INTRODUCTION TO PUBLIC

HEALTH
Prepared by: Katelyn Anne L. Solero, RMT
OBJECTIVES
This presentation aims to discuss the following:
1. The definition of Public Health
2. Different divisions of public health
3. Core functions & Levels of Prevention
4. Determinants of Health
5. Public Health History in the Philippines
WHAT IS PUBLIC HEALTH?
"It aims to improve the health of community through an
organized (planned) community effort”

"The science and art of preventing disease, prolonging life and

promoting health through the organized efforts and informed
choices of society, organizations, public and private communities
and individuals”

It is concerned with threats to the overall health of a community

based on population health analysis
DIVISIONS OF PUBLIC HEALTH
• Epidemiology
• Biostatistics
• Health Services/Health Policy and Management/Health Administration
• Environmental Health
• Occupational health
• Social and Behavioral Health
• Nutrition
CHARACTERISTICS OF PUBLIC HEALTH:
• It deals with the PREVENTIVE ASCPECTS of health rather than
curative aspects.

• It deals with POPULATION LEVEL, rather than individual health

issues.
3 CORE FUNCTIONS OF PUBLIC HEALTH
1. Assessment
a. Monitor health status to identify community health problems.
b. Diagnose and investigate health problems and health hazards in the
community.

2. Policy Development
a. Inform, educate and empower people about health issues.
b. Mobilize community partnerships to identify and solve health problems.
c. Develop policies and plans that support individual and community health
efforts.
3 CORE FUNCTIONS OF PUBLIC HEALTH
3. Assurance
a. Enforce laws and regulations that protect health and ensure safety.
b. Link people to needed personal health services and assure the
provision of health care when otherwise unavailable.
c. Assure a competent public health and personal healthcare
workforce.
d. Evaluate effectiveness, accessibility, and quality of personal and
population based health services.
5 STEPS OF PUBLIC HEALTH APPROACH IN ADDRESSING
HEALTH PROBLEMS IN COMMUNITY

1. Define the health problem.

2. Identify the risk factors associated with the problem.
3. Develop and test community-level interventions to control or
prevent
the cause of the problem.
4. Implement interventions to improve the health of the population.
5. Monitor those interventions to assess their effectiveness.
LEVELS OF PREVENTION
1. Primary Prevention - prevents an illness or an injury from occurring
at
all, by preventing exposure to risk factors.

2. Secondary Prevention - seeks to minimize the severity of the illness

or the damage due to an injury-causing event once the event has
occurred.

3. Tertiary Prevention - seeks to minimize disability by providing

medical care and rehabilitation services.
HEALTH - person’s physical and psychological capacity to establish and
maintain balance.
Successful defense of the host against forces that disturb body
equilibrium.

DISEASE- failure of the body’s defense mechanism to cope with

forces tending to disturb body equilibrium
ASPECTS OF HEALTH
• Physical health - condition that enables person to maintain a strong
and health body.

• Mental health - refers to how a person feels, thinks of himself, control

his emotions and adjust to the environment.

• Social health - refers to how a person feels, thinks and act towards
everybody around him.
DETERMINANTS OF HEALTH
Income and Social Status
Education
Physical environment
Employment and working conditions
Social support networks
Culture
Genetics
Personal behavior and coping skills
Health services
Gender
STAGES OF DISEASE
1. Pre-disease stage

2. Latent stage (asymptomatic)

3. Symptomatic stage
RISK FACTORS FOR DISEASE
1. Biologic and Behavioral Factors
2. Environmental Factors
3. Immunologic Factors
4. Nutritional Factors
5. Genetic Factors
6. Services, Social Factors and
Spiritual Factors
HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES
BASED ON SOCIO-POLITICAL PERIODS

1. Pre-American Occupation ( up to 1898 )

2. American Military Government ( 1898-1907)
3. Philippine assembly (1907-1916)
4. The Jones law (1916-1936)
5. The Commonwealth (1936-1941)
6. Japanese occupation ( 1941-1945)
7. Post World War II (1945-1972)
8. Post EDSA revolution (1986 to present)
1. PRE-AMERICAN OCCUPATION ( UP TO 1898 )
• Public health works began at the old Franciscan Convent in
Intramuros where Fr. Juan Clemente put up a dispensary in 1577 for
treating indigents in Manila. This eventually became the San Juan de
Dios Hospital.

During Spanish Colonization

• First medical school in the Philippines - UST
• Public health laboratory
2. AMERICAN MILITARY GOVERNMENT (1898-
1907)
• Control of epidemics such as cholera, smallpox and plague
• Fight against communicable diseases such as leprosy, diarrhea,
malaria, beri-beri (vit b1 deficiency)
PROJECTS AND ACTIVITIES
1. Established a garbage crematory
2. Approved the first sanitary ordinance and rat control
3. Amoebic dysentery- caused by contaminated water and unclean vegetables,
and Malaria- Anopheles minismus flavirotris was pointed out as vector.
4. Cholera vaccine was first tried
5. Confirmed that plague in man comes from infected rat
6. Opened a leper colony in Culion.
7. Founded the manila Medical society and Philippine Island Medical Association
8. Opened the UP College of Medicine
9. Established Bureau of Science
3. PHILIPPINE ASSEMBLY (1907-1916)
• New waterworks in Manila was inaugurated to control cholera
• Nursing school at Philippine Normal School
• Hygiene and Physiology were included in curriculum of public elementary
school
• Anti-TB campaign was started
• Philippine Tuberculosis Society was organized
• Pasteur prophylaxis treatment against rabies was offered
• Opening of the Philippine General Hospital (PGH)
• Use of anti-typhoid vaccine was initiated
• Hypochlorite of lime was first used for treating the water supply of Manila
• Etiology of Amoebic dysentery was made clear
• Dry vaccine against smallpox was first used
4. THE JONES LAW (1916-1936)
Retrogression rather than progression in so far as the health was
concern
1. Increase Crude Death Rate (CDR) - death rate per 1000 person
2. Increase Infant Mortality Rate (IMR) -infant death per 1000
3. Increase Morbidity- rate of incidence of disease

• Increased deaths from smallpox, cholera, typhoid, malaria, beri-beri

(B1 def. Thiamine) and TB.
• Re-organization happened (re-organized the health service and encouraged effective supervision)

1. Study the cause and prevalence of typhoid fever

2. The composition, value and vitamin distribution of many Philippine foods were studied.
3. Schick test was used to determine the causes of diphtheria
4. Campaign against Hookworm was launched
5. Anti-dysentery vaccine was first tried
6. The roles of seafood in transmission of cholera and the pollution of fishing sector to typhoid were
studied
7. First training course for sanitary inspector was given
8. Women and Child labor was passed
9. The mechanism of transmission of dengue fever through Aedes aegypti was studied
10. Construction of Novaliches dam
11. Establishment of School of Hygiene and Public Health
12. National Research Council of the Philippines was organized
13. BS in Education major in Health Education was opened in UP
14. Philippine Public Health Association(PPHA) was organized
5. The Commonwealth (1936-1941)
• Process of gaining and maintaining altitude (because the later years under Jones
Law was successful)
• The epidemiology of life threatening diseases was studied diphtheria, yaws,
dengue
• Research in the field of health was promoted
• UP school of Public health was established to train public health leaders
• Construction of Quezon institute for PTB patients
• Research and Control of TB, malaria, leprosy and yaws
• Development of Maternal and Child Health (MCH)
• 1939, creation of Department of Public Health and WelfareDr. Jose fabella as the
first secretary
• 1940, Bureau of Census and Statistics was created to gather vital statistics
6. JAPANESE OCCUPATION (1941-1945)
• During this time. All public health activities were practically paralyzed
• After 5 years of Japanese occupation, public health tried to pick up
the debris and rise from the ruins
• Survey: Increased incidence of TB, venereal disease, malaria, leprosy
and malnutrition.
• General sanitation has been reduced to level enough to constitute a
national hazard
• US congress passed an emergency measures to control diseases: TB,
VD, malaria. Leprosy, malnutrition
• Immunization program
7. POST WORLD WAR II (1945-1972)
• The Philippine Independence
1. Completion of a research on Dichlorodiphenyltrichloroethane (DDT) saw
dust as larvicide and DDT residual spraying of houses in the control of
malaria.
2. Construction of the National Chest Center-for control case registry for TB,
mass immunization with BCG
3. Industrial hygiene laboratory
4. Introduction of one-infection method for gonorrhea with penicillin
5. Creation of central Health laboratory in the Philippines
6. Creation of Institute of Nutrition under BRL, then it was transferred to
National Institute of Science and Technology and was renamed as Food
and Nutrition Research Center, it was again renamed as FNRI
• Manila was selected as Headquarters for the WHO Western pacific
Office.
• Strengthening Health and Dental services in rural areas This is thru
RHU program (per municipalities with 5,000-10,000 population)
1 Municipal Health Officer (MHO)
1 Public health Nurse (PHN)
1 Midwife
1 sanitary Inspector
• Reorganization of DOH - creation of several offices

1. Dental health services

2. Malaria Education services
3. Disease Intelligence Center
4. Food and Drug Administration
5. National Schistosomiasis Control Commission
6. National Nutrition Program
•Initiation of programs with multilateral assistance
1. WHO and UNICEF assisted TB and BCG programs
2. TB control program as basic service of RHU
3. TB sputum case finding by microscopy
4. Serum and vaccine production in Alabang
5. Expanded Maternal and Child Health (MCH) and Mental Health
Program
6. Training programs for Midwives
7. Strengthened graduate health programs at the UP-CPH
DURING MARTIAL LAW

• Creation of National Economic Development Authority (NEDA)

• Department of health was renamed as Ministry of Health (MOH)
ACCOMPLISHMENT DURING THIS PERIOD
1. Formulation of National Health Plan - Implementation of restructure Health
care delivery system (primary, secondary, tertiary) - Construction of tertiary
hospitals (Philippine heart center, Lung center, Kidney center,Lunsod ng
kabataan/ PCMC)
2. Adaptation of the Primary Health Care - Promotive and preventive rather than
curative care - Philippines was the first country to implement PHC
3. Launching of Operation Timbang and Mothercraft - Nationwide program
providing supplementary food for infants and preschool children
4. Birth of integrated Provincial Health Office (IPHO)
5. Oral rehydration Therapy for the National Control of Diarrheal Diseases
6. Community-based health programs
7. Progress in Public Health research - Nutrition council of the Philippines- to
address problems on malnutrition - RITM- for infectious and tropical diseases -
PCHRD- mandated to lead, direct and coordinate science and technology
activities in health and nutrition.
8. POST EDSA REVOLUTION (1986 TO PRESENT)
EDSA REVOLUTION
• From Ministry of Health it was renamed again as Department of
Health
• Increase in life expectancy slowed down
• Morbidity and Mortality rates from preventable causes stabilized at
high rates
• Declined in infant and child mortality decelerated
• Increased incidence of malnutrition
• Declined practice of family planning
AQUINO ADMINISTRATION
• 1987 constitution – more provision on health making comprehensive health care
available
• Active participation of private sector and NGO
• Major activities influencing public health during this period
1. Milk code- EO51- required the marketing of breast milk substitute
2. Universal child and mother immunization
3. International safe and motherhood initiative was launched to reduced maternal
mortality rate.
4. Act prohibiting discrimination against women (RA6725)
5. National Epidemic Surveillance System (NESS)- this was made to track down the
occurrence of 14 diseases with potential causing outbreaks.
6. National drug policy and Generic Act- ensure the availability of safe, effective and
affordable quality drugs (RA6675)
7. Local government code- from national government to governors and mayors (RA7160)
8. Organ Donation Act of 1991 (RA7170)- Legalizing donation of all or body parts after
death for specified purpose.
RAMOS ADMINISTRATION
• “Health in the Hands of People” and “Lets DOH it”- by the Sec. Juan Flavier
• Continue to adopt PHC as a strategy
• Memorable initiative during the leadership of Flavier:
1. National Immunization Day – BCG, DPT, OPV, MMR
2. Mother and Friendly Hospital Initiative
3. This strategy ensures the survival and health of children through breast feeding
4. Promotion of Philippine Traditional medicine- DOH and DOST
5. Hospital as Center of Wellness- transformed 45 government hospitals from
disease places to centers of wellness
6. Yosi Kadiri- Anti smoking campaign
7. Araw ng Sangkap ponoy- aimed to prevent vitamin A, iron and iodine deficiency
8. Voluntary Blood Donation Program
9. Kung Sila’y Mahal mo Magplano- Family planning program
10. Doctors to the Barrio
LAWS
1. RA 7394- Consumer Act of the Philippines- an act providing penalties for
manufacture, distribution and sales of adulterated foods, drugs and cosmetics
2. RA 7610- Special protection of Children against child abuse, exploitation and
discrimination
3. EO 39- which created the Philippines National AIDS Council as a national policy
and advisory body in the prevention and control of HIV-AIDS
4. RA 7432- Senior Citizen’s Act- which grant benefits and special privileges in
order to maximize the contributions of senior citizen to nation building
5. RA 7719- The National Blood Services Act of 1994 which was passed to
promote voluntary blood donation
6. RA 8172- An Act of Salt Iodization Nationwide (ASIN)- providing salt iodization
nationwide approved in 1996 and renamed FIDEL _fortified for Iodine
Elimination)
CHANGES IN THE HEALTH SCENARIO
1. Rapid decline in mortality and morbidity,
but health improvements were slowed down during the late 1970’s to the
mid 1980’s due to severe economic contraction during the period. Infant
mortality declined and slowed down but recovered modestly by late 1980’s.

2. Steady progress was made towards control of infectious diseases

through.
Introduction of chemotherapy such as MDT introduced for leprosy
Short course chemotherapy for TB
Praziquantel for Schistosomiasis
Adoption of rehydration for management of diarrheal diseases
CHANGES IN THE HEALTH SCENARIO
3. The current status of service delivery infrastructure indicated that
preventive and Promotive health programs had not sufficiently
covered the population.
The proportion of medically attended deaths showed that 60% did not
have reliable access to medical care. There were still pockets of rural
and urban areas unserved and underserved.

4. The 1980 Primary Health Care (PHC) strategy focused on the

delivery of maternal and child care services, control of prevalent
diseases, nutrition and family planning.
MAJOR FACTORS THAT INFLUENCED THE
PUBLIC HEALTH DEVELOPMENT
1. The role of international organizations:
they provide technical assistance that facilitated technology transfer,
provide financial support for the testing and implementation of
innovative approaches

WHO, UNICEF, United Nations Family Planning Administration (UNFPA),

US-AID, World Bank, Rockefeller Foundation, Japanese International
Cooperation Agency (JICA), Australian Agency for International
Development (AUSAID)
MAJOR FACTORS THAT INFLUENCED THE
PUBLIC HEALTH DEVELOPMENT
2. The advances in bio-medical and bio-engineering research. The
introduction of chemotherapy.

3. The increasing recognition that public health could not be solely bio-
medically oriented but psycho-socially based as well.

4. Increasing scientific approach to program management

FUTURE CHALLENGES
1. URBANIZATION – it has been forecasted that by the year 2020, the urban
population comprise 65 to 75% of the total population.

Update: There has been a phenomenal shift towards urbanization, with 5 out
of every 10 Filipinos living in cities, with an estimated 84 percent of Filipinos
expected to reside in urban areas by 2050.

The chaotic growth of cities will result in a multitude of economic and social
problems. The rise of slums, criminality, disease and unemployment,
overcrowding, inadequate housing facilities, poor environmental sanitation
FUTURE CHALLENGES
2. INDUSTRIALIZATION – Occupational hazards become a major
concern. People are much more in exposed to air, soil and water
pollutions.

3. ENVIRONMENTAL CONCERN – environmental degradation caused by

deforestation, deterioration of seas and rivers due to industrial waste,
indiscriminate disposal of waste. All these lead to ecological imbalance
and pave the way for the emergence of the new types of
microorganisms.
FUTURE CHALLENGES
4. THE REVENGE OF THE GERMS – the discriminate consumption and
overuse of antibiotics have resulted in drug-resistant bacteria, viruses
and parasites. Switching from inexpensive penicillin to other drugs
increased treatment costs which are beyond the reach of the poor.
REFERENCES
• Rollo, C. E. (n.d.). Urbanization in Philippines: Building inclusive and
Sustainable Cities. Urbanization in Philippines: Building inclusive &
sustainable cities.
https://unhabitat.org/philippines#:~:text=There%20has%20been%20a%20
phenomenal,in%20small%20and%20intermediate%20cities.
• Slideshare. (2017, May 4). History of public health in the Philippines.
HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES.
https://www.slideshare.net/KeanAgapito/history-of-public-health-in-the-
philippines
• Singh Gujral, H., & Singh, Dr. G. (2022). Industrialization and its impact on
human health – a critical appraisal. Journal of Student Research, 11(4).
https://doi.org/10.47611/jsrhs.v11i4.3037