THE PHILIPPINE HEALTHCARE DELIVERY SYSTEM PT. 2 Flashcards
defined as essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development.
Primary Health Care or PHC defined by WHO
refers to essential health care that is based on scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in community.
PHC defined by Wikipedia
refers to essential health care that is based on scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in community.
PHC defined by Wikipedia
PRIMARY HEALTH CARE
BRIEF HISTORY
PHC was declared during the ________ held in ________ on ________ by ____.
First International Conference on Primary Health Care; Alma Ata, USSR; September 6-12, 1978; WHO
PRIMARY HEALTH CARE
LEGAL BASIS
Adopted by the Philippines through the ___________ signed by __________ on _______- with an underlying theme ,_________.
Letter of Instruction (LOI) 949 ; President Ferdinand E. Marcos; October 1979; “Health in the Hands of the People by 2020
Goal of Primary Health Care
“Health for All by the year 2000”
The concept of PHC is characterized by ______ and ______ of the people that shall permeate as the core strategy in the effective provision of essential health services that are ______, _______, _______ and _______ at a cost which the community and the government can afford.
partnership and empowerment of the people; community based, accessible, acceptable and sustainable
PHC is a strategy which focuses _______ on the ____, his ____ and the _____; it includes _______ and ___________ towards the development of self-reliant people, capable of achieving an acceptable level of health and well being.
responsibility for health on the individual, his family and the community
full participation; active involvement of the community
PHC also recognizes interrelationship between ____ and the overall ____, _______ and ____ development of society; although the goal of PHC of Health of Health for All in the Year 2020 may have already been challenged as unrealizable in the given time frame, the concept and processes has already taken root all over the world and has shown progress in the lives of peoples in communities it has empowered.
health and the overall political, socio-cultural and economic development of society
ELEMENTS/COMPONENTS OF PRIMARY HEALTH CARE
- Environmental Sanitation (adequate supply of safe water and good waste disposal)
- Control of Communicable Diseases
- Immunization
- Health Education
- Maternal and Child Health and Family Planning
- Adequate Food and Proper Nutrition
- Provision of Medical Care and Emergency Treatment
8.Treatment of Locally Endemic Diseases - Provision of Essential Drugs
PRINCIPLES AND STRATEGIES
1. _____ and ______ of the ________ with the establishment of functional support mechanism in support of the mandate of devolution under the __________.
Reorientation and reorganization of the national health care system; Local Government Code of 1991
PRINCIPLES AND STRATEGIES
2. ________ and ________ for health action at all levels.
Effective preparation and enabling process
PRINCIPLES AND STRATEGIES
3. ______ of the people to know their communities and identifying their ________ with the end in view of providing appropriate solutions (including legal measures) leading self- measures) leading to self determination.
Mobilization; basic health needs
PRINCIPLES AND STRATEGIES
4. Development and utilization of appropriate ______ focusing on ________ available in and acceptable to the community.
technology; local indigenous resources
PRINCIPLES AND STRATEGIES
5. _________ arising from their expressed needs which they have decided to address and that this is continually ____ in pursuit of their own development.
Organization of communities; evolving
PRINCIPLES AND STRATEGIES
6. ________ for community participation in local level planning, management, monitoring and evaluation within the context of regional and national objectives.
Increase opportunities
PRINCIPLES AND STRATEGIES
7. Development of _________ with other government and private agencies so that programs of the health sector is closely linked with those of other socio-economic sectors of the national, intermediate and community levels.
intra-sectoral linkages
PRINCIPLES AND STRATEGIES
8. Emphasizing _______ so that the health workers and the community leaders/members view each other as partners rather than merely providers and receivers of healthcare especially.
partnership
The framework of meeting the goal of PHC is _________, which calls for active and continuing partnership among the communities, private and government agencies in health development.
organizational strategy
FOUR CORNERSTONES/PILLARS IN PRIMARY HEALTH CARE
1.Active community participation
2. Intra and Inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made available.
about avoiding disease before it starts. It has been defined as the plans for, and the measures taken to prevent the onset of a disease or other health problem before the occurrence of the undesirable health event.
LEVELS OF PREVENTION
three distinct levels of prevention
- Primary Prevention
- Secondary Prevention
- Tertiary prevention
-the preventive measure that prevent the onset of illness or injury
before the disease begins.
- directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals.
– General health promotion
– Specific protection
- Primary Prevention
-those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Here health educators such as Health Extension Practitioners can help individuals acquire the skills of detecting diseases in their early stages
- early detection and prompt intervention during the period of early disease pathogenesis
- Secondary Prevention
- those preventive measures at rehabilitation following significant
illness.
At this level, health services workers can work to retain re-educate and rehabilitate people who have already developed an impairment or
disability; targets populations that have experienced disease or injury and focuses on limitation of disability and rehabilitation. - aims to reduce the effects of disease and injury and to restore individuals to their optimal level of functioning.
- Tertiary prevention
ACTIVITIES / EXAMPLES OF LEVELS OF PREVENTION
Immunization
Promotion of good nutrition
Provision of adequate shelter
Encouraging regular exercise
PRIMARY PREVENTION
ACTIVITIES / EXAMPLES OF LEVELS OF PREVENTION
Screening for sexually transmitted disease Mammography
Blood pressure screening
Newborn screening
Sputum examination
SECONDARY PREVENTION
ACTIVITIES / EXAMPLES OF LEVELS OF PREVENTION
Teaching how to perform insulin injection
Referring a patient with a spinal cord injury
for occupational and physical therapy
TERTIARY PREVENTION
is also referred to as Kalusugan Pangkalahatan(KP) , is the “provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public.”
UNIVERSAL HEALTH CARE (UHC)
New UHC Act is a critical step towards health for all Filipinos. ____ years after the Philippines made it policy to gradually provide total medical service for its people through a medical care act, the President of the Philippines, ______, signed into law the __________ on _________ at ________.
Fifty; Rodrigo R. Duterte; Universal Health Care Act (Republic Act 11223); February 20, 2019; Malacaňang Palace, Manila
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
Filipinos will begin benefitting from the Universal Health Care (UHC) Act this year, with every citizen entitled to _______ that will ________.
health coverage; lower out-of-pocket health expenses
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
The passage of the _________ was hailed a path-breaking as it set the direction for the reform of the health care sector in the Philippines.
Republic Act 11223
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
WHO earlier urged the Philippine government to make a “_______” in health, as it would save lives.
real investment
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
Currently, __________, __________ along with experts and concerned agencies are crafting the ___________.They will have __ days to complete the IRR, which will include details on how the law is executed.
Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth); Implementing Rules and Regulations (IRR); 180
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
Eight (8) things to know about UHC:
1.All Filipinos are _____.
2. It is not completely ____.
3. PhilHealth will become the “_________” of health goods and services.
4. DOH will still be in charge of “________” health services.
5. Health systems will become ______ and _______.
6. ________ in public health sector.
7. A “___________” (HTAC) will be created.
8. ________ will be collected.
1.All Filipinos are covered.
2. It is not completely free.
3. PhilHealth will become the “national purchaser” of health goods and services.
4. DOH will still be in charge of “population-based” health services.
5. Health systems will become city-wide and province-wide.
6. Return service in public health sector.
7. A “Health Technology and Assessment Council” (HTAC) will be created.
8. Health information will be collected.
Every single Filipino citizen is automatically enrolled into the newly- created National Health Insurance Program (NHIP); two classifications of members:
Direct contributors
Indirect contributors
those who pay PhilHealth premiums, are employed and are bound by an “employer-employee relationship”, e self-earning, professional practitioners, and migrant workers.
Direct contributors
those not considered as direct contributors along with their qualified dependents whose health premiums are
subsidized by the government.
Indirect contributors
The law outlines that basic services accommodations will be covered by PhilHealth.
- It is not completely free.
PhilHealth will be in charge of paying health care providers like hospitals and clinics for services given to Filipinos
Allocating more funds to PhilHealth will also strengthen its negotiating power with heath care providers, which will foreseeably improve the quality of services and lower health costs.
- PhilHealth will become the “national purchaser” of health goods and services.
While PhilHealth, along with other private health insurance companies, is expected to cover services for individuals, the DOH is still in charge of delivering health services that cover the entire population; DOH will do this by contracting public health care providers in cities and provinces.
- DOH will still be in charge of “population-based” health services.
Provinces and highly urbanized cities will now be in charge of overseeing health services in areas as opposed to the current set-up where municipalities and are tasked with managing their own health centers.
DOH will need to work with the Department of the Interior Local Government (DILG) to have province and city-wide health systems or networks in about two years after the law takes effect.
- Health systems will become city-wide and province-wide.
Graduates of health and health-related courses who received government- funded scholarships will be required to work in the public at least 3 full years.
- Return service in public health sector.
is a group of health experts who will be responsible for evaluating latest health developments and recommending their use to DOH and PhilHealth; they will be responsible for assessing the safety and effectiveness of health technology, devices, medicines, vaccines, health procedures and other health- related advances developed to solve health problems.
HTAC; 7. A “Health Technology and Assessment Council” (HTAC) will be created.
Both public and private hospitals and health insurers will be required to maintain a health information system that will contain electronic health records, prescription logs, and “human resource information.”
- Health information will be collected.
automatically enrolls all Filipino citizens in the National Health Insurance Program and prescribes complementary reforms in the health system.
This gives citizens access to the full continuum of health services they need, while protecting them from enduring financial hardships as a result.
Universal Health Care (UHC) Law Republic Act 11223)
Population-Focused Approach and Community Health Nursing Interventions
* Focuses on the _________.
* Is based on assessment of the populations’
_______.
* Considers the _________
* Emphasizes all ______
* Intervenes with communities, systems, individuals and families
- Focuses on the entire population
- Is based on assessment of the populations’
health status - Considers the broad determinants of health
- Emphasizes all levels of prevention
- Intervenes with communities, systems, individuals and families
Defined as a system of beliefs that provides a basis for and guides action
* It provides the direction and describes the whats, whys and hows of activities within the profession
PHILOSOPHY
Defined as a system of beliefs that provides a basis for and guides action
* It provides the direction and describes the whats, whys and hows of activities within the profession
PHILOSOPHY
Philosophy of CHN Practice
* H – ______ of the nursing profession upheld
* U – unique & distinct component of ______
* M – _____ of health considered
* A – _______ of clients encouraged
* N – nurse considers _______
* I – ______ among health team members
practiced
* S – _____ and up-to-date
* T – ___ of CH nurse vary with time and place
* I – _____ or self-reliance is the end goal
* C – _______ of health & development regarded
- H – humanistic values of the nursing profession upheld
- U – unique & distinct component of health care
- M – multiple factors of health considered
- A – active participation of clients encouraged
- N – nurse considers availability of resources
- I – interdependence among health team members
practiced - S – scientific and up-to-date
- T – tasks of CH nurse vary with time and place
- I – independence or self-reliance is the end goal
- C – connectedness of health & development regarded
Basic Principles of CHN
* The _____ is the PATIENT in CHN
– _____ is the UNIT OF CARE
– FOUR LEVELS OF CLIENTELE:
COMMUNITY; FAMILY
a. individuals
b. families
c. population groups
d. Community
- ____ is considered an ACTIVE PARTNER
- Affected by developments in health technology in particular and changes in society in general
Client
- The goal is achieved through _______.
MULTISECTORAL EFFORTS
- CHN is part of ________ and the larger _______.
HEALTH CARE SYSTEM; HUMAN SERVICES SYSTEM
CLIENT OR PATIENT
May or may not be sick
CLIENT
CLIENT OR PATIENT
* sick
*From the Greek word pathein
which means “to suffer”
PATIENT
CLIENT OR PATIENT
Collaborates with the health
professionals when it comes to
his/her care
CLIENT
CLIENT OR PATIENT
Dependent on health professionals
for decisions and health care
PATIENT
CLIENT OR PATIENT
Assumes an active role in health care
CLIENT
CLIENT OR PATIENT
Passive receiver of health services
PATIENT
CLIENT OR PATIENT
Health professionals perform health promotion and disease prevention activities
CLIENT
CLIENT OR PATIENT
Health professionals generally perform disease prevention
activities
PATIENT
- Deals with sick or well
- Consults the health center & receives health services in different forms
- Can be seen both as clients and patients
- Can be used as an “entry point” in working with the whole family
Individual as a Client
Individual as a Client
* Can be seen in two ways/approach:
a. atomistic
b. holistic
- Proposed by Byrne and Thompson
Views man as an organism
Sees the whole as equal to the sum of its parts or subparts
ATOMISTIC APPROACH
ATOMISTIC APPROACH
Levels of organization include: 8-12
a. chemical level
b. organelle level
c. cellular level
d. tissue level
e. organ level
f. system level
Traces the pattern of man’s relationship with other beings in the suprasystem of society
How man acts and reacts to situational stimuli provide clues in understanding his responses and the reasons behind them
Man as a whole is different from and is more then the sum of his component parts
Dimensions include: physical, social, spiritual, cognitive and psychological
HOLISTIC APPROACH
Five Dimensions of Man
- PHYSICAL BEING
- SOCIAL BEING
- SPIRITUAL BEING
4.THINKING OR INTELLECTUAL BEING - PSYCHOLOGICAL BEING
Five Dimensions of Man
- Genetic endowment
- Sex
- PHYSICAL BEING
Five Dimensions of Man
- Capable of relating to others
- Process of social learning by which a person acquires KSA and roles appropriate to sex, social class, and ethnic or cultural group
- SOCIAL BEING
Five Dimensions of Man
- capable of virtues such as faith, hope and charity
- Believes in a power beyond himself and in transcending
one’s limitations in order to become a better person
- SPIRITUAL BEING
Five Dimensions of Man
- Capable of perception, cognition & communication
- Capable of logical thinking and reasoning
4.THINKING OR INTELLECTUAL BEING
Five Dimensions of Man
- capable of feeling, rationality, and all conscious and unconscious mental states
- PSYCHOLOGICAL BEING
Defined by Murray and Zentner, 1997, a small social system and primary reference group made up of two or more persons living together who are related by blood, marriage, or adoption or who are living together by arrangement over a period of time
FAMILY
Is a group of people sharing the same characteristics, developmental stage, or common exposure to particular environmental factors
Examples are:
a. children
b. women
c. farmers
d. cultural minorities
e. elderly
POPULATION GROUP OR AGGREGATE
- Most vulnerable to different types of diseases, especially those brought about by socio-economic difficulties
- Predominantly afflicted with infectious diseases and nutrition problems
CHILDREN
- Individuals belonging to the age group of 60 years and above
- With the lengthening of the lifespan of the Filipinos, it is best that health professionals understand the health needs of the elderly
ELDERLY
Primary function of the family is to ________, both biologically through procreation and socially through socialization; for parents
ensure the continuation of society
Basic functions of the family are:
1) regulate _______ and activity
2) provide an _______
3) nurture and socialize _____
4) ascribe _______
1) regulate sexual access and activity
2) provide an orderly context
3) nurture and socialize children
4) ascribe social status
Families further impart ______, _____ and _______ functions.
affection, care and adaptive functions.
The family tasks areas include ____, _____ and ____ tasks.
basic, developmental and crisis tasks.
is concerned with the provision of food, money, shelter
and other necessities of life.
Basic task
include infancy, childhood, adolescence, adulthood and aging.
Individual development stages
include providing care and support to someone with health care needs, an important component of their role can include carrying out tasks that are of clinical in nature which might include caring for wounds, catheter or tracheostomy care, managing ventilation or the administration of medicines.
Health care tasks
CHARACTERISTICS OF A HEALTHY FAMILY suggested by ______
Fr. J. Pimenta
Even if the family members have to move far away from home, will retain a feeling of caring, closeness and belonging.
1) The healthy family has a strong sense of family belonging.
Religious and social traditions are important to the health of a family.
2) A healthy family has meaningful social and religious celebrations.
Family life has not be ruled by an outside calendar of social celebrations and obligations, however, valuable in themselves.
3) A healthy has control of its family life.
All family members, children included, are to be responsible towards the common needs and burdens of the family.
4) A healthy family demands responsibility from all members towards the common needs.
Respect thrives in the family that never humiliates others, not even the smallest children, nor discusses anyone’s shortcomings in front of others, belittles them or makes them victims of others’ failures.
5) A healthy family demands mutual respect for one other.
We learn by trial and error. Do not expect the members of your family to be perfect from the very start.
6) A healthy Family allows its members to do mistakes.
The healthy family gathers together in an effort to deal with any problem, be it unemployment, alcoholism, school or college failure or whatever,
7) The healthy family is able to deal with adversity as well as success.
The healthy family enjoys sharing with one another their joys and sorrows not good news only but also, disappointments, failures and dreams as well.
8)The healthy family communicates.
This is the time when one person spends time alone with another member of the family.
9) Members of a healthy family spend time along with each other.
The degree of fun and humor among families varies widely.
10) The healthy family develops a sense of play and humour.
Children must be trusted and at the same time they should know and experience that they can trust their parents. Lack of trust at home becomes the most destructive weapon and sickness within the family.
11) The healthy family develops trust.
Some families unfortunately force their children into a mould of conformity. The motto of a healthy family should be:“Be and let be” Children like beautiful flowers should should grow to be; what God want them to be. Parents should be like careful gardeners, not like ruthless stone sculptors.
12) The healthy family lets each child to be the person God created:
Parents shouldn’t be too much possessive, when the time comes for the child to leave home, let him/her go.
13) The healthy family lets go.
Primary level health facility in the municipality. Focuses on preventive and promotive health services. Supervises the BHSs
1 RHU: 20,000 population
The Rural Health Unit
first-contact health care facility offering basic services at the barangay
Manned by the RHM and BHWs
Barangay Health Station
A.k.a. Rural Health Physician
Administrator of the RHU
Municipal Health Officer (MHO)
Medico-legal officer of the municipality 1
MHO: 20,000 population
Community physician
Supervises and guides all RHMs in the municipality. Prepares FHSIS quarterly and annual reports of the municipality for submission to the Provincial Health Office
Utilizes the nursing process in responding to health care needs, including needs for health education and promotions, of individuals, families, and catchment community.
Collaborates wit the other members of the health team, government agencies, private businesses, NGOs, and people’s organizations to address the community’s health problems.
1:20,0000 population
Public Health Nurse (PHN)
Manages the BHS and supervises and trains the BHW.
Provides midwifery services and executes health care programs and activities for women of reproductive age.
Conducts patient assessment and diagnosis for referral or further management.
Performs health information , education, and communication activities.
Organizes the community.
Facilitates barangay health planning and other community health
services.
1;5,000 population
Rural Health Midwife (RHM)
A set of activities undertaken by a health care provide or facility in response to its inability to provide the necessary health intervention to satisfy a patient’s need.
Referral
Occur within the health facility.
- Internal referrals
Movement of a patient from one health facility to another
- External referrals
Defined catchment population within a defined geographical area.
Covers all sectors involved in the delivery off health services.
The Inter-Local Health Zone
Components of The Inter-Local Health Zone
People
Boundaries
Health facilities
Health workers
Components of
People
Boundaries
Health facilities
Health workers
Components of
People
Boundaries
Health facilities
Health workers
Consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health.
Building blocks
Service delivery
Health workforce
Information
Medical products, vaccines, and technologies
Financing
Leadership and governance or stewardship
Health System
Factors Influencing the Health Care Delivery System
Health care “reforms
Demographics
Globalization
Poverty and growing disparities Social disintegration
