HANDOUT NO.

1  Health services
OVERVIEW OF CHN  Gender
Public Health 3. Nursing (means to achieve the health
 The science and practice of protecting product)
and improving health of the  Focused on detailed orientation care of
community, as by preventive medicine, individuals, families and communities in
health education, control of attaining, maintain and recovering
communicable diseases, application of optimal health and functioning.
sanitary measures and monitoring of  Nursing process
environmental hazards.
Important points in the definition of CHN
 ‘’TO ENABLE EVERY CITIZEN TO REALIZE
HIS BIRTHRIGHT TO HEALTH AND
LONGEVITY’’.
 The art of applying science in the The goal = promotion and preservation of the
context of politics so as to reduce health of population
inequalities in health while ensuring the
best health for the greatest number.
The nature = comprehensive, general, continual
Important terms: and episodic
1. Community (Recipient of care)
 Group of people sharing common
geographical boundaries, values, The knowledge = comes from nursing and public
interests and characteristics; common health
rights and privileges, same laws and
regulation.
2. Health CHN deals with different levels of clientele
 A state of complete physical, mental
and social well-being and not merely
the absence of disease or infirmity
The practitioner’s recognition of the population
(WHO)
as a whole
 Multi-dimensional
1947: DOH was divided into three bureaus:
Determinants of Health:
 Hospital
 Income and social status
 Quarantine
 Education
 Health
 Physical Environment
 Employment and working conditions Strengths of CHN
 Social support networks and politics
 Culture  There is greater control for both the
 Genetics client in making decisions
 Personal Behaviour
  There is equal collaboration of nurse  Transfer of power and authority from
and client national to local
 Recognition of different factors that  AIM: to build a self-government and
affect the health of community self-reliance in each community
 The nurse has wide-range of awareness  Creation of the local health board which
of their clients and situations concerns budget proposals, operations
and maintenance of health facilities and
Individual services.
 Sick or well
Before RA7160
 Seen in daily basis
 Seen in community-based activities  DOH principal agency that has direct
 Can be an entry point in working with authority over municipal city, provincial
family. health and hospital services.

Family The municipal and city health services and

hospitals were placed directly under the mayor.
 Basic unit of care
 Composed of two or more persons who Provincial health services and hospitals are
are joined together by bonds of sharing under the governor
and emotional closeness (Friedman)
 Performs 2 major functions: Only regional officers and some hospitals
o Reproduction remained under control of DOH
o Socialization HISTORY OF CHN IN PHILIPPINES
 Can be contributions in health
development and nursing problems 1901
 Can be source of support of each
 Act No.157 of the Philippines
members
Commission created a Bored of Health
 Social changes can affect the concept of
of the Philippines.
family
1905
Population Group
 Act No.1407 (Reorganization Act)
 Group of people who shares common
abolished the Board of Health and its
characteristics, developmental stage
Function and activities were taken over
and health problem
by the Bereau of Health under the
Community Department of interior.

 Functions within a particular socio- 1915

cultural context (no communities are
 The Bureau of Health was renamed
alike)
Philippine Health Service with a director
Republic Act 7160 of Health as its Head. The office of
District Nursing was also created due to
 increasing demands of nurses to work students in medicine, nursing, health
outside the Hospital, in the homes and education, nutrition and social work.
the need for direction, supervision and The first Supervising Training Nurse was
guidance of public health nurses. Miss Martha Obana.

1927 1953

 Philippine Health Service was abolished  Philippine Congress approved Republic

and supplanted by the section of Public Act No. 1082 or the rural health law. It
Health Nursing Mrs. Genara De Guzman created the first 81 rural health units.
acted as consultant to the Director of
health on Nursing Matters. 1975

 The functions of the health team

December 08, 1941
members ( Municipal Health Officer
 At the outbreak of World War II, Public ,Public Health Nurse, Rural Health
Health Nurses in Manila were assigned Midwife, Rural Sanitary Inspector) were
to devastated areas to attend to the redefined. The roles of public health
sick and wounded. nurse and the midwife were expanded.

June 1942 1990-1992

 A group of Public Health Nurses with  The Local Government Code (R.A. 7160)
physicians and administrators of Manila was passed and implemented.
Health Department went to the Devolution.
internment camp in Capas,Tarlac, to
receive sick prisoners of war released 2002
by the Japanese army.  R.A.9173 or the Philippines Nursing Act
1948 expanded the roles of nurses in both
hospital and community-based practice.
 The first training center of the Bereau of
Health was organized. Physicians and 2009
Nurses undergoing preservice and in-  Commision on Higher Education (CHEd)
service training in public health/public Memorandum Order (CMO) Number
health nursing as well as student nurses 14, Series of 2009. Policies and
on affiliation were assigned to the standards for Bachelor of Science
above training center. Nursing Program.
1950 Goal
 Organization of Rural Health  To raise the level of health of every
Demonstration and Training Center. citizenry
This was use a laboratory for the field of  To help communities and families cope
experience of graduated and basic with the discontinuities in health and
 threats in such a way as to maximize  CHN must provide educative
their potential for high level wellness supervision
 To promote reciprocally supportive  CHN must have proper documentation
relationship between people and their
physical and social environment ROLES OF NURSE IN CHN
 To uplift the health of every Filipino Planner/Programmer
citizen
 Identified needs, priorities and
Concepts problems of Individual, Families and
 Primary focus is on HEALTH Community
 Formulates and implements nursing
PROMOTION
 Benefits not only the individual but the plan, program policies and
WHOLE family and community memorandum
 Womb to tomb care
 Client contact may continue over long
period of time includes all ages and all Provider of Nursing Care
types of health care
 To sick and disabled
 Requires current knowledge derived
from biological and social sciences, Manager/Supervisor
clinical nursing and community health
organization be utilized  Organizes, workforce, resources,
 Nursing process equipment, supplies and delivery of
health care
PRINCIPLES OF CHN  Requisition, allocation and distribution
of materials
 CHN practice must be based on needs
 Regular visits and meeting to different
of client
RHMs
 CHN must know the laws that governs
the practice Community Organizer
 Family is an important client
 Service for all  Motivates and enhances community
 Health teaching is the first responsibility participation
 CHN collaborates with other healthcare
Coordinator of service
team
 Evaluation of CHN service to improve  Coordinates with Individual, Family and
itself Community and groups for health and
 CHN must continue to pursue higher health-related services
level of education  Coordinates nursing program with other
 CHN must be resourceful health program
 CHN should make use of existing
community group Educator
  Identifies and interprets training needs
of RHMs, BHWs and hilots
 Formulates and conducts training
 Acts as resource speaker
 Development and distribution of
information material
 Pre-marital counselling

Evaluator

 Detects deviation from health

 Uses symptomatic and objective
observation to determine health status
of IFC

Role Model

 Example of healthy living

Change Agent

 Motivates modification in health

behaviour

Statistician

 Prepares and submits required reports

and record

Researcher

 Participates in conduction of surveys,

studies and research
 Coordinates with government
HANDOUT NO. 2 e.g: ONA, JBL, Mabalacat
district
HEALTH CARE DELIVERY SYSTEM IN THE
PHILIPPINES 2. Private Sectors – largely market-
oriented and utilizes users fee to finance health
 A nation’s health care delivery system services.
has a tremendous impact not only on
the health of its people but also on their 2.1 Commercial or business –
total development, including their profit-oriented such as private clinics,
socio-economic status. laboratories and practitioners.

WHO 2.3 Non-commercial – service-

oriented such as socio-civic groups, religious
 Founded in 1945 as a specialized agency
organizations or foundations.
of the UN
 147 country offices 30% - uses private health facilities
 6 world regional offices
70% - health professionals employed in
OBJECTIVE: this sector

 The attainment by all peoples of the Department of Health

highest possible level of health
 National agency mandated to lead the
CORE FUNCTIONS: health sector towards assuring quality
health of every Filipino.
 Providing leadership  Over-all technical authority on health
 Shaping the research agenda and  National health policy-maker and
stimulating the generation regulatory institution.
 Setting norms and standards and
VISION BY 2030:
promoting and monitoring their Global leader for attaining
implementations better health outcomes, competitive
 Articulating ethical and evidence-based and responsive health care system and
policy options equitable health financing
 Providing technical support, catalysing MISSION:
change and building sustainable To guarantee equitable,
institutional capacity by offering sustainable and quality health for all
trainings in the field of MCH Filipinos, especially the poor and to lead
2 SECTORS OF HEALTH CARE DELIVERY SYSTEM: the quest for excellence in health.

1. Public Sector – financed through a tax- 3 MAJOR ROLES specified in EO 102

based budgeting system at national and series 1999 (former president joseph
local levels, where health care is given Estrada on may 24, 1999)
for FREE 1. Leadership in health
 2. Enabler and capacity 2. Providing specific programs
builder components for conditions that affect
3. Administrator of specific large segments of population, such as
services tuberculosis, malaria, schistosomiasis,
HIV/AIDS, and micronutrient deficiency.
Function in the Leadership role: 3. Developing of strategies for responding
1. Planning and formulating policies of to emerging health needs
health programs and services 4. Providing leadership in health
2. Monitoring and evaluating the emergency preparedness and response
implementation of health programs, services, including referral and
projects, research, training and services networking system for trauma,injuries
3. Advocating for health promotion and and catastrophic events.
healthy lifestyle LEVELS OF HEALTH CARE FACILITIES AND
4. Serving as technical authority in disease
REFERRAL CENTERS:
control and prevention
5. Providing administrative and technical 1. General Hospital – provide services for
leadership in health care financing and all kinds of illness, injuries or
implementing the National Health deformities.
Insurance Law A. Primary Care Facility
 first contact facility that offers basic
Functions in the role as enabler and capacity services including emergency services
builder: and provision for normal deliveries.
1. Providing logistical support to LGUs, the  Includes health centers, out-patient
private sector and other agencies in clinics, dental clinics, short-stay facilities
implementing health programs and like infirmaries and lying-in facilities
services B. Custodial Care Facility
2. Serving as the lead agency in health and  Provides long-term care including basic
medical research services like food and shelter to
3. Protecting standards of excellence in patients with chronic conditions
training and education of health care requiring on-going health and nursing
providers at all levels of the health care care due to impairment and reduced
system degree of independence in ADLs and
patients in need of rehabilitation.
Functions in the role as administrator of specific  Custodial psychiatric facilities,
services: substance/drug abuse tx and
rehabilitation centers,
1. Administrator of referral centers for
sanitaria/leprosaria and nursing homes.
local health system such as tertiary and
C. Diagnostic/Therapeutic Facility
special hospital, reference laboratories,
 A facility for the examination of the
training centers, center for health
human body, specimens from the
promotion, center for disease control
human body for the diagnosis,
and prevention and regulatory offices.
 sometimes tx of dse or water for  Public Health Nurse
drinking water analysis.  Rural Sanitary Inspector
Category classified into:  Rural Health Midwife
A. Laboratory facilities such as  Barangay health worker
clinical, HIV testing, Blood
service, drug testing, PHN functions:
newborn screening and A. Supervises and guides all RHMs in the
laboratory for water municipality
analysis. B. Prepares FHSIS quarterly/annual
B. Radiologic facility providing reports of the municipality submission
services such as X-ray, CT to provincial health office
scan, mammography, MRI C. Utilizes the nursing process in
and ultrasonography. responding to health care needs,
C. Nuclear medicine facility is including health education and
regulated by the PNRI promotion of individuals, families and
utilizing applications of communities
radioactive materials in D. Collaborates with other members if the
diagnosis, tx or medical health team, gov. agency, private
research with the exception business, NGOs and people’s
of the use of sealed organization to address the
radiation sources in community’s health problems.
radiotherapy as in internal
radiation therapy.
2. Specialty Hospitals – services for
specific disease or condition or type of
patient such as children and elderly.
e.g: dialysis clinic, ambulatory clinic,
cancer chemotherapeutic clinic, cancer
radiation facility and physical medicine
and rehabilitation center/clinic

Rural Health Unit

 Known as health center, primary care

facility
 Focuses on preventive and promotive
health services and supervision of BHSs
under its jurisdiction
 1 RHU:20,000 population

RHU PERSONNEL:

 Municipal Health officer