Dagupan City: Among highly urbanized city in Pangasinan.

(2nd Class city)

18 barangay health stations

•Demographic profile:

Land size: 4,008 hectares

Population size: 174,302 people

23 Inland barangays:

3 coastal barangays:

5 island barangays

CHO

Vision: ?

Mission: ?

•Community health: involves environment.

•According to winslow: public health is the science and art of health in community.

•Classifications:

Primary healthcare: universally accessible

Primary health center – basic structural unit in community health.

Chw: integral part of community health.

•Different Services:

Maternal care and services: to reduce maternal and neonatal mortality and morbidity.

-target clients: pregnant woman and the child

Early prevention of risk factors.

•Prenatal needs: (4 pre natal check ups)

1 on first trimester

1 on second trimester

2 on third trimester

Physical exam

•Immunization: Mother is Given tetanus diphtheria.

Td1, Td2, Td3, Td4 (10 year immunity)

Td5 – lifetime immunity

•Supplementation of iron, iodine capsule, folic acid

(given one dose every morning anthelmintic)

(Lab testing: CBC, Hemog, Hbsag, HIV Screening)

Prepartum

Intrapartum

Postpartum

2 postpartum checkup

7 days after delivery

(iron supplementation)

•EO 51 – Milk code  Tama, sapat, ekslusibo (most nutritious for baby; colostrum – prevent infections
and allergies + make the child feel loved and cared.)

•Family planning: woman of reproductive age (15-49 year old)

•Birth control Methods: permanent: (Vasectomy and bilateral tubal ligation)

Temporary: (birth control pills, iud, condom)

Child care & nutrition services: (feeding programs and immunizations)

•0-28 days (immunization at birth)

Hepa B(2doses); Bcg (1dose); DPT (3 doses); Pneumococcal pcv; MMR (2doses) inactivated
vaccinations

IPV; (2Dosage) – considered fully immunized

•LBW infants 1-3 mos (seen and given fe supplements + micro and macronutrients)

OPV (0-5 YR OLD)

Wednesday: nationwide as immunization day.

•Oral health care:

•0-11 mos:

•1-4 yrs old: Oral prophylaxis

Topical application of fluoride.

Supervised brush of teeth.

Infectious dse prevention and control services:

• Natl tb cntrll program – mycobacterium tuberculosis.

Treatment: TB DOTS – Directly Observed Therapies (95% efficacy rate)

• Leprosy control program – leprosy is contagious that affects peripheral nerve and skin. (Hypo and
hyperpigmentation + lack of sensation in affected part) Hair growth over skin lesions. Eye; Hand; Foot

•Treatment: MGT (multi graph therapy), MB (more than 5 lesions, PB (less than 5 lesions).

MTG is taken for a year course everyday

PB (Paucibacillary) is 6-9 mos

MB (Multibacillary) is 12-18 mos

(After the full duration of treatment, the pt is not considered cured thus needing a follow up)

If late dx: complications arises

Rabies prevention and control services: according to WHO, once the pt had symptoms it will be fatal and
not curable. S&s: hydrophobia, photophobia, hallucinations, aggressiveness as clinical manifestations.

Post-exposure Treatment: NO treatment available once symptoms arises but early prevention method
works: (Rabies Prophylaxis Vaccine.) to minimize the inoculation and prevent the spread of virus.

Local wound care: avoid suturing; tandok (sipsip)

•Category of exposure:

Category I touching or feeding animals, animal licks on intact skin (no exposure);

Category II nibbling of uncovered skin, minor scratches or abrasions without bleeding (exposure);

Category III single or multiple transdermal bites or scratches, contamination of mucous membrane.

•Non communicable dse prevention and control services:

CDV Dse; Cancer; Respiratory dse; Diabetes (risk assessed) some of them are also termed lifestyle dses.

Risk factors: poor diet, lack of exercise, lack of sleep, alcohol consumption and stress. (Behavioural
factors)

Treatment: No specific treatment; Risk assessment (lifestyle modification); Screening tests.

HPN: (Typically 150/90 mmHg)

Treatment: diet modification (low fat and low Na) + hpn drugs

(Treatable but not curable)

Early stage: stress

Late stage: Can lead to renal failure and cardiac complications

Diabetes Mellitus: has no cure but can be controlled, caused by high blood sugar d/t failure to produce
enough insulin and/or the inability to absorb/secrete glucose.

3ps (clinical manifestations)

DM1: insulin dependent

DM2: insulin resistance

Treatment: diet modification + subcu administration of insulin for DM1; metformin

Sulfonylureas, sodium-glucose, co-transporters type 2 (SGLT-2) inhibitors for DM2.

•CANCER: Most common is lung cancer

(High risk are primary smokers, secondary smokers and tertiary smokers)

Management: screening, palliative care, associated with NCD.

Objective for cancer: morbidity and mortality are reduced.

Male – prostate, lung, liver

Female – lung cancer, breast, cervix

Children – leukaemias, lymphomas

•CHO Services:

Cancer screening

Breast examination

Paps smear

Vaccines for cervical cancer (HPV given on female adolescent)

•Emerging and re emerging dse: Newly appeared or have existed before but are rapidly increasing on the
present times.

Corona virus:

Dengue: vector type of infection transmitted via bite of mosquitos.

Prevention: 5s kontra dengue.

Treatment: for post exposure, palliative treatment.

•Natality rate: Number of live births/population x 1000

•Morbidity rate: the rate at which an illness or disease occurs within a population.

•Mortality rate: the rate of death. Number of deaths due to a disease divided by the total population.
•Maternal mortality rate: maternal death/livebirth x 1000

•Neonatal mortality rate: Infant death/live birth x 1000