FAMILY HEALTH

BY: drlcb

PRIMARY HEALTH CARE 2

PHC

WHO define PHC as essential health care made universally accessible to individual and families in the community by means

Paradigm of PHC

Essential health care

e.g.Family healthEPI

Family planning

Infant breast feeding

Individual/ families

Universally accessible

Community based

Primary health

workers

Social development

Essential Health Care Program

1. Family Health 2. Prevention and control of non-communicable

disease 3. prevention and control of communicable disease 4. Environmental Health and sanitation 5. Other priority health programs

Family Health program

1. Maternal health program 2. Family planning program 3. Child health program 4. Expanded program of immunization 5. Nutrition program 6. Oral health program 7. Other health program

Family health

The DOH- Family health office- is responsible for the creation, implementation and evaluation of health family programs

The summary of its objective is to improve the survival, health and well being of each members of the family as well as the reduction of morbidity and mortality rates in the family and community.

Maternal Health Program

Philippine statistics reveal 25% maternal deaths due to hypertension 20.3% Postpartum hemorrhage 9% Pregnancy related diseases Objective: To improve the survival, health and well being of

mothers and unborn child

Maternal Health Services

1. Antenatal Registration- pregnant women can avail the free prenatal services at their respective health center.

2. Tetanus Toxoid Immunization-A series of 2 doses of tetanus toxiod vaccination must be received by a pregnant women one month before delivery and 3 booster doses after childbirth

3. Micronutrient Supplementation- Vitamin A and Iron supplement for the prevention of anemia

4. treatment of diseases and other conditions- These is for the women who is diagnosed as under the high risk pregnancy

5. Clean and Safe delivery- ensuring an aseptic areas for labor and delivery

The Family Planning Program

In 2003, there are about 84 million Filipinos to grow annually at 2.36 percent and expected to double in 29 years.

The total fertility rate is at 3.5 children/ women The use of contraceptive increases gradually from

15.4% (1996) to 48.9% (2003) 44% of women got pregnant with their first child

at the age of 20-24.

The objectives: To help couples and individuals achieve their

desired family size within the context of responsible parenthood and to improve their reproductive health to attain sustainable growth.

Family planning Method

Female Sterilization 1. Tubal Ligation- It involves the cutting or

blocking the 2 fallopian tubes. Advantages: Permanent method of contraception No repeated clinic visits Does not interfere with sex- result to increase

enjoyment No known side effects

Male Sterilization 1. Vasectomy- The vas deferens is blocked or cut,

to prevent the passage of sperm Advantages: Very effective 3 month after the procedure Permanent, safe, simple and easy to perform Does not interfere with sex

Use of Pill- These pill contains hormone: estrogen and progesterone, this is taken daily to prevent conception. Advantages: Safe, convenient and easy to use Make menstrual cycle occur regularly Reduces gynecological symptoms like painful

menstruation and reduce the risk of ovarian and endometrial cancers

Disadvantage: It has side effects like; nausea, dizziness, breast

tenderness, blurring of vision It suppress lactation Requires regular supply

Use of Condom- It’s a thin sheath of latex rubber made to fit on a man’s erected penis, it prevent the passage of sperm into the internal vagina Advantages: Safe and no hormonal effects; 98% effective It protect individual in sexually transmitted diseases Disadvantages: Allergies to rubber latex Decrease in sensation, interrupts the sexual act

Injectibles- It contains synthetic hormone, progestin which suppresses ovulation, it thickens the cervical mucus thus making it difficult for sperm to pass through Advantages: Reversible and no daily intake No sexual inference

Lactating amenorrhea method or LAM- A temporary postpartum method of postponing pregnancy based on the physiological infertility experienced by breast feeding mothers. Advantages: Available to all postpartum lactating mothers

Mucus/Billing/Ovulation Method- Abstaining from sexual intercourse during fertile (wet) days

Advantages: Can be use by healthy women, no known diseases Disadvantages: Not reliable

Basal Body temperature- BBT is use to identify the fertile and infertile period of a woman’s cycle by daily taking and recording the rise and fall in body temperature during and after ovulation Advantage: Very effective Disadvantage: Couples abstinence during fertile period

Sympto-Thermal Method- It’s the combination of BBT and Billings method. Combination of observation made on cervical mucus and BBT Effectiveness 80%

Child Health Program

Which includes the newborn, infants and children Programs for children Infant and young child feeding Newborn screening Expanded program on Immunization Management of Childhood diseases Micronutrient supplementation Dental health

Early child development Child Health injuries

Overall objective To reduce morbidity and mortality rate among

children from 0-9 years old.

Infant & young child feeding

Importance of breast feeding- Exclusive breast feeding is giving only breast milk

to infants, This is recommended up to 6 months and can be extended up to 2 years.

Benefits for the infants A complete food for the infants Strengthen immune system thus preventing

infections Increases IQ points

Benefit for the mothers Reduces excessive blood loss after birth Natural method of delaying pregnancies Reduces the risk of ovarian and breast cancers

Laws that protects infant and young child feeding Milk code (EO 51) – products covered by milk

code consist of breast milk substitute, e.g. infant formula, other milk products, bottlefed complementary foods

Rooming-In Breastfeeding Act of 1992- requires both public and private institution to promote rooming-in, it encourage and support the practice of breastfeeding

Food fortification Law or An act establishing the Philippine Food fortification Program and for other purpose- Food fortification law- Republic Act 8976

Food fortification law is vital in the promotion of optimal health and to compensate for the loss of nutrients during processing and storage of food.

Infant screening tests

or Neonatal screening tests Newborn screening is a process of testing newborn

babies from treatable genetic, endocrinologic, metabolic and hematologic diseases

The test is mandated in the RA 9288 otherwise known as Newborn screening program of 2004

Disorders screened

1. CH -(congenital hypothyroidism)- 1: 4000 ratio 2. CAH – (Congenital adrenal hyperplasia) 3. GAL – (Galactosemia) 4. PKU – (Phenylketonuria) 5. G6PD – ( glucose-6-phosphate dehydrogenase)

How the test is performed:

Blood tests: A health care professional will prick the babys heel to obtain a few drops of blood. The blood is sent to a lab for analysis.

Hearing test: An audiologist will place a tiny earpiece or microphone in the infant ' s ear or �stick electrodes on the baby ' s head.�

How to prepare for the test:

There is no preparation necessary for newborn screening tests. The tests are performed when the baby is between 24 hours and 7 days old, typically before the baby goes home from the hospital.

How the test will feel: The baby will most likely cry when his or her heel

is pricked to obtain the small blood sample. The hearing test should not cause the baby to feel pain, cry, or respond

EPI

Our commitment to Universal Child Immunization has lead to the mandate of laws regarding EPI.

Accelerated EPI coverage started in 1986 and in 1992 Hepatitis B immunization has been integrated into EPI manual of operation.

In early 1990 there is a declined of numerous cases of the immunizable disease such as: Polio disease, Measles and neonatal tetanus

Routine schedule of Immunization

Every Wednesday is designated as immunization day in all parts of the country.

A fully immunized child- receives one dose of BCG, 3 doses of OPV, DPT, HB and one dose measles vaccine before the child’s 1st birthday

Vaccine Minimum age at 1st dose

Number of doses

Minimum interval

between doses

Reason

BCG Birth or anytime after

birth

1 BCG protects the infant from possibility of

TB meningitis & other TB infections

DPT 6 weeks 3 4 weeks Reduce the chance of pertussis

OPV 6 weeks 3 4 weeks Protection against polio

disease

Schedule of immunization

Vaccine Minimum age at 1st dose

Number of doses

Minimum interval

between doses

Reason

Hepatitis B At birth 3 6 weeks interval from 1st

dose to 2nd dose; 8 weeks interval from 2nd to 3rd dose

Reduces the chance of being

infected and becoming a

carrier

Measles 9 months Prevents deaths, malnutrition

and protection from measles

EPI vaccines and its characteristics

Type/Form of vaccine Storage Temperature

Most Sensitive to heat Oral Polio (live attenuated ) -15°C to -25°C ( at the freezer)

Measles ( Freeze dried) -15°C to -25°C ( at the freezer)

Type/Form of vaccine Storage Temperature

Least sensitive to heat DPT/Hep B

“D” toxoid is a weakened toxin

“P” killed bacteria“T” toxoid is a weakened

toxin

+2 °C to + 8°C ( in the body of refrigerator)

Hepatitis B +2 °C to + 8°C ( in the body of refrigerator)

BCG (freeze dried) +2 °C to + 8°C ( in the body of refrigerator)

Tetanus toxoid +2 °C to + 8°C ( in the body of refrigerator)

Administration of the vaccineVaccine Dose Route of

AdministrationSite of

Administration

BCG 0.05 ml Intradermal Right deltoid region

DPT 0.5 ml Intramuscular Upper outer portion of the thigh

OPV 2 drops or depending on the manufacturer instruction

Oral Mouth

Measles 0.5 ml Subcutaneous Outer part of the arm

Hepa B 0.5 ml Intramuscular Upper outer portion of the thigh

Tetanus toxoid

0.5 ml Intramuscular Deltoid region

Nutritional program

Common nutritional deficiencies in the Philippines according to DOH

Vitamin A Iron Iodine

Goal of Nutrition program- is to improve quality of life of every Filipinos through better nutrition, improved health and increase productivity.

Programs and projects

1. Micronutrient supplementation- 2x a year distribution of vitamin A capsules through the “Araw ng Sangkap Pinoy”- (ASAP) also known as GP- garantisadong pambata

2. Food Fortification- 3. Essential Maternal and child health service

package 4. Nutrition information 5. Home, school and community food production 6. Food assistance 7. Livelihood assistance

The End