gracyespino@uc-bcf.edu.

ph
 COMMUNITY
• A group of people
with common
interests living
together within a
geographical
boundary.
 Community Health
- part of paramedical
and medical
intervention/ approach
which is concerned on
the health of the whole
population
_________
______ (2 words)
Public Health Nursing
• the term used before for Community Health
Nursing
• According to Dr. C.E. Winslow, It is a science &
art of 3 P’s
§ Prevention of Disease
§ Prolonging life
§Promotion of health and efficiency
through organized community effort
• According to Winslow, all public health efforts
are for people to realize their birthrights of health
and longevity.
Community Health Nursing
“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.”
- Maglaya, et al
Community Health Nursing
• a specialized field of nursing practice
• a science of Public Health combined
with Public Health Nursing Skills
and Social Assistance with the goal
of raising the level of health of the
citizenry, to raise optimum level of
functioning of the citizenry
(Characteristic of CHN)
ROLES OF THE PUBLIC HEALTH NURSE
•Clinician
•Health Educator
•Facilitator
•Supervisor
•Health Advocator
•Advocator
•Collaborator
 BASIC PRINCIPLES OF CHN
• Philosophy of CHN: Worth and dignity of
man.
• Ultimate goal of CHN: To raise the health
level of citizenry
• Primary Goal: Self reliance
• Client in CHN: Community
• Basic unit of care: Family
• 4 levels of clientele (I,F,PG,C): Individual,
Family, Population group, community
 Types of Clientele (IFC)
1. I - Individual
2. F - Family
3. C – Community
Population groups:
– Infants & young children
– School-age
– Adolescents
– Mothers
– Males
– Elderly
PHILIPPINE HEALTH CARE SYSTEM - is a complex set of
organizations interacting to provide an array of health
services
(Dizon, 1977).
 Categories of health care delivery
System
Type Services Level of example Location
prevention
Primary Common health Health Health RHU
problems promotion education Community
Health education Illness Immunization hospitals
Preventive care prevention
Secondary Medical services Diagnosis & Prompt District hospital
Surgery treatment treatment Provincial/ city
Complication Contact tracing hospitals
prevention Case finding
screening
Tertiary Advanced and Disability PT/OT Regional ,
specialized services prevention Facility specialized ,
Rehabilitation employment medical and
national health
centers
 Health services in DOH
(H.O.M.E.L.E.M.E.N.T.S)
H - health education
O - Oral health services
M - Mental health services
E – Education-Health information & communication
L – Locally endemic diseases
E – Expanded program on Immunization
M – Maternal and child health programs
E – Essential drugs
N – Nutrition programs
T – Treatment of communicable diseases
S – Safe water and sanitation
 DOH programs
1. Health education – a process to change the
attitude, knowledge and skills
2. Locally endemic diseases
a. Schistosomiasis control program
b. Malaria control program
c. Filariasis control program
d. Dengue control program
3. EPI (Expanded program on immunization)
- BCG, OPV,HPV, DPT
- Tetanus toxoid
6. Maternal and child health services
- Prenatal visit –at least 4
- Reproductive health
10 elements (Violence against women,
Infertility and sexual disorder tx, Breast
cancer & gynecology, adolescent RH, FP,
Abortion complication management,
Reproductive tract infection mgmt.)
- Under five care program
CARI (Control of acute respi. Infxn)
Immunization
Breastfeeding
Oresol rehydration therapy
Growth monitoring
7. Nutritional program
- Vitamin A & iodine supplementation
8. Treatment of communicable diseases
- National TB control program
- Leprosy control program
8. Environmental sanitation
- Water supply sanitation program
- Proper Excreta & sewage disposal
system
- Food sanitation
- Hospital waste management
9. Mental health program
 What is Universal Health Care?
• UHC ALSO REFERRED TO AS KALUSUGAN PANGKALAHATAN
• means all Filipinos are guaranteed equitable access to quality
and affordable health care goods and services and protected
against financial risk.
• President Duterte signed R.A. 11223 or the Universal Health
Care Act into law last February 20, 2019.
• The UHC Act contains comprehensive and progressive
reforms that will ensure every Filipino is healthy, protected
from health hazards and risks, and has access to affordable,
quality, and readily available health service that is suitable
to their needs.
 UHC’S THREE THRUSTS
1) Financial risk protection through expansion
in enrollment and benefit delivery of the
National Health Insurance Program (NHIP);
2) Improved access to quality hospitals and
health care facilities; and
3) Attainment of health-related Millennium
Development Goals (MDGs).
 Who will benefit from UHC act?

• All Filipinos will benefit from the UHC

Act.
• The government will ensure that the
wellbeing and health needs of all
Filipinos, especially those of the
vulnerable population, will be
addressed.
 3. How will the UHC Act ensure that every
Filipino has access to quality and affordable
health care?
• Every Filipino should be able to access preventive,
promotive, curative, rehabilitative, and palliative health
services.
• The UHC Act will improve and strengthen existing
health sector processes and systems by highlighting
primary care close to families and communities,
supported by hospitals that are contracted as part of a
network, and making PhilHealth membership
automatic for every Filipino.
• This will eventually lead to the establishment of better
networks of providers and facilities, making health
accessible for all.
Will all health services be free
through UHC?
• One of the goals of the UHC Act is
to decrease the out-of-pocket
expenses of families.
• At the very least, the prices of
health goods and services will be
predictable and affordable.
 What are the legal basis of
UHC?
• Under the UHC Law, all citizens are
automatically entitled to PhilHealth benefits,
including comprehensive outpatient services.
• PhilHealth will be responsible for purchasing
all individual-based services, including
supplies, medicines, and commodities, as well
as maintenance and operating expense of
health facilities.
COPAR
 COPAR
• COPAR stands for Community
Organizing Participatory Action
Research
• A process of change and
empowerment for building the
capability of people for future
community action.
Process
• The sequence of steps whereby
members of a community come
together to critically assess to
evaluate community conditions and
work together to improve those
conditions.
Structure
• Refers to a particular group of
community members that
work together for a common
health and health related
goals.
 Emphasis
• Community working to solve its own problem.
• Direction is established internally and externally.
• Development and implementation of a specific
project less important than the development of
the capacity of the community to establish the
project.
• Consciousness raising involves perceiving health
and medical care within the total structure of
society.
 Principles
• People especially the most oppressed,
exploited and deprived sectors are open
to change, have the capacity to change
and are able to bring about change.
• COPAR should be based on the interest
of the poorest sector of the community.
• COPAR should lead to a self-reliant
community and society.
 OBJECTIVES OF COPAR
• Patterns to be followed:
1. Organize people
2. Mobilize people
3. Work with people
4. Educate people
- Knowledge
- Attitude
- Skills
 Phases of COPAR

• COPAR has four phases namely:

P - Pre-Entry Phase,
E - Entry Phase,
O- Organization-building phase, and
S - sustenance and strengthening phase.
T – Turn over/Termination Phase
1. Pre-Entry Phase (C.A.S.E.D)
• Is the initial phase of the organizing process
where the community organizer looks for
communities to serve and help.
• Activities include:
C – Courtesy call
A – An initial ocular survey
S – Site selection(poor health sanitation,
inaccessibility of health services, economically
depressed, relative peace & order)
E – Encourage dialogues with the people
D – Demographic profiling
2. Entry Phase (C.O.I.N.E.D)

• sometimes called the social preparation

phase.
• C – courtesy call with the students
• O – Ocular survey
• I – Integration
• N – Noting /formation of core group
• E – Election of Officers
• D – Diagnosis with core group
 3. Organization-building
Phase (S.T.A.R.T)
• It is at this phase where the organized leaders or
groups are being given training (formal, informal,
OJT) to develop their style in managing their own
concerns/programs.
• S – Setting up organization committee
• T – Team buildings
• A – ARAS
• R- Rigid trainings of CHN
• T –The formation of CHO
4. Sustenance and Strengthening
Phase ( R.E.M.I.N.D)
• Occurs when the community organization has
already been established and the community
members are already actively participating in
community-wide undertakings.
• R – ratification of by-laws
• E – evaluation
• M- Monitoring
• I - Implementation
• N – Networking & linkages
• D – Doling out – prevent dependence
5. Turn –over/ termination Phase
• Endorsement
• Turn-over