HEALTH

>is a state of physical, mental social and spiritual well

being, and not merely an absence of disease or infirmity.

CONCEPT OF HEALTH
>Health has evolved over the centuries as a concept from
individual concern to world wide social goal and
encompasses the whole quality of life.

 BIOMEDICAL CONCEPT
>viewed as an “ABSENCE OF DISEASE”, and if one was free
from disease, then the person was considered healthy.
>has the basis in the “GERM THEORY OF DISEASE”.
>the medical profession viewed the human body as a
machine, disease as consequence of the breakdown of the
machine and one the doctor’s task as repair of the machine.

 ECOLOGICAL CONCEPT
>It raises 2 issues: IMPERFECT MAN and IMPERFECT
ENVIRONMENT
>Ecological POV; health is viewed as a dynamic equilibrium
between human being and environment, and disease is a
maladjustment of the human organism to environment.

 PSYCHOSOCIAL CONCEPT
>refers to an individual’s experience, perception,
psychological processes, behavior, and lifestyle.

 HOLISTIC CONCEPT
>This concept is the synthesis of all the above concept.

DIMENSIONS OF HEALTH

 PHYSICAL DIMENSION
>can be assessed at community level by the measurement
of morbidity and mortality rates.
>it conceptualizes health that as biologically a state in
which each and every organ even a cell is functioning at
their own optimum capacity and in perfect harmony with the
rest of body.

 MENTAL DIMENSION
>ability to think clearly and coherently. This deals with
sound socialization in communities.
>is not merely an absence of mental illness.

 SOCIAL DIMENSION
>refers to the ability to make and maintain relationships
with others or community.

 SPIRITUAL DIMENSION
>is connected with religious beliefs, and practices. It also
deals with personal creeds, principles of behavior and ways
of achieving peace of mind and being at peace with oneself.

CONCEPT OF WELLNESS
>Wellness is more all-encompassing. It involves various
aspects of well-being, specifically physical, emotional,
occupational, spiritual, social, environmental, and
intellectual.

DIMENSION OF WELLNESS
 PHYSICAL SPIRITUAL
 EMOTIONAL OCCUPATIONAL
 INTELLECTUAL ENVIRONMENTAL
 SOCIAL FINANCIAL

CONCEPT OF ILLNESS
>”Illness is a condition characterized by a deviation from a
normal health state which is manifested by physical &
psychological symptoms.”-Koizer
>”Illness is a state in which a person’s physical, intellectual,
emotional, social or spiritual functioning is diminished or
impaired in comparison with the previous experience.”-
Potter & Perry
 BEYOND DISEASE
>Illness is not merely the presence of a disease or a medical
diagnosis. It is a subjective experience that encompasses
physical, emotional, social, and psychological aspects of a
person's well-being.
 INDIVIDUAL EXPERIENCE
>Illness is unique to each individual, influenced by their
personal history, beliefs, cultural background, and social
context.
 DYNAMIC PROCESS
>Illness is a dynamic process that evolves over time. It can
be influenced by various factors, including treatment,
lifestyle changes, and social support.

DIMENSION OF ILLNESS
 BIOLOGICAL
 SOCIAL
 SPIRITUAL
 CULTURAL
 DIFFERENT MODELS OF HEALTH
 RELIGIOUS MODEL
> health is perceived as a ‘correct way of living’ and not just
as a state of being free from disease.
> health views well-being through the lens of faith.

 BIOMEDICAL MODEL
> combines ‘biology’ and ‘medicine’ to understand and treat
health related issues. Medical interventions are used to
bring the patient back to good health.
Ex. X-ray Scans Surgery Ultrasound Blood Test
Heart Lung Machines Dialysis Machine

 PSYCHOSOMATIC MODEL
> ‘Psycho’ means ‘relating to mind’
> ‘Somatic means ‘relating to body’
> has to be practiced by everyone, himself/herself.
Providers do recognize that many physical diseases involve
psychosomatic factors, and that stress often makes them
worse.

Condition includes:
> OBESITY > FIBROMYALGIA > HIGH BLOOD
PRESSURE
> ARTHRITIS > SLEEP DISOORDER (HYPERTENSIVE)
> DIABETES > HEART DISEASE

 HUMANISTIC MODEL
> refers to a perspective that emphasizes the unique
qualities, potential and experiences of human beings. It
focuses on values, Maslows Hierarchy of needs:
Physiological Needs, Safety Needs, Belongingness, Esteem
Needs, Self-actualization.

 EXISTENTIAL MODEL
> it is a philosophy that emphasizes individual freedom,
responsibility, and the search for meaning in universe that
lacks inherent purpose. It challenges us to create our own
values and purpose in a world that often feels meaningless.
 TRANSPERSONAL MODEL
> takes a holistic approach to therapy with an emphasis on
spirituality.
> it aims to address the client’s mental, physical, social,
emotional, creative, and intellectual needs in order to
facilitate healing and growth.
Ex. Techniques: Meditation, Guided Visualization,
Hypnotherapy, Dream Work, Art, Music, Journal, Mindfulness
Practices.

LEVELS OF PREVENTION PREVENTION

- Actions taken to avoid an incident or to intervene to stop
an incident from occurring, which involves actions taken to
protect lives and property.

 PRIMORDIAL PREVENTION
- Defined as prevention or risk factors themselves,
beginning with change in social and environmental
conditions in which these factors are observed to develop,
and continuing for high risk children, adolescents and young
adults.
- many adult health problems (obesity, Hypertension)have
their early origins in childhood, because this is the time
when lifestyle are formed.
Ex. smoking, eating patterns and physical exercises

 PRIMARY PREVENTION
- defined as the action taken prior to the onset of disease
will ever occur.
- Primary prevention may be accomplished by measures of -
Health promotion and Specific protection.
1. HEALTH PROMOTION
- It is the process of enabling people to increase control over
the determinants of health and hereby improve their health.
- Health Promotion is directed towards strengthening the
host
main aims of health promotion is to enable people to
increase control over health & to improve the over all health
- The aim can be achieved by the Health Education & Life
style Change
2. SPECIFIC PROTECTION
- Efforts directed toward protection against specific diseases
- The provision of conditions for normal mental and physical
functioning of the human beings in group, it includes the
promotion of Health
Aim of Specific Protection:
>Immunization
>Use of specific nutrients
>Protection against accidents

 SECONDARY PREVENTION
- Is designed to identify and adequately treat a disease or
injury process as soon as possible, often before any
symptoms have developed.
Specific intervention:
>Early diagnosis (e.g. screening test, case findings, breast
self examination, pap smear test, radio graphic
examinations etc.)
>Adequate Treatment
>Referral

 TERTIARY PREVENTION
- It is used when the diseases process has advanced beyond
its early stages.
- It is defined as “all the measures available to reduce or
limit impairments and disabilities and to promote the
patients” adjustments to irremediable conditions”
Specific intervention:
>Disability limitation- Any restriction or lack of ability in
normal range of human being.
>Rehabilitation- is the combined and coordinated use of
medical, social, educational, and vocational measures for
training and retraining the individual to the highest possible
level of function ability.
Types:
1. Medical rehabilitation- restoration of bodily function
2. Vocational rehabilitation- restoration of the capacity to
earn a livelihood
3. Social rehabilitation- restoration of family and social
relationship
4. Psychological rehabilitation- restoration of personal
dignity and confidence.

FACTORS THAT CAN AFFECT HEALTH

AND HEALTHCARE ADHERENCE
HEALTHCARE ADHERENCE
-also known as medication adherence or treatment
adherence, refers to the extent to which individuals follow
the recommendations of their healthcare providers. This
includes taking medications as prescribed, attending
appointments, making lifestyle changes, and engaging in
other recommended behaviors.

 MEDICAL ADHERENCE - Taking medications as

prescribed, including the correct dosage,
frequency, and duration. This also includes refilling
prescriptions on time and storing medications properly.

 LIFESTYLE ADHERENCE - Attending scheduled

appointments with healthcare providers, such as doctor
visits, therapy sessions, and follow-up appointments.

 APPOINTMENT ADHERENCE - Making recommended

changes to lifestyle habits, such as diet, exercise,
smoking cessation, and alcohol consumption, to improve
overall health and manage conditions.

 BEHAVIORAL ADHERENCE - Following other

recommendations, such as using medical devices,
attending support groups, or engaging in self-monitoring
activities.

FIVE MAIN DIMENSION

 PATIENT-RELATED FACTORS
> These factors encompass individual characteristics and
beliefs that influence adherence.
SOME KEY PATIENT-RELATED FACTORS INCLUDE;
> Knowledge about the disease > Depression and stress
> Motivation > Fear of possible
negative effect
> Self-efficacy

 SOCIAL/ECONOMIC FACTORS
> These factors encompass the broader social and economic
environment in which individuals live, which can
significantly impact their ability to access and adhere to
healthcare.
SOME KEY PATIENT-RELATED FACTORS INCLUDE;
> Health literacy > Medication/treatment costs
> Social support > Access to healthcare

 CONDITION-RELATED FACTORS
> These factors relate to the specific health condition itself
and its treatment.
SOME KEY CONDITION-RELATED INCLUDE;
> Chronicity
> Visibility of symptoms
> Severity of symptoms

 THERAPY-RELATED FACTORS
> These factors relate to the specific treatment regimen
itself, including its complexity, duration, and potential side
effects.

SOME KEY THERAPY-RELATED FACTORS INCLUDE;

> Complication of therapy > Effort required
> Duration of therapy >Adverse effects
> Barrier with lifestyle

 HEALTH SYSTEM/HEALTHCARE TEAM FACTORS

>These factors encompass the role of the healthcare system
and the healthcare team in promoting adherence

SOME KEY HEALTH SYETEM/ HEALTHCARE FACTORS

INCLUDE;
> Availability and accessibility of medications and
treatments
> Medication costs
> Wait times
> Communication and patient education
> Provider-patient relationship
> Positive reinforcement

 SEVERAL REASONS WHY HEALTHCARE ADHERENCE IS

CRUCIAL
• Improved health outcomes
• Reduced healthcare costs
• Enhanced quality of life
In addition, Healthcare providers and patients can work
together to improve adherence by;
• Open communication
• Patient education
• Medication reminders
• Support systems
COMPOUND THE CURRENT NATIONAL HEALTH
CARE SITUATION AND COMPONENTS OF THE
PHILIPPINES HEALTH CARE DELIVERY SYSTEM

 PUBLIC FUNDED HEALTH CARE – is a form of health care

financing designed to meet the cost of all or most health
care needs from a publicly managed fund.

 DEPARTMENT OF HEALTH (DOH) – is the executive

department of the Government of the Philippines
responsible for ensuring access to basic public health
services by all Filipinos through the provision of quality
health care and the regulation of all health services and
products.

HEALTH CARE DELIVERY SYSTEM COMPONENTS:

 PRIMARY HEALTH CARE FACILITIES

 SECONDARY HEALTH CARE FACILITIES

 TERTIARY HEALTH CARE FACILITIES

HEALTHCARE FINANCING
 PHILHEALTH – National Health Insurance Program
 GOVERNMENT FUNDING – Budget allocation for public
hospitals and health programs
 PRIVATE SECTOR – Out of pocket expenses and private
health care

CHALLENGES:
 WORKFORCES ISSUES
 INSFRASTRUCTURE LIMITATIONS
 FUNDING CONTRAINTS

OPPORTUNITIES:
 INNOVATION AND TECHNOLOGY
 POTENTIAL FOR POLICY IMPROVEMENTS
The video "A Brief Overview of the Philippine Healthcare
System" by Lakan Cortez MD presents a comprehensive
analysis of the state of healthcare in the Philippines,
focusing on the six building blocks of a health system as
defined by the World Health Organization (WHO).

6 BUILDING BLOCKS:
> HEALTH SERVICE DELIIVERY > HEALTH
INFORMATION
> HEALTH WORKFORCE > HEALTH FINANCE
> ACCESS TO ESSENTIAL MEDICINE > LEADERSHIP AND
GOVERNANCE

The Philippine Healthcare System: A Dual System

PUBLIC HEALTHCARE - in the Philippines is largely financed
through taxes, making services available for free or at
subsidized costs. This system aims to provide healthcare
access to the majority of the population, particularly the
poor.
PRIVATE HEALTHCARE - in the Philippines is market-oriented
and relies heavily on user fees. This system is typically
associated with better facilities, shorter wait times, and
higher quality of care.

CHALLENGES:
OPPORTUNITIES:
> Limited Access to Healthcare in Rural Areas > Increased
Funding of Public Hospitals
> Shortage of Healthcare Professionals >
Strengthen the Role of Healthcare Providers
> Inadequate Infrastructure and Equipment > Expansion
of Health Insurance Coverage
> High Out-of-Pocket Spending
> Fragmented Health Financing Systems
> Devolution Challenges

Department of Health (DOH)

LEGAL FRAMEWORK:
R.A. 7160 (1991) Local Government Code
 Provided for the decentralization of the entire
government.
 All structures, personnel, and budgetary allocations from
the provincial health level down to the barangay’s were
 devolved to the local government units (LGU’s) to
facilitate health service delivery
 LGU’s are now responsible for the delivery of basic health
services (implementation function)
 DOH (governance function)

E.O. 102 (1999)

> The Department of Health is the national authority on
health, providing technical and other resource assistance to
local government units, people’s organization, and other
members of the civic society in effectively implementing
programs, projects, and services that will:
(a) promote the health and well-being of every Filipino,
(b) prevent and control diseases among population at risks,
(c) protect individuals, families, and communities exposed
to hazards and risks that could affect their health, and
(d)treat, manage, and rehabilitate individuals affected by
diseases and disability

ROLES AND FUNCTIONS: DOH

1. Leadership in Health
> national policy and regulatory institution where LGUs and
NGOs will base their direction for health
2.Enabler and Capacity Builder
> innovates new strategies in health to improve
effectiveness of health programs
- ensures highest achievable standards of quality health
care
3. Administrator of Specific Services
> manage selected national health facilities that shall serve
as national referral centers
> administers health emergency response services

MISSION:
VISION: Ensure accessibility and
Health for all Filipinos quality health care to
improve the quality of life of
 Filipinos, especially the poor

DOH shall guarantee

DOH is the leader, staunch equitable, sustainable, and
advocate, and model in quality health for all
promoting Health for All in Filipinos, especially the poor,
the Philippines and shall lead the quest in
excellence for health

OBJECTIVES:
 Improve the general health status of the population
 Reduce morbidity, mortality, disability and complications
from diseases and disorders
 Eliminate the certain diseases as public health problems
-Schistosomiasis
-Malaria
-Filariasis
-Leprosy
-Rabies
-Vaccine- preventable diseases: measles, tetanus,
diphtheria, and pertussis
-Vitamin A deficiency
- Iodine deficiency disorders
 Promote healthy lifestyle and environmental health
 Protect vulnerable groups with special health and
nutrition needs
 Strengthen national and local health systems to ensure
better health services delivery
 Pursue public health and hospital reforms
 Reduce cost and ensure the quality of essential drugs
 Institute health regulatory reforms to ensure quality and
safety of health goods and services
 Strengthen governance and management support
systems
 Institute safety nets for the vulnerable and marginalized
groups
 Expand the coverage of social health insurance
 Mobilize more resources for health
 Improve efficiency in the allocation, production and
utilization of resources for health

GOAL: HEALTH SECTOR REFORM AGENDA (HSRA)

 Set in National Objectives for Health 1999-2004
 Health sector reform is the overriding goal of the DOH
 Conceptualized because although there has been a
significant improvement in the health status of Filipinos
for the fast 50 years
 Some the following conditions were still seen in the
population:
-slowing down in the reduction of Infant Mortality Rare (IMR)
-persistence of large variations in health status across
population groups
-high burden from infectious diseases
-rising burden from chronic and degenerative diseases
-unattended emerging health risks
-burden of disease heaviest among the poor

REASONS FOR CONDITIONS STATED INCLUDE:

 Inappropriate health delivery system (poor coverage of
public health and PHC services)
 Inadequate regulatory mechanisms for health services
(poor quality and high cost of health care services,
drugs)
 Poor health care financing (inefficient generation of
funds)

SUPPORT MECHANISMS OF HSRA:

 Sound organizational development
 Strong Policies, Systems, and procedures
 Capable Human Resources
 Adequate Financial Resources

FRAMEWORK FOR IMPLEMENTATION: FORMULA ONE FOR

HEALTH
 Engages the entire health sector, including the public
and private sectors, national agencies and local
government units, external development agencies, and
civil society to get involved in the implementation of
health reforms.
 It is an invitation to join the collective race against
fragmentation of the health system of the country,
against the inequity of healthcare and the impoverishing
effects of ill- health.

4 ELEMENTS
 Health financing
- fosters greater, better, and sustained investments in
health
- involves Philippine Health Insurance Corporation
PHIC) through National Health Insurance Program (NHIP)
and DOH
 Health regulation- ensure quality and affordability of
health goods
 Health Service Delivery- improve and ensure the
accessibility and availability of basic and essential care
 Good governance- enhance health system performance at
national and local levels

KEY FEATURES: NHIP

- supports each element through:
 Financing - reduces financial burden of health care costs
 Governance - it influences health market and related
institutions by being a practical purchaser of health care
 Regulation - plays a role in accreditation, acts as driver
for improved performance in health sector
 Service Delivery - demands fair compensation for the
costs of care

GOALS:
 Better health Outcomes
 More responsive health systems
 Equitable health care financing

INTERNATIONAL ORGANIZATION
 World Health Organization (WHO):
> the directing and coordinating authority for health within
the United Nations system
> World Health Assembly- the supreme decision-making
body for WHO. It meets each year in May in Geneva, and is
attended by delegations from all 193 Member States.
> Executive Board- composed of 34 members technically
qualified in the field of health. Members are elected for
three-year terms

GOAL: The attainment by all peoples of the highest possible

level of health

CORE FUNCTIONS:
 Providing leadership on matters critical to health and
engaging in partnerships where joint action is needed
 Shaping the research agenda and stimulating the
generation, translation and dissemination of valuable
knowledge
 Setting norms and standards and promoting and
monitoring their implementation
 Articulating ethical and evidence-based policy options;
 Providing technical support, catalysing change, and
building sustainable institutional capacity
 Monitoring the health situation and assessing health
trends

UNITED NATIONS CHILDREN’S FUND (UNICEF)

- the United Nations (UN) body responsible for the rights of
children
Roles:
- required by the UN Convention to promote the effective
implementation and to encourage international cooperation
for the benefit of children.
- UNICEF is represented during UN Conventions and may be
invited to provide expert advice on the implementation of
the convention

GLOBAL STRUCTURE OF UNICEF:

 International offices:
New York and Geneva
 Specialised offices:
 Copenhagen- Supply Division which manages the supply
centres that are
essential in emergencies
 Florence- Innocenti Research Centre well- known for its
authoritative
publications on children

My explanation (letter) as to the issue transpired during the

midterm exam.

Several weeks/months ago, during a Primary Health Care

quiz or exam, I observed a classmate exhibiting behavior
inconsistent with the principles of academic integrity.
Specifically, I witnessed them actively sharing answers with
another student, and also receiving answers from a different
classmate. This involved whispering answers and passing
notes, While I understand that reporting this incident after
a significant time lapse might raise questions, I felt a strong
obligation to document this observation. The integrity of
academic assessments is paramount, and I believe it's
important to maintain a fair and equitable learning
environment for all students. Therefore, despite the delay, I
felt it necessary to report what I witnessed.

My Insights on Primary Health Care and Midwifery

This semester's focus on Primary Health Care (PHC) has been a real eye-opener, especially in
relation to my aspirations as a midwife. It's made me realize how much bigger the picture is than
just delivering babies!

1. Prevention is Key: It's Not Just About "Fixing" Things

Before this semester, I viewed midwifery as primarily reactive – dealing with complications
during pregnancy and childbirth. Now I see the huge potential for preventative care. PHC's
emphasis on preventing illness really resonates. We can make such a difference by educating
women about healthy lifestyles before they even conceive, ensuring they get proper folic acid,
and promoting healthy eating habits throughout pregnancy. It's about empowering women to
make informed choices that lead to healthier pregnancies and babies. For example, I'd love to
develop a program focusing on nutrition and exercise during pregnancy, tailored to the specific
needs of the women in our community.

2. Teamwork Makes the Dream Work: We're All in This Together

I always knew midwifery involved teamwork, but PHC has highlighted the importance of inter-
professional collaboration. It's not just about midwives; it's about doctors, nurses, social
workers, and everyone else working together seamlessly. We need to be able to communicate
effectively and share information to ensure the best possible care. I've already started thinking
about how I can improve communication with other healthcare professionals, maybe by creating
a shared online platform for case notes and updates.

3. It's Personal: Understanding the Whole Person

PHC isn't just about physical health; it's about the whole person – their mental health, their
social circumstances, everything. I've learned how crucial it is to understand the social
determinants of health – poverty, lack of education, access to resources – and how these factors
can massively impact a woman's pregnancy and postpartum experience. This semester has
made me more aware of the need to be sensitive to these issues and to advocate for better
support systems for vulnerable women. For example, I'd like to volunteer at a local community
center to connect with women and offer support beyond just medical advice.

4. Community is Everything: Building Relationships, Not Just Delivering Babies

PHC emphasizes community engagement, and that's something I'm incredibly passionate about.
It's not just about treating individuals; it's about building relationships within the community and
empowering women to take control of their health. I'm excited to explore ways to better engage
with the community, perhaps by offering antenatal classes that are culturally sensitive and
accessible to everyone.

In short, this semester has completely changed my perspective on midwifery. It's not just about
delivering babies; it's about being a crucial part of a holistic healthcare system that prioritizes
prevention, collaboration, and community engagement. I'm eager to put these learning into
practice and make a real difference in the lives of the women and families I serve.