Community Health Nursing

Weighing Scale or tape measure for mid-upper arm circumference (Malnourishment) 2 types of community: - Geo political community Barangay Lectured by: Z. Famorca, PhD, RN City Province A Pre-test on Basic Concepts - Phenomenological 1. D. GIDA- Geographically Isolated and Deprived Areas 2. B. - Cooperative Development Authority 3. B. 4. B. Under the office of the president 5. A. - Many are from Mindanao 6. A. - Hospice home care 7. C. - Parish Community Nursing 8. A. - Faith community nursing 9. C. DOTS 10. C. - Treatment partner follows up medication Public health is supposed to be given for free FALSE Financing of health services PHN appoints a treatment partner - Out of pocket Another health worker that is accessible - Health maintenance organization (Phil Health) BHW - Free at the point of care 3. Population/aggregatefocused GovernmentTaxes are paid - The greater good of the majority Test taking technique - Community Diagnosis - When choosing numbers choose the middle ground Vital Statistics - Do not choose the extreme numbers Demography CHN: Definition - Magnitude (prevalence) of a problem 1. Developmental Services A criterion for priority setting - Development of health capability of Individual, 4. Promotive and preventive Family, Group, Community - Preventive treatment, e.g. DOTS Groups with common susceptibility - Health Education Same working group - Enabling service self- reliance 5. Pre-paid service - Health educationdone for health promotion - Taxation (public and school health) Patient EducationDone when person - Passed on to consumer (occupational) is sick Transfer of Technology - Community organizing 6. Generalist Practice Labor Code: Health, Safety and Welfare Benefits 2. Community-based - Catchment - Book 4: Health, safety and welfare benefits - Natural environment of people Number of workers OH services Home PHN 10-50 Graduate first aider who may be one of the workers School SHN 50-200 Non-hazardous: full-time first Workplace OHN aider 3 fields of CHN Practice Case-finding of CHN practice Direct Sputum Smear Microscopy (TB)
200-300 Hazardous workplace: OHN OHN, Part-time physician and dentist (at least 2hrs a day), emergency clinic (1 bed: 100 workers) or hospital within 5 km Full time DMD and MD

>300

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RA 124mandates all schools to have a school clinic for the treatment of minor ailments and attendance to emergency cases (1947) - School health physician reports to the board of health (DOH) Functions of OHN and SHN 1. Health care provider - Promotive and preventive services Health advocacy Health education and counseling Immunization, prenatal care - Treatment of common ailments and emergency nursing care CD control - Screening for health problems: School health and nutrition survey done on the 1st visit by the nurse and every 3 years thereafter Random/rapid classroom inspection Annual individual health inspection o Interview o Height and weight measurement Head to foot examination for cleanliness, skin disease and other obvious abnormalities Visual acuity test: a child with visual acuity of 20/40 or poorer to be referred Ear exam and hearing acuity test: otoscopy, whisper test, ballpen click test or with the use of tuning fork (ototoxicity for Streptomycin) 2. Environmental Manager - Monitoring environmental conditions - Recognizing and reporting accident and health hazards in workplace/school - Healthful school living - Application of ergonomic principles (physical environment) 3. Health coordinator - Making referrals to other agencies and health personnel - Coordination with public health nurse, e.g. for immunization of school children

Public Health (C.E.Winslow) Philosophy of public heatlh - Health and longevity as birth rights - Premature death (*untimely death) Objectives of public health - To prevent disease - To prolong life - To promote health and efficiency Organized community efforts - People Primary Health Care RHU - Private sector Philosophy of public health nursing (Margaret Shetland) - PHN is based on the worth and dignity of man Contribute to the integrity of the Individual, Family and Community - The family is the basic unit of service in PHN - Physical and emotional health are inseparable Consider physical and emotional aspects of the needs of all the members of the family Public Health Nursing (WHO expert committee on nursing) - PHN is a special field of nursing that combines the skills of: Public health Nursing Some phases of social assistance feeding program 4Ps Pantawid pamilyang Pilipino Program (CCT- conditional cash transfer) - Poverty alleviation MDG1: Eliminate hunger and poverty th - 5 Quintile and instrument to identify True Poor Benefits: 1. P500/month 2. For every qualified child (max of 4 up to 15yrs) - P300/month for 10 mos. Conditions: 1. 85% of class days, students should be present 2. Immunization up to the age of 4 3. Children will be in the garantisadong pambata program

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PHN functions as part of a total public health program Health team 1 municipal health plan - Objectives of PHN Promotion of health Improvement of conditions in the physical and social environment Rehabilitation Prevention of illness and disability Basic competencies of the Public Health Nurse - Patient care competencies CHN process Nursing procedures during clinic and home visits Surveillance - Health promotion and education - Communication - Collaboration: community organizing - Empowering competencies Legal responsibility Ethico-moral responsibilities Personal and professional development - Enabling competencies Management of resources and environment Record management - Enhancing competencies Research Quality improvement Pre-test 1. 1 2. 2 3. 1 4. 1 5. 2 6. 1 7. 3 8. 2 9. C 10. B. Level of Prevention - Target population: Beneficiaries (For whom?) Purpose of the nursing action: aspect of prevention (for what?)

Primary level - Target population: well individuals, families, groups and communities - Aspects of prevention General health promotion Specific disease prevention o Prevent from a single person Specific protection o Groups of people o ASIN Law- An Act for Salt Iodization Nationwide Secondary Level - Target Population: Early sick + subclinical cases (asymptomatic) - Aspects of prevention Early diagnosis and prompt treatment Prevention of complications Tertiary Level - Target population: Late sick: convalescent, disabled, complicated case, terminal ill Natural hx of disease PrePathogenesis Pathogenesis Interaction

Pre-test 1. A 2. D 3. 3 4. 4 5. 1 6. 2 7. D 8. A 9. B 10. D 11. B. 12. A Millennium Summit: September 6-8, 2000 1. Eradicate extreme poverty and hunger 2. Achieve universal primary education 3. Promote gender equality and empower women 4. Reduce by2/3 the under 5 mortality rate (1990:80/1000 live births 2015: 26.7/1000) Margadi BSN 2013

5. Reduce by the maternal mortality rate (1990: 2.09/1000 live births 2015: 52/1000 live births) 6. Combat HIV/AIDS, malaria and other disease 1993: eradication of 1. Polio 2. Neonatal Tetanus 3. Measles 4. Rabies 7. Ensure environmental sustainability 8. Develop a global partnership for development World Health Organization (MDG4-6) The Department of Health Vision- Mission Vision To staunch advocate, model and leader of health for all in the Philippines A global leader for attaining better health
outcomes, competitive and responsive health care system, and equitable health financing.

Universal Health Care (2010-2016) FOURmula One for Health (2005-2010) Health Sector Reform Agenda (1999-2004)

Priority Health Policy Directions of the Aquino Administration

Financial Risk Protection

Achieving MDGmax

Health facilities enhancement

Mission To guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health. Roles and functions of the DOH 1. Leader a. Planner and policy-maker b. Regulator of health services c. Advocate in the adoption of health policies, plans and programs 2. Enabler and capacity builder a. Develop new strategies in health b. Initiate public discussion on health issues and disseminate info on research outputs c. Ensure standards of health promotion, protection and care (training) 3. Administrator of specific services a. Manage selected national health facilities b. Administer direct services for emergent health concerns that require new complicated technologies c. Administer health emergency responses

Universal Health Care Strategies 1 2 Health Financing Service Delivery 6 Health Human Resource Goals Better Health outcomes 5 Health information

3 Policy and regulation 4 Governance for Health

Responsive health system

Equitable health financing

Health care delivery system of the Philippines Primary Level - Promotion and prevention - Management of prevalent conditions - Out-patient services Secondary - Hospitalization Tertiary - Specialized care Specially trained personnel Highly departmentalized Margadi BSN 2013

Sophisticated equipment

National hospitals/DOH national office/ medical centers/ university hospitals/ special hospitals Center for health development Provincial hospital (PHO) District hospital (DHO) RHU/CHC/CHO BHS RA 7160devolution code Inter Local Health System - To ensure quality of health care service at the local level integrate hospital and public health services holistic health care - Inter Local Health Zone (ILHZ) Clustered municipalities (defined population within a defined area) Primary level facilities (RHUs and BHSs) Central referral hospital Components of the ILHZ - Peoplemay vary, according to WHO, between 100, 000 to 500, 000 - Boundariesto determine accountability of health service providers - Health facilities- secondary level hospital (district of provincial), RHUs BHSs and other health facilities - Health workersboth government and nongovernment Two-way referral system - Communication among facilities The RHU team Epidemiology 1. B 2. B 3. B 4. D Prove Health Board Chair: Governor Vice-chair: IPHO

5. 6. 7. 8. 9. 10. 11.

D B A B C A D

Municipal/city Health Board Chair: Mayor Vice-chair: Municipal Health Officer

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