Community Health Nursing 101 by Jhun

HEALTH 1.
Political
a. safety
• “State of complete physical, mental and social well-being, not merely the b. oppression
absence of disease or infirmity”
c. people empowerment
• Major contributor to the overarching goal of poverty reduction
2. Socio-economic
a. employment
Determinants of Health
b. education
• Affected by a combination of many factors
c. housing
• Determined his circumstances and environment
3. Environment
• It is inappropriate therefore to blame or credit the persons state of health to

a. air
himself alone because he is unlikely able to directly control many of these
factors
b. food
• Knowledge of these factors is important in order to effectively promote

c. water
health and prevent illnesses
d. urban/rural
e. noise
f. radiation
Factors that make people healthy or not:
g. pollution
1. Income and social status
4. Behavior
2. Education
a. culture
3. Physical environment
b. habits
4. Employment and Working conditions
c. mores
5. Social support networks
d. ethnic customs
6. Culture
5. Heredity
7. Genetics
a. genetic endowment
8. Personal behavior and coping skills
i. defects
9. Health services
ii. strengths
10. Gender
iii. risks
iv. familial ethnic racial

PUBLIC HEALTH
6. Health Care Delivery System
a. Promotive
• “Science and Art of preventing disease, prolonging life, promoting health
and efficiency through organized community effort for the sanitation of b. Preventive
environment, control of communicable diseases, education of individuals in
personal hygiene, organization of medical and nursing services for the early
c. Curative
diagnosis and preventive treatment of disease and the development of the
social machinery to ensure everyone a standard of living adequate for the
d. Rehabilitative
maintenance of health, so organizing these benefits as to enable every citizen
to realize his birthright of health and longevity”.
Core business of Public Health

FACTORS:
1. disease control
2. injury prevention
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3. health protection 4. Reduce child mortality
4. health public policy 5. Improve maternal health
5. promotion of health and equitable health gain 6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
ESSENTIAL PUBLIC HEALTH FUNCTIONS 8. Develop a global partnership for development
Needed to achieve the core business of public health
Following are essential health functions: OVERVIEW OF THE PUBLIC HEALTH NURSING
1. Health situation monitoring and analysis
2. Epidemiological surveillance/disease prevention and control Public Health Nursing and Community Health Nursing often used interchangeably
3. Development of policies and planning in public health
4. Strategic management of health systems and services for population health PHN defined by WHO:
gain
“Special field of nursing that combines the skills of nursing, public health and some
5. Regulation and enforcement to protect public health phases of social assistance and functions as part of total public health programme for the
promotion of health, improvement of the conditions in the social and physical
6. Human resources development and planning in public health environment, rehabilitation of illness and disability”
7. Health promotion, social participation and empowerment
8. Ensuring the quality of personal and population based health services CHN defined by Freeman:
9. Research, development and implementation of innovative public health “Service rendered by a professional nurse with communities, groups, families and
solutions individuals at home, in health centers, in clinics, in schools and in places of work for the
promotion of health, prevention of illness, care of the sick at home and rehabilitation”
GLOBAL AND COUNTRY HEALTH IMPERATIVES

CHN defined by Jacobson
Ongoing changes which exert a number of pressures on the public health system
“Nursing practice in a wide variety of community services and consumer advocate areas
1. Shifts in demographic and epidemiological trends in diseases and in a variety of roles at times including independent practice… community nursing is
certainly not confined to public health nursing agencies”
2. New technologies for health care, communication and information
3. Existing and emerging environmental hazards some associated with

globalization The original thrust of Public Health Nursing:
4. Health reforms “Nursing for the health of the entire public/community versus nursing only for the public
who are poor”
United Nations General Assembly

Standards of Public Health Nursing:
Common vision
Poverty reduction and sustainable development in September 2000

Public Health Nursing
• Refers to the practice of nursing in national and local government health

Exemplified by Millennium Development Goals which are based on the fundamental departments and public schools
values of freedom, equality, solidarity, tolerance, health, respect for nature and shared
responsibility: • It is a community health nursing practice in the public sector
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education Public Health Nurses
3. Promote gender equality and empower women
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• Refers to the nurses in the local/national health departments or public • Mandated as the lead agency in health
schools whether their official position title is public health nurse or nurse or
school nurse • Maintains specialty hospitals, regional hospitals and medical centers
• Maintains provincial health teams made up of DOH representatives to the

local health boards and personnel involved in CDC, specifically for malaria
PUBLIC HEALTH NURSES and schistosomiasis
• Leaders in providing quality health services to the communities
• First level of health workers to be knowledgeable about new public health Philippine General Hospital
technologies and methodologies
• Part of national level which provide health care services
• Usually the first ones to be trained to implement new programs and apply
new technologies
Local level (Local Health System)
THE PHILIPINE HEALTH CARE DELIVERY SYSTEM • Run by LGU
Major players of the HCDS Provincial government
1. Private sector • Provincial and District hospitals
a. Largely market oriented

City/Municipal government
b. Health care is paid through user fees at the point of service

• Health centers/RHU
c. Includes profit and non-profit health providers

• Barangay health stations
d. Includes providing health services in
i. Clinics
Local Chief Executive
ii. Hospitals
• Chaired the local health board
iii. Health insurance
• Function is mainly to serve as advisory body to the local executive and the
e. Manufacture of sanggunian or local legislative council on health-related matters
i. Medicines
ii. Vaccines
iii. Medical supplies
iv. Medical equipment PHILIPPINE DEPARTMENT OF HEALTH
v. Other health and nutrition products HISTORICAL BACKGROUND
vi. Research and development PRE-SPANISH and SPANISH PERIOD
vii. Human resource development
2. Public sector 1888
a. largely financed through a tax-based budgeting system at both • Superior board of health and charity was created by the Spaniards which
national and local levels established a hospital system and a board of vaccination
b. health care is generally given free at the point of service June 23, 1898
c. consist of the national and local government agencies • Department of Public Works, Education and Hygiene was created by virtue
of decree signed by President Emilio Aguinaldo
September 29, 1898
• General Orders No. 15 established the Board of Health for the City of
NATIONAL LEVEL Manila
Department of Health July 1, 1901
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• Act No. 157 created Board of Health for the Philippine Islands, also April 13, 987
functioned as the Local Health Board of Manila
• EO No. 119 transformed the Ministry of Health back to the Department of
December 2, 1901 Health
• Act Nos. 307, 308 established the Provincial and Municipal Boards October 10, 1991
completing the health organization in accordance with the territorial division
of the islands • RA 7160 (Local Government Code) provided for the decentralization of the
entire government; DOH changed its role from one of implementation to one
• Board of Health for the Philippine Islands became Insular Board of Health of governance
October 26, 1905 May 24, 1999
• Act No. 1407 abolished the Insular Board of Health and replaced by the • EO No. 102 (Redirecting the Functions and Operations of the DOH) granted
Bureau of Health under the Department of Interior the DOH to proceed with its Rationalization and Streamlining Plan.
• Act No. 1487 (1906) replaced the provincial boards of health with district • Mandates the DOH to provide assistance to LGU, people’s organization and
health officers other members of civic society in effectively implementing programs,
projects and services that will
1915
o Promote the health and well being of every Filipino;
• Act No. 2468 transformed the BOH into a commissioned service called the
Philippine Health Service o Prevent and control diseases among population at risk;
1932 o Protect individuals, families and communities exposed to

hazards and risks;
• Act No. 4007 (Reorganization Act of 1932) reverted back the Philippine
Health Service into the Bureau of Health and combined the Bureau of Public o Treat, manage and rehabilitate individuals affected by diseases
Welfare under the Office of the Commissioner of Health and Public Welfare and disability
1999-2004
PHILIPPINE COMMONWEALTH AND THE JAPANESE OCCUPATION (1935-1945) Development of Health Sector Reform Agenda
May 31, 1939 ROLES AND FUNCTIONS OF DOH (Mandated by the EO No. 102)
• Commonwealth Act No. 430 created the Department of Public Health and ROLE
Welfare
Providing technical and other resource assistance
January 7, 1941
GENERAL FUNCTIONS UNDER THREE SPECIFIC ROLES
• EO No. 317 fully implemented Commonwealth Act No. 430
1. Leadership in Health
January 1, 1951
2. Enabler and Capacity Builder
• Office of the President of the Sanitary District was converted into RHU
3. Administrator of Specific Services
carrying out 7 basic health services; Maternal and Child Health,
environmental Health, CDC, Vital Statistics, Medical Care, Health
Education and Public Health Nursing
February 20 1958 VISION
The DOH is the leader, staunch advocate and model in promoting Health for All in the
• EO No. 288 effort to decentralize governance of health service. An office of
Philippines
the regional health director was created in 8 regions and all health services
were decentralized to the regional, provincial and municipal levels
1970
MISSION
• Restructured Health Care Delivery System was conceptualized, classified
Guarantee equitable, sustainable and quality health for all Filipinos, especially the poor
health services into Primary, Secondary and Tertiary
and shall lead the quest for excellence in health
June 2, 1978
• PD 1397 renamed the Department of Health to the Ministry of Health

GOAL: Health Sector Reform Agenda (HSRA)
December 2, 1982
Health Sector Reform is the overriding goal of the DOH. Support mechanisms will be
through sound organizational development, strong policies, systems and procedures,
• EO No. 851 created Integrated Provincial Health Office capable of human resources and adequate financial resources
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General Objective:
FOURmula ONE for Health is aimed at achieving critical reforms with speed, precision
Rationale for Health Sector Reform and effective coordination directed at improving the quality, efficiency, effectiveness
and equity of the Philippine health system in a manner that is felt and appreciated by
Filipinos, especially the poor.
1. Slowing down in the reduction in the IMR and the MMR
2. Persistence of large variations in health status across population groups and

geographic areas
Specific Objectives:
3. High burden from infectious diseases Fourmula One for Health will strive, within the medium term, to:
4. Rising burden from chronic and degenerative diseases • Secure more, better and sustained financing for health
• Assure the quality and affordability of health goods and services
5. Unattended emerging health risks from environmental and work related • Ensure access to and availability of essential and basic health packages
factors • Improve performance of the health system
6. Burden of disease is heaviest on the poor
Defining the Rules of Engagement:

Seven (7) General Guidelines for Health Reform Implementation
Reason for the existence of the above conditions
1. Inappropriate health delivery system – shown by an inefficient and poorly F1 Rule No.1:
targeted hospital system ineffective mechanism for providing public health
programs on top of health human resources maldistribution FOURmula ONE for Health will organize the critical reform initiatives into
four implementation components, namely, Financing, Regulation, Service Delivery and
2. Inadequate regulatory mechanisms for health services resulting to poor Governance.
quality of health care, high cost of privately provided health services, high
cost of drugs and presence of low quality of drugs in the market F1 Rule No. 2:
3. Poor health care financing and inefficient sourcing or generation of funds for
The implementation of FOURmula ONE for Health will focus on a few
healthcare
manageable and critical interventions. Such interventions will be identified using the
following criteria:
Framework for the implementation of HSRA: FOURmula ONE for Health • Doable given available resources - Critical interventions identified for each
component must be deemed doable given the available time, human and
financial resources.
• Sufficient groundwork and buy-in - The chosen interventions must be backed
FOURmula ONE for Health is the implementation framework for health sector reforms by sufficient groundwork and buy-in from implementation partners,
in the Philippines for the medium term covering 2005-2010. It is designed to implement especially in the development of reform packages for local implementation.
critical health interventions as a single package, backed by effective management
• Triggers a reform chain reaction - These critical interventions must be able
infrastructure and financing arrangements.
to trigger a chain of reaction that will spur the implementation of other
FOURmula ONE for Health interventions, within and across the four
components.
• Produces tangible results and generates public support - These critical
FOURmula ONE for Health engages the entire health sector, including the public and
interventions must be able to show tangible results within the immediate and
private sectors, national agencies and local government units, external development medium terms, which in turn generate support and cooperation from the
agencies, and civil society to get involved in the implementation of health reforms. It is public;
an invitation to join the collective race against fragmentation of the health system of the
country, against the inequity of healthcare and the impoverishing effects of ill-health.
With a robust and united health sector, we can win the race towards better health and a
brighter future for generations to come.
F1 Rule No. 3:
The reforms will be implemented under a sector-wide approach, which

Goals of FOURmula one for Health encompasses a management perspective that covers the entire health sector and an
investment portfolio that encompasses all sources.
Starting the Race with the End in Mind:

Fourmula One for Health Goals and Objectives F1 Rule No. 4:
Over-all Goals: The National Health Insurance Program (NHIP) will serve as the main lever
The implementation of FOURmula ONE for Health is directed towards achieving the to effect desired changes and outcomes in each of the four implementation components,
following end goals, in consonance with the health system goals identified by the World where the main functions of the NHIP including enrollment, accreditation, benefit
Health Organization, the Millennium Development Goals, and the Medium Term delivery, provider payment and investment are employed to leverage the attainment of the
Philippine Development Plan: targets for each of the reform components.
• Better health outcomes F1 Rule No. 5:

• More responsive health system
• More equitable healthcare financing. The functional and financial management arrangements will be defined in
terms of specific offices having clear mandates, performance targets and support systems,
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within well-defined time frames in the implementation of reforms within each Governance in local health systems may be improved by undertaking the following
component. strategies:
F1 Rule No. 6: FOUR-IN-ONE Convergence Sites have to be established. These convergence sites will
undertake integrated implementation of FOURmula ONE for Health components in
appropriately delineated localities or inter-local health zones.
The functional clustering of teams and assignment of specific Team Leaders
shall facilitate implementation, monitoring and supervision in a coordinative manner and
shall not, in any way, prejudice the corporate nature of the DOH-attached agencies nor
the autonomy of Local Government Units.
A FOURmula ONE for Health LGU Scorecard will be developed and employed to
track the progress and compare the performance of various localities or inter-local health
zones.
F1 Rule No. 7:
The selection of FOUR-in-ONE Convergence Sites will be governed by the following

criteria: A FOURmula ONE for Health Professional Development and Career Track will be
institutionalized where competent and dedicated health personnel will provide quality
health services and sound advice to local chief executives with regard to health reforms.
• Willingness of the LGU to participate in the FOURmula ONE for Health
implementation, in terms of willingness to provide the requisite
counterpart resources, and willingness to enter into formal national
government to local government, inter-local government and government
to private sector networking, partnership and resource sharing
arrangements;
• Presence of local initiatives or start-up activities relevant to FOURmula PRIMARY HEALTH CARE AS AN APPROACH TO DELIVERY OF HEALTH CARE
ONE strategies, to include, but not limited to: development of inter-local SERVICE
health zones, enrollment of indigents into the social health insurance
system, improvement in drug management systems, among others;
• Relatively high feasibility of success and sustainability, to include factors
such as capacity to enter into loans, capacity to absorb investments and
sustain the reform process, etc.; and PRIMARY HEALTH CARE
• Availability of funds from GOP and external sources for capital
investment requirements.  Essential health care made universally accessible to individuals and families
in the community by means of acceptable to them through their full
participation and at a cost that the community and country can afford at
every stage of development
Carrying out the Game Plan:

 Primary health care was declared during the First International Conference
Winning Strategies to Attain FOURmula ONE for Health Component-
Specific Objectives on PHC held in Alma Ata USSR on September 6 – 12, 1978 by WHO with a
goal of “Health for All by the year 2000”
 Primary Health Care was adopted in the Philippines through LOI 949 signed
by Pres. Marcos on October 19, 1979 and has an underlying theme of
F1 Component No. 1: HEALTH FINANCING “Health in the hands of the People by 2020”
Objective: The objective of financing reforms under FOURmula ONE for Health is to
secure more, better and sustained investments in health to provide equity and improve
health outcomes, especially for the poor. Concept of PHC is characterized by;
 Partnership and empowerment of the people
F1 Component No.2: HEALTH REGULATION

 PHC is a strategy
Objective: The main objective of health regulation under FOURmula ONE for Health is
assuring access to quality and affordable health products, devices, facilities and services,  which focuses responsibility for health on the
especially those commonly used by the poor. individual, his family and the community
F1 Component No. 3: HEALTH SERVICE DELIVERY  PHC includes full participation and active involvement of the
community
Objective: FOURmula ONE for Health interventions in service delivery are aimed at
improving the accessibility and availability of basic and essential health care for all,  towards the development of self-reliant people,
particularly the poor. This shall cover all public and private facilities and services capable of achieving an acceptable level of health
and well being
F1 Component No.4: GOOD GOVERNANCE IN HEALTH
 PHC recognizes the interrelationship between health and the
Objective: The objective of good governance in health is to improve health systems overall political, socio-cultural and economic development of
performance at the national and local levels. FOURmula ONE for Health will introduce society
interventions to improve governance in local health systems, improve coordination across
local health systems, enhance effective private-public partnership, and improve national
capacities to manage the health sector.
Elements/Components of PHC
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1. Environmental Sanitation a. General medical practitioners
2. Control of communicable diseases b. PHN
3. Immunization c. RSI
4. Health Education d. RHM
5. Maternal and Child Health and Family Planning LEVELS OF HEALTH CARE AND REFERRAL SYSTEM
6. Adequate Food and Proper Nutrition  Primary Level of Care
7. Provision of Medical Care and Emergency Treatment o Devolved to the cities and municipalities
8. Treatment of Locally Endemic Diseases o Health care provided by the center physicians, PHN, RHM,
BHW, TBAs and others
9. Provision of Essential Drugs
o Usually the first point of contact between the community
Strategies members and other levels of health facility
 Reorientation and reorganization of the national health care system (RA  Secondary Level of Care
7160)
o Given by physicians with basic health training
 Effective preparation and enabling process for health action at all levels
o Usually given in health facilities either privately owned or
 Mobilization of the people government operated such as infirmaries, municipal and district
hospitals, out-patient departments of provincial hospitals
 with the end view of providing appropriate solutions leading to
self-reliance and self determination o Serves as a referral center for the primary health facilities
 Development and utilization of appropriate technology o Capable of performing minor surgeries and perform some
simple laboratory examinations
 focusing on local indigenous resources available in and
acceptable to the community  Tertiary Level of Care
 Organization of communities arising from their expressed needs o Rendered by specialists in health facilities including medical
centers as well as regional and provincial hospitals and
 Increase opportunities for community participation specialized hospitals
 Development of intra-sectoral linkages with other government and private o Referral center for the secondary care facilities
agencies
LEVELS OF HEALTH CARE SERVICES
 Emphasizing partnership
 Tertiary level care facilities
o National and Regional Health Services

Framework for meeting the goal of PHC
o Medical centers
 Organizational strategy
o Teaching and Training hospitals
o calls for active and continuing partnership among the

 Secondary level care facilities
communities, private and government agencies in health
development
o Provincial / City health services and hospitals
Four cornerstones/Pillars in PHC
o Emergency and District hospitals
1. Active community participation
 Primary level care facilities
2. Intra and Inter-sectoral linkages
o RHU
3. Use of appropriate technology
o Community hospitals & health centers
4. Support mechanisms made available
o Private practitioners, puericulture centers
Two levels of PHC workers
o BHS
1. Village or Barangay Health Workers
2. Intermediate Level Health Workers

THE PUBLIC HEALTH NURSE
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 The PHN visits the patient
Qualifications and Functions  Bag technique
Must be professionally qualified and licensed to practice in the arena of public health  Tool by which the nurse during her visit will enable her to
nursing perform a nursing procedure with ease and deftness, save time
and effort
Consistent with the nursing law of 2002 (RA 9173)
 Most important principle
• Management function
Minimize if not prevent the spread of any infection
– Inherent in the practice of PHN
 Important points to consider in the use of the bag
– Organizes the nursing service of the local health agency
Contain all necessary articles

• Supervisory function
Cleaned very often

– Supervisor of the midwives and other health workers
Well protected
• Nursing care function
– Inherent function of the nurse Arrangement-most convenient
– Based on the science of art and caring
– Caring for all levels of clientele toward health promotion and ASSESSING COMMUNITY HEALTH NEEDS
disease prevention
• Collaborating and coordinating function

COMMUNITY HEALTH NURSING
– Care coordinators for communities and their members
• COMMUNITY
– Establishes linkages and collaborative relationships with other
health professionals, government agencies, private sectors, – Primary client
NGO’s people’s organizations to address health problems
• HEALTH
• Health promotion and education function
– Goal
– Activities goes beyond health teachings and health information
campaigns • NURSING
• Training function – Means
– Initiates the formulation of staff development and training

programs for midwives and other auxiliary workers
COMMUNITY
• Research function
• Group of people sharing common geographic boundaries, common values
– Participates in the conduct of research and utilizes research and interest
findings in her practice
• Functions within a particular socio-cultural context, which means that no
• Disease surveillance two communities are alike
– Measure the magnitude of the • Primary client of CHN

problem
– Has a direct influence on the health of the individual, families
– Measure the effect of the control and sub-populations
program
– It is at this level that most health service provision occurs
• Regarded as an organism with its own stages of development

NURSING PROCEDURES
– Matures through time
 Clinic visit
 Patient visits the health center

COMMUNITY DIAGNOSIS
Most common is BP measurement
• Done to come up with a profile of local health situation
 Home visit
– Will serve as a basis of health programs and services to be
 Family-nurse contact delivered to the community
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• Transportation system
• Starts with determining the health status of the community
• Educational level
• Housing conditions
PROCESS OF COMMUNITY DIAGNOSIS
– Economic indicators
• Consists of;
• Poverty level income

– Collecting, organizing & synthesizing data
• Employment rate
• In order to identify the different factors that may
directly or indirectly influence the health of the
• Types of industry present in the community
population
• Occupation common in the community

– Analyzing & interpreting health data
– Environmental indicators
• Seek explanations for the occurrence of health
needs and problems of the community
• Physical/geographical/topographical
characteristics
– Formulation of Community Health Nursing Diagnoses
• Water supply
• Will become the bases for developing and
implementing community health nursing
• Waste disposal
interventions and strategies
• Air, Water and Land pollution

Types of Community Diagnosis
– Cultural factors
• Comprehensive community diagnosis
• Variables that may break up people into groups

– Aims to obtain general information about the community
within the community e.q.
• Problem Oriented community diagnosis
– Ethnicity
– Responds to a particular need
– Social class
– Language
ELEMENTS OF COMPREHENSIVE COMMUNITY DIAGNOSIS
– Religion
1. DEMOGRAPHIC VARIABLES
– Race
– Total population & Geographical distribution including Urban-
– Political orientation
Rural index & Population Density
• Cultural beliefs and practices that affect health

– Age & Sex composition
• Concepts about Health and Illness

– Selected vital indicators e.q. Growth rate, CBR, CDR & Life
expectancy rate
– Patterns of migration
3. HEALTH & ILLNESS PATTERNS
– Population projection
– Leading cause of mortality
• Note:
– Leading cause of morbidity
– Population groups that need special attentions:
– Leading cause of infant mortality
• Indigenous people
– Leading cause of maternal mortality
• Internal refugees
– Leading cause of hospital admission
• Socially dislocated groups as a result of disasters,
calamities & development programs
4. HEALTH RESOURCES
2. SOCIO-ECONOMIC & CULTURAL VARIABLES – Manpower resources
– Social indicators – Material resources
• Communication network
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5. POLITICAL/LEADERSHIP PATTERNS
– Reflects the action potential of the state and its people to DEMOGRAPHY
address the health needs and problems of the community
• Science which deals with the study of the human population’s
– Mirrors the sensitivity of the government to the people’s
struggle for better lives – Size
– Composition
IDENTIFYING COMMUNITY HEALTH NURSING PROBLEMS – Distribution in space
 Health Status Problems
Increased/decreased morbidity, mortality fertility or reduced SOURCES OF DEMOGRAPHIC DATA

capability for wellness
-Can be obtained from a variety of sources
 Health Resources Problems
• Censuses
Lack of or absence of manpower, money, materials or
institutions necessary to solve health problems • Sample surveys
 Health Related Problems • Registration systems
Existence of social, economic, environmental and political

factors that aggravate the illness-inducing situations in the
community Two ways of assigning people when the census is being taken
De jure
PRIORITY-SETTING • Done when people are assigned to the place where they usually live
regardless of where they are at the time of the census
• Nature of the condition/problem presented
De facto
– Classified as health status, health resources or health related
problems • People are assigned to the place where they are physically present at the time
of the census regardless of their usual place or residence
• Magnitude of the problem
– Severity of the problem which can be measured in terms of the

proportion of the population affected by the problem POPULATION SIZE
• Modifiability of the problem • Refers to the number of people in a given place or area at a given time
– Probability of reducing, controlling or eradicating the problem • Allows the nurse to make comparisons about population changes over time
• Preventive potential • Helps rationalize the types of health programs or interventions which are
going to be provided for the community
– Probability of controlling or reducing the effects posed by the
problem
• Social concern TWO METHODS IN DETERMINING POPULATION SIZE
– Perception of the population or the community as they are Method 1

affected by the problem and their readiness to act on the
problem • Determining the increase in the population resulting from excess of births
compared to deaths
• Application of Public Health Tools
NATURAL INCREASE
• Difference between the number of births and the number of deaths occurring
COMMUNITY HEALTH NURSING in a population in a specified period of time
• Three important tools Nat. increase = no. births – no. of deaths / specified year
The health disciplines of RATE OF NATURAL INCREASE
• Demography • Difference between the CBR and the CDR occurring in a population in a
specified period of time
• Vital statistics
Rate of Nat. increase = CBR – CDR / specified year
• Epidemiology
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The sex ratio represents the number of males for every 100 females in the
population
Method 2
• Determine the increase in the population using data obtained during two
census periods. This implies that the increase in the size of the population is AGE COMPOSITION
not merely attributed to excess in births but also the effect of migration
• Two ways to describe the age composition of the population
MEDIAN AGE
ABSOLUTE INCREASE PER YEAR
• Divides the population into two equal parts.
• Measures the number of people that are added to the population per year.
DEPENDENCY RATIO
Abs. Increase/year = Pt – Po / t
• Compares the number of economically dependent with the economically
• where: productive group in the population.
– Pt = pop. Size at a later time • Economically dependent
– Po = pop. Size at an earlier time – 0 – 14
– t = no. of years between 0 and time t. – 65 and above
• Method 2 • Economically productive
– Within 15 – 64 age group
RELATIVE INCREASE
• Actual difference between the two census counts expressed in percent POPULATION DISTRIBUTION
relative to the population size made during an earlier census
• The measures help the nurse decide how meager resources can be justifiably
Relative increase = Pt – Po / Po allocated based on concentration of population in a certain place
• where: 1. Urban-Rural distribution
– Pt = population size at a later time 2. Crowding Index
– Po = population size at an earlier time 3. Population Density
POPULATION COMPOSITION VITAL STATISTICS
Pertaining to population size’s variables such as: • Refers to the systematic study of vital events such as births, illnesses,
marriages, divorces/separations and deaths
• Age
• Tool in estimating the extent or magnitude of health needs and problems in
• Sex the community
• Occupation • Common health indicators
• Educational level • Fertility rates
• Commonly described in terms of its age and sex – Crude birth rate (CBR)
• Nurse utilizes data on age and sex composition to decide who among the – General fertility rate (GFR)
population groups merits attention in terms of health services and programs
• Mortality rates
– Crude death rate (CDR)

SEX COMPOSITION
– Specific mortality rate (SMR)
• To describe the sex composition of the population, the nurse computes for
– Cause of death rate
the “sex ratio”
– Infant mortality rate (IMR)

• Sex ratio compares the no. of females in the population
– Maternal mortality rate (MMR)

Sex ratio = Number of males / Number of females
– Proportionate mortality rate (PMR)
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– Swaroops index • Disease development does not rest on a single cause
– Case fatality rate (CFR) • Health conditions result from a multitude of factors
• Morbidity rate Model that explain the MCT
– Incidence rate – Ecologic Triad/Epidemiologic triangle
– Prevalence rate AGENT
• Any element, substance or force, either animate or inanimate. The presence

or absence of which may serve as stimulus to initiate or perpetuate a disease
MORBIDITY process
• TEN LEADING CAUSES OF MORBIDITY – Disease process happens only when the agent comes in contact
No. & Rate/100,000 Population with a susceptible host and under proper environmental
PHILIPPINES, 2002 conditions
• MORBIDITY (2002) – Intrinsic property of microorganism to survive and multiply in

the environment to produce disease
HOST
• Any organism that harbors and provides nourishment for another organism
• Characteristics of the host will affect his or its risk of exposure to sources of
infection and his or its susceptibility or resistance
• Intrinsic factors of the host
– Genetic
– Age
MORTALITY – Sex
• Ten Leading Causes of Mortality by Sex – Ethnic group

Number, Rate/100,000 Population & Percentage
Philippines, 2002 – Physiologic
• MORTALITY – Immunologic experience (immunization)
– Inter-current or pre-existing disease
EPIDEMIOLOGY – Human behavior
• EPIDEMIOLOGY • RESISTANCE
• Study of the occurrence and distribution of health conditions such as disease, • Specific
deformities or disabilities on human populations
– Results from an immunologic experience such as;
• Two main areas of concern immunization or vaccination
– Study of occurrences and distribution of diseases • Non-specific
– Search for the determinants (causes) of the disease and its – Results from an intact skin, mucous membrane, reflexes as
observed distributions lacrimation, coughing, diarrhea or vomiting
• Backbone of the prevention of diseases – Can be maintained through personal hygienic practices,
environmental sanitation, proper nutrition and a healthy
lifestyle
Epidemiology rests on two important concepts; • COMMUNITY
• Multiple Causation Theory • Community as a host
• Levels of Prevention of Health Problems – Protects its health by the nurse by increasing its herd immunity
• Herd Immunity
Multiple Causation Theory – Probability of a group or community developing an epidemic

introduction of an infectious agent
12 | P a g e
– It is the proportion of the immunes and the susceptible in the • Interrupt the chain of infection through
group environmental manipulation
• Prevention of spread to human reservoirs and other

susceptible human hosts
ENVIRONMENT
• Primary prevention can be done through;
• Sum total of all external conditions and influences that affect the life and
development of an organism – Personal surveillance
• Affects the agent and the host – Quarantine
Three components of environment – Segregation or isolation
– Physical environment • Health promotion activities include;
• Composed of the inanimate surroundings e.q. – Provision of proper nutrition

geophysical conditions or the climate
– Safe water supply and waste disposal system
– Biological environment
– Vector control
• Makes up the living things around us e.q. plant and
animal life – Promotion of a healthy lifestyle
• Human population – Good personal habits
– Socio-economic environment • Specific measures include provision of;
• May be in the form of level of economic – Immunization

development of the community, presence of social
disruptions – Prophylaxis to vulnerable or at-risk groups
LEVELS OF PREVENTION OF HEALTH PROBLEM SECONDARY PREVENTION
• Promoting health and Preventing health problems • Aims to identify and treat existing health problems at the earliest possible
time
• Make up most of the nurse’s activities in the community
• Interventions can still lead to the control or eradication of the health problem
– Screening
PREVENTION
– Case finding
• Refers to identification of potential problems
– Disease surveillance
• Directed to the healthy population
– Prompt and appropriate treatment
– Primordial prevention
• In Communicable disease control;
• Focusing on prevention of emergence of risk
factors
– Health education on signs and symptoms will enable the client
to identify illness and seek early care or treatment
– Specific protection
• Removal of the risk factors or reduction of their – Knowledge of risk behaviors that contribute to the spread of the
levels disease may influence patients and the families to modify this
behavior and, thus, assist in the prevention of disease
PRIMARY PREVENTION
TERTIARY PREVENTION
• In Communicable disease prevention
• Limits disability progression
– Activities on primary prevention are targeted at intervening
before the agent enters the host and cause pathological changes – The nurse attempts to reduce the magnitude or severity of the
residual effects of;
– It aims to;
• Infectious diseases
• strengthen the host resistance
– E.q hearing impairment from frequent
• Inactivate the agent (source of infection) ear infections
13 | P a g e
• Non-communicable diseases – Done to look for previously unidentified cases of diseases
– Mental illness, CVD • Screening & Case Finding
– Day care centers and sheltered workshops are examples of – Should consider the sensitivity and specificity of the tests
opportunities to achieve the objective of tertiary prevention in
mental illness and drug abuse • ASPECT 1
• SENSITIVITY
THE EPIDEMIOLOGICAL APPROACH – Proportion of persons with a disease who test positive on a
screening test
• PHASES
– Measures the probability of the test correctly identifying a
1. Descriptive epidemiology positive case of a disease
• Concerned with disease distribution and frequency • SPECIFICITY
2. Analytical epidemiology – Proportion of a persons without a disease who have negative

results on a screening test
• Attempts to analyze the causes or determinants of disease
through hypothesis testing – Measures the probability of correctly identifying non-cases
3. Intervention or Experimental epidemiology • ATTACK RATE
• Answers questions about the effectiveness of new methods for – Used to calculate an identifiable population exposed to an
controlling diseases or for improving underlying conditions infectious agent
4. Evaluation epidemiology – Represents the incidence of the illness among the exposed
population
• Attempts to measure the effectiveness of different health
services and programs – Frequently used in surveillance and control of communicable
diseases
– ASPECT 2
DESCRIPTIVE EPIDEMIOLOGY
II. Description of the disease/condition as to person, place and time
Aspects involved in descriptive epidemiology characteristics
1. Observation and recording of existing patterns of occurrence of the health – After the disease or condition has been identified with
condition under study reasonable certainty; the number of persons who possess the
disease are recorded noting down the;
2. Description of the disease/condition as to person, place and time
characteristics • Characteristics of the afflicted persons
3. Analysis of the general pattern of occurrence of the disease or condition • Time the disease was initially recognized
• ASPECT 1 • Characteristics of the place where the cases came

from
I. Observation and recording of existing patterns of occurrence of the health
condition under study • ASPECT 2
1. Herd Immunity
 In order to describe the occurrence of disease condition; the
nurse needs to recognize or identify the disease with reasonable
certainty – Basis for determining the community’s reaction against disease
invasion since it represents the immunity and susceptibility
• Done by conducting levels of individuals comprising the population
– Screening – The immunity level is inversely proportional to susceptibility

level
– Case finding activities
2. EXPOSURE or CONTACT RATE
• ASPECT 1
– Represents opportunities for progressive opportunities for
• SCREENING progressive transfer or transmission of an infectious agent to a
susceptible host and depends on the;
– Presumptive identification of unrecognized diseases or defects
through the application of diagnostic tests or laboratory • Frequency of contact
examinations and clinical assessment
• Facility of transmission
• CASE FINDING
14 | P a g e
3. CHANCE • Characteristics of the individual who were exposed
and who contacted the infection or the disease
– Probability of contact between the
– Place
• Source of infection
• Features, factor or conditions which existed in or
• Susceptible host described the environment in which the disease
occurred
– Depends upon the
• Patterns of occurrence and distribution
• Number of sources of infection
• Sporadic
• Number of immunes
– Intermittent occurrence (rabies)
• Location of the source of infection
• Endemic occurrence
Disease occurrence can be described by the following:
– Continuous occurrence throughout a period of time
A) Short time fluctuations common in epidemics
• Malaria – Palawan
– Common source epidemic – characterized by simultaneous
exposure of a large number of susceptible to a common • Schistosomiasis – Leyte and Samar
infectious agent
• Filariasis – Sorsogon
– Propagated epidemic – caused by a person-to-person
transmission of disease agent • Tuberculosis – all specific areas of the country
B) Cyclic variation – refers to recurrent fluctuations of disease that may exhibit • Epidemic occurrence
cycles lasting for certain periods
– Unusually large number of cases in a relatively short period of
C) Secular variation – refers to changes in disease frequency over a period of time
many years
• Pandemic occurrence
• ASPECT 3
– Simultaneous occurrence of epidemic of the same disease in
3. Analysis of the general pattern of occurrence of the disease or condition several countries
– Establishing the
• Disease frequency PUBLIC HEALTH PROGRAMS
• Disease distribution in a population  Sets of interventions put together to operationalize policies and
standards directed towards the prevention of certain public health
– Defining the characteristics of the disease or condition in problems
relation to
 Family Health
• Time
 Non-communicable Disease Prevention and Control
• Place
 Communicable Disease Prevention and Control
• Person
 Environmental Health and Sanitation
– Correlating the data and formulate a causal association between
the
 Other priority health programs
• Disease under study

 Sentrong Sigla
• Probable factors surrounding it

 Herbal Medicine
• DISEASE DISTRIBUTION
 Health Emergency Preparedness and Response Program
• Variables affecting disease distribution
 National Voluntary Blood Services Program
– Time
 Botika ng Barangay
• Period during which the cases of the disease being
studied were exposed to the source of infection and FAMILY HEALTH
the period during which the illness occurred
 Basic unit of the community
– Persons
 Concerned with the health of the mother, unborn, newborn, infant,
child, adolescent and youth, adult men and women and older persons
15 | P a g e
 Aims to:  Prenatal  Period of pregnancy
visits
 Improve the survival, health and well being of mothers and the
unborn
 As early in pregnancy as possible before
 1st visit
four months or during the first trimester
 Pre-pregnancy
 Prenatal  2nd visit  During the 2nd trimester
 Natal  3rd visit  During the 3rd trimester
 Postnatal stages
 Every two  After 8th month of pregnancy till delivery
 Reduce morbidity and mortality rates: weeks
 Children 0-9 years old
 Among Filipino adults and older persons and improve MICRONUTRIENT SUPPLEMENTATION
quality life
Vitamins Dose Schedule Remarks
 Mortality from preventable causes among adolescents
and young people
Vitamin A 10,000 IU 2x a week starting on the 4th Do not give Vitamin A
MATERNAL HEALTH PROGRAM month of pregnancy before 4th month of
pregnancy. It might cause
Tasked to reduce MMR by three quarters by 2015 to achieve MDG congenital problems in the
baby
 Maternal Mortality Rate (2003)
Iron 60mg/400 ug Daily
 CAUSE tablet
 Other Complications related to pregnancy occurring in the course of

labor, delivery and puerperium
 Recommended Schedule for Post Partum Care Visits
 Hypertension complicating pregnancy, childbirth and puerperium
(25%)
 1st visit  1st week post partum preferably 3-5 days
 Postpartum hemorrhage (20.3%)

 6 weeks post partum
 2nd visit
 Pregnancy with abortive outcome (9%)
 Hemorrhage related to pregnancy

FAMILY PLANNING PROGRAM
 Strategic thrusts for 2005-2010
 Annual Population Growth
 Launch and implement Basic Emergency and Obstetric Care
(BEMOC) strategy in coordination with DOH
 2.36%
 Entails establishment of facilities that provide emergency

 Population expected to double in 29 years
obstetric care for every 125,000 population and which are
located strategically
 Total fertility rate
 Improve quality of prenatal and postnatal care

 3.5 children/woman
 Pregnant women should have at least four (4) prenatal

 3 to 4 million getting pregnant/year
visits
 85% expected to progress full term

 Reduce women’s exposure to health risks
 National Demographic and Health Survey (2003)

 Institutionalization of responsible parenthood
 Stakeholders must advocate for health  44% women got pregnant with 1st child ages 20-24
 Resource generation and allocation for health services  6.1% Ages 15-19
 35-39 – highest percentage of using contraceptives
ANTENATAL REGISTRATION  15-19 – lowest percentage
Married women
16 | P a g e
 48.8% - use any form of contraceptive method  Simple fertility awareness based method
 33.4% - modern method Cervical secretions as an indicator of fertility
 15.5% - traditional method Checking the presence of secretions daily
 51.1% - do not use any form of contraceptive method  Standard days method
 Users with menstrual cycle between 26 and 32 days are

counseled to abstain from SI on days 8-19 to avoid
FAMILY PLANNING METHODS pregnancy
 Female sterilization
 Cutting or blocking two fallopian tubes (BTL) CHILD HEALTH PROGRAMS
 Male sterilization Main goal is to reduce morbidity and mortality rates for children 0-9 years old
 Vas deferens is tied and cut or blocked through a small  Strategic thrusts for 2005-2010
opening on the scrotal skin (Vasectomy)
 Pursuing the sentrong sigla initiative
 Effective 3 months after the procedure
 Apply REB strategy for immunization
 Pill
 Intensify health education and information campaign
 Hormones – estrogen and progesterone
 IMCI and BEMOC strategy
 Taken daily PO
 Implementation of laws and policies for the protection of newborns
 Male condom
 Early Childhood Development Act of 2000
 Thin sheath of latex
 Newborn Screening Act of 2004
 Dual protection from STIs including HIV
 EO 286, Bright Child Program
 Injectables
 EO 51, Milk Code
 Synthetic hormone – progestin which suppresses
ovulation, thickens cervical mucus  Rooming-in and Breastfeeding Act
 LAM
 Postpartum method of postponing pregnancy based on Infant and Young Child Feeding (IYCF)
physiological infertility experienced by breast feeding
women  Global Strategy for IYCF issued jointly by the WHO and UNICEF in
2002 as endorsed by the World Health Assembly in May 2002 and
 Effective only for a maximum of 6 months postpartum the UNICEF Executive Board in September 2002
 Mucus/Billings/Ovulation  Strategy calls for the:
 Abstaining from SI during fertile days  Promotion of breastmilk as the ideal food for the healthy
growth and development of infants
 Can not be used by woman with unusual disease or
condition that results in extraordinary vaginal discharge  Exclusive breastfeeding for the first 6 months of life
that makes observation difficult
 Overall objective:
 BBT
 Improve the survival of infants and young children by
 Identifying the fertile and infertile period by daily taking improving their nutritional status, G & D through optimal
and recording rise in BT during and after ovulation feeding
 Temp is taken 3 hours of undisturbed rest (usually  National Plan of Action for 2005 – 2010 for IYCF
morning)
 Sympto-thermal method
GOAL
 Combination of BBT and Billing/Mucus method
 Reduce Child Mortality Rate by 2/3 by 2015
 Two day method
OBJECTIVE
17 | P a g e
 Improve health and nutrition status of infants and young  Schools
children
 Introducing the “breastfeeding culture”
OUTCOME
Laws that protects IYCF
 Improve exclusive and extended breast feeding and
complementary feeding  EO 51, Milk Code
 Specific Objectives  Rooming-in and Breastfeeding Act of 1992
 70% of newborns are initiated to breastfeeding within one  RA 8976, Food Fortification Law of 2000
hour after birth
 60% of infants are exclusively breastfed up to 6 months

EXPANDED PROGRAM IMMUNIZATION
 90% of infants are started on complementary feeding by 6
months of age  General principles which apply in vaccinating children
 Median duration of breastfeeding is 18 months  Safe and immunologically effective to administer all EPI vaccine on
the same day at different sites of the body
 Key messages on IYCF
 Measles vaccine should be given as soon as the child is 9 months old
 Initiate breastfeeding within 1 hour after birth
 9 months – 85% protection
 Exclusive for the first 6 months of life
 1 year above – 95% protection
 Complemented at 6 months, excluding milk supplements
 Vaccination schedule should not be restarted from the beginning
 Extend breastfeeding up to 2 years and beyond even if the interval between doses exceeded the recommended
interval by months or years
National IYCF strategy
 Moderate fever, malnutrition, mild respiratory infection, cough,
 Health Facilities diarrhea and vomiting are not contraindicated to vaccination; unless
the child is so sick that he needs to be hospitalized
 Mother-baby friendly hospitals
 Absolute contraindications to immunizations are:
 Health workers
 DPT2 or DPT3 to a child who has had convulsions or
Advocates shock within 3 days the previous dose
Protectors  Vaccines containing the whole pertussis component

should not be given to children with an evolving
Promoters of IYCF neurological disease
 Live vaccines like BCG must not be given to

Enforcers of laws, not violators
immunosuppressed due to malignant disease (child with
clinical disease), therapy with immunosuppressive agents
 Family/Community
or irradiation
 Supportive family
 Safe and effective with mild side effects after vaccination. Local
reaction, fever and systemic symptoms can result as part of the
 Milk Code “vigilantes” normal immune response
 Lay/Peer counselors  Giving doses of vaccine at less than the recommended 4

weeks interval may lessen the antibody response.
 IYCF “bayanihan” spirit Lengthening the interval between doses of vaccines leads
to higher antibody levels
 Mother-baby friendly public places
 No extra doses must be given to children who missed a dose of
 Working places DPT/HB/OPV/TT
 Maternity leave  Strictly follow the principle of never, ever reconstituting the freeze
dried vaccines in anything other than the diluents supplied with them
 Lactation/Breastfeeding room
 Repeat BCG vaccination if the child does not develop a scar after the
 Breastfeeding breaks 1st injection
 Industry  Use one syringe one needle per child during vaccination
 Comply with the “Code”  Routine Immunization Schedule for Infants
18 | P a g e
 Occupational Health Program
 A child is said to be “Fully Immunized Child” (FIC) when a child
receives 1 dose of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of
 Health Development Program for Older Persons (Elderly Health)
HB and 1 dose of measles before a child’s 1st birthday
 Persons with Disabilities Program

 Tetanus Toxoid Immunization Schedule for Women
 Prevention of Blindness Program

 EPI vaccines and characteristics
 Rabies Control Program
OTHER HEALTH PROGRAMS  Safe Motherhood and Women's Health
 Adolescent and Youth Health and Development Program  Schistosomiasis Control Program
 Botika Ng Barangay  Smoking Cessation Program
 Breastfeeding Program / Mother and Baby Friendly Hospital Initiative  Soil Transmitted Helmenthiasis
 Blood Donation Program  TB Control Program
 Child Health
 Diabetes Mellitus Prevention Program LAWS AFFECTING PUBLIC HEALTH
 Dengue Control Program REPUBLIC ACT
 Dental Health Program

 Republic Act 9288 - Newborn Screening –
 Doctors to the Barrios (DttB) Program

 An Act Promulgating A Comprehensive Policy and A
 Emerging Disease Control Program National System For Ensuring Newborn Screening
 Environmental Health
 Republic Act 9165 - Dangerous Drugs Act of 2002 -
 Expanded Program on Immunization

 An Act Instituting the Comprehensive Dangerous Drugs
 Family Planning Act of 2002, repealing republic act no. 6425, otherwise
known as the Dangerous Drugs Act of 1972, as amended,
 Food and Waterborne Diseases Prevention and Control Program providing funds therefor and for other purposes
 Food Fortification Program  Republic Act 9257 - Expanded Senior Citizens Act of 2003
 FOURmula One
 An Act Granting Additional Benefits and Privileges to
Senior Citizens Amending for the Purpose Republic Act
 Garantisadong Pambata No. 7432 Otherwise Known As "An Act To Maximize the
Contribution of Senior Citizens to Nation Building, Grant
 GMA 50 / Parallel Drug Importation (PDI) Benefits and Special Privileges and for other Purposes"
 Healthy Lifestyle Program  Republic Act 7883 - Barangay Health Workers Benefits and
Incentives Acts of 1995
 Knock-Out Tigdas
 Leprosy Control Program

 An Act Granting Benefits and Incentives to Accredit
Barangay Health Workers and for Other Purposes.
 Malaria Control Program

 Republic Act 6675 - Generics Act of 1988
 Measles Elimination Campaign (Ligtas Tigdas)

 An Act to Promote, Require and Ensure the Production Of
 National Cardiovascular Disease Prevention and Control Program An Adequate Supply, Distribution, Use And Acceptance Of
Drugs And Medicines Identified By Their Generic Names
 National Filariasis Elimination Program
 Republic Act 4226 - Hospital Licensure Act
 National Mental Health Program
 An Act Requiring the Licensure of all Hospitals in the
 Natural Family Planning Philippines and Authorizing the Bureau of Medical
Services to Serve as the Licensing Agency
 Newborn Screening
 Republic Act 3573
 Nutrition
19 | P a g e
 Declared that all communicable diseases should be  Republic Act 7305
reportes to the nearest health station
 Magna Carta for Public Health Workers
 Republic Act 7719 - National Blood Services Act of 1994
 Aims to promote and improve the social and economic
well-being of health workers
 An Act Promoting Voluntary Blood Donation, Providing
For An Adequate Supply Of Safe Blood Regulating Blood
Banks And Providing Penal Ties For Violation Thereof
EXECUTIVE ORDER
 Republic Act 7875 - National Health Insurance Act of 1995
 Executive Order No. 663

 An Act Instituting A National Health Insurance Program
For All Filipinos And Establishing The Philippine Health
Insurance Corporation For The Purpose
 Implementing the the National Commitment for "Bakuna
ang Una Sa Sanggol At Ina", Attaining World Health
Organization's goals to Eliminate Measles and Neonatal
 Republic Act 8504 - Prevention and Control of 1988
Tetanus, Eradicate Polio, Control Hepatitis B and Other
Vaccine-Preventable Diseases
 Promulgating Policies And Prescribing Measures For The
Prevention And Control Of Hiv/Aids In The Philippines,  Executive Order No. 102
Instituting A Nationwide HIV/Aids Information And
Educational Program, Establishing A Comprehensive
Hiv/Aids
 Redirecting the Functions and Operations of the
Monitoring System, Strengthening The Philippine National Department of Health.
Aids Council, And For Other Purposes
 Executive Order No. 51
 Republic Act 8423 - Traditional and Alternative Medicine Act (TAMA of
1997)  Adopting a National Code of Marketing of Breastmilk
Supplements and related products, penalizing violations
 An Act creating the PHILIPPINE INSTITUTE OF thereof, and for other purposes.
TRADITIONAL AND ALTERNATIVE HEALTH CARE
(PITAHC) to accelerate the development of traditional and  Executive Order No. 472
alternative health care in the Philippines, providing for a
TRADITIONAL AND ALTERNATIVE HEALTH CARE
 Transferring the National Nutrition Council from the
DEVELOPMENT FUND and for other purposes
Department of Agriculture to the Department of Health
 Republic Act 8749 - Philippine Clean Air Act of 1999

PRESIDENTIAL DECREE
 An Act Providing For A Comprehensive Air Pollution  Presidential Decree No. 856
Control Policy And For Other Purposes
 Code on Sanitation of the Philippines
 Republic Act 8344 - An Act Prohibiting the Demand of Deposits or
Advance Payments  Presidential Decree No. 522
 Prescribing Sanitation Requirements for the Operation of

 An Act Prohibiting The Demand Of Deposits Or Advance
Establishments and Facilities for the Protection and
Payments For The Confinement Or Treatment Of Patients
Convenience of the Travelling Public
In Hospitals And Medical Clinics In Certain Cases
 Presidential Decree No. 651

 Requiring the Registration of Births and Deaths in the

 An Act Regulating The Practice Of Pharmacy And
Philippines which occurred from January 1, 1974 and
Settings Standards Of Pharmaceutical Education In The
thereafter
Philippines And Other Purposes

 Philippine Food Fortification Act of 2000

 Providing for Compulsory Basic Immunization for Infants
and children below eight years of age

 Code of conduct and Ethical Standards for Public Officials

and Employees  A Decree Requiring Applicant for Marriage License to
Receive Instructions on Family Planning and Responsible
 Republic Act 7160 Parenthood
 Responsibility for the delivery of basic services and  Presidential Decree No. 384
facilities of the national government has been transferred
to the local government
20 | P a g e
for the Purpose Republic Act No. 7432 Otherwise Known As "An Act To Maximize
 Amending Republic Act Numbered 4073, entitled an An the Contribution of Senior Citizens to Nation Building, Grant Benefits and Special
Act Further Liberalizing the Treatment of Leprosy by Privileges and for other Purposes"
Amending and Repealing certain Sections of the Revised
Administrative Code
Republic Act 9211 - Tobacco Regulation Act of 2003
An Act Regulating the Packaging, Use, Sale Distribution and Advertisements of
 Presidential Decree No. 893 Tobacco Products and for other Purposes
 Reconstituting the National Schistosomiasis Control Republic Act 7883 - Barangay Health Workers Benefits and Incentives Acts of
Commission into the Schistosomiasis Control Council and 1995
An Act Granting Benefits and Incentives to Accredit Barangay Health Workers
for other Purposes
and for Other Purposes.
Republic Act 8203 - Special Law on Counterfeit Drugs"

An Act of Prohibiting Counterfeit drugs, Providing Penalties for Violations and
Appropriating Funds Thereof
Presidential Decree
Republic Act 6425 - Dangerous Drugs Act of 1972
This Act shall be known and cited as "The Dangerous
• Presidential Decree 881
Drugs Act of 1972."
January 30, 1976
Empowering the Secretary of Health to regulate the labeling, sale and
distribution of hazardous substances Republic Act 6675 - Generics Act of 1988
• Presidential Decree No. 856 An Act to Promote, Require and Ensure the Production Of An Adequate Supply,
Distribution, Use And Acceptance Of Drugs
Code on Sanitation of the Philippines And Medicines Identified By Their Generic Names
(with Implementing Rules and Regulations)
• Presidential Decree No. 522
Republic Act 4226 - Hospital Licensure Act
Prescribing Sanitation Requirements for the Operation of
An Act Requiring the Licensure of all Hospitals in the Philippines and Authorizing
Establishments and Facilities for the Protection and Convenience of
the Bureau of Medical Services to Serve as the Licensing Agency
the Travelling Public
Requiring the Registration of Births and Deaths in the Philippines Republic Act No. 7876 - Senior Citizens Center Act of the Philippines
which occured from January 1, 1974 and thereafter An Act to Maximize the Contribution of Senior Citizens to Nation Building, Grant
Benefits and Special Privileges
Providing for Compulsory Basic Immunization for Infants and children
below eight years of age Republic Act 7305 - Magna Carta of Public Health Workers
Magna Carta of Public Health Workers (Republic Act No. 7305)
Amending sections two, three, four, seven, eight, eleven, thirteen,
sixteen, seventeen, twenty-one and twenty-nine of Republic Act No. Republic Act 7719 - National Blood Services Act of 1994
5527, also known as the Philippine Medical Technology Act of 1969 An Act Promoting Voluntary Blood Donation, Providing For An Adequate Supply
Of Safe Blood Regulating Blood Banks And Providing Penal Ties For Violation
• Presidential Decree No. 965 Thereof
A Decree Requiring Applicant for Marriage License to Receive
Instructions on Family Planning and Responsible Parenthood
Republic Act 7875 - National Health Insurance Act of 1995
An Act Instituting A National Health Insurance Program For All Filipinos And
Creating the Lunsod ng Kabataan Establishing The Philippine Health Insurance Corporation For The Purpose
Creating the Lung Center of the Philippines
Republic Act 7432 - Senior Citizen Act of 1992)
• Presidential Decree No. 384 An Act to Maximize the Contribution of Senior Citizens to Nation Building, Grant
Amending Republic Act Numbered 4073, entitled an An Act Further Benefits and Special Privileges
LIberalizing the Treatment of Leprosy by Amending and Repealing
certain Sections of the REvised Administrative Code
Amendment to RA 7170 - Organ Donation Act of 1991
• Presidential Decree No. 1832 An Act To Advance Corneal Transplantation In The Philippines, Amending For
Creating National Kidney Foundation of the Philippines The Purpose Republic Act Numbered Seven Thousand One Hundred And
Seventy (R.A. N0. 7170) Otherwise Known As The Organ Donation Act Of 1991
Reconstituting the National Schistosomiasis Control Commission into
the Schistosomiasis Control Council and for other Republic Act 8504 - Prevention and Control of 1988
Purposes Promulgating Policies And Prescribing Measures For The Prevention And Control
• Presidential Decree No. 79 Of Hiv/Aids In The Philippines, Instituting A Nationwide HIV/Aids Information And
Educational Program, Establishing A Comprehensive Hiv/Aids
Revising the Population Act of Nineteen Hundred and Seventy-one
Monitoring System, Strengthening The hilippine National Aids Council, And For
Other Purposes
Republic Act
Republic Act 8423 - Traditional and Alternative Medicine Act (TAMA of 1997)
An Act creating the PHILIPPINE INSTITUTE OF TRADITIONAL AND
Republic Act 9288 - Newborn Screening - An Act Promulgating A Comprehensive ALTERNATIVE HEALTH CARE (PITAHC) to accelerate the development of
Policy and A National System For Ensuring Newborn Screening traditional and alternative health care in the Philippines, providing for a
TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND and
for other purposes
Republic Act 9165 - Dangerous Drugs Act of 2002 - An Act Instituting the
Comprehensive Dangerous Drugs Act of 2002, repealing republic act no. 6425,
otherwise known as the Dangerous Drugs Act of 1972, as amended, providing Republic Act 8749 - Philippine Clean Air Act of 1999
funds therefor and for other purposes An Act Providing For A Comprehensive Air Pollution Control Policy And For Other
Purposes
Republic Act 9257 - Expanded Senior Citizens Act of 2003
An Act Granting Additional Benefits and Privileges to Senior Citizens Amending
21 | P a g e
Republic Act 8344 - An Act Prohibiting the Demand of Deposits or Advance Republic Act 7305 - Magna Carta of Public Health Workers
Payments Magna Carta of Public Health Workers (Republic Act No. 7305)
An Act Prohibiting The Demand Of Deposits Or Advance Payments For The
Confinement Or Treatment Of Patients In Hospitals And Medical Clinics In
Certain Cases Republic Act 7719 - National Blood Services Act of 1994
An Act Promoting Voluntary Blood Donation, Providing For An Adequate Supply
Republic Act 5921 Thereof
An Act Regulating The Practice Of Pharmacy And Settings Standards Of
Pharmaceutical Education In The Philippines And Other Purposes
Republic Act 9165 - An Act Instituting The Comprehensive Dangerous Drugs Act Establishing The Philippine Health Insurance Corporation For The Purpose
Of 2002, Repealing Republic Act No. 6425, Otherwise Known As The Dangerous
Drugs Act Of 1972, As Amended, Providing Funds Thereof, And For Other
Purposes Republic Act 7432 - Senior Citizen Act of 1992)
An Act to Maximize the Contribution of Senior Citizens to Nation Building, Grant
Republic Act 7394
The Consumer Act Of The Philippines
Amendment to RA 7170 - Organ Donation Act of 1991
An Act To Advance Corneal Transplantation In The Philippines, Amending For
Republic Act 8976 The Purpose Republic Act Numbered Seven Thousand One Hundred And
Philippine Food Fortification Act of 2000 Seventy (R.A. N0. 7170) Otherwise Known As The Organ Donation Act Of 1991
Republic Act 4688 - An Act Regulating the Operation and Maintenance of Republic Act 8504 - Prevention and Control of 1988
Clinical Laboratories and Requiring the Registration of the same with the Promulgating Policies And Prescribing Measures For The Prevention And Control
Department of Health, Providing Penalty for the Violation thereof, and for Other Of Hiv/Aids In The Philippines, Instituting A Nationwide HIV/Aids Information And
Purposes Educational Program, Establishing A Comprehensive Hiv/Aids
Other Purposes
Republic Act
Republic Act 9288 - Newborn Screening - An Act Promulgating A Comprehensive An Act creating the PHILIPPINE INSTITUTE OF TRADITIONAL AND
Policy and A National System For Ensuring Newborn Screening ALTERNATIVE HEALTH CARE (PITAHC) to accelerate the development of
traditional and alternative health care in the Philippines, providing for a
TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND and
Republic Act 9165 - Dangerous Drugs Act of 2002 - An Act Instituting the for other purposes
otherwise known as the Dangerous Drugs Act of 1972, as amended, providing
funds therefor and for other purposes Republic Act 8749 - Philippine Clean Air Act of 1999
An Act Providing For A Comprehensive Air Pollution Control Policy And For Other
Purposes
Republic Act 9257 - Expanded Senior Citizens Act of 2003
An Act Granting Additional Benefits and Privileges to Senior Citizens Amending
for the Purpose Republic Act No. 7432 Otherwise Known As "An Act To Maximize Republic Act 8344 - An Act Prohibiting the Demand of Deposits or Advance
the Contribution of Senior Citizens to Nation Building, Grant Benefits and Special Payments
Privileges and for other Purposes" An Act Prohibiting The Demand Of Deposits Or Advance Payments For The
Confinement Or Treatment Of Patients In Hospitals And Medical Clinics In
Certain Cases
Republic Act 9211 - Tobacco Regulation Act of 2003
An Act Regulating the Packaging, Use, Sale Distribution and Advertisements of
Tobacco Products and for other Purposes Republic Act 5921
An Act Regulating The Practice Of Pharmacy And Settings Standards Of
Pharmaceutical Education In The Philippines And Other Purposes
Republic Act 7883 - Barangay Health Workers Benefits and Incentives Acts of
1995
An Act Granting Benefits and Incentives to Accredit Barangay Health Workers Republic Act 9165 - An Act Instituting The Comprehensive Dangerous Drugs Act
and for Other Purposes. Of 2002, Repealing Republic Act No. 6425, Otherwise Known As The Dangerous
Drugs Act Of 1972, As Amended, Providing Funds Thereof, And For Other
Purposes
Republic Act 8203 - Special Law on Counterfeit Drugs"
An Act of Prohibiting Counterfeit drugs, Providing Penalties for Violations and
Appropriating Funds Thereof Republic Act 7394
The Consumer Act Of The Philippines
Republic Act 6425 - Dangerous Drugs Act of 1972
This Act shall be known and cited as "The Dangerous Republic Act 8976
Drugs Act of 1972." Philippine Food Fortification Act of 2000
Republic Act 6675 - Generics Act of 1988 Republic Act 4688 - An Act Regulating the Operation and Maintenance of
An Act to Promote, Require and Ensure the Production Of An Adequate Supply, Clinical Laboratories and Requiring the Registration of the same with the
Distribution, Use And Acceptance Of Drugs Department of Health, Providing Penalty for the Violation thereof, and for Other
And Medicines Identified By Their Generic Names Purposes
Republic Act 4226 - Hospital Licensure Act Republic Act

the Bureau of Medical Services to Serve as the Licensing Agency
Republic Act 9288 - Newborn Screening - An Act Promulgating A Comprehensive
Policy and A National System For Ensuring Newborn Screening
Republic Act No. 7876 - Senior Citizens Center Act of the Philippines
Benefits and Special Privileges Republic Act 9165 - Dangerous Drugs Act of 2002 - An Act Instituting the
otherwise known as the Dangerous Drugs Act of 1972, as amended, providing
funds therefor and for other purposes
22 | P a g e
Republic Act 9257 - Expanded Senior Citizens Act of 2003 Republic Act 8344 - An Act Prohibiting the Demand of Deposits or Advance
An Act Granting Additional Benefits and Privileges to Senior Citizens Amending Payments
for the Purpose Republic Act No. 7432 Otherwise Known As "An Act To Maximize An Act Prohibiting The Demand Of Deposits Or Advance Payments For The
the Contribution of Senior Citizens to Nation Building, Grant Benefits and Special Confinement Or Treatment Of Patients In Hospitals And Medical Clinics In
Privileges and for other Purposes" Certain Cases
Republic Act 9211 - Tobacco Regulation Act of 2003 Republic Act 5921
An Act Regulating the Packaging, Use, Sale Distribution and Advertisements of An Act Regulating The Practice Of Pharmacy And Settings Standards Of
Tobacco Products and for other Purposes Pharmaceutical Education In The Philippines And Other Purposes
Republic Act 7883 - Barangay Health Workers Benefits and Incentives Acts of Republic Act 9165 - An Act Instituting The Comprehensive Dangerous Drugs Act
1995 Of 2002, Repealing Republic Act No. 6425, Otherwise Known As The Dangerous
An Act Granting Benefits and Incentives to Accredit Barangay Health Workers Drugs Act Of 1972, As Amended, Providing Funds Thereof, And For Other
and for Other Purposes. Purposes
Republic Act 8203 - Special Law on Counterfeit Drugs" Republic Act 7394
An Act of Prohibiting Counterfeit drugs, Providing Penalties for Violations and The Consumer Act Of The Philippines
Appropriating Funds Thereof
Republic Act 8976

Republic Act 6425 - Dangerous Drugs Act of 1972 Philippine Food Fortification Act of 2000
This Act shall be known and cited as "The Dangerous
Drugs Act of 1972."
Republic Act 4688 - An Act Regulating the Operation and Maintenance of
Clinical Laboratories and Requiring the Registration of the same with the
Republic Act 6675 - Generics Act of 1988 Department of Health, Providing Penalty for the Violation thereof, and for Other
An Act to Promote, Require and Ensure the Production Of An Adequate Supply, Purposes
Distribution, Use And Acceptance Of Drugs
And Medicines Identified By Their Generic Names
Executive Order 102
MALACAÑANG
Republic Act 4226 - Hospital Licensure Act
the Bureau of Medical Services to Serve as the Licensing Agency MANILA
BY THE PRESIDENT OF THE PHILIPPINES

Republic Act No. 7876 - Senior Citizens Center Act of the Philippines
EXECUTIVE ORDER NO. 102
Republic Act 7305 - Magna Carta of Public Health Workers

REDIRECTING THE FUNCTIONS AND OPERATIONS OF THE DEPARTMENT OF
Magna Carta of Public Health Workers (Republic Act No. 7305)
HEALTH
Republic Act 7719 - National Blood Services Act of 1994

WHEREAS, the Department of Health, hereafter referred to as DOH, has been
An Act Promoting Voluntary Blood Donation, Providing For An Adequate Supply
transformed from being the sole provider of health services, to being a provider of
specific health services and technical assistance provider for health, as a result of the
Thereof
devolution of basic services to local government units;

WHEREAS, the DOH seeks to serve as the national technical authority on health, one
that will ensure the highest achievable standards of quality health care, health promotion
Establishing The Philippine Health Insurance Corporation For The Purpose
and health protection, from which local governments units, non-government
organizations, other private organizations and individual members of civil society will
Republic Act 7432 - Senior Citizen Act of 1992) anchor their health programs and strategies;
WHEREAS, to effectively fulfill its refocused mandate, the DOH is required to undergo
changes in roles,: functions, organizational processes, corporate values, skills technology
Amendment to RA 7170 - Organ Donation Act of 1991 and structures;
An Act To Advance Corneal Transplantation In The Philippines, Amending For
The Purpose Republic Act Numbered Seven Thousand One Hundred And
WHEREAS, Section 20, Chapter 7, Title I Book III of Executive Order No. 292 series of
Seventy (R.A. N0. 7170) Otherwise Known As The Organ Donation Act Of 1991
1987, otherwise known as the Administrative Code of 1987, empowers the President of
the Philippines to exercise such powers and functions as are vested in him under the law:
Republic Act 8504 - Prevention and Control of 1988
Promulgating Policies And Prescribing Measures For The Prevention And Control
WHEREAS, Section 78 of the General Provisions of RA 8522, otherwise known as the
Of Hiv/Aids In The Philippines, Instituting A Nationwide HIV/Aids Information And
General Appropriations Act of 1998, empowers the President to direct changes in
Educational Program, Establishing A Comprehensive Hiv/Aids
organization and key positions of any department, bureau or agency;
Other Purposes
WHEREAS, Section 80 of the same General Provisions directs heads of departments,
bureaus and agencies to scale down, phase out or abolish activities no longer essential in
the delivery of health services;
An Act creating the PHILIPPINE INSTITUTE OF TRADITIONAL AND
ALTERNATIVE HEALTH CARE (PITAHC) to accelerate the development of
traditional and alternative health care in the Philippines, providing for a NOW, THEREFORE, I, JOSEPH EJERCITO ESTRADA, President of the Republic of
TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND and the Philippines, by virtue of the powers vested in me by law, do hereby order the
for other purposes following:
Republic Act 8749 - Philippine Clean Air Act of 1999 SECTION 1. Mandate. Consistent with the provisions of the Administrative Code of
An Act Providing For A Comprehensive Air Pollution Control Policy And For Other 1987 and RA 7160 (the Local Government Code), the DOH is hereby mandated to
Purposes provide assistance to local government units (LGUs), people's organization (PO) and
23 | P a g e
other members of civic society in effectively implementing programs, projects and d) Maintain national health facilities and hospitals with modern and advanced capabilities
services that will: to support local services;
a) promote the health and well-being of every Filipino; e) Promote health and well-being through public information and to provide the public
with timely and relevant information on health risks and hazards;
b) prevent and control diseases among populations at risks;

d) the resource allocation shift, specifying the effects of the streamlined set-up on the
agency budgetary allocation and indicating where possible savings have been generated;
c) protect individuals, families and communities exposed to hazards and risks that could
affect their health; and
f) Develop and implement strategies to achieve appropriate expenditure patterns in health
as recommended by international agencies;
d) treat, manage and rehabilitate individuals affected by disease and disability.
g) Development of sub-national centers and facilities for health promotion. disease

SECTION 2. Roles. To fulfill its responsibilities under this mandate, the DOH shall serve control and prevention, standards. regulations and technical assistance;
as the:
h) Promote and maintain international linkages for technical collaboration;

a) lead agency in articulating national objectives for health to guide the development of
local health systems, programs and services;
i) Create the environment for development of a health industrial complex;
b) direct service provider for specific programs that affect large segments of the
population, such as tuberculosis, malaria, schistosomiasis, HIV-AIDS and other emerging j) Assume leadership in health in times of emergencies, calamities and disasters; system
infections, and micronutrient deficiencies; fails;
c) lead agency in health emergency response services, including referral and networking k) Ensure quality of training and health human resource development at all levels or the
systems for trauma, injuries and catastrophic events; health care system;
d) technical authority in disease control and prevention; l) Oversee financing or the health sector and ensure equity and accessibility to health
services; and
e) lead agency in ensuring equity, access and quality of health care services through
policy formulation, standards development and regulations; m) Articulate the national hea1th research agenda and ensure the provision of sufficient
resources and logistics to attain excellence in evidenced-based interventions for health.
f) technical oversight agency in charge of monitoring and evaluating the implementation

of health programs, projects, research, training and services; SECTION 4. Preparation of a Rationalization and Streamlining Plan In view of the
functional and operational redirection in the DOH and to effect efficiency and
effectiveness in its activities, the Department shall prepare a Rationalization and
g) administrator of selected health facilities at sub national levels that act as referral Streamlining Plan (RSP) which shall be the basis of the intended changes. The RSP Plan
centers for local health systems i.e. tertiary and special hospitals, reference laboratories, shall contain the following:
training centers, centers for health promotion; centers for disease control and prevention,
regulatory offices among others;
a) the specific shift in policy directions. functions, programs and activities/ strategies;
h) innovator of new strategies for responding to emerging health needs;

b) the structural and organizational shift stating the specific functions and activities by
organizational unit and the relationship of each units;
i) advocate for health promotion and healthy life styles for the general population;
c) the staffing shift, highlighting and itemizing the existing filled and unfilled positions;
j) capacity-builder of local government units, the private sector, non-government and
organizations, people's organizations, national government agencies, in implementing
health programs and services through technical collaborations, logistical support,
provision of grant and allocations and other partnership mechanisms; d) the resource allocation shift, specifying the effects of the streamlined set-up on the
agency budgetary allocation and indicating where possible, savings have been generated.
k) lead agency in health and medical research;

The RSP shall submitted to the, Department of Budget and Management for approval
before the corresponding shifts shall be affected by the DOH Secretary.
l) facilitator of the development of health industrial complex in partnership with the
private sector to ensure self-sufficiency in the production of biologicals, vaccines and
drugs and medicines; SECTION 5. Redeployment of Personnel. The redeployment of officials and other
personnel on the basis of the approved RSP shall not result in diminution in rank and
compensation of existing personnel. It shall take into account all pertinent Civil Service
m) lead agency in health emergency preparedness and response; laws and rules.
n) protector of standards of excellence in the training and education of health care SECTION 6. Funding. The financial resources needed to implement the Rationalization
providers at all levels of the health care system; and and Streamlining Plan shall be taken from funds available in the DOH, provided that the
total requirements for the implementation of the revised staffing pattern shall not exceed
available funds for Personnel Services.
o) implementor of the National Health Insurance Law; providing administrative and
technical leadership in health care financing.
SECTION 7. Separation Benefits. Personnel who opt to be separated from the service as
a consequence of the implementation of this Executive Order shall be entitled to the
SECTION 3. Powers and Functions. To accomplish its mandate and roles the Department
benefits under existing laws. In the case of those who are not covered by existing laws,
shall:
they shall be entitled to separation benefits equivalent to one month basic salary for every
year of service or proportionate share thereof in addition to the terminal fee benefits to
a) Formulate national policies and standards for health; which he/she is entitled under existing laws,
b) Prevent and control leading causes of health and disability; c) Develop disease SECTION 8. Implementing Authority. Following the approved RSP, the DOH Secretary,
surveillance and health information systems; in addition to his authority to implement the RSP is hereby authorized to determine the
type of agencies and facilities necessary to carry out the Department's mandate and roles,
24 | P a g e
including the pilot testing of programs and such-pre corporization of hospitals following i. Disease surveillance
strictly the principles of efficiency and effectiveness.
1. Measure the magnitude of the problem
SECTION 9. Effectivity. This Executive Order shall take effect immediately
2. Measure the effect of the control
program
DONE in the City of Manila this 24th day of May in the year of Our Lord, Nineteen
Hundred and Ninety-Nine.
By the President:
OVERVIEW OF THE PUBLIC HEALTH NURSING
RONALDO B. ZAMORA
Executive Secretary
Public Health Nursing and Community Health Nursing often used
interchangeably
THE PUBLIC HEALTH NURSE
PHN defined by WHO:

Qualifications and Functions
“Special field of nursing that combines the skills of nursing, public health and
Must be professionally qualified and licensed to practice in the arena of public some phases of social assistance and functions as part of total public health
health nursing programme for the promotion of health, improvement of the conditions in the
social and physical environment, rehabilitation of illness and disability”
Consistent with the nursing law of 2002 (RA 9173)
I. Management function
CHN defined by Freeman:
a. Inherent in the practice of PHN
“Service rendered by a professional nurse with communities, groups, families
b. Organizes the nursing service of the local health agency and individuals at home, in health centers, in clinics, in schools and in places of
work for the promotion of health, prevention of illness, care of the sick at home
II. Supervisory function and rehabilitation”
a. Supervisor of the midwives and other health workers
III. Nursing care function CHN defined by Jacobson
a. Inherent function of the nurse “Nursing practice in a wide variety of community services and consumer
advocate areas and in a variety of roles at times including independent
b. Based on the science of art and caring practice… community nursing is certainly not confined to public health nursing
agencies”
c. Caring for all levels of clientele toward health promotion and
disease prevention
IV. Collaborating and coordinating function The original thrust of Public Health Nursing:
a. Care coordinators for communities and their members “Nursing for the health of the entire public/community versus nursing only for the
public who are poor”
b. Establishes linkages and collaborative relationships with other
health professionals, government agencies, private sectors,
NGO’s people’s organizations to address health problems
Standards of Public Health Nursing:
V. Health promotion and education function
Public Health Nursing
a. Activities goes beyond health teachings and health information
campaigns • Refers to the practice of nursing in national and local government
health departments and public schools
VI. Training function
• It is a community health nursing practice in the public sector
a. Initiates the formulation of staff development and training
programs for midwives and other auxiliary workers
VII. Research function

Public Health Nurses
a. Participates in the conduct of research and utilizes research

• Refers to the nurses in the local/national health departments or public
findings in her practice
schools whether their official position title is public health nurse or
nurse or school nurse
25 | P a g e
PUBLIC HEALTH NURSES
• Leaders in providing quality health services to the communities
• First level of health workers to be knowledgeable about new public

health technologies and methodologies
• Usually the first ones to be trained to implement new programs and

apply new technologies
By Jhun
Echipare
26 | P a g e

Community Health Nursing 101 by Jhun

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Community Health Nursing 101 by Jhun

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HEALTH 1.

• It is inappropriate therefore to blame or credit the persons state of health to

• Knowledge of these factors is important in order to effectively promote

iv. familial ethnic racial

Core business of Public Health

4. health public policy 5. Improve maternal health

7. Ensure environmental sustainability

ESSENTIAL PUBLIC HEALTH FUNCTIONS 8. Develop a global partnership for development

Needed to achieve the core business of public health

1. Health situation monitoring and analysis

3. Development of policies and planning in public health

7. Health promotion, social participation and empowerment

GLOBAL AND COUNTRY HEALTH IMPERATIVES

3. Existing and emerging environmental hazards some associated with

United Nations General Assembly

Poverty reduction and sustainable development in September 2000

• Refers to the practice of nursing in national and local government health

1. Eradicate extreme poverty and hunger

2. Achieve universal primary education Public Health Nurses

3. Promote gender equality and empower women

• Maintains provincial health teams made up of DOH representatives to the

• Leaders in providing quality health services to the communities

Local level (Local Health System)

THE PHILIPINE HEALTH CARE DELIVERY SYSTEM • Run by LGU

Major players of the HCDS Provincial government

1. Private sector • Provincial and District hospitals

a. Largely market oriented

b. Health care is paid through user fees at the point of service

c. Includes profit and non-profit health providers

iii. Medical supplies

iv. Medical equipment PHILIPPINE DEPARTMENT OF HEALTH

v. Other health and nutrition products HISTORICAL BACKGROUND

vi. Research and development PRE-SPANISH and SPANISH PERIOD

vii. Human resource development

2. Public sector 1888

September 29, 1898

Department of Health July 1, 1901

October 26, 1905 May 24, 1999

1932 o Protect individuals, families and communities exposed to

February 20 1958 VISION

• PD 1397 renamed the Department of Health to the Ministry of Health

2. Persistence of large variations in health status across population groups and

6. Burden of disease is heaviest on the poor

Defining the Rules of Engagement:

The reforms will be implemented under a sector-wide approach, which

Starting the Race with the End in Mind:

• Better health outcomes F1 Rule No. 5:

The selection of FOUR-in-ONE Convergence Sites will be governed by the following

Carrying out the Game Plan:

 Partnership and empowerment of the people

F1 Component No.2: HEALTH REGULATION

2. Control of communicable diseases b. PHN

4. Health Education d. RHM

6. Adequate Food and Proper Nutrition  Primary Level of Care

o National and Regional Health Services

o calls for active and continuing partnership among the

2. Intermediate Level Health Workers

Qualifications and Functions  Bag technique

Contain all necessary articles

Cleaned very often

– Inherent function of the nurse Arrangement-most convenient

– Based on the science of art and caring

• Collaborating and coordinating function

• Training function – Means