HEALTH PROGRAMS & SERVICES

A) COMPREHENSIVE MATERNAL AND CHILD CARE PROGRAMS

OBJECTIVES: To improve the wellbeing of mothers and children through the delivery of comprehensive maternal and child related services utilizing the Primary Health Care (PHC) approach. Reduction of maternal mortality & infant mortality.

1)Maternal Care/Safe Motherhood Program

Target Clients pregnant women - safety of the mother and the child Services during the Pre-natal visits: - Physical examination - Laboratory examination (urinalysis & hemoglobin det.) - Giving of iron or ferrous sulfate - Tetanus Toxoid Immunization - Counseling on proper nutrition, prenatal & neonatal care,proper hygiene, breastfeeding, early psycho-social stimulation of the baby, etc.


1. 2. 3. 4.

IMPORTANCE OF PRE-NATAL VISITS: Early assessment & detection of high risk factors Early prevention, monitoring and treatment of HR factors Ensuring safe delivery and a healthy baby Getting correct advise on proper care during pregnancy, preparing for delivery.

Schedule of Pre-natal visits in the health centers

1st to 7th month once a month 8th month twice a month 9th month - weekly

Immunization sched of Tetanus toxoid for childbearing women of age, including pregnant women DOSE SCHEDULE TT 1 TT 2 TT 3 At first contact, or as early as possible during preg. 4 wks after TT 1 6 to 12 mos. aftr TT2 or during subsequent preg 1 to 3 yrs. After TT3 or during subsequent preg 1 to 5 yrs. After TT4 or during subsequent preg

TT 4
TT 5

Relationship bet tet toxoid dose & duration of protection

Dose TT1 Minimum interval % protected Duration of protection -

TT2
TT3 TT4 TT5

4 wks
6 months 1 yr 1 yr

80 %(60-90)
95 % 99% 99%

3 yrs
5 yrs 10 yrs Life long

 If a mother has received 2 doses of Tetanus Toxoid Immunization she is considered FULLY IMMUNIZED MOTHER (FIM)

High Risk Pregnancies

Too young less than 18 yrs. old Too old - more than 34 years old Too many more than 4 children Too close less than 3 years interval Getting pregnant while sick with chronic diseases like TB or Malaria or with Iron Deficiency.

2) Family Planning/Reproductive Health Program

Target clients women of reproductive age (WRAs) aged 15-49 years old. Helping couples achieved their desired family size in the context of responsible parenthood. Health intervention program of DOH to promote overall health of women & children Contributes to the reduction of maternal & infant deaths in the country.

 Services:
- FP counseling - Physical examination - Provision of FP methods using cafeteria approach. o FP Methods - Permanent ( Vasectomy and Bilateral Tubal Ligation) - Temporary ( pill, iud, dmpa/injectables, condom, fertility awareness- based methods)

 PROMOTION OF EXCLUSIVE BREASTFEEDING STRENGTHENED THE MILK CODE (Executive Order No. 51)
a law which protects and promote breastfeeding.

3) BREASTFEEDING PROGRAM

KEY POINTS:
It is the most nutritious & the cheapest form of infant feeding. Mothers milk contains colostrum which has antibodies that protect the

baby from sickness. It is the best natural means of feeding, available anytime & does not get spoiled. Breastmilk protects the baby against viruses, bacteria & allergy. Strengthens mother-child bonding because it: Promotes the feeling of security in the child Makes the child feel loved and wanted Helps develop & heighten the childs senses Frequent breastfeeding delays the return of menses & helps to protect from another pregnancy.

Tips to successfully breastfeed the baby:

The mother has to believe that she has the natural

capability to breastfeed. To observe proper sucking position. Use both breasts at each feeding time. Practice exclusive breastfeeding. Continue breastfeeding even when tired or sick. Increase intake of nutritious foods and drink plenty of fluids. Ask the husband to suck the breast if the milk is not coming out or if it not sufficient. Get enough rest. Share with the husband & other family members her worries & needs. Continue breastfeeding even if the mother is working.

COMMON PROBLEMS WITH BREASTFEEDING:

1)Engorged breast/mastitis 2)Soreness/swollen nipples 3)Inverted nipples.

4) Expanded Program on Immunization (EPI)

OBJECTIVE: To reduce morbidity & mortality among infants and children caused by the 7 childhood immunizable diseases: diptheria pertussis measles hepatitis B tetanus tuberculosis polio

Table 1.Routine Immunization

Vaccine
1.BCG 2.DPT 3. Hep B

Age
At birth/sch.entrants 6,10,14 wks AT BIRTH

Dosage
.05ml/.01ml .5ml(3 doses) -do-

Route
ID IM IM

Site
R deltoid of the arm/L deltoid(sch.) Upper outer portion of the anterior thigh Upper outer portion of the anterior thigh

4. OPV
5.Measles

6, 10, 14 weeks
9 months

3 drps(3 Doses)
.5ml

oral
SQ

mouth
Outer part of the upper arm

What is Fully Immunized Child (FIC)

A Fully Immunized Child (FIC) in EPI shall mean a child who has 1 BCG,3 DPT,3 OPV,3 Hepa B & 1 MV given at the right intervals by the time he reaches 12 months old (revised in 1996) Wednesday has been declared nationwide as Immunization Day.

5)Under Five Care Program

Package of care services given to 0-71 months old children. (0-5 years old) Services: Newborn screening Immunization Vitamin A Supplementation 100,000 IU 6 11 months. (blue) 200,000 IU 1 yr to 5 yrs. old (red) Deworming Dental check-up

6) Nutrition Program
Target Clients: 0-71 months old children, pregnant and lactating mothers. OBJECTIVE: Decrease the prevalence of malnutrition among our children & pregnant/lactating mothers. Classification of Nutritional Status based on International Reference Standard (IRS) : N - Normal AN Average Normal BNL Below Normal Level VLBN Very Low Below Normal

COMMON NUTRITIONAL DEFICIENCY:

Protein- Energy Malnutrition Vit A Deficiency (VAD) Iron Deficiency Anemia (IDA) Iodine Deficiency Disorder (IDD)
FOOD FORTIFICATION PROGRAM (RA 8976)

- Sangkap Pinoy Seal (SPS) Mandatory fortification of staple foods Diamond Seal Salt iodine rice - iron oil Vit. A Sugar vit. A flour- vit. A & iron

7) Control of Acute Respiratory Infection (CARI)

OBJECTIVE: Reduction of infant mortality & morbidity. Respiratory Infections can affect the following areas of the respiratory tract: nose, throat and lungs If not detected and treated early enough, it may lead to pneumonia and eventual death.

Signs & symptoms of ARI: fast breathing noisy/difficult breathing cough runny nose or colds may or may not have fever

 1. 2. 3. 4. 5. 6.

TIPS ON PREVENTING ARI: Immunization (measles & DPT) Breastfeed babies (up to 2 yrs old) Nutritious Food/Balanced Diet Vit. A Supplementation Keep away from smokers Avoid exposure to extreme cold/heat. 7. Avoid crowded places.

8) Control of Diarrheal Diseases (CDD)

Diarrhea is the passing out of loose or watery stool 3 or more times a day. It is mainly caused by germs that enter the body through the mouth. 7 out 10 cases are caused by a virus, therefore no drugs and antibiotics are necessary. Prevention of Dehydration: 3 Fs Fluids (Oresol/Home Made) Feeding ( continue breastfeeding) Fast Referrals (health facilities) A CHILD HAS SIGNS OF DEHYDRATION IF HE HAS ANY 2 OF THE FOLLOWING: - passes out stools 3 or more times a day. - very thirsty - has sunken eyes/no tears when crying - fever - the skinfold remains raised for a few seconds when pinched - sleepy and irritable - has blood in stool

PREVENTION OF DIARRHEA

1. 2. 3. 4. 5. 6. 7.

Exclusive breastfeeding Improved weaning practices Proper hand washing Access to safe water use of sanitary toilets proper disposal of babys stool measles immunization

B) COMMUNICABLE & NON-COMMUNICABLE DISEASES

9) NATIONAL TUBERCULOSIS CONTROL PROGRAM

Infectious disease usually affecting the lungs caused by Mycobacterium tuberculosis. Transmitted from TB patients through coughing Most common sign is cough lasting for 2 weeks or more. Diagnosed through sputum examination (microscopy)

Strategy: Directly Observed Treatment Short Course Chemotheraphy (TB-DOTS) What DOTS can do? Will cure TB patients (high cure rate as high as 95%) Prevents new infections among children & adults Prevents resistance to Anti-TB Drugs No hospitalization required Saves money

10) LEPROSY CONTROL PROGRAM

Disease affecting the skin caused by Mycobacterium Laprae or Leprosy Bacilli. Early signs: Changes in skin Loss of feeling on the lesions of the skin Decrease or even loss of sweating, and hairgrowth over the skin lesions Thickened or painful nerves in neck, forearm, near elbow & at back of knees Weakness of limbs

Treatment & Management of Leprosy

Multi-Drug Therapy
Benefits of Early Treatment:

1. 2.

3. 4. 5.

Cured within a shorter period Will not be able to infect other susceptible members of the household Prevent the progress of skin lesions in the body. Prevent nerve damage leading to deformities. Prevent relapse & resistance to drugs.

11) Cardio-Vascular Disease Control Program

Healthy Life-Style Practices among Filipinos thru the promotion of the following: Anti-Smoking Proper Diet Regular Exercise Iwas Stress Activities: - Case finding BP Taking - Referral

12) Cancer Control Program

OBJECTIVE: Morbidity and mortality rates from cancer are reduced. Cancer largely considered a lifestyle disease. Males lungs, liver and prostate Females- breast, cervix and lungs Children leukemias, lymphomas

Services:

Counselling patient on: - tobacco use cessation - diet modification & moderate alcohol consumption Cancer screening Breast Examination Pap smear screening Hepa B vaccination among infants Establish support care program for cancer patients.

13) Renal Disease Control Program

About 6500 yearly deaths in the country secondary to various kidney diseases. Risk Reduction Objectives: Increase awareness of preventing renal diseases: adequate water intake, healthy lifestyle practices, BP check-up, yearly urinalysis. Increase awareness of the signs & symptoms of kidney disease 3. Increase the proportion of schoolchildren, adolescents, young adults routinely screened for UTI, diabetes and kidney disease.

1.

2.

Strategies & Services

1)Increase referral of abnormal urinary findings to nephrologist for early & adequate management & monitoring. 2)Counseling of patients 3)Upgrade capabilities of hospitals to cater to kidney patients.

14) Diabetes Control Program

Diabetes condition where there is poor activity or decrease production of a hormone called insulin resulting in an increase in blood sugar. - 4 out of 100 Filipinos are diabetics - Higher in urban than in rural areas - 63% are unaware that they had diabetes - No known cure for diabetes.

4 Levels of Diabetes Prevention:

1) (-) risk (+) disease primordial 2) (+) risk (-) disease primary ( educated & encouraged in promoting & maintaining healthy lifestyle) 3) (+) risk (+) disease secondary ( they will be educated on proper self-care to prevent complications) 4) (+) disease (+) complications tertiary - be provided with adequate access to rehabilitation services & referrals to facilities with specialist.

15) STI/HIV & AIDS

Services; 1) Case Finding/Consultation 2) Referral 3) Health Education 4) Contact Tracing 5) Treatment

16) Rabies Control Program

Services: 1) Massive Campaign on Responsible Pet Ownership 2) Referral to Animal Bites Center 3) Provision of Anti-rabies vaccines ( 3 5 doses) 4) Health Education

C) TROPICAL DISEASE CONTROL PROGRAM

17) Dengue Control Program

Dengue - a viral infection characterized by sudden onset of fever which would last for 2 - 7 days. Types of dengue: 1. dengue fever 2. dengue hemorrhagic fever 3. undifferentiated fever
Carriers:

1) Aedes Aegypti - primary vector of the disease - prefers to breed indoor in artificial container. 2) Aedes Albopictus - most common in rural areas
- secondary vector of dengue - prefers to breed outside

PREVENTION AND CONTROL: 1. Environmental Management 2. Biological control 3. Chemical control 4. Personal protection 5. Space spray applications

18) Schistosomiasis Control Program

Schistosomiasis is a tropical parasitic disease caused by a blood fluke known as schistosoma japonicum. Transmiited through an intermidiary host a tiny frshwater snail identified as Oncomelania hupensis quadrasi. The disease is transmitted to man or animal when they come in contact with bodies of freshwater infested with cercariea coming from infested snails.

Prevention & Control: Treatment of cases Environmental Sanitation Snail Control Health Education

19) Malaria Control Program

Malaria is a disease caused by

protozoa of genus plasmodium. Most of those affected are the upland farmers, miners, forest related workers, IPs, soldiers Four species of the malaria parasite are known to infect humans: plasmodium vivax, falcifarum, malariae and ovale. The disease is transmitted by inoculation of the infective sporozoites through the bite of a female anopheles at night.

Activities/Strategies:
1) PROMOTIVE community health education 2) PREVENTIVE treated mosquito nets indoor residual spraying seeding of streams clearing of streams other personal protection measures 3) CURATIVE Early diagnosis & prompt treatment 4) SUPPORT MECHANISMS Surveillance Epidemiological Investigation

20) Filariasis Control Program

Filariasis is a parasitic infection transmitted by a mosquito. Two species of the parasite that cause filariasis:

wuchereria & brugia malayi

ELEPHANTIASIS OF THE UPPER EXTREMITIES

ELEPHANTIASIS OF THE BREAST

ELEPHANTIASIS OF THE SCROTUM (HYDROCOELE)

ELEPHANTIASIS OF THE LOWER EXTREMITIES

Strategies:
Use

of mosquito nets Residual spraying Screening of houses Use of protective clothing among plantation workers elimination of mosquito breeding places. Mass Treatment

In the implementation of these programs CITY HEALTH OFFICE is using the: PRIMARY HEALTH CARE APPROACH seeing to it that at the brgy level health services are available, acceptable, & accessible. teaching them to be self-reliance Encouraging communities to participate in any health endeavor activities. Raising their level of understanding and awareness that health and development are interrelated. HEALTHY FAMILIES MEANS HEALTHY & PRODUCTIVE COMMUNITY MEMBERS.

SOMETHING BOTHERING AND WORRYING YOU??

DOES STUDYING EXHAUST YOU?

IT DOESNT EXHAUST THEM!

DONT YOU LIKE GREEN VEGETABLES?

THEY HAVE NO CHOICE!

ARE YOU ON DIET ALL THE

THEY WISH TO EAT...

DOES YOUR PARENTS SUPER PROTECTION BOTHER YOU?

THEY DON'T HAVE PARENTS!

ARE YOU BORED PLAYING THE SAME THEY DONT HAVE GAMES...? ANY OPTION!!!

DID THEY BUY YOU ADIDAS, WHEN YOU

WANTED NIKE?

THEY ONLY HAVE

THIS BRAND!!!

ARE YOU UPSET WHEN THEY ORDERED YOU TO BED...?

THEY DONT WANT TO WAKE UP!!!

DONT COMPLAIN...

AND IF, INSPITE OF EVERYTHING, YOU KEEP GETTING YOURSELF WORRIED...

LOOK AROUND YOU.. THANK GOD FOR EVERYTHING THAT HE ALLOWS YOU TO HAVE IN THIS BRIEF LIFE...

REMIND YOURSELF TO ASK LESS, AND THANK MORE!!!