BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
Source:
● Gesmundo, M. (2010) The Basics of Community
Health Nursing, C and E Publishing
● Maglaya, Araceli (2009) Nursing Practice in the
Community, 5 th Ed. Arganauta Publishing:
Marikina City.
● Cuevas, F., et al. (2007), Public Health Nursing in
the Philippines, 10 th Edition.Manila: C&E
Publishing Corporation.
Module 1: Introductory Concepts of Community
Health Nursing
Concepts of Public Health, Public Health Nursing, and
Community Health Nursing
● Public Health - A science and art of preventing
disease, prolonging life, promoting health and
efficiency through organized community effort for
the sanitation of the environment, control of
communicable diseases, the education of
individuals in personal hygiene, the organization of
medical and nursing services for the early
diagnosis and preventive treatment of disease, and
the development of the social machinery to insure
everyone a standard of living adequate for the
maintenance of health, so organizing these
benefits as to enable every citizen to realize his
birthright of health and longevity. (Dr. Charles
Edward Winslow)
● Public Health - is dedicated to the common
attainment of the highest level of physical, mental
and social well-being and longevity consistent with
available knowledge and resources at a given time
and place. (Hanlon)
● Public Health - is the art of applying science in the
context of politics so as to reduce inequalities in
health while ensuring the best health for the
greatest number. It points to the fact that public
health is a core element of the government’s
attempts to improve and promote the health and
welfare of their citizens. (WHO)
● Public Health Nursing
○ The practice of nursing in national and
local government health department, and
public schools.
○ It is community health nursing practiced in
the public sector. (Standard of Public
Health Nursing in the Philippines, 2005)
● Public Health Nursing - is a special field of
nursing that combines the skills of nursing, public
health and some phases of social assistance and
functions as part of the total public health
programme for the promotion of health, the
improvement of the conditions in the social and
physical environment, rehabilitation of illness and
disability.(WHO Expert Committee of Nursing)
● Community Health Nursing - is a unique blend of
nursing and public health practice woven into a
human service that when properly developed and
applied has a tremendous impact on human
well-being. Its responsibilities extend to the care
and supervision of individuals and families in their
homes, in places of work, in schools and clinics. It
is one of the basic services of the health
departments.
● Community Health Nursing - is the utilization of
MIFLORES, VENSON | BSN 2
the nursing process in the different levels of
clientele concerned with the promotion of health,
prevention of disease and disability and
rehabilitation. (Maglaya, Araceli)
○ Broader sense
○ Includes CHN in both public and private
sectors
● Community Health Nursing is a learned practice
discipline with the ultimate goal of contributing, as
individuals and in collaboration with others, to the
promotion of the client’s optimum level of
functioning through teaching and delivery of care.
(Jacobson)
History of Community Health Nursing
The history of Public Health Nursing is embedded in the
history of the Department of Health which was first
established as the Department Public Works, Education and
hygiene in 1898.
● 1912. The Fajardo act (Act NO. 2156) created the
sanitary divisions
○ PGH sent 4 nurses to Cebu to take care of
mothers and their babies.
● 1914. School nursing was rendered by a nurse
employed by the Bureau of Public Health in
Tacloban, Leyte.
● Two nurses, Mrs. Casilang Eustaquio and Mrs.
Matilde Azurin were employed for MCH and
sanitation
● 1916-1918 - Ms. Perlita Clark took charge of the
Public Health Nursing work.
● 1917 - Four graduate nurses paid by the city
of Manila were employed to work in the city
division.
● 1918 - The office of Miss Clark was abolished
due to lack of funds.
● 1919 - Ms. Carmen del Rosario, the first Filipino
nurse supervisor was appointed under the
Bureau of Health.
● 1923 - Two government schools of nursing were
established
○ Zamboanga General Hospital School of
Nursing
○ Baguio General Hospital
● July 1, 1926 - Ms. Carmen resigned and Ms.
Genara Manongdo, ranking supervisor of
American Red Cross replaced her.
● 1927 - The office of District Nursing under the
Office of General Inspection of Health Service was
abolished and replaced by the Section of Public
Health Nursing with Mrs. Genara de Guzman as
consultant to the Director of Health.
● 1928 - First convention of nurses was held until the
advent of World War II.
● 1930 - Conversion of Section of Public Health
Nursing into Section of Nursing
● 1933 - Reorganization Act 4007 transferred the
Division of Maternal and Child Health of the Office
of Public Welfare Commission to the Bureau of
Health.
● 1941 - Transferring of activities and personnel of
the Metropolitan Division and Bureau of Health
transferred to a new department with Dr. Mariano
Icasiano as City Health Officer of Manila; also and
Office of Nursing was established with Mrs. Vicenta
C. Ponce as Chief Nurse and Mrs. Rosario A.
Ordiz as her assistant.
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● December 8, 1941 - Health nurses in Manila were
assigned to devastated areas to attend to the sick
and wounded during World War II.
● 1942 - A group of health nurses, doctors and
administrators from the Manila Health Department
went to the internment camp in Capas, Tarlac to
receive sick prisoners of war by the Japanese
army. They were confined at San Lazaro Hospital
and sixty-eight National Public Health Nurses took
care of them.
● July 1942 - Thirty-one nurses taken prisoners of
war by the Japanese army and jailed in Bilibid
Prison in Manila were released to the Director of
the Bureau of Health, Dr. Eusebio Aguilar, their
guarantor. Public Health Nurses joined guerillas
during the World War II.
● February 1946 - Comparison of war records of the
Bureau of Health: a. 308 public nurses and 38
supervisors (post war), b. 556 nurses and 38
supervisors (pre-war). Mrs. Genara M. de Guzman,
technical assistant in Nursing of the Department of
Health recommended the creation of a Nursing
Office of the DOH.
● October 7, 1947 - Executive Order (EO) NO. 94
reorganized government offices and created the
Division of Nursing under the Office of the
Secretary of Health implemented on December 16,
1947. Mrs. Genara de Guzman was appointed as
Chief of the Division with three assistants: Ms.
Annie Sand (Nursing Ed.), Mrs. Magdalena C.
Valenzuela (Public Health Nursing) and Mr.
Patrocinio Montellano for Staff Education.
● The Nursing Division was placed directly under the
Secretary of Health for bureaus and units to help
carry out health programs. At the Bureau of Health,
the Section of Nursing Supervision took over the
former function of the Section of Nursing. Mrs.
Soledad Buenafe was appointed Chief with Ms.
Marcela Gabatin as assistant Chief. The newly
created Section of Puericulture Center of the
Bureau of Hospitals had Mrs. Teresa Malgapo as
Chief.
● 1948 - The first training Center of the Bureau of
Health was organized in cooperation with Pasay
Cit Health Department housed at the Tabon Health
Center which was later renamed as Doña Marta
Health Center. The staff consisted of Dr. Trinidad
A. Gomez, Center Physician; Ms. Marcela Gabatin,
Nurse Supervisor; Ms. Constancia Tuazon, Mrs.
Bugarin and Ms. Ramos as Nurse Instructors, later
on joined by Ms. Zenaida Panlilio, National Public
Health Nurse of the Bureau of Health.
● 1950 - The Rural Health Demonstration and
Training Center (RHDTC) was established by the
Dept. of Health through Dr. Hilario Lara, Dean of
the Institute of Hygiene, now College of Public
Health, University of the Philippines. Dr. Amansia
Mangay (Mrs. Andres Angara), a Doctor of Public
Health graduate of Harvard was chosen to be
Chief of the RHDTC. Dr. Antonio N. Acosta, former
Physician of the Manila Health Dept. was Medical
Training Officer. The first Supervising Training
Nurse was Ms. Marta Obaña with Ms. Jean
Bactat, Mrs. Mary Velono and Mrs. Natividad B.
Asuque as Nurse Instructor.
● 1953- The office of the Health Ed. and Personnel
Training was established with Dr. Trinidad Gomez
as Chief. Four nurse instructors were recruited,
MIFLORES, VENSON | BSN 2
BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
two from the Manila Health Dept, Mrs. Venancia
Cabanos and Mrs. Damasa Torrejon and two from
the BOH, Ms. ZenaidaY. Panlilio and Ms. Leonora
Liwanag (first graduates of the University of the
Philippines, College of Nursing to join the BOH).
● Republic Act No. 1082 or the Rural Health Law
created the first 81 Rural Health Units. Among the
first public health nurses assigned to the Rural
units were two graduates of class 1952 of the
Philippine General Hospital School of Nursing,
Miss Florida B. Ramos (Mrs. Martinez) and Ms.
Lydia Amurao (Mrs Cabigao).
● 1957 - Republic Act 1891 was approved amending
Sections II, III, IV, VII and VIII of the R.A. 1082.
This second Rural Health Act created 8 categories
of rural health units based on population. ❖ 1958-
1965- R.A. 977 passed by the Congress in 1954
abolished the Division of Nursing, creating nursing
positions at different levels. Ms. Annie Sand was
appointed Nursing Consultant under the Office of
the Secretary of Health.
● Two nurses of the former Bureau of Hospitals
worked with the Nursing consultant: Ms. Rosita
Furia for Hospital Nursing Service, and Ms. Eva
Obsequio for Nursing Education. Mrs. Rosita
Villanueva and Mrs. Juanita Hospitals vice Ms.
Furia and Ms. Obsequio when they retired.
● The Department of Health National Leagues of
Nurses, Inc was founded by Ms. Annie Sand in
1969 and became its President and Adviser. The
Reorganization Act embodied in EO 288, Series of
1959 de centralized and integrated health services
creating 8 Regional Health offices in the country.
● At the Regional level two supervising positions for
nurses were created: Regional Nurse Supervisor
and Regional Public Health Nurse.
● The Supervising Public Health Nurses (SPHN) at
the Provincial Health supervised the public health
nurses at the Rural Health Units as well as the
Chief Nurses in Hospitals.
● The reorganization of 1959 also merged two
Bureaus in the Dept. of Health: The Bureau of
Health (in charge of preventive programs) merged
with Bureau of Hospitals (curative programs and
regulatory/licensing functions) to form the Bureau
of Health and Medical Services.
● In the merged Bureau of Health and Medical
Services, Nursing program supervisors were
appointed for the different programs. In the
Maternal and Child Health Division, Ms. Saturnina
Latorre, Mrs. Fe Bacaloso and later Mrs. Rosario
Zaraspe, Mrs. Isabel Pascua and Mrs. Emilia
Briones. In the occupational Health Division, Mrs.
Felisa V. Chanco was nurse in charge of
Occupational Health Nursing.
● 1967 – In the Bureau of Disease Control, Mrs.
Zenaida Panlilio-Nisce was appointed as Nursing
Program Supervisor and served as consultant on 5
diseases: TB. Leprosy, Venereal Diseases, Cancer
and Filariasis; and Mental Health.
● At the Office of Health Education and Personnel
Training, the nurses were Mrs. Josefina A.
Mendoza, Supervising Nurse Instructor, Ms.
Carmen Panganiban, Ms. Virginia Orais and later
Mrs. Constancia Asinas.
● November 1971 – Mrs. Josefina A. Mendoza,
Supervising Nurse Instructor, Office of the Health
Education and Personnel Training succeeded Ms.
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Annie Sand as Nursing Consultant. Later, Mrs.
Nelida K. Castillo, former Nurse Instructor at San
Lazaro Hospital and counterpart to Ms. Helen
Filmore, WHO consultant of Pediatric Nursing was
appointed Nursing Program Supervisor, Office of
the Secretary of Health
● 1974 - The Project Management Staff was
organized as part of Population Loan II of the
Philippine Government with Dr. Francisco as
Project Manager. Experts on different fields were
recruited and Mrs. Nelida Castillo joined the PMS
staff. Her position as Nursing Program Supervisor,
Office of the Secretary of Health was taken over
by Mrs. Zenaida Nisce, Nursing Program
supervisor Bureau of Disease Control. Ms. Julita
Yabes, faculty member of the Institute of Hygiene
(now College of Public Health) University of the
Philippines served as consultant on nursing
matters in the Project Manage Staff.
● 1975 – As a result of the restructuring of the health
care delivery system based on the findings of the
Operations Research (WHO assisted) conducted in
the province of Rizal the functions of the health
team were redefined.
● 1976-1986 – The Nursing Consultant and Nursing
Program Supervisor of the Office of the Secretary
of Health were involved in the Rural Health
Practice Program which required medical and
nursing graduates to serve for two months in rural
areas before the licenses could be issued by the
Professional Regulatory Commission.
● 1986 – The reorganization of the Department of
Health during this period placed the position of
Nursing Consultant at the Bureau of Health and
Medical Services later abolished when Mrs.
Mendoza retired. Mrs. Zenaida Nisce remained as
Nursing Program Supervisor of the Office of the
Secretary of Health.
● The other nursing positions at the Central Office
were at the National Family Planning Service.
Among these nurses were Miss Leonora Liwanag,
Ms. Virginia Orais, Mrs. Vilma Paner, Mrs. Sarah
Austria and Mrs. Leticia Daga, Mrs. Nelia Hizon
joined the NFPS when Miss Liwanag retired.
● 1987-1989 – Executive Order No. 119 reorganized
the Department of Health and created several
offices and services within the Department of
Health.
● 1990-1992 – The number of positions of Nursing
Program Supervisors (Nurse VI) was increased as
there were three or more appointed in each
service. In the Maternal and Child Health Services
Mrs. Emilia Briones and Mrs. Nilda Silvera and
Mrs. Vicenta Borja. Mrs. Asucena Alcantara and
Mrs. Lucila Agripa later joined them.
● In the non-communicable Disease Control Service
(NCDCS), the first two Nursing Program
Supervisors were Mrs. Gloria Temelo and Miss
Gilda Estipona who were with the cardiovascular
and cancer control programs respectively. In 1989,
Mrs. Carmen Buencamino joined the Occupational
Health Division. When these three nurses retired
one after another, their positions were taken over
by Miss Ma. Thelma Bermudez, Ms. Frances
Prescilla Cuevas and Mrs. Ma. Theresa Mendoza.
● The three nurses at the Communicable Disease
Control Service, Mrs. Zenaida P. Nisce, Mrs.
Carolina A. Ruzol and Mrs. Zenaida Recidoro
MIFLORES, VENSON | BSN 2
BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
participated in the planning, training, monitoring,
supervision and evaluation of diseases. At the
Community Health Service, the Nursing Program
Supervisor was Mrs. Patrocinio Ferrera. At the
Department of Health Administrative Service there
were four Public Health
● Nurses and one Senior Public Health Nurse
assigned at the Medical Examination Division and
Infirmary (MEDI) formerly called the Physical
Examination Division.
● January 1999 – Department Order No. 29
designated Mrs. Nelia F. Hizon, Nurse VI, then the
President of the National League of Philippine
Government Nurses as Nursing Adviser
● May 24, 1999 – Executive Order No. 102 was
signed by the President Joseph Ejercito Estrada
redirecting the functions and operations of the
DOH.
● 2005-2006 – The development of the
rationalization plan to streamline (simplify) the
bureaucracy (official procedure) was started and is
in the last stages of finalization.
Historical Development of Community Health Nursing in
the Philippines
● Before (1898) – Traditional health care practices
especially the use of herbs and rituals for healing
were practiced. In 1876, Medicos Titulares,
equivalent to provincial health officers were already
existing. In 1888, a Superior Board of Health and
Charity was created by the Spaniards which
established a hospital system and a board of
vaccination.
● June 23, 1898 – Shortly after the proclamation of
the Philippine independence from Spain. The
Department of Public Works, Education and
hygiene was created by a decree signed by Pres.
Emilio Aguinaldo. However, this was short live
because of the American invasion.
● September 29, 1898 – With the primary objective of
protecting the health of the American soldiers,
General Orders No. 15 established the Board of
Health for the City of Manila.
● July 1, 1901 - because it was realized that it was
impossible to protect the American soldiers without
protecting the natives, a board of Health for the
Philippine Islands was created through Act No. 157.
It became an Insular Board of Health when Act
Nos. 307, 308 dated December 2, 1901 established
the Provincial and Municipal boards respectively.
The Insular Board of Health proved to be inefficient
operationally so it was abolished and replaced with
the Bureau of Health under the Department of
Boards of Health.
● 1912 - Act No. 2156 also known as the Fajardo act,
consolidated municipalities into sanitary divisions
and established the Health Fund for travel and
salaries.
● 1915 - Act No. 2468 transformed the Bureau of
Health into a commissioned service called the
Philippine Health Service.
● August 2, 1916 - The passage of the Jones Law
also known as the Philippine Autonomy Act
provided the highlight in the struggle of the Filipinos
for independence from the American Rule. The
establishment of an elective Philippine Senate
completed an all Filipino Philippine Assembly which
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majored in reorganization, culminating the
Administrative Code of 1917 (Act 2711), which
included the Public Health Law of 1917.
● 1932 - Because of the need to coordinate public
health, Act No. 4007 known as the Reorganization
Act of 1932 reverted back the Philippine Service
into Bureau of Health, and combined the Bureau of
Public Welfare under the Office of the
Commissioner of Health and Public Welfare
The Philippine Commonwealth and the Japanese
Occupation (1935- 1945)
● May 31, 1939 - Commonwealth Act No. 430 created
the Department of Public Health and Welfare but
the full implementation was only completed through
Executive Order no. 317, January 7, 1941. Dr Jose
Fabella became the First Department Secretary of
Health and Public Welfare Act in 1941.
● 1942 - During the period of the Japanese
occupation reorganizations and issuances for the
health and welfare of people were instituted.
● October 4, 1947 - Executive Order No. 94 provided
for the post war reorganization of the Department
of Health and Public Welfare which resulted in the
split of the Department and transfer of the Bureau
of Public Welfare (became Social Welfare
Administration) and the Philippine General Hospital
to the office of the President.
● January 1, 1951 - The office of the President of the
Sanitary District was converted into a Rural Health
Unit, carrying out seven basic Health services:
maternal and child health, environmental health,
communicable disease control, vital statistics,
medical care, health education and public health
nursing. The impact of the community was so
strong that it resulted in the passage of the Rural
Health Act of 1954 (RA 1082). This Act created
more health units and created posts for municipal
health.
● February 20, 1958 - Executive Order No. 288
provided for what is described as the “most
sweeping” reorganization in the History of the
Department. This came about as an effort to
decentralize governance of health services.
● 1970 - The Restructured Health Care Delivery
System was conceptualized. It classified health
services into primary, secondary and tertiary levels
of care. Under this concept the ration of a nurse to a
population is 1: 20,000. The expanded role of the
public health nurse was highlighted
● June 2, 1978 - With the proclamation of martial law
in the country, Presidential Decree 1397 renamed
the Department of Health to the Ministry of Health
with Sec. Gatmaitan as its first Minister of Health. ❖
December 2, 1982- Executive Order No. 851 signed
by President Ferdinand Marcos reorganizes the
Ministry of Health as an integrated health care
delivery system through the creation of the
Integrated Provincial Health Officers.
● April 13, 1987 - Executive Order No. 119,
“Reorganizing the Ministry of Health” by President
Corazon C. Aquino saw a major change in the
structure of the ministry. EO 119 clustered agencies
and programs under the Office for Public Health
Regulations and Office of Management Services.
The Field Offices were composted of the Regional
Health Offices and National Health Facilities. The
MIFLORES, VENSON | BSN 2
BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
latter was composed of National Medical Centers,
Special Research Centers and Hospitals.
● October 10, 1991 - Republic Act 7160 also known
as the Local Government Code provided for the
decentralization of the entire government. Under
this law, all structures, personnel and budgetary
allocations from the provincial health level down to
the barangays were devolved to the Local
Government Units to facilitate health service
delivery.
● May 24, 1999 - EO No. 102, “Redirecting the
Functions and Operations of the Department of
Health” by President Joseph Estrada granted the
DOH to proceed with its Rationalization and
Streamlining Plan which prescribed the current
organizational, staffing and resource structure
consisted with its new mandate. EO 102 mandates
the Department of Health to provide assistance to
local government units, people’s organization, and
other members of the civic society in implementing
programs, projects and services which promote the
health and well-being of every Filipino.
● 1999-2004 – Development of the Health Sector
Reform agenda which describes the major
strategies, organization and policy changes and
public investments needed to improve the way
health care is delivered, regulated and financed.
● 2005 - on-going!
Roles of a Community Health Nurse
A) Client-oriented roles
● Caregiver
● Educator
● Counselor
● Referral resource
● Role model
● Case manager
B) Delivery-oriented roles
● Coordinator
● Collaborator
● Liaison
C) Population-oriented roles
● Case finder
● Leader
● Change agent
● Community mobilizer
● Coalition builder
● Policy advocate
● Social marketer
● Researcher
Functions of a Public Health Nurse
● Provision of Health and Nursing Care
○ Utilizes the nursing process in the care of
client in the home setting through home
visits and in public health care facilities;
conducts referral of patients to appropriate
levels of care when necessary. Health
Education
○ Utilizes teaching skills to improve the
health knowledge, skills and attitude of the
individual, family and the community and
conducts health information campaigns to
various groups for the purpose of health
promotion and disease prevention.
4

● Coordination & Collaboration
○ Establishes linkages and collaborative
relationships with other health
professionals, government agencies, the
private sector, non-government
organizations and people’s organizations
to address health problems
● Supervision
○ Monitors and supervises the performance
of midwives and other auxillary health
workers; also initiate the formulation of
staff development and training programs
for midwives and other auxillary health
workers as part of their training function as
supervisor.
● Leader and Change Agent
○ Influences people to participate in the
overall process of community
development.
● Management
○ Organizes the nursing service component
of the local health agency or local
government unit; and as program
manager, the PHN is responsible for the
delivery of the package of services
provided by the health program to the
target clientele.
● Researcher
○ Participates in the conduct of research and
utilizes research findings in practice.
Levels of Clientele
A) Individual
● Individual - Sick or well individuals in the home
and health center.
● Considered as the entry point in working with the
family.
B) Family
● Family-two or more persons bound together by
blood, marriage, or adoption.
C) Population group
● Population Group-a group of people sharing the
same characteristics, developmental stage, or
common exposure to particular environmental
factors thus resulting in community health
problems.
D) Community
● Community-group of people sharing common
geographic boundaries and/or common values
and interests.
● No two communities are the same.
● Exerts a strong influence on health of individuals,
families and communities.
Module 2: Concepts of an Individual, His Rights, and
the Determinants of Health
A. Biological Concepts in Looking at Individual
1. ATOMISTIC - Divided into separate elements
2. HOLISTIC - Relating to a study of the whole instead
of a separation into parts
MIFLORES, VENSON | BSN 2
BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
B. Perspetives in Understanding an Individual
Biological
● Biological - Related by consanguinity, especially to
parents
● Unified whole - Operates as a single entity
● Holon - something that is both a part and a whole
e.g. an individual is autonomous, but also part of a
family, which is part of an extended family, which is
part of the community.
● Dimorphic - Existing in two different forms
● Dimorphism - The occurrence in an animal species
of two distinct types of individuals
Anthropological
● Anthropology - The holistic and scientific and
social study of humanity.
● Anthropological - Relating to the study of human
kind.
● Essentialism (sociology) - The view that all
members of certain groups of people (such as those
of the same race, gender, age or sexual orientation)
have common, essential traits inherent to the
defining feature of the group.
● Constructionism (in social science) - The idea that
people learn about, or perceive the world by
constructing mental models
● Culture - The arts, customs, lifestyles, background,
and habits that characterize a particular society or
nation.
○ The beliefs, values and behavior and
material objects that constitute a people’s
way of life.
○ In anthropology-any knowledge passed
from one generation to the next.
Psychological
● Psychosexual - Involving the psychological
aspects of the sexual impulse
● Sigmund Freud - (Surname of German origin) an
Austrian neurologist, psychotherapist, and founder
of psychoanalysis-(oral-birth to 1 year, anal-1-3
years, phallic-3-6 y, latent-6-puberty –libido inactive,
genitals-puberty to death-maturing sexual interests)
● Psychosocial - Relating to the interrelation of
social factors and individual thought and behavior.
● Erik Erikson (8 stages) - trust vs mistrust,
autonomy vs shame and doubt, initiative vs guilt,
industry vs inferiority, identity vs confusion, intimacy
vs isolation, generativity vs isolation, integrity vs
despair
○ Described the impact of social
experienceacross the whole lifespan
○ Interested in how social interaction and
relationships played a role in the
development and growth of human beings
● Behaviorism - An approach to psychology focusing
on observable behavior, denying any independent
significance for mind, and usually assuming that
behavior is determined by the environment.
Sociological
● Social learning - Theorized by Albert
Bandura-posits that people learn from one another
via observation, imitation and modelling.
○ 1. Family and kinship
○ 2. Social groups
● Sociological - Pertaining to sociology
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● Sociology is the study of society, patterns of social
relationships, social interaction and culture of
everyday life. It is a social science that uses various
methods of empirical investigation and critical
analysis to develop a body of knowledge about
social order, acceptance, and change or social
evolution.
C. The Individual as a Client
● Individual is a single human being, a person, a
distinct indivisible entity.
● The CHN deals with individuals; sick or well on a
daily basis.
● Since the health problems of individuals are
intertwined with those of the other members of the
family and community,
● Individuals are considered as the entry point in
working with the family and community.
D. The Rights of an Individual
Article III: Bill of Rights
1987 PHILIPPINE CONSTITUTION
ARTICLE III, BILL OF RIGHTS
Section 1. No person shall be deprived of life, liberty, or
property without due process of law, nor shall any person be
denied the equal protection of the laws.
Section 2. The right of the people to be secure in their
persons, houses, papers, and effects against unreasonable
searches and seizures of whatever nature and for any
purpose shall be inviolable, and no search warrant or warrant
of arrest shall issue except upon probable cause to be
determined personally by the judge after examination under
oath or affirmation of the complainant and the witnesses he
may produce, and particularly describing the place to be
searched and the persons or things to be seized.
Section 3. (1) The privacy of communication and
correspondence shall be inviolable except upon lawful order
of the court, or when public safety or order requires
otherwise, as prescribed by law. (2) Any evidence obtained
in violation of this or the preceding section shall be
inadmissible for any purpose in any proceeding.
Section 4. No law shall be passed abridging the freedom of
speech, of expression, or of the press, or the right of the
people peaceably to assemble and petition the government
for redress of grievances.
Section 5. No law shall be made respecting an establishment
of religion, or prohibiting the free exercise thereof. The free
exercise and enjoyment of religious profession and worship,
without discrimination or preference, shall forever be
allowed. No religious test shall be required for the exercise of
civil or political rights.
Section 6. The liberty of abode and of changing the same
within the limits prescribed by law shall not be impaired
except upon lawful order of the court. Neither shall the right
to travel be impaired except in the interest of national
security, public safety, or public health, as may be provided
by law.
Section 7. The right of the people to information on matters
of public concern shall be recognized. Access to official
records, and to documents and papers pertaining to official
MIFLORES, VENSON | BSN 2
BSN-2 | Community Health Nursing 1 🧑‍🤝‍🧑
acts, transactions, or decisions, as well as to government
research data used as basis for policy development, shall be
afforded the citizen, subject to such limitations as may be
provided by law.
Section 8. The right of the people, including those employed
in the public and private sectors, to form unions,
associations, or societies for purposes not contrary to law
shall not be abridged.
Section 9. Private property shall not be taken for public use
without just compensation.
Section 10. No law impairing the obligation of contracts shall
be passed.
Section 11. Free access to the courts and quasi-judicial
bodies and adequate legal assistance shall not be denied to
any person by reason of poverty.
Section 12. (1) Any person under investigation for the
commission of an offense shall have the right to be informed
of his right to remain silent and to have competent and
independent counsel preferably of his own choice. If the
person cannot afford the services of counsel, he must be
provided with one. These rights cannot be waived except in
writing and in the presence of counsel. (2) No torture, force,
violence, threat, intimidation, or any other means which
vitiate the free will shall be used against him. Secret
detention places, solitary, incommunicado, or other similar
forms of detention are prohibited. (3) Any confession or
admission obtained in violation of this or Section 17 hereof
shall be inadmissible in evidence against him. (4) The law
shall provide for penal and civil sanctions for violations of this
section as well as compensation to the rehabilitation of
victims of torture or similar practices, and their families.
Section 13. All persons, except those charged with offenses
punishable by reclusion perpetua when evidence of guilt is
strong, shall, before conviction, be bailable by sufficient
sureties, or be released on recognizance as may be provided
by law. The right to bail shall not be impaired even when the
privilege of the writ of habeas corpus is suspended.
Excessive bail shall not be required.
Section 14. (1) No person shall be held to answer for a
criminal offense without due process of law. (2) In all criminal
prosecutions, the accused shall be presumed innocent until
the contrary is proved, and shall enjoy the right to be heard
by himself and counsel, to be informed of the nature and
cause of the accusation against him, to have a speedy,
impartial, and public trial, to meet the witnesses face to face,
and to have compulsory process to secure the attendance of
witnesses and the production of evidence in his behalf.
However, after arraignment, trial may proceed
notwithstanding the absence of the accused: Provided, that
he has been duly notified and his failure to appear is
unjustifiable.
Section 15. The privilege of the writ of habeas corpus shall
not be suspended except in cases of invasion or rebellion,
when the public safety requires it.
Section 16. All persons shall have the right to a speedy
disposition of their cases before all judicial, quasi-judicial, or
administrative bodies.
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Section 17. No person shall be compelled to be a witness
against himself.
Section 18. (1) No person shall be detained solely by reason
of his political beliefs and aspirations. (2) No involuntary
servitude in any form shall exist except as a punishment for a
crime whereof the party shall have been duly convicted.
Section 19. (1) Excessive fines shall not be imposed, nor
cruel, degrading or inhuman punishment inflicted. Neither
shall death penalty be imposed, unless, for compelling
reasons involving heinous crimes, the Congress hereafter
provides for it. Any death penalty already imposed shall be
reduced to reclusion perpetua. (2) The employment of
physical, psychological, or degrading punishment against
any prisoner or detainee or the use of substandard or
inadequate penal facilities under subhuman conditions shall
be dealt with by law.
Section 20. No person shall be imprisoned for debt or
non-payment of a poll tax.
Section 21. No person shall be twice put in jeopardy of
punishment for the same offense. If an act is punished by a
law and an ordinance, conviction or acquittal under either
shall constitute a bar to another prosecution for the same
act.
Section 22. No ex post facto law or bill of attainder shall be
enacted.
Appendix B
PHILIPPINE PATIENT’S BILL OF RIGHTS
1. The patient has the right to considerate and respectful
care irrespective of socio-economic status.
2. The patient has the right to obtain from his physician
complete current information concerning his diagnosis,
treatment and prognosis in terms the patient can reasonably
be expected to understand. When it is not medically
advisable to give such information to the patient, the
information should be made available to an appropriate
person in his behalf. H has the right to know by name or in
person, the medical team responsible in coordinating his
care.
3. The patient has the right to receive from his physician
information necessary to give informed consent prior to the
start of any procedure and/or treatment. Except in
emergencies, such information for informed consent should
include but not necessarily limited to the specific procedure
and or treatment, the medically significant risks involved, and
the probable duration of incapacitation. When medically
significant alternatives for care or treatment exist, or when
the patient requests information concerning medical
alternatives, the patient has the right to such information.
The patient has also the right to know the name of the
person responsible for the procedure and/or treatment.
4. The patient has the right to refuse treatment/life – giving
measures, to the extent permitted by law, and to be informed
of the medical consequences of his action
5. The patient has the right to every consideration of his
privacy concerning his own medical care program. Case
discussion, consultation, examination and treatment are
confidential and should be conducted discreetly. Those not
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directly involved in his care must have the permission of the
patient to be present.
6. The patient has the right to expect that all communications
and records pertaining to his care should be treated as
confidential.
7. The patient has the right that within its capacity, a hospital
must make reasonable response to the request of patient for
services. The hospital must provide evaluation, service
and/or referral as indicated by the urgency of care. When
medically permissible a patient may be transferred to another
facility only after he has received complete information
concerning the needs and alternatives to such transfer. The
institution to which the patient is to be transferred must first
have accepted the patient for transfer.
8. The patient has the right to obtain information as to any
relationship of the hospital to other health care and
educational institutions in so far as his care is concerned.
The patient has the right to obtain as to the existence of any
professional relationship among individuals, by name who
are treating him.
9. The patient has the right to be advised if the hospital
proposes to engage in or perform human experimentation
affecting his care or treatment. The patient has the right to
refuse or participate in such research project.
10. The patient has the right to expect reasonable continuity
of care; he has the right to know in advance what
appointment times the physicians are available and where.
The patient has the right to expect that the hospital will
provide a mechanism whereby he is informed by his
physician or a delegate of the physician of the patient’s
continuing health care requirements following discharge.
11. The patient has the right to examine and receive an
explanation of his bill regardless of source of payment.
12. The patient has the right to know what hospital rules and
regulation apply to his conduct as a patient.
E. Determinant of Health
● Many factors combine together to affect the health
of individuals and communities. Whether people are
healthy or not, is determined by their circumstances
and environment.
● To a large extent, factors such as where we live, the
state of our environment, genetics, our income and
education level, and our relationships with friends
and family all have considerable impacts on health,
whereas the more commonly considered factors
such as access and use of health care services
often have less of an impact.
● Determinants of health are a range of factors that
influence the health status of individuals or
populations. At every stage of life, health is
determined by complex interactions between social
and economic factors, the physical environment and
individual behavior. They do not exist in isolation
from each other.
● The social determinants of health are the conditions
in which people are born, grow, live, work and age.
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● These circumstances are shaped by the distribution
of money, power and resources at global, national
and local levels.
● The social determinants of health are mostly
responsible for health inequities - the unfair and
avoidable differences in health status seen within
and between countries.

● The determinants of health include:

● The social and economic environment, the physical
environment, and the person’s individual
characteristics and behaviors.
● The context of people’s lives determines their
health, and so blaming individuals for having poor
health or crediting them for good health is
inappropriate. Individuals are unlikely to be able to
directly control many of the determinants of health.

● Income and social status - higher income and

social status are linked to better health. The greater
the gap between the richest and poorest people, the
greater the differences in health
● Education – low education levels are linked with
poor health, more stress and lower self-confidence.
● Physical environment – safe water and clean air,
healthy workplaces, safe houses, communities and
roads all contribute to good health.
● Employment and working conditions – people in
employment are healthier, particularly those who
have more control over their working conditions
● Social support networks – greater support from
families, friends and communities is linked to better
health.
● Culture - customs and traditions, and the beliefs of
the family and community all affect health.
● Genetics - inheritance plays a part in determining
lifespan, healthiness and the likelihood of
developing certain illnesses.
● Personal behavior and coping skills – balanced
eating, keeping active, smoking, drinking, and how
we deal with life’s stresses and challenges all affect
health.
● Health services - access and use of services that
prevent and treat disease influences health
● Gender - Men and women suffer from different
types of diseases at different ages.

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