BACHELOR OF SCIENCE IN PHARMACY:

INTRODUCTION TO THE HEALTH CARE

SYSTEM
INTRODUCTION TO THE PCAR111
COURSE TITLE COURSE CODE
HEALTH CARE SYSTEM
COURSE PREREQUISITE/S/CO- None
CREDIT UNITS 2 Units
REQUISITE
First Year, First
CONTACT HOURS 2 Hours Lecture COURSE PLACEMENT
Semester
Rationale: This course is designed to introduce the basics of Health Care System and its
importance in delivering health care services based on health needs of target population.

Focus: This course covers fundamental concepts of Health Care System and its goal towards
universal health care including basic principles of Primary Health Care, components of health
care delivery system, health care services provider, resources of health care, accreditation
COURSE DESCRIPTION
bodies, and the status of Philippine Health Care System which includes Health sectors,
programs and initiatives established by the government.

Outcomes: At the end of the course, students are expected to demonstrate competency in
applying fundamental concepts of Health Care System particularly in establishing better policies
in delivering health services.
 COURSE GUIDE:

Topics Activity
Course Orientation, OLFU and College Vision, Mission,1. Online Orientation
Core Values 2. Assignment no. 1
Basic Principles of Primary Health Care 1. Online Lecture
2. Discussion Board no. 1
Importance of Health Care System 1. Online Lecture
2. Quiz no.1
3. Assignment no. 2
Components of Health Care System 1. Online Lecture
Health Care Process 1. Online Lecture
2. Quiz no. 2
3. Assignment no. 3
PRELIMINARY EXAMINATION
Health sectors governing Health Care System 1. Online Lecture
2. Discussion Board no. 2
3. Quiz no. 3
Accrediting bodies/organization for Health Care 1. Online Lecture
Systems 2. Assignment no. 4
Stages and Needs of Human Life 1. Online Lecture
2. Assignment no. 5
Wellness and Illness 1. Online Lecture
2. Quiz # 4
MIDTERM EXAMINATION
Factors Affecting Health Care Systems 1. Online Lecture
2. Quiz no. 5
3. Assignment no. 6
Status of Health Care System in the Philippines 1. Online Lecture
2. Discussion Board no. 3
3. Quiz no. 6
The Role of Pharmacists in the Health Care Delivery 1. Online Lecture
System 2. Assignment no. 6
Extended pharmacy services in the Health Care System 1. Online Lecture
Philippine Pharmacists’ Advocacy Programs 2. Quiz no.7

FINAL EXAMINATION

CHECKLIST:
ü Read course and unit objectives
ü Read study guide prior to class attendance
ü Read required learning resources; refer to unit
terminologies for jargons
ü Proactively participate in discussions
ü Participate in weekly discussion board (Canvas)
 ü Answer and submit course unit tasks

TOPIC 1: Basic Principles of Primary Health Care

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Define Health care and Primary Health Care
2. Understand the rationale and goal behind Primary Health Care.
3. Understand the importance of Health Care System
4. Describe the Main areas of Primary Health Care
5. Differentiate the Levels of Health Care
6. Familiarize with the Principles of Primary Health Care

REQUIRED READINGS
l http://triotree.com/blog/healthcare-primary-secondary-and-tertiary-brief-description/

RELATED LINKS AND VIDEOS:

l What is primary healthcare? (https://www.youtube.com/watch?v=a3UhtiAwbog)
l Primary Health Care (https://www.youtube.com/watch?v=1l_PHw3rrp8)
l US Healthcare System Explained (https://www.youtube.com/watch?v=DublqkOSBBA)

l
NOTES:
TERMINOLOGIES:
l HEALTH CARE - Is the various services for the prevention or treatment of illness and injuries
The set of services provided by a country or an organization for the treatment of the physically and the
mentally ill.
l PRIMARY HEALTH CARE - Is about caring for people, rather than simply treating specific
diseases or conditions. Is on essential part of health care and its main principles are equity, health
promotion and disease prevention, community participation, appropriate health technology and
multisectoral approach.

HISTORY
n WHO-UNICEF held international conference in 1978 at Alma-Ata (USSR), the governments of 134
countries and many voluntary agencies called for a revolutionary approach to health care.
n The Alma-Ata Conference defined PHC as follows:
"Primary health care is essential health care based on practical, scientifically sound, and socially
acceptable methods and technology made universally accessible to individuals and families in
 the community through their full participation and at a cost the community & country can afford
to maintain at every stage of their development in the spirit of self determination".
n The Declaration of Alma-Ata states that “PHC involves in addition to the health sector, all related
sectors & aspects of national & community development, in particular agriculture, animal
husbandry, food, industry, education, housing, public works, communication & others sectors“.

PRIMARY HEALTH CARE is equally valid for all countries, although it takes varying forms in each of
them.
n The concept of PHC has been accepted by all countries as the key to the attainment of HFA
(Health For All). It is accepted as an integral part of the country's health system.
n Primary Health Care is essential health care made universally accessible to individuals and
acceptable to them, through full participation and at a cost the community and country can
afford
n MAIN AREAS of PHC:
l Empowered People and Communities
l Multisectoral Policy and Action
l Primary care and essential Public Health functions as the core of the integrated health
services
n Differences in PHC depends on:
l Needs of the residents
l Availability of Health care providers
l The communities geographic location
l Proximity to other health care services in the area.

DIFFERENT LEVELS OF HEALTH CARE

l PRIMARY HEALTH CARE

ü The “first” level of contact between the individual and the health system.
ü Essential health care (PHC) is provided.
ü A majority of prevailing health problems can be satisfactorily managed.
ü The closest to the people.
ü Provided by the primary health centers
l SECONDARY HEALTH CARE
ü More complex problems are dealt with.
ü Comprises curative services
ü Provided by the district hospitals
ü The 1st referral level
l TERTIARY HEALTH CARE
ü Offers super-specialist care
ü Provided by regional/central level institution.
ü Provide training programs

PRINCIPLES of PRIMARY HEALTH CARE

1. Equitable distribution
l Health services must be shared equally by all people irrespective of their ability to pay.
l TO ENSURE EQUITY:
n The population to be served must be known.
n The vulnerable groups are to be identified & reached.
n The health services (not necessarily health centers) have to be dispersed into:
l The farthest remote rural areas.
l The deepest parts of the underserved urban population.
l The failure to reach the needy & the majority is usually due to limited geographical
access.
n The accessibility has to be improved by :
l Increasing the number of health facilities.
l Improving transport conditions.
l Organizing outreach services, thus substituting one when the other is not available.
l PHC aims to:
n Correct imbalance in accessibility
n Bring health services as near to people's homes as possible.
n To achieve this, PHC is supported by higher level of health care to which patients can be
referred for extended care.

2. Community participation
l Involvement of individuals, families, & communities in promotion of their own health & welfare.
l There must be a continuing effort to secure meaningful involvement of the community in:
n Planning
n Implementation
n Maintenance of health services
n Evaluation of health services.
n Maximum reliance on local resources such as: Manpower, Money and Materials.

3. Intersectoral coordination
l There is an increased realization of the fact that the components of PHC cannot be provided by the
health sector alone.

4. Appropriate technology
l TECHNOLOGY that is scientifically sound, adaptable to local needs, & acceptable to those who
apply it & those for whom it is used, & that can be maintained by the people themselves in keeping
with the principle of self reliance with the resources the community & country can afford.
l HEALTH TECHNOLOGIES are needed in:
ü Diagnostic maneuvers.
ü Therapeutic maneuvers.
ü Disease prevention.
ü Disease control.
ü Health promotion.
 TOPIC 2: Importance of Health Care System
EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Understand the importance of Health care system.
2. Differentiate the different types of health care facilities.
3. Familiarize with the different Health care services and providers.
4. Understand the Components of Health care delivery system.

REQUIRED READINGS
l https://www.researchgate.net/publication/257830385_The_Role_and_Organization_of_Health_Care_Systems

RELATED LINKS AND VIDEOS:

l Philippine Health Care Delivery System (https://www.youtube.com/watch?v=EHoUEX0gjCQ)

NOTES:
l Importance of Health Care System
ü It facilitate documentation of data, diagnosis, plans, client responses and evaluation.
ü It evaluates the efficiency and effectiveness of care
ü It gives directions, guidance, and planning to healthcare
ü It provide for continuity of care and to reduce omissions
ü It individualize client participation in care
ü It promotes creativity and flexibility in health care practices.

l Health care facilities

1. Primary Health Care Facilities
a) The rural health units
b) Their sub-centers
c) Chest clinics
d) Malaria eradication units and schistosomiasis control units operated by the DOH
e) Puericulture centers operated by League of Puericulture Centers
f) Tuberculosis clinics and hospitals of the Philippine Tuberculosis Society
g) Private clinics, clinics operated by the Philippine Medical Association
h) Clinics operated by large industrial firms for their employees
i) Community hospitals and health centers operated by the Philippine Medicare Care
Commission;
j) Other health facilities operated by voluntary religious and civic groups
 2. Secondary Health Care Facilities
Ø are the smaller, non-departmentalized hospitals including emergency and regional hospitals.
Ø Services offered to patients with symptomatic stages of disease, which require moderately
specialized knowledge and technical resources for adequate treatment.

3. Tertiary Health Care Facilities

Ø the highly technological and sophisticated services offered by medical centers and large
hospitals.
Ø These are the specialized national hospitals.
Ø Services rendered at this level are for clients afflicted with diseases which seriously threaten
their health and which require highly technical and specialized knowledge, facilities and
personnel to treat effectively

l Health care Providers

Ø Members of the administrative staff schedule the appointment, find the medical record, make a
reminder call, greet the patient and verify insurance information.
Ø A nurse or medical assistant record the patient's weight and vital signs, escort the patient to an
exam room and record the reason for the visit.
Ø The PCP may be a doctor, physician's assistant or nurse practitioner who examines and talks
with the patient to develop a diagnosis and plan of care.
Ø If a lab or radiology test is ordered, a technician performs the test. Administrative staff may help
ship out the sample (blood, skin, saliva), a lab will perform the analysis and write up the test
results.
Ø The technician, nurse, or doctor will discuss the results with the patient. If treatment, such as
Ø medication is prescribed, a pharmacist fills the prescription.Medical billing experts then bill the
patient's insurance for the office visit and either the test or the medication.

TOPIC 3: Components of Health Care System

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Determine the Essential Components of Health Care
2. Identify the Five Common Short Comings of Health Care Delivery
3. Enumerate the Basic Requirements for Sound PHC
4. Understand the Strategies of Primary Health Care
5. Understand the Health Care System and its goals
6. Differentiate the Health Care System in an Urban and Rural Areas

REQUIRED READINGS
• https://www.who.int/healthsystems/publications/hss_key/en/
 RELATED LINKS AND VIDEOS:
l What is primary healthcare? (https://www.youtube.com/watch?v=a3UhtiAwbog)
l Primary Health Care (https://www.youtube.com/watch?v=1l_PHw3rrp8)
l US Healthcare System Explained (https://www.youtube.com/watch?v=DublqkOSBBA)

NOTES:
TERMINOLOGIES
l HEALTH SYSTEM
ü A health system is the combined entity of all resources, actors and institutions related to the
financing, regulation and provision of all activities whose primary intent is to improve or maintain
health (WHO, 2000)

l HEALTH CARE SYSTEM

ü Is an arrangement in which health care is delivered. There are many variations health care
systems around the world. (WHO)

l HEALTH CARE DELIVERY SYSTEM

ü refers to the totality of resources that a population or society distributes in the organization and
delivery or health services. It also includes all personal and public services performed by
individuals or institutions for the purpose of maintaining or restoring health. (Stanhope 2001)

l 8 ESSENTIAL COMPONENTS OF HEALTH CARE

1. Health education concerning prevailing health problems & the methods of preventing &
controlling them.
2. Promotion of food supply & proper nutrition
3. An adequate supply of safe water & sanitation.
4. Maternal & child health care.
5. Immunization against major infectious diseases.
6. Prevention & control of locally endemic diseases.
7. Appropriate treatment of common diseases & injuries.
8. Provision of essential drugs.
l ELEMENTS OF PRIMARY HEALTH CARE

Education

Drug Water and

Availability Sanitation

Treatment ELEMENTS Nutrition

Prevention Maternal
of endemic and Child
disease Health
Immunization

l FIVE COMMON SHORT COMINGS OF HEALTH CARE DELIVERY

1. Inverse Care
2. Impoverishing Care
3. Fragmented and Fragmenting Care
4. Unsafe Care
5. Misdirected Care

l THE BASIC REQUIREMENTS FOR SOUND PHC (THE 8 A’S AND THE 3 C’S)
ü Appropriateness
ü Availability
ü Adequacy
ü Accessibility
ü Acceptability
ü Affordability
ü Assessability
ü Accountability
ü Completeness
ü Comprehensiveness
ü Continuity

l STRATEGIES of PHC
1. Reducing excess mortality of poor marginalized populations:
Ø PHC must ensure access to health services for the most disadvantaged populations, and focus
on interventions which will directly impact on the major causes of mortality, morbidity and
disability for those populations.

2. Reducing the leading risk factors to human health:

Ø PHC, through its preventative and health promotion roles, must address those known risk
factors, which are the major determinants of health outcomes for local populations.

3. Developing Sustainable Health Systems:

Ø PHC as a component of health systems must develop in ways, which are financially
sustainable, supported by political leaders, and supported by the populations served.
 4. Developing an enabling policy and institutional environment:
Ø PHC policy must be integrated with other policy domains, and play its part in the pursuit of
wider social, economic, environmental and development policy.

l GOALS OF HEALTH CARE SYSTEM

ü Good health
ü Responsiveness to the expectations of the population
ü Fair financial contribution
ü Health care system in an urban and rural areas

TOPIC 4: Health Care Process

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Determine the different Health care Processes and its components
2. Understand the Purpose of healthcare processes
3. Enumerate the Characteristics of Healthcare Processes
4. Define the Pharmaceutical Care
5. Explain the Pharmaceutical Care Processes
6. Differentiate the different Dimensions of Health

REQUIRED READINGS
• https://qualitysafety.bmj.com/content/20/Suppl_1/i41

RELATED LINKS AND VIDEOS:

l Pharmacists Taking an Active Role in Health
(https://www.youtube.com/watch?v=9x4TKx6gsxo)
l The pharmacist's role in healthcare: Mayo Clinic Radio
(https://www.youtube.com/watch?v=znSNgwnnLZQ)

NOTES:
l HEALTH CARE PROCESSES
Ø Healthcare process is a deliberate activity whereby the practice of a Health Worker is performed in
a systematic manner.

l COMPONENTS OF HEALTH CARE PROCESSES

Ø Assessment
Ø Diagnosis
Ø Planning
Ø Implementation
 Ø Evaluation

l PURPOSES OF HEALTHCARE PROCESSES

ü The main purpose of healthcare is to provide a systematic methodology for health worker
practice.
ü To facilitate documentation of data, diagnosis, plans, client responses and evaluation.
ü To evaluate the efficiency and effectiveness of care
ü To give directions, guidance, and planning to healthcare
ü To provide for continuity of care and to reduce omissions
ü To individualize client participation in care
ü To promote creativity and flexibility in health care practices.

l CHARACTERISTICS OF HEALTHCARE PROCESSES

Ø The system is open and flexible to meet the unique needs of client, family, group, or
community.
Ø It is cyclic and dynamic.
Ø It is client centered
Ø It is interpersonal and collaborative.
Ø It is planned.
Ø It is goal directed.
Ø It permits creativity for the healthcare worker and client in devising ways to solve the stated
health problems.
Ø It emphasizes feedback, which leads either to reassessment of the problem or to revision of
the care plan.
Ø It is universally applicable.

l APPLICATION OF HEALTHCARE PROCESSES TO INDIVIDUAL PATIENTS

Ø Caring for the individuals working with more than the client and his or her isolated health
concerns.
Ø The client’s family and significant others, beliefs and background all influence the patients and
subsequent care.
Ø The patient’s perception of health concerns and related responses, reasons for seeking health
care, and expectations of achieving optimum health are essential data in the health care
assessment.
Ø Data reflecting the client’s biographical status and biophysical, psychological, socio-cultural,
and spiritual health are needed to ensure multifocal approach to care.
Ø Health workers use their empirical and personal knowledge, experience and judgment for
determining the type of data to obtain during the assessment.
Ø Data to be collected should be relevant to generate diagnoses for independent health actions.

l PHARMACEUTICAL CARE

Ø Pharmaceutical Care is the responsible provision of drug therapy for the purpose of achieving
definite outcomes that improve a patient’s quality of life.

l OUTCOMES OF PHARMACEUTICAL CARE

ü Cure of the disease
ü Elimination or reduction of symptoms
ü Arresting or slowing disease processes
ü Prevention of a disease or symptomatology
l PHARMACEUTICAL CARE PLAN
Ø Pharmaceutical care is provided to ensure patient’s benefit and quality of care.

l THE PHARMACEUTICAL CARE PROCESS

1. Determining the Patient’s Health Care Needs
a) Gather background information
Ø Sources:
1. Patient encounter
2. Patient interview
3. Physical assessment of patient
4. Patient’s medical chart or profile
5. Review of laboratory tests results
6. Other healthcare professionals caring for the patient
7. Family members and caregivers who are not healthcare professionals.
b) Apply clinical reasoning
Ø Develop the problem list
Ø Determine therapeutic options

2. Designing the Patient’s Care Plan

a) Specify goals
b) Design pharmacotherapeutic regimen
c) Design monitoring plan
d) Determine the amount of support necessary

3. Implementing the Patient Care Plan

a) Recommend the regimen
b) Initiate care and monitoring plan

4. Assessing the Patient’s Response to Care

a) Evaluate the results/outcomes from the implementation of the plan
b) Redesigning the patient care plan based upon patient progress and outcomes
c) Document changes, progress and outcomes as needed

l DIMENSIONS OF HEALTH
Different factors affecting health:
Ø Physical health
n Genetic make-up, age, developmental level, race, sex are all part of an individual’s
physical dimension and strongly influence health status and health processes.

Ø Emotional Health
n This refers to the way the mind and body interacts to affect body function and respond
to body conditions also influence health. Long-term stress affects the body systems
and anxiety affects health habits; conversely, calm acceptance and relaxation can
actually change body responses to illness.

Ø Intellectual health
n This encompasses cognitive abilities, educational background and past experiences.
This influence a patient’s responses to teaching about health and reactions to
healthcare during illness. Intellectual dimensions also play a major role in health
behaviors.
 Ø Spiritual health
n Spiritual and religious beliefs and values are important components of a person’s
behavior regarding health and illness.

Ø Socio-cultural health
n Health practices and beliefs are strongly influenced by a person’s economic level, life
style, family and culture. Low income groups are less likely to seek health care to
prevent or treat illness; high income groups are more prone to stress related habits
and illness. The family and the culture to which the person belong determine patterns
of living and values about health and illness that are often unalterable.

Ø Occupational Safety and Health

n It is the promotion and maintenance of the highest degree of physical and social well-
being of workers in all occupations; it calls for the prevention of any impairment in the
health and well-being of workers caused by their working conditions or work
environment.

TOPIC 5: HEALTH SECTORS GOVERNING HEALTH CARE SYSTEM

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Understand the Health system and Health sector in the Philippines
2. Enumerate and explain the differences and similarities of different Healthcare sectors in the
Philippines
3. Understand the top ten cause of the Mortality in the Philippines

REQUIRED READINGS
l https://www.who.int/healthsystems/topics/stewardship/en/

RELATED LINKS AND VIDEOS:

l Philippine HealthCare System (https://www.youtube.com/watch?v=ocLQVBjFy58)
l

NOTES:
l HEALTH SYSTEM
Ø is a functional network of health-care providers, including public sector and privately-run services,
which range from traditional healers to the most technologically advanced hospitals.
Ø Health systems consist of organizations, people and actions whose primary intent is to promote,
restore or maintain health.

l HEALTHCARE SECTORS
Ø Healthcare sector is the sector of the economy made up of companies that specialize in products
and services related to health and medical care.

l Different Health Sectors

Ø Bureau of Health Devices and Technology (BHDT)
n The BHDT was created in 1999 to perform the same functions of the BFAD/FDA but
for medical devices.
n Develops plans, programs and strategies for regulating health and health-related
devices and technology.
n The BHDT conducts its own research on health technologies and medical devices,
and it advises the Secretary of the DOH on medical device policy.
n Formulates rules, regulations and standards for licensing and accreditation of health-
related devices and technology. Conducts licensing and accreditation of health and
health-related devices and technology.
Ø Bureau of International Health Cooperation
n General Functions
üPromotes and sustains international partnership through agreements and other
instrumentalities;
üEnhances policies, plans, agreements and systems for international cooperation/
partnership
üEstablishes effective systems and mechanisms for collaboration/ coordination
üMonitor FAPs Plans, Bilateral/Multilateral Agreements

Ø Food and Drugs Administration

n Formerly called the Bureau of Food and Drugs
n Was created under the Department of Health to license, monitor, and regulate the flow
of food, drugs, cosmetics, medical devices, and household hazardous waste in the
Philippines.
n The Food and Drug Administration is responsible for protecting the public health by
ensuring the safety, efficacy, and security of human and veterinary drugs, biological
products, and medical devices; and by ensuring the safety of our nation’s food supply,
cosmetics, and products that emit radiation.

Ø Bureau of Local Health systems and Development (BLHsD)

n Responsive, collaborative, sustainable, and resilient local health systems for all
Filipino, especially the poor.
n The lead Bureau in the DOH in developing functional local health systems, especially
for the marginalized and disadvantaged communities.

Ø Bureau of Local Health systems and Development (BLHsD)

n General Function
ü Identify and assess priorities in local health systems development
ü Develop policies, guidelines and standards on sustainable local health systems
ü Ensure multi-stakeholder participation in local health system development
ü Monitor and evaluate functionality of local health system.
n Divisions
u Health Systems Development Division (HSDD)
ü Identify and assess priorities in local health systems development
ü Develop policies, guidelines and standards on sustainable local health systems
ü Ensure multi-stakeholder participation in local health system development
ü Monitor and evaluate functionality of local health system
 u Health Systems monitoring and Evaluation Division (HSMED)
ü Develop policies, plans and standards to build and enhance capacity for local
health leadership and governance
ü Provide technical assistance to monitor and evaluate local health system
performance
ü Promote beat practices in local health systems development for wide-spread
replication.

Ø Bureau of Quarantine and International Health Surveillance

1. International Health Surveillance Division
2. Special Services Division
3. Port and Airport Health Services Division
4. Administrative Division
n Formulates and enforces quarantine laws and regulations
l Conducts surveillance and institutes measures to prevent the entry of diseases
subject to International Health Regulations and other emerging and re-emerging
diseases and health concerns from other countries that may impact on public health in
the Philippines.
l Provides technical assistance and supervision, consultative and advisory services on
health and sanitation programs and activities in international ports and airports and
their immediate environs.
l Conducts medical examination on aliens and foreign based Filipinos for immigration
purposes.
l Advises the Secretary and the Undersecretary of Health on matters pertaining to
international health regulations and international health surveillance

Ø National Center for Disease Prevention and Control

n Develop plans, policies, programs, projects and strategies for disease prevention and
control health protection.
n Provides coordination, technical assistance, capability building, consultancy, and
advisory services related to disease prevention and control and health protection.
n Divisions:
ü Infectious Diseases for Elimination Division
ü Infectious Disease for Prevention and Control Division
ü Environmental-Related Diseases Division
ü Occupational Disease Division
ü Essential Non-Communicable Diseases Division
ü Lifestyle-Related Diseases Division
ü Women and Men’s Health Development Division
ü Children’s Health Development Division

Ø National Center for Mental Health (NCMH)

n NCMH was established in 1925 through Public Works Act 3258. It was formally
opened on December 17, 1928 and was originally called the INSULAR
PSYCHOPATIC HOSPITAL. It was later called the National Mental Hospital.
n On November 12, 1986, it was renamed NATIONAL CENTER FOR MENTAL
HEALTH (NCMH) through Memorandum Circular No. 48 issued by the Office of the
President.
n The National Center for Mental Health is dedicated to delivering preventive, curative
and rehabilitative mental health care services.
Ø National Epidemiology Center (NEC)
n Known as Epidemiology Bureau
n Develop and evaluate surveillance systems and other health information systems
n Collect, analyze and disseminate reliable and timely information on the health status
n Investigate disease outbreaks and other threats to public health
n Network public health laboratories in support of epidemiological and surveillance
activities
n Divisions
1. Applied Epidemiology Health Management Division
ü Investigate and respond to epidemics and other urgent public health threats as
the need arises
ü Develop and maintain field epidemiology training programs for public health
workers
ü Develop, capture, filter, verify, assess, respond, disseminate and evaluate event-
based surveillance systems
ü Collect and maintain resource materials on epidemiology, surveillance,
management and monitoring and evaluation in public health.
2. Public Health Surveillance Division
ü Undertake notifiable disease surveillance through Philippine Integrated Disease
Surveillance and Response.
3. Survey, Monitoring & Evaluation Division
ü Provide statistical services to priority health programs of the DOH
ü Monitoring non-behavioral risk factors priority non-communicable diseases
through globally standardized survey
ü Monitor HIV and AIDS Registry and Integrated HIV Behavioral and Serologic
Surveillance, size estimates and Most At-Risk Population
ü Provide program health indicators information.

Ø National nutrition council

n Formulate national food and nutrition policies and strategies and serve as the policy,
coordinating and advisory body of food, nutrition and health concerns.
n Coordinate planning, monitoring, and evaluation of the national nutrition program
n Coordinate the hunger mitigation and malnutrition prevention program to achieve
relevant Millennium Development Goals.
n Strengthen competencies and capabilities of stakeholders through public education,
capacity building and skills development
n Coordinate the release of funds, loans, and grants from government organizations
and nongovernment organizations
n Call on any department, bureau, office, agency and other instrumentalities of the
government for assistance in the form of personnel, facilities and resources as the
need arises.

Ø Philippine National Aids Council (PNAC)

n was created to advise the government on the development of policies to prevent and
control HIV/AIDS.
n It is composed of high-ranking government officials, the heads of nongovernmental
organizations, members of the HIV/AIDS network, and a representative of an
organization of people living with HIV.

Ø Philippine National Aids Council (PNAC)

 n The first two committees created by PNAC were the Committee on Policy
Development, which was charged with developing a national prevention and control
strategy, and the Committee on Law and Ethics, which promotes a supportive legal
environment for people with HIV/AIDS and provides legal support to the PNAC.

Ø Philippine National Aids Council (PNAC)

n This latter committee has created an AIDS Health Rights Desk which will act from its
base in the Department of Health to provide free legal assistance to poor people
whose health rights have been violated.
n A third committee is being organized to help disseminate accurate information on
HIV/AIDS.
n Philippine Institute of Traditional and Alternative Health Care (pitahc)
n FUNCTIONS
1. To encourage scientific research on and develop traditional and alternative health
care systems that have direct impact on public health care;
2. To promote and advocate the use of traditional, alternative, preventive, and curative
health care modalities that have been proven safe, effective, cost effective and
consistent with government standards on medical practice;
3. To develop and coordinate skills training courses for various forms of traditional and
alternative health care modalities;
4. To formulate standards, guidelines and codes of ethical practice appropriate for the
practice of traditional and alternative health care as well as in the manufacture, quality
control and marketing of different traditional and alternative health care materials,
natural and organic products, for approval’ and adoption by the appropriate
government agencies;
5. To formulate policies for the protection of indigenous and natural health resources
and technology from unwarranted exploitation, for approval and adoption by the
appropriate government agencies;
Philippine Institute of Traditional and Alternative Health Care (pitahc)
6. To formulate policies to strengthen the role of traditional and alternative health care
delivery system; and
7. To promote traditional and alternative health care in international and national
conventions, seminars and meetings in coordination with the Department of Tourism,
Duty Free Philippines, Incorporated, Philippine Convention and Visitors Corporation
and other tourism-related agencies as well as non-government organizations and
local government units.

TOPIC 6: ACCREDITING BODIES/ORGANIZATION for HEALTH CARE SYSTEMS

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Define the Health Status Indicator and its examples.
2. Understand the significance of Health status indicators.
3. Cite the Common Risk Factors for Non-Communicable Diseases
4. Describe and differentiate the Accrediting bodies/ organization for Health Care Systems
5. Differentiate the Public and Private Health System in the Philippines
 REQUIRED READINGS
• https://pubmed.ncbi.nlm.nih.gov/11184667/

RELATED LINKS AND VIDEOS:

l HealthCare in Singapore (https://www.youtube.com/watch?v=WtuXrrEZsAg)
l Australian HealthCare (https://www.youtube.com/watch?v=ylsO0VVy29U)

NOTES:
TERMINOLOGIES
l HEALTH STATUS INDICATOR
n These are the measurement of the health status for a given population using a variety of
indices, including morbidity, mortality, and available health resources.
l MORBIDITY
n refers to the disease state of an individual, or the incidence of illness in a population.
l MORTALITY
n refers to the state of being mortal, or the incidence of death (number of deaths) in a population.

HEALTH STATUS INDICATOR

l Different health indicators include disease, morbidity, and mortality measures the health of the
community.
l Access to health care contributes to the trends in disease, morbidity and mortality and illustrates
changes in the status of the country.
l Local or city health departments, the Department of Health (DOH) and the Field Health Service
Information System (FHSIS) provide morbidity, mortality and health status related data.

HEALTH STATUS INDICATOR EXAMPLES

1. Life expectancy at birth
l Definition: Average number of years that a newborn is expected to live if current mortality rates
continue to apply.
l Rationale for use:
n Life expectancy at birth reflects the overall mortality level of a population.
n It summarizes the mortality pattern that prevails across all age groups - children and
adolescents, adults and the elderly.

2. Probability of dying (per 1000) between ages 15 and 60 years (Adult Mortality Rate)
l Definition: Probability that a 15 year old person will die before reaching his/her 60th birthday.
l Rationale for use
n Disease burden from non-communicable diseases among adults - the most economically
productive age span - is rapidly increasing in developing countries due to ageing and health
transitions.
n Therefore, the level of adult mortality is becoming an important indicator for the comprehensive
assessment of the mortality pattern in a population.

3. Probability of dying (per 1000) under age one year (Infant Morality Rate)
l Definition: Infant mortality rate is the probability of a child born in a specific year or period dying
before reaching the age of one, if subject to age-specific mortality rates of that period.
l Rationale for use
n Infant mortality rate is a leading indicator of the level of child health and overall development in
countries.

HEALTH STATUS INDICATOR

l For a broader view of other health status indicators, view the WHO’s definitions of many different
health status indicators found at http://www.who.int/whosis/indicatordefinitions/en/index.html
l Indicators of mortality determine the health status of a society because changes in mortality reflect
several social, economic, health service, and related trends (Torrens, 1999).
l These data may be useful in analyzing health patterns over time, comparing communities from
different geographical regions, or comparing different aggregates within a community.
l National and local health departments are responsible for collecting morbidity and mortality data
and forwarding the information to the FHSIS

COMMON RISK FACTORS FOR NON-COMMUNICABLE DISEASES

RISK FACTORS CONDITION
CARDIOVASCULAR DIABETES CANCER RESPIRATORY CONDITION
SMOKING
NUTRITION
PHYSICAL

INACTIVITY
OBESITY
ALCOHOL
RAISED BP
BLOOD GLUCOSE
BLOOD LIPIDS

ACCREDITING BODIES/ ORGANIZATION FOR HEALTH CARE SYSTEMS

l List of international healthcare accreditation organizations:
n Australia
1. The Australian Council on Healthcare Standards (ACHS) was the pioneer in accreditation in
Australia.
Ø It began as a collaboration between doctors and administrators in adjacent states, based
on the Canadian model, and was supported by the W.K. Kellogg Foundation.
2. Australian General Practice Accreditation Ltd (AGPAL) is a not-for-profit company made up
of members from all the major organizations representing general practice.
Ø It is voluntary, but the Federal Government and the profession agreed that all practices
that wish to continue to receive a Practice Incentive Payment (PIP) would need to be
accredited by 1 January 2002.
3. The Quality Improvement Council (QIC) programme was the Community Health
Accreditation and Standards Program (CHASP).
 Ø QIC was registered in 1997 as an independent body and began operations the following
year; it focuses on primary care.
n Canada
1. The Canadian Council on Health Services Accreditation (CCHSA) was set up following the
separation of the United States and Canadian accrediting bodies in 1958.
Ø It is the second longest established programme in the world and was the principal
influence in the formulation of the ACHS in Australia
n Japan
Ø In 1995 the Japan Council for Quality Health Care (a nongovernmental organization) set
up an accreditation programme funded by the Ministry of Health and Welfare and the
Japan Medical Association
n Malaysia
Ø The origins of hospital accreditation in Malaysia can be traced to the quality assurance
programme formalized in 1985. Authority for accreditation was given by the Ministry of
Health to an independent body, the Malaysian Society for Quality in Health
n Singapore
Ø The accreditation programme was started in 1991 as a function of the Medical
Accreditation and Audit Unit of the Ministry of Health.
n Philippines
Ø A national programme for accreditation was established in 1999.

THE PHILIPPINE HEALTH SYSTEM

l Dual health system: composed of the public sector and the private sector.
n The public sector is largely financed through a tax-based budgeting system, where health
services are delivered by government facilities run by the National and local governments.
u National Government Level
l The DOH acts as the national lead agency in health.
l Consists of 18 Bureaus and services for policy development, programme planning,
standards setting and regulation.
l 17 regional health offices
l Autonomous agencies: National Nutrition Council(NNC)and the Population
Commission
u Local Government Level
l The local government consists of 81 provinces, 145 cities (of which 33 are highly
urbanized cities and five are independent component cities), 1489 municipalities and
42,025 barangays (Philippine Statistics Authority, 2015).
n The private sector, consisting of for-profit and nonprofit health-care providers, is largely
market-oriented where health care is generally paid for through user fees at the point of
service (Department of Health, 2005b).
u The private sector consists of thousands of for-profit and non-profit health providers, which
are largely market-oriented and where health care is generally paid for through user fees
at the point of service.
u The private sector consists of
l Clinics
l Infirmaries
l Laboratories
l Hospitals
l Drug manufacturers and distributors
l Drugstores
l Medical supply companies and distributors
l Health insurance companies
 l health research institutions and academic institutions offering medical, nursing,
midwifery, and other allied professional health education.
l Nonformal health service providers include traditional healers ( herbolarios ) and
traditional birth attendants ( hilots).

TOPIC 7: STAGES AND NEEDS OF HUMAN LIFE

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Understand the human growth development.
2. Describe and comprehend the difference of physical, emotional, social and mental
development.
3. Understand the different stages of life based on their physical, emotional, social and mental
development.

REQUIRED READINGS
l https://www.institute4learning.com/resources/articles/the-12-stages-of-life/

RELATED LINKS AND VIDEOS:

l 8 Stages of Development by Erik Erikson (https://youtu.be/aYCBdZLCDBQ)

NOTES:
HUMAN GROWTH DEVELOPMENT
l It is a process that begins at birth and does end until death.

LIFE STAGES
A. INFANCY - birth to 1 year
B. EARLY CHILDHOOD - 1 to 6 years
C. LATE CHILDHOOD - 6 to 12 years
D. ADOLESCENCE - 12 to 20 years
E. EARLY ADULTHOOD - 20 to 40 years
F. MIDDLE ADULTHOOD - 40 to 65 years
G. LATE ADULTHOOD - 65 years and up

FOUR MAIN TYPES OF GROWTH AND DEVELOPMENT OCCUR:

l Physical - refers to body growth and includes height and weight changes, muscle and nerve
development, and changes in the body organs.
l Mental - refers to the development of the mind and includes learning how to solve problems. Make
judgments, and deal with situations.
l Emotional - refers to feelings and includes dealing with love, hate, joy, fear, excitement, and other
similar feelings.
l Social - refers to interactions and relationships with other people.

A. INFANCY
l Physical Development
n Newborn usually weighs approximately 6-8 pounds and measures 18 to 22 inches. By the end
of the first year of life, weight has usually tripled, to 21 to 24 pounds and height has increased
to approximately 29 to 30 inches. ‘
n Muscular system and nervous system developments are also dramatic.
n Reflex action: Present at birth that can allow the infant to respond to the environment. Include
the Moro, or startle, refer to a loud noise or sudden movement, the rooting reflex, in which a
slight touch on the cheek causes the mouth to open and the head to turn, the sucking reflex,
caused by a slight touch on the lips, and the grasp reflex, in which infants can grasp an object
placed in the hand.
n Muscle coordination
u At first infants are able to lift the head slightly.
u By 2 months, they can usually roll form the side to back.
u By 4 - 5 months - they can turn the body completely around, accept objects handed to
them, grasp stationary objects and with support, hold the head up while sitting.
u By 6 - 7 months - infants can sit unsupported for several minutes, grasp moving objects,
and crawl on the stomach.
u By 12 months - infants frequently can walk without assistance, grasp objects with the
thumb and fingers, and throw small objects.
u Most infants are born without teeth, but usually have 10 to 12 teeth by the end of the first
year of life.
u Vision: poor at birth and is limited to black and white, eye movements are not coordinated.
By 1 year of age: close vision is good, in color and can readily focus on small objects.
u Sensory abilities such as those of smell, taste, sensitivity to hot and cold, and hearing,
while good at birth, become more refined and exact.
n Emotional Development
u Observed very early in life.
u Newborns show excitement
u By 4 to 6 months of age, distress, delight, anger, disgust, and fear can often be seen.
u By 12 months of age , elation and affection for adults is evident.
n Social Development
u Progresses gradually from the self-centeredness concept of the newborn to the
recognition of others in the environment.
u Food, cleanliness and rest are essential for physical growth.
u Love and security are essential for emotional and social growth.
u Stimulation is essential for mental growth.

B. EARLY CHILDHOOD
n Physical Development
u Growth is slower than during infancy.
u By age 6: average weight is 45 pounds and the average height is 46 inches
u Skeletal and muscle development helps the child assume a more adult appearance.
u The legs and lower body tend to grow more rapidly than do the head, arms and chest.
u Muscle coordination allows the child to run, climb, and move freely.
u As muscles of the fingers develop, the child learns to write, draw and use a fork and knife.
 u By age 2 or 3, most teeth have erupted, and the digestive system is mature enough to
handle most adult foods.
u Between 2 to 4 years of age, most children learn bladder and bowel control.
n Mental Development
u Advances rapidly during early childhood. Verbal growth progresses from the use of several
words at age 1 to a vocabulary of 1,500 to 2,500 words at age 6.
u Two year olds have short attention spans but are interested in many different activities.
They can remember details and begin to understand concepts.
u Four year old ask frequent questions and usually recognize letters and some words. They
begin to make decisions based on ,logic rather than on trial and error.
u By age 6, children are very verbal and want to learn how to read and write.
u Memory has developed to the point where the child can make decisions based on both
past and present experiences.
n Emotional Development
u Ages 1 to 2 : children begin to develop self - awareness and to recognize the effect they
have on other people and things.
u Limits are usually established for safety, leading the 1 or 2 year old to either accept or defy
such limits.
u Children feel impatience and frustration as they try to do things beyond their abilities.
u Anger, often in the form of “temper tantrums”, occurs when they cannot perform as
desired. Children at this age also like routine and become stubborn, angry, or frustrated
when changes occur.
u From ages 4 to 6, children They understand the concept of right and wrong, they
achieved more independence, and they are not frustrated as much by their lack of ability.
u By age 6, most children also show less anxiety when faced with new experiences,
because the have learned they can deal with new situations.
n Social Development
u Expands from self - centered 1 -year old to a very sociable 6 year old. In the early years,
children are usually strongly attached to their parents and they fear any separation. They
begin to enjoy the company of others, but are still very possessive.
u Playing alongside other children is more common than playing with other children.
u Have interest on others and learn to put “self” aside
u They learn to trust other people and make more of an effort to please others by becoming
more agreeable and social.
u The needs of early childhood still include food, rest, shelter, protection, love and security.
u In addition, children need routine, order and consistency in their daily lives.
u They must be taught to be responsible and must learn how to conform to rules. This can
be accomplished by making reasonable demands based on child’s ability to comply.

C. LATE CHILDHOOD
n Physical Development
u Covers ages 6 to 12
u Also called preadolescence
u Physical development is slow but steady
u Weight gain averages 5 to 7 pounds per year and height usually increases approximately
2 to 3 inches per year.
u Muscle coordination is well developed, and children can engage in physical activities that
require complex motor sensory coordination
u During this age, most of the primary teeth are lost, and permanent teeth erupt.
u The eyes are well developed, and visual acuity is at its best. During ages 10 - 12 , sexual
maturation may begin in some children
 n Mental Development
u Increases rapidly because much of the child’s life centers around school.
u Speech skills develop more completely, and reading and writing skills are learned.
u Children learn to use information to solve problems and the memory becomes more
complex
u They begin to understand more abstract concepts such as loyalty, honesty, values, and
values.
u Children use more active thinking and become more adept at making judgments.
n Emotional Development
u Continues to help the child achieved a greater independence and a more distinct
personality.
u At age 6, children are often frightened and uncertain as they begin school. Reassuring
parents and success in school help children gain self confidence.
u Gradually, fears are replaced by the ability to cope.
u Emotions are slowly brought under control and dealt with in a more effective manner.
u By ages 10-12, sexual maturation and changes in body functions can lead to periods of
depression followed by periods of joy.
u These emotional changes can cause children to be restless, anxious, and difficult to
understand.

D. ADOLESCENCE
n Physical Development
u Ages 12 - 20
u Often a traumatic life stage
u A sudden “growth spurt” can cause rapid increase in weight and height.
u A weight gain of up to 25 pounds and a height increase of several inches can occur in a
period of months.
u Muscle coordination does not advance as quickly.
u This can lead to awkwardness or clumsiness in motor coordination.
u The growth spurt usually occurs anywhere from ages 11 to 13 in girls and age 13 to 15 in
boys.
u Development of sexual organs and the secondary sexual characteristics, frequently called
puberty.
u Secretion of sex hormones leads to the onset of menstruation in girls and the production of
sperm and semen in boys.
n Emotional development
u Often stormy and in conflict
u As adolescents try to establish their identities and independence, they are often uncertain
and feel inadequate and insecure.
u They worry about their appearance, their abilities and their relationships with others
u They frequently respond more and more to peer group influences. At times, this lead to
changes in attitude and behavior and conflict with values previously established.
u At this point, teenagers feel more comfortable with who they are and turn attention toward
what they become.
u They gain more control of their feelings and become more mature emotionally.
n Social development
u Usually involves spending less time with family and more time with peer groups.
u Adolescents attempt to develop self - identity and independence, they seek security in
groups of people their own age who have similar problems and conflicts.
u If these peer relationships held develop self-confidence through the approval of others,
adolescents become more secure and satisfied. Toward the end of this life stage,
 adolescents develop a more mature attitude and begin to develop patterns of behavior that
they associate with adult behavior or status.
u Adolescents also need reassurance, support, and understanding
u Many problems that develop during this life stage can be traced to the conflict and feelings
of inadequacy and insecurity that adolescents experience. Examples include eating
disorders, drug and alcohol abuse, and suicide.

E. EARLY ADULTHOOD
n Physical development
u Ages 20 to 40
u Frequently the most productive life stage
u Physical development basically is complete, muscles are developed and strong, and motor
coordination is at its peak
u The prime childbearing time and usually produces the healthiest babies.
u Both male and female sexual development is at peak
n Mental development
u Usually continues throughout this age
u Frequently, formal education continues for many years.
u The young adult often also deals with independence, makes career choices, establishes a
lifestyle, selects a marital partner, starts a family, and establishes values, all of which
involve making many decisions and forming many judgments
n Emotional developments
u Usually involves preserving the stability established during previous stages.
u Young adults are subjected to many emotional stresses related to career, marriage, family,
and other similar situations.
u If emotional structure is strong, most young adults can cope with these worries. They find
satisfaction in their achievements take responsibility for their actions, and learn to accept
criticism and to profit from mistakes.
n Social development
u Frequently involves moving away from peer group, and young adults instead tend to
associate with others who have similar ambitions and interests, regardless of age.
u The young adult
u Young adults do not necessarily accept traditional sex roles, and frequently adopt
nontraditional roles.

F. MIDDLE ADULTHOOD
n Physical development
u Middle adulthood, ages 40 to 65 , is frequently called middle age.
u Physical changes begin to occur during these years. The hair tends to gray and thin, the
skin begins wrinkle, muscle tone te nds to decrease, hearing loss starts, visual acuity
declines, and weight gain occurs.
u Females experience menopause, or the end of menstruation, along with decrease
hormone production that causes physical and emotional changes
u Males also experience a slowing of hormone production. This can lead to physical and
psychological changes, a period frequently referred to as the male climaceric.
n Mental development
u Mental ability can continue to increase during middle age, a fact that has been proven by
the many individuals in this life stage who seek formal education.
u Middle adulthood is a period of when individuals have acquired an understanding of life
and have learned to cope with many different stresses. This allows them to be more
confident in decision making and excellent at analyzing situations.
 n Emotional development
u Middle age can be a period of contentment and satisfaction, or it can be a time of crisis.
u The emotional foundation of previous life stages and the situations that occur during
middle age determine emotional status during middle age determine emotional status
during this period.
u Job stability, financial success, the end of child rearing and good health from disease
prevention can all contribute to emotional satisfaction.
u Stress created by loss of job, fear of aging, loss of youth and vitality, illness, marital
problems, or problems with children or aging parents, can contribute to emotional feelings
of depression, insecurity, anxiety, and even anger.
u Therefore emotional status varies in this age group and is largely determined by events
that occur during this period.
n Social development
u Social relationships also depend on many factors.
u Family relationships often see a decline as children begin lives of their own and prevents
die.
u Works relationships frequently replace family.
u Relationships between husband and wife can become stronger as they have more time
together and opportunities to enjoy success.
u Friendships are usually with people who have the same interests and lifestyles.

G. LATE ADULTHOOD
n Physical development
u Age 65 and up
u These include elderly, senior citizen, golden age and retired citizen
u Much attention has been directed toward this life stage in recent years because people are
living longer, and because people in this age group is increasing daily.
u Physical development is on the decline.
u All the body systems are usually affected. The skin becomes dry, wrinkled, and thinner.
u Brown or yellow spots (frequently called “age spots” appear. The hair becomes thin and
frequently loses its luster or shine. Bones become more brittle and porous and are more
likely to fracture or break.
u Cartilage between the vertebrae thins and can lead to a stooping posture.
n Mental development
u Elderly people who remain mentally active and are willing to learn new things tend to show
fewer signs of decreases mental ability.
u Some 90 year old remain alert and well oriented, other elderly individuals show decrease
mental capacities at much earlier ages.
u Short term memory is usually first to decline
u Many elderly individuals can clearly remember events that occurred 20 years ago, but no
not remember yesterday’s events.
n Emotional development
u Some elderly people cope well with the stresses presented by aging and remain happy
and able to enjoy life.
u Others become lonely, frustrated, withdrawn, and depressed.
u Emotional adjustment is necessary throughout this cycle.
u Retirement, death of spouse and friends, physical disabilities, financial problems, loss of
independence and knowledge that life must end all can cause emotional distress. The
adjustments that the individual makes during this life stage are similar to those made
throughout life
n Social development
 u Social adjustment also occurs during late adulthood
u Retirement can lead to a loss of self - esteem, especially if work is strongly associated with
self identity.
u Less contact with coworkers and more limited circle of friends
u Many elderly individuals engage in other activities and continue to make new social
contacts.
u Death of a spouse and friends and moving to a new environment can also changes in
social relationships
u Needs of this life stage are the same as those of all other life stages. In addition to basic
needs, the elderly need a sense a sense of belonging, self-esteem, financial security,
social acceptance, and love.

TOPIC 8: WELLNESS AND ILLNESS PART 1

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Define the difference of health, wellness and illness.
2. Understand the differrent dimensions of Health.
3. Differentiate and comprehend the different Models of Health.
4. Understand the different stages of Illness Behavior
5. Comprehend the different levels of Prevention
6. Enumerate the Factors affecting Health

REQUIRED READINGS
• http://www.uobabylon.edu.iq/eprints/publication_12_30892_233.pdf
• https://www.scribd.com/doc/3573731/Health-Wellness-and-Illness

RELATED LINKS AND VIDEOS:

l Dimensions of Health (https://www.youtube.com/watch?v=2NR4_5dt7JA)

NOTES:
TERMINOLOGIES
l HEALTH
n This is the state of complete physical, mental and social well-being, and not merely the
absence of disease or infirmity. (WHO, 1947)
l WELLNESS
n This is an integrated method of functioning which is oriented toward maximizing the potential of
which the individual is capable. It requires that the individual maintain a continuum of balance
and purposeful direction within the environment where he is functioning. (Hilbert Dunn)
l ILLNESS
 n This is a state in which someone’s needs are not sufficiently met to allow the individual to have
a sense of physical and psychosocial well-being

l DIMENSIONS OF HEALTH
Ø Physical Dimensions
Ø Emotional Dimensions
Ø Intellectual Dimensions
Ø Environmental Dimensions
Ø Socio-cultural Dimensions
Ø Spiritual Dimensions

l MODELS OF HEALTH
1. Medical Model (M.B Belloc and Breslow – 1972)
l Health is the state of being free of signs or symptoms of disease. Illness is the presence of
signs and symptoms of disease.
2. Health-Illness Continuum (McCann/Flynn and Heffron - 1984)
l Health is a constantly changing state with high level of wellness and death being on opposite
ends of a graduated scale or continuum.
l If an individual copes and functions effectively in daily living, he is said to be within the health
spectrum.
l Failure to cope or poor reintegration means a presence of illness and if the body fails
completely, irreversible damage results leading to death.
3. Role-performance Model (Parsons 1958)
l Health is the ability to perform all those roles from which one has socialized
4. High-level wellness (Dunn 1961)
l High-level wellness refers to functioning to one’s maximum potential while maintaining balance
and purposeful direction in the environment.
l Halbert Dunn describe his concept of High Level Wellness as functioning to the maximal
possible level of one’s ability within one’s environment.
l Concepts in Dunn’s High Level Wellness include:
n Totalitarity – involves the biopsychosocial components in humans.
n Uniqueness
n Energy – required by every living thing which include physical energy such as food, water
and air and psychosocial energy which is obtained from contacts and interactions with
other environmental elements.
n Inner and Outer world – refers to reflection of human’s experiences with his past and
present inner self and with the outer world. These reflections become the basis for
behavior.
n Self-integration – uses reflection of the past and present as a basis for behavior.
5. World Health Organizations (WHO 1947)
l Health is the state of complete physical, mental, social being and not merely the absence of a
disease or infirmity.
6. Wellness education Model (John Travis)
l John Travis is a wellness-oriented physician who focused his approach on a concept of
wellness education.
7. Holistic Model of Health Care
l The concept of holism is based on the idea that it is more fruitful to study the human being as a
whole than to study its separate parts.
8. Needs – fulfillment Models
l Health is the state in which needs are being sufficiently met to allow an individual to function
successfully in life with the ability to achieve the highest possible potential.
 l This model is reflected on Abraham Maslow’s Model of Basic Human Needs.
l A knowledge of this model will help us understand health and illness through man’s need.

STAGES OF ILLNESS BEHAVIORS

l Stage 1: Experience symptoms
n The person is aware that “something is wrong”.
n A person usually recognizes a physical sensation or a limitation in functioning but does not
suspect a specific diagnosis.
n The person’s perception of a symptom includes awareness of a physical change such as pain,
a rush or a lump; evaluation of this change and a decision that it is a symptom of an illness;
and an emotional response.
l Stage 2: Assumption of the Sick Role
n If symptoms persist and become severe, clients assume the sick role.
n At this point the illness becomes a social phenomenon, and sick people seek confirmation from
their families and social groups that they are indeed ill and that they be excused from normal
duties and role expectations.
l Stage 3: Medical Care Contact
n If symptoms persist despite the home remedies, become severe or require emergency care,
the person is motivated to seek professional health services.
n In this stage the client seeks expert acknowledgement of the illness as well as the treatment.
l Stage 4: Dependent Client Role
n The client depends on health care professionals for the relief of symptoms.
n The client accepts care, sympathy and protection from the demands and stresses of life.
n A client can adopt the dependent role in a health care institution, at home or in a community
setting.
n The client must also adjust to the disruption of a daily schedule.
l Stage 5: Recovery and Rehabilitation
n The stage can arrive suddenly such as when the symptoms first appeared.
n In the case of chronic illness, the final stage may involve an adjustment to prolonged reduction
in health and functioning.
n This stage describes two conditions, namely convalescence and rehabilitation.
n Convalescence is the period of recovery following illness while rehabilitation is the restoration
of the functioning to maximal self sufficiency.

OTHER PEOPLE IDENTIFY THREE STAGES OF ILLNESS:

l Stage of Denial – characterized by the person’s refusal to acknowledge illness.
n Anxiety, fear, irritability and aggressiveness are often manifested behaviors at this stage.
n The patient may avoid, refuse or even forget needed care.
l Stage of acceptance – when the person no longer denies being ill and is aware of what is
happening to him, he tends to move toward a stage of acceptance and ordinarily turns to
professional help for assistance.
l Stage of recovery – the last of the three stages of illness is recovery, rehabilitation or
convalescence.
n Depending on the illness, it maybe a relatively short or long period.

FACTORS CAUSING ILLNESSES

l Predisposing factors – these are conditions that is characterized by a previous tendency or
susceptibility.

n Example: Family history of heart attack appears to predispose a person to having one.
l Contributory factors – a condition that helps bring about result.
 n Example: A sedentary life, smoking and obesity appear to contribute to the development of
heart attack.
l Precipitating factors – a condition that hastens or brings on result hurriedly.
n Example: Death of a loved one precipitates heart attack or any stressful event.

LEVELS OF PREVENTION
l Primary Prevention
n This is the most desirable form of prevention.
n It is the provision of specific protection against disease.
n Primary prevention efforts spare the client the cost, discomfort and the threat to the quality of
life that illness poses or, at least delay the onset of illness.
n Preventive measures consist of counseling, education and adoption of specific health practices
or changes in life style.
n Examples:
u Mandatory immunization of children belonging to the age range of 0-59 months old to
control acute infectious diseases.
u Minimizing the contamination of work or general environment by asbestos dust, silicone
dust, smoke, chemical pollutants and excessive noise.
l Secondary Prevention
n It consists of organized, direct screening efforts or education of the public to promote early
case finding of an individual with disease so that prompt intervention can be instituted to halt
pathologic processes and limit disability.
n Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise
result to the individual and family from advanced illness and its complications.
n Examples:
u Screening programs for hypertension, diabetes, uterine cancer (Pap Smear), breast
cancer (examination and mammography) glaucoma and sexually transmitted diseases.
l Tertiary Prevention
n It begins early in the period of recovery from illness and consists of such activities as
consistent and appropriate administration of medications to optimize the therapeutic effects,
moving and positioning to prevent complications of immobility and passive and active
exercises to prevent disability.
n Continuing health supervision during rehabilitation to restore an individual to an optimal level of
functioning.
n Minimizing residual disability and helping clients learn to live productively with limitations are
the goals of tertiary prevention.

FACTORS AFFECTING HEALTH

l Political
n Involves one’s leadership, how he/she rules, manages and involves other people in decision
making.
n Safety
u The condition of being free from harm, injury or loss (Webster)
u Protection from exploitative working conditions
u Expanding access to social security
n Oppression
u Unjust or cruel exercise of authority or power (Webster)
n Political will
u Determination of a person to do something which is the interest of the majority.
n Empowerment
u The ability of a person to do something
 u Creating the circumstances where people can use their faculties and abilities at the
maximum level in the pursuit of common goals
l Cultural
n This refers to the representation of non-physical traits, such as values, beliefs, attitudes and
customs shared by group of people and passed from one generation to the next. ( Potter,
1993)
n Practices – a customary action usually done to maintain or promote health like use of anting-
anting or lucky charms.
n Beliefs – a state or habit of mind wherein a group/people place a trust into something or a
person. (Webster)
l Heredity
n The genetic transmission of traits from parents to offspring: genetically determined. (Miller –
Keanne, 1987)
l Environment
n This is the sum total of all the conditions and elements that make up the surrounding and
influence the development of an individual. (Miller-Keanne, 1987)
l Socio-economic
n This refers to the production activities, distribution and consumption of goods of an individual

TOPIC 9: WELLNESS AND ILLNESS PART 2

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Understand and define needs.
2. Familiarize with Abraham Maslow and his hierarchy of needs.
3. Understand the 5 types of human needs.

REQUIRED READINGS
• https://www.scribd.com/doc/3573731/Health-Wellness-and-Illness
• http://www.uobabylon.edu.iq/eprints/publication_12_30892_233.pdf

RELATED LINKS AND VIDEOS:

l Maslow Hierarchy of needs (https://www.youtube.com/watch?v=O-4ithG_07Q)

NOTES:
TERMINOLOGIES
NEED
l is something that is essential to the emotional and physiologic health and survival of humans.
l All people strive to meet basic needs, at any given time an individuals needs may be met, partially
met, or unmet.
ABRAHAM MASLOW’S HIERARCHY OF NEEDS
l Abraham Maslow (April 1, 1908 – June 8, 1970)
n A Psychology professor at Brandeis University, Brooklyn College, New School for Social
Research and Columbia University. (US)
l Maslow’s framework of basic needs is based on the theory on meeting needs and its effect on
health:
l It’s absence results in illness.
l It’s presence prevents illness or signals health
l Meeting an unmet need.
l Maslow arranges basic human needs in a hierarchy in which certain needs are more basic than
others.
l Although all the needs are present, the individual strives to meet certain needs, at least to a
minimal level, before attending to the others.

l FIVE LEVELS OF BASIC NEEDS

1. Physiological Needs
n These are the physical needs inherent in all human beings.
n Physiological needs are sometimes referred to as basic needs.
n Physiological needs must be met at least minimally for life to continue.

2. Safety Needs
n Safety needs have to do with establishing stability and consistency in a chaotic world.
n The need for safety is subordinate only to basic physiological needs.
n Safety is both physiological and psychological.
n We need not only a safe physical environment, a shelter, but also the feeling of
psychological safety.
n To feel safe, we need regular contact with people we trust and feel close to.

3. Love and Belonging Needs (Need to Belong)

n Humans have a desire to belong to groups
n We need to feel loved by others, to be accepted by others, e.g. Performers appreciate
applause.
n The security we gain from love and belonging enhances the feeling of safety.
n Our feeling of structure and security is reinforced when we know where we stand in
relation to others and who we are to them.

4. Self-Esteem Needs
n Self-esteem need is derived largely from the feeling that we are valued by those around
us.
n We feel good about ourselves when people who are important to us express acceptance
and approval.
n But self-esteem comes from within, it is related to the assessments of our own adequacy,
our performance and our capacity in the various arenas of lives, both personal and
professional and that others hold one on high regard.
n This is similar to the sense of belonging level, however, wanting admiration has to do with
the need for power.
n E.g. people who have all of their lower needs satisfied, often drive very expensive cars
because doing so raises their level of esteem.

5. Self-Actualization Needs
 n The need for self-actualizations is "the desire to become more and more what one is, to
become everything that one is capable of becoming."
n In general, each lower level of need must be met to some degree before this need can be
satisfied.
n E.g. it is usually middle-class to upper-class students who take up environmental causes,
go off to a monastery, etc.
n The process of self-actualization is one that continues throughout life.
n The following are qualities that indicate achievement of one’s potential:
u Acceptance of self and others as they are
u Focus of interest on problems outside of self
u Ability to be objective
u Feelings of happiness and affection for others
u Respect for all persons
u Ability to discriminate between good and evil
u Creatively as a guideline for solving problems and carrying out interest.

TOPIC 10: FACTORS AFFECTING HEALTH CARE SYSTEMS

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Understand the different Health Care Strategies
2. Familiarize with the Health Care in the Philippines
3. Familiarize with the 8 Health Issues That Made Headlines In 2018 (Philippines)
4. Understand the different key challenges in health care.

REQUIRED READINGS
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122083/#:~:text=Healthcare%20providers%20identified%20nine
%20organisational,identity%2C%20and%20chances%20for%20promotion.

RELATED LINKS AND VIDEOS:

l COVID-19 (https://www.youtube.com/watch?v=BtN-goy9VOY)

NOTES:
HEALTHCARE STRATEGIES
1. Prevention - delivered prior to the onset of a disorder, these interventions are intended to
prevent or reduce the risk of developing a problem, such as underage alcohol use, prescription
drug misuse and abuse, and illicit drug use.
l any medical service that defends against health emergencies.
l It includes doctor visits, such as annual physicals, well-woman appointments, and dental
cleanings.
l Some medicines are preventive, such as immunizations, contraception, and allergy
medications.
l Screenings, such as tests for skin cancer, high cholesterol, and colonoscopies, are effective
preventive measures.
n 5 TYPES OF PREVENTION
1. Primordial prevention
u Primordial prevention refers to measures designed to avoid the development of risk
factors in the first place, early in life.
u It is done by health promotion and awareness.
u For example: Restricted salt diet in young children
2. Primary prevention
u Methods to avoid occurrence of disease either through eliminating disease agents or
increasing resistance to disease.
u Examples include vaccination against diseases, maintaining a healthy diet and
exercise regimen for young adults and avoiding smoking.
3. Secondary prevention
u It is done via early diagnosis and early treatment. Measures are taken to arrest
u Examples include treatment of hypertension (a risk factor for many cardiovascular
diseases),
4. Tertiary prevention
u It includes methods to reduce the harm and agony of
u Examples include surgical procedures that halt the spread or progression of
untreatable cancer.
5. Quaternary prevention
u Methods to mitigate or avoid results of unnecessary or excessive interventions in the
health system
u These terms overlap as treatment and health care can not be strictly limited under one
term.

2. Promotion-these strategies are designed to create environments and conditions that support
behavioral health and the ability of individuals to withstand challenges.
l Promotion strategies also reinforce the entire continuum of behavioral health services.

3. Curative care implies to treatment of a medical pathology such that the patient becomes free
from the disease/pathology process along with its symptoms.
l For example: Antibiotics in bacterial infection, surgery of an excisable tumor or the
chemotherapy for other treatable diseases.

4. Rehabilitation is an important part of the recovery process after surgery or significant injury.
l Rehabilitation has a whole of person approach that aims to achieve the highest possible level
of function, maximize quality of life and minimize the need for ongoing health and community
support.
l Rehabilitation aims to restore function across physical, psychological, social and vocational
domains.
l An allied health rehabilitation team may include the following:
n Audiologists to assess for hearing impairment and fit hearing devices
n Optometrists and orthoptists to provide services for low vision
n Occupational therapists and rehabilitation counsellors to assist with equipment and
modifications to the home, school or workplace to support independence and participation
n Podiatrists to provide services promoting foot health and mobility
n Orthotists/prosthetists to prescribe devices and that promote mobility, limb function and
independence
 n Physiotherapists and exercise physiologists to assist with strength training and improving
balance, mobility and limb function.
n Occupational therapists and physiotherapists to provide training around self-care and
undertake activities of daily living, pain control and management
n Exercise physiologists and physiotherapists also can provide health promoting wellness
programs to develop strength, balance and prevent falls
n Arts therapists and music therapists to assist people with psychosocial aspects of
rehabilitation, particularly people with longer-term rehabilitation programs
n Dietitians to assess nutritional status, including the risk of malnutrition, and provide advice
on specialised nutritional support such as tube feeding or nutritional strategies to manage
chronic conditions such as diabetes
n Speech pathologists to assess and treat people with speech and swallowing difficulties
n Psychologists and appropriately trained social workers and occupational therapists to
encourage self-management skills, resilience and provide supports for people to manage
and overcome mental health issues that may have a negative impact on achievement of
rehabilitation goals.

l HEALTHCARE IN THE PHILIPPINES

n The health care system in the Philippines has undergone dramatic changes in the last 20
years as the government has instituted various reforms and policies to provide easy
access to health benefits for every Filipino.
n The Department of Health (DOH) lists 1,071 licensed private hospitals, and 721 public
hospitals.
n The Department takes care of 70 of the public hospitals while local government units and
other state-run agencies manage the rest.

l HEALTHCARE GOVERNANCE STRUCTURE

n A decentralized health delivery system
n DOH-apex regulatory authority
n Develop national plans, technical standards and healthcare guidelines for all Filipinos.
n LGUs and Private sector agencies-act as adjuncts.
n CHDs (Centers for Health Department).
n RHUs (Rural Health Units)-exist in every municipality to improve access to healthcare.
l 8 HEALTH ISSUES THAT MADE HEADLINES IN 2018
l DIABETES
n More than three-fourths of the respondents (77 percent) from the Philippines believe that
diabetes is inherited from their parents. About 32 percent of those who were included in
the survey are willing to change their diet to support a member of their family with
diabetes, and 47 percent are willing to exercise with a diabetic family member.
n With the current population at over 100 million, the Philippines has more than 5 million
diagnosed diabetes.
l TUBERCULOSIS
n Manuel L. Quezon, the president of the Commonwealth of the Philippines, was in exile in
the United States when he died of tuberculosis (TB) at Saranac Lake, New York, on
August 1, 1944.
n Seventy-four years later, TB is still around killing 73 Filipinos every day, according to Dr.
Willie T. Ong, who writes a regular column for a national daily.
n The Philippines ranked eighth among the 30 countries with the largest number of TB
cases in the world, as per 2016 Global Tuberculosis Report.
l DENGUE
n There are actually two types of dengue: dengue and severe dengue. The latter, also
known as dengue hemorrhagic fever, was first recognized in the 1950s during dengue
epidemics in the Philippines.
n Before 1970, only nine countries had experienced severe dengue epidemics. The disease
is now endemic in more than 100 countries, with Southeast Asia and the Western Pacific
regions as among the most seriously affected, according to the World Health Organization
(WHO).
l MEASLES
n It has returned as a major public health threat. In Davao City, for instance, 22 of the 45
people who were confirmed with measles died.
n The Davao City Health Office has recorded a total number of 602 suspected measles
cases during the first three quarters of 2018, ending in September. During the period in
review, 22 of the 45 confirmed cases died of the disease.
n We have almost eradicated measles, but we are now seeing a rise in cases, because the
trust in vaccines is declining this year.
l HIV/AIDS
n It has returned as a major public health threat. In Davao City, for instance, 22 of the 45
people who were confirmed with measles died.
n The Davao City Health Office has recorded a total number of 602 suspected measles
cases during the first three quarters of 2018, ending in September. During the period in
review, 22 of the 45 confirmed cases died of the disease.
n We have almost eradicated measles, but we are now seeing a rise in cases, because the
trust in vaccines is declining this year.
l CERVICAL CANCER
n Every day, cervical cancer kills 12 Filipinos, mostly women. Although it does not spared
men, cervical cancer is women’s enemy number two.
 n “In the Philippines, cervical cancer is second to breast cancer as the most common
malignancy that afflicts and kills women,” reports Dr. Cecilia Ladines-Llave, former
chairman of the University of the Philippines-Philippine General Hospital Cancer Institute.
l ALCOHOLISM
n Alcohol kills more than HIV/AIDS, violence and road accidents combined, according to the
recent report released by the United Nations health agency.
n The report said HIV/AIDS is responsible for 1.8 percent of global deaths, road injuries for
2.5 percent and violence for 0.8 percent.
n In comparison, the harmful use of alcohol kills more than 3 million people each year.
That’s about 1 in 20 deaths—and most of them belong to the male species. “More than
three quarters of these deaths were among men,” pointed out the WHO report, Global
Status Report On Alcohol And Health 2018.
l MEDICAL MARIJUANA
n A couple of years back, the President replied when asked by a television reporter on the
subject: “Medical marijuana, yes, because it is really an ingredient of modern
medicine. There are medicines being developed, or are now in the market, that contain
marijuana for medical purposes.”
n “We’ve seen massive changes overtake a global cannabis culture already establishing
itself at a remarkable pace,” the American magazine pointed out. “Canada has joined
Uruguay as the second country in the world to legalize cannabis for adult use, markets in
the US are growing with every election season, and even countries like Lebanon—whose
long-standing diplomatic efforts with the West and its drug warriors caused a long tradition
of excellent cannabis to fall by the wayside—are rethinking their relationship to the plant.”

l HEALTH OUTCOMES
n In a state of double disease burden
n Communicable diseases are the major causes of morbidity and mortality in Philippines.
Morbidity rate in communicable diseases-42.8 /100,000 population(2009)
n Morbidity Rate in Non Communicable Diseases-90.4/100,000 population.(2009)
n Maternal mortality rate(MMR)-94 deaths/100,000 live births(2009)
n Unlikely for Philippines to accomplish targets for 2015 MDG

l HEALTH BUDGET
n Low efficiency in health spending.
n Health expenditure- 3.8% of GDP
n Tax funding system adopted by Department of Finance and Internal Revenue Allotment in
case of Local Governments.
n Three major groups of healthcare payers:
(i) national and local governments,
(ii) social health insurance,
(iii) private sources.

l PRIMARY GOALS OF THE HEALTH SECTOR

n Better health outcomes
 n Attaining the best coverage level of health care for the entire populations and attaining the
smallest feasible differences in health status among individuals and groups.
n More responsive health system
n Meeting the people’s expectations of how they should be treated by health providers and
the degree by which people are satisfied with the health system.
n More equitable health care financing
n Distributing the risk that each individual forces due to cost of health core according to
ability to pay rather than the risk of illness.

l HEALTH IMPROVEMENT PLANS

n SHIELD (Sustainable Health Improvement through Empowerment and Local
Development) project in ARMM –Philippine government’s Sector development agenda for
health, USAID funded-5 year project
n Integrated Community Health Services Project (ICHSP) and the National Centre for Health
Facility Development (NCHFD)- to strengthen referral system , enhance local planning,
decision making and monitoring.

l KEY CHALLENGES IN HEALTHCARE

n Prevailing conditions of inequity in health status.
n Poor infrastructure in the healthcare sector which needs to be worked upon to attract more
tourist.
n Lack of IT governance structures.
n Diseases emerging new communicable diseases adding to the existent prevalence of
communicable.
n Common solitary governing body is required to be set up to coordinate activities of human
resources.
n Wide gap between the rich and the poor

TOPIC 11: STATUS OF HEALTH CARE SYSTEM IN THE PHILIPPINES

EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Familiarize with the Philippine Health Agenda 2016-2022
2. Understand the Philippine Health Agenda Goals
3. Familiarize with the Philippine Health Agenda 3 Guarantees
4. Analyze the Philippine Health Agenda Startegies

REQUIRED READINGS
• https://apps.who.int/iris/bitstream/handle/10665/274579/9789290226734-eng.pdf?sequence=1&isAllowed=y
• https://www.doh.gov.ph/sites/default/files/basic-page/chapter-one.pdf
 RELATED LINKS AND VIDEOS:
l Universal Health Care Act (https://www.youtube.com/watch?v=RlO9Z9YF3yM)
l Universal Health Coverage: Philippines (https://www.youtube.com/watch?v=X5XGOi_hEVU)

NOTES:
PHILIPPINE HEALTH AGENDA 2016-2022
l GOALS:
n Financial Protection
n Better Health outcomes
n Responsiveness
l VALUES:
n Equitable & inclusive to all
n Provides high quality services
n Uses resources efficiently
n Transparent & accountable
l MILESTONES:
n Devolution
n Use of Generic
n Milk Code
n PhilHealth (1995)
n DOH resources to promote local health system development
n Fiscak autonomy for government hospitals
n Good Governance Programs (ISO, IMC, PGS)
n Funding for UHC
l Persistent Inequities in Health Outcomes
n Every year, around 2000 mothers die due to pregnancy-related complications.
n A Filipino child born to the poorest family is 3 times more likely to not reach his 5th birthday,
compared to one born to the richest family.
n Three out of 10 children are stunted.
l Restrictive and Impoverishing Healthcare Costs
n Every year, 1.5 million families are pushed to poverty due to health care expenditures
n Filipinos forego or delay care due to prohibitive and unpredictable user fees or co-payments
n Php 4,000/month healthcare expenses considered catastrophic for single income families.
l Poor quality and undignified care synonymous with public clinics and hospitals
n Long wait times
n Limited autonomy to choose provider
n Less than hygienic restrooms, lacking amenities
n Poor record-keeping
n Privacy and confidentiality taken lightly
n Overcrowding & under-provision of care

l ATTAIN HEALTH-RELATED SDG TARGETS

n Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience
n 3 GUARANTEEs:
1. ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE
l Communicable diseases
 n HIV/AIDS, TB, Malaria, Diseases for Elimination, Dengue, Lepto, Ebola, Zika
l Non-Communicable diseases & Malnutrition
n Cancer, Diabetes, Heart Disease and their Risk Factors – obesity, smoking, diet,
sedentary lifestyle, Malnutrition
l Diseases of rapid urbanization & industrialization
n Injuries, Substance abuse, Mental Illness, Pandemics, Travel Medicine, Health
consequences of climate change / disaster
2. SERVICE DELIVERY NETWORK GUARANTEE
l Fully functional (complete equipment, medicines, health professional)
l Compliant with clinical practice guidelines
l Available 24/7 & even during disasters
l Practicing gatekeeping
l Located close to the people (mobile clinic or subsidize transportation cost)
l Enhanced by telemedicine
3. UNIVERSAL HEALTH INSURANCE
l Services are financed predominantly by philhealth
l Philhealth as the gateway to free affordable care
n 100% of filipinos are members
n Formal sector premium paid through payroll
n Non-formal sector premium paid through tax subsidy
l Simplify philhealth rules
n No balance billing for the poor/basic accommodation & fixed co-payment for non-
basic accommodation
l Philhealth as main revenue source for public health care providers
n Expand benefits to cover comprehensive range of services.
n Contracting networks of providers within SDNs.

l STRATEGY
n Advance quality, health promotion and primary care
u Conduct annual health visits for all poor families and special populations (NHTS, IP, PWD,
Senior Citizens).
u Develop an explicit list of primary care entitlements that will become the basis for licensing
and contracting arrangements.
u Transform select DOH hospitals into mega-hospitals with capabilities for multi-specialty
training and teaching and reference laboratory.
u Support LGUs in advancing pro-health resolutions or ordinances (e.g. city-wide smoke-
free or speed limit ordinances).
u Establish expert bodies for health promotion and surveillance and response.
n Cover all Filipinos against health-related financial risk
u Raise more revenues for health, e.g. impose healthpromoting taxes, increase NHIP
premium rates, improve premium collection efficiency.
u Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with PhilHealth.
u Expand PhilHealth benefits to cover outpatient diagnostics, medicines, blood and blood
products aided by health technology assessment.
u Update costing of current PhilHealth case rates to ensure that it covers full cost of care
and link payment to service quality.
u Enhance and enforce PhilHealth contracting policies for better viability and sustainability.
n Harness the power of strategic HRH development
u Revise health professions curriculum to be more primary care-oriented and responsive to
local and global needs.
u Streamline HRH compensation package to incentivize service in high-risk or GIDA areas.
 u Update frontline staffing complement standards from profession-based to competency-
based.
u Make available fully-funded scholarships for HRH hailing from GIDA areas or IP groups.
u Formulate mechanisms for mandatory return of service schemes for all heath graduates.
n Invest in eHealth and data for decision-making
u Mandate the use of electronic medical records in all health facilities.
u Make online submission of clinical, drug dispensing, administrative and financial records a
prerequisite for registration, licensing and contracting.
u Commission nationwide surveys, streamline information systems, and support efforts to
improve local civil registration and vital statistics.
u Automate major business processes and invest in warehousing and business intelligence
tools.
u Facilitate ease of access of researchers to available data.
n Enforce standards, accountability and transparency
u Publish health information that can trigger better performance and accountability.
u Set up dedicated performance monitoring unit to track performance or progress of reforms.
n Value all clients and patients, especially the poor, marginalized, and vulnerable
u Prioritize the poorest 20 million Filipinos in all health programs and support them in non-
direct health expenditures.
u Make all health entitlements simple, explicit and widely published to facilitate
understanding, & generate demand.
u Set up participation and redress mechanisms.
u Reduce turnaround time and improve transparency of processes at all DOH health
facilities.
u Eliminate queuing, guarantee decent accommodation and clean restrooms in all
government hospitals.
n Elicit multi-sectoral and multi-stakeholder support for health
u Harness and align the private sector in planning supply side investments.
u Work with other national government agencies to address social determinants of health.
u Make health impact assessment and public health management plan a prerequisite for
initiating large-scale, high-risk infrastructure projects.
u Collaborate with CSOs and other stakeholders on budget development, monitoring and
evaluation.

TOPIC 12: THE ROLE OF PHARMACISTS IN THE HEALTH CARE DELIVERY SYSTEM
EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Define the roles and reponsibilities of a Pharmacist.
2. Familarize with the Different Areas of Pharmacy Practice.

REQUIRED READINGS
• https://www.researchgate.net/publication/235418627_Pharmacists'_Role_in_the_Healthcare_System
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819958/
 RELATED LINKS AND VIDEOS:
l What does a Pharmaicst do? (https://www.youtube.com/watch?v=M4VE7aOz6lQ)
l Careers in Pharmacy (https://www.youtube.com/watch?v=rQu7p9MbUnc)
l Pharmacist in Cruise Ships (https://www.youtube.com/watch?v=4xp9wG4dMSs)

NOTES:
TERMINOLOGY:
l PHARMACIST
n are medication experts and play a critical role in helping people get the best results from their
medications.

DIFFERENT AREAS OF PHARMACY PRACTICE

l Community pharmacy
n is practiced by about 85% of pharmacy graduates who make a unique hybrid of businessmen
and professionals.
n a professional in his own right, a partner in the health team who handles drugs of great
potency and value, manufactured by a highly sophisticated industry
n The pharmacist may establish her own drugstore or be employed in an existing drugstore or
chain drugstore.
l Wholesale pharmacy
n offers opportunities for a limited number of pharmacists.
n serves as the middleman between manufacturer and the retailer
n all wholesale drug firms employ registered pharmacists in supervisory capacities.
l Hospital pharmacy
n is the practice of pharmacy in private and government-owned hospitals.
n Hospital pharmacists are responsible for the procurement, preservation, storage,
compounding, manufacturing, packaging, controlling, assaying, dispensing and distribution of
medications to hospitalized and ambulatory patients.
l Industrial pharmacy
n Marketing and administration. A great number of pharmacists are / or detailman is in contact
with physicians and pharmacists regarding his company’s product.
n Production where a pharmacist can work as staff or be given a supervisory position.
n Quality control where a pharmacist can work as a drug analyst or be given a supervisory
position.
n Research and development where a pharmacist can work as a researcher
n Company pharmacist. The pharmacist works as a liaison of a company to FDA and in charge
of the registration of company products.
l Government service
n offers opportunities to pharmacists in various capacities.
n Department of Health
n Food and Drug Administration
n Dangerous Drug Board
n National Bureau of Investigation
n Veterans and Army Hospital
n Government-funded research institutions like NSDB, NRCP
n Central Bank
 n Government Hospital
l Public Health Pharmacy
n Identifies appropriately the health and pharmaceutical needs of the population as well as the
appropriate interventions to address them.
n Support activities aimed at protecting and improving the health and well-being of the
population.
n Participates in policy and strategy development and implementation.
n Contributes to the evidence base on how medicines-related interventions, programs and
policies improve and protect the health of the population through academic/pharmacy practice
research.
n Ensures clinical governance and continuous quality improvement in service design and
delivery.
l Pharmaceutical education
n offers excellent opportunities for pharmacists with advanced degrees in any of the professional
specialties.
n Expanding enrolment in colleges to meet the manpower needs of the future offers excellent
opportunities for careers in college teaching.
l Pharmaceutical journalism
n offers rewarding experiences to a limited number of pharmacists with writing and editing talent.
l Clinical pharmacy
n is the practice of pharmacy in a hospital setting, which is patient-oriented.
n The clinical pharmacist is responsible not only for safe and appropriate use of drugs on
patients but also the rational selection, monitoring, dosing, and control of patient’s overall drug
therapy program.

TOPIC 13: EXTENDED PHARMACY SERVICES IN THE HEALTH CARE SYSTEM

PHILIPPINE PHARMACISTS’ ADVOCACY PROGRAMS
EXPECTED OUTCOMES:
At the end of this unit, the students are expected to:
1. Define the Philippine Practice Standard for Pharmacist
2. Understand the Core Competency Standards of a Pharmacist
3. Familiarize with the Standards in Academe, Manufacturing, Community, Regulatory and
Public Health Pharmacy

REQUIRED READINGS
• https://quizlet.com/463415053/philippine-pharmacists-association-advocacy-programs-flash-cards/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483753/

RELATED LINKS AND VIDEOS:

l Introduction to Core Competencies for a Clinical Pharmacist
(https://www.youtube.com/watch?v=cLimQiGYsHY)
 NOTES:
PHILIPPINE PRACTICE STANDARDS FOR PHARMACISTS
CORE COMPETENCY STANDARDS
1. Practices in a professional, legal and ethical manner.
2. Places client’s/patient’s welfare at the center of practice.
3. Demonstrate leadership and management skills
4. Demonstrate cultural competence and effective communication.
5. Engages in interprofessional collaboration.
6. Commits oneself to continuing professional development.

COMMON COMPETENCY STANDARDS ACROSS THE PRACTICE AREAS:

l ACADEMIC PHARMACY
1. Prepares students to become professional pharmacists through effective teaching.
l ELEMENT 1.1: Applies educational theories and principles to improve teaching and
learning
l ELEMENT 1.2: Facilitates learning among students
l ELEMENT 1.3: Assesses learning outcomes among students
2. Contributes to existing body of knowledge through conduct of scientific research
l ELEMENT 2.1: Identifies critical research areas to improve pharmacy practice and health
outcomes of the community
l ELEMENT 2.2: Conducts ethical and technically sound scientific research
l ELEMENT 2.3: Translates scientific research findings for the benefit of clients/ patients
and communities.
3. Shares technical expertise to the members of the community.
l ELEMENT 3.1: Provides extension services.
4. Enriches teaching with additional training and practice experience.
l ELEMENT 4.1: Seeks formal learning opportunities to improve knowledge and
professional skills.
l ELEMENT 4.2: Maintains up-to-date understanding of practice issues and developments

l REGULATORY PHARMACY
1. Represents the organization to regulatory authorities.
l ELEMENT 1.1: Possesses adequate product knowledge.
l ELEMENT 1.2: Possesses knowledge on regulatory policies and laws.
l ELEMENT 1.3: Demonstrates effective negotiation skills.
l ELEMENT 1.4: Applies for license to operate of the organization.
l ELEMENT 1.5: Applies product registration to regulatory authorities.
l ELEMENT 1.6: Maintains existing registrations.
2. Coordinates pertinent regulatory-related marketing activities of the organization.
l ELEMENT 2.1: Participates in product planning and related activities.
l ELEMENT 2.2: Ensures that all labeling and marketing-related materials comply with
ethical and regulatory guidelines.
3. Participates in the development of regulatory guidelines.
l ELEMENT 3.1: Explains local and international guidelines to the members of the
organization.
l ELEMENT 3.2: Contributes in policy-making and regulatory guidelines development.
4. Ensures quality regulatory documentation.
l ELEMENT 4.1: Contributes to the development of policies and standard operating
procedures (SOPs) in the organization.
 l ELEMENT 4.2: Secures relevant regulatory documents.
5. Ensures compliance to health vigilance requirements.
l ELEMENT 5.1: Contributes to the development of a health vigilance system within the
organization.
l ELEMENT 5.2: Participates in post-marketing surveillance (PMS).
l ELEMENT 5.3: Participates in organization- or regulatory authority-initiated product
recalls.

l MANUFACTURING PHARMACY
1. Participates in Quality Management System.
l ELEMENT 1.1: Contributes to good paper- and electronic- based QMS documentation.
l ELEMENT 1.2: Participates in the implementation of the organization’s QMS.
l ELEMENT 1.3: Engages in activities related to continuous improvement.
2. Contributes in product life cycle management.
l ELEMENT 2.1: Understands production and control operations.
l ELEMENT 2.2: Adheres to established change control systems.
l ELEMENT 2.3: Understands the principles of Good Distribution Practice (GDP).
3. Maintains adequate premises and equipment.
l ELEMENT 3.1: Observes the logical arrangement of materials, equipment, operations and
personnel in the workplace.
l ELEMENT 3.2: Understands the principles of Good Storage Practice (GDP).
l ELEMENT 3.3: Complies with the policies and procedures related to sanitation and
hygiene.
4. Participates in health vigilance programs.
l ELEMENT 4.1: Contributes in the development of a health vigilance system within the
organization.
l ELEMENT 4.2: Participates in the Post Marketing Surveillance (PMS).
l ELEMENT 4.3: Participates in organization- or regulatory authority-initiated product
recalls.

l COMMUNITY, HOSPITAL AND INSTITUTIONAL PHARMACY

1. Provides quality medicines and other health products appropriate to the need of the
client/patient.
l ELEMENT 1.1: Implements a system of good dispensing practice in accordance with
national standards, guidelines and policies.
l ELEMENT 1.2: Undertakes prescription validation and assessment.
l ELEMENT 1.3: Maintains pertinent client/patient information and medication records.
l ELEMENT 1.4: Promotes the judicious, appropriate, safe and effective use of prescribed
medicines.
l ELEMENT 1.5: Fills prescriptions accurately.
l ELEMENT 1.6: Checks the product and its label against the prescription.
l ELEMENT 1.7: Identifies the client/patient when dispensing medicines.
l ELEMENT 1.8: Manages the record with privacy and confidentiality.
l ELEMENT 1.9: Displays additional appropriate care when dispensing antimicrobials.
2. Compound products in a manner that ensures product quality, safety and efficacy.
l ELEMENT 2.1: Possesses necessary knowledge and skills to deliver the level of
compounding required.
l ELEMENT 2.2: Implements a systematic process of preparing compounded drug products,
both sterile and non-sterile, in accordance with established standards and guidelines.
l ELEMENT 2.3: Compounds products in accordance with recognized standards and
guidelines, and as appropriate to the practice setting.
 l ELEMENT 2.4: Optimizes packaging and labeling of compounded products.
3. Counsel client/patient on the safe and judicious use of medicine and other health products.
l ELEMENT 3.1: Counsels client/patient in a structured and logical manner.
l ELEMENT 3.2: Tailors care and counseling according to the needs of the client/patient.
l ELEMENT 3.3: Utilizes a range of communication methods to ensure that counseling is
effective.
l ELEMENT 3.4: Collaborates with the client/patient to positively impact on adherence.
l ELEMENT 3.5: Refers to other healthcare providers or support services, when
appropriate.
4. Engages actively in client/patient safety and health promotion activities.
l ELEMENT 4.1: Ensures continuity of care and safety of clients/patients
l ELEMENT 4.2: Contributes in the management of the client’s/patient’s disease states.
l ELEMENT 4.3: Engages in health promotion, education and disease prevention activities.
5. Ensures business sustainability through efficient processes and systems.
l ELEMENT 5.1: Manages financial viability of pharmacy business.
l ELEMENT 5.2: Manages human resources.
l ELEMENT 5.3: Procures equipment and resources.
l ELEMENT 5.4: Oversees inventory management.
l ELEMENT 5.5: Supervises effectively the execution of merchandising plan and marketing
strategies.

l PUBLIC HEALTH PHARMACY

1. Identify appropriately the health and pharmaceutical needs of the population as well as the
appropriate interventions to address them.
l ELEMENT 1.1: Evaluates relevant, accurate and comprehensive data to understand the
public health situation.
l ELEMENT 1.2: Integrates updated, high-quality scientific evidence to inform medicines-
related policy and program decisions.
2. Supports activities aimed at protecting and improving the health and well-being of the
population.
l ELEMENT 2.1: Engages in activities that can support and enable the people to adopt
healthier lifestyles.
l ELEMENT 2.2: Participates in activities that prevent harm towards the population and
community.
3. Participates in policy and strategy development and implementation.
l ELEMENT 3.1: Recognizes pharmacy-related laws and regulations as legal bases of
pharmacy practice.
l ELEMENT 3.2: Demonstrates capacity to health policy studies and investigations.
l ELEMENT 3.3: Establishes strategic partnerships to advance policies and strategies for
the population and community.
4. Contribute to the evidence base on how medicines related interventions, programs and policies
improve and protect the health of the population through academic and/or pharmacy practice
research.
l ELEMENT 4.1: Engages in health, medicines or pharmacy practice research.
5. Ensures clinical governance and continuous quality improvement in service design and delivery.
l ELEMENT 5.1: Maintains an effective and efficient quality assurance system in
conjunction with stakeholders involved.
 REFERENCES:

1. Romualdez, et.al (2011). The Philippine Health System Review. Health Systems in Transition,
vol.1
2. Nisce, et. al. (1995). Community Health Nursing Services in the
Philippine Department of Health. 8th Edition. Manila.
3. Kuyegkeng. T. (1991). Basic Health Care for the Community.
Manila.
4. Population Center Foundation. 1990). Community Organizing:
A Manual on the HRDP Experience. Manila
5. Miller and Keane. (1987). Encyclopedia and Dictionary of
Medicine, Nursing and Allied Heath. Philadelphia
6. Dizon, E. (1979). Community Health Nursing in the Philippines.
Manila.
7. Rivera, A.K.B., & Antonio, C.A.T (2017). Mental health stigma
among Filipinos: Time for a paradigm shift. Philippine Journal
of Health Research and Development, 21 (2), pp. 20-24.
8. http://apps.who.int/medicinedocs/en/d/Jh2995e/1.6.2.html

RECOMMENDED OUTPUTS PER COURSE:

NO. OF UNITS IN PER RECOMMENDED RECOMMENDED RECOMMENDED

COURSE NUMBER OF QUIZZES NUMBER OF NUMBER OF
ASSIGNMENTS DISCUSSION BOARD
(including Journal Article Review)
6 units lecture 15-18 quizzes 7-9 assignments 3-4 discussion board
5 units lecture 12-14 quizzes 7-9 assignments 3-4 discussion board
4 units lecture 10-12 quizzes 6-8 assignments 3-4 discussion board
3 units lecture 8-10 quizzes 6-8 assignments 3-4 discussion board
2 units lecture 7-8 quizzes 5-6 assignments 3-4 discussion board
1 unit lecture 6-7 quizzes 5-6 assignments 3-4 discussion board

25 items per Quiz: (recommended)

• 5 Morse Type
• 5 True or False
• 5 Matching type
• 10 MCQ

Deliverables Due July 10, 2020

• Lecture Guide for assigned courses
• Quizzes
• Assignments
• Discussion Board