After this lesson, you should be

able to:
 Discuss the global and national
health situations.
 C omparethe different fields of
community health nursing practice.
LEARNNG  Apply the competency standards of
OBJECTIVES nursing practice in the Philippines
in community health nursing
practice.
 Outline the historical development
of public health and public health
nursing in the Philippines.
 Understand the role and
responsibilities of a community
health nurse.
GLOBAL HEALTH
• focuses on the health needs of people around the
world.
• It has a medical but also a political dimension.
• it draws on a variety of disciplines, from economics,
environmental science, epidemiology, sociology, and
many others.
THE IMPORTANCE OF GLOBAL HEALTH
• our world has become interconnected, and our
health as individual human beings is influenced by
global health issues.
• The increase in global trade and travel in recent
decades has provided benefits, but there are also
related problems.
 GLOBAL HEALTH TRENDS

1. Noncommunicable diseases

2. Infectious disease and pandemics

3. Food supplies
4. Environmental factors
5. Inequality
6. Healthcare in war zones
 The global population
 life expectancy of less than 50 years.
 % of all deaths via specific age range
 Leading causes of death
 deaths among children under
five - 9 7 % of them in the developing world, and most of them due
to infectious diseases such as pneumonia and diarrhea, combined
with malnutrition.
 Average life expectancy at birth in 1955 was just 48 years; in
1995 it was 65 years; in 2025 it will reach 73 years.
 The national budget allocation for health care is relatively
small.
 Local government units augment the national budget to an
undetermined extent.
 This scenario requires strategies that will allow maximization of
limited resources:
 Health promotion
 Disease prevention
 Community/public health nursing is the synthesis of nursing
practice and public health practice.
 The major goal of community health nursing is to preserve the
health of the community and surrounding populations by focusing
on health promotion and health maintenance of individuals,
families, and groups within the community.
 The mission of public health is SOCIAL JUSTICE, which entitles all
people to basic necessities such as adequate income and health
protection and accepts collective burdens to make this possible.
 DAY 2
CONTINUATION
 The variety of characterizations of the word illustrates
the difficulty in standardizing the conceptualization of
health.
 Common concepts in various definitions include:
 Goal-directed/ purposeful actions, processes,
responses or behaviors.
 Soundness, wholeness, and/ or well-being
 Before 1996: definitions of community focused on
geographical boundaries, combined with social
attributes of people.
 Laterpart of the decade: geographical location
became a secondary characteristic in the discussion
of what defines a community.
-Baldwin, et.al, 1998
Ø People
Ø Place
Ø Interaction
Ø Common characteristics, interests or goals

• -Maurer and Smith,

2009
Ø Geopolitical/ Territorial community

Ø Phenomenological / Functional community

-Maurer and Smith, 2009

 Biology
 Behaviors
 Social environment
 Physical environment
 Policies and interventions
SOCIAL DETERMINANTS OF HEALTH
• Conditions in which people are born, grow, live, work and age
• Circumstantial elements(housing, work conditions, and access to
recreational activities)
• Circumstances that influence how an individual will develop sickness
• What risk factors they are exposed to
• How they access services
• How they utilize the appropriate services
• Distribution of money, power and resources at global, national and
local levels
 Part
of paramedical and medical intervention/approach
which is concerned on the health of the whole population

Aims:
 Health promotion
 Disease prevention
 Management of factors affecting health
 Health promotion activities e n h a n c e r e s o u r c e s
directed at improving well-being, whereas disease
prevention activities protect people from disease and
the effects of disease.
LEVELS OF PREVENTION

1. Primary – health promotion and illness

prevention
2. Secondary – early detection, early screening
3. Tertiary – rehabilitation, palliative ( give a quality
life) pain management, supportive care
 Public health nursing may b e defined as a field of
professional practice in nursing and in public health in
which technical nursing, interpersonal, analytical, and
organizational skills are applied to problems of health as
they affect the community.
-Freeman, 1963

 Thepractice of promoting and protecting the health of

populations using knowledge from nursing, social, and
public health sciences
-ANA/APHA, 1996
 Application of the nursing processin caring for individuals,
families and groups where they live, work or go to school
or as they move through the health care system
-McEwen and Pullis, 2008
 Focuses on the entire population
 Isbased 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

-Minnesota Department of Health, 2003

 Individual
 Family
 Group/ Aggregate
 Community
 C ommunity health services and community health
nursing services, are generally free at the point of care.
 The services have already been pre-paid by the
community/aggregate.
 Taxes cover government-provided healthcare services
 Tuition fees cover school-health services
 Consumers pay for the occupational health services of
employees of a company.
 Home health care: This practice involves providing
nursing care to individuals and families in their own
places of residence mainly to minimize the effects of
illness and disability.

 Hospice home care: This is home care specifically

rendered to the terminally ill.
 EntrepreNurse: T h i s i s a project initiated b y the
D e p a r t m e n t of L a b o r a n d E m p l o y m e n t ( D O L E ) , i n
collaboration with the Board of Nursing of the Philippines,
Department of Health, Philippine Nurses Association, and
other stakeholders to promote nurse entrepreneurship.

 Faith community nursing or parish nursing: This is the

practice of nursing combined with spiritual care. They may
work in either paid or unpaid positions in a variety of
religious faiths.
 Safe and quality nursing care
 Management of resources and environment
 Health education
 Legal responsibility
 Ethico-moral responsibility
 Personal and professional development
 Quality improvement
 Research
 Records management
 Communication
 Collaboration and Teamwork
 1577: Friar Juan Clemente opened a medical dispensary in Intramuros
for the indigent.
 1690: Dominican Father Juan de Pergero worked towards installing a
water system in San Juan del Monte (now San Juan City, Metro Manila)
and Manila.
 1805: Dr. Francisco de Balmis introduced Smallpox vaccination.

 1876: The first medicos titulares were appointed and worked as

provincial health officers.
 1888:The University of Santo Tomas opens a two-year,
cirujanos ministrantes course to produce male nurses
and sanitary inspectors.
 1901:The Board of Health of the Philippine Islands was
created through Act 157, which eventually evolved into
the Department of Health (DOH)
 1912:
The Fajardo Act law created sanitary divisions
made up one to four municipalities.
Asociacion de Feminista Filipina founded La Gota
 1905:
de Leche: the first center dedicated to the service of
mothers and babies
 1947: The D O H w a s r e o r g a n i z e d into b u r e a u s a n d the
administration of city health departments was placed at bureau
level.
 1954: The congress passed R.A. 1082 or the Rural Health Unit
Act which provided an RHU in every municipality.
 1957: R.A. 1891 was enacted to have a more equitable
distribution of health personnel.
 1958: Regional health offices were created as a result of
decentralization efforts, thus creating the position: Regional
Health Officer.
 1970: the Philippine health care delivery system was restructured,
paving the way for the health care system that exists to this day
where health services are classified into primary, secondary and
tertiary levels.
 1991: R.A.7160 or the Local Government C o d e mandated the
devolution of basic services, including health services, to local
government units and the establishment of a local health board in
every province and city or municipality.
 1999: Health Sector Reform A genda was launched to direct
government efforts towards comprehensive reforms.
 2005: FOURmula One (F1) for health was launched to provide an
implementation framework to the reform agenda.
 2010: Universal Health Care was launched to provide the
necessary revisions to the F1 framework.
 Supervision and care of women during pregnancy,
labor and puerperium
 Performance of internal examination and delivery
of babies
 Suturing lacerations in the absence of a physician
 Provision of first aid measures and emergency
care
 Recommending herbal and symptomatic
meds…etc.
Ø health care provider
Ø health educator
Ø Program implementer
Ø Community Organizer
Ø Manager/Leader
Ø Researcher/Epidemiologist
Ø Client advocate
Ø Coordinator of Services
Ø Trainer
Ø Health Monitor
Ø Role Model
Ø Change Agent
Ø Recorder
Thank
you.