Report in phn

CONNECTING CIRCUITS

EPIDEMIOLOGY AND VITAL STATISTICS

INTRODUCTION

Complexity of Human Behavior Disease Intervention Alternative Solution

CHANGE

OTTAWA CHARTER

Health promotion to:Increase CONTROL

(Health is a LIFE resource)

Structure of the Health

System

Health Status

Health Sector

Health Sector Population

Health related sectors

Health related sectors

EPIDEMIOLOGY

Concern: EpidemicWebster’s New Collegiate Dictionary:

“Medical science treating of epidemics”New standard dictionary of English

Language:” the science or doctrine of epidemics”

Stedman’s Practical Medical Dictionary: “the science of epidemics and endemic diseases”

The American College Dictionary: “That branch of medicine dealing with epidemic diseases.”

EPIDEMIOLOGY

Concern: All Infectious Diseases Stallybass: “The science of infective diseases, their

primary causes propagation and prevention.” Frost:”The science of the mass phenomena of

infectious diseases or the natural history of infectious diseases.”

Frost2: “ a science which will give, firstly, a picture of the occurrence distribution and the types of the infectious diseases of mankind, in distinct epochs of time and at various points of the earth’s surface; and secondly, will render an account of the relations of these diseases to the external surroundings of the individual and determining his manner of life.”

EPIDEMIOLOGY

Concern: Infectious and Non InfectiousGreenwood: “The study of disease, as a mass phenomenon.”Lumsden: “The study of conditions known or reasonably supposed to

influence the prevalence of disease.”American Epidemiological Society: “The science which concerns itself

with the natural history of disease as it is expressed in groups of persons related by some common factors of age, sex, race, location or occupation, as distinct from the development of diseases in an individual”

Hilleboe: “ a science of mass phenomena of diseases and human defects; it delineates significant variations of these phenomena in time and place and draws upon statistical methods and theory, all phases of medicine, and the natural science to give true picture of the occurrence, distribution and types of diseases or defects; it weighs the importance of variations of human traits and renders an account of the causal relationships of diseases or defects to the environmental factors surrounding the individuals under observations, representatives of the group from which they are drawn.

EPIDEMIOLOGY

Concern: Ecology of Health and Disease

Maxcy: that field of medical science which is concerned with the relationships of the various factors and conditions which determine the frequency and distribution of an infectious disease, a process, or a physiologic state in a human community”

EPIDEMIOLOGY

Three Greek word roots make up the word epidemiology -- epi, demos, and logos. Epi means upon, on or over. Demos means people or populace. And logos can mean study, word, discourse, count, tell, say, or speak.

http://www.usetinc.org/Programs/USET-THPS/TribalEpiCenter/DefiningEpidemiology.aspx

Clinical Epidemiology is defined as the “study of groups of people to achieve the background evidence needed for clinical decisions in patient care.” (White, 1996).

http://clinical-epidemiology.ph/2009_10/modules/sections/index.php?op=viewarticle&artid=2

EPIDEMIOLOGY

Problem Solving Process Diagnostic Process Nursing Process Scientific Process Quality Improvement Cycle Public Health Intervention

http://www.usetinc.org/Programs/USET-THPS/TribalEpiCenter/DefiningEpidemiology.aspx

EPIDEMIOLOGY

CONCERNING ON: -Epidemic-All infectious Disease-Infectious and Non Infectious-Ecology of Health and Disease

Agent, host and Environment

Primary point of interest in epidemiology is what happens to the host-whether it gets sick or not, whether it becomes a carrier, a source or a reservoir. To a greater extent, a fair deal of information about the agent can be gathered by studying the host reaction to it.

-Remigio Mercado MD,MPHEpidemiology for the health administrator 1998, 2nd Edition

Agent, host and Environment

“ Social work is the profession which is concerned with man’s adjustment to his environment------“social functioning”-roles

How HEALTH IS OBJECTIVELY MEASURE??

Health measures

Health Behavior

Socio economic

and environmental indicators

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

National Statistics Office

National Demographic and Health survey

NSO household-based survey collected every 5 years.(2003)

High Cost of conducting national population surveys

Maternal and Child

NSO household-based regular survey among female members aged 15 to 49 years who have surviving children below three years of age (MCHS, 2001)

Important indicators are sometimes not reported (MMRinNDHS 2003)

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

Family Planning FPS

NSO based survey that collects data on prenatal and postpartum care, protection at birth against neonatal,tetanus, breastfeeding, and immunization (FPS, 2004)

None

Food and Nutrition Research Institute (FNRI)

National Nutrition Survey (NNS)

FNRI based survey collected every 4-5 years (NNS, 2003)

High cost of conducting the survey especially the clinical phase

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATIONLead Agency Major Sources Description,

frequency and latest available data

Limitations and common problems

National Statistical Coordination Board (NSCB)

National health Accounts (NHA)

Annual tracking of all sources of finances for health and how funds are utilized (NHA,2003)

Categorization of Sources and uses of funds being harmonized with international standards

Local Health Accounts

The LGU data system is more responsive to the requirements of the LHA than that of the National Government Agencies

Needs to improve estimates of out of pocket expenditures.Local Health accounts not yet institutionalized.Initial estimates available for years 1998-2000 are for six provinces only.

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

Department of Health

Special Surveys contracted out or DOH special studies and researches

Baseline Survey for National Objectives for Health (BSNOH) is a special survey conducted to established baseline for NOH 2000-2004.Comprise of nationwide community household ,health institutions, health providers, schools and workplace surveys.(BSNOH, 2000)Other studies such as National Tuberculosis Prevalence Survey NTPS , 1997,national disability survey, 2004,national diabetes Survey, 2003.

High cost of conducting national baseline surveys and special studies. No regional or provincial disaggregation. Low dissemination of the results

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

Field health Service Information System (FHSIS)

Major health information system of the Philippine health system that collects health accomplishments, delivery of health services, and morbidity reports from RHU’s to National Epidemiology Center, DOH (FHIS, 2002)

Passive reporting system of notifiable diseases publication due to non-compliance of some LGUsorincompleteness of data Information under utilized at LGU levels and national program planning Indicators have not be standardized; frequent changes in what is to be reported

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

National Epidemiology Sentinel Surveillance System (NESSS)

NESSS is a hospital-based system for monitoring 14 infectious diseases with epidemic potential (Cholera, typhoid, malaria, hepatitis A and B., Dengue, diphtheria, leptospirosis, measles, meningococcal disease, neonatal and non neonatal tetanus, pertussis, and rabies

Private facility data sources not comprehensive.lt covered laboratory diagnosis is costly

MAJOR SOURCES OF PHILIPPINE HEALTH INFORMATION

Lead Agency Major Sources Description, frequency and latest available data

Limitations and common problems

HIV serologic surveillance (HSS) and Behavioral Sentinel Surveillance (BSS)

Active HIV serologic surveillance (HSS) among high risk groups in key cities that started in 1993 combined with prevalence of risk behaviors among the most at risks behaviors among the most at risks population in 2005

Limited to 10 sentinel sites due to-Funding is external; Limited funding from national and local government

OTHER INFORMATION

FOUNDATION FOR THE ADVANCEMENT OF CLINICAL EPIDEMIOLOGY Inc.

-member of the International Clinical Epidemiology Network.

-non-profit

http://clinical-epidemiology.ph/2009_10/modules/sections/index.php?op=listarticles&secid=3

INSTITUTE OF CLINICAL EPIDEMIOLOGY-identification of effective and efficient

health interventions.- They train “people” in this.=)

- http://clinical-epidemiology.ph/2009_10/modules/sections/index.php?op=viewarticle&artid=3&page=3

ONE of their WORKS

A) Dr. Cecilia S. Acuin

2002 Effectiveness Trial of Zinc Supplementation + ORT for Acute Watery Diarrhea (WHO-JHU-INCLEN)

2002 Process Documentation of the Convergence Strategy of the Health Sector Agenda (MSH-HSRTAP-DOH)

2002 National Health Research System Assessment (COHRED-DOH-PCHRD)

2001-2002 Prioritizing the Research Needs of the Health Sector Reform Agenda (DOH-ENHR)

2001 A Baseline Assessment of the Philippine Strategy for IMCI in HKI-USAID Assisted Areas (DOH-HKI-USAID)

2001 Mid-Term Review of DOH Vit. A Supplementation Program, “Garanstisadong Pambata”, (DOH-HKI-USAID)

2000- 2001 Development of an Integrated Reproductive Health Training Package (DOH-UNFPA)

2000- 2001 Development of a Reproductive Health Data Base, (PCHRD)

1999- 2000 Evaluation Study of an MCH/FP Matching Grant Program In the Philippines (Population Council, USAID)

1999- 2000 Evaluating the Impact of Devolution as a Strategy for Equity in Health Care Delivery (WHO,DLSU-CEU)

1998- 2000 Effectiveness of Dissemination of Clinical Practice Guidelines on UTI in the Philippines (co-author,INRUD, WHO, PSMID)

One of their works

C) Prof. Rachel A. Delino

2001-2003 Baseline Surveys for the National Objectives of Health (DOH)

Ongoing works

ONGOING RESEARCHES

A) Dr. Cecilia S. Acuin

2002-2003 Child Health Nutrition Research in Asia and the Pacific: An Assessment of Research Priorities and Research Institutions (Global Forum for Health Research)

B) Prof. Rachel A. Delino

2002-2003 Effectiveness and Safety of a Community-Based Pill Dispensing Package (MSH-GTZ)

2002-2003 World Health Survey (Philippines)(WHO)

2003 Effectiveness of Clinical Practice Guidelines in Improving the Quality of Tuberculosis Care (DOH)

2003-2004 An International Study of Health Research Funding Agencies’ Support and Promotion of Knowledge Translation in Low- And Middle-Income Countries (CIHR)

C) Dr. Jesus Emmanuel A.D. Sevilleja

Jan 2003 - present Effectiveness of Clinical Practice Guidelines in Improving the Quality of Tuberculosis Care in Public-Private Urban Settings

Jan 2003- present Clinical Practice Guidelines on Urinary Tract Infections, update

July 2002-present Building a Collaborative Quality Improvement Model to Implement Hospital Infection Control Programs

Feb 2002-present Cost-Effectiveness Analysis of Different Dissemination Strategies Using Clinical Practice Guidelines on Urinary Tract Infection

http://clinical-epidemiology.ph/2009_10/modules/sections/index.php?op=viewarticle&artid=3&page=7

ADDITIONAL INFORMATIONUnderemployement rate 17.8% April 2010 (19.7% Jan 2010)DOH

Unemployment Rate 8.0% April 2010 (7.3% Jan 2010)DOH

Employment rate(the proportion of the total number of employed persons to the total number of persons in the labor force.)

94.80 of Jan 2010 of NSO

Unemployment Rate 5.20% of Jan 2010 of NSO

ADDITIONAL INFORMATION

apologizing to the officers working with the NSCB for suggesting in a previous column that “some” amount of doctoring was going on their Board because of the addition of 146, 582 babies to the actual number recorded in the 2000 census.

--By BERNARDO VILLEGASOctober 17, 2010, 11:52amManila bulletin

ADDITIONAL INFORMATION

The Philippines estimates its 2010 population at 94.01 million..making it the 12th most populous nation in the world.

September 23, 2010, 8:00pmBy Helen Flores of the PHILIPPINE

STAR

ADDITIONAL INFORMATION

Preliminary results from the 2008 National Demographic Health Survey (NDHS) showed that there was a significant decline in infant mortality rate IMR from 351 percent in 1998 to 249 percent in 2008. Infant mortality rate in the country declined from 35 infant deaths per 1,000 live births in the period 1993 to 1997 to 25 deaths per 1000 live births in 2003 to 2007, NSO administrator Carmelita Ericta told a media forum in Quezon City.

ADDITIONAL INFORMATION

“The Philippines is among 68 countries which contributed to 97 percent of maternal, neonatal and child health deaths worldwide”

--United Nations Children's Fund (UNICEF) in its State of the World's Children 2009 report.

ADDITIONAL INFORMATION nutritional status of Filipino ----the FNRI has

commenced another survey, the 2003 National Nutrition Surveys (NNS). The survey is made up of the following components:

(a) Anthropometric Nutrition Survey; (b) Biochemical Nutrition Survey; (c) Dietary Assessment Among 0-5 Year-Old Children,

Pregnant and Lactating Women; Baseline Food Consumption Survey for Evaluating the Impact of the Food Fortification Program in the Philippines; and Household Food Security Survey; and

(d) Clinical Phase: National Nutrition and Health Survey.

ReSEARCHES

THESIS TITLE: Nurse’s structured Health Teaching Mother’s socio demographic characteristics and their knowledge and skills on Diarrhea

SAYS THAT: There is a significant Difference in the level of knowledge and skills before and after structured Health teaching.

--Malapitan Rosemarie LJuly 2000

Researches

Thesis Title: Extent of Performance of the roles and functions of Community Nurses in Northern Samar basis for Educational Program Development

SAYS THAT: There is a relationship Between socio-demographic profile and extent of performance as community organizer and recommends determination of number of service and training of Public Health Nurses.

Cagro, Maryflor2003

THANK you!!ROSALIE CASTRO RN, MSN

rosaliecastrorn@yahoo.com