INTRODUCTION TO CPH AND HISTORY OF PUBLIC HEALTH

IN THE PHILIPPINES
PUBLIC HEALTH
 Ecological in perspective, multi-sectoral in scope and collaborative in strategy
 It aims to improve the health of community through an organized (planned)community effort
 The science and art of preventing disease, prolonging life and promoting health through the
organized efforts and informed choices of society, organizations, public and private communities
and individuals.
 It is concerned with threats to the overall health of a community based on population health
analysis.
 Public health is typically divided into Epidemiology, Biostatistics and Health services.
Environmental, social, behavioral, and occupational health are other important subfields.

KEY CHARACTERISTICS OF PUBLIC HEALTH

Prevention essentials Management essentials
Promotion of healthy behaviors Person-centered care and support
Prevention of exposure to adverse events and risks Family and community support

Early detection Coordinated, holistic care

Intersectoral collaboration Continuity of care and proactive follow-up

Life course approach

FUNCTIONS OF A HEALTH PROFESSIONAL IN PH

 Monitor the health status of a community to identify potential problems
 Diagnose and investigate health problems and hazards in the community
 Inform, educate, and empower people about health issues, particularly the underserved and those
at risk
 Mobilize community partnerships to identify and solve health problems
 Develop policies and plans that support individual and community health efforts
 Enforce laws and regulations that protect health and ensure safety
 Link people to needed personal health services and ensure the provision of health care when
otherwise unavailable
 Ensure a competent public health and personal health care workforce
 Evaluate effectiveness, accessibility, and quality of personal and population-based health services
 Research new insights and innovative solutions to health problems

PUBLIC HEALTH ACC TO NOTABLE PEOPLE

DR. CHARLES EDWARD AMORY WINSLOW

- American bacteriologist and public health expert. He is the author of American Journal of Public
Health and a consultant in the World Health Organization

Definition: The science and art of preventing disease, prolonging life, promoting health and efficiency
through organized community effort.

DR. JOHN J. HANLON

- Assistant Surgeon General of the US Public Health Services and father of modern public health

Definition: It is dedicated to the common attainment of the highest level of physical, mental and social
well- being and longevity consistent with available knowledge and resources at a given time and
place. It holds this goal as its contribution to the most effective total development and life on the
individual and this society. (Holistic)
LORENCE NIGHTINGALE
- English social reformer and the founder of modern nursing. She trained nurses during the Crimean
war in which she organized care for wounded soldiers at Constantinople

Definition: The act of utilizing the environment of the patient to assist him in his recovery. Any
individual is capable of reparative process.

1. Waldemar Mordechai Wolff Haffkine- credited for the development of anti cholera vaccine in
India. Firs Microbiologist to develop and use vaccines against cholera and bubonic plague victims
2. Jonas Salk- developed the vaccines that eradicated the Polio in most of the parts of the world
3. Alexander Fleming- discovered the Penicillin in 1928
4. Lee Jong Wook- Director General of the WHO. Developed the Global Program for Vaccines and
Immunization and eradication of Tuberculosis
5. Alice Hamilton- mother of occupational epidemiology
6. Edward Jenner- developed the small pox vaccine
7. Clara Barton- founded the American Red Cross
8. Margaret Sanger- Mother of family planning

THE COMMUNITY
It is a group of people with common characteristics or interests living together within a territory or
geographical (physical) boundary.
a social group of any size whose members reside in a specific locality, share government, and often
have a common cultural and historical heritage.

COMMUNITY HEALTH- is a medical practice which focuses on people's well-being in a particular

geographical area. This essential public health sector covers programs to help neighborhood members
in protecting and improving their health, deter the transmission of infectious diseases, and plan for
natural disasters.

TYPES OF COMMUNITY DISEASES BASED ON PREVALENCE

ENDEMIC- disease outbreak that is consistently present but limited to a particular region. This
makes the disease spread and rates predictable.
Eg: Malaria in Palawan

EPIDEMIC- unexpected increase in the number of disease cases in a specific geographical area
Eg: The 1961 Cholera epidemic in Manila, 2003 SARS in Southeast Asian Countries

PANDEMIC- when a disease’s growth is exponential. This means growth rate skyrockets, and each
day cases grow more than the day prior.
Eg: COVID19, 1918 Spanish Flu

SPORADIC- occurs only infrequently, haphazardly, irregularly or occasionally from time to time
in a few isolated places with no discernible temporal or spatial pattern, as opposed to a recognizable
epidemic or endemic pattern
Eg: Flu during winter season, Diarrhea during rainy season

THE COMMUNITY- AS A CLIENT

 The community is the client only when the health practitioner focus is on the collective or
common good of the population instead of on individual health. Population-centered practice
seeks healthful change for the whole community’s benefit.
 Although the practitioner may work with individuals, families or other interacting groups,
aggregates, or institutions, or within a population, the resulting changes are intended to affect the
whole community.
 The community client also highlights the complexity of the change process. Change for the
benefit of the community client must often occur at several levels, ranging from the individual to
society as a whole.

HEALTH
As per World Health Organization, Health is a state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity.

2 MAJOR TYPES OF HEALTH

1. PHYSICAL HEALTH- Physical well-being involves pursuing a healthful lifestyle to decrease the
risk of disease. Maintaining physical fitness, for example, can protect and develop the endurance of a
person’s breathing and heart function, muscular strength, flexibility, and body composition.

2. MENTAL HEALTH- refers to a person’s emotional, social, and psychological well-being. Mental
health is as important as physical health as part of a full, active lifestyle.
**Spiritual, emotional, and financial health also contribute to overall health. Medical experts have
linked these to lower stress levels and improved mental and physical well-being.

HEALTH-ILLNESS CONTINUUM MODELS

DUNN’S HIGH LEVEL WELLNESS GRID

- describes a health grid in which a health axis and an environmental axis intersect. The grid
demonstrates the interaction of the environment with the illness-wellness continuum.
- The axis extends from peak wellness to death, and the environment axis extends from very
favorable to very unfavorable. The intersection of the two axes forms four quadrants of health and
wellness.

 High-level wellness in a favorable environment: Example is a person who implements healthy

lifestyle behaviors and has the biopsychosocial, spiritual, and economic resources to support his
lifestyle.
 Emergent high-level wellness in an unfavorable environment: Example is a woman who has the
knowledge to implement healthy lifestyle practices but does not implement adequate self-care
practices bec of family responsibilities, job demands, or other factors.
 Protected poor health in a favorable environment: Example is an ill person whose needs are met
by the health care system and who has access to appropriate medications, diet, and health care
instruction.
 Poor health in an unfavorable environment: Example is a young child who is starving in a
drought-stricken country.

TRAVIS’ ILLNESS- WELLNESS CONTINUUM

- Ranges from high-level wellness to premature death. It demonstrates two arrows pointing in
opposite directions and joined at a neutral point. Movement to the right of the neutral point indicates
increasing levels of health and well-being for an individual.
- In contrast, movement to the left of the neutral point indicates progressively decreasing levels
of health and premature death.

VARIABLES INFLUENCING HEALTH STATUS, BELIEFS AND

PRACTICES
 INTERNAL VARIABLES- include those which are usually non-modifiable such as :
 Biologic dimension - genetic makeup, sex, age, and developmental level all significant to a
person’s health.
 Psychological dimension - emotional factors which include mind-body interactions and self-
concept.
 Cognitive dimension - intellectual factors which include lifestyle choices and spiritual and
religious beliefs.
 EXTERNAL VARIABLES- the macrosystem which include:
 Environment- geographical locations determine climate, and climate affects health;
environmental hazards.
 Economics- standards of living reflecting occupation, income and education is related to health,
morbidity and mortality.
 Family and cultural beliefs- the family passes on life patterns of daily living and lifestyles to off
springs (e.g. physical/emotional abuse or climate of open communication). Culture and social
 interactions also influence how a person perceives, experiences, and copes with health and
illness.

HISTORY OF PUBLIC HEALTH

based on socio-political periods
 Spanish Occupation
 Pre-American Occupation ( up to 1898 )
 American Military Government ( 1898-1907)
 Philippine assembly (1907-1916)
 The Jones law (1916-1936)
 The Commonwealth (1936-1941)
 Japanese occupation ( 1941-1945)
 Post World war II (1945-1972)
 Martial Law Years
 Post EDSA revolution (1986 to present)
1. SPANISH OCCUPATION
-Creation of vaccinators to prevent small pox
Creation of Board of Health
Hospital Real was built in Cebu 1565
First Medical School in the Philippines was established-UST
School of Midwifery, Forensic Medicine and Public Health Laboratory was established

2.PRE-AMERICAN OCCUPATION
1577- Public health began at the old Franciscan Convent in Intramuros where Fr. Juan Clemente put
up dispensary for treating indigents in Manila.
1578- San Juan De Dios Hospital was erected
Hospital de San Lazaro was rehabilitated from Hospital de Naturales

HOSPITALS THAT WERE ERECTED BEFORE THE AMERICANS CAME

1.GENERAL HOSPITALS
San Juan de Dios
Chinese General Hospital
Hospicio de San Jose in Cavite
Casa dela Caridad in Cebu
Enfermeria de Sta. Cruz in Laguna

2.CONTAGIOUS HOSPITALS
-San Lazaro Hospital
-Hospital de Palestina in Camarines Sur
-Hospital delos Lesporosos in Cebu
-Hospital de Argencina in Manila for smallpox and cholera

3.AMERICAN MILITARY GOVERNMENT ERA

-Control of epidemics such as cholera, small pox and plague
-Fight against communicable diseases such as common cold, Hepa A-D, chickenpox, SARS, flu,
mumps, malaria, herpes, STD, measles
-Garbage crematory
-First sanitary ordinance and rat control
-Cholera vaccine was first tried
-Confirmed that plague in man comes from infected rat
-Opened the UP College of Medicine
-Established Bureau of Science

4.PHILIPPINE ASSEMBLY ERA

Hygiene and Physiology were included in curriculum of public elementary school
Anti-TB campaign was started
Philippine Tuberculosis Society was organized
Opening of PGH (Phil. Gen. Hospital)
Use of anti-typhoid vaccine was initiated
Dry vaccine against small pox was first use

5. JONES LAW YEARS

-retrogression rather than progressio in sof far as the health was concern
1. Increase communcable disease report
2. Increase infant moertality rate
3. Increase modbidity
-increase death from small pox, cholera, thyphoid,malaria and TB
-Re-organized happened (reorganized the health service and encouraged effective supervision)
-Study the cause and prevalence of typhoid fever
-Schick test was used to determine the causes of diphtheria
-Campaign against Hookworm was launched
-Anti-dysentery vaccine was first tried
-First training course for sanitary inspector was given
-Women and child labor law was passed
-Mechanisms of transmission of dengue fever through Aedes aegypti was studied
-Establishment of School of Hygiene and Public Health
-National Research Council of the Philippines was organized
-BS in Education Major in Health Education was opened in UP
-(PPHA) Philippine Public Health Association was organized

6. COMMONWEALTH PERIOD
The epidemiology of life threatening disease was studied- diphtheria, yaws, dengue
Research in the field of health was promoted
UP School of Public Health was established
Development of Maternal and Child Health (MCH)
1939– Creation of Dept. of Public Health and Welfare- Dr. Jose Fabella as the First secretary
1940- Bureau of Census and Statistics was created to gather vital statistics
In spite of development
Inequitable distribution of health services remained
a problem
80% of those who died were never given medical attention

7. JAPANESE OCCUPATION AND WORLD WAR II

- During this time, all public health activities were practically paralyzed.
- Increase incidence of TB, venereal diseases, malaria, leprosy and malnutrition.

8. POST WORLD WAR II

- Completion of a research on Dichlorodiphenyltricholorothanel (DDT-as larvicidal/insecticide to
control malaria)
- Introduction of one-infection method for gonorrhea with penicillin
- Manila was selected as Headquarters for World Health Organization (WHO) Western Pacific Office
- Strengthening Health and Dental services in rural areas (per municipalities with 5,000-10,000
population)

9. MARTIAL LAW YEARS

- Creation of National Economic Development Authority
-Department of Health was renamed as Ministry of Health (MOH)
-Formulation of National Health Plan
-Adaptation of the Primary Health Care. Philippines was the first country to implement PHC
-Launching of Operation Timbang and Mother craft Nationwide providing supplementary food for
infants, pre-school school children ***Nutribun
-Construction of Tertiary Hospitals- PHC, NKTI, Lung Center, Lungson ng Kabataan (now PCMC)
- Progress in Public Health research
RITM- Research Institute for Topical Medicine
PCHRD- Philippine Council for Health Research and Development

10. POST EDSA REVOLUTION YEARS

A. AQUINO ADMINITRATION
1987 Constitution- more provisions on health making comprehensive health care available
Milk code- required the marketing of breast feed milk substitute
Universal child and mother immunization
RA. 6725- Act prohibiting discrimination against women
NESS- National Epidemic Surveillance System
RA. 6675- National Drug Policy and Generics Act
RA. 7170- Organ Donation Act

B. RAMOS ADMINISTRATION
- Health in the Hands of People” and “Let‟s DOH it”- by Sen Juan Flavier
- Memorable initiative during leadership of Flavier
› National Immunization Day
BCG (Bacille Calmette-Guérin (BCG) is a live strain of Mycobacterium bovis developed by Calmette
and Guérin for use as an attenuated vaccine to prevent tuberculosis and other mycobacterial
infections.)
DPT (diphtheria, pertussis(whooping cough) and tetanus)
OPV –Oral Polio Vaccine
MMR- Immunization shot against measles, mumps, and rubella (also called German measles)
› Promotion of Traditional Medicine- Herbal Medicine
› Yosi Kadiri
› Araw ng Sangkap Pinoy- aimed to prevent Vitamin A, Iron and Iodine deficiency
› Voluntary Blood Donation Program
› Kung Sila’y Mahal Mo Magplano- Family Planning Program
› Doctors to the Barrio

C. ESTRADA ADMINISTRATION
Envionmental sanitation program
Hospital waste management program
Rural Water Supply and Sanitation project
National AIDS prevention program
National TB control program
Malaria Control Program
National Rabies Control Program
National Dengue Prevention Program

D. ARROYO ADMINISTRATION
-The Philippine Health Insurance Corp. (PhilHealth) replaced the Medicare system and was created
under the National Health Insurance Act of 1995.
-free or subsidized hospitalization and other medical assistance to government and private sector
employees and indigent families.
-