module 1 (my version) Flashcards
From “hal” meaning hale, sound, whole
The New Oxford Dictionary of English
▫Free from illnesses or injury
health
WHO (1946) : world health organization
▫A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.
▫Optimum levels of functioning of individuals, families, communities and populations.
health
Payne, Hahn and Mauer’s Model:
▫A dynamic state or condition that is multi- dimensional in nature and results from a person’s adaptation to his or her environment.
health
dimensions of health
▫Physical
▫Emotional
▫Social
▫Intellectual
▫Spiritual
▫Occupational
▪A geographic area with specific boundaries
▪Collective body of individuals identified by common characteristics
community
▪1. Membership
▪2. Common Symbol systems and norms
▪4. Mutual influence
▪5. Share needs and commitment to meeting them
▪6. Shared emotional connection
elements of a community
Institute of Medicine (IOM):
▫“What we as a society do collectively to assure the conditions in which people can be healthy.”
public health
▪Refers to the health status of a defined group of people and the actions and conditions, both private and public (governmental) to promote, protect and preserve their health.
community health
community health components
▪1. Promotion of health
▪2. Prevention of health problems
▪3. Treatment of disorders
▪4. Rehabilitation
▪5. Evaluation
▪6. Research
- All efforts that seek to move people closer to a higher level of wellness
promotion of health
– disease prevention
prevention of health problems
- Providing direct service to people with health problems or indirect services that helps people to obtain treatment; Development of programs to correct unhealthy conditions
treatment of disorders
- Specialized healthcare dedicated to improving or maintain or restoring physical strength, cognition and mobility with maximized results
rehabilitation
- Process by which a practice is analyzed, judged, and improved according to established goals and standards
evaluation
- Systematic investigation to discover facts affecting community health and community health practices
research
▪Similar to community health
▪“the health outcomes of a group of individuals, including the distribution of such outcomes within the group”
population health
▪“Health problems, issues, and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions”
global health
factors that effect the health of a community
physical
social and cultural
community organization
individual behaviors
physical factors that effect the health of a community
geography
environment
community size
industrial development
- range of health problems and usage of health resources
community size
– added resources for health programs but it could also introduce environmental pollution and occupational illness
industrial development
– influenced by climate and latitude; tropical vs temperate countries
geography
– directly related to quality of stewardship over it; uncontrolled population growth-depletion of resources
environment
– directly related to quality of stewardship over it; uncontrolled population growth-depletion of resources
social factors
▫arise from guidelines that individuals inherit from being part of a particular society
cultural factors
▫1. Beliefs, traditions and prejudices
▫2. Economy (health and social services)
▫3. Politics
▫4. Religion
▫5. Social norms
▫6. Socio-Economic status
Factors that contribute to culture:
▪Can affect health choice-making decisions and behaviors
▪Choices of food or diet, health services and health professional to handle diseases
▪Affects the development of health programs
▪Prejudice against a specific ethnic or racial group
→ violence and crime
beliefs, traditions, prejudices
▪National and local economies can negatively impact community health through reductions in health and social services
▪Economic downturn → lower tax → decreased funding for welfare, community health care and other community services
▪Unemployed or underemployed → poverty
economy (health and social services)
▪Political offices can improve or jeopardize the health of their community through the decisions they make
politics
▪Can also affect how people choose and make decisions about their health
▪Some religious communities limit the type of medical treatment, some do not permit immunizations, others do not permit their members to be treated by physicians
▪Some communities actively address moral and ethical issues such as abortion, premarital intercourse and homosexuality
religion
▪Determines what is socially acceptable that could either be healthy or detrimental
▪Could change over time
▪Social acceptability of smoking in most settings in 1960s vs 21st century
social norms
▪Those in the community with the lowest socioeconomic status also have the poorest health and the most difficult in gaining access to health care
▪Higher income enables people to afford better housing, live in safer neighborhoods and increase the opportunity to engage in health – promoting behaviors
socio economic factors
▪“The process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies for reaching their collective goals.”
community organization
increased effectiveness and productivity; reduction of duplication of efforts and avoiding the imposition of solutions that are not congruent with local culture and needs
effective organization
▪Contributes to the health of the entire community to make a program work
▪It takes a concerted effort of many if not most of individuals in a community to make a program work
▪Community participation in programs
individual behaviors
the more individuals become immunized against a specific disease, the slower the disease will spread and the fewer people will be exposed
herd immunity
HISTORICAL BACKGROUND OF PUBLIC HEALTH
(PHILIPPINE SETTING)
pre spanish and spanish period
american military government
philippine assembly
recent years
▪ Traditional health care practices were observed
(use of herbs and rituals for healing)
▪ First dispensary for indigent patients of Manila
ran by a Franciscan Friar began in 1577
spanish
▪ Creation of the Board of Vaccinators in1806 to prevent smallpox
▪ Medicos titulares, equivalent to provincial health officers
were created together with the Board of Health
spanish
▪ 1885, maritime quarantine was instituted - galleon trade
▪ 1876, construction of the Carriedo
spanish
▪ 1871, founding of medical school (UST), a school of midwifery in 1879 and a public health laboratory in 1883
spanish
▪ The “Facultad de Medicina y Farmacia” – the beginnings of the UST Faculty of Medicine and Surgery – was formally opened on May 28, 1871 by decree of the “Superior Gobierno de Filipinas”.
▪ At that time, there were only 12 practicing doctors in the Philippines, all trained in Europe.
spanish
▪ The first group of enrollees were 9 (3 Spaniards, 6 Filipinos) and all graduated on March 10, 1877.
▪ At that time, the medical curriculum was patterned after leading European medical school (6 years, 1 year preparatory instruction, 5 years proper), and the language of instruction was Spanish.
spanish
▪ 1892, introduction of medicos forensic (forensic medicine)
▪ June 23, 1898 - the Department of Public Works , Education and Hygiene was created by virtue of a decree signed by President Emilio Aguinaldo
spanish
1989 to 1907
american
▪ Control of epidemics such as cholera, smallpox
and plagues
▪ Fight against communicable diseases such as leprosy, diarrhea, malaria and beri-beri
▪ Establishment of health organization and administration and general sanitation
american
- Established a garbage crematory (1899)
- Approved the first sanitary ordinance and rat control measures (1901)
- Established technologically that contaminated water and unclean vegetables were important factors in the control of amoebic dysentery while Anoepheles minimus was pointed as the vector of malaria (1904)
american
- Cholera vaccine was first tried (1905) followed by compulsary vaccination of school children
- Confirmed the theory that plague in man comes from infected rats (1905)
- Opened leper colony in Culion and detained lepers (1906)
american
- Founded the Manila Medical Society and the Phil. Islands Medical Association (1902-1903))
- Opened UP College of Medicine with Preventive Medicine as one of the departments (1907)
- Established the Bureau of Science in 1905
american
1907 to 1916
philippine
- The search for germ carriers was instituted.
- New waterworks in Manila were inaugurated
- Nursing students who began studies were recruited by sponsors.
- Employers Liability Law was made
pilippine 1908
- Hygiene and Physiology were included in the curriculum of public elementary school.
- Anti-TB campaign started.
- First sanitary survey of rural community was conducted.
- Results of first nutrition survey were announced.
philippine 1909
- Philippine Tuberculosis Society, Inc was organized. 2. Pasteur Prophylaxis treatment against rabies was
offered. - PGH was opened.
philippine 1910
- Eradication of beri-beri among Philippine scouts by means of a simple change in diet was demonstrated.
pilippine 1911
- Use of anti-typhoid vaccine was initiated.
- Hypochlorite of lime was first used for treating the water
supply in Manila. - Vitamin deficiency was found to be the caused of beri-beri which
ultimately culminated in the isolation of Vit B. Othiamine.
philippine 1912
- Etiology of amoebic dysentery was made clear.
- Dry vaccine against smallpox was first used.
- A graduate course in hygiene and tropical medicine was first offered at the UP College of Medicine.
philippine 1913
- Tiqui-tiqui was manufactured and distributed to treat beri-beri.
- First “clean up week” inaugurated.
philippine 1914
1916 to 1936
jones law
▪ Characterized by retrogression rather that by progression in health
▪ CDR and IMR rose.
▪ Deaths from smallpox, cholera, typhoid, malaria, beri-beri and TB increased.
jones law
▪ Campaign against hookworm was launched.
▪ Anti-dysentery vaccine was first tried locally.
▪ First training course for sanitary inspector.
jones law
▪ The mechanism of transmission of dengue through Aedes egypti was successfully studied.
▪ Required notification and inoculation of reportable diseases.
jones law
▪ Governor General Frank Murphy - launched a well – designed public health and social welfare programs to raise the health level of Filipinos
jones law
1936 to 1942
commonwealth
▪ The UP School of Public Health was
established.
▪ Creation of Department of Public Health and Welfare ( Commonwealth Act No. 430)
commonwealth
▪ The Bureau of Census and Statistics was created.
▪ Establishment of charity clinics – Philippines Charity Sweepstakes.
commonwealth
▪ Paralyzed all activities
▪ Activities for health
- handling emergencies
- prevention of occurrence of epidemics
- regulations for slaughtering of cattle, hogs and carabaos
- Creation of the Board of Nutritional Research.
japanese
1936 to 1942
japanese
1945
philippine independence
▪ Confronted with grave rebuilding of the nation’s economy , restoring peace and order, coupled with facing the challenges and responsibilities of a newly attained independent nationhood.
philippine independence
▪ DDT – larvacide for control of malaria
▪ Mass case finding survey and mass BCG immunization for TB control
▪ Food Drug Administration created (1963)
philippine independence
▪ Implementation of Restructured Health Care Delivery system (primary, secondary, tertiary)
▪ Adoption of Primary Health Care (PHC) on September 11, 1981
▪ Oral Rehydration Tharapy – one of the thrusts of DOH is the control of diarrheal diseases
martial law
▪ Community based health programs started.
▪ Nutrition Council of the Phils. created.
▪ RITM – research arm of DOH in infectious and tropical diseases
martial law
1972 to 1986
martial law
1986
edsa revolution
▪ Ministry of Health renamed as Department of Health
▪ Five DOH office created ( E.O No. 119)
▪ Chief of Staff, Public Health, Hospitals and Facilities, Standard and Regulation and Management
edsa revolution
1986 to 1992
aquino administration
▪ Milk Code ( E.O. No. 51)
▪ Universal Child and Mother Imumunization (Proclamation No. 6)
aquino
▪ International Safe Montherhood Initiative RA 6725
▪ Formation of Population and Development Foundation
▪ National epidemic Surveillance System
aquino
▪ RA 6675 – National drug Policy and Generics Act of 1988
▪ RA 7160- Local Government Code of 1991
▪ RA 7170 – Organ Donation Act
aquino
▪ RA 7305 – Magna Carta for Public Health Workers
▪ RA 7277 – Magna Carta for Disabled Persons
aquino
1992
ramos
▪ Shifted from curative to preventive and primary care
▪ Health services shifted from the central office to the local governments
ramos
▪ MEDIC – Media-friendly, Exciting, Doable, Innovative and Current
▪ Let’s DOH it! – national battle cry
ramos
▪ Anti-Smoking Campaign – Yosi Kadiri
▪ Micro-nutrient Campaign – Araw ng Sangkap pinoy
▪ Voluntary blood donation
dr flavier
▪ Family Planning – Kung sila’y mahal mo, Magplano
▪ Water for Life
▪ Oplan Sagipmata
dr flavier
▪ Oplan Bating Buhay
▪ Doctors to the Barrios
▪ Disaster Management
▪ Urban Health and Nutrition Program
▪ Kayang-kaya ang Cancer
dr flavier
▪ Privatization as a national government program and policy intensified
▪ Privatization of public health care services
▪ The Philippine Heart Center, Lung Center of the Philippines, National Kidney and Transplant Institute and Philippine Children’s Medical Center became government-owned and controlled corporations – from its previous categorization as public hospitals – and are now earning profits through its expensive health services thus depriving indigent patients of accessible and affordable health care.
ramos
▪ Implemented the Health Sector Reform Agenda and Executive Order 102 that transformed the functions of the Department of Health (DOH) from a direct service provider to a mere regulator and monitor of services.
▪ According to the NOP, the said EO resulted in massive lay offs of DOH employees
▪ Dissolution of health programs such as the Malaria and Leprosy Control.
▪ Administrative Order No. 181 series of 2001 was also passed, which proposed to corporatize 38 public hospitals. Separate legislations were also filed to corporatize Quirino Memorial Medical Center, Ilocos Training and
Regional Medical Center and Western Visayas Medical Center.
estrada
▪Corporatization was the buzzword for privatization. It also pushed for corporatization of 68 public hospitals under the DOH.
▪Universal Health Care
arroyo and aquino
▪The Duterte administration severely neglected the public health system of the country.
▪the government has not taken significant measures that will strengthen the public health system and make health services accessible and equitable to the Filipino people.
▪Already widespread privatization of health and devolution of public hospitals in the country
▪Pushed the public health system further into collapse
▪Passage of the Universal Health Care Act in 2019
duterte
1 st, Duterte’s health sector budget remains low and misallocated. Every year, the budget share of the health sector is much lower compared to the country’s military and infrastructure budget. A large portion of this small budget for health goes to social health insurance and not to direct health services such as the operational budget of several government hospitals and laboratories.
duterte
- Second, despite the Duterte administration’s focus on infrastructure projects, there is a glaring lack of health administration’s Infrastructure Flagship Projects (IFPs) infrastructure built. Only four out of 112 of the are dedicated to the health sector, compared to 76 projects dedicated to transport and mobility.
- Even the most basic Barangay Health Station (BHS) is not available for every Filipino since only 49% of the country’s barangays have one. Additionally, not even all BHS can give basic health services because many of them still sorely lack basic equipment and healthcare personnel.
duterte
- Third, Filipino healthcare workers remain overworked and underpaid in their own country. Among their biggest issues are low wages and benefits.
- For example, the entry level salary for a public nurse in the country ranges from Php22,000 to Php23,500 while for a public medical technologist it could be from Php25,000 to Php27,000.
- A 2020 study stated that healthcare workers in the Philippines are among the lowest paid across Southeast Asian nations.
- Filipino nurses earn 57% less than their counterparts in Vietnam and 486% less than nurses in Singapore. The dire situation of low wages among health workers in the country pushes scores of
Filipinos to accept job opportunities abroad.
duterte
▪Even in the middle of the pandemic, medical front liners were still paid dust compared to the huge service that they have rendered to the Filipino people during the crisis. Filipino health workers called the national government out for its slow disbursement of their risk allowance—which is actually miniscule compared to the needs of healthcare workers to begin with.
▪The government is also not hiring enough health workers despite the huge need, especially in the country’s far-flung areas.
▪Health workers are also unevenly distributed across the country:
duterte
▪Even in the middle of the pandemic, medical front liners were still paid dust compared to the huge service that they have rendered to the Filipino people during the crisis. Filipino health workers called the national government out for its slow disbursement of their risk allowance—which is actually miniscule compared to the needs of healthcare workers to begin with.
▪The government is also not hiring enough health workers despite the huge need, especially in the country’s far-flung areas.
▪Health workers are also unevenly distributed across the country:
duterte
▪The Duterte administration hypes PhilHealth as a solution to the worsening inaccessibility of healthcare services to the Filipino masses.
▪But PhilHealth, which only serves as a purchaser of health services, does not in any way strengthen the country’s public health system.
▪In the middle of the COVID-19 pandemic, the health insurance corporation was caught in a Php15-billion corruption issue that resulted in the resignation of former PhilHealth President Ricardo Morales.
duterte
▪The Duterte administration hypes PhilHealth as a solution to the worsening inaccessibility of healthcare services to the Filipino masses.
▪But PhilHealth, which only serves as a purchaser of health services, does not in any way strengthen the country’s public health system.
▪In the middle of the COVID-19 pandemic, the health insurance corporation was caught in a Php15-billion corruption issue that resulted in the resignation of former PhilHealth President Ricardo Morales.
duterte
▪Priority Agenda: Affordable Health Care For All
▪Four major pillars of the framework:
1) A society that promotes physical, mental, and social well-being;
2) Empowering communities and households to make healthy and informed choices;
3) Giving access to both public and private health care delivery systems; and
4) Capacitating measures to bolster the health system in support of
other outcomes.
marcos
▪Priority Bills:
1. Magna Carta for Barangay Health Workers
2. Medical Reserve Corps
3. Philippine Center for Disease Control and Prevention
4. Virology Institute of the Philippines
marcos
▪Accomplishments
1. Prioritized the establishment of specialty hospitals, health centers and mobile clinics to bring quality services to the poor – UP-PGH Cancer Center
2. Opening of Bagong Urgent Care and Ambulatory Service (BUCAS) Centers to decongest public hospitals and to provide competent ambulatory care - primary care to Filipinos at community level
3. Increased number of free generic medicines from 21 to 53
4. Aggressive hiring strategies, enhanced medical and allied health programs, seed funds for public medical schools
marcos
