♥ Weighing Scale or tape measure for

Community Health mid-upper arm circumference

(Malnourishment)
Nursing 2 types of community:
- Geo political community
♥ Barangay
Lectured by: Z. Famorca, PhD, RN 
♥ City
♥ Province
A Pre-test on Basic Concepts
- Phenomenological
1. D.
2. B. GIDA- Geographically Isolated and Deprived Areas
3. B. - Cooperative Development Authority
4. B. ♥ Under the office of the president
5. A. - Many are from Mindanao
6. A.
- Hospice home care
7. C.
- Parish Community Nursing
8. A.
9. C. - Faith community nursing
10. C. DOTS
“Public health is supposed to be given for free” FALSE - Treatment partner – follows up medication
Financing of health services ♥ PHN appoints a treatment partner
- Out of pocket ♥ Another health worker that is accessible
- Health maintenance organization (Phil Health)
 – BHW
- Free at the point of care
3. Population/aggregate—focused
♥ Government—Taxes are paid
Test taking technique - “The greater good of the majority”
- When choosing numbers choose the middle - Community Diagnosis
ground ♥ Vital Statistics
- Do not choose the extreme numbers ♥ Demography
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
♥ Groups with common susceptibility - Preventive treatment, e.g. DOTS
♥ Same working group - Health Education
- Enabling service  self- reliance 5. Pre-paid service
- Health education—done for health promotion - Taxation (public and school health)
♥ Patient Education—Done when person
- Passed on to consumer (occupational)
is sick
-
Transfer of Technology
- Community organizing
6. Generalist Practice
2. Community-based Labor Code: Health, Safety and W elfare Benefits
- Catchment
- Book 4: Health, safety and welfare benefits
- Natural environment of people
Number of workers OH services
Home PHN 10-50 Graduate first aider who may be
School  SHN one of the workers
50-200 Non-hazardous: full-time first
Workplace OHN aider
3 fields of CHN Practice Hazardous workplace: OHN
200-300 OHN, Part-time physician and
- Case-finding of CHN practice dentist (at least 2hrs a day),
♥ Direct Sputum Smear Microscopy (TB) emergency clinic (1 bed: 100
workers) or hospital within 5 km
>300 Full time DMD and MD

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RA 124—mandates all schools to have a school clinic for
the treatment of minor ailments and attendance to
emergency cases (1947)
- School health physician reports to the board of  -
health (DOH)
Functions of OHN and SHN
1. Health care provider
- Promotive and preventive services
♥ Health advocacy
♥ Health education and counseling
♥ Immunization, prenatal care
- Treatment of common ailments and emergency
nursing care
♥ CD control
- Screening for health problems:
♥ School health and nutrition survey —
st
done on the 1 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
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BSN 2013
 - PHN functions as part of a total public health Primary level
program - Target population: well individuals, families,
♥ Health team groups and communities
♥ 1 municipal health plan - Aspects of prevention
- Objectives of PHN ♥ General health promotion
♥ Promotion of health ♥ Specific disease prevention
♥ Improvement of conditions in the o Prevent from a single person
physical and social environment ♥ Specific protection
♥ Rehabilitation o Groups of people
♥ Prevention of illness and disability o ASIN Law- “An Act for Salt
Basic competencies of the Public Health Nurse Iodization Nationwide ”
- Patient care competencies Secondary Level
♥ CHN process - Target Population: Early sick + subclinical cases
♥ Nursing procedures during clinic and (asymptomatic)
home visits - Aspects of prevention
♥ Surveillance ♥ Early diagnosis and prompt treatment
- Health promotion and education ♥ Prevention of complications
- Communication Tertiary Level
- Collaboration: community organizing - Target population: Late sick: convalescent,
- Empowering competencies disabled, complicated case, terminal ill
♥ Legal responsibility Natural hx of disease
♥ Ethico-moral responsibilities Pre- Pathogenesis
♥ Personal and professional development Pathogenesis
- Enabling competencies Interaction
♥ Management of resources and
environment
Pre-test
♥ Record management
1. A
- Enhancing competencies
2. D
♥ Research
3. 3
♥ Quality improvement
4. 4
Pre-test
5. 1
1. 1
6. 2
2. 2
7. D
3. 1
8. A
4. 1
9. B
5. 2
10. D
6. 1
11. B.
7. 3
12. A
8. 2
9. C
Millennium Summit: September 6-8, 2000
10. B.
1. Eradicate extreme poverty and hunger
Level of Prevention
2. Achieve universal primary education
- Target population:
3. Promote gender equality and empower women
♥ Beneficiaries (For whom?)
4. Reduce by2/3 the under 5 mortality rate
♥ Purpose of the nursing action: aspect of 
(1990:80/1000 live births 2015: 26.7/1000)
prevention (for what?)

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BSN 2013
 5. Reduce by ¾ the maternal mortality rate (1990:
2.09/1000 live births 2015: 52/1000 live
births) Universal Health Care
(2010-2016)
6. Combat HIV/AIDS, malaria and other disease
1993: eradication of  FOURmula One for
1. Polio Health (2005-2010)

2. Neonatal Tetanus
Health Sector Reform
3. Measles Agenda (1999-2004)
4. Rabies
7. Ensure environmental sustainability
8. Develop a global partnership for development Priority Health Policy Directions of the Aquino
World Health Organization (MDG4-6) Administration

The Department of Health

Financial Risk
Vision- Mission Protection
Vision
To staunch advocate, model and leader of health for all
in the Philippines
“A global leader for attaining better health Health
Achieving
facilities
MDGmax
outcomes, competitive and responsive health enhancement
care system, and equitable health financing. ”

Mission
“To guarantee equitable, sustainable and quality health Universal Health Care
for all Filipinos, especially the poor, and to lead the Strategies
quest for excellence in health. ” 1 2 3
Health Financing Service Delivery Policy and
Roles and functions of the DOH regulation
1. Leader 6 5 4
Health Human Health Governance for
a. Planner and policy-maker
Resource information Health
b. Regulator of health services
c. Advocate in the adoption of health policies,
Goals
plans and programs
Better Health Responsive Equitable health
2. Enabler and capacity builder outcomes health system financing
a. Develop new strategies in health
b. Initiate public discussion on health issues Health care delivery system of the Philippines
and disseminate info on research outputs Primary Level
c. Ensure standards of health promotion, - Promotion and prevention
protection and care (training) - Management of prevalent conditions
- Out-patient services
3. Administrator of specific services Secondary
a. Manage selected national health facilities - Hospitalization
b. Administer direct services for emergent Tertiary
health concerns that require new - Specialized care
complicated technologies ♥ Specially trained personnel
c. Administer health emergency responses ♥ Highly departmentalized

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BSN 2013
 ♥ Sophisticated equipment 5. D
6. B
National hospitals/DOH national office/ medical 7. A
centers/ university hospitals/ special hospitals 8. B
9. C
Center for health development 10. A

Prove Health Board 11. D

Provincial hospital (PHO) Chair: Governor
Vice-chair: IPHO
District hospital (DHO)

RHU/CHC/CHO Municipal/city Health Board

Chair: Mayor
BHS Vice-chair: Municipal Health Officer

RA 7160—devolution code

Inter Local Health System

- To ensure quality of health care service at the
local level integrate hospital and public
health services  holistic health care
- Inter Local Health Zone (ILHZ)
♥ Clustered municipalities (defined
population within a defined area)
♥ Primary level facilities (RHU’s and
BHS’s)
♥ Central referral hospital
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

Epidemiology
1. B
2. B
3. B
4. D

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BSN 2013