Community Health -

♥ Under the office of the president

Many are from Mindanao

Nursing -
-
Hospice home care
Parish Community Nursing
- Faith community nursing
Lectured by: Z. Famorca, PhD, RN DOTS
- Treatment partner – follows up medication
“Public health is supposed to be given for free” FALSE ♥ PHN appoints a treatment partner
Financing of health services
♥ Another health worker that is accessible
- Out of pocket
- Health maintenance organization (Phil Health) – BHW
- Free at the point of care 3. Population/aggregate—focused
♥ Government—Taxes are paid - “The greater good of the majority”
Test taking technique - Community Diagnosis
- When choosing numbers choose the middle ♥ Vital Statistics
ground
♥ Demography
- Do not choose the extreme numbers
CHN: Definition - Magnitude (prevalence) of a problem
1. Developmental Services ♥ A criterion for priority setting
- Development of health capability of Individual, 4. Promotive and preventive
Family, Group, Community - Preventive treatment, e.g. DOTS
♥ Groups with common susceptibility - Health Education
♥ Same working group 5. Pre-paid service
- Enabling service self- reliance
- Taxation (public and school health)
- Health education—done for health promotion
♥ Patient Education—Done when person - Passed on to consumer (occupational)
is sick -
- Community organizing 6. Gen eralist Practice
Transfer of Technology

Labor Code: Health, Safety and Welfare Benefits

2. Community-based
- Book 4: Health, safety and welfare benefits
- Catchment
Number of workers OH services
- Natural environment of people 10-50 Graduate first aider who may be
Home PHN one of the workers
50-200 Non-hazardous: full-time first
School  SHN aider
Workplace OHN Hazardous workplace: OHN
200-300 OHN, Part-time physician and
3 fields of CHN Practice dentist (at least 2hrs a day),
- Case-finding of CHN practice emergency clinic (1 bed: 100
workers) or hospital within 5 km
♥ Direct Sputum Smear Microscopy (TB)
>300 Full time DMD and MD
♥ Weighing Scale or tape measure for RA 124—mandates all schools to have a school clinic for
mid-upper arm circumference the treatment of minor ailments and attendance to
(Malnourishment) emergency cases (1947)
2 types of community: - School health physician reports to the board of
- Geo political community health (DOH)
♥ Barangay Functions of OHN and SHN
♥ City
1. Health care provider
♥ Province
- Phenomenological - Promotive and preventive services
GIDA- Geographically Isolated and Deprived Areas ♥ Health advocacy
- Cooperative Development Authority ♥ Health education and counseling
♥ Immunization, prenatal care
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 - Treatment of common ailments and emergency
nursing care
♥ CD control
- Screening for health problems:
♥ School health and nutrition survey—
done on the 1st visit by the nurse and
every 3 years thereafter
♥ Random/rapid classroom inspection
♥ Annual individual health inspection
o Interview
o Height and weight
measurement
♥ Head to foot examination for
cleanliness, skin disease and other
obvious abnormalities
♥ Visual acuity test: a child with visual
acuity of 20/40 or poorer to be referred
♥ Ear exam and hearing acuity test:
otoscopy, whisper test, ballpen click
test or with the use of tuning fork
(ototoxicity for Streptomycin)
2. Environmental Manager
- Monitoring environmental conditions
- Recognizing and reporting accident and health
hazards in workplace/school
- Healthful school living
- Application of ergonomic principles (physical
environment)
3. Health coordinator
- Making referrals to other agencies and health
personnel
- Coordination with public health nurse, e.g. for
immunization of school children
Public Health (C.E.Winslow)
Philosophy of public heatlh
- “Health and longevity” as “birth rights”
- Premature death (*untimely death)
Objectives of public health
- To prevent disease
- To prolong life
- To promote health and efficiency
Organized community efforts
- People
- RHU Primary Health Care
- Private sector
Philosophy of public health nursing (Margaret Shetland)
- PHN is based on the worth and dignity of man
♥ Contribute to the integrity of the
Individual, Family and Community
- The family is the basic unit of service in PHN
- Physical and emotional health are inseparable
♥ Consider physical and emotional
aspects of the needs of all the members
of the family
Public Health Nursing (WHO expert committee on
nursing)
- PHN is a special field of nursing that combines
the skills of:
♥ Public health
♥ Nursing
♥ Some phases of social assistance –
feeding program
4P’s Pantawid pamilyang Pilipino Program
(CCT- conditional cash transfer)
- Poverty alleviation
♥ MDG1: Eliminate hunger and poverty
th
- 5 Quintile and instrument to identify “True
Poor”
Benefits:
1. P500/month
2. For every qualified child (max of 4 up to 15yrs)
- P300/month for 10 mos.
Conditions:
1. 85% of class days, students should be present
2. Immunization up to the age of 4
3. Children will be in the garantisadong pambata
program
- PHN functions as part of a total public health
program
♥ Health team
♥ 1 municipal health plan
- Objectives of PHN
♥ Promotion of health
♥ Improvement of conditions in the
physical and social environment
♥ Rehabilitation
♥ Prevention of illness and disability
Basic competencies of the Public Health Nurse
- Patient care competencies
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 ♥ CHN process
♥ Nursing procedures during clinic and
home visits
♥ Surveillance
- Health promotion and education
- Communication
- Collaboration: community organizing
- Empowering competencies
♥ Legal responsibility
♥ Ethico-moral responsibilities
♥ Personal and professional development
- Enabling competencies
♥ Management of resources and
environment
♥ Record management
- Enhancing competencies
♥ Research
♥ Quality improvement
Level of Prevention
- Target population:
♥ Beneficiaries (For whom?)
♥ Purpose of the nursing action: aspect of
prevention (for what?)
Primary level
- Target population: well individuals, families,
groups and communities
- Aspects of prevention
♥ General health promotion
♥ Specific disease prevention
o Prevent from a single person
♥ Specific protection
o Groups of people
o ASIN Law- “An Act for Salt
Iodization Nationwide”
Secondary Level
- Target Population: Early sick + subclinical cases
(asymptomatic)
- Aspects of prevention
♥ Early diagnosis and prompt treatment
♥ Prevention of complications
Tertiary Level
- Target population: Late sick: convalescent,
disabled, complicated case, terminal ill
Natural hx of disease
Pre- Pathogenesis
Pathogenesis
Interaction
Millennium Summit: September 6-8, 2000
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce by2/3 the under 5 mortality rate
(1990:80/1000 live births 2015:
26.7/1000)
5. Reduce by ¾ the maternal mortality rate (1990:
2.09/1000 live births 2015: 52/1000 live
births)
6. Combat HIV/AIDS, malaria and other disease
1993: eradication of
1. Polio
2. Neonatal Tetanus
3. Measles
4. Rabies
7. Ensure environmental sustainability
8. Develop a global partnership for development
World Health Organization (MDG4-6)
The Department of Health
Vision- Mission
Vision
To staunch advocate, model and leader of health for all
in the Philippines
“A global leader for attaining better health
outcomes, competitive and responsive health
care system, and equitable health financing. ”
Mission
“To guarantee equitable, sustainable and quality health
for all Filipinos, especially the poor, and to lead the
quest for excellence in health.”
Roles and functions of the DOH
1. Leader
a. Planner and policy-maker
b. Regulator of health services
c. Advocate in the adoption of health policies,
plans and programs
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 2. Enabler and capacity builder
a. Develop new strategies in health
b. Initiate public discussion on health issues Goals
and disseminate info on research outputs Better Health Responsive Equitable health
c. Ensure standards of health promotion, outcomes health system financing
protection and care (training)
Health care delivery system of the Philippines
3. Administrator of specific services Primary Level
a. Manage selected national health facilities - Promotion and prevention
b. Administer direct services for emergent - Management of prevalent conditions
health concerns that require new - Out-patient services
complicated technologies Secondary
c. Administer health emergency responses - Hospitalization
Tertiary
- Specialized care
♥ Specially trained personnel
Universal Health Care ♥ Highly departmentalized
(2010-2016)
♥ Sophisticated equipment
FOURmula One for
Health (2005-2010) National hospitals/DOH national office/ medical
centers/ university hospitals/ special hospitals
Health Sector Reform
Agenda (1999-2004)
Center for health development
Prove Health
Provincial hospital (PHO) Board Chair:
Priority Health Policy Directions of the Aquino
Governor Vice-
Administration District hospital (DHO) chair: IPHO

RHU/CHC/CHO Municipal/city Health Board

Financial Risk Chair: Mayor
Protection
BHS Vice-chair: Municipal Health Officer

RA 7160—devolution code
Health
Achieving
facilities enhancement
MDGmax Inter Local Health System
- To ensure quality of health care service at the
local level integrate hospital and public
health services  holistic health care
Universal Health Care - Inter Local Health Zone (ILHZ)
Strategies ♥ Clustered municipalities (defined
1 2 3 population within a defined area)
Health Financing Service Delivery Policy and
♥ Primary level facilities (RHU’s and
regulation
BHS’s)
6 5 4
Health Human Health Governance for ♥ Central referral hospital
Resource information Health

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Components of the ILHZ
- People—may vary, according to WHO, between
100, 000 to 500, 000
- Boundaries—to determine accountability of
health service providers
- Health facilities- secondary level hospital
(district of provincial), RHU’s BHS’s and other
health facilities
- Health workers—both government and non-
government
Two-way referral system
- Communication among facilities
The RHU team