DET Prelim
DET Prelim
DET Prelim
MODULE I DECENT WORK & EMPLOYMENT +Child welfare and maternity protection;
Adequate nutrition, housing, and facilities for recreation and culture; and
LESSON 1 : DECENT WORK BY ILO assurance of equality of educational and vocational opportunity
What is Decent Work Employment? ILO and the Health Service Sector
• Decent Work Employment is a concept that promotes social justice in the • Health services are one of the fundamental sectors of society and the
workplace. economy. The ILO endorses the fundamental principles of the human right
to health and social protection. Providing social health protection and equal
• It seeks to ensure workers have fair wages, safe working conditions, and access to quality health care has significant positive effects on individual
freedom of association and public health, economic growth and development. The health sector is
also a major employment sector, with important potential in job creation.
• It also works to provide equal access to employment opportunities for all. • Decent work for health workers is essential to provide quality health care.
The ILO supports improvement of working conditions and labor relations
Decent Work Employment in the health sector through sectoral labor standards and social dialogue,
• is a concept that was created by the International Labour Organization and collaborates with World Health Organization (WHO ) to promote
(ILO). supportive, enabling and healthy work environments for the health
workforce, including through the ILO-OECD-WHO Working for Health
• The ILO has put forward 8 core labour standards that are related to Decent Programme.
Work Employment. •Organization for Economic Co-operation and Development
• In 2019, the ILO adopted a new set of principles and rights at work that is ILO and the Philippines
aimed at protecting vulnerable workers. PHILIPPINES ILO MEMBERSHIP since 1948, 2 years after gaining
independence from the U.S.
Concept of Decent Work
• Social justice: The fair and just distribution of resources and Four strategic objectives at the heart of the Decent Work agenda
opportunities in a society. I. Set and promote standards and fundamental principles and rights at work.
• Fair wages: A payment amount given to an employee for their services Il. Create greater opportunities for women and men to decent employment
which allows them to maintain a decent standard of living. and income.
• Freedom of association: The right of individuals to come together and III. Enhance the coverage and effectiveness of social protection for all.
collectively express, promote, pursue and defend common interests. IV. Strengthen tripartism and social dialogue.
• 15 June 1999, the 87th Session of the International Labor Conference,
commenting on ILO Director-General Juan Somavia's ground-breaking
report Decent work. (Decent Work Agenda) LESSON 2 : NATURE OF EMPLOYMENT
• Reduced stress levels 1.Interfering with the formation or administration of a labor union: It
• Better sleep and lifestyle habits is an unfair labor practice for an employer to interfere with the formation or
• Decrease risk of cardiovascular disease, gastrointestinal and reproductive administration of a labor union by nurses, such as by coercing or
disorders, musculoskeletal disorders, chronic infections and mental illness intimidating employees who seek to join a union or by discriminating
• Fewer workplace accidents and injuries against employees who are members of a union.
• Increased productivity 2. Discriminating hiring or promotion: An employer who discriminates
• Higher job satisfaction and motivation against nurses based on their union membership, age, gender, religion, race,
• Lower rates of absenteeism and staff turnover or other prohibited grounds, is commit ing an unfair labor practice.
3.Retaliation for engaging in protected concerted activity: An employer
LESSON 6: EMPLOYMENT BENEFITS may not retaliate against nurses who engage in protected concerted activity,
such as participating in a strike or advocating for improved working
EMPLOYMENT OF WOMEN conditions.
• the Labor Code of the Philippines provides comprehensive protections 4 Refusing to bargain in good faith: An employer who refuses to engage
and benefits for women in the workplace, aimed at ensuring equal treatment in good-faith collective bargaining with a recognized nurses 'union is
and promoting the rights of women workers. committing an unfair labor practice.
• / Entitled for maternity leave, and prohibition of night work for women 5. Violating collective bargaining agreements: An employer who violates
engaged in hazardous occupations. the terms of a collective bargaining agreement, such as by failing to
• / Women should not be required to work overtime, except in exceptional implement agreed-upon wages and benefits or by changing working
circumstances. conditions without proper negotiations, is committing an unfair labor
• Women should be given adequate facilities and rest periods during their practice.
working day.)
• The law prohibits discrimination based on gender, and provides for a Unfair Labor Practices that an employer may commit against nurses
range of protections and benefits to ensure that women are able to work in in the Philippines:
safe and secure conditions, with access to the same opportunities as male If a nurse believes that their employer has committed an unfair labor
workers. practice, they may file a complaint with the Department of Labor and
Employment (DOLE) or with the National Labor Relations Commission
Employment of Minors (NLRC). The DOLE or NLRC will investigate the complaint and determine
+ minors (persons below 18 years of age) are considered as children and are whether the employer has violated the provisions of the Labor Code of the
therefore entitled to special protection from economic exploitation and any Philippines. If the employer is found to have provisions an of unfair the
work that is hazardous, oppressive, or otherwise prejudicial to their health, Labor wirdmitlabor Code practice, and of determine the they Philippines.
morals, or welfare. may whether be ordered If the the employer employer to rectify has is the
+ Minors are prohibited : found violated violation, to havethepay
x from working in certain types of establishments, such as bars, nightclubs, committed damages, and/or face other penalties as provided by law.
and other entertainment or leisure establishments.
x from working in hazardous or deleterious occupations, such as those
involving exposure to dangerous machinery, equipment, and chemicals, as LESSON 8: LAWS PROTECTING WORKERS
well as work in underground mines, deep sea fisheries, and construction
work. Magna Carta for Public Health Workers
/ Minors are allowed to work may only do so with the permission of their +Republic Act No. 7305 - provides for the rights and benefits of public
parents or legal guardians and with a work permit issued by the DOLE. health workers, including nurses, and seeks to improve the delivery of
/ The employer is also required to provide adequate supervision, working health services in the country.
conditions, and protection to the employee. The law provides for security of tenure, reasonable working hours, humane
workingconditions, benefits and incentives, self-organization, and
Employment of Home-based workers continuous professional development opportunities.
+ Homeworker/ home-based workers - those who perform work in or about
their homes for an employer who is not their immediate family member. Salary Standardization Law of 2019 or SSL V, series of 2020
+ are entitled to the same rights and privileges as those enjoyed by other + Republic Act No. 11466 - provides for the standardization of
workers, including the right to just and humane conditions of work, security compensation and position classification in the national government,
of tenure, security and welfare benefits, and the right to form and join labor including the salaries of nurses working in public health institutions. The
organizations. SSL V aims to harmonize the salaries of government employees and align
+ Employers of homeworkers are also required to comply with labor them with prevailing market rates, in order to attract and retain highly
standards, including the payment of minimum wage, overtime pay, holiday qualified and competent personnel in the public sector.
pay, and night-shift differential pay, as well as compliance with + Under the SSL V, nurses working in the public sector are assigned to
occupational health and safety standards specific salary grades, based on their position, education, and length of
service. The SSL
Unfair Labor Practices V also provides for cost-of-living allowances, performance-based bonuses,
any act that interferes with the exercise of the right to self-organization and hazard pay, night shift differential, and other benefits for government
collective bargaining, as well as other labor rights guaranteed by the employees, including nurses.
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• Identify key challenges to global health.
Forty-Hour Week Law • Recognize the importance of information sharing in
Republic Act No. 5901 - the 40-hour workweek is a standard established the area of global health
by law in the Philippines, but the actual number of hours that nurses work • Recognize the importance of preventive activities in improving global
may vary depending on the needs of their employer and the nature of their health
work. • Recognize the need for global networking to improve global health
locally and globally.
Anti-Age Discrimination in Employment Act
+Republic Act No. 10911 - Anti-Age Discrimination in Employment Act “If a health outcome is seen to a greater or lesser extent between
is a law in the Philippines that prohibits discrimination in employment populations, there is disparity. Race or ethnicity, sex, sexual identity, age,
based on age. The law aims to ensure that individuals of all ages have equal disability, socioeconomic status and geographic location all contribute to an
opportunities in the workplace and are protected from harassment and individual’s ability to achieve good health.”
abuse based on their age.
- According to Healthy People .gov.,Published on July 31, 2020
• The Mental Health Act (2018)
• Republic Act No. 11036 - governs the delivery of mental health services HEALTH DISPARITIES inequities in the quality of health, health care
in the country. It provides a comprehensive framework for the promotion, and health outcomes experienced by groups based on social, racial, ethnic,
protection, and delivery of mental health services in the Philippines. economic and environmental characteristics—persist across the nation.
• The Anti-Sexual Harassment Act
• Republic Act No. 7877 - sexual harassment is prohibited in the are inequitable and are directly related to the historical and current unequal
workplace, including hospitals, clinics, and other healthcare facilities. distribution of social, political, economic, and environmental resources.
Employers are also required to establish policies and procedures to prevent
and address sexual harassment, including the appointment of a person FACTORS THAT CONTRIBUTE HEALTH DISPARITIES
responsible for receiving and investigating complaints. Nurses and other INCLUDES:
healthcare professionals are also protected by ethical codes and guidelines ● Genetics
established by professional organizations, such as the Philippine Nurses ● Access to care
Association. ● Poor quality of care
● Community features (e.g. inadequate access to healthy foods, poverty,
TERMS HEALTH limited personal support systems and violence)
➢ “A state of complete physical, mental and social well-being and not ● Environmental conditions (e.g. poor air quality)
merely the absence of disease or infirmity” (WHO,1948) ● Language barriers and health behaviors These social, economic and
environmental conditions where people live, learn, work and play are
INTERNATIONAL HEALTH known as social determinants of health.
➢ Refers to the interlocking and interrelated health status of people
throughout the world and to efforts to improve the health of all people of WHO has identified several critical global health inequalities,
every country. including (but not limited to) the following: • Early childhood mortality
GLOBAL HEALTH caused by preventable diseases such as malaria, tuberculosis, and
Is defined as “the area of study, research and practice that places pneumonia
a priority on improving health and achieving equity in health for • Maternal mortality, particularly in developing countries
all people.” • Premature death or disability from non-communicable diseases such as
high cholesterol, hypertension, and Type 2 diabetes
It is an important new term, and important new concept.
It emphasizes transnational health issues, determinants and
MORBIDITY
solutions. It involves multiple disciplines collaborating.
GLOBAL HEALTH ➢ It is the state of having a specific illness or condition. ➢ It can refer to
“Health problems, issues and concerns that transcend national an acute condition, such as a respiratory infection, it often refers to a
boundaries, may be influenced by circumstances or experiences in condition that’s chronic (long-lasting).
other countries and are best addressed by cooperative actions and ➢ The morbidity rate measures the portion of people in a specific
solutions” – The Institute of Medicine geographical location who contracted a particular disease during a specific
GLOBAL NURSING period of time. It indicates the frequency of the disease appearing in a
The adoption of a global health perspective by nursing professionals population.
interested in seeking collaborative and sustainable solutions to health
problems irrespective of national boundaries. Request respect for EXAMPLES OF COMMON MORBIDITIES INCLUDE:
differences in language, culture, customs and health beliefs. • Diabetes
Effects of Globalization • High blood pressure (hypertension)
Globalization has led to growing interdependence of the • Heart disease
world’s population • Obesity
Potential for infectious diseases to spread rapidly in a • Lung diseases, such as asthma and chronic obstructive pulmonary
world with extensive travel. disorder (COPD)
Includes food, insects, animals and other vectors. • Stroke
• Chronic kidney disease
Bioterrorism necessitates surveillance for suspicious
• Infections, such as the flu, COVID-19, and HIV
clusters at a global level.
• Cancer
Unhealthy populations can destabilize economies
• Alzheimer’s disease
Shift in health conditions from an acute care focus to • Mental health conditions, such as anxiety and depression
chronic care
MORTALITY
OBJECTIVES OF GLOBAL HEALTH CARE
➢ Refers to the number of deaths that have occurred due to a specific
1. A high life expectancy and ageing populations. An
expansive health and medical care system. illness or condition.
2. A rapidly growing private health market 3. Health as a ➢ This is the number of deaths due to an illness divided by the total
dominant theme in social and political discourse population at that time.
4. Health as a major personal goal in life ➢ Often expressed in the form of mortality rate.
➢ A mortality rate is a measure of the frequency of occurrence of death in
WHY SHOULD MEDICAL STUDENTS LEARN ABOUT GLOBAL a defined population during a specified interval.
HEALTH? EPIDEMIOLOGY
• Medical schools have very few lectures on global health in their curricula ➢ It is branch of medical science that studies the distribution of disease in
• Health is becoming a global problem, with chronic diseases being number human populations and the factors determining that distribution, chiefly by
on killer around the globe the use of statistics.
• By learning more about global health research, medical students will be ➢ Unlike other medical disciplines, epidemiology concerns itself with
better equipped to face challenges of their unique profession groups of people rather than individual patients and is frequently
• Know the differences between global and international health research retrospective, or historical, in nature.
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➢ It developed out of the search for causes of human disease in the 19th
century, and one of its chief functions remains the identification of
populations at high risk for a given disease so that the cause may be Anthropology- an academic discipline that is concerned with the scientific
identified and preventive measures implemented. study of humans, past and present.
➢ In epidemiology, a rate is a measure of the frequency with which an Four areas of Anthropology
event occurs in a defined population over a specified period of time. 21 1. Sociocultural anthropology,
STATISTICS 2. Biological/physical anthropology,
3. Archaeology, and
➢the science of collecting, analyzing, presenting, and interpreting data.
4. Linguistics
➢Statistics are a vital part of public health's assessment function, used to One of the central concepts that anthropologist’s study is culture.
identify special risk groups, detect new health threats, plan public health
programs and evaluate their success, and prepare government budgets. “ Leininger defines culture as the “learned, shared, and transmitted values,
➢Health statistics are used for all aspects of public health policy beliefs, norms, and lifeways of a particular group of people that guide
development and evaluation. thinking, decisions, and actions in a patterned way.”
➢Uses of the data include health need identification, analysis of problems Cultures are dynamic and not static as they change in different ways over
and trends, epidemiologic research, program evaluation, program planning, time and under different circumstances or conditions. (M. Leininger,
budget preparation and justification, administrative decision making and McFarland 2002)
health education.
➢ There is ample evidence that social factors, including education, Culture is where “care” is embedded
employment status, income level, gender and ethnicity have a marked What culture does:
influence on how healthy a person is. ✔Culture influences
➢ In all countries – whether low-, middle- or high-income – there are wide ✔Culture determines
disparities in the health status of different social groups
. ➢ The lower an individual’s socio-economic position, the higher their risk "the way of life for an entire society.” -defined as all the ways of life
of poor health. including arts, beliefs and institutions of a population that are passed down
➢ Health inequities are systematic differences in the health status of from generation to generation. -it includes codes of manners, dress,
different population groups. language, religion, rituals, art.
➢ These inequities have significant social and economic costs both to Elements of Culture
individuals and societies. ❑ Values, Beliefs, principles
OUTBREAKS FROM 2000 TO PRESENT ❑ Customs, rituals & activities
2012 – Whooping Cough ❑ Marriage and Family
2012 – MERS-CoV ❑ Government and Law
2014 – Ebola 2016 – Zika Virus ❑ Games and Leisure
2020 – COVID-19
❑ Economy and Trade
2012 – WHOOPING COUGH ❑ Language
● Also known as pertussis, this respiratory disease surmounted to 48,277 ❑ Religion
cases in the U.S. in 2012. Culture connotation :
● Coughing fits last up to 10 weeks or more and can be lifethreatening for ETHNIC / RACE
infants. NON-ETHNIC :
● Worldwide, the estimation of whooping cough cases is 24.1 million with ➢ SOCIO-ECONOMIC STATUS
about 160,700 deaths per year according to the National Center for ➢ ABILITY/ DISABILITY
Biotechnology Information. 24 2012 – MERS-CoV ➢ SEXUAL ORIENTATION
● Middle East Respiratory Syndrome was first found in the Arabian
➢ AGE
Peninsula in 2012 and was also associated with the coronavirus once the
illness became viral. ➢ OCCUPATION/ PROFESSION “
● Only two cases were found in the U.S. in 2014, one in Indiana and Other terms linked to culture :
another in Florida, linked to health care providers who previously worked ╺ Subculture ╺ refers to groups that have values and norms that are distinct
in Saudi Arabia. from those held by the majority within a wider society.
● Up until 2019, 2,494 cases have been reported, including 858 deaths. ╺ Ethnicity is defined as the perception of one- self and a sense of
belonging to a particular ethnic group or groups.
2014 – Ebola ╺ Race refers to a group of people who share such genetically transmitted
Ebola was found in Africa near the Ebola River in 1976, but the outbreak traits as skin color, hair texture, and eye shape or color
that recently caught the world’s attention started in Guinea before spreading “ Three levels of Culture by Edward Hall (1984) 19
to neighboring countries, with the highest cases in Sierra Leone of 14,124 I. Primary level of culture - the implicit rules known and followed
and 3,956 deaths. by members of the group, but seldom stated or made explicit, to
● Ebola reached the U.S. but only recorded four cases and one fatality, and outsiders.
in 2015 the CDC announced a vaccine against the disease. II. Secondary level - underlying rules and assumptions that are
● The most recent outbreaks of Ebola occured in the Democratic Republic known to members of the group but rarely shared with
of Congo in 2018. 26 2016 – Zika Virus outsiders.
● The most at threat potential victims for this mosquito-transmitted disease III. Tertiary level
are pregnant women, whom if bitten, their pregnancy could result in
stillbirth, preterm birth or fetal loss. Historical and Theoretical Foundations of TCN
● In November of 2016, 84 countries were reported to have Zika virus Transcultural Nursing
cases in the Americas, with the first cases reported in Brazil, then spreading ❑ Leininger used the term Transcultural nursing (TCN) to describe the
in high numbers to New York, Florida and Texas. 27 2020 – COVID-19 blending of nursing and anthropology into an area of specialization within
● On Jan. 30, the World Health Organization declared a “public health the discipline of nursing.
emergency of international concern” for the new coronavirus, COVID-19, ❑ “Nursing and Anthropology: Two Worlds to Blend,” Leininger (1970)
originating from Wuhan, Hubei Province in China. Like SARS and MERS, ❑ TCN is interchangeable with cross-cultural, intercultural, and
this virus originates from certain animals before infecting humans, and has multicultural nursing.
spread quickly. Goal of TCN is to develop a scientific and humanistic body of knowledge
● The confirmed locations of the virus’ presence are in Asia, the U.S., in order to provide culture-specific and culture-universal nursing care
Canada, Australia, Europe and Russia. practices for individuals, families, groups, communities, and institutions of
similar and diverse cultures.
Decent Work Employment and Transcultural Nursing Culture – Specific
Introduction to Transcultural Nursing refers to particular values, beliefs, and patterns of behavior that tend to be
“Nurses who are prepared to deal with differences are prepared to deal with special or unique to a group and that do not tend to be shared with members
diversity. The more sensitive we are to cultural differences in our patients, of other cultures.
the more sensitive we are to all differences in our patients, making us better Culture – Universal
at providing the unique care each of them deserves.” – Malone, 1998
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refers to the commonly shared values, norms of behavior, and life patterns
that are similarly held among cultures about human behavior and lifestyles.
Dr. Madeleine M. Leininger
(July 13, 1925 – August 10, 2012) The first nurse anthropologist and the
“mother” of transcultural nursing. Theory: Culture care theory of diversity
& universality
TCN exists today as an evidence-based, dynamic area of specialization
within the nursing profession because of the visionary leadership of its
founder, Madeleine Leininger, and many other nurses committed to the
provision of care that is consistent with and “fits” the cultural beliefs and
practices of those receiving it
Dr. Leininger’s contributions (overview)
I. Culture care theory of diversity & universality (1950s) ╺ -
describes, explains, and predicts nursing similarities and
differences in care and caring in human cultures
(Leininger, 1991).
Culturally congruent nursing care
refers to those cognitively based assistive, supportive, facilitative, or
enabling acts or decisions that are mostly tailor-made to fit with an
individual’s, group’s or institution’s cultural values, beliefs, and lifeways in
order to provide meaningful, beneficial, satisfying care that leads to health
and well-being.
II. Sunrise Enabler Originally developed as a model. -depicts
multiple factors predicted to influence culture care
expressions and their meanings.
Ethnonursing Research
A qualitative research method to investigate phenomena of interest in
TCN
➢ is the first research methodology developed by a nurse for use in
studying topics relevant to nursing.
Dr. Leininger’s Protégés
Marilyn (Dee) A. Ray
Marilyn R. McFarland
Margaret M. Andrews
Margeret Andrews & Joyceen Boyle’s ( overview )
Transcultural Interprofessional Practice (TIP) Model -its goal is to
provide a patient- or client-centered systematic, logical, orderly, scientific
process for delivering safe, culturally congruent and competent, affordable,
accessible, evidence-based, and quality care for people from diverse
backgrounds across the life span
Key components of the TIP model
▪ Cultural Context
▪ Interprofessional health care team
▪ Effective verbal and nonverbal communication among all team members
▪ Five-step systematic, scientific problem-solving process