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DENGUE: Problem
Identification
 When left undetected and
  untreated, dengue could lead to a
  number of complications and even
  death.
 Currently, no applicable/available
  effective vaccine.
 Current climate change, and variable
  vector behavior.
Burden of Disease
 DOH latest figures show a total of 27,071 dengue
  cases recorded from January to June 11 this
  year. This is 4.12 percent lower compared to the
  same period last year (28,234).
 Ages of cases ranged from less than 1 month to
  89 years old, with most (40%) belonging to the 1
  to 10 years age group. Majority (53%) of the
  cases were male. There were 172 deaths
  reported.
 Most of the reported cases were from the
  following regions: National Capital Region
  (8,184), Region III or Central Luzon
  (4,624), Region IV-A (3,935). In the National
  Capital Region, most of the cases came from
  Quezon City (2,017), Pasig City (970), and
  Kalookan City (951).
Implications
   Social status is a significant factor in terms of who is affected
    by the dengue fever. The impact of the outbreak was greater
    for poor communities in the urban and semi-rural
    areas, particularly for women who described themselves as
    housewives and mothers, and their children. In addition, they
    experienced the greatest loss of time as a consequence of
    the outbreak.
   The main effect of the outbreak on work activities not
    traditionally remunerated with money, such as
    housework, was the inability of adult females in the
    household to perform their routine activities to maintain family
    life.
   Moreover, the monetary costs of health care absorbed a
    significant percentage of the household weekly income.
   The impact on psychological well-being was related to the
    stress produced by the clinical, social, and economic
    consequences of the outbreak for women.
DOH Dengue Control
Program health problems during rainy
 One of the major
    season is the incidence of Dengue Hemorrhagic
    Fever. It occurs in all age groups. This disease
    (transmitted by Aedes, a day-biting mosquito) is
    preventable but is prevalent in urban centers where
    population density is high, water supply is inadequate
    (resulting to water storage and a good breeding place
    for the vector), and solid waste collection and storing
    are also inadequate.
   The thrust of the Dengue Control Program is
    directed towards community-based prevention and
    control in endemic areas. Major strategy is advocacy
    and promotion, particularly the Four O’clock
    Habit which was adopted by most LGUs. This is a
    nationwide, continuous and concerted effort to
    eliminate the breeding places of Aedes aegypti. Other
Four o clock Habit
   The Four-o'clock Habit (―4 o’clock habit‖) is an
    initiative of the Philippine government that
    requests residents to practice the cleaning of
    their surroundings and draining water containers
    to prevent the spread of mosquitoes, in support
    of the Dengue Control Program and
    the Malaria Control Program. This is also
    known as ―operation kaya–kulub (upside down).‖

JUNE AS DENGUE PREVENTION MONTH
 SOCIAL With the month of June declared as
  Dengue Awareness month, private companies
  such as SNI Philippines are actively pitching in to
  help the DOH combat dengue through
  nationwide info drives.
STRATEGIES
 Dr. Lyndon Lee Suy, DOH program manager
  of anti-dengue program, noted different
  strategies in dengue prevention and control
  program including the introduction Ovi-Larvi
  Trap System, a mosquito trap and putting up
  of insecticide-treated nets in the school
  premises.
 Lee Suy called on the (SOCIAL) public to be
  partners in cleaning their surroundings
  particularly on possible breeding areas of
  mosquitoes — stagnant water in refrigerator
  containers, dish drainers, flower vases, and
  gutters -- should be removed.
STRATEGIES
 ECONOMICAL/SOCIAL/POLITICAL
the DOH signed a memorandum of agreement
  with barangay officials led by Liga ng Mga
  Barangay who pledged that each member-
  barangay will implement a dengue
  prevention and control program coming
  from their Internal Revenue Allotment
  (IRA).
 Likewise, the DOH has renewed its call to the
  public to consider their slogan: "Kilos Na!
  Mag-4S Kontra Dengue!" and it 4S strategies
  such as Search and destroy, Seek early
  consultation, Self-protective measures and
  Say no to indiscriminate fogging.
STRATEGIES: OVITRAPS
 The OL mosquito trap is a technology developed by
  the Department of Science and Technology (DOST)
  designed to reduce the population of the dengue-
  carrying Aedes mosquitoes by attracting and killing their
  eggs in a simple but proven effective system. This
  technology will be distributed nationwide in cooperation
  with the Department of Health (DOH).
 (Political) The Governor also encouraged his fellow
  officials and local constituents to be involved and not
  to wait until they become victims of the disease. He also
  stated that the local government of Tacloban will
  allocate funds to buy extra OL mosquito trap kit to
  distribute to all houses specially the identified high
  dengue risk areas.
 DOST and DOH will distribute 2,800 kits to each of the
  16 regions of the country. National Capital
  Region (NCR) will get a separate allocation of 5,200 OL
  mosquito trap kits.
OVITRAP LAUNCHING
Local executives in Region VIII thumb up with DOST
  Secretary Mario G. Montejo (third from right) and DOH
  Secretary Enrique T. Ona (4th from right) to this new
  dengue control and prevention program of the DOST and
  DOH.
STRATEGIES: PROMOTION
   SOCIAL health promotion, since
    health is a collective social good. The
    paradigm for promotion is centered on
    the principle that health is the greatest
    resource for social, economic, and
    personal development, as well as an
    important dimension of the quality of
    life. It also recognizes that
    political, economic, social, cultural, e
    nvironmental, behavioral and
    biological factors can help a person's
    health as much they can damage it.
STRATEGIES
   ECONOMICAL and SOCIAL holistic
    vision of promotion. When it comes to
    dengue, nothing is easy, simple, or
    cheap. It is essential to promote
    changes—behavioral changes—not
    only in the community, but also in the
    structure and organization of
    prevention and control programs.They
    have been successful or sustainable
    over the years because of their very
    costly vertical structure, based on
    chemical control (the use of
    insecticides),
STRATEGIES: COMMUNITY
INVOLVEMENT
 SOCIAL because they utilize
  community participation and health
  education only in epidemics and
  emergencies.
 Community participation is normally
  centered around mass clean-up
  campaigns (trash removal), the
  distribution of printed matter, and
  mass radio and television campaigns
  to disseminate information about the
  vector, its breeding sites and the
  disease.
STRATEGIES: BEHAVIOR
 SOCIAL Because dengue a problem
  linked to the residential
  environment, the existence of
  breeding sites is due to specific
  human behaviors
  (individual, community, and
  institutional), since any receptable
  capable of holdingwater is a potential
  breeding site for Aedes eggs.
 investigate, select, and
  apply, appropriate to the situation of
  each individual, family, or other
  institutions outside the health sector.
STRATEGIES: POLITICAL
 POLITICAL Understanding the
  linkages between global, national and
  local level policymaking.
 PROPER REFERRAL SYSTEM
 – Impact of such policies on prudent
  and equitable use of antibiotics and
  other drugs.
 – Access to basic services by
  vulnerable populations.
 ability to respond to key health issues
SOCIAL CULTURAL POLITICAL
   health management—integrated
    control programs—is considered a
    synergistic point
KEY POINTS
   Integrated epidemiological and entomological surveillance.
   Advocacy and implementation of intersectoral actions among
    health, environment, and education, as well as other sectors such as
    industry and trade in new materials, tourism, and the legislative and
    judicial branches of government.
   Effective community participation.
   Environmental management and attention to basic services such as
    water supply, wastewater disposal, solid waste management, and
    the proper disposal of used tires.
   Patient care inside and outside the health system .
   Case notification (clinical cases, confirmed, cases of and deaths
    from DHF, circulating serotypes).
   Incorporation of dengue/health into the formal education curriculum.
   Critical analysis of the function and use of insecticides.
   Formal training of health professionals and workers (from the
    medical and social sectors).
   Emergency preparedness, setting up new mechanisms and
    preparing to deal with outbreaks and epidemics.
SUMMARY OF STRATEGIES
   Strong leadership in program management.
   Political and financial support to provide continuity for interventions.
   Selective vector control based on effective social
    communication, community participation, and environmental
    management aimed at individual and collective behavior .
   Environmental management and related activities
    (water, refuse, and solid waste).
   Active integrated surveillance based on an efficient, reliable health
    information system (epidemiological and entomological).
   Medical care to patients inside and outside the health system, which
    includes recognition of warning signs and appropriate responses .
   Evaluation tools that can periodically measure the effectiveness of
    the action taken.
   Knowledge of the economic impact of the various components of the
    prevention and control programs.
   Continuing education for human resources in the social and
    biomedical sciences at all levels (from local to national)
IS THE PROGRAM
SUCCESSFUL?
Foundations of Healthcare System Factor Analysis on Dengue

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Foundations of Healthcare System Factor Analysis on Dengue

  • 1. DENGUE: Problem Identification  When left undetected and untreated, dengue could lead to a number of complications and even death.  Currently, no applicable/available effective vaccine.  Current climate change, and variable vector behavior.
  • 2. Burden of Disease  DOH latest figures show a total of 27,071 dengue cases recorded from January to June 11 this year. This is 4.12 percent lower compared to the same period last year (28,234).  Ages of cases ranged from less than 1 month to 89 years old, with most (40%) belonging to the 1 to 10 years age group. Majority (53%) of the cases were male. There were 172 deaths reported.  Most of the reported cases were from the following regions: National Capital Region (8,184), Region III or Central Luzon (4,624), Region IV-A (3,935). In the National Capital Region, most of the cases came from Quezon City (2,017), Pasig City (970), and Kalookan City (951).
  • 3. Implications  Social status is a significant factor in terms of who is affected by the dengue fever. The impact of the outbreak was greater for poor communities in the urban and semi-rural areas, particularly for women who described themselves as housewives and mothers, and their children. In addition, they experienced the greatest loss of time as a consequence of the outbreak.  The main effect of the outbreak on work activities not traditionally remunerated with money, such as housework, was the inability of adult females in the household to perform their routine activities to maintain family life.  Moreover, the monetary costs of health care absorbed a significant percentage of the household weekly income.  The impact on psychological well-being was related to the stress produced by the clinical, social, and economic consequences of the outbreak for women.
  • 4. DOH Dengue Control Program health problems during rainy  One of the major season is the incidence of Dengue Hemorrhagic Fever. It occurs in all age groups. This disease (transmitted by Aedes, a day-biting mosquito) is preventable but is prevalent in urban centers where population density is high, water supply is inadequate (resulting to water storage and a good breeding place for the vector), and solid waste collection and storing are also inadequate.  The thrust of the Dengue Control Program is directed towards community-based prevention and control in endemic areas. Major strategy is advocacy and promotion, particularly the Four O’clock Habit which was adopted by most LGUs. This is a nationwide, continuous and concerted effort to eliminate the breeding places of Aedes aegypti. Other
  • 5. Four o clock Habit  The Four-o'clock Habit (―4 o’clock habit‖) is an initiative of the Philippine government that requests residents to practice the cleaning of their surroundings and draining water containers to prevent the spread of mosquitoes, in support of the Dengue Control Program and the Malaria Control Program. This is also known as ―operation kaya–kulub (upside down).‖ JUNE AS DENGUE PREVENTION MONTH  SOCIAL With the month of June declared as Dengue Awareness month, private companies such as SNI Philippines are actively pitching in to help the DOH combat dengue through nationwide info drives.
  • 6. STRATEGIES  Dr. Lyndon Lee Suy, DOH program manager of anti-dengue program, noted different strategies in dengue prevention and control program including the introduction Ovi-Larvi Trap System, a mosquito trap and putting up of insecticide-treated nets in the school premises.  Lee Suy called on the (SOCIAL) public to be partners in cleaning their surroundings particularly on possible breeding areas of mosquitoes — stagnant water in refrigerator containers, dish drainers, flower vases, and gutters -- should be removed.
  • 7. STRATEGIES  ECONOMICAL/SOCIAL/POLITICAL the DOH signed a memorandum of agreement with barangay officials led by Liga ng Mga Barangay who pledged that each member- barangay will implement a dengue prevention and control program coming from their Internal Revenue Allotment (IRA).  Likewise, the DOH has renewed its call to the public to consider their slogan: "Kilos Na! Mag-4S Kontra Dengue!" and it 4S strategies such as Search and destroy, Seek early consultation, Self-protective measures and Say no to indiscriminate fogging.
  • 8. STRATEGIES: OVITRAPS  The OL mosquito trap is a technology developed by the Department of Science and Technology (DOST) designed to reduce the population of the dengue- carrying Aedes mosquitoes by attracting and killing their eggs in a simple but proven effective system. This technology will be distributed nationwide in cooperation with the Department of Health (DOH).  (Political) The Governor also encouraged his fellow officials and local constituents to be involved and not to wait until they become victims of the disease. He also stated that the local government of Tacloban will allocate funds to buy extra OL mosquito trap kit to distribute to all houses specially the identified high dengue risk areas.  DOST and DOH will distribute 2,800 kits to each of the 16 regions of the country. National Capital Region (NCR) will get a separate allocation of 5,200 OL mosquito trap kits.
  • 9. OVITRAP LAUNCHING Local executives in Region VIII thumb up with DOST Secretary Mario G. Montejo (third from right) and DOH Secretary Enrique T. Ona (4th from right) to this new dengue control and prevention program of the DOST and DOH.
  • 10. STRATEGIES: PROMOTION  SOCIAL health promotion, since health is a collective social good. The paradigm for promotion is centered on the principle that health is the greatest resource for social, economic, and personal development, as well as an important dimension of the quality of life. It also recognizes that political, economic, social, cultural, e nvironmental, behavioral and biological factors can help a person's health as much they can damage it.
  • 11. STRATEGIES  ECONOMICAL and SOCIAL holistic vision of promotion. When it comes to dengue, nothing is easy, simple, or cheap. It is essential to promote changes—behavioral changes—not only in the community, but also in the structure and organization of prevention and control programs.They have been successful or sustainable over the years because of their very costly vertical structure, based on chemical control (the use of insecticides),
  • 12. STRATEGIES: COMMUNITY INVOLVEMENT  SOCIAL because they utilize community participation and health education only in epidemics and emergencies.  Community participation is normally centered around mass clean-up campaigns (trash removal), the distribution of printed matter, and mass radio and television campaigns to disseminate information about the vector, its breeding sites and the disease.
  • 13. STRATEGIES: BEHAVIOR  SOCIAL Because dengue a problem linked to the residential environment, the existence of breeding sites is due to specific human behaviors (individual, community, and institutional), since any receptable capable of holdingwater is a potential breeding site for Aedes eggs.  investigate, select, and apply, appropriate to the situation of each individual, family, or other institutions outside the health sector.
  • 14. STRATEGIES: POLITICAL  POLITICAL Understanding the linkages between global, national and local level policymaking.  PROPER REFERRAL SYSTEM  – Impact of such policies on prudent and equitable use of antibiotics and other drugs.  – Access to basic services by vulnerable populations.  ability to respond to key health issues
  • 15. SOCIAL CULTURAL POLITICAL  health management—integrated control programs—is considered a synergistic point
  • 16. KEY POINTS  Integrated epidemiological and entomological surveillance.  Advocacy and implementation of intersectoral actions among health, environment, and education, as well as other sectors such as industry and trade in new materials, tourism, and the legislative and judicial branches of government.  Effective community participation.  Environmental management and attention to basic services such as water supply, wastewater disposal, solid waste management, and the proper disposal of used tires.  Patient care inside and outside the health system .  Case notification (clinical cases, confirmed, cases of and deaths from DHF, circulating serotypes).  Incorporation of dengue/health into the formal education curriculum.  Critical analysis of the function and use of insecticides.  Formal training of health professionals and workers (from the medical and social sectors).  Emergency preparedness, setting up new mechanisms and preparing to deal with outbreaks and epidemics.
  • 17. SUMMARY OF STRATEGIES  Strong leadership in program management.  Political and financial support to provide continuity for interventions.  Selective vector control based on effective social communication, community participation, and environmental management aimed at individual and collective behavior .  Environmental management and related activities (water, refuse, and solid waste).  Active integrated surveillance based on an efficient, reliable health information system (epidemiological and entomological).  Medical care to patients inside and outside the health system, which includes recognition of warning signs and appropriate responses .  Evaluation tools that can periodically measure the effectiveness of the action taken.  Knowledge of the economic impact of the various components of the prevention and control programs.  Continuing education for human resources in the social and biomedical sciences at all levels (from local to national)