Community health nursing (CHN), also called public health nursing or community nursing,

combines primary healthcare and nursing practice in a community setting. Community health
(CH) Nurses provide health services, preventive care, intervention and health education to
communities or populations Community Health Nurse Unlike a nurse who works with patients
one-on-one in other clinical settings, community health nurses focus on communities. CH
nurses can have various roles in a community setting such as: Health education. Community
advocacy. Ensuring a safe and healthy environment. Abuse and neglect prevention. Policy
reform. Community development. What they do depends on the communities they serve; lower
income, school, and culturally diverse communities all have different needs. GLOBAL,
NATIONAL and LOCAL HEALTH SITUATION The country is facing a health crisis at present
due to COVID19 pandemic. Where large number of the population is affected. The Philippines
has presently recorded new increased cases and a daily additional COVID-19 cases still
reported. The Department of Health and the Local Government Units are working together to
find ways of controlling the spread of the disease. With their joint efforts national and local
health facilities are involved in the management of cases. There is a problem in the scarcity of
health workers( Doctors, Nurses, Medical Technologists). Several private hospitals across
Metro Manila earlier said beds allocated for COVID-19 cases had reached full capacity following
the easing of quarantine restrictions in a bid to revive the economy. According to the DOH the
current population of the country is estimated about 109,653,229 where the Philippines ranked
13th in the highest population rate. The Philippine population is considered young and for
global population increase is 1.05 % per year. According to the DOH top leading causes of
MORBIDITY in the Philippines includes all forms respiratory diseases, hypertension, kidney and
urinary tract problems, all forms of diarrheal diseases, and diabetes mellitus. For MORTALITY, it
includes cardiovascular diseases, pneumonias, malignant neoplasms/cancers, all forms of
tuberculosis, accidents, COPD and allied conditions, diabetes mellitus, nephritis/nephritic
syndrome and other diseases of respiratory system. Morbidity-refers to the cases of illness in a
given population in a specified period of time. Mortality-refers to the cases of deaths in a given
population in a specified period of time HEALTH AND LONGEVITY AS BIRTHRIGHTS
HEALTH IS A BASIC HUMAN RIGHT FOR EVERY FILIPINO. LONGEVITY-average lifespan
The lifespan increases among Filipinos according to the DOH and varies per year. There is an
increase every year which is closely related to the different DOH health programs Life
expectancy in the country in 2010-2015 was 68.6 years. Life expectancy at birth male/female in
2016- 66/73. The life expectancy for Philippines in 2017 was 70.87 years. The life expectancy
for Philippines in 2018 was 71.03 years, a 0.23% increase from 2017 The life expectancy for
Philippines in 2019 was 71.16 years, a 0.18% increase from 2018. DEFINITION AND FOCUS
COMMUNITY It is a group of people with common characteristics or interests living together
within a territory or geographical boundary It is a place where people under usual conditions are
found It is derived from a latin word “comunicas” which means a group of people. 3 Elements of
a community 1. Geographical Entity 2. Social Entity 3. Psycho-cultural Entity Two specific types
of a community Rural Urban Urban area" can refer to towns, cities, and suburbs. An urban area
includes the city itself, as well as the surrounding areas. Rural areas are the opposite of urban
areas. Rural areas have low population density and large amounts of undeveloped land
(Barios). HEALTH According to WHO Health is defined as a state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity. The state of being free
from illness or injury. The enjoyment of the highest attainable standard of health is one of the
fundamental rights of every human being without distinction of race, religion, political belief,
economic or social condition. The health of all peoples is fundamental to the attainment of
peace and security and is dependent on the fullest co-operation of individuals and States. The
achievement of any State in the promotion and protection of health is of value to all. Community
Health Community health refers to the health status of the members of the community, to the
problems affecting their health and to the totality of the health care provided for the community.
Community health is a branch of public health which focuses on people and their role as
determinants of their own and other people's health AIMS of CHN To promote health and
efficiency. To prevent and control of diseases and disabilities. To prolong life through need-
based health care. OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter for
Health Promotion is the name of an international agreement signed at the First International
Conference on Health Promotion, organized by the World Health Organization(WHO) and held
in Ottawa, Canada, in November 1986. It launched a series of actions ng international
organizations, national governments and local communities to achieve the goal of "Health For
All" by the year 2000 and beyond through better health promotion OTTAWA CHARTER FOR
HEALTH PROMOTION Five action areas for health promotion were identified in the charter:
1.Building healthy public policy 2.Creating supportive environments 3.Strengthening community
action 4.Developing personal skills 5.Re-orienting health care services toward prevention of
illness and promotion of health The basic strategies for health promotion were prioritized as:
Advocate: Health is a resource for social and developmental means, thus the dimensions that
affect these factors must be changed to encourage health. Enable: Health equity must be
reached where individuals must become empowered to control the determinants that affect their
health, such that they are able to reach the highest attainable quality of life. Mediation: Health
promotion cannot be achieved by the health sector alone; rather its success will depend on the
collaboration of all sectors of government (social, economic, etc.) as well as independent
organizations (media, industry, etc.). JAKARTA DECLARATION ON LEADING HEALTH
PROMOTION INTO THE 21ST CENTURY The Fourth International Conference on Health
Promotion: New Players for a New Era - Leading Health Promotion into the 21st Century,
Jakarta, Indonesia, 21- 25 July ,1997. PRIORITIES FOR HEALTH PROMOTION IN THE 21ST
CENTURY Promote social responsibility for health Increase investments for health development
Consolidate and expand partnerships for health Increase community capacity and empower the
individual Jakarta Declaration on Leading Health Promotion into the 21st Century Investments
for health should reflect the needs of particular groups such as women, children, older people,
and indigenous, poor and marginalized populations. Definition of COMMUNITY HEALTH
NURSING It is a synthesis of nursing and public health practice applied to promoting and
preserving the health of the people. According to Maglaya, CHN is the utilization of the nursing
process in the different levels of clientele-individuals, families, population groups and
communities, concerned with the promotion of health, prevention of disease and disability and
rehabilitation. The goal of CHN as stated by Nisce is to raise the level of citizenry by helping
communities and families to cope with the discontinuities in and threats to health in such a way
as to maximize their potential for high-level wellness. The definition of CHN by the WHO
Committee on expert in nursing is a special field of nursing that combines the skills of nursing,
public health and some phases of social assistance and functions as part of the total public
health program for the promotion of health, the improvement of the conditions in the social and
physical environment, rehabilitation of illness and disability From Jacobson point of view CHN is
learned practice discipline with the ultimate goal of contributing as individuals and in
collaboration with others to the promotion of the client’s optimum level of functioning thru’
teaching and delivery of care (Jacobson) DR. Ruth B. Freeman: A service rendered by a
professional nurse to I.F.C.s, population groups in health centers, clinics, schools, workplace for
the promotion of health, prevention of illness, care of the Public Health Mission of CHN Health
Promotion Health Protection Health Balance Disease prevention Social Justice PHILOSOPHY
OF CHN According to Dr. M. Shetland the philosophy of CHN is based on the worth and dignity
on the worth and dignity of man. The community is the patient in CHN, the family is the unit of
care and there are four levels of clientele: individual, family, population group (those who share
common characteristics, developmental stages and common exposure to health problems – e.g.
children, elderly), and the community. In CHN, the client is considered as an ACTIVE partner
NOT PASSIVE recipient of care, CHN practice is affected by developments in health
technology, in particular, changes in society, in general The goal of CHN is achieved through
multi-sectoral efforts CHN is a part of health care system and the larger human services
system. OBJECTIVES OF PUBLIC HEALTH C.O.D.E.S C ontrol of Communicable Diseases O
rganization of Medical and Nursing Services D evelopment of Social Machineries E ducation of
IFC on personal Hygiene.Health Education is the essential task of every health worker S
anitation of the environment 3 ELEMENTS IN HEALTH EDUCATION 1.Information: to share
ideas to keep population group knowledgeable and aware 2.Education: change within the
individual 3.Communication: interaction involving 2 or more persons or agencies 12 BASIC
PRINCIPLES OF CHN Community Health Nursing (CHN) is a vital part of Public Health. The
following are the 12 Principles of CHN. 1. The recognized need of individuals, families and
communities provides the basis for CHN practice. Its primary purpose is to further apply public
health measures within the framework of the total CHN effort. 2. Knowledge and understanding
of the objectives and policies of the agency facilities goal achievement. 3. CHN considers the
family as the unit of service. Its level of functioning is influenced by the degree to which it can
deal with its own problems and effective and available channel for the most of the CHN efforts.
4. Respect for the values, customs and beliefs of the clients contribute to the effectiveness of
care to the client. CHN services must be available sustainable and affordable to all regardless of
race, creed, color or socio-economic status. 5. CHN integrated health education and counseling
as vital parts of functions. These encourage and support community efforts in the discussion of
issues to improve the people’s health. 6. Collaborative work relationships with the co-workers
and members of the health team facilities accomplishments of goals. Each member is helped to
see how his/her work benefits the whole enterprise. 7. Periodic and continuing evaluation
provides the means for assessing the degree to which CHN goals and objectives are being
attained. Clients are involved in the appraisal of their health program through consultations,
observations and accurate recording. 8. Continuing staff education program quality services to
client and are essential to upgrade and maintain sound nursing practices in their setting.
Professional interest and needs of Community Health Nurses are considered in planning staff
development programs of the agency. 9. Utilization of indigenous and existing community
resources maximizing the success of the efforts of the Community Health Nurses. The use of
local available ailments. Linkages with existing community resources, both public and private,
increase the awareness of what care they need what are entitled. 10. Active participation of the
individual, family and community in planning and making decisions for their health care needs,
determine, to a large extent, the success of the CHN programs. Organized community groups
are encouraged to participate in the activities that will meet community needs and interests. 11.
Supervision of nursing services by qualified by CHN personnel provides guidance and direction
to the work to be done. Potentials of employees for effective and efficient work are developed.
12. Accurate recording and reporting serve as the basis for evaluation of the progress of
planned programs and activities and as a guide for the future actions. Maintenance of accurate
records is a vital responsibility of community as these are utilized in studies and researches and
as legal documents. ROLES OF THE PUBLIC HEALTH NURSE Clinician - who is a health care
provider, taking care of the sick people at home or in the RHU Health Educator - who aims
towards health promotion and illness prevention through dissemination of correct information;
educating people Facilitator - who establishes multi-sectoral linkages by referral system
Supervisor - who monitors and supervises the performance of midwives Health Advocate - who
speaks on behalf of the client Collaborator - who working with other health team member In the
event that the Municipal Health Officer (MHO) is unable to perform his duties/functions or is not
available, the Public Health Nurse will take charge of the MHO’s responsibilities. ✓ Other
Specific Responsibilities of a Nurse, spelled by the implementing rules and Regulations of RA
9173 (Philippine Nursing Act of 2002) includes: 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 medicines Responsibilities of a CH
Nurse In the care of the families: Provision of primary health care services
Developmental/Utilization of family nursing care plan in the provision of care In the care of the
communities: Community organizing mobilization, community development and people
empowerment Case finding and epidemiological investigation Program planning,
implementation and evaluation Influencing executive and legislative individuals or bodies
concerning health and development Responsibilities of CHN Be a part in developing an overall
health plan, its implementation and evaluation for communities Provide quality nursing services
to the three levels of clientele Maintain coordination/linkages with other health team members,
NGO/government agencies in the Provision of public health services Conduct researches
relevant to CHN services to improve provision of health care Provide opportunities for
professional growth and continuing education for staff development EVOLUTION OF CHN
WORLDWIDE AND IN THE PHILIPPINES ______________________ ____________ ____
INFLUENCES OF ANCIENT CULTURES ON PUBLIC HEALTH EGYPTIAN CIVILIZATION (ca
3000 BC) Built irrigation canal and granaries for storage of food Practice of prophylaxis by the
medicine man and high priest Emphasis on personal hygiene, cleanliness within & outside the
body Sanitation measures ( removal of refuse and crude fumigation in times of epidemics)
HEBREWS (C.A. 1400 BC) Founders of public hygiene Moses was regarded as “Father of
Sanitation” Mosaic Health Code pertained to every aspect of individual, family & community
hygiene, included: a. Principles of personal hygiene (rest, sleep, hours of work, cleanliness) b.
Environmental sanitation 1. Inspection of food . Methods of disposal of excreta 3. Detecting
and reporting diseases 4. Practice of isolation, quarantine, fumigation and disinfection 5.
Detailed instructions on the correct way of hand washing GREEKS (CA. 600 BC) Hippocrates –
“Father of Medicine” , exponent of the science of preventive medicine and introduced the
philosophy of the interrelationship between physical and mental health ( “A healthy mind dwells
in a healthy body”) ROMANS (CA. 50 BC) Contributed to the field of sanitation (building of
Aqueducts, purification of water supply) , appointing of public health medical officers and
establishment of hospitals which emphasized both preventive and curative aspects of care
DEVELOPMENT OF PUBLIC HEALTH NURSING AS A WORLD MOVEMENT EARLY
CHRISTIAN PERIOD (1 ST CENTURY) Order of Deaconesses- called visiting
nurses,forerunner of CHN and endeavored to practice the corporal works of mercy (feeding the
hungry, caring for the sick, burying the dead) Phoebe a friend of St Paul and the first Deaconess
and visiting nurse. MIDDLE AGES (500-1500) Beguines of Flanders- worked as nursing sister
in the hospital, but also gave care to the sick in their homes, staying with the dying and
consoling the families of the bereaved. RENAISSANCE (1500-1700) St Vincent De Paul-
introduced modern principles of visiting nurse, social services, taught that indiscriminate giving
was harmful, emphasized the concept of helping people. maintained the family is the unit of the
service and recognized the importance of supervision of those who render service to the sick
EARLY 19 TH CENTURY Pastor Theodor Fliedner- German Lutheran pastor, went tour to raise
funds when the main industry of his community failed, came back with money and ideas for a
program social work. Fredericka Munster Fliedner- a wife pastor organized women society for
visiting nursing the sick poor in their homes Couple recognized the need for preparing the
training those who care for the sick , organized a hospital school of nursing in Germany (
Kaiserswerth Institute for the training of Deaconesses) Development of Modern PHN
Characterized by: Clean-up measures in the control of communicable disease Removal of
refuse Clean-up campaign of prison and asylums Improvement of working conditions of women
and children William Rathbone- Father of modern district nursing with the encouragement of
Florence Nightingale, organized a training school for nurses in the Liverpool Royal Infirmary
which provided training for hospital nurses, private duty nurses and district nurse. STANDARDS
IN CHN Theory Data Collection Diagnosis Planning Intervention Evaluation Quality
Assurance and Professional Development Interdisciplinary Collaboration Research Legal basis
of CHN Practice Code of Ethics for Nurses R.A. # 9173(Nursing Law of 2002) Competency
Standards of Nursing Practice in the Philippines COMMUNITY HEALTH NURSE ROLES and
FUNCTIONS Qualifications Bachelor of Science in Nursing Registered Nurse of the Philippines
Planner/Programmer Identifies needs, priorities, and problems of individuals, families, and
communities. Formulates municipal health plan in the absence of a medical doctor. Interprets
and implements nursing plan, program policies, memoranda, and circular for the concerned staff
personnel. Provides technical assistance to rural health midwives in health matters. Provider of
Nursing Care Provides direct nursing care to sick or disabled in the home, clinic, school, or
workplace Develops the family’s capability to take care of the sick, disabled, or dependent
member Community Organizer Motivates and enhances community participation in terms of
planning, organizing, implementing, and evaluating health services Initiates and participates in
community development activities Coordinator of Services Coordinates with individuals,
families, and groups for health related services provided by various members of the health
team. Coordinates nursing program with other health programs like environmental sanitation,
health education, dental health, and mental health Trainer/Health Educator Identifies and
interprets training needs of the RHMs and Barangay Health Workers (BHW). Conducts training
for RHMs and BHW on promotion and disease prevention Conducts pre and post-consultation
conferences for clinic clients; acts as a resource speaker on health and health related services
Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education
purposes Conducts pre-marital counseling Health Monitor Detects deviation from health of
individuals, families, groups, and communities through contacts/visits with them Role Model
Provides good example of healthful living to the members of the community Change Agent
Motivates changes in health behavior in individuals, families, groups, and communities that also
include lifestyle in order to promote and maintain health Recorder/Reporter/Statistician
Prepares and submits required reports and records Maintain adequate, accurate, and complete
recording and reporting Reviews, validates, consolidates, analyzes, and interprets all records
and reports Prepares statistical data/chart and other data presentation Researcher
Participates in the conduct of survey studies and researches on nursing and health-related
subjects Coordinates with government and non-government organization in the implementation
of studies/research NURSING CORE VALUES AS A COMMUNITY HEALTH NURSE Mission
The National League for Nursing promotes excellence in nursing education to build a strong and
diverse nursing workforce to advance the health of our nation and the global community. CORE
VALUES CARING: promoting health, healing, and hope in response to the human condition A
culture of caring, as a fundamental part of the nursing profession, characterizes our concern
and consideration for the whole person, our commitment to the common good, and our outreach
to those who are vulnerable. INTEGRITY: respecting the dignity and moral wholeness of every
person without conditions or limitation; A culture of integrity is evident when organizational
principles of open communication, ethical decision-making, and humility are encouraged,
expected, and demonstrated consistently. DIVERSITY: affirming the uniqueness of and
differences among persons, ideas, values, and ethnicities. A culture of inclusive excellence
encompasses many identities, influenced by the intersections of race, ethnicity, gender, sexual
orientation, socio-economic status, age, physical abilities, religious and political beliefs, or other
ideologies. EXCELLENCE: co-creating and implementing transformative strategies with daring
ingenuity. A culture of excellence reflects a commitment to continuous growth, improvement,
and understanding. It is a culture where transformation is embraced, and the status quo and
mediocrity are not tolerated. Community Health Nurses face daily challenges not experienced
in a hospital setting, and experience more autonomy than hospital-based nurses. Nursing ethics
and professional core values play a substantial role in the decision-making process outside of
the hospital setting. THE HEALTH CARE DELIVERY SYSTEM THE HEALTH CARE DELIVERY
SYSTEM Health care delivery system is defined as the aggregate of institutions, organizations
and persons who enter, the health care system, Who has responsibility that, Include the
promotion of health, prevention of illness, detection and treatment of disease and rehabilitation
DEFINITION OF TERMS HEALTH CARE DELIVERY SYSTEM (HCDS) It is the totality of all
policies, facilities, equipment, products, human resources and services which address the
health needs, problems and concerns of the people. It is large, complex, multi-level and
multi-disciplinary. HCDS is often used to describe the way in which health care is provided to the
people. It is the network of health facilities and personnel which carries out the task of
rendering health care to the people. (Williams-Tungpalan, 1981) HEALTH CARE SYSTEM
(HCS) It is a complex set of organizations interacting to provide an array of health services
(Dizon, 1977). It is an organized plan of health services (Miller-Keane, 1987) HEALTH CARE
DELIVERY (HCD) It is rendering health care services to the people (Williams-Tungpalan,
1981). HEALTH CARE DELIVERY SYSTEM The primary objectives of any health delivery
system are: To enable all citizens to receive health care services whenever needed To deliver
health services that are cost-effective and meet pre- established standards of quality. Three
levels of health care & health care facility: Primary Level of care -Primary Level of Health care
Facility Secondary Level of care -Secondary Level of Health care Facility Tertiary Level of care
-Tertiary Level of Health care facility PRIMARY LEVEL OF CARE This includes prevention of
illness or promotion of health. It is the initial entry point for clients of the health care delivery
system which is directed towards the promotion and maintenance of health, the prevention of
disease, the management of common specific illnesses and usually ambulatory or outpatient
settings. Services are offered by the Primary level of Health Care Facility. RHU/MHO Private
Clinics Birthing/Lying in Centers SECONDARY LEVEL OF CARE It centers on early diagnosis
and treatment of diseases. This includes provision of specialized medical services by physician
or a hospital on a referral by the primary care provider. Services are offered by Secondary Level
of Health Care facility. Community hospitals District and emergency hospitals TERTIARY LEVEL
OF CARE Rehabilitation is restoring health and aimed at lessening the pain and discomfort of
illness and helping clients live with disease and disability. It also includes care of chronic ailment
that requires long term care and prevention of complications. Services are offered by Tertiary
Level of Health Care facility. Provincial Hospitals Specialized hospitals 3 LEVELS OF
PREVENTION 1. PRIMARY LEVEL • Target: HEALTHY individuals • GOAL: To prevent/delay
the actual occurrence of disease • INTERVENTION: Health Promotion and Disease Prevention •
HEALTH EDUCATION • Basic health service that aims to modify harmful practices of people
and their unscientific knowledge and attitude • ACTIVITIES: 1. Health Education 2. Family
Planning 3. Genetic Counseling 2. Healthy Lifestyle Habits 1. Health Diet 2. Rest 3. Exercise 4.
Not Smoking 3. Hygiene (HANDWASHING) 4. Immunization/Inoculation 1. Isolation of the
diagnosed sick child to pregnant mother 2. Intake or use of Prophylactic drugs 3. Antiretroviral
drugs 4. Chloroquine tablets (Prophylaxis of malaria) 5. Doxycycline (Prophylaxis of
leptospirosis) 6. Crede’s Prophylaxis (prevent gonorrheal/chlamydial eye infection) 3. Vector
Control 1. Destroy breeding sites (for Dengue, Zika prevention) Clear hanging trees in the
riverbanks (for Malaria prevention) 1. SECONDARY LEVEL • Target: Sick or at risk individuals •
GOAL: SCREENS clients for early detection and prompt treatment of the disease •
INTERVENTION: Early diagnosis and treatment • ACTIVITIES: 1. Case finding tools 2. Skin Slit
Smears for leprosy 3. Sputum smear for TB 4. Swab Test for COVID-19 2. Blood tests 1. CBC
for blood disorders (Pancytopenia) 2. ELISA (Confirmatory for Dengue) 3. Western Blot for HIV
(Confirmatory) 4. CD4 T cell Count (Confirmatory for AIDS) 3. Contact tracing 1. Quarantine
(separation of contact to well individuals) 2. Disease surveillance 3. Diagnostic Tests 4.
Ultrasound 5. CXR 6. MRI 7. CT Scan 8. Mammography 4. Treatment/Cure of disease 5.
Examination of breast (BSE) 6. Examination of Testes (TSE) 7. OPLAN Timbang 8. Screening
Test & Selective Examinations 1. Newborn Screening 2. Screening for hypertension 9. Trauma
& CRISIS PREVENTION (stress debriefing) 1. TERTIARY LEVEL • Target: Individuals with
diagnosed illness and advance disease • GOAL: Reduce impact/limit disability, prevent
sequelae and prevent death • INTERVENTION: Rehabilitation • ACTIVITIES: 1. Therapies 2.
Physical therapy 3. Occupation therapy (Prostheses use) 2. Health care and treatment for those
infected by COVID-19 3. Use of assistive devices 4. Maintenance drugs among patient with
hypertension 5. Blood pressure and Blood sugar monitoring 6. Self-Management Education for
patient with diabetes 7. Use of chemotherapeutic drugs and radiation for cancer 8. Provide
family therapy for abusive families; remove children from home FACTORS AFFECTING THE
DELIVERY OF HEALTH CARE SERVICES Socio-economic factor Technological advancement
Access to health care facility High cost of hospitalization Health consumers Unequal distribution
of health services and health personnel Demographic changes THE WORLD HEALTH
ORGANIZATION (WHO) The World Health Organization is a specialized agency of the United
Nations responsible for international public health. The WHO Constitution, which establishes the
agency's governing structure and principles, states its main objective as "the attainment by all
peoples of the highest possible level of health. The WHO was established by constitution on 7
April 1948, which is commemorated as World HealthDay. The WHO's broad mandate includes
advocating for universal healthcare, monitoring public health risks, coordinating responses to
health emergencies, and promoting human health and well being. It provides technical
assistance to countries, sets international health standards and guidelines, and collects data on
global health issues through the World Health Survey. Its flagship publication, the World Health
Report, provides expert assessments of global health topics and health statistics on all nations.
The WHO also serves as a forum for summits and discussions on health issues. The WHO
Eight Millennium Development Goals: To eradicate extreme poverty and hunger; To achieve
universal primary education; To promote gender equality and empower women; To reduce child
mortality; To improve maternal health; To combat HIV/AIDS, malaria, and other diseases; To
ensure environmental sustainability; and To develop a global partnership for development • 8
MDGs 1. Eliminate Extreme Poverty And Hunger 2. Achieve Global Primary Education 3.
Promote Gender Equality And Empower Women 4. Reduce Child Mortality (reduce the
under-five mortally rate by 2/3 in year 2015) • Pneumonia = single largest infectious cause of
death in children worldwide (under-five) • Diarrhea = • Asphyxia = Common cause of newborn
deaths 5. Improve Maternal Health (reduce maternal mortality by 3 quarters (3/4) in 2015) •
Direct Maternal Deaths (HOUSE) 1. Hemorrhage 2. Obstructed Labor 3. Unsafe Abortion 4.
Sepsis 5. Eclampsia 6. Combat Malaria, HIV/AIDS, And Other Diseases (Including neglected
tropical diseases) 7. Ensure Environmental Sustainability 8. Develop A Universal/Global
Partnership For Development The WHO 17 sustainable development goals (SDGs) to transform
our world: GOAL 1: No Poverty GOAL 2: Zero Hunger GOAL 3: Good Health and Well-being
GOAL 4: Quality Education GOAL 5: Gender Equality GOAL 6: Clean Water and Sanitation
GOAL 7: Affordable and Clean Energy GOAL 8: Decent Work and Economic Growth GOAL 9:
Industry, Innovation and Infrastructure GOAL 10: Reduced Inequality GOAL 11: Sustainable
Cities and Communities GOAL 12: Responsible Consumption and Production GOAL 13:
Climate Action GOAL 14: Life Below Water GOAL 15: Life on Land GOAL 16: Peace and
Justice Strong Institutions GOAL 17: Partnerships to achieve the Goal THE PHILIPPINE
HEALTH CARE DELIVERY SYSTEM It is a complex set of organization between the public and
the private sector to provide health services. PUBLIC SECTOR PRIVATE SECTOR Government
Funded from Taxes Voluntary Funded/Foundations/Privately Owned/ Corporation DOH
(National) LGU (Local) NGO (Non Profit Private Corporation (Profit Specialty Tertiary Hospitals
Provincial Hospitals Civic groups/Organizations Private clinics Regional Hospital District and
Emergency Hospitals Religious Groups/Organizations Private Hospitals Medical Centers
Medicare and Community Hospital Foundations Private Practitioners DOH representatives
RHU/MHO/CHO/BHS Other social voluntary groups Private Laboratories Department of Health
(DOH) The Department of Health (DOH; Kagawaran ng Kalusugan) is the executive department
of the Government of the Philippines responsible for ensuring access to basic public health
services by all Filipinos through the provision of quality health care and the regulation of all
health services and products. It is the government's over-all technical authority on health THE
DEPARTMENT OF HEALTH MANDATE: The Department of Health shall be responsible for the
following: Formulation and development of national health policies, guidelines, standards and
manual of operations for health services and programs; Issuance of rules and regulations,
licenses and accreditations; promulgation of national health standards, goals, priorities and
indicators; Development of special health programs and projects and advocacy for legislation
on health policies and programs. The primary function of the Department of Health is the
promotion, protection, preservation or restoration of the health of the people through the
provision and delivery of health services and through the regulation and encouragement of
providers of health goods and services (E.O. No. 119, Sec. 3). DEPARTMENT OF HEALTH
(DOH) VISION by 2030 A global leader for attaining better health outcomes, competitive and
responsive health care systemand equyitable health financing. MISSION To guarantee
equitable, sustainable and quality healtrh for every Filipinos leading to the quest for excellence
in health amongf the Filipino people. Health as a right. Health for All Filipinos The mission of
the DOH, in partnership with the people to ensure equity, quality and access to health care: By
making services available By arousing community awareness By mobilizing resources By
promoting the means to better health GOAL To enable the Filipino population to achieve a
level of health which will allow Filipino to lead a socially and economically- productive life, with
longer life expectancy, low infant mortality, low maternal mortality and less disability through
measures that will guarantee access of everyone to essential health care OBJECTIVES To
promote equity in health status among all segments of society To address specific health
problems of the population To upgrade the status and transform the HCDS into a responsive,
dynamic and highly efficient, and effective one in the provision of solutions to changing the
health needs of the population To promote active and sustained people’s participation in health
care DOH Roles and Functions (EO 102) Leadership in Health Enable and Capacity Builder
Administrator of Specific Services The DOH is composed of: 1 central offices 16 Centers Health
Development 70 hospitals 4 attached agencies REFERRAL SYSTEM IN LEVELS OF THE
HEALTH CARE: (Philippine Ratio) Barangay Health Station (BHS) is under the management of
Rural Health Midwife (RHM) Rural Health Midwife 1:500 catchment population Rural Health
Unit (RHU) is under the management or supervision of PHN Public Health Nurse (PHN) caters
to 1:20,000 catchment population, acts as managers in the implementation of the policies and
activities of RHU, directly under the supervision of MHO (who acts as administrator) Municipal
Health Officer (MHO/Physician) 1:20,000catchment population FEATURES OF DOH
REORGANIZATION 1958- RA 1082 1st Rural Health Act which increases the number in the
employment of more physicians, dentists, nurses, midwives and sanitary inspectors assigned to
RHU’s and 1st 81 rural health units were defined. 1972- RA 5435- defined authorities of
regional directors for more meaningful decentralization and 13 regional health offices were
created. 1974I- RHCDS was implemented, RHM were sent to BHS to man BHS and Midwives
were trained and roles expanded 1982- EO 851 integrated public health and hospital systems
with emphasis on importance of putting together promotive, preventive, curative and
rehabilitative components of health care and utilization of BHW Implementation of DOH impact
programs, Role of Society in RHCDS and participation in information drive of HCDS
PHILIPPINE HEALTH AGENDA 2016 - 2022. With the Philippine Health Agenda 2016- 2022,
we will all ACHIEVE a health system with the values of Equity, Quality, Efficiency, Transparency,
Accountability, Sustainability, Resilience towards “Lahat Para sa Kalusugan! Tungo sa
Kalusugan Para sa Lahat”. PRIMARY HEALTH CARE Primary Health Care (PHC) is an
essential health care made universally acceptable 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 and can afford at every stage of development. Primary Health Care (PHC)
characterized by partnership and empowerment of people shall permeate as core strategy in
effective provision of essential health services. Letter of Instruction (LOI) 949: signed on Oct.
19, 1979 by then Pres. Ferdinand E. Marcos pr5ovides Legal basis in the official adoption of
PHC in the Philippines. The following are the eight (8) essential elements of primary health care:
1. Education for Health This is one of the potent methodologies for information dissemination. It
promotes the partnership of both the family members and health workers in the promotion of
health as well as prevention of illness. 2. Locally Endemic Disease Control The control of
endemic disease focuses on the prevention of its occurrence to reduce morbidity rate. Example
Malaria control and Schistosomiasis control 3. Expanded Program on Immunization This
program exists to control the occurrence of preventable illnesses especially of children below 6
years old. Immunizations on poliomyelitis, measles, tetanus, diphtheria and other preventable
disease are given for free by the government and ongoing program of the DOH 4. Maternal and
Child Health and Family Planning The mother and child are the most delicate members of the
community. So the protection of the mother and child to illness and other risks would ensure
good health for the community. The goal of Family Planning includes spacing of children and
responsible parenthood. 5. Environmental Sanitation and Promotion of Safe Water Supply
Environmental Sanitation is defined as the study of all factors in the man’s environment, which
exercise or may exercise deleterious effect on his well-being and survival. Water is a basic
need for life and one factor in man’s environment. Water is necessary for the maintenance of
healthy lifestyle. Safe Water and Sanitation is necessary for basic promotion of health 6.
Nutrition and Promotion of Adequate Food Supply One basic need of the family is food. And if
food is properly prepared then one may be assured healthy family. There are many food
resources found in the communities but because of faulty preparation and lack of knowledge
regarding proper food planning, Malnutrition is one of the problems that we have in the country.
7. Treatment of Communicable Diseases and Common Illness The diseases spread through
direct contact pose a great risk to those who can be infected. Tuberculosis is one of the
communicable diseases continuously occupies the top ten causes of death. Most
communicable diseases are also preventable. The Government focuses on the prevention,
control and treatment of these illnesses 8. Supply of Essential Drugs This focuses on the
information campaign on the utilization and acquisition of drugs. In response to this campaign,
the GENERIC ACT of the Philippines is enacted. PRIMARY HEALTH CARE Goal: Health for all
Filipinos and Health in the hands of the people by the year 2020 The ultimate goal of primary
health care is better health for all. WHO has identified the following key elements to achieving
that goal: Reducing exclusion and social disparities in health (universal coverage reforms);
Organizing health services around people’s needs and expectations (service delivery reforms);
Integrating health into all sectors (public policy reforms); Pursuing collaborative models of policy
dialogue (leadership reforms); and Increasing stakeholder participation Mission To strengthen
the health care system by increasing opportunities and supporting conditions wherein people
will manage their own health care. PRIMARY HEALTH CARE Adopting primary health care has
the following rationales: Magnitude of Health Problems Inadequate and unequal distribution of
health resources Increasing cost of medical care Isolation of health care activities from other
development activities Objectives Improvement in the level of health care of the community
Favorable population growth structure Reduction in the prevalence of preventable,
communicable and other disease. Reduction in morbidity and mortality rates especially among
infants and children. Extension of essential health services with priority given to the
underserved sectors. Improvement in basic sanitation Development of the capability of the
community aimed at self- reliance. Maximizing the contribution of the other sectors for the
social and economic development of the LEVELS OF PREVENTION Primary Prevention Health
Promotion Practices and Specific Protection from specific Illnesses Secondary Prevention-
Practices on Early Diagnosis and Treatment of Diseases Tertiary Prevention Rehabilitation,
Restoration and Maintenance of health and prevention of complications and disability limitation
FOUR PILLARS OF PUBLIC HEALTH CARE Active Community Participation Intra and
Inter-sectoral linkages Use of appropriate technology Support mechanism made available