PHC1- MIDTERM

HEALTH AS A MULTIFACTORIAL PHENOMENON

FACTORS AFFECTING HEALTH

 POLITICAL-
 ECONOMIC FACTORS
 SOCIO- CULTURAL FACTORS
 BEHAVIORAL
 ENVIRONMENT
 HEREDITY

Political – refers to one’s leadership, how he rules manages and how other people concerned are
followed to actively participate in the decision-making.

Political Will- determination to pursue something that is in the interest of the majority.

Empowerment – ability of the person to do something.

-people can use their faculties and abilities at the maximum level in the pursuit of common goals.

Economic factors – refers to the production distribution and consumption lf common goods and
services and how these affect health and development.

Socio- cultural Factors- social and cultural variables influences a client health practice the dynamic
of health care and the client care provider relationship.

-meets a fundamental need for social ties

-making life less stressful

Behavioral Factors

 Culture
 Mores
 Ethnic custom

Culture- as shared system of beliefs, values and behavioral structure for daily living.

-includes belief, habits, likes, dislike, rituals learned from ones family.

Environmental Factors- refers to the sum of all the conditions and elements that make up the
surroundings and influence the health and health practices in clients.

Heredity- Genetic Endowment

Levels of Prevention

 Primary Prevention – providing specific protection against disease to prevent its occurrence
is the most desirable form of Prevention. Ex: Mandatory immunization
 Secondary Prevention- direct screening efforts or education of the public to promote early
case finding of an individual with disease so that prompt intervention can be instituted. Ex:
public teaching, screening program
 Tertiary Prevention- begins in the period of recovery from illness and consists of such
activities and consent and appropriate administration of medications to optimize.

Concept of Health and Illness

-traditionally health has been define in terms of the presence or absence of disease.

Health- state of complete, physical, mental and social well being and nit merely connote the
presence or absence of disease or infirmity (according to WHO)

-state of well being and using every power individual possesses for the fullest extent (Florence
Nightingale)

- ability to maintain normal roles (Talcott Parsons 1951) American Sociologist

-developmental and behavioral potential of an individual than a state is realized to the fullest
extent possible (American Nurses Association)

Wellness- active process of becoming aware and making choices.

-self-concept, culture and environment

A. State of Well-being

 Physical
 Social
 Emotional
 Intellectual
 Spiritual Dimensions

Well Being- subjective, perception of balance, harmony and viability.

-state rather than a process.

Illness – highly personal state which person feels unhealthy or ill.

Acute Illness- characterized by severe symptoms of relatively short duration.

Chronic Illness- lasts for an extended period of time usually 6 months or longer.

-remission (symptom disappear) exacerbation (symptoms reappear)

Sickness- usually associated with disease or illness but can occur independently of them.

Disease - alteration in body functions, reduction of capacity or shortening of the normal

span.

Wellness- full integration of physical, mental and spiritual well being.

Seven Dimensions

 Environmental
 Spiritual
 Emotional
 Social
 Occupational
 Physical
 Spiritual
 Sexual
 Societal

Social wellness – ability to relate and interact

-develop respect and tolerance for those with different opinions and beliefs.

Emotional Wellness – ability to understand ourselves and cope with the challenges life
can bring.

-manage stress

Spiritual Wellness – to establish peace and harmony

-to develop congruency between value and actions.

-meaning and purpose of human life

Environmental Wellness – ability to recognize our own responsibility for the quality of
the air, the water and the land that surrounds us.

-positive impact on the quality of your environment.

Occupational Wellness- ability to get personal fulfillment from our jobs or our chosen
career fields.

-balance between work and leisure time.

Intellectual Wellness- ability to open our minds to new ideas and experience.

-learn and use information effectively for personal, family and career development.

Physical Wellness – maintain healthy quality of life that allows us to get through our
daily activities without fatigue or physical stress.

FACTORS AFFECTING HEALTH AND ILLNESS

Physical Dimensions – Genetic make up.

-person with family history of DM/CA

-Age
-Developmental Level (the toddler just to learning to walk is prome to fall and injure
himself.

-race

-sex

Emotional Dimension- how the mind and body interact to affect body functions and to
respond to body conditions also influences health

-long term stress affect the body system and anxiety affects health habit

Intellectual Dimension- cognitive abilities educational background and past

experiences.

Education – low education level are linked with poor health more stress and lower self
confidence

Environmental Dimensions- has many influences on health and illness, housing,

sanitation, climate and pollution of air, food and water are aspect of environmental
conditions.

Socio-Cultural Dimensions – health practice and beliefs are strongly influenced by a

person’s economic level, lifestyle, family and culture.

Social Support Network – greater support from family, friends and communities is
linked to better health.

Health Services- access to use of service that prevent and treat disease influence health.

Spiritual Dimensions – spiritual and religious are important component of the way the
person behaves in health and illness.

Models of Health

Medical Model- state of being free of sign or symptoms of disease. Illness is the
presence of sign or symptoms of disease.

-virtue

-draught (lack of fluid)

-germs

-bad luck

Health Illness Continuum – constantly changing state with high level wellness and death
being on opposite ends of a graduated scale or continuum

Role Performance Model – health is the ability to perform all those roles from which
one has been socialized.
High Level Wellness- refers to function to ones maximum potential while maintaining
balance and purposeful direction in the environment.

Needs Fulfillment Model- needs are being sufficient met to allow an individual to
function successful in life with the ability to achieve the highest possible potential.

The Philippines Health Care Delivery System

 National Health Situation

 Components of the Health Care Delivery System
 Goals and Objectives
 Organized Structure (DOH)
 Levels Of Health Care Facilities
 Levels and Types of Health Care Workers
 Two Way Referral System
 Multi Sectoral Approach to Health (Sector- Group/Organization)
 Policies, Thrust and Strategies
 National Health Plan

Nurse/Midwife Roles

 Collaborator
 Advocate
 Change agent
 Leader
 Education
 Researcher
 General Economic Researcher
 SDG/SMOG
 Land and Water (hospital-medicine-plants)
 Labor
 Technology
 Capital Money

System- interrelated and independent parts that form a complex whole. Can be
reviewed as a subsystem.

Health System – interrelated ways in which a country organized avoidable resources

for the maintenance and improvement of the of its citizens and communities.

Health Sector- group of service or institution on the community/country which are

concerned with the health protection of the population.

Health Care System- an organized plan of health services (Miller -keane 1987)

Health Care Delivery – rendering health care service to the people (Williams –
Tungpalan 1981)
 Health Care Delivery System – the network of health facilities and personnel which
carries out the task of rendering health care to the people.

Philippine Health Care System – it is a complex set of organization interacting to

provide an arrow of health services (Dizon 1977)

The National Health Situations – cannot avail of adequate health care because of
misdistribution of health personnel and facilities and high cost medicine and
services.

A Vision of Healthy Tomorrow

 Preventive, promotive health care

 Community Participation
 Traditional Medicine
 Affordable Medicine
 Adequate food, clothing and shelter
 Available basic health services
 Accessible health care facilities
 Clean Environment

Characteristics of Health Care System Based on PHC

-system should encompasses the entire population on the basis of equality and
responsibility.

-the essential elements of PHC should be delivered at the first point of contract
between individual and the health system.

Components of Health Care Delivery System

-shall be responsible for the ff

 Formulation and development of National Health Policies guidelines standard

and mandual of operations for health services and program
 Issuance of rules and regulations
 Promulgation pf National Health standard goals, priorities amd indications
 Development of special health programs and project

DOH PROGRAM

D- dental health program

O- osteoporosis prevention

H- health education and community organizing

P- PHC

R- reproductive health

O- older person health service

G- guidelines for good nutrition

R- respiratory infection control

A- Acupressure

M- maternal and child care

S- entrong sigla movement

Primary Function of DOH

-Promotion, Protection, Preservation, or Restoration of the health of the people

through the provision and delivery of health services and through the regulations
and encouragement lf provies of health good services (E.O 119 Sec 3)

Vision

 Health as a right
 Health for all Filipinos by the year 2000 and health in the hands of the
people by thus year 2020

Mission

The mission of DOH in the partnership with the people to ensure equity , quality
and access to healthcare

 By making services available

 By arousing community awareness
 By mobilizing resources
 By promoting the means to better health

Levels of Health Care Facilities

-Primary Level of HCF

 RHU
 PRIVATE CLINICS
 HEALTH CENTER
 COMMUNITY HOSPITAL

-Secondary Level of HCF

 PROVINCIAL HEALTH SERVICE AND FACILITIES

-Tertiary Level of HCF

 SPECIALIZED NATIONAL HOSPITAL

FACTORS ON THE VARIOUS CATEGORIES OF HEALTH WORKERS AMONG

COUNTRIES AND COMMUNITIES

 AVAILABLE HEALTH MANPOWER RESOURCES

  LOCAL HEALTH NEEDS AND PROBLEM
 POLITICAL AND FINANCIAL FEASIBILITY

THREE LEVELS OF PHC WORKERS

 VILLAGE GRASSROOT HEALTH WORKER- first contacts, provide

simple curative and preventive health care measures.
 INTERMEDIATE LEVEL HEALTH WORKERS- first source of
professional health care, beyond the competence of village
workers
 FIRST LINE HOSPITAL PERSONNEL- provide back up health
services for cases that require hospitalization. Physician with
specialty, nurses, dentist, pharmacist other health professionals.

Two Way Referral – need to be stablished between each level of health

facility.

Leadership and Governance

-RA 7160 THE LOCAL GOVERNMENT CODE OF 1991 LGU’S WERE GIVEN
INCREASED POWERS TO MOBILIZE THEIR RESOURCES

-DOH AS FACILITATOR

-LGU’S AS IMPLEMENTERS

-A RN MUST APPLY IN THE RHU THROUGH THE MUNICIPAL HEALTH

OFFICER.

THE PHILIPPINE HEALTH CARE SYSTEM

A. STRUCTURE OF THE HEALTH SECTOR

B. HEALTH FACILITIES
C. HEALTH SERVICES
D. HEALTH HUMAN RESOURCES DEVELOPMENT

ELEMENTS OF PHC

E- Education for Health

L- locally Endemic Disease Control Program
E- Expanded Program on Immunization (NIP)
M- Maternal and Child and Responsible Parenthood
E- Essential Drugs and Herbal Medicine
N- Nutrition
T- Treatment of Communicable and Non-Communicable Disease
S- Safe Water and Sanitation