OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINE CONTEXT

INTRODUCTION:

 Public Health Nurses (PHNs)

o First level of health workers to be knowledgeable about new public health technologies
and methodologies
o First to be trained to implement new programs and apply new technologies
o Have good understanding of the workings of the current health system and its political
infrastructure
o Adept in public relations and can relate with anybody (socially, politically, religiously
and economically)
o Comprehensive grasp of current situations that impact on the health of the people
o History: 1900s – nurses working in the community (thus in the country: public and
community nursing can be used interchangeably)
o 2005 – nurses in the local / national health departments / public schools
 Department of Health (DOH)
o Government agency mandated to protect and promote people’s health and biggest
employer of health workers including PHNs.
 Millennium Development Goals (MDGs)
o Significant contribution of the nursing workforce to the achievement of health outcomes
o Based on 8 fundamentals:
 Eradicate extreme poverty and hunger
 Achieve universal primary education
 Promote gender inequality and empower women
 Reduce Child Mortality
 Improve Maternal Health
 Combat HIV / AIDS, malaria and other diseases
 Ensure environmental sustainability
 Develop a global partnership for development
 NOTE: 2 & 3 are not health-related | Health as an essential achievement and a
major contributor to the overarching goal of poverty reduction!
o Followed by Health Sector Reform Agenda’s (HSRA) FOURmula ONE along with the
Medium-Term Development Plan
 Health
o WHO: state of complete physical, mental and social well-being, not merely the absence
of disease or infirmity
o Determinants: person’s circumstance + environment
 Income and Social Status
 Education
 Physical Environment
 Employment and Working Conditions
 Social Support Networks
 Culture
 Genetics
 Personal Behavior and Coping Skills
 Health Service
  Gender
o Other Determinants: Optimum Level of Functioning (OLOF)

 Public Health
o Dr. C.E. Winslow: science and art of preventing disease, prolonging life, promoting
health and efficiency through organized community effort for the sanitation of the
environment, control of communicable diseases, the education of individuals in personal
hygiene, the organization of medical and nursing services, development of the social
machinery.
 For a person to realize his birthright of health and longevity
o WHO: art of applying science in the context of politics so as to reduce the inequalities in
health while ensuring the best health for the greatest number
 Core element of government’s attempts to improve and promote health and
welfare
 Disease Control
 Injury Prevention
 Health Protection
 Healthy Public Policy
 Promotion of Health and Equitable Health Gain
 Achieved: w/ proper delivery of essential public health functions (public goods)
o Health Situation monitoring and analysis
o Epidemiological Surveillance / Disease Prevention and Control
o Development of policies and Planning in Public Health
o Strategic Management and Services
o Regulation and Enforcement
o Human Resources Development and Planning
 o Health Promotion, Social Participation and Empowerment
o Ensuring the quality of personal and population-based health
services
o Research, Development and Implementation of innovative public
health solutions
o Achieved: adequately delivered, well defined, coordinated
system / infrastructure
 Yach: a set of fundamental activities that address the determinants of
health, protect a population’s health and treat disease
 Public Health Nursing
o By Lillian Wald – director of the Henry Street Settlement in NYC
o WHO Expert Committee of Nursing: specialized nursing field that combines the skills of
nursing, public health and some phases of social assistance and functions as part of the
total public health programme for the promotion of health, improvement of the conditions
in the social and physical environment, rehabilitation of illness and disability
o Ruth B. Freeman: (Community Health) service rendered by a professional nurse with
communities, groups, families, individuals at home, in health centers – clinics – schools –
workplace for the promotion, prevention, care at home and rehabilitation
o (Community Health) broader than public health
 Jacobson: encompasses practices in a wide variety of community services and
consumer advocate areas, variety of roles + independent practice
o 2005 – practice in national and local government health departments (health centers +
rural health units) ; community health nursing practiced in public health arena

 Primary Health Care (PHC)

o WHO: essentially made universally accessible to individuals and families in the
community by means acceptable to them thru their full participation and at a affordable
cost at every stage of development
o DECLARED: First International Conference on PHC (Alma Ata, USSR | Sept 6-12,
1978
 ADAPTED BY PH: Letter of nstruction 949 signed by President Marcos
( October 19, 1979) w/ theme of Health in the Hands of the People by 2020
o Partnership and empowerment of the people = core strategy of focusing responsibility for
health (individual, family, community)
o Full participation and active involvement of the community towards the development of
self-reliant people, capable of achieving an acceptable level of health and well-being.
o Recognizes interrelationship between health and society
o 9 Elements / Components:
 EN