4os.
;. Inants 0e 6i5en ti4el, a1e/ate an1 sae
)o4*le4entar oo1s%. Breastee1in6 0e )ontin/e1 /* to : ears
an1 0eon1
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D EO &"- P+il. Co1e o Mar!etin6 o
Breast4il! S/0stit/tes
D R.A.- =
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D A..O. No. :##
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D A.O. No. :##
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P/0li) Healt+
D - science and art of preventing diasease,
prolonging life, promoting health and efficiency thruorganized community effort for the sanitation of theenvironment, control of communicable diseases,
the education of individuals in personal hygiene, theorganization of medical and nursing services forthe early diagnosis and preventive treatment ofdiseases and the development of social machineryto ensure everyone a standard of living adequate
for the maintenance of health, so organizing thesebenefits as to enable every citizen to realize hisbirthright off birth and longevity (R. C.E.inslo2'
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Co44/nit Healt+ N/rsin6
D - s*e)ial iel1 o n/rsin6 t+at )o40ines t+e
s!ills o n/rsin6, */0li) +ealt+ an1 so4e
*+ases o so)ial assistan)e an1 /n)tions
as *art o t+e total */0li) +ealt+ *ro6ra4or t+e *ro4otion o +ealt+, t+e
i4*ro5e4ent o t+e )on1itions in t+e so)ial
an1 *+si)al en5iron4ent, re+a0ilitation oillness an1 1isa0ilit HO E*ert
Co44ittee o N/rsin6 '
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CHN
D - a learne1 *ra)ti)e 1is)i*line 2it+ t+e /lti4ate
6oal o )ontri0/tin6 as in1i5i1/als an1 in
)olla0oration 2it+ ot+ers to t+e *ro4otion o t+e
)lients o*ti4/4 le5el o /n)tionin6 t+r/tea)+in6 an1 1eli5er o )are a)o0son '
D - a ser5i)e ren1ere1 0 a *roessional n/rse to
I3Cs, *o*/lation 6ro/*s in +ealt+ )enters,
)lini)s, s)+ools , 2or!*la)e or t+e *ro4tion o+ealt+, *re5entiono illness, )are o t+e si)! at
+o4e an1 re+a0ilitation (R. R/t+ B. 3ree4an'
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Conce&t'
D Te &r%6ar4 !oc,' o! co66,n%t4 ea"tn,r'%n %' ea"t &ro6ot%on.
D Co66,n%t4 ea"t n,r'e' &rov%e carenece''ar4 to 6eet te re,%re6ent' o! an
%n%v%,a" a"" tro,o,t te "%!e c4c"e.D no"ee on %!!erent !%e"' (/%o"o%ca" an
'oc%a" 'c%ence' c"%n%ca" n,r'%n an
co66,n%t4 ea"t oran%:at%on' %' ,'e.D N,r'%n &roce'' %n co66,n%t4 ea"t n,r'%ncane' /a'e on te nee' o! teco66,n%t4.
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=oa"D To ele5ate t+e le5el +ealt+ o t+e
4/ltit/1e.
D ort+ an1 1i6nit o 4an.
".T+e nee1 o t+e )o44/nit is t+e 0asis o
)o44/nit +ealt+ n/rsin6.:.T+e )o44/nit +ealt+ n/rse 4/st
/n1erstan1 /ll t+e o0e)ti5es an1*oli)ies o t+e a6en) s+e re*resents.
PhilosophyPhilosophy
PrinciplesPrinciples
* Te !a6%"4 %' te ,n%t o! 'erv%ce
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*. Te !a6%"4 %' te ,n%t o! 'erv%ce.
?. CHN 6,'t /e ava%"a/"e to a"" rear"e'' o!
racecree an 'oc%oecono6%c 'tat,'
5. Te CHN or' a' a 6e6/er o! te ea"t tea6
2. Tere 6,'t /e &rov%'%on !or &er%o%c eva",at%on
o! co66,n%t4 ea"t n,r'%n 'erv%ce'
7. O&&ort,n%t%e' !or cont%n,%n 'ta!! e,cat%on&rora6' !or n,r'e' 6,'t /e &rov%e /4 te
co66,n%t4 ea"t n,r'%n aenc4 an te CHN
a' e""
. Te CHN 6ae' ,'e o! ava%"a/"e co66,n%t4
ea"t re'o,rce'
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@. T+e CHN ta*s t+e alrea1 eistin6 a)ti5eor6anize1 6ro/*s in t+e )o44/nit
"#. T+ere 4/st 0e *ro5ision or e1/)ati5e
s/*er5ision in )o44/nit +ealt+ n/rsin6
"". T+ere s+o/l1 0e a))/rate re)or1in6 an1
re*ortin6 in )o44/nit +ealt+ n/rsin6
":. Healt+ tea)+in6 is t+e *ri4ar
res*onsi0ilit o t+e )o44/nit +ealt+ n/rse
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Stan1ar1s in CHN
I. T+eor
A**lies t+eoreti)al )on)e*ts as 0asis or
1e)isions in *ra)ti)e
II. (ata Colle)tion
Gat+ers )o4*re+ensi5e , a))/rate 1ata
sste4ati)all
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Stan1ar1s
III. (ia6nosis
Analzes )olle)te1 1ata to 1eter4ine t+e
nee1s? +ealt+ *ro0le4s o I3C
I7. Plannin6
At ea)+ le5el o *re5ention, 1e5elo*s *lans
t+at s*e)i n/rsin6 a)tions /ni/e tonee1s o )lients
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Stan1ar1s
7. Inter5ention
G/i1e1 0 t+e *lan, inter5enes to *ro4ote,
4aintain or restore +ealt+, *re5ent illness
an1 instit/te re+a0ilitation
7I. E5al/ation
E5al/ates res*onses o )lients to inter5entions
to note *ro6ress to2ar1 6oal a)+ie5e4ent,re5ise 1ata 0ase, 1ia6noses an1 *lan
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Stan1ar1s
7II. 9/alit Ass/ran)e an1 Proessional
(e5elo*4ent
Parti)i*ates in *eer re5ie2 an1 ot+er
4eans o e5al/ation to ass/re /alit o
n/rsin6 *ra)ti)e
Ass/4es *roessional 1e5elo*4ent
Contri0/tes to 1e5elo*4ent o ot+ers
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Stan1ar1s
I8. Resear)+
In1/l6es in resear)+ to )ontri0/te to t+eor
an1 *ra)ti)e in )o44/nit +ealt+
n/rsin6
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T*es o Clientele
D ". IN(I7I(UALS
D :. 3AMILIES
D ;. COMMUNITIES
D %. POPULATION GROUPS- A66re6ate o *eo*le 2+o s+are )o44on
)+ara)teristi)s, 1e5elo*4ental sta6e or )o44on
e*os/re to *arti)/lar en5iron4ental a)tors t+/s
res/ltin6 in )o44on +ealt+ *ro0le4s Clar!,
"@@&$&' e.6. )+il1ren . el1erl, 2o4en, 2or!ers et).
P+il H lt+ C ( li
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P+il.Healt+ Care (eli5er
Sste4D ".PRIMARY LE7EL 3ACILITIES
D:. SECON(ARY LE7EL 3ACILITIES
D ;. TERTIARY LE7EL 3ACILITIES
Cl i t + t l l t+
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Classi as to 2+at le5el t+e .
0elon6
D ". Tea)+in6 an1 Trainin6 Hos*itals
D :. Cit Healt+ Ser5i)es
D;. E4er6en) an1 (istri)t Hos*itals
D %. Pri5ate Pra)titioners
D &. Heart Instit/tes
D
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THE (EPARTMENT O3HEALTH
7ISION$ Healt+ or all 3ili*inosMISSION$ Ens/re a))essi0ilit /alit
o +ealt+ )are to i4*ro5e t+e /alit o
lie o all 3ili*inos, es*e)iall t+e *oor.
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NATIONAL OBECTI7ES". I4*ro5e t+e 6eneral +ealt+ stat/s o t+e *o*/lation
re1/)e inant 4ortalit rate, re1/)e )+il1 4oralit rate,re1/)e 4aternal 4ortalit rate, re1/)e total ertilit rate,in)rease lie e*e)tan) t+e /alit o lie ears'.
:. Re1/)e 4or0i1it, 4ortalit, 1isa0ilit )o4*li)ationsro4 (iarr+eas, Pne/4onias, T/0er)/losis, (en6/e,Intestinal Parasitis4, Se/all Trans4itte1 (iseases,He*atitis B, A))i1ent In/ries, (ental Caries Perio1ontal (iseases, Car1io5as)/lar (iseases,Can)er, (ia0etes, Ast+4a C+roni) O0str/)ti5e
P/l4onar (iseases, Ne*+ritis C+roni) Ji1ne(iseases, Mental (isor1ers, Protein Ener6Maln/trition, Iron (ei)ien) Ane4ia O0esit.
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;.Eli4inate t+e . 1iseases as */0li) +ealt+*ro0le4s$
D S)+istoso4iasis
D Malaria
D 3ilariasis
D Le*ros
D Ra0ies
D Measles
D Tetan/s
D (i*+t+eria Pert/ssis
D 7ita4in A (ei)ien) Io1ine (ei)ien)
(isor1ers
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%. Era1i)ate Polio4elitis
&. Pro4ote +ealt+ liestle t+ro/6+ +ealt+ 1iet n/trition, *+si)al a)ti5it itness, *ersonal
+6iene, 4ental +ealt+ less stress/l lie
*re5ent 5iolent ris!-ta!in6 0e+a5iors.
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=. Pro4ote en5iron4ental +ealt+ an1
s/staina0le 1e5elo*4ent t+ro/6+ t+e
*ro4otion an1 4aintenan)e o +ealt+
+o4es, s)+ools, 2or!*la)es,esta0lis+4ents an1 )o44/nities to2ns
an1 )ities.
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Pri4ar Strate6ies to A)+ie5e
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Pri4ar Strate6ies to A)+ie5e
Goals". In)reasin6 in5est4ent or Pri4ar Healt+
Care.
:. (e5elo*4ent o national stan1ar1s an1
o0e)ti5es or +ealt+.
;. Ass/ran)e o +ealt+ )are.
%. S/**ort to t+e lo)al sste4
1e5elo*4ent.
&. S/**ort or rontline +ealt+ 2or!ers.
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PHC as a Strate6
$RI+ARY HEA8TH CARE ($HC
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(
D Ma "@== -;#t+ orl1 Healt+ Asse40l
1e)i1e1 t+at t+e 4ain +ealt+ tar6et o t+e
6o5ern4ent an1 HO is t+e atta%n6ent o! a
"eve" o! ea"t tat o," &er6%t te6 to
"ea a 'oc%a""4 an econo6%ca""4 &ro,ct%ve"%!e /4 te 4ear 000.
D Se*te40er - 3irst International
Coneren)e on PHC in Al4a Ata, R/ssiaUSSR' T+e Al4a Ata(e)larationstate1 t+at
PHC 2as t+e !e to attain t+e K+ealt+ or all
6oal
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O)to0er "@, "@=@ - Letter o Instr/)tion LOI'
@%@', t+e le6al 0asis o PHC 2as si6ne1 0
Pres. 3er1inan1 E. Mar)os,
2+i)+ a1o*te1 PHC as an a**roa)+ to2ar1st+e 1esi6n, 1e5elo*4ent an1 i4*le4entation o
*ro6ra4s o)/sin6 on +ealt+ 1e5elo*4ent at
)o44/nit le5el.
RATIONALE FOR ADOPTING PRIMARY HEALTH CARE:
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RATIONALE FOR ADOPTING PRIMARY HEALTH CARE:
Ma6nit/1e o Healt+ Pro0le4sIna1e/ate an1 /ne/al 1istri0/tion o
+ealt+ reso/r)es
In)reasin6 )ost o 4e1i)al )areIsolation o +ealt+ )are a)ti5ities ro4
ot+er 1e5elo*4ent a)ti5ities
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=OA8 OF $RI+ARY HEA8TH CAREG
HEALTH FOR ALL FILIPINOS by the year
2000 AND HEALTH IN THE HANDS OF THEPEOPLE by the year 2020.
An i4*ro5e1 state o +ealt+ an1 /alit o lie or
all *eo*le attaine1 t+ro/6+ SE8F-RE8IANCE.EY STRATE=Y TO ACHIE@E THE =OA8G
Partners+i* 2it+ an1 E4*o2er4ent o t+e *eo*le-*er4eate as t+e )ore strate6 in t+e ee)ti5e*ro5ision o essential +ealt+ ser5i)es t+at are)o44/nit 0ase1, a))essi0le, a))e*ta0le, an1s/staina0le, at a )ost, 2+i)+ t+e )o44/nit an1 t+e6o5ern4ent )an aor1.
OBECTI@ES OF $RI+ARY HEA8TH CARE
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OBECTI@ES OF $RI+ARY HEA8TH CARE
I4*ro5e4ent in t+e le5el o +ealt+ )are o t+e )o44/nit
3a5ora0le *o*/lation 6ro2t+ str/)t/re
Re1/)tion in t+e *re5alen)e o *re5enta0le, )o44/ni)a0le
an1 ot+er 1isease.
Re1/)tion in 4or0i1it an1 4ortalit rates es*e)iall a4on6
inants an1 )+il1ren.Etension o essential +ealt+ ser5i)es 2it+ *riorit 6i5en to t+e
/n1erser5e1 se)tors.
I4*ro5e4ent in Basi) Sanitation
(e5elo*4ent o t+e )a*a0ilit o t+e )o44/nit ai4e1 at sel-relian)e.
Mai4izin6 t+e )ontri0/tion o t+e ot+er se)tors or t+e so)ial
an1 e)ono4i) 1e5elo*4ent o t+e )o44/nit.
+ISSION
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+ISSIONGD To stren6t+en t+e +ealt+ )are sste4 0
in)reasin6 o**ort/nities an1 s/**ortin6t+e )on1itions 2+erein *eo*le 2ill4ana6e t+eir o2n +ealt+ )are.
TO 8E@E8S OF $RI+ARY HEA8TH CAREORERS
". Baran6a Healt+ or!ers - traine1 )o44/nit
+ealt+ 2or!ers or +ealt+ a/iliar 5ol/nteers ortra1itional 0irt+ atten1ants or +ealers.
:. Inter4e1iate le5el +ealt+ 2or!ers in)l/1e t+e P/0li)Healt+ N/rse, R/ral Sanitar Ins*e)tor an1
4i12i5es.
$RINCI$8ES OF $RI+ARY HEA8TH CARE
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C S O C
1.? A' A))essi0ilit, A5aila0ilit,
Aor1a0ilit A))e*ta0ilit,A&&ro&r%atene'' o! ea"t 'erv%ce'. Teea"t 'erv%ce' 'o," /e &re'ent erete ',&&o'e rec%&%ent' are. Te4 'o,"
6ae ,'e o! te ava%"a/"e re'o,rce' %t%nte co66,n%t4 ere%n te !oc,' o," /e6ore on ea"t &ro6ot%on an &revent%ono! %""ne''.
2. CO++NITY $ARTICI$ATION+eart an1 so/l o PHC
D ;. $eo&"e are te center o/3ect an ',/3ect
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o! eve"o&6ent.D T+/s, t+e s/))ess o an /n1erta!in6 t+at ai4s at
ser5in6 t+e *eo*le is 1e*en1ent on *eo*les*arti)i*ation at all le5els o 1e)ision-4a!in6F *lannin6,i4*le4entin6, 4onitorin6 an1 e5al/atin6. An/n1erta!in6 4/st also 0e 0ase1 on t+e *eo*les
nee1s an1 *ro0le4s PC3, "@@#'D Part o t+e *eo*les *arti)i*ation is t+e *artners+i*0et2een t+e )o44/nit an1 t+e a6en)ies o/n1 in t+e)o44/nitF so)ial 4o0ilization an1 1e)entralization.
D In 6eneral, +ealt+ 2or! s+o/l1 start ro4 2+ere t+e*eo*le are an1 0/il1in6 on 2+at t+e +a5e. Ea4*le$S)+e1/lin6 o Baran6a Healt+ or!ers in t+e +ealt+)enter
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BARRIERS OF CO++NITY IN@O8@E+ENT
D La)! o 4oti5ation
D Attit/1e
D Resistan)e to )+an6eD (e*en1en)e on t+e *art o )o44/nit
*eo*le
D La)! o 4ana6erial s!ills
% SE8F RE8IANCE
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%.SE8F-RE8IANCE
&.$artner'%& /eteen te co66,n%t4
an te ea"t aenc%e' %n te
&rov%'%on o! ,a"%t4 o! "%!e.
Pro5i1in6 lin!a6es 0et2een t+e6o5ern4ent an1 t+e non-6o5ern4ent or6anization an1 *eo*les
or6anization.
2. Recon%t%on o! %nterre"at%on'%&
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/eteen te ea"t an eve"o&6ent
HEA8THD is not 4erel t+e a0sen)e o 1isease. Neit+er it is onla state o *+si)al an1 4ental 2ell-0ein6. Healt+
0ein6 a so)ial *+eno4enon re)o6nizes t+e inter*la o*oliti)al, so)io-)/lt/ral an1 e)ono4i) a)tors as its
1eter4inant. Goo1 Healt+ t+ereore, is 4anieste1 0t+e *ro6ressi5e i4*ro5e4ents in t+e li5in6 )on1itionsan1 /alit o lie enoe1 0 t+e )o44/nit resi1entsPC3, DE@E8O$+ENTis t+e /est or an i4*ro5e1/alit o lie or all. (e5elo*4ent is 4/lti-1i4ensional. It +as a *oliti)al, so)ial, )/lt/ral,instit/tional an1 en5iron4ental 1i4ensionsGonzales"@@%'. T+ereore, it is 4eas/re1 0 t+e a0ilit o*eo*le to satis t+eir 0asi) nee1s.
7 SOCIA8 +OBI8I
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7. SOCIA8 +OBI8I
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J
CAREA. E8E@ATIN= HEA8TH TO A CO+$REHENSI@E
AND SSTAINED NATIONA8 EFFORTS.D Attainin6 Healt+ or all 3ili*ino 2ill re/ire
e*an1in6 *arti)i*ation in +ealt+ an1 +ealt+ relate1
*ro6ra4s 2+et+er as ser5i)e *ro5i1er or 0enei)iar.
E4*o2er4ent to *arents, a4ilies an1 )o44/nities to
4a!e 1e)isions o t+eir +ealt+ is reall t+e 1esire1
o/t)o4e.
D A15o)a) 4/st 0e 1ire)te1 to National an1 Lo)al*oli) 4a!in6 to eli)it s/**ort an1 )o44it4ent to
4aor +ealt+ )on)erns t+ro/6+ le6islations, 0/16etar
an1 lo6isti)al )onsi1erations.
B. $RO+OTIN= AND S$$ORTIN= CO++NITY
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O O = S O = CO
+ANA=ED HEA8TH CARE
T+e +ealt+ in t+e +an1s o t+e *eo*le0rin6s t+e 6o5ern4ent )losest to t+e
*eo*le. It ne)essitates a *ro)ess o
)a*a)it 0/il1in6 o )o44/nities an1or6anization to *lan, i4*le4ent an1
e5al/ate +ealt+ *ro6ra4s at t+eir
le5els.
C. INCREASIN= EFFICIENCIES IN THE
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HEA8TH SECTOR
D Usin6 a**ro*riate te)+nolo6 2ill 4a!e
ser5i)es an1 reso/r)es re/ire1 or t+eir1eli5er, ee)ti5e, aor1a0le, a))essi0le an1
)/lt/rall a))e*ta0le. T+e 1e5elo*4ent o
+/4an reso/r)es 4/st )orres*on1 to t+ea)t/al nee1s o t+e nation an1 t+e *oli)ies it
/*+ol1s s/)+ as PHC. T+e (OH 2ill )ontin/e
to s/**ort an1 assist 0ot+ */0li) an1 *ri5ateinstit/tions *arti)/larl in a)/lt 1e5elo*4ent,
en+an)e4ent o rele5ant )/rri)/la an1
1e5elo*4ent o stan1ar1 tea)+in6 4aterials.
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D. AD@ANCIN= ESSENTIA8 NATIONA8
HEA8TH RESEARCHEssential National Healt+
Resear)+ ENHR' is an inte6rate1
strate6 or or6anizin6 an14ana6in6 resear)+ /sin6interse)toral, 4/lti-1is)i*linar an1
s)ientii) a**roa)+ to +ealt+*ro6ra44in6 an1 1eli5er.
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D FOR CORNERSTONESJ $I88ARS IN
$RI+ARY HEA8TH CARE
". A)ti5e Co44/nit Parti)i*ation
:. Intra an1 Inter-se)toral Lin!a6es
;. Use o A**ro*riate Te)+nolo6%. S/**ort 4e)+anis4 4a1e a5aila0le
HERBA8 +EDICINES ENDORSED BY THE
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HERBA8 +EDICINES ENDORSED BY THEDE$ART+ENT OF HEA8TH
Na4e In1i)ations (osa6e".3i5e-lea
C+aste tree
La6/n1i'
". Ast+4a
:. Co/6+
;. Bo1 Pain%. 3e5er
D(i5i1e t+e 1e)o)tioninto ; *arts$
3or ast+4a an1)o/6+, 1rin! " *art ;
ti4es a 1a.
3or e5er an1 0o1
*ains, 1rin! " *arte5er % +rs.
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:.Mars+-MintFPe**er4int
Yer0aB/ena'
". Bo1 *ain D(i5i1e1e)o)tion into
: *arts an11rin! " *arte5er ; +o/rs.
;.Sa40on6 ". S2ellin6
:. In1/)in6
1i/resis anti-
/rolit+iasis'
D(i5i1e1e)o)tion into
; *arts an11rin! " *art ;ti4es a 1a.
%.Tsaan6G 0 t
". Sto4a)+a)+e D(rin! t+e 2ar41e)o)tion I it
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G/0at 1e)o)tion. I it*ersists, or i t+ere isno i4*ro5e4ent an
+o/r ater 1rin!in6 t+e1e)o)tion, )ons/lt a1o)tor.
&.
Ulasi4an6Bato?Pansit-Pansitan
". Go/t Art+ritis D(i5i1e t+e
1e)o)tion into ;*arts an1 1rin! "*art ; ti4es a 1aater 4eals.
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:. Ht*erli*i1e4ia 6arli) to6et+er2it+ 4eals
=.Nio6-Nio6an
". As)ariasis DC+e2 an1 s2allo2onl 1rie1 see1s :+o/rs ater 1innera))or1in6 to t+eollo2in6$
D A(ULTS >-"# see1s
@-": ?o .G/a5a ". Cleanin6 D3or 2o/n1 )leanin6,
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62o/n1s
:. Mo/t+ 2as+
or 4o/t+ine)tion,sore 6/4s toot+ 1e)a
6,/se 1e)o)tion or2as+in6 t+e 2o/n1 :
ti4es a 1aD3or toot+ 1e)a an1s2ellin6 o 6/4s,6ar6le 2it+ 2ar4
1e)o)tion ; ti4es a 1a
@.A!a*/l!o
". Rin6 2or4: At+letes
DA**l t+e /i)e on t+e ae)te1area " to : ti4es a 1a
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A!a*/l!o :. At+lete soot
;. S)a0ies
DI t+e *erson 1e5elo*s an aller62+ile /sin6 t+e a0o5e *re*aration,
*re*are t+e ollo2in6$oP/t " )/* o )+o**e1 res+ lea5esin an eart+en ar. Po/r in : 6lasseso 2ater an1 )o5er it.
oBoil t+e 4it/re /ntil t+e :6lasses o 2ater ori6inall *o/re1+a5e 0een re1/)e1 to " 6lass o2ater
oStrain t+e 4it/re. Use it 2+ile it
is 2ar4.oA**l t+e 2ar4 1e)o)tion on t+e
ae)te1 area " to : ti4es a 1a.
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"#.Bitter Go/r1?Melon
A4*alaa'
". Mil1 Non-Ins/lin(e*en1e
nt(ia0etesMellit/s
D(rin! )/*o )oole1 or2ar4
1e)o)tion ;ti4es a 1aater 4eals.
"".Gin6er
". Motionsi)!ness
DAn a0ortia)ient i ta!enin lar6e a4o/ntsF s+o/l1
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Gin6er
in6i0er
oi)inale'
si)!ness,sore t+roat,na/sea 5o4itin6,4i6raine+ea1a)+es,art+ritis
in lar6e a4o/ntsF s+o/l1not 0e /se1 0 *ersons2it+ )+olelit+iasis /nless1ire)te1 0 t+e *+si)ianF4a in)rease t+e ris! o0lee1in6 2+en /se1)on)/rrentl 2it+anti)oa6/lants anti*latelets.
DC+o* an1 Mas+ a *ie)e o6in6er root, an1 4i in a 6lass
o 2aterDBoil t+e 4it/re
D(rin! t+e )oole1 or 2ar41e)o)tion as nee1e1.
E8E+ENTS OF $RI+ARY HEA8THCAREG
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CAREG
Is one o t+e *otent 4et+o1olo6ies
or inor4ation 1isse4ination. It
*ro4otes t+e *artners+i* o 0ot+ t+ea4il 4e40ers an1 +ealt+ 2or!ers in
t+e *ro4otion o +ealt+ as 2ell as
*re5ention o illness.
E!"c#$ion For He#l$h
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T+e )ontrol o en1e4i) 1isease
o)/ses on t+e *re5ention o its
o))/rren)e to re1/)e 4or0i1itrate. Ea4*le Malaria Control
an1 S)+istoso4iasis Control
Locally Endemic Disease
Control
E&ane $rora6 on
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T+is *ro6ra4 eists to )ontrol t+eo))/rren)e o *re5enta0le illnesses
es*e)iall o )+il1ren 0elo2 < ears
ol1. I44/nizations on *olio4elitis,4easles, tetan/s, 1i*+t+eria an1
ot+er *re5enta0le 1isease are 6i5en
or ree 0 t+e 6o5ern4ent an1
on6oin6 *ro6ra4 o t+e (OH
I66,n%:at%on
M#$ern#l #n! Chil! He#l$h #n!
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T+e 4ot+er an1 )+il1 are t+e 4ost
1eli)ate 4e40ers o t+e )o44/nit.
So t+e *rote)tion o t+e 4ot+er an1)+il1 to illness an1 ot+er ris!s 2o/l1
ens/re 6oo1 +ealt+ or t+e
)o44/nit. T+e 6oal o 3a4ilPlannin6 in)l/1es s*a)in6 o )+il1ren
an1 res*onsi0le *arent+oo1.
M#$ern#l #n! Chil! He#l$h #n!
F#%ily Pl#nnin&
Env%ron6enta" San%tat%on an
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En5iron4ental Sanitation is 1eine1 as t+est/1 o all a)tors in t+e 4ans en5iron4ent,
2+i)+ eer)ise or 4a eer)ise 1eleterio/s
ee)t on +is 2ell-0ein6 an1 s/r5i5al.
ater is a 0asi) nee1 or lie an1 one a)tor in
4ans en5iron4ent. ater is ne)essar or
t+e 4aintenan)e o +ealt+ liestle.
Sae ater an1 Sanitation is ne)essar or
0asi) *ro4otion o +ealt+.
$ro6ot%on o! Sa!e ater S,&&"4
N"$ri$ion #n! Pro%o$ion o' A!e("#$e
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One 0asi) nee1 o t+e a4il is oo1. An1i oo1 is *ro*erl *re*are1 t+en one 4a
0e ass/re1 +ealt+ a4il. T+ere are
4an oo1 reso/r)es o/n1 in t+e)o44/nities 0/t 0e)a/se o a/lt
*re*aration an1 la)! o !no2le16e
re6ar1in6 *ro*er oo1 *lannin6,Maln/trition is one o t+e *ro0le4s t+at 2e
+a5e in t+e )o/ntr.
N"$ri$ion #n! Pro%o$ion o' A!e("#$e
Foo! )"pply
Treat6ent o! Co66,n%ca/"e
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T+e 1iseases s*rea1 t+ro/6+ 1ire)t)onta)t *ose a 6reat ris! to t+ose 2+o )an0e ine)te1. T/0er)/losis is one o t+e)o44/ni)a0le 1iseases )ontin/o/sl
o))/*ies t+e to* ten )a/ses o 1eat+. Most)o44/ni)a0le 1iseases are also*re5enta0le. T+e Go5ern4ent o)/ses ont+e *re5ention, )ontrol an1 treat4ent ot+ese illnesses.
D%'ea'e' an Co66on I""ne''
)"pply o' Essen$i#l Dr"&s
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T+is o)/ses on t+e inor4ation )a4*ai6n on t+e /tilization an1a)/isition o 1r/6s.
In res*onse to t+is )a4*ai6n, t+e GENERIC ACT o t+eP+ili**ines is ena)te1 . It in)l/1es t+e ollo2in6 1r/6s$Cotri4oazole, Para)eta4ol, A4o)illin, Oresol, Nie1i*ine,Ria4*i)in, INHisoniazi1' an1 Prazina4i1e,Et+a40/tol,Stre*to4)in,Al0en1azole,9/inine
)"pply o' Essen$i#l Dr"&s
3AMILY HEALTH NURSING
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3AMILY HEALTH NURSING
D - t+at le5el o CHN *ra)ti)e 1ire)te1 tot+e 3AMILY as t+e /nit o )are 2it+
HEALTH as t+e 6oal an1 NURSING as
t+e 4e1i/4, )+annel or *ro5i1er o )are
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T*es o 3a4ilies
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T*es o 3a4ilies
D >. Sin6le a1/lt li5in6 alone
D @. Co+a0itin6? Li5in6 in
D "#. No- !in
D "". Co4*o/n1
D ":. Ga
D "%. Co44/ne
Sta6es o 3a4il Lie C)le
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Sta6es o 3a4il Lie C)le
D ". Ne2l 4arrie1 )o/*leD :. C+il10earin6
D ;. Pres)+ool a6e
D %. S)+oola6eD &. Teena6e
D
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3AMILY 3ree4an, "@>"'
D ". re)o6nizin6 interr/*tions o +ealt+ or1e5elo*4ent
D :. see!in6 +ealt+ )are
D;. 4ana6in6 +ealt+ an1 non-+ealt+ )risesD %. *ro5i1in6 n/rsin6 )are to t+e si)!, 1isa0le1 an1
1e*en1ent 4e40er o t+e a4il
D &. 4aintainin6 a +o4e en5iron4ent )on1/)i5e to
6oo1 +ealt+ an1 *ersonal 1e5elo*4entD
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3a4il N/rsin6 Pro0le4
D Arises 2+en t+e a4il )annot ee)ti5el*eror4 its +ealt+ tas!s
N/rses Roles in 3a4il Healt+
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N/rsin6
D ". HEALTH MONITOR
D :. PRO7I(ER O3 CARE TO A SICJ
3AMILY MEMBERD ;. COOR(INATOR O3 3AMILY
SER7ICES
D %. 3ACILITATORD &. TEACHER
D
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NURSING PRACTICE
D 3a4il str/)t/re, C+ara)teristi)s, an1(na4i)s
". Me40ers o t+e +o/se+ol1 an1 relations+i*
to t+e +ea1 o t+e a4il:. (e4o6ra*+i) 1ata a6e, se, )i5il stat/s,
*osition in t+e a4il
;. Pla)e o resi1en)e o ea)+ 4e40er 2+et+er li5in6 2it+ t+e a4il or else2+ere
%.T*e o a4il str/)t/re e.6.
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4atriar)+al or *atriar)+al, n/)lear or
eten1e1&. (o4inant a4il 4e40ers in ter4s o
1e)ision-4a!in6, es*e)iall in 4atters
o +ealt+ )are
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C+ara)teristi)s
". In)o4e an1 E*enses O))/*ation, *la)e o 2or! an1 in)o4e o
ea)+ 2or!in6 4e40ers
A1e/a) to 4eet 0asi) ne)essities
+o 4a!es 1e)isions a0o/t 4one an1
+o2 it is s*ent
:. E1/)ational attain4ent o ea)+ ot+er
;. Et+ni) 0a)!6ro/n1 an1 reli6io/s
ailiation
% Si6nii)ant Ot+ers roles'
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%. Si6nii)ant Ot+ers roles'
t+e *la in a4ils lie&. Relations+i* o t+e a4il to
lar6er )o44/nit Nat/rean1 etent o *arti)i*ation ot+e a4il in )o44/nit
a)ti5ities
D Ho4e an1 En5iron4ent
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". Ho/sin6
A1e/a) o li5in6 *ea)e Slee*in6 arran6e4ent
Presen)e o 0ree1in6 or restin6 sites o5e)tors o 1iseases
Presen)e o a))i1ents +azar1s
3oo1 stora6e an1 )oo!in6 a)ilities
ater s/**l so/r)e, o2ners+i*, *orta0ilit
Toilet a)ilit t*e, o2ners+i*, sanitar)on1ition
(raina6e sste4 t*e, sanitar )on1ition
: Ji 1 i +0 + 1
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:. Jin1 o nei6+0or+oo1, e.6.
)on6este1, sl/4, et).;. So)ial an1 +ealt+ a)ilities
a5aila0le%. Co44/ni)ation an1
trans*ortation a)ilitiesa5aila0le
D Healt+ Stat/s o ea)+ 3a4il Me40er
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". Me1i)al an1 n/rsin6 +istor in1i)atin6)/rrent or *ast si6nii)ant illnesses or0elies an1 *ra)ti)es )on1/)i5e to +ealt+illness
:. N/tritional assess4ent
Ant+ro*o4etri) 1ata$ Meas/res o n/tritionalstat/s o )+il1ren, 2ei6+t, +ei6+t, 4i1-/**erar4 )ir)/4eren)e$ Ris! assess4ent4eas/res o o0esit$ 0o1 4ass in1e, 2aist
)ir)/4eren)e, 2aist +i* ratio (ietar +istor s*e)iin6 /alit an1 /antit
o oo1?n/trient inta!e *er 1a
Eatin6? ee1in6 +a0its? *ra)ti)es
;.(e5elo*4ental assess4ents o inants,
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*
to11lers, an1 *res)+oolers e.6., Metro
Manila%.Ris! a)tor assess4ent in1i)atin6 *resen)e
o 4aor an1 )ontri0/tin6 4o1iia0le ris!
a)tors or s*e)ii) liestles, )i6arettes4o!in6, ele5ate1 0loo1 li*i1s, o0esit,
1ia0etes 4ellit/s, ina1e/ate i0er inta!e,
stress, al)o+ol 1rin!in6 an1 ot+er s/0stan)e
a0/se
& P+si)al assess4ent
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&.P+si)al assess4ent
in1i)atin6 *resen)e o illnessstate?s
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Pro4otion, Maintenan)e an1 (iseasePre5ention.
Ea4*les in)l/1e$
". I44/nization stat/s o a4il 4e40ers
:. Healt+ liestle *ra)ti)es. S*e)i.
;. A1e/a) o$ rest an1 slee* eer)ise /se o *rote)ti5e 4eas/res- e.6. a1e/ate
oot2ear in *arasite-ineste1 areasF relaation an1 ot+er stress 4ana6e4enta)ti5ities
%. Use o *ro4oti5e-*re5enti5e +ealt+ ser5i)es
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A TYPOLOGY O3 NURSING
PROBLEMS IN 3AMILY NURSINGPRACTICE
3IRST-LE7EL ASSESSMENT
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3IRST LE7EL ASSESSMENTI. Presen)e o ellness Con1ition state1 as
Potential or Rea1iness- a )lini)al or n/rsin6/164ent a0o/t a )lient in transition ro4 as*e)ii) le5el o 2ellness or )a*a0ilit to a+i6+er le5el. e""ne'' &otent%a"is a n/rsin6
/164ent on 2ellness state or )on1ition 0ase1
on )lients *eror4an)e, )/rrent )o4*eten)iesor )lini)al 1ata 0/t no e*li)it e*ression o)lient 1esire. Rea%ne'' !or enancee""ne''state is a n/rsin6 /164ent on2ellness state or )on1ition 0ase1 on )lients
)/rrent )o4*eten)ies or *eror4an)e, )lini)al1ata e*li)it e*ression o 1esire to a)+ie5e a+i6+er le5el o state or /n)tion in s*e)ii) areaon +ealt+ *ro4otion an1 4aintenan)e.
D Ea4*les o t+ese are t+e ollo2in6$
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". Potential or En+an)e1 Ca*a0ilit or$
Healt+ liestle e.6. n/trition?1iet,eer)ise? a)ti5it
Healt+ Maintenan)e
Parentin6
Breastee1in6
S*irit/al ell-0ein6 *ro)ess o a )lients
/nol1in6 o 4ster t+ro/6+ +ar4onio/s
inter)onne)te1ness t+at )o4es ro4 innerstren6t+?sa)re1 so/r)e?GO( NAN(A :##"'
Ot+ers,
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I. Presen)e o Healt+ T+reats
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)on1itions t+at are )on1/)i5e to
1isease, a))i1ent or ail/re to*realize ones +ealt+ *otential.
Ea4*les o t+ese are t+e ollo2in6$
". 3a4il +istor o +ere1itar
)on1ition, e.6. 1ia0etes
:. T+reat o )ross ine)tion ro4 a)o44/ni)a0le 1isease )ase
;. 3a4il size 0eon1 2+at a4il
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reso/r)es )an a1e/atel
*ro5i1e
%. A))i1ental +azar1s
Bro!en stairs
S+ar* o0e)ts, *oison, an1
4e1i)ines i4*ro*erl !e*t3ire +azar1s
&. 3a/lt n/tritional +a0its or
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ee1in6 *ra)ti)es.
Ina1e/ate oo1 inta!e 0ot+ in
/alit /antit
E)essi5e inta!e o )ertainn/trients
3a/lt eatin6 +a0its
Inee)ti5e 0reastee1in6
3a/lt ee1in6 *ra)ti)es
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Ina1e/ate li5in6
s*a)e La)! o oo1 stora6e
a)ilities
Poll/te1 2ater s/**l
Presen)e o 0ree1in6
sites o 5e)tors o
1isease I4*ro*er 6ar0a6e
Unsanitar
2aste 1is*osal I4*ro*er
1raina6e
sste4 Poor 5entilation
Noise *oll/tion
Air *oll/tion
>. Unsanitar oo1 +an1lin6 an1 *re*aration
@ Un+ealt+/l liestles an1 *ersonal +a0its-
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@. Un+ealt+/l liestles an1 *ersonal +a0its Al)o+ol 1rin!in6
Ci6arette s4o!in6 Ina1e/ate oot2ear
Eatin6 ra2 4eat
Poor *ersonal +6iene
Sel-4e1i)ation
Se/al *ro4is)/it
En6a6in6 in 1an6ero/s s*orts
Ina1e/ate rest La)! o ina1e/ate eer)ise
La)! o relaation a)ti5ities
Non-/se o sel *rote)tion 4eas/res
"#.In+erent *ersonal )+ara)teristi)s e.6.
*oor i4*/lse )ontrol
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*oor i4*/lse )ontrol
"".Healt+ +istor 2+i)+ in1/)e t+eo))/rren)e o a +ealt+ 1ei)it, e.6.
*re5io/s +istor o 1ii)/lt la0or
":.Ina**ro*riate role ass/4*tion e.6.)+il1 ass/4in6 4ot+ers role, at+er not
ass/4in6 +is role
";.La)! o i44/nization? ina1e/atei44/nization stat/s s*e)iall o
)+il1ren
"% 3a4il 1is/nit
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"%.3a4il 1is/nit
Sel-oriente1 0e+a5ior o4e40ers'
Unresol5e1 )onli)ts o
4e40ers'
Intolera0le 1isa6ree4ent
Ot+er"&.Ot+er
III. Presen)e o Healt+ (ei)its
i t il i + lt+
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instan)es o ail/re in +ealt+
4aintenan)e.Ea4*les in)l/1e$
". Illness states, re6ar1less o 2+et+er it
is 1ia6nose1 or 0 4e1i)al *ra)titioner:. 3ail/re to t+ri5e? 1e5elo* a))or1in6 to
nor4al rate
;. (isa0ilit 2+et+er )on6enital or
arisin6 ro4 illnessF te4*orar
I7. Presen)e o stress Points? 3oreseea0le Crisis
Sit/ations anti)i*ate1 *erio1s o /n/s/al 1e4an1
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* *
o t+e in1i5i1/al or a4il in ter4s o a4il
reso/r)es.Ea4*les o t+ese in)l/1e$
". Marria6e @. Meno*a/se
:. Pre6nan) "#. Loss o o0
;. Parent+oo1 "". Hos*italization o a%. A11itional 4e40er a4il 4e40er
&. A0ortion ":. (eat+ o a 4anner
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Se)on1 Le5el Assess4ent
D 3o)/s on 1eter4inin6 a4ils )a*a)it to *eror4 t+e+ealt+ tas!s
D State4ents on a4il +ealt+ n/rsin6 *ro0le4$
a. Ina0ilit to re)o6nize t+e *resen)e o t+e )on1ition or*ro0le4
0. Ina0ilit to 4a!e 1e)isions 2it+ res*e)t to ta!in6a**ro*riate +ealt+ a)tion
). Ina0ilit to *ro5i1e a1e/ate n/rsin6 )are to t+e si)!,1isa0le1 , 1e*en1ent or 5/lnera0le 4e40er o t+e a4il
1. Ina0ilit to *ro5i1e a +o4e en5iron4ent )on1/)i5e to+ealt+ 4aintenan)e or *ersonal 1e5elo*4ent
e. 3ail/re to /tilize )o44/nit reso/r)es or +ealt+ )are
S)ale or Ran!in6 Healt+Con1itions an1 Pro0le4s a))or1in6
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6
to *rioritiesD Criteria$a. Nat/re o t+e )on1ition or *ro0le4 *resente1
2ellness state, +ealt+ 1ei)it, +ealt+ t+reat,
orseea0le )risis'0. Mo1iia0ilit o t+e )on1ition or *ro0le4
easil, *artiall, not 4o1iia0le'
). Pre5enti5e Potential +i6+, 4o1erate , lo2'1. Salien)e nee1s i44e1iate attention, not
i44e1iate, not *er)ei5e1 as a *ro0le4'
COMMUNITY HEALTH CARE
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PROCESSD Assess4ent$,r&o'e G To %ent%!4 te ea"t nee' o! te &eo&"e
D Plannin6 o n/rsin6 a)tions
$,r&o'e G To act on te eter6%ne nee' o! teco66,n%t4 &eo&"e
D I4*le4entation
$,r&o'e G To ac%eve te o&t%6,6 "eve" o! ea"t o!
te co66,n%t4 &eo&"eD E5al/ation
P/r*ose $ To 1eter4ine t+e ee)ti5eness o +ealt+ )are*ro6ra4s
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D ISOLATION TECHNI9UE IN THE HOME
-one /4 G
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4
1. 'e&arat%n te art%c"e' ,'e /4 a c"%ent
%t co66,n%ca/"e %'ea'e to &revent te'&rea o! %n!ect%onG
. !re,ent a'%n an a%r%n o! /e%n'
an oter art%c"e' an %'%n!ect%on' o! roo6
*. ear%n a &rotect%ve on to /e ,'e on"4
%t%n te roo6 o! te '%c 6e6/er
?. %'car%n &ro&er"4 a"" na'a" an troat
%'care' o! an4 6e6/er '%c %t
co66,n%ca/"e %'ea'e
5. /,rn%n a"" 'o%"e art%c"e' %! co," /e orconta6%nate art%c"e' /e /o%"e !%r't %n
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ater *0 6%n,te' /e!ore "a,ner%n
D INTRA@ENOS THERA$Y- %n'ert%on o! a nee"e or cateter %nto a
ve%n to &rov%e 6e%cat%on an !",%'
/a'e on &4'%c%an;' r%tten &re'cr%&t%on- can /e one on"4 /4 n,r'e' accre%te /4
ANSA$
PRINCIPLES O3 HEALTH
E(UCATION
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E(UCATION
D It )onsi1ers t+e +ealt+ stat/s o t+e*eo*le, 2+i)+ is 1eter4ine1 0 t+e
e)ono4i) an1 so)ial )ons)ien)e o t+e
)o/ntr.D It is a *ro)ess 2+ere0 *eo*le learn to
i4*ro5e t+eir *ersonal +a0its an1
attit/1es, to 2or! res*onsi0l or t+ei4*ro5e4ent o +ealt+ )on1itions o t+e
a4il, )o44/nit, an1 nation.
D It in5ol5es 4oti5ation e*erien)e
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D It in5ol5es 4oti5ation, e*erien)e,
an1 )+an6e in )on1/)t an1 t+in!in6,2+ile sti4/latin6 a)ti5e interest. It
1e5elo*s an1 *ro5i1es e*erien)e
or )+an6e in *eo*les attit/1es,)/sto4s, an1 +a0its in relation to
+ealt+ an1 e5er1a li5in6.
D It s+o/l1 0e re)o6nize1 as t+e 0asi)/n)tion o all +ealt+ 2or!ers.
It t ! l i t+ + i t+
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D It ta!es *la)e in t+e +o4e, in t+e
s)+ool, an1 in t+e )o44/nit.D It is a )oo*erati5e eort re/irin6
all )ate6ories o +ealt+*ersonnel to 2or! to6et+er in
)lose tea42or! 2it+ a4ilies,
6ro/*s, an1 t+e )o44/nit.
D It 4eets t+e nee1s interests
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It 4eets t+e nee1s, interests,
an1 *ro0le4s o t+e *eo*leae)te1.
D It in1s 4eans an1 2as o
)arrin6 o/t *lans 0en)o/ra6in6 in1i5i1/al an1
)o44/nit *arti)i*ation.
D It is a slo2 )ontin/o/s *ro)ess
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D It is a slo2, )ontin/o/s *ro)ess
t+at in5ol5es )onstant )+an6esan1 re5isions /ntil o0e)ti5es are
a)+ie5e1.
D Ma!es /se o s/**le4entar
ai1s an1 1e5i)es to +el* 2it+ t+e
5er0al instr/)tions.
D It /tilizes )o44/nit reso/r)es 0
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It /tilizes )o44/nit reso/r)es 0
)are/l e5al/ation o t+e 1ierent
ser5i)es an1 reso/r)es o/n1 in t+e
)o44/nit.
D It is a )reati5e *ro)ess re/irin64et+o1s an1 te)+ni/es 2it+ 5ario/s
)+ara)teristi)s, not ollo2in6 a ri6i1
an1 lei0le *attern.
D It ai4s to +el* *eo*le 4a!e /se o
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t+eir o2n eorts an1 e1/)ation to
i4*ro5e t+eir )on1itions o li5in6,
D It 4a!es )are/l e5al/ation o t+e
*lannin6, or6anization, an1
i4*le4entation o all +ealt+
e1/)ation *ro6ra4s an1 a)ti5ities.
THE COMMUNITY HEALTH
NURSE
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NURSE
D K,a"%!%cat%on'
".Ba)+elor o S)ien)e in
N/rsin6
:.Re6istere1 N/rse o t+eP+ili**ines
D $"annerJ$rora66er
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". I1entiies nee1s, *riorities, an1 *ro0le4s o
in1i5i1/als, a4ilies, an1 )o44/nities:. 3or4/lates 4/ni)i*al +ealt+ *lan in t+e a0sen)e
o a 4e1i)al 1o)tor
;. Inter*rets an1 i4*le4ents n/rsin6 *lan, *ro6ra4*oli)ies, 4e4oran1a, an1 )ir)/lar or t+e
)on)erne1 sta *ersonnel
%. Pro5i1es te)+ni)al assistan)e to r/ral +ealt+
4i12i5es in +ealt+ 4atters
D $rov%er o! N,r'%n
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Care". Pro5i1es 1ire)t n/rsin6 )are to si)! or1isa0le1 in t+e +o4e, )lini), s)+ool, or
2or!*la)e:. (e5elo*s t+e a4ils )a*a0ilit to ta!e
)are o t+e si)!, 1isa0le1, or
1e*en1ent 4e40er
D +anaerJS,&erv%'or
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1. For6,"ate' %n%v%,a" !a6%"4 ro,& an
co66,n%t4-centere &"an. Inter&ret' an %6&"e6ent' &rora6'
&o"%c%e' 6e6orana an c%rc,"ar'
*. Oran%:e' or !orce re'o,rce'e,%&6ent' an ',&&"%e' at "oca" "eve"
?. $rov%e' tecn%ca" an a6%n%'trat%ve
',&&ort to R,ra" Hea"t +%%ve' (RH+5. Con,ct' re,"ar ',&erv%'or4 v%'%t' an6eet%n' to %!!erent RH+' an %ve'!ee/ac on acco6&"%'6ent'
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D Coor%nator o! Serv%ce'
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". Coor1inates 2it+ in1i5i1/als,
a4ilies, an1 6ro/*s or +ealt+relate1 ser5i)es *ro5i1e1 0 5ario/s
4e40ers o t+e +ealt+ tea4
:. Coor1inates n/rsin6 *ro6ra4 2it+
ot+er +ealt+ *ro6ra4s li!e
en5iron4ental sanitation, +ealt+e1/)ation, 1ental +ealt+, an1 4ental
+ealt+
D Tra%nerJHea"t E,cator1 Ient%!%e' an %nter&ret' tra%n%n nee'
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1. Ient%!%e' an %nter&ret' tra%n%n nee'o! te RH+' Barana4 Hea"t orer'
(BH an %"ot'. Con,ct' tra%n%n !or RH+' an %"ot'
on &ro6ot%on an %'ea'e &revent%on
*. Con,ct' &re an &o't-con',"tat%oncon!erence' !or c"%n%c c"%ent') act' a' are'o,rce '&eaer on ea"t an ea"t-re"ate 'erv%ce'
?. In%t%ate' te ,'e o! tr%-6e%a (ra%oJT@c%ne6a &",' an &r%nt a' !or ea"te,cat%on &,r&o'e'
5. Con,ct' &re-6ar%ta" co,n'e"%n
D Hea"t +on%tor
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". (ete)ts 1e5iation ro4 +ealt+o in1i5i1/als, a4ilies,
6ro/*s, an1 )o44/nities
t+ro/6+ )onta)ts?5isits 2it+
t+e4
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D Cane Aent
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". Moti5ates )+an6es in +ealt+
0e+a5ior in in1i5i1/als,
a4ilies, 6ro/*s, an1
)o44/nities t+at also
in)l/1e liestle in or1er to
*ro4ote an1 4aintain +ealt+
D RecorerJRe&orterJStat%'t%c%an
" Pre*ares an1 s/04its re/ire1
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". Pre*ares an1 s/04its re/ire1
re*orts an1 re)or1s:. Maintain a1e/ate, a))/rate, an1
)o4*lete re)or1in6 an1 re*ortin6
;. Re5ie2s, 5ali1ates, )onsoli1ates,
analzes, an1 inter*rets all re)or1s
an1 re*orts%. Pre*ares statisti)al 1ata?)+art an1 ot+er
1ata *resentation
D Re'earcer
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". Parti)i*ates in t+e )on1/)t os/r5e st/1ies an1 resear)+es on
n/rsin6 an1 +ealt+-relate1
s/0e)ts:. Coor1inates 2it+ 6o5ern4ent an1
non-6o5ern4ent or6anization in
t+e i4*le4entation o
st/1ies?resear)+
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Co44/nit Or6anizin6
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D Prin)i*les o CO$D ". Peo*le es*. t+e o**resse1, e*loite1 an1
1e*ri5e1 se)tors are 4ost o*en to )+an6e,
+a5e t+e )a*a)it to )+an6e an1 are a0le to0rin6 a0o/t )+an6e. Hen)e , CO is 0ase1 on
t+e $
D A. Po2er 4/st resi1e in t+e *eo*le
D B. (e5t. is ro4 t+e *eo*le to t+e *eo*le
D C. Peo*le *arti)i*ation
Prin)i*les o CO
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D :.-4/st 0e 0ase1 on t+e *oorest se)torso so)iet. T+e sol/tions o *ro0le4s
)o44onl s+are1 0 t+ese se)tors 4/st
0e o)/se1 on )olle)ti5e or6anizations,*lannin6 an1 a)tion
D ;. s+o/l1 lea1 to sel-reliant
)o44/nities
THE HR(P-COPAR PROCESS
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D ". PRE-ENTRY PHASED :. ENNTRY PHASE
D ;. COMMUNITY STU(Y?(IAGNOSIS
PHASE?RESEARCH PHASED %.COMMUNITY ORGANIATION AN(
CAPABILITY-BUIL(ING PHASE
D &. COMMUNITY ACTION PHASE
D
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*+ase o COPAR ea)+ 0elon6$
D ".Con1/)ts )o44/nit 4eetin6s to 1ra2 /*6/i1elines or t+e or6anization o CHOD :. Trains BHsD ;. Sets /* o lin!a6es?net2or! an1 reerral sste4s
D %. PIME o +ealt+ ser5i)es an1 or )o44/nit 1e5t.Proe)tsD &. Pro5i1es )ontin/in6 e1/)ation to lea1ers or
resi1entsD . I1entiies !e lea1ers
Contin/e1Q.
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D @. (e5elo*s )riteria or site sele)tionD "#. 3or4s t+e )ore 6ro/*
D "".Con1/)ts SALT
D ":.Sele)ts 4e40ers o t+e resear)+ tea4
D ";. Assists t+e resear)+ tea4 in *resentin6res/lts 1/rin6 t+e 6eneral asse40l
D "%. Hel*s t+e *eo*le i1entiin6 t+e )o44/nit
nee1s an1 +ealt+ *ro0le4sD "&. 3a)ilitates or t+e or4/lation an1 ratii)ationo t+e )onstit/tion an1 0-la2s o t+e or6anization
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P/0li) Healt+ Pro6ra4s
CO+$REHENSI@E +ATERNA8
AND CHI8D HEA8TH $RO=RA+
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AND CHI8D HEA8TH $RO=RA+
1. E$I (E&ane $rora6 onI66,n%:at%on
. CDD (Contro" o! D%arrea"D%'ea'e'
*. CARI (Contro" o! Ac,te
Re'&%rator4 In!ect%on'?. FC (ner-F%ve C"%n%c'
5. +C (+aterna" Care
2. BF (Brea't!ee%n
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(
7. +R$ (+a"n,tr%t%on Rea/%"%tat%on$rora6
. @AD ( @%ta6%n A De!%c%enc4
9. IDDJIDA (Io%ne De!%c%enc4D%'orer'J Iron De!%c%enc4
Ane6%a
10.F$ (Fa6%"4 $"ann%n
E$I (EL$ANDED $RO=RA+ ONI++NI
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D TAR=ET SETTIN=G
1.INFANTS 0-1 +ONTHS.$RE=NANT AND $OST $ART+ O+EN
*.SCHOO8 ENTRANTSJ =RADE 1 J 7 YEARS
O8D
D OBECTI@ES OF E$IG
TO REDCE +ORBIDITY AND+ORTA8ITY RATES A+ON= INFANTS ANDCHI8DREN !ro6 SIL CHI8DHOODI++NI
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EL$ANDED $RO=RA+ ON I++NI
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Ae o! 1't
Do'e
r o!
Do'e'
Interva"
BeteenDo'e'
1. BC=
(Bac%"",'
Ca"6ette
=,er%n
Birt+ or
anti4eater
0irt+
S)+ool
entrants
" BCG is 6i5enat t+e earliest
*ossi0le a6e*rote)tsa6ainst t+e*ossi0ilit oTB ine)tion
ro4 t+e ot+era4il
4e40ers
. D$T
(D%&ter%a$ert,'%'Tetan,'
2 ee'
; % 2ee!sAn earl start 2it+(PT re1/)es t+e)+an)e o se5ere*ert/ssis
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*. O$@(Ora" $o"%o@acc%ne
2 ee' ; % 2ee!s T+e etent o*rote)tion a6ainst*olio is in)rease1t+e earlier OP7 is
6i5en.?.
He&at%t%' B2 ee' ; % 2ee!s An ear"4 'tart o!He&at%t%' B re,ce'
te cance o! /e%n%n!ecte an /eco6%n
a carr%er.
5. +ea'"e' 9 6ont' " At "ea't 5M o! 6ea'"e'can /e &revente /4%66,n%:at%on at t%' ae.
CDD (CONTRO8 OF DIARRHEA8 DISEASES+ANA=E+ENT OF THE $ATIENT ITH
DIARRHEA
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A. NO DEHYDRATIOND Con1ition 2ell, alert
D Mo/t+ an1 Ton6/e 4oist
D Ees nor4alD T+irst 1rin!s nor4all, not t+irst
D Tears *resent
D S!in *in)+ 6oes 0a)! /i)!lD TREATMENT PLAN A- HOME TTT.
THREE R8ES FOR HO+E
TREAT+ENT
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1.=%ve te c%" 6ore !",%' tan,',a"
/se +o4e l/i1 s/)+ as )ereal 6r/el
6i5e ORESOL, *lain 2ater
TREAT+ENT
. =%ve te c%" &"ent4 o! !oo to &revent,nern,tr%t%on
)ontin/e to 0reastee1 re/entl
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i )+il1 is not 0reastee1, 6i5e /s/al 4il!
i )+il1 is less t+an < 4ont+s an1 not et
ta!in6 soli1 oo1, 1il/te 4il! or : 1as
i )+il1 is < 4ont+s or ol1er an1 alrea1 ta!in6
soli1 oo1, 6i5e )ereal or ot+er star)+ oo1 4ie1
2it+ 5e6eta0les, 4eat or is+F 6i5e res+ r/it /i)e
or 4as+e1 0anana to *ro5i1e *otassi/4F ee1
)+il1 at least < ti4es a 1a. Ater 1iarr+ea sto*s,6i5e an etra 4eal ea)+ 1a or t2o 2ee!s.
;. Tae te c%" to te ea"t orer
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%! te c%" oe' not et /etter %n *a4' or eve"o&' an4 o! te !o""o%n$
4an 2ater stools
re*eate1 5o4itin6 4ar!e1 t+irst
eatin6 or 1rin!in6 *oorl
e5er 0loo1 in t+e stool
ORESO8 TREAT+ENTAe A6o,nt o!
ORS to %veA6o,nt o! ORS to&rov%e !or ,'e at
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a!ter eac
"oo'e 'too"
&o6e
?
6ont'
50-1006".
500 6".Ja4
104ear'
100-006".
1000 6".Ja4
104ear',&
A' 6,c a'ante
000 6".Ja4
B. SO+E DEHYDRATIOND Con1ition restless, irrita0le
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D Mo/t+ an1 Ton6/e 1rD Ees s/n!en
D T+irst t+irst, 1rin!s ea6erlD Tears a0sent
D S!in *in)+ 6oes 0a)! slo2lD EIGH PT, TTT. PLAN B
APPRO8. AMT. O3 ORS- TO GI7E IN "ST
% HRSA=E EI=HT
=
ORS
+8
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% MOS. & :##-%##
%-""MOS &-=.@ %##-
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Use o (r/6s 1/rin6 (iarr+ea
A ti0i ti + l1 l 0 1
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Anti0ioti)s s+o/l1 onl 0e /se1 or
1senter an1 s/s*e)te1 )+olera
Anti*arasiti) 1r/6s s+o/l1 onl 0e
/se1 or a4oe0iasis an1 6iar1iasis
C. SE@ERE DEHYDRATIONCon1ition let+ar6i) or /n)ons)io/sF lo**
Ees 5er s/n!en an1 1r
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Ees 5er s/n!en an1 1r
Tears a0sentMo/t+ an1 ton6/e 5er 1r
T+irst- 1rin!s *oorl or not a0le to 1rin!
S!in *in)+ 6oes 0a)! 5er slo2lTTT PLAN C- ttt. /i)!l
".Brin6 *t. to +os*ital
:. I73 La)tate1 Rin6ers Sol/tion or Nor4alSaline
;.Re-assess *t. E5er "-: +rs
% Gi5e ORS as soon as t+e *t )an 1rin!
RO8E OF BREASTFEEDIN= IN THE
CONTRO8 OF DIARRHEA8 DISEASES
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$RO=RA+
". T2o *ro0le4s in C((
D ". Hi6+ )+il1 4ortalit 1/e to1iarr+ea
D :. Hi6+ 1iarr+ea in)i1en)e
a4on6 /n1er i5es
:. Hi6+est in)i1en)e in a6e < :;4ont+s
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4ont+s
;. Hi6+est 4ortalit in t+e irst : ears olie
%. Main )a/ses o 1eat+ in 1iarr+ea $
DEHYDRATION +A8NTRITION
&. To *re5ent 1e+1ration, 6i5e +o4e l/i1s
Ka4 as soon as 1iarr+ea starts an1 i
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1e+1ration is *resent, re+1rate earl,)orre)tl an1 ee)ti5el 0 6i5in6 ORS
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>. Ris! o se5ere 1iarr+ea "#-;# +i6+er in0ottle e1 inants t+an in 0reaste1
inants
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inants.
@. A15anta6es o 0reastee1in6 in relationto C((
".Breast 4il! is sterile:.Presen)e o anti0o1ies *rote)tion
a6ainst 1iarr+ea
;.Intestinal 3lora in B3 inants *re5ents6ro2t+ o 1iarr+ea )a/sin6 0a)teria.
"#.Breastee1in6 1e)reases in)i1en)e
t 0 > :# 1 t lit 0 :%
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rate 0 >-:# an1 4ortalit 0 :%-
:= in inants /n1er < 4ont+s o
a6e.
"".+en to 2ean%-< 4ont+s sot 4as+e1 oo1s : a
1a
< 4ont+s 5ariet o oo1s % a 1a
":.S/44ar o HO-C(( re)o44en1e1strate6ies to *re5ent 1iarr+ea
1. I6&rove N,tr%t%on
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1. I6&rove N,tr%t%on
- e)l/si5e 0reastee1in6 or t+e irst %-< 4ont+so lie an1 *artiall or at least one ear.
- I4*ro5e1 2eanin6 *ra)ti)es
.'e o! 'a!e ater
- )olle)tin6 *lent o 2ater ro4 t+e )leanest
so/r)e
- *rote)tin6 2ater ro4 )onta4ination at t+e
so/r)e an1 in t+e +o4e
*.=oo &er'ona" an o6e't%c
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4%ene- +an12as+in6
- /se o latrines
- *ro*er 1is*osal o stools o o/n6)+il1ren
?.+ea'"e' %66,n%:at%on
CARI (CONTRO8 OF ACTE RES$IRATORYINFECTIONS
C8ASSIFICATIONG
A NO $NE+ONIA CO=H OR CO8D
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A. NO $NE+ONIAG CO=H OR CO8D
1. No ce't %n ra%n
. No !a't /reat%n ( 6o'- 20J6%n-16o'. "e'' tan 50 &er 6%n,te) 1 6o'. 5
4ear' "e'' tan ?0 &er 6%n,teTREAT+ENTG
". I )o/6+in6 4ore t+an ;# 1as, reer orassess4ent
:. Assess an1 treat ear *ro0le4s?sore t+roat i*resent
;. A15ise 4ot+er to 6i5e +o4e )are
%.Treat e5er?2+eezin6 i *resent
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HO+E CAREG1. FEED THE CHI8D
". 3ee1 t+e )+il1 1/rin6 illness
:. In)rease ee1in6 ater illness
;. Clear t+e nose i it intereres 2it+ ee1in6
. INCREASE F8IDS
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". oer t+e )+il1 etra to 1rin!:. In)rease 0reastee1in6
*. SOOTHE THE THROAT ANDRE8IE@E THE CO=H ITH A
SAFE RE+EDY
?. ATCH FOR THE FO88OIN=
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SI=NS AND SY+$TO+S ANDRETRN KIC8Y IF THEY
OCCR
". Breat+in6 0e)o4es 1ii)/lt
:. Breat+in6 0e)o4es ast
;. C+il1 is not a0le to 1rin!%. C+il1 0e)o4es si)!er
B. $NE+ONIA1. No ce't %n ra%n
. Fa't /reat%n ( "e'' tan 6o'- 20J6%n
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. Fa't /reat%n ( "e'' tan 6o' 20J6%n
or 6ore ) -1 6o'. 50J6%n or 6ore) 16o'. 5 4ear' ?0J6%n or 6ore
TREAT+ENT
".A15ise 4ot+er to 6i5e +o4e )are
:.Gi5e an anti0ioti)
;.Treat e5er?2+eezin6 i *resent
%.I t+e )+il1s )on1ition 6ets 2orst,reer
/r6entl to +os*italF i i4*ro5in6, inis+ & 1as
o anti0ioti).
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C. Se5ere Pne/4onia
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D C+est in1ra2in6D Nasal larin6
D Gr/ntin6 s+ort so/n1s 4a1e 2it+ t+e5oi)e'
D Canosis
TTT.
". Reer /r6entl to +os*ital
:. Treat e5er *ara)eta4ol', 2+eezin6 sal0/ta4ol'
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ASSESSMENT O3 RESPIRATORYIN3ECTION
AS THE +OTHERG
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". Ho2 ol1 is t+e )+il1:. Is t+e )+il1 )o/6+in6 3or +o2 lon6
;. A6e : 4ont+s /* to & ears$ Is t+e )+il1 a0le
to 1rin!
A6e less t+an : 4ont+s$ Has t+e o/n6 inant
sto**e1 ee1in6 2ell
%. Has t+e )+il1 +a1 e5er 3or +o2 lon6
&. Has t+e )+il1 +a1 )on5/lsions
D 8OO 8ISTENG". Co/nt t+e 0reat+s in one 4in/te.
Ae0 Fa't Breat%n
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:.Loo! or )+est in 1ra2in6.
;.Loo! an1 listen or stri1or.Stri1or o))/rs 2+en t+ere is a narro2in6 o t+e
larn, tra)+ea or e*i6lottis 2+i)+ intereres 2it+
air enterin6 t+e l/n6s.
Ae0 Fa't Breat%n
Less t+an : 4ont+s
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s+o2s si6ns t+at 0reat+in6 o/te+ale'is 1ii)/lt.
&. See i t+e )+il1 is a0nor4all slee* or
1ii)/lt to 2a!e. S/s*e)t 4enin6itis'
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C"a''%!%cat%on o! Ear In!ect%on
A. +ASTOIDITIS ten1er s2ellin6 0e+in1 t+e
ear in inants, s2ellin6 4a 0e a0o5e t+e ear'
TREAT+ENT
1. Ant%/%ot%c'
.S,r%ca" %ntervent%on
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B. ACTE EAR INFECTION */s 1rainin6ro4 t+e ear or less t+an : 2ee!s, ear
*ain, re1, i44o0ile ear 1r/4 A)/te Otitis
Me1ia'TREAT+ENT
1.Cotr%6oa:o"eA6o4c%""%nor
A6&%c%""%n.Dr4 te ear /4 %c%n
C. CHRONIC EAR INFECTION */s 1rainin6 ro4t+e ear or 4ore t+an : 2ee!s C+roni) Otitis Me1ia'
TREAT+ENT
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+o't %6&ortant > e!!ect%ve treat6entG Keep theear dry by wicki!.
$araceta6o" 6a4/e %ven !or &a%n or % !ever.
$reca,t%on' !or a c%" %t a ra%n%n earG
1.Do not "eave an4t%n %n te ear ',c a' cottonoo" /eteen %c%n treat6ent'.
.Do not &,t o%" or an4 oter !",% %nto te ear.
*.Do not "et te c%" o '%66%n or et ater %nte ear.
Maternal an1 C+il1 Healt+
N/rsin6
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P+iloso*+
D Pre6nan), la0or an1 1eli5er an1 */er*eri/4
are *art o t+e )ontin//4 o t+e total lie ))le
D Personal, )/lt/ral an1 reli6io/s attit/1es an1
0elies inl/en)e t+e 4eanin6 o *re6nan) or
in1i5i1/als an1 4a!e ea)+ e*erien)e /ni/e
D MCN is 3AMILY CENTERE(- t+e at+er is asi4*ortant as t+e 4ot+er
D Goals
D To ens/re t+at e*e)tant 4ot+er an1 n/rsin6
4ot+er 4aintain 6oo1 +ealt+ learn t+e art o
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4ot+er 4aintain 6oo1 +ealt+, learn t+e art o
)+il1 )are, +as a nor4al 1eli5er an1 0ear+ealt+ )+il1ren
D T+at e5er )+il1 li5es an1 6ro2s /* in a
a4il /nit 2it+ lo5e an1 se)/rit, in +ealt+
s/rro/n1in6s, re)ei5es a1e/ate
no/ris+4ent, +ealt+ s/*er5ision an1 ei)ient4e1i)al attention an1 is ta/6+t t+e ele4ents
o +ealt+ li5in6
Classii)ation o *re6nant2o4en
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D Nor4al +ealt+ *re6nan)D it+ 4il1 )o4*li)ations- re/ent +o4e
5isits
D it+ serio/s or *otentiall serio/s ) reerre1 to 4ost s!ille1 so/r)e o 4e1i)al
an1 +os*ital )are
Ho4e Base1 Mot+ers Re)or1 HBMR '
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D Tool /se1 2+en ren1erin6 *renatal )are
)ontainin6 ris! a)tors an1 1an6er si6ns
Ris! 3a)tors
D "%& )4 tall % t @ in)+es'
D Belo2 "> rs ol1 a0o5e ;& rs ol1
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Belo2 "> rs ol1, a0o5e ;& rs ol1
D Ha5e +a1 % *re6nan)ies
D it+ TB, 6oiter, +eart 1isease, (M, 0ron)+ialast+4a, se5ere ane4ia
D Last 0a0 0orn 2as less t+an : ears a6oD Pre5io/s )esarian se)tion 1eli5er
D Histor o : or 4ore a0ortions, 1ii)/lt 1eli5er,6i5en 0irt+ to t2ins , : or 4ore 0a0ies 0orn
0eore E((, still0irt+D ei6+s less t+an %& !6s. or 4ore t+an ># !6s.
(an6er Si6ns
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D ". an t*e o 5a6inal 0lee1in6D :. +ea1a)+e, 1izziness, 0l/rre1 5ision
D ;. */iness o a)e an1 +an1s
D %. *allor
Prenatal Care
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D S)+e1/le o 7isitsD "st as earl as *re6nan), "sttri4ester
D:
n1
- :n1
tri4ester
D ;r1 s/0se/ent 5isits - ;r1tri4ester
D More re/ent 5isits or t+ose at ris! 2it+ )
TETANS TOLOID I++NI
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@acc%n
e
+%n%6,6 Ae
Interva"
$ercent
$rotecte
D,rat%on o!
$rotect%on
TT"
As earl as *ossi0le1/rin6 *re6nan)
>#
TT: At least %2ee!s later
>#
Inants 0orn tot+e 4ot+er 2ill 0e*rote)te1
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*rote)te1
ro4 neonatal
tetan/s.
Gi5es ; ears
*rote)tion ort+e 4ot+er ro4tetan/s.
TT;
At least &
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D Una**ro5e1 t*e o 2ater a)ilit
D A))ess to sae an1 *ota0le 1rin!in62ater
D ater /alit an1 4onitorin6 s/r5eillan)e
D ater2or!s?ater sste4 an1 2ell)onstr/)tion
A**ro5e1 t*e o 2ater a)ilities
D Le5el " Point So/r)e'- a *rote)te1 2ell or
a 1e5elo*e1 s*rin6 2it+ an o/tlet 0/t
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2it+o/t a 1istri0/tion sste4
D in1i)ate1 or r/ral areasF
D ser5es "&-:& +o/se+ol1sF its o/trea)+ is
not 4ore t+an : 4 ro4 t+e art+est
/ser
D iel1s %#-"%# L? 4in
Le5el II Co44/nal 3a/)et or
Stan1 Posts'
D it+ a so/r)e, reser5oir, *i*e1 1istri0/tion
net2or! an1 )o44/nal a/)ets
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D Lo)ate1 at not 4ore t+an :& 4 ro4 t+e
art+est +o/se
D (eli5ers %#-># L o 2ater *er )a*ital *er
1a to an a5era6e o "## +o/se+ol1s
D 3it or r/ral areas 2+ere +o/ses are
1ensel )l/stere1
Conne)tions or ater2or!sSste4'
D it+ a so/r)e, reser5oir, *i*e1 1istri0/tor
net2or! an1 +o/se+ol1 ta*s
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D 3it or 1ensel *o*/late1 /r0an
)o44/nities
D Re/ires 4ini4/4 treat4ent or
1isine)tion
EN7IRONMENTAL SANITATION-t+e st/1 o all a)tors in 4ans
*+si)al en5iron4ent, 2+i)+ 4aeer)ise a 1eleterio/s ee)t on +is
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+ealt+, 2ell-0ein6 an1 s/r5i5al.
In)l/1es$
"." ater sanitation
".: 3oo1 sanitation
".; Re/se an1 6ar0a6e 1is*osal
".% E)reta 1is*osal".& Inse)t 5e)tor an1 ro1ent )ontrol
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".& Inse)t 5e)tor an1 ro1ent )ontrol
".< Ho/sin6
".= Air *oll/tion
".> Noise
".@ Ra1iolo6i)al Prote)tion
"."# Instit/tional sanitation
"."" Strea4 *oll/tion
$RO$ER ELCRETA AND SEA=E DIS$OSA8
$RO=RA+
EHS sets *oli)ies on$
A**ro5e1 t*es o toilet a)ilities $
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** *
LEVEL ILEVEL I
Non-water carriage toilet facility no waterNon-water carriage toilet facility no waternecessary to wash the waste into receiving space e.g.pitnecessary to wash the waste into receiving space e.g.pit
latrines, reed odorless earth closet.latrines, reed odorless earth closet.
Toilet facilities reqiring s!all a!ont of water toToilet facilities reqiring s!all a!ont of water to
wash the waste into the receiving space e.g. por flsh toilet "wash the waste into the receiving space e.g. por flsh toilet "
aqa priviesaqa privies
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FOOD SANITATION $RO=RA+
-sets *oli) an1 *ra)ti)al *ro6ra4s to
*re5ent an1 )ontrol oo1-0orne 1iseases toalle5iate t+e li5in6 )on1itions o t+e
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alle5iate t+e li5in6 )on1itions o t+e
*o*/lation
HOS$ITA8 ASTE +ANA=E+ENT $RO=RA+
(is*osal o ine)tio/s, *at+olo6i)al an1 ot+er
2astes ro4 +os*ital 2+i)+ )o40ine t+e4 2it+
t+e 4/ni)i*al or 1o4esti) 2astes *ose +ealt+
+azar1s to t+e *eo*le.
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Hos*itals s+all 1is*ose t+eir +azar1o/s 2astes
t+r/ in)inerators or 1isine)tants to *re5enttrans4ission o noso)o4ial 1iseases
$RO=RA+ ON HEA8TH RIS +INI+I
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*. re'earce' on e!!ect' o! =8OBA8 AR+IN= toea"t (e&"et%on o! te 'trato'&ere o:one "a4er
%c %ncrea'e' ,"trav%o"et ra%at%on c"%6atecane an oter con%t%on'
NRSIN= RES$ONSIBI8ITIES AND ACTI@ITIES
D Healt+ E1/)ation IEC 0 )on1/)tin6
)o44/nit asse40lies an1 0en)+ )oneren)es.
D T+e O))/*ational Healt+N/rse, S)+ool Healt+
N/rse an1 ot+er N/rsin6 sta s+all i4*art t+e1 ti 1 i i t
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nee1 or an ee)ti5e an1 ei)ient
en5iron4ental sanitation in t+eir *la)es o 2or!
an1 in s)+ool.
D A)ti5el *arti)i*ate in t+e trainin6 )o4*onent ot+e ser5i)e li!e in 3oo1 Han1lers Class, an1 atten1trainin6?2or!s+o*s relate1 to en5iron4ental +ealt+.
D Assist in t+e 1e2or4in6 a)ti5ities or t+e s)+ool
)+il1ren an1 tar6ete1 6ro/*s.D Ee)ti5el an1 ei)ientl )oor1inate
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D Ee)ti5el an1 ei)ientl )oor1inate*ro6ra4s?*roe)ts?a)ti5ities 2it+ ot+er 6o5ern4ent
an1 non-6o5ern4ent a6en)ies.D A)t as an a15o)ate or a)ilitator to a4ilies int+e
)o44/nit in 4atters o
*ro6ra4?*roe)ts?a)ti5ities on en5iron4ental+ealt+ in )oor1ination 2it+ ot+er 4e40ers o R/ral
Healt+ Unit RHU' es*e)iall t+e R/ral Sanitar
Ins*e)tors.
D A)ti5el *arti)i*ate in en5iron4ental
sanitation )a4*ai6ns an1 *roe)ts in t+e
)o44/nit. E. Sanitar toilet )a4*ai6n1ri5e or *ro*er 6ar0a6e 1is*osal
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1ri5e or *ro*er 6ar0a6e 1is*osal,
0ea/tii)ation o +o4e 6ar1en, *ar!s
1raina6e an1 ot+er *roe)ts.D Be a role 4o1el or ot+ers in t+e
)o44/nit to e4/late ter4s o )leanliness
in t+e +o4e an1 s/rro/n1in6.
Non-Co44/ni)a0le (iseases an1
Re+a0ilitation
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D ". Pre5ention an1 Control o Car1io5as)/lar (iseases
D - +eart "st lea1in6 )a/se o, 1eat+ F 0l1 5essels - :n1D Con6enital Heart (isease CH('$ Res/lt o t+e a0nor4al
1e5elo*4ent o t+e +eart t+at e+i0its se*tal 1ee)t, *atent1/)t/s arterios/s, aorti) an1 */l4onar stenosis, an1)anosisF 4ost *re5alent in )+il1ren
D Ca/ses$ en5tl a)tors, 4aternal 1iseases or 6eneti)a0errations
R+ ti 3 R+ ti H t (i S t ti
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D R+e/4ati) 3e5er or R+e/4ati) Heart (isease$ Sste4ati)inla44ator 1isease t+at 4a 1e5elo* as a 1elae1 rea)tionto re*eate1 an1 an ina1e/atel treate1 ine)tion o t+e /**er
res*irator tra)t 0 6ro/* A 0eta-+e4olti) stre*to)o))i.D H*ertension$ Persistent ele5ation o t+e arterial 0loo1
*ress/re.D *ri4ar or essential' Fre/ent a4on6 e4ales 0/t
se5ere,4ali6nat or4 is 4ore )o44on a4on6 4ales
Is)+e4i) Heart (isease? At+eros)lerosis$Con1ition /s/all )a/se1 0 t+e o))l/sion
o t+e )oronar arteries 0 t+ro40/s or
)lot or4ation.D +i6+er a4on6 4ales t+an e4ales or t+e
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+i6+er a4on6 4ales t+an e4ales or t+e
latter are *rote)te1 0 estro6en 0eore
4eno*a/seD P3$ HPN, (M, S4o!in6
D Minor R3$ stress, stron6 a4il +istor,
o0esit
C7(
$ERIOD OF 8IFE TY$E OF C@D $RE@A8ENCE
At 0irt+ to earl )+il1+oo1 Con6enital Heart (isease : ? "### s)+ool )+il1rena6e1 & "& .o.'
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Earl to late )+il1+oo1 R+e/4ati) 3e5er ?R+e/4ati) Heart
(isease
" ? "### s)+ool )+il1rena6e1 & "& .o.'
Earl A1/lt+oo1 (iseases o Heart M/s)lesEssential H*ertension
"# ? "## a1/lts
Mi11le a6e to ol1 a6e Coronar Arter (isease
Cere0ro5as)/lar A))i1ent
& ? "## a1/lts
C7(D%'ea'e' Ca,'e' J R%' !actor'
Con6enital Heart (isease Maternal Ine)tions, (r/6inta!e, Maternal (isease,Geneti)
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Geneti)
R+e/4ati) 3e5er?R+e/4ati)Heart (isease
3re/ent Stre*to))o)al SoreT+roat
Essential H*ertension Here1it, Hi6+ Salt Inta!e
Coronar Arter (iseaseHeart Atta)!'
S4o!in6, O0esit,H*ertension, Stress
H*erli*i1e4ia, (ia0etesMellit/s Se1entar Lie Stle
Cere0ro5as)/lar A))i1entStro!e'
H*ertension,Arterios)lerosis
Pri4ar Pre5ention$ C7(
D%'ea'e $r%6or%a" S&ec%!%c $rotect%on
Con6enital Heart
- Pre5ention o5iral ine)tion an1
- A1e/ate treat4ent o5iral ine)tion 1/rin6
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(isease inta!e o +ar4/l1r/6s 1/rin6
*re6nan).- A5oi1an)e o4arria6e0et2een 0loo1
relati5es
6*re6nan).
- Geneti) )o/nselin6 o0loo1 relate1 4arrie1)o/*les.
R+e/4ati)Heart (isease
- Pre5ention ore)/rrent sore
t+roat t+r/a1e/ateen5iron4ental
- I1entii)ationo )ases o
r+e/4ati) e5er- Pro*+lais
it+ i illi
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en5iron4entalsanitationF
a5oi1an)e oo5er)ro21in6Fa1e/atetreat4ent
2it+ *eni)illin orert+ro4)in
EssentialH*ertension
- 3ro4 earl)+il1+oo1
W lo2 salt 1ietW a1e/ate
- Contin/e1 lo2salt 1iet an1
a1e/ateeer)ise
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W a1e/ate*+si)aleer)ise
Coronar Heart(iseaseHeartAtta)!'
- Pre5ention o1e5elo*4ent?a)/isition oris! a)tors
W )i6arettes4o!in6
- )essation os4o!in6
- )ontrol?treat4ent o
1ia0etes,+*ertension
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W +i6+ at inta!e
W +i6+ salt
inta!e
-2ei6+tre1/)tion
-)+an6e to*ro*er 1iet
-A1/st4ent oa)ti5ities
Cere0ro5as)/la
r A))i1entStro!e'
- all 4eas/res
to *re5ent+*ertension arterios)lerosis
- all 4eas/res
to )ontrol+*ertension *ro6ression o
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arterios)lerosis *ro6ression oarterios)lerosis
D Pri4ar Pre5ention t+r/ +ealt+ e1/)ation
is t+e 4ain o)/s o t+e *ro6ra4$
D ". 4aintenan)e o i1eal 0o1 2t.
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D :. 1iet - lo2 at
D ;. al)o+ol?s4o!in6 a5oi1an)eD %. eer)ise
D &. re6/lar BP )+e)! /*
:. Can)er Pre5ention an1 Earl (ete)tionD An 4ali6nant t/4or arisin6 ro4 t+e
a0nor4al an1 /n)ontrolle1 1i5ision o )ells
)a/sin6 t+e 1estr/)tion in t+e s/rro/n1in6tiss/es.
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D Co44on Can)er$ L/n6 )an)er, )er5i)al
)an)er, )olon )an)er, )an)er o t+e 4o/t+,0reast )an)er, s!in )an)er, *rostate )an)er.
D ;r1lea1in6 )a/se o illness an1 1eat+ P+il.'
D In)i1en)e )an onl 0e re1/)e1 t+r/prevention and early detection
NINE ARNING SIGNS O3CANCER$
D C+an6e in 0loo1 0o2el or 0la11er +a0its
D A sore t+at 1oes not +ealD n/s/al 0lee1in6 or 1is)+ar6e
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6 6D T+i)!enin6 or l/4* in 0reast or else2+ereD In1i6estion or 1ii)/lt in s2allo2in6
D O05io/s )+an6e in 2art or 4oleD Na66in6 )o/6+ or +oarseness
D ne*laine1 ane4iaD S/11en /ne*laine1 2ei6+t loss
Pre5ention Earl (ete)tion
CA t*e
L/n6Uterine
Pre5ention
No s4o!in6Mono6a4
(ete)tion
NonePa*s s4ear
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Cer5i)al
Li5er
6
Sae se
He* B5a))ination
Less aal)o+olinta!e
A5oi1an)e o4ol1 oo1s
*e5er "-; rs
None
ColonRe)t/4
Hi6+ i0er 1ietLo2 at inta!e
Re6/lar4e1i)al )+e)!-/* ater %# rso a6e
3e)al o))/lt0loo1 test
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(RE
Si64oi1os)o*
Mo/t+ No s4o!in6,0etel n/t
)+e2in6
Oral +6iene
Re6/lar 1ental)+e)!-/*s
Breast none Mont+l SBEYearl ea4 01o)tor
Ma44o6ra*+
or rs ol1an1 a0o5e l
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e4ales
S!in
Prostate
No e)essi5es/n e*os/re
none
Assess4ent os!in
(i6ital trans-re)tal ea4
D $RINCI$8ES OF TREAT+ENT OF
+A8I=NANT DISEASES
D One t+ir1 o all )an)ers are )/ra0le i
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D One t+ir1 o all )an)ers are )/ra0le i
1ete)te1 earl an1 treate1 *ro*erl.
Tree 6a3or !or6' o! treat6ent o!
cancerG
D S/r6er
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D S/r6er
D Ra1iation T+era*
D C+e4ot+era*
D ;. Natl (ia0etes Pre5ention an1 ControlPro6ra4
D Ai4$D Controllin6 an1 assi4ilatin6 +ealt+
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Controllin6 an1 assi4ilatin6 +ealt+liestle in t+e 3ili*ino )/lt/re :##&-:#"#'
t+r/ IECD Main Con)ern$ 4o1iia0le ris!
a)tors 1iet, 0o1 2t., s4o!in6, al)o+ol,stress, se1entar li5in6, 0irt+ 2t. ,4i6ration
D ?. $revent%on an Contro" o! %ne4 D%'ea'eD Ac,te or Ra&%"4 $rore''%ve Rena" Fa%",re GA
s/11en 1e)line in renal /n)tion res/ltin6 ro4 t+eail/re o t+e renal )ir)/lation or 0 6lo4er/lar ort/0/lar 1a4a6e )a/sin6 t+e a))/4/lation o
s/0stan)es t+at is nor4all eli4inate1 in t+e /rine int+e 0o1 l/i1s lea1in6 to 1isr/*tion in +o4eostati),en1o)rine an1 4eta0oli) /n)tions
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en1o)rine, an1 4eta0oli) /n)tions.D Ac,te Ne&r%t%'GA se5ere inla44ation o t+e !i1ne
)a/se1 0 ine)tion, 1e6enerati5e 1isease, or 1iseaseo t+e 0loo1 5essels.
D Cron%c Rena" Fa%",reGA *ro6ressi5e 1eterioration orenal /n)tion t+at en1s as /re4ia an1 its)o4*li)ations /nless 1ialsis or !i1ne trans*lant is
*eror4e1.
D Ne&ro"%t%a'%'GA 1isor1er )+ara)terize1 0 t+e*resen)e o )al)/li in t+e !i1ne.
D Ne&rot%c S4nro6eGA )lini)al 1isor1er oe)essi5e lea!a6e o *las4a *roteins into t+e /rine
0e)a/se o in)rease1 *er4ea0ilit o t+e6lo4er/lar )a*illar 4e40rane
% T t I ! t% A 1i 1 0 t+
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D r%nar4 Tract In!ect%onGA 1isease )a/se1 0 t+e*resen)e o *at+o6eni) 4i)roor6anis4s in t+e
/rinar tra)t 2it+ or 2it+o/t si6ns an1 s4*to4s
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