Saint Mary’s University

SCHOOL OF HEALTH and NATURALSCIENCES

Nursing Department
Bayombong, Nueva Vizcaya
1st Semester, SY 2022-2023

Course No.: NCM 104

Subject: Community Health Nursing 1
Year Level: BSN 2
Contact Hours: 2 hours per week
Credit Units: 2 units

MODULE 1
OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES

I. INTRODUCTION
Nursing is a profession aimed at helping the population achieve better health thru their own hands.
It is for this reason why nurses in the community should have a deeper understanding of health both as a
concept and as a reality. This chapter focuses on the overview of public health nursing in the Philippines
which include the global and national health situation, Standards of public health nursing in the Philippines,
Evolution of public health nursing in the Philippines and the Roles and responsibilities of a Community
Health Nurse.

II. Learning Objectives:

At the end of this module, students should be able to
1. Know the current global and national health situations.
2. Define important terms related to public health nursing.
3. Understand the historical background of community health nursing in the Philippines.
4. Determine the Standards of Public Health Nursing in the Philippines.
5. Identify the roles and responsibilities of a Community Health Nurse.

III. CORE CONTENT OF THE CHAPTER:

A. GLOBAL AND NATIONAL HEALTH SITUATION

10 Threats to Global Health

The world is facing multiple health challenges. These range from outbreaks of vaccine-preventable
diseases, increasing report of drug resistant pathogens, growing rates of obesity and physical inactivity to
the health impacts of environmental pollution and climate change and multiple humanitarian crises.
To address these and other threats, the World Health Organization (WHO) crafted a 5-year
development plan – the 13th General Program of Work. This plan focuses on a triple billion target ensuring
1 billion more people benefit from access to universal health coverage, 1 billion more people are protected
from health emergencies and 1 billion more people enjoy better health and well-being. However, reaching
the goal will require addressing the threats to health from a variety of angles.

Here are 10 of the many issues that will demand attention from WHO and health partners in 2019:

1. AIR POLLUTION AND CLIMATE CHANGE

 In 2019, air pollution is considered by WHO as the greatest environmental risk to health
killing 7 million people prematurely every year.
 The primary cause of air pollution (burning fossil fuels) is a also a major contributor to
climate change.
 By 2030 and 2050, climate change is expected to cause additional 250,000 deaths per
year due to malnutrition, malaria, diarrhea, and heat stress

2. NON-COMMUNICABLE DISEASES
 Diabetes, cancer and heart diseases are just some of the common noncommunicable
diseases that are collectively responsible for over 70% of all deaths worldwide, or 41M
people.
 The rise of these diseases are driven by 5 major factors: tobacco use, physical inactivity,
use of alcohol, unhealthy diets and air pollution

3. GLOBAL INFLUENZA PANDEMIC

 WHO is constantly monitoring the circulation of influenza viruses to detect potential
pandemic strains.
 Every year, WHO recommends which strains should be included in the flu vaccine to
protect people from seasonal flu.
 In the event that a new flu strain develops pandemic potential. WHO has set up a unique
partnership with all the major players to ensure effective and equitable access to
diagnostics, vaccines, and antivirals especially in developing countries

4. FRAGILE AND VULNERABLE SETTINGS

 More than 1.6 billion people (22% of the global population) liv in places where protracted
crises (through a combination of challenges such as drought, famine, conflict, and
population displacement) and weak health services leave them without access to basic
care.
 Fragile settings exist in almost all regions of the world, and these are where half of the key
targets in the SDG, including on child and maternal health, remains unmet.

5. ANTIMICROBIAL RESISTANCE
 The development of antibiotics, antivirals and antimalarials are some of modern medicine’s
greatest successes.
  Antimicrobial resistance threatens to send us back to a time when we were unable to
easily treat infections such as pneumonia, TB, gonorrhea and salmoneliosis.
 The inability to prevent infections could seriously compromise surgery and procedures
such as chemotherapy.

6. EBOLA AND OTHER HIGH THREAT PATHOGENS

 Aside from Ebola virus that has killed thousands of people especially in the African region,
the whole world is trying again to fight an unseen enemy which is COVID-19.
 This highly infectious disease has already killed thousands of hundred of people in the
whole world without regard to age and social status.

7. WEAK PRIMARY HEALTH CARE

 Primary health care is usually the first point of contact people have with their health care
system, and ideally should provide comprehensive, affordable, community-based care
throughout life
 Health systems with strong primary health care services are needed to achieve universal
health coverage.
 But still, many countries do not have adequate Primary health care facilities. This is
maybe due to lack of resources in low or middle income countries

8. VACCINE HESITANCY
 The reluctance or refusal to vaccinate despite the availability of vaccines – threatens to
reverse progress made in tackling vaccine- preventable diseases.
 Vaccination is one of the most cost-effective ways of avoiding disease. It currently
prevents 2-3M of deaths a year, and a further 1.5M could be avoided if global coverage of
vaccinations improved

9. HIV/AIDS
 The progress made against HIV has been enormous in terms of getting people tested,
providing them with anti- retrovirals, and providing access to preventive measures
 However, the epidemic continues to rage with nearly a million death every year.

10. DENGUE
 A mosquito-borne disease that causes flu-like symptoms and can be lethal to kill up to
20% of those with severe dengue, has been a growing threat for decades
 An estimated 40% of the world is at risk of dengue fever, and there are around 390M
infections a year
 WHO’s Dengue control strategy aims to reduce deaths by 50% by 2020.
 THE NATIONAL HEALTH SITUATION

10 Leading Causes of Mortality

1. Diseases of the heart 7. Chronic obstructive and pulmonary

2. Diseases of the vascular system diseases, and allied conditions
3. Pneumonias 8. Other diseases of the respiratory system
4. Malignant neoplasms
9. Diabetes mellitus
5. TB, all forms
6. 6. Accidents 10. Diarrheal diseases

10 Leading Causes of Morbidity

1. Diarrheas 7. chickenpox
2. Pneumonias 8. diseases of the heart
3. Bronchiolitis 9. measles
4. Influenza 9. dengue H-fever
5. TB, all forms
6. malaria

B. DEFINITION OF TERMS

1. HEALTH
 State of complete, physical, mental and social well-being and not merely the absence of
disease or infirmity (WHO).

2. NURSING
 Assisting sick individual to become healthy and healthy individual to achieve optimum level
of wellness or functioning.

3. PUBLIC HEALTH
 Is the science and art of preventing disease, prolonging life, and promoting health and
efficiency through organized community effort for sanitation of the environment, control of
communicable infections, education of the individual in personal hygiene (Dr. C. E.
Winslow)

4. PUBLIC HEALTH NURSING

  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)

 The practice of promoting and protecting the health of populations using knowledge from
nursing, social, and public health sciences (ANA/APHA, 1996)
5. COMMUNITY
 Social structure that exhibits and creates norms and values that establish social institution
(WHO)
 A group of people sharing a common geographic boundaries and/ or common values and
interest. It functions within a particular sociocultural context with varying physical
environment, coping and behaving. (Maglaya 2003, Nsg. Practice in Community)

6. COMMUNITY HEALTH NURSING

 Unique blend of public health and nursing for human service with holistic approach.

C. STANDARDS OF PUBLIC HEALTH NURSING IN THE PHILIPPINES

STANDARDS OF CARE

1. Assessment The public health nurse collects comprehensive data

pertinent to the health status of populations

2. Population diagnosis and The public health nurse analyzes the assessment data to
priorities determine the population diagnoses and priorities
3. Outcomes identification The public health nurse identifies expected outcomes for a
plan that is based on population

4. Planning The public health nurse develops a plan that reflects best
practices by identifying strategies, action plans, and
alternatives to attain expected outcomes

5. Implementation The public health nurse implements the identified plan by

partnering with others

a. Coordination Coordinates programs, services and other activities to

implement the identified plan

b. Health education and Employs multiple strategies to promote health, prevent

health promotion disease, and ensure a safe environment for populations

c. Consultation Provides consultation to various community groups and

 officials to facilitate the implementation of programs and
services

d. Regulatory activities Identifies, interprets, and implements public health laws,

regulations, and policies

6. Evaluation The public health nurse evaluates the health status of the
population

STANDARDS OF PROFESSIONAL PERFORMANCE

7. Quality of practice The public health nurse systematically enhances the quality
and effectiveness of nursing practice

8. Education The public health nurse attains knowledge and competency

that reflects current nursing and public health practice

9. Professional practice The public health nurse evaluates ones own nursing practice
evaluation in relation to professional practice standards and guidelines,
relevant statutes, rules and regulations

10. Collegiality and professional The public health nurse establishes collegial partnerships
relationships while interacting with representatives of the population.

11. Collaboration The public health nurse collaborates with the representatives
of the population, organizations and health human services
professionals in providing for and promoting the health of the
population.

12. Ethics The public health nurse integrates ethical provisions in all
areas of practice.

13. Research The public health nurse integrates research findings in

practice

14. Resource utilization The public health nurse considers factors related to safety,
population effectiveness, cost and impact on practice and in the
planning and delivery of nursing and public health programs,
policies, and services

15. Leadership The public health nurse provides leadership in nursing and
public health.
D. EVOLUTION OF PUBLIC HEALTH NURSING IN THE PHILIPPINES
Records of public health services in the Philippines date back to the Spanish regime.

 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.
 1905: Asociacion de Feminista Filipina founded La Gota de Leche: the first center dedicated to the
service of mothers and babies
 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 Code 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.

E. ROLES AND RESPONSIBILITIES OF A COMMUNITY HEALTH NURSE

MANAGER/SUPERVISOR  monitors midwives and other auxiliary health workers

 Give in-service health education program to the other health
team
 Guides group discussion and helps staff overcome their
difficulties in work
CLINICIAN  healthcare provider/ client advocate

ADVOCATE  The nurse works on behalf of patients to maintain quality of

care and protect patients rights
FACILITATOR  uses multi-sectoral linkages (Referral system)

TRAINER/ HEALTH  Organizes orientation/training of concerned groups including

EDUCATOR/COUNSELOR non-government organization
 disseminates information to people with emphasis on health
promotion and disease prevention

PLANNER/ PROGRAMMER  Interprets and implements the nursing plan, program policies,
memoranda for the concerned personnel and staff

COMMUNITY ORGANIZER  Responsible for motivating and enhancing community

participation in terms of planning, organizing, and implementing
and evaluating health programs/services
 Initiates and participates in community development activities

HEALTH MONITOR  Uses symptomatic and objective observation and other forms of
data gathering like morbidity, registry, questionnaire, checklist,
and anecdo-report/record to monitor growth and development
and health status of individuals, families and communities

ROLE MODEL  Promotes good example/model of healthful living to the public

and community

CHANGE AGENT  Motivates changes in health behavior of individuals, families,

group and community including lifestyle in order to promote and
maintain health.

RESEARCHER  Participates/assists in the conduct of surveys studies and

researches in nursing and health related subjects
 Coordinates with government and non-government organization
of studies/research

VI. BIBLIOGRAPHY

Zenaida U. Famorca et.al. Nursing Care of the Community, Elsevier Mosby 2013
pp. 16-17

Public Health Nursing in the Philippines, National League of Philippine Government Nurses,
Inc.