RNHEALS and RHMPPs of BANTAY

Exit Report
2012 - 2013

Contents
Mission Vital Ten Ten

and Vision

Statistics 2012

Leading Causes of Morbidity Leading Causes of Mortality Care

Maternal Family Child

Planning

Care
(OPT)

Nutrition Program Disease KP

Control

CHT Strengths and Weaknesses

Summary

of Deployment

Mission and Vision of the Facility

Vital Statistics 2012

Total No. of Livebirths Total No. of Deaths Total No. of Infant Death Total No. of Neonatal Death Total No. of Maternal Death Total Morbidity Total Population 606 157 0 0 0 7002 35598

TEN LEADING CAUSES OF MORBIDITY

1. URTI 2. Bronchitis 3. HCVD 4. GID/AGE 5. Dermatological Disorder 6. Musculo Skeletal Disorder 7. UTI 8. Minor Injuries 9. EENT 10. Pneumonia 2507 672 593 567 485 385 292 232 201 194

Upper Respiratory Tract Infection or URTI tops the list on the leading cause of morbidity. There are 2,507 clients who had been diagnosed having this disease. Other respiratory-related diseases include Bronchitis and Pneumonia which ranked number 2 and 10 consecutively. A contributive factor includes the changing weather tends to affect ones resistance in getting the causative agent of the diseases. These diseases are transferred via airborne and droplet. Productive cough and colds are the main chief complaint of those patients having

these diseases. However the main problem here is that, the clients either never had or seek medical consultation too late. Boosting the immune system is the foremost key to prevent these diseases. Good nutrition which includes exclusive breastfeeding for infants aged 0 6 months and maybe extended upto 2 years old and so with proper hygiene are very much important and easy ways to avert such diseases. Pneumonia has a vaccine and thus recommendation to the National Government and the Department of Health shall be made Pneumococcal Conjugate Vaccines (PCVs). Patients with cardiovascular disorders seek medical Attention allyear round. A huge number of patients with HCVDs come for medical consultation only during symptomatic stages (time when signs and symptoms of the diseases appear and become pronounced). Most of the patients who were assessed usually present symptoms such as headache, nape pain, blurred vision, and numbness of various parts of the body. On blood pressure assessment, data reveals blood pressure above 120/80mmHg.

TEN LEADING CAUSES OF MORTALITY

1. Pneumonia 2. HCVD 3. CVA 4. Malignancy 5. Accident 6. Undetermined Cause 7. COPD 8. Sepsis 9. Anemia; Kidney Disease; Status Asthmaticus; DM; Multi-Organ Failure 10. BPU; PTB; UGIB; Malnutrition; Graves Dse; Atrial Fib. 2o to CAD; Intestinal Obstruction 2o to P. Emphysema; LBP 2o Degenerative Osteoarthritis; Asphyxiation 42 30 22 17 13 7 4 3 2

In the 2012 annual report of Municipal Health Unit of Bantay, the top leading cause of death is PNEUMONIA, a severe respiratory infection. Incidence of pneumonia is increased at extreme ages among the very young and the very old. It is spread from one person to another via sneezing and coughing after which it invades the nose and throat then the lungs. Vulnerable persons usually catch the bacteria

from infected persons in overcrowded places. Smoking and pollution were other contributory factors. Pneumonia is actually one of the worlds leading preventable diseases. Good nutrition and strong immune system was one way of combating the disease. Exclusive breast-feeding during the first six months of life was an important and easy way to help protect children from pneumonia and other diseases. Frequent hand washing also reduced the spread of bacteria. There is also a vaccine for this disease - Pneumococcal Conjugate Vaccines (PCVs). And I want to recommend that the government especially the Department of Health should include this vaccine into the National Immunization Program to be given to infants and among elderly clients. HCVD or Hypertensive Cardiovascular Disease, CVA or Cerebrovascular Accidents, Atrial Fibrillation 2o to Coronary Artery Disease and Diabetes Mellitus are also in the list of the leading cause of mortality in Bantay. Its prevention, diagnosis and management are of fundamental importance to public health and require a cooperative and multidisciplinary approach. These diseases are preventable in the first place. You dont have to wait to have these diseases. The common risk factors that could be avoided are sedentary lifestyle and lack of exercise, smoking, excessive consumption of alcohol, dietary excesses particularly in the

consumption of fats and sugar, and faulty regimen in taking of maintenance drugs. And with these things, healthy lifestyle is the prevention for these diseases. We, as healthcare providers should educate them about these diseases and what are the things they should or should not do in order not have or aggravate more these diseases. Health education includes the disease, its causes, signs and symptoms, and prevention. Also, there should be a kit for those hypertensive and diabetic patients and they should be monitored monthly. Malignancy is the 4th leading cause of mortality in the town. Patients are referred to hospital for the care and management. Road Accidents is also in the list. In relation with us healthcare team, we should prepare ourselves in any accidents that may happen in the road. We should equip with the items that are essential during accidents. The problem here in the municipality of Bantay is the communication and coordination of the Police Officers and the equipment of the Ambulance and the first aid kit. And with this, I want to recommend that the LGU and MHU of Bantay shall equip the ambulance the necessary equipments for ambulance management and also, they should conduct trainings in first aid, ambulance management and other essential trainings. There is also one case of death that the cause is Pulmonary Tuberculosis. Tuberculosis prevention and control efforts primarily rely on the vaccination of infants and the detection and appropriate

treatment of active cases. But the problem is that people dont know the symptoms and they ashamed of what will be the result for the test. The healthcare team should conduct sputum exams in the community for the screening diagnosis of the disease to whether a person has sign of positive TB. Malnutrition, a simple and treatable condition but sadly to say that there is one case of death that this is the cause. There is a Barangay Nutritionist Scholar in every barangay and they are the one who are reporting to us if there are cases on that particular barangay. Feeding programs are initiated in the community through DSWD in day care centers. Also, we are conducting GP (Garantisadong Pambata) Program that is done during the months of April and October. Monthly, we are conducting Child Growth Standard monitoring. As a summary for these things HEALTH EDUCATION is the main keypoint for all of this. Everyone has the right to have information for these diseases.

MATERNAL CARE
1. Pregnant women w/ 4 or more prenatal visits 2. Pregnant women given 2 doses of TT 3. Pregnant women given TT2 plus 4. Pregnant given complete iron w/ folic acid 5. Pregnant given Vit. A supplementation 6. Postpartum women w/ @ least 2 PPV 7. Postpartum given complete iron 8. Postpartum given Vit. A 9. Postpartum women initiated B Feeding 10. Pregnant women w/ 4 or more prenatal visits

2507 672 593 567 485 385 292 232 201 194

FAMILY PLANNING
NU 1. Female Sterilization 2. Pills 3. Injectables 4. SDM 5. LAM 6. Condom 7. IUD 25 105 64 7 388 0 56 CU 447 899 219 17 388 2 52

CHILD CARE
1. Fully Immunized Children 2. Infant 6-11 mos. Old given Vit. A 3. Newborn screened infant 4. Sick children 6-11 mos. Seen & given Vit. A 5. Sick children 12-59 mos. Seen & given Vit. A 6. Sick children 60-71 mos. Seen & given Vit. A 7. Infant 2-6 mos. w/ LBW seen & given iron 8. Anemic children 2-59 mos. Seen & given iron 9. Diarrhea cases 0-59 mos. Given tx, ORS & zinc 10. Pneumonia cases 0-59 mos. seen & given tx

905 905 202 98 285 13 4 32 263 110

NUTRITION PROGRAM (OPT)

1. Total no. of 0-71 mos. old children weighed 2. Total no. of 0-71 underweight children mos. old 183 5072

3. Total no. of 0-71 mos. old severely underweight 4. Total no. of 0-71 overweight children mos. old

43

57 4789

5. Total no. of 0-71 mos. old normal children

DISEASE CONTROL
LEPROSY New Cases Diagnosed Completed Treatment Continuing Treatment TUBERCULOSIS New Sputum (+) Initiated tx XRAY (+) Initiated tx New Smear (+) Cured TB All Forms Detection Rate 1 5 1 44 101 35/35 (100%) 145/98 (148%)

KP CHT Strengths and Weaknesses

Many Filipino families in our communities suffer from health conditions that could have been prevented if they had only been treated early enough or had received the proper attention and care. In Kalusugan Pangkalahatan, I have seen that this is very effective in the health implementation of the people especially in the Municipality of Bantay. They are now capacitated to access health services, but not all because of the hesitance to learn and go in the health facilities to have their medical consultation. Through us RNHeals and other health personnel and community health partners, town folks are now more educated in the different diseases including Dengue Fever and Hypertension. They now know their health risk and needs. Through this KP or the Universal Health Care, financial means to get the health services are now possible especially the poor ones who belongs to NHTS PR families (National Household Targetting System Poverty Reduction) through PHILHEALTH and the government and DSWDs 4Ps (Pantawid Pamilyang Pilipino Program). The problem that I can see in this matter is that some members of the NHTS-PR families that are much deserving than those who are chosen. Moreover, through this KP, it is a great help for us nurses especially those who are unemployed ones to have this kind of training with honoraria to enhance our skills and knowledge through the DOHs programs, RNHeals (Registered Nurses for Health Enhancement and Local Services) and RHMPP (Registered Health Midwives Placement Program). And with this, nursing workforce in the MHU is now augmented meaning more improved health care services is given to the town folks. The weakness is that some of the chosen ones are not

dedicated to their work. They just only work when there is an instruction coming from the supervisors or anyone who is superior to them. The CHTs or Community Health Teams are doing a nationwide door-to-door visit to reach all families, especially the poorest Filipino households. The mobilization of the CHTs aims to link these families to social and health service providers, provide critical social services when needed, deliver key health messages, providing information on certain diseases, immunizing those defaulters or non-FICs and those senior citizens, and other health services as the need arises. As far as weaknesses is concerned, insufficient resources for the effectiveness of health promotion and disease prevention in community health were observed for example is lack of people who perform in joint effort door to door visits especially those mountainous areas wherein they have to walk vast distances to reach their clients. Another is that the lack of compensations for the local or the members of the CHT because due to this most of them are not doing their job because the compensation is not enough for them in their daily needs. Nevertheless, the close connection that community health has to its local community and the ability to communicate directly with local communities was observed as the major strengths, and there is no competition between the team members. And in addendum, each should have commitment and willingness to accept the responsibility of being a CHT partner for that to have a better output in reaching Kalusugan Pangkalahatan.

Summary of Deployment
Last March 6, 2012, the Department of Health spearheaded the deployment of nurses (RNheals Batch III) and midwives (RHMPP Batch II.) Its aim is to assist in the provision of health services in poor communities as part of the DOHs support to the Pantawid Pamilyang Pilipino Program (4Ps) of the DSWD and also, it seeks to augment the inadequate nursing workforce in DOH hospitals and a number of Local Government Unit (LGU) health facilities to i mprove patient care and health services. Were deployed as part of the program as a Public Health Nurse and undergone learning and development in public health during one (1) year of deployment. We were exposed to the implementation of public health programs and provision of health services. Here are some of the activities we did in our one-year experienced and training as RNHEALS and RHMPP. Assessment for patients with different complaints one of our daily activities in the MHU. Carry out doctors orders properly, monitoring in-patients Assisting deliveries and performing newborn care as the facility is a BEMONC facility Assisting and Giving medicines for TB-DOTS patients Giving lectures on family planning every Monday. Routine immunization of children every Wednesday.

 Health Teachings on Prenatal Care, Neonatal Care, Nutrition, Pregnancy, Newborn Screening, and Breastfeeding every Thursdays and Fridays. Health teachings on Dengue Prevention, Proper Sanitation, Healthy Lifestyle Verification, Profiling and Enrolment of members and dependents of PhilHealth and also Distributing of ID Cards Briefing and discussion on the benefits of being a Philhealth member Attended KP Orientation seminar together with the other CHT partners headed by the DOH. We had also assigned to gave a mini deployment as part of the training. Profiling those 4Ps members Gathering information and updates of disabled in the community Garantisadong Pambata Program to ensure wellness of children Monitoring CGS or the OPT for children identifying those malnourished children Being part of the Department of Health for a period of 1 year is such a great opportunity. Lots of programs have been encountered and different people have met. And with this, we consider this training as enlightenment. There is still so much to learn regarding public health nursing. Knowledge and competencies are enhanced through the help of professionals and even nonprofessionals. It was not really complicated when we attended these entire tasks because we did the best we can. We deal with everybody the proper way we know, and with gratitude, this is our profession.

Learning/Insights During the Program During the RNHeals program, we learned how to apply our knowledge and skills in real life setting. Actual experience is way better than reading whats written in a book. Though we already experienced or seen some of the activities listed above when we were still students, were still grateful that weve been a part of those activities. Continuous practice makes one grow professionally. Wed encounter different kinds of people on my

Memorable and Negative Experiences Funny Experiences Being a part of Actually, It is not the RNHEals program is huge number of things one of the most that we do that makes memorable as tired. In fact, it is the experienced wed ever negative attitudes of the had. Weve been with community that different people with saddens us a lot. There different walks of life are some community yet weve learn to people who are taking appreciate, share, and for granted their health care for each other so with the things that especially when we we used to advise them. are in the community. It is okay to spend all We admit that it is not our time there in the easy to walk under the community to educate sun just to reach out them as long as they will people. However they will listen and allow

Recommendations to Improve the Program We strongly recommend continuation of the RNHeals program having all its goals executed and implemented properly. Additional training and seminars must also be added to improve skills and knowledge not only in the community aspects but also in clinical and other areas of nursing that would be of great help to the humanity. It is a program that provides opportunity to the hopeless nurses that were needing and finding a job to have a better and stable life that will

designated community those efforts are paid from high profile to low off when you see that profile thus learning their they are learning. attitudes towards things. When we see a smile This program is of great that shines on their help for the low class the faces, though how program of the government tired we are, at the in the provision of health end of the day it is all services like the PhilHealth worth it! and the 4Ps (Pantawid Pamilyang Pilipino Program) We will never forget of the DSWD. Expanding those times that we and adding members that are patiently reaching are truly in the low class out patients in their and qualified will be a homes to render our countless benefit to the tender loving care society. without waiting for something in return. Our social skills were There were times that challenged. Dealing because of our

us to enter into their lives so that we can work hand in hand for the betterment of their health. However, this isnt always the scenario. Even though the health care teams were the ones who are reaching them, some still refuses and even get rid of us. As if they dont welcome us. It also worries us a lot because some community peoples mind setting is that they are just wasting their time and

let them grow financially and professionally. With regards to unemployment issues of nurses in the Philippines. The RNHeals program must find ways to help more the nurses to land a job not just for a year but as long as they are willing and deserving enough for the job. If not to extend the nurses on this program, the government might find ways to have other program that serves as continuum of RNHeals program for nurses that are skillful, persevere enough and deserves such promotion.

different types of people from the municipality is one of the things we should consider professionally. You have to maintain respect and confidence in dealing with them. We learned how to possess control and at the same time be determined in giving necessary nursing measures. Showing compassion and information while being treated. Above all, to have lots and lots of patience to those who are irritable and demanding patients in order to give the best you can.

eagerness to finish all our work, it is so funny that at the end of the day we will find out that we didnt eat yet our meals. Even though were starving, still it seems nothing because we still managed to smile and laugh at ourselves because of what had happened. Up to now, whenever we remember those times, we cant help but smile. We will definitely miss these moments in my life.

that there are more important things to do that of health dissemination and disease prevention because for them they are already and will always be healthy.