COMMUNITY AND DEVELOPMENT CONCEPTS, THEORIES, AND STRATEGIES

Pre-Spanish Era (before 1565)

Babaylans were considered as healer, prietess and leader

Spanish Era (1565-1898)

Hospitals were created for the welfare of spanish soldiers that succumbed to tropical diseases

Spanish Era (1565-1898)

First epidemic 1574: small pox (bolotong); smallpox vaccine was introduced

Health Care Under the Americans (1898-1918)

PGH was opened; UP College of Medicine was opened

Health Care Under the Americans (1898-1918)

Worst epidemic in Philippine History: cholera; cholera vaccine was first tried

Health Care Under the Americans (1898-1918)

Building more hospitals and formal medical education and medical benefits were given to Filipinos

Commonwealth Period (1936-1941)

Reorganization of public health laboratory with modern facilities – establishment of a unit for treatment and study of cancer

Japanese Occupation (1941-1945)

Increase incidence of TB, venereal diseases, Malaria, leprosy and malnutrition

Post Word War II (1945-1972)

Introduction of penicillin to treat gonnorhe

Post Word War II (1945-1972)

BCG (Bacille Calmette Guerin) was used for mass vaccination for prevention of tuberculosis

Post Word War II (1945-1972)

Rural Health Units)were established in municipalities under Pres. Ramon Magsaysay who introduced “Health Care for the masses”

BCG (Bacille Calmette Guerin)

was used for mass vaccination for prevention of tuberculosis

Health

"a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."

Community Health

the health of a community's members, the health care they receive, and the factors that affect their health

Public Health

The science and art of preventing disease, prolonging life, and promoting health through organized community efforts.

Wellness

A dynamic process of becoming aware of and making choices toward a healthy and fulfilling life

Illness

A subjective state of feeling unwell or experiencing symptoms

Disease

An objectively measurable condition that impairs normal functioning

Physical health

The ability of the body to function properly, free from illness, injury, or disability

Mental health

Psychological and emotional well-being, affecting how individuals think, feel, and behave in daily life

Social health

Ability to form relationships and adapt to social situations

Spiritual health

Finding meaning and purpose in life

Environmental health

Living in harmony with one's surroundings

DETERMINANTS OF HEALTH AND DISEASE

1. Biological factors

2. Environmental factors

3. Socio-economic factors

Biological factors

inherent characteristics that influence a person's health and susceptibility to diseases

Environmental factors

external conditions that affect health of an individual

Socio-economic factors

influence health through:

a. Income

b. Education

c. Employment

d. social support, and

e. healthcare access

ASSESSMENT

involves systematically collecting, analyzing, and interpreting data to monitor the health status of the population.

POLICY DEVELOPMENT

involves creating policies, laws, and regulations that guide public health practice

ASSURANCE

involves ensuring that necessary health services are available and accessible to the population, promoting health equity

Public health achievements

refer to the significant improvements in the overall health of a population, which are typically the result of wellcoordinated interventions and policies aimed at preventing disease, promoting health, and improving well-being.

LEVELS OF PREVENTION

1. Primary prevention

2. Secondary prevention

3. Tertiary prevention

4. Quaternary prevention

Primary prevention

preventing the onset of disease or injury before it occurs

Secondary prevention

focuses on the early detection and intervention of diseases before they cause significant harm

Tertiary prevention

managing and mitigating the impact of an already established disease or injury

Quaternary prevention

prevent unnecessary or potentially harmful medical interventions

LEVELS OF CLIENTELE

1. Individual

2. Family

3. Community

3. Community

Individual

focusing on personalized healthcare needs

Family

targets the family as the primary unit of health intervention

Community

involves public health interventions that focus on populations within a specific community or locality

Population

interventions are aimed at the entire nation or large population groups

ETHICAL VALUES IN PUBLIC HEALTH

Beneficence

Justice

Respect for Autonomy

Non-maleficence

Beneficence

Promoting public good

Justice

Fair distribution of health resources

Respect for Autonomy

Individual right to make health decisions

Non-maleficence

Avoiding harm

Primary Sources

• Census (Philippine Statistics Authority)

• Civil Registration

• Sample Surveys

Secondary Sources

• Philippine Health Statistics

• Local Government Unit Records

• Hospital Records

Crude Birth Rate (CBR)

number of live births per 1,000 people in a given population in a specific year

Maternal Mortality Ratio (MMR)

number of maternal deaths per 100,000 live births

Crude Death Rate (CDR)

number of deaths per 1,000 people in a given population over a specific period (usually one year

Infant Mortality Rate (IMR

number of deaths of infants under 1 year of age per 1,000 live births

Swaroop’s Index

proportion of deaths that occur in individuals aged 50 years and above

Ludwig von Bertalanffy

General Systems Theory (GST) proponent

General Systems Theory (GST)

posits that various systems, whether biological, social, or ecological, share common principles and can be understood through their interconnections and interactions.

General Systems Theory (GST)

This theory emphasizes the holistic nature of systems, where the sum of parts is greater than the individual components.

General Systems Theory (GST)

It helps us understand how different social, economic, and environmental factors interact to influence health outcomes.

Social Learning Theory (SLT)

emphasizes the importance of observation, imitation, and modeling in learning behaviors.

Social Learning Theory (SLT)

Social Learning Theory (SLT) proponent

Social Learning Theory (SLT)

This theory suggests that individuals learn new behaviors by watching others, especially those they perceive as role models. In community development, this theory highlights the role of social networks in promoting health and well-being.

Social Learning Theory (SLT)

This theory underscores the importance of incorporating social dynamics into health promotion strategies, making it essential for developing effective community interventions.

Health Belief Model (HBM)

is a psychological framework that seeks to explain and predict health behaviors based on individuals' beliefs and attitudes.

Irwin M. Rosenstock

Health Belief Model (HBM) proponent

Health Belief Model (HBM)

It posits that people are more likely to engage in health promoting behaviors if they perceive a high level of personal susceptibility to a health issue, believe the consequences of the health issue are severe, think that taking a specific action would reduce their risk, and feel that the benefits of taking that action outweigh the barriers.

Health Belief Model (HBM)

can help community developers tailor their strategies to address specific beliefs and misconceptions that hinder health-promoting behaviors.

Milio’s Framework for Prevention

expands the understanding of health determinants by focusing on the social and environmental contexts that shape individual behavior.

Nancy Milio

Milio’s Framework for Prevention proponent

Milio’s Framework for Prevention

emphasizes the need to assess both individual choices and the broader societal factors that influence those choices.

Pender’s Health Promotion Model

emphasizes the role of individual characteristics and experiences in shaping health behaviors. It focuses on the intrinsic motivations that drive individuals to engage in health-promoting activities.

Nola J. Pender

Pender’s Health Promotion Model proponent

Pender’s Health Promotion Model

This model reinforces the idea that effective health promotion should be person-centered, taking into account individual preferences and motivations.

Transtheoretical Model

outlines a five-stage process that individuals typically follow when changing behavior.

James O. Prochaska and Carlo DiClemente

Transtheoretical Model proponents

1. Precontemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

five stages of the transtheoretical model

Precontemplation stage

individuals are not yet considering change, often due to a lack of awareness of the problem.

Contemplation stage

they recognize the need for change but are ambivalent about taking action.

Preparation stage

involves planning for change, where individuals may start small efforts toward their goal.

Action

is the stage where individuals actively modify their behavior

Maintenance

involves sustaining these new behaviors over the long term.

Precede-Proceed Model

serves as a comprehensive planning framework for health promotion and education.

Lawrence W. Green and Marshall W. Kreuter

Precede-Proceed Mode proponents

PRECEDE

which focuses on assessing needs before implementing a program

Precede

The ________ phase includes several assessments: social assessment, epidemiological assessment, behavioral and environmental assessment, and educational and organizational assessment. This ensures that interventions are based on community needs and are contextually relevant

PROCEED

emphasizes the implementation and evaluation of health programs

Proceed

The __________ phase involves the actual implementation of the program and its ongoing evaluation to measure effectiveness and make necessary adjustments. This model underscores the importance of a data-driven approach to health promotion, ensuring that interventions are not only effective but also sustainable

PRIMARY HEALTH CARE

Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that community and the country can afford … (Alma-Ata, 1978)

PRIMARY HEALTH CARE

is essential health care that is a socially appropriate, universally accessible, scientifically sound first level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most in need, maximizes community and individual self-reliance and participation and involves collaboration with other sectors.

Accessibility

refers to the ease with which individuals can obtain health services, which is crucial for underserved populations.

Community participation

emphasizes involving individuals in the planning and implementation of health services, ensuring that they are culturally appropriate and effective.

Comprehensive care

indicates that PHC addresses a wide array of health issues, including preventative, curative, and rehabilitative services, thus promoting overall well-being rather than merely treating illness.

1970s

The concept of Primary Health Care emerged in the _____ as a response to the inadequacies of traditional health systems.

Declaration of Alma-Ata in 1978

The landmark ______________________________ marked a pivotal moment, recognizing that health is a fundamental human right and advocating for the need to provide primary health care as part of comprehensive health systems.

Equitable distribution of health care

according to this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, caste, color, urban/rural location and social class

Community participation

in order to make the fullest use of local, national and other available resources. Community participation was considered sustainable due to its grass roots nature and emphasis on self sufficiency, as opposed to targeted (or vertical) approaches dependent on international development assistance

Health workforce development

comprehensive healthcare relies on an adequate number and distribution of trained physicians, nurses, allied health professions, community health workers and others working as a health team and supported at the local and referral levels

Use of appropriate technology

medical technology should be provided that is accessible, affordable, feasible and culturally acceptable to the community.

Multi-sectional approach

recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self-reliance of communities.