Emile I. Sabbagh
11- Decrease the burden of chronic diseases.
12- Smoking, alcohol, and drug prevention programs.
13- Enhancing safe environment.
14- Elderly care program.
15- Water sources inspection.
16- Restaurant inspection.
The goal is to provide help and information to people in order to determine the number and spacing of their children.
Prevention of unintended pregnancies and prevention of child abuse are primary concerns of family planning.
This services is closely tied to infant and maternal morbidity and mortality, and to family health.
The service includes:
Complete medical history, physical exam, pap smear, urinalysis, screening for anemia, abnormal condition of breast and cervix, screening and treatment for sexually transmitted diseases STDs, and immunization.
Also, a pregnancy testing, information about prenatal care and contraceptive methods are accessible.
Instruction concerning effectiveness, proper use, risks, benefits of contraceptive methods is provided.
Any person who requests a family planning services is eligible. A complete personal privacy and confidentiality is provided.
The program should provide a complete prenatal care and follow- up for the mother and her infant for up to one year after infant birth.
A team consists of (at least) a physician, nurse, dietitian, and a social worker should be available within the service area. This team should coordinate and collaborate with the private provider, and should provide psychological, nutrition assessments and interventions.
Interventions focus on minimizing the risks ( such as late or no prenatal care, substance abuse, smoking, nutritional needs ) associated with poor pregnancy outcomes ( such as low birth weight, infant death, premature delivery ) and quality of life for the mother, child and the whole family.
So, the service includes: Identify high- risk pregnancies, pregnancy testing and case management for enrolled people. Follow- up for the mother and her child, based on identified risks, is available during the first year after delivery. Also, collaborating with other services such as family planning, pediatric services, child health assessments, nutrition programs and immunization is required.
Pregnant adolescents, substance abusers, women at health, nutritional or psychological risk and / or experiencing barriers to care ( financial problem) are the priority for services.
The program should provide primary and preventive services to children and adolescents to assist them maintaining and living healthy life and help them to grow and mature into physically and mentally healthy, productive adults. (1)
The program includes:
1- Comprehensive physical exam pre school entry.
2- Provide and train school nurses.
3- Immunization services.
4- Day care center inspections.
5- Oral health services.
6- Nutrition services.
7- Alcohol, tobacco, violence prevention.
8- Lead poisoning prevention.
9- Screening services ( vision, hearing, scoliosis).
All children and adolescents, birth through age 21 years are eligible for health services with priority to the uninsured and low- income individuals and those with limited access to care.
The program goal is to prevent vaccine- preventable diseases.
Vaccines are responsible for the control of many infectious diseases that were once common in this country. However, the viruses and bacteria that cause vaccine- preventable diseases and death still exist and can be passed on to people who are not protected by vaccines. Vaccine- preventable diseases have a costly impact, resulting in doctors visits, hospitalization and premature deaths. Sick children can also cause parents to lose time from work (2).
Thus, children need immunization to protect them from dangerous childhood diseases. Theses diseases have serious complications and can even kill children.
An immunization program should provide vaccine for:
Measles, Mumps, Polio, Rubella, Pertussis, Diphtheria, Tetanus, Heamophilus Influenzae type b, Hepatitis A, Hepatitis B, and Varicella.
Also, the program should provide information regarding age of first shot, number of shots, vaccines side effects, safety, and specific information about each disease.
-Immunization must begin at birth and most vaccinations must be completed by age 2.
-Infants and children up to 2 years of age should have received at least 3 or 4 doses of
Diphtheria, Tetanus and acellular pertussis ( DtaP) vaccine by 2 years of age.
-Parents must be aware that a child with less than the minimum of 3 recommended doses
of DtaP may not be protected from Pertussis.
-Three doses of MMR vaccine should be administered to children 12 months of age or
-Three doses of Polio vaccine are recommended for all infants and children by 2 years of
-Three doses of Hepatitis B vaccine are recommended for all infants and children by 2
years of age.
-Three or four doses of Hib vaccine are recommended by age 2 years.
The program will provide free vaccines to needy children. Eligible children include those without health insurance coverage, and all those who are enrolled in Medicaid.
Vaccines are not just for kids. So many adults become ill, disabled, and die each year from diseases that could easily have been prevented by vaccines. Thus, everyone from young adult to senior citizens can benefit from immunization.
Some vaccines are very important for most adults, especially senior citizens. This is a list of diseases that can be prevented by vaccines:
Diphtheria, Tetanus, Hepatitis A, Hepatitis B, Measles, Mumps, Rubella ( MMR), Influenza (Flu), Lyme disease, Haemophilus Influenzae type b, Pneumococcus, Polio, Varicella ( chickenpox) .
Especially Serious diseases for adults over age 65 are:
Diphtheria, Influenza ( Flu), Pneumococcus, Tetanus.
Vaccine Recommendation For Travelers: 6
Children over two years old should be on Schedule with each vaccines primary series schedule, while adults should have completed the primary series.
Adults travelers may want to consider Influenza and Pneumococcal vaccines especially for adults 65 years old or more.
Also, some other vaccines should be considered and recommended when traveling to certain areas of the world like (Africa, South America, Middle East..) such as yellow fever vaccine, Hepatitis A vaccine and / or Immune Globulin IG, Typhoid vaccine, Meningococcal vaccine, Japanese encephalitis, Cholera
The program should provide a guideline of recommendation for those who need to travel to specific areas of the world, plus a complete physical exam before they leave.
The injury prevention program mission is to decrease the number and severity of unintentional injuries to children age 0 to 14.
Each year, injuries lead to about 300,000 child hospitalizations, 8,700,000 emergency room visits, and 10,500,000 physicians office visits.
The major unintentional injury risk areas are:
1- Traffic Injury.
2- Fire and Burns.
4- Poisoning and Choking.
So, Injury prevention program should define the high risk children / adolescents, who
1- Children of low- income families.
2- Children of low physical, mental level.
3- Children who live in low income apartment complex with swimming pool that lacks
4- children who use bicycles without supervision from parents.
Injury prevention program activities should include:
1- Car seat program, which provides low cost care seats for needy people.
2- Car seat checks, a team checks car seats and help to educate parents on the proper use
of their car seats.
3- Smoker detector installation and evaluation program.
4- Playground injuries prevention program.
5- fire work-injuries prevention program.
6- Drowning prevention program.
7- Bicycle- Related head injuries program. Aiming to increases bike helmet use, by education, legislation and helmet distribution programs.
Regular physical activity is essential too the mental and physical health of each child and adolescent. Positive exercise habits formed in childhood frequently carry over into adulthood and will help to decrease the burden of chronic diseases such as high blood pressure, or heart diseases, or even reduce the death from these diseases.
A physical activity program should mandate all children to be involved in some type of physical activity. These activities should be every day for at least 20 - 30 minutes and should be performed at a moderate intensity level.
-Also, walking, jogging, swimming, cycling should be emphasized.
-Parents should be educated and encouraged to support sports activities and to monitor
the time their children spend watching TV, playing with video games, and using
computer, if children are spending long time in passive activity, the parents should
intervene at this point.
- Schools should be informed and monitored to encourage sports and exercise sessions.
- Health and medical professions should also participate and contribute to this program.
Enhance healthy Habits for Elderly: 9
All senior residents should be encouraged to perform a regular light physical activities, 2-3 days per week. Examples are walking, cycling, swimming, and dancing.
Light- intensity sports are proper and safe.
Every one should be examined and evaluated before starting any exercise. A complete cardiac and respiratory evaluation should be done by a physician or health professional.
The importance of exercise for older people should be reflected in designing community facilities such senior centers, parks, shopping malls, senior citizen housing complexes.
- Senior citizen organizations should encourage their members to participate in regular
light physical exercise programs.
- Radio and TV commercials and advertisements should promote and encourage senior
citizens to exercise.
- Finally, emphasizing that light regular physical activities decrease the risk of heart
diseases, high blood pressure, diabetes, strokes, and certain kinds of cancers such as
breast and colon cancer.
The program should provide short- term nutrition and food support to poor, high-risk pregnant women, poor new mothers and their infants and / or children.
The program should promote breast-feeding and increase the duration of breast-feeding.
A public health department should have a STDs program which provides services to individuals who test positive for Chlamydia, Gonorrhea, syphilis and HIV.
-Treatment and prophylaxis medication should be free of charge for patients and their partners.
- The program has to report STD rates to other health departments.
- A coordination with private physician and other health professionals should be
- A program should include a strict follow on the patients to check the course of their
Another program is HIV program, which should focus on developing a good effective service for preventing HIV, provide a good care for HIV patients, identify high risk people, psychological support, collaboration between private physicians, hospitals and other health care professionals .
The program should facilitate laboratory and diagnostic facilities regarding pregnant women and HIV, the program should assist pregnant women or high risk pregnant women in assessing their risk.
The program should provide infected pregnant women with the best treatment to protect their kids from infection.
And finally every patient enrolled in the program should be strictly follow up.
Another important program is Tuberculosis prevention program. Since TB is a serious highly infectious disease, which may spread from person to another through the air.
The program should provide :
1- Community education sessions about TB, how it spreads, diagnosis, treatment, and
2- Identify high risk people (low- income), check for their household looking for TB
3- Provide medication for free to treat and prevent TB.
4- The program should have surveillance on the incidence of TB cases.
5- Strict treatment and assessment follow- up, even if that requires to follow the patient to their homes.
The breast and cervical cancer early detection programs goal is to reduce mortality from these diseases through education, surveillance and free screening services.
Free services should be provided to low-income women.
The program should provide education and teach women how to perform self- breast examination, also it should provide a complete set of cancer screening tests ( pap-smear, pelvic examination, mammogram).
The prostate cancer prevention program should provide services to men 40 years old or older. It should provide free screening test for low- income ( or eligible people) .Also, it should identify high-risk group such as African-American over 45 years old.
It should provide a tips for preventing cancers, such as, eating healthy food, exercise, not smoking.