THE PHILIPPINE

HEALTHCARE
DELIVERY SYSTEM
 THE WORLD
H E A LT H
O R G A N I Z AT I O N
• Constitution was established on April 7, 1948
• Headquarters in Geneva, Switzerland
• Has 147 country offices
• Has 6 regional offices ( Africa, the Americas, Eastern
Mediterranean, Europe, Southeast Asia, Western Pacific
Global and National Health Situations
• The eight MDGs:
1. Eradicate extreme poverty and hunger.
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop global partnerships for development
(Except for goals 2 and 3, all MDGs are health or health-related.
Health is essential to the achievement of these goals and is a major
contributor to the overarching goal of poverty reduction.
• Core Functions:
– Providing leadership on matters critical to health and engaging in
partnerships where joint action is needed.
– Setting norms and standards and promoting and monitoring their
implementation.
– Articulating ethical and evidence-based policy options.
– Providing technical support, catalyzing change, and building
sustainable institutional capacity.
– Shaping the research agenda and stimulating the generation,
translation, and disseminating valuable knowledge.
*Priorities *Capacity
*Organization *Translation
*Standards
 SUSTAINABLE DEVELOPMENT GOALS
• The Sustainable Development Goals are a set of 17 goals
defined by the United Nations launched in September
2015. It addresses a number of social and environmental
development issues. The goals are also known as
“Transforming our World: the 2030 Agenda for Sustainable
Development.”
 PHILIPPINES
DEPARTMENT OF
H E A LT H
 PHILIPPINE DEPARTMENT OF HEALTH
• Historical Background
• Pre-Spanish and Spanish Periods (before 1898)
– Use traditional health care practices; Western concept of healing
were widely practiced
– Establishment of the first medical dispensary for indigent patients of
Manila by Franciscan Friar Juan Clemente that was began in 1577
• 1690
– Installation of water system in San Juan del Monte and Manila by
Dominican Father Juan de Pergero
• 1805
– Introduction of smallpox vaccination by Dr. Francisco de Balmis
DOH HISTORICAL BACKGROUND
• 1876
– Appointment of the first Medicos Titulares , equivalent to provincial health officers
• 1888
• A Superior Board of Health & Charity was created by the Spaniards which established a hospital system & a board
of vaccination
• Graduation of the first cirujanos ministrantes from UST
• 1898, June 23
• Department of Public Works, Education & Hygiene was created by virtue of a decree signed by
• 1901
– Creation of the Board of Health of the Philippine Islands by the United States Philippine Commission through
Act 157.
• 1905
– Foundation of La Gota de Leche by Asociacion Feminista Filipina
• 1912
– Creation of sanitary divisions by the Fajardo Act
• 1915
– Organization of the Social and Home Care Service unit of PGH
DOH HISTORICAL BACKGROUND
• Before WW II
– Establishment of municipal and charity clinics
• 1947
– Reorganization of DOH into bureaus
• 1954
– Approval of R.A.1082 (Rural Health Act) by the Congress
• 1957
– Enactment of R. A. 1891 amending certain provisions in the Rural Health Act
• 1970s
– Restructure of the Philippine health care delivery system classifying health
services
• 1954
– Approval of R.A.1082 (Rural Health Act) by the Congress
DOH HISTORICAL BACKGROUND
• 1957
– Enactment of R. A. 1891 amending certain provisions in the Rural
Health Act
• 1970s
– Restructure of the Philippine health care delivery system classifying
health services
• 1991
– enactment of R.A. 7160 ( Local Government Code)
• 1999
– Launched the Health Sector Reform Agenda; Its implementation
framework FOURmula One (F1) in 2005 and Universal Health
Care in 2010
• September 2000
– Signed to the United Nations Millennium Declaration
ROLES AND FUNCTIONS OF DOH
Leadership in Health
➢Serve as the national policy and regulatory institution.
➢Provides leadership in the formulation, monitoring and
evaluation of national health policies, plans, and programs.
➢Serve as advocate in the adoption of health policies, plans
and programs to address national and sectoral concerns.
ROLES AND FUNCTIONS OF DOH
Enabler and Capacity Builder
➢Innovate new strategies in health.
➢Initiate public discussions on health issues.
➢Disseminate policy research outputs.
➢Exercise oversight functions and monitoring and evaluation of
national health plans, programs, and policies.
➢Ensure the highest achievable standards of quality health care,
health promotion and health protection.
ROLES AND FUNCTIONS OF DOH
Administrator of Specific Services
➢Manages selected national health facilities and hospitals
and referral centers.
➢Administer direct services for emergent health concerns
that require new complicated technologies.
➢Administer health emergency response services.
Vision of DOH
The DOH is the leader, staunch advocate and model
promoting Health for All in the Philippines.

Mission of DOH
Guarantee equitable, sustainable and quality health
for all Filipinos, especially the poor and shall lead the quest
for excellence in health.
Core Values of DOH
1. Integrity
2. Excellence
3. Compassion and respect for human dignity
4. Commitment
5. Professionalism
6. Teamwork
7. Stewardship of the health of the people
LOCAL HEALTH SYSTEM
HISTORICAL BACKGROUND
• For over 40 years after post war independence, the
Philippine health care system was administered by a
central agency based in Manila; this provided the singular
sources of resources, policy direction, technical and
administrative supervision to all health facility nationwide.
LOCAL HEALTH SYSTEM
HISTORICAL BACKGROUND
• In 1991, major shift took place – Local Government Code
known as Republic Act 7160, under this law, all structures,
personnel and budgetary allocations from the provincial
health level down to the barangays were devolved
(transfer or delegate; from central to local/regional) to the
local government units to facilitate health service delivery.
LOCAL HEALTH SYSTEM
• Devolution made local government executives responsible
to operate local health services;
• New centers of authority for local health services emerged
– provincial, city, municipal governments, including an
autonomous regional government and a metropolitan
authority.
• Provincial governments operate the hospital system -
Provincial and District Hospitals; while city/municipal
governments operate the Health Centers (HC) Rural
Health Units(RHU) and Barangay Health Stations (BHS).
 CLASSIFICATION OF HEALTH FACILITIES
(DOH AO-0012A)
• DOH Administrative Order No. 2012-0012 : Rules
and regulations governing classification of Hospitals and
other Health Facilities in the Philippines (Approved in
July 18, 2012).
 CLASSIFICATION OF HEALTH FACILITIES
(DOH AO-0012A)
• Classification of General Hospitals :
OLD NEW
Level 1 Reclassify to other
Health Facilities
Level 2 Level 1
Level 3 Level 2
Level 4 Level 3 *no more level 4 hospitals
Levels of Health Care Delivery and the Rural Health Unit
• General Hospital
➢ Provides services for all kinds of all illnesses, injuries, or deformities.
➢ Services offered are classified as level 1, level 2, or level 3.

Hospitals Other Health Facilities

GENERAL A. Primary Care Facility

• Level 1
• Level 2 B. Custodial Care Facility
• Level 3 (Teaching / Training) C. Diagnostic Facility

SPECIALTY D. Specialized Out-Patient Facility

 GENERAL Level 1 Level 2 Level 3
Consulting specialists in: Level 1 plus all: Level 2 plus all:
Medicine
Pediatrics Teaching/training with accredited
Departmentalized
OB-GYNE residency training program in the
Clinical Services
Surgery 4 major clinical services
Clinical services
Emergency and Out-patient
for inpatients Respiratory Unit Physical Medicine and
Services
Rehabilitation Unit
Isolation Facilities General ICU
Surgical Maternity Facilities High Risk Pregnancy Unit Ambulatory Surgical Unit
Dental Clinic NICU Dialysis Clinic
Secondary Clinical Tertiary Clinical Tertiary lab with
Laboratory Laboratory histopathology
Ancillary Blood Station Blood Station Blood Bank
services 2nd Level X-ray with
1st Level X-ray 3rd Level X-ray
mobile unit
Pharmacy
NEW CLASSIFICATION OF OTHER HEALTH FACILITIES
B C D
A
Custodial Care Diagnostic / Specialized Out-
Primary Care Facility
Facility Therapeutic Facility Patient Facility
Laboratories:
• Clinical Lab/HIV Dialysis Clinic (DC)
With In-patient Beds: • Blood Service
• Infirmary/Dispensary Psychiatric Care Facility Facilities
• Birthing Home • Drug Test Lab Ambulatory Surgical
• NB Screening Lab Clinic (ASC)
• Water Lab
With In-patient Beds: Ionizing Machines as X-
Drug Abuse Treatment
• Infirmary/Dispensary ray, CT scan, In-Vitro Fertilization
and Rehabilitation
• Birthing Home mammography and (IVF) Centers
Center (DATRC)
others
Non-Ionizing Machines as
Radiation Oncology
Sanitarium/Leprosarium ultrasound, MRI and
Facility
others
Nursing Home Nuclear Medicine Oncology Center Clinic
 INCONSISTENCY OF OLD CLASSIFICATION VS LAW
CATEGORY BED SPACE OR DR OPD LAB XRAY P I M Consistent with Law

Level 1 NO
Level 2 YES
Level 3 YES
Level 4 YES

OR – Operating Room P – Pharmacy

DR – Delivery Room I – Isolation Facilities
OPD – Out-patient Department M – Morgue
Lab – Clinical Laboratory Level 2 – cadaver holding area
Level 3 and 4 - mortuary
Therefore, Level 1 does not
qualify as a hospital and must
be given a different category
for licensure purposes.
 CLASSIFICATION OF HOSPITALS
According to Ownership:
A. Government
Created by law. May be under DOH, DND, DOJ, PNP, LGU,
SUCs, and others
B. Private
May be a single proprietorship, partnership, corporation,
cooperative, foundation, religious, non-government
organization and others.
 CLASSIFICATION OF HOSPITALS
According to Functional Capacity:
A. General Hospital
Provides medical and surgical care to the sick and injured and
maternity care and shall have as minimum, the following clinical
services: medicine, pediatrics, obstetrics, emergency services, out-
patient and ancillary services.
B. Private
Specializes in a particular disease or condition or in one type of
patient.
EXAMPLES OF SPECIALTY HOSPITALS
Particular Group
Particular Disease Particular Organs
of Patients
National Orthopedic Philippine Children’s
Lung Center
Hospital Medical Center
National Center for Philippine Heart National Children’s
Mental Health Center Hospital
National Kidney and Dr. Jose Fabella
San Lazaro Hospital
Transplant Institute Memorial Hospital
 CLASSIFICATION OF HOSPITALS
According to Trauma Capability:
A. DOH licensed hospital designated as a trauma center.
B. DOH licensed hospital within the trauma service area
which receives trauma patients for transport to the
point of care or a trauma center.
Other Health Facilities
• Primary Care Facility (Category A)
➢ A first-contact health care facility offers basic services including emergency services and provision
for normal deliveries

• Custodial care facility (Category B)

➢ Provides long-term care, including basic services, to patients with
chronic conditions requiring ongoing health and nursing care due to
impairment and a reduced degree of independence in ADLs, and
patients in rehabilitation.
• Diagnostic/therapeutic facility (Category C)
➢For the examination of the human body, specimens from the
human body for the diagnosis, sometimes treatment of disease,
or water for drinking water analysis.
➢Laboratory facility, radiologic facility, nuclear medicine facility
• Specialized Outpatient Facility
➢Performs highly specialized procedures on an outpatient basis.
PHILIPPINE HEALTH AGENDA 2010-2012
 PRIMARY HEALTH CARE
• Primary Health Care or PHC is defined as essential health care
made universally accessible to individuals and families in the
community by means acceptable to them through their full
participation and at a cost that the community and country can
afford at every stage of development. (WHO)
• PHC refers to essential health care that is based on scientifically
sound and socially acceptable methods and technology, which make
universal health care accessible to all individuals and families in
community. (Wikipedia)
PRIMARY HEALTH CARE
BRIEF HISTORY
• PHC was declared during the First International Conference on
Primary Health Care held in Alma Ata, USSR on September 6-12,
1978 by WHO.
LEGAL BASIS
• Adopted by the Philippines through the Letter of Instruction (LOI)
949 signed b”y President Ferdinand E. Marcos on October 1979 with
an underlying theme ,“Health in the Hands of the People by 2020.
GOAL
• “Health for All by the year 2000”
PRIMARY HEALTH CARE
DEFINITION
• The concept of PHC is characterized by partnership and
empowerment of the people that shall permeate as the core strategy
in the effective provision of essential health services that are
community based, accessible, acceptable and sustainable at a cost
which the community and the government can afford.
• PHC is a strategy which focuses responsibility for health on the
individual, his family and the community; it includes full participation
and active involvement of the community towards the development
of self-reliant people, capable of achieving an acceptable level of
health and well being.
PRIMARY HEALTH CARE
DEFINITION

• PHC also recognizes interrelationship between health and the overall

political, socio-cultural and economic development of society;
although the goal of PHC of Health of Health for All in the Year
2020may have already been challenged as unrealizable in the given
time frame, the concept and processes has already taken root all
over the world and has shown progress in the lives of peoples in
communities it has empowered.
PRIMARY HEALTH CARE
ELEMENTS/COMPONENTS OF PRIMARY HEALTH CARE
• 1. Environmental Sanitation (adequate supply of safe water and good
waste disposal)
2. Control of Communicable Diseases
3. Immunization
4. Health Education
5. Maternal and Child Health and Family Planning
6. Adequate Food and Proper Nutrition
7. Provision of Medical Care and Emergency Treatment
PRIMARY HEALTH CARE
ELEMENTS/COMPONENTS OF PRIMARY HEALTH CARE

8.Treatment of Locally Endemic Diseases

9. Provision of Essential Drugs
PRINCIPLES AND STRATEGIES
1. Reorientation and reorganization of the national health care
system with the establishment of functional support mechanism in
support of the mandate of devolution under the Local Government
Code of 1991.
2. Effective preparation and enabling process for health action at all
levels.
PRIMARY HEALTH CARE
PRINCIPLES AND STRATEGIES
3. Mobilization of the people to know their communities and
identifying their basic health needs with the end in view of provi-
ding appropriate solutions (including legal measures) leading self-
measures) leading to self determination.
4. Development and utilization of appropriate technology focusing on
local indigenous resources available in and acceptable to the
community.
5. Organization of communities arising from their expressed needs which
they have decided to address and that this is continually evolving in
pursuit of their own development.
PRIMARY HEALTH CARE
PRINCIPLES AND STRATEGIES
6. Increase opportunities for community participation in local level
planning, management, monitoring and evaluation within the
context of regional and national objectives.
7. Development of intra-sectoral linkages with other government and
private agencies so that programs of the health sector is closely
linked with those of other socio-economic sectors of the national,
intermediate and community levels.
8. Emphasizing partnership so that the health workers and the com-
munity leaders/members view each other as partners rather than merely
providers and receivers of healthcare especially.
PRIMARY HEALTH CARE
• The framework of meeting the goal of PHC is organizational strategy,
which calls for active and continuing partnership among the com-
munities, private and government agencies in health development.
• FOUR CORNERSTONES/PILLARS IN PRIMARY HEALTH CARE
1.Active community participation
2. Intra and Inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made available.
LEVELS OF PREVENTION
-Prevention as it relates to health, is about avoiding disease before
it starts. It has been defined as the plans for, and the measures
taken to prevent the onset of a disease or other health problem
before the occurrence of the undesirable health event. The
following are the three distinct levels:
• Primary Prevention
-the preventive measure that prevent the onset of illness or injury
before the disease begins.
- directed at preventing a problem before it occurs by altering
susceptibility or reducing exposure for susceptible individuals.
– General health promotion
– Specific protection
 LEVELS OF PREVENTION

• Secondary Prevention
-those preventive measures that lead to early diagnosis and prompt
treatment of a disease, illness or injury to prevent more severe
problems developing. Here health educators such as Health Extension
Practitioners can help individuals acquire the skills of detecting diseases
in their early stages
- early detection and prompt intervention during the period of early
disease pathogenesis
 LEVELS OF PREVENTION

• Tertiary prevention
- those preventive measures at rehabilitation following significant
illness.
At this level, health services workers can work to retain re-educate
and rehabilitate people who have already developed an impairment or
disability; targets populations that have experienced disease or injury
and focuses on limitation of disability and rehabilitation.
- aims to reduce the effects of disease and injury and to restore
individuals to their optimal level of functioning.
LEVELS OF PREVENTION ACTIVITIES / EXAMPLES

PRIMARY PREVENTION ▪ Immunization

▪ Promotion of good nutrition
▪ Provision of adequate shelter
▪ Encouraging regular exercise

SECONDARY PREVENTION ▪ Screening for sexually transmitted disease

▪ Mammography
▪ Blood pressure screening
▪ Newborn screening
▪ Sputum examination

TERTIARY PREVENTION ▪ Teaching how to perform insulin injection

▪ Referring a patient with a spinal cord injury
for occupational and physical therapy
 UNIVERSAL HEALTH CARE (UHC)
• UNIVERSAL HEALTH CARE (UHC) is also referred to as Kalusugan
Pangkalahatan(KP) , is the “provision to every Filipino of the highest
possible quality of health care that is accessible, efficient, equitably
distributed, adequately funded, fairly financed, and appropriately used by
an informed and empowered public.”
• LEGAL BASIS
-New UHC Act is a critical step towards health for all Filipinos. Fifty years
after the Philippines made it policy to gradually provide total medical
service for its people through a medical care act, the President of the
Philippines, Rodrigo R. Duterte, signed into law the Universal Health
Care Act (Republic Act 11223) on February 20, 2019 at Malacaňang
Palace, Manila.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
➢Filipinos will begin benefitting from the Universal Health Care
(UHC) Act this year, with every citizen entitled to health coverage
that will lower out-of-pocket health expenses.
➢The passage of the Republic Act 11223 was hailed a path-breaking
as it set the direction for the reform of the health care sector in the
Philippines.
➢WHO earlier urged the Philippine government to make a “real
investment” in health, as it would save lives.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
➢Currently, Department of Health (DOH), Philippine Health
Insurance Corporation (PhilHealth) along with experts and
concerned agencies are crafting the Implementing Rules and
Regulations (IRR). They will have 180 days to complete the IRR,
which will include details on how the law is executed.
➢Filipinos can now already expect to avail some of the law’s benefits
as the full effects of the law will be gradually felt over the years as
DOH and PhilHealth start transitioning to the universal health care
system.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
➢Eight (8) things to know about UHC:
1. All Filipinos are covered.
❖Every single Filipino citizen is automatically enrolled into the newly-
created National Health Insurance Program (NHIP); two
classifications of members:
Direct contributors – those who pay PhilHealth premiums, are
employed and are bound by an “employer-employee relationship”, e
self-earning, professional practitioners, and migrant workers.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
Indirect contributors – those not considered as direct contributors
along with their qualified dependents whose health premiums are
subsidized by the government.
2. It is not completely free.
❖The law outlines that basic services accommodations will be
covered by PhilHealth.
3. PhilHealth will become the “national purchaser” of health
goods and services.
❖PhilHealth will be in charge of paying health care providers like
hospitals and clinics for services given to Filipinos
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
❖ Allocating more funds to PhilHealth will also strengthen its
negotiating power with heath care providers, which will foreseeably
improve the quality of services and lower health costs.
4. DOH will still be in charge of “population-based” health
services.
❖While PhilHealth, along with other private health insurance
companies, is expected to cover services for individuals, the DOH is
still in charge of delivering health services that cover the entire
population; DOH will do this by contracting public health care
providers in cities and provinces.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
5. Health systems will become city-wide and province-wide.
❖Provinces and highly urbanized cities will now be in charge of overseeing health
services in areas as opposed to the current set-up where municipalities and are
tasked with managing their own health centers.
❖DOH will need to work with the Department of the Interior Local
Government (DILG) to have province and city-wide health systems or
networks in about two years after the law takes effect.
6. Return service in public health sector.
❖Graduates of health and health-related courses who received government-
funded scholarships will be required to work in the public at least 3 full years.
UNIVERSAL HEALTH CARE (UHC)
Background and Rationale
7. A “Health Technology and Assessment Council” (HTAC) will be created.
❖HTAC is a group of health experts who will be responsible for evaluating latest
health developments and recommending their use to DOH and PhilHealth; they
will be responsible for assessing the safety and effectiveness of health
technology, devices, medicines, vaccines, health procedures and other health-
related advances developed to solve health problems.
8. Health information will be collected.
❖Both public and private hospitals and health insurers will be required to
maintain a health information system that will contain electronic health records,
prescription logs, and “human resource information.”
UNIVERSAL HEALTH CARE (UHC)
Objectives and Thrust
➢Universal Health Care (UHC) Law Republic Act 11223)
automatically enrolls all Filipino citizens in the National Health
Insurance Program and prescribes complementary reforms in the
health system.
➢This gives citizens access to the full continuum of health services
they need, while protecting them from enduring financial hardships
as a result
Population-Focused Approach and
Community Health Nursing
Interventions
• Focuses on the entire population
• Is based on assessment of the populations’
health status
• Considers the broad determinants of
health
• Emphasizes all levels of prevention
• Intervenes with communities, systems,
individuals and families
Philosophy of Community
Health Nursing Practice

PHILOSOPHY
• Defined as a system of beliefs that provides a basis for and guides
action
• It provides the direction and describes the whats, whys and hows of
activities within the profession
Philosophy of CHN Practice
• H – humanistic values of the nursing profession upheld
• U – unique & distinct component of health care
• M – multiple factors of health considered
• A – active participation of clients encouraged
• N – nurse considers availability of resources
• I – interdependence among health team members
practiced
• S – scientific and up-to-date
• T – tasks of CH nurse vary with time and place
• I – independence or self-reliance is the end goal
• C – connectedness of health & development regarded
 Basic Principles of CHN
• The COMMUNITY is the PATIENT in CHN
– FAMILY is the UNIT OF CARE
– FOUR LEVELS OF CLIENTELE:

a. individuals
b. families
c. population groups
d. Community
• Client is considered an ACTIVE
PARTNER
• Affected by developments in health
technology in particular and changes in
society in general
• The goal is achieved through
MULTISECTORAL EFFORTS
• CHN is part of HEALTH CARE
SYSTEM and the larger HUMAN
SERVICES SYSTEM
Levels of Clientele
Individual as a Client
• Deals with sick or well
• Consults the health center & receives health services in different forms
• Can be seen both as clients and patients
• Can be used as an “entry point” in working with the whole family
• Can be seen in two ways/approach:
a. atomistic
b. holistic
A. ATOMISTIC APPROACH
• Proposed by Byrne and Thompson
➢ Views man as an organism
➢ Sees the whole as equal to the sum of its parts or subparts
➢ Levels of organization include: 8-12
a. chemical level
b. organelle level
c. cellular level
d. tissue level
e. organ level
f. system level
B. HOLISTIC APPROACH
➢ Traces the pattern of man’s relationship with other beings in the
suprasystem of society
➢ How man acts and reacts to situational stimuli provide clues in
understanding his responses and the reasons behind them
➢ Man as a whole is different from and is more then the sum of his
component parts
➢ Dimensions include: physical, social, spiritual, cognitive and psychological
 Five Dimensions of Man

1. PHYSICAL BEING
• Genetic endowment
• Sex
• Physical attributes
2. SOCIAL BEING
• Capable of relating to others
• Process of social learning by which a person acquires KSA
and roles appropriate to sex, social class, and ethnic or
cultural group
 Five Dimensions of Man
3. SPIRITUAL BEING
• capable of virtues such as faith, hope and charity
• Believes in a power beyond himself and in transcending
one’s limitations in order to become a better person
4. THINKING OR INTELLECTUAL BEING
• Capable of perception, cognition & communication
• Capable of logical thinking and reasoning
5. PSYCHOLOGICAL BEING
• capable of feeling, rationality, and all conscious and
unconscious mental states
FAMILY
• Defined by Murray and Zentner, 1997, a small social system and
primary reference group made up of two or more persons
living together who are related by blood, marriage, or adoption
or who are living together by arrangement over a period of
time
POPULATION GROUP OR AGGREGATE
• Is a group of people sharing the same characteristics,
developmental stage, or common exposure to particular
environmental factors
Examples are:
a. children
b. women
c. farmers
d. cultural minorities
e. elderly
A. CHILDREN
• Most vulnerable to different types of diseases, especially
those brought about by socio-economic difficulties
• Predominantly afflicted with infectious diseases and
nutrition problems
B. ELDERLY
• Individuals belonging to the age group of 60 years and
above
• With the lengthening of the lifespan of the Filipinos, it is
best that health professionals understand the health
needs of the elderly
C. WOMEN
 FAMILY
FUNCTION
➢Primary function of the family is to ensure the continuation of
society, both biologically through procreation and socially through
socialization; for parents
➢Basic functions of the family are:
1) regulate sexual access and activity
2) provide an orderly context
3) nurture and socialize children
4) ascribe social status
➢Families further impart affection, care and adaptive functions.
FAMILY
FAMILY DEVELOPMENTAL:
STAGES OF THE FAMILY LIFE CYCLE
1) unattached adult
2) newly married adults/married couple without children
3) childbearing adults/families with the oldest child between birth and
30 months
4) families with pre-school age children
5) families with school-age children
6) teen-age years
7) launching center
8) middle-aged adults
9) retired adults
 FAMILY
FAMILY HEALTH TASK
➢The family tasks areas include basic, developmental and crisis tasks.
➢Basic task is concerned with the provision of food, money, shelter
and other necessities of life.
➢Individual development stages include infancy, childhood,
adolescence, adulthood and aging.
➢Health care tasks include providing care and support to someone
with health care needs, an important component of their role can
include carrying out tasks that are of clinical in nature which might
include caring for wounds, catheter or tracheostomy care, managing
ventilation or the administration of medicines.
FAMILY
CHARACTERISTICS OF A HEALTHY FAMILY
suggested by Fr. J. Pimenta
1) The healthy family has a strong sense of family belonging.
Even if the family members have to move far away from home,
will retain a feeling of caring, closeness and belonging.
2) A healthy family has meaningful social and religious celebrations.
Religious and social traditions are important to the health of a
family.
3) A healthy has control of its family life.
Family life has not be ruled by an outside calendar of social celebrations
and obligations, however, valuable in themselves.
FAMILY
CHARACTERISTICS OF A HEALTHY FAMILY
-suggested by Fr. J. Pimenta
4) A healthy family demands responsibility from all members
towards the common needs.
All family members, children included, are to be responsible towards
the common needs and burdens of the family.
5) A healthy family demands mutual respect for one other.
Respect thrives in the family that never humiliates others, not even
the smallest children, nor discusses anyone’s shortcomings in front of
others, belittles them or makes them victims of others’ failures.
FAMILY
CHARACTERISTICS OF A HEALTHY FAMILY
-suggested by Fr. J. Pimenta
6) A healthy Family allows its members to do mistakes.
We learn by trial and error. Do not expect the members of your
family to be perfect from the very start.
7) The healthy family is able to deal with adversity as well as success.
The healthy family gathers together in an effort to deal with any
problem, be it unemployment, alcoholism, school or college failure
or whatever,
8) The healthy family communicates.
The healthy family enjoys sharing with one another their joys and
sorrows not good news only but also, disappointments, failures and dreams
as well.
FAMILY
CHARACTERISTICS OF A HEALTHY FAMILY
-suggested by Fr. J. Pimenta
9) Members of a healthy family spend time along with each other.
This is the time when one person spends time alone with another
member of the family.
10) The healthy family develops a sense of play and humour.
The degree of fun and humor among families varies widely.
11) The healthy family develops trust.
Children must be trusted and at the same time they should know
and experience that they can trust their parents. Lack of trust at home
becomes the most destructi e weapon and sickness within the family.
FAMILY
CHARACTERISTICS OF A HEALTHY FAMILY
-suggested by Fr. J. Pimenta
12) The healthy family lets each child to be the person God created:
Some families unfortunately force their children into a mould of
conformity. The motto of a healthy family should be: “Be and let
be” Children like beautiful flowers should should grow to be; what
God want them to be. Parents should be like careful gardeners, not
like ruthless stone sculptors.
13) The healthy family lets go.
Parents shouldn’t be too much possessive, when the time comes
for the child to leave home, let him/her go.
 PUBLIC HEALTH WORKERS (PHW)

➢ Members of the health team who are professionals namely:

– Medical Officer (MO)-Physician
– Public Health Nurse (PHN)-Registered Nurse
– Rural Health Midwife (RHM)- Registered Midwife
– Dentist
– Nutritionist
– Medical Technologist
– Pharmacist
– Rural Sanitary Inspector (RSI)- must be a sanitary engineer
 The Rural Health Unit
Primary level health facility in the municipality.
Focuses on preventive and promotive health services.
Supervises the BHSs
1 RHU: 20,000 population
 Barangay Health Station
➢first-contact health care facility offering basic services
at the barangay
➢Manned by the RHM and BHWs

The RHU Personnel

Municipal Health Officer (MHO)
➢A.k.a. Rural Health Physician
➢Administrator of the RHU
Community physician
Medico-legal officer of the municipality
1 MHO: 20,000 population
Public Health Nurse (PHN)
➢Supervises and guides all RHMs in the municipality.
➢Prepares FHSIS quarterly and annual reports of the
municipality for submission to the Provincial Health
Office
➢Public Health Nurse (PHN)
➢Utilizes the nursing process in responding to health
care needs, including needs for health education and
promotions, of individuals, families, and catchment
community.
➢Collaborates wit the other members of the health
team, government agencies, private businesses, NGOs,
and people’s organizations to address the community’s
health problems.
➢1:20,0000 population
• Rural Health Midwife (RHM)

➢Manages the BHS and supervises and trains the BHW.

➢Provides midwifery services and executes health care programs
and activities for women of reproductive age.
➢Conducts patient assessment and diagnosis for referral or
further management.
➢Performs health information , education, and communication
activities.
➢Organizes the community.
➢Facilitates barangay health planning and other community health
services.
➢1;5,000 population
 The Health Referral System
• Referral
➢ A set of activities undertaken by a health care provide or facility in response to its inability to
provide the necessary health intervention to satisfy a patient’s need.

• Internal referrals
➢ Occur within the health facility.

• External referrals
➢Movement of a patient from one health facility to another
The Inter-Local Health Zone

➢Defined catchment population within a defined

geographical area.
➢Covers all sectors involved in the delivery off health
services.
➢Components
People
Boundaries
Health facilities
Health workers;
Health System
➢Consists of all organizations, people, and actions
whose primary intent is to promote, restore, or
maintain health.
➢Building blocks
Service delivery
➢Building blocks
✓Service delivery
✓Health workforce
✓Information
✓Medical products, vaccines, and technologies
✓Financing
✓Leadership and governance or stewardship
Factors Influencing the Health Care Delivery
System
Health care “reforms
Demographics
Globalization
Poverty and growing disparities
Social disintegration