BARANGAY

HEALTH
WORKERS’
Pocket
Handbook

Towards
Effective
Service
Provision and
Improved
Health
Outcomes

Department of Health
2015
BARANGAY HEALTH WORKERS’ Pocket Handbook
Towards Effective Service Provision and Improved Health Outcomes
January 2015

Published by the Health Human Resource Development Bureau (HHRDB), in cooperation

with the Bureau of Local Health Systems Development (BLHSD) Department of Health
San Lazaro Compound, Rizal Avenue, Sta. Cruz, Manila 1003 Philippines
Telephone +632 651-7800

Articles may not be reproduced in full or in part for any purpose without prior
permission from the aforementioned DOH offices.

ISBN No.
February 2015
Acknowledgment

The Department of Health-Health Human Resource Development Bureau

(HHRDB) and the Bureau of Local Health Systems Development (BLHSD)
acknowledge the individuals, DOH offices and other partners that have
contributed to the development of the Barangay Health Workers’(BHW)
Reference Manual and Pocket Handbook. We are very grateful to Dr. Jennifer
G. Coritico as the main author of this document. The BHW Reference Manual
and Pocket Handbook were put together through the efforts of a core team--
without which these documents would not materialize. The core team that
spent countless hours consolidating technical materials, coordinating with
technical and support offices, facilitating consultative meetings and pilot tests
with BHWs, and facilitating administrative and technical processes, are
composed of: Ms. Marjorie Dungca, Dr. Maria Lourdes Gajitos, Ms. Maria Olga
Bulasa , Ms. Maria Teresa Santiago, Ms. Ma. Graziella Cardano, Ms. Dina Sarne
and Ms. Janice Feliciano. Contributing to the focus group discussions, manual
and handbook framework, editing and proofreading is Dr. Christine Joan Co.
We also acknowledge the efforts of Ms. Cristina Flor Marifosque for the design
and layout for both the BHW Reference Manual and Pocket Handbook.

We very much appreciate the assistances rendered by the following DOH

offices: Disease Prevention and Control Bureau, Health Emergency
Management Bureau, and the Philippine Institute for Traditional and
Alternative Health Care, for contributing to the contents of this document; and,
DOH Regional Offices 1, 4-A and 9 for supporting the on-site consultative FGDs
with regional BHWs. Special thanks to the regional BHW Coordinators and
BHWs who were involved in the regional consultative meetings.

Sincere appreciation is being extended to Director Nestor Santiago of the

BLHSD and Director Kenneth Ronquillo of the HHRDB for their support.
Table Of Contents

Guide to Use this Manual

Acronyms

Chapter I. Overview of the Role and Effective Qualities of a BHW

Chapter II. Role of BHWs per DOH program, project and

activity

Chapter III. The BHW on Special Health Concerns

in the Community

a. Environmental Health
b. Violence against Women and their
Children
c. Disaster Risk Reduction and Management

Annex: Herbal Medicine

References
Guide to Use this Pocket Handbook

This handbook provides the BHW a quick overview of the

key messages they should discuss to the community per priority
DOH program.
In Chapter II, the key messages focus on the causative
factor of the disease or illness; the mode of transmission; signs
and symptoms; and, preventive measures that the community as
a whole can do.
The reference manual, which comes along with this
handbook, should always be initially referred to by the BHW until
such time that there has been familiarity on the basic concepts,
knowledge and skills required of the BHWs on the different DOH
programs. By that time, the reference manual will only be
referred to by the BHW as necessary; but this handbook will have
to be regularly carried by the BHW during their household or
community visits, as a quick reference tool.
List of Acronyms
BCG Bacillus Calmette–Guérin
BHW Barangay Health Worker
BNS Barangay Nutrition Scholar
BP Blood Pressure
BTL Bilateral Tubal Ligation
COPD Chronic Obstructive Pulmonary Disease
CPR Cardiopulmonary Resuscitation
DASH Dietary Approach to Stop Hypertension
DOH Department of Health
DPT Diptheria, Pertussis, Tetanus
DSWD Department of Social Welfare and Development
EDC Expected Date of Confinement
EINC Essential Intrapartum and Newborn Care
EPI Expanded Program on Immunization
FP Family Planning
GP Garantisadong Pambata Program
HBMR Home Based Maternal Record
HIV Human Immunodeficiency Virus
HPN Hypertension
Integrated Management of
IMCI Childhood Illnesses
IUD Intra-uterine Device
IYCF Infant and Young Child Feeding Program
LAM Lactational Amenorrhea Method
Last Menstrual Period
LMP Measles, Mumps, Rubella
MMR Non-Communicable Disease
NCD Natural Family Planning
NFP No-scalpel Vasectomy
National Tuberculosis Program
NSV Oral Polio Vaccine
NTP Post-exposure prophylaxis
OPV Public Health Nurse
PEP Rural Health Midwife
PHN Short Message Service
RHM Soil Transmitted
SMS Helminthiasis
STH Sexually Transmitted Infection
STI Tuberculosis
TB Tetanus Toxoid
TT
Chapter I. Overview of the Role and Effective
Qualities of a BHW

The roles and contribution of BHWs in the attainment of

the DOH thrusts under the Kalusugang Pangkalahatan (KP)
framework cannot overlooked. They are mandated to perform
different tasks, depending on the need of members of their
household (HH) catchment areas, and the existing health demand
of the entire community as well. It is very important that they
clearly understand their respective roles and responsibilities.

SPECIFIC ROLES OF A BHW:i

1. An advocate of current health programs, projects and

activities to improve access and use of health services
2. An educator who will advise and counsel the community
3. A disseminator to maintain regular communication between
local professional health workers and their catchment
household
4. A linker to facilitate access to or association of the
community with relevant network of health and non-health
service providers within or outside their catchment areas
5. A record keeper to maintain updated lists/records of health
data, health activities/events in the community
Table 1. Examples of the different roles of a BHW

Roles Of The BHW Examples

An advocate of current BHWs are expected to know:

health programs,
projects and activities to 1. The basic concepts on the
improve access and use priority programs of DOH:
of health services a. MNCHN
b. RPRH
c. IYCF
d. GP
e. Communicable and Non-
communicable diseases
f. Healthy lifestyle
2. How to encourage members
of their household catchment
area to become PhilHealth
members
3. How to encourage active
community participation in
disease prevention and
control

An educator who will Providing basic information and

advise and counsel the education campaigns on the
community priority programs of the DOH
(e.g., importance of
immunization, pre/post natal
visits or preventive methods) to
either minimize or control the
spread of infectious diseases
(e.g., TB or dengue)
A disseminator to Acts as a distributor of IEC
maintain regular materials (e.g., pamphlets and
communication between brochures) if available, while
local professional health conducting household
workers and their education campaign or
catchment household counselling

A linker to facilitate 1. Knowledgeable of when and

access or association of where to refer clients for
the community between their specific needs or health
local professional health facilities that provide
workers and their specific services needed by
catchment household members of their household
catchment areas
2. Constantly update their
household catchment areas
on the latest ordinances
for health programs or
health related activities
supported by local officials
or NGOs

A record keeper to 1. Regularly update family

maintain updated profile of household
lists/records of health catchment areas
data, health
2. Regularly record important
activities/events in the
information regarding
community
compliance of members of
the household catchment
areas with the needed
medications (e.g, NTP, HPN
or DM)
 Becoming a BHW is not an easy role most especially if
confronted with uncooperative members of the community on
the different promotive and preventive aspects of illnesses or
diseases.
It is thus also essential that the BHW clearly understands the
general qualities that any community health volunteer should
have which include the following:

1. Teachable – openness to learn new things and to accept

feedback/mistakes for further improvement
2. Team player – cooperate and work harmoniously with
other team members
3. Diligent and dedicated to work – perseverance in
doing
his/her job despite difficulties, setbacks and lack of
financial support
4. Kind, sensitive and considerate to others
 Chapter II. Role of BHWs per program, project and
activity

A. FAMILY PLANNING

What is the importance of family planning (FP)?

FP prevents high-risk pregnancies among those younger than 18
years old or older than 35 years old; those with 4 or more
pregnancies; who have closely spaced pregnancies; or, who
are concurrently ill.
FP allows the Women of Reproductive Age (WRA) to regain her
strength after pregnancies and avoid prematurity and
malnutrition.
FP allows the couple to produce healthy children and avoid
malnutrition.
FP allows the couple to provide their children with better education
and improved social welfare.

o If the couple decides to space their children, they can avail

of the short-acting methods.
o On the other hand, if the couple decides to limit their
number of children, they can avail of long-term or
permanent methods such as IUD insertion or no-scalpel
vasectomy (NSV).
o Comprehensive discussion on the different FP methods
can be counselled by the RHMs in the community.
B. MATERNAL HEALTH IN PREGNANCY

PRE-NATAL CARE
What is the importance of having a pre-natal check-up?
1. Prenatal check-ups are given to pregnant women to
monitor the following:
a. Health of the mother and the baby, and detect any
abnormality brought about by pregnancy, such as high
blood pressure, eclampsia or diabetes.
b. Nutritional status of the mother because of its consequent
effects on the baby (e.g., Vitamin A deficiency)
c. Good nutrition is important during pregnancy and this can
be achieved by eating a balanced diet. A balanced diet
refers to eating a variety of food from the 4 food groups
namely:
Rice, or its alternatives like corn and sweet potato,
which provide energy, fiber, vitamins and minerals
Fruits which are necessary for the normal functioning
of the body through adequate blood formation and
building of body resistance
Vegetables which are good sources of vitamins,
minerals and dietary fiber
Meat, or its alternatives, which is necessary for the
growth and repair of body tissues, and used for the
formation of the fetus’ organs
d. Growth, size and position of the baby in each trimester
e. Presence of infection to the mother, whether viral or
bacterial, which may greatly affect the condition of the
baby (e.g., Rubella)
 f. Help women and couples prepare for delivery and plan
subsequent pregnancy
2. Health care services given during prenatal check-ups include:
a. Tetanus toxoid immunization to protect the baby against
neonatal tetanus
Table 2. Tetanus Toxoid Immunization Schedule

VACCINE MINIMUM DURATION OF

AGE/INTERVAL PROTECTION

TT1 As early as Provides

possible during protection for
pregnancy the mother for
the first delivery

TT2 At least 4 weeks Provides 3 yrs

after 1st dose protection
for the
mother

TT3 At least 6 months Provides 5 yrs

after last dose protection
for the
mother

TT4 At least 1 year Provides 10 yrs

after last protection for
dose the mother

TT5 At least 1 year Provides

after last LIFETIME
dose protection to
both mother and
child
 b. Micronutrient supplementation (e.g., Ferrous sulphate
with folic acid) once a day for 6 months to prevent
nutritional disorders.
Iron is essential to prevent anemia in mothers; anemia
causes them to get tired easily and look pale. Iron
intake also helps to build the baby’s stored iron during
the first 6 months of life. It is found in liver, meat, fish,
eggs, green leafy vegetables.
Folic acid is needed for cell growth and reproduction. A
deficiency in folic acid also causes anemia in mothers.
It is found in green leafy vegetables, eggs, nuts and
liver.
Calcium helps in the development of a baby’s bones and
teeth. A pregnant woman should consume 2-4 glasses
of milk per day to meet their calcium requirement.

Prenatal check-ups should be done at least once

during the 1st and 2nd trimester, and at least
twice during the 3rd trimester.

3. Pregnant women should have a total weight gain of 11-15 kg

during the 2nd and 3rd trimesters of pregnancy. If the woman
is already overweight before pregnancy, she has to gain only
6-9 kg more.
4. To prevent excessive weight gain, pregnant women must limit
their intake of sweets and sweetened drinks. They should also
eat less fried food and chocolate.
5. The adolescent should seek medical consult from the nearest
adolescent or teen health center if there are signs and
symptoms of suspected pregnancy for proper evaluation and
management. These include:
Missed menstrual period
Signs of morning sickness (e.g., nausea and vomiting)
Swelling or soreness of breasts

6. A urine pregnancy test can still be read as negative for up to 2

weeks after a missed period even if a woman is already
pregnant.

The pregnancy test should be repeated more than 2 weeks

after the missed menstrual period.ii Once the test shows a
positive result, the BHW should refer the adolescent to the
nearest health worker in the nearest adolescent or teen
health center available in the community.

7. Conversations held in adolescent or teen health centers are

strictly confidential.

INTRAPARTUM CARE
(Woman in Labor until 6 hours post-partum)
What does the expectant mother need to prepare prior to her
delivery?
Expectant mothers should have pre-packed the following prior to
her expected date of delivery:
1. Home-Based Maternal Record (HBMR) or Mother and Baby
book
2. Birth plan, if any
3. PhilHealth documents, (e.g., PhilHealth card or Member
Data Record, MDR), if she is a member/beneficiary
4. Materials for her and her baby (e.g., diapers, blanket,
clothes and cap for the newborn)
 If the pregnant woman cannot avail of
PhilHealth membership, request a
certification from the barangay/municipality.

What are the signs and symptoms of active labor?

The following are the signs and symptoms of active labor:
Increased urgency to urinate or defecate
Presence of blood-tinged or brownish discharge from the
pregnant woman’s cervix
Fluid gushing or leaking from the vagina
Regular Contractions at intervals <10 minutes

POSTPARTUM CARE
(More than 6 hours after delivery until 6 weeks)
What are the danger signs after delivery?
Go to the nearest Rural Health Midwife (RHM) or health
facility if there are any of the following:
Difficulty of breathing
Severe headache with or without blurring or loss
of vision High-grade fever
Foul smelling vaginal
discharge Severe lower
abdominal pain
Profuse or severe vaginal
bleeding Paleness
Breast engorgement and
tenderness Loss of consciousness or
convulsions
As early as 30 minutes after delivery or childbirth,
breastfeeding may already be initiated.
 Breastfeeding is also a natural method of family planning
termed as Lactational Amenorrhea Method (LAM) and helps
reduce the risk of ovarian and breast cancer.

Breastmilk is always available, highly nutritious,

safe and economical for the newborn baby.

C. NEWBORN HEALTH (0-28 days old)

ESSENTIAL INTRAPARTUM AND NEWBORN CARE (EINC)

There are 4 important interventions during the immediate
postpartum phase of pregnancy:
1. immediate drying;
2. skin-to-skin-contact and delayed cord clamping;
3. non-separation of baby from mother; and,
4. exclusive breastfeeding.

NEWBORN SCREENING
What is Newborn Screening?
Newborn Screening is a procedure that detects congenital
metabolic disorder that may lead to mental retardation or
even death if not detected early. It uses the Heel
Prick Method.
When should it be done?
It is done ideally in the first 24 hours of life but not later than 3
days after complete delivery. The procedure is performed
only by a physician, nurse, trained midwife, or medical
technologist.
Where can it be availed?
It is available in hospitals, lying-in clinics, rural health units,
health centers and some private clinics.iii

BREASTFEEDING
Exclusive breastfeeding is the best source of nutrition for
babies until 6 months of age. It may be continued until 2 years of
age and beyond. It is always available, safe and economical.

Source: mypositiveparenting.org

What do we mean by “exclusive” breastfeeding?

Exclusive breastfeeding means giving only breastmilk without
water, other liquids, teas, herbal preparations or other food
and fluid intake for the first 6 months of life.iv It provides
protection to the child against common infections such as
diarrhea and pneumonia.
 Proper Latching

Source: thepassionatemom.wordpress.com

For working mothers, she can still continue breastfeeding by

storing expressed breastmilk in a clean, safe and cool place that
is properly labelled and covered, or they may bring along with
them their babies if there is a breastfeeding area within their
office or establishment.
Manual Expression of Breastmilk

Source: www.lactationconsultant.info

How do we store breastmilk?

Key points in storing milk:
o Expressed breastmilk that is not refrigerated can be stored
for at least 8 hours at room temperature
o When stored in a refrigerator, it is good for 24 hours
o When stored in a freezer compartment of the refrigerator,
it is good for 2 weeks
o When stored in a freezer section or refrigerator with
separate door, it is good for 3 months
o When stored in deep freeze in 180C or lower, it is good for
6-12 months
D. NEONATE AND INFANT HEALTH

EXPANDED PROGRAM ON IMMUNIZATION (EPI)

What are the vaccines needed to be administered to be
considered as fully immunized?
A fully-immunized child has 1 dose of BCG; 3 doses of Penta; 3
doses of OPV; 3 doses of PCV; and 1 dose of measles before
the age of 12 months.

What are the vaccines included in Pentavalent vaccine?

At present DPT vaccination is included in the Pentavalent
vaccine which also contains immunizations against
Haemophilus influenza type B (Hib) virus and Rotavirus.

What are the possible side effects after immunization?

Fever may present after immunization, and swelling at the
injection site is expected from administration of BCG vaccine.

Table 3. EPI Schedule

VACCINE MINIMUM NUMBER MINIMUM PURPOSE
AGE AT 1ST OF DOSES INTERVAL
DOSE BETWEEN
DOSES
BCG Birth or 1 dose None To prevent the
(Bacillus- anytime possibility of
Calmette- after birth tuberculosis
Guérin) meningitis and
other
tuberculosis
infections

Pentavalent 6 weeks old 3 doses 6 weeks To reduce the

vaccine (DPT 1), risk of severe
10 weeks
(DPT2), pertussis, severe
14 weeks forms of
(DPT 3) pneumonia and
diarrhea
 MINIMUM MINIMUM
AGE AT 1ST NUMBER INTERVAL
VACCINE OF DOSES PURPOSE
DOSE BETWEEN
DOSES
OPV (Oral 6 weeks old 3 doses 4 weeks The extent of
Polio protection
Vaccine) against polio
is
increased the
earlier the OPV
is given
HepaB At birth 4 doses 4 weeks Reduces the
(Hepatitis B) (final 3 likelihood
doses as of
part of
Pentavalent becoming a
vaccine) carrier or
becoming
infected
Measles 9 months 1 dose None Measles is
vaccine preventable
through
immunization in
almost 85% of
those who
vaccinated

MMR 12-15 mos 1 dose None Intended for

(Measles, those who do
Mumps, not respond to
Rubella) first dose
INFANT AND YOUNG CHILD FEEDING PROGRAM
When does complementary feeding begin?
Complementary feeding may be given to infants 6 months of
age or older

How do you initiate complementary feeding?

Start with small amounts of nutrient-rich foods and increase
gradually as the child gets older
Among infants 6-8 months of age, complementary feeding
should be given 2-3 meals per day; 3-4 meals per day for
infants 9-23 months of age
 Table 4. Complementary Feeding Guidev
AGE OF
APPROPRIATE INTRODUCTION METHOD OF
FOOD(S) PREPARATION EXAMPLE AMOUNTS
(IN MONTHS)

Cereals 6 months Cooked, well Thick rice gruel, ½ cup thick

(first semi- strained oatmeal gruel
solid foods 2-3
given to the Cooked, mashed
root crops tablespoons
baby)
8 months Cooked Thick gruel, soft ¾ cup thick
cooked rice gruel
10-12 months Cooked Soft cooked rice 1 cup
Sliced bread, 1 piece
biscuits
Fruits 6 months Mashed Ripe bananas, 2½
ripe papaya, ripe tablespoons
mango
8 months Cut into small Soft fruit 3
pieces tablespoons
10-12 months Cut into Any fruit 4
finger sized tablespoons
pieces
Vegetables 7 months Cooked very Carrots, sayote, 1 tablespoon
soft squash,
abitsuelas,
potatoes,
kamote tops,
kangkong tops,
pechay,
malunggay
leaves

8 months Cooked and All vegetables 1 tablespoon

finely
chopped
10-12 months Cooked and All vegetables 1-2
coarsely tablespoons
chopped
 AGE OF
APPROPRIATE INTRODUCTION METHOD OF
FOOD(S) PREPARATION EXAMPLE AMOUNTS
(IN MONTHS)

Meat and 7 months Cooked Chicken egg ½ egg yolk

alternatives
11 months Cooked Chicken egg ½ egg
Meat/fish/ 6-11 months Deboned, Minced meat, 1 1/3 servings
poultry or cooked well, fresh or dried
legumes, mashed or fish or minced 1 serving
cooked
dried beans ground chicken, mashed meat = 30 g
monggo or about

10-12 months Deboned, Meat, fresh or 3 cm cube;

cooked, dried fish or fish:2 pieces,
flaked or chicken monggo medium size
chopped well (55-60 g
each), about
16 cm long; 1
1/2 cups
cooked dried
beans/nuts
preferably
taken 3 times
a week

Whole milk/ 12 months 2 cups

Follow on
formula
(if not on
breastmilk)
Other foods 8 months Steamed, Custards, simple 1 teaspoon
baked pudding, plain
gulaman or jello
Fats and oils 6-11 months Margarine 4 teaspoons
Cooking oil
Sugar 6-11 months 3 teaspoons
Source: FNRI-DOST, 2000
E. CHILD HEALTH

GARANTISADONG PAMBATA (GP) PROGRAM

What is the importance of the GP?
GP is an integrated package of services concerning health,
nutrition and environmental sanitation but mainly covers
micronutrient supplementation of Vit. A and Iron
children. This program also includes deworming among
preschoolers ages 1-5 years old.
among
What is the importance of Deworming, Vit. A and Iron
Supplementation?
Deworming significantly improves language and memory
development.vi
Vit. A supplementation provides protection to children against
measles and prevents malnutrition which causes decreased
resistance against infections.
Iron supplementation provides protection to children against
iron-deficiency anemia which is one of the most common
forms of nutritional deficiency among children; iron deficiency
anemia causing paleness and easy fatigability.

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES

(IMCI)
What are the childhood symptoms included in the IMCI
program?
Included in the IMCI program are the following common
childhood symptoms:
o Cough
o Diarrhea
o Fever
o Ear infection
Cough, with or without phlegm, and difficulty of breathing,
despite increased fluid intake lasting for more than 2 days should
be consulted to BHWs, the RHM or nearest health facility for
adequate treatment.

NEVER self-medicate with antibiotics to prevent

the development of antibiotic-resistant bacteria.

What can mothers do at home when their children have cough?

For ordinary cough and colds, encourage mothers to increase
their child’s fluid intake and provide nutrient-rich foods to
improve resistance against infection and prevent dehydration.
Adequately trained BHWs may teach mothers of sick children
the ways to prepare lagundi decoction (refer to Annex on
Herbal Medicine), a DOH recommended medicinal plant for
cough and asthma.
Refer the sick child to the RHM or to the nearest health facility if
cough persists for more than 3 days with or without signs of
pneumonia for adequate management.

Diarrhea is a symptom of gastrointestinal infection that is highly

preventable and curable. It caused by a virus, bacteria or parasitic
organism. Not all forms of diarrhea will require antibiotics.
NEVER self-medicate with antibiotics to prevent complications.
Diarrhea often results from ingestion of contaminated food
and water because of poor personal hygiene and poor
sanitation.
 Neonates and infants are at a higher risk for dehydration; a
few hours of diarrhea can cause dehydration; thus, should be
immediately consulted to the RHM or nearest health facility
when there are any of the following:
o Profuse, watery stools at least 3 times a day
o Foul smelling, yellowish to greenish stools with or without
blood
o Excessive thirst
o Sunken eyeballs
o Sunken fontanel in infants

What can mothers do at home when their children have

diarrhea?
Mothers are encouraged to continue breastfeeding her child
with diarrhea and/or give “am” or oresol to replace lost body
fluids
Oresol sachets may be requested from BHWs or at the nearest
health facility
If there are no available oresol sachets, homemade oresol may
be prepared by mixing the following:
o 1 Liter of clean water (5 glasses of 200 ml each)
o 6 teaspoons of sugar
o ½ teaspoon of salt
The best and practical way to prevent diarrhea include the
following:
o Regularly practice good hand washing techniques before
eating and after using the toilet
o Wash fruits and vegetables before eating or cooking
o Drinking water only from safe sources and avoiding street
foods that are not properly covered against insects or
bacteria
Fever is an increase in body temperature (37.8° C and above). It is
not a disease but a sign that the body is ill. Therefore, check for
other signs and symptoms that may be causing the fever.

What can mothers do at home when their children have fever?

Never wrap the child with several blankets or clothing.
Do sponge bath continuously until the temperature goes
down.
Give the child lots of fluids (water, juice, soup).
Refer to a health facility if temperature does not go down
despite first aid measures.

Ear Infection is an infection in the ear caused by bacteria or virus

that may have spread from the nose or throat.

What are the usual signs and symptoms of ear infections?

The usual signs and symptoms of ear infections include any of
the following:
o Foul-smelling ear discharge
o Ear pain
o Fever
o Impaired hearing capacity on the affected ear

ORAL HEALTH PROGRAM

What are the causes of oral health diseases?
Risk factors causing oral health diseases include the following:
o Unhealthy diet
o Poor oral hygiene
o Tobacco use and alcohol, among adults
How can oral health diseases be prevented?
Healthy diet should start from birth up to 6 months through
exclusive breastfeeding and continued with complementary
feeding up to 2 years of age.
Good oral hygiene should start as soon as the first tooth
erupts at 5-6 months of age. It is important to visit the dentist
as they are more knowledgeable to discuss good oral hygiene
and have follow-up visits every 6 months thereafter.
Low-grade fever (T = 37.80C to 38.50C) may still be due to
tooth eruption among infants; diarrhea and moderate to high-
grade fever is no longer due to tooth eruption. Go to the
nearest health facility for adequate management.
Adequate tooth brushing techniques may also be already
taught to children as early as 1 to 2 yrs of age

Source: dentalofollowingicesinhuntersville.wordpress.com
F. ADOLESCENT HEALTH

SUBSTANCE/DRUG ABUSE
What are the risk factors for drug abuse?
Anxiety and depression are the most common factors that
cause initial drug dependence and subsequent addiction.
How can it be prevented?
Parental supervision is most critical during this phase to
prevent the adolescent from experimenting with drug use.
Active community participation on the promotion of healthier
activities (e.g., sportsfest) is also one of the practical ways to
prevent adolescents from drug addiction.
Family members or relatives are highly encouraged to
immediately refer adolescents who are suspected for drug
dependence and/or addiction, to the nearest drug
rehabilitation or treatment facility to prevent further
complications.
ALCOHOL ABUSE
What are the risk factors for alcohol abuse?
It is caused by a complex group of genetic, psychological and
environmental factors.
Peer pressure is one of the causative factors for alcohol abuse
among adolescents.
How can it be prevented?
Because alcohol abuse is multifactorial in nature, it is essential
that there is active community participation for support, along
with mutual family support and personal desire to achieve
treatment and rehabilitation.
SEXUALLY –TRANSMITTED INFECTIONS (STI)
What is an STI?
Sexually transmitted infections or STIs are caused by a variety
of bacteria, viruses and parasites that are spread primarily
through sex.
How are STIs transmitted?
STIs (e.g., syphilis and HIV) are not only spread through
person-to-person sexual contact but may also be transmitted
through:
o Infected blood products (e.g., single infected needle used
by multiple drug addicts or infected needles used in
unsterile body piercing or tattooing);
o From mother to child during pregnancy and childbirth.

What are the usual signs and symptoms of STIs?

Some STIs which are asymptomatic, but the usual signs and
symptoms include any of the following:
o Pain when urinating
o Unusual discharge from the genitals
o Itching
o Soreness
o Unusual lumps or sores

What is Human Immunodeficiency Virus (HIV)?

HIV attacks and weakens the immune system, making the
body more susceptible to infections
HIV does not have specific signs and symptoms
A person living with HIV may look and feel healthy even if
already infected with the virus
HIV infection is PREVENTABLE but it has NO CURE
HIV is transmitted only through 4 body fluids namely:
o blood  vaginal fluid

o semen  breast milk

 ANY person can get HIV by:
o Having sex with a person who has HIV
o Blood transfusion or organ transplant contaminated with
HIV
o Using or sharing contaminated needles and syringes
o Mother to child transmission from an HIV-infected mother
to her child through pregnancy, delivery and breastfeeding

What are the usual signs and symptoms of HIV infection?

The usual signs and symptoms of HIV may include any of the
following:
o Fever
o Swollen lymph nodes
o Diarrhea
o Cough
o Weight loss
o Shortness of breath

If you know anyone within your community who may have the
signs and symptoms of STIs, do not hesitate to consult anyone
of in the health facility for early detection and adequate
management. All consultations in STI/HIV clinics are strictly
confidential.
How can it be prevented or controlled?
The best and practical way to prevent STI or HIV infection is to
maintain a mutually monogamous relationship between
couples or practice safe sex (e.g., correct use of condoms
among promiscuous individuals or those with multiple sex
partners).
Avoid sharing of needles or sharp objects which may have
been contaminated.
G. HEALTHCARE FOR ADULTS

COMMUNICABLE DISEASESvii
Discussions on this section will only include common
communicable diseases such as: Dengue; Hepatitis A, B and C;
Influenza; Rabies; Tuberculosis; and, Typhoid Fever.

DENGUE
What is dengue infection?
Dengue is a mosquito-borne viral infection that causes flu-like
symptoms and occasionally develops into a potentially fatal
complication such as dengue hemorrhagic fever. It may affect
ANYONE in the community but seldom causes death if detected
early.

What are the usual signs and symptoms of Dengue?

The usual signs and symptoms of dengue include the
following:
o High-grade fever
o Joint and muscle pain
o Skin rashes
o Loss of appetite
o Nausea/Vomiting

Danger signs of possible bleeding from dengue infection may

present with any of the following:
o Nose bleeding usually when the fever subsides
o Abdominal pain
o Vomiting of coffee-ground vomitus
o Dark-colored stools
o Difficulty of breathing
 Go to the nearest health facility within the community if
there are any of the signs and symptoms of dengue infection.

How is dengue infection prevented or controlled?

For prevention and control, follow the 4-S against dengue:

Search and destroy

Cover water containers which may serve as
breeding sites of dengue mosquitoes
Replace water of flower vases at least once
a week Regularly clean gutters of leaves and
debris
Dispose all unused materials that can collect and
hold water

Self-protection
Use mosquito repellant or
mosquito nets Wear long pants and
long-sleeved shirt

Seek early medical consultation if

there is/are:
o Nose bleeding usually when the fever subsides
Persistent fever for more than 2
o Abdominal pain
days
o Vomiting of coffee-ground vomitus
Rashes
o Dark-colored stools
Any signs of possible internal
 Saybleeding
yes to fogging ONLY WHEN there is an impending
outbreak or hotspot
 Dengue fever patient may be given PARACETAMOL.
DO NOT give Aspirin.

Increase fluid intake to prevent dehydration from

high-grade fever

HEPATITIS
What is a Hepatitis infection?
Hepatitis A is a viral infection that is preventable and curable.
It is transmitted through the oro-fecal route (i.e., from
ingestion of food contaminated with human waste or urine of
persons who also have Hepatitis A infection).

Hepatitis B is preventable but NOT curable. It is transmitted in

various ways:
o From mother to child during childbirth
o Through blood transfusion
o Through sharing of contaminated or infected sharp objects
(e.g., needles)
o Through sexual intercourse with an infected individual

Hepatitis C is also preventable but NOT curable. There is NO

vaccine for Hepatitis C. It is transmitted through any of the
following:
o Through blood transfusion
o Through sharing of contaminated or infected sharp objects
(e.g., needles)
o Through sexual intercourse with an infected individual

Persons infected with Hepatitis B and Hepatitis C may become

carriers for life, or may have liver cirrhosis, liver failure or liver
cancer later in life.
What are the usual signs and symptoms of Hepatitis?
The usual signs and symptoms of Hepatitis A include any of
the following:
o Fever
o Flu-like symptoms (e.g., muscle and joint pains, loss of
appetite)
o Fatigue or tiredness
o Abdominal discomfort
o Dark/brownish urine
o Yellowish discoloration of the eyes or jaundice

The usual signs and symptoms of Hepatitis B include any of

the following:
o Weakness
o Stomach upset
o Dark urine or very pale stools
o Yellowish discoloration of the eyes or jaundice

Hepatitis B carriers have no symptoms

Infected individuals with Hepatitis C usually have

no symptoms but may also present with any of the following:
o Headache
o Nausea and vomiting
o Abdominal pain
o Yellowish discoloration of the eyes or skin
o Weakness and fatigue
o Dark yellow urine, light-colored stools, and yellowish eyes
How can it be prevented or controlled?
Proper hand washing techniques after using the toilet, before
preparing food, and before eating is still the best and practical
method to prevent the spread of Hepatitis A.
Transmission of Hepatitis B infection from mother to child
during childbirth can be prevented through complete (3 doses)
immunization of Hepa B vaccine. Hepa B immunoglobulin is
also given in addition to the 3 doses of Hepa B vaccine for
newborns who have mothers properly diagnosed with Hepa B.
Mutual monogamous relationship between couples, consistent
practice of safe sex among those with multiple partners, and
avoid use of any object that may be contaminated with the
blood of an infected person are practical methods to prevent
infection of both Hepatitis B and C.
Hepatitis infections DO NOT require ANY type of antibiotic
treatment.

INFLUENZA
What is influenza?
Influenza is a viral infection commonly called “flu” and usually
lasts from 1-3 days even without treatment. It is transmitted
when an infected persons coughs or sneezes, or when there is
direct contact with contaminated surfaces, materials and
clothing of an infected person.

What are the usual signs and symptoms of influenza?

The usual signs and symptoms include any of the following:
o Fever with or without joint pains
o Headache
o Runny nose
o Sore throat
o Cough
 Go to the nearest BHW or RHM or health facility if
cough and fever persist despite increased oral
fluid intake and eating of nutrient-rich foods (e.g.,
citrus fruits), for more than 2 days.

How can it be prevented or controlled?

Adequate cough manners is one of the best and practical
methods to prevent its spread.
Proper hand washing techniques are also a practical method
of preventing contamination of surfaces or clothing in the
household.
It is self-limiting and that does not usually require treatment.
It may only be treated with rest, increased oral fluid intake
and eating nutrient-rich foods (e.g., fruits).

RABIES
What is Rabies?
Rabies is a deadly viral infection that is spread by infected
animals such as dogs, cats or bats. It is transmitted
through direct contact with infected saliva of a rabid animal (bites
or scratches)

What are the usual signs and symptoms of Rabies?

The usual signs and symptoms include any of the
following:
o Fever and headache
o Pain or numbness of bite site
o Pain or difficulty in swallowing
o Fear of looking at water (hydrophobia)
o Fear of air (aerophobia)
o A lot of thick, sticky saliva dripping from his/her mouth
o Delirium and paralysis in severe cases
 Rabies cannot be treated.
How can it be prevented?
The only way to prevent rabies infection is to be vaccinated.
Post-exposure prophylaxis (PEP) must begin immediately after
the biting incident to prevent the onset of symptoms and
death. PEP consists of local treatment of: the wound right
after rabies exposure; a course of potent and effective rabies
vaccine; and, the administration of rabies immunoglobulin, if
indicated.
Pre-exposure and post-exposure anti-rabies vaccines are
available at animal bite treatment centers.

What is the first-aid management for animal bites?

For any incidence of animal bites, wash the wound
immediately with soap and running water for at least 10
minutes. DO NOT apply garlic or tandok on the site of bite to
avoid contamination and further complications. DO NOT
bleed the area of the wound.
Go to the nearest animal bite treatment center or health
facility for proper management.

What should pet owners do?

For pet owners:
o Have your pet vaccinated by a veterinarian at 3 months
old and every year thereafter, or during mass vaccination
of pets scheduled in your community
o If your pet has bitten any person:
 Leash your pet or put it in its cage
 Observe for 14 days for possible signs of rabies
 DO NOT kill or eat the dog
 Assist the bitten victim to the nearest animal bite and
treatment center for proper post-exposure anti-rabies
vaccination
  Report to the animal bite treatment center or health
facility (where the post-exposure anti-rabies
vaccination was given) when there are any of the
following:
- Pet becomes wild
- Pet drools
- Pet bites any moving or non-moving objects
- Pet does not eat or drink
- Pet dies within the observation period

TUBERCULOSIS
What is TB?
TB is a disease caused by Mycobacterium bacilli acquired
through inhalation of air droplets when an infected person
coughs, sneezes, or spits in public areas.

What are the usual signs and symptoms of TB?

The usual signs and symptoms of presumptive TB patients
include the following:
o Cough for 2 weeks or more
o Afternoon fever
o Chest or back pain not referable to other diseases
o Loss of weight
o Lack of appetite
o Blood-streaked sputum
How can it be prevented or controlled?
Continuing spread of TB may be controlled through:
o BCG vaccination of newborns
o Active community participation:
 Avoid spitting in public areas
 Cover mouth when sneezing or coughing within or
outside their household
 Referral of presumptive TB patients to trained health
workers
 Completion of treatment modality

TYPHOID FEVER
What is typhoid fever?
Typhoid fever is a bacterial infection caused by Salmonella
typhi. It is transmitted through the feco-oral route
(contaminated food and water is ingested).

What are the usual signs and symptoms of typhoid fever?

The usual signs and symptoms may include any
of the
following:
o High-grade fever
o Headache
o Body malaise
o Loss of appetite
o Either diarrhea or constipation
o Abdominal discomfort
Go to the RHM or nearest health facility if high-grade fever is
persistent despite increased oral fluid intake and Paracetamol
intake.
NEVER self-medicate with antibiotics to prevent complications.

How can it be prevented or controlled?

Proper hand washing techniques are still the best form of
preventing its spread.
NON-COMMUNICABLE DISEASES
Life-style related or non-communicable diseases (NCDs)
are major public health concerns worldwide. (Note: this section
will only include common non-communicable diseases such as
Breast Cancer, Cervical Cancer, Lung Cancer, Prostate Cancer,
Chronic Obstructive Pulmonary Disease, Diabetes and
Hypertension).

BREAST CANCER
What is Breast CA?vii
Breast cancer is a cancer that starts from the cells
of the
breast.

What are the risk factors for Breast Cancer?

Risk factors include any of the following:
o Family history of cancer
o Obesity
o High fat diet
o Smoking and drinking
o Women who are > 30 yrs old and above during their first
pregnancy or those who never gave birth

What are the usual signs and symptoms of Breast CA?

The usual signs and symptoms include any of the following:
o Lump or swelling of the breast
o Skin dimpling on the area of the breast
o Retraction of the nipple
o A sore or wound in the nipple

Go to the nearest RHM or health facility for proper evaluation

and management of any lump or swelling or discharge in the
nipple.
How can it be prevented or controlled?
Regular breast self-examination after menstruation is one of
the key factors for early detection of breast cancer.

How to conduct a self-breast examination

o In a clockwise direction, move 3 fingers of your left hand in
a downward and upward motion over your right breast
while the right arm is raised over your head.
o Check for any lump or thickening around your breast.
o Repeat the cycle in 3 circles and then check the other
breast in the same manner
o Gently press your nipple and note if there is any pus or
discharge

Regular exercise and eating healthy foods (rich in fiber)

minimizes the risk for breast cancer.
Self-Breast Examination

Source:magazine.raghunter.com
CERVICAL CANCER
What is Cervical Cancer?

Cervical cancer is caused by an infectious agent, known as

human papillomavirus (HPV), usually transmitted through sexual
intercourse with multiple sexual partners, or whose sexual
partners have several sexual partners, or among those who have
had sexual intercourse at an early age (15 or 16 years old).

What are the usual signs and symptoms of Cervical

Cancer?
The signs and symptoms of cervical cancer usually
manifest only during the advance stage of the disease.
Generally it has no symptoms.
The most reliable and practical way to detect cervical
cancer is through a pap smear.
Refer WRA who present with signs and symptoms of
unusual vaginal bleeding, with or without unpleasant vaginal
discharge, to the RHMs or the nearest health facility for
further evaluation and management

LUNG CANCER
What is Lung Cancer?
Lung Cancer is one of the common health risks associated
with smoking, whether voluntarily or involuntarily (e.g., second
hand smoke).

What are the risk factors for Lung Cancer?

Risk factors may include any of the following:
o Smoking
o Second hand smoking or passive smoking
o Air pollution
What are the usual signs and symptoms of Lung Cancer?
The usual signs and symptoms include any of the following:
o Persistent dry cough that gets worse over time
o Constant chest pain
o Shortness of breath, wheezing or hoarseness
o Difficulty of breathing
o Weight loss
o Easy fatigability
Go to the nearest RHM or health facility when there are any of
the signs and symptoms of lung cancer.

How can it be prevented or controlled?

The best and only way to prevent lung cancer is to stop
smoking or avoid second hand smoke.
Regular exercise and healthy eating habits minimize the risk
for lung cancer.

PROSTATE CANCER
What is Prostate Cancer?
Prostate cancer is the most common type of cancer among
Filipino men > 50 yrs old. It is multifactorial in nature.

What are the risk factors for Prostate Cancer?

Risk factors may include any of the following:
o Age > 50
o Family history of prostate cancer
o High fat diet
o High intake of calcium
What are the usual signs and symptoms of Prostate Cancer?
The usual signs and symptoms may include any of the
following:
o Difficulty in urinating
o Blood in the urine
o Blood in the semen
o Discomfort in the pelvic area
Go to the nearest RHM or health facility when there are any of
the signs and symptoms of prostate cancer.

How can it be prevented or controlled?

Eat a balanced diet and avoid too much alcohol intake
Self-medication can hamper early detection of prostate cancer
among high-risk individuals
Regular exercise and healthy eating habits minimize the risk
for prostate cancer

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

What is COPD?vii
COPD is a life-threatening lung disease, usually affecting
those who are > 40 yrs old, and is NON-INFECTIOUS. The 2 most
common types are emphysema and chronic bronchitis.

What are the risk factors for COPD?

Risk factors include any of the following:
o Tobacco smoking
o Indoor and outdoor air pollution
o Occupational dusts and chemicals
What are the usual signs and symptoms of COPD?
Both emphysema and chronic bronchitis have symptoms of
breathlessness and chronic cough
Cough with phlegm is more commonly seen in chronic
bronchitis, while wheezing is more prominent in emphysema
Not all wheezing (noisy breathing) is caused by asthma

How can it be prevented or controlled?

Quit smoking or avoid second-hand smoke
Wear proper face masks if your work will require exposure to
dusts and chemicals
Influenza and pneumococcal vaccination will
help in decreasing the risk of acquiring
respiratory infections
NEVER self-medicate with antibiotics to prevent further
complications

DIABETES
What is diabetes?
Diabetes results when the body cannot properly regulate the
amount of sugar in your blood.
There are 4 clinical types of diabetesviii
o Type 1
these refer to insulin dependent diabetics
o Type 2
these refer to those who can be managed through
oral anti-diabetic medications but may eventually
also require insulin treatment to attain good blood
glucose control
o Gestational diabetes
refers to diabetics who were first diagnosed to have
diabetes during pregnancy
 o Secondary diabetes
refers to those who have acquired diabetes
(may be drug or chemical-induced such as those
who are being treated for AIDS); or from other
endocrine diseases such as hyperthyroidism

What are the risk factors for diabetes?

Risk factors include any of the following:
o High blood pressure
o High levels of triglyceride (form of fat)
o Giving birth to an 8-pound baby
o Sedentary lifestyle
o Obesity
o Family history of type 2 diabetes mellitus among first
degree relatives

What are the usual signs and symptoms of diabetes?

The usual signs and symptoms include any of the
following:
o Fatigue
o Unexplained weight loss
o Excessive thirst
o Excessive hunger
o Excessive urination
o Poor wound healing
If you know anyone within your community who may have the
signs and symptoms of diabetes, do not hesitate to consult
anyone of us in the health facility. Early detection is an
important factor for preventing further complications.

How can it be prevented?

Diabetes is a lifestyle-related disease which can be prevented
through regular exercise (at least 30 minutes every other day)
and eating a “heart healthy” diet ( i.e. low-salt, low-fat diet)
 Avoid smoking and excessive alcohol consumption to lessen
the likelihood of diabetes.

HYPERTENSION
What is hypertension?
Hypertension is an increase in blood pressure higher than or
equal to 140/90 mmHg in 2 or more separate occasions. It is
one of the leading causes of disability among Filipinos due to
stroke.

Table 5. Classification of blood pressure for adultsix

BLOOD PRESSURE
SYSTOLIC BP DIASTOLIC BP
CLASSIFICATION

Normal < 120 mmHg < 80 mmHg

Prehypertension 120-139 mmHg 80-89 mmHg

Stage 1 Hypertension 140-159 mmHg 90-99 mmHg

Stage 2 Hypertension >160 mmHg >100 mmHg

What are the risk factors for hypertension?

Risk factors include any of the following:
o Smoking
o Excessive alcohol consumption
o Overweight
o Family history of hypertension, heart disease, diabetes and
kidney disease
o Sedentary lifestyle
o Chronic stress
o Advancing age
What are the usual signs and symptoms of hypertension?
Not all hypertensive patients have symptoms, but the usual
signs and symptoms may include any of the following:
o Headache
o Dizziness
o Blurring of vision
o Nape/neck discomfort
If you know anyone within your community who may have the
signs and symptoms of hypertension, do not hesitate to
consult anyone of us in the health facility. Early detection is
an important factor for preventing further complications.

What are the possible complications of hypertension?

Chronic, undiagnosed and untreated hypertension usually
result to any of the following:
o Heart attack
o Stroke
o Kidney failure
o Loss of vision

How can it be prevented?

Hypertension is a lifestyle-related disease which can be
prevented through regular exercise and eating a “heart
healthy” diet (i.e., low-salt, low-fat diet)
Excessive alcohol consumption and cigarette smoking also
increases the likelihood of hypertension.
H. ELDERLY

VACCINES FOR THE ELDERLY

What are the DOH vaccines available for the elderly?x
Pneumococcal vaccines and influenza vaccines
Pneumococcal and influenza vaccines are given FOR FREE AS
SINGLE DOSE to all indigent senior citizens
Who are qualified to avail of these vaccines?
These vaccines shall cover all indigent senior citizens 60 years
old and above, living in:
o RESIDENTIAL CARE FACILITIES for INDIGENT senior citizens
 What is meant by a “residential care facility”?
It refers to a DSWD accredited-facility that 24-hour
residential care services operated for the purpose of
promoting the well-being of abandoned, neglected,
unattached, or homeless senior citizens.
o In the community based on the National Household
Targeting System for Poverty Reduction (NHTS-PR) list of
the Department of Social Welfare and Development
(DSWD)

An indigent senior citizen who has received a

PNEUMOCOCCAL vaccine in the LAST 5 YEARS
and was less than 60 years of age at the time of
immunization should receive another dose of
pneumococcal vaccine.
 An indigent senior citizen who has received a
pneumococcal vaccine when he/she was 60
years old and above at the time of
immunization is NOT required to receive
another dose of pneumococcal vaccine.

Where are these vaccines available?

It is available in designated city/municipal health centers,
government run residential facilities and DSWD-accredited,
non-governmental home care facilities for senior citizens.

Only health workers TRAINED AND SKILLED at

administering vaccines are authorized by the
DOH to give immunizations.

20% SENIOR CITIZEN DISCOUNT ON HEALTH RELATED

GOODS AND SERVICES
Who are qualified to avail of the 20% senior citizens
discount?
ALL Filipino citizens who are residents of the Philippines and
60 years old and above
All senior citizens with “dual citizenship”, provided, they prove
their Filipino citizenship and they have been residents for at
least 6 months in the Philippines
All senior citizens who are recipients of the DSWD NHTS-PR
program
What are the necessary documents needed to avail of the 20%
discount?
1. Any document, or proof of being a senior citizen, shall suffice
namely:
ID issued by the city or municipal mayor or the Office of
Senior Citizens Affairs or of the barangay captain of the
place where the senior citizen or the elderly resides
The passport of the elderly person or senior citizen
concerned
Other government issued certificates which may include
any of the following:
o Birth certificate
o Voter’s ID

2. EXCEPT for over the counter drugs such as paracetamol, a

doctor’s prescription shall be presented having the following
information:
Name, age, sex, and address of the senior citizen
Date of consultation
Generic name of the medicine, dosage form, dosage
strength and quantity
Name and signature, address, professional license number
and S2 license number, if applicable, of the prescribing
physician

3. Purchase slip booklets

What are the health-related goods and services that are
included?
1. Medical and dental services
2. Diagnostic and laboratory services (e.g., x-rays, CT scan, blood
tests, hemodialysis)
3. Professional fees of attending physicians and other health
professionals confined in pay sections provided
the
confinement are in accordance with available clinical practice
guidelines or hospital treatment protocols
4. All medical devices (e.g., supplies, kits used or consumed
during check-up or confinement) regardless of the number of
days
5. All medical devices to be used during the recovery at home, or
for monitoring of a particular ailment or disease (e.g.,
glucometer set including lancets and test strips, insulin syringe
and needle, blood pressure apparatus, wheelchair) PROVIDED
that the prescription for the use of a particular medical device
shall be provided by the physician

The 20 % discount and VAT exemption shall apply only

once for personal use of the senior citizen of non-
disposable medical devices such (e.g., glucometer, blood
pressure apparatus, weighing scale)

What are NOT included?

Services that are not medically necessary for treatment and
diagnosis which may include any of the following:
o Cosmetic surgery procedures
o Executive check-up packages
Chapter III. The BHW on Special Health Concerns
in the Community

A. ENVIRONMENTAL HEALTH

PROPER WASTE DISPOSAL:

1. Using the latest forms for environmental sanitation, gather
the following data from your designated household catchment
areas:
Name of members of the household catchment area
What type of garbage materials are disposed
How are these garbage materials are disposed
2. Encourage members of the household to regularly practice
proper waste disposal:
Throw garbage only on designated pick-up points/storage
in the community for garbage collection.
DO NOT burn waste products to prevent further damage to
the ozone layer.
Burying waste products within the backyard is an
alternative way of disposing garbage. It will at the same
time serve as a fertilizer for organic gardening.
Recycle non-biodegradable products such as plastic bottles,
or sell them to junk shops within the community.
DO NOT throw garbage in rivers or canals to prevent
contamination of water.
3. Coordinate with barangay officials and local sanitary officer to
facilitate identification of household without sanitary toilets,
or if there is possible water contamination within the
household catchment area.
PROVISION OF SAFE DRINKING WATER:
1. Using the latest forms for environmental sanitation, gather
the following data within your designated household
catchment areas:
Name of members of the household catchment area
Source of drinking water

2. Encourage members of the household and barangay officials

to regularly promote safe water handling practices:
Regularly clean water containers at least once a week
Regularly clean water source at least every 6 months
Drink chlorinated/treated/boiled water only
Make sure that the water for drinking is safe:
o Boil water from unsafe or doubtful sources
 Spring
 Rain water
 Other surfaces of water
 Unprotected wells
 Unprotected springs
o Use clean, covered containers when collecting and
transporting water from source
o If the container does not have any faucet, use a clean
dipper to get water
o DO NOT put hands or dirty cups into the water source

3. Coordinate with barangay officials and the local sanitary

officer to facilitate identification of household with potentially
contaminated water source, or if there is possible water
contamination within the household catchment area.
CONSTRUCTION AND USE OF SANITARY TOILETS:
1. Using the latest forms for environmental sanitation, gather
the following data within your designated household
catchment areas:
Name of members of the household catchment area
Availability and use of sanitary toilets, if any

2. Encourage members of the household to regularly use

sanitary toilets to prevent parasitism which will aggravate
malnutrition among children (the most vulnerable group
affected).
3. People should dispose their feces properly to prevent the
spread of germs and parasites that can cause diseases such as
cholera, parasitism, and typhoid fever.
4. Unclean public toilets will also affect the entire community
since it may potentially contaminate nearby water sources. Its
maintenance should therefore be considered as a public
health concern by the entire community.
5. Coordinate with barangay officials and the local sanitary
officer to facilitate identification of household without
sanitary toilets.

FOOD SAFETY
To prevent food and water-borne diseases, the following
guidelines should be considered:
Meat (pork, beef and chicken) must come from
healthy animals and must have been approved by the meat
inspector
Fruits and vegetables must be fresh and washed
with clean water
 Fresh milk from cows, carabaos and other animals must be
boiled before drinking
Fish and shellfish (oysters, mussels, clams) must come from
clean sources
Food in plastic wrappers must be dry
Food must be carried in clean containers and covered
Always take note of the expiry date when buying any type of
food products

B. VIOLENCE AGAINST WOMEN AND CHILDEN

What are the different types of gender-based violence?

Violence against women does not only refer to physical or
sexual violence.
Acts of withdrawing financial support to children, or
preventing women from engaging in a legitimate profession,
is considered an economic abuse which is also a form of
violence against women.
Stalking, public ridicule or humiliation is considered
psychological violence which is also another form of violence
against women.
If there is anyone among the community who may be a victim
of violence against women and their children, it is best that
they go to the nearest women and child protection unit for
proper counselling, or approach anyone among the health
facility who can assist you.
C. DISASTER RISK REDUCTION AND MANAGEMENT

1. Using the latest family profiling forms and risk assessment

forms for disaster preparedness and management, gather the
following data within your designated household catchment
areas:
Name of members of the household catchment area
Proximity to identified disaster prone areas within the
community such as:
o Low lying areas below sea level
o Households near denuded mountains or garbage
dumpsite
o Households inside or near the earthquake fault line
o Areas frequently visited by typhoons

2. Regularly coordinate with local officials to facilitate

identification of potential evacuation site/s of members of the
household catchment area for ease of referral and
management once a disaster occurs. Include emergency
hotline numbers and point persons to contact.

3. Regularly remind household members within your catchment

areas what to do for incoming typhoons which will potentially
affect the community:
Multimedia services (e.g., radio, TV, internet) can be
utilized for announcements or news updates
Prepare set of clothing, canned goods, rice, flashlight, fully
charged batteries for cellphones or emergency lights or
radio and bottled drinking water.
Prepare a set of first-aid kit and medicines for fever, colds,
wounds and diarrhea.
 Never panic. Anxiety and panic only adds problems to the
current situation.
Go to the nearest BHW or other local officials designated to
the household for information on evacuation procedures, if
necessary.

4. Educate and regularly update the community on the following:

What to do during emergencies based on type of hazard How,
when and where to evacuate
What should be included in the family/
household emergency kit

5. Advocate active community participation on drills and

exercises like earthquake drills, or fire drills

6. Advocate active community participation among household

heads on attending training on Basic Life Support (BLS)

7. Assist health workers at the evacuation center in the provision

of public health care and proper referral of patients

8. Act as Surveillance in Post Extreme Emergencies & Disasters

(SPEED) reporter by reporting diseases, injuries and other
health trends through the SPEED system, if applicable
ANNEX: HERBAL MEDICINE
LAGUNDI

Lagundi is a shrub
approximately 5 meters
in height which is used for
cough.

How to prepare lagundi decoction:

1. Chop the leaves and place them in an earthen jar according
to the following amounts corresponding to the age:

AGE GROUP IF DRIED LEAVES IF FRESH

LEAVES

Adult 4 tbsp 6 tbsp

7-12 yrs old 2 tbsp 3 tbsp

2-6 yrs old 1 tbsp 1 ½ tbsp

2. Pour in 2 glasses of water and cover.

3. Bring the mixture to a boil.
4. Remove the cover and let it continue to boil for 15 minutes
or until one glass of decoction is left.
5. Let it cool, and then strain the mixture.
6. Divide the decoction into 3 parts:
7. For cough, drink 1 part 3 times a day.
YERBA BUENA

Yerba buena is a creeping plant with rough and wrinkled leaves. It

is used to treat body pains as a decoction (similar in preparation
to Lagundi decoction) or as crushed fresh leaves placed directly
over the affected site. DO NOT give to children less than 7 yrs of
age.

How to prepare yerba buena decoction:

1. Chop the leaves and place them in an earthen jar according
to the following amounts corresponding to the age:

AGE GROUP IF DRIED IF FRESH

LEAVES LEAVES

Adult 4 tbsp 6 tbsp

7-12 yrs old 2 tbsp 3 tbsp

2. Pour in 2 glasses of water and cover.

3. Bring the mixture to a boil.
4. Remove the cover and let it continue to boil for 15 minutes.
5. Let it cool, and then strain the mixture.
6. Divide the decoction into 2 parts and drink 1 part 3 times a
day.
SAMBONG

Sambong has rough leaves and grows 2 to 3 meters in height. It is

used for kidney stones as a decoction (similar in preparation to
Lagundi decoction). DO NOT give to children less than 7 yrs of
age.

How to prepare sambong decoction:

1. Chop the leaves and place them in an earthen jar according
to the following amounts corresponding to the age:

AGE GROUP IF DRIED IF FRESH

LEAVES LEAVES

Adult 4 tbsp 6 tbsp

7-12 yrs old 2 tbsp 3 tbsp

2-6 yrs old 1 tbsp 1 ½ tbsp

2. Pour in 2 glasses of water and cover.

3. Bring the mixture to a boil.
4. Remove the cover and let it continue to boil for 15 minutes
or until one glass of decoction is left.
5. Let it cool, and then strain the mixture.
6. Divide the decoction into 3 parts and drink 1 part 3 times a
day.
TSAANG GUBAT

Tsaang gubat is a shrub about 5 meters in height. It is used for

stomach ache as a decoction. DO NOT give to children less than 7
yrs of age.

How to prepare tsaang gubat decoction:

1. Chop the leaves and place them in an earthen jar according
to the following amounts corresponding to the age:

AGE GROUP IF DRIED IF FRESH

LEAVES LEAVES

Adult 2 tbsp 3 tbsp

7-12 yrs. old 1 tbsp 1 tbsp

2. Pour in 1 glass of water and cover

3. Bring the mixture to a boil
4. Remove the cover and let it continue to boil for 15 minutes
or until ½ glass decoction is left.
5. Let it cool, and then strain the mixture.
6. Take the decoction.
ULASIMANG BATO or PANSIT-PANSITAN

Ulasimang Bato is a plant

that grows 40 centimeters in
height and is usually seen
during rainy seasons. It is
used to lower uric acid level.

There are 2 ways to prepare it:

Prepare 1-2 cups of fresh leaves and chew 3 times a day, or
prepare and tale a decoction as follows::
1. Put 1-2 cups of fresh leaves in an earthen jar.
2. Pour in 2 glasses of water and cover.
3. Bring the mixture to a boil.
4. Remove the cover and let it continue to boil until the 2
glassfuls of water.
5. Let it cool, and strain the mixture.
6. Divide the decoction into 3 parts and drink 1 part 3 times a
day, after meals.

GARLIC

Garlic is a popular medicinal

plant that helps control and
decrease cholesterol levels.
Eat 2 cloves of garlic together
with each meal.
NIYOG-NIYOGAN

Niyog-niyogan is a shrub about 8 meters in height with hairy

leaves that give a rusty color. It is used for deworming ascaris.
DO NOT give to children less than 4 yrs of age.

2 hours after dinner, chew and swallow only dried seeds

according to the following measurements, then drink water.

AGE GROUP DRIED SEEDS

Adults 8-10

9-12 yrs old 6-7

6-8 yrs old 5-6

4-5 yrs old 4-5

GUAVA

Guava is a popular medicinal

plant for cleansing wounds. It
is also used as mouthwash for
mouth infection and sore gums
or tooth decay.

How to prepare guava decoction:

1. Wash the leaves very well.
2. Put 2 handfuls of chopped leaves in an earthen jar.
3. Pour in 4 glassfuls of water.
4. Boil for 5 minutes and let it cool then strain.
5. Use as mouth wash or gargle.

AKAPULKO

Akapulko is a shrub with oblong-shaped leaf and has

yellow flowers at the tip of its branches. It is used to treat
ringworm and athlete’s foot. Pound sufficient amount of fresh
leaves and apply the juice on the affected area 1 to 2 times a day
for 3 weeks.
AMPALAYA

Ampalaya is a popular
medicinal plant to help control
blood sugar level.

There are 2 ways to prepare ampalaya leaves to be used as

adjunct treatment for persons with diabetes:

Eaten as a salad:
Measure ½ cup of packed leaves and steam.

Taken as a decoction:
1) Wash young leaves very well.
2) Put 6 tablespoonfuls of chopped leaves in an earthen jar.
3) Pour 2 glasses of water and cover.
4) Boil the mixture for 15 minutes.
5) Strain the mixture.
6) Divide decoction into 3 parts and drink 1 part 3 times a day,
after meals.
REFERENCES

i. DOH Department Memorandum 2009-0302 Reiteration of DOH

Support for the Continuing Development of BHWs
ii. Adolescent Job Aid Manual (2008)

iii. Basic Information about NB Screening, accessed at

www.newbornscreening.ph
iv. DOH Administrative Order 2006-0012 Revised IRR of E.O 51

(Milk Code)
v. Infant and Young Child Feeding Guidelines

vi. DOH Administrative Order 2010-0023 Guidelines on

Deworming
Drug Administration and the Management of Adverse Events
Following Deworming
vii. 2012 Philippine Health Advisories

viii. 2014 UNITE for Diabetes: Philippine Practice Guidelines for

Diabetes Mellitus
ix. 7 Joint National Committee Classification for Hypertension
TH

x. DOH Administrative Order A.O 2011-0018 Implementing

Guidelines on Influenza and Pneumococcal Immunization for

Indigent Senior Citizens