DOH PROGRAM

Trust in the Lord with all your heart and lean not on your own understanding
Prov 3:5

Objectives:
At the of discussion students will be able:
1.To know what are the DOH Programs

DOH Programs Related to Family Health

A. Expanded Program of
Immunization (EPI)
B. Integrated Management of
Childhood Illnesses (IMCI)
C. Early Essential Intrapartal and
Newborn Care (EEINC)
D. Newborn Screening
E. BEmONC/CEmONC
F. Nutrition
G. MhGap
H. Other Related Programs

EXPANDED PROGRAM ON IMMUNIZATION

•National Immunization Program
•PD 996 compulsory immunization
•RA 7846 HEPA B VACCINATION
•PP 1066 TETANUS ELIMINATION
•PP773 KNOCK OUT POLIO CAMPAIGN
•RA10152 INFANT AND CHILD HEALTH IMMUNIZATION

TETANUS TOXOID IMMUNIZATION FOR PREGNANT WOMAN:

•TT is given not only to protect the mother from tetanus but also to prevent occurrence of
neonatal tetanus
•TT is 0.5 ml given IM at the deltoid region of the upper arm

VACCINE INTERVAL PROTECTION DURATION

TT1 AS EARLY AS POSSIBLE ----- ----

TT2 AFTER 4 WEEKS 80% 3YRS
TT3 AFTER 6 MONTHS 95% 5YEARS
TT4 AFTER 1 YR 99% 10YRS
TT5 AFTER 1 YR 99% LIFETIME

•Because of the global burden om child morbidity and mortality expanded program on immunization was developed
•It primarily focusses on reaching the bright goal of fully immunized child (fic) and to improve the rate for child protected at
birth (cpab) in the country
•Epi was established to ensure the access of infant and children (0-12 months old) to the recommended vaccines which return
could prevent the seven common diseases ; tuberculosis, poliomyelitis, diptheria, tetanus, pertussis or whooping cough,
measles and hepatitis.

REPUBLIC ACT NO. 10152

•AN ACT PROVIDING FOR MANDATORY BASIC IMMUNIZATION SERVICES FOR INFANTS AND CHILDREN, REPEALING FOR THE
PURPOSE PRESIDENTIAL DECREE NO. 996, AS AMENDED
•SECTION 1. Title.—This Act shall be known as the “Mandatory Infants and Children Health Immunization Act of 2011”.
•SEC. 2. Declaration of Policy
•SEC. 4. Education and Information Campaign
•SEC. 5. Obligation to Inform.
•SEC. 6. Continuing Education and Training of Health Personnel.
•SEC. 7. Appropriations.(The Philippine Health Insurance Corporation (PHIC) shall include the basic immunization services in
•its benefit package)
•SEC. 8. Implementing Rules and Regulations
•SEC. 9. Separability Clause.
•SEC. 10. Repealing Clauss.
•SEC. 11. Effectivity.
EPI PRINCIPLE
•The program is based on epidemiological situation: schedules are drawn on the basis of occurrences and characteristic
features of the said diseases
•The whole community rather that just an individual is to be protected, thus mass approach is applied
•Immunization is basic health services and as such, it is integrated into the health services provided for by the RHU
•IMMUNIZATION- is a process by which vaccines are introduce to the body, before infectious sets in
EPI ELEMENTS
1.Target setting (0-12 mos.)
2.Cold chain management (for vaccine life span and utilization)
3.Information, education and communication
Three reasons:
a. for parents to be motivated to submit their child to immunization
b. to provide health teachings on benefits and importance of immunization
c. to inform the public about its availability and schedule(RHU every Wednesday, BHS every once a month, and
remote area every quarterly)
4. Assessment and evaluation of the programs over all performance
5. Surveillance, studies and research

Bacille Calmette-Guérin (BCG)

• Given intradermally (ID)
• The dose of BCG is 0.05 ml for children < 12 months of age and 0.1 ml for children > 12 months of age
• Given at the earliest possible age after birth preferably within the first 2 months of life
• For healthy infants and children > 2 months who were not given BCG at birth, PPD prior to BCG vaccination is not
necessary.

BCG Vaccines
• Given at birth = 0.05ml intradermal at right deltoid
• INTERVAL= GIVEN ONCE
• Booster school entrance= 0.1ml at left deltoid

Side effects of BCG:

•Koch ‘s phenomenon- acute inflammatory process starting within 24 hours and may last for 2-4 days. Wheal must disappear
in about 30 mins to 1hr.
•Abscess formation- 1st week (soreness and inflammation), 2nd week to 11th week healing of abscess and ulceration. If no
scar develop repeat the procedure after 2 months
•Indolent ulceration : wrong technique, or exposure of infant to patient with active TB
•Glandular enlargement: unsterile syringe or needle was used, too much vaccine was injected, the vaccine might be injected
under the skin layer, and not instead in its superficial layer
Management: incision and drainage: isoniazid

Hepatitis B Vaccine (HBV)

• Given intramuscularly (IM)
• Administer the first dose of monovalent HBV to all newborns >2kgs within 24 hours of life.
• A 2nd dose is given 1-2 months after the birth dose
• The final dose is administered not earlier than 24 weeks of age. Another dose is needed if the last dose was given at age <24
weeks.

For infants born to HBsAg (+) mothers:

• Administer HBV and HBIG (0.5ml) within 12 hours of life. HBIG should be administered not later than 7 days of age if not
immediately available
Haemophilus influenzae Type b Conjugate Vaccine (Hib)
• Given intramuscularly (IM)
• Given as a 3-dose primary series with a minimum age of 6 weeks and a minimum interval of 4 weeks
• A booster dose is given between 12-15 months of age with an interval of 6 months from the 3rd dose Refer to Vaccines for
Special Groups for Hib recommendation in high risk children

Diphtheria and Tetanus Toxoid and Pertussis Vaccine (DTP)

• Given intramuscularly (IM)
• Given at a minimum age of 6 weeks with a minimum interval of 4 weeks
• Complete a 5-dose series at ages 2, 4, 6, 15 through 18 months, and 4 through 6 years. The recommended interval between
the 3rd and 4th dose is 6 months, but a minimum interval of 4 months is valid

Inactivated Poliovirus Vaccine (IPV)

• Given intramuscularly (IM)
• Usually given in combination with DTaP and Hib, with or without Hep B
• Given at a minimum age of 6 weeks with a minimum interval of 4 weeks
• The primary series consists of 3 doses
• A booster dose should be given on or after the 4th birthday and at least 6 months from the previous dose

Rotavirus Vaccine (RV)

• Given per orem (PO)
• Given at a minimum age of 6 weeks with a minimum interval of 4 weeks between doses. The last dose should be
administered not later than 32 weeks of age.
• The monovalent human rotavirus vaccine (RV1) is given as a 2-dose series and the pentavalent human bovine rotavirus
vaccine (RV5) is given as a 3-dose series.

Pentavalent vaccines:
Compose of : DPT, HEP B. HIB-MENINGITIS
Given at upper outer portion of the thigh intramuscularly 0.5 ml
3 doses
1st dose given at 6 weeks
2nd dose given at 10 weeks
3rd dose given at 14 weeks
4 weeks interval

Pneumococcal Conjugate Vaccines (PCV)

• Given intramuscularly (IM)
• Given at a minimum age of 6 weeks for PCV10 and PCV 13
• Primary vaccination consists of 3 doses with an interval of at least 4 weeks between doses plus a booster dose given 6
months after the 3rd dose.
• Healthy children 2 to 5 years old who do not have previous PCV vaccination may be given 1 dose of PCV 13, or 2 doses of PCV
10 at least 8 weeks apart.Refer to Vaccines for Special Groups for Pneumococcal Vaccine recommendation in high-risk children

PCV( Pneumococcal conjugate vaccine)

=3 dose; 0.5ml
=IM Vastus lateralis
=6week,1oweeks and 14 weeks
=4 weeks interval

MCV
=for measles
2 doses
=0.5ml SQ deltoid
=MCV1(monovalent measles: rubeola) 85% at 9 months
=MCV2(combination: MMR) 95%
=give 12-15 months
Side Effects of Measles Vaccine:
1.Fever and Rashes – for rashes mother mjay giveANTIHISTAMINES (Benadryl) and for itchiness (Calamine Lotion)

Japanese Encephalitis Vaccine (JE)

• Given subcutaneously (SC)
• Given at a minimum age of 9 months
• Children 9 months to 17 years of age should receive one primary dose followed by a booster dose 12-24 months after the
primary dose
• Individuals 18 years and older should receive a single dose only

Hepatitis A Vaccine (HAV)

• Given intramuscularly (IM)
• Given at a minimum age of 12 months
• 2 doses of the vaccine are recommended
• The 2nd dose is given at least 6 months from the 1st dose

HPV VACCINE
3 DOSES IM DELTOID
1ST FROM 10-18 YEARS OLD
2ND AFTER 1 MONTH
3RD AFTER 5 MONTHS

I can do all things through Christ who strengthens me

Philippians 4:13
 Integrated management of childhood illness chart booklet

EARLY ESSENTIAL INTRAPARTUM AND NEWBORN CARE(EEINC)

Is a package of evidence-based practices recommended by the Department of Health (DOH), Philippine Health Insurance
Corporation (PhilHealth), and the WHO as the standard of care in all births by skilled attendants in all government and private
setting

FROM 0-30 SECONDS 1 minute

3 minutes 90 minutes
Have I not commanded you? Be strong and courageous, do not be frightened, and do not be dismayed, for- GOD IS WITH
YOU WHEREVER YOU GO.
JOSHUA 1:9

•Newborn screening laws RA 9288

•Within 48-74 hours
•
•To determine: basic
•Congenital adrenal hyperplasia
•Congenital hypothyroidism
•Galactosuria
•G6PD
•MSUD
•PKU

EXPANDED NBS
•ENBS Allows the detection of more genetic disorder

•The expanded newborn screening program increased the screening panel of disorders from
six (6) to more than twenty-eight.

•Aside from the six conditions in the present panel

•Congenital Hypothyroidism,
•Congenital Adrenal Hyperplasia,
•Galactosemia,
•Phenylketonuria,
•Maple Syrup Urine Disease and
• Glucose-6-Phosphate Dehydrogenase deficiency

Expanded newborn screening will screen for additional disorders falling under various groups of conditions namely:
hemoglobinopathies,
disorders of amino acid and organic acid metabolism,
disorders of fatty acid oxidation,
disorders of carbohydrate metabolism,
disorders of biotin metabolism and cystic fibrosis.