UNIT V. DOH PROGRAMS RELATED TO FAMILY HEALTH Flashcards
are a prerequisite to national
development.
Health
The DOH uses the l___ to design programs and assists in the
delivery of health services to specific age groups
life span approach
is defined as the basic unit of the
community
“family”
have significant roles in ensuring the health of the family. Every
effort has to be made to provide packages of health services to the family for a better and
quality life. This unit presented the different programs of the Department of Health (DOH)
concerning Family Health.
Public Health Nurses
was established in 1976 to ensure
that infants/children and mothers have access to routinely recommended
infant/childhood vaccines.
Expanded Program on Immunization (EPI)
Six vaccine-preventable diseases were initially included in the
tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis, and measles.
signed by President Benigno Aquino III on July 26, 2010. The
mandatory includes basic immunization for children under 5 including other types that
will be determined by the Secretary of Health.
Republic Act No. 10152 “Mandatory Infants and Children Health
Immunization Act of 2011
an adaptation of the WHO-UNICEF Reaching Every District (RED),
was introduced in 2004 and aimed to improve the access to routine immunization and
reduce drop-outs. There are 5 components of the strategy, namely: data analysis for
action, re-establish outreach services, strengthening links between the community and
service, supportive supervision, and maximizing resources.
Conduct Routine Immunization for Infants/Children/Women through
the Reaching Every Barangay (REB) strategy
activities are used to reach children who have not
been vaccinated or have not developed sufficient immunity after previous
vaccinations. It can be conducted either national or sub-national –in selected areas.
Supplemental Immunization Activity (SIA)
This is critical for the eradication/elimination efforts, especially in identifying
true cases of measles and indigenous wild poliovirus
Strengthening Vaccine-Preventable Diseases Surveillance
One of the strategies
. Procurement of adequate and potent vaccines and needles and syringes to all
health facilities nationwide
Vaccination among infants and newborns (0-12 months) against the seven
vaccine-preventable diseases. These include:
- Tuberculosis
- Diphtheria
- Pertussis
- Tetanus
- Poliomyelitis
- Measles
- Hepatitis
y is designated as immunization day and is adopted in all parts
of the country. In a barangay health station immunization is done monthly while in farflung areas it is done quarterly. However, some areas adopted local practices to provide
everyday vaccination in their areas to cover all targets.
Wednesday
when a child receives one dose
of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of HB, and one dose of measles before a
child’s first birthday.
“Fully Immunized Child”
for women is important to prevent tetanus
in both mother and baby. When two doses of TT injection are given at a one-month
interval between each doses during pregnancy or even before the pregnancy period the
baby is protected against neonatal tetanus. Completing the five doses following the
schedule provide lifetime immunity.
Tetanus Toxoid vaccination
are substances very sensitive to various temperatures. To avoid spoilage
and maintain their potency, vaccines need to be stored at the correct temperature. Below are
the recommended storage temperatures of EPI vaccines.
Vaccines
is practiced to assure that all vaccines are
utilized before their expiry date. Proper arrangement of vaccines and/or labeling of
vaccines’ expiry date is done to identify those near to expire vaccines.
“first expiry and first out” (FEFO)
is done at all levels of health facilities to monitor
vaccine temperature. This is done twice a day early in the morning and in the afternoon
before going home. Temperature is plotted every day in a temperature monitoring chart
to monitor breaks in the cold chain.
Temperature monitoring
Procedures in the giving of vaccines
- Always keep the diluent cold by sustaining with BCG vaccine ampules in a refrigerator or
vaccine carrier. - Using a 5 ml. syringe fitted with a long needle, aspirate 2 ml. of saline solution from the
opened ampule of diluent. - Inject the 2 ml. saline into the ampule of freeze-dried BCG.
- Thoroughly mix the diluent and vaccine by drawing the mixture back into the syringe and
expel it slowly into the ampule several times. - Return the reconstituted vaccine to the slit of the foam provided in the vaccine carrier.
Giving BCG Vaccine
- Clean the skin with a ‘cotton ball moistened with water and let the skin dry.
- Hold the child’s being with your left hand so that: your hand is under the arm and your
thumb and fingers come around the arm and stretch the skin - Hold the syringe in your right hand with the bevel and the scale pointing up towards you.
- Lay the syringe and needle almost flat along the child’s arm.
- Insert the tip of the needle into the skin - just the bevel and a little bit more. Keep the
needle flat along the skin and the bevel facing upwards, so that the vaccine only goes into
the upper layers of the skin. - Put your left thumb over the needle end of the syringe to hold it in position. Hold the
plunger end of the syringe between the index and middle fingers of your right hand and
press the plunger in with your right thumb. - If the vaccine is injected correctly into the skin, a flat wheal with the surface pitted like an
orange peel will appear at the injection site. - Withdraw the needle gently
Giving Oral Polio Vaccine
- Read the manufacturer’s instructions to determine the number of drops to be given. Use
the dropper provided for. - Let the mother hold the child lying firmly on his back.
- If necessary open the child s mouth by squeezing the cheeks gently between your fingers
to make his lips point upwards. - Put drops of vaccine straight from the dropper onto the child’s tongue but do not let the
dropper touch the child’s tongue. - Make sure that the child swallows the vaccine. If he spits it out, give another dose
Hepatitis B and DPT
- Ask the mother to hold the child across her knees so that his thigh is facing upwards. Ask
her to hold the child’s legs. - Clean the skin with a cotton ball, moistened with water, and let the skin dry.
- Place your thumb and index finger on each side of the injection site and grasp the muscles
slightly. The best injection site is the outer part of the child’s mid-thigh - Quickly push the needle into the space between your fingers, going deep into the muscle.
- Slightly pull the plunger back before injecting to be sure that the vaccine is not injected
into a vein (if using disposable - Inject the vaccine. Withdraw the needle and press the injection spot quickly with a piece
of cotton.
Reconstituting the Freeze-Dried Measles Vaccine
- Using a 10 ml. syringe fitted with a long needle, aspirate 5 ml. of special diluent, from
the ampule. b. Empty the diluent from the syringe into the vial with the vaccine. - Thoroughly mix the diluent and vaccine by drawing the mixture back into the Syringe
and expelling it slowly into the vial several times. Do not shake the vial. - Protect reconstituted measles vaccine from sunlight. Wrap the vial in foil.
- Place the reconstituted vaccine in the slit of the foam provided in the vaccine carrier.
Giving Measles Vaccine
- Ask the mother to hold the child firmly.
- Clean the skin with a cotton ball, and moistened the upper arm.
- With the fingers of one hand, pinch up the skin on the outer side of the upper arm.
- without touching the needle, push the needle into the pinched-up skin so that it is not
pointing. - Slightly pull the plunger back to make sure that the vaccine is not injected into a vein ( if
using disposable syringes and needles) - Press the plunger gently and inject.
Giving Tetanus Toxoid
- Shake the vial.
- Clean the skin with a cotton ball, moistened with water, and let the skin dry.
- Place your thumb and index finger on each side of the injection site and grasp the
muscles, slightly. The best injection site for a woman is the outer side of the left upper
arm. - Slightly pull the plunger back before injecting to be sure that the vaccine is not injected
into a vein. - Quickly push the needle into the space between your finger, going deep into the muscle.
- Inject the vaccine. Withdraw the needle and press the injection spot quickly with a piece
of cotton.
As a nurse you need to:
- Actively master list infants eligible for vaccination in the community
- Immunize infants following the recommended immunization schedule, route
administration, correct dosage, and following the proper cold chain storage of vaccines. - Observe the aseptic technique on immunization and use one syringe and needle per child.
This reduces blood-borne diseases and promotes safety injection practices. - Dispose of used syringes and needles properly. by using a collector box and disposing of
it in the septic vault to prevent a health hazard. - Inform, educate, and communicate with the parents.
a. to create awareness/motivate to submit their children for vaccination to provide
health teachings on the importance and benefits of immunization, the importance
of following up the dose to avoid defaulters, and the normal course of vaccine.
b. to inform immunization schedule as adopted by local units - Conduct health visits in the community to assess other health needs of the community
and be able to provide a package of health services to targets. - Identify cases of EPl target diseases per standard case definition.
- Manage vaccines properly by following the recommended storage of vaccines.
- Record the children given with vaccination in the Target Client list and GECD/ GMC card
or any standard recording form utilized. - Submit reports and records of children vaccinated, cases and deaths of EPI diseases,
vaccines received and utilized, and any other EPl-related reports. - Identify and actively search cases and deaths of EPI target diseases following standard
The top cause of death among newborns
s Pneumonia at the rate of 2/1,000 live births closely followed by bacterial sepsis at 1.8/1,000 live births.
are identified
as the top cause of mortality among older children five to nine years old followed by
pneumonia and malignant neoplasm
Accidents
has been established as an
approach to strengthening the provision of comprehensive and essential health packages to
children.
e Integrated Management of Childhood Illnesses
Methods in Managing Childhood Illnesses
- Assess the patient
Taking the history of the patient is one way of getting information about the disease
condition. This can be done by asking and observing the patient’s condition to explore
the possible causes. - Classify the disease
A thorough assessment supported by laboratory results is necessary for the
classification of illnesses and confirmation of the disease. Classification of the disease
are:1) mild, 2) moderate, 3) severe - Treat the patient
Treatment is a curative method of treating diseases. This varies on the condition of
the patient. - Counsel the patient
Providing health education to clients promotes health and avoids the risk of infection
These are important for parents/caregivers, especially those who lack knowledge of
health practices and risk factors that contribute to disease ailments.
To address problems, child health
programs have been created and available in all health facilities which include:
programs have been created and available in all health facilities which include:
1. Infant and Young Child Feeding
2. Newborn screening
3. Expanded Program on Immunization
4. Management of Childhood Illnesses
5. Micronutrient Supplementation
6. Dental Health
7. Early Child Development
8. Child Health Injuries
during the first half-year of life is an important factor that can prevent infant and childhood
morbidity and mortality.
Breastfeeding, especially exclusive breastfeeding
Timely, adequate, safe, and proper complementary feeding will
prevent
childhood malnutrition.
n form an inseparable biological and social unit.
Mothers and children
as the ideal food for the healthy
growth and development of infants;
breastmilk
has approved the implementation of the expanded newborn screening program
The Department of Health (DOH) Advisory Committee on Newborn Screening (ACNBS)
The newborn screening program in the Philippines currently includes a screening of six disorders:
congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), phenylketonuria (PKU), glucose-6- phosphate dehydrogenase (G6PD) deficiency, galactosemia (GAL), and maple syrup urine disease (MSUD).
is a procedure intended for the early identification of infants who are affected by certain genetic, metabolic, or infectious conditions that may lead to mental retardation or morbidity if left untreated.
Newborn screening
The NBS was integrated into the public health delivery system with the enactment of the
Republic Act 9288 or Newborn Screening Act of 2004.
is an indicator of access and use of health care during pregnancy. It constitutes screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective; and educating pregnant women about planning for safe childbirth (facility-based deliveries), emergencies during pregnancy, and how to deal with them. (WHO; Indicator Definitions and Metadata 2008).
Antenatal Care Coverage
provider is a capable private health facility or an appropriately upgraded public health facility that is either a Rural Health Unit (RHU) and/or its satellite Barangay Health Station (BHS) or Hospital capable of performing the following emergency obstetric functions:
- parenteral administration of oxytocin in the third stage of labor; 2. parenteral administration of loading dose of anti-convulsants; 3. parenteral administration of the initial dose of antibiotics; 4. performance of assisted deliveries in the imminent breach; 5. removal of retained placental products; and 6. manual removal of retained placenta.
The provider
is a tertiary level regional hospital or medical center, provincial hospital, or an appropriately upgraded district hospital. It can also be a capable privately operated medical center.
provider
continues to be a public health concern in the country.
Malnutrition
The common nutritional deficiencies are,
- Vitamin A 2. Iron and, 3. lodine.
is to improve the quality of life of Filipinos through better nutrition improved health and increased productivity.
nutrition program
nutrition program objectives
- Reduction in the proportion of Filipino households with intake below 100% of the dietary energy requirement from 53.2% to 44.0%. 2. Reduction in: a. underweight among preschool children b. stunting among preschool children c. chronic energy deficiency among pregnant women d. iron deficiency among children 6 months to five years old, pregnant and lactating mothers e. prevalence of overweight, obesity, and non-communicable diseases f. reduction in the prevalence of low birth weight g. elimination of moderate and severe IDD among school children and pregnant women h. reduction in the prevalence of low birth weight
nutrition program Strategies:
- Food-based interventions for sustained improvements in nutritional status
- Life-cycle approach with strategic attention to 0-3 years old children, adolescent females, and pregnant /lactating women 3. Effective complementation of nutrition interventions with other services
- Geographical focus to needier areas
is one of the interventions to address the health and nutritional needs of infants and children and improve their growth and survival.
Micronutrient supplementation
is the approach adopted to provide micronutrient supplements to 6-71 months old preschoolers on a nationwide scale.
“Araw ng Sangkap Pinoy” (ASAP), known as Garantisadong Pambata (GP), or Child Health Week
provide for the giving of iron supplements to specific target groups, the availability of iron supplements depends on the capability of LGUS to procure the drugs
Micronutrient Guidelines
is also pushed to improve the nutritional status of the populace including the children.
Food fortification
This ensures the right of the child to survival, development, protection, and participation. It includes the delivery of essential maternal and child health and nutrition package of services that will ensure the right to survival, development, protection, and participation
Essential Maternal and Child-Health Service Package
these include the promotion of nutritional guidelines for Filipinos and other nutrition key messages and training of health workers.
Nutrition information, communication, and education
It includes the establishment of kitchens, and gardens in homes, schools, and. in communities in urban and rural areas to serve as a source of additional food for the home and establishment of demonstration centers and nurseries, and distribution of planting materials
Home, School, and Community Food Production
includes center-based complementary feeding for wasted/ stunted children and pregnant women with delivering low birthweight. This may be done in school. Rice distribution is done in school through the efforts of local units. Food discounts were provided through the Tindahan Natin Program.
Food Assistance
is done by provision of credit and livelihood opportunities to poor households especially those with malnourished children through linkage with lending and financial institutions. Functional literacy training helps in this endeavor.
Livelihood Assistance
Knowing that malnutrition is a frequent community health problem, you decided to conduct a nutritional assessment. What population is particularly susceptible to protein energy malnutrition (PEM)?
1-4-year-old children
Which biological used in EPI is stored in the freezer?
Measles vaccine
Unused BCG should be discarded how many hours after reconstitution?
4
In immunity school entrants with BCG, you are not obliged to secure parental consent. This
is because of which legal document?
PD 996
Which immunization produces a permanent scar?
BCG
A 4-week-old baby was brought to the health center for his first immunization. Which
can be given to him?
Infant BCG
You will not give DPT 2 if the mother says that the infant had?
Seizures a day after DPT1
A 2-month-old infant was brought to the health center for immunization. During the
assessment, the infant’s temperature registered at 38.1 C. Which is the best course of action
that you will take?
Refer the infant to the physician for further assessment
A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her
baby will have protection against tetanus for how long?
10 years
This ensures the right of the child to survival, development, protection, and participation
Essential Maternal and Child-Health Service Package.
