Module 2

Community Health

The community you live in is part of who you are. Even if you don’t see your neighbors
every day, you recognize that the decisions you make impact those around you. You’re all in it
together, and you wouldn’t have it any other way!
Improving your community and helping others is often at the top of your mind. So, when
the phrase “community health” crossed your radar, you had to know more. What is community
health? And how does it affect the lives of those in your area?
Community refers to the people of a district or country considered collectively, especially in the
context of social values and responsibilities; society.
According to the Vitalyst Health Foundation, a healthy community is one where people
have the opportunity to make healthy choices, in environments that are safe, free from violence,
and designed to promote health.
Health is the condition of having freedom from illness and injury. It allows the individual to
effectively deal with the demands of daily life through a sound body, mind, or spirit.
What is community health?
Community health is the intersection of healthcare, economics and social interaction.
Unfortunately, many people are unaware of the role this type of healthcare plays in their
everyday lives. Let us explore the impact of community health on your neighborhood and what
you can do to improve it.
Community health is a medical specialty that focuses on the physical and mental well-
being of the people in a specific geographic region. This important subsection of public health
includes initiatives to help community members maintain and improve their health, prevent the
spread of infectious diseases and prepare for natural disasters.
Working at the community level promotes healthy living, helps prevent chronic diseases
and brings the greatest health benefits to the greatest number of people in need .
Strong community health requires residents to look beyond themselves and take
“collective responsibility,” says Caleb Backe, health and wellness expert at Maple Holistic. “It’s
not just about the healthcare system, but focuses on the importance of leading a generally healthy
lifestyle in order to protect the community as a whole.”
Community health is inextricably tied to individual wellness. “Good community health
equates to healthy people, as a community is the ecosystem or environment in which people
live,” says Thomas G. Bognanno, president and CEO of Community Health Charities. “It’s
difficult to be healthy personally if your community is unhealthy.”
 Community health is the collective well-being of community members. In addition to
living in the same neighborhood or region, these populations often share health characteristics,
ethnicities, and socioeconomic conditions.
For instance, some low-income communities might experience high obesity rates due to
limited availability of nutritious foods in local grocery stores. This places them in an area
commonly known as a food desert.
In addition, a population might be exposed to contaminants from a nearby plant or waste
facility. Community health programs improve access to preventive health care services, engage
citizens in care decisions, and seek out lower medical costs.

Community Health Elements

Public health professionals engaged in community health identify how variables related
to socioeconomic status — such as income levels, nutrition, crime, and transportation resources
— impact people. They also determine how the community’s medical and educational resources
contribute to residents’ lifestyles and what improvements are called for. Key elements of
community health include:

• Identifying top public health concerns within the specific geographic area, such as
environmental and social factors that affect healthy life choices.
• Developing an intervention plan to address resource gaps in the community, such as
establishing community health centers, mobile clinics, and outreach programs.
• Educating residents on the benefits of preventive care and healthy behaviors to facilitate
life changes.
• Providing essential services such as screenings, social support, and counseling.
• Helping residents gain access to resources such as affordable medical, dental, and mental
health care services; insurance (Medicare or Medicaid enrollment); translation and
transportation services; or housing, food, and education.
• Reducing the need for expensive emergency care and hospitalizations.
• Advocating for improved care for at-risk populations to state and federal policymakers.
• Working with other community agencies to address the area’s mental, physical, cultural,
and social characteristics, including nutrition, housing, and transportation.

The Far-Reaching Impact of Community Health

Community health flips the script on the old adage, “You take care of you; I’ll take care
of me.” Instead, public health experts agree that the health of a community can have far-reaching
and sometimes surprising impacts on individual health and beyond.
“Community health impacts everything educational achievement, safety and crime,
people’s ability to work and be financially healthy, life expectancy, happiness and more,”
Bognanno says. “Health impacts every other facet of life, from a child’s ability to learn to an
adult’s ability to work, so health is critical for education and financial well-being.”
The effect of health on quality of life can also impact the desire to participate in civic
duties like voting, social functions and leisure activities, according to Healthy People 2020, an
initiative of the Office of Disease Prevention and Health Promotion. 2
“Communities that are attentive to public health can even reduce inequality among their
residents, also helps to reduce health gaps caused by differences in race and ethnicity, location,
social status, income and other factors that can affect health,” reports th e CDC.

Our health is largely influenced by the choices we make for ourselves and our families.
And our ability to make healthy choices depends greatly on conditions in the conditions in
communities where we live, learn, work and play.
Research shows that communities with smoke-free air laws, access to healthy foods,
quality affordable housing, good schools and safe places to play are healthier than those that
don't. In fact, the economic, social and physical environments that surround us can have a much
greater impact on our health than how often we go to the doctor's office.
Many factors that influence health are outside the traditional health care setting.
Accumulating evidence shows that social factors such as education, child care, income, housing
and neighborhood conditions also called social determinants influence health.
For example, rates of chronic illness such as diabetes and heart disease have been shown
to increase with poverty, and people living in poor or undereducated regions of the country have
been shown to be more prone to illness. Widespread health disparities in our nation often caused
by differing levels of education, employment, economic status, housing, and community
resources pose significant obstacles to improving our nation’s overall health.

The Consequences of Neglecting Community Health

A lack of focus on community health can lead to a range of complex problems that aren’t
easy to correct.
• Crime and safety issues that result from neglected community health can quickly
becoming a self-perpetuating cycle. “Repeated exposure to crime and violence
may be linked to an increase in negative health outcomes. Children exposed to
violence may show increased signs of aggression starting in upper-elementary
school,” reports Healthy People 2020.2
• Chronic diseases, such as diabetes and heart disease, can also increase if a
community’s overall well-being is suffering. “An unhealthy community tends to
be obese and struggle more from chronic diseases and other health challenges,”
Bognanno says.
 • Chronic diseases like these not only reduce life expectancy, they have a dramatic
effect on the economy. The CDC reports that 90 percent of the nation’s annual
healthcare expenses are for people with chronic health conditions. 3
Curbing the spread of infectious disease is also a priority of community health programs.
Without them, communities may find themselves battling outbreaks of illnesses that put
vulnerable populations like the elderly at higher risk.
“If a community has to recover from an emergency event, such as a natural disaster, reducing the
spread of disease becomes a crucial part of the recovery process,” Backe says.

Factors That Improve Community Health

Improving community health is a huge undertaking that involves cooperation between
public health workers, local government, volunteers and average citizens alike, and the end
products of their work can take a lot of forms. “Communities benefit from walking trails and
bike paths, from access to healthy food and playgrounds, from accessible healthcare services,
schools and places of employment, as well as affordable housing,” Bognanno says.
Education also plays a large role in maintaining community health. Health fairs and
advertising campaigns that expose the dangers of risk factors like tobacco exposure, poor
nutrition and physical inactivity can raise awareness about the importance of choosing a healthy
lifestyle. The community health centers has also focused on promoting nutrition guidelines in
schools and increasing the amount of physical education children received.
Individuals can step up to the plate for their community’s health by volunteering at health
fairs or blood drives, petitioning local officials to develop more green space and walking trails
and maintaining their own health. “The collective responsibilities that individuals have for their
communal health can lead to positive interactions within the community as a whole,” Backe
says.
Foundations of Community Health
The foundations of community health include the history of community health practice,
factors that affect community and population health, and the tools of community health practice.
These tools include epidemiology, community organizing, and health promotion and disease
prevention planning, management, and evaluation.

History of Community Health Practice

In all likelihood, the earliest community health practices went unrecorded. Recorded
evidence of concern about health is found as early as 25,000 b.c., in Spain, where cave walls
included murals of physical deformities. Besides these cave carvings and drawings, the earliest
records of community health practice were those of the Chinese, Egyptians, and Babylonians. As
early as the twenty-first century b.c., the Chinese dug wells for drinking.
 Between the eleventh and second centuries b.c., records show that the Chinese were
concerned about draining rainwater, protecting their drinking water, killing rats, preventing
rabies, and building latrines. In addition to these environmental concerns, many writings from
770 b.c., to the present mention personal hygiene, lifestyle, and preventive medical practices.
Included in these works are statements by Confucius (551–479 b.c.) such as "Putrid fish … food
with unusual colors… foods with odd tastes … food not well cooked is not to be eaten."
Archeological findings from the Nile river region as early as 2000 b.c., indicate that the
Egyptians also had environment health concerns with rain and waste water. In 1900 b.c.,
Hammurabi, the king of Babylon, prepared his code of conduct that included laws pertaining to
physicians and health practices.
During the years of the classical cultures, there is evidence that the Greeks were
interested in men's physical strength and skill, and in the practice of community sanitation. The
Romans built upon the Greek's engineering and built aqueducts that could transport water many
miles. Remains of these aqueducts still exist. The Romans did little to advance medical thinking,
but the hospital did emerge from their culture.
In the Middle Ages, health problems were considered to have both spiritual causes and
spiritual solutions. The failure to account for the role of physical and biological factors led to
epidemics of leprosy, the plague, and other communicable diseases. The worst of these, the
plague epidemic of the fourteenth century, also known as the Black Death, killed 25 million
people in Europe alone. During the Renaissance there was a growing belief that diseases were
caused by environmental, not spiritual, factors. It was also a time when observations of the sick
provided more accurate descriptions of the symptoms and outcomes of diseases. Yet epidemics
were still rampant.
The eighteenth century was characterized by industrial growth, but workplaces were
unsafe and living conditions in general were unhealthful. At the end of the century several
important events took place. In 1796 Dr. Edward Jenner successfully demonstrated the process
of vaccination for smallpox. And, in 1798, in response to the continuing epidemics and other
health problems in the United States, the Marine Hospital Service (the forerunner to the U.S.
Public Health Service) was formed.
The first half of the nineteenth century saw few advances in community health practice.
Poor living conditions and epidemics were still concerning, but better agricultural methods led to
improved nutrition. The year 1850 marks the beginning of the modern era of public health in
the United States. It was that year that Lemuel Shattuck drew up a health report for the
Commonwealth of Massachusetts that outlined the public health needs of the state. This came
just prior to the work of Dr. John Snow, who removed the handle of the Broad Street pump
drinking well in London, England, in 1854, to abate the cholera epidemic.
The second half of the nineteenth century also included the proposal of Louis
Pasteur of France in 1859 of the germ theory, and German scientist Robert Koch's work in the
last quarter of the century showing that a particular microbe, and no other, causes a particular
disease. The period from 1875 to 1900 has come to be known as the bacteriological era of public
health.
The twentieth century can be divided into several different periods. The years between
1900 and 1960 are known as the health resources development era. This period is marked by the
growth of health care facilities and providers. The early years of the period saw the birth of the
first voluntary health agencies: the National Association for the Study and Prevention of
Tuberculosis (now the American Lung Association) was founded in 1904 and the American
Cancer Society in 1913. The government's major involvement in social issues began with
the Social Security Act of 1935. The two world wars accelerated medical discoveries, including
the development of penicillin. In 1946, Congress passed the National Hospital Survey and
Construction Act (Hill-Burton Act) to improve the distribution and enhance the quality of
hospitals.
The social engineering era (1960–1975) included the passage of amendments to
the Social Security Act that set up Medicare (payment of medical bills for the elderly and certain
people with disabilities) and Medicaid (payment of medical bills for the poor).
The final period of the twentieth century is the health promotion era (1974–1999).
During this period, it was recognized that the greatest potential for improving the health of
communities and populations was not through health care but through health promotion and
disease prevention programs. To move in this direction, the U.S. government created its
"blueprint for health" a set of health goals and objectives for the nation. The first set was
published in 1980 and titled Promoting Health/Preventing Disease: Objectives for the Nation.
Progress toward the objectives has been assessed on a regular basis, and new goals and
objectives created in volumes titled Healthy People 2000, and Healthy People 2010. Other
countries, and many states, provinces, and even communities, have developed similar goals and
targets to guide community health.
Factors that Affect Community and Population Health.
There are four categories of factors that affect the health of a community or population.
Because these factors will vary in separate communities, the health status of individual
communities will be different.
The factors that are included in each category, and an example of each factor, are noted
here.
• Physical factors geography (parasitic diseases), environment (availability of natural
resources), community size (overcrowding), and industrial development (pollution).
• Social and cultural factors such as: beliefs, traditions, and prejudices (smoking in public
places, availability of ethnic foods, racial disparities), economy (employee health care
benefits), politics (government participation), religion (beliefs about medical treatment),
social norms (drinking on a college campus), and socioeconomic status (number of
people below poverty level).
 • Community organization – available health agencies (local health department, voluntary
health agencies), and the ability to organize to problem solve (lobby city council).
• Individual behavior - personal behavior (health-enhancing behaviors like exercising,
getting immunized, and recycling wastes
Three Tools of Community Health Practice.
Much of the work of community health revolves around three basic tools: epidemiology,
community organizing, and health education. Though each of these is discussed in greater length
elsewhere in the encyclopedia, they are mentioned here to emphasize their importance to
community and population practice. Judith Mauser and Shira Kramer have
defined epidemiology as the study of the distribution and determinants of diseases and injuries in
human populations. Such data are recorded as number of cases or as rates (number per 1,000 or
100,000).
Epidemiological data are to community health workers as biological measurements are to
a physician. Epidemiology has sometimes been referred to as population medicine. Herbert
Rubin and Irene Rubin have defined community organizing as bringing people together to
combat shared problems and increase their say about decisions that affect their lives. For
example, communities may organize to help control violence in a neighborhood.
Health education involves health promotion and disease prevention (HP/DP)
programming, a process by which a variety of interventions are planned, implemented, and
evaluated for the purpose of improving or maintaining the health of a community or population.
A smoking cessation program for a company's employees, a stress management class for church
members, or a community-wide safety belt campaign are examples of HP/DP programming.

COMMUNITY AND POPULATION HEALTH THROUGH THE LIFE SPAN

In community health practice, it is common to study populations by age group and by
circumstance because of the health problems that are common to each group. These groupings
include mothers, infants (less than one year old), and children (ages 1–14); adolescents and
young adults (ages 15–24); adults (ages 25–64); and older adults or seniors (65 years and older).
Maternal, infant, and child (MIC) health encompasses the health of women of
childbearing age from pre pregnancy through pregnancy, labor, delivery, and the postpartum
period, and the health of a child prior to birth through adolescence. MIC Health statistical data
are regarded as important indicators of the status of community and population health.
Unplanned pregnancies, lack of prenatal care, maternal drug use, low immunization rates, high
rates of infectious diseases, and lack of access to health care for this population indicate a poor
community health infrastructure.
Early intervention with educational programs and preventive medical services for
women, infants, and children can enhance health in later years and reduce the necessity to
provide more costly medical and/or social assistance later in their life.
 Maternal health issues include family planning, early and continuous prenatal care, and
abortion. Family planning is defined as the process of determining and achieving a preferred
number and spacing of children. A major concern is the more than 1 million U.S. teenagers who
become pregnant each year. About 85 percent of these pregnancies are unintended. Also, a part
of family planning and MIC is appropriate prenatal care, which includes health education, risk
assessment, and medical services that begin before the pregnancy and continue through birth.
Prenatal care can reduce the chances of a low-birthweight infant, and the poor health outcomes
and costs associated with it. A controversial way of dealing with unintend ed or unwanted
pregnancies is with abortion. Abortion has been legal in the United States since 1973 when the
Supreme Court ruled in Roe v. Wade that women have a constitutionally protected right to have
an abortion in the early stages of pregnancy. According to the Centers for Disease Control and
Prevention (CDC), approximately 1.6 million legal abortions were being performed in the United
States each year during the late 1990s.
Infant and child health is the result of parent health behavior during pregnancy, prenatal care,
and the care provided after birth. Critical concerns of infant and childhood morbidity and
mortality include proper immunization, unintentional injuries, and child abuse and neglect. .
The health of the adolescent and young adult population sets the stage for the rest of adult
life. This is a period during which most people complete their physical growth, marry and start
families, begin a career, and enjoy increased freedom and decision making. It is also a time in
life in which many beliefs, attitudes, and behaviors are adopted and consolidated. Health issues
that are particularly associated with this population are unintended injuries; use and abuse of
alcohol, tobacco, and drugs; and sexual risk taking.
There are no easy, simple, or immediate solutions to reducing or eliminating these
problems. However, in communities where interventions have been successful, they have been
comprehensive and communitywide in scope and sustained over long periods of time.
The health problems associated with this population can often be traced to the
consequences of poor socioeconomic conditions and poor health behavior during earlier years.
To assist community health workers, this population has been subdivided into two groups: ages
twenty-five to forty-four and ages forty-five to sixty-four. For the younger of these two
subgroups, unintentional injuries, HIV (human immunodeficiency virus) infection, and cancer
are the leading causes of death.
For the older group, noncommunicable health problems dominate the list of killers,
headed by cancer and heart disease, which account for almost two-thirds of all deaths. For most
individuals, however, these years of life are the healthiest. The key to community health
interventions for this population has been to stress the quality of life gained by good health,
rather than merely the added years of life.
. From a community and population health perspective, greater attention will need to be
placed on the increased demands for affordable housing, accessible transportation, personal care
created by functional limitations, and all segments of health care including adult day care and
respite care. Though many communities have suitable interventions in place to deal with the
issues of seniors (including meal services like congregate meals at senior centers, and Meals-on-
Wheels), the demands will increase in all communities.

HEALTH PROMOTION
Health Promotion may be defined as any combination of educational and social
efforts designed to help people take greater control of and improve their health. Health protection
and health services differ from health promotion in the nature or timing of the actions taken.
Health protection and services include the implementing of laws, rules, or policies approved in a
community as a result of health promotion or legislation. An example of health protection would
be a law to restrict the sale of hand guns, while an example of health services would be a policy
offering free flu shots for the elderly by a local health department. Both of these actions could be
the result of health promotion efforts such as a letter writing campaign or members of a
community lobbying their board of health.

The three strategies by which community health practice is carried out are health
promotion, health protection, and the provision of health services and other resources. Figure 3
presents a representation of these strategies, their processes, their objectives, and anticipated
benefits for a community or population.
As noted earlier, health promotion includes educational, social, and environmental
supports for individual, organizational, and community action. It seeks to activate local
organizations and groups or individuals to make changes in behavior (lifestyle, selfcare, mutual
aid, participation in community or political action or in rules or policies that influence health.
Two areas in which communities employ health promotion strategies are mental and
social health, and recreation and fitness. Though both of these health concerns seem to be
problems of individuals, a health concern becomes a community or population health concern
when it is amenable to amelioration through the collective actions noted above. Action to deal
with these concerns begins with a community assessment, which should identify the factors that
influence the health of the subpopulations and the needs of these populations.
In the case of mental and social health, the need will surface at the three levels of
prevention: primary prevention (measures that forestall the onset of illness), secondary
prevention (measures that lead to an early diagnosis and prompt treatment), and tertiary
prevention (measures aimed at rehabilitation following significant pathogenesis).
• Primary prevention activities for mental and social health could include personal
stress management strategies such as exercise and meditation, or school and
workplace educational classes to enhance the mental health of students and
workers.
• Secondary prevention strategy could include the staffing of a crisis hot line by
local organizations such health department or mental health center.
 • Tertiary prevention might take the form of the local medical and mental health
specialists and health care facilities providing individual and group counseling, or
inpatient psychiatric treatment and rehabilitation. All of these prevention
strategies can contribute to a communitywide effort to improve the mental and
social health of the community or population. During and after the
implementation of the strategies, appropriate evaluation will indicate which
strategies work and which need to be discontinued or reworked.
As with mental and social health promotion, community recreation and fitness needs
should be derived via community assessment. The community or population enhances the quality
of life and provides alternatives to the use of drugs and alcohol as leisure pursuits by having
organized recreational programs that meet the social, creative, aesthetic, communicative,
learning, and physical needs of its members. Such programs can provide a variety of benefits that
can contribute to the mental, social, and physical health of the community, and can be provided
or supported by schools, workplaces, public and private recreation and fitness organizations,
commercial and semipublic recreation, and commercial entertainment. As with all health-
promotion programming, appropriate evaluation helps to monitor progress, appropriate
implementation of plans, and outcomes achieved.
HEALTH PROTECTION
Community and population health protection revolve around environmental health and
safety. Community health personnel work to identify environmental risks and problems so they
can take the necessary actions to protect the community or population.
Such protective measures include the following:
• The control of unintentional and intentional injuries;
• the control of vectors;
• the assurance that the air, water, and food are safe to consume;
• the proper disposal of wastes; and
• the safety of residential, occupational, and other environments.
These protective measures are often the result of educational programs, including self -
defense classes; policy development, such as the Safe Drinking Water Act or the Clean Air Act;
environmental changes, such as restricting access to dangerous areas; and community planning,
as in the case of preparing for natural disasters or upgrading water purification systems.
HEALTH SERVICES AND OTHER RESOURCES
The organization and deployment of the services and resources necessary to plan,
implement, and evaluate community and population health strategies constitutes the third general
strategy in community and population health. Today's communities differ from those of the past
in several ways. Even though community members are better educated, more mobile, and more
independent than in the past, communities are less autonomous and more dependent on those
outside the community for support.
 • The organizations that can assist communities and populations are classified into:
governmental, quasi-governmental, and nongovernmental groups.
• Organizations can also be classified by the different levels (world, national,
state/province, and local) at which they operate.
Community Health Services
Community health centers, also referred to as community health services (CHSs), operate
across the state and aim to provide a broad range of services and health promotion activities to
local populations, particularly those who have or are at risk of the poorest health and have the
greatest economic and social needs.

CHSs are agencies that receive Community Health Program funding from the Department of
Health. There are approximately 100 CHSs in Victoria operating from approximately 350 sites.

Community health services sit alongside general practice and privately funded services, and
other health and support services, to make up the majority of the primary health sector in
Victoria. State-funded primary health care predominantly refers to dental, allied health,
counselling, nursing services and health promotion.

The services available depend on the needs of individuals, families and the community living in
the area. Most community health program funding supports flexibility in the delivery of services,
and enables CHSs to develop models of care that meet the needs of their local communities.
However, specific initiatives deliver particular services to vulnerable population groups.

Community health services focus on health promotion, and disease prevention and management,
which are designed to improve the health and wellbeing of local residents, as well as take
pressure off the acute care health system.

Aims of community health services

Community health services aim to improve the health and wellbeing of local residents by:
• Encouraging people to actively participate in their own health care
• Working together with other primary health care providers such as general practitioners
(GPs) to provide coordinated care
• Liaising with other health agencies and service providers to fill service gaps
• Encouraging individuals and community groups to actively participate in the centers
activities, including service planning, fundraising and volunteer work
• Promoting prevention of lifestyle-related diseases and conditions
• Developing health care programs and activities to improve social and physical
environments in the community.
Services offered
The services offered vary between community health services, depending on the needs of
the local area. Primary health services could include:

• Counselling and support services

• Health promotion activities
• Medical and nursing services
• Dental health
• Allied health, including audiology, dietetics, exercise physiology, physiotherapy,
podiatry, occupational therapy and speech therapy.
Other services and supports may include:

• Aged care services

• Alcohol and drug programs
• Maternal and child health services
• Mental health programs
• Disability services
• Outreach services
• Problem gambling programs
• Rehabilitation programs
• Support for self-help
Here are four ways that community health centers work to address disparities and improve health
for everyone in communities around.

a. Access to quality, affordable care

Community health centers address disparities in access to care by seeing everyone,
charging a nominal fee on a sliding scale for uninsured patients with limited incomes.
People with a regular source of health care have better health, fewer disparities and lower
costs. Patients are more likely to receive preventive services, catching chronic conditions
earlier, resulting in better outcomes.

b. Culturally competent service

When patients are treated with dignity and care that embraces their cultural background,
they’re more likely to develop a positive relationship with a health care provider.

c. Preventive Integrated Care

 Health centers provide medical, dental, mental health care and health promotion in one
setting. More importantly, providers from all these disciplines work together to make sure
the patient receives the best care possible.

d. Connecting Patients to Additional Services

Knowing that the complex needs of their patients don’t stop at health care, health centers
also connect patients to social services, such as food and housing assistance. Many
employ care management staff to help patients navigate systems and get help so they’re
in the best position to take care of their health.

Community health services are available to everyone

CHSs offer affordable health care, particularly for people on low incomes. Services are
available to all local residents, regardless of income, although fees apply.
These fees are charged for services according to the client’s ability to pay, and can be
negotiated or waived if payment is difficult. Health Care Card holders are charged a heavily
discounted fee.

Where to get help

Your doctor
Your local community health center
Health services directory

Community Health System in The Philippines

The Philippines established community health teams in 2010 to help achieve
universal health coverage by enrolling the poorest families in the national health insurance plan,
improving their access to health facilities, and providing them with selected critical health and
social services.
Community health service delivery in the Philippines is managed and coordinated across
the national, regional, provincial, municipal/city, and barangay levels, as follows.
• At the national level, the DOH, the National Nutrition Council (NNC), and the Population
Commission (POPCOM) provide general direction to community programs. Specifically, the
NNC guides the BNS program and has committees at each level of the health system. The
POPCOM directed the BSPO program in the past, but is currently active only in areas where the
LGU population offices still operate. These national-level entities mobilize resources and
develop and disseminate policies; guidelines; operations and technical reference manuals;
prototype information, education, and communication materials; and training modules and
materials. They also organize award systems for top-performing community health providers.
• At the regional level, the regional offices of the DOH, NNC, and POPCOM provide support to
the national-level offices, such as input during policy development. Regional offices may adapt
policies and curricula developed at the national level for their own use. • At the provincial level,
the provincial health office (PHO), the provincial nutrition committee (PNC), and the provincial
population office (PPO) (if still active) determine community health priorities for the province,
adapt policies and health worker training curricula, and fund and support programming. In some
areas, the PHO houses the PNC and PPO.
• At the municipal/city level, 1 the municipal/city health office (M/CHO), municipal/city
nutrition committee (M/CNC), and the municipal/city population office (M/CPO) (if still active)
hold similar roles as their provincial-level counterparts in supporting implementation of policies
and programs and their associated community health providers. In some areas, the M/CHO
houses the M/CNC and M/CPO.
• At the barangay level, the barangay captain (BC),2 the elected leader of the barangay, conducts
administrative oversight of the community health providers and supports them alongside a
barangay council comprising 6–8 councilors who are the community’s key decision makers. The
barangay council may provide guidance and support for community health providers, such as
honoraria for their work. In some areas, M/CPO directly supervises BSPOs and the M/CNC
directly supervises BNSs.
Health Information System
Community health providers use logbooks, master lists, activity diaries, and recording
forms to collect and record data on the services they provide and the community members they
serve. They compile reports and send them to the midwives at the BHS. The midwives then
incorporate the data into their official records for further follow-up. They also input the data into
the Field Health Service Information System, an electronic information network the DOH
created to collect, monitor, and analyze health programs and service delivery activities from the
barangay to the national level.
Health Supply Management
BHWs receive supplies and commodities from midwives at the BHS or BHC, which may
include TB drugs, oral contraceptive pills and condoms. BNSs obtain commodities for feeding
programs at the BHS, the BHC, the rural health unit, or directly from the M/CHO.
Policy does not specify how CHT members receive the commodities they need, but since
the teams partially comprise BHWs and BNSs, their supply processes may be similar. While
there is no formal guidance for BSPOs, it is likely they acquire supplies through similar
channels— midwives or the M/CPO or M/CHO. Policy does not indicate how community health
providers obtain emergency backup supplies or how they must dispose of medical waste.
Selected Medicines and Products Included in the Philippines’ Essential Medicines List
(2008)
Category Medicine / Product
Family Planning
• Cycle Beads, Condoms, Emergency contraceptive pills, Implant, Injectable
contraceptives, IUDs, Oral contraceptive pills

Maternal health
• Calcium supplements, Iron/folate, Misoprostol, Oxytocin, Tetanus toxoid

Newborn and child health

• Chlorhexidine, Cotrimoxazole, Injectable gentamicin, Injectable penicillin, Oral
amoxicillin, Tetanus immunoglobulin, Vitamin K

HIV and TB
• Antiretrovirals, Isoniazid (for preventive therapy)
Diarrhea
• Oral rehydration salts  Zinc
Malaria
• Artemisinin combination therapy, Insecticide-treated nets, Paracetamol, Rapid diagnostic
tests
Nutrition

• Albendazole, Mebendazole, Ready-to-use supplementary food, Ready-to-use therapeutic

food, Vitamin A
Modes of Service Delivery
Service Mode
Clinical services Door-to-door
Periodic outreach at fixed points
Health posts or other facilities
Special campaigns
Health education Door-to-door
Health posts or other facilities
In conjunction with other periodic outreach services
 Community meetings
Mothers’ or other ongoing groups
Community mobilization Health posts or other facilities
Community meetings
Mothers’ or other ongoing groups

Lastly, the constant interaction of humans to its surroundings affects the years of healthy
life lived, and even health disparities. Thus, our action and choices also brought an impact to our
environment. The latter has vital effect on our personal health, safety and ways of living.
Therefore, protecting and creating healthy environments is a critical component to a prolific
community and sustainable life. This will aid to our country’s economic development and
ultimately help students to be healthier and fit to learn so they would sooner or later succeed
academically.
Activity
Make a poster for community health with your own advocacy. Any materials will do. Once you
are done post it outside your house to remind everybody on the importance of a healthy
community. Then get a photograph of your displayed poster and post it in our fb page.

Rubrics for Poster Making

Relevance to the 5 4 3-2 1
title of The content is The content is The content is The content is
advocacy: exceptionally relevant to the less relevant to irrelevant to the
Community relevant to the topic. Its the topic. Its topic and poorly
Health topic and well- constructed is construction is constructed.
constructed good acceptable.
5 4 3-2 1
The concept is The concept is
exceptionally satisfactorily The concept is The concept is a
Creativity eye creative. creative. less creative and rehash of other
opener to the Suggested ways Suggested ways suggested ways people’s old
reader that are unique, that are that are merely slogans.
interesting and interesting and suitable to the
suitable to the suitable to the community`
community. community.
Originality/ 5 4 3-2 3-2
Clarity of Exceptional new Good new ideas Less use of new No use of new
Thought ideas and clarity and clarity of ideas and clarity ideas and clarity
of details that details that of details that of details that
contribute to contribute to contribute to contribute to
reader’s reader’s reader’s reader’s
comprehension comprehension comprehension comprehension

Evaluation:
Please answer the following questions.
1. Is your community an ideal one? Why?
2. How can you practice your role to help your community an ideal one?
3. Does your family also receive any help from the different health services in your
community? State what particular services it is and the extent of help.