 PUBLIC HEALTH NURSE  Program management

(reports on program accomplishments is

o Nursing has responded to advances in a documentation of her management
medical sciences, modern technology, skills.)
changing health care delivery system,
technological and social forces.  FUNCTION OF PUBLIC HEALTH NURSE

o Public health nurses are found in various 1. SUPERVISORY FUNCTION

 The public health nurse is the
health settings and occupying various
supervisor of the midwives and other
positions in the hierarchy. Public health
auxiliary health workers
nurse can be seen in:
 Formulates a supervisory plan and
 RHU
conducts supervisory visits
 City Healthcare Centers
 Agencies policies in a manner that
 Provincial Health Offices
improves performance and promotes
 Regional Health Offices
job satisfaction.
 National Health Office (DOH)
 Provides a checklist
 Public schools
 The supervisory identifies the
 Government agencies
problem within the agency and
address the problem by providing
o Have broad roles and functions that is
solution.
dependent on the position description.

Sentrong Sigla Program has develop

o Uses various tools and procedures necessary
supervisory package.
for her to properly practice her profession
and deliver basic health service.
2. NURSING CARE FUNCTION
 USES THE ADPIE:
 QUALIFICATIONS AND FUNCTIONS
 Assessment
 Diagnosis
o The standard of public health nursing in the
 Planning
Philippines, they developed the
 Implementation
NATIONAL LEAGUE OF PHILIPPINE
 Evaluation
GOVERNMENT OF NURSES in 2012.
 Establishes rapport to the client
(individual, family or community) to
QUALIFICATIONS:
ensure good quality data to facilitate
 Must be professionally qualified and
and enhanced partnership in
licensed to practice
addressing identified health needs
 Must possess personal qualities and
and problem.
“people skills”
 Uses her knowledge and skill in the
 Functions within the ethico-legal
nursing process
framework of the nursing profession
 Home visits- visible manifestation of
 Consistent with the Nursing Law 2002
a nurses caring function.
and program policies formulated by the
 Referral of patients to appropriate
Department of Health and Local
levels of care
government health agencies.
 During assessment, nurse
encounters a problem that is
 MANAGEMENT FUNCTION
beyond the scope of nursing
1 nurse in the municipality
and thus referral is done.

 Planning
 Organizing
 Staffing
 Directing
 Controlling
3. COLLABORATING AND  DISEASE SURVEILLANCE
COORDINATING FUNCTION - surveillance is an integral part to
 Bring activities or group of activities any programs. It is important in
systematically monitoring the progress of the
 Establishes linkages and disease reduction initiatives such as
collaborative relationships with the eradication of poliomyelitis,
health professionals, government elimination of neonatal tetanus and
agencies, the private sectors, non other diseases that are usually
government organization, peoples communicable and non
organization to address health communicable diseases.
problems.
 The nurse identifies groups, persons, Purpose:
organizations, other agencies and  To measure the magnitude of
communities, whos resources are the problem
available within and outside the  To measure the effect of the
community. control program.
 LINKAGES to various groups in the
community  FUNCTION OF A PUBLIC HEALTH
NURSE IN A CITY HEALTH OFFICE
4. HEALTH PROMOTION AND
EDUCATION FUNCTION  PUBLIC HEALTH NURSE II
 Understands the multidimensional  Works in a health center
nature of health will help enable the  First contact of the patient
nurse to plan and implement health  Provides health education to the
promoting intervention for individual public giving pre and post clinical
and communities. lectures.
 Uses her skills in advocacy for the  Performs home visits or follow-up
creation of a supportive environment cases
through policies and re-engineering  Prepare and submit the necessary
of the physical environment for reports required of her which are
healthier actions. done weekly, monthly and
 Provides clients with information quarterly.
 Frontline health worker
5. TRAINING FUNCTION  Prime mover to all programs and
 Formulate, does assessment, activities
evaluates training outcomes
 Participates in the training itself  PUBLIC HEALTH NURSE III
 Initiates PROGRAMS that could  Same functions but differs from the
help develop the workers (midwives PHN II
and BHW)  Acts as the nurse-in-charge of PHN
II (supervises, coordinates and
6. RESEARCH FUNCTION evaluates the work of the co-nurses)
 Conduct of research and utilizes  Interprets policies and participate in
research findings in her practice planning health programs and
 Disease surveillance is a research activities that involves nursing
activity of the nurses service.
 Participates in the conduct of
research and utilizes research  PUBLIC HEALTH NURSE V
findings in her practice.  “Supervising Public Health
Nurse”
 Assigned in a health center with a
lying-in clinic
  Supervise and coordinates the work  Surveillance
of nurses, midwives and other  Records and reports
health personnel.
 Guides the co workers in carrying
out activities, ensuring that they
THE PHILIPPINE HEALTH CARE
used correct procedures and
DELIVERY SYSTEM
techniques. Participate in program
planning and guidance, to student “A public health nurse does not function in a
trainees and affiliates. vacuum.”
 Attends meeting and seminar for her
own career growth and for the - A nurse is a member of a team, working within the
improvement of health services. system. In order for that nurse to function
 Evaluate the performance of her effectively, she has to understand the healthcare
staff and analyze records and delivery system wherein she is working. It
reports influences her status and functions. The nurse needs
to properly relate with the dynamics of the political,
 PUBLIC HEALTH VI organizational structure surrounding her position in
 “Nurse Program Supervisor” the health care delivery system.
 Manages and oversees the
performance of a group of nurses
assigned in a number of health  HEALTH CARE DELIVERY SYSTEM:
centers covered by a particular MAJOR PLAYERS:
district or area.  Public sector
 Performs consultations and - financed through a tax-based budgeting
objective assessment and system at both national and local levels.
evaluation of nursing programs, - healthcare is generally given for free at
problems and services. the point of service.
 Consolidates and evaluates, - National and local government
analyzes the necessary weekly, agencies providing health services.
monthly, quarterly and annual - Department of Health (DOH) is
reports of the health center. mandated as the lead agency in health.
 Studies and evaluates the Philippine General Hospital (part of
performance ratings of nurses DOH sector)
 Initiates meetings, discussions - run by Local Government Units
and conferences. To provide joint (LGUs). LGUs are now in charge of the
planning, to stimulate activities local health system.
among nurses and other health - The provincial and district hospitals are
personnel. under the provincial government.
 Conducts program orientation to - The city or municipal government,
pre-service and in-service nurse manages the health centers or rural
trainees and students. health units and barangay health stations.
Coordinates with other health
discipline in implementation of  Private sector
program. - market-oriented and where health care
 Likewise acts as a nursing is paid through user fees at the point of
consultant on technical matters service.
- includes for profit- and non profit
 COMPETENCIES, SKILLS AND health providers
KNOWLEDGE - providing health services in clinical
 Community health nursing process and hospitals, health insurance,
 Nursing procedures during clinic and manufacture of medicines, vaccines,
home visits medical supplies, equipment and other
 Community or organizing health and nutrition products, research
 Health promotion and education and development, human resource
 development and other health-related  Creation of an Inter Local Health
services. System (ICHS) by clustering
municipalities into Inter Local
 LOCAL HEALTH SYSTEM Health Zone (ILHZ)
 Defined population within a
Was over 40 years after post war defined geographical area
independence, the Philippine Healthcare  Central referral hospital
System was administered by a central  Rural Health Units and
agency based in Manila. This agency Barangay Health Station
provided the singular sources of resources,
policy direction, technical and Stakeholders of Inter-Local
administrative supervision to all health Health System:
facilities nationwide.  LGUs
 Department of Health
 Post war: central agency based in  Philippine Health Insurance
Manila Cooperation (PHIC)
 MAJOR SHIFT- 1991: passage of  Communities
the Local Government Code also  Non-government
known as Republic Act 7160. Organization (NGOs)
Under this law, all structures, private sector
personal and budgetary allocation
from the provincial health level  EXPECTED ACHIEVEMENT
down to the barangays were 1. Universal coverage of health insurance
devolved to the local government 2. Improved quality of hospital and Rural
units to facilitate health service Health Units (RHU) service.
delivery. 3. Effective referral system
 Local health services emerged 4. Integrated planning
5. Appropriate health information system
 OBJECTIVES OF THE LOCAL HEALTH 6. Improved Drug Management System
SYSTEM 7. Developed human resources
8. Effective leadership through Inter-LGU
1. Establish local health systems for corporation
effective and efficient delivery of health 9. Financially visible or self sustaining
care services. hospitals
2. Upgrade the health care management 10. Integration of public health and curative
and service capabilities of local health hospital care
facilities. 11. Strengthened cooperation between LGU
3. Promote inter-LGU linkages and cost and health sectors.
sharing schemes including local health
care financing systems for better  UNIVERSAL HEALTH CARE ACT
utilization of local health resources.
4. Foster participation of the private, sector,  The act will automatically enroll Filipino
non-government organizations (NGOs) citizens into the National Health Insurance
and communities in local health systems Program and expand PhilHealth coverage
development. to include free medical consultations and
5. Ensure the quality of health service laboratory tests.
delivery at the local level.

 INTER LOCAL HEALTH SYSTEM

 Supported by the DOH inorder to
ensure quality of health care service
at the local level.
 Provide quality equitable and
accessible health care
 GUIDING PRINCIPLES  “HEALTH IN THE HANDS OF THE
PEOPLE BY 2020”
 Financial and administrative autonomy
(LGUs)  ELEMENTS/COMPONENTS OF
 Strong political support PRIMARY HEALTH CARE
 Strategic synergies and partnerships 1. Environmental sanitation
 Community participation 2. Control of Communicable Diseases
 Equity of access to health services by the 3. Immunization
population, especially the poor 4. Health Education
 Affordability of health services 5. Maternal and Child Health and Family
 Appropriateness of health programs Planning
 Decentralized management 6. Adequate Food and Proper Nutrition
 Sustainability of health initiatives 7. Provision of Medical Care and Emergency
 Upholding of standards of quality health Treatment
service 8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs
 COMPOSITION
1. People  STRATEGIES FOR PRIMARY
- According to WHO, the ideal health HEALTHCARE
district would have a population size  Reorientation and reorganization of the
between 100, 000- 500, 000 for optimum national health care system under the
efficiency and effectiveness. local government code of 199.
 Effective preparation and enabling
2. Boundaries process
- clear boundaries between zone  Mobilization of the people to know their
- determine the accountability and communities and identifying their self
responsibility of health service providers. needs, leading to self reliance and self
determination
3. Health facilities  Development and utilization of
- District or provincial hospitals, RHUs, appropriate technology focusing on local
barangay health stations. indigenous resources available in and
acceptable to the communities.
4. Health workers  Organization of communities
- The DOH, district hospitals, RHU,  Increase opportunities for community
barangay health stations, private clinic, participation
volunteer health workers, non government  Development of intra-sectoral linkages
organization and community based with other government and private
organization is needed to deliver agencies
comprehensive health services. Together  Emphasizing partnership
they form the INTER LOCAL HEALTH
ZONE TEAM to plan joint strategies for The framework for meeting the goal
district health care. of primary health care is
organizational strategy.
 PRIMARY HEALTH CARE
 Describe during the First International  FOUR CORNERSTONES/PILLARS
Conference in Alma Ata, USSR on 1. Active community participation
September 6-12, 1978 by WHO 2. Intra and inter-sectoral linkages
 Goal was “Health for All by the year 3. Use of appropriate technology
2000” 4. Support mechanism made availble
 Adopted in the Philippines through
letter of instruction 949 signed by
President Marcos on October 19,
1979.
 TYPES OF PRIMARY HEALTH CARE  TERTIARY LEVEL OF CARE
WORKERS - rendered by specialists in health
 Available health manpower resources facilities including medical centers and
 Local health needs and problems as well as regional and provincial
 Political and financial feasibility hospitals and specialized hospitals.
- referral center for secondary care
PRIMARY HEALTH CARE TEAM IS facilities
COMPOSED OF - complicated cases requires tertiary
 Physician level of care
 Nurse
 Midwives
 Nurse oxillaries
 Local trained community health worker
 Traditional birth attendant
 Healers

 TWO LEVELS OF PRIMARY HEALTH

CARE WORKERS
1. Village or Barangay Health Workers
- BHW, trained community health
workers or health auxillary volunteers or
traditional birth attendant, healer  LEVELS OF HEALTH CARE SERVICES
 Health problems that are beyond the
2. Intermediate level Health Workers capability of PHC units and beyond the
- intermediate level healh workers. competence of PHC workers are referred
General medical practioners to an intermediate health facility, usually
- public health nurse a Rural health Unit (RHU).
- rural sanitary inspectors  The higher the level, the more qualified
- midwives the health personnel and the more
sophisticated the health equipment.
 LEVELS OF HEALTH CARE AND  Team planning by health personnel in
REFERRAL SYSTEM the same level and the various health
levels will be essential for the
 Primary Level of Care effectiveness and efficiency of health
- cities and the municipalities services.
- provided at the barangay health stations  Teamwork entails joint planning,
and rural health units. implementation, and evaluation of
- Usually the first contact between the community’s activities.
community members and the other levels
of health facility.

 SECONDARY LEVEL OF CARE

- given by physicians with basic health
training
- serves as a referral center for the
primary health facilities.
- is given at government operated or
privately owned
- capable of performing minor surgeries
and perform some simple laboratory
examination.