REVIEW ON EPIDEMIOLOGY

TYPES OF EPIDEMIOLOGUCAL APPROACH

1. DESCRIPTIVE EPIDEMIOLOGY
2. ANALYTICAL EPIDEMIOLOGY
3. EXPERIMANTAL EPIDEMIOLOGY
4. EVALUATION EPIDEMIOLOGY
ANALYTICAL EPIDEMIOLOGY
• Attempts to analyze the cause or determinants of the disease through
hypothesis testing.
• 2 common studies
• Case Control Studies
• Cohort studies
COHORT STUDY
• MEASURES THE RELATIVE RISK
• PROSPECTIVE STUDIES STUDY

CASE CONTROL STUDY

• MEASURES THE ODDS RATIO
• RETROSEPCTIVE STUDIES
3. EXPERIMANTAL EPIDEMIOLOGY
• Answers questions about the effectiveness of a new method for
controlling disease or improving underlying condition

4. EVALUATION EPIDEMIOLOGY
• Measures effectiveness of different health services and programs
ENVIRONMENTAL
SANITATION
• twenty five million of the 2.3 billion people worldwide who lack
access to a basic sanitation service
• The spread of water-borne diseases, for instance, results in billions of
pesos in costs to the government and poor quality of life for many
citizens.
• Diarrheal cases is still one of the top leading causes of morbidity
among general population
• Other sanitation related disease, dengue, intestinal parasitism,
cholera hepatitis infection etc.
8 Environmental Health Indicators
• Household with access to improved or safe water
• Household with sanitary toilets
• Households with satisfactory disposal of solid waste
• Household with basic sanitation facilities
• Food establishments
• Food establishments with sanitary permits
• Food handlers
• Food handler with health certificates
Policies and Laws

• PD No. 856 – Code on Sanitation of the Philippines

• EO No. 489 s. 1991 – The Inter-Agency Committee on Environmental Health
(IACEH)
• National Objectives for Health (NOH) 2011-2016
• DOH A.O. 2010-0021 - Sustainable Sanitation as a National Policy and a National
Priority Program of the
• DOH A.O. 2014-0027 – National Policy on Water Safety Plan (WSP) for All
Drinking-Water Service
• DOH A.O. 2017-0006 – Guidelines for the Review and Approval of the Water
Providers
Safety Plans of Drinking-Water Service
• DOH A.O. 2017-0010 – Philippine National Standards for Drinking Water (PNSDW)
Providers
of 2017
Environmental health service policies is aimed
towards
• Approved types of water facilities
• Unapproved type of water facilities
• Access to safe potable water
• Quality monitoring and surveillance
• Waterworks and water system
3 levels of Approved types of water Facility
1. LEVEL 1/ POINTSOURCE= protected well or developed spring with
an outlet but without distribution system. Serves 15 to 25
households
• Reach must not be more than 250 meters for the farthest user
• 40-140 liters per minute
2. Level II (Communal faucet System and Stand-post)= a system with
reservoir a piped distribution network and communal faucets
• Located not more than 25 meters from the farthest house
• 40-40 liters of water per capita per day
• Average 100 household
• With 1 faucet per 4-6 household
3 levels of Approved types of water Facility
3. Level 3 (Waterworks System or individual House
Connections) = a water system with source, a
reservoir, piped distributor network and household
taps.
Unapproved type of water facility
• Water coming form doubtful sources such as open dug well,
unimproved springs, wells that needs priming.
Access to safe and potable drinking water
• All household shall be provided with safe adequate water supply
WATER QUALITY MONITORING SURVEILLANCE
• RHU should have operational plan for water quality monitoring every
year
• Require that meet the provision of the national standards for drinking
water set by the DOH
• Examination of drinking water shall be performed only in private and
government laboratories duly accredited by DOH
• Disinfection of water supply if
• Newly constructed water supply
• Repaired/improved water supply
• Positive bacteriologically
Water works system and well construction
• Well site shall require approval of the Secretary of Health
• Shall comply with sanitary requirements
• Supply safe and adequate in quantity
• Readily made available to consumers
• Adequate pressure & Volume to distribution lines
PROPER SEWAGE DISPISAL
PROGRAM
TYPES OF TOILETS FACILITIES
1. LEVEL 1 non-water carriage toilet facility - no water necessary to
wash waste int the receiving space.
2. LEVEL 2 on site toilet facilties of the water carriage type with water-
sealed and flush type vault/tank
3. LEVEL 3 water carriage types of toilets facilities connects to septic
tanks and or to sewerage system to treatment plant
• The blind drainage type of waste water collection and disposal facility
shall continue to be the emphasis until such time that sewer facilities
and off-site treatment shall be made available
• Other policies embedded in the Sanitation Code of the Philippines
FOOD SANITATION PROGRAM
• Food establishment shall be appraised as to the following sanitary
conditions.
• Inspection/approval of all food sources, containers, transport vehicle
• Compliance to sanitary permit requirements for all food
establishment
• Provision of updated Health Certificate for food handlers
• Destruction or banning of food unfit for human consuption
• Training of food handlers an operators on food sanitation
• Food establishments shall be rated and classified as followes
• Class A –Excellent
• Class B –Very Satisfactory
• Class C –Satisfactory
• Ambulant food vendors shall comply with the requirements as to the
issuance of health certificate
• Household food sanitation are to be promoted
Nursing Responsibilities
• Health Education
• Participate in training
• assist in deworming
• Effectively and efficiently coordinate with program
• Advocate
• Participate in environmental sanitation campaigns
 Epidemiological
approach EXPLORATION/COMMUNITY
IMMERSION

ESTABLISH RAPPORT

SET OJECTIVE IDENTIFY WHAT NEEDS TO BE INVESTIGATED

PLANNING DATA COLLECTION. METHODS AND TOOLS

TRAINING INTERVIEWERS

PRETESTING
REWORKING DATA AND INSTRUMENTS
 DETERMINING SAMPLING PROCEDURES

Epidemiological DATACOLLECTION AND COLLATION

approach ANALYSIS OF DATA AND DETERMINING

IMPLICATIONS

PREPARATION OF REPORT

FEEDBACK TO RELEVANT GROUPS AND WORK WITH

THEM OF IMPLICATIONS

PLANNING ACTION AND HEALTH PROG

ACTION
QUSTIONS?
CLASSIFICATION OF HEALTH CLUSTER FOCUS

•HEALTH PUBLIC
•WASH
•NUTRITION
•MHPSS
HEALTH/PUBLICH HEALTH FOCUS
• COMMUNICABLE AND NONCOMMUNICABLE
• MATERNAL AND CHILD
• REPRODUCTIVE HEALTH

WATER SANITATION AND HYGIENE

NUTRITION
• refer to essential nutrition services that are components of
emergency preparedness, response, and recovery phases aimed at
preventing death and worsening of malnutrition in the affected
population, particularly in the most nutritionally vulnerable groups:
infants, children, pregnant women and breastfeeding mothers, and
older persons.
WASH WATER SANITATION AND HYGIENE
ENVIRONMENTAL AND OCCUMATIONAL
HEALTH
!Water
supply !
Sanitation
!Waste Management
!Vector Control !
Hygiene education !
Planning & organizing
MENTAL HEALTH AND PSYCHOSOCIAL
SUPPORT SERVICES
• includes any support that people receive to protect or promote their
mental health and psychosocial wellbeing.
 NCM CHAPTER 3
Nursing Process in care of
Population Groups and Community
COMMUNITY HEALTH NURSING PROCESS
• DEMOGRAPHY
ASSESSMENT • VITAL HEALTH
STAT •
EPIDEMIOLOGY

DIAGNOSIS

EVALUATION PLANNING

IMPLEMENTATION
What is community diagnosis?
As a PROFILE, it is a description of the community’s state of health
as determined physical, economic, political and social factors. It
defines the community and states the community problems.

Purpose: To be able to obtain a quick ‘picture’ of a community’s

which is as accurate as possible.

A community profile should:

• Summarize information;
• Present results and figures clearly;
• Be useful for planning and monitoring;
As a PROCESS, it is a continuous learning experience for the
nurse/program coordinator and the staff, as well as the community
people, for the following reasons:

"It enables the nurse /program coordinator/ staff to adjust or

alter the program for optimum effectiveness.

"It allows the community to gradually become aware of the solution.

"It is an organized attempt to involve people in recognizing

and resolving problems that concern them most.

"It enables the community to understand at its own pace the

potential advantages o change, which may eventually lead to
alterations in attitudes, values, and behaviour.
Why undertake community diagnosis?

To have a clear picture of the problems of the community and

to identify the resources available to the community people.

Community diagnosis enables the nurse/ program coordinator to

set priorities for planning and developing programs of health care for
the community. The data gathered through the process serve as the
material for analysis.
What are the types of community diagnosis?
! The types of a community diagnosis may vary according to:
! The objectives or degree of detail or depth of the assessment
! The resources, and
! The time available for the nurse to conduct the community diagnosis.

A. COMPREHENSIVE COMMUNITY DIAGNOSIS- aims to obtain general information

about the community or a certain population .
group
B. PROBLEM-ORIENTED COMMUNITY DIAGNOSIS –
type of assessment that responds to a particular need (Spradly, 1990)
Example: a nurse was confronted with health and medical problem
from mine tailings being disposed into river systems by a mining company.
resulting
starts by investigating the meaning of the p roblem to the community
proceeds
people, to identifying the population affected by the hazards of the
Nurse
mine tailings, and then goes to the characterize the environmental factors and
elements relevant to the
problem.
other
 ELEMENTS OF COMMUNITY
DIAGNOSIS

DEMOGRAPHIC
POLITICAL
OLOF LEADERSHIP

POLITICAL

SOCIO-
HEALTH SOCIO
ECONOMIC BEHAVIORAL
RESOUCE ECONOMIC

COMMUNITY
HEALTH
ENVIRONMENT HEREDETARY PATTERN AND
ILLNESS
HEALTH CARE
DELIVERY
SYSTEM
What are the ELEMENTS of a comprehensive community diagnosis?
According to the Dones, as cited in Maglaya (2003), the following are elements of a
comprehensive community diagnosis:

A. DEMOGRAPHIC VARIABLE
! A comprehensive community diagnosis should show the size, composition, and geographical
distribution of the population, as indicated by the fo l
lowing:
! Total population and geographical distribution, including urban-rural index and population density.

! Age and sex composition.

! Selected vital indicators such as growth rate, crude birth rate, and life expectancy at birth.
! Patterns of migration.

! Population projections.

dislocated groups.
! Population groups with special needs – indigenous people, internal refugees, and other socially
B. SOCIO-ECONOMIC AND CULTURAL VARIABLES
1. Social indicator
Communication network (whether formal or in ormal channe s)
a. f l
necessary
disseminating health information or facilitating referral of the client to the
for care system.

b. Transportation system, including road networks, necessary for accessibility of

health care system.

c. Educational level that may be indicative of poverty and may reflect on the
health perception and health utilization pattern of the community.

d. Housing condition that may suggest health hazards (congestion and exposure
to harmful elements) and safety hazards (fire)
2. Economic indicator
a. Poverty level / income

b. Unemployment and underemployment rates

c. Proportion of the total economically active population that are salaried and wage
earners.

d. Types of industry present in the community

e. Occupation common in the community

f. Land ownership

g. Recreational facilities
Environmental indicators
A. Physical/Geographical/ Topographical characteristics of the
community ! Land areas that contribute to vector problems
! Terrain characteristics that contribute to accidents or pose as geohazard
zones ! Land usage in industry
! Climate /season
B. Water supply
! Percentage of population with access to safe, adequate water supply
! Source of water supply for drinking and other activities
C. Waste disposal
! Percent of population reached by the daily garbage collection system
! Percent of population with safe excreta disposal system
! Types of waste disposal and garbage disposal system
D. Air, water, and land pollution
! Industries with in the community that are hazardous to health
! Air and water pollution index
4. Cultural factors
a. Variables that may break the people into groups within the community
!Ethnicity
!Social class
!Language
!Religion !
Race
!Political orientation

b. Cultural beliefs and practices that affect health

c. Concepts about health and illness

d. Other factors that may directly or indirectly affect the health status of the
community
C. HEALTH AND ILLNESS PATTERNS
If the nurse has the access to recent and reliable secondary data,then
those could be used; otherwise nurse will have to gather the following:

!Leading causes of morbidity

!Leading causes of mortality

!Leading causes of infant mortality

!Leading causes of maternal mortality

!Leading causes of hospital admission

D. HEALTH RESOURCES Refers to manpower, institutional and material resources provided
not only by the state, but also those that are contributed by the private sector and other non-governmental
organization
s

1. Manpower resources !
Categories of health manpower available
! Geographical distribution of health manpower
! Manpower-population ratio
! Distribution of health manpower according to health facilities ( hospitals, rural health units, etc) !
Distribution of health manpower according to type of organization (government, non-government, private) !
Quality of health manpower
! Existing manpower development/policies
2. Material resources
! Health budget and expenditure
! Sources health funding
! Categories of health institutions available in the community
! Hospital –bed ratio
! Categories of health services available
E. POLITICAL /LEADERSHIP PATTERNS
eeds and problems of the community. It mirrors the sensitivity of
Reflect the oaction
government potential
the peoples of the for
struggle state and it’s people to address the health
a better
the
n
life.
t
!Power structure in the community ( formal or informal ) –leadership patterns,
community organizations, and government
structures
!Attitudes of the people toward authority

!Conditions / events / issues that cause social conflict or that lead to social
bonding or unification

!Practices /approaches that are effective in settling issues and concerns within
the community
SOURCES of data in the conduct of community diagnosis:

1. PRIMARY DATA---source would be the community people

through !Surveys
!Interviews
!Focused group discussions
!Observations
!Actual minutes of community meetings

2. SECONDARY DATA
!Organizational records of the program
!Health center records
!Other public records
STEPS in conducting community diagnosis
A. PLANNING

1.Determine the objectives

Nurse decides on the depth and scope of data to be gathered. Nurse
must determine the occurrence and distribution of
environmental,
selected socio- economic, and behavioural conditions
important to disease prevention and wellness
promotion
! STATEMENT of objectives should be SMART (Specific, Measurable,
Attainable, Realistic, Time-
bound)
2. Define the study population
Nurse identifies the population group based on the objectives
of the study;The study population may be the entire
population Focused on a population
community
group
3. Prepare the community
Courtesy calls for meetings are a must to enable the nurse to
formulate the community diagnosis objectives with the leaders
the
of community; the following initial data are gathered through the
key
leaders;
! Spot map of the entire community
! Initial secondary data, e.g., total numbers of household per area,
total population per area list of traditional healers, list of
CHWs
4. Choose the Methodology and Instrument of Community diagnosis
Three Levels of Data Gathering
! Community people---household heads, traditiona l, and
traditional
non- leaders; 30% of the total population of household for the
survey sample spread out proportionally would be
representation increases or decreases proportionally depending on
ideal;
the size of the area ; ideally , 10% of traditional leaders ( while
corresponding
a number of non-traditional leaders ) be obtained !
Community health workers---ideally, 20% of all enlisted CHWs as of
th previous year
! Program staff
Instrument---may be the following
! Survey questionnaire

! Observation checklist

! Interview guide ( CHWs, leaders, program staff )

Instrument-simplified to avoid overburden on the data gatherers in terms of

educational preparation and time
constraints
Instrument analyze and discuss by data gatherers

Role-play an interview scene to place oneself in an actual situation

5. Setting the Targets- involves

! Constructing a timetable of activities
! Sample size
! Number of personnel that will work
IMPLEMENTATION
Actual data gathering-nurse supervises the data collectors,
check the completeness, accuracy, and reliability of
information.
the Data gathered should cover the
following:
! Community dimensions secondarily related to health

! demographic data

! economic characteristics

! social indicators

! political characteristics

! cultural characteristics
! environmental indicators
!Community dimensions directly related to health

! general health indicators – birth, death, morbidity, mortality

rates.
! Maternal and child health care – family planning, midwifery
services, child care .
! Immunization status of children
! Food and nutrition – daily food budget, daily food intake,
knowledge of basic food
! groups.
Illness and injury – type of sickness, medical personnel
attending to the sick, where the sick go for consultation and
treatments, types and sources of medicines, dental
mental
care, health accidents, causes of death.
Cont.
!Water environment –water supply and storage, food storage, sanitation
(excreta, garbage, waste water disposal, pets and vermin control)
!Endemic diseases
!Essential drugs !
Health education
!Health resources –(government/private ) health manpower, health
centers, health services.
!Perception of health problems- concepts of health, perceived health
problem, solution to health problems.
Collation/ Organizational of data- there are two types of
data that may be genera
ted:
Numerical data –data that can be counted.
Descriptive data- description of observable characteristics
of different
factors.
Before collation is done, the accomplished questionnaires
are edited. Editing means going through
questionnaire
the to ensure that all the questions have been
properly entered.
!NR- No response
!Na- Not applicable

To facilitate data col lection, the nurse must

categories
develop for the classification of the responses,
sure that the categories are MUTUALLY EXCLUSIVE
making EXHAUSTIVE.
and
a. MUTUALLY EXCLUSIVE choices do not overlap
b. EXHAUSTIVE CATEGORIES anticipate all possible answers that a respondent give.
To classify Educational attainment:
monthly income a. No formal education
: b. elementary undergraduate
c. elementary graduate
d. High school undergraduate
Below P1,000
e. High school graduate
P1,001 – P5,000
f. College undergraduate
P5,101- P 10,000
g. Post graduate level
P10,001- P15,000
h. Others(please specify)
Above P15,001

(a) (b)
• For FIXED-RESPONSE questions, choices must be provided to serve as
categories for the respondent’s answer.

• OPEN-ENDED questions do not provide choices or categories and the

answers may be given freely by the respondent.
The next step will be to summarize the data.
Manual Tallying or counting

Dieases Tally Mark Frequency

Pneumonia IIIII-IIIII-IIIII-II 17
Diarrhea IIIII-IIIII-III 13
Coughs and IIIII-IIIII-IIIII-IIIII- 28
Colds IIIII-III
Computer tallying- Responses should be given codes.

Waste Disposal :

Open dumping 1
Burial in pit 2
Composing 3
Open Burning 4
3. Presentation / organization of data= data collected may be
presented as:
"Statistical
tables "Graphs
"Descriptive data- Examples : geographic data, history of
village, health beliefs.

4. Analysis of data- aims to establish trends and patterns in terms in

health needs and problem of the community. It allows comparison of
an obtained data with standard values.
5 . Identification of community health nursing
roblems- make a list of the health s and
categorize
p
problem them
as :
Health status problems- may be described in terms of increased or
!
decreased
morbidity,mortality
ascariasis. or fertility. Example : 40% of the school-age children have

! Health
absence
resources problems – they may be described in terms of lack of
of manpower , money , materials, or insti tutions necessary to
or
solve problems. Example : 25 % of the BHWs lack skills in vital-signs taking.
health
Health-related problems- they may be described in terms of existence
!
of
social,economic,environmental, and political
inducing situations in the community. factors
Example: 30% that aggravate
of the the illness-
households
dump
their garbage in the river.
6. Priority-Setting of Community Health Nursing-Problems- make use of
the following criteria:
"Nature of the problem presented – the problems are classified by
the nurse as health status, health resources, or health- related
problems.
"Magnitude of the problem- refers to the severity of the problem,
which can be measured in terms of the proportion of the population
affected by the problem.
"Modifiability of the problem- refers to the probability of
reducing, controlling, or eradicating the problem.
"Preventive potential- refers to the probability of controlling or
reducing the effects posed by the problem.
"Social concern- refers to the perception of the population or
the community as they are affected by the problem.
 =0` WEIGHT Prob1 Prob2
Name of the problem
Health Status 3 1
Health resources 2
Health-related 1

Magnitude of the problem

75%- 100% affected 4 3
50%- 74% affected 3
25%- 49% affected 2
<25% affected 1

Modifiability of the problem

High 3 4
Moderate 2
Low 1
Not modifiable 0

Preventive Potential
High 3 1
Moderate 2
Low 1

Social Concern
Urgent community concern 2 1
Recognized as a problem but not needing urgent attention 1
Not a community concern 0
SCORING SYSTEM IN PRIORITIZING HEALTH PROBLEMS

STEPS IN PRIORITIZING PROBLEMS

"Score each problem according to each criteria.
"Divide score by the highest possible score .
"Multiply the answer by the weight of the criteria
"Add the final score for each criterion to get the total score for the
problem. The highest possible score is 10, while the lowest possible
score is 1 5/12.
"The problem with the highest total score is given high priority by
the nurse.
CS = Score
x Weight
Highest C.
Score

Activity
 1. DETERMINING • IDENTIFY SCOPE OF DATA THAT NEED TO COVER
OBJECTIVES • Determine the occurrence of the problem

2. DEFINING STUDY • DEMOGRAPHICS

POPULATION • DEFINE THE POPULATION GROUPS

3. DETERMINING THE • DENTIFY SPECIFIC DATA TO COLLECT

DATA TO BE COLLECTED • FOCUSED ON SPECIFIC PROBLEM

4. COLLECTING DATA • RECORDS

• INTERVIEW, SURUVEYS, PARTICIPANTS OBSERVATION

5. DEVELOPING THE • SURVEY QUESTIONAIRE

• INTERVIEW GUIDE
INSTRUMENTS • OBSERVATION CHECKLIST
 6. ACTUAL DATA • PRE-TESTING
GATHEING • TRAIN DATA COLLECTORS

• NUMERICAL AND DESCRIPTIVE DATA

7. DATA • CATEGORIES DESCRIPTIVE RESPONSE
COLLATION

• LINE GRAPH
8. DATA • PIE, PROPORTION, HISTOGRAM
PRESENTATION

9. DATA ANALYSIS 10. IDNETIFYING THE COMMUITY HEALT PROB.

• ATTERNS • COMPARISON OF VALUES
A
N
A
Y • HEALTH STATUS
S • HEALTH RESOURCE PROBLEMS
I • HEALTH RELATED PROB
S

O
F

T
R
E
N
D
S

A
N
D

P
 • NATURE OF THE PROBLEM
• MAGNITURE OF THE PROBLEM
11.PRIORITY • MODEFIABILITY OF THE PROBLEM
SETTING • PREVENTIVE POTENTIAL
• SOCIAL CONCERN
CRITERIA WEIGHT PROB 1
NATURE OF THE PROBLEM 1
HEALTH STATUS 3
HEALTH RESOURCES. 2
HEALTH RELATED. 1
MAGNITUDE OF THE PROBLEM 3
75%-100% 4
50%-74%. 3
25%-49%. 2
< 25%. 1
MODIFIABLE OF THE PROBLEM 4
HIGH 3
MODERATE 2
LOW 1
NOT MODIFIABLE. 0
PREVENTIVE POTENTIAL 1
HIGH. 3
MODERATE 2
LOW 1
SOCIAL CONCERN 1
URGENT CONCERN
EXPRESSED BY READINESS 2
REGOCNIZED BUT NEEDING URGENT CONCERN. 1
NOT A COMMUNITY CONCERN 0
TOTAL
Planning for Community Health
Nursing Programs and Services
What is Planning
•Is a process that entails formulation of steps to
be undertaken in the future in to achieve a
order
desired end.
CONCEPTS OF PLANNING
FUTURISTIC

CHANGE
SYSTEMATIC
ORIENTED

PLANNING

FLEXIBLE DYNAMIC
 SITUATIONAL

PLANNING CYCLE ANALYSIS

•DATA GATHERING
•DATA ANALYSIS
•PROBLEM
IDENTIFICATION
•SET PRIORITY

GOAL AND
EVALUATION OBJECTIVE SETTING
•DETERMINE OUTCOMES •DEFINE GOALS AND
•SPECIFY CRITERIA AN OBJECTIVS
STANDARDS •ALIGN PRIORITIES
AMONG OBJECTIVES

STRATEGY/ACTIVITY
SETTING
•DESIGN CHN PROGRAMS
•ASCERTAIN RESOURCES
•IDENTIFY GAPS
Steps
1. Identify Community Issue
• High Incidence and prevalence of intestinal parasitism among children
2. Analyze opportunity of the problem
• Stakeholders
• Time
• Fund
• Other resources
3. Gather resources
• Team
• Tasking
SITUATIOAL High Incidence and
prevalence of
intestinal parasitism Community Issues

ANALYSIS among children

Direct Causes
PERSONAL HYGIENE UNSANITARY WASTE POOR UTILIZATION OF
HABITS DISPOSAL SYSTEM POOR CHILD CARE HEALTH

PREOCCUPATION
LOW LEVEL OF UNSANITARY WASTE NEGATIVE ATTITUDE
WITH EARNING A
EDUCATION DISPOSAL SYSTEM OF HEALTH WORKERS
LIVING

LACK OF BASIC
POVERY JOB DISSATISFACTION
HEALTH FACILITIES
GOVERNMENT
NEGLECT
Problem Tree
Provides an overview of all the known causes and
effects to an identified problem.
 Mortalities
P
Low
R
Morbidities
O
education

Poor health
Malnutrition
B
Poor class
attendance

L
High Incidence and prevalence
of intestinal parasitism among
children
E
M
PERSONAL UNSANITARY POOR
WASTE DISPOSAL POOR CHILD
HABITS UTILIZATION OF
SYSTEM CARE HEALTH
GOAL AND OBJECTIVE SETTING

• Where do we want to go?

• Serve as guide to nurses efforts
 TO REDUCE THE INCIDENCE AND
PREVALENCE OF INTESTINAL PARASITISM IN
BARANGAY

Educate children and parents of personal hygiene

Objectives: 75% of the target age group student and parents in barangay
11 are educated on personal hygiene and promotion

Provision of basic sanitation products

SMARTER OBJECTIVES
S SPECIFIC
M MEASURABLE
A ATTAINABLE
R RELEVANT
T TIME BOUNDED
E EVALUATED
R REVIEWED
Objective:
• 80% of household will have access to safe waste disposal system
within 6 months
 S
Mortalities
O
Morbidities
Low

IMPACT education
L
Malnutrition Poor health U
Poor class
attendance
T
TO REDUCE THE INCIDENCE
AND PREVALENCE OF
GOAL I
INTESTINAL PARASITISM IN
BARANGAY O
PERSONAL UNSANITARY
WASTE DISPOSAL POOR CHILD POOR OBJECTIVES &
N
HABITS UTILIZATION OF ACTIVITIES
SYSTEM CARE HEALTH
QUESTIONS?
 ACTIVITY
• IDENTIFY A COMMUNITY HEALTH PROBLEM IN YOUR CURRENT
COMMUNITY
• CREATE A PROBLEM TREE ANALYSIS OF THE PROBLEM
• IDENTIFY DIRECT AND INDIRECT CAUSES
• IDENTIFY GOAL AND OBJECTIVES
• USE SMARTER FORMAT IN FORMULATING OBJECTIVES