Health Promotion, Risk Reduction, and Capacity-  Generalist (Level 1)

Building Strategies  Nurse Clinician (Level 2)

 Nurse Clinician II (Level 3)
Lecturer: Cajigas
 Clinical Nurse Specialist (Level 4)
Discussed by: Ivy V. Rosales, man (car)
2. Development and Utilization of Policies and
Procedures
REPUBLIC ACT 9173 o Define the type of nursing service provided
States that as independent nurse practitioners, o Listing the criteria for admission, enrollment,
nurse are primarily responsible for the promotion of health discharge from program and
and prevention of illness. services
o Delineating the areas of responsibilities,
BOARD OF NURSING
functions of team members
Given the mandate to supervise and regulate the o Establishing system of documentation
practice of nursing o Setting up a system of payment and
Standards For The Safe Practice Of Mother Child Nursing disbursement
In The Philippines 3. Use appropriate Standards and Practice Guidelines
Document which includes a section making Nursing Practice guidelines refer to how nursing
Maternity Child Association of the Philippines (MCNAP) care will be provided. It includes essential data for
the accrediting organization for mother child nursing assessment and intervention options
specialty accreditation.
In nursing clinic of UPCN, clients coming with nutritional
DOH Programs on the Promotion of Healthy Lifestyle concerns will:.
 Risk Assessment on Hypertension  Be a assessed using anthropometric
 Alcohol Abuse measurements like triceps skinfold thickness,
 Physical Activity weight and height, BMI, waist circumference, hip
 Smoking circumference, 24 hr dietary recall for at least 1
 Family History of Disease regular day and 1 weeken.
 Have a dietary and body composition analysis
January 2020, Health Promotion Nursing Clinic based on
 Participate in meal planning to ensure that it is
UP Manila College of Nursing formally accepted clients
patterned to personal needs and based on the
with concerns on Nutrition, Health Maintenance, Mobility
Filipino Pyramid Food Guide and Recommended
and Sleep Patterns
Energy and Nutritional Intake (RENI)
 2 Practitioners  Be given pointers on therapeutic diets with
emphasis on what is eaten and what needs to be
 1. Faculty Member
avoided
 2. Apprentice Graduate Student  Upon detection of risk conditions and medical
problems, will be referred to doctor
3 Ways Of Ensuring Delivery Of A Competent Nursing
 Be monitored on progress
Care That Is Client Centered And Outcome Oriented
1. Qualified and competent nurses to deliver care
- MCNAP Credentialing Levels of Specialization
In general, basic components of Nursing Practice 3 Criteria From Establishing A Risk Factor
Guidelines includes
1. The frequency of the disease varies by category
 What data is essential to assess the clients or amount of the factor.
condition? How should the assessment be done? 2. Risk factor precede the onset of the disease
 What are the intervention options: independent, 3. The association of concern must not be due to
dependent and collaborative interventions any source error
 What are the signs and indicators that the client 4 MAIN STEPS OF A RISK ASSESSMENT
needs referral to a doctor/other health
professional 1. Hazard identification
 What are the signs that the client is not making 2. Risk description
progress?
3. Exposure Assessment
HEALTH PROMOTION AND COMMUNITY HEALTH
NURSING 4. Risk estimation

Case Example TWO TYPES OF RISKS

• Mina has been an athlete since high school. 1. Modifiable Risk factors
Married with 3 grown children, she rises at 5am 2. Non modifiable Risk factors
every morning to jog around her neighborhood
RISK REDUCTION: proactive process in which
before going to he job as a professor in a
individual’s participate in behaviors that enable them to
university. A non smoker, Mina rarely drinks
react to actual or potential threats to their health
alcohol and eats a diet consisting mostly of meat,
(Pender,1996)
fish, vegetables , rice and fruit. Mina’s body mass
index is in a normal range and though her RISK COMMINICATION: The process through which the public
cholesterol levels is slightly elevated, she does receives information regarding possible or actual threats to
health
not require medication for this issue. After work,
Mina and her husband, relax by watching TV and DIET
reading. An early riser, Mina is in bed by 10 PM Balance caloric intake with physical activity!!
almost every night. At 50 years of age, Mina is
youthful and energetic.
HEALTH PROMOTION: any combination of health
education and related organizational, economic and
environmental supports for behavior of individuals, groups
or communities conducive to health (Green and
Kreuter,1991)
HEALTH PROTECTION: refers to behaviors in which one
engages with the specific intent to prevent disease, to
detect disease in the early stages or to maximize health
within the constraints of disease (Parse,1990) Read the 10 Nutritional Guidelines for Filipinos
PHYSICAL ACTIVITY AND HEALTH
RISK FACTOR: Probability that a specific event will occur
in a given time frame ( Oleckno, 2002). an exposure that The most important idea is that one must take a first step to try
is associated with the disease (Friis, 2004) exercise. Walking, biking, taking the stairs and swimming-
there is something for everyone and any exercise is better
WHAT ARE MINA’S RISK FACTOR? than none!!
SLEEP - Neurologic conditions- long term risk of
alcohol use such as dementia and stroke,
Adult : 7-9 hours of Sleep
- CARDIOVASCULAR- MI, hypertension
Note: Practice Sleep Hygiene! - PSYCHIATRIC PROBLEM such as
depression , anxiety
1. need to avoid caffeine and nicotine in the bedtime - SOCIAL PROBLEM - employment and
2. avoid alcohol because it can cause sleep distraction family dysfunction
3. get up on the same time everyday - Cancer of the mouth, throat ,liver and breast
4. exercise regularly – 3 hours before bedtime - Liver diseases- cirrhosis
5. establish a regular relaxing bed time routine
6. create a dark quit cool sleep environment The Ottawa Charter for Health Promotion
7. have a comfortable beddings
November 17-21, 2020: the first International
8. use the bed for sleep only
Conference on Health Promotion was held at Ottawa, Canada
9. avoid large meals before bed time
Ottawa Charter defines health promotion as the process of
Sleep assessment is an important approach especially if the
enabling people to increase control over and to improve their
person reports sleep apnea, restlessness.
health which requires that an individual or group must be able
TOBACCO AND HEALTH RISK to identify and realize aspirations, to satisfy needs and change
or cope with the environment
In 2009, among the 10 leading causes of death in the
Philippines, 8 were associated to smoking. PREREQUISITES FOR HEALTH identified by Ottawa Charter

Smoking cessation is a steps to quit smoking: The fundamental Conditions and resources for health are:

1. Decide to quit • Peace

2. Sets a date to quit and set a plan
• Shelter
3. Deal with withdrawal through avoiding temptations
4. Stay of tobacco is a lifelong process – unexpected • Education
craving may feel, tell the person to be reminded the
• Food
reason why he needs to quit
5. Wait out for craving • Income
6. Avoid alcohol
7. Practice exercise and healthy diet • A stable ecosystem

ALCOHOL CONSUMPTION AND HEALTH • Sustainable resources

A common in the society, serving alcohol is • Social Justice and equity

considered customary in occasions THREE BASIC STRATEGIES FOR HEALTH PROMOTION
Heavy drinking: consuming more than 2 drinks per day on 1. Advocacy for health to provide for the conditions and
average for men or more than 1 drink per day for women resources essential for health
Binge drinking: drinking 5 or more drinks on a single occasion 2. Enabling all people to attain their full health potential
for men or 4 or more drinks on single occasion for women
3. Mediating among the different sectors of society in
Excessive drinking: can take the form of heavy drinking, binge efforts to achieve health
drinking or both.
FIVE PRIORITY ACTIONS
WHAT ARE THE HEALTH PROBLEMS ASSOCIATED??
• 1. Build Healthy Public Policy
- Liver disease
- Frequent accidents • 2. Create Supportive Environments
- Risky behaviors
• 3. Strengthen Community Actions
- Motor vechicle accidents
- Drowning • 4. Develop Personal Skills
- Miscarriage
• 5. Reorient Health Services
HEALTH EDUCATION: the process of changing peoples  Regardless of the client of Public Health Nurses
knowledge, skills and attitudes for health promotion and risk (PHN’s) a go through same process.
reduction Assessment, Planning, Implementation and
PATIENT EDUCATION: refers to series of planned teaching- Evaluation.
learning activities designed for individuals, families or groups  Evaluation specifies the worth of nursing
with an identified alteration in health interventions and public health programs. Also
provides very critical information to decision
BASIC PRINCIPLE THAT GUIDE THE EFFECTIVE
makers at different levels.
NURSE EDUCATION
 PHN - responsible for evaluating nursing care
1. Message rendered to client.
2. Format  Evaluation of public health programs is the
3. Environment primary responsibility of the unit head (physician),
4. Experience PHN participated in evaluating programs.
5. Participation Sometimes, a person external do the
6. Evaluation organization.
COMPETENCY-BASED TRAINING OF BARANGAY  PHN - responsible for evaluating the midwives
HEALTH WORKERS (BHW) performance and submits recommendations to
unit head. Requires knowledge on Civil Service
 COMMUNITY HEALTH WORKERS: should be and process of performance.
members of the communities where they work,
should be selected by the communities for their
activities, should be supported by the health EVALUATION
system but not necessarily a part of its ASSESSM DIAGNO PLANNI IMPLEMENT
organization and have shorter training than ENT SIS NG ATION
professional workers. Determine Determi Determi Analyze how
 Known as BHW/Barangay Health Workers changes in ne if the ning if the plan was
health problem the implemented
COMPETENCIES REQUIRED status. requiring intervent
nursing ions are Determine
 Communication
Make sure care are appropri factors related
 Interpersonal assessme resolved ate and with success
 Teaching Organizational nt data are , adequat in
 Advocacy Skills accurate improve e to implementing
 Knowledge on Community Health Issues and d and achieve plan.
 Training on basic health assessment (VS, PA) complete controlle client
 Training on Evidence based home remedies for d. outcome
. Specify
dia..(natatahuban ngadto kan maam ppt)
Consider client
Respiratory Infections and febrile conditions if there status
The book Where is No doctor: A Village Health Care are new based
Handbook provides a practical guide in BHW and BHW problem on
training (Werner, 2010) expecte
d
NURSING PROCESS IN THE CARE OF POPULATION outcome
GROUPS AND THE COMMUNITY of care.

MONITORING AND EVALUATING COMMUNITY

HEALTH PROGRAMS IMPLEMENTED  To facilitate evaluation, objectives should be
client centered and outcomes focused.
  Objectives cam be further evaluated by using effectiveness and impact of activities in the light of their
more specific criteria. own objectives. (UN, 1978)
 Criteria are objective, measurable, relevant and
3 TYPES OF EVALUATION
flexible indicators related to performance,
behaviour, circumstances or clinical status. ONGOING – the analysis during the implamentation of
 Example: page 406 Maglaya Book the activity of its continuing relevance, efficiency and
 In other settings (such as US), evaluation of effectiveness and present and likely future outputs,
heath care given focuses on outcomes. effects and impacts.
 Noted that objectives are statements of patient TERMINAL EVALUATION – undertaken from 6-12
outcomes months after the project completion. This is also a
Advantages on Focusing on Outcomes substitute for an ex post evaluation of project with short
 Can easily pinpoint effective and in effecting duration.
nursing interventions can show value of nursing
care/service EX-POST EVALUATION: is undertaken some years after
 See example page 407 Maglaya project completion when full progrsm/project benefits and
 KNOWLEDGE: relevant questions should be impacts are expected to have been realized.
asked. Clear and easy to understand questions MAJOR FOCUS OF PROGRAM EVALUATION
 SKILLS: client should be asked to demonstrate
the specific skills that he/she learned or observed 1. Input
for specific health practices or behaviours. 2. Processes
3. Results or outcomes
 ATITTUDE: Can be assessed through qualitative,
semi-structured or unstructured interview. STEPS IN PROGRAM EVALUATION
 FEEDBACK sessions: done after collection and
analysis of data/information. 1. Decide what to evaluate
2. Design evaluation plan
 In designing evaluation plan, PHN should specify
3. Collect relevant data
the criteria and corresponding evaluation tool for
4. Analyse data
each objective.
5. Make decisions
 Tools for outcome evaluation of nursing
6. Report/give feedback
interventions: Thermometer, BP apparatus,
weighing scale, tape measure or ruler, checklist, INDICATORS; performance measure. It is specific and
interview guide. objective verifiable measure of changes or results brought
about by an activity.
Table 9. SAMPLE FORM IN DESIGNING
EVALUATION PLAN  Should be valid, reliable, objective, sensitive,
OBJEECTIVE CRITERIA FOR EVALUATION specific, cost effective and timely.
EVALUATION TOOL  Example page 425 Maglaya
 Effectiveness refers to the extent to which the
programs objectives have been achieved.
CHECKLIST – if there are number of criteria for an
objective.
DOCUMENTATION AND REPORTING
PROGRAM EVALUATION
RECORD: a written document about a target client,
EVALUATION – the analysis of effectiveness, quality, whether an individual person, a family, a group or a
scope and timeliness of the service given. whole community is involved, which relates and event
pertinent to health and healthcare services like clinic
 Defined as the process for determining systematically
consultation, hospitalization. Home visit,
and objectively the relevance, efficiency and immunization, births, deaths, marriages, and others
REPORT: an account or summary of the services  Family planning
rendered to the clients and rationalizes the continues  Maternal care
existence of the program.
DOH PROGRAMS AS FOCUS OF FHIS
In the context of CHN, Field Health Service System
(FHISIS) is a source of information in the effort of the  Tuberculosis, Malaria, Schistosomiasis And
DOH to effectively and efficiently monitor and Leprosy Control Program
evaluate the National Health Service delivery system  Dental Health
in the form of a report or record.  Environmental Health

FIELD HEALTH SERVICES INFORMATION COMPONENTS OF FHIS

SYSTEM (FHIS): A network information source
1. RECORDING
developed by Department of Health (DOH). It is
a. Individual Treatment/ Family Treatment
intended to address the short term data needs of the
Record
DOH stand with managerial or supervising functions
b. Target Client List
in the DOH facilities and in each of the program
c. Summary Table
areas.
d. Monthly Consolidation Table
OBJECTIVES 2. REPORTING
a. Tally/Reporting Forms
1. To provide summary of data on health services b. Output reports/Tables produced at the
and selected program indicators at all levels Provincial Health Office (PHO) from the data
2. To provide data, which in combination with other reported in the FHIS Reporting Foms. Then
sources, can be used for program monitoring and disseminate to RHU/MHC then thru DOH to
evaluation purposes and can be accessed for the Regional Health Office
more in depth studies
3. To ensure that data reported to FHIS re useful,
accurate and easy to understand
IMPORTANCE OF THIS
1. Helps local government to determine public
health priorities
2. Basis for monitoring and evaluating health
program implementation
3. Basis for planning, budgeting, logistics and
decision making at all levels
4. Source of data for detecting unusual occurrences
of a disease
5. Helps in monitoring the health status of
community.
6. Helps midwives/CHN nurse in monitoring clients
7. Helps in documentation of CHN day to day
activities.
DOH PROGRAMS AS FOCUS OF FHIS
 Maternal and Child Health ( MCH)
 Expanded Program on Immunization (EPI)
 Control Of Diarrheal Disease (CDC)
 Nutrition
 LAWS TO ENACT ENVIRONMENTAL PROTECTION
AND CONSERVATION
Environmental Health and Sanitation Mrs. Rosales
Environmental Health Declaration of Policy:
Branch in public health that deals with the study of • Right of people to a balance and
preventing illness by managing the environment and healthful ecology
changing people’s behavior to reduce exposure to
• Promote and protect the global
biological agents of disease and injury
environment
The Ecological Triangle
• State recognizes the principles that
Man pollutes must pay
• State recognizes that a clean and
healthy environment is for the good and concern
of all.

ENVIRONMENTAL AND OCCUPATIONAL HEALTH

Disease Environment OFFICE (EOHO)
Under the National Center for Disease Prevention and
Man – the role of man is to manipulate the environment to
Control Program of DOH, responsible for the promotion of
prevent contracting the disease by blocking disease the
healthy environmental conditions and prevention of
disease agents from entering/attacking his body, however
environmental related diseases. Strategies Include:
if the man fails to keep the environment clean and healthy
so these provides a good breeding place for the disease 1. Water quality and surveillance
agents or vectors to live, propagate, and eventually attack
2. Evaluation of food establishments
man who will now serve as hosts for the microorganism
3. Proper solid and liquid waste
management
The Ecological Triangle Preventive Strategies:
4. Sanitation of public place
1. Change people’s behavior to manipulate
5. Sanitation management of disaster areas
the environment and reduce exposure to
biological and non-biological disease agents 6. Impact assessment of environmentally
critical projects
2. Manipulate the environment to prevent
production or presence of disease agents 7. Enforcement of sanitation laws, rules,
regulations, and standards Two Divisions of
a. R.A. 9275 (Clean Water Act) of 2004 aims to protect
EOHO:
the country's water bodies from pollution from land-based
sources 1. Water and Sanitation Division 2. Healthcare Waste on
Toxic/Hazardous Division Programs of EOHO:
3. Increasing the persons resistance to
infectious diseases as demonstrated in the • Water for Life
various maternal and child health programs of
Expanded Program for Immunization (EPI) and • Hospital Waste Management
Nutrition. • Urban Health and National Projects
• Pasig River Rehabilitation Project
Environmental health mainly focuses on preventing 6. Absence of a rationalized lands use plan
diseases thru integration of the different programs such
7. Improper and indiscriminate disposal of
as:
solid and wastes
• Child Survival Programs
8. Unregulated management of toxic and
• EPI hazardous chemicals and substances
• Center for Disease Development and 9. Loss of primary agricultural lands
other programs of DOH
10. Weak Implementation and enforcement
of environmental laws and regulations
Environmental Sanitation 11. Inappropriate assessment of adverse
impacts on the development or industrialization to
The study of all factors in mans physical environment
affected stakeholder, i.e. local communities
which may negatively affect his health and well-being.
12. Traditional approach in environmental
Factors:
governance: regulatory versus development
1. Water supply sanitation
13. Sustainable development concerns are
2. Proper Excreta disposal not fully integrated in planning, programming and
policy making
3. Solid waste management (refuse and
garbage disposal) 14. Lack of logistic and facilities
4. Insect vector and rodent control
5. Food sanitation 6. Air pollution The following key areas that require improvement:

7. Proper housing 1. Specific policies and legislation for

environmental health
8. Noise
2. Institutional development and
9. Radiological Protection intersectoral collaboration
10. Institutional Sanitation 3. Human resource development
11. Stream Pollution 4. Monitoring and Surveillance

Priority Environmental Health Issues Inter-Agency Committee on Environmental Health

1. Biologically dead rivers due to water (IACEH)
pollution • Formed through EO 489 of 1991
2. Presence of smoke belching motor • Composed of 11 members chaired by the
vehicles causing air pollution secretary of DOH, with secretary of DENR as
3. Rapid Population growth vice chair. Committee members from Department
of Public Works and Highways (DPWH),
4. Inadequate sewerage system and sludge Department of the Interior and Local Government
management system for septic tanks
(DILG), Department of Trade and Industry (DTI),
5. Inadequate monitoring of drinking water
sources Department of Transportation and Communications
(DOTC), Department of Labor and Employment (DOLE),
National Economic and Development Authority (NEDA) o Decreasing the aromatic and
and Philippine Information Agency (PIA) benzene levels in unleaded gasoline
Functions of Inter-Agency Committee on Environmental o Smoking in public places are
Health (IACEH) banned in public places for example:
1. Formulate policies and guidelines and  Public transport
develop programs for environment health
protection • RA 9003 (Ecological Solid waste
management act of 2000) – which declares the
2. Coordinate, monitor and evaluate EH adoption of a systematic, comprehensive and
programs and development projects ecological waste management program as a
3. Undertake information dissemination and policy of a state using the community-based
education campaigns on EH programs approach and mandating this diversion through
composting and recycling.
4. Coordinate, assist and/support the
conduct of research and relevant activities for • RA 9275 (Clean water act of 2004) –
environmental maintenance protection aims to establish waster water treatment facilities
that will clean waste water before it is released
into the bodies of water such as rivers, seas,
oceans, and others. Also requires the local
Laws and Policies that affect Environmental Health and
government unit to form water management
Sanitation
areas that will manage waste water in their
• Senate Resolution 6776 (Persistent respective areas.
Organic Pollutants were banned)
• Supplemental IRR of chapter II of
• RA 6969 (Toxic substance and nuclear Sanitation Code of the Philippines – Water
waste control act of 1990) – regulates the refilling stations should regularly monitor their
importation, cues, movement, treatment, and drinking water qualities using the following
disposal of toxic chemicals, hazardous and schedules: o Monthly for bacteriological quality o
nuclear wastes in the Philippines. 6 months for physical and chemical properties
• RA 8749 (Clean Air Act of 1999) – o Annually for biological quality
provides a comprehensive air pollution and radiological quality when the need
management and control program to achieve and arises.
maintain healthy air.
o Water analysis procedures
o Section 20 bans the use of should be
incineration for municipal biomedical and
hazardous wastes but allows the done in DOH accredited laboratories and water quality
traditional method of small-scale should follow the Philippines National Standards of
community burning Drinking Water
o All motor vehicles are required to • PD 856 – supplemental rules and
pass the smoke emission test. o Leaded regulations on sewage collection and disposal
gasoline should be faced out by the end and excreta disposal and drainage of the
2000. sanitation code of the Philippines regulates and
provides proper guidelines for local government
o Lowering sulfur content of all
unit and establishment involved in this lodging,
automotive diesel fuel
collection, handling, transport, and disposal of
communal septic tanks.
 • Cholera
Water Supply Sanitation Program • Typhoid Fever
Approved types of Water supply In 2001, Diarrhea was the top cause of illness of children
under 5 years of age
• Level 1 or point source type – a covered
well without distribution system generally Preventable through proper hygiene practices
adaptable for rural areas. Can serve 15-25
Water Sources requiring Disinfection
households and its outreach must not be 250
meters from the furthest user. Its yield discharge 1. Newly constructed water supply facilities
is from 40 to 140 liters per minute.
2. Water supply facility that has been
• Level 2 or Communal Type – also known repaired/improved
as Stand post type, composed of a water source,
a reservoir, a pipe distribution network, and a 3. Water supply sources fond to be positive
communal faucet. This system is designed to bacteriologically by laboratory analysis
deliver 40 to 80 liters of water per capital per day 4. Container disinfection of drinking water
to an average of 100 households with one faucet collected from water facilities subject to
per 4 to 6 households. Should be located not recontamination.
more than 25 meters from the furthest home.
Generally suitable for rural areas where houses
clustered densely to justify a simple pipe system. Household Water treatment
• Level 3 or Waterworks Systems – also 1. Boiling
known as individual house connection type.
Composed of a source, a reservoir, a pipe 2. Chemical Coagulation – use of aluminum
distribution network, and household tap. sulfate to coagulate suspended materials in water
Generally suited for densely populated urban 3. Filtration – sand, piece of cloth can be
areas an requires minimum treat. used
Unapproved types of Water supply – unapproved 4. Chlorination – adding chlorine to the
because the water comes from doubtful sources water
• Open Dug wells 5. Softening – adding certain chemicals to
• Unimproved Springs reduce calcium and magnesium salts which
causes to be hard. Chemicals used are
• Wells that need priming ammonia, borax, calcium hydroxide, or trisodium
DOH secretary/duly authorized representative: Issues the phosphate.
certification of portability of existing water source

Proper Excreta Disposal Program

Water Quality and monitoring Surveillance Approved type of toilet facilities
• By government or private laboratories 1. Level 1 type. 2 categories
duly accredited by DOH and meets the provisions
of National Standards of Drinking Water -Non water carriage toilet facility

• Yearly -Small amount of required to wash the waste

Water Supply Sanitation-related Diseases 2. Level II types

-onsite toilet facilities of the water carriage type with water Hog feeding
sealed and falsh type with septic volt or tank disposal -leftover food or waste is used as a hog feed
facilities
Open dumping
3. Level III types
-wherein the garbage is piled in a dumpling place with no
-treatment plan involve soil covering.
“Blind drainaige” types of waste water collection and Open burning
disposal facility in rural areas
-piled and later burned in the open air
Conventional Sewerage facilities for poblacion and cities
Burial in pit
PAIL SYSTEM
-the garbage is placed in a pit and covered when filled up
-a pail or a box is used and then a ballot system is with no intention of use as fertilizer
included
Composting
OPEN PIT PRIVY
-wherein biodegradable materials or garbage are
-A PIT COVERED WITH by platform with uncovered hole. converted into a composed or soil conditioner
BORED HOLE LATRINE Collection
-a deep but relatively narrow hole made with a boring -the garbage is collected regularly via facility for proper
equipment. disposal.
OVERHUNG LATRINE VECTOR CONTROL PROGRAM
-A TOILET HOUSE IS CONSTRUCTED OVER A BODY -Focuses on sustainable preventive and vector control
measures against malaria parasite and mosquito vector.
OF WATER
-to reduce the source of infection in the human population
ANTIPOLO TYPE
by reducing or eliminating man vector contact and
-an elevated toilet house shallow pit is extended upward. reducing the density of mosquito vector population.

-has more privacy Vector borne diseases

WATER SEALED LATRINE -Malaria

-a water sealed water bowl is placed over a pit privy -Plague

FLUSHED TYPE LATRINE -Dengue hemorrhagic fever

-waste is diposed by flushing water through pipe into a Vector control measures
septic tank or through a sewage system.
1.insecticide treatment of mosquito nets
2.House spraying insecticide
SOLID WASTE MANAGEMENT/GARBAGE DISPOSAL
3.On stream seeding
Solid waste
4.On stream clearing
-mga basura
Food Sanitation program
Hazardous waste
POLICIES
-these are toxic waste generated from large industries
hospitals.
1. Appraisal of food establishment as to following sanitary -Shortness of breath
conditions:
LEGAL ISSUES IN AIR POLLUTION
a. inspection/ approval of all food sources,
-Industries control of air and water pollution and disposal
containers and transport vehicle
of solid and hazardous waste
b. Compliance of sanitary permit requirements for
-Buses and jeepney use of second hand engines
all food establishment
-smoke belchers
c. Provision of health certificate for food handlers,
cooks, helpers SURFACE AND GROUND WATER POLLUTION
2. DOH Administrative Order NO. 1-2006 -Solid waste disposal
3. Destruction or banning of food unfit for human -Biologically dead rivers
consumption
-Use of fertilizers and pesticides
4. Training of food handlers and operators on food
sanitation CAPACITY FOR MONITORING ENVIRONMENTAL
QUALITY
5. Rating and classification of food establishment
CAPACITY FOR DATA COLLECTION AND
Class A- Excellent
PROCESSING
Class B- Very satisfactory
PROPER HOUSING Housing and the homeless
Class C- Satisfactory
-government provision for social housing to qualified
6. Ambulant food vendor health certificates urban households for informal settlers, homeless and no
income poor.
7. Household sanitation
Diseases related to poor housing
FOUR “RIGHTS” TO FOOD SAFETY
-pulmonary disease
1. Right source
-Tuberculosis
2. Right preparation
-Bronchitis
3. Right cooking
-pneumonia
4. Right storage
OTHER ENVIRONMENTAL HEALTH SERVICES
ENVIRONMENTAL QUALITY
ELECTRICITY
Air pollution
FIREFIGHTING AND MERGENCY EQUIPMENT
Respiratory disease related to outdoor air pollution
TRANSPORT RELATED ISSUE
-COPD
-traffic crashes
-Bronchitis
-traffic accidents injuries
-Chronic Cough
*Road safety is still an important concern in the
-Chronic phlegm
Philippines
-Wheezing