Chn Lecture New

8/11/2019 Chn Lecture New

1/11

CHN Lecture

PHCDS: Philippine Health Care

Delivery System

*under ng PHCDS yong DOH

Department of Health (DOH):

National Lead Agency for Health

- RA 71! : Local "o#ern$ent

Code of 1%%1 Decentrali&ation De#olution

- 'O 1!( : Redirecting the role)

and oeration ofDeart$ent of

Health

Decentralization

-Local "o#ern$ent

+udget Allocation ,anoer .nfra)tructure

Devolution

-/co$o)ition0

MunicipalHealth Board(MHB)

ProvincialHealth Board(PHB)

Chairman:,ayor Chairman:"o#ernor

ice Chairman:,unicial HealthOcer 2 ,HO 34City Health Ocer2CHO3

ice Chairman :Pro#incial HealthOcer

( Sector) of PHCDS

Pri#ate 5 /,ar6et-oriented0 Pulic 5 /8ree0 4 /rea)onale0 4

/ta9 a)ed0

Role) of DOH 2according to 'O 1!(3

!"#

!eader in Health

8unction: 8or$ulate)

La and Regulation);

Adot) Policy "naler and caacity uilder

8unction: .nno#ate;

'n)ure highe)t

achie#ale )tandard ;

'9erci)e 4 O#er)ight

#d$ini)trator of )eci


2/11

National Health

.n)urance Progra$

2 NH.P3 5 Phil Health

*No +alance +illing 2N++3 :

2rogra$ of hil? Health

6ung )aan alang

aayran3

N++ Re>uire$ent):

o C81 : co$anyo ,e$er) data recordo C8( : doctor4

Ho)ital

'le$ent) 2 Stategy -

hil? Health3 &inancin,:

/$oney0 5 =o

reduce)


3/11

2Progra$): 'P.; .,C.;

,icronutrient Sule$entation362 .$ro#ed $aternal Health

2.,PAC 5 .ntegrated

,anage$ent of regnant and

Child +irth; ==372 Co$at H.J; A.DS; ,alaria and

other ulic health di)ea)e82 'n#iron$ental Su)tainaility

02 De#elo "loal Partner)hi inHealth

2Note: ( and are non health

related hile 1;- are health

related rogra$)3

P9B!$C H"#!/H %9+S"

COMM9%$/; H"#!/H %9+S"

Pulic Health 2Dr? Charle) 'dard

Ein)lo3

- Science and art of PM) 2cla))ic

de


4/11

d2 &orseeale Crisis:any

e#ent) 4 )ituation in life that

ro$ote) )tre))

32 3ndlevel of assessment :

/'9lain hy there i) a

role$I / /hy0 4 'tiologye2,a2 $naility to reco,nize :

/@ne9lained0

Prolem Prioritization

&amily

12 %ature of the Prolem (1pt2)(Prolem Presented)

cit (4pts) :gat eteen actual and

achie#ale Health /hreat (3pts) :

ro$ote di)ea)e or

inury &oreseeale

Crisis(1pt) :/)tre))

oint0

circu$)tance)4ho you

react

32 Modi>aility of theProlem(3 points) :

roaility of reducing;

eradicating and controlling a

condition42 Preventive potential(1pt2)52 Saliance(1pt2) : Percetion of

a fa$ily to a role$

Community

12 %ature of the Prolem (1pt2)

(Prolem presented) Health Status (4pts2):

increa)e ca)e) of

$ortality and $oridity Health +esource

(3pts2):

a)ence4lac6ing of

$aterial) and $oney Health +elated (1pt2)

32 Modi>aility of the Prolem

(5pts2) : 'radication; control

and redirection

42 Preventive Potential (1 pt) :,ini$i&e

52 Ma,nitude (4 pts2) : )e#erity

of the condition 2igure4 nu$er362 Social Concern (1pt2) :

Percetion of entire

oulation4co$$unit

Shetland (PH%) : Proo)ed guiding

hilo)ohy in Pulic Health Nur)e

*oal of PH% :=o increa)e the le#el of

health of the eole

#%# (PH%) :Practice ro$ote) and

re)er#e the health of the oulation

y integrating the )6ill) and 6noledge

of nur)ing and ulic health

Health (


5/11

K? PeoleM) aarene)) that they

are a co$$unity? .t ha) a territorial oundary

OLO8 5 aected 'CO )y)te$

2SH'+HP3

Socioecono$ic

Hereditary

"n#iron$ental 2$an-$ade

ollution3

Beha#ioral 2life)tyle related

di)ea)e)4 Non CD3

Health Care Deli#ery Sy)te$

Politic)

Common Ma?or %on@

Communicale diseases2+eha#ioral3

12 Cancer32 Chronic O)tructi#e Pul$onary

Di)ea)e2COPD342 Cardio#a)cular Di)ea)e 2CJD352 Diaete) ,ellitu) 2D,3

@)ual Ri)6 8actor):

12 Oesity ,ale - K inche) 8e$ale 5 1?K inche)

g4$( : +,.

Pound): (?( l)4 1 6g

%ormal: 1?K 5 ((?%

9nder-ei,ht:under 1?K

Over-ei,ht: (

Oese 1: (?1 5 (?%

Oese 3: (K 5 (%?%

32 Ci,arette Smo.ers

1 cigarette5 7 $in)?

42 Physical in activity52 Poor ve,etale and &ruits

inta.e

Jegetale): (- )er#ing)4day

1 )er#ing 5 1 cu ra #eg) and

cu coo6ed #eg)

8ruit): ( )er#ing)4day 2$orning and

afternoon3

62 &amily -ith a history of HP%1(!4! ( reading in 1 ee6

Pre HP% :)y)tole 1(!-1(!

Dia)tole !-%

HP% Sta,e 1 : )y)tole 1!-1!

dia)tole %!-%%HP% Sta,e 3 : )y)tole 1!-1K%

dia)tole 1!!HP% crisis : )y)tole 1!

Dia)tole 1!!

72 &amily -ith a history of DM&BS: 7!-11! $g4dl

HB#1C : -Q 2accurate3

*oal of Primary Health Care

- Health 8or all- Self reliance

,i))ion of PHC: Peole ill $anage the

health care

- =o )trengthen the health care

)y)te$ y increa)ingoortunitie) and )uorting

the condition) herein eole

ill $anage their on health

care

/-o level of Primary Health Care


6/11

(? Attitude of the eole? Re)i)tance to change? Deendence on the art of

co$$unity eoleK? Lac6 of $anagerial )6ill)

"lements of Primary Health Care

"ducation for Health

!ocally 'nde$ic Di)ea)e Control

"9anded Progra$ on .$$uni&ation

Maternal and Child and 8a$ily

Planning

"n#iron$ental Sanitation and

Pro$otion of Safe Eater Suly

%utrition and ro$otion of ade>uate

food )uly

/reat$ent of Co$$unicale Di)ea)e)

and Co$$on .llne))

Suly of '))ential Drug)

&ield Health Service $nformation

System (&HS$S)

- =o ro#ide the a)ic )er#ice

data needed to $onitor

acti#itie) in each rogra$) and

ha) co$o)ition

Composition of &ield Health

Service $nformation System

(&HS$S)

&amily treatment +ecord

- 8unda$ental uilding loc6 :

Health Care Sy)te$ Record /ar,et Client !ist

- (nduilding loc6 : )er#ice and

dataa)e +eportin, /ally forms

- Data routinely tran)$itted fro$one to another facility

Output +eports

- '#aluation and outco$e

DOH Pro,rams

/Se (/ama Sapat ".s.lusio)

- +rea)tfeeding- Sign of "ood Attach$ent- A6a Sto; =i$ely; Ade>uate;

Proerly 8ed 2S=AP3- Attain the


7/11

5 CO+" S/"P O& "%C

.$$ediate and thorough drying

2ithin ! )econd) U ( lan6et)3 'arly )6in to )6in contact Proerly ti$ed cord cla$ing

eteen 1 5 $inute)

2ul)ation ha) cea)ed or )to3 Non )earation of the Neorn

ith $other for early initiation

of rea)tfeeding 2%! $in)? Of

life3

'arly Cue) 2+83

Stirring ,outh Oening =urning head Suc6ing4Rooting

,id Cue)

Stretching .ncrea)e hy)ical $o#e$ent Head to $outh

Late Cue)

Agitated odily $o#e$ent Color red Crying

Maternal Health Pro,ram

- #,e : 1K-% year) old- ==; .ron 8olate; Jita$in A

Maternal $mmunization a,ainst

/etanus

All o$en gi#ing irth and their

Neorn +aie) )hould e

rotected again)t tetanu) Ad$ini)ter if the o$an ha)

not re#iou)ly een #accinated

or if her i$$uni&ation )tatu) i)

un6non Child Protected at +irth 2 CPA+ 3

"i#e to do)e) of ==4 =d

one $onth aart efore

deli#ery and further

do)e) 2!Q rotection

oth $other and ay U

year) 5 $other3.f the o$en ha) had 1-

do)e) of == in the

a)t; gi#e one do)e of

==4=d efore gi#ing irth

8., 28ully .$$uni&ed ,other3 :K== 2co$o)ed of ( )tandard

do)e) efore gi#ing irth and

oo)ter do)e)3

==1

At uentregnancy

Atlea)tKyear)

,other4ay

==

At lea)t 1

year after== orduring)u)e>uentregnancy

At

lea)t1!year)

,other4ay

==K

At lea)t 1year after== orduring)u)e>uentregancy

,4+ :rotectedall)ucceedregnancy

*DOSA"'-S.='-RO@='

Age atla)t#accination

Pre#iou)i$$uni&ation a)edon record

Atre)entcontact4regnancy

Later2atinter#al ofatlea)t 1year3

.nfancy D=P(do)edof ==of

ee6)inter#al et?do)e)

1do)eof

==4td

Childhood

D=P 1do)eof==4=d

1 do)eof==4td

SchoolAge

D=P F 1D=4 =d

1do)eof==4=d

1 do)eof==4td

School

Age

D=P F 1

D=4=d

1

do)eof==4=d

none

Adole)cent

D=P F1D=4=d at- year)old F=d4==at 1-1year) old

nonenone

8or the o$en to e rotected

during regnancy; the la)t do)e

of == $u)t e gi#en at least 3-ee.srior to deli#ery

Record the do)e) gi#en on a

)tandard == i$$uni&ation

*Note that tetanu) antito9in )hould

ha#e a )6in te)t


8/11

Ca)e of neonatal tetanu) 2identi$onth

rd#i)it During the rdtri$e)ter

7$onth): once>$onth$onth): > (ee6)

> (ee6)

After $onth)of regnancytill deli#ery

> ee6

B P a g e


9/11

Post natal visit

&reuency

Homevisit

Clinicvisit

1)t Eithin (hour)

Eithin 1ee62ideally -

K day)3(nd Eithin 1ee6

ee6)

Post natal visit

&reuency Homevisit

Clinicvisit

1)t Eithin in( hour)

Eithin 1ee6

(nd Eithin 1ee6

( ee6)

rd

ee6)th ee6)

,aternal Child Health Care

$ntestinal Parasite (5th@6th

month): Meendazole

6m, talet sin,le doseAnyti$e fro$ -%

$onth) of regnancy

if none a) gi#en in

the a)t $onth)?

Do not gi#e

$eenda&ole in the

1)t1- $onth) of

regnancy? =hi)

$ight cau)e

congenital role$)

in ay?

Malaria (5th@6thmonth) :

Sulfadoin6m, :

Pyrimethamine36m,

"i#e )ulfado9in-Pyri$etha$ine to

o$en fro$ $alaria

ende$ic area) ho

are in 1)tor (nd

regnancy;

K!!$g4(K$g ta;

ta) at the eginning

of (ndto rdtri$e)ter #nemia (any month)

T11$g4dl 5 1)tand rd

T1!?K$g4dl 5 (nd

8or$: =alet 2enteric coated3

"lemental $ron &olate : 7m, 5

mc,

itamin #

Pre@ natal Post natal

1!; !!! .@ (!!;!!! .@ $onth until irth Eithin ee6)1 ta4tice a ee6 Single do)e'#ery =hur)day 2con)ultation$aternal3: ag $ay /night lindne))0 ;gi#e na anyti$e; ; inter#al (- day)after 1)tdo)e,icronutrient Sule$entationI Eag

ng $agigay

$ron &olate 2enteric coated3

,etaolic A)ortion Site

Dude .)

Duodenum E $ron

Wu)t 8eeling

=e?unum E &olate

.ll; +ro

$leum B13

I1 ta once a day for 10 days

2around $onth)4(ndtri$e)ter3

*Pre#ent Neural tue defect)

*+e)t ti$e to gi#e folateI 1)ttri$e)ter

*Safe)t do)eI !! $cg

*On the la)t $onth of regnancy; gi#e

( ta4day

itamin #

$nfant Children

1!! .@ (!! .@Single do)e '#ery $onth)

( gtt) "i#e all-11 $onth)

.f T $onth) K!

.@ 2 1dro 3

Pentavalent accine introduction

(6 in 1)

Hea +;

Dihteria;Pertu))i);

=etanu); Hae$ohilu)

.nuen&ae =ye + !?K $l; right

deltoid4#a)tu)

laterali)4uerthigh4outer thigh

ee6)41! ee6)41

ee6) Contraindicated for

er)on) 6non to ha#e

e9erienced a )e#ere

allergic reaction

2anahyla9i)3 folloing a

rior data

% B P a g e


10/11

Hea + : !--1!-1 All ee6)-11 $onth

old infant)

&ully $mmunized Child (&$C):efore

1 year old

Completely $mmunized Child (C$C):

After 1 year old

*eneral Principles on accine

#dministration

1? ,ini$u$ inter#al for #accine

ad$ini)tration i) ee6)(? .t i) )afe to ad$ini)ter all

#accine) on the )a$e day u)ing

dierent route and )ite of

ad$ini)tration? Regardle)); hen a) the la)t

inter#al gi#en; gi#e the ne9t

do)e a) the )ucceeding do)e? ?K increa)e : do not gi#e the

#accine : ?K

decrea)e: gi#e the #accineK? Child ha) diarrhea; cold and

$alnouri)hed: gi#e the #accine

&alse Contraindication $ndication

?K elo Nau)ea4#o$iting ,alnouri)hed

Chro$o)o$al A)y$to$atic )ign of H.J 8a$ily hi)tory of Sei&ure

Contraindication

Sy$to$atic 2H.J4Hea +3 Pregnant $other) 2li#e

attenuated #accine3 OPJ; +C"; ,,R : Do not gi#e to

tho)e i$$uno)ure))ed4

.$$unoco$ro$i)ed

Iuse 1 syrin,evaccine

IMana,e >rst the sic. illness and

then ,o ac.

BC* (Bacille Calmette@*uerin)

!?!K $l; right deltoid4 right

uer ar$; .D; anyti$e after

irth 2note: 6ahit )aang )ite

a)ta $ay alat3 +oo)ter do)e: gi#en uon

)chool; !?1 $l; Left deltoid Loo6 li6e: end of an

un)harened encil : S$ooth;

)hiny; glo))y K$ in dia$eter %ursin, +esponsiility:

Do not aly alcohol on

the inection )ite

Do not touch the )car4

Do not ay any

oint$ent Local i)onia&id oder :

$edication for +C" )car %ote: no to )ucutaneou) and

dee : .nci)ion and drainage for

+C"

Hepatitis B

!?K $l; Right outer a)ect of

thigh; .,; i$$ediately right

after irth; gi#en do)e) 2-1!-

1342!--13; on enta#alent;

gi#en do)e) 2 !--1!-13 /la)$a deri#ed #accine0 RNA

reco$inant-t; )eru$ a)ed

#accine Do not $a))age Alternate

ar$ and cold co$re))

Diptheria Pertussis /etanus

(DP/)

Ditheria 5 ea6ened to9in Pertu))i) 5 6illed acteria =etanu) 5 ea6ened

to9in4to9oid 2no need for )6in

te)ting3 !?K $l; Left outer a)ect of the

#a)tu) laterali); .,; gi#en

do)e) 2 -1!-13 Do not $a))age '9ect ithin ( hour) that ha)

fe#er ut not con#ul)ion) 2 gi#e

araceta$ol3 .f con#ul)ion e9i)t; e do not

gi#e ertu))i) in)tead D= only Pertu))i) i) a hole cell; it

tra#el) into CNS =he DP= i) only gi#en elo

year) old; if the child i) year)

old ao#e e gi#e only D=

Oral Polio accine (OP)

Li#e attenuated Jiru) ( gtt); )ide of the $outh; PO;

gi#en do)e) 2 -1!-13 NPO for ! $inute);2a)ortion

ti$e of the #accine3 .f #o$it); gi#e another ( gtt)

again; and if #o$it) again; do

not gi#e? No o#erdo)age of OPJ Seet-)our-itter ta)te

thdo)e : 1 ee6 U if the child

ha) a diarrhea on the )chedule

of OPJ #accination

#nti Measles accine (#M)

Li#e attenuated #iru) !?K $l; Right outer art of the

uer ar$; )ucutaneou);

gi#en % $onth)

1! B P a g e


11/11

,ea)le) ra)he) after -K day)

a)ter ad$ini)tration i) nor$al A)irate efore ad$ini)ter 2-

11 $onth) hindi a fully

de#eloed ang )ucutaneou);

tendency you $ight hit the

ner#e3 A,J F JAC 1!!6 .@ Prohylactic agent) ede

)iyang iigay ag outrea6 ng

$ea)le) @ntil K year) old

!east Sensitive to heat (ody

refri,erator)

=e$erature : ( 5 C +C"; DP=; Hea +

Chiller 5 +C"

Most Sensitive to heat (&reezer)

=e$erature : -1K - -(K C MOS/ : ,ea)le); Oral olio

Sen)iti#e =alaga

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