to reduce inequalities in health while ensuring the best health for the greatest number -WHO
nursing, public health and some phases of social assistance and functions as part of the total public health programme for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability -WHO Expert Committee of Nursing
environmental hazards such as in the workplace, housing, food, water, etc. Promotion of health and equitable health gain
number of people or the population as a whole. The processes used by public health nurses including working with the client(s) as an equal partner. Primary prevention is the priority in selecting appropriate activities. The focus is on selecting strategies that create healthy environmental, social and economic conditions in which populations may thrive. There is an obligation to actively identify and reach out to all who might benefit from a specific activity or service. Optimal use of available resources to assure the best overall improvement in the health of the populations is a key element of the practice. Collaboration with a variety of other professions, populations, organizations and other stakeholder groups is the most effective way to promote and protect the health of the people.
Supervisory function:
-supervisor of midwives and other auxilliary health workers -formulates a supervisory plan and conducts supervisory visits to implement the plan -conducts supervisory visits using a supervisory checklist
-based on the science and art of caring -uses knowledge and skill in the nursing process -establishes rapport with the client to ensure good quality data and to facilitate or enhance partnership in addressing identified health needs and problems -home visit is a must activity for a PHN
-establishes linkages and collaborative relationships with other health professionals, government agencies, the private sector, non-government organizations, and people s organizations to address health problems
-uses skills in advocacy for the creation of supportive environment through policies and reengineering of the physical environment for healthier actions -provides clients with information that allows them to make healthier choices and practices -health education activities is a major component of any public health program
Training function:
-initiates the formulation of staff development and training programs for midwives and other auxiliary workers -does training needs assessment, designs training program and conducts them in collaboration with other resource persons, and evaluates training outcomes -community organizing is a means of mobilizing people to solve their own problems
Research function:
-disease surveillance is a research activity of a nurse -surveillance is an integral part of many programs -data collected can be used to improve strategies and thus prevent these diseases from occuring
Concept of CHN
levels of clientele namely the INDIVIDUALS, FAMILIES, POPULATION GROUPS, and COMMUNITIES, concerned with the promotion of health, prevention of disease and disability, and rehabilitation
contributing as individuals and in collaboration with others to the promotion of the client s optimum level of functioning through teaching and delivery of careJacobson
communities, groups, families, individuals at home, in health centers, in clinics, in schools, in places of work for the promotion of health, prevention of illness, care of the sick at home and rehabilitation-Ruth B. Freeman
20
CHN IS A SYNTHESIS OF NURSING AND PUBLIC HEALTH PRACTICE: emphasis on the importance of the greatest good for the greatest number assessing health needs PLANNING, IMPLEMENTING, and EVALUATING the impact of health services on population groups priority of HEALTH-PROMOTIVE and DISEASE-PREVENTIVE over CURATIVE interventions tools for measuring and analyzing community health problems application of principles of management and organization in the delivery of health services to the community
BASIC CONCEPTS AND PRINCIPLES OF CHN: the FAMILY is the unit of care, the community is the patient and there are four levels of clientele in CHN the goal of improving community health is realized through multidisciplinary effort the community health nurse works WITH and not FOR the individual patient, family, group or community. The latter are active partners, not passive recipients of care the practice of CHN is affected by changes in society in general and by developments in the health field in particular CHN is part of the community health system which in turn is part of the larger human services system
health care provider, taking care of the sick people at home or in the RHU HEALTH EDUCATOR aim is towards health promotion and illness prevention through dissemination of correct information; educating people FACILITATOR establishes multi-sectoral linkages by referral system SUPERVISOR monitors and supervises the performance of midwives
Other specific responsibilities of a Nurse spelled by the implementing rules and regulations of R.A. 7164 (Phil. Nursing Act of 1991)
supervision and care of women during pregnancy,
labor, and puerperium performance of internal examination and delivery of babies suturing lacerations in the abscence of the physician provision of first aid measures and emergency care recommending herbal and symptomatic meds.
development, and people empowerment case finding and epidemiological investigation program planning, implementation, and evaluation influencing executive and legislative individuals or bodies concerning health and development
-a unique clinical process which includes an integration of concepts from nursing, mental health, social psychology, psychology, community networks and the basic sciences
MMR Persistence of large variations in health status across population groups and geographic areas High burden from infectious diseases Rising burden from chronic and degenerative diseases Unattended emerging health risks from environmental and work related factors Burden of disease is heaviest on the poor
services Poor health care financing and inefficient sourcing or generation of funds for healthcare IMPLICATIONS: Poor coverage of public health and primary care services Inequitable access to personal health care services Low quality and high cost of both public and personal health care
Primary Health Care held in Alma Ata, USSR on Sept. 6-12, 1978 by WHO Goal: Health for all by the year 2000 Adopted in the Phils. through Letter of Instruction 949 signed by Pres. Marcos on Oct. 19, 1979 Theme: Health in the Hands of the People by 2020
-devolved to the cities and municipalities -health care provided by health center physicians, PHN, RHM, BHW, traditional healers and others at the barangay health stations and RHU Secondary Level of Care -given by physicians with basic health trainings -given in health facilities privately owned or government operated such as infirmaries, municipal and district hospitals, and OPD of provincial hospitals -capable of performing minor surgeries and simple laboratory exams Tertiary Level of Care -rendered by specialists in health facilities including medical centers as well as regional and provincial hospitals, and specialized hospitals -complicated cases and intensive care requires tertiary care
Public health nurses need to know the laws affecting health and nursing practice in the Philippines. As practicing nurse in the community setting, the PHN must be familiar with the existing laws and standards that governs safe nursing practice.
Types of Laws/Policies: Republic Acts Administrative Orders Department Memorandum Executive Orders Presidential Decrees
Republic Acts Laws (RA's) created by the Congress and signed by the President. Administrative Orders Prescribed policies, rules, and regulations and procedures (AO's) individuals and organizations outside of the DOH. Department Memorandum Issuances that deals usually with guidelines/reminders of action and obligations of all or group of offices within the Department . Executive Orders Executive legislations (EO's) that are health-related. Presidential Decrees Executive decrees (PD's) that are health-related.
Magna Carta any fundamental constitution or law guaranteeing rights and liberties
RULE I COVERAGE
These Rules and Regulations shall cover all person engaged in health and health-related work, employed in all hospital, sanitaria, health centers, rural health units, barangay health station, clinics and other health-related establishments owned and operate by the government or its political subdivisions, regardless of the employment status. Also covered are medical and allied professional and support services personnel.
RULE II INTERPRETATION This Act aims: To promote and improve the social and economic wellbeing of health workers, their living and working conditions and terms of employment To develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs To encourage those with proper qualifications and excellent abilities to join and remain in government
CODE ON SANITATION
PRESIDENTIAL DECREE No. 856
The Code on Sanitation provides for the control of all factors in man s environment that affect health including the quality of water, food, milk, control of insects, animal carriers, transmitters of disease, sanitary and recreation facilities, noise, pollution, unpleasant odors and control of nuisance.
AN ACT PROVIDING FOR A COMPREHENSIVE AIR POLLUTION CONTROL POLICY AND FOR OTHER PURPOSES
The State shall protect and advance the right of the people to a balanced and healthful ecology in accord with the rhythm and harmony of nature. The State shall promote and protect the global environment to attain sustainable development while recognizing the primary responsibility of local government units to deal with environmental problems. The State recognizes that the responsibility of cleaning the habitat and environment is primarily area-based. Finally, the State recognizes that a clean and healthy environment is for the good of all and should therefore be the concern of all.
The following rights of citizens are hereby sought to be recognized and the State shall seek to guarantee their enjoyment: The right to breathe clean air;
1. The right to utilize and enjoy all natural resources according to the principle of sustainable development; 2. The right to participate in the formulation, planning, implementation and monitoring of environmental policies and programs and in the decision-making process; 3. The right to participate in the decision-making process concerning development policies, plans and programs projects or activities that may have adverse impact on the environment and public health; 4. The right to be informed of the nature and extent of the potential hazard of any activity, undertaking or project and to be served timely notice of any significant rise in the level pollution and the accidental or deliberate release into the atmosphere of harmful or hazardous substances; 5. The right of access to public records which a citizen may need to exercise his or her rights effectively under this Act; 6. The right to bring action in court or quasi-judicial bodies to enjoin all activities in violation of environmental laws and regulations, to compel the rehabilitation and cleanup of area, and to seek the imposition of penal sanctions against violators of environmental laws; and 7. The right to bring action in court for compensation of personal damages resulting from the adverse environmental and public health impact of a project or activity.
Generics Act
Republic Act 6675
The Generics Act of 1988 which promotes, requires and ensures the production of an adequate supply, distribution, use and acceptance of drugs and medicines identified by their generics name.
Statement of Policy
To promote, encourage and require the use of generic terminology in the importation, manufacture, distribution, marketing, advertising and promotion, prescription and dispensing of drugs; To ensure the adequate supply of drugs with generic names at the lowest possible cost and endeavour to make them available for free to indigent patients; To encourage the extensive use of drugs with generic names through a rational system of procurement and distribution; To emphasize the scientific basis for the use of drugs, in order that health professionals may become more aware and cognizant of their therapeutic effectiveness; and To promote drug safety by minimizing duplication in medications and/or use of drugs with potentially adverse drug interactions.
National Health Insurance Act of 1995 This Act seeks to: a. provide all citizens of the Philippines with the mechanism to gain financial access to health services; b. create the National Health Insurance Program, hereinafter referred to as the Program, to serve as the means to help the people pay for health care services; c. prioritize and accelerate the provisions of health services to all Filipinos, especially that segment of the population who cannot afford such services; and d. establish the Philippine Health Insurance Corporation, hereinafter referred to as the Corporation, that will administer the Program at central and local levels.
In order to promote public health, it is hereby declared the policy of the State:
a. to promote and encourage voluntary blood donation by the citizenry and to instil public consciousness of the principle that blood donation is a humanitarian act; to lay down the legal principle that the provision of blood for transfusion is a professional medical service and not a sale of a commodity; to provide for adequate, safe, affordable and equitable distribution of supply of blood and blood products; to inform the public of the need for voluntary blood donation the hazards caused by the commercial sale of blood; to teach the benefits and rationale of voluntary blood donation existing health subjects of the formal education system in all public /private schools, in the elementary, high school and college levels as the non-formal education system; to mobilize all sectors of the community to participate in mechanisms for voluntary and non-profit collection of blood;
b.
c. d. e.
f.
g.
h.
i. j. k. l.
to mandate the Department of Health to establish and organize a National Blood Transfusion Service Network in order to rationalize and improve the provision of adequate and safe supply of blood; to provide for adequate assistance to institutions promoting non-profit blood services, either through a system of reimbursement for costs from patients who can afford to pay, or donations from governmental and non-governmental entities; to require all blood collection units and blood banks/center to operate on a non-profit basis; to establish scientific and professional standards for the operation of blood collection units and blood banks/center in the Philippines; to regulate and ensure the safety of all activities related to the collection, storage and banking of blood; and to require upgrading of blood banks/center to include preventive services and education to control spread of blood transfusion transmissible diseases.
Stiff penalties are also been imposed on convicted dangerous drug financiers, protectors, coddlers and traders who use cellular phones and the Internet in making illegal deals. The new law seeks the speedy destruction of seized dangerous drugs as it provides punishment for policemen and prosecutors who delay or bungle drug cases. To protect the people from the bad effects of dangerous drugs, the new law provides mandatory drug tests for drivers and firearms holders, random drug tests for students and workers in the government and private sectors, and compulsory education on dangerous drugs in all school levels. RA 9165 also gives Congress oversight functions over drug cases, while providing funds to fully implement the law. An initial P25 million has been appropriated for various activities.
A notifiable disease is any disease that is required by law to be reported to government authorities. This collation of information allows the authorities to monitor the disease, and provides early warning of possible outbreaks. Many governments have enacted regulations for reporting of both human and animal (generally livestock) diseases. This usually happens during pandemics.
Purpose of Notification
I. Immediate Purposes: Serves as a warning device for local health authorities in the occurrence of diseases for immediate action. Stimulate prompt action for preventing the spread of infectious disease Institute preventive and control measures Educate public to observe precautionary measures. II. Subsequent Purposes: To obtain specific knowledge that will serve as a basis in planning more effective program for prevention and control of those diseases Information used for the epidemiological study on the natural history of diseases. To provide statistical material to those engaged in medical research. To meet the needs of commercial organization in planning & development of their services and products.
Notifiable Diseases
Notifiable Diseases
accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development (WHO)
GOAL: Health for all Filipinos and Health in the Hands of the People by the year 2020 MISSION: To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care
Characteristics
1.
Partnership and empowerment of the people as the core strategy in the effective provision of essential health services that are community based, accessible, acceptable and sustainable at a cost which the community and government can afford. Strategy responsible for the health of individuals, his family and the community
2.
Strategies:
1.
2. 3.
Establishment of functional support mechanism in support of the Mandate of Devolution under Local Government Code of 1991. Effective preparation and enabling process for health action at all levels Mobilization of the people to know their community, identifying their basic health needs and providing appropriate solutions on their own. (Self-reliance, Self-determination)
5. 6.
7. 8.
technology focusing on local indigenous resources available. Community organization as it continually evolves in pursuit of their own development. Increased opportunities for community participation in planning, management, monitoring and evaluation. Development of intra-sectoral linkages Partnership between health worker and the community
Health Education
Is one of the potent methodologies for information dissemination. It promotes the partnership of both the family members and health workers in the promotion of health as well as prevention of illness.
Health Education
- Process whereby knowledge, attitude and practice of
people are changed to improve individual, family and community health - Basic health services provided by every member of the health care team - Means of improving health of people by using various methods to show the most healthful ways of living
Mode of transmission: Skin penetration from contaminated fresh water Methods of control: A. Preventive Measures 1. education regarding mode of transmission 2. proper waste disposal 3. improve irrigation and agricultural practices 4. Treatment of snail-breeding sites
5. Proper hygiene and safety practices (wearing of boots, etc) 6. Safe water for drinking, bathing and washing clothes. 7. Treatment of infected patients to prevent further transmission. B. Control 1. Report to local health authority
2. Filariasis - chronic parasitic infection caused by nematodes Wuchereria bancrofti, Brugia malayi or Brugia timori. Mode of Transmission: Mosquito bites ( Aedes poecilius) S/Sx: Lymphadenitis, lymphangitis, lymphedema, elephantiasis
hydrocoele,
Prevention and Control: A. Control of vector - environmental sanitation - use of insecticides B. Protection - use of mosquito nets - use of long sleeves, long pants and socks - insect repellents - health education
3. Malaria - produced by Plasmodium falciparum, P. Vivax, P. ovale, P. malariae. Mode of Transmission: - mosquito bites S/Sx - recurrent chills, fever, profuse sweating, anemia, malaise, hepatomagaly, spleenomegaly.
Prevention and Control a. treatment of mosquito net b. house spraying c. on stream seeding d. on stream clearing e. wearing long clothing f. avoiding outdoor night activities g. using mosquito repellents h. planting neem tree
months) against 7 vaccine preventable diseases. - Fully immunized one dose BCG
3 doses OPV 3 doses DPT 3 doses Hep B one dose measles BEFORE 1ST Birthday
EPI
y TARGET SETTING: 1. INFANTS 0-12 MONTHS 2. PREGNANT AND POST PARTUM WOMEN 3. SCHOOL ENTRANTS/ GRADE 1 / 7 YEARS OLD y OBJECTIVES OF EPI:
TO REDUCE MORBIDITY AND MORTALITY RATES AMONG INFANTS AND CHILDREN from SIX CHILDHOOD IMMUNIZABLE DISEASE
Interval
Route
ID
Hep B
4 weeks
IM
DPT
4 weeks
IM
Interval
4 weeks
Route
oral SQ
Measles
Tetanus Toxoid
Vaccine
TT1
TT2
4 weeks later
80%
TT3
6 mos later
95%
Vaccine
Min. Age
At least 1 year later At least 1 year later
% Protected
99%
Duration of Protection
10 years for mother Lifetime protection for mother
TT4
TT5
99%
FAMILY HEALTH
AIMS TO: - Improve the survival, health and well-being of mothers and the unborn - Reduce morbidity and mortality rates for children 0-9 years - Reduce mortality from preventable causes among adolescent and young adults - Reduce morbidity and mortality among Filipino adults - Reduce morbidity and mortality of older persons
Maternal Health
- To reduce the maternal mortality ratio by three
quarters by 2015. Thrusts for 2005-2010 - Launch and implement the Basic emergency Obstetric Care - Improve quality of pre and postnatal care - Reduce women s exposure to health risks - LGU and NGOs must advocate health
Essential Health Services Antenatal Registration Tetanus Toxoid Immunization Micronutrient Supplementation y Vitamin A and Iron 4. Treatment of Diseases and other conditions. 5. Clean and Safe Delivery 6. Support to Breast Feeding 7. Family Planning Counselling
1. 2. 3.
FAMILY PLANNING PROGRAM - Overall goal is to provide universal access to family planning information and services wherever and whenever these are needed
Methods of Family Planning: 1. Female sterilization 2. Male sterilization 3. Pill 4. Male condom 5. Injectables 6. Lactating Amenorrhea (LAM) 7. Mucus/Billings/Ovulation 8. Basal Body Temperature 9. Sympto-thermal Method 10. Two day Method 11. Standard Days Method
Misconceptions:
- Some family planning methods causes
Child Health
- Reduce morbidity and mortality rates for children 0-9
years Infant and Young Child feeding - Improve the survival of infants and young children by improving their nutritional status, growth and development through optimal feeding
Key Points; - Initiate breastfeeding within 1 hour after birth - Exclusive for the first 6 months of life - Complemented at 6 months with appropriate foods - Extend breastfeeding up to two years and beyond
Laws on Infant and Young Child Feeding Milk Code (EO 51) 2. Rooming-in and Breastfeeding Act of 1992 3. Food Fortification Law or Food Fortification Law ( Ra 8976)
1.
Nutrition Program
y
y
Goal:
To improve the quality of life of Filipinos through better nutrition, improved health and increased productivity.
Programs: 1. Micronutrient supplementation - Twice a year distribution of Vitamin A to 6-71 month olds - Iron supplements to target groups
2. Food Fortification - Food Fortification act of 2000 provides for mandatory fortification of: flour- with iron and vitamin A cooking oil and refined sugar with Vit A rice with iron and household utilization of iodized salt
3. Essential Maternal and Child Health Service Package 4. Nutrition information, communication and education 5. Home, school and community Food Production - establishment of kitchens and gardens in homes and schools to serve as source of additional food.
6. Food Assistance - food discounts and rice distribution 7. Livelihood Assistance - provision of credit and livelihood opportunities
Non-Communicable Diseases
A. Cardiovascular Diseases
1. Hypertension- sustained elevation in mean arterial pressure Risk Factors: Family history, age, high salt intake, obesity, excessive alcohol intake
y Prevention
- encourage proper nutrition (low fat and salt intake) - weight reduction - smoking cessation - identify people with risk factors and encourage regular check-ups
2. Coronary Artery Disease caused by impaired coronary blood flow. Also known as ischemic heart Disease Risk Factors: elevated blood lipids/cholesterol, smoking/tabacco use
Prevention; - promote regular physical activity -encourage proper nutrition - maintain normal body weight - advise smoking cessation - early diagnosis, prompt treatment and control
3. Cerebrovascular Disease or Stroke - loss or alteration of bodily function that results from an insufficient supply of blood to some parts of the brain. Risk Factors: Increasing age, sex, heredity and race, hypertension, cigarette smoking, diabetes mellitus, heart disease, high rbc count, season and climate, socioeconomic factors, excessive alcohol intake, drug abuse
Prevention: - Treatment and control of hypertension - smoking cessation - prevent thrombus formation with medications - limit alcohol intake - avoid intravenous drug abuse - prevent all other risk factors of atherosclerosis
B. Cancer - cancer develops when cells in part of the body begin to grow out of control Causes: Hereditary, carcinogens, chemicals and environmental agents, benzopyrene, nitrosamines, radiation, viruses.
Prevention: - smoking cessation - proper nutrition - limit alcohol consumption - weight control - early detection and treatment
3. Diabetes Mellitus Type I characterized by absolute lack of insulin due to damaged pancreas, prone to develop ketosis, and dependent on insulin injections Risk factors: genetic, environment or viruses and chemical toxins Type II fasting hyperglycemia despite availability of insulin. Risk factors: family history, overweight, sedentary lifestyle, hypertension, high cholesterol
Prevention: - maintain normal body weight - encourage proper nutrition - promote regular physical activity - smoking cessation
4. Chronic Obstructive Pulmonary Disease - airflow limitation that is not fully reversible. Risk Factor: cigarette smoking
5. Bronchial Asthma - inflammatory disorder of the airways Risk factors: Hereditary, allergy, gender, race, environmental factors (allergens), smoke, infections, diet and drugs, obesity
Prevention: - recognize triggers - avoid triggers - promote exclusive breastfeeding as long as possible
Healthy Lifestyle
Healthy Lifestyle- a way of life that promotes and protects health and well-being Promotion of healthy lifestyle is imperative to preventing these non communicable diseases.
1.
Promoting physical activity - at least 30 minutes, cumulative, moderate intensity, most days of the week - at least 30 minutes, cumulative, vigorous intensity 3 times a week
2. Promoting Proper Nutrition Strategies: - Aim for ideal body weight -Build healthy nutrition-related practices -Choose foods wisely
- eat a variety of foods everyday - breastfeed exclusively up to 6 months - maintain children s normal growth - consume fish, lean meat, poultry or dried beans - eat more vegetables, fruits and root crops - eat foods cooked in edible/cooking oil daily - consume milk and milk products and other calcium rich foods everyday - use iodized salt - eat clean and safe food - exercise regularly, do not smoke and avoid alcoholic beverages
Communicable Diseases
1.
Tuberculosis worlds deadliest disease - highly infectious chronic disease caused by Mycobacterium tuberculosis, M. africanum, M. bovis. Mode of transmission: -airborne droplet
S/Sx: cough for 2 weeks or more, fever, chest or back pains, hemoptysis, significant weight loss, body malaise, fatigue, shortness of breath Prevention: - prompt diagnosis and treatment - BCG vaccination - education - improve social conditions - make available medical facilities - home supervision of patients
TB DOTS (National TB Control Program) Recommended Category Treatment Regimen Category I Type New + smear, New smear but extensive lesions in CXR, EPTB, HIV Intensive Continuation treatment 2HRZE 4HR
Category II
Type Tx failure, relapse, return after default, others New smear with min lesions Chronic + smear after treatment
III
2HRZE
4HR
IV
2. Dengue Hemorrhagic Fever -caused by Aedes Aegypti bite 3 stages: First 4 days invasive stage high fever, abdominal pain and headache, later flushing which may be accompanies by vomiting, conjunctival infection and epistaxis 4th - 7th days Toxic/ hemorrhagic stage lowering of temp, severe abdominal pain, vomiting, frequent bleeding from GIT, unstable BP, (+) torniquet test
generalized flushing, appetite regained, blood pressure stable Prevention: - early recognition of the disease - isolation of patient - epidemiological investigation - case finding - health education
Prevention: - eliminate vectors by changing stagnant water once a week - destroy breeding places - proper disposal of rubber tires, empty bottles, cans - keep water containers covered - avoid too many hanging clothes - residual spraying of insecticides
3. Measles - acute highly communicable infection Mode of transmission: - droplet spread or direct / indirect contact S/Sx fever, rashes, coryza, koplik spots
Prevention: - avoid exposure - isolation of cases until 5-7 days after onset of rash - vaccination
4. Hepatitis A - acute hepatitis introduced by fecally contaminated water or food. S/Sx : headache, malaise, anorexia, abdominal pain, nausea/vomiting, fever, lymphadenopathy, jaundice
Prevention - ensure safe drinking water - sanitary preparation of food - proper waste disposal - handwashing - separate and proper cleaning of articles used by patient
5. Rabies - acute viral encephalomyelitis by rabies virus Mode of transmission: - bites of rabid animals, thru breaks in the skin S/Sx: sense of apprehension, headache, fever, sensory change near animal bite, spasms of muscles or deglutition, paralysis, delirium or convulsions
National Rabies Prevention and Control Strategies: - manpower development - social mobilization - local program implementation - dog immunization - conduct of dog vaccination - post-immunization evaluation
Environmental Sanitation is defined as the study of all factors in the man s environment, which exercise or may exercise deleterious effect on his well-being and survival. Water is a basic need for life and one factor in man s environment. Water is necessary for the maintenance of healthy lifestyle. Safe Water and Sanitation is necessary for basic promotion of health.
- Level II (Communal faucet system) composed of a source, reservoir, piped distribution network and communal faucets, not more than 25 meters fro the farthest house, one faucet per 46 households. - Level III (Waterworks systems) system with a source, reservoir, piped distributor network and household taps.
2. Unapproved type of water facility - water coming from doubtful sources shall not be allowed fro drinking water unless treated through proper container disinfection. 3. Access to safe and potable drinking water. - all households shall be provided with safe and adequate water. 4. Water quality and monitoring surveillance - done every year and must meet provisions of the National Standards for Drinking Water set by the DOH
5. Waterworks/water system and well construction - should comply with sanitary requirements of the Department of health.