HEALTH PROGRAMS & SERVICES

A) COMPREHENSIVE MATERNAL AND CHILD CARE PROGRAMSOBJECTIVES: To improve the well-being of mothers and children through the delivery of comprehensive maternal and child related services utilizing the Primary Health Care (PHC) approach.Reduction of maternal mortality & infant mortality.

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

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

Schedule of Pre-natal visits in the health centers1st to 7th month once a month8th month twice a month9th month - weekly

Immunization sched of Tetanus toxoid for childbearing women of age, including pregnant women

Relationship bet tet toxoid dose & duration of protection

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

High Risk PregnanciesToo young less than 18 yrs. oldToo old- more than 34 years oldToo many more than 4 childrenToo close less than 3 years intervalGetting pregnant while sick with chronic diseases like TB or Malaria or with Iron Deficiency.

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

Services:FP counselingPhysical examinationProvision of FP methods using cafeteria approach.

FP Methods- Permanent ( Vasectomy and Bilateral Tubal Ligation)- Temporary ( pill, iud, dmpa/injectables, condom, fertility awareness- based methods)

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

KEY POINTS:It is the most nutritious & the cheapest form of infant feeding.Mothers milk contains colostrum which has antibodies that protect the baby from sickness.It is the best natural means of feeding, available anytime & does not get spoiled.Breastmilk protects the baby against viruses, bacteria & allergy.Strengthens mother-child bonding because it:Promotes the feeling of security in the childMakes the child feel loved and wantedHelps develop & heighten the childs sensesFrequent breastfeeding delays the return of menses & helps to protect from another pregnancy.

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

COMMON PROBLEMS WITH BREASTFEEDING:

Engorged breast/mastitisSoreness/swollen nipplesInverted nipples.

4) Expanded Program on Immunization (EPI)OBJECTIVE: To reduce morbidity & mortality among infants and children caused by the 7 childhood immunizable diseases:diptheria pertussismeasleshepatitis Btetanustuberculosispolio

Table 1.Routine Immunization

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

5)Under Five Care ProgramPackage of care services given to 0-71 months old children. (0-5 years old)Services:Newborn screeningImmunizationVitamin A Supplementation100,000 IU 6 11 months. (blue)200,000 IU 1 yr to 5 yrs. old (red)DewormingDental check-up

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

COMMON NUTRITIONAL DEFICIENCY:

Protein- Energy MalnutritionVit A Deficiency (VAD)Iron Deficiency Anemia (IDA)Iodine Deficiency Disorder (IDD)

FOOD FORTIFICATION PROGRAM (RA 8976)- Sangkap Pinoy Seal (SPS) Mandatory fortification of staple foods Diamond SealSalt iodine rice - iron oil Vit. ASugar vit. A flour- vit. A & iron

7) Control of Acute Respiratory Infection (CARI)OBJECTIVE:Reduction of infant mortality & morbidity. Respiratory Infections can affect the following areas of the respiratory tract: nose, throat and lungsIf not detected and treated early enough, it may lead to pneumonia and eventual death.

Signs & symptoms of ARI:fast breathingnoisy/difficult breathingcoughrunny nose or coldsmay or may not have fever

TIPS ON PREVENTING ARI:Immunization (measles & DPT)Breastfeed babies (up to 2 yrs old)Nutritious Food/Balanced DietVit. A SupplementationKeep away from smokersAvoid exposure to extreme cold/heat.Avoid crowded places.

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

PREVENTION OF DIARRHEA

1. Exclusive breastfeeding2. Improved weaning practices3. Proper hand washing4. Access to safe water5. use of sanitary toilets6. proper disposal of babys stool7. measles immunization

COMMUNICABLE & NON-COMMUNICABLE DISEASES

9) NATIONAL TUBERCULOSIS CONTROL PROGRAMInfectious disease usually affecting the lungs caused by Mycobacterium tuberculosis.Transmitted from TB patients through coughingMost common sign is cough lasting for 2 weeks or more.Diagnosed through sputum examination (microscopy)

Strategy: Directly Observed Treatment Short Course Chemotheraphy (TB-DOTS)What DOTS can do?Will cure TB patients (high cure rate as high as 95%)Prevents new infections among children & adultsPrevents resistance to Anti-TB DrugsNo hospitalization requiredSaves money

10) LEPROSY CONTROL PROGRAM

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

Treatment & Management of Leprosy Multi-Drug TherapyBenefits of Early Treatment:Cured within a shorter periodWill not be able to infect other susceptible members of the householdPrevent the progress of skin lesions in the body.Prevent nerve damage leading to deformities.Prevent relapse & resistance to drugs.

11) Cardio-Vascular Disease Control ProgramHealthy Life-Style Practices among Filipinos thru the promotion of the following: Anti-SmokingProper DietRegular ExerciseIwas StressActivities:- Case finding BP Taking- Referral

12) Cancer Control ProgramOBJECTIVE:Morbidity and mortality rates from cancer are reduced.Cancer largely considered a lifestyle disease.Males lungs, liver and prostateFemales- breast, cervix and lungsChildren leukemias, lymphomas

Services:Counselling patient on: - tobacco use cessation- diet modification & moderate alcohol consumptionCancer screeningBreast ExaminationPap smear screeningHepa B vaccination among infantsEstablish support care program for cancer patients.

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

Strategies & Services1)Increase referral of abnormal urinary findings to nephrologist for early & adequate management & monitoring.2)Counseling of patients 3)Upgrade capabilities of hospitals to cater to kidney patients.

14) Diabetes Control ProgramDiabetes condition where there is poor activity or decrease production of a hormone called insulin resulting in an increase in blood sugar. 4 out of 100 Filipinos are diabeticsHigher in urban than in rural areas63% are unaware that they had diabetesNo known cure for diabetes.

4 Levels of Diabetes Prevention:1) (-) risk (+) disease primordial2) (+) risk (-) disease primary ( educated & encouraged in promoting & maintaining healthy lifestyle)3) (+) risk (+) disease secondary( they will be educated on proper self-care to prevent complications)4) (+) disease (+) complications tertiary - be provided with adequate access to rehabilitation services & referrals to facilities with specialist.

15) STI/HIV & AIDSServices;Case Finding/ConsultationReferralHealth EducationContact TracingTreatment

16) Rabies Control ProgramServices:1) Massive Campaign on Responsible Pet Ownership2) Referral to Animal Bites Center3) Provision of Anti-rabies vaccines ( 3 5 doses)4) Health Education

TROPICAL DISEASE CONTROL PROGRAM

17) Dengue Control ProgramDengue - a viral infection characterized by sudden onset of fever which would last for 2 - 7 days. Types of dengue:dengue feverdengue hemorrhagic feverundifferentiated feverCarriers: 1) Aedes Aegypti - primary vector of the disease- prefers to breed indoor in artificial container.2) Aedes Albopictus - most common in rural areas- secondary vector of dengue- prefers to breed outside

PREVENTION AND CONTROL:Environmental ManagementBiological controlChemical controlPersonal protectionSpace spray applications

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

Prevention & Control:Treatment of casesEnvironmental SanitationSnail ControlHealth Education

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

Activities/Strategies:1) PROMOTIVEcommunity health education2) PREVENTIVEtreated mosquito netsindoor residual sprayingseeding of streamsclearing of streamsother personal protection measures3) CURATIVEEarly diagnosis & prompt treatment4) SUPPORT MECHANISMSSurveillanceEpidemiological Investigation

20) Filariasis Control ProgramFilariasis is a parasitic infection transmitted by a mosquito.Two species of the parasite that cause filariasis: wuchereria & brugia malayi

ELEPHANTIASIS OF THE UPPER EXTREMITIESELEPHANTIASIS OF THE BREAST

ELEPHANTIASIS OF THE SCROTUM (HYDROCOELE)

ELEPHANTIASIS OF THE LOWER EXTREMITIES

Strategies:

Use of mosquito netsResidual sprayingScreening of housesUse of protective clothing among plantation workers elimination of mosquito breeding places.Mass Treatment

In the implementation of these programs CITY HEALTH OFFICE is using the:PRIMARY HEALTH CARE APPROACH

seeing to it that at the brgy level health services are available, acceptable, & accessible.teaching them to be self-relianceEncouraging communities to participate in any health endeavor activities.Raising their level of understanding and awareness that health and development are interrelated.HEALTHY FAMILIES MEANS HEALTHY & PRODUCTIVE COMMUNITY MEMBERS.

SOMETHING BOTHERING AND WORRYING YOU??

DOES STUDYING EXHAUST YOU? IT DOESNT EXHAUST THEM!

DONT YOU LIKE GREEN VEGETABLES? THEY HAVE NO CHOICE!

ARE YOU ON DIET ALL THE TIME...? THEY WISH TO EAT...

DOES YOUR PARENTS SUPER PROTECTION BOTHER YOU?THEY DON'T HAVE PARENTS!

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

DID THEY BUY YOU ADIDAS, WHEN YOU WANTED NIKE? THEY ONLY HAVE THIS BRAND!!!

ARE YOU UPSET WHEN THEY ORDERED YOU TO BED...? THEY DONT WANT TO WAKE UP!!!

DONT COMPLAIN...

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

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

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