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Community Health interactive groups, in which the place or

setting is more abstract, and people
Nursing 1 share a group perspective or identify
based on culture values, history,
interests and goals.
COMMUNITY HEALTH NURSING SCOPE OF ----------------------------------------------------------------
REVIEW FOR FINAL EXAM HEALTH - state of complete physical, mental,
and social well-being and not merely the
Related terms in community health nursing and absence of disease or infirmity. (WHO, 1958,
Principles in the practice of community health p.1)
nursing - 5 items
➢ State of well being in which the person
COMMUNITY - (WHO 1998) social group
is able to use purposeful, adaptive
determined by geographical boundaries and/or
responses and processes physically,
common values and interests. Members interact
mentally, emotionally, spiritually, and
with each other, function within a particular
socially. (Murray et. al, 2009, p. 53)
social structure, exhibit and create norms and
➢ Actualization of inherent and acquired
values, and establish social institutions.
human potential through goal directed
➢ “Collection of people who interact with
behavior, competent self-care and
one another and whose common
satisfying relationships with others.
interest or characteristics form the basis
(Pender et. al, 2006, p. 22)
for a sense of unity or belonging”
SOCIAL HEALTH - community vitality as a
(Alexander et al. 2009, p.6)
result of positive interaction among groups
➢ “A group of people who share
within the community with emphasis on health
something in common and interact with
promotion and illness prevention.
one another, who may exhibit a
Socialized Conceptualization of Health by WHO
commitment with one another and may
in 1986, p. 73
share a geographic boundary.” (Lundy
“The extent to which an individual or group is
and Jones, 2009, p.16)
able, on the one hand, to realize aspirations and
➢ “A group of people who share common
satisfy need and on the other hand to change or
interests, who interact with each other,
cope with the environment. Health is therefore
and who function collectively within a
the resource of everyday life, it is a positive
defined social structure to address
concept emphasizing social and personal
common concerns.” (Clark, 2008, p.27)
resources and physical capacities.”
-Four (4) defining attributes by Maurer and
PUBLIC HEALTH - science and art of
Smith (2009)-
preventing disease, prolonging life, promoting
1. PEOPLE
health, and efficiency through organized
2. PLACE
community effort for; (C.E Winslow)
3. INTERACTION
➢ Sanitation of environment
4. COMMON CHARACTERISTICS,
➢ Control of communicable infections
INTERESTS, OR GOALS
➢ Education of the individual in personal
-Two (2) main types according to Smith and
hygiene
Maurer (2009)-
➢ Organization of medical and nursing
1. GEOPOLITICAL COMMUNITIES -
services for the early diagnosis and
defined or formed by both natural and
preventive treatment of disease
man-made boundaries and include
➢ Development of the social machinery to
barangays, municipalities, cities,
ensure everyone a standard of living
provinces, regions, and nations
adequate for the maintenance of health,
2. PHENOMENOLOGICAL
so organizing these benefits as to
COMMUNITIES - refer to relational,
enable very citizen to realize his

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birthright of health and longevity LEVEL 1 (PRIMARY PREVENTION) - relates to

(Hanlon, 1960, p. 23) activities directed at preventing a problem before
-Primary Functions of Public Health (Institute of it occurs by altering susceptibility or reducing
Medicine of the United States, 1988)- exposure. General health promotion and specific
➢ ASSESSMENT - regular collection, protection. Prevention of problems before
analysis, and information sharing about they occur.
health conditions, risks and resources in ➢ EXAMPLES: good nutrition, provisions
the community of shelter, encouraging exercises,
➢ POLICY DEVELOPMENT - use of immunization and water purification.
information gathered during assessment LEVEL 2 (SECONDARY PREVENTION) - refers
to develop local and state health policies to early detection during the early period of early
and to direct resources toward those disease pathogenesis. Early detection and
policies. intervention.
➢ ASSURANCE - focuses on the ➢ EXAMPLES: screening for sexually
availability of necessary health services transmitted disease, dental
throughout the community. It includes examinations, diabetes screening, vision
maintaining the ability of both public screening, blood pressure screening,
health agencies and private providers to newborn screening, mass sputum
manage day to day operations and examination for tuberculosis.
having the capacity to respond to critical LEVEL 3 ( TERTIARY PREVENTION) - target
situations and emergencies. populations that have experienced disease or
COMMUNITY HEALTH - jurisdiction of public injury and focuses on limitation of disability and
health organized health efforts at the community rehabilitation. Aims to reduce the effects of
level through government and private efforts. disease and injury and to restore individuals to
➢ The family is the unit of care ,hence the their optimal individuals to their optimal level of
community health nurse consider the functioning. (Keller et. al., 2004 McEwen and
health needs of all the members of the Pulli, 2008). Correction and prevention of
family in providing nursing services deterioration of a disease state.
➢ The community as a whole is the locus ➢ EXAMPLES: teaching insulin
of service and the patient administration in the home, exercise
➢ The goal in improving the community is therapy after stroke, skin care for
realized through a multidisciplinary incontinent patients, mental health
approach. counseling.
➢ The community health nurse is deeply
concerned with increasing the capability Emerging fields in nursing- 5 items
of the four levels of clientele ➢ Registered Nurse
➢ Clinical Nurse Specialist
➢ The public health nurse works with and
➢ Nurse Anesthetist
not for the client who is an active partner ➢ Environmental Health Nursing
➢ Practice is affected by changes in ➢ Mental Health Nursing
society in general, and by development ➢ Public Health Nursing
in the healthfield. ➢ Neonatal Nursing
➢ Community health nursing is a part of ➢ Nurse Practitioner
functions within a large and complex ➢ Pediatric Nurse
➢ Nurse Midwife
system and any change in this system
➢ Surgical Nursing
affects it
➢ Hospitals
➢ Nursing Home
Preventive Approach to health - 5 items ➢ Clinics
➢ Military

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➢ Education ➢ Theory-based practice guides data

➢ Law Firms & Insurance Companies collection and interpretation in a clear
➢ Self-Practice and organized manner to easily
HOME HEALTH CARE
diagnosed and address health problems
➢ Providing nursing care to individuals and
➢ Theory is like a map of a territory is does
families in their own places of residence
not give the full terrain (full
to minimize the effects of illness and
picture)instead it picks out those parts
disability
that are important for its given purpose
➢ Allows patient to remain at home and
(Barnum, 1998,p.1)
still receive care instead of staying in a
GENERAL SYSTEMS THEORY
hospital
➢ Viewed as an open system
HOSPICE HOME CARE
➢ Client exchange energy, matter or
➢ Home care specifically rendered to the
information with the external
terminally ill
environment (Katz and Kahn, 1966)
➢ Intended to provide comfort to the
➢ Individual is a set of several
terminally ill patient,improve his/her
dimensions physical, psychological,
quality of life and provide support to the
social and spiritual that are
family as they go through the process of
interdependent and interrelated.
dying and grieving
➢ Family and group are set of
➢ Palliative care is particularly important
interrelated individuals
PARISH NURSING OR FAITH COMMUNITY
➢ The Geographic community is
NURSING
composed of a set of families.
➢ Practice of the art and science of
➢ Useful for nurses in analyzing
nursing combined with spiritual care
interrelationships of the elements within
➢ Focuses on health promotion and
the client as well as those of the client
provision of holistic care to members of
and environment.
the faith community
SOCIAL LEARNING THEORY
➢ Health educator, personal health
➢ Learning takes place in a social
counselor, developer and coordinator of
context,people learn from one another
support groups in the faith community
by modeling or observing other people
and integrator of health and healing.
➢ Persons are thinking beings with
self-regulatory capacities, capable of
Theories in applied in community health
nursing-5 items making decisions and acting to
➢ The complexity of community health expected consequences of their
problems makes it impossible for a behavior.
nurse to make substantial improvements ➢ The environment affects learning, but
in health. learning
➢ The nurses need to think strategically to ➢ Outcomes depends on the learners
know where to focus. individual characteristics (Bandura,
➢ The nurse need to build strong 1977)
relationships with community partners
➢ Nurses need to advocate for their
constituencies in a scientifically, Attention Retention Motor Motivation
responsible,logical and persuasive reproduction
manner. The nurse The nurse The nurse The nurse
➢ The goal of theory is to improve is catching demonstr allows the explains the
nursing practice the ates the mothers to benefits for
mother’s different return both mother
attention positionin demonstrate and baby

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through a g during the steps on

➢ Health deficits often result from an
video on breastfee positioning imbalance between health needs and
breastfeedi ding and during health sustaining resources
ng. proper breastfeeding
latching and proper ➢ Diseases associated with excess
latching (obesity and alcoholism)afflict affluent
Stimuli Rehearse Practice Reward
societies, and the diseases that result
Focus Encode Feedback Reinforce from inadequate or unsafe food , shelter
and the water afflict the poor.
> APPLICATION OF MILIO’S FRAMEWORK IN
PERCEIVED PERCEIVED PUBLIC HEALTH NURSING (MILIO, 1976)
SUSCEPTIBILITY SEVERITY
I’m safe… I only have Having an STD might MILIO’S POPULATION

“clean” partners. really affect me. PROPOSITION HEALTH
HEALTH BELIEF MODEL SUMMARY EXAMPLES
➢ Information alone is rarely enough to Population health deficits Individuals or families living
motivate one to act results from deprivation in poverty have poorer
and or excess of critical health status compared
➢ Information must be related in someway health resources with middle and upper
to individual’s needs class individual and
families
➢ Individuals must know what to do and
how to do it before they can take action. Behaviors of populations Positive and negative
➢ Determinant of preventive health result from selection from lifestyle choices are
limited choices, these arise strongly dependent on
behavior is disease avoidance from actual and perceived culture, socioeconomic
options available as well as status and educational
➢ In practice this model focuses the beliefs and expectations level.
resulting from socialization,
nurse's energies on interventions education and experience
designed to modify the client’s distorted
perceptions,without acknowledging the
Organizational decisions Health insurance coverage
health professional's responsibility to and policies dictate many and availability are largely
reduce or alter health care barriers other options available to determined and financed
individuals and populations by the government through
than patients' perspectives. and influence choices national health insurance
➢ Nurses need to examine the root causes corporation and private
insurance; the source and
of health opportunities and behaviors in
funding of insurance
the communities causing inaction or influences health provider
inappropriate health action choices bad services.
MILIO’S FRAMEWORK FOR PREVENTION

➢ Noted that available health choices is Individual choices related Choices and behaviors of
critical in shaping a society’s overall to health promotion or individuals are strongly
health damaging behaviors influenced by desires,
health status are influenced by efforts to values, and beliefs.
➢ Policy decisions in governmental and minimized valued
resources.
private organizations shape the range of
choices available to individuals
➢ National-level policymaking is the best Alteration in patterns of Behaviors become difficult
way to impact health rather than behavior resulting from to maintain in many
decision making of a settings or situations in
concentrating efforts on imparting significant number of response to organizational
information in an effort to change people in a population can and public policy mandates
result in social change
individual patterns of behavior
Without concurrent Addressing persistent

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availability of alternative health problems is

emotional encouragement), and
health promoting options hindered because most modeling (vicarious learning through
for investments of personal people are very aware of observing others engaged in a particular
resources, health what causes the problem
education will be largely but reluctant to make behavior).
ineffective in changing lifestyle changes. ➢ Primary sources of interpersonal
behavior patterns.
influences are families, peers, and
healthcare providers.
SITUATIONAL INFLUENCES
HEALTH PROMOTION MODEL ➢ Personal perceptions and cognitions of
➢ Health Promotion Model notes that each any given situation or context can
person has unique personal facilitate or impede behavior.
characteristics and experiences that ➢ Include perceptions of options available,
affect subsequent actions. demand characteristics, and aesthetic
➢ The set of variables for behavioral features of the environment in which
specific knowledge and effect have given health-promoting is proposed to
important motivational significance take place.
➢ Health-promoting behavior is the ➢ Situational influences may have direct or
desired behavioral outcome and is the indirect influences on health behavior.
endpoint in the Health Promotion Model PRIOR RELATED BEHAVIOR
➢ Pender’s health promotion model Perceived Benefits of Action
defines health as “a positive dynamic ➢ Anticipated positive outcomes that will
state not merely the absence of occur from health behavior.
disease.” Health Promotion is directed Perceived Barriers to Action
at increasing a client's level of ➢ Anticipated, imagined, or real blocks
well-being. and personal costs of understanding a
➢ It describes the multi-dimensional nature given behavior.
of persons as they interact within the Perceived Self-Efficacy
environment to pursue health. ➢ The judgment of personal capability to
PERSONAL FACTORS organize and execute a health-
➢ Personal factors are categorized as promoting behavior
biological, psychological, and Activity-Related Affect
socio-cultural. ➢ Subjective positive or negative feeling
➢ Personal biological factors. Include age, occurs before, during, and following
gender, body mass index, pubertal behavior based on the stimulus
status, aerobic capacity, strength, agility, properties of the behavior itself.
or balance. ➢ Activity-related affect influences
➢ Personal psychological factors. Include perceived self-efficacy, which means the
self-esteem, self- motivation, personal more positive the subjective feeling, the
competence, perceived health status, greater its efficacy
and definition of health. COMMITMENT TO PLAN OF ACTION
➢ Personal socio-cultural factors. Include ➢ The concept of intention and
race, ethnicity, acculturation, education, identification of a planned strategy leads
and socioeconomic status. to the implementation of health
behavior.
INTERPERSONAL INFLUENCES IMMEDIATE COMPETING DEMANDS AND
➢ Behaviors, beliefs, or attitudes of others. PREFERENCES
➢ Interpersonal influences include ➢ Competing demands are those
norms(expectations of significant alternative behaviors over which
others), social support (instrumental and individuals have low control because of

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environmental contingencies such as progress to the next stage , or return to

work or family care responsibilities. the previous stage.
HEALTH-PROMOTING BEHAVIOR NOTE: Change is difficult even for the most
➢ A health-promoting behavior is an motivated of individuals
endpoint or action-outcome directed People resist change ....change may be...
toward attaining positive health ➢ Unpleasant (exercising)
outcomes such as optimal wellbeing, ➢ Require giving up pleasure (eating
personal fulfillment, and productive desserts or fruits)
living ➢ Painful (insulin injections)
➢ Persons are more likely to commit to ➢ Stressful (eating new foods)
and engage in health-promoting ➢ Jeopardize social relationship
behaviors when significant others model ➢ Not seem important
the behavior, expect the behavior to ➢ Require change in self-image (from
occur, and provide assistance and couch potato to athlete)
support to enable the behavior. > TRANSTHEORETICAL MODEL STAGES OF
➢ Families, peers, and health care CHANGE
providers are important sources of NOT THINKING (PRE-CONTEMPLATION) - No
interpersonal influence that can increase intention to take action
or decrease commitment to and Thinking Relapse Maintena Action Preparati
engagement in health-promoting (Contem nce (Making on
plation) Changes)
behavior.
➢ Situational influences in the external Has Returns Change Change Intend to
some to overt overt take
environment can increase or decrease
intention previous behavior behavior action,
commitment to or participation in to take behavior for more taking
health-promoting behavior. action than 6 steps,
(pros/co months. and plan
➢ The greater the commitments to a ns) Strives of action
specific plan of action, the more likely to
prevent
health-promoting behaviors will be relapse
maintained over time.
STABLE IMPROVED LIFESTYLE
➢ Commitment to a plan of action is less
likely to result in the desired behavior
> PRECEDE-PROCEED MODEL
when competing demands over which
➢ Provides a model for community
persons have little control require
assessment, health education planning
immediate attention.
and evaluation
➢ Commitment to a plan of action is less
➢ PRECEDE stands for predisposing ,
likely to result in the desired behavior
reinforcing, and enabling constructs in
when other actions are more attractive
educational diagnosis and evaluation
and preferred over the target behavior.
used for community diagnosis.
➢ Persons can modify cognitions, affect,
PREDISPOSING FACTOR - refer to people’s
and the interpersonal and physical
characteristics that motivate them toward
environment to create incentives for
health-related behavior
healthy actions.
ENABLING FACTOR - refer to conditions in
----------------------------------------------------------------
people and the environment that facilitate or
> THE TRANSTHEORETICAL MODEL
impede health related behavior.
➢ Based on the assumption that behavior
REINFORCING FACTOR - refer to feedback
change takes place over time,
given by support persons or groups resulting
progressing through sequence of stages
from the performance of the health related
➢ Each stage is both stable and open to
behavior.
change , one may stop in one stage,

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➢ PROCEED stands for policy, regulatory, History of Primary Health Care

and organizational constructs in ➢ What: Alma Ata Conference , first
educational and environmental International Conference on PHC
development ➢ When: September 6-12,1978
➢ Model for implementing and evaluating ➢ Where: Alma, Ata USSR (Russia)
health programs based on PRECEDE ➢ Who:WHO/UNICEF
➢ Who: Dr. Dizon and Dr. Villar
Primary health care- 5 items > ALMA ATA CONFERENCE DECLARATIONS
> PRIMARY HEALTH CARE ➢ Health is a basic fundamental right
➢ “Essential health care based on ➢ There exist global burden of health
practical, scientifically sound and inequalities among populations
socially acceptable methods and ➢ Economic and social development is
technology made universally basic importance for the full attainment
accessible to individuals and families of health for all
in the community through their full ➢ Governments have a responsibility for
participation and at a cost that the the health of their people
community and country can afford to ➢ October 19,1979- formal launching of
maintain at every stage of their PHC Letter of Instruction 949 signed
development in the spirit of self reliance by President Ferdinand Marcos directing
and self determination” Alma Ata the Ministry of Health to develop a
Declaration improvement strong PHC system.
PRIMARY HEALTH CARE ➢ Pilot testing was conducted in a
➢ An approach of organizing the province in each of the twelve regions
community thru involvement and under the term of the Minister of Health
participation by the use of community Dr. Jesus C. Azurin the father of PHC
resources, indigenous technologies and in the Philippines
linkages in attaining self-reliance and ➢ Universal Goal of PHC as stated in the
development Alma Ata Declaration is “HEALTH FOR
➢ Community-based approach to make ALL BY YEAR 2000”.Health for all
basic needs accessible and effective to means an acceptable level of health for
the people through partnership among all the people of the world through
government, non-government and community and individual self-reliance.
community to achieve self-reliance ➢ Ferdinand Marcos signed Letter of
➢ Essential health services are made Instruction 949 that has an underlying
available, accessible, affordable and theme, "HEALTH IN THE HANDS OF
sustainable through active community THE PEOPLE BY 2020”
participation utilizing appropriate > DOH VISION
technology supported by intra-inter ➢ “Filipinos are among the healthiest
sectoral collaboration leading to people in Southeast Asia by 2022, and
self-reliance and social transformation. Asia by 2040”
➢ Partnership approach to community “Health in the hands of the People by the
development through services which are Year 2020” underlying theme of PHC in the
community based, affordable accessible Philippines by means of developing essential
,sustainable through community quality health services by means of providing
participation, intersectoral linkages promotive, preventive, curative and rehabilitative
towards self-reliance as knowledge services utilizing technology which is relevant,
response to the interrelated needs of the effective, affordable and acceptable to the
community. community.
BRIEF HISTORY OF PRIMARY HEALTH CARE

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> KEY PRINCIPLES OF PRIMARY HEALTH ➢ Affordability

CARE (SCAAME) ➢ Simplicity
➢ Support mechanisms ➢ Acceptability
➢ Community participation active ➢ Feasibility and reliability
➢ Accessibility, affordability, acceptability ➢ Ecological effects
and availability ➢ Potential to contribute to individual and
➢ Appropriate technology community development
➢ Multisectoral approach MULTISECTORAL APPROACH - health and
➢ Equitable distribution of health disease are outcomes of multiple interrelated
resources factors, PHC requires
SUPPORT MECHANISMS - resources for communication,cooperation, and collaboration
essential health services from the people, within and among various sectors
government and private sectors. INTRASECTORAL LINKAGES -
COMMUNITY PARTICIPATION - health is communication, cooperation, and collaboration
achieved through self-reliance and self within the health sector, among the members
determination and that individuals, families and of the health team and among health agencies.
communities are not recipients of care but INTERSECTORAL APPROACH - encompass
active participants in achieving goals. the communication, cooperation, and
> THE 4 A’s OF PRIMARY HEALTH CARE collaboration between the health sector and
1. ACCESSIBILITY - physical distance of other sectors of society like education, public
a health facility or the travel time works, education, agriculture and local
required for the people to get the government officials
needed or desired health services.WHO EQUITABLE DISTRIBUTION OF HEALTH
guidelines states that facility should be RESOURCES - Philippines has an oversupply of
within 30 minutes from the graduates of medicine and nursing but they flock
communities. to the urban rather than to the rural areas (FDG
2. AFFORDABILITY - ability of the on the HMDTS , 2001) and graduates of
community or government to avail health-related college programs prefer to work
health services, out of pocket expenses abroad rather than to stay in the Philippines.
for health care the actual cost to the
family for health services less any Department of health and its functions- 5 items
coverage of insurance likePhilhealth and DEPARTMENT OF HEALTH (DOH)
other private companies or health ➢ is the principal health agency in the
management organizations. Philippines
3. ACCEPTABILITY - healthcare offered is ➢ Responsible for ensuring access to
inconsonance with the prevailing culture basic public health services to all
and traditions. Filipinosthrough the provision of quality
4. AVAILABILITY - basic health services health care and regulation of providers
required by the people are offered in the of health goods and services.
healthcare facilities provided on a VISION
regular and organized manner. Filipinos are among the healthiest people in
APPROPRIATE TECHNOLOGY - refer to SoutheastAsia by 2022, and Asia by 2040
technology that is suitable to the community MISSION
that will use it. People’s technology and To lead the country in the development of a
indigenous technology. productive, resilient, equitable and people-
> CRITERIA FOR APPROPRIATE HEALTH centered health system
TECHNOLOGY > MAJOR ROLES OF DOH
➢ Safety ➢ Leader in Health
➢ Effectiveness ➢ Enabler and capacity builder

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➢ Administrator of specific services (DOH, including referral and networking

2013) systems for trauma, injuries and
> LEADERSHIP ROLE ELUCIDATED IN catastrophic events.
EXECUTIVE ORDER 102, SERIES OF 199 IN > DOH CORE VALUES
TERMS OF THE FF: ➢ Integrity
➢ Planning and formulating policies of ➢ Excellence
health programs and services ➢ Compassion
➢ Monitoring and evaluating the ➢ Respect for human dignity
implementation of health programs, ➢ Commitment
projects, research, training and services. ➢ Stewardship of the health
➢ Advocating for health promotion and ➢ of the people
healthy lifestyles > DOH ADMINISTRATIVE ORDER 2012-0012
➢ Serving as a technical authority in CLASSIFIES OTHER HEALTH FACILITIES AS
disease control and prevention FOLLOWS:
➢ Providing administrative and technical CATEGORY A - primary care facility - first
leadership in health care financing and contact health care facility that offers basic
implementing the national health services including emergency services and
insurance law provision for normal deliveries.
> ENABLER AND CAPACITY BUILDER DOH CATEGORY B - Custodial care facility - health
PERFORMS THE FF: facility that provides long term care,including
➢ Providing logistical support to LGU’s the basic services like food and shelter, to patients
private sector and other agencies in with chronic conditions requiring ongoing health
implementing health programs and and nursing care due to impairment and a
services reduced degree of independence in ADL and
➢ Serving as the lead agency in health patients need rehabilitation.
and medical research CATEGORY C - Diagnostic/therapeutic
➢ Protecting standards of excellence in facility a facility for the examination of the
the training and education of health care human body, specimens from the human body,
providers at all levels of the health care for the diagnosis, sometime treatment of disease
system. or water for drinking water analysis.
>ADMINISTRATOR OF SPECIFIC SERVICES ➢ Laboratory facility
DOH TASKED TO: ➢ Radiologic facility
➢ Serve as administrator of selected ➢ Nuclear medicine
health facilities and subnational levels CATEGORY D - Specialized outpatient facility
that act as referral centers for local that performs highly specialized procedures on
health systems, that is, tertiary and an outpatient basis.
special hospitals, reference laboratories,
training centers,centers for disease
Hospitals Level 1 Level 2 Level 3
control and prevention and regulatory
offices. Clinical Consulting Level 1 plus Level 2 plus
Service for specialist in Department Teaching/tr
➢ Provide specific program components Inpatients medicine, alized aining with
for conditions that affect large segments pediatrics, clinical accredited
of the populations, such as tuberculosis, OB, services residency
Surgery training
malaria,schistosomiasis, HIV/AIDS,and program in
micronutrient deficiencies. four
major
➢ Develop strategies for responding to clinical
emerging health needs services
➢ Provide leadership in health emergency
Emergency Respiratory Physical
preparedness and response services,

lOMoARcPSD|13571890
and Unit medicine

1 Rural Health Nurse: 20,000
outpatient and 1 Rural health Midwife: 5,000
services rehabilitatio 1 Barangay health worker: 20 households
n unit
Isolation General
facilities ICU PUBLIC HEALTH NURSE
➢ Supervise and guides all RHM’s
Surgical/ma High-risk Ambulatory
ternity pregnancy surgical unit ➢ Prepares the Field health services
facilities unit information system
➢ Utilizes nursing process in responding to
Dental clinic NICU Dialysis unit
health care needs of individual, families,
Ancillary Secondary Tertiary Tertiary and catchment community
Service clinical clinical clinic ➢ Collaborates with the other members of
laboratory laboratory laboratory
with the health team, government agencies ,
histopatholo NGO and peoples organizations.
gy
RURAL HEALTH MIDWIFE
Blood Blood bank ➢ Manages the BHS and supervises and
station trains BHW
First level Second Third level ➢ Provide midwifery services
x-ray level x-ray x-ray ➢ Conduct patient assessment and
with mobile
unit
diagnosis for referral or further
management
Pharmacy ➢ Performs health information, education
and communications
RURAL HEALTH UNIT - (health Center) the ➢ Organizes the community
primary level health facility in the municipality. ➢ Facilitates barangay health planning and
The focus of RHU is preventive and promotive other community health services (DOH,
services and the supervision of BHS’s under its 2001)
jurisdiction (DOH, 2001) RURAL SANITARY INSPECTOR
➢ (health Center) ratio to catchment ➢ Ensure a healthy physical environment
population is 1 RHU :20,000population ➢ Monitors and regulates activities such
(DOH, 2009)BHS’s the first contact as inspection of water supply and
healthcare facility that offers basic unhygienic household conditions. (DOH,
services at the barangay level. Manned 2001)
by volunteerBHW’s (barangay health BARANGAY HEALTH WORKERS
workers) under the supervision of the ➢ Trained in preventive health care
RHM(midwife) (DOH, 2001) ➢ Equipped with basic skills for prevention
> RURAL HEALTH UNIT PERSONNEL and management of common diseases
Municipal Health officer or Rural health > LOCAL HEALTH SYSTEM AND
Physician heads the health services at the DEVOLUTION OF HEALTH SERVICES
municipal level and carries out the ff: DEVOLUTION - is the transfer of power and
➢ Administrator of the RHU authority from the national government to LGU’s
➢ Community physician as the territorial and political subdivisions of the
➢ Medico-legal officer of the municipality state to enable them to perform specific
(DOH, 2001) functions and responsibilities.
Ratio of RHU personnel to the population R.A R.A 7160 or LOCAL GOVERNMENT CODE -
7305 Magna carta of Public health Workers was enacted to bring about genuine and
stipulate that: meaningful local autonomy. This will enable local
1 Rural Health Physician: 20,000 government's to attain their fullest development
as self-reliant communities

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R.A 7160 or LOCAL GOVERNMENT - provided CLASSIFY DIARRHEA FOR DEHYDRATION

for the creation of the Provincial health Board Two of the following signs:
and the City/Municipal Health boards or Local - Movement only when
stimulated or no movement at Pink:
Health Boards SEVERE
all
> FUNCTIONS OF LOCAL HEALTH BOARDS DEHYDRATION
- Sunken eyes
➢ Proposing to the Sanggunian annual - Skin pinch goes back very
slowly.
budgetary allocations
➢ Serving as an advisory committee to the Two of the following signs: Yellow:
- Restless and irritable SOME
Sanggunian on health matters DEHYDRATION
- Sunken eyes
➢ Creating committees that shall advise - Skin pinch goes back slowly.
local health agencies on various matters
- Not enough signs to classify Green:
related to health service operations as some or severe NO
dehydration DEHYDRATION
Integrated Management of Childhood Illness
(sick child age 2 months up to 5 and sick young
infant birth up to 2 months) focus only on Assess CHECK FOR FEEDING PROBLEM OR LOW
and Classify. 10 items WEIGHT FOR AGE
CHECK FOR VERY SEVERE DISEASE AND
- Not well attached to breast or
LOCAL BACTERIAL INFECTION - Not suckling effectively or
- Less than 8 breastfeeds in 24 Yellow:
Any one of the following hours or FEEDING
signs - Receives other foods or PROBLEM
- Not feeding well or drinks or OR LOW
- Convulsions or - Low weight for age or WEIGHT
- Fast breathing (60 breaths - Thrush (ulcers or white
per minute or more) or Pink: patches in mouth).
- Severe chest indrawing or VERY
- Fever (37.5 or above) or SEVERE
- Low body temperature (less DISEASE - Not low weight for age and no Green:
than 35. 5) or other signs of inadequate NO FEEDING
- Movement only when feeding. PROBLEM
stimulated or no movement at
all.
CHECK FOR FEEDING PROBLEM OR LOW
- Umbilicus red or draining pus Yellow: WEIGHT FOR AGE IN NON-BREASTFED
- Skin pustules LOCAL
BACTERIAL INFANTS
INFECTION
- Milk incorrectly or
unhygienically prepared or
- None of the signs of very Green: Giving inappropriate Yellow:
severe disease or local SEVERE replacement feeds or FEEDING
bacterial infection DISEASE OR Giving insufficient PROBLEM
LOCAL replacement feeds or OR LOW
INFECTION - An HIV positive mother mixing WEIGHT
UNLIKELY breast and other feeds before
6 months or
- Using a feeding bottle or
CLASSIFY JAUNDICE - Low weight for age or
- Thrush (ulcers or white
- Any jaundice if age less than Pink: - patches in mouth).
24 hours or SEVERE
- Yellow palms and soles at any JAUNDICE - Not low weight for age and no Green:
age other signs of inadequate NO FEEDING
feeding. PROBLEM
- Jaundice appearing after 24 Yellow:
hours of age and JAUNDICE
- Palms and soles not yellow SICK CHILD AGE 2 MONTHS UP TO 5 YEARS
- No jaundice Green:
NO CHECK FOR GENERAL DANGER SIGNS
JAUNDICE

lOMoARcPSD|13571890
- Any general danger signs Pink:

CLASSIFY FEVER (HIGH OR LOW MALARIA
- Lethargic, Vomit Everything, VERY RISK)
Had Convulsions, Convulsing SEVERE
Now, and Able to Drink or DISEASE - Any general danger signs or Pink:
Breastfeed - Stiff neck VERY
SEVERE
FEBRILE
DISEASE
CLASSIFY COUGH OR DIFFICULT
BREATHING - Malaria test POSITIVE Yellow:
MALARIA
- Any general danger sign or Pink:
- Stridor in calm child SEVERE
- Malaria test NEGATIVE Green:
PNEUMONIA
- Other cause of fever FEVER: NO
OR VERY
PRESENT MALARIA
SEVERE
DISEASE CLASSIFY FEVER (NO MALARIA RISK AND
- Chest Indrawing or NO TRAVEL TO MALARIA RISK AREA)
- Fast Breathing
- Any general danger sign Pink:
2 months up to 12 months = 50 breaths Yellow:
- Stiff Neck VERY
per minute or more PNEUMONIA
SEVERE
12 Months up to 5 years = 40 breaths
FEBRILE
per minute or more
DISEASE
- No signs of pneumonia or Green:
- No general danger signs Green:
very severe disease. COUGH OR
- No stiff neck FEVER
COLD
IF MEASLES NOW OR WITHIN LAST 3
MONTHS, CLASSIFY
CLASSIFY DIARRHEA FOR DEHYDRATION
- Any general danger sign or Pink:
Two of the following signs: - Clouding of cornea or SEVERE
- Lethargic or unconscious - Deep or extensive mouth COMPLICATED
- Sunken eyes Pink: MEASLES****
SEVERE ulcers.
- Not able to drink or drinking
DEHYDRATION
poorly
- Pus draining from the eye or Yellow:
- Skin pinch goes back very MEASLES WITH
slowly. - Mouth ulcers. EYE OR
MOUTH
COMPLICATIONS
Two of the following signs: ****
- Restless, irritable Yellow:
- Sunken eyes SOME Green:
DEHYDRATION
- Measles now or within the last
- Drinks eagerly, thirsty 3 months. MEASLES
- Skin pinch goes back slowly.
- Not enough signs to classify Green:

NO
CLASSIFY EAR PROBLEM
as some or severe
dehydration. DEHYDRATION
- Tender swelling behind the Pink:
ear MASTOIDITIS
AND IF DIARRHEA IS 14 DAYS OR MORE
- Dehydration present. Pink: - Pus is seen draining from the Yellow:
SEVERE ear and discharge is reported ACUTE EAR
PERSISTENT for less than 14 days, or INFECTION
DIARRHEA - Ear pain.
----------------------------------------------------- -------------------
- Pus is seen draining from the Yellow:
- No Dehydration Yellow:
ear and discharge is reported CHRONIC
PERSISTENT
for 14 days or more. EAR
DIARRHEA
INFECTION
AND IF BLOOD IN STOOL
- No ear pain and No pus seen Green:
- Blood in the Stool Yellow: draining from the ear. NO EAR
DYSENTERY INFECTION
CHECK FOR ACUTE MALNUTRITION

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their being, the community and society and their

- Oedema of both feet
interrelations based on culture, history, heritage,
OR and consciousness
- WFH/L less than -3 z- scores Pink:
➢ B-awang
OR MUAC less than 115 mm COMPLICATED
AND any one of the following:
SEVERE ACUTE
MALNUTRITION
➢ A-kapulko
- Medical complication present ➢ B-ayabas
or
- Not able to finish RUTF or ➢ Y-erba Buena
- Breastfeeding problem. ➢ P-ansit-pasitan/Ulasimang Bato
➢ L-agundi
- WFH/L less than -3 z- scores Yellow:
OR
UNCOMPLICATED
SEVERE ACUTE ➢ A-mpalaya
MALNUTRITION
- MUAC less than 115 mm ➢ N-iyug-niyogan
AND
- Able to finish RUTF. ➢ T-saang Gubat
----------------------------------------------------- Yellow: ➢ S-ambong
- WFH/L between -3 and -2 MODERATE
z-scores ACUTE > BAWANG
MALNUTRITION
OR Uses: lower cholesterol in the blood,
- MUAC 115 up to 125 mm.
hypertension and toothache
Preparation:
- Fried
- WFH/L - 2 z-scores or more Green:
OR
NO ACUTE - Roasted
MALNUTRITION
- MUAC 125 mm or more. - Soaked in vinegar for 30 minutes
- Blanch in boiled water for 5 minutes
CHECK FOR ANAEMIA - Take 2 pcs. Three times a day after meals
- Pound and apply to affected tooth
- Severe palmar pallor Pink:
SEVERE
Caution: Take on a full stomach to prevent
ANEMIA stomach and intestinal ulcer
➢ ALLICIN is a compound that may help
- Some pallor Yellow:
SOME ease swelling and impede free radicals
ANEMIA that harm cells and tissues within the
body and lead to disease.
- No palmar pallor Green:
NO ANEMIA ➢ Impact your blood vessels and help
lower your, Blood sugar , Blood
pressure and Lipids or molecules within
Herbal plants (10 approved plants by the DOH
BABY-PLANTS) - 5 items the blood and cells made up fats and
➢ R.A 8423 Traditional and Alternative proteins
Medicine Act of 1997 through the effort ➢ Allicin help muscles recover faster after
of Secretary Juan Flavier you work out
➢ Created the Philippine Institute Of ➢ Support immune health by warding off
Traditional and Alternative Health Care agents that cause illness such as virus
which tasked to promote and advocate and fungus
the use of traditional and alternative > AKAPULKO (Cassia alata/herpetic alata)
healthcare modalities through scientific Uses: Antifungal, Tinea flava, ringworm, athletes
research and product development. foot and scabies
TRADITIONAL MEDICINE - is defined as sum Preparation:
total of knowledge, skills and practice on health - Fresh and matured leaves are
care, not necessarily explicable in the context of pound
modern, scientific philosophical framework, but - Apply sap to the affected part
recognized by the people to help maintain and 1-2 times a day
improve their health towards the wholeness of

lOMoARcPSD|13571890
➢ Acapulco contains chrysophanic acid, a • 7-12 3 tbsp. dried leaves, 2 tbsp. fresh leaves
fungicide used to treat fungal infections, • Pruritus - boil plants or with eucalyptus in
like ringworms, scabies, and eczema. water. Use decoction as a wash on affected area
➢ Acapulco also contains saponin, which ➢ Rheumatism, Arthritis and headache-
acts against ringworms. This variant is crush the fresh leaves and squeeze sap.
excellent for tinea/skin infections, Massage sap on the painful parts with
itchiness and insect bites. eucalyptus
> BAYABAS ➢ Swollen gums - boil the fresh plant for
Uses: 30 minutes and use solution as gargle
- Diarrhea - take 2-3 times a day ➢ Toothache - cut fresh plant and squeeze
- Washing wounds twice a day sap. Soak a piece of cotton in the sap
- Gargle and to relieve toothache. Warm and insert in aching tooth cavity
decoction is used. Freshly pounded leaves ▪ Relax the digestive tract muscles.
are sued for toothache ▪ Alleviate itching and pain and to hasten
- Leaves are to be washed well and chopped recovery.
- Boil for 15 min.at low fire ▪ It is also used in vaporizers to calm the body
- Do not cover the pot and as scent mixed over baths.
- Cool and strain before use ▪ Calming the muscles in the respiratory system.
➢ Guava leaf extracts and essential oil are The scent can come from extracted oil as used
very active against S. aureus, thus in vaporizers or by burning the leaves and
making up important potential sources inhaling the fumes.
of new antimicrobial compounds. ▪ Rosmarinic acid inhibits the formation of
➢ Guava leaf extract is antimicrobial. This leukotrienes, an agent responsible for
means that it can neutralize harmful allergic reactions
microbes in gut that can cause diarrhea ▪ The minty scent and flavor used in vaporizers
➢ Antiplaque, antimicrobial, anti- to unclog the nasal passage due to
inflammatory and antioxidant agent, accumulation of phlegm and helps to relieve
guava leaves help maintain strong teeth inflammation. It also acts as an expectorant.
and gums. ▪ Antibacterial and Antifungal properties. Used to
> YERBA BUENA treat various skin infections and conditions that
➢ Cough and colds - get about 10 fresh include eczema, insect bites, scars and wounds,
leaves and soak in a glass of hot water. burns, scabies, ringworms and other skin
Drink as tea infections.
➢ Insect bites - crush leaves and apply ▪ Minty and relaxing effect is used as a topical
juice on the affected part or pound aid in alleviating the pain associated with
leaves until paste-like. Rub on affected arthritis, gout, headache and other body and
part joint pains.
➢ Menstrual and gas pains: soak a handful > PANSIT-PASITAN/ULASIMANG BATO
of leaves in a glass of boiling water. Uses: Lowers uric acid (Rheumatism and gout)
Drink infusion. Induces menstrual flow Preparation
and sweating - May be eaten as salad
➢ Nausea and fainting - crush leaves and - Boil in two glassful of water over low fire, divide
apply at nostrils of patients in three parts, drink each part three times day
➢ Pain in different parts of the body as after meals
headache, stomachache ➢ Analgesic, anti-inflammatory, and
• Preparation: boil chopped leaves in 2 glasses anti-hyperuricemic properties
of water for 15 minutes. Cool and strain > LAGUNDI
• Adults: 6 tbsp. Dried leaves, 4 tbsp. fresh ➢ Dysentery, colds, and pain any in part of
leaves the body as in influenza - boil a handful

lOMoARcPSD|13571890
of leaves and flowers to produce a • If at first try, the worms are not expelled, the
glassful of decoction dosage may be done again after a week. If
➢ Aromatic bath for sick patients - prepare nothing happens even after the second dose,
leaf decoction and use for bathing of seek medical help as there may be other
sick and newly delivered patients underlying conditions.
➢ Skin disease and wounds - prepare • Do not give seeds to children below four years
decoction and wash and clean the old
wound with decoction • Adults take at least 10 niyog-niyogan seeds for
➢ Headache - crushed leaves apply on the best results.
forehead • Children aged 4 to 7 years old, let them take at
➢ Rheumatism, sprain, contusions, insect least four seeds.
bites - pound the leaves and apply on • For children aged 8 to 9 years old, they can
affected part take around six seeds.
➢ Asthma and fever - boil raw fruits or • Children aged 10 to 12 years old, they can eat
leaves in 2 glasses of water for 15 min. not more than seven seeds.
until 1 glass of water is left. Side Effects
• Adult: 4 tbsp.. Dried leaves, 6 tbsp..Fresh • If taken in unusually large doses, may
leaves experience a few hiccups, dizziness, abdominal
• 71-2 : 2 tbsp. dl, 3 tbsp.fl pain, diarrhea, and vomiting. Some even lose
• 2-6 : 1 tbsp.dl,1 1⁄2 tbsp fl consciousness. Watch out for certain allergic
➢ Anti-inflammatory, expectorant, reactions as well.
tranquilizer, antispasmodic, anti • If patients develop skin rashes or experience
convalescent, rejuvenate, anti-arthritic, swelling of the ankles, skin itchiness, or increase
anthelmintic, anti-fungal and antipyretic in body temperature, stop using the plant and
> AMPALAYA contact a physician immediately.
Uses: Diabetes Mellitus (Mild non-insulin > TSAANG GUBAT
dependent) Uses:
Preparation: - Diarrhea: boil chopped leaves in 2 glasses of
- boil 2 tbsp. of chopped leaves in two glassfuls water for 15 minutes until 1 glass
of water for 15 minutes slow fire. - Adult:10 tbsp. dl, 12 tbsp.fl
- Take one third cup 3 time daily after meals - 7-12: 5 tbsp. dl, 6 tbsp. fl
- Young leaves may be blanched /steamed and - 2-6 : 2 1⁄2 tbsp. dl, 3 tbsp. fl
eaten - Stomachaches: boil chopped leaves in 1 glass
➢ Bitter melon has properties that act like of water for 15 minutes
insulin, which helps bring glucose into - Adult: 2 tbsp. dl, 3 tbsp.fl
the cells for energy. - 7-12: 1 tbsp dl, 1 1⁄2 tbsp fl
➢ The consumption of bitter melon can ➢ It contains alpha-amyrin, beta-amyrin,
help cells use glucose and move it to and baurenol which have shown
the liver, muscles, and fat. analgesic activity, anti-diarrheal and
➢ The melon may also be able to help the anti-spasmodic activity.
body retain nutrients by blocking their > SAMBONG
conversion to glucose that ends up in Uses
the bloodstream. • Anti-edema
> NIYOG-NIYOGAN • Diuretic
Uses: Anthelmintic use to expel roundworms • Anti-urolithiasis
causing ascariasis • Boil leaves in a glassful water for 15 min. until
• Only mature dried seeds are used. These dried one glass remain
seeds are normally taken orally at least 2 hours • Adult : 4 tbsp.dl, 6 tbsp.fl
after dinner. • 7-12 y/0: 2 tbsp dl, 3 tbsp fl

lOMoARcPSD|13571890
➢ Sambong formulation effectively ➢ Every newborn and mother pair secures

increased the volume of urine excretion proper postpartum and newborn care
among patients experiencing edema. with smooth transitions to the women’s
➢ This diuretic effect of the sambong health care package for the mother and
formulation is also comparable to effects child survival package for the newborn
of other thiazide diuretics but without >MNCHN CORE PACKAGE OF SERVICES
causing urinary potassium loss ➢ Paradigm shift from risk approach that
➢ Inhibits calcium oxalate stone formation focuses on identifying pregnant
in the women at risk of complications to one
that considers all pregnant women at
risk of such complications
Maternal, Newborn and Child Health and > PRE PREGNANCY PACKAGE
Nutrition - 5 items
NUTRITION
> KEY STRATEGIES OF MNCHN
NUTRITION COUNSELING - Eating a nutritious
➢ Ensuring universal access to and
diet during pregnancy is linked to good brain
utilization of an MNCHN core packages
development and a healthy birth weight, and can
of services and interventions directed
reduce the risk of many birth defects. A
not only to individual women of
balanced diet will also reduce the risks of
reproductive age and newborn at
anemia, as well as other unpleasant pregnancy
different stages of the life cycle-referring
symptoms such as fatigue and morning
to the pre-pregnancy, pregnancy,
sickness.
childbirth, postpartum, newborn and
PROMOTION OF THE USE OF IODIZED SALT
childhood periods but also the
- combined with table salt it help prevent iodine
community
deficiency, thyroid gland uses iodine to produce
➢ Establishment of as service delivery
thyroid hormones, which aid in tissue repair,
network at all levels of care to provide
regulate metabolism and promote proper growth
the package of services and
and development
administration
PROVISION OF MICRONUTRIENT
➢ Organized use of instruments for health
Iron and folate: 60 mg elemental iron/ 400
systems development to bring all
microgram folic acid 1 tablet daily for 3-6 months
localities to create and sustain service
(Folic acid helps prevent neural tube defects,
delivery networks, which are crucial for
iron-folate supplementation reduces iron
the provision of health services to all
deficiency anemia, preterm birth, early neonatal
➢ Rapid build up of institutional capacities
death, and low birth weight)
of DOH and PhilHealth, being the lead
Vitamin A at least 5,000 IU every week or daily
national agencies that provide support
multivitamin supplement may be taken as an
to local planning, and development
option when required Vitamin A is not available.
through appropriate standards, capacity
(DOH, 2009) (important for baby's embryonic
build up of implementers and financing
growth, including the development of the heart,
mechanisms (DOH, 2011)
lungs, kidneys, eyes, and bones as well as the
> MNCHN STRATEGY AIMS TO ACHIEVE THE
circulatory, respiratory, and central nervous
FOLLOWING RESULTS
systems. Vitamin A is particularly essential for
➢ Every pregnancy is wanted, planned
women who are about to give birth because it
and supported
helps with postpartum tissue repair.) given twice
➢ Every pregnancy is adequately
a week starting on the 4th month of pregnancy
managed throughout its course
to prevent congenital problems in the baby
➢ Every delivery is facility-based and
PROMOTION OF HEALTHY LIFESTYLE -
managed by skilled birth attendants or
Smoking during pregnancy can cause tissue
skilled health professionals

lOMoARcPSD|13571890
damage in the unborn baby particularly in the cervical cancer or cell changes that may
lung and brain lead to cervical cancer.)
PREVENTION AND MANAGEMENT OF TETANUS TOXOID FOR WOMEN TO
INFECTION, COUNSELING ON STI/HIV/AIDS - PREVENT TETANUS
Premature labor (labor before 37 weeks of ➢ an infection caused by bacteria called
pregnancy). Early (preterm) birth is the number Clostridium tetani. When the bacteria
one cause of infant death and can lead to invade the body, they produce a poison
long-term developmental and health problems in (toxin) that causes painful muscle
children contractions. Another name for tetanus
PROVISION OF ORAL HEALTH - High levels of is “lockjaw”. It often causes a person's
the hormones progesterone and estrogen during neck and jaw muscles to lock, making it
pregnancy can temporarily loosen the tissues hard to open the mouth or swallow in
and bones that keep the teeth in place. This can both the mother and baby.
make the teeth loose. Periodontal disease ➢ Tetanus Toxoid 0.5ml is injected
(also called periodontitis or gum disease). intramuscularly on the deltoid muscles
ADVICE ON FAMILY PLANNING AND ➢ The newborn develops protection
PROVISION OF FAMILY PLANNING through passive immunity (provided
SERVICES - responsible decision made by when a person is given antibodies to a
individuals and couples as to the desired family disease rather than producing them
size and timing of births through his or her own immune system)
as maternal antibodies pass through the
> PRENATAL PACKAGE placenta into the fetal circulation
PRENATAL VISITS (DOH,1995)
Prenatal Visits Period of Pregnancy TT Dose Interval Percent Duration of
Protected Protection
1st Visit As early as pregnancy as
possible before four
months or during the 1st TT1 As early as
trimester possible
during
2nd Visit During the 2nd Trimester pregnancy
3rd Visit During the 3rd Trimester TT2 At least 4 80% 3 years
weeks later protection
Every 2 Weeks After 8th month of
pregnancy till delivery TT3 At least for 95% 5 years
6 months protection
PRENATAL ASSESSMENT TT4 At least 1 99% 10 years

year later protection
➢ Weight, Vital signs, fundal height against
the age of gestation, fetal heartbeat, and TT5 At least 1 99% Lifetime
fetal movement year protection
➢ Diagnostic examinations (blood count,
blood typing, urinalysis, screening, ➢ Micronutrient supplementations
pregnancy test, cervical cancer ➢ Promotion of exclusive breastfeeding,
screening using acetic acid wash, and newborn screening and infant
Papanicolaou smear (procedure in immunization
which a small brush is used to gently ➢ Counseling on healthy lifestyle
remove cells from the surface of the ➢ Early detection and management of
cervix and the area around it so they complications
can be checked under a microscope for ➢ Birthing planning and promotion of
facility based delivery (DOH, 2011)

lOMoARcPSD|13571890
HOME BASED-MOTHERS RECORD (HBMR) ➢ Continuous maternal support by having

➢ Used when rendering care to pregnant a companion of choice during labor and
woman delivery
➢ Simplified record of the history of ➢ Freedom of movement during labor
present and past pregnancies ➢ Monitoring progress of labor using the
> USES OF HBMR partograph
➢ Provides means of promoting continuity ➢ Non drug pain relief before offering
of care through a woman’s reproductive anesthesia
life ➢ Position of choice during labor and
➢ Promotes early recognition of women delivery
who are at risk of developing conditions ➢ Spontaneous pushing in a semi upright
like anemia, hypertension, bleeding, and position
moderate to severe edema ➢ Hand hygiene
➢ Encourages self-care where appropriate ➢ Nonroutine episiotomy
and referral suited to the needs of the ➢ Active management of the third stage of
woman labor (AMTSL)
➢ Supports initiation of appropriate care 3. Access to basic emergency obstetric and
according to woman’s identified needs newborn care (BEmONC) where they can
➢ Serves as useful record of care and function the following:
health information and source of ➢ Parenteral administration of oxytocin
statistics (stimulates the uterine muscles to
➢ Guides the health workers in providing contract and also increases production
for the health educational needs of the of prostaglandins, which increase the
client about risk and care during contractions further) in the third stage of
pregnancy and the periods in between labor
pregnancies and care of the newborn ➢ Parenteral administration of loading
and the postpartum. dose of anticonvulsants
> CHILDBIRTH PACKAGE ➢ Parenteral administration of initial dose
1. Skilled birth attendance/skilled of antibiotics
professional-assisted delivery and ➢ Performance of assisted deliveries
facility based deliveries using (imminent breech delivery)
partograph ➢ Removal of retained products of
A partograph is a graphical record of the conception
observations made of a woman in labor. For ➢ Manual removal of retained placenta
progress of labor and salient conditions of the ➢ Newborn resuscitation
mother and fetus. ➢ Treatment of neonatal sepsis/infection
The best strategy to prevent maternal deaths is ➢ Oxygen support
promote facility based childbirth and with a Access to Comprehensive emergency
skilled health professional attendance (Campbell obstetric and newborn care (CEmONC)
and Graham, 2006) services wherein they provide services like
2. Proper management of pregnancy BEmONC as well as:
and delivery complications and ➢ Cesarean delivery services
newborn complications (DOH, 2011) ➢ Blood banking and transfusions
DOH, PhilHealth and WHO recommended ➢ Highly specialized obstetric
essential intrapartum and newborn care interventions
practices (EINC/Unang Yakap) ➢ Neonatal emergency interventions
> RECOMMENDED EVIDENCE-BASED ➢ Management of low birth weight or
PRACTICES INCLUDES preterm newborn and other specialized
newborn services.

lOMoARcPSD|13571890
> POSTPARTUM PACKAGE NEWBORN SCREENING - (screening of six

1. Postpartum visits: with in 72 hours and disorders: Congenital Hypothyroidism (CH),
on the 7th day postpartum check up for Congenital Adrenal Hyperplasia (CAH),
conditions such as bleeding or infections Phenylketonuria (PKU), Galactosemia (GAL),
(DOH, 2011) Glucose-6-Phosphate Dehydrogenase (G6PD)
2. Micronutrient supplementation Deficiency and Maple Syrup Urine Disease
- Iron and folate (MSUD)
(60mg/400ug)once a day for 3 ➢ Republic Act 9288, otherwise known as
months or 90 tablets (DOH-IMS, the Newborn Screening Act of 2004,
2011) illustrates a procedure to detect a
- Vitamin A 200,000 IU within 4 genetic and metabolic disorder in
weeks after delivery (DOH-IMS, newborns that may lead to mental
2011) retardation and even death if left
3. Counseling on nutrition, child care, untreated.
family planning and other available HEARING SCREENING - On June 12, 2009,
services (DOH, 2011) Republic Act 9709 also known as the
> NEWBORN (1ST WEEK OF LIFE) PACKAGE Universal Newborn Hearing Screening and
1. Interventions within the first 90 Intervention Act was approved and signed into
minutes law. RA 9709 establishes a UNHS program for
- Immediate and thorough drying the prevention, early diagnosis, and early
- Skin to skin contact intervention of hearing loss and requiring all
- Cord clamping 1-3 minutes after newborns to have access to hearing screening
birth
- Early initiation of breastfeeding Immunization-10 items
- Non Separation of the baby EXPANDED PROGRAM ON IMMUNIZATION
from the mother (EPI) - was established in 1976.
2. Essential newborn care after 90 ➢ To ensure that infants/children and
minutes to 6 hours mothers have access to routinely
- Vitamin k prophylaxis (helps recommended infant/childhood
the blood to clot and prevents vaccines.
serious bleeding) ➢ Tuberculosis, poliomyelitis, diphtheria,
- Hepatitis and BCG vaccine tetanus, pertussis and measles
- Examination of the baby for birth > OVER-ALL GOAL
injuries, malformations or ➢ To reduce the morbidity and mortality
defects among children against the most
- Additional care for a small baby common vaccine-preventable diseases
(a baby with a birth weight > SPECIFIC GOALS
<2,500 g) or twin 1. To immunize all infants/children against
3. Care prior to discharge: after the first the most common vaccine-preventable
90 minutes (DOH,2011) diseases.
- Support unrestricted , per 2. To sustain the polio-free status of the
demand breastfeeding, day and Philippines.
night 3. To eliminate measles infection.
- Ensure warmth of the baby 4. To eliminate maternal and neonatal
(Kangaroo mother care) tetanus
- Washing and bathing 5. To control diphtheria, pertussis, hepatitis
- Look for danger signs b and German measles.
- Look for jaundice and local 6. To prevent extra pulmonary tuberculosis
infection among children.

lOMoARcPSD|13571890
> MANDATES ➢ Live vaccines tend to create a strong

REPUBLIC ACT NO. 10152 - “Mandatory and lasting immune response and
Infants and Children Health Immunization Act of include some of our best vaccines.
2011 Signed by President Benigno Aquino III on ➢ Live vaccines may not be suitable for
July 26, 2010. The mandatory includes basic people whose immune system doesn’t
immunization for children under 5 including other work, either due to drug treatment or
types that will be determined by the Secretary of underlying illness. This is because the
Health. weakened viruses or bacteria could in
REPUBLIC ACT NO. 7846 - provided for some cases multiply too much and
compulsory immunization against hepatitis B for might cause disease in these people
infants and children below 8 years old and ➢ EXAMPLES: Measles, Mumps, Rubella
hepatitis B immunization within 24 hours after (MMR combined), Rotavirus, Smallpox,
birth of babies of women with hepatitis B Chickenpox, Yellow fever, BCG
> TYPES OF IMMUNITY ➢ ADVANTAGES: Can be freeze dried,
NATURALLY ACQUIRED PASSIVE IMMUNITY Easily stored, No risk of killing the
- occurs during pregnancy, in which certain pathogen, Safer, no risk of mutating into
antibodies are passed from the maternal blood a disease causing form
into the fetal bloodstream in the form of IgG INACTIVATED VACCINES
(protects against bacterial and viral infections). ➢ Inactivated vaccines contain whole
Antibodies are transferred from one person to bacteria or viruses which have been
another through natural means such as in killed or have been altered, so that they
prenatal and postnatal relationships between cannot replicate.
mother and child ➢ Inactivated vaccines do not contain any
ARTIFICIALLY ACQUIRED PASSIVE live bacteria or viruses, they cannot
IMMUNITY - is protection acquired by giving a cause the diseases against which they
person an injection or transfusion of antibodies protect, even in people with severely
made by someone else. Like Gamma globulin weakened immune systems.
injections are usually given in an attempt to ➢ Inactivated vaccines do not always
temporarily boost a patient's immunity against create such a strong or long-lasting
disease immune response as live attenuated
NATURALLY ACQUIRED ACTIVE IMMUNITY - vaccines
occurs when the person is exposed to a live ➢ EXAMPLES: Inactivated poliovirus IPV,
pathogen, develops the disease, and becomes Pertussis, Rabies, Hepatitis A, DPT
immune as a result of the primary immune TOXOID VACCINES
response. Once a microbe penetrates the body's ➢ when they attack the body, and it is the
skin, mucous membranes, or other primary toxins rather than the bacteria itself that
defenses, it interacts with the immune system. we want to be protected against.
ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY ➢ The immune system recognizes these
- is protection produced by intentional exposure toxins in the same way that it recognizes
of a person to antigens in a vaccine other antigens on the surface of the
> TYPES OF VACCINES bacteria, and is able to mount an
LIVE ATTENUATED VACCINES immune response to them.
➢ Live attenuated vaccines contain whole ➢ Some vaccines are made with
bacteria or viruses which have been inactivated versions of these toxins.
“weakened”(attenuated) so that they They are called ‘toxoids’ because they
create a protective immune response look like toxins but are not poisonous.
but do not cause disease in healthy They trigger a strong immune response.
people. ➢ EXAMPLES: Tetanus toxoid, Diphtheria
vaccine, Pertussis

lOMoARcPSD|13571890
VIRUS LIKE PARTICLES or use a fluid vaccine for reconstitution

➢ Virus-like particles (VLPs) are molecules of a freeze dried vaccine(DOH, 2003)
that closely resemble viruses, but are ➢ When a vaccine is administered to an
non-infectious because they contain no infant at the same time with other
viral genetic material. injectable vaccines, the vaccines should
➢ They can be naturally occurring or be administered on different sites.
synthesized through the individual ➢ If more than one injection has to be
expression of viral structural proteins, given on the same limb, the injection
which can then self-assemble into the sites should be 2.5-5 cm apart to
virus-like structure. prevent overlapping of local reactions
➢ The structural proteins of the VLP can (DOH, 2006)
act as adjuvants, helping to strengthen ➢ The recommended sequence of the
the immune response to the primary coadministration of vaccines is OPV first
target antigen. followed by rotavirus vaccine, then after
➢ EXAMPLE: Hepatitis B appropriate vaccines (DOH, 2012)
CONJUGATE VACCINES ➢ Oral polio vaccine is administered by
➢ ‘Conjugate’ means ‘connected’ or putting drops of the vaccine straight
‘joined’. With some bacteria, to get from the dropper onto the child's tongue.
protection from a vaccine you need to Do not let the dropper touch the tongue
train the immune system to respond to (DOH,1995)
polysaccharides (complex sugars on the ➢ Only monovalent (antigen against single
surface of bacteria) rather than proteins. disease) hepatitis B vaccine must be
if the polysaccharide was attached used for the birth dose
(conjugated) to something else that ➢ Pentavalent vaccine (contains antigens
creates a strong immune response. against five diseases: diphtheria,
➢ In most conjugate vaccines, the pertussis, tetanus, hepatitis b and
polysaccharide is attached to diphtheria Hemophilus influenzae B) must not be
or tetanus toxoid protein .The immune used for the birth dose because DPT
system recognizes these proteins very and Hib vaccine should not be given at
easily and this helps to generate a birth
stronger immune response to the > TARGET SETTING
polysaccharide. To compute eligible population:
➢ EXAMPLES: Pentavalent, DPT, DP, 1. Estimated number of infants (0- 12 mos.) =
MMR total population x 2.7%
> IMPORTANT CONSIDERATIONS RELATED Ex. 15,000 x 0.027=405 infants
TO THE SCHEDULE AND MANNER OF 2. Estimated number of 12 - 59 months old
ADMINISTERING INFANT IMMUNIZATIONS children = total population x 10.8%
➢ Use one sterile syringe and needle per Ex. 10,00 x 0.108=1,080
client 3. Estimated number of pregnant women =
➢ No need to restart a vaccination series total population x 3.5%
regardless of the time that has elapsed Ex. 3,000 x 0.035=105 pregnant women
between doses (DOH, 2006) > VACCINE REQUIREMENTS
➢ All EPI antigens are safe and effective Vaccine requirement for the year = eligible
when administered simultaneously, that population x number of doses x wastage
is during the same immunization multiplier
session but at different sites ➢ Eligible population: number of patient
➢ It is not recommended to mix different who will receive the vaccine
vaccines in one syringe before injection, ➢ Number of doses: the number of
vaccine dose a patient needs to receive

lOMoARcPSD|13571890
➢ Wastage multiplier: doses of vaccine supplies.(freezer/refrigerator, transport

being wasted box, vaccine bags/carrier, cold chain
Wastage multiplier may be computed using the monitors, thermometers and cold
following formula: packs.)
Wastage multiplier =
Total number of doses per unit (ampule of vial) Types/Forms of Storage
Vaccines Temperature
Number of doses used
Most Sensitive to Oral Polio (live -15 C to -25 C
Ex.= Oral polio vaccine vial 10 doses Heat attenuated) (at the freezer)
8 doses used Vaccine bag
placed in contact
= 1.25 wastage multiplier with cold packs
Vaccine requirement for the year = eligible
population x number of doses x wastage
Less Sensitive to Measles (freeze + 2C to +8C (in
multiplier Heat dried) the body of the
Determine the OPV requirement of a refrigerator)
Wrap the
municipality for a year containers
1. Eligible population = 15,000 x.027= 405 before putting
infants them in the
vaccine bag with
2. OPV requirement for the year = 405 infants x cold packs
3 doses of OPV
DPT 2C to +8C (in the
Wastage multiplier may be computed using the
“D”- toxoid body of the
following formula: which is a refrigerator)
Wastage multiplier = weakened toxin
“P”- killed
Total number of doses per unit (ampule of vial) bacteria
“T”- toxoid which
is a weakened
Number of doses used toxin
Ex.= Oral polio vaccine vial 10 doses
8 doses used Hep B + 2C to +8C (in
the body of the
= 1.25 wastage multiplier refrigerator)
Vaccine requirement for the year = eligible
population x number of doses x wastage
BCG (freeze + 2C to +8C (in
multiplier dried) the body of the
= 405 infants x 3 doses of OPV=1,215 x 1.25 refrigerator)
wastage= 1,518.75 doses Tetanus Toxoid + 2C to +8C (in
Vaccine requirement for the year = eligible the body of the
population x number of doses x wastage refrigerator)
multiplier
= 1,000 infants x 3 doses of Pentavalent=3,000
➢ Keep diluents cold by storing them in
x 1.25 wastage= 3,750 doses
the refrigerator in the lower or door
> MAINTAINING THE POTENCY OF EPI
shelves
VACCINES
➢ Observe the first expiry-first out (FEFO)
➢ Maintain the cold chain- a system for
policy
ensuring the potency of a vaccine from
➢ Storage with a refrigerator duration
the time of manufacture to the time it is
should not exceed one month
given to eligible client (DOH, 1995)
➢ Using transport boxes vaccines can be
➢ Cold chain officer at the RHU/health
kept only up to maximum of 5 days
center is the public health nurse. In
➢ Vaccine vial monitor is a round disc of
charge of maintaining the cold chain
heat-sensitive material placed on a
equipment and

lOMoARcPSD|13571890
vaccine to register cumulative heat Protect BCG from sunlight (DOH 1995) and
exposure (the lower the temperature, Rotavirus vaccine from light (DOG, 2012)
the slower the color change, the higher > ROUTINE IMMUNIZATION SCHEDULE FOR
the temperature, the faster the color INFANTS
change, WHO, 1999)
VIAL VACCINE MONITOR
Vaccine: Bacillus Calmette Guerin

Contents: Live , attenuated bacteria
Dose: .05 ml
Route and site: Intradermal /Right deltoid
Protection of TB infections and meningitis
Side effects:
Open –vial policy-multidose vial may be ➢ Acute inflammatory reaction within 2-4
opened for one or two clients if the health worker days(indicate previous exposure to
feels that client cannot come back for the tuberculosis)
scheduled immunization session ➢ Deep abscess at vaccination site (due to
Multidose liquid vaccines (OPV, TT, Hepatitis subcutaneous or deep injection) refer to
B and pentavalent) which one or more doses physician for incision and drainage
have been taken following standard sterile ➢ Glandular enlargement (if suppuration
procedures may be used in the next occurs treat as deep abscess)
immunization sessions for up to a maximum of 4
weeks provided: Vaccine: Hepatitis B
➢ Expiry date has not passed Contents: RNA-recombinant, using hepatitis B
➢ Vaccine has not been contaminated surface antigen
➢ Vials have been stored under Dose: .5 ml
appropriate cold chain conditions Route and site: Intramuscular/Upper outer of
➢ Vaccine vial septum has not been the thigh
submerged in water Protection of Hepatitis B
➢ Vaccine vial monitor has not reached the Side effects:
discard point ➢ Local soreness at the injection site
Reconstitute freeze-dried vaccine such as BCG, ➢ No treatment necessary
AMV, MMR only with diluents supplied with them
(DOH, 2003) Vaccines: DPT, Hepa B,Hib (Pentavalent)
Discard reconstituted freeze-dried vaccines 6 Diphtheria:Toxoid Pertussis:inactivated pertussis
hours after reconstitution or at the end of the bacteria Tetanus;toxoid, recombinant DNA
immunization session

lOMoARcPSD|13571890
surface antigen, synthetic conjugate of

Haemophilus influenza B Bacilli Vaccine: Rotavirus
Dose: .5 ml Contents: live attenuated virus
Route and site: Intramuscular/Upper outer of Dose: .5ml
the thigh Route and site: oral/mouth
Protection of Hepatitis B, Hemophilus Protection for diarrhea
influenzae, diphtheria, pertussis, tetanus Side effects: mild vomiting, diarrhea, fever,
Side effects: irritability (give antipyretic and oresol)
➢ Fever for only 1 day, fever beyond 24 > CONTRAINDICATIONS TO EPI VACCINES:
hours ais not due to vaccine but to DO NOT GIVE
other causes (give antipyretic) ➢ Pentavalent vaccine/DPT to children
➢ Local soreness at the injection site (sore over 5 years of age
will disappear after 3-4 days) ➢ Pentavalent vaccine/DPT to a child with
➢ Abscess after a week or more indicates recurrent convulsions or another active
injection was not deep enough or needle neurological disease of CNS
was not sterile (incision and drainage ➢ Pentavalent vaccine/DPT 2 or 3 to child
may be necessary) who has had convulsions or shock
➢ Convulsions though rare caused by within 3 days of the most recent dose
pertussis vaccine (convulsion ➢ Rotavirus vaccine when child has
management, pertussis vaccine should history of hypersensitivity to a previous
not be given anymore) dose of vaccine, intussusceptions or
intestinal malformation
Vaccine: Oral Polio Vaccine ➢ BCG to a child who has signs and
Contents: Live attenuated virus symptoms of AIDS or other immune
Dose: 2-3 gtts deficiency conditions or who are
Route and site: Oral/mouth Protection of Polio immunosuppressed (DOH, 2003)
Instruct the caregiver NPO for 30 minutes after > MAY CONTINUE WITH VACCINES
administration ➢ Malnutrition
➢ Low grade fever
Vaccine: Inactivated Polio Vaccine ➢ Mild respiratory infection
Dose: .5ml ➢ Diarrhea
Route and site: Intramuscular/Upper outer of A child is considered fully immunized, when
the thigh he/she has received one dose of BCG, three
doses of DPT and hepatitis B (3 doses of
Vaccine: Anti Measles Vaccine pentavalent) and OPV each and one dose of
Contents: live attenuated virus measles by the age of 12 months.
Dose: .5ml A child is considered fully immunized, when
Route and site: subcutaneous/deltoid he/she has received one dose of BCG, three
Protection for measles doses of DPT and hepatitis B (3 doses of
Side effects: fever 5-7 days after vaccination pentavalent) and OPV each and one dose of
sometimes mild rash (give antipyretic) measles by the age of 12 months.
Completely immunized children, refer to
Vaccine: Measles, Mumps , Rubella children who completed their immunization
Contents: live attenuated viruses schedule at the age of 12-23 months (DOH-IMS,
Dose: .5ml 2011)
Route and site: subcutaneous/deltoid Child protected at birth (CPAB) describe a
Protection for measles child whose mother has received two doses of
Side effects: local soreness, fever, irritability TT during pregnancy ,provided that the second
and malaise (give antipyretic) dose is given at least one month prior to delivery

lOMoARcPSD|13571890
or at least 3 doses of TT vaccine anytime prior ➢ Preparation for own death and dealing
to pregnancy with this child.(DOH-IMS, 2011) with the loss of spouse and /or siblings
and other peers
For final period
Family structure-5 items
Functions of family-5 items Family Structure - Refers to the characteristics
To meet the needs of society: and demographics (age, sex, number) of
Procreation- reproduction and child bearing. individual members who make up family units
Socialization- learning how to become NUCLEAR- family of marriage, parenthood, or
productive members of the society.Involved in procreation, composed of a husband, wife and
transmission of the culture of social groups. their immediate children- natural or adopted or
Status placement -hierarchy of its members both (Friedman et al, 2003,p.10)
into social classes.(Medina ,2001) DYAD FAMILY- consisting only of husband and
Economic function -urban family is a unit of wife such as newly married couples and “empty
production, urban family is a unit of consumption nesters”.
(Medina 2001) EXTENDED FAMILY- consisting of three
To meet the needs of individual: generations, which may include married siblings
Physical maintenance-provides for survival and their families and/or grandparents.
needs BLENDED FAMILY-which results from a union
Welfare and protection-support spouses, where one or both spouses bring a child or
source of motivation and morale. children from a previous marriage into a new
living arrangement.
Developmental stages of family-5 items COMPOUND FAMILY-where a man has more
MARRIAGE(joining of families) than one spouse, approved by Philippine
➢ Formation of identity as a couple authorities only among Muslims by virtue of P.D.
➢ Inclusion of spouse in realignment of no.1083, also known as the Code of Muslim
relationships with extended families personal Laws of the Philippines (Office of the
➢ Parenthood: making decisions President, 1977)
FAMILIES WITH YOUNG CHILDREN COHABITING FAMILY-which is commonly
➢ Integration of children into family unit described as a “live-in "arrangement between an
➢ Adjustment of tasks: child rearing, unmarried couple who are called common-law
financial and household spouses and their child or children from such an
➢ Accommodations of new parenting and arrangement.
grandparenting roles SINGLE PARENT-which results from the death
FAMILIES WITH ADOLESCENTS of a spouse from the death of spouse,
➢ Development of increasing autonomy for separation, or pregnancy outside of wedlock
adolescents GAY AND LESBIAN FAMILY-made up of a
➢ Midlife reexamination of marital and cohabiting couple of the same sex in a sexual
career issues relationship. The homosexual family may or may
➢ Initial shift towards concern for older not have children. Because the family Code of
generation the Philippines (Executive Order No.209)
FAMILIES AS LAUNCHING CENTERS expressly states that marriage is a special
➢ Establishment of independent identities contract of permanent union between a man and
for parents and grown children a woman entered into in accordance with the
➢ Renegotiation of marital relationship law for the establishment of conjugal and family
➢ Readjustment of relationships to include life, same-sex marriage is not legally acceptable.
in-laws and grandchildren
➢ Dealing with disabilities and death of Family code-5 items
older generation No marriage shall be valid, unless these
AGING FAMILIES essential requisites are present:
➢ Maintaining couple and individual ➢ Legal capacity of the contracting parties
functioning while adapting to the aging who must be a male and a female; and
process ➢ Consent freely given in the presence of
➢ Support role of middle generation the solemnizing
➢ Support and autonomy of older The following marriages shall be void from the
generation beginning for reasons of public policy:

lOMoARcPSD|13571890
➢ Between collateral blood relatives ➢ Illegitimate children may establish their

whether legitimate or illegitimate, up to illegitimate filiation in the same way and
the fourth civil degree; on the same evidence as legitimate
➢ Between step-parents and step-children; children.
➢ Between parents-in-law and children-in ➢ Illegitimate children shall use the
law; surname and shall be under the parental
➢ Between the adopting parent and the authority of their mother, and shall be
adopted child; entitled to support in conformity with this
➢ Between the surviving spouse of the Code.
adopting parent and the adopted child; ➢ Legitimation shall take place by a
➢ Between the surviving spouse of the subsequent valid marriage between
adopted child and the adopter; parents. The annulment of a voidable
➢ Between an adopted child and a marriage shall not affect the legitimation.
legitimate child of the adopter; (270a)
➢ Between adopted children of the same ➢ Legitimated children shall enjoy the
adopter; and same rights as legitimate children.
➢ Between parties where one, with the
intention to marry the other, killed that Family health tasks- 5 items
other person's spouse, In order to attain wellness among family
A petition for legal separation may be filed on members and reduce or eliminate family health
any of the following grounds: problems the family as a unit should perform the
➢ Repeated physical violence or grossly ff: health tasks: (Bailon and Maglaya,1997,2004)
abusive conduct directed against the 1. Recognize the presence of a wellness state or
petitioner, a common child, or a child of health condition or problem
the petitioner; 2. Make decisions about taking appropriate
➢ Physical violence or moral pressure to health action to maintain wellness or manage
compel the petitioner to change religious the health problem
or political affiliation; 3. Provide nursing care to sick, disabled,
➢ Attempt of respondent to corrupt or dependent or at risk members
induce the petitioner, a common child, or 4. Maintain home and environment conducive to
a child of the petitioner, to engage in health maintenance and personal development
prostitution, or connivance in such 5.Utilize community resources
corruption or inducement;
➢ Final judgment sentencing the Typology of Nursing problems in the family
respondent to imprisonment of more nursing practice -15 items
than six years, even A. Wellness Condition potential or readiness of
➢ Drug addiction or habitual alcoholism of a client from a specific level of wellness or
the respondent; capability to a higher level.
➢ Lesbianism or homosexuality of the ➢ Wellness potential - wellness state or
respondent; condition based on client’s performance,
➢ Contracting by the respondent of a current competencies, or clinical data
subsequent bigamous marriage, but no explicit expression of client’s
whether in the Philippines or abroad desire
➢ Sexual infidelity or perversion; ➢ Readiness for enhanced wellness
➢ Attempt by the respondent against the state - based on client’s competencies
life of the petitioner; or or performance, clinical data and explicit
➢ Abandonment of petitioner by expression of desire to achieve a higher
respondent without justifiable cause for level of state or function in a specific
more than one year. area on health promotion and
➢ Children conceived and born outside a maintenance
valid marriage are illegitimate, unless B. HEALTH THREATS conditions that are
otherwise provided in this Code. conducive to disease and accident, or may
➢ The child shall be considered legitimate result to failure to maintain wellness or realize
although the mother may have declared health potential
against its legitimacy or may have ➢ Examples:

lOMoARcPSD|13571890
➢ 1) Presence of risk factors of specific

diseases
➢ 2) Threat of cross infection from a
communicable disease case
➢ 3) Family size beyond what family
resources can adequately provide
➢ 4) Accident hazards
➢ 5) Faulty/ unhealthful nutritional/ eating
habits or feeding techniques practices
➢ 6) Stress-provoking factors
➢ 7) Poor home/ environmental
condition/sanitation
➢ 8) Unsanitary food handling and
preparation
➢ 9) Unhealthful lifestyle and personal
habits/practices
➢ 10) Inherent personal characteristics
➢ 11)Health history which may participate/
induce the occurrence of a health deficit
➢ 12) Inappropriate role assumption
➢ 13) Lack of immunization/ inadequate
immunization status
➢ 14) Family disunity
C. HEALTH DEFICITS instances of failure in
health maintenance
➢ 1) Illness states, regardless of whether it
is diagnosed or undiagnosed by medical
Practitioner
➢ 2) Failure to thrive/ develop according to
normal rate
➢ 3) Disability – whether congenital or
arising from illness; transient/ temporary
or permanent
D. PRESENCE OF STRESS POINTS/

FORESEEABLE CRISIS SITUATIONS –
anticipated periods of unusual demand on the
individual or family in terms of adjustment/ family
resources
➢ Examples:
➢ 1) Marriage
➢ 2) Pregnancy, labor, puerperium
➢ 3) Parenthood
➢ 4) Additional member – e.g. newborn,
lodger
➢ 5) Abortion
➢ 6) Entrance at school
➢ 7) Adolescence
➢ 8) Divorce or separation
➢ 9) Menopause
➢ 10) Loss of job
➢ 11) Hospitalization of a family member
➢ 12) Death of a member
➢ 13) Resettlement in a new community
➢ 14) Illegitimacy

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Community Health interactive groups, in which the place or

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birthright of health and longevity LEVEL 1 (PRIMARY PREVENTION) - relates to

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➢ Education ➢ Theory-based practice guides data

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through a g during the steps on

I’m safe… I only have Having an STD might MILIO’S POPULATION

MILIO’S FRAMEWORK FOR PREVENTION

Without concurrent Addressing persistent

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availability of alternative health problems is

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environmental contingencies such as progress to the next stage , or return to

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➢ PROCEED stands for policy, regulatory, History of Primary Health Care

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> KEY PRINCIPLES OF PRIMARY HEALTH ➢ Affordability

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➢ Administrator of specific services (DOH, including referral and networking

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and Unit medicine

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R.A 7160 or LOCAL GOVERNMENT - provided CLASSIFY DIARRHEA FOR DEHYDRATION

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- Any general danger signs Pink:

- Not enough signs to classify Green:

CHECK FOR ACUTE MALNUTRITION

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their being, the community and society and their

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➢ Sambong formulation effectively ➢ Every newborn and mother pair secures

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PRENATAL ASSESSMENT TT4 At least 1 99% 10 years

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HOME BASED-MOTHERS RECORD (HBMR) ➢ Continuous maternal support by having

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> POSTPARTUM PACKAGE NEWBORN SCREENING - (screening of six

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> MANDATES ➢ Live vaccines tend to create a strong

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VIRUS LIKE PARTICLES or use a fluid vaccine for reconstitution

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➢ Wastage multiplier: doses of vaccine supplies.(freezer/refrigerator, transport

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Vaccine: Bacillus Calmette Guerin

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surface antigen, synthetic conjugate of

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➢ Between collateral blood relatives ➢ Illegitimate children may establish their

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➢ 1) Presence of risk factors of specific

D. PRESENCE OF STRESS POINTS/

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