'

I
Department of Health Programs Related to Family Healthit

A. Expanded Program of Immunization

established in 1976
ensures that infants/children and mothers have access to routinely
recommended infant/childhood vaccines
seven vaccines are included in the EPI
Tuberculosis
◦
°

Pertussis
0

Poliomyelitis Measles
:
Diphtheria Hepatitis B
:
Tetanus
Schedule and Manner of Administration of infant immunization
Antigen Age Dose Route Site
Right deltoid
BCG Vaccine At birth 0.05 ml Intradermal
region (arm)
Hepatitis B Anterolateral
At birth 0.5 ml Intramuscular
Vaccine high muscle
DPT Hepa B-Hib Anterolateral
(Pentavalent 6,10,14 weeks 0.5 ml Intramuscular
high muscle
Vaccine
Oral polio vaccine 6,10,14 weeks 2 drops Oral Mouth

Anti Measle Outer part of

9-11 months 0.5 ml Subcutaneous
Vaccine AMV1 the upper arm

Measles mumps
Outer part of
rubella vaccine 12-15 months 0.5 ml Subcutaneous
the upper arm
AMV 2

Rotavirus
6-10 weeks 1.5 ml Oral Mouth
vaccine
 Fully immunized child
1 dose of BCG
3 doses of OPV Before child’s 1st birthday
3 doses of Hepa B
1 dose of measles

Completely immunized children

completed immunization schedule at age of 12-23 months

It
Child protected at birth CPAB
Term used to describe a child whose mother has reciprocal two doses of
Tetanus Toxoid during pregnancy
*second dose given a month prior to delivery; or
*at least 3 doses any time prior to pregnancy

EPI VACCINES AND CHARACTERISTICS

Vaccines
substances sensitive to various temperatures
needs to be stored at correct temperatures to avoid spoilage and
maintain potency

First expiry and first out (FEFO) vaccines

protected to assure that all vaccines are utilized before expiry date

temperature monitoring is done in all levels of health facilities to monitor

vaccine temperature (2x a day)
early in the morning and in after before going home

Temperature is plotted in monitoring chart to monitor break in the cold chain

Cold chain equipment Other cold chain logistics supply
A. Cold room A. Thermometers
B. Freezer B. Cold chain monitor
C. Transport box C. Ice pack
D. Refrigerator D. Temperature monitoring chart
E. Vaccine carrier E. Safety collector box

Handling of vaccines
Vaccines must be placed in a special cold pack during immunization
sessions

EPI vaccines and special diluent cold chain requirements

OPV -15 to -25 C
: Stored in vaccine bag
0

Stored in freezer Placed in contact with cold packs

Measles vaccines, MMR, and Rotavirus vaccine

•

Refrigerator at +2 to +8 C •

Do not stock at refrigerator door shelves

Stocked neatly in the shelves

:
Hepatitis B vaccines, pentavalent vaccine, rotavirus vaccine, and tetanus
Toxiod vaccines
Damaged by freezing. Do not store in freezer
Wrap containers with paper before putting in vaccine bag with cold
packs

Diluents
Must be kept cold in refrigerator (lower or door shelves)
0
DOH Strategies
A. 23 in 93
National immunization day slogan “Ceasefire for Children: Support
National Immunization Day!”
No shooting of Bullet only shooting of vaccines concept
Polio eradication project with the goal to completely eradicate polio
by 1995
Formulation of plans for an improve biologic production service
Done to dev. Self sufficiency in vaccines production while
decreasing dependence on imported vaccines

B. Health for more in 94

Buwan ng Oplan Alis disease II
GOALS: To completely eradicate/control childhood killer disease that
are immunizable
LEGAL BASIS: PPD 996 Compulsory Basic Immunization for Infants and
Children below 8 years of age (Infants and school entrants)

May 2012 World Health Assembly

Declared completion of polio virus eradication to be a pragmatic
emergency for global public health

Polio eradication and endgame strategic plan 2013-2018

Endorsed by WHA
To eradicate both wild polioviruses and vaccine derived poliovirus

Major Objective
To introduce at least 1 dose of inactivated Polio vaccine (IPV) in routine
immunization schedules by end of 2015
Shift from using trivalent OPV to Bivalent OPV by 2016
Why IPV needs to be introduced
1. To reduce risks
2. To interrupt transmission in case of Polio virus type 2 outbreaks
3. To hasten eradication of polio viruses

Inactivated Polio Vaccine

All infants at 14 weeks of age, must be integrated in essential
vaccination of all infants
Dose Min age Vaccine Route and dosage

1st dose 6 weeks OPV ORAL, 2 drops in mouth

2nd dose 10 weeks OPV ORAL, 2 drops in mouth

3rd dose OPV and ORAL, 2 drops in mouth

14 weeks
OPV and IPV IPV 0.5 ml, left upper thigh

IMMUNIZABLE DISEASES
1. Tuberculosis
Infectious bacterial disease characterized by growth of nodules (tubercles)
in tissues, especially in lungs
CAUSES
Bacteria from other person
Someone with untreated, active form of TB
Contagious but not easy to catch
TB from workmates or you live with than a stranger
TB with drug treatment at least 2 weeks is no longer contagious

SIGNS and SYMPTOMS

O

Long term coughing o

Chills o

Chest pain
O

Coughing up blood -

Fever o

Fatigue
TUBERCULOSIS causative organism

Mycobacterium Tuberculosis
Gram positive, acid fast bacillus

TB MODE OF TRANSMISSION
Droplet infection
Inhalation of bacilli fresh from patients

:
Dust inhalation of bacilli which have dried in ground floor and
suspended in air

2. Poliomyelitis
Crippling and potentially deadly infectious disease
Caused by poliovirus
②

Spreads from person to person

②

Can invade an infected person’s brain and spinal cord, causing paralysis
⊖

PREVENTION FACTORS
Polio vaccine
DISEASES OR CONDITIONS CAUSED
Paralysis

CAUSES
•

Fecal-oral contact Sneezing or coughing

•

Poor hand washing Child is most contagious

•

Consuming contaminated food or water

ooo

before any symptoms show up

SYMPTOMS may vary depending on kind of polio and on child to child. Most
common are:
•

Fever (103 F) Bo
Sore throat ☆
Abdominal pain
Bo

Decreased appetite BB

Not feeling well

BB
Nausea or vomiting BB
Constipation
3. Diphtheria
Infection caused by bacterium Corynebacteriumdiptheriae
•

Causes a thick covering in back of throat

•

Can lead to difficulty breathing, heart failure, paralysis, and even death
•

CDC recommends, vaccines for infants, children, teens, and adults

BOB

4. Tetanus
Serious illness caused by Clostridium bacteria
:
Bacteria live in soil, saliva, dust, and manure
↳ Can enter the body through deep cut

Infection causes painful tightening of muscles, usually all over the body

SIGNS AND SYMPTOMS

can appear anytime (days to weeks)
3

Average incubation period: 7-10 days

: Spasms and stiffness in jaw muscles (trismus)

Stiffness in neck muscles
Difficulty swallowing
Stiffness of abdominal muscles
Painful body spasms lasting for several minutes, triggered by minor
occurrences (draft, loud noise physical touch or light )

Possible other signs

Fever
:
Sweating
Elevated blood pressure
Rapid heart rate
0
 5. Pertussis
Also known as whooping cough
:
Highly contagious disease
: Caused by bacterium bordetella pertussis
Known for uncontrollable coughing which makes it hard to breathe

6. Measles
Infectious viral disease - causing fever & red rash on the skin
③

Typically occurring in childhood

⑨

Highly infectious caused by rubeola virus,

•

"
Signs & symptoms 10 to 14 days after exposure to virus "
Fever Sore throat
D8

Dry cough BB
Inflamed eyes
•
Runny nose .
Tiny white spots with blush white centers in red

,
background found in mouth Koplik's spots
,
CB
Skin rash made of large flat blotches that flow into one another

7. Hepatitis B
•
Liver infection caused by B types of hepatitis virus
Boo
Attacks the liver often resulting in inflammation

Mode of transmission
•
Child to child or mother to child after birth
•
Mother to child during birth
•

Blood transfusion
•

Sharing of unsterelized needles, knives, or razors

is

Sexual intercourse
B. Integrated management childhood illnesses
so
Aims to reduce death, illness, & disability, and to promote improved
growth e development among children below 5 years old
-0
Includes both preventive & curative elements implemented by families
& communities & health facilities

Three main components

1. improvements in case management skills of healthcare staff
2. Improvements in health system needed for effective management
of childhood illness
3. Improvements in family & community practices

Imci case management

Protocol guides for health worker
BO
Assessing signs that indicate severe disease
•
Assessing child's nutrition, immunization, & feeding
•
Teaching parents how to care for child at home
•
Counseling parents to solve feeding problems
•
Advising parents about when to return to health facility

Elements
Assess Urgent-pink
:
Classify Specific-yellow
Simple advice-green
Identify
: Treatment
•

Counsel
•
Give follow up care
Early essential intrapartal Newborn care (EINC)

Evidence based standard practices

:
Standards for safe & quality care of birthing mothers & their newborns
Within 48 hours of intraportum period (labor & delivery) I a week
life of a newborn
③

Called unang yakap consist of measures based on scientific evidence

±
It includes ,
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I

•
Continuous maternal support by having companion of choice during delivery
•
Freedom of movement during labor
•
Monitoring progress of labor using partograph
'
=
Partographi'
Graphic recording of labor progress & significant conditions of mother
& fetus
Useful in detecting deviations from normal & early decision making on
referral
•
Non drug pain relief before offering labor anesthesia
DO
Position of choice during labor & delivery
00
Spontaneous pushing in a semi upright position
•
Hand hygiene
Non routine episiotomy
00

Active management of the third stage of labor (amstl)

☆

Post partum package

Visits within 72 hours & on 7th day postpartum check for conditions
(bleeding & infections)
Micro nutrient supplementation
Iron & folate once a day for 3 months (90 tablets)
Counsels on nutrition, child care, family planning, etc.
Newborn package (first week of life)

1. Intervention on first 90 minutes

0

Drying Breastfeeding initiation

•

Skin to skin Non separation of baby & mother

°

•
Cord clamping (1-3 mins)

2. Intervention from 90 minutes to 6 hours

Vitamin K prophylaxis

: Hepa b and bcg vaccination

Examination for injunes, malformation, defects
Additional care for babies less than 2500 grams

3, prior to discharge: after first 90 minutes

Support unrestricted; breastfeeding day & night
0

Ensure baby's warmth

0

Washing & bathing

: Look for danger signs & signs of jaundice & local infection
Newborn screening e newborn hearing screening
Instructions on discharge

Newborn screening
↳
Procedure intended for early identification of infants affected
by genetic, metabolic, or infectious conditions.
Republic act 9288
Public health program aimed at the early identification of
infants affected by health conditions
States that prior to delivery, any health practices has the obligation to
inform parents about the availability, nature & benefits of the NBS
 Disorders tested for newborn screening
1. Congenital hypothyroidism
↳
Baby is born with inability to produce enough thyroid hormone
2. Congenital adrenal hyperplasia
↳
Group of inherited disorders with the inability of adrenal gland to secrete
cortisol on aldosterone or both
3. Galactosemia ( Inherited )
↳
Body is unable to metabolize galactose & person cannot tolerate any milk
- human or animal
4. Phenylketonuria
↳
Baby is born & cannot properly breakdown amino and ( phenylalanine )
5. Glucose 6 phosphate dehydrogenase ( C6PD ) deficiency (Hereditary )
↳
RBC breakdown when body is exposed to certain, drugs, food stress etc
6. Maple syrup urine disease (Genetic )
↳
Person cannot breakdown the amino acids leucine, isoleucine, & valine
& urine smells like maple syrup

Basic emergency obstetric and newborn care (bemonc)

Primary healthcare level initiative promoted in low & middle income

:
countries to reduce maternal & newborn mortality

43rd nutrition month

Healthy diet, gawing habit- FOR LIFE!

Nutrition month
Annual campaign held every July to create greater awareness on the
importance of nutrition among Filipinos
10 kumainments
: Popular version of revised nutritional guidelines for Filipinos
Consists of shorter simpler messages for better recall and
&
understanding
Mhgap
Aim
b

Scale up services for mental, neurological, & substance use disorders

for countries with low & medium income
Theme (2020)
Sleep & our struggles with it