Antenatal RegistrationTetanus Toxoid ImmunizationMicronutrient SupplementationTreatment of Diseases and other conditionsClean and safe deliverySupport to breast feedingFamily Planning counseling

B.) Tetanus Toxoid Immunization

Do a quick check upon admission for emergency signs

Make the woman comfortable

Assess woman in labor

Determine stage of labor

Decide if woman can safely deliver

Give supportive care throughout labor

Monitor and manage labor

Monitor within 1 hr after delivery

Educate and counsel on FP

Inform, teach, counsel on: Birth registration Importance of BF NBS Schedule of postpartum

visits

Unconscious/ convulsionsVaginal bleedingSevere abdominal painLooks very illSevere headache with visual disturbance

Severe breathing difficultyFeverSevere vomiting

•Antenatal•Clean and safe obstetric delivery•Emergency obstetric care•Family Planning

A sick woman needs more nutrients and rest. Although pregnancy is a normal event, it may be an additional burden for her body. Her condition may become worse.

A sick woman is more likely to have a miscarriage or a premature birth.

A sick woman is more likely to become anemic and is prone to infection.

A sick woman is more likely to give birth to a low-birth-weight baby.

Ensure that she is physically ready Detect any medical problems that

need treatment Find out if she has to observe any

special precautions during pregnancy and childbirth.

3 C’s of Home Delivery

Clean HANDSClean SURFACEClean CORD

Delay in…DECIDING to SEEK medical Care

IDENTIFYING and REACHING APPROPRIATE Facility

RECEIVING appropriate and adequate CARE at the FACILITY

•Failure to recognize danger signs•Unplanned/ Unwanted pregnancy

•Distance•Road•Transport•Communication

•Lack of health care personnel•Shortage of supply•Health not prioritized

Delay in deciding to seek medical care

Delay in reaching facility

Delay in receiving adequate care at facility

REFERRAL LEVELS

BEmOC Give parenteral AB

Give parenteral oxytocin

Give parenteral anticonvulsants

Perform manual removal of placenta

Remove retained placental products

Perform assisted vaginal delivery

CEmOCPerform six function of a BEmOC facility plus CS and Hysterectomy and give Blood transfusions

4 Pillars of Family Planning: Responsible parenthood Respect for life Birthspacing Informed choice

To provide universal access to family planning information and services wherever and whenever

these are needed

Reduce infant deathsReduce Neonatal deathsReduce Under five deaths

Reduce maternal deaths

Focus service delivery to the urban and rural poor

Reestablish the FP outreach programStrengthen FP provision in regions

with high unmet needsPromote frontline participation of

hospitalsMainstream modern natural family

planning

when a woman is between 20 and 35 years old;

when a woman has not been pregnant for the last 2-3 years;

when a woman has fewer than 4 children;

when a woman has no illness that would place herself or her baby in danger;

and when the couple wants to have a baby.

there are more chances for the pregnancy to end in abortion or miscarriage;

the woman is more likely to become anemic and malnourished. (prone to develop obstetrical complications such as prolonged labor and hemorrhage as well as gynecologic problems such as uterine prolapse)

the baby has more chances of being born premature or with low birth weight. The incidence of stillbirths and fetal death will be higher.

1. The benefits of contraception It saves mothers' and children's lives. It helps clients plan their pregnancies

to protect their health and that of their babies.

It helps a couple provide a better life for their children.

It improves quality of life by removing the fear of an unwanted pregnancy.

2. The different contraceptive methods available.

Discuss: description and use; effectiveness; advantages and disadvantages; and possible side-effects.

3. Where they can obtain specific family planning services Some clients will come directly to you for services. Others will only need information about the methods and how they are used, and others may need more explanation and encouragement.

the age of the woman; the woman's reproductive

stage; the effectiveness of a method; the woman's health status; and personal considerations.

•Infant and young child feeding•Newborn screening•Expanded program on immunization•Management of Childhood illnesses•Micronutrient supplementation•Dental Health•Early child development•Child Health injuries

Overall objective: To improve the survival of

infants and young children by improving their nutritional status, growth and development through optimal feeding

Goal: Reduce child mortality rate by 2/3 by

2015

Objective: To improve health and

nutritional status of infants and young children

Outcome: To improve exclusive and

extended breastfeeding and complementary feeding

Initiate breastfeeding within 1 hr after birth Exclusive for the first 6 months of live Complemented at 6 months with appropriate

foods, excluding milk supplements Extend breastfeeding up to 2 yrs and beyond3 E’s of Breastfeeding

Early breastfeeding Exclusive breastfeeding for the 1st 6 months Extend up to 2 years

TimelyAdequateProperly fedSafe

Water is good for the thirstNo drinks high in sugarTea and coffee reduce iron absorbed

from foodDrinks should not replace foods or

breastfeedingChildren not receiving breastmilk

need special attention

Encourage child to drink and eat with lots of patience

Feed small amounts frequentlyGive foods that the child likesGive a variety of nutrient rich foodsContinue to breastfeed

Give extra breastfeedsFeed an extra mealGive an extra amount Use extra rich foodsFeed with extra patience

Breasfteeding for 2 years or longer helps a child to develop and grow strong.

Complementary feeding at 6 months helps a child grow well.

Foods that are thick enough to stay in the spoon give more energy

Animal-source foods help children grow strongPeas, beans, lentils, nuts and seeds are goodDark green leaves, yellow-coloured fruits and

vegetables help a child have healthy eyes and fewer infections.

Growing child needs 3 meals plus snacks.Growing child needs increasing amounts of foodsGrowing child needs to learn to eat.Encourage child to drink and eat during illness.

RA 9288 Ideally done 48th – 72nd hour of life (1st 2 -3

days); also done 24 hours from birth Heel Prick, blood dried for 4 hours,

transport within 24 hours to NSF Results in 7 days Positive screen means NEWBORN MUST

BE SUBJECT TO CONFIRMATORY TESTS and FURTHER MANAGEMENT

Goal: To improve the quality of life of Filipinos through better nutrition, improved health and increased productivity

Vitamin AIronIodine

STRATEGIES: Food based interventions

for sustained improvements in nutritional status

Life-cycle approach Effective complementation

of nutrition interventions with other services

Geographical focus to needier areas

PROGRAMS AND PROJECTS:

Micronutrient supplementation

Food fortification Essential maternal and

child health service package

Nutrition information, communication and education

Home, school, and community food production

Food assistance Livelihood assistance

VITAMIN A SUPPLEMENTATION

THREE CLASSIFICATIONS OF ORAL INTERVENTIONSPreventive servicesCurative servicesPromotive services

Oral examinationOral hygienePit and fissure sealant programFluoride utilization program

Permanent fillingGum treatmentAtruamatic restorative treatmentExtractionTreatment of post extraction

complicationsDrainage of localized oral abscess

Health education activities

Overall Goal: Achieve Better Quality Life among

Filipinos

Reducing maternal mortality rate Reducing child mortality Halting and reversing spread of HIV/AIDS Increasing access to reproductive health

information and services

4 Major NCDs:Cardiovascular diseasesCancerCOPDDiabetes Mellitus

Tobacco SmokingPhysical inactivityUnhealthy diet

Comprehensive approach focused on primary prevention

Community Based approach Integrated approach

KEY INTERVENTION STRATEGIES:

Establishing program direction and infrastructure

Changing Environments

Changing lifestyle Reorienting health

services

ROLES OF THE PHN IN NCD PREVENTION AND CONTROL:

Health advocate Health educator Health care provider Community organizer Health trainer Researcher

HEALTH ADVOCATE

Inform people about rightness of cause

Discuss nature of alternatives, content and consequences

Support people’s right to make a choice and to act on the choice

Influence public opinion

HEALTH EDUCATOR

Inform people Motivate people Guide people into

action

HEALTH CARE PROVIDER

Health promotion and disease prevention

Secondary level of care - relieve pain, etc

Disability limitation and rehabilitation

COMMUNITY ORGANIZER

Raising level of awareness regarding NCDs

Organizing and mobilizing community

Influencing executive and legislative bodies for policies that favor a healthy environment

HEALTH TRAINER

Provides technical assistance to auxiliary health workers

Teaches and supervises on clinical management of non-communicable diseases

Records, reports, and utilization of health information related to NCDs

RESEARCHER

Conducts community assessments, epidemiological studies and intervention studies

RISK FACTOR ASSESSMENT

Cigarette smoking Nutrition/diet (ABC) Overweight/obesity Physical inactivity

/Sedentary lifestyle Excessive alcohol

drinking

NATIONAL PREVENTION OF BLINDNESS PROGRAM

VISION 2020: THE RIGHT TO SIGHT

All Filipinos enjoy the right to sight by year 2020.

PRIORITY 5 PREVENTABLE/TREATABLE CONDITION:

Cataract Refractive errors and

low vision Trachoma Onchocerciasis Childhood blindness

MENTAL HEALTH

Four facets: Defined burden Undefined burden Hidden burden Future burden

Nursing Responsibilities: Mental health promotion Prevention and control Rehabilitation Research and epidemiology

MAN

DISEASE AGENT

ENVIRONMENT

3 PREVENTIVE STRATEGIES:

Change the people’s behavior

Manipulate environment

Increase man’s resistance or immunity

MAJOR ENVIRONMENTAL HEALTH AND SANITATION PROGRAMS:

Water sanitation Food sanitation Refuse and garbage

disposal Hospital waste

management program

MAN

DISEASE AGENT

ENVIRONMENT

1. Change people’s behavior

1. Change people’s behavior

3. Increase man`s immunity or resistance

to disease agents

3. Increase man`s immunity or resistance

to disease agents

2. Prevent production of disease agents

2. Prevent production of disease agents

WATER SUPPLY SANITATION PROGRAMAPPROVED TYPES:

Level I (Point source) - protected well or developed spring

Level II (Communal faucet or Stand posts) – system composed of a source reservoir, piped distribution and communal faucet

Level III ( Waterworks System or Individual House connections) – system with a source, reservoir, a piped distributor network and household taps

PROPER EXCRETA AND SEWAGE DISPOSAL PROGRAM

Level I – Non water carriage and toilets requiring small amounts of water

Level II – On site toilet facilities with water-sealed and flush type

Level III – toilet facilities connected to septic tanks or to sewerage system to treatment plant

FOOD SANITATION

Four rights in Food safety

Right source Right Preparation Right Cooking Right storage

RULE IN FOOD SAFETY

When in doubt, Throw it out !!!!