COMMUNITY HEALTH NURSING LEC

PUBLIC HEALTH  Protection

- Is the science of protecting and improving the  Environmental hazards
health of people and their communities. This  Managing health emergencies
work is achieved by promoting healthy lifestyles,  Control of infectious
researching disease and injury prevention, and
detecting, preventing and responding to  Promotion
infectious.  Promoting health behaviors
 Promoting social determinants of health
- A discipline that addresses health at a
population level ( look at groups of people sick &  Prevention
well, community or global health)  Vaccination
 Screening
Goal:
- Contribution to the most effective total PUBLIC HEALTH NURSING
development and life of the individual and his - is the practice of promoting and protecting the
society. health of populations using knowledge from
nursing, social, and public health science.
 UNDERSTAND
 Thru research and surveillance - A specialty practice within nursing and public
 Exposure health.
 Risk With a multi-level view of health, public
 Plan intervention to improve health health nursing action occurs through community
applications of theory, evidence, and a
 ACT commitment to health equity.
 Prevention and Care & Treatment
 Promote behavior change - Practice includes advocacy, policy development,
 Reduce exposure risk and planning which addresses issues of social
 Access to effective treatment justice.
 Health system to provide care
COMMUNITY HEALTH
CORE AREAS OF SERVICES: - Considered a sub-discipline of public health,
 Governance focused on improving the health outcomes of
 Advocacy different groups of individuals, often at the local
 Capacity level.
 Information
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- Focuses on the physical and mental well being - unique blend nursing and public health practice:
of the people in a specific geographic region.  Human service
 Care & supervision of individuals, families,
- This includes initiatives to help community places of work, schools and clinics.
members maintain and improve their health,
prevent the spread of infectious diseases and CONCEPTS OF CHN
prepare for natural disasters.  Health promotion
 Benefit not only the individual but the whole
- Working at the community level promotes family.
healthy living, helps prevent chronic diseases and  CH nurses are generalists in terms of their
brings the greatest health benefits to the practice through life’s continuum
greatest number of people in need.  Contact with client and/or the family may
continue over a long period of time which
COMMUNITY HEALTH NURSING include all ages and all types of health care.
- A special field of nursing that combines the  Requires that current knowledge derived
skills of nursing, public health & some phases of from the biological and social sciences,
social assistance and functions as part of the ecology, clinical nursing & community health
total public health programme for the organizations be utilized.
promotion of health, the improvement of the  The dynamic process of assessing, planning,
conditions in the social and physical implementation and intervening, provide
environment, rehabilitation of illness and periodic measurements of progress,
disability (WHO). evaluation and a continuum of the cycle
until the termination of nursing is implicit.
Goals:
- is to raise awareness about certain public PUBLIC HEALTH NURSING STANDARDS: Scope
health issues and help stop the spread of and Standards of Practice
preventable diseases and illnesses. STANDARDS OF CARE
1. Assessment
Community Health Nursing (CHN) 2. Population diagnosis and priorities
- Learned practice discipline with ultimate goal 3. Outcome identification
of contributing, as individuals and in 4. Planning
collaboration with others, to the promotion of 5. Implementation
the client’s optimum level of the functioning 6. Evaluation
through teaching and delivery care.
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STANDARDS OF PROFESSIONAL PERFORMANCE  1805
7. Quality of practice  Dr. Francisco de Balmis introduced
8. Education smallpox vaccination
9. Professional practice evaluation  1876
10. Collegiality & Professional relationships  First medicos titulares (provincial health
11. Collaborations officers)
12. Ethics  1888
13. Research  UST offered a 2-year course of
14. Resource Utilization fundamental medical & dental subjects.
15. Leadership  Cirujanos Ministrantes – male nurses &
sanitation inspectors.
EVOLUTION OF PUBLIC HEALTH & PUBLIC  1898
HEALTH NURSING  Creation of the Board of Health for
 Pre-Spanish Era before 1565 Physicians (American Regime)
 Ancient Filipinos regarded health as a  1901
harmonious relationship with the  United States Philippine Commission
environment, both natural and (ACT 157) created the Board of health
supernatural. of the Philippine Islands.
 Creation of Board of Health for City of
 The Spanish Era (1565-1898) Manila, Provincial and Municipal Boards
 The San Lazaro Church and Hospital of Health.
represents early medical healthcare in  Act # 157 (Board of Health of the
the Spanish era. As the Spanish were Philippines)
not accustomed to the climate, food,  Act # 309 (Provincial and Municipal
and other challenges of living in the Boards of Health)
Philippines, Spanish soldiers succumbed  1905
to a number of diseases and were  BOH evolved into DOH.
treated in hospitals specially created for  La Gota de Leche, first center to serve
their welfare. mothers and babies, charity clinics
 1915
 1577 Intramuros  PGH began to extend PHN services in
 Public health services opened by a the homes – Social & Home Care Service.
Franciscan Friar Juan Clemente.  Community organizations
 Women’s club
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 1947  Training function (Nurse educator)
 DOH was reorganized into bureaus  Research Function (Researcher)
 1954
 Congress passed RA 1082 (Rural Health
Act) THE HEALTH CARE DELIVERY SYSTEM (HCDS)
 Or the creation of rural health unit - A well-functioning health system working in
in every municipality. harmony is built on having trained and
 Physician, nurses, midwives, motivated health workers, a well-maintained
sanitation inspectors. infrastructure, and a reliable supply of medicines
 Provincial health officers and technologies, backed by adequate funding,
 Dentist strong health plans and evidence-based policies.
 1957
 RA 1891 was enacted & amended - Integrated health services encompasses the
provisions in RA 1082. management and delivery of quality and safe
 1970s health services so that people receive a
 the Philippines health care Delivery continuum of health promotion, disease
system was restructured. prevention, diagnosis, treatment, disease-
 Health services are classified: management, rehabilitation and palliative care
primary, secondary, tertiary levels services, through the different levels and sites of
 1991 care within the health system, and according to
 RA 7160 (Local Government Code) their needs throughout the life course.
 Devolution of basic health services
 Establishment of local health board THE GLOBAL AND NATIONAL HEALTH CARE
in very province, city, & SYSTEM SITUATION
municipality. •It focuses at its centered care for people which
includes organized health needs to meet the
ROLES & RESPONSIBILITIES OF A COMMUNITY expectations of the communities.
HEALTH NURSE •This includes the management and delivery of
 Management Functions (Nurse Manager) a safe health services with good quality to
 Supervisory functions (Supervisor) provide a continuum health promotion, disease
 Nursing care function (Care provider) prevention, disease management, and palliative
 Collaborating & Coordinating function care services in different levels of intervention.
(collaborator & coordinator)
 Health promotion & education function
(Teacher)
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THE GLOBAL HEALTH CARE SYSTEM  Our actions and recommendations are
 World Health Organization is a specialized independent
agency of the United Nations (UN) that  Our decisions are fair, transparent and
manages the international public health. timely

GOAL: is to ensure that a billion more people  Professionals committed to excellence in

have universal health coverage, to protect a health
billion more people from health emergencies,  We uphold the highest standards of
and provide a further billion people with better professionalism across all roles and
health and well-being. specializations
OBJECTIVE: “The attainment by all peoples of  We are guided by the best available
the highest possible level of health" science, evidence and technical
expertise
 WHO is supporting countries in  We continuously develop ourselves and
implementing people-centered and innovate to respond to a changing
integrated health services by way of world
developing policy options, reform strategies,
evidence-based guidelines and best  Persons of integrity
practices that can be tailored to various  We practice the advice we give to the
country settings. world
 We engage with everyone honestly and
VALUES OF WORLD HEALTH ORGANIZATION in good faith
It reflects on:  We hold ourselves and others
 The principles of human rights accountable for words and actions
 Its universality
 Its established equity  Collaborative colleagues and partners
 Ethical standards of the organization  We engage with colleagues and
 Adheres to the UN values of integrity, partners to strengthen impact at
professionalism and respect for diversity country level
 We recognize and use the power of
WHO INDIVIDUALLY AND COLLECTIVELY diversity to achieve more together
COMMITTED TO PUT THESE VALUES INTO  We communicate openly with everyone
PRACTICE. and learn from one another
 Trusted to serve public health at all times
 We put people’s health interest first
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 People caring about people WORLD HEALTH ORGANIZATION HISTORY
 We courageously and selflessly defend
 Everyone’s right to health
 We show compassion for all human
beings and promote sustainable
approaches to health
 We strive to make people feel safe,
respected, empowered, fairly treated
and duly recognized
WORLD HEALTH ORGANIZATION (WHO)
MISSION:
- “To promote health, keep the world
safe and serve the vulnerable with
measurable impact for people at
country level”
VISION:
- “All people attain the highest possible
level of health.”
World Health Organization Structure
• More than 7000 people from more than 150
countries working in 150 country offices, in 6
regional offices and at WHO headquarters in
Geneva, Switzerland
• Organization of 194 Member States. The
Member States elect the Director-General, who
leads the organization in achieving its global
health goals.
 “Together for a healthier world”- Dr Tedros
Adhanom Ghebreyesus (WHO Director-
General)
 Dr Graham Harrison (Officer-in-charge office
of the WHO)- Representative of the Phil.
 The Philippines, one of the WHO founders,
joined WHO on 9 July 1948.
 On 1 June 1951, the Philippine Government
and the World Health Organization signed a
Host Agreement for the establishment of
the Regional Office in Manila.
 The WHO Representative Office for the
Philippines was established in Manila in
January 1973.
 1945: diplomats met to form the United
Nations and one of the things they discussed
was setting up a global health organization.
 April 7, 1948 – WHO’s Constitution came
into force on and World Health Day.
For Universal Health Coverage, WHO:
• focus on primary health care to improve access
to quality essential services
• work towards sustainable financing and
financial protection
• improve access to essential medicines and
health products
• train the health workforce and advise on
labour policies
• support people's participation in national
health policies
• improve monitoring, data and information.
For Health Emergencies, WHO:
 prepare for emergencies by identifying,
mitigating and managing risks.
 detect and respond to acute health
emergencies
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 prevent emergencies and support
development of tools necessary during
outbreaks
 support delivery of essential health services
in fragile settings.
For Health and Well-being, WHO:
• address social determinants
• promote inter-sectoral approaches for health
• prioritize health in all policies and healthy
settings.
WHO works to address:
• human capital across the life-course
• Non-communicable diseases prevention
• mental health promotion
• climate change in small island developing
states
• antimicrobial resistance (AMR)
• elimination and eradication of high- impact
communicable diseases.
MILLENNIUM DEVELOPMENT GOALS (MDG)
•Were eight international development goals for
the year 2015 that had been established
following the Millennium Summit of the United
Nations in 2000, following the adoption of the
United Nations Millennium Declaration.
•The Sustainable Development Goals succeeded
the MDGs in 2016.
8 MDG’s:
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower
women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/Aids, malaria and other diseases
7. Ensure environmental sustainability
8. A global partnership for development
SUSTAINABLE DEVELOPMENT GOALS (SDGs)
- or Global Goals, were adopted by all United
Nations Member States in 2015 as a universal
call to action to end poverty, protect the planet
and ensure that all people enjoy peace and
prosperity by 2030.
1. No poverty
2. No hunger
3. Good health
4. Quality education
5. Gender equality
6. Clean water and sanitation
7. Renewable energy
8. Good jobs and economic growth
9. Innovation and infrastructure
10. Reduced inequalities
11. Sustainable cities and communities
12. Responsible consumption
13. Climate action
14. Life below water
15. Life on land
16. Peace and justice
17. Partnerships for the goals
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THE DEPARTMENT OF HEALTH Undersecretary of Health
(Kagawaran ng Kalusugan)  Dr. Lilibeth C. David, MPH, MPM, CESO I
- The Department of Health (DOH) is the (Health Policy and Infrastructure
principal health agency in the Philippines. It is Development Team/ HPIDT)
responsible for ensuring access to basic public
health services to all Filipinos through the  Dr. Abdullah B. Dumama, Jr., MPA, CESO I
provision of quality health care and regulation of (Field Implementation and Coordination
providers of health goods and services. Team/ FICT)
Philippine HealthCare System.
VISION: Filipinos are among the healthiest Local Health System Historical Background
people in Southeast Asia by 2022, and Asia by  Philippine Health Care System – based in
2040 Manila Control agency provided the singular
MISSION: To lead the country in the sources of resources, policy direction,
development of a productive, resilient, equitable technical, and administrative supervision to
and people-centered health system all health facility nationwide.
 1991 – passage of the Local Government
DOH Major Roles: Code RA 7160 all structures, personnel, &
1. Leadership in health budgetary allocations from the provincial
2. Enabler and capacity builder health level down to the barangays.
3. Administrator of specific services
RA 7160 (Local Government Code)
DOH Work Values •Local government executives responsible to
 Integrity operate local health care services.
 Excellence •Centers of authority consist of: provincial, city,
 Professionalism municipal governments, including an
 Commitment autonomous regional government & a
 Compassion and respect for human dignity metropolitan authority.
 Teamwork •Each center controls a portion of the health
 Stewardship of the health of the people care system as part of the political &
administrative mandate.
DOH Officer-in-charge Provincial Governments: Operates the:
 Dr. Maria Rosario S. Vergeire, MPH, CESO II Hospital system, Provincial & District
hospitals
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City/Municipal Governments: Operate KEY ACTORS AND THEIR RELATIONSHIPS

the : Health Centers Rural Health Units

(RHUs) Barangay Health Stations(BHS)

Objectives for Local Health Systems:

1. Establish local health systems for effective &
efficient delivery of health care services.
2. Upgrade the health care management &
services capabilities of local health facilities.
3. Promote Inter-LGU linkages & cost sharing
schemes including local health care financing
systems for better utilization of local health
resources.
4. Foster participation of the private sector, non-
government organizations (NGOs) &
communities in local health systems
development.
5. Ensure the quality of health services delivery
at the local level.
Managing Service Delivery
Level Administrative Point
Body
National DOH National Hospital
NNC
POPCOM
Regional DOH Regional Hospital
NNC
POPCOM
L Provincial PHO Provincial
G PNC Hospital
U PPO
Municipal/C M/CHO Community
ity M/CNC Hospital
M/CPO
Barangay District Health BHC
Unit BHS