PAMANTASAN NG LUNGSOD NG MAYNILA

(University of the City of Manila)

Intramuros, Maynila

COLLEGE OF NURSING

Implementing Family Care Plan to Evaluation

of Nursing Care
In partial fulfilment of the Subject
Community Health Nursing

Submitted by:

ABAPO, Janette Joyce G.

ILAW, Ma. Mikaela S.
LAZARO, Sofia Kayle R.
LUSTADO, Geva Therese L.
MANALLO, Ma. Julia D.
ZULUETA, Christine Joie

Submitted to:
Dean Lynnette G. Cleto R.N., M.A.N
 I. IMPLEMENTING FAMILY CARE PLAN
1. CATEGORIES OF INTERVENTION
Nurses are following the nursing process when they take care of patients.
This involves creating a plan and setting the patient's objectives. Nursing
interventions are the actual treatments and actions that are taken to help the
patient to achieve the objectives that are set for them. The nurse utilizes her
wisdom, experience and critical thinking abilities to decide which procedures will
help the patient the most.
There are different categories of nursing interventions that may involve the
care of the entire patient. This may be pro-motive, preventive, curative and
rehabilitative.

Determining Appropriate Interventions

Depending on circumstances, interventions may range from the simple or

immediate, such as offering information about external health resources available to the
family.

Freeman and Heinrich (1981) categorize nursing interventions into three types:

 Supplemental interventions: actions the nurse performs on behalf of

the family

 Facilitative interventions: actions that remove barriers to appropriate

health action, such as assisting the family.

 Developmental interventions: aim to improve the capacity of the family

to provide for its own heath needs

1. CATEGORIES OF INTERVENTION

 Promotive

- A process of enabling people to increase control over and improve their

health. It involves the population as a whole in the context of their everyday
lives, rather than focusing on people at risk for specific diseases.
 - prevention of disease, injury and illness

- It entails health education

 Example: Promoting breastfeeding, Promoting child and family

nutrition, Smoking cessation programs such as ‘quit’ activities and
‘brief interventions’

 Preventive

- Focuses on specific efforts aimed at reducing the development and severity

of chronic diseases and other morbidities

 Example: Vaccinations/Immunization

 Curative

- Health care intervention that treat patients with the intent of curing them, not
just reducing their pain or stress

 Example: antibiotics for bacterial infection changing of lifestyle

 Rehabilitative

- An intervention that aims to help a person who has suffered an illness or

injury restore lost skills and so regain maximum self-sufficiency.

 Example: Rehabilitation work after a stroke may help the patient

walk and speak clearly again

2. TOOLS OF PUBLIC HEALTH NURSE

 Bag Technique and the PHN Bag

- The bag technique is a tool by which the nurse, during her visit will enable her to
perform a nursing procedure with ease and deftness, to save time and effort with
the end view of rendering effective nursing care to clients.
 - The public health bag is an essential and indispensable equipment of a public
health nurse, which she has to carry along during her home visits. It contains
basic medication and articles, which are necessary for giving care.

 Contents of the PHN Bag

The following are the lists of different contents/materials inside the PHN bag and its proper
arrangement:

 Front of bag left to right

 Thermometers (oral and rectal)

 Tape measure

 Micropore plaster

 Cotton applicator

 On right rear of bag

 2 test tubes and 1 holder

 Medicine dropper

 Alcohol lamp

 On left rear of bag

 Medicine glass

 Baby scale

 Bandage scissor

 Rubber suction
  Back of bag left-right

Solutions of:

 Betadine

 70% alcohol

 Zephiran solution

 Hydrogen peroxide

 Spirit of ammnonia

 Ophthalmic ointment

 Acetic acid

 Benedict’s solution

 In the center of the bag

 2 pairs of scissors (surgical and bandage)

 2 pairs of forceps (curved and straight)

 Disposable syringes with needles (g. 23 & 25)

 Hypodermic needles (g. 19, 22, 23, 25)

 Sterile cord clamps

 On the top pile, center of bag

 Hand towel

 Soap in soap dish

 Apron

 Plastic

 Pocket of bag

 Surgical gloves
  Waste paper receptacle

 We should take note that the stethoscope and BP apparatus are carried
separately and are never placed in the bag

Principles and techniques in the use of phn bag

 Bag technique helps the nurse in infection control. The proper use of the bag
minimizes or prevent the spread of any infection. It also allows the practice of
medical aseptic technique during home visitation where in the family residing and
their things are potential for infection. Another purpose is the protection of the
nurse itself. The bag technique sets as an example to the family on methods of
infection control like hand washing which is a basic thing to learn to avoid the
spread of infection.
 Bag technique allows the nurse to give care efficiently. It saves time and
effort in the performance of nursing procedures. It ensures that materials needed
for nursing care is available. That’s why nurses should check the bag if it is
complete and the materials are functioning properly. The traditional nursing bag
is constructed to allow efficient arrangement of its contents. Articles piled on top
of each other must be arranged according to use, with the article to be used first
placed on top.
 Bag technique should not take away the nurse’s focus on the patient and
the family. The bag is just an assistive tool to provide care.
 Bag technique may be performed in different ways. There are different ways
of using the bag technique as per agency policies but the principle of asepsis is
the primary purpose and should be practiced all the time.

2. TYPES OF FAMILY-NURSE CONTACTS

Nurses use the type of family-nurse contact suitable to the purpose and the given
situation.

Clinic Visit. It takes place in a private clinic, barangay health station, health center or in
an ambulatory clinic during community outreach activity. Its great advantage is that the
family takes the initiative to visit a clinic meaning they are aware and active to
participate in health care process. It saves resources and the nurse is given control over
the environment and the situation. The disadvantages are when a family cannot
transport a member that needs the care. Also, because the nurse has the control over
the environment, the family may feel inferior and less confident to tackle health
concerns of the family.

Home Visit. It is a professional, purposeful interaction that takes place in the family’s
residence aimed at promoting, maintaining or restoring the health of the family. Instead
of going to the nurse, in this contact, nurse goes to the family. Nurse makes a home
visit as per family’s request regarding health concerns like result of case finding,
response to referral or to follow-up clients who have utilized services of a health facility
such as health center, lying-in clinic or hospital. The advantages are that it helps the
nurse assess the home situation first-hand, like the family dynamics, environmental
factors affecting health and resources within home. Also, nurse practices adaptation in
interventions according to family resources. It will also be an opportunity for the nurse to
look at the previous unidentified needs of the family. And it will promote collaboration
between the family and the nurse. The nurse will focus on the family as a unit. Heath
teaching at home will be easier fort he family for they see their actual home situation.
Home visit will make the family confident and trust the agency more. The disadvantage
is that it will cost time and effort. In this contact, the nurse doesn’t have control so there
may be presence of distractions and nurse’s safety is also at stake.
Phases of a home visit:
1. Pre-visit phase. Planning for a visit is crucial. These are specific principles in
planning for a home visit.
 The home visit should have a purpose.
 Use information about the family collected from all possible resources.
 The home visit plan focuses on identified family needs, particularly needs
recognized by the family as requiring urgent attention.
 The client and the family should actively participate in planning for continuing
care.
 The plan should be practical and adaptable.
2. In-home phase. This phase begins as nurse asks for permission to enter and
lasts until she or he leaves the family’s home.
 Initiation- Knock or ring the door bell and at the same time say your name
and who are you reasonably loud or a similar greeting in the vernacular or
some other language that can be both understood by the nurse and the
family.
 Implementation- This phase involves the application of the nursing process:
assessment, provision of direct nursing care as needed, and evaluation.
 Termination- It’s about summarizing the vents during the entire home-visit or
another form of family-nurse contact with the family.
3. Post-visit phase. This phase focuses on when the nurse returned to the health
facility. It involves the documentation of the visit during which the nurse records
events that happened including observations and feelings of the nurse about the
visit. If appropriate, a referral may be made.

Group Conference. Like mother’s conference in the neighbourhood, it provides an

opportunity for the initial contact between the nurse and the target families of the
community. It might happen either in the health facility or in the community. This contact
favors development of cooperation, leadership, self-reliance and/ or community
awareness among group members. However, attending conference will be a struggle
for the families for it will test their motivation and availability. Therefore, the nurse won’t
be able to fully reach the families and their needs in this contact.
Telephone Calls. If there are resources, this contact provides an easy access between
the nurse and the family. The wide reach of mobile/ cell phone communication services
in the country provides the nurse and the family ways to contact each other via text
messages or calls. The disadvantage is that information given via phone is limited
because accurate assessment of the condition of the family needs a face-to-face
contact.

Written Communication. This contact is used to give specific instructions to the

families. The disadvantage is that it may be a one-way communication. It will require
literacy and interest for the family to write back. Therefore, it doesn’t ensure the nurse if
the family actually receive the information.

II. FAMILY HEALTH CARE RESEARCHES

ITS RELATED STUDIES AND EVIDENCE-BASED PRACTICES
The family is group of persons that are usually living together that are related through
marriage, blood-bound or thru adoption. The family works as a system and not only the
presenting individual be considered to be a client but also the family members, he/she
lives and interacts with. Family interaction encourages the members to understand and
connect to whatever is happening within their group. They are there to affirm and support
each other to better engage in flexible role relationship and prepare the members to
affiliate themselves with other families, collectively in the community. It is important to
consider the members of the family especially when tracking and diagnosing a particular
patient’s diseases. Disease that are passed thru genetic information, airborne diseases
that are present in family members and the main interaction of each member makes a
family setting vulnerable.
Since there are different kinds of families, it is a must to know what kind of family do they
have. In history taking of a patient, family history is always asked and in what environment
he/she usually lives in since that could take part on the patient’s chief complaint. Having
asked of the health history guarantees that all practices and interventions that will be done
and executed to the patient will be evidence-based. When we say evidence-based, it only
means that the practice done relies on scientific and accurate data evidence for guidance,
decision making and planning of care for the individual and the family. Subjective and
objective data is obtained thru assessment and it is being carried on thru the nursing
process that would formulate the plan appropriate for the patient’s medical health needs.
Sample Case # 1:
On an afternoon of a prenatal clinic day, the community health nurse was going over the
files of patients seen in the morning. She cross-checked the prenatal appointment book
and realized that Mrs. A, a 37 year old patient, on her second trimester of pregnancy,
missed her appointment for that day. The nurse took the family envelope and went over
her record of previous follow-up. She obtained the patient’s prenatal checkup done a
week ago
 G8P7 Other significant finding:
Age of Gestation: 21 weeks Slight pedal edema
BP: 140/90 ; Weight: 118 lbs Impression:
Abdominal Palpation: Pregnancy uterine, 21 weeks
Breech Presentation R/O Pre-eclampsia
Fundic height: 14 cm Management:
Fetal heart tone: 135 bpm, RUQ Low salt diet
Regular but faint Urinalysis
To comeback for next prenatal clinic day

The nurse decided to do a follow-up on the patient and read the clinical records of other
members of the family that have gone thru the clinic for consultation and noted the
following:
Rina, three years old, got sick of bronchopneumonia three months ago, weigh -10kgs
Lita, four years old and Andres, six years old were brought to the clinic a month ago for
scabies; management included personal hygiene and Benzyl Benzoate in two
applications 12 hours apart and followed by a shower after 12-24 hours.
The afternoon of the next day, the nurse made her home visit and obtained the following
data:
The family lives in a two-room house of light materials situated in a congested urban
community about 3km from the health center
Lita and Andres have varying degrees of infected and healed skin eruptions and scabs
on their hand and feet.
Rina looks pale, lethargic and apathetic; infected with scabies and is markedly
underweight and undernourished.
Mother verbalized “ I did not have problems during my previous pregnancies and even
with my present pregnancy, it just happened that I passed by the health center on my way
to my in-laws and thought of dropping by the clinic. But actually I feel alright and I don’t
think I have to worry because I have had seven pregnancies and they were all normal”
CUES/DATA FAMILY NURSING PROBLEMS
 Possible Complicated pregnancy
 37 year old mother of seven at 21 1. Inability to recognize presence
weeks of AOG, with BP of 140/90 of a possible complication of
and slight pedal edema; wt:118 lbs pregnancy due to lack of
knowledge
 Mother verbalized “ I did not have 2. Inability to provide adequate
problems during my previous nursing care due to: lack of
pregnancies and even with my knowledge on nature and
present pregnancy, it just management of health condition
 happened that I passed by the
health center on my way to my in-
laws and thought of dropping by the
clinic. But actually, I feel alright and
I don’t think I have to worry because
I have had seven pregnancies and
they were all normal.”
 The family lives in a two-room
house of light materials situated in
a congested urban community
about 3km from the health center
 Rina, three years old, got sick of
bronchopneumonia three months
ago, weigh -10kgs and looks pale,
lethargic and apathetic; infected
with scabies
; lack of knowledge on the
nature and extent of nursing
care needed.
 Failure to utilize community
resources for healthcare due to:
1. Failure to perceive benefits of
healthcare and
2. Physical inaccessibility of
required service facility for
urinalysis
 Malnutrition as a health deficit
1. Inability to recognize the
presence of malnutrition in a
dependent member due to lack
of knowledge
 Threat of cross-infection from a
communicable disease case
1. Inability to recognize health
threat due to lack of knowledge
about the condition

Sample Case # 2:
Jenny Reyes is a public health nurse at the Rural Health unit. She met 26 year old Rina
Yap, married and 6 moths pregnant with her first child in a outreach health service that
visits an ambulatory clinic in the barangay where the Yap family is residing
Assessment:
 Rina never had a prenatal consultation
 She was underweight with 48 kg and a height of 155cm
 She probably have her baby be delivered through home delivery under the care of
the local hilot since she thought that it may be expensive to deliver in a lying-in
 Her husband prodded her to visit the ambulatory clinic
 Nurse Jenny asked if she could home visit Rina, which Rina agreed since she
wants to learn on how to prevent problems with her pregnancy and delivery
 Nurse Jenny noted that Rina lives with her 32 year old husband, Mario who is at
work during the day
  They live in a rented shack of mixed materials and a bedroom, bathroom, toilet
and a small multipurpose room that serves as their dining room, living room and
kitchen
 Rina’s activities consists of household chores and sometimes she visits her
neighbor friends
 Nurse Jenny found out during the course of interview that Rina had inadequate
knowledge about community health service, prenatal nutrition, preparation for
childbirth and infant care
 Her physical examinations were normal except for palmar pallor and underweight
 Rina also stated that she limits her food intake because she didn’t want to have a
caesarean section which may be needed if the baby grew too big
Individual Level: Diagnosis
 Deficient knowledge regarding community health services, prenatal nutrition,
preparation for delivery and infant care related to lack of familiarity with right
sources of information
 Risk prone behavior related to inadequate understanding of available health
resources
 Imbalance nutrition: less than body requirements related to misinformation
regarding prenatal nutrition
Planning: Goal
 Rina will deliver her baby full-term without evidence of maternal or fetal
complications
Objectives:
 Rina will gain atleast 2kg per month before delivery
 She will visit the health center or barangay for prenatal services
 Rina will engage in activities in preparation for delivery within a month after the
home visit
 Her decision on the facility-based delivery as in a lying in clinic
Interventions
 Explore the possible motivations for participating in teaching-learning activities and
reinforce the positive motivations
 Assess in detail the knowledge of skills and attitudes relevant to the situations
 Based on her knowledge, provide information and guidance on the activities for
promotion and prevention of maternal and fetal problems (regular prenatal
consultation, prenatal nutrition, preparation for delivery, accessible and affordable
community health services)
 Set an appointment and make referrals to her choice of agency
  Invite her to attend mothers’ classes on pregnancy hygiene and delivery
preparations including infant care
Evaluation
 Nurse Jenny constructed a 3 day meal plan based on her family’s budget
 Thoroughly explained the procedure and expected expenses at the most
accessible government run lying-in
 Rina attended a mothers’ class and went for her first prenatal clinic consultation

Family level: Diagnosis

 Readiness for enhanced family coping related to availability of developmental
support for needs during pregnancy and delivery
Planning: Goal
 The couple will express confidence in their ability to cope with Rina’s pregnancy
and forthcoming delivery
Objectives:
 Couple will express their feelings about changes in their family life
 Couple will utilize their resources, family strengths and outside support systems to
cope with the demands of pregnancy, delivery and parenting
Interventions:
 Establish a relationship of trust with the couple
 Encourage the couple to express their feelings about the changes brought by the
pregnancy and forthcoming delivery
 Guide the couple in identification and utilization of resources
 Provide experiences to help them prepare for delivery and infant care
Evaluation:
 Nurse Jenny was able to establish a relationship of trust with Rina but didn’t have
the opportunity to talk to Mario
 Rina actively participated in the discussion of the mothers’ class
 Rina decided to make avail of their services since the midwife answered the
question and stated the estimated expense of childbirth at their facility.
 She was convinced to deliver the baby in the lying-in and that she would tell to
Mario about her experiences.
THEORIES AND CONCEPTS
 The family unit is not static for it changes over time in response to the individual’s
need and outside influences. It also considered as the family’s life cycle development and
with the help of the community nurse to promote changes in behavior and increase
wellness.
THE LIFE CYCLE PERSPECTIVE
This was defined as the explanation and optimization of developmental processes
of human life course from conception to death. This is rooted to the individual’s changing
perspective in life. There is a parallel life course of the individual to the family, leading to
the family life cycle. The family life cycle is viewed in terms of independent life course and
life histories of its members. Duvall identifies sequential stages of family development
throughout the life cycle, understanding each stage as a unit.
The life cycle perspective allows the community nurses to:
 Anticipate what is to expect from families at each level of development
 Compare how families at same stage of development differ from one
another
 Analyze family growth and health promotion at different points in the cycle
 Anticipate family’s needs and provide them with support as they develop
over time
The family life cycle gives emphasis on the developmental tasks ad stages and when
development over time is fairly consistent with the normative expectations.
THE CONCEPT OF WELLNESS
DISTINGUISHING WELLNESS FROM HEALTH PROMOTION
Wellness is a state of well-being of individuals and families strive to achieve health
promotion and can be viewed as a strategy to use to achieve wellness. Brubaker
emphasizes the health promotion aiming high levels of wellness by encouraging
alterations in personal habits or the environment which people live in.
HIGH LEVEL WELLNESS
High level wellness is the ultimate goal of health promotion. This states the the pioneer if
wellness movement represents a state which an individual’s potential capacity for
integrated functioning on his or her environment is maximized. This is achieved thru and
integrated and dynamic lifestyle where individuals pursue highest level of health with the
capability of incorporating some aspect of each wellness dimension, such as self-
responsibility, nutritional awareness and stress management. Family lifestyle is a key
factor that can improve or impede the maximum state of health individual members
achieve. The family lifestyle consists of the family’s: Values (system of ideas, attitudes
and beliefs that binds them together), Roles (how they function together) and
Communication Network (the way they transmit feelings, ideas, and information among
each other within the system and the society).
THE CRISIS THEORY
This conceptual framework is useful to the community as a preventive psychiatry
and was influenced by the works of theorists and researchers. The theory was developed
with a public health focus that emphasized the concept of prevention of illness in the
community. That is why the theory is guided to their practice within individuals and
families.
Crisis is defined as “upset in a unsteady state” wherein a situation occurs when an
individual faces a problem that he or she cannot solve and result in inner tension.
According to Caplan (1964) the person “faces an obstacle to important life goals that is
for a time, insurmountable through the utilization of customary methods of problem-
solving. A period of disorganization ensues a period of upset during which time abortive
attempts at solutions are made”. Customary coping strategies and problem-solving
method do not work and the person becomes “upset”
Crisis Resolution is the outcome of the crisis depending on the state of the
individual at the time of the critical event. That chance aspects the development of
extreme stress, the availability of resources and personality of the individual including if
crisis event is linked symbolically to past events or whether or not individual perceives the
situations as stressful. Individual perception is utmost important depending upon the
cultural, environmental and personal circumstance. If it is symbolically linked with a
situation the individual or family-coped successfully in the past, most likely it will become
successful with the new situation.
Rapoport (1974) states three things to happen in response to crisis: the problem
be solved, the problem be redefined in order to achieve the need satisfaction or the
problem be avoided by ignoring the needs and relinquishing the goals. If problem cant be
solved by any the there would be a major disorganization. A healthy crisis resolution
involves:
 Correct cognitive perception of the situation
 Management of affect through awareness of feelings and appropriate verbalization
leading toward tension discharge and mastery
 Development of patterns of seeking and using help with actual tasks and feelings
by using interpersonal and institutional resources.
Different types of crisis happen to individuals and numerous families face troubles,
stressful life events and procedures to which crisis events arise. Crisis delineated into two
primary types: situational and maturational
Situational: unavoidable stressful events of life changes that occur in an individual life
course. These threaten the individual’s biological and social integrity and cause some
degree of disequilibrium. Example is a death of a loved one
Maturational: these are conflicts encountered by all human beings as they develop and
are faced with transition or normal biological periods of growth throughout the life cycle.
These periods of growth are characterized by marked physical, psychological and social
change associated with tasks that must be faced and mastered to a reasonable degree
of effectiveness in next maturational stage to yield full potential for further growth and
development.
Stages of family Major family Stage of Typical types of
development developmental tasks psychosocial situational crisis
development
Beginning families Establish a mutual Intimacy vs. Isolation Marriage
satisfying marriage
Families with young Establish a mutually Trust vs. Mistrust Pregnancy
children satisfying home for (infants) Gaining a new
parents and infants family
Families with Adopting to needs Autonomy vs Shame Birth defects
preschool children and interests and Doubt
Coping with energy
depletion and lack of
privacy
Families with school Encouraging Industry vs. Personal injury
age children educational inferiority or illness
achievement accidents
Fitting in with Work related
community of school changes
children
Families with Balancing teenage Identity vs. Role Changing to a
adolescents responsibilities and confusion new school
freedom, establishing Divorce or
post-parental interest marital
separation
Residential
change
Families launching Rebuilding marital Intimacy vs. isolation Major business
young adults relationship readjustment
Major change in
financial state
Child leaving
home
Families with Maintaining ties with Generativity vs. Self- Onset of chronic
middle-aged other generations absorption illnesses
members Intergenerational
conflicts
Aging families Adjust to retirement, Integrity vs. Despair Physical
loneliness and old problems
age
 Death of a
spouse

III. INTERPROFESSIONAL CARE IN THE PHILIPPINES

1. RURAL HEALTH UNIT PERSONNEL
Rural Health Unit (RHU), or known as the health center which is considered as
the primary level facility in every municipality. Its focus is considered to provide
preventive and promotive health services and to supervise barangay health stations that
is under its jurisdiction. The rural health unit personnel consists of the Municipal Health
Officer (MHO) or the Rural Health Physician which heads the health services at the
municipal level and is task to do the following roles and functions.
1. Administrator of the RHU
 Prepares the municipal health plan and budget
 Monitors the implementation of basic health services
 Management of the RHU staff
2. Community Physician
 Conducts epidemiological studies
 Formulates health education and campaigns on disease prevention
 Prepares and implements control measures or rehabilitation plans
3. Medico-legal officer of the municipality
Based on R.A. 7305 or the Magna Carta of Public Health Workers it is stipulated that
there should be one rural health physician to a population of 20,000. RHU personnel
also consist of Public Health Nurses (PHN) which is also stipulated to be in a same ratio
as rural health physicians. PHN is tasked to do the following roles and taks:
1. Supervises and guides all RHMs in the municipality
2. Prepares the FHSIS quarterly and annual reports of the municipality for
submission to the Provincial Health Office.
3. Utilizes the nursing process in responding t health care needs, including needs
for health education and promotions, of individuals, families, and catchment
community.
4. Collaborates with the other members of the health team, government agencies,
private businesses, NGOs, and people’s organizations to address the
community’s health problems.
Rural Health Midwives are also a big part of the RHU, they should be in a ratio of 1 for
every 5,000 population, the RHM does the following:
1. Manages the BHS and supervises and trains BHWs.
2. Provides midwifery services and executes health care programs and activities for
women of reproductive age, including family planning counselling and services;
 3. Conducts patient assessment and diagnosis for referral or further management;
4. Performs health information, education, and communication activities;
5. Organizes the community; and
6. Facilitates barangay health planning and other community health services.
There are also Rural Sanitation Inspectors which ensures a healthy environment in the
municipality, they advocate, monitor and create regulatory activities such as inspection
of water supply and unhygienic household conditions. And BHWs which are considered
as the interface between the community and RHU. They provide basic services at the
BHS and RHU because they are also trained with basic skills for prevention and
management of common diseases. They also gave emphasis in providing preventive
health care, especially on maternal and child care, family planning, reproductive health,
nutrition and sanitation.
2. LOCAL GOVERNMENT UNIT
The Constitution of the Philippines recognizes the importance of local
governments. It provides as a policy that "the State shall guarantee and promote the
autonomy of the local government units -- especially the barangays -- to ensure their
fullest development as self-reliant communities."
SEC. 2. Declaration of Policy. - (a) It is hereby declared the policy of the State that the
territorial and political subdivisions of the State shall enjoy genuine and meaningful local
autonomy to enable them to attain their fullest development as self-reliant communities
and make them more effective partners in the attainment of national goals. Toward this
end, the State shall provide for a more responsive and accountable local government
structure instituted through a system of decentralization whereby local government units
shall be given more powers, authority, responsibilities, and resources. The process of
decentralization shall proceed from the national government to the local government
units.
For a Municipality:
SEC. 17. Basic Services and Facilities.
(a) Local government units shall endeavor to be self-reliant and shall
continue exercising the powers and discharging the duties and functions currently
vested upon them. They shall also discharge the functions and responsibilities of
national agencies and offices devolved to them pursuant to this Code. Local
government units shall likewise exercise such other powers and discharge such
other functions and responsibilities as are necessary, appropriate, or incidental to
efficient and effective provision of the basic services and facilities enumerated
herein.

(b) Such basic services and facilities include, but are not limited to, the
following:
 (iv) Social welfare services which include programs and projects on
child and youth welfare, family and community welfare, women's welfare,
welfare of the elderly and disabled persons; community-based
rehabilitation programs for vagrants, beggars, street children, scavengers,
juvenile delinquents, and victims of drug abuse; livelihood and other pro-
poor projects; nutrition services; and family planning services;
3. GOVERNMENT ORGANIZATION
Department of Social Welfare and Development
Department of Social Welfare and Development is the executive department of the
Philippine Government responsible for the protection of the social welfare of rights of the
Filipino and to promote social development.
History
Social welfare as a basic function of the state was a concept that materialized only
after the Second World War, although different groups were undertaking pockets of social
work in the first decade of the American occupation in the country. After the war, the
Philippine government gradually assumed the responsibility for social welfare.
1915 – The Public Welfare Board (PWB) was created. Its functions were to study,
coordinate and regulate all government and private entities engaged in social services.
1921 – The PWB was abolished and replaced by the Bureau of Public Welfare under the
Department of Public Instruction.
1939 – Commonwealth Act No. 439 created the Department of Health and Public Welfare.
1941 – The Bureau of Public Welfare officially became a part of the Department of Health
and Public Welfare. In addition to coordinating services of all public and private social
welfare institutions, the Bureau also managed all public child-caring institutions and the
provision of child welfare services.
1947 – President Manuel A. Roxas abolished the Bureau of Public Welfare and in its
place created the Social Welfare Commission (SWC) under the Office of the President.
1948 – President Elpidio Quirino created the President’s Action Committee on Social
Amelioration (PACSA) to effect socio-economic reforms in the countryside to counteract
social unrest.
1951 – The SWC and PACSA were merged into Social Welfare Administration (SWA)
which marked the beginning of an integrated public welfare program.
1968 – Republic Act 5416 known as the Social Welfare Act of 1968 elevated the SWA
into a Department, placing it under the executive branch of government in equal status
with other social agencies like health and education.
1976 – The Department of Social Welfare was renamed Department of Social Services
and Development (DSSD) with the signing of Presidential Decree No. 994 by President
Ferdinand E. Marcos. It gave the Department a more accurate institutional identity in
keeping with its productivity and developmental thrusts.
1978 – The DSSD was renamed Ministry of Social Service and Development (MSSD) in
line with change in the form of government, from presidential to parliamentary.
1987 – The MSSD was reorganized and renamed Department of Social Welfare and
Development (DSWD) under the Executive Order 123 signed by President Corazon C.
Aquino. Executive Order 292, also known as Revised Administration Code of 1987,
established the name, organizational structure and functional areas of responsibility of
DSWD and further defined its statutory authority.
1991 – The passage of Republic Act 7160 otherwise known as the Local Government
Code of 1991 effected the devolution of DSWD basic services to local government units.
1998 – President Joseph Ejercito Estrada issued Executive Order No. 15 “Redirecting the
Functions and Operations of the Department of Social Welfare and Development” to
strengthen the DSWD’s repositioning efforts that began soon after the implementation of
the Local Government Code of 1991.
2003 – President Gloria Macapagal Arroyo issued Executive Order No. 221 amending
Executive Order No. 15 which defined the mandate roles, powers and functions of the
DSWD.
2005 – The Department of Budget and Management (DBM) approved the DSWD’s
Rationalization and Streamlining Plan (RSP) on January 28, 2005 for implementation over
the next five years. The RSP emphasizes the Department’s shift in policy, functions and
programs in line with its steering role.

VISION
The Department of Social Welfare and Development envisions all Filipinos free
from hunger and poverty, have equal access to opportunities, enabled by a fair, just, and
peaceful society.

MISSION
To lead in the formulation, implementation, and coordination of social welfare and
development policies and programs for and with the poor, vulnerable, and disadvantaged.

Core Values and DSWD Brand

 Maagap at Mapagkalingang Serbisyo
 Serbisyong Walang Puwang sa Katiwalian
 Patas na Pagtrato sa Komunidad

Organizational Outcomes
1. Well-being of poor families improved
2. Rights of poor and vulnerable sectors promoted and protected
3. Immediate relief and early recovery of disaster victims/survivors ensured
 4. Continuing compliance of social welfare and development (SWD) agencies to
standards in the delivery of social welfare services ensured
5. Delivery of social welfare and development (SWD) programs by local government
units (LGUs), through local social welfare and development offices (LSWDOs),
improved

As the lead agency in social welfare and development, the Department exercises the
following functions:
 Formulates policies and plans which provide direction to intermediaries and other
implementers in the development and delivery of social welfare and development
services.
 Develops and enriches existing programs and services for specific groups, such
as children and youth, women, family and communities, solo parents, older
persons and Persons with Disabilities (PWDs);
 Registers licenses and accredits individuals, agencies and organizations engaged
in social welfare and development services, sets standards and monitors the
empowerment and compliance to these standards.
 Provides technical assistance and capability building to intermediaries; and
 Provides social protection of the poor, vulnerable and disadvantaged sector,
DSWD also gives augmentation funds to local government units so these could
deliver SWD services to depressed municipalities and barangays and provide
protective services to individuals, families and communities in crisis situation.

Major Programs and Projects

A. Pantawid Pamilyang Pilipino Program

 A human development program of the national government that

invests in the health and education of poor households, particularly
of children aged 0-18 years old.

 Patterned after the conditional cash transfer scheme implemented in

other developing countries, the Pantawid Pamilya Program provides
cash grants to beneficiaries provided that they comply with the set of
conditions required by the program.

 Serves as the vehicle for combating the poverty cycle in Filipino

households.

 Implemented by the Department of Social Welfare and Development,

it is one of the key poverty alleviation programs of the national
government that seeks to contribute in breaking the intergenerational
transmission of poverty in the country.

Objectives:
 1. Social Assistance – to provide cash assistance to the poor to alleviate
their immediate need (short term poverty alleviation)
2. Social Development – to break the intergenerational poverty cycle
through investments in human capital

Program Objectives:

1. To improve the health of young children and mothers by promoting

preventive health care.
2. To increase the enrollment and attendance rate of children in Day Care,
Kindergarten, elementary, and secondary schools
3. To contribute to the reduction of incidence of child labor
4. To raise the average consumption rate in food expenditure of poor
households
5. To encourage parents to invest in their children’s health, nutrition, and
education
6. To enhance the performance of parenting roles of beneficiaries and their
participation in community development activities

B. Sustainable Livelihood Program

“Sibol Kakayahan, Sibol Kabuhayan”

Sustainable Livelihood Program is a capability-building program that

provides access to opportunities that increase the productivity of the livelihood
assets of poor, vulnerable, and marginalized communities, in order to improve their
socio-economic well-being.

C. Kalahi-CIDSS

Kalahi-CIDSS, otherwise known as the Kapit-Bisig Laban sa Kahirapan-

Comprehensive and Integrated Delivery of Social Services, is one of the poverty
alleviation programs of the Philippine Government being implemented by the
Department of Social Welfare and Development. It uses the community-driven
development approach, a globally recognized strategy for achieving service
delivery, poverty reduction, and good governance outcomes.

Started in 2003, its scale-up was approved on 18 January 2013 by the

National Economic Development Authority (NEDA) Board, which was headed by
President Benigno Aquino III.

The development objective of Kalahi-CIDSS is to have

barangays/communities of targeted municipalities become empowered to achieve
improved access to services and to participate in more inclusive local planning,
budgeting, and implementation.
NATIONAL NUTRITION COUNCIL
The NNC, as mandated by law, is the country's highest policy-making and
coordinating body on nutrition.
The NNC Logo
Improving the nutrition situation in cannot be achieved by spoonfeeding alone nor
by the generosity of a single sector's spoon.
It requires collaboration in creating and recreating ideas; seeking unity and totality
of approach toward nutritional adequacy for all Filipinos.
NNC Core Functions
 Formulate national food and nutrition policies and strategies and serve as the
policy, coordinating and advisory body of food, nutrition and health concerns;
 Coordinate planning, monitoring, and evaluation of the national nutrition
program;
 Coordinate the hunger mitigation and malnutrition prevention program to
achieve relevant Millennium Development Goals;
 Strengthen competencies and capabilities of stakeholders through public
education, capacity building and skills development;
 Coordinate the release of funds, loans, and grants from government
organizations (GOs) and nongovernment organizations (NGOs); and
 Call on any department, bureau, office, agency and other instrumentalities of
the government for assistance in the form of personnel, facilities and resources
as the need arises.
History of Composition and Legal Bases
1947 Creation of the Philippine Institute of Nutrition (PIN) as a first attempt to
institutionalize a national nutrition program
1958 Reorganization of the PIN into the Food and Nutrition Research Center (FNRC)
under the National Science and Development Board
1960 Organization of the National Coordinating Council on Food and Nutrition (NCCFN),
a loose organization of government and non-government agencies and organizations
involved in nutrition and related projects.
1971 Promulgation of Executive Order No. 285, mandating the National Food and
Agriculture Council (NFAC) to coordinate nutrition programs in addition to coordinating
national food programs, thus, superseding the NCCFN.
1974 Promulgation of Presidential Decree No. 491 (Nutrition Act of the Philippines, 25
June 1974), which created the National Nutrition Council (NNC) as the highest policy-
making and coordinating body on nutrition.
1987 Promulgation of Executive Order No. 234 (Reorganization Act of NNC, 22 July
1987) reaffirming the need for an intersectoral national policy-making and coordinating
body on nutrition. It expanded the membership of the NNC to include the Departments of
Budget and Management (DBM), Labor and Employment (DOLE), Trade and Industry
(DTI), and National Economic and Development Authority (NEDA). The Department of
Social Welfare and Development was named chair of the NNC Governing Board.
1988 Administrative Order No. 88 named the Department of Agriculture as the NNC
Chair of the NNC Governing Board.
2005 Executive Order No. 472 named the Department of Health (DOH) as the chair of
the NNC, with the Department of Agriculture (DA) and the Interior of Local Government
(DILG) as vice-chairs. In addition to its policy and coordinating functions, NNC was also
tasked to focus on hunger-mitigation and authorized to generate and mobilize resources
for nutrition and hunger-mitigation programs.
2007 Executive Order No. 616 designated the NNC as oversight of the Accelerated
Hunger-Mitigation Program to ensure that hunger-mitigation measures are in place, and
are reported to the President.
Structure for Nutrition Policy and Program Coordination

The functions and multisectoral composition of the NNC are replicated at

subnational levels. Regional, provincial, city, municipal and barangay nutrition
committees are organized to manage and coordinate the planning, implementation,
monitoring and evaluation of local hunger-mitigation and nutrition action plan as a
component of the local development plan.

Local chief executives serve as chairpersons. Nutrition action officers are designated or
appointed to attend to the day-to-day operations of the local nutrition progam.

NNC Vision Statement

NNC is the authority in ensuring the nutritional well-being of all Filipinos,

recognized locally and globally, and led by a team of competent and committed public
servants.

NNC Mission Statement

To orchestrate efforts of government, private sector, international organizations and

other stakeholders at all levels, in addressing hunger and malnutrition of Filipinos through:

 Policy and program formulation and coordination;

 Capacity development;
 Promotion of good nutrition;
 Nutrition surveillance;
 Resource generation and mobilization
 Advocacy; and
  Partnership and alliance building

NNC Quality Policy

The NNC, as the highest policy-making body on nutrition, is committed to ensure

imporved access to quality nutriiton and related interventions of policies and programs
with excellence, integrity and transparency.

We shall endeavor to continually improve the quality management system to

satisfy the needs and expectations of our clients with strict adherence to existing laws,
rules and regulations.

NNC Core Values

Integrity

We conduct our work and relate with our various stakeholders and partners
with deep sense of honesty and openness.

Zeal

We serve with enthusiasm and dedication characterized by versatility and

dynamism, discipline and strict adherence to work ethics.

Excellence

We provide high quality and timely service characterized by a unified,

innovative and competent performance.

Sensitivity

We respond to the needs of our employees and various publics with love
and respect and recognize the valuable contribution of each member of the
organization.

Transparency

We conduct our business with openness and truthfulness with strict

adherence to existing laws, rules, regulations of government and the principles of
good governance.

Philippine Plan of Action for Nutrition (PPAN)

 (2011-2016) is the country's response to malnutrition.

 Provides the framework for improving the nutritional status of Filipinos.
  The NNC believes that nutrition should and would have influence and would be
influenced by other concerns in the PDP -- from pursuit of inclusive growth to
macroeconomic policy, industry, agriculture and fisheries, infrastructure,
governance, peace and security, and environment and natural resources.

The PPAN, like the PDP is also anchored on the Millennium Development Goals
(MDGs), particularly those related to nutrition that targets halving the 1990 levels of
underweight among under-fives and or households with inadequate energy intake.

The PPAN takes off from the nutrition situation as determined by the 2008 national
nutrition survey and in essence, there is a need to catch up with many of the targets, and
at the same time sustain and protect gains already achieved. The PPAN presents the
following challenges that should be addressed:

1. Hunger
2. Child undernutrition
3. Maternal undernutrition
4. Deficiencies in iron, iodine and vitamin A
5. Obesity and overweight

The PPAN 2011-2016 aims to address the nutrition situation, providing a guide for
all who want to be involved in nutrition action. It lays out targets, directions, and priority
actions, among others.

Actions to address nutritional problems and achieve the targets will be based on
several guiding principles that include, among others, a human-rights perspective that
recognizes that good nutrition is a basic human right. As such, each Filipino and Filipino
family, as claim holders are responsible for the attainment of the nutritional well-being of
the families and family members. Government and others in the development sector, as
duty bearers, have the responsibility to assist those who are unable as of yet to enjoy the
right to good nutrition.

The PPAN builds on past national plans. Many nutrition and related interventions
have been implemented in the past with varying degrees of success. The current PPAN
builds on these experiences to identify a mix of strategies and interventions.

Barangay Nutrition Scholar (BNS) Program

Background

The Barangay Nutrition Scholar (BNS) Program is a human resource development

strategy of the Philippine Plan of Action for Nutrition, which involves the recruitment,
training, deployment and supervision of volunteer workers or barangay nutrition scholars
(BNS). Presidential Decree No. 1569 mandated the deployment of one BNS in every
barangay in the country to monitor the nutritional status of children and/or link
communities with nutrition and related service providers. PD 1569 also mandated the
NNC to administer the program in cooperation with local government units.

Qualifications of a Barangay Nutrition Scholar

A BNS is a trained community worker who links the community with service providers,
with the following qualifications:

 bonafide resident of the barangay for at least four years and can speak the local
language well;
 possess leadership potentials as evidenced by membership and leadership in
community organizations;
 willing to serve the barangay, part-time or full-time for at least one year;
 at least elementary graduate but preferably has reached high school level;
 physically and mentally fit;
 more than 18 years old, but younger than 60 years old.

Basic Tasks

 Caring for the malnourished

The BNS locates and identifies malnourished children through a community

survey. This survey involves weighing all preschoolers and interviewing mothers
to determine how the child is cared for, and the resources available in the family
for their participation in nutrition and related interventions.

Based on the results of the annual weighing of all preschoolers in the barangay
called Operation Timbang (OPT), the BNS weighs every month all underweight
preschoolers, with weights below normal, very low (BNVL). The BNS also weighs
every month all 0-24 month-old children to monitor their growth which is most critical
at this stage. The BNS also does a quarterly follow-up weighing of children, 25-71
months old, to the extent possible. The regular weighing provides the basis for
corrective actions which may include referral to the appropriate service or
implementation of nutrition projects, together with the community.

 Mobilizing the community

The BNS also moves the community to organize into networks of 20-25
households, or into community-based organizations working for the improvement
of their nutrition situation.

 Linkage-building

In the presence of other barangay-based development workers, the BNS

may not necessarily deliver direct nutrition services to the community but serve as
linkage-builder, to ensure that members of the community, especially those with
 underweight children, avail of nutrition and related services. The BNS must be
aware of the services available and of those who need these services, and
establish a system through which those needing certain services are referred to
the appropriate service provider.

 Other forms of assistance

The BNS assists in delivering nutrition and related services which include:

 Organizing mothers’ class or community nutrition education

 Providing nutrition counseling services, especially on exclusive
breastfeeding and appropriate complementary feeding, through
home visits
 Managing community-based feeding programs under the
supervision of a nutritionist-dietitian;
 Distributing seeds, seedlings, and small animals from the local
agriculture office and other government organizations and
nongovernment organizations to promote home or community food
gardens; and
 Informing the community on scheduled immunization and other
health activities but always together with the local midwife,
agriculture officer, social welfare officer, and other workers.

 Keeping records

To help other barangay workers and the local officials, the BNS keeps a
record of the results of the regular weighing as well as records on the nutrition and
health profile of families in the barangay. The BNS also formulates a BNS Action
Plan as guide in managing the different tasks assigned to him/her. The BNS also
prepares a record of monthly accomplishments to monitor his or her performance
in relation to the action plan. The record helps identify adjustments in the plan of
action to meet targets set. The BNS also keeps track of his or her daily activities
through a diary. The diary should list not only the BNS’s activities but also
observations and insights as may be appropriate.

Training

The BNS undergoes a ten-day didactic training. The training facilitates the
acquisition of knowledge, attitudes, and skills needed for effective performance of the
tasks of identifying the malnourished, monitoring the malnourished, and referring them to
appropriate service providers.

After the didactic phase, the BNS undergoes a twenty-day practicum to learn how
to weigh preschoolers properly and interview mothers on matters which may relate to
their child-rearing practices. During this phase, the BNS collects and analyzes data on
the barangay nutrition situation using the family and barangay profile forms. He or she
also formulates his or her action plan.

In some instances, and due to resource constraints, the 30-day training is reduced
to 3-4 days and the practicum phase becomes part of the BNS’s service period.

The BNS trainer-supervisor or the district/city nutrition program coordinator

(D/CNPC) organizes, conducts, and supervises the training. In the absence of the
D/CNPC, the nutrition action officer (NAO) assumes these responsibilities.

To reinforce skills during the formal training, BNSs also attend monthly
meetings. During these meetings, the D/CNPC or NAO provides more information on
proper weighing and record keeping, good nutrition, breastfeeding or other information to
update their knowledge and skills. The D/CNPC or NAO visits the BNS regularly
observing and encouraging the BNS to do things correctly.

COMMISSION ON POPULATION
Vision
We are the lead organization in population management for well-planned and
empowered Filipino families and communities
Mission
We commit, in collaboration with partners, to create an enabling environment to:
 Empower couples and individuals to achieve their desired number, timing,
and spacing of children in the context of informed choice and responsible
parenthood;
 Enable adolescents to realize their full potential and total wellbeing;
 Mainstream population factors in sustainable development initiatives
Goal
To attain a better quality of life for all Filipinos through management and
maintenance of population level resources and the environment.
Programs
Responsible Parenthood And Family Planning (Rp-Fp) Program

Preface

Specifically, POPCOM would like to help couples / parents exercise responsible

parenting to achieve their desired number, timing and spacing of their children, and to
contribute in improving the maternal, neonatal and child health, and nutrition (MNCHN).
POPCOM does these through the following:

 Fund releases for the conduct of Responsible Parenting Classes in the barangays
  Partnership with MSWD in the conduct of Family Development (FDS) Sessions in
4Ps areas in the region
 Partnership with DOH in the Kalusugang Pangkalahatan (KP) through tracking of
couples with unmet need in family planning during FDS sessions
 Establishment and maintenance of an online web-based reporting system of
couples reached
 Conduct of capability building activities on Pre-Marriage Counseling for LGUs, and
other related competencies
 Development, production and dissemination of advocacy/ IEC materials
 Observance of special population events (e.g. Natural Family Planning Week,
Family Planning Month)

ADOLESCENT HEALTH AND DEVELOPMENT (AHD)

Adolescent Health and Development (AHD)

The Adolescent Health and Development Program (AHDP) is one of the key
component programs of the Philippine Population Management Program (PPMP). The
overall goal of the AHD Program is to contribute to the improvement and promotion of the
total well-being of young Filipinos ages 10-14; 15-19 and 20-24 through their sexual and
reproductive health. Specifically, it aims to contribute to the reduction of the incidence of
teenage pregnancies and sexually transmitted infections (STIs) and HIV/AIDS among
young people which are aligned with the thrusts of the International Conference on
Population and Development (ICPD) Program of Action (PoA).

As the government agency tasked to manage the AHD Program, the Philippine
Commission on Population leads in the coordination and monitoring of relevant initiatives
in the areas of:

 Policy support
 Service delivery
 Capacity building
 Advocacy and information, communication and education (IEC)
 Research and management information system

Moreover, the Commission works hand in hand with the Department of Health and
other stakeholders both public and private in linking demand and services through the
development and piloting of demand generation strategies and conduct of researches
that merit appropriate policy and program responses.

The efforts of the Commission involve and target the various levels of stakeholders
including the young people themselves as the primary stakeholder, the family, specifically
the parents as primary sexuality educators and the school, government, church and
media as supporting institutions. With concerted efforts, necessary services and
information which are crucial to the development of the total well-being of the young
people will be made available wherever they go--- home, school, church and community.
POPULATION AND DEVELOPMENT (POPDEV) INTEGRATION

Preface

The need to integrate population concerns in development has long been

recognized internationally and nationally. The 1967 UN Declaration of Population stated
that the population problem is a principal element in long-range national planning. This
was seconded by the World Population Conference in Bucharest in1974 which stated in
its World Population Plan of Action that “the essential aim of the population program is
the social, economic and cultural development of countries; it recognizes that population
variables and development are interdependent; and that population policies and
objectives are an integral part (constituent elements) of socioeconomic development
policies.”

During the ICPD in 1994, the indisputable interrelationship of population and

development (POPDEV) was given emphasis in its Programme of Action. The ICPD
articulated the need to meet the needs of individuals within the framework of universally
recognized human rights standards instead of merely meeting demographic goals. The
adoption of this Programme of Action marks a new phase of commitment and
determination to effectively integrate population issues into socioeconomic development
proposals and to achieve a better quality of life for all individuals, including those of future
generations. Essentially, it promoted the integration of population factors in sustainable
development initiatives. Recognizing the interrelationships between population, sustained
economic growth, and sustainable development is a key element of the integrated
strategy.

Recognizing the importance and necessity of integrating population dimensions in

development initiatives and processes, the PPMP will continue to adopt POPDEV
integration as its key strategy. This key program component and strategy essentially
seeks to put people – their needs and aspirations – as the main consideration in
developing policy and program interventions. It promotes a mindset that explicitly
recognizes people as the subject and object of development.

As a population management strategy, POPDEV integration is defined as the

explicit consideration and integration of population dynamics and dimensions in the
critical steps of any development initiative, such as plan and program development, policy
formulation, database management and utilization, and other efforts that aim to improve,
in a sustainable manner, the development conditions of the people and the locality in
which they live.

The strategy seeks, in the long term, to enable institutions to create an enabling
environment for people to achieve their development goals through a well-managed
population. Having a well-managed population means the achievement of population
processes and outcomes that are consistent with, complementary to, and facilitative of
socioeconomic and human development. It is about making a connection between
population factors and development initiatives to ensure integrated and sustainable
development.

Explicitly integrating population into economic and development strategies will

both speed up the pace of sustainable development and poverty alleviation and contribute
to the achievement of population objectives and an improved quality of life of the
population.

GENDER AND DEVELOPMENT (GAD)

The Gender and Development Program of the Commission on Population

(POPCOM)

The Magna Carta of Women. The enactment of the Magna Carta of Women (RA
9710) has been regarded nationally and internationally as a significant milestone in the
empowerment of Filipino women. The law provides and entrenched women’s rights
particularly among those who are marginalized, underserved, and discriminated.

As of today, the law is being implemented through the leadership of the Philippine
Commission on Women (PCW) with the institutional support and collaboration with the
Department of the Interior and Local Government (DILG) particularly for the localization
and monitoring of the provisions of the Magna Carta. Capacity building and appropriate
institutional mechanisms have been set in place for the mobilization of DILG and LGUs
in the implementation of the Magna Carta specifically at the local level.

The Millennium Development Goals (MDGs) in 2000 addresses extreme

poverty in its many dimensions-income poverty, hunger, disease, lack of adequate
shelter, and exclusion-while promoting gender equality, education, and environmental
sustainability.

The Commission on Population (POPCOM), as the policy making and coordinating

body in the implementation of the population program has developed the six-year
Philippine Population Management Program Directional Plan (PPMP DP) wherein GAD
as a cross cutting issue is included in all its three (3) major program components, namely:
Responsible Parenthood and Family Planning (RPFP), Adolescent Health and Youth
Development (AHYD), and Population and Development (PopDev). Furthermore,
POPCOM is the monitoring arm in tracking down the progress of the MDGs, specifically
target #5 – Maternal Health as well as of the accomplishments of the RPRH Law.

Gender issues and other relevant concepts are likewise explicitly integrated in the
PPMP’s training and communication tools and materials. POPCOM is continuously
attending capacity building for its officials and employees as well as conducting programs,
projects and activities. To date, initiatives like Men’s Responsibilities in Gender and
Development (MR GAD) and Kalalakihang Tapat sa Responsibilidad at Obligasyon sa
Pamilya (KATROPA) are the banner programs of POPCOM in advocating GAD.
The MR GAD is…
 … An initiative that took-off as a research with intervention initiatives on “Filipino
Men and Domestic Violence” by the Health Management and Research Group
Foundation, Inc. (HMRG) in Davao City.

 Evolved into a good practice which intended to transform pilot communities to

become more responsive to gender and RH concerns of men and boys.

 Its management and implementation is being made through by men champions

and advocates who believe in the gender equality and that promoting gender
equality should start among men and boys at the barangay level.

 The project employs various strategies such as: men-talking-to men; counseling;
medico-legal assistance; passage and support of gender related policies and
ordinances among others. All these would result to rational attitudinal and
behavioural change among men.

The objectives are (1) to harness the influence and respectability of men in key
positions in the communities to advocate reforms in gender and reproductive health (RH)
and become gender and RH champions; (2) to improve the handling and processing of
the victims and doers of violence by community-based service providers; and (3) to
improve the gender and RH knowledge and skills of the different NGOs.

The KATROPA or Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya is…

 … An aspiration or movement which aims to shape and change

men as responsible individuals, parents, and partners for the development of their
family and the community.

 … Advancing innovative views on the role and responsibility of men in society with
emphasis on their ability to be responsible for their decisions and advocate
of health for themselves and their families; family planning, healthy and
safe pregnancy of their wife or partner, and active participation in the development
of the society. Every man forged innovative insight into the real man; he would
be expected to be an advocate of change in his own family, peers, and the
entire community.

4. NON-GOVERNMENT ORGANIZATIONS
Socio-Civic Organizations
Socio-Civic organizations are made up of different people towards a goal that is
similar and beneficial to a specific problem in a community, their purpose is to provide
services to the betterment of the people, without the pursuit of earning money. These
organizations are a great help to the people who are not helped by government
institutions. The following are socio-civic organizations in our country:
  Red Cross Philippines
 Volunteer Youth Leaders for Health Philippines
 Greenpeace Philippines
 Love Yourself
Religious Organizations
Religious organizations are made up of people with a purpose of helping others
and providing services for them but with an added guidance through their beliefs and
customs in their own religious ways. The following are religious organizations in our
country:
 Operation Blessings Philippines
 Adventist Development and Relief Agency
 Habitat for Humanity Philippines
Schools
 History
The first school health program required by law in our country that consisted
mostly of school health services with the passage of R.A. 124 in 1947 known as an Act
to Provide for Medical Inspection of Children Enrolled in Private Schools, Colleges, and
Universities in the Philippines which states that it was the duty of the school heads with
atotal enrolment of 300 or more to provide a part time or full time physician for annual
medical examinations which should be reported every quarter if the school year to the
Director of Health.
A holistic approach in order to strengthen health and nutrition is a concept stated
by the Redesigned Approach in School Health Nursing (RASHN), which is adopeted
through the Department of Education, Culture and Sports (DECS) Memorandum No. 37
series of 1991. Which states a philosophy that the academic performance of the pupils
and the instructional outcomes are determined by the auality of health of the school
population and their community.
And in 2011, the Department of Education Order No. 43, s. 2011 on the subject
Strengthening the School Health and Nutrition Programs for the achievement of
Education for All (EFA) and Millennium Development Goals seeks to strengthen School
Health and Nutrion Program (SHNP) through activities and programs like Integrated
School Health and Nutrition Program (ISHNP) which maintains and improves health of
school children through prevention of diseasesa and promotion of health knowledge,
skills and practices.

 Services
 Comprehensive school health programs should include the following 8
components:
1. Health Education
o It should be culture sensitive and specific based on the needs of the
target population.
2. Physical Education
o Habits developed in childhood are likely to continue during adulthood,
that is why physical activity should be taught at schools.
3. Health Services
o Health care in schools includes preventive services such as health
screening, and also other services like emergency care, management
of acute and chronic diseases, appropriate referrals and even refular
deworming.
4. Nutrition Services
o Nutritional education is very important because the need to know and
understand what is the purpose of the food pyramid and how should
someone make healthy choices is very important to maintain a healthy
body.
5. Counseling, psychological and social services
o One of the most important role of a nurse is to be a counselor and a
confidante because the nurse or other personnels may be the only
stable adult in a child’s life who can listen without judgement.
6. Healthy School Environment
o According to WHO, a healthy school environment should include:
o A physical, psychological and social environment that is
developmentally oriented and culturally appropriate, and that
enables students to achieve their potential
o Healthy organizational culture within the school; and
o Productive interaction between school and community
7. Health promotion for staff
o Health promotional programs at work creates beneficial results for their
health and well being.
8. Family and community involvement
o School nurses can be a ready resource to the community whenever
health related problems occurs.

IV. EVALUATION OF FAMILY NURSING CARE

To evaluate is to determine or fix the value (Merriam-Webster Online Dictionary, 2012).

In family nursing, evaluation is determining the value of nursing care that has been
given to a family. The product of this step is used for further decision making/; to
terminate, continue or modify the intervention(s). Well-formulated goals and objectives
in the nursing care plan serve as the framework for evaluation.

• Determination whether goals / objectives are met.

• Determination whether nursing care rendered to the family are effective.

• Determines the resolution of the problem

According to Alfaro-LeFevre:

Evaluation is being applied through the steps of the nursing process:

• Assessment – changes in health status.

• Diagnosis – if identified family nursing problems were resolved, improved or

controlled.

• Planning – are the interventions appropriate & adequate enough to resolve

identified problems.

• Implementation – determine how the plan was implemented, what factors aid in

the success and determine barriers to the care.

Formative Evaluation

-judgement made about effectiveness of the nursing interventions as they are

implemented (Maurer and Smith, 2009).

-ongoing and continuing while family nursing care is being implemented and family-
nurse interactions are taking place.

-guides the nurse and the family in updating plans as necessary.

Summative Evaluation

-determining the end results of family nursing care and usually involves measuring
outcomes or the degree to which the goals have been achieved (Maurer and Smith,
2009)

Aspects of Evaluation

 Effectiveness

-is determination of whether goals and objectives were attained.

-answers the question, “Did we produce the expected results” or “Did we attain
the objectives?”

 Appropriateness

-refers to the suitability of the goals/objectives and interventions to the identified

family health need.

-answers the question, “Are our goals/objectives and interventions in correct in

relation to the family health needs we intend to address?”

 Adequacy

-the degree of sufficiency of goals/objectives and interventions in attaining the

desired change in the family.

-answers the question, “Were our interventions enough to bring about the desired
change in the family?”

 Efficiency

-the relationship of resources used to attain the desired outcomes.

Answers the question, “Are the outcomes of family nursing care worth the nurse’s
time effort and other resources?”
Types of Evaluation:

• Ongoing Evaluation – analysis during the implementation of the activity, its

relevance,

efficiency and effectiveness.

• Terminal Evaluation – undertaken 6-12 months after the care was completed.

• Ex-post Evaluation – undertaken years after the care was provided

IMPORTANCE OF EVALUATION

There are foremost reason why nurses should evaluate their activities and/or
intervention:

- To eliminate or stop the continued performance of useless activities and

interventions

- To increase the efficiency of nursing interventions

- To provide documentation of the results of nursing efforts and justification of the

cost of nursing services

- To promote growth of the profession and refinement of nursing practice.

REFERENCES

Commission on Population. Programs and Projects. Retrieved from

http://www.popcom.gov.ph/programs-and-projects
Commission on Population. Transparency Seal. Retrieved from
http://nnc.gov.ph/index.php/plans-and-programs.html
Department of Social Welfare and Development. Citizen’s Charter. Retrieved from
https://www.dswd.gov.ph/about-us-2/citizens-charter/
Department of Social Welfare and Development. History of DSWD. Retrieved from
https://www.dswd.gov.ph/about-us/history/
Department of Social Welfare and Development. Major Programs and Project.
Retrieved from
https://transparency.dswd.gov.ph/files/ts2018/mppa/a/MPProjects.pdf?fbclid=IwA
R0oaabDJ5_sGnShM8smnDQkmWYCscHrHLsn_NxWNwzmyPwqYegS1zEDN
Q0
National Nutrition Council. Plans and Programs. Retrieved from
http://nnc.gov.ph/index.php/plans-and-programs.html
National Nutrition Council. Transparency Seal. Retrieved from
http://nnc.gov.ph/index.php/transparency.html
Robles, C. (n.d). The Local Government Code of the Philippines. Retrieved from
http://www.chanrobles.com/localgov1.htm#.XWupmvZuJYc
Maglaya, A. (2004) Nursing Practice in the Community: 4th edition. Marikina City:
Argonauta Corporation
Famorca, Z. (2013) Nursing Care of the Community. Singapore: Elsevier
WEBSITES/LINK

https://www.who.int/disabilities/care/activities/en/

https://rehabnurse.org/about/roles/rehabilitation-staff-nurse

https://www.jacksonvilleu.com/blog/nursing/the-role-of-nurses-in-health-promotion-and-
preventive-care/

https://study.com/academy/lesson/what-is-nursing-intervention-definition-examples.html

https://www.verywellhealth.com/curative-care-2615157