HANDOUT (BABADDANG GROUP)

ETHICAL CONSIDERATION IN COMMUNITY HEALTH NURSING

1. THE MAGNA CARTA OF PUBLIC HEALTH WORKERS

Republic Act No. 7305             March 26, 1992

- Be it enacted by the Senate and House of Representatives of the Philippines in Congress

assembled:

This Act shall be known as the "Magna Carta of Public Health Workers"

The State shall instill health consciousness among our people to effectively carry out the health programs
and projects of the government essential for the growth and health of the nation. Towards this end, this
Act aims: (a) to promote and improve the social and economic well-being of the health workers, their
living and working conditions and terms of employment; (b) to develop their skills and capabilities in order
that they will be more responsive and better equipped to deliver health projects and programs; and (c) to
encourage those with proper qualifications and excellent abilities to join and remain in government
service.

For purposes of this Act, "health workers" shall mean all persons who are engaged in health and
health-related work, and all persons employed in all hospitals, sanitaria, health infirmaries, health
centers, rural health units, barangay health stations, clinics and other health-related
establishments owned and operated by the Government or its political subdivisions with original
charters and shall include medical, allied health professional, administrative and support
personnel employed regardless of their employment status.

The Magna Carta of Public Health Workers (RA 7305) was enacted to ensure that health workers are
properly compensated, thereby helping to promote better delivery of quality health care service. Thus, its
intention was supposed to be for the benefit of the overall health care delivery service.
Under RA 7305, public health workers are entitled to a host of benefits, including subsistence allowance,
laundry allowance, longevity pay, hazard pay, and higher salary grade upon retirement, among others.
Since its passage in 1992, however, successive governments have failed to fully provide for the payment
of all the benefits prescribed in the law in the public hospitals’ budget. Only the subsistence and laundry
allowances2 are provided and only partially, for subsistence allowance. Of the PHP 1,500 under the
Implementing Rules and Regulations (IRR) of the Magna Carta, only PHP 900 per month was funded
from the General Appropriations Act (GAA) while the balance of PHP 600 per month was sourced from
hospital savings; for laundry allowance, only PHP 125 per month was funded from the GAA while the
balance was sourced from savings. Hazard allowances were also budgeted but only for x-ray
technicians. The rest of the benefits prescribed in the Magna Carta were not funded at all. Since the
Magna Carta law was vague in specifying the sources of funds for payment of all the benefits, there is no
real accountability on who should fund it. For instance, the law stated that payment must be based on
“LGU capacity,” yet the PIDS study on local services delivery had shown that there is no real logic to the
compliance by local government units (LGUs) on the payment of Magna Carta benefits. Differences in
the LGUs’ capacity to pay have resulted in differences in benefits received by health workers, even
among those of equal ranks.
These differences in pay and benefits have an adverse effect of sowing discontent rather than
empowerment of health workers. Since the DOH does not also provide in the hospitals’ budgets the
funding to fully finance the benefits under the law, public hospitals have no choice but to derive payment
of Magna Carta allowances from their own savings.
Unfortunately, the current financial status of most hospitals suggests that they are already overstretched
in meeting hospital operational expenses. Giving them the additional burden of shouldering the expenses
to pay for Magna Carta benefits results in unequal compensation of hospital workers among public
hospitals.

- The Congress of 1992 passed a law to give health workers increased benefits through two
mechanisms: outright, across-the-board salary increases for all rural doctors, and laundry and
subsistence allowances for all other health workers.
- Over a five-year period, the DOH was also authorized to increase other benefits such as medico-legal
fees, overtime pay, hazard pay and hardship allowances for health workers laboring under difficult
circumstances.
- Under the law, the DOH would set up a mechanism for managing health worker and
management issues through multi-level consultative councils. The law also provided for a code of
conduct by health workers, with penalties for any violations.
- By 1997, a national consultative council had been in operation for three years, but
local government participation in the consultative process remained poor or, in some cases, only token in
nature. During its early years of implementation, it was clear that if implemented, the magna carta would
create the highest paid sectoral workforce in the Philippines civil service.

2. SANITATION CODE
- Also known as the Presidential Decree no. 856 on December 23, 1975 focuses on the
improvement of the way of the Filipinos by directing public health services towards the protection
and promotion of the health of the people. 

CODE ON SANITATION
Whereas, the health of the people, being of paramount importance, all efforts of public services should be
directed towards the protection and promotion of health; and
Whereas,  with the advance in the field of sanitation in recent years, there arises the need for updating
and codifying our scattered sanitary laws to ensure that they are in keeping with modern standards of
sanitation and provide a handy reference and guide for their enforcement;

Importance of the sanitation code of the Philippines

*Sanitation is one of the most important aspects of community well-being because it protects human
health, extends life spans, and is documented to provide benefits to the economy.

Benefits
* To improve the way of the life of the Filipino people.
* One key goal of sanitation is to safely reduce human exposure to pathogens. Pathogens are excreted
by infected individuals and if not properly contained or treated, may present a risk to humans who come
in contact with them. These individuals can also be exposed to pathogens through drinking water or
eating food contaminated with pathogens found in human excreta. Similarly, the JMP has specified that
safely managed drinking water must be free from fecal contamination (WHO, 2017).

3. CLEAN AIR ACT

 What is clean air? Well, it is the air that has no harmful levels of pollutants.

             As the cities and industries around the country increase in number, however, clean air has
become polluted that it was necessary for the Philippine government to pass a law that would ensure
safe air for Filipinos to breathe in.
What:
 Republic Act No. 8749, otherwise known as the Philippine Clean Air Act, is a comprehensive air
quality management policy and program which aims to achieve and maintain healthy air for all
Filipinos.

 It provides for a comprehensive air pollution control policy, as it outlines the government’s
measures to reduce air pollution by including environmental protection activities into its
development plans. It has adopted the “polluters pay principle” and other market-based
instruments to promote self-regulation among the population. Emission standards are set for all
motor vehicles and had issued pollutant limitations among industries. 
Examples of air pollution;
 Burning of garbage
 Transportation
 Industrial emission 
 Burning of fossil fuel, ect.

*How does air pollution affect humans? Studies show that air pollution is one of the causes of
cardiopulmonary diseases and the increase in air pollution-related deaths. Moreover, air pollution can
weaken the body’s defenses against assorted viruses and bacteria. It impacts on one’s health – from
becoming sluggish to acquiring deadly diseases, such as lung cancer.

Where: First regular session Begun and held at Metro Manila

When: Monday of July 27 1998 and approved on June 23 1997
Who: By our late President Joseph Estrada

Purpose
According to Declaration of Principles on Philippine clean air Act of section 2 
The State shall protect and advance the right of the people to a balanced and healthful ecology in accord
with the rhythm and harmony of nature. 
 The State recognizes that a clean and healthy environment is for the good of all and should therefore be
the concern of all.

The 3 major provisions of the Clean Air Act

- The act establishes federal standards for mobile sources of air pollution and their fuels and
for sources of 187 hazardous air pollutants, and it establishes a cap-and-trade program for the
emissions that cause acid rain. It establishes a comprehensive permit system for all major
sources of air pollution.

4. GENERIC ACT
AN ACT TO PROMOTE , REQUIRE AND ENSURE THE PRODUCTION OF AN ADEQUATE SUPPLY,
DISTRIBUTION, USE AND ACCEPTANCE OF DRUGS AND MEDICINES IDENTIFIED BY THEIR
GENERIC NAMES.
SECTION 1. TITLE. – This act shall be known as the “Generics Act of 1998”.
SECTION 2. Statement of Policy. – It is hereby declared the policy of the State:
a. To promote, encourage and require the use of generic terminology in the
importation, manufacture, distribution, marketing, advertising and promotion,
prescription and dispensing of drugs;
b. To ensure the adequate supply of drugs with generic names at the lowest possible
cost and endeavor to make them available for free to indigent patients;
 c. To encourage the extensive use of drugs with generic names through a rational
system of procurement and distribution;
d. To emphasize the scientific basis for the use of drugs, in order that health
professionals may become more aware and cognizant of their therapeuatic
effectiveness; and
e. To promote drug safety by minimizing duplication in medications and/or use f drugs
with potentially adverse drug interactions.
BENEFITS: To emphasize the scientific basis for the use of drugs, in order that health professionals may
become more aware and cognizant of their therapeutic effectiveness; and. To promote drug safety by
minimizing duplication in medications and/or use of drugs with potentially adverse drug interactions.

5. NATIONAL HEALTH INSURANCE ACT (PhiHealth)

HISTORY
The National Health Insurance Program (NHIP) administered by the Philippine Health Insurance
Corporation (PhilHealth) was established in 1995 with the passage of Republic Act (RA) 7875. PhilHealth
took over the Medicare functions previously administered by the Philippine Medical Care Commission
(PMCC) since 1972. PhilHealth’s mandate is to provide health insurance coverage to all Filipinos. In
1997, it assumed Medicare functions for government workers from the Government Service Insurance
System (GSIS) and a year later, for the private sector workers, which was previously administered by the
Social Security System (SSS). In the same year, PhilHealth started the Indigent Program. In partnership
with Local Government Units (LGUs), PhilHealth has enrolled millions of families who otherwise have no
access to health services. Since then, this program has been at the heart of PhilHealth’s program and
now forms the bulk of membership. To date, all families in the DSWD’s National Household Targeting
System for Poverty Reduction (NHTS-PR) are covered by PhilHealth. For 2014, 14.7 million families are
being enrolled through full National Government subsidy. The provision of full National Government
subsidy was made possible by an amendment introduced in RA 10606 enacted into law in 2013. In 1999,
PhilHealth started covering self-employed and the informal sector and in 2005, PhilHealth assumed
Medicare functions from the Overseas Workers Welfare Administration (OWWA) for Overseas Filipino
Workers. Now on its 19th year, PhilHealth has improved the way health services are delivered, financed
and regulated. It has introduced a primary and catastrophic benefit package as it had shifted to an all-
case rates system from the previous inflationary and ineffective fee for service which has been in place
since Medicare. PhilHealth endeavors to cover the financing of every Filipino’s health needs, from
preventive primary to hospital care including catastrophic conditions. With Kalusugan Pangkalahatan as
the overall sectoral agenda, PhilHealth is committed to ensure a coordinated and intensified effort
towards its end goal of “Bawat Pilipino, Miyembro, Bawat Miyembro, Protektado, Kalusugan Natin
Segurado”.

RA. NO 7875:
SUBJECT: MEDICAL CARE AND SICKNESS BENEFIT
Provides a National Health Insurance Program for all Filipinos and establishes the Philippine Health
Insurance Corporation for that purpose. S.2 sets forth guiding principles of the program, including
universality, equity, social solidarity, devolution, informed choice and cost sharing. Also provides for the
establishment of local health insurance offices, regulations concerning accreditation of health care
providers, and procedures for grievances and appeals.

REPUBLIC ACT No. 10606

AN ACT AMENDING REPUBLIC ACT NO. 7875, OTHERWISE KNOWN AS THE “NATIONAL
HEALTH INSURANCE ACT OF 1995″, AS AMENDED, AND FOR OTHER PURPOSES

Declaration of Principles
It is hereby declared the policy of the State to adopt an integrated and comprehensive approach to health
development which shall endeavor to make essential goods, health and other social services available to
all the people at affordable cost and to provide free medical care to paupers. Towards this end, the State
shall provide comprehensive health care services to all Filipinos through a socialized health insurance
program that will prioritize the health care needs of the underprivileged, sick, elderly, persons with
disabilities (PWDS), women and children and provide free health care services to indigents

The implementation on the rules and regulation of the said acts aims to:
a. Provide all citizens of the Philippines with the mechanism to gain financial access to health services;
b. Establish the Program to serve as the means to help the people pay for health care services; and,
c. Prioritize and accelerate the provision of health services to all Filipinos, especially that segment of the
population who cannot afford these services.

Establishment and Purpose – There is hereby created the National Health Insurance Program which
shall provide health insurance coverage and ensure affordable, acceptable, available and accessible
health care services for all citizens of the Philippines, in accordance with the policies and specific
provisions of this Act.

Mandatory Coverage – All citizens of the Philippines shall be covered by the National Health Insurance
Program. In accordance with the principles of universality and compulsory coverage enunciated in
Section 2(b) and 2(l) hereof, implementation of the Program shall ensure sustainability of coverage and
continuous enhancement of the quality of service: Provided, That the Program shall be compulsory in all
provinces, cities and municipalities nationwide, notwithstanding the existence of LGU-based health
insurance programs: Provided, further, That the Corporation, Department of Health (DOH), local
government units (LGUs), and other agencies including nongovernmental organizations (NGOs) and
other national government agencies (NGAs) shall ensure that members in such localities shall have
access to quality and cost-effective health care services. (RA 10606)