Health Care Lecture

HEALTH CARE
Definition of Health Care

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Health care, or healthcare, is the prevention,
treatment, and management of illness and the
preservation of mental and physical well being
through the services offered by the medical,
nursing, and allied health professions.
Health care embraces all the goods and services
designed for your health, including preventive,
curative and palliative interventions, whether directed
to individuals or to populations.
Health Care Process

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Definition
A systematic, rational method of planning and
providing health care by identifying a clients
actual or potential health care needs,
establishing plans to meet the identified needs
and delivering specific health care interventions
to meet those needs for the purpose of attaining,
maintaining, and promoting optimal
biopsychosocial functioning.
Health as a Continuum between biological

and social factors across the Lifespan
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Health From Cells to Society
Peoples Right to Daily Life

The
United Nations (Article 25, 1948)
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declaration for peoples rights to daily life:
All people have the right to a standard of living
adequate for the health and well-being of a
person and of ones family, including food,
clothing, housing, and medical care, and
necessary social services, and the right to
security in the event of unemployment, sickness,
disability, widowhood, old age, or lack of
livelihood in circumstances beyond ones
control.
Health and Illness

THE STUDY OF MAN
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THE ATOMISTIC APPROACH

Views man as an organism
composed of different organ
systems, each system
composed of organs and each
organ made up of tissue cells.
Health and Illness

THE STUDY OF MAN
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THE HOLISTIC APPROACH
Stimuli in the environment provide the

necessary forces to enable man to
demonstrate consciously or
unconsciously, the nature of his
responses and the subsequent quality
of his relationship with his environment.
Health and Illness

THE STUDY OF MAN
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THE HOLISTIC APPROACH

It provides a fundamental framework on
which one can base his perception or
observation of the total behavior of man in
relation to society.
Health and Illness

THE STUDY OF MAN
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MOTIVATION TO OVERCOME HARDSHIP

Motivation may come either from natural
or supernatural forces.
Man reasons that it comes naturally to
man to suffer for those whom he loves
and wishes to protect from pain and
suffering.
Health and Illness

THE STUDY OF MAN
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MOTIVATION TO OVERCOME HARDSHIP

The other type of motivation may be
supernatural wherein one transcends pain
and suffering to a higher place in the hope
of non-material reward.
Health and Illness

ABRAHAM
MASLOWS
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HIERARCHY OF NEEDS
The five level of basic needs:
Physiologic needs
Safety and security needs
Love and belonging needs
Self-esteem needs
Self-actualization needs
Health and Illness

FACTORS
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AFFECTING HEALTH AND
ILLNESS (PEISES)
Physical dimension
Emotional dimension
Intellectual dimension
Socio-cultural dimension
Environmental dimension
Spiritual dimension
Health and Illness

Physical dimension genetic make Adela
up,develop mental level,race & sex
Emotional dimension- how the mind and
body interact to affect body function &
respond to body condition
Intellectual dimension- cognitive
abilities,educational background & past
experiences
Health and Illness

Socio-cultural dimension- these are health
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practices & beliefs w/c influences a
persons economic, lifestyle,family &
culture
Environmental dimension - such as
housing, sanitation, climate & pollution
Spiritual dimension- spiritual & religious
beliefs and values
Health and Illness

SOCIAL DETERMINANTS OF HEALTH
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Are the social conditions in which
people live which determine their
health, illnesses and generally related
to social, economic, political and
environment circumstances. It greatly
influenced collective and personal
well-being
Health and Illness

MODELS
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OF HEALTH
Medical Model
Health is the state of being free of signs
or symptoms of disease. Illness is the
presence of signs or symptoms of
disease.
Nedra B. Belloc and Lester Breslow 1972
Health and Illness

MODELS
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OF HEALTH
Health-Illness Continuum
Health is a constantly changing state,
with high level wellness and death
being on opposite ends of a graduated
scale, or continuum.
J-B. McCann Flynn and P.B. Heffron 1984
Health and Illness

MODELS
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OF HEALTH
Role-Performance Model
Health is the ability to perform all those
roles for which one has been socialized.
-Defined with reference to the individuals
participation in the social system.
Talcott Parsons, 1964
Health and Illness

MODELS OF HEALTH
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High-Level Wellness
High-level wellness refers to functioning
to ones maximum potential while
maintaining balance and purposeful
direction in the environment.
Halbert Louis Dunn MD, PhD - 1961
John Travis, 1975
Health and Illness

MODELS OF HEALTH
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World Health Organization

Health is the state of complete physical,
mental, social well-being and not merely
the absence of disease. WHO, 1947
At the first International Conference on Health Promotion in Ottawa,

Canada (1986), the Ottawa Charter for Health Promotion built on the
WHO's concept and further defined health as "a resource for everyday
life ... a positive concept emphasizing social and personal resources,
as well as physical capabilities." Good health enables one to function
independently within a changing environment.
Health and Illness

MODELS OF HEALTH
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Needs-Fulfillment Model
Health is state in which needs are being
sufficiently met to allow an individual to
function successfully in life with the
ability to achieve the highest possible
potential.
Health and Illness

STAGES
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Stage 1: Symptom Experience

The person is aware that something is
wrong. A person usually recognizes a
physical sensation or a limitation in
functioning but does not suspect a
specific diagnosis.
Health and Illness

STAGES
Stage 1: Symptom Experience
The persons perception of a symptom

includes awareness of a physical change
such as pain, a rash or a lump; evaluation
of this change and a decision that it is a
symptom of an illness, and an emotional
response.
Health and Illness

STAGES
Stage 2: Assumption of the Sick Role
If symptoms persist and become severe,
clients assume the sick role. At this point the
illness becomes a social phenomenon, and
sick people seek confirmation from their
families and social groups that they are
indeed ill and that they be excused from
normal duties and role expectations.
Health and Illness

STAGES
Stage 3: Medical Care Contact
If symptoms persist despite the home
remedies, become severe, or require
emergency care, the person is motivated to
seek professional health services. In this
stage the client seeks expert
acknowledgement of the illness as well as
the treatment.
Health and Illness

STAGES
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OF ILLNESS BEHAVIOR
Stage 4: Dependent Client Role

The client depends on health care
professionals for the relief of
symptoms. The client accepts care,
sympathy and protection from the
demands and stresses of life.
Health and Illness

STAGES
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OF ILLNESS BEHAVIOR
Stage 4: Dependent Client Role

A client can adopt the dependent role
in a health care institution, at home, or
in a community setting. The client
must also adjust to the disruption of a
daily schedule.
Health and Illness

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STAGES OF ILLNESS BEHAVIOR

Stage 5: Recovery and Rehabilitation
This stage can arrive suddenly, such as
when the symptoms appeared. In the
case of chronic illness, the final stage
may involve in an adjustment to a
prolonged reduction in health and
functioning.
What Determines Health:

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Income and social status
Social support networks
Education
Employment & working
conditions
Social environments
Physical environments
Personal health practices

and coping
Healthy child development
Biology and genetic
endowment
Health services
Gender
Culture
Causes of Chronic Disease

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Socioeconomic,
Cultural, and
Environmental
Determinants
Urbanization
Population Aging
Globalization
Individualspecific
Modifiable Risk
Factors
Biochemical/
Physiological
Risk Factors
Main
Chronic
Diseases
Raised Blood
Pressure
Raised Blood
Glucose
Abnormal Blood
Lipids
Overweight/
Obesity
Cancer
Heart
Disease
Stroke
Chronic
Respiratory
Diseases
Diabetes
Unhealthy Diet
Physical Activity
Tobacco Use
Individualspecific NonModifiable
Risk Factors
Age
Heredity
Population Impact
Levels of Causation
Environmental
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Influences
Social
Position
Social & Cultural
Processes
Interventions
Healthy Public Policy
Organization & Community Interventions
Primary & Secondary Prevention
Psychological
Processes
Primary & Secondary Prevention / Treatment
Biological &
Genetic Factors
Primary & Secondary Prevention / Treatment
Source: McKinlay & Marceau (2000). Public health matters. Am J Pub Health, 90, 25-33, p. 29.
Health and Illness

LEVELS OF PREVENTION
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Primary Prevention
Providing specific protection against
disease to prevent its occurrence is the
most desirable form of prevention.
Preventive measures consists of
counseling, education and adoption of
specific health practices or changes in
life style.
Health and Illness

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Primary Prevention
Examples:
Mandatory immunization of children
belonging to the age range of 0-59
months old to control acute infectious
disease.
Health and Illness

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Primary Prevention
Examples:
Minimizing contamination of the work
or general environment by asbestos
dust, silicone dust, smoke, chemical
pollutants and excessive noise.
Primary Prevention
(infectious disease)
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Primary PreventionPrevention
measures before the disease happens.
Methods of Primary Prevention:
Seclusion or avoidancestaying away from
infected individuals
Keeping yourself cleanwash hands with
antibacterial soaps & shower
Get enough rest
Exercise on a regular basis
Eat Right
Primary Prevention
(noninfectious disease)
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Prevention measures before the disease occurs.
Methods of Primary Prevention:

Not Smoking or drinking in excess
Eating right
Exercise on a regular basis
Get enough rest
Stress management (Yoga, Tai Chi, Progressive
Muscle Relaxation)
Health and Illness

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Secondary Prevention
Consist of organized, direct screening
efforts or education of the public to
promote early case finding of an
individual with disease so that prompt
intervention can be instituted to halt
pathologic processes and limit
disability.
Health and Illness

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Early diagnosis of a health problem can
decrease the catastrophic effects that
might otherwise result for the individual
and the family from advanced illness
and its many complications.
Health and Illness

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Examples:
Public education to promote breast
self-examination, use of home kits for
detection of occult blood in stool
specimens and familiarity with the
seven cancer danger signals.
Warning Signs of Cancer
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C Change in bowel or bladder habits;
A A sore that does not heal;
U Unusual bleeding or discharge;
T Thickening or lump in breast or elsewhere;
I Indigestion or difficulty in swallowing;
O Obvious change in wart or mole;
N Nagging cough or hoarseness;
U Unexplained anemia; and

S Sudden unexplained weight loss.
Health and Illness

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Examples:
Screening programs for hypertension,
diabetes, uterine cancer (Pap smear),
breast cancer (examination and
mammography), glaucoma and
sexually transmitted diseases.
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Secondary PreventionPreventive measures
that lead to early diagnosis and prompt
treatment of a disease or injury to limit
disability and prevent a more severe disease.
Methods:
Visit your doctor on a regular basis
Visit your doctor for regular physicals
Health and Illness

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Tertiary Prevention
It begins early in the period of recovery from
illness and consists of such activities as
consistent and appropriate administration of
medications to optimize therapeutic effects,
moving and positioning to prevent
complications of immobility and passive and
active exercises to prevent disability.
Health and Illness

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Tertiary Prevention
Continuing health supervision during
rehabilitation to restore an individual to an
optimal level of functioning. Minimizing
residual disability and helping the client to
learn to live productively with limitations
are the goals of tertiary prevention.
Tertiary Prevention
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Tertiary PreventionMeasures aimed at
rehabilitation following significant disease.
Methods:
Medications
Chemotherapy
Surgery
Dialysis
Summary: Levels of Prevention

Primary
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before it occurs (e.g., immunization against the
seven childhood illnesses).
Secondary Prevention activities provide early
detection and intervention (e.g., screening for
presence of diabetes).
Tertiary Prevention activities correct a disease
state and prevent it from further deteriorating (e.g.,
teaching insulin administration in the home).
Health as a Multifactorial
Phenomenon
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FACTORS AFFECTING HEALTH

Political
involves ones leadership, how he/she rules,
manages and involves other people in decision
making
- protection from exploitative working

conditions
Health as a Multifactorial Phenomenon

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Political
- expanding access to social security
- creating the circumstances where people
can use their faculties and abilities at the
maximum level in the pursuit of common
goals

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Cultural
relating to the representation of nonphysical
traits, such as values, beliefs, attitudes and
customs shared by a group of people and
passed from one generation to the next.
practices a customary action usually done to maintain
or promote health like use of anting-anting or lucky
charms
beliefs a state or habit of mind wherein a group of
people place trust into something or a person (Webster)
Definition of Values
Values
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important by an individual or a family, such as
freedom, independence, privacy, physical
appearance, money, health and fitness, integrity
and honesty.
Values influence behavior and understanding a
populations values leads to better tolerance why
they react or respond to issues of health or are
resistant to change, among other facets of
behavior.
Components of
Culture Roots
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Culture refers to the sum total
of customs, values, traditions,
art, history and other norms
that are developed, learned
and shared by a specific group
of people.
As these practices are passed
down from generation to
generation, they may be
modified with time, knowledge,
acculturation, and lifestyle that
would result in security,
comfort and betterment of well
being.

FACTORS
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AFFECTING HEALTH
Heredity
the genetic transmission of traits from
parents to offspring: genetically determined
(Miller-Keane, 1987)
Newborn Screening (NBS)

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simple procedure using the heel prick method (a few
drops of blood are taken from the babys heel and blotted
on a special absorbent filter card, dried for 4 hours and
sent to the Newborn Screening Center) to determine if the
baby has a congenital metabolic disorder that may lead to
mental retardation and even death if left untreated.
Most babies with metabolic disorders look normal at birth.

One will never know that the baby has the disorder until
the onset of signs and symptoms and more often ill
effects are already irreversible.
Newborn screening is mandated by

RA 9288 signed by PGMA in April 2004
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Newborn screening is ideally done on the 48th
72nd hour or at least 24 hours from birth. Some
disorders are not detected if the test is done
earlier than 24 hours. The baby must be
screened again after 2 weeks for more accurate
results.
Babies with positive results should be referred at
once to the nearest hospital or specialist for
confirmatory test and further management.
Disorders Screened in Newborns

Effect Screened
Effect if Screened
& Treated
Severe Mental
Retardation
Normal
Death
Alive and Normal
Galactosemia (GAL),
A condition in which the body is unable to process galactose,
the sugar present in milk.
Death or Cataracts,
Liver/Brain
Damage
Alive and Normal
Phenylketonuria (PKU),
A rare condition in which the baby cannot properly use one of
the building blocks of protein called phenylalanine.
Severe Mental
Retardation/
Brain Damage
Disorder Screened
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Congenital Hypothyroidism (CH),

Results from lack or absence of thyroid hormone which is
essential to growth of the brain and the body.
Congenital Adrenal Hyperplasia (CAH),
An endocrine disorder that causes severe salt loss,
dehydration and abnormally high levels of male sex
hormone in both boys and girls.
Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD Def),

A condition in which the body lacks the enzyme G6PD.
Severe Anemia,
Kernicterus
Normal
Normal
Source: Department of Health

FACTORS
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AFFECTING HEALTH
Environment
the sum total of all the conditions and
elements that make up the surroundings
and influence the development of an
individual (Miller-Keane, 1987)

FACTORS
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AFFECTING HEALTH
Socio-economic
refers to the production activities,
distribution and consumption of goods
of an individual
Health Care Delivery

A PYRAMIDAL
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National Health Services
Care
Regional Health Services

Health Care
District Health Services
Rural (Local Hospital) Services
Rural Health Units

Care
Barangay Health Stations
National
Health
Services
Regional/District
Health Service
Rural (Local Hospital
Services)
Rural Health Units

Barangay Health Stations
Tertiary Health
Secondary
Primary Health
OVERVIEW OF THE
PHILIPPINE HEALTH SECTOR
THE PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
ORGANIZATION OF THE HEALTH

SYSTEM
Dual health system consisting of the
public sector and the private sector
Public Sector
- Largely taxed based financing
- Generally given free at point of service
- Socialized user charges introduced

SYSTEM
Private Sector
- For profit and non-profit providers
- Largely market-oriented
- Paid through users fees at point of
service

SYSTEM
( Public Sector )
Devolution of health services under Local
Government Code of 1991 leading to
fragmentation of health services
DOH as lead agency providing national
policies and plans, regulations, standards
and guidelines on health, including tertiary
and specialized health care
LGUs as direct providers of health services,
particularly public health programs & primary,
secondary and general tertiary hospital care

SYSTEM
( Private Sector )
For profit and non-profit health providers
- clinics and hospitals
- health insurance
- providers of health products
- research & academic institutions
Individuals, families and communities
- consumers and seekers of health care
- partners in health care
HEALTH CARE FACILITIES

>Local health facilities are poorly-equipped
and poorly-staffed;
>Regional and national hospitals are
congested
>Health facilities in the public and private
sectors are unevenly distributed
>National-local and public-private
networking and patient referral systems
are inadequate
THE HEALTH STATUS OF THE

FILIPINOS
DEMOGRAPHIC CHARACTERISTICS
Population growth rate remains high
Half of the population is below 21 years
old
Average life expectancy is increasing
Proportion of older persons is growing
GENERAL HEALTH STATUS

Life expectancy at births has increased,
with females having longer life expectancy
than males;
IMR and UFMR are declining, but the rate
of decline has slowed down;
TFR and MMR are declining, but still one
of the highest in Southeast Asia
Large variations in health status among
different regions in the country
BURDEN OF DISEASE
Leading causes of morbidity are
communicable diseases
Leading causes of mortality are
degenerative and other noncommunicable diseases
Double burden of disease places a great
toll of the economy
Threat from emerging and resurgent
diseases is increasing
UTILIZATION OF HEALTH SERVICES

Fairly widespread use of health facilities in
the country with 77 % of households
having used a health facility
Government facilities were most
frequented( 39%) compared to private
facilities ( 30 % )
Traditional healers were visited by 8 % of
the population
THE VISION, MISSION AND GOALS OF

THE PHILIPPINE HEALTH SECTOR
VISION : Health for all Filipinos
MISSION : To ensure accessibility and
quality of health care to improve the
quality of life of all Filipinos, especially the
poor.
THE PRIMARY GOALS OF THE HEALTH

SECTOR
Better Health Outcomes

- Attaining the best average level of health
for the entire population and attaining the
smallest feasible differences in health
status among individuals and groups
More Responsive Health System
- Meeting the peoples expectations of how
they should be treated by health providers
and the degree by which people are
satisfied with the health system
THE PRIMARY GOALS OF THE

HEALTH SECTOR
More Equitable Health care Financing
- Distributing the risk that each individual
faces due to cost of health care according
to the ability to pay rather than to the risk
of illness
Health Promotion
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Public health efforts focus on health
promotion and disease prevention.

Health promotion activities enhance
resources directed at improving well being,
whereas disease prevention activities
protect people from disease and the
effects of disease.
Primary Health Care

DEFINITION
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Universal Definition
- Essential care based on scientifically sound
and socially acceptable methods and technology
made universally accessible to individuals,
families and communities through their full
participation, at a cost they can afford at any
given stage of development, and with the goal of
self-reliance and self-determination.
Primary Health Care

GENERAL
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Health and development are

interrelated.
Essential health services must be
accessible, available, acceptable and
affordable.
Genuine peoples participation is
essential.
Primary Health Care

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Mission and Goals
Mission: To strengthen the health care system by
increasing opportunities and supporting the
conditions wherein people will manage their own
health care.
Key Strategy to Achieve the Goal:
Partnership with and empowerment of the People.
Health for All by the Year 2000
The strategy for achieving health

for all is based on four (4) basic points:
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Use of technology that is scientifically
and socially acceptable as well as

economically sound.
Political efforts to improve health,
thus improving peoples economic and
social status.
Cooperation of the health sector with
other sectors such as education,
agriculture, industry and media.
Community and individual
participation.
Primary Health Care

Mission
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and Goals
Key Strategy to Achieve the Goal:
Partnership with and empowerment of the People.
Health for All by the Year 2000
Health in the Hands of the People by the Year 2020
Strategy: Advocacy and Social Mobilization
Primary Health Care

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Primary Health Care

H-O-M-E
E-L-E-M-E-N-T-S
H - Hospital as a Center of Wellness

O - Oral and Dental Health
M - Mental Health
E - Elderly Care
Primary Health Care

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Primary Health Care
E-L-E-M-E-N-T-S
E- Education for Health

L- Local Endemic Disease Prevn & Control
E- Expanded Program on Immunization
M- Maternal and Child Health
E- Essential Drugs
N- Nutrition
T- Treatment of Communicable Diseases
S- Safe Water and Sanitation
Four Pillars of Safe Motherhood

DOH
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Antenatal/Prenatal Care
Emergency OB Care
Clean & Safe Delivery
Family Planning
Herbal Medicine Community-Based Program

Focuses on the promotion
and advocacy of 10
scientifically-proven
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medicinal plants endorsed
by DOH.
Lagundi,
Yerba Buena,
Sambong,
Tsaang Gubat,
Niyug-niyugan,
Bayabas,
Akapulko,
Ulasimang Bato,
Bawang
Ampalaya.
Care Enhancement Qualities

STEPS
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(A-D-P-I-E)
ASSESSMENT: COLLECT DATA

DIAGNOSIS: DEFINE THE PROBLEM
PLAN: SELECT STRATEGIES
IMPLEMENTATION: TAKE ACTION
EVALUATION: EVALUATE RESULTS

CARATIVE
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ELEMENTS
Humanistic-altruistic value system

Faith and hope
Sensitivity to self and others
Helping trust relationship
Ability to accept positive and
negative expression of feelings

CARATIVE
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ELEMENTS
Interpersonal teaching and

learning abilities
Personality type
Solid family background
Experience of having been loved
and the ability to love

CARATIVE
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ELEMENTS
Sense of humor
Relaxed attitude
Open-mindedness
Quick decision making
HEALTH CARE 2
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COMMUNITY ORGANIZING
PARTICIPATORY ACTION RESEARCH

(COPAR)
COMMUNITY
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A social group determined by geographic

boundaries and/or common values and
interests
Members know and interact with each
other
Functions within a particular social
structure and exhibits and creates
norms, values and social institutions
COMMUNITY
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Classification
Urban
Rural
Rurban
URBAN
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High density
Socially heterogeneous population and
a complex structure, non-agricultural
occupations
Complex interpersonal social relations
RURAL
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Small and the occupation of the people

is usually farming, fishing and food
gathering
Primary group relation, well-knit and
high degree of group feeling
RURBAN
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Rural families
continuously
migrate to the
metropolis
forming
communities of
urban poor
HEALTH INDICATORS
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Birth
Death
Marriages
Migration
BIRTH
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A coming into being; the act or process of

being born.
Crude Birth Rate is only a rough
measure of fertility in a population since it
makes use of midyear population as its
denominator.
DEATH
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The cessation of all physical and chemical

processes that occurs in all living things.
Crude Death Rate is only a rough
measure of mortality because death rates
are largely influenced by age and sex
composition of the population.
MARRIAGE
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The
institution whereby a
man and a woman are
joined in a special kind of
social and legal
dependence for the
purpose of founding and
maintaining a family.
MIGRATION
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The transfer of one individual from

one locality to another.
Community Health Care

Development Process (COPAR)
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Approaches to Community
Development
1.
2.
3.
Welfare Approach
Modernization Approach
Transformatory/
Participatory Approach
Welfare Approach
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- The immediate and/or spontaneous

response to ameliorate the
manifestation of poverty, especially on
the personal level.
- Assumes that poverty is God-given;
destined, hence the poor should accept
their condition since they will receive
their just reward in heaven.
Welfare Approach
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- Believes that poverty is caused by bad luck,

natural disasters and certain circumstances
which are beyond the control of people.
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Also referred to as project development
approach.
- Introduces whatever resources are lacking
in a given community.
- Also considered a national strategy which
adopts the western mode of technological
development.
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Assumes that development consists of
abandoning the traditional methods of

doing things and must adopt the
technology of industrial countries.
- Believes that poverty is due to lack of
education; lack of resources such as
capital and technology.
Transformatory/Participatory
Approach
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- The process of empowering/

transforming the poor and the oppressed
sectors of society so that they can
pursue a more just and humane society.
Transformatory/Participatory
Approach
- Assumes
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that poverty is not God-given,
rather it is rooted in the historical past
and is maintained by the oppressive
structure in society
- Believes that poverty is caused by
prevalence of exploitation, oppression,
domination and other unjust structure
Community Health Care

Development Process (COPAR)
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Phases
1.
2.
3.
4.
5.
Pre-entry Phase
Entry Phase
Organization-Building Phase
Community Action Phase
Sustenance and Strengthening Phase
Pre-Entry Phase
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- The initial phase of the organizing

process where the community organizer
looks for community to serve or help.
- Considered the simplest phase in terms
of actual outputs, activities, strategies
and time spent for it.
Pre-Entry Phase
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Activities:
Designing a plan for community
development including all its activities and
strategies for care/ development.
Community consultations/dialogues
Designing criteria for the selection of site.
Pre-Entry Phase
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Activities:
Site selection
Preliminary Social Investigation
Networking with local government units,
NGOs and others
Entry Phase
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- Sometimes
called the social
preparation phase as the activities
done here includes the sensitization
of the people on the critical events in
their life, motivating them to share
their dreams and ideas on how to
manage their concerns and
eventually mobilizing them to take
collective action on these.
Entry Phase
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Guidelines:
1. Recognize the role of local authorities

by paying them visits to inform them of
their presence and activities.
Entry Phase
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Guidelines:
2. Appearance, speech, behavior and

lifestyle should be in keeping with those
of the community residents without
disregard of their being role models.
3. Avoid raising the consciousness of the
community residents; adopt a low-key
profile.
Entry Phase
Activities:
Adela
Integration with the community

Sensitization of the
community/information campaigns
Continuing social investigation
Entry Phase
Activities:
Adela
Core group formation

- Development of criteria for selection of
CG members
- Defining the role/functions/tasks of the
CG
Entry Phase
Activities:
Adela
Coordination/Dialogue/Consultation with
other community organizations
Self Awareness and Leadership Training/
Action planning
- Adela
Entails the formation of more formal
structures and the inclusion of more formal
procedures of planning, implementing and
evaluating community wide activities
- It is at this phase where the organized
leaders or groups are being given training
to develop their AKS in managing their
own concerns/programs.
Adela
Activities:
Community meetings to draw up

guidelines for the organization of the
CHO
Election of officers
Adela
Activities:
Development of management systems

and procedures, including delineation of
the roles, functions and tasks of officers
and members of the CHO
Team building/Action Reflection Action
(ARA)
Activities:
Adela
Working out legal requirements for the

establishment of the CHO
Organization of working committees/task
groups (e.g. education and training,
membership of committees)
Training of the CHO Officers/community
leaders

Activities:
Adela
Organization and training of community

health workers
- Development of criteria for the selection of
CHWs
- Selection of CHWs
- Training of CHWs

Activities:
Adela
Setting up of linkages/network referral

systems
Initial identification and implementation of
resource mobilization schemes
Sustenance and Strengthening

Phase
-Adela
Occurs when the community
organization has already been

established and the community
members are actively participating
in community-wide undertakings

Phase
- Adela
The different committees set-up in the
organization-building phase are already

expected to be functioning by way of
planning, implementing and evaluating
their own programs with the overall
guidance from the community wide
organization.

Phase
Adela
Strategies:
- Education and training
- Networking and linkaging
- Conduct of mobilization on health and
development concerns
- Implementation of livelihood projects

Phase
Adela
Strategies:
- Formulation and ratification of
constitutions and by-laws
- Identification and development of
secondary leaders
- Setting up and institutionalization of
financing scheme for community health
program/activities

Phase
Adela
Strategies:
- Development and implementation of

viable management systems and
procedures, committees, continuing
education/training of leaders, CHWs,
community residents

Phase
Adela
Strategies:
- Continuing education and upgrading of

community leaders, CHWs and CHO
members
- Development of medium/long term
community health and development
plans.
Critical Steps in Building

Peoples Organization
Adela
1. Integration
a. Immerse himself in the poor community
b. Understand deeply the culture,
economy, leaders, history, rhythms and
lifestyle in the community

Adela
2. Social Investigation
- A systematic process of collecting,
collating, analyzing data to draw a
clear picture of the community
- Also known as community study

3.
Adela
Tentative Program Planning
A community organizer choose one

issue to work on in order to begin
organizing the people.
4. Groundwork
Going around and motivating the people
on one on one basis to do something on
the issue that has been chosen.

Adela
5. The Meeting
People collectively ratifying what they

have already decided individually. It
gives the people the collective power
and confidence. Problems and issues
are discussed.

6.
Adela
Role Play
Means to act out the meeting that will

take place between the leaders of the
people and the government
representative.
- It is a way of training the people to
anticipate what will happen and prepare
themselves for such eventuality.

Adela
7. Mobilization or action
Actual experience of the people in

confronting the powerful and the actual
exercise of people power.
8. Evaluation
The people reviewing steps 1-7 to
determine whether they were
successful or not in their objectives.

Adela
9. Reflection
- Dealing with deeper, on-going
concerns to look at the positive values
CO is trying to build in the organization
- Gives the people time to reflect on the
stark reality of life compared to the
ideal.

Adela
10. Organization
- The peoples organization is the result
of many successive and similar actions
of the people.
- A final organization is set up with
elected officers and supporting
members.
Community Health Worker

One
Adela
who provides basic community health
care services for promotion of health,

prevention of illness, simple treatment and
rehabilitation.
Qualities of a Health Worker

a.Adela
Open accepts need for joint planning
and decision relative to health care in a

particular situation not resistant to
change.
b. Tactful one who presides over an
assembly, meeting or discussion in a
subtle manner; does not embarrass but
gives constructive criticisms.

c.Adela
Coordinator brings into consonance or
harmony the communitys health care

activity.
d. Objective unbiased and fair in
decision-making.
e. Good listener always available for the
participant to voice out their sentiments
and needs.

Efficient knowledge about everything
f. Adela
relevant to his practice; has the
necessary skills expected of him
g. Flexible able to cope with different
situations
h. Critical thinker decides on what has
been analyzed
Functions of a Health Worker

1.Adela
Community Health Service Provider
Carries out health services contributing

to the promotion of health, prevention
of illness, early treatment of illnesses
and rehabilitation.
Appraises health needs and hazards.

2.Adela
Facilitator
- Helps plan a comprehensive health

program with the people
- Continuing guidance and supervisory
assistance

3.Adela
Health Counselor
- Provides health counseling including

emotional support to individuals, family,
group and community

4.Adela
Co-Researcher
- Provides the community with

stimulation necessary for a wider or
more complex study of problems
- Enforce community to do prompt and
intelligent reporting of epidemiological
investigation of diseases

4.Adela
Co-Researcher
- Suggest areas that need research

- Participate in planning for the study
and in formulating procedures
- Assist in collecting of data
- Help interpret findings collectively
- Act on the result of the research

5.Adela
Member of a Team
- In operating within the team, one must

be willing to listen as well as to
contribute, to teach as well as to learn,
to lead as well as to follow, to share
authority as well as to work under it.

5.Adela
Member of a Team
- Helps make multiple services which

the family receives in the course of
health care, coordinated, continuous
and comprehensive.
- Consults with and refers to appropriate
personnel for any other community
service.

6.Adela
Health Educator
- One who improves the health of the

people by employing various methods
of scientific procedures to stimulate,
arouse and guide people to healthful
ways of living.
TRENDS AND ISSUES IN

HEALTH CARE
Adela
Changing demographics and cultural diversity

Improving health care delivery system
Technological advances and research
Increasing globalization
Preventing terrorism
TRENDS AND ISSUES IN

HEALTH CARE
Adela
Increasing consumer/client involvement

Outcome management
Increasing the availability of skilled health
professionals, especially nurses and
physicians (also RNDs)
Improving infrastructure in rural areas
Extending education/outreach programs to
remote areas (DDUs)
WORLD LESSONS LEARNED

ABOUT HEALTH CARE
Adela
Healthcare systems vary depending on the

development level of a country. But the key
to implementation is publicly mandated
services (public or private). Such services
cannot be few and must include those that
accommodate accountability in ensuring
universal delivery. Supplementary
insurance must be allowed for items not
covered in the universal system. )
Source: World Economic Forum 28 Jan 2009
WORLD LESSONS LEARNED ABOUT

HEALTH CARE
Japan has the worlds oldest population. Health and
longevity
Adela create wealth and, thus, health begets
wealth. It is documented that nations that develop a
5-year life expectancy advantage also create a larger
GDP. A healthy childhood and adulthood contribute to
a more productive old age.
New markets and industries are arising silver
industries such as financial services, health, housing
and hospitality geared to senior citizens. Longevity
needs to be linked to health including cognitive
health and lifestyle choices play a major role in
health.

HEALTH CARE
The public health focus is shifting from infections to
Adela
cardiovascular
diseases. Complex new models are
necessary to develop better responses and improved
health with the primary emphasis on really good
primary healthcare and prevention to lower costs.
Prevention increases the healthy years of a persons
life. The challenge is creating the incentive for
prevention: how can people be encouraged to make
healthy choices? Mobilized populations can drive the
change.
Finland has an 80% lower incidence of heart disease
than 30 years ago due to such incentives.

HEALTH CARE
Improved nutrition and food security also play a
Adela
role in health outcomes. Increasingly,
governments are willing to come to grips with
outcomes and to acknowledge that healthcare
providers must be geared to supply intervention
to the most vulnerable people.
Indeed, the World Economic Forum could play an
important role in fielding a public-private health
initiative or supporting efforts to mine large
healthcare databases to unearth previously
unsuspected correlations.

HEALTH CARE
Adela
Governments
must recognize the health, social
and political aspects of a serious influenza
pandemic. On all levels whether public or private
the mantra remains proper diagnosis, correct
intervention and appropriate ways of delivering
solutions. But how best to ensure that poorer
countries can be prepared to support such efforts?
Many of the poorest including migrant
populations and refugees are off the radar and
may unwittingly be reservoirs of infectious ailments.

HEALTH CARE
Adela
Alzheimers and dementia are on the
increase. New research suggests that they

relate to the same causes and could
respond to the same preventive measures
including physical activity and moderate
alcohol intake; but this still awaits thorough
investigation. . .

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HEALTH CARE

Definition of Health Care

Health Care Process

Health as a Continuum between biological

Health From Cells to Society

Peoples Right to Daily Life

Health and Illness

THE ATOMISTIC APPROACH

Health and Illness

THE HOLISTIC APPROACH

Stimuli in the environment provide the

Health and Illness

THE HOLISTIC APPROACH

Health and Illness

MOTIVATION TO OVERCOME HARDSHIP

Health and Illness

MOTIVATION TO OVERCOME HARDSHIP

Health and Illness

Safety and security needs

Love and belonging needs

Health and Illness

Health and Illness

Health and Illness

Health and Illness

Health and Illness

Health and Illness

Health and Illness

Health and Illness

John Travis, 1975

Health and Illness

World Health Organization

At the first International Conference on Health Promotion in Ottawa,

Health and Illness

Health and Illness

Stage 1: Symptom Experience

Health and Illness

The persons perception of a symptom

Health and Illness

Health and Illness

Health and Illness

Stage 4: Dependent Client Role

Health and Illness

Stage 4: Dependent Client Role

Health and Illness

STAGES OF ILLNESS BEHAVIOR

What Determines Health:

Personal health practices

Causes of Chronic Disease

Organization & Community Interventions

Primary & Secondary Prevention

Primary & Secondary Prevention / Treatment

Primary & Secondary Prevention / Treatment

Health and Illness

Health and Illness

Health and Illness

Methods of Primary Prevention:

Health and Illness

Health and Illness

Health and Illness

Warning Signs of Cancer

U Unexplained anemia; and

Health and Illness

Health and Illness

Health and Illness