NHP

NATIONAL HEALTH PLAN
17/12/2015 1
National Health Plan in Myanmar
Aims
• To rise the level of the country
• To promote the physical and mental wellbeing
of the objective of achieving HFA 2000 goals
using Primary Health Care Approach
( prevention and curative measure can be
initiated)
17/12/2015 2
HFA 2000
• Mean level of health
- Capable of working productively and
participating actively in the social life of
activity
• Not mean
- In 2000 doctors & nurses provide medical care
for everybody in the world
17/12/2015 Daw Nyein Moh Moh Myint 3

HFA 2000, cont;
• Mean – health beginning at home, schools,
factories
• Better approach– preventing diseases
_ alleviating unavoidable
diseases & disability
_better way of growing up,
growing old & dying gracefully

Six broad programs for NHP(1993-96)
• Community health care program
• Disease control program (CDC & NCDC)
• Hospital care program
• Environmental health program
• Health systems development program
• Organizational and management program

Broad Programme
• Community Health Care Programme
• Disease Control Programme
• Hospital Care Programme
• Environmental Health Programme
• Health System Development Programme
• Health Promotion Programme
• Health Management Information System
Programme
• Development of Human Resources for Health
Programme
• Health Research Programme
• Laboratory Services and Blood Safety
Programme
• Food and Drug Control Programme
• Traditional Medicine Development
Programme
Concept of PHC
• Care provide according to need(equitable
distribution)
• Promotive, preventive, curative and rehabilitative
(focus on prevention)
• Services should be effective, curative culturally
acceptable effortable and
managable(appropriate technology)
• Community participation
• Multisectorial approach
Strategies
• Need to change to health care system

• Intersectoral action for health
• PHC as a level of health care (peripheral level)
• Inernation efforts for health
Essential Elements in PHC
• E- Education concerning prevailing the problem

and methods of preventing and controlling
them
• L - prevention and control locally &endemic
disease
• E – immunization against the major infectious
diseases
• M- Maternal and child health
Essential Elements in PHC
• E – Environmental sanitation
• N- promotion of food supply and proper
nutrition
• T - Appropriate of common diseases and
injuries
• S – Provision of essential drugs
• X- Mental health , Dental health, Drug abuse,
eye care
Primary level
1.In primary level, nutrition development has
been establish as a project especially for the
maternal and child health
2.As oral health care, health education which is

related to oral cancer
3.Primary medical care and referral of patients, in

the peripheral area, there are medical care for
such as hypertension, heart disease, rheumatic
arthritis and diabetes
4.If accessory referral system is done according to
the condition of the clients
5.Elderly health care is important. In Myanmar a

project for elderly health care is introduced in
both peripheral and urban area
6.Drug abuse and mental health especially in

adult
7.Disaster preparedness
8.Community health promotion through sports

and physical education
9.Vector borne disease control

programme(eg,malaria japanese encephalitis)
10.Tuberculosis control programme(eg,suspected

person)
11.AIDS control programme(eg, counselling, HE)
12.Control for diarrhoeal disease(CDD) control

programme(eg,HE)
13.STD control programmeeg, (HE)
14.Leprosy control programme

15.Trachoma control and prevention of
blindness(eg,cataract, glaucoma )
16.Viral hepatitis control programme(eg,HE)
17.Expended programme of immunization

(eg,pregnancy, injuries)
18.Zoonosis control programme(eg,rabies, plgue)

19.Cardiovascular disease prevention and
control programme(eg,HE)
20.Cancer prevention and control

programme(eg,HE)
21. Accidents and rehabilitation prevention and

control programme(eg, home accident,
community based rehabilitation)
22.Prevention of deafness
23.Diabetes prevention and control programme
24.Occupational health
25.Community water supply(eg, chlorination)

26.Air and water pollution control(keeping the
high way bus and industries at the outside of
the town )
27.Food and drug control(eg, National

Laboratory)
28.Development of human resources for health
29.Health management information system

30.Health research programme
31.Traditional medicine development
32.Information, Education, and Communication

for health
33.Model township development

34.Development of laboratory services
35.Policy construction(NGOs)
36.Health infrastructure development(man,

money, material)
37.Planning, implementing, monitoring,

supervision and evaluation
38.Multisectorial, intrasectoral, NGOS
cooperation and coordination
39.Explore alternative financing mechanism for

health system
Secondary Level
1. Medical social work

2.Border area health development
3.Quality of care in health institution(eg,
workshop, continuous education)
4.Essential drugs programme(peripheral area to
township area)
5.Snake bite control programme(eg, HE)
Tertiary Prevention
1. Elderly health care

2. Drug abuse control and mental health
3. Community health promotion through sports
and physical education
4. Leprosy control programme
5. Cardiovascular disease prevention and
control programme
6.Cancer prevention and control programme
7.Accidents prevention and rehibilitation

programme
8.Prevention of deafness
9.Diabetes prevention and control

programme
10.Policy construction(NGOs)
11.Health infrastructure
development(man, money, material)
12.Planning, implementing,
monitoring, supervision and
evaluation
13.Multisectoral, intrasectoral and NGOs
cooperation and coordination
14.Explore alternative financing mechanism

for health
GROWTH AND DEVELOPMENT OF ADULT
AND AGE
- Adult phase – from the end of adolescence

to death
Adult hood is considered in three phases…

- the young adult phase ( 18- 35 years)
- the middle adult phase ( 36- 65years)
- the older adult phase (over 65 years)
THE NATURE OF GROWTH AND
DEVELOPMENT
• Interrelated factors- heredity & environment
• Growth refers to increase in size or change

in structuring function or complexity
• Development is the pattern lifelong

changes in through or behavior that involve
as the organism matures
Man and Environment Concept
• The process of living involves interplay of an

organism and environment known as ecology.
• All organism modify their environment for

give and take between the organism and
environment.

• Man and Environment Concept(Cont:)
• Man interacting with his environment

dynamically and continuously.
• Man receive information from his external
environment and he also gives information to
his environment.
• Man exchanges information given from
environment within the body and produce
outcome into the environment.
Man
• Man is a human being who is integrated whole of
Bio-psycho-social spiritual and intellectual
dimension.
• Man cannot be separated into psychosocial and
physiological entity.
• Man is open system. He has reciprocal relationship
with his environment by adapting various changes
of environment to maintain homeostasis. All men
have various kind of human needs according to
their level of development.
Environment
• The surrounding thing of man which influence
the behavior of man.
• The environment should be considered as the
total economic, physical , natural and cultural
complex within which man lives.
• It consists of two components. There are
external and internal environment.

External environment.
• External environments are hazardous outside
factors influencing on health.
• Some External environments influences are;
Microorganisms, animals and plants
Geographical condition
Air, water, nutrients, shelter and weather.
Daily living events and economic variables.
Social relationship with friends and family.
Work experience and education level.
17/12/2015 34
Internal environment.
• Internal environment consists of surrounding
cells and carrying materials.
• Survival of the cell and maintenance of its
functions are dependent on conditions in the
cells immediate fluid environment.
• The internal environment maintain the
relative stability of the physical and chemical
characteristics of the intercellular fluid and
intercellular fluid.

Internal environments influences are;
• Physiological process of human being
• Genetic factors and body cells
• Body defense` mechanism
• Psychological variables
• Intellectual variables
• Spiritual variables

HEALTH AND ILLNESS
HEALTH – ILLNESS CONCEPT
- Health of mind and body is so fundamental

- Health and illness are qualitatively different
(Penders)
- Begins with conception and ends in death

DEFINITION OF HEALTH
W.H.O( 1974)
“Health is a state of complete physical ,

mental ,and social well being and merely
the absence of disease or infirmity.”
17/12/2015 38
VARIABLES AFFECTING ON HEALTH
Genetic make up
Race and sex
Age and development stages
Mind and body relationship
Method of coping with stress
Physical environment
Living standard
Culture and value system on health
Self concept

Geographic area and climate
Environmental factors:
- Gravity - Light
- Sound - Temperature
- Wind velocity - Atmospheric pressure
-Radiation - Air pollutants
-Infectious agent - Housing
-Sanitation,etc:
17/12/2015 40
Objectives For Health Profession
1. The promotion of health
2. Prevention of onset of illness / disease/
maintenance of health
3. Restoration of the sick person to health (cure)
4. Prevention of the extension of injury
consequent to illness or disease
5. Prevention of complications of disease and/ or
its medical treatment

6.Prevention of avoidable deleterious
dependence as a consequence of disease and
/or its medical treatment
7. Prevention of death as an avoidable
consequence of disease , injury or medical
treatment
8. Prevention of avoidable suffering in the
presence of incurable or irreversible disease

Health Status Indicators
Types
1. Life expectancy rates
3. Disability
4. Risk factors

Types
- depends availability & accuracy of written
records
- reflecting as they do sociocultural ,economic
and political characteristics of each country
2. General mortality
- Much more value when acute infectious
disease were the leading cause of death
17/12/2015 44
3.Disability
-Unless death is sudden, the sick person
experience a period of partial or complete in
ability to function physically , mentally , socially,
economically
4. Risk factors
-More death among heavy drinkers and smokers
-not eating breakfast
-getting too little or too much sleep
- failure to exercise regularly
Purpose
• Public information
• Administration
• Medical science

Measure to Promote Health
Nursing activities - teaching

- counseling
- motivating
17/12/2015 47
The most important components
1. Nutrition - adequate , safe and well
appropriate
2. Mental hygiene- Beginning an early age.
Important on appreciation of the values of
family life , acceptance of oneself& one’s
limitation
3. Moderate and well -balanced personal
habits(no smoking, exercise, personal
hygiene)
4. Adequate housing - proper safeguards for all
ages ( children, aged, handicapped)
The most important components
(cont:)
5. Sense of personal security
6. A useful and productive role in society
7. A safe and healthful working environment
8. General education and educational for health
9. Recreation , including access to recreational
opportunities
17/12/2015 49
Illness
• A condition characterized by a deviation from
a normal healthy state.
The opposite of wellness
Illness & wellness have a strong subjective
component
Implied malfunctioning or lower level of
functioning
Inadequate or inappropriate defense
mechanism
17/12/2015 50
Disease
Diseases are specific pathologic condition which

characterized by signs &symptoms
Involve a specific organ or the whole body

Impaired function of body part or system
Have a natural life history
- acute - sudden onset & short duration
- chronic - gradual onset & long duration
17/12/2015 51
Concepts of illness
• Biological , genetic factors contribute to
disease is strongly r/t individuals, family,
social, environment, culture
• Disease is merely an inhibitor of health
• Illness is the human experience of disease

Prevention of Illness
- Inhibiting the development of disease,

slowing down the profession of disease
and protecting the body from further
harmful effects

Three different levels of protection
1. Primary prevention of disease
e.g Immunization ,environmental sanitation
2. Secondary prevention
- Early detection and treatment
- Breast self examination
3. Tertiary prevention of disability and rehabilitation

e.g – prevention of complication
- prevention of contracture in patient with
arthritis

Emotional reaction of illness
1. Anxiety
2. Fear
3. Anger
4. Depression
5. Confusion
6. Attack or withdrawl
17/12/2015 55
Influencing factor on illness
• Stress and other emotional factors
• Immune system and immune response
• Degree of infection & inflammation
• Aging & severity of trauma
• Nutritional status
• Personal character or personality
• Health care facility
• Concepts of illness
HOMEOSTASIS AND ADAPTATION
• the process of maintaining uniformity ,stability
or constancy
• relative consistancy in the internal environment
of body
• strives to maintain stability and constant by
adjusting from everything
• maintained by adaptive responses that
promote health survival, various sensory
feedback
17/12/2015 57
Three of major homeostasis mechanisms are controlled
by medulla oblongata,
reticular formation and
pituitary glands
Some of functions controlled are heart rate ,blood

pressure , body temperature , fluid and electrolytes
balance, respiration , glandular secretion and
haematopiosis

HOMEOSTASIS AND PATHOPHYSIOLOGIC
PROCESS
When the body is threatened or suffer or injured
Functional or structural changes involved
May be adaption or maladaptation
Health or Illness
17/12/2015 59
STRESS
Definition
- as a common experience in life
- describe as specific conditions or event which
increase tension in the person
- physiological or psychological tension can effect
a person
- A person’s response is influenced by the
intensity ,duration, scope and number of
stressors present at once time

- A universal phenomenon , become a
household word in 20 th century
- Individual has unique , highly personalized
responses
- Responses are adaptatives or maladaptative
- Influenced by the context of stress , person’s
vulnerability and the stressor
- Nurses need to know about stress and its
management to help patient prevent illness ,
maintain health and cope with stressors

- A useful training point for increasing
communication about health and nursing
interventions
- Necessary point of all of life and essential for
growth
- If stress related to is not present , we will die
of dehydration
- Even when sleeping, stress is present as
internal organs work to maintain homeostasis

Characteristics of stress
1. not nervous energy
2. not always the result of damage to the
body(experience on competing in game)
3. not always result in feelings of distress
4. not necessary to be avoided entirely
necessary part of all life
essential for normal growth & development
5. When a stressor is strong, body respond
harmoniously (integrated manner)
Factors influencing stress response
1. Stimulus characteristics
- intensity, duration, number, scope
2. Personal characteristics
- Meaning of stressor to person
- Availability of resources and coping responses
- Health status

STRESS CAUSE THE EFFECTS OF ILLNESS
- Any emotional, physical, social, economic or
other factors that require a responses or
changes are:
- Dehydration cause an increase in the body
temperature
- Separation from parent’s cause a young child
to cry
- Standing erect stress musculoskeletal system
- Breathing stress respiratory system
- Eating stresses digestive system
STRESSORS
(1) Environmental stressor
e.g - attacks of animal ,microorganism
(2) Physical Stressor
e.g - Heat , cold ,radiation
(3) Emotional Stressor
e.g - anger, sadness, unmet basic needs
(4) Sociologic Stressor
e.g - Social isolation
(5) Psychological Stressor
e.g - Loss of spouse
FACTORS INFLUENCING THE EFFECT OF
STRESSOR
Stressors affects an individual depand on
The nature of the stressor

The number of stressors coped as one time
The duration of exposure to the stressor
Age and experience of person
Availability of supportive people

Local Adaption Syndrome (LAS)
• Topical injury
• Emotional arousal
• Cerebral cortex arousal
• Resystem or metabolism response
• Hormone
• LAS -effect

Phases of the General Adaption
Syndrome(GAS)
- Local response is inadequate
then body respond by GAS
1. Alarm reaction stage

2. Resistance stage
3. Exhaustion stage

Psychological responses to stressor
• Anxiety
• Fear
• Anger
• Hostility
• Self-pity

EFFECTIVE STRESS MANAGEMENT
1. Relaxation and physiological control
a. A quiet environment
b. Close eyes
c. A comfortable position
d. A repetitive mental device
2. Meditation
- One concentrates attention on a single
unchanging or repetitive stimulus
- Simple sets comfortable , close eyes &
engages in a effortless mental repetitive of a
special sound
3. Biofeedback
- Physiological sensing devices for providing

feedback to individual
- Moving graphs or dials on present body states
- Monitor and control temperature, blood
pressure ,muscle tension and heart rate

Aids Used to Reduce Stress
1. Do one thing at a time

2. Develop more passive attitude towards
irritation
3. Provide period of relaxation every day
4. See to object ( about problem, lack to friend ,
family and counsellor)
5. Work of release tension(recreation , exercise)

6. Change parts of your life that cause stress
7. Learn to be satisfied
8. Do not hold unrealistic expectations
9. Analysis what causes of stress
10. Accept your own anger response, accept
things which you cannot changes
11. Keep religious belief as your life where you
can find a heaven of rest

Cell
Normal cell and cellular imbalance
Cell
• Basic unit of structural organization of the
body
• More than 75 million cells in body
• Specialized for the performance of specific
activities
• E.g. muscle cells- contractility

Cell components
• Nucleus
• Cytoplasm
• Plasma membrane
Plasma membrane
• a highly selective-barrier that affects the
movement of substances into and out of cells

Nucleus
• Contains genetic material- in the forms of

chromatin thread (DNA combined with
protein and RNA).
• DNA instructs cells to synthesize particular
polypeptides or proteins
• Polypeptides or proteins synthesis according
to DNA specification act as enzyme
• DNA serves as a template in RNA synthesis

RNA
• Messenger RNA - coded information derived
from DNA that is used to direct protein
synthesis
• Ribosomal RNA –
Ribosomes – cytoplasmic organ cells that consist
of r-RNA and protein

Cell division

Abnormal cells
• Cancer
• Genetic defects
• Aging

INFECTION ,INFLAMMATION AND IMMUNE
SYSTEM
Infection
The Successful invasion ,establishment and growth
of micro-organisms in the tissue of the host.
Inflammation
-the reaction of living tissues to injury, infection or
oulitation, characterized by pain ,swelling,
redness and heat
-caused by chemical , heat , mechanical trauma or
bacterial invasion

Definition of Infection
An infection , which is a disease state from the
present of pathogen in or on the body ,occurs
as a result of a cyclical process.
Infectious disease process
1. The agent
2. The reservoir
3. The exit
4. The vehicle of transmission
5. The portal of entry
6. The susceptable host
Immune system
Humoral immunity
 B lymphocytes – stem cell precursors (red

bone marrow/ liver or spleen in fetal life)
 Circulate blood , tissue, lymph
 Localized lymph, spleen, lymphoid tissues

Immune system
Cellular or cell mediated immunity
 T lymphocytes- stem cells (red bone marrow)
 Proliferate & differentiate in the thymus gland
 Circulate blood , tissue, lymph
 Localized lymph, spleen, lymphoid tissues

Antigen
• A substance that elicits a specific

immune response when it is present
in the body

Antibody
• Specialized protein that is produced in
response to the presence of an antigen
• Belong to a family of globulin
• immunoglobulin

5 immunoglobulin
• Ig G immunity against bacteria & viruses
• Ig M
• Ig E - certain allergic response
• Ig A - release from lymphoid t/s
protect these areas(GI tract,
urogenital , respiratory tract)
• Ig D - surface of B cells
involve humoral immunity

2 types B lymphocyte
• Plasma cell
• Memory B lymphocyte
4 types of T Lymphocyte
• Helper T
• Cytotoxic T
• Memory T
• Suppressor T

Immunity
naturally- subclinical d/s
Active immunity
artificially- immunization
naturally – mother to foetus

Passive immunity
artificially–anti-snake venom

PAIN
Definition
• The international association on pain defined
as an unpleasant sensory and emotional
experience associated with actual or potential
tissue damage , described in terms of such
damage.
• Pain has physiological, psychological and

sociological components which make every
client’s pain very individual and personal.

• Stimuli strong enough to cause tissue damage
commonly gives rise to a sensation of pain.
• Stimuli such as excessive mechanical stress,

extremes of heat or cold ,and various chemical
substances stimulate PAIN RECEPTORS.

• Referred pain
impulses from pain receptors in internal
organs are incorrectly interpreted by the brain
as coming from areas quiet distant from the
actual sites of stimulation –particularly as
coming from sites on the body surface.
• e.g a heart attack frequently causes referred

pain in the skin over the heart, the left
shoulder , and down surface the medial of
the left arm

• Phantom Pain
• The phenomenon where by a person who has
undergone an amputation on continuous to feel
pain that he or she perceives as coming from the
amputated body part.
• Like referred pain ,is a case of inaccurate
protection of the pain sensation by the brain.
• Anesthesia
• Commonly used to reduce a person’s sensitively
to painful stimuli
• A number of local anesthesia (e.g procaine,
tetracune)
Types of Pain
1. General types of pain
(a) Acute pain

- Last no longer than 6 months
- Sudden onset
- Transient episode
- Muscle tension ,anxiety
(b) Chronic pain
- Persists longer than 6 months
- Source of pain is unknown
- Often more diffuse
- Difficult to identify pain site
2. Specific types of pain
a. Somatic versus visceral pain
b. Referred pain
c. Psychogenic pain
d. Phantom limb pain
e. Neurologic pain

Factors that influence pain tolerance
• Increase tolerance Decrease tolerance
1 .Alcohol 1. Fatigue
2. Drugs 2. Anger
3.Hypnosis 3. Boredom
4. Warmth 4. Anxiety
5. Rubbing 5. Persistent pain
6. Distraction 6. illness
7. Faith
8. Strong beliefs

Factors that influence reaction to pain
1. Meaning of pain to individual
2. Degree of pain perception
3. Past experience
4. Cultural values
5. Social expectations
6. Physical and mental health
7. Parental attitudes towards pain
8. Setting in which pain occurs
9. Fear ,anxiety
10. Usual way of responding to stressor
11.Age

SHOCK OR ACUTE CIRCULATORY FAILURE
Definition
- Is a clinical syndrome of relatively rapid onset
- By inadequate tissue perfusion, as a result ,the
metabolic need of cells are not met
- A state of acute circulatory failure
- Leading to inadequate microcirculation and
poor cellular perfusion
- Associated with inadequate cardiac output,
changes in peripheral blood flow
- Complex group of signs and symptoms

• Etiology and Classification of Shock
1. Hypovolemic shock
-loss of intravascular fluid volume
-e.g Haemorrhage, burn, and scald ,severe
diarrhoea or vomiting
2. Cardiogenic Shock
- Cardiac failure results in decrease tissue
perfusion (myocardial infraction)

3.Anaphylactic shock
- Unable to respond sympathetic impulses due to
hypersensitivity reaction
- Massive vasodilatation, decrease venous return
- Decreased perfusion and decreased cardiac
Output( e.g Injection Pen Shock)
4. Neurogenic Shock
- decrease in efferent impulses from the
sympathetic nervous system to the vascular
smooth muscle
- causes pooling of blood , decreased venous
return to heart , decreased cardiac output
- (e.g head injury , pain)

5. Septicaemic shock
-occur when bacterial toxic cause an systemic
infection
6. Miscellaneous
a. Electric shock
b. Psychological shock (fear, fright)
c. Insulin shock
d. Food or Chemical poisoning

• Systemic Responses To Shock
Clinical Manifestations of Shock
Organ or system Objective Data
Skin Pallor, Cyanosis, Sweating
cool &clammy, altered
temperature ,diaphoresis
Mucous membrane Dry and pale, thirsty
Brain Restlessness, confusion
disoreintation,confusion
brain cell hypoxia, coma
drowsiness

Cardiovascular Tachycardia , BP Systolic ↓,
cardiac output ↓, dysrhythmias,
ischemic , ECG changes
Pulmonary ↑ respiratory rates,hyperventilation
Renal ↓ glomerular filtration, low urine
output(30ml/hr)
Blood Agglutination platelets,
leukocytes and erythrocytes
Metabolic Acidosis ,hypoglycemia

NURSING CONSIDERATIONS AND NURSING
MANAGEMENT
1. Identify the patient’s risk to develop shock.
-Assist in preventing development of shock
2. Position should be remain flat in bed or footened
raised
- Trandelenburg position should be avoided
3. Kept warm but external heat should be avoided
4.Monitored continuously assess until recovery
5. Blood volume must be restored quickly
6. Respiratory assistance with high oxygen conc;

7. Nothing by mouth and sedatives, tranquilizers
or narcotics
8.Reassure, show confidence and techanical
expertise in care
help to reduce anxiety
2. Respiratory Monitoring
-Respiratory rate , depth -Po2
-Breath sounds -Pco2
-Blood gases -Percent saturation
-pH

3. Fluid and Electrolytes Monitoring
- Serum electrolytes
- Blood lactate and pyruvate levels
- Intake( by mouth,I.V, Nasal feeding, irrigation
solutions, solutions in medications)
- Output ( urinary, GIT, sweating, dressings)
- Weight
- Serum creatinine level, BUN level
- Serum and urinary osmolality
- Urinary specific gravity

4. Neurologic Monitoring
- Alertness, orientation, confusion
5. Haematologic Monitoring
- Erythrocytes, haematocrit and hemoglobin
levels
- Leukocytes ,platelets
- Prothrombin and partial thrombin times
- Clotting time
6. Other monitoring
-bowel sounds
- Skin temperature
Anxiety
-Psychological responses to stress with physiologic
and psychologic components
Levels of Anxiety
Mild anxiety Alertness
Quick eye movements
↑ hearing ability ,↑awareness
Moderate anxiety Decreased awareness of
environmental details
Focus on selected aspects of self
or illness

Severe anxiety Disturbances in thought pattern
Incongruency of thoughts,
feelings and actions
Panic anxiety Distorted perceptions of
environment
Inability to see or understand
situation
Unpredictable responses rang
on motor activity

NURSING MANAGEMENT
1. Physical activity Encourage the patient
2. Stress reduction strategies
3. Decreasing Knowledge Deficit
Nursing Intervention Into Severe Anxiety Or Panic

Anxiety
a. Stay with patient
b. Maintain a clam ,sorene manner
c. Use short, simple sentences
d. Use a firm and authoritative voice

e. Move the patient to a quieter, smaller, and
less stimulating environment
f. Focus the patient diffuse energy on repetitive
or physically tiring task
g. Administer antianxiety medication, if ordered
Antianxiety medication
1.Chloridiazepoxide ( diazepam, valium)
2. Antipsychotic medication thioridizine
(mellarit),cholopromazing,


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NATIONAL HEALTH PLAN

17/12/2015 Daw Nyein Moh Moh Myint 3

17/12/2015 Daw Nyein Moh Moh Myint 4

17/12/2015 Daw Nyein Moh Moh Myint 5

• Need to change to health care system

• E- Education concerning prevailing the problem

2.As oral health care, health education which is

3.Primary medical care and referral of patients, in

5.Elderly health care is important. In Myanmar a

6.Drug abuse and mental health especially in

8.Community health promotion through sports

9.Vector borne disease control

10.Tuberculosis control programme(eg,suspected

12.Control for diarrhoeal disease(CDD) control

13.STD control programmeeg, (HE)

14.Leprosy control programme

16.Viral hepatitis control programme(eg,HE)

17.Expended programme of immunization

18.Zoonosis control programme(eg,rabies, plgue)

20.Cancer prevention and control

21. Accidents and rehabilitation prevention and

23.Diabetes prevention and control programme

25.Community water supply(eg, chlorination)

27.Food and drug control(eg, National

28.Development of human resources for health

29.Health management information system

31.Traditional medicine development

32.Information, Education, and Communication

33.Model township development

36.Health infrastructure development(man,

37.Planning, implementing, monitoring,

39.Explore alternative financing mechanism for

1. Medical social work

1. Elderly health care

7.Accidents prevention and rehibilitation

9.Diabetes prevention and control

14.Explore alternative financing mechanism

- Adult phase – from the end of adolescence

Adult hood is considered in three phases…

• Growth refers to increase in size or change

• Development is the pattern lifelong

• The process of living involves interplay of an

• All organism modify their environment for

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• Man interacting with his environment

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HEALTH – ILLNESS CONCEPT

- Health of mind and body is so fundamental

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“Health is a state of complete physical ,

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Nursing activities - teaching

Diseases are specific pathologic condition which

Involve a specific organ or the whole body

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- Inhibiting the development of disease,

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3. Tertiary prevention of disability and rehabilitation