CHN -- prelims to finals -- ata

World health organization

— WHO is the directing and coordinating authority for health within the United Nations system.

— m. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

Established 7 April 1948.

— a date we now celebrate every year as World Health Day. Headquarters in Geneva, Switzerland

What we do

— WHO works worldwide to promote health, keep the world safe, and serve the vulnerable.

— Our goal is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being.

Millennium Development Goal

— On September 6 to 8, 2000, world leaders in the UN General Assembly participated

— The result of the summit was a resolution entitled the United Nations Millennium Declaration. In this declaration, the world leaders recognized their collective responsibility to uphold the principles of human dignity, equality and equity at the global level.

— The declaration expressed the commitment of the 191 member states, including the Philippines, to reduce extreme poverty and achieve seven other targets - now called the Millennium Development Goals (MDG’s) by the year 2015.

Goal 1

— End poverty 

Goal 2

— End Hunger

Goal 3

— Ensure healthy lives

Goal 4

— Ensure inclusive and equitable quality education

Goal 5

— Achieve gender equality

Goal 6

— Ensure availability and sustainable management of water and sanitation for all 

Goal 7

— Ensure access to affordable, reliable, sustainable and modern energy for all

Goal 8

— Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

Goal 9

— Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

Goal 10

— Reduce inequality within and among countries

Goal 11

— Make cities and human settlements inclusive, safe, resilient and sustainable

Goal 12

— Ensure sustainable consumption and production patterns

Goal 13

— Take urgent action to combat climate change and its impacts

Goal 14

— Conserve and sustainably use the oceans, seas and marine resources for sustainable development

Goal 15

— Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss

Goal 16

— Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

Goal 17

— Strengthen the means of implementation and revitalize the global partnership for sustainable development

Mission

— To lead the country in the development of a productive, resilient, equitable and people-centered health system

Vision

— Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040

Mandate

— To develop national plans, technical standards, and guidelines on health

The 1987 Philippine Constitution

— mandated the Congress to “enact a local government code which shall provide for a more responsive and accountable local government structure instituted through a system of decentralization with effective mechanisms of recall, initiative and referendum, allocate among the different local government units their powers, responsibilities, and resources, and provide for the qualifications, election, appointment and removal, term, salaries, powers and functions and duties of local officials, and all other matters relating to the organization and operation of the local units (Section 3, Article X).” In response to this Constitutional directive, the Congress legislated the Republic Act No. 7160,

Republic Act No. 7160,

— known as the Local Government Code of 1991 (hereafter Code), which was signed into law on October 10, 1991 and took effect on January 1, 1992.

DOH5 

— become the leader, enabler, standard setter (or regulator-enforcer of standards/ regulation) for health services planning and service provision and delivery, policy maker, health advocate, resource center, mobilizer, and technical adviser as well as administrator of regional and special hospitals (DOH-BLHD nd; Mercado et al. 1996; Romualdez et al. 2011; DOH-BLHD 2013).

Department of Health (DOH) Rules and Regulations Implementing the Local Government Code of 1991 (DOH Task Force on Decentralization 1992)

— primary health services are otherwise known as basic health services, which are delivered at health centers or rural health units (RHUs) and barangay health stations (BHS). These services include health education; control of locally endemic diseases such as malaria, dengue, schistosomiasis; expanded program of immunization (against tuberculosis, polio, measles, diphtheria, whooping cough, and tetanus); maternal and child health and family planning; environmental sanitation and provision of safe water supply; nutrition; treatment of common diseases; and supply of essential drugs (DOH-LGAMS 1993).

Category A

— Primary Health Care Facility – a first contact health care facility that offers basic service including emergency services and provision for normal deliveries.

1. Without in-patient beds like health centers, out-patient clinics, and dental clinics

2. With in-patient beds – a short-stay facility where the patient spends on the average of one to two days before discharge.

Category B

— Custodial Care Facility – a health facility that provides long-term care, including basic services like food and shelter, to patients with chronic conditions requiring ongoing health and nursing care due to impairment and a reduced degree of independence in activities of daily living, and patients in need of rehabilitation

Category C

— Diagnostic/Therapeutic Facility - a facility for the examination of the human body, specimens from the human body for the diagnosis, sometimes treatment of disease or water for drinking analysis. The test covers the preanalytical, analytical and post analytical phases of examination.

Category D

— Specialized outpatient facility – a facility that performs highly specialized procedures on an outpatient basis.

The Rural Health Unit

— Commonly known as a health center, is a primary level health facility in the municipality

— Focus is preventive and promotive health services and the supervision of BHSs under its jurisdiction

BHS

— It is the first contact health care facility that offers basic services at the barangay level. It is a satellite station of the RHU. It is manned by Volunteer Barangay Health Workers (BHW’s) under the supervision of Rural Health Midwife (RHM).

Very severe disease

• Pink

Any of the following:

— Not feeding well or convulsions

— Fast breathing 60 bpm or more

—Severe chest indrawing

Local bacterial infection

• Yellow

— Umbilicus red or draining pus or skin pustules

• Give oral antibiotic

• Teach mother to treat local infections at home

• Advise the mother to give home care for the young infant

• Assess and counsel mother on care and development

• Follow up in 2 days

Severe jaundice

• Pink

— Any jaundice if age is less than 24 hours or yellow palms and soles at any age

• Refer urgently to hospital

• Treat to prevent low blood sugar

• Advise how to keep the infant warm on the way to the hospital

Jaundice

• Yellow

Jaundice appearing after 24 hours of age and palms and soles NOT yellow

• Advice the mother to give home care for young infant

• Advise to return immediately if palms and soles appear yellow

• If the young infant is older than 14 days, refer for assessment

• Assess and counsel the mother on care for development

• Follow up in 1 day

Severe dehydration

• Pink

Two of any of the following:

— Movement only when stimulated or no movement at all, sunken eyes, and skin pinch goes back very slowly

• If the infant does not have VERY SEVERE DISEASE, nor DYSENTERY, give fluid for severe dehydration or PLAN C

• If the infant also has a VERE SEVERE DISEASE, SEVERE JAUNDICE OR DYSENTERY: Refer urgently to hospital, with mother giving frequent sips of ORS on the way

• Advise to continue breastfeeding

• Keep the infant warm

Some dehydration

• Yellow

— Two of the following signs: restless or irritable, sunken eyes, skin pinch goes back slowly

• Give some fluid for some dehydration (PLAN B) 

• If the infant also has a VERY SEVERE DISEASE, SEVERE JAUNDICE OR DYSENTERY:

• Refer urgently to hospital, with mother giving frequent sips of ORS on the way

• Advise to continue breastfeeding

• Assess and counsel the mother on care for development 

No dehydration

• Green

— Not enough signs to classify as some or severe dehydration

• Give fluid to treat diarrhea at home(PLAN A)

• Assess and counsel the mother n care for development

Severe, Persistent diarrhea

• Pink

— Diarrhea lasting for more than 14 days

• If the young infant has dehydration, treat dehydration before referral, unless infant also has VERY SEVERE DISEASE

• Refer to hospital

Dysentery

• Pink

— Blood in the stool

• Refer urgently to the hospital, with mother giving frequent sips of ORS on the way

Feeding problem or lo weight for age

• Yellow

— Not well attached to the breast or not sucking effectively or less than 8 breakfast in 24 hours or receives other foods or drinks or low weight for age thrush 

• Not able to attached well or not sucking effectively

• Feeding is less than 8 times a day

• Giving other food and drinks, Not breastfeeding at all.

• Advise the mother how to feed and keep the low weight infant warm at home

• With thrush. Follow up any feeding problem or thrush in 2 days

• Follow up low weight for age in 14 days

• Assess and counsel the mother on care for development

July 1976

— DOH, WHO, & UNICEF launched the national immunization program

PD No. 996

— Sept. 16, 1976

— Signed by Marcos Sr.

— Aimed to protect children below 8 against 6 diseases

— Vaccines are compulsory 

— Child should be vaccinated

RA 7846

— Dec 30, 1994

— Hep. B vaccine as added

— Now 7 vaccines 

RA 10152

— 11 vaccines 

— National Immunization program 

— Implemented and renamed vaccines 

— Does not punish parents if vaccines are not given

PP No.6

— April 3, 1996

— Mandated Wednesdays as immunization day 

— Implementing a United Nations goal on Universal Child Immunization 

2001-2020

— Decade of Vaccines

— Envision a world of which all individuals a communities enjoy lives free from vaccine-preventable diseases (WHO)

Active immunity

— Permanent immunity

— Your own immune system 

— You need to live and survive so your body can produce antibodies

Passive immunity 

— temporary immunity 

— Could last for weeks, months, years depending on the vaccine

Live attenuated vaccines

— Made to mimic Active immunity

— BCG, OPV, measles, mumps, rubella 

Inactivated Vaccines

— Pathogens are already dead, usually killed prior to injection

—  So they are incapable of replicating inside the body

Whole Viruses — Inactivated

— Influenza, IPV, rabies

Whole Bacteria — Inactivated

— Pertussis, typhoid, cholera

Subunit or fractional vaccines — Inactivated

— Influenza, hepa b

Toxoid — Inactivated

— Diphteria, tetanus

Baccilus Calmette Guerin

— 0-11months or 0-1 years at birth

— 0.05 mL — ID, right upper deltoid 

— Fights TB and meningitis 

— Freeze dried then reconstituted with diluent it came with

Hepa V vaccine

— At birth (health facility)

— Less than 7 days (at home birth)

— 0.5 mL, IM, Vastus Lateralis

OPV

— 1st dose in 6 weeks 

— 0.1 mL or 2-3 drops PO

— 6, 10, 14 days

— Color - Clear pink or pale orange 

Rotavirus

— Optional

— 6 weeks  and 14 weeks

— 2 doses

— Defense against common causes of diarrhea 

— 1.5 PO

Pentavalent

— Hep. B, DPT, pertussis, tetanus, & InfluenzaB

— 3 doses, 0.5mL, IM, vastus lateralis

— 6, 10, 14 weeks 

—  Reduces chances of acquiring pneumonia and meningitis 

Inactivated Polio Vaccine

— 0.5 mL, IM, Vastus Lateralis

— 3 and a half month and 9 months

Pneumococcal conjugate vaccine

— 0.5 mL, IM, vastus lateralis

— Fight against pneumonia 

— Given every 4 weeks

Measles

— 9 - 11 months

— In cases of epidemics, can be given at 6 months SIA

— 0.5 mL, SC, any arm (outer art of the upperarm, preferably left)

Measles, mumps, rubella (MMR)

— 9 and 12 months

— 0.5 mL, SC, any arm(deltoid)

— Given with vitamin A(or retinol) 200,000 IU red

Retinol/ Vit A Blue

— Low dose

— 100,000 IU 

— Given to children with AMV1 either 6 or 9 months depending on the protocol of your BHS (but by the book it is 9 months)

Retinol/ Vit A RED

— High dose

— 200,000 IU

— Given to children with AMV2 at 12 months together with albendazole or mebendazole (if agency protocol permits) 

RA 7600

—The rooming-in and breastfeeding Act of 1992

— baby straight to mommy’s room 

— Provides incentives to all government and non government hospitals with rooming in and breast feeding practices

— Encourage, protect and support breastfeeding 

EO51

— Milk code

— Banned the breastmilk infant substitutes

Rooming in

— Mom and baby stay in on room from birth to discharge

— 23 out of 24 hours together

— When in need of separation, encourage visitation

free

free

1577

— Franciscan FriarJuan Clemente opened medical dispensary in Intramuros for the indigent

1690

— Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte and Manila

1805

— smallpox vaccination was introduced by Francisco de Balmis , the personal physician of King Charles IV of Spain

1876

— first medicos titulares were appointed by the Spanish government

1888

— 2-year courses consisting of fundamental medical and dental subjects was first offered in the University of Santo Tomas.

— Graduated were known as “cirujanosministrantes” and serve as male nurses and sanitation inspectors

1901

— United States Philippines Commission, through Act 157, created the Board of Health of the Philippine Islands with a Commissioner of the Public Health ,as its chief executive officer (now the Department of Health)

Fajardo Act of 1912

— created sanitary divisions made up of one to four municipalities. Each sanitary division had a president who had to be a physician

1915

the Philippine General hospital began to extend public health nursing services in the homes of patients by organizing a unit called Social and Home Care services

Asociacion Feminista Filipina (1905)

— Lagota de Leche was the first center dedicated to the service of the mothers and babies

1947

— the Department of Health was reorganized into bureaus: quarantine, hospitals that took charge of the municipal and charity clinics and health with the sanitary divisions under it

1954

— Congress passed RA 1082 or the Rural Health Act that provided the creation of RHU in every municipality

RA 1891

— enacted in 1957 amend certain provisions in the Rural Health Act Created 8 categories of rural health units corresponding to the population size of the municipalities

RA 7160 (Local Government Code)

— enacted in 1991, amended that devolution of basic health services including health services, to local government units and the establishment of a local health board in every province and city of municipality

Millennium Development Goals

— adopted during the world summit in September 2000 FOURmula One (F1) for health, 2005 and Universal Health Care in 2010 – agenda launched in 1999

Universal Health care

— aims to achieve the health system goals of better health outcomes, sustained health financing, and responsive health system that will provide equitable access to health care

Covid 19

— poses major challenges to population health and well-being globally and hinders progress in meeting the SDGs and WHOs Triple Billion Targets

WHO Triple Billion Targets

— A shared vision among WHO and Member States, which help countries to accelerate the delivery of the SDGs

— By 2023 they aim to achieve: one billion more people enjoying better health and well-being, one billion more people benefiting from universal health coverage (covered by health services without experiencing financial hardship) and one billion more people better protected from health emergencies.

Tuberculosis

— Remains the world’s leading cause of death from a single infectious agent.

— Globally, an estimated 10 million (range, 8.9–11 million) people fell ill in 2019, a number that has been declining very slowly in recent years but not fast enough to reach the 2020 milestone of a 20% reduction between 2015 and 2020.

Universal health coverage

— is one of the targets the nations of the world set when adopting the SDGs in 2015 and when reaffirming this commitment at the United Nations General Assembly High Level Meeting on UHC in 2019.

— It means that all individuals and communities receive the health services they need without suffering financial hardship

Health workforce

— The global health workforce has responded heroically since the pandemic began. And fittingly, 2021 has been designated International Year of Health and Care Workers in appreciation of their unwavering dedication in the fight against COVID-19. Yet the world needs millions more of them if it is to achieve universal health coverage by 2030.

DOH — Mission 

— To lead the country in the development of a productive, resilient, equitable and people-centered health system

DOH — Vision

— Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040

Public health 

— Definition of public health according to: C. E. Winslow- “Public health is the science and art of (1) preventing disease, (2) prolonging life, and (3) promoting health and efficiency through organized community effort

— Combination of Science + Politics = to ensure that there are No inequalities in health

— believes that "health and longevity as birthright" of everybody

Pre - Di

— Prevent disease

Pro-li

— Prolong life

Pro-h

— Promote health