Nurs 05: Community Health Nursing 1 Community Health Nursing of Individual and Family As Client

Republic of the Philippines
CAVITE STATE UNIVERSITY

Don Severino de las Alas Campus
Indang, Cavite
(046) 415-0010 / (046) 415-0011
www.cvsu.edu.ph
cvsu.op206@gmail.com
NURS 05
COMMUNITY HEALTH NURSING 1
Community Health Nursing

of
Individual and Family as Client
MODULE 3
Health Care Delivery System
Jocelyn B. Dimayuga
UNIT I – Community Health Nursing 1- Individual and Family

1 as Client
Module 1: Concepts of Health Care Delivery System
１
NURS 05 - CARE OF INDIVIDUAL AND FAMILY AS CLIENT
About the Author:
The authors are Instructor 1 and Over All Coordinator of the College of Nursing, Cavite State
University. She is a Registered Nurse and Master Degree holders.
Acknowledgement:
The authors would like to extend their heartfelt gratitude and appreciation to the students, faculty
and staff of College of Nursing who in one way extended their unsurpassed and unfailing support and
valuable assistance and contributed much for the achievement of this module.

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TABLE OF CONTENTS
Page
Cover Page 1
Title page 1
Preface 1
About the author 1
Table of contents 2
Learning Outcomes 3
Objectives 3
Module Instruction 3
Concept of Health Care Delivery System 4
Topic 1. World Health Organization 4
Philippine Department of Health (DOH) 5
Mission-Vision 5
Historical Background 6
Local Health System and Devolution of Health Services 6
Classification of Health Facilities (DOH AO -0012A) 7
Philippine Health Agenda 2010- 2022 7
Topic 2. Primary Health Care (PHC) 8
Brief History 9
Goals 9
Elements 10
Principles and Strategies 10
Topic 3. Levels of Prevention 11
Topic 4. Universal Health Care (UHC) 15
Legal Basis 15
Background and Rationale 15
Objectives and Thrusts 16
Activity 18
Assignment 19
Glossary 20
References 20

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Module 1: Concept of Health Care and Delivery System
_________________________________________________________________________
Learning Outcome:
This module is written in accordance with the course content of the New Nursing Curriculum (CMO
15 s 2017) . It deals with the concepts, principles, theories and techniques in the provision of basic
care in terms of health promotion, disease prevention, restoration and maintenance, and
rehabilitation at the individual and family level. The learners are expected to provide safe
appropriate and holistic nursing care to individual and family as clients in community settings
utilizing the nursing process.
Objectives:
Upon completion of this module, the students are expected to:
1. Discuss how the World Health Organizations (WHO) affects health issues in the
Philippines.
2. List the Millennium Development Goals (MDGs) and the targets of the health related
MDGs.
3. Describe the Philippine Health Care Delivery system in terms of the different levels of
services.
4. Explain how the Department of Health (DOH) provides health leadership in the
Philippines.
5. Explicate on the functions of the members of the health team in the rural health unit
/health center
6. Differentiate the referral system from the interlocal health zone.
7. Relate the strategic thrusts of Universal Health Care to the current health situation and
the goals and objectives of Universal Health Care.
8. Enumerate Major Public Health Programs.
9. Participate in class discussions and activities.
10. Perform assigned tasks required for video conferencing activity
Module Instruction: This module will serve as supplemental learning material to First Year Nursing
students of Cavite State University enrolled in NURS 05. Use this as a guide during interactive
online discussion as well as when complying with assigned requirements and activities.

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A nation health care delivery system has a tremendous impact not only on the health of its people
but also on their total development ,including their socio-economic status .
Issues
 Cost
 Challenges
Topic 1. WORLD HEALTH ORGANIZATIONS (WHO)

 specialized agency of United Nations (UN)
 Provides global leadership on health matters
Health Services are provided by the government and the private sector -for profit as well as non
profit. Which frequently referred to NGOs.
National Level - directions is set by the Department of Health (DOH)
R. A. 7160( Local Government Code )- Local Government Unit (LGU) should have an operating
mechanisms to meet the priority needs and service requirements of their communities .
Basic Health Services are regarded as priority services for which LGU’s are primarily responsible.

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6 Building blocks or component of Health Care System:
1. Service delivery
2. Health workforce
3. Information
4. Medical products,vaccines,and technologies
5. Financing
6. Leadership and governance or stewardship
Nurse is an essential member of the health workforce in the country
An appreciation of the value of the nurses role in the system provides

motivation to work despite sometimes seemingly overwhelming odds.
History : diplomats formed the UN in 1945, there is creation of global health organization,
 WHO is the outcome of this discussion.
 April 7,1948 - WHO came into force . This day is celebrated yearly as World Health Day
 Headquarters is in - Geneva, Switzerland.
 147 country offices
 6 World Regional Offices (Africa, America, Eastern Mediterranean, Europe,Southeast
Asia and the Western Pacific.)
 Philippines is a member of Western Pacific Region where hold office in Manila(2007)
WHO constitutions ( 2006) , Objective: the attainment by all peoples of the highest possible level
of health
Core functions

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Core functions
1. Providing leadership on matters critical to health and engaging in partnerships where joint action is
needed.
2. Shaping the research agenda and stimulating the generation ,translation and disseminating valuable
knowledge.
3. Setting norms and standards and promoting and monitoring their implementation
4. Articulating ethical and evidence base policy options.
5. Providing technical support ,catalyzing change ,and building sustainable institutional capacity.
WHO Country Focus is directed toward providing technical collaboration with member
states in accordance with each country’s needs and capacities.
 Shaping the research agenda and stimulating the generation ,translation and disseminating
valuable knowledge.
Setting norms and standards and promoting and monitoring their implementation,
 WHO develop norms and standards for various health and health related issues
 (pharmaceutical products -vaccines and other biological products used in immunizations practices in
maternal and child health care and environmental conditions)
Articulating ethical and evidence base policy options. WHO

 is involve in various issues on health ethics , in collaboration with other government and
NGO
 worked on bio ethical concerns ( human organ and tissue transplantation, reproductive
technology ,
and public health response response to threats of infectious diseases like AIDS, influenza,and
tuberculosis ( WHO,2013)
Providing technical support ,catalyzing change ,and building sustainable institutional capacity.
WHO
 offers technical support and training to its members countries in the field of ( maternal and child
health,control of diseases,and environmental health services)
 monitoring the health situation and assessing health trends .
 develop guidance and tools on measurement ,monitoring , and evaluation ( WHO ,2013f)

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-is a member of a global

system of nations interacting with
each other at different levels and in
different ways. Events that happen
in other countries can affect the
health status of Filipinos
In the past decade ,WHO has work as a partner of the Philippine DOH in the development and
provisions of services towards the attainment of health related Millennium Development
Goals(MDG’s).
For
better understanding of MDG please copy the link provided and read further the topic about MDG
https://www.google.com/search?q=mdg+goals&source.

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Topic 2 . The Philippine Health Care Delivery System
Department of Health (DOH)
 serves as the main governing body of health services in the country.

 Provides guidance and technical assistance to LGU through the Center for Health Development
in each of the 17 regions
Provincial governments
 are responsible for administration of provincial and district hospitals.
Municipal and City governments
 in - charge of primary care through rural health units (RHU’s) or health centers.
Satellite Outpost or Brgy. Health Stations (BHS’s)
 provide health services in the periphery of the municipality or city
Local Government Code

:History of LGC - Refer to this web link -http://docshare01.docshare.tips/files/22355/223553382.pdf
 mandated the devolution or decentralization of basic health services.

 this means that LGU have the autonomy and responsibility to plan and implement basic
health services(primary care )in behalf of the constituents
 this is a mandate for LGU’s
 depending on the capability and political will of the municipality/city government ,higher
levels of
services may be provided.
 it is possible for a city or a municipality to administer a secondary or even a tertiary hospital.
Private Sector - ( For Profit And Nonprofit Agencies)
 Provides all level of services and accounts for a large segment of health service providers in the
country
3 Major Groups who finances Health Services
1. The Government ( National and Local)

2. Private Sources
3. Social Health Insurance

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Philippine Health Insurance Corporation ( PhilHealth or PHIC)
 created by the National Health Insurance Act of 1995( R.A. 7875)

 it is a tax exempt government corporation attached to the DOH for policy coordination and
guidance and aims for universal health coverage of all Filipino citizens ( Congress of the
Republic of the Philippines , 1995a)
The Department of Health (DOH)
 National agency mandated to lead the health sector towards assuring quality health care for all
Filipinos
Major Roles of DOH
References: http://ro1.doh.gov.ph/transparency-seal/9-transparency/2-mandates-and-functions

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https://hfsrb.doh.gov.ph/wp-content/uploads/2019/07/ao2012-0012-1.pdf

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Topic 3. LEVELS OF HEALTH CARE DELIVERY SYSTEM :
Hospitals Other health facilities

General A. Primary care facilty
 Level 1
 Level 2 B. Custodial Care Facility
 Level 3
( teaching /training) C. Diagnostic/Therapeutic Facility
Specialty D. Specialized Outpatient Facility
Hospitals are broadly classified as general or specialty hospital
General hospitals provide services for all kinds of illnesses,injuries or deformities ( Level 1,2,3)
Specialty hospitals offers services for a specific disease or condition or type of patient ,such as
children,the elderly,or women
Classifications of Health facilities (DOH Administrative Order 2012-0012)

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Category C. is further classified into:

1. Laboratory facility, such as, but not limited to the following:
a. Clinical laboratory
b. HIV testing laboratory
c. Blood service facility
d. Drug testing laboratory
e. Newborn screening laboratory
f. Laboratory for drinking water analysis
2. Radiologic facility providing services such as X-ray, CT scan, mammography, MRI, and
ultrasonography.
3. Nuclear medicine facility – a facility regulated by the Philippine Nuclear Research Institute utilizing
applications of radioactive materials in diagnosis, treatment, or medical research, with the exception
of the use of sealed radiation sources in radiotherapy as in internal radiation therapy.
New classifications of general hospitals ( DOH, 2012)
Hospitals Level 1 Level 2 Level 3

Clinical services for Consultin specialist in Level 1 plus Level 2 plus
inpatients Medicines
Departamentalized Teaching/training
Pediatrics
Clinical services with accredited
Obstetrics - Gynecology
residency training
Surgery
program in 4 major
clinical services
Emergency and Respiratory Unit Physical medicine
outpatient services and rehabilitation
Isolation facilties General ICU unit
Surgical /maternity High Risk Ambulatory
facilities pregnancy unit surgical unit
Dental clinic NICU Dialysis Clinic
Ancillary services Secondary clinical Tertiary Clinical Tertiary Clinical
laboratory laboratory laboratory with
histopathology
Blood station Blood bank
First level xray Second level x-ray Third Level x-ray
with mobile unit
Pharmacy
Rural Health Unit
 The Rural Health Unit (RHU) - commonly known as a health center, is a primary level health
facility in municipality.
 The focus of the RHU is preventive and promotive health services and the supervision of BHSs
under its jurisdiction (DOH, 2001)
 The recommended ratio of RHU to catchment population is 1 RHU:20,000 population (DOH,
2009).
 The BHS is the first-contact health care facility that offers basic services at the barangay level.
 It is a satellite station of the RHU (DOH, 2009).
 It is manned by volunteer Barangay Health workers (BHWs) under the supervision of the Rural
Health Midwife (RHM) (DOH, 2001).
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The Rural Health Unit personnel
The Municipal Health Officer (MHO) or Rural Health Physician heads the health services at the
municipal level and carries out the following roles and functions:
1. Administrator of the RHU
a. Prepares the municipal health plan and budget
b. Monitors the implementation of basic health services
c. Management of the RHU staff
2. Community physician
a. Conducts epidemiological studies
b. Formulates health education campaigns on disease prevention
c. Prepares and implements control measures or rehabilitation plans
3. Medico-legal officer of the municipality (DOH, 2001)
The revised implementing rules and regulations (IRRs) of R.A. 7305 or the Magna Carta of
Public Health Workers stipulate that there be one (1) rural health physician to a population of 20,000
(DOH, 1999).
The Public Health Nurse (PHN)
1. Supervises and guides all RHMs in the municipality (DOH, 1999).
2. Prepares the FHSIS quarterly and annual reports of the municipality for submission to the
Provincial Health Office (DOH-IMS, 2011);
3. Utilizes the nursing process in responding to health care needs, including needs for health
education and promotions, of individuals, families, and catchment community; and
4. Collaborates with the other members of health team, government agencies, private
businesses, NGOs, and people’s organizations to address the community’s health
problems.
R.A. 7305 IRRs provide for the same nurse-population ratio as that of the Rural Health Physician,
that is, 1:20,000 (DOH, 1999). With a recommended ratio of 1 for every 5,000 population (DOH,
2009), the RHM
1. Manages the BHS and supervises and trains the BHW;
2. Provides midwifery services and executes health care programs and activities
for women of reproductive age, including family planning counseling 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
Rural Sanitation Inspector are directed towards ensuring a healthy physical environment
in the municipality. This entails advocacy, monitoring, and regulatory activities, such
as inspection of water supply and unhygienic household conditions (DOH, 2001)
BHWs are considered as the interface between the community and the RHU.
 They are trained in preventive health care, with a strong emphasis on maternal and child care,
family planning and reproductive health, nutrition, and sanitation.
 They are also equipped with basic skills for prevention and management of common diseases.

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 They assist in providing basic services at the BHS and the RHU (DOH, 2001). BHWs are
accredited by the local health board according to DOH guidelines.
 Although they carry the status of volunteers, R.A. 7883 or the Barangay Health Workers’
Benefit and Incentives Act entitles them to hazard and subsistence allowances and other
benefits (Congress of the Republic of the Philippines, 1995b). The recommended ratio of BHW
to catchment population is 1 BHW:20 households (DOH, 2009)
Local Health Boards
 R.A. 7160 or Local Government Code was enacted to bring about genuine and meaningful
local autonomy. This will enable local governments to attain their fullest development as self-
reliant communities and make them more effective partners in the attainment of national goals.
 It mandates devolution of basic services from the national government to LGUs. Devolution
refers to the act by which the national government confers power and authority upon the
various LGUs to perform specific functions and responsibilities (Congress of the Republic of the
Philippines, 1991).
 R.A. 7160 provided for the creation of the Provincial Health Board and the City/Municipal Health
Officer serves as vice chairman. Members of the board are composed of the chairman of the
committee on health of the Sanggunian, a representative from the private sector or NGO
involved in health services, and a representative of the DOH (Congress of the Republic of the
Philippines, 1991).
The functions of local health boards are as follows.
1. Proposing to the Sanggunian annual budgetary allocations for the operation and
maintenance of health facilities and services within the province/city/municipality;
2. Serving as an advisory committee to the Sanggunian on health matters; and
3. Creating committees that shall advise local health agencies on various matters related to
health service operations.
The health referral system

 Implemented since 1992, devolution has brought decision making and accountability on basic
government services closer to the people.
 This has allowed local leaders to have a greater hand in the future of communities. However, it
has brought about fragmentation of the health care delivery system in the Philippines.
 It resulted in a three-level system where local and national governments are responsible for
independent services. Also, municipalities/cities began operating separately from each other
causing further segregation of public health services (DOH, 2001).
 Certain provisions of the Local Government Code deal with relations among local and national
governments. These provisions present a built-in mechanism for a referral system among
different government agencies (Congress of the Republic of the Philippines, 1991).
 A referral is a set of activities undertaken by a health care provider or facility in response to its
inability to provide the necessary health intervention to satisfy a patient’s need.
 A functional referral system is one that ensures the continuity and implementation of health and
medical services.
 It is comprehensive, encompassing promotive, preventive, curative, and rehabilitative care. It
engages all health facilities from the lowest to the highest level.

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 It usually involves movement of a patient from the health center of first contact and the hospital
at first referral level. When hospital intervention has been completed, the patient is referred
back to the health center. This accounts for the term two-way referral system (DOH, 2001).
Referrals may be internal or external.

1. Internal referrals occur within the health facility, from one health personnel to another.
Examples of internal referral are RHM to PHN and PHN to MHO.

 An internal referral may be made to request for an opinion or suggestion, comanagement, or
further management or specialty care (DOH, 2001).
2. An external referral is a movement of a patient from one health facility to another. It may be
vertical, where the patient referral may be from a lower to a higher level of health facility or
the other way round.
 The referral may also be horizontal, where the patient is referred between similar facilities
in different catchment areas.
The Inter-Local Health Zone

 As stated earlier, devolution has resulted in a fragmented health care system and segregation
of public health services among different LGUs. The referral system functioning within the
context of the Inter-Local Health Zone (ILHZ) provides a means for consolidating health care
efforts.
 The ILHZ is based on the concept of the District Health System, a generic term used by WHO
to describe an integrated health management and delivery system based on a defined
administrative and geographical area.
 An ILHZ has a defined catchment population within a defined geographical area. It has a central
or core referral hospital and a number of primary level facilities such as RHUs and BHSs.
 The ILHZ does not only cover government health services but includes all other sectors
involved in the delivery of health services. It may include community-based NGOs and the
private sector-both local and foreign. Not synonymous with a political congressional district, an
ILHZ may be composed of one large municipality or several municipalities (DOH, 2002).
 The ILHZ has the following components (DOH, 2002):

 People. Although WHO has described the ideal population size of a health district between
100,000 and 500,000, the number of people may vary from zone to zone, especially when
taking into consideration the number of LGUs that will decide to cooperate and cluster.
 Boundaries. Clear boundaries between ILHZs establish accountability and responsibility of
health service providers.
 Health facilities. RHUs. BHSs, and other health facilities that decide to work together as an
integrated health system and a district or provincial hospital, serving as the central referral
hospital, make up the health facilities of an ILHZ.
 Health Workers. To deliver comprehensive services, the ILHZ health workers include
personnel of the DOH, district or provincial hospitals, RHUs, BHSs, private clinics, volunteer
health workers from NGOs, and community-based organizations.

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Topic 4 : Health Sector reform: Universal Health Care
Universal Health Care (UHC) (Kalusugan Pangkalahatan), also called the Aquino Health
Agenda, is the latest in a series of continuing efforts of the government to bring about health sector
reforms. UHC was built upon the strategies of two previous platforms of reform: the initial Health
Sector Reform Agenda (1999-2004) and FOURmula One (F1) for health (2005-2010). UHC is
planned for implementation until 2016 (DOH, 2010).
Rationale
Health sector reforms are intended to bring about equity in health service delivery. Survey
data show that this has not been achieved as of yet, despite health sector reforms since 1999. A
DOH and PhilHealth review highlighted the need to improve health-related financial risk protection
among Filipinos. More importantly, PhilHealth benefit delivery was found to be lowest among the
target population – the poorest quintile. The concern on inequitable access to health resources has
not been resolved (DOH, 2010).
Neglect of public hospitals and health facilities due to inadequate health budgets has been
observed. As of October 2010, a total of 892 RHUs and 99 government hospitals had yet to qualify
for accreditation by PhilHealth. Data show that the poorest of the population are the main users of
government health facilities. This means that the deterioration and poor quality of many government
health facilities is particularly disadvantageous to the poor who needs the services the most (DOH,
2010).
 To achieve health-related MDGs are in order. The MDG 4 target is to reduce maternal mortality
rate from 209 maternal deaths/100,000 live births by 2015 (NEDA, 2010).
 The preliminary 2009 FHSIS report shows that the country had a maternal mortality rate of 64
per 100,000 live births in that year (DOH-NEC, 2009). Considering the short span of time to the
year 2015, attainment of the MDG target looks difficult.
 The decrease in infant and child mortality rates over the past two decades has been remarkable.
From a high under-five child mortality rate of 80 per 1,000 live births in 1990, the 2008 data
shows a decrease to 34 per 1,000 live births.
 There us a high probability of meeting MDG goal 5 (NEDA, 2010).
To address these challenges, UHC (Kalusugan Pangkalahatan) was launched through

Administrative Order 2010-0036 (DOH, 2010).
UHC Goals and Objectives
(1) better health outcomes,

(2) sustained health financing, and
(3) a responsive health system by ensuring that all Filipinos,
Strategic thrusts
The attainment of the goal of UHC is through the pursuit of three strategic thrusts:
A. Financial risk protection through expansion in NHIP enrollment and benefit delivery
B. Improved access to quality hospitals and health care facilities

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C. Attainment of the health-related MDGs (DOH, 2010)
To achieve the three strategic thrusts, six strategic instruments shall be optimized:
1. Health financing – instrument to increase resources for health that will be effectively
allocated and utilized to improve the financial protection of the poor and the vulnerable
sectors.
2. Service delivery – instrument to transform the health service delivery structure to address
variations in health service utilizations and health outcomes across socioeconomic
variables.
3. Policy, standards, and regulation – instrument to establish the mechanisms for efficiency,
transparency, and accountability, and prevent opportunities for fraud.
4. Governance for health – instrument to establish the mechanisms for efficiency,
transparency, and accountability, and prevent opportunities for fraud.
5. Human resources for health – instrument to ensure that all Filipinos have access to
professional health care providers capable of meeting their health needs at the
appropriate level of care,
6. Health information – instrument to establish a modern information system that shall:
a. Provide evidence for policy and program development;
b. Support for immediate and efficient provision of health care and management of
province-wide health systems (DOH, 2010).
Public health programs

Major public health programs that will be tackled in subsequent chapters include the
following:
1. Reproductive and maternal health prepregnancy services and care during pregnancy,
delivery, and postpartum period
2. Expanded Garantisadong Pambata (child health): advocacy for exclusive breastfeeding
in the first 6 months of life, newborn screening program, immunization, nutrition services,
and integrated management of childhood illness
3. Control of communicable diseases such as tuberculosis, mosquito-borne diseases,
rabies, schistosomiasis, and sexually transmitted infections
4. Control of noncommunicable or lifestyle diseases
5. Environmental health
SUMMARY
WHO provides global leadership in matters of health, whereas DOH provides leadership at
the national level. Health services are provided by three levels of health facilities, with the
RHU/health center providing primary care at the municipal/city level. This is the usual setup where
the PHN, together with the other members of the public health team, serves the community.
Devolution has brought basic services closer to the people, but it has also caused
fragmentation and segregation of the health care delivery system in the country. The referral system,
especially through the ILHZs, consolidates the fragmented health care delivery system.
Knowing one’s role in the system enables one to contribute effectively to system goals. A
thorough understanding of the health care delivery system in the country will better equip the nurse
practitioner in the Philippines – regardless of the work setting- in providing integrated care to clients.

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Learning Activity
1. Share a news about recent undertakings of WHO that you think will impact on the
health situation in the Philippine . Discuss the potential effects of these undertakings
on the local health situation.
2. Get current PHilHealth data on coverage and benefits package ,and take note of
the community health services covered by PhilHealth.

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Assignment : ESSAY 1
(30 points. Not less than 500 words)

Deadline:_______October 6,2020______
Reading Assignment:
Please do advance reading on the next topic =)

A. DOH Programs related to Family Health
1. EPI
2. IMCI
3. EEINC
4. Newborn Screening
5. BEmONC/CEmONC
6. Nutrition
7. MhGap
8. Other related program
B.Ethical Considerations in Community Heath
Nursing:Public Heath Laws

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References :
Nursing Care of the Community, Famorca, Z , Nies M.,Mewen , M.(2018)
Public Health Nursing in the Philippines, Cuevas F.,10th edition (2007)

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Republic of the Philippines

CAVITE STATE UNIVERSITY

COMMUNITY HEALTH NURSING 1

Community Health Nursing

Health Care Delivery System

UNIT I – Community Health Nursing 1- Individual and Family

NURS 05 - CARE OF INDIVIDUAL AND FAMILY AS CLIENT

About the Author:

UNIT I – Community Health Nursing 1- Individual and Family

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concept of Health Care and Delivery System

Upon completion of this module, the students are expected to:

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

Topic 1. WORLD HEALTH ORGANIZATIONS (WHO)

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

Nurse is an essential member of the health workforce in the country

An appreciation of the value of the nurses role in the system provides

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

Articulating ethical and evidence base policy options. WHO

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

-is a member of a global

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

Topic 2 . The Philippine Health Care Delivery System

Department of Health (DOH)

 serves as the main governing body of health services in the country.

 are responsible for administration of provincial and district hospitals.

Municipal and City governments

Local Government Code

 mandated the devolution or decentralization of basic health services.

Private Sector - ( For Profit And Nonprofit Agencies)

3 Major Groups who finances Health Services

1. The Government ( National and Local)

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

 created by the National Health Insurance Act of 1995( R.A. 7875)

The Department of Health (DOH)

Major Roles of DOH

UNIT I – Community Health Nursing 1- Individual and Family

Module 1: Concepts of Health Care Delivery System

UNIT I – Community Health Nursing 1- Individual and Family

Topic 3. LEVELS OF HEALTH CARE DELIVERY SYSTEM :

Hospitals Other health facilities

Specialty D. Specialized Outpatient Facility

Hospitals are broadly classified as general or specialty hospital

Classifications of Health facilities (DOH Administrative Order 2012-0012)

UNIT I – Community Health Nursing 1- Individual and Family

Category C. is further classified into:

New classifications of general hospitals ( DOH, 2012)

Hospitals Level 1 Level 2 Level 3

Rural Health Unit

The Rural Health Unit personnel

UNIT I – Community Health Nursing 1- Individual and Family

Local Health Boards

The functions of local health boards are as follows.

The health referral system

UNIT I – Community Health Nursing 1- Individual and Family

Referrals may be internal or external.