COMMUNITY HEALTH NURSING 1 values of freedom, equality, solidarity, tolerance, health respect for  Culture.

om, equality, solidarity, tolerance, health respect for  Culture. Customs and traditions, and the beliefs of the family and
nature and shared responsibility. community all affect health.
NCM 104  Genetics. Inheritance plays a part in determining lifespan,
COMMUNITY healthiness and the likelihood of developing certain illnesses.
Course learning:  a group of people with common characteristics or interests living  Personal behavior and coping skills. Balanced eating, keeping
 Assess with the individual and family one’s health together within a territory or geographical boundary active, smoking, drinking, and how we deal with life’s stresses and
status/competence.  place where people under usual conditions are found challenges all affect health.
 Formulate with the client a plan of care to address the health  Derived from a latin word “comunicas” which means a group of  Health Services. Access and use of services that prevent and treat
conditions, needs, problems, and issues based on priorities. people. diseases influence health.
 Implement safe and quality interventions with the client to  Gender. Men and women suffer from different types of diseases at
address the health needs, problems, and issues. different ages.
 Provide health education using selected planning models to COMMUNITY HEALTH NURSING
targeted clientele (individuals and families) in the community.  “The utilization of the nursing process in the different levels of HEALTH CARE DELIVERY SYSTEM
 Participate in the research study as member of a research team. clientele-individuals, families, population groups and  It is the totality of “societal services and activities designed to
 Ensure working relationship with the individual and family based communities, concerned with the promotion of health, prevention protect or restore the health of individuals, families, groups and
on trust, respect and shared decision-making using appropriate of disease and disability and rehabilitation.” (Maglaya, et al) communities.
communication/interpersonal techniques/strategies.  It includes both government and non-government health facilities
 Ensure intra-agency, inter agency, multidisciplinary and sectoral  Goal: “To raise the level of citizenry by helping communities and (hospitals, clinics, diagnostic centers, health centers), programs,
collaboration in the delivery of health care. families to cope with the discontinuities in and threats to health in services and activities (preventive, promotive, curative and
 Implement strategies/approaches to enhance/support the such a way as to maximize their potential for high-level wellness” rehabilitative).
capability of the client and care providers to participate in decision (Nisce, et al)  Preventive health care is a major concern of the government-
making by inter-professional team. owned health centers while curative care is provided by hospitals,
 Collaborate with other members of the health team in the  Special field of nursing that combines the skills of nursing, public both government and private.
implementation of programs and services. health and some phases of social assistance and functions as part
 Coordinate the task/functions of other nursing personnel of the total public health program. WHAT IS COMMUNITY HEALTH?
(midwife, BHW, and utility workers).  A part of paramedical and medical intervention or approach which
 Collaborate with GOs, NGOs and other socio-civic agencies to The following statement characterize CHN: is concerned with the health of the whole population.
improve the health care services, support environment protection  Promotion of health and prevention of disease are the goals of  A discipline that concerns with the study and betterment of the
policies and strategies, and safety and security mechanisms in the professional practice; health characteristics of biological communities.
community.  CHN practice is comprehensive, general, continual and not  Its aims are:
 Evaluate with the client the health status competence. episodic; 1. Health promotion
 Institute appropriate corrective actions to prevent or minimize  There are different levels of clientele --- individuals, families, and 2. Prevention of disease
harm arising from adverse effects. population groups and the practitioner recognizes the primacy of 3. Management of factors affecting health
the population groups as a whole;
OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES  The nurse and the client have greater control in making decisions
related to health care and they collaborate as equals; PUBLIC HEALTH (DEFINITIONS)
A. GLOBAL AND NATIONAL HEALTH SITUATIONS  The nurse recognizes the impact of different factors on health and Major concepts of Public health:
- Public health systems are operating within a context of has a greater awareness of his/her client’s lives and situation. 1. Health promotion and disease prevention
ongoing changes, which exert a number of pressure on the 2. People's participation towards self-reliance: active and full involvement
public health system. with people in the decision-making process:
DETERMINANTS OR THINGS THAT MAKE PEOPLE HEALTHY OR NOT - - assessment, planning, implementation, monitoring and evaluation.
1. Shift in demographic and epidemiological trends in diseases, WHO
including the emergence and re-emergence of new diseases and in  Income and social status. Higher income and social status are Dr CE Winslow:
the prevalence of risk and protective factors. linked to better health. The science and art of preventing disease, prolonging life, promoting health
2. New technologies for health care, communication and information;  Education. Low education levels are linked with poor health, more and efficiency through organized community effort.
3. Existing and emerging environmental hazards some associated stress and lower self confidence
with globalization;  Physical Environment. Safe water and clean air, healthy Hanlon:
4. Health reforms. workplaces, safe houses, communities and roads all contribute to It is dedicated to the common attainment of the highest level of physical,
good health. mental and social wellbeing and longevity consistent with available
- In response to above trends, the global community, represented by  Employment and working conditions. People in employment knowledge and resources at a given time and place. It holds this goal as its
the United Nations General Assembly, decided to adopt a common are healthier, particularly those who have more control over their contribution to the most effective total development and life on the
vision of poverty reduction and sustainable development in working conditions. individual and this society. (Holistic)
September 2000. This vision is exemplified by the Millennium  Social support networks. Greater support from families, friends
Development Goals (MDG) which are based on the fundamental and communities is linked to better health. Purdom:

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It prioritizes the survival of human species, the prevention of conditions 1. Garbage crematory
which lead to the destruction or retardation of human function and potential 2. First sanitary ordinance and rat control COMMUNITY HEALTH NURSES’ ROLES
in early years of life, the achievement of human potential and prevention of 3. Cholera vaccine was first tried 1. Disease prevention specialist/ Clinician
the loss of productivity of young adults and those in the middle period of life 4. Confirmed that plague in man comes from  Focus is on the health of the population or individuals on the
and the improvement of the quality of life especially in later years. infected rat larger context of the community. Provide nursing care to the sick
5. Opened the UP College of Medicine and disabled in order to reduce disease, discomfort, disability, and
6. Establishes Bureau of Science premature death, among others.
Nightingale :
The act of utilizing the environment of the patient to assist him in his 2. Community educator
recovery. Any individual is capable of reparative process. 3. PHILIPPINE ASSEMBLY  Acts as health educator which is one of the most important roles in
1. Hygiene and Physiology were included in curriculum of public CHN. They provide information to individuals, families, and
HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES elementary school communities that create a framework for healthy living and
History of Public health in the Philippines based on socio-political periods 2. Anti-TB campaign was started healthy choices. In schools they may teach sex education and HIV
1. Pre-American Occupation (up to 1898) 3. Philippine Tuberculosis Society was organized education classes. Overall, they focus on community health
2. American Military Government (1898-1907) 4. Opening of PGH (Phil. Gen. Hospital) education as a step to preventive health care. Enables clients to
3. Philippine assembly (1907-1916) 5. Use of anti-typhoid vaccine was initiated make informed decisions, identifies at risks, and explores learning
4. The Jones law (1916-1936) 6. Dry vaccine against small pox was first use strategies.
5. The Commonwealth (1936-1941)
6. Japanese occupation (1941-1945) 4. JONES LAW YEARS 3. Advocate
7. Post World War II (1945-1972)  Retrogression rather than progression in so far as the health was  Speaks or acts for those who cannot speak/act for themselves. For
8. Post EDSA revolution (1986 to present concern self-care and self-determination.
1. Increase CD
1. PRE-AMERICAN OCCUPATION 2. Increase IMR 4. Researcher
 1577 3. Increase Morbidity  As researchers, community health nurses collect and use evidence
- Public health began at the old Franciscan Convent in Intramuros  Increase deaths from smallpox, cholera, typhoid, malaria and TB to execute positive changes for better health. Research is used to
where Fr. Juan Clemente put up dispensary for treating indigents validate funding for public health programs, reduce inequalities in
in Manila. Laws: healthcare, and increase access to services.
- San Juan de Dios Hospital  EO 39 - which created the Philippines National AIDS Council as a
national policy and advisory body in the prevention and control of 5. Consultant
During Spanish Time HIV-AIDS  Catalyst to bring change, helping people understand processes and
1. Creation of Vaccinators to prevent Smallpox  RA 7719 - the National Blood Services Act of 1994, this to promote actions, and assisting them in making decisions.
2. Creation of Board of Health voluntary blood Donation
3. First medical school in the Philippines- UST  RA 8172 - Salt lodization Nationwide (ASIN), providing salt 6. Collaborator
4. School of Midwifery iodization nationwide approved in 1996 and renamed FIDEL  Brings together strengths and weaknesses of people involved
5. Public Health Laboratory (Fortified for lodine Elimination) toward a common goal. She works with people in the community
6. Forensic Medicine toward a common goal and relies on joint or shared decision
STANDARD OF PUBLIC HEALTH NURSING IN THE PHILIPPINES making.
Hospital before the Americans came to Philippines  It is developed by the National League of Philippine Government
General Hospitals Nurses in 2005 described by the qualification and functions of 7. Counselor
1. San Juan de Dios Hospital Public Health Nurse.  Listen and provides feedback and information, strengthen and
2. Chinese General Hospital  Public Health Nurse must possess personal qualities and “people guides people’s own decision making skills, and explores feelings
3. Hospicio de San Jose in Cavite skills” that would allow her practice to make a difference in the and attitudes for people understand themselves and their
4. Casa dela Caridad in Cebu lives of these people. decisions.
5. Enfermeria de Sta. Cruz in Laguna
Contagious Hospitals This is where her physical, mental and emotional strength will be needed; 8. Case Manager
1. San Lazaro Hospital leadership, resourcefulness, creativity, honesty, integrity will be tested. Her  Coordinates care in a system that is made up of many different
2. Hospital de Palestina in Camarines Sur interest, willingness and capacity to work with people will spell the programs which has different policies, services and missions in
3. Hospital delos Lesporosos in Cebu differences between a token performance and making a difference in the lives order avoid the gaps in services and breakdown in the care
4. Hospital de Argencina in Manila for smallpox and cholera of people. system.

2. AMERICAN MILITARY GOVERNMENT The functions of the PHN are consistent with the Nursing Law 2002 and MANAGEMENT FUNCTIONS OF THE COMMUNITY HEALTH NURSE
 Control of epidemics such as cholera, small pox and plague program policies formulated by the DOH and local government health 1. Planning
 Fight against communicable diseases such as common cold, Hepa agencies. They are related to management, supervision, provision of nursing - entails establishing the mission, vision, philosophy and goals of the
A-D, chickenpox, SARS, flu, mumps, malaria, herpes, STD, measles care, collaboration and coordination, health promotion and education organization.
 Projects and activities: training and research.
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 - Mission of the CHN is to provide and promote healthy lifestyle  Assessment – is the regular collection and analysis of health data 3) Strengthening national and local health systems through the
choices through education, public awareness and community  Policy Development – involves advocacy and political action to implementation of the Health Sector Reform Agenda;
activities. develop policies in various levels of decision making. 4) Improvement of health care management system;
- Objectives of the CHN are the attainment and maintenance of the  Assurance – is making sure that health services are effective, 5) Improvement of health and productivity;
optimum individual and community health. available and accessible to the people. 6) Establishment of drug treatment and rehabilitation centers and
the expansion of existing ones.
2. Organizing The Philippine health care delivery system - CHN
- putting order and system to be able to implement the goals and 1) Department of Health HEALTH SECTOR REFORM AGENDA
achieve the objectives of planning. 2) Millennium Development Goals Towards the end of the 20th century, the DOH has come up with the
3) Medium-Term Philippine Development Plan HSRA 1999-2004 that included the ff reforms:
3 Components: 4) Health Sector Reform Agenda 1) Provide fiscal autonomy to government hospitals;
 Man or the people, in this case, the health workers; 5) FOURmula One for Health 2) Secure funding for priority public health programs;
 Work, which involves machines and equipment; and 6) National Objectives for Health and local health care system 3) Promote the development of local health systems and ensure its
 Interpersonal relationships focusing on holistic and team concept (devolution of health services). effective performance;
approach, leadership and management functions, intersectoral 4) Strengthen the capacities of health regulatory agencies;
collaborations and linkaging.  The DOH leads in efforts to improve the health of Filipinos, in 5) Expand the coverage of the National Health Insurance Program
partnership with other government agencies, the private sector,
3. Directing NGOs and communities. With the exception of a few government
- Involves communicating or conveying to the health workers what agencies (UP and AFP) and affluent cities (Manila, Makati, and ALL FOR HEALTH TOWARDS HEALTH FOR ALL
have transpired during the planning and organizing stages. It gives Quezon City) operating their own health facilities, the DOH Phil Health Agenda – Healthy Philippines – 2022
direction for leadership, motivation and communication. remains to be the national government’s biggest health care
provider. THE HEALTH SYSTEM WE ASPIRE FOR 3 GUARANTEES: GOALS
4. Coordinating
- Involves bringing together people in the health team and “getting  DOH used to have control and supervision overall barangay 1. FINANCIAL PROTECTION
their acts together” so that they will “singing the same tune” stations, rural health units and hundreds of hospitals throughout - Filipinos, especially the poor, marginalized, and vulnerable are protected
resulting in harmony, achievement of objectives, and the the country. from high cost of health care
development of teamwork.
 DOH exercises regulatory powers over health facilities and 2. BETTER HEALTH OUTCOMES
5. Controlling products. It takes the lead in the formulation of policies and - Filipinos attain the best possible health outcomes with no disparity
- A processes which measures and corrects the activities or standards related to health facilities, health products and health
functions of the people so that objectives are met. It clearly sets human resources. It provides the LGUs the necessary support in 3. RESPONSIVENESS
the standards or parameters of the desired performance and managing their local health system. - Filipinos feel respected, valued, and empowered in all of their interaction
outputs based on the set objectives; measures performance with the health system.
criteria; and corrects deviations from normal or below average  DOH has undergone transformations to be more responsive to its
performance. post-devolution functions. One of the major changes at the Central THE HEALTH SYSTEM WE ASPIRE FOR: VALUE
Office is the creation of the Bureau of Local Health Development.  EQUITABLE & INCLUSIVE TO ALL
6. Evaluating  TRANSPARENT & ACCOUNTABLE
- Assessing or appraising performance by comparing it with THE UNITED NATIONS SPEARHEADED THE FORMULATION OF THE  USES RESOURCES EFFICIENTLY
performance standards and performing the needed modifications MDGS WITH THE CORRESPONDING TARGETS:  PROVIDES HIGH QUALITY SERVICES
or revisions. 1) Eradicate extreme poverty and hunger;
2) Achieve universal primary education; During the last 30 years of Health Sector Reform, we have undertaken key
PUBLIC HEALTH 3) Promote gender equality and empower women; structural reforms and continuously built on programs that take us a step
- Is generally regarded as a responsibility of government. 4) Reduce child mortality; closer to our aspiration.
- It is the science and art of preventing disease, prolonging life, and 5) Improve maternal health;
promoting health and efficiency through organized community 6) Combat HIV/AIDS, malaria and other diseases; Milestones
effort; 7) Ensure environmental sustainability;  Devolution
a) for the sanitation of the environment; 8) Develop a global partnership for development.  Use of Generics
b) The control of communicable infections;  Milk Code
c) Education of the individual in personal hygiene; MEDIUM –TERM PHILIPPINE DEVELOPMENT PLAN  PhilHealth (1995)
d) The organization of medical and nursing services for the early 2004-2010 spells out the priority strategies to meet the basic needs of  DOH resources to promote local health system development
diagnosis and preventive treatment of disease; the poor.  Fiscal autonomy for government hospitals
e) The development of the social machinery to ensure everyone s 1) Reduction of the cost of medicines;  Good Governance Programs
standard of living adequate for the maintenance of health. 2) Expansion of health insurance particularly for indigents through  Funding for UHC
premium subsidy;
Today public health can be defined in terms of its 3 Core functions:
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FOURmula One for Health – F1 2. Secondary Level - RA 7160 known as Local Government Code.
- It is the implementation of framework of the HSRA, has 3 goals: - includes smaller, often non-departmentalized hospitals that offer a Aims to: transforms local government units into self-reliant
1) Better health outcomes; variety of health care services which require moderately- communities and active partners in the attainment of national
2) More responsive health system specialized knowledge and technical resources adequate case goals through a more responsive and accountable local
3) Equitable health care financing management; includes Provincial and Regional government structure instituted through a system of
decentralization.
4 ELEMENTS OF THE STRATEGY 3. Tertiary - Each province, city and municipality has Local Health Board. It is a
1) Health Financing – the goal of this reform area is to foster, better - includes healthcare facilities that offer highly-technological and good venue for making the local health system more responsive to
and sustained investments in health. sophisticated healthcare services as such those offered by the needs of the people.
2) Health Program – the goal is to ensure the quality and specialty national hospital and medical centers. - At the provincial level, it is composed of the governor, PHO,
affordability of health goods and services. chairman of the Committee on Health of the Sangguniang
3) Health service delivery – the goal is to improve and ensure the HEALTH CARE WORKERS AT THE PRIMARY LEVEL Panlalawigan, DOH representative and NGO representative.
accessibility and availability of basic and essential health care in 1. Village or grassroots healthcare workers - City and municipal level, LHB is composed of: mayor, MHO, chair of
both public and private facilities and services. - serves as the first contacts of the community and the initial link to the committee on Health of the Sangguniang Bayan, DOH
the healthcare system. representative and NGO representative.
Good governance - They provide simple curative and preventive healthcare measures - Municipal level, public health nurses appointed as DOH
- the goal is to enhance health system at the national and local that promote a healthy environment. representatives. PHN has dual functions.
levels. - Participate in activities that are aimed at improving the socio-
- 3 levels of health care facilities in the Philippines that comprise the economic status of the community such as food production.
basic structure of its health care delivery system. - they include barangay health worker, volunteers or traditional WHO ‘S 17 SUSTAINABLE DEVELOPMENT GOALS
1) Primary Level birth attendants or hilots.
2) Secondary level
3) Tertiary level 2. Immediate
- level health workers - these group represents the first source of
GOVERNANCE RESPONSE TO PHC professional healthcare.
- The PHC recognizes the interrelationship between health and the - They attend to health problems that are beyond the knowledge
over-all socio-economic development and was adapted in the and skills of health workers
Philippines through LOI 949, October 19, 1979 signed by the - Support front-line health workers in terms of supervision, training,
President F.E. Marcos with the goal of “Health in the Hands of the supplies, and midwives
People by year 2020”. - Include doctors, nurses and midwives
- PHC is a level of service delivery characterized by accessibility,
generalist orientation, continuity of care, and recognition of the 3. First line hospital personnel
family and social context of health and illness. - health care professionals provide backup services for cases
require hospitalization. GOAL 1: No Poverty
4 DIMENSIONS – STRATEGY FOR RE-ORIENTING THE HEALTH CARE - They are in close contact with the immediate level health workers
SYSTEM or the village health workers.
GOAL 2: Zero Hunger
1. Focus – from illness and cure to health, prevention, and care - These include specialty doctors, nurses, dentist, pharmacists, and GOAL 3: Good Health and Well-being
2. Content – from treatment and episodic care of specific problems other healthcare professionals in the hospital setting. GOAL 4: Quality Education
to health promotion and continuous and comprehensive care GOAL 5: Gender Equality
3. Organization – from specialist, physician, and single-handed LEVEL OF PREVENTION GOAL 6: Clean Water and Sanitation
practice to generalist practitioner, other healthcare professionals, GOAL 7: Affordable and Clean Energy
and teams GOAL 8: Decent Work and Economic Growth
4. Responsibility – from health sector alone, professional- GOAL 9: Industry, Innovation and Infrastructure
dominated with passive reception to intersectoral collaboration
with active community participation and self-responsibility
GOAL 10: Reduced Inequality
GOAL 11: Sustainable Cities and Communities
LEVELS OF PREVENTION GOAL 12: Responsible Consumption and Production
1. Primary level GOAL 13: Climate Action
- Rural Health Units, GOAL 14: Life Below Water
- Sub-centers, GOAL 15: Life on Land
- Community hospital GOAL 16: Peace and Justice Strong Institutions
- Specialty clinics/health centers operated by both government and GOAL 17: Partnerships to achieve the Goal
private entities, and other health facilities operated by non-
government agencies and other group.
Goodluck!! 
DEVOLUTION OF HEALTH SERVICES LavaRN!!

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