1.

COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH

COMMUNITY ORGANIZING
PROCESS:
 Educating the people to let them understand and develop their critical
awareness of existing conditions.
STRUCTURE:
 Particular group of community members themselves that work together for
common health and health related problems.
 People organize themselves into a working team to solve their own health
problems.
PARTICIPATORY ACTION RESEARCH
 It an investigation on problems and issues concerning life and environment
of the underprivileged by way of research collaboration.
 PAR is a community-directed process of gathering and analyzing
information or an issue for the process of taking actions and making
changes.
 The essential element of PAR is participation
 The beneficiaries of the research are the people.
 it enables the community to experience a collective consciousness of their
own situation.
 PAR involves research, education and action to empower the people to
determine the cause of their problems; analyze these problems and act by
themselves in responding to their own problems.

COMMUNITY ORGANIZING PARTICIPATORY ACTIONRESEARCH (COPAR) AS A

TOOL FOR DEVELOPMENT

 A middle ground where the health care worker and the people need to
attain community organization.
 A liberal freedom of the community where the people are allowed to
participate in the overall health care status of their community.
  A transformation force, that enables the individuals, families and
communities to be responsible for their own health.
 A phenomenon of interest's goals and objectives at the health care worker
and the people in their way to health citizenry.
 It is a social development approach that aims to transform the apathetic,
individualistic and voiceless poor into dynamic, participatory and politically
responsive community.
 Vital part of public health nursing.
 Collective, participatory, transformative, liberative, sustained and
systematic process of building people’s organizations by mobilizing and
enhancing the capabilities and resources of the people for the resolution of
their issues and concerns towards effecting change in their existing
oppressive and exploitative conditions (1994 National Rural Conference).
 Process by which a community identifies its needs and objectives, develops
confidence to take action in respect to them and in doing so, extends and
develops cooperative and collaborative attitudes and practices in the
community (Ross 1967).
 A continuous and sustained process of educating the people to understand
and develop their critical awareness of their existing condition, working
with the people collectively and efficiently on their immediate and long-
term problems, and mobilizing the people to develop their capability and
readiness to respond and take action on their immediate needs towards
solving their long-term problems (CO: A manual of experience, PCPD).

IMPORTANCE OF COPAR:
 COPAR is an important tool tor community development and people
empowernment as this helps the community workers to generate
community participation in development activities.
 COPAR prepares people to eventually take over the management of a
deveiopment program in the future.
 COPAR maximizes community participation and involvement, community
resources are mobilized for health development services.
PRINCIPLES OF COPAR:
 People, especially the most oppressed, exploited and deprived sectors are
open to change, have the capacity to change and are able to bring about
change.
 COPAR should be based on the interests of the poorest sectors of society.
 COPAR should lead to a self-reliant community and society.

METHODS USED IN COPAR:

1. Progressive cycle of action-reflection-action
 It begins with small, local and concrete issues identified by the people and
the evaluation and retlection of and on the action taken by them.

2. Consciousness-raising
 Experiential learning is central to the COPAR process because it places
emphasis on learning that emerges irom concrete action and which
encircles succeeding action.

3. Participatory and mass-based

 it is primarily directed towards anc biased in favor of the poor, the
powerless and the oppressed.

4. Group-centered and not leader -centered

 Leaders are identitied, emerge und are tested through action rather than
appointed or selected by some external force or entity.

ACTIVITIES IN COPAR:
1. Integration
 The health care worker becomes one with the people in order to immerse
hmself/herself in the community, understand deeply the Culture, economy,
leaders, history and litestyle in the community.
Methods of integration
 participation in direct production activities of the people
 conduct of house-to- house visits
 Participation in activities on specinl occasions
  conversing with the people where they usually gather
 helpng out in household ehores

2. Social investigation
 Known as community study
 a systematic process of collecting, collating, analyzing data to draw a clear
picture of the community.
 the health worker must remember the following:
 Use of survey questionnaire is discouraged.
 Community leaders can be trained to initially assist the community
worker.
 secondary data should be thoroughly examined because much of the
information mighit already be available.
 Social investigation is tacilitated it he health worker is properly
integrated and has acquired the trust of the people.
 -Confirmation and vulzdatron of community should be done
regularly.

3. Tentative Program Planning

 Community organizer to choose one issue to work on in order to begin
organizing the people.

4. Groundwork
 Going around and motivating the people on a one on one basis to do
something on community issue

5. The Meeting
 The people collectively ratily what they have already decided individualy. lt
gives the people the collective power and confidence and the problems and
issues are discussed.

6. Role Play
 It means acting out the meeting that will take place between the leaders of
the people and the government representatives. It is a way of training the
 people to anticipute what will happen and prepare them for such
eventuality
7. Mobilization or Action
 It is the actual experience of the people in confronting the powertul and
the actual exercise of people power
8. Evaluation
 To determine whether the objectives were attained.

9. Refection
 It gives the people time to retlect reality of life compared to the ideal one.
Community organizer is trying to build in the organization.

10. Organization
 The people's organization is the result of many successive and similar
actions of the people. A linal organization structure is set up with elected
officers and supporting members.

PHASES OF COPAR PROCESS

1. PRE- ENTRY PHASE
 The initial phase of the organizing process where the community organizer
looks for communities to serve or help. It is the most complex phase in
terms of actual outputs, activities and strategies and time spent for it.

Recommended Activities:
 Statement of objectives, and realization of COPAR guidelines
 Laying out the site criteria.
 Site selection

ACTIVITIES:
 Develop criteria for site selection
 ldentily potenttal munieipuliucs Catchment areas through preliminary
social investigation (to gather information about the area)
 Identify potential Barangay
 Choose the final project Barangay
 CRITERIA FOR SITE SELECTION:
 Depressed, deprived and unserved rural communities with majority of the
people belong to poor sectors
 Poor health status of the community
 No serious peace and order problem
 No strong resistance from the community
 Not currently served by similar agencies or program
 Meeting and courtesy call to the local government unit of the selected site.
 Courtesy call to the barangay level.
 Meeting with the "will be'" foster parents of the health care students
 Setting the target date immersion, exposure, and departure.

2. ENTRY PHASE (Immersion)

 Sometimes called the immersion phase as it the activities done here
includes the sensitization of the people on the critical events in their life,
motivating them to share their dreams and ideas on how to manage their
concerm and eventually mobilizing them to make collective action on
these. This phase signals the actual entry of the community
worker/organizer into the community.

Recommended Activities:
 Courtesy Call to mayo, or the local government leader of the selected site
 Courtesy call to the barangay level.
 Meeting with the foster parents.
 Appreciating the environment.
 Meeting the community officials and residents.
 General assembly.
 Preparation of survey torms.
 Actual survey.
 Analysis of the data gathered.

ACTIVITIES:
 Integration
  Conduct information
HOW TO CONDUCT INFORMATION CAMPAIGN
 Discussion during home visit
 Small group discussion
 Purok meetings and assemblies
 General meeting
 Conduct deepening social investigation( is systematically looking for issues
arournd which to organize the people)
 Identificati on of potential leaders

CHARACTERISTICS OF POTENTIAL LEADERS

 They mast belong to the poor sector
 Must be respected member
 Responsive and willing to work for change
 Willing to learn
 Possess relatively good communication skill
 Identification of potential leaders is a NEVER ending process
 Provision of basic health services

PURPOSE:
 Draw out the people's interest in the project
 Enhances the team's integration into the community
 Focus on health problems that may need immediate attention.

3.ORGANIZATION BUILDING PHASE

 It is the formation of more formal structures and the inclusion of more
formal procedures of planning. implementing, and evaluating community-
wide activities. It is at this phase where the organized leaders or groups are
being given trainings (formal, informal) to develop their ASK (attitude
knowledge and skills) in managing their own concerns/programs.

Recommended Activities:
 Meeting with the officials.
 Identitying problems
  Spreading awareness and soliciting solution or suggestions.
 Analysis of the presented solution.
 Planning of the activities.
 Organizing to build their own organization.
 Registration of the organization. (Legality purposes.)
 Implementation of the said activities.
 Evaluation.

4. SUSTENANCE AND STRENGTHENING PHASE

 It occur when the community organization has already been established
and the community wide undertakings. At this point, the different
committee's set-up in the organization-building phase is already expected
to be fiunctioning by way of planning. implementing and evaluating their
own prograns, with the overall guidance trom the community wide
organization.

Recommended Activities:
 Meeting with organizational leaders.
 Evaluation of the programs
 Re-implementation of the programs. (For unmet goals).
 Education and training
 Networking and linking
 Conduct of mobilization on health and development concerms.
 Implementation of livelihood projects.
 Developing secondary leaders.

5. PHASE OUT
 It is the phase when the health care workers leave the community to stand
alone. This phase should be stated during the entry phase so that the
people will be ready for this phase. The organizations built should be ready
to sustain the test of the community itself because the real evaluation will
be done by the residents of the community itself.

Recommended Activities:
  Leaving the immersion site.
 Documentation.
IDEAL COPAR AGAINST PRACTICED COPAR
1. TIME FRAME AND MODE OF EXPOSURE
Ideal COPAR:
 Three (3) to six (6) weeks immersion.
 Three to six weeks duty, cight hours a day. five to six days a week
Practiced COPAR
 Sometimes eight to sixteen hours a week, for two to four weeks depending
on the time allotted by the school or institution.

2. METHODOLOGY AND SURVEY FORM

Ideal COPAR:
 The survey torm will vary to the needs of the community (custom made)
and the methodology is surveying the partipants.
Practiced COPAR
 Use of ready made survey form from the school, books, or from the
institution they are working for.
 Some use survey but others just collect data from previous studies. E.g.
health situation from the barangay.

3. NUMBER OF RECIPIENTS
Ideal COPAR:
 30%, 60%, or 100% depending on the number of population and situation
of the community.
 With allotted 10-15 data or tally sheets for deadfiles.
Practiced cOPAR
 25-50 families or depending on the required number of families by the
school or institution.

4. ORGANIZATION BUILDING STAGE

Ideal COPAR:
  A primary and secondary organization should be built and it should be
strengthened by set ot officers, bylaws; registrations to the proper
institutions (SECDT).
 he primary and secondary leaders are committed and the members are all
coming rom the community and not from the healtheare workers.
Practiced cOPAR:
 No organizations built or sometimes the organizations are not properly
strengthened or registered, no bylaws are present. Therelore the functtons
are not clear and the responsibilities are not well stated.

5. PROBLEM STATEMENT
Ideal COPAR
 The problems will only the stated ater the survey has been done, tallied
andanalyzed.
 The problem will all be coming trom the survey torm and not from the
judgment of the healthcare worker, because of the simple reason that any
problem not perceived is not a problem
 Any problem too big or too complicated to the health worker to manage
should not be prioritized. The principle within is that we should not
prioritize something that we can do nothing about.
Practiced COPAR:
 Misjudging complex problems as simple ones.
 Not considering the result of the survey form but the say of the few. Eg.
barangay officials.

6. IMPLEMENTATION
Ideal COPAR:
 The "tishing rod effect" should be done "teach the man to fish, and he will
never be hungry, give the man fish and he will ask for more". The programs
that will be implemented should stand or remain feasible even after the
Phase out or even after the healthcare worker leave the community.
 The programs should not be one day afTair, (eg. Medical mission, one-day
mother's class, one day feeding. or nutrition program) but should be
 program that will last even after the phase out. It should be something that
you will leave with community.
Practice COPAR:
 The "fish effect" programs that are meant to last.
 One day programs are often done this programs also diminishes after the
health workers leave.

7. EVALUATION
Ideal COPAR:
 The health worker should learn to accept reality that not all programs will
prosper and not all their goals will be met.
 After evaluation there should be a re-implementation.
Practiced COPAR:
 Some results are manipulated just to say that the goals are met.
 No re-implementation

COMMUNITY IMMERSION PROGRAM

 Community immersion program (CIP) is the community health nursing
practicum of health care students, an integral part of the Community
Health Nursing.
 It isa third level experience designed to enable the students to apply the
concepts of primary healtlh care (PHC) and community organizing (CO) in a
real community set-up.
 The Students will be living with selected foster families and learn to
integrate with the whole community for four weeks.
 This would be the actual application of the knowledge, skills and attitudes
in dealing with the family and the community as a whole.
 In the process, the student nurses arouse the people's awareness about
health and wellness. Through CIP the people wil realize the importance of
seif-reliance making them more productive, thus improving the quality of
life in the community.
 PROPER EXCRETA DISPOSAL

 Safe disposal of excreta, so that it does not contaminate the environment,

water, food or hands, is essential for ensuring a healthy environment and
for protecting personal health. This can be accomplished in many ways,
some requiring water, others requiring little or none. Regardless of
method, the safe disposal of human faeces is one of the principal ways of
breaking the faecal–oral disease transmission cycle.
 The methods used for excreta disposal vary and depend on community
habits and practices (such as wiping or washing the anal area), socio-
economic status of the individual, availability of water and the method of
water supply.
 Excreta disposal varies from district to district. Urban centres have more
excreta disposal facilities. This is with the exception of informal
settlement areas where latrine facilities are very few and those available
are in such condition that they can no longer be used without risk of
infection. In such slum areas, “flying toilet syndrome” is common
whereby residents defecate into plastic bags in their rooms then throw
the contents on to an existing toilet floor, compound or open drain
channel.
 Sanitation is therefore a critical barrier to disease transmission. Plans for
locating sanitation facilities, and for treating and removing waste, must
consider cultural issues, particularly as sanitation is usually focused on the
household.
 Excreta disposal may be a difficult subject for a community to discuss: it
may be taboo, or people may not like to discuss issues they regard as
personal and unclean. In some cases, people may feel that sanitation
facilities are not appropriate for children, or that children’s faeces are not
harmful. In others, separate facilities may be required for men and
women, and it may be necessary to locate the facilities so that no one can
 be seen entering the latrine building. If the disposal facilities smell and
are a breeding ground for flies, people may not use them.
 Health improvement comes from the proper use of sanitation facilities,
not simply their physical presence, and they may be abandoned if the
level of service does not meet the social and cultural needs of community
members at an affordable cost. Within a community, several different
sanitation options may be required, with varying levels of convenience
and cost (sometimes called a sanitation ladder). The advantage of this
approach is that it allows households to progressively upgrade sanitation
facilities over time.

Role of Excreta in the Spread of Diseases

 Hygienic disposal of excreta is important because the infective organisms
may enter diseases leave the human body in faeces and urine. The
infective organisms may enter the human body directly or sometimes
after an intermediate stage which may be free living or in an
intermediate host.
 The following infections mainly occur through consumption of foods
contaminated with the disease organisms. They may be classified as
follows:
 Viral diseases: poliomyelitis, infectious hepatitis and gastro-enteritis.
 Bacterial diseases: cholera, typhoid and paratyphoid, bacillary
dysentery
 Protozal diseases: amoebic dysentery
 Parasitism: ascariasis (roundworm), trichuariasis (whipworm),
pinworm, tapeworm.
 Almost all the above viral, bacterial and protozal infections may be
transmitted through drinking water contaminated with infected faecal
matter. In addition, the other infection of faecal origin is schistosomiasis,
both urinary (schist soma haematobium) and intestinal (schist stoma
mansoni).
 Likewise, all the above bacterial diseases may be spread through flies
and other insects like cockroaches. The mode of spread may be
mechanical, through insects’ hairs and feet, or by regurgitation of
 organisms on to food. The domestic housefly can also spread
conjunctivitis.
 Most bacterial infections may be spread through contamination of
uncovered food or by soil and dust blown by wind. Other forms of
infection from soil are ankylostomiasis (hookworm) where the infective
form of the worm in the soil penetrates the skin and enters the body.
 Proper excreta disposal methods provide safe disposal of excreta to stop
it from contaminating the environment. Any method selected for
disposal of excreta should be:
● Simple, cheap and easy to use.
● Constructed of locally available materials.
● Easy to maintain.
● Fly-proof.
● Acceptable to users.
● As odourless as possible.
● Private.
● Non-polluting.

 It is significant to note that there has been an increase in the households

having sanitary toilet facilities number both in of the persons, urban and
which rural areas there is also an increase in the absolute an access to
sanitary toilet facilities.
 Health surveys reveal that there is utilization of sanitary toilet facilities in
the sense that the mothers still children to move their bowel elsewhere
despite of the presence of toilets in own homes. Again, the EHS set
policies on the approved types of toilet

Approved types of toilet facilities

LEVEL 1
● Non-water carriage toilet facility - no water is necessary to wash
the waste into the receiving space. Examples are pit latrines, reed odor,
less earth closet.
 ● Toilet facilities requiring small amount of water to wash the waste into
the receiving space. Examples are pour flush toilet and aqua privies.

LEVEL Il
● On site toilet facilities of the water carriage type with water-sealed and
flush type with septic vault/tank disposal facilities.

LEVEL IlI
● Water carriage types of toilet facilities connected to septic tanks
and/or to sewerage system to treatment plant.

 In rural areas, the "blind drainage" type of wastewater collection and

disposal facility shall continue to be the emphasis until such time that
sewer facilities and off—site treatment facilities shall be made available
to clustered houses in rural areas.
 Conventional sewerage facilities are to be promoted for construction in
"Poblacions"' and cities in the country as developmental objectives to
attain control and prevention of fecal-water-borne diseases.
 Other policies embodied in Code of Sanitation of the Philippines shall be
pursued and enforced by the local government units.

Sanitation Facilities:

Box and can privy (bucket latrine)

● Fecal matter is collected in a can or bucket, which is periodically removed
for emptying and cleaning. Each day, the bucket is emptied into a larger
container and the contents disposed of.

● Bucket latrines should not be promoted because they pose health risks to
both users and collectors and may spread disease.
 Pit latrine (pit privy)
● Fecal matter is eliminated into a hole in the ground that leads to
a dug pit. Generally, a latrine refers to toilet facilities without a
bowl. It can be equipped with either a squatting plate or a riser
with a seat.

● pit latrines do not require periodic emptying; once a pit is full it

is sealed and a new pit dug. If fecal matter is left decompose in
dry conditions for at least two years, the contents can best
emptied manually and the pit reused. Indeed, some pit latrines
are designed to allow fecal matter to compost and be reused in
agriculture. Other designs use two alternating pits, reducing the
need for new pits. Some designs are meant to be completely dry,
while some use small quantities of water. Ventilation to remove
odors and flies is incorporated into certain designs, while others
are very basic and use traditional materials and approaches. As
 with all sanitation designs, it is important to community
members want and can pay for before embarking on
construction.

Antipolo toilet
● It is made up of an elevated pit privy that has a covered latrine. This is a
pit privy in which the superstructure, constructed to provide the
necessary privacy and protection from the rain and sun, elevated to the
same level as the main building of the house.
Septic Privy
● Fecal matter is collected in a build septic tank that is not connected to a
sewerage system.

Aqua privy
● Fecal matter is eliminated into a water-sealed drop pipe that leads from
the latrine to a small water filled septic tank located directly below the
squatting plate. An aqua privy is similar to a septic tank; it can be
connected to flush toilets a take most household wastewater. It consists
of a large tank with a water seal formed by a simple down pipe into the
tank to prevent odor and fly problems. Its drawback is that water must be
added each day to maintain the seal, and this is often difficult to do unless
water is piped into the home .The tank is connected to a soak away to
dispose of effluent. Unlike a septic tank, the aqua privy tank is located
directly below the house, but it, too requires periodic emptying and must
be accessible to a vacuum tanker A are expensive and do not offer any
real advantages over pour-flush latrines.
Overhung latrine
● Fecal matter is directly eliminated into a body of water such as a flowing
river that is underneath the facility.

Ventilated-improved pit (VIP) latrine

● A pit latrine with a screened air vent installed directly over the pit. When
air flows across the top of the vent pipe, air is drawn up the pipe from the
pit and fresh air is drawn into the pit from the building. Offensive odors
from the pit thus pass through the vent pipe and do not enter the
building. The location of VIP latrines is important: unless a clear flow of
 air is maintained across the top of the vent, the ventilations may not be
effective. VIP latrines should therefore be located away from trees or high
buildings that may limit airflow. A dark vent pipe also helps the air to rise.
The top of the pipe is usually covered with mosquito meshing if the inside
of the building is kept partially dark, the flies will be to light at the top of
the pipe, where they will be trapped and die.

● When the VIP latrine is constructed and used properly, it provides great
improvements in fly and odour control, but may not eliminate either
completely. A VIP latrine is designed to work as a dry system, with any
liquid in the content infiltrating into the surrounding soil. Although some
liquid inevitably will enter the pit, it should be minimized. For example, it
would not be appropriate to dispose of household wastewater into the
pit as this may prevent decomposition of the contents. VIP latrines are
most appropriate where people do not use water for cleaning themselves
after defecating, but use solid materials such as paper, corncobs or leaves.
Concrete vault privy
● Fecal matter is collected in a pit
privy lined either a concrete in
such a manner so as to make it
water tight.

Chemical privy
● Fecal matter is collected into a tank that contains a caustic chemical
solution, which in turn controls and facilitates the waste decomposition.
Compost Privy
● Fecal matter is collected into a pit with urine ad anal cleansing materials with the
addition of organic garbage such as leaves and grass to allow biological decomposition
and production of agricultural or fishpond compost.

Pour flush latrine

● It has a bowl with a water seal trap similar to the conventional tank flush
toilet expect that it requires only a small volume of water for flushing.
Tank-flush toilet
● Feces are excreted into a bowl with a water sealed trap. The water tank
that receives a limited amount of water empties into the bowl for flushing
of fecal materials through the water sealed trap and into the sewerage
system.
 FOOD SAFETY
 Refers to handling, preparing and storing food in a way to best reduce
the risk of individuals becoming sick from foodborne illnesses. Food
safety is a global concern that covers a variety of different areas of
everyday life.
 Access to sufficient amounts of safe and nutritious food is key to
sustaining life and promoting good health. Unsafe food containing
harmful bacteria, viruses, parasites, or chemical substances can cause
more than 200 different diseases – ranging from diarrhea to cancers.
 Food safety, nutrition, and food security are closely linked. Unsafe food
creates a vicious cycle of disease and malnutrition, particularly affecting
infants, young children, elderly, and the sick.
 In addition to contributing to food and nutrition security, a safe food
supply also supports national economies, trade, and tourism, stimulating
sustainable development.
 The globalization of food trade, a growing world population, climate
change and rapidly changing food systems have an impact on the safety
of food. WHO aims to enhance at a global and country-level the capacity
to prevent, detect, and respond to public health threats associated with
unsafe food.
Why Is Food Safety Important?

 Foo
db
orne illnesses are a preventable and underreported public health
problem. These illnesses are a burden on public health and contribute
significantly to the cost of health care. They also present a major
challenge to certain groups of people. Although anyone can get a
foodborne illness, some people are at greater risk.
 Safer food promises healthier and longer lives and less costly health
care, as well as a more resilient food industry.

PRINCIPLES OF FOOD SAFETY

 The principles of food safety aim to prevent food from becoming
contaminated and causing food poisoning. This is achieved through a
variety of different avenues, some of which are:
 Properly cleaning and sanitizing all surfaces, equipment and utensils
 Maintaining a high level of personal hygiene, especially hand-
washing
 Storing, chilling and heating food correctly with regards to
temperature, environment and equipment
  Implementing effective pest control
 Comprehending food allergies, food poisoning and food intolerance
 Regardless of why you are handling food, whether as part of your job or
cooking at home, it is essential to always apply the proper food safety
principles. Any number of potential food hazards exist in a food handling
environment, many of which carry with them serious consequences.

FIVE FOOD SAFETY RULES

The core messages of the Five Keys to Safer Food are:
1. Keep clean
2. Separate raw and cooked
3. Cook thoroughly.
4. Keep food at safe temperatures.
5. Use safe water and raw materials.

What is the greatest threat to food safety?

 Of all the microorganisms, bacteria are the greatest threat to food
safety. Bacteria are single-celled, living organisms that can grow quickly at
favorable temperatures. Some bacteria are useful. We use them to make
foods like cheese, buttermilk, sauerkraut, pickles, and yogurt.
 Other bacteria are infectious disease-causing agents called pathogens
that use the nutrients found in potentially hazardous foods to multiply.
 Some bacteria are not infectious on their own, but when they multiply in
potentially hazardous food, they eject toxins that poison humans when the
food is eaten.
Food handling practices are risky when they allow harmful bacteria to
contaminate and grow in food. If you touch a food during preparation, you
may transfer several thousand bacteria to its surface.
  Under the right conditions, bacteria can double every 10 to 30 minutes. A
single bacterium will double with each division—two become four, four
become eight, and so on. A single cell can become billions in 10 to 12
hours.

THE IMPLEMENTING RULES AND REGULATIONS OF REPUBLIC ACT NO. 10611,

“AN ACT TO STRENGTHEN THE FOOD SAFETY REGULATORY SYSTEM IN THE
COUNTRY TO PROTECT CONSUMER HEALTH AND FACILITATE MARKET ACCESS
OF LOCAL FOODS AND FOOD PRODUCTS, AND FOR OTHER PURPOSES”
OTHERWISE KNOWN AS THE “FOOD SAFETY ACT OF 2013.”
Pursuant to the provisions of Section 39, Republic Act 10611, otherwise
known as the “Food Safety Act of 2013”, the Department of Agriculture (DA)
and the Department of Health (DOH) hereby jointly adopt and promulgate the
following Rules and Regulations:
Food safety standards refer to the formal documents containing the
requirements that foods or food processors have to comply with to safeguard
human health. They are implemented by authorities and enforced by law; and
are usually developed and published under the auspices of a national standards
body.
WHO "Golden Rules" for Safe Food Preparation
WHO data indicate that only a small number of factors related to food
handling are responsible for a large proportion of foodborne disease episodes
everywhere. Common errors include:
 preparation of food several hours prior to consumption, combined with
its storage at temperatures which favour growth of pathogenic bacteria
and/or formation of toxins;
 insufficient cooking or reheating of food to reduce or eliminate
pathogens;
 cross contamination; and
 people with poor personal hygiene handling the food.
 The Ten Golden Rules respond to these errors, offering advice that can
reduce the risk that foodborne pathogens will be able to contaminate, to
survive or to multiply.
Despite the universality of these causes, the plurality of cultural settings
means that the rules should be seen as a model for the development of culture-
specific educational remedies.
Users are therefore encouraged to adapt these rules to bring home
messages that are specific to food preparation habits in a given cultural setting.
Their power to change habitual practices will be all the greater.
The World Health Organization regards illness due to contaminated food as
one of the most widespread health problems in the contemporary world. For
infants, immunocompromised people, pregnant women and the elderly, the
consequences can be fatal. Protect your family by following these basic rules.
They will reduce the risk of foodborne disease significantly.

These are the WHO "Golden Rules"

1. Choose foods processed for safety
While many foods, such as fruits and vegetables, are best in their natural state,
others simply are not safe unless they have been processed. For example, always
buy pasteurized as opposed to raw milk and, if you have the choice, select fresh
or frozen poultry treated with ionizing radiation. When shopping, keep in mind
that food processing was invented to improve safety as well as to prolong shelf-
life. Certain foods eaten raw, such as lettuce, need thorough washing.
2. Cook food thoroughly
Many raw foods, most notable poultry, meats, eggs and unpasteurized milk, may
be contaminated with disease-causing organisms. Thorough cooking will kill the
pathogens, but remember that the temperature of all parts of the food must
reach at least 70 °C. If cooked chicken is still raw near the bone, put it back in the
oven until it's done - all the way through. Frozen meat, fish, and poultry, must be
thoroughly thawed before cooking.
3. Eat cooked foods immediately
When cooked foods cool to room temperature, microbes begin to proliferate. The
longer the wait, the greater the risk. To be on the safe side, eat cooked foods just
as soon as they come off the heat.
4. Store cooked foods carefully
If you must prepare foods in advance or want to keep leftovers, be sure to store
them under either hot (near or above 60 °C) or cool (near or below 10 °C)
conditions. This rule is of vital importance if you plan to store foods for more than
four or five hours. Foods for infants should preferably not be stored at all. A
common error, responsible for countless cases of foodborne disease, is putting
too large a quantity of warm food in the refrigerator. In an overburdened
refrigerator, cooked foods cannot cool to the core as quickly as they must. When
the center of food remains warm (above 10 °C) for too long, microbes thrive,
quickly proliferating to disease-causing levels.
5. Reheat cooked foods thoroughly
This is your best protection against microbes that may have developed during
storage (proper storage slows down microbial growth but does not kill the
organisms). Once again, thorough reheating means that all parts of the food must
reach at least 70 °C.
6. Avoid contact between raw foods and cooked foods
Safely cooked food can become contaminated through even the slightest contact
with raw food. This cross-contamination can be direct, as when raw poultry meat
comes into contact with cooked foods. It can also be more subtle. For example,
don't prepare a raw chicken and then use the same unwashed cutting board and
knife to carve the cooked bird. Doing so can reintroduce the disease-causing
organisms.
7. Wash hands repeatedly
Wash hands thoroughly before you start preparing food and after every
interruption - especially if you have to change the baby or have been to the toilet.
After preparing raw foods such as fish, meat, or poultry, wash again before you
start handling other foods. And if you have an infection on your hand, be sure to
bandage or cover it before preparing food. Remember, too, that household pets -
dogs, cats, birds, and especially turtles - often harbor dangerous pathogens that
can pass from your hands into food.
8. Keep all kitchen surfaces meticulously clean
Since foods are so easily contaminated, any surface used for food preparation
must be kept absolutely clean. Think of every food scrap, crumb or spot as a
potential reservoir of germs. Cloths that come into contact with dishes and
utensils should be changed frequently and boiled before re-use. Separate cloths
for cleaning the floors also require frequent washing.
9. Protect foods from insects, rodents, and other animal
Animals frequently carry pathogenic microorganisms which cause foodborne
disease. Storing foods in closed containers is your best protection.
10. Use safe water
Safe water is just as important for food
preparation as for drinking. If you have any
doubts about the water supply, boil water
before adding it to food or making ice for drinks.
Be especially careful with any water used to
prepare an infant's meal.
Benefits of Food Safety
 Keeps foodborne illnesses away.
 Sustains life enables healthy diets.
 Helps safely produce and prepare food.
 Facilitates trade and access to new
markets
 Reduces food loss and waste.
  SANITATION
KEEPING OUR ENVIRONMENT CLEAN
Community sanitation means the work we do to keep our
environment clean. We must live in a healthy, clean environment. There
are some activities we need to do in order to live in a clean environment.
As good citizens, we must not litter the environment with dirty things.
When we live in a clean surroundings, we will be healthy and happy.

HOW TO CLEAN OUR SURROUNDINGS?

By sweeping the compound

and cleaning our surroundings
clean

Proper use of the toilets and

urinary: This places must always with
disinfectant to prevent bad
odour from coming out of them. And
also shut the doors to prevent flies
from getting in.

By disposing the refuses in the dustbin

 Do not throw dirty things about. Wastes, especially those that can infect
or harm other people when touched, must be taken to incinerator for burning.
Some refuses can be reused or recycled.
What can go in your rubbish bin or sack?
 Dirty foil (clean foil can be reused or recycled)
 Polystyrene

 Pet waste and pet food pouches

 Pyrex glass and ceramics

 Nappies, tissues and sanitary

products
 Plastic film

 Shredded paper

 Single use masks and gloves.

By keeping the gutters clean regularly

Not leaving dirty water and things in the
gutters and dropping refuse in them which blocks
from flowing which may lead to flooding and it is
dangerous to health and properties.

Cutting down bushes is also

important to avoid snakes and some
dangerous animals from entering the
home

OUR ROLES IN COMMUNITY SANITATION

 We have roles to play to make our surroundings clean. As individuals, we
must keep our surroundings clean. As a community, we must work together to
keep our environment clean. We must cooperate with the government to keep
our surroundings clean. We must observe the clean-up exercise of the
government that comes up once a month in our different states.

The Following Are Our Duties in Community Sanitation:

1. To take active part in community sanitation.
2. To encourage others to join in the community sanitation.
3. To maintain good sanitation in our own houses.
4. To educate people in the community on our need for cleanliness.

BENEFITS OF IMPROVING SANITATION

Benefits of improved sanitation extend well beyond reducing the risk of
diarrhoea. These include:

1. Reducing the spread of intestinal worms, schistosomiasis and trachoma,

which are neglected tropical diseases that cause suffering for millions;
2. Reducing the severity and impact of malnutrition;
3. Promoting dignity and boosting safety, particularly among women and
girls;
4. Promoting school attendance: girls’ school attendance is particularly
boosted by the provision of separate sanitary facilities; and
5. Potential recovery of water, renewable energy and nutrients from faecal
waste.

PROGRAMS IMPLEMENTED IN THE PHILIPPINES FOR COMMUNITY SANITATION

GoAL WaSH Philippines

Achieving the SDGs through the Integrated Safe Water, Sanitation and
Hygiene Approach – iWaSH Governance.

GOALS
A. Increase the number of households, schools and health centers with
access to safe water, sanitation and hygiene.
B. Improve national and local policies on integrated safe water, sanitation
and hygiene.

CHALLENGES
Millennium Development Goals progress in terms of water, sanitation and
hygiene showed that use of improved drinking water sources was at 84 percent
in 1990 and rose to 92 percent in 2015. Use of improved sanitation facility was
measured at 57 percent in 1990 and by 2015 it was recorded at 74 percent.
Despite steady progress, it is estimated that 7 million Filipinos still
defecate in the open. Additionally, there are 323 municipalities in the
Philippines who continue to have no sustained access to safe water, sanitation
and hygiene. These municipalities are difficult to access and are clearly left
behind in terms of achieving SDG 6.
Exacerbating the problem is the fragmentation of structures, policies and
programs on safe water, sanitation and hygiene at the national and local levels
resulting in uncoordinated and ambiguous policies for the sector.

OPPORTUNITIES
 The Philippines is a signatory of the 2030 Agenda and the 17 SDGs. These
are expressed in the Philippine Development Plan 2017 – 2022, providing an
opportunity to effectively sustain the implementation of the integrated safe
water, sanitation and hygiene (iWaSH) approach.
Through GoAL WaSH, there is an opportunity to institutionalize iWaSH in
national policies specifically in the water and sanitation roadmaps. The Regional
Water and Sanitation Hubs (RHubs), composed of partner state universities,
water districts, non-government organizations and civil society organizations,
are organized to assist the local government units in mainstreaming iWaSH in
local plans and budgets. The RHubs are tasked to support the government in
preparing local government units and communities to develop local projects in
establishing, improving and expanding water and sanitation systems and
facilities.

STRATEGIES
The iWaSH approach ensures a complete package of interventions
consisting of social preparation and community organizing, construction of
water supply and sanitation facilities and behavioral change campaigns. All
these interventions are implemented in an integrated manner. The project
focuses on 13 municipalities that are left behind in terms of achieving SDG 6.
GoAL WaSH will also support the development of policies and governance
instruments to broadening access to safe water, sanitation and hygiene.
Local citizens groups are being established to monitor the implementation
of integrated safe water, sanitation and hygiene at the community level.
Furthermore, GoAL WaSH is supporting coordination among WASH sector
institutions at the national level.

ACHIEVEMENTS
In total, 7,169 households in six regions received improved access to
water supply following the construction of water supply systems. Moreover, the
provision of the water quality monitoring kits by the project has been valuable
in the identification of the contaminated drinking water sources in the target
municipalities. In one municipality, drinking water sources tested revealed that
majority, 87 out of the 110 water sources, tested positive for E.Coli and Total
Coliform. Local government authorities had the opportunity to immediately
take action and communicate this to the community. 

DEPED, DOH AND UNICEF UNITE TO BRING CLEAN HANDS FOR ALL ON
OCTOBER 15, 2020
Two of the most crucial government agencies in shaping the future and well-
being of a generation are coming together to mark the beginning of a stronger
partnership.

Manila, 15
October 2020 — As the
COVID-19 pandemic
continues, the world turns
to a simple age-old solution
to reduce the risk of disease
transmission – hand
washing with soap and
water.
On October 15,
2020, this year’s celebration
of Global Hand washing Day
will be its most significant
yet. For the first time, two of the most crucial government agencies in shaping
the future and well-being of a generation are coming together to mark the
beginning of a stronger partnership.

“DepEd has been celebrating Global Hand washing Day in schools since
2008, in recognition of the importance of building the habit of hand washing
among children to ensure their health. Through our WASH in Schools Program,
DepEd has institutionalized actions to improve hand washing facilities and instill
hand washing behaviour among learners. And now under the new normal, our
Basic Education-Learning Continuity Plan also integrates hand washing practice
as part of the required health standards. With the children continuing their
learning at home because of the pandemic, we call on families to make their
homes a safe environment to live and learn; and teach their children to make
hand washing a habit. And when we do return to school, hand washing will be
key in ensuring safety of our children,” says DepEd Secretary Leonor Briones.

With the theme “Clean Hands for All”, the Department of Education

(DepEd) and the Department of Health (DOH), with support from UNICEF, unite
various development partners, sector representatives and local chief executives
in an online symposium on October 15 and 16, 2020. The event aims to identify
key directions for sustaining the hand washing habit beyond the COVID-19
pandemic and promote sustainable proper hand hygiene culture in the
Philippines.

DOH has been promoting hand washing practice as an integrated part of

their health programs and particularly through the Zero Open Defecation
Program (ZODP) that utilizes approaches and strategies under the umbrella
concept of total sanitation to curb open defecation practices and promoting
frequent and proper hand washing among others.

Hand washing with soap is key in the fight against COVID-19. It destroys
the outer membrane of the virus and thereby inactivates it. One study found
that regular hand washing with soap can reduce the likelihood of common
coronavirus infection by 36%. However, based on 2019 data, over 7 million
Filipinos are unable to wash their hands due to lack of access to a hand washing
facility, water, and/or soap. This is found to be highest among poorest
households and those living in rural areas. From school year 2018-2019 data,
only half of schools have at least one group hand washing facility with soap.

The lack of access to hand hygiene facilities is not just in homes and
schools but can also be found in workplaces, healthcare facilities, and public
spaces as well. Even when awareness and knowledge around hand washing is
high – actual practice is often found to be much lower. In a study in 2018 by the
Department of Education and UNICEF among school children, observations
demonstrated that less than 8% did actually wash their hands after using the
toilet even when a handwashing facility with soap and water was available. The
issue is a detriment to public health and safety and requires structural change
from the whole of society and the government, acting together.

 VERMIN AND VECTOR CONTROL

 Vermin is used by some people as a term of abuse, either individually
or collectively. Vermin are pests or nuisance animals that spread
diseases or destroy crops or livestock.
 Vector is an organism, typically a biting insect or tick that transmits a
disease or parasite from one animal or plant to another.
 Any method to limit or eradicate the mammals, birds, insects or other
arthropods (here collectively called "vectors") which transmit disease
pathogens. The most frequent type of vector control is mosquito
control using a variety of strategies.
 Vector control focuses on utilizing preventive methods to control or
eliminate vector populations. Common preventive measures are:
Habitat and environmental control, Reducing contact, Chemical control
and Biological control.
Methods of Vector Control

 Environmental Management
 Environmental Management seeks to change the environment in
order to prevent or minimize vector propagation and human contact
with vector-pathogen by destroying, altering, removing or recycling
non-essential containers that provide larval habitats. Such actions
should be the mainstay of dengue vector control. Three types of
environmental management are defined:
  Environmental modification - long-lasting physical transformations
to reduce vector larval habitats
 Environmental manipulation - temporary changes to vector habitats
involving the management of “essential” containers.
 Changes to human habitation or behaviour - actions to reduce
human - vector contact.

 Improvement of Water Supply and Water-Storage Systems

 Improving water supplies is a fundamental method of controlling
Aedes vectors, especially Ae.aegypti. Water piped to households is
preferable to water drawn from wells, communal standpipes, rooftops
catchments and other water-storage systems.
 Potable water must be supplied reliably so that water-storage
containers that serve as larval habitats - such as drums, overhead or
ground tanks and concrete jars - are not necessary. In urban areas the
use of cost-recovery mechanisms such as the introduction of metered
water may actually encourage household collection and storage of
roof catchment rainwater that can be harvested at no cost, resulting
in the continued use of storage containers.

 Mosquito-Proofing of Water-Storage Containers

 Water-storage containers can be designed to prevent access by
mosquitoes for oviposition. Containers can be fitted with tight lids or,
if rain-filled, tightly-fitted mesh screens can allow for rainwater to be
harvested from roofs while keeping mosquitoes out. Removable
covers should be replaced every time water is removed and should be
well maintained to prevent damage that permits mosquitoes to get in
and out.
  Solid Waste Management
 In the vector control, “solid waste” refers mainly to non-
biodegradable items of household, community and industrial waste.
The benefits of reducing the amount of solid waste in urban
environments extend beyond those of vector control, and applying
many of the basic principles can contribute substantially to reducing
the availability of Ae. aegypti larval habitats.
 Proper storage, collection and disposal of waste are essential for
protecting public health. The basic rule of “reduce, reuse, recycle” is
highly applicable. Efforts to reduce solid waste should be directed
against discarded or non-essential containers, particularly if they have
been identified in the community as important mosquito-producing
containers.
 Solid waste should be collected in plastic sacks and disposed of
regularly. The frequency of collection is important: twice per week is
recommended for housefly and rodent control in warm climates.
Integration of Ae. aegypti control with waste management services is
possible and should be encouraged.

 Street Cleansing
 A reliable and regular street cleansing system that removes
discarded water-bearing containers and cleans drains to ensure they do
not become stagnant and breed mosquitoes will both help to reduce
larval habitat and remove the origin of other urban pests.

 Building Structures
 During the planning and construction of buildings and other
infrastructure, including urban renewal schemes, and through legislation
and regulation, opportunities arise to modify or reduce potential larval
habitats of urban disease vector.
  Chemical Control: Larvicides
 Although chemicals are widely used to treat Ae. aegypti larval
habitats, larviciding should be considered as complementary to
environmental management and – except in emergencies – should be
restricted to containers that cannot otherwise be eliminated or managed.
 Larvicides may be impractical to apply in hard-to-reach natural sites
such as leaf axils and tree holes, which are common habitats of Ae.
albopictus, or in deep wells. The difficulty of accessing indoor larval
habitats of Ae. aegypti (e.g. water-storage containers, plant vases,
saucers) to apply larvicides is a major limitation in many urban contexts.

Target Area
Productive larval habitats should be treated with chemicals only if
environmental management methods or other non-chemical methods cannot
be easily applied or are too costly. Perifocal treatment involves the use of hand-
held or power-operated equipment to spray, for example, wettable powder or
emulsifiable-concentrate formulations of insecticide on larval habitats and
peripheral surfaces. This will destroy existing and subsequent larval infestations
in containers of non-potable water, and will kill the adult mosquitoes that
frequent these sites.

Treatment Cycle
The treatment cycle will depend on the species of mosquito, seasonality of
transmission, patterns of rainfall, duration of efficacy of the larvicide and types
of larval habitat. Two or three application rounds carried out annually in a
timely manner with proper monitoring of efficacy may suffice, especially in
areas where the main transmission season is short.

Precautions
Extreme care must be taken when treating drinking-water to avoid dosages
that are toxic for humans. Label instructions must always be followed when
using insecticides.
Methods of Vermin Control
 Hygiene
 When houses and yards are kept clean, there is no food for pests
and nowhere for them to live and breed, and this in turn means that there
are few pests.

 Pests can be controlled by practicing good hygiene in the following

ways:
 Clean up after meals. Put foods scraps in the bin, and wash and dry
plates, cups, glasses, cutlery and cooking pots after use.
 Put all rubbish into the bin
 Wrap all food scraps tightly in paper before putting them in the bin
 Keep all the benches, cupboards and floors clean and free of foods
scraps
 Regularly clean behind stoves, refrigerators and other household
appliances
 Keep food in containers with tight-fitting lids
 Use the toilet properly. Make sure that all urine and faeces goes
into the pedestal pan and that the toilet is flushed after use. Toilet
paper is the only kind of paper that should be flushed down the
toilet.
 Make sure the toilet is clean and the cistern works correctly
 Make sure that all septic tanks and leach drains are well sealed

 Biological Control Methods

 Biological control methods can also be used to control pests. These
methods include using natural enemies of the pest and biologically
interfering with their ability to breed. Pesticides are not used.
  BUILT ENVIRONMENT
 Refers to the human-made surroundings that provide the setting for
human activity, ranging in scale from buildings and parks or green
space to neighborhoods and cities that can often include their
supporting infrastructure, such as water supply or energy networks.
 Our built environment includes all the human-made physical spaces
where we live, recreate and work. These include our buildings,
furnishings, open and public spaces, roads, utilities and other
infrastructure. These structures and spaces affect our health by bringing
pollutants into our environments and by allowing or restricting access
to physical activity, transportation and social interactions.

Indoor Environments and Health

 Because close to 90 percent of time is spent indoors on average in
developed countries, and because indoor spaces in developing nations
are often greatly impacted by burning solid fuels, indoor
environments have a huge potential to influence health
worldwide.The features of our indoor environments that can affect
our health and well-being include noise, temperature, humidity and
mold, light, air quality, lead paint, electromagnetic and radio
frequency radiation and water quality.
Air Quality
 Indoor environments can concentrate some pollutants such that indoor
levels can be many times higher than outdoor levels. Poor indoor air quality
may increase rates of asthma, allergies, and infectious and respiratory
diseases.
1. Radon
2. Carbon Monoxide
3. Particulate Pollution
 Cooking
 Burning of fuels, candles and other material
 Smoking
 Some electronics, such as laser printers
4. Chemicals

Water Quality
 The built environment's plumbing infrastructure can affect water quality,
Lead pipes or solder either within buildings or connecting buildings to water
mains can contaminate water coming into homes with enough lead to cause
permanent harm to children's brains and also affect adult health.
 Chlorine and other disinfectants added to water can interact with other
materials in water to create disinfectant by-products, such as
trihalomethanes and haloacetic acids. These by-products are associated with
some forms of cancer, reproductive health impacts and neural tube
defects in fetuses. Indoor chlorinated swimming pools can be a significant
source of exposures to chlorine and by-products.
 Fluoride may be added to municipal water supplies, and in some places
occurs naturally in water. High levels can have health impacts, including
dental fluorosis, joint pain, bone deformity, and adverse cognitive
development in children
Lead Paint
 Small chips of flaking paint can adhere to hands or dusty surfaces and then
be transferred to food and ingested. Crawling children and toddlers are
especially likely to encounter paint chips on floors, and they often put their
hands in their mouths.
 Lead is toxic to people of any age but is especially damaging to fetuses and
young children. Very small amounts of lead cause permanent brain and
neurological damage to children. Other health impacts include reproductive
health effects, anemia, renal disease, cataracts, coronary artery
disease, hearing loss, hypertension, psychiatric disturbances, seizures and
more.

Pesticides
 Pesticides are often used to control insects, rodents and other pests within
buildings, where residues on surfaces and in the air can expose occupants.
Various pesticides are associated with cancer, neurodevelopmental
impacts, reproductive impacts, asthma attacks, immune suppression,
hearing loss, psychiatric disturbance and other effects.

Humidity and Mold

 Humidity levels in buildings affect our comfort levels, but of much greater
importance is the contribution of high humidity to the growth of mold and
some bacteria. All mold needs to thrive is water and a food source, which is
readily available in buildings from wood, paper, tile glue, rugs and other
textiles, sheetrock and other building materials.
 Symptoms and conditions associated with mold include nasal stuffiness, eye
irritation, wheezing or skin irritation. People with serious allergies to molds
may have more severe reactions, and mold exposures have been found to
contribute to asthma incidence and episodes in children.
Excess water or moisture in indoor environments can accrue from
these sources:

 leaking plumbing
 inadequately ventilated showers, laundry areas and
cooking areas; dishwashers can also create steam
 seepage into basements and crawl spaces
 overflow from heavy rain or floods

Noise
 Noise levels indoors can sustained level at which hearing loss
occurs. Excessive indoor noise can come from appliances, such as hair dryers
and kitchen exhaust fans, or from music, television or recreational
electronics. Noise from outside buildings can also intrude into indoor spaces:
traffic, trains, airplanes, heavy equipment, generators, lawn equipment,
fireworks and more.
 Lower levels of noise can produce sleep disturbance, cardiovascular
effects including heart attacks and stroke, learning impairment, psycho
physiological effects, psychiatric symptoms and impaired fetal development.
Noise also has widespread psycho-social effects including noise annoyance,
reduced performance and increased aggressive behavior.

Light
 Artificial light has changed many
aspects of human life, from allowing us to
be productive long outside daylight hours
to reducing the risk of damage and injury
from uncontrolled fire. Light has its
negative side, however, in disrupting
 circadian rhythms of sleep and wakefulness. Early research indicates that
artificial light, and especially blue light from electronic screens and some
energy-efficient bulbs, may contribute to the incidence of chronic disease
and obesity.

Temperature
Our ability to heat and cool indoor environments has a huge impact not only on
comfort but on our health. Controlled temperature environments bring these
benefits.

 Reduce heat's exacerbation of many chronic diseases and, at extreme levels,

damage to the brain, heart, lungs, kidneys and liver
 Reduce heat stroke
 Reduce hypothermia and its effects on cardiovascular health
 Reduce deaths from either heat or cold

At the same time, the built environment can create problems by concentrating
ambient heat and creating urban heat islands. The annual mean air temperature
of a city with one million people or more can be 1.8–5.4°F (1–3°C) warmer than
its surroundings. In the evening, the difference can be as high as 22°F (12°C).
Indoor temperatures can be considerably greater than in nearby rural
areas. Dense urban areas without indoor cooling can experience substantial
health impacts during heat episodes.

Outdoor Built Environments

Transportation
Beginning with the invention of the automobile, and accelerating after World
War II, environments from neighborhoods to regions worldwide have been
designed or adapted to allow and
promote automobile and other vehicle use.
These decisions and designs have had far-reaching consequences for
communities and societies:

 Increased road construction and maintenance

 Promoted neighborhood sprawl
 Increased traffic noise, pollution and congestion
 Increased reliance on petroleum
 Reduced opportunities for walking and other active transportation

These consequences all have implications for our health. Designing or altering
transportation systems to focus on clean community transit and walkability
could have far-reaching public health benefits.

Road Construction and Maintenance

More vehicle use generally means more paved roads and parking lots. Building
and maintaining roads release toxic fumes and involve polluting and noisy
heavy equipment. Rain runoff from roads and parking lots impacts water quality
and can increase levels of heavy metals in water.

Increased Traffic
Traffic noise-can directly impact health. For example, a 2016 study found that
the risk of myocardial infarction (heart attack) rose with exposure to road noise
or railroad noise. The association was strongest, and extended to airplane noise,
among those whose heart attacks were fatal. Traffic noise is also associated
with impacts on respiratory and metabolic health.

Air pollution -from vehicles includes

several pollutant types: fine particulate
matter (PM), air toxicants, and volatile
organic compounds (VOCs), carbon
monoxide and nitrogen oxides which
combine to form ground-level ozone (smog). Traffic pollution contributes to
poor respiratory and cardiovascular health, and it is a factor in preterm birth,
low birth weight, miscarriage and stillbirth. Early research has connected air
pollution to poor cognitive performance, both in children and in elders.
Traffic congestion-has both direct and indirect costs to societies beyond the
pollution it generates’
Longer driving times and more frequent commuting by car are associated with
these health effects:

 Weight gain, even among physically

active adults
 Higher cholesterol levels
 Higher blood sugar
 Lower cardiorespiratory fitness
 Higher continuous metabolic score
 A higher tendency toward depression, anxiety, and social isolation
 A greater risk of hypertension
 More traffic accidents

Reliance on Petroleum

Although there has been some movement toward vehicles that are not powered
by fossil fuels, as yet the overwhelming majority of vehicles rely on petroleum
products.

The oil and gas industry is the largest industrial source of emissions of volatile
organic compounds (VOCs), which contribute to the formation of ground-level
ozone. Exposure to ozone is linked to aggravated asthma, increased emergency
room visits and hospital admissions, and premature death.

Every stage of petroleum production and use impacts health:

 Exploration, drilling and extraction- involve road building, use of heavy
equipment (often diesel-powered) and increased vehicle traffic, with health
effects. Studies found moderate evidence that oil and natural gas extraction
increase risks of preterm birth, miscarriage, birth
defects, decreased semen quality and prostate
cancer.
 Refining petroleum releases hazardous toxicants
including particulates, sulfur oxides, carbon
monoxide, hydrocarbons, benzene, aldehydes and ammonia.
 Transporting crude oil and refined petroleum products produces pollution
on shipping lanes, at ports, along railways and on highways all along
shipping routes.
 Oil and fuel spills can and often do happen at any stage of extraction and
transporting oil. Crude oil contains hundreds of substances, many of which
are known carcinogens and have other health impacts
 Consumption of the final products: Both the vapors from gasoline and the
substances produced when it is burned (carbon monoxide, nitrogen oxides,
particulate matter, and unburned hydrocarbons) contribute to air pollution.
Burning petroleum products also releases carbon dioxide, which contributes
to climate change.

Energy and Heating

The introduction of electricity to buildings has had a huge positive impact on
quality of life and health worldwide. In fact, lack of reliable electric power is a
health concern: many parts of the world do not have reliable access to
electricity in their health care facilities, impeding their ability to care for
patients during night time hours, to operate equipment, store medications and
vaccines, manage hazardous waste and even pump water. The ways we heat
our buildings and power our electricity have widespread impacts on our
outdoor environments and health, with huge differences in impacts depending
on the sources of electricity.
Built Environment and Socioeconomic Status

The built environment interacts with socioeconomic

status: inequitable distributions of power, money
and resources create inequitable access to built
environments that support health. Poverty, age and
mobility also make some populations more
vulnerable to built environment-related disease
than others. Youth, elderly, those with limited
incomes and people with disabilities
disproportionately experience poor built
environments, such as those with high traffic
volumes, noise and crime rates, or neighborhoods close to polluting industries.
Indoor environments in low-income areas are more likely to expose residents to
lead paint and mold. Exposure to more toxicants and fewer opportunities to
engage in physical activity are a double whammy against low-income and
disabled people.

Built Environment and Mental Health

Exposures like noise, air pollution, overcrowding and a lack of access to nature
can increase our physical and emotional stress. Conversely, integrating
opportunities to interact with nature into the way we build our cities can have
positive effects on our health, including allowing us to think more clearly and to
reduce stress.

Built Environment Scale

Two scales of the built environment are typically considered: the regional and
the local.

The regional scale considers major areas of population and how people get to

and interact with places of employment and housing. Considerations include
transportation to and from work, housing availability and cost, and school
district and neighborhood quality. Healthier regional built environments focus
on pedestrian-friendly design.

The local scale, or that of the neighborhood, also focuses on transit but more on
household travel needs. The distance to frequent destinations, such as grocery
stores, schools and recreation areas, and the ease of traveling by foot or bike
both impact a person’s choices of active transportation. In disconnected
neighborhoods, families often have to drive to access schools or recreational
areas

A. MONITORING AND EVALUATING COMMUNITY HEALTH PROGRAMS

IMPLEMENTED
 Having a Healthy Communities Program evaluation strategy ensures that
national program objectives are described and measured. Evaluation
results will be used to document funded community and partner
challenges and successes, as well as to inform similar programs working
to promote and replicate Healthy Communities Program environmental
change strategies. Assessment activities will address process, outcome,
and impact measures. Local communities, national partners, and CDC
will be responsible for various aspects of program monitoring and
evaluation.
 Monitoring a process of measuring, recording, collecting and analyzing
data on actual implementation of the programme and communicating it
to the programme managers so that any deviation from the planned
operations are detected, diagnosis for causes of deviation is carried out
and suitable corrective actions are taken.
 Evaluation It is a systematic way of learning from experience and using
the lessons learnt to improve current activities and promote better
planning by careful selection of alternatives for future action.
 Used to assess the performance of projects, institutions and programs
set up by governments, international organizations and NGOs. Its goal is
to improve current and future management of outputs, outcomes and
impact.
  Monitoring is a continuous assessment of programs based on early
detailed information on the progress or delay of the ongoing assessed
activities.
 An evaluation is an examination concerning the relevance,
effectiveness, efficiency and impact of activities in the light of specified
objectives.
 Monitoring and evaluation processes can be managed by the donors
financing the assessed activities, by an independent branch of the
implementing organization, by the project managers or implementing
team themselves and/or by a private company. The credibility and
objectivity of monitoring and evaluation reports depend very much on
the independence of the evaluators. Their expertise and independence is
of major importance for the process to be successful.

1. DESIGNING AND IMPLEMENTING EVALUATION PLAN

 Evaluation plan is an integral part of a grant proposal that provides
information to improve a project during development and
implementation.
 To generate a good plan means logically working through a series of issues.
 stakeholders and their concerns
 constraints
 translate concerns into key evaluation questions
 selection of data gathering methods to address key questions that are to be
the focus
 Steps on designing and impleting evaluation plan:
When do you make a plan:
 Planning for evaluation should occur as part of the other planning activities
associated with project start up.
Form a team:
 An evaluation group should be established and basic management issues
need to be addressed
Identifying stakeholder:
 Understanding the stakeholders and the audience of the evaluation report(s)
will shape:
 the goals/objectives of the evaluation
 the questions to be asked and when
 the methods of data collection, analysis and reporting
Identifying concerns:
 takeholders will likely differ in their concerns and what they want to find
out, but these are not necessary mutually exclusive.
 Concerns will vary from project to project.
 Concerns will change over the life of the project.
Stages:
 Pre-implementation
Which concerns need to be addressed during the design and development
of the project?
 Post-implementation
 Short term
 Medium term
 Long term
Constraints:
 These factors will determine the size and scale of the evaluation and what
the evaluation team can do practically.
 Budget and resources
 Time
 Availability of competent staff
 Pre-specified evaluation objectives, methodologies and/or reporting
procedures
 Legal or ethical issues
 Availability of data
 Political’ considerations
The questions:
 You must spend time on getting the evaluation questions right.
 OR, you may get the wrong answers, or answers to questions you didn't ask
or want to know about.
 Action Questions
 High Value Questions

Data gathering:
 It is best to use a number of data gathering techniques and/or sources of
data to substantiate findings.
 This is known as a process of triangulation — the use of multiple
investigative methods or information sources to get the answer to the
question at hand.
Data sources:
 Students — prospective, current, past, withdrawn
 Colleagues — teaching partners, tutors, teachers external to the project
 Discipline/instructional design experts
 Professional development staff
 Graduates and employers
 Documents and records — teaching materials, assessment records, past
SETLs, assessment statements and tasks
Selecting methods:
 Paradigm for the study (empirical, interpretive, critical theory-based,
pragmatic)
 Time involved in preparing to use the particular method/tool (e.g.
preparation of a bank of questions for a questionnaire)
 Time involved in gathering or recording the data — on the part of the data
collector; on the part of the 'evaluee/s'
 the time needed to analyse and report the data
 the scale involved — the number of students, staff required for
valid/authentic data.
Method:
  The skill/expertise required to use the method
 The expertise, personnel and/or resources required to analyze and/or
report the data.
Storing the data:
 Making sure that data is safe and not lost
 Thinking through filing categories; e.g. by question type; data source; data
method
 Considering confidentiality requirements & other safeguards arrangements
to access data
Ethical consideration:
 In any evaluation, the rights and welfare of 'subjects' need to be respected
and protected.
 Privacy: Some data gathering techniques may be perceived as an invasion
of privacy if prior consent on the part of the subject(s) has not been gained.
 Confidentiality: Much information that subjects provide is given in
confidence unless specific permission to use 'private' information.

 MONITORING
 Continuous assessment that aims at providing all stakeholders with early
detailed information on the progress or delay of the ongoing assessed
activities. It is an oversight of the activity's implementation stage. Its
purpose is to determine if the outputs, deliveries and schedules planned
have been reached so that action can be taken to correct the deficiencies
as quickly as possible.
 Good planning, combined with effective monitoring and evaluation, can
play a major role in enhancing the effectiveness of development
programs and projects. Good planning helps focus on the results that
matter, while monitoring and evaluation help us learn from past
successes and challenges and inform decision making so that current and
future initiatives are better able to improve people's lives and expand
their choices.
 Monitoring and Evaluation is used to assess the performance of projects,
institutions and programmes set up by governments, international
 organisations and NGOs. Its goal is to improve current and future
management of outputs, outcomes and impact.

 EVALUATION
 Process that critically examines a program. It involves collecting and
analyzing information about a program's activities, characteristics, and
outcomes. Its purpose is to make judgments about a program, to
improve its effectiveness, and/or to inform programming decisions.
 Evaluation is a systematic determination of a subject's merit, worth and
significance, using criteria governed by a set of standards. ... The primary
purpose of evaluation, in addition to gaining insight into prior or existing
initiatives, is to enable reflection and assist in the identification of future
change.

2. TYPES OF EVALUATION
 PLANNING
 Process of deciding in advance where we want to get to (our goal)
and how we will get there.
 helps us to decide what that contribution should be and how to
achieve it.
 evaluation plan is a written document that describes how you will monitor
and evaluate your program, as well as how you intend to use evaluation
results for program improvement and decision making. The evaluation
plan clarifies how you will describe the “What,” the “How,” and the “Why
It Matters” for your program.

 FORMATIVE
 Method for judging the worth of a program while the program
activities are forming (in progress).
 Ongoing, flexible, and more informal diagnostic tool.
 A formative evaluation (sometimes referred to as internal) is a method for
judging the worth of a program while the program activities are forming (in
 progress). They can be conducted during any phase of the process. This
part of the evaluation focuses on the process.

 SUMMATIVE
 Evaluation of the sum product of the lesson.
 More formal, structured, and often used to normalize performance
so they can be measured and compared.
 Summative assessment, summative evaluation, or assessment of learning
is the assessment of participants where the focus is on the outcome of a
program. This contrasts with formative assessment, which summarizes the
participants' development at a particular time.

3. STEPS OF PROGRAM EVALUATION

 The program evaluation process goes through four phases — planning,
implementation, completion, and dissemination and reporting — that
complement the phases of program development and implementation.
Each phase has unique issues, methods, and procedure
 Six connected steps together can be used as a starting point to tailor an
evaluation for a particular public health effort, at a particular point in
time. An order exists for fulfilling each step – in general, the earlier
steps provide the foundation for subsequent progress.
 Engage stakeholders, including those involved in program
operations; those served or affected by the program; and
primary users of the evaluation.
 Describe the program, including the need, expected effects,
activities, resources, stage, and context and logic model.
 Focus the evaluation design to assess the issues of greatest
concern to stakeholders while using time and resources as
efficiently as possible. Consider the purpose, users, uses,
questions, methods and agreements.
 Gather credible evidence to strengthen evaluation judgments
and the recommendations that follow. These aspects of evidence
gathering typically affect perceptions of credibility: indicators,
sources, quality, quantity and logistics.
 Justify conclusions by linking them to the evidence gathered and
judging them against agreed-upon values or standards set by the
stakeholders. Justify conclusions on the basis of evidence using
these five elements: standards, analysis/synthesis,
interpretation, judgment and recommendations.
 Ensure use and share lessons learned with these steps: design,
preparation, feedback, follow-up and dissemination.