CPH Week 1 (Community) - The extent to which an individual or group is able,

on the one hand, to realize aspirations and satisfy

Two main types
needs; and, on the other hand, to change or cope with
1. Geopolitical- defined or formed by both natural
the environment.
and manmade boundaries and include barangays,
- Health is therefore seen as a resource for everyday life,
municipalities/cities, provinces, regions, nations;
not the objective of living; it is a positive concept
congressional districts and neighborhoods.
emphasizing social and personal resources, and physical
2. Phenomenological- relational, interactive groups,
capacities (WHO, 1986)
in which the place or setting is more abstract, and
- The modern concept of health refers to OLOF
people share a group perspective or identity based on
( optimum level of functioning) which is influenced
culture, values, interests, goals. Also described as
by the ecosystem
functional; Examples are schools, churches,
groups/organizations. Individual (Personal) Health Models
- WHO
Community defined (based on attributes)
-Medical
1. A collection of people who interact with one another
-Needs Fulfillment
and whose common interests or characteristics form the
-Role Performance
basis for a sense of unity or belonging (Allender, 2009)
-Adaptation
2. Group of people who share something in common
Health-illness continuum
and interact with one another and may share a
geographic boundary (Clark, 2008) Community Health
3. A locality-based entity, composed of systems of - Health status of a community is associated with a
formal organizations reflecting society’s institutions, number of factors such as health care access, economic
informal groups and aggregates (Goeppinger, 2008) conditions, social and environment issues as well as
4. A group or collection of locality-based individuals, cultural practices.
interacting in social units and sharing common interests, - Optimum level of Functioning (OLOF)
characteristics, values, and/or goals
5. A group of people with common characteristics or
interest living together within a territory or
geographical boundary
6. The community is the object or focus of care in
community public health with the family as the unit
of service
Other related terms
1. Population- group of people having common
personal/environmental characteristics
2. Aggregates- subgroups or subpopulations that have
some common characteristics or concerns

Facts of Public Health

Focus: promotion and preservation of health
Area of Content: skills and knowledge relevant to
public health
Clients: general population (individuals, families,
community)
Time: Continual; not limited to episodic care
Scope: comprehensive and general, not limited to
particular age or group
Health is the goal of Public Health
- Health is the state of complete physical, mental and
social well-being and not merely the absence of disease
or infirmity (WHO, 1958)
Characteristics of a Healthy Community
1. Awareness that “we are a community”
2. Conservation of natural resources
3. Recognition of and respect for the existence of sub
groups
4. Participation of subgroups in community affairs
5. Preparation to meet crises
6. Ability to solve problems
7. Resources available to all
8. Communication through open channels
9. Settling disputes through legitimate mechanisms
10. Participation by citizens in decision making community health problems
11. Wellness of a high degree among its members Diagnose and investigate health
problems and health hazards in the
Public Health community
- Science and art of preventing disease, prolonging Policy Inform, educate, and empower
life, and promoting health and efficiency through Developmen people about health issues
organized community effort (Winslow, 1920) t
- Fulfilling society’s interest in assuring conditions in Mobilize community partnerships
to identify and solve health
which people can be healthy (IOM,1988)
problems
- Dedicated to the common attainment of the highest
Develop policies and plans that
level of physical, mental, and social well-being and support individual and community
longevity consistent with available knowledge and health efforts
resources at any given time and place (Hanlon,1984) Assurance Enforce laws and regulations that
Core Functions of Public Health protect health and ensure safety
Link people to needed personal
- Assessment
health services and assure the
- Policy Development
provision of health care when
- Assurance otherwise unavailable
Assure competent public health
Focus of Public Health and personal healthcare workforce
- Prevention Evaluate effectiveness, accessibility
- Intervention and quality of personal and
population-based health services
Philosophy of Public Health
Serving all Research for new insights and
-Based on the dignity and worth of man functions innovative solutions to health
problems
Ultimate Goal of Public Health
- Helps communities and families cope the
discontinuities in health and threats Five Step process of PH approach to health
- Maximize their potential for high level wellness problems in the community
- Promote reciprocally supportive relationship Define the health problem
between people and their physical and social Identify the risk factors associated with the
environment problem
Develop and test community-level interventions to
control or prevent the cause of the problem
Objectives of Public Health
Implement interventions to improve the health of
- Promote Health
the population
- Prevent Disease Monitor those interventions to assess their
- Prolong Life effectiveness

Basic Public Health Services

- Environmental Sanitation Elected features of Public Health
- Health Education • Basis in social justice philosophy
- Prevention of Communicable Diseases • Inherently political nature
- Medical Services • Dynamic, ever-expanding agenda
- Nursing Services • Grounding in the sciences
- Vital Statistics • Use of prevention as a prime strategy
- Public Health Laboratories • Uncommon culture and bond
- Maternal and Child Health Services
Function of Public Health Worker
1. Manager- planner, programmer, supervisor,
Ten Essential Public Health Services coordination of service
Core Services 2. Health care provider- direct nursing care
Functions 3. Researcher- epidemiologist, health monitor,
Assessment Monitor health status to identify recorder, statistician
4. Community Organizer- change agent The National Health Situation
5. Trainer- health educator, counselor Health Care Delivery System
6. Role Model is “the totality of all policies, facilities, equipment,
products, human resources and services which
In the care of the families:
address the health needs, problems and concerns of
1. Provision of primary health care services
the people, it is large, complex, multi-level and multi-
2. Development/Utilization of family nursing care
disciplinary”
plan in the provision of care
Philippine 1987 Constitution
In the care of the communities: “Health is a right of every Filipino citizen and the
1. Community organizing mobilization, community state is duty-bound to ensure that all Filipinos have
development and people empowerment equitable access to effective health care services’
2. Case finding and epidemiological investigation
3. Program planning, implementation and evaluation Philippine Health Care System
4. Influencing executive and legislative individuals or • Public Sector
bodies concerning health and development - services devolved to local government units
• Private Sector
- more doctors are in the private sector
1. Establishing a working relationship with the - Almos the same number of hospitals and hospital
patient beds between public and private sectors
- Initiating contact
- Communicating interest in the client’s welfare
- Showing willingness to help with expressed need Hospitals Other Health Facilities
of the client General A. Primary Care
- Maintaining a two-way communication with the Facility
client Level 1 B. Custodial Care
2. Assessment of needs, taking into consideration Facility
personal, environmental and psycho-socio-cultural Level 2 C. Diagnostic/
factors influencing health Therapeutic Facility
- Situation and trends revealed in personal, socio- Level 3
economic and environmental history (Teaching/Training)
- Physical, emotional, intellectual ability to Specialty D. Specialized Out-
perform a function Patient Facility
-Attitudes, knowledge and perceptions of health
and illness
- Health behavior and patterns of health care According to According to the Type of
- Resources available to meet own needs Increasing Service
- Other factors affecting health Complexity of the
3. Planning of care Services Provided
- Summarizing problems and needs Type Service Type Example
- Establishing priorities of care Primary Health Health Informatio
- Setting objectives of care Promotion, Promotion n
- Determining approaches or strategies to meet Preventive and illness Disseminati
identified objectives care, Prevention on
4. Implementation of care continuing
- Actual delivery of case care for
- Institution of planned interventions common
- Application of coordination, supervision, social health
mobilization, health education, therapeutic problems,
communication attention
5. Evaluation of care to
- Monitoring of status psychologi
- Systematic documentation of results cal and
- Analysis of effectiveness of care provided social care,
(structural elements and outcome elements referrals
Seconda Surgery, Diagnosis Screening
ry Medical and
services by Treatment
specialists New Classification of Other Health Facilities
Tertiary Advanced, Rehabilitati PT/OT A B C D
specialized on Primary Custodial Diagnostic/ Specialize
, Care Care Therapeutic d Out-
diagnostic, Facility Facility Facility patient
therapeuti facility
c and With in- Psychiatric Laboratories: Dialysis
rehabilitati patient Care - Clinic Lab/ Clinic
ve care beds: Facility HIV (DC)
- - Blood
Infirmary service
PRIMARY SECONDARY TERTIARY / facilities
LEVEL LEVEL LEVEL dispensar - Drug Test Ambulator
Health Prevention of Prevention of y Lab y Surgical
Promotion and Complications Disability, etc - -NB Clinic
Illness thru Early Dx Birthing screening lab (ASC)
Prevention and Tx home - Water Lab
Provided at- When When highly Without Drug Abuse Ionizing In-vitro
Health hospitalization specialized beds: Treatment Machines as fertilizatio
care/RHU is deemed medical care is - Medical and X-ray, CT n (IVF)
Brgy. Health necessary and necessary out Rehabilitati scan, centers
Stations referral is made patient on Center mammograp
Main Health to emergency Referrals are clinics (DATRC) hy and others
Center (now district), made to hospital - OFW
Community provincial or & medical clinics
Hospital and regional or center such as - Dental
Health Center private hospitals PGH, PHC, clinics
Private and POC, National Sanitarium/ Non-Ionizing Radiation
Semi-private Center for Leprosarium machines as Oncology
agencies Mental Health, ultrasound, Facility
and other gov’t MRI and
private hospitals others
at the municipal Nursing Nuclear Oncology
level Home medicine Center

The Health Sector

1. LGU
Types of Primary Health Workers 2. DOH
Village/ Intermediate Health 3. NGO/PS
Grassroots Health Level Personnel of ====== Self-reliant, Healthy Filipino
Workers First-Line
Hospitals The DEPARTMENT OF HEALTH as:
Initial Link, 1st 1st source of Establish close Lead agency for Health and Healthcare Services:
contact of the professional contact with 1. As mandated by law to protect, promote and maintain
community healthcare the village and the health of Filipinos
intermediate 2. As an influential leader of the health sector
level HW
3. As it continues to provide guidelines, policies,
Trained General Physicians
standards and state of the art in health and healthcare
Community Medicine with specialty
Health worker; Practitioners area
health auxiliary Public Health Nurses 3 Major Functions:
volunteer; Nurses Dentists 1. Leadership in Health
traditional birth Midwives - National policy—formulation, monitoring and
attendant evaluation
- Regulatory institution 2005-2010 delivery, regulation,
- Advocates adoption of health policies, plans and governance
programs Universal Health Care To improve, streamline,
2011-2016 and scale up above
2. Enabler and Capacity Builder reforms
- Innovate new strategies to improve health programs
- Exercise oversight function
- Ensure highest achievable standards
Fourmala One Plus for Health Strategy Map
Vision Filipinos are among the healthiest
3. Administrator of Specific Services people in Southeast Asia by 2022,
- Manage selected national health facilities and hospitals and by Asia by 2040
- Administer direct services for emergent health Mission To lead the country in the
concerns development of a Productive,
- Administer health emergency response services Resilient, Equitable, and People
center-centered health system for
DOH Programs Universal Health
Dental Health Core Values Professionalism
Operations for Environmental Sanitation Responsiveness
Health Education and Community Organizing Integrity
Prevention and Control of Communicable Disease Compassion
Excellence
Reproductive Health
Strategic Better health outcomes, more
Older Persons Health Services
Goals responsive health system, and more
Guidelines for Nutrition equitable healthcare financing
Rehabilitation and Management of Non-communicable
disease 1. Financing- secure sustainable
Alternative Health Care Practices investments to improve health
(HerbalMeds/Acupressure) outcomes and ensure efficient and
Maternal and Child Health and IMCI equitable use of health resources
Sentrong Sigla Movement 2. Service Delivery- ensure the
accessibility of essential quality
health services at appropriate levels
of care
3. Regulation- ensure high quality
and affordable health products,
devices, facilities and services
4. Governance- strengthen leadership
& management capacities,
coordination, and support
mechanisms necessary to ensure
functional people-centered and
participatory health systems
Performance Use management systems to drive
Accountabilit better execution of policies and
y programs in the DOH while ensuring
responsibility to all stakeholders.

Comprehensive Reform Agenda

Reforms Focus
Health Sector Reform Public health, hospital,
Agenda, 1999-2004 health care financing,
governance and
regulations National Objectives for Health
Fourmula One for Health, Financing, service 2016-2022
• “All for Health towards Health for All” > Every sex act should be free of coercion
(Lahat Para sa Kalusugan! Tungo sa Kalusugan Para sa > Every family should achieve its desired size
Lahat)
PILLARS
• All Life Stages & Triple Burden of Disease
A. Multi-sectoral approach
Pregnant, newborn, infant, child, adolescents, adults and
Intersectoral linkages (population control, private
elderly
sectors, social welfare, public service, environmental,
• Communicable diseases; Non-communicable including
etc.)
malnutrition;
Intersectoral linkages (people’s empowerment; within
disease of rapid urbanization and Industrialization
own system)
Primary Health Care
WHO:PHC was declared in the ALMA ATA B. Community Participation
CONFERENCE (USER) in September 6-12, e.g Community Organizing
1978, as a strategy to community health
development C. Appropriate Technology
Philippines: Adopted through LOI 949 signed by - method used to provide a socially and environmentally
President Marcos on October 19, 1979 with the acceptable level of service or quality product at the least
theme cost
“Health in The Hands of the People by 2020”
Criteria:
Primary Health Care Safe
- Community based Acceptable
- Affordable Feasible
- Accessible Effective
- Acceptable Scope-wise
- Sustainable Affordable
Complex
Framework
People Empowerment + Partnership Example:
= Health for All Filipinos by the Year 2000 and ORS
Health in the Hands of the People by 2020 Herbal Meds
Botica sa Baryo
How can PHC be possible? Use of Indigenous Materials
Controls of Communicable Diseases
Offers Health Education
Maternal and Child Care
Provision of Medical Care and Emergency
Treatment
Offers Immunization
Nutrition and Food Supply
Environmental Sanitation
N “Family Planning”
Treatment of Locally Endemic Diseases
Supply and Proper Use of Essential Drugs

Reproductive Health
- Exercise of reproductive right & responsibility
- Vision: RH practice as a way of life for every
man and woman throughout life
Goals: 4 E’s
> Every pregnancy should be intended
> Every birth should be healthy