INTRODUCTION of COMMUNITY HEALTH NURSING SERVICES

 INTERPROFESSIONAL CARE IN THE COMMUNITY

o The World Health Organization defines it as “multiple health workers from different
professional backgrounds working together with patients, families, caregivers, and
communities to deliver the highest quality of care.”
o Benefits of Interprofessional Collaboration in Healthcare
 Improve patient care and outcomes
 Start treatment faster
 Reduce inefficiencies and healthcare costs
 Improve staff relationships and job satisfaction
o “Health in All Policies” as a concept and as a collaborative approach across sectors to
consider the health implications and impacts of public policies and decisions, including
mechanisms and tools for assessing such impacts, is a current limitation of the policy
development process in the health sector. However, several multisectoral mechanisms are
in place to discuss concerns and take appropriate actions on the health-related impacts of
policies, programs, and projects of other sectors.

 HEALTH CARE DELIVERY SYSTEM IN THE PHILIPPINES

o The Philippine health care system has rapidly evolved with many challenges through
time.
o Health service delivery was devolved to the Local Government Units (LGUs) in 1991,
and for many reasons, it has not completely surmounted the fragmentation issue. Health
human resource struggles with the problems of underemployment, scarcity, and skewed
distribution.
o There is a strong involvement of the private sector comprising 50% of the health system
but regulatory functions of the government have yet to be fully maximized.

o Health Human Resource

 The health human resources (health educators and health service providers) are
the main drivers of the health care system and are essential for the efficient
management and operation of the public health system.
 The Philippines has a huge human reservoir for health. However, they are
unevenly distributed in the country. Most are concentrated in urban areas such as
Metro Manila and other cities.

I. RURAL HEALTH UNIT PERSONNEL

o RURAL HE Rural Health Unit (RHU)
 Serves as the main source of free basic healthcare for rural communities.
 It is at these clinics where one doctor and a handful of nurses have the sole
responsibility of looking after a community of thousands of people whilst at the
same time having only a limited number of resources at their disposal.
 Each unit is meant to serve a population of 5,000 people, normally in a village
and maybe a few smaller settlements around it
 Dispenses basic health care services such as but not limited to:
 maternal and childcare
 immunizations
 treatment of simple medical conditions
 nutrition
 family planning
 sanitary health care
 emergency treatment
 health education
o RURAL HEALTH TEAM includes the following:
 A Physician (the one in-charged)
 A Registered Nurse
 An Assistant Midwife
 An Assistant Sanitarian and a Laboratory Assistant

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II. LOCAL GOVERNMENT UNITS (LGUs)
o Oversee governance of localities in 81 provinces, 144 cities, 1,490 municipalities, and
42,028 barangays across the country
o Responsible in providing direct and basic services to the people
o Ensure peace and order within the communities
o Have administrative authority over their health services and derive technical guidance
and in-kind commodity support from the DOH.
o Coordination & Collaboration with the National Government (with DOH)
 The mandate for providing health services is shared by the National and local
governments.
 The DOH sets policies, standards, and guidelines at the national level for public
health programs.
 These vertical programs, including for immunization, TB control, family
planning and many others, are implemented at the local government level
by provinces and municipalities that comprise the devolved health
system.

Figure 1 shows the responsibilities of the National and Local Governments in the provision of
health care

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 Figure 2 presents the common structure of the Local Health

PERFORMANCE OF LGUs
 To monitor the performance of LGUs in the implementation of the national programs, a health
scorecard has been developed, which is a self-reporting instrument with 34 indicators classified in
the following six categories:
o (i) efficient health sector spending (four indicators);
o (ii) health facility enhancement (two indicators);
o (iii) human resources (three indicators);
o (iv) health governance (six indicators);
o (v) public health interventions (14 indicators); and
o (vi) financial risk protection (five indicators).
 In 2014, the performance of LGUs on the goal to reducing child mortality was assessed against
two benchmarks: the 2012 baseline average and the 2016 national targets. Below is a quotation
from the DOH report:
o “The health sector still falls short of reducing child mortality which is one of the
commitments in the Millennium Development Goals. Looking at the proxy indicators for
child health – namely the percentage of fully immunized children and the percentage of
0–6-month-old infants exclusively breastfed – more than half of the provinces and cities
were still below the 2012 national baselines of 76.91% (fully immunized children) and
61.81% (exclusive breastfed infants)” (HIV/AIDS ART Registry of the Philippines,
2016).

III. GOVERNMENT ORGANIZATIONS

A. Department of Social Work and Development (DSWD)

 VISION and MISSION are aligned toward the fulfillment of its primary
mandates to develop, implement, and coordinate social protection and poverty
reduction solutions for and with the poor, vulnerable, and disadvantaged.
 Organizational Outcomes:
 1. Well-being of poor families improved

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  2. Rights of poor and vulnerable sectors promoted and protected
 3. Immediate relief and early recovery of disaster victims/ survivors
ensured
 4. Continuing compliance of social welfare and development agencies to
standards in the delivery of social welfare services ensured
 5. Delivery of social welfare and development programs by LGUs,
through local social welfare and development offices, improved

B. Nutrition Council
 VISION:
 “Nutrition Council is the authority in ensuring the nutritional well-being
of all Filipinos, recognized locally and globally, and led by a team of
competent and committed public servants.”
 MISSION:
 “To orchestrate efforts of government, private sector, international
organizations and other stakeholders at all levels, in addressing hunger
and malnutrition of Filipinos.”
 CORE FUNCTIONS:
 Formulates national food and nutrition policies and strategies
 Serves as the policy, coordinating and advisory body of food, nutrition,
and health concerns
 Coordinates planning, monitoring, and evaluation of the national
nutrition program
 Coordinates the hunger mitigation and malnutrition prevention program
to achieve relevant development goals
 Strengthens competencies and capabilities of stakeholders through public
education, capacity building, and skills development

C. Population Commission
 The Commission on Population and Development (POPCOM) is a government
agency created through Republic Act 6365 (Population Act of the Philippines) as
amended by Presidential Decree No. 79 (Revised Population Act of the
Philippines).
 POPCOM is mandated to be the central policymaking, planning, coordinating,
and monitoring agency for the Philippine Population Management Program
(PPMP). The PPMP has the following
objectives:
 To enable couples and individuals to achieve their desired number,
timing, and spacing their children within the context and demand of
responsible parenthood and informed choice;
 To enable adolescents (aged 10-19 years) to prevent early and repeated
pregnancies; and
 To enable national, sectoral, and local government agencies to
effectively integrate population variables and dynamics in developing
people-centered development interventions.

 VISION:
 “We are the lead organization in population management for well-
planned and empowered Filipino families and communities.”

IV. NON-GOVERNMENT ORGANIZATIONS (NGOs)

A. Socio-civic organizations
 Community organizations and or associations that are primarily engaged in
promoting civic, social, or other interests or purposes of their members and the
immediate locale.
 Examples include the following:
i. GREENPEACE Philippines
ii. HARIBON Foundation

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 iii. Philippine Animal Welfare Society
iv. World Vision Philippines
v. Gentle Hands
vi. Amnesty International

B. Religious organizations
 Include nondenominational ministries, interdenominational and ecumenical
institutions
 Religious organizations are recognized as therapeutic communities and resources
for both the prevention and amelioration of mental and physical health problems.
 Religious organizations and clergy function in a variety of health-related roles in
the areas of primary, secondary, and tertiary prevention and as advocates and
catalysts for health-related behavioral and social change.
 Distinctive values and orientations operating within faith-based settings and
shared (to various degrees) by the health and human services professions (e.g.
community mental health and public health) are central to their roles in disease
prevention and the promotion of health and well-being. These values and
orientations include service to others, an emphasis on community perspectives
and the impact of the social environment, individual and community
empowerment, a focus on promoting health and well-being, a holistic view of
persons and problems, and a strong ethic for social responsibility and social and
economic justice.

C. Schools
 Academic institutions get help from NGOs for the betterment, volunteer work
and support for the realization of certain school projects and programs
 School Nursing
 Aims:
o To promote the health of school personnel and pupil/students
o To prevent health problems that could hinder students’ learning
and performance of their developmental tasks
 Health: considered as an important resource in education
 Major considerations in school nursing practice:
o Laws such as the Child and Youth Welfare Code (PD 603) and
Letter of Instruction 764 (declaring the School Health Program
the priority program of the national government)
o Policies and Standards of the Department of Education and the
DOH and the standards of the nursing profession
 More important influences:
o Socioeconomic realities in the schools, homes, communities, and
local government units (LGUs)
 School Nurses activities:
o Health advocacy
o Health promotion
o Disease prevention
o Early detection of disease
 Specific functions of school nurses:
o Health and nutrition assessment, screening, and case-finding
o Treatment of common ailments and attending to emergency
cases
o Counseling and health education
o Nursing procedures
o Supervision of the health and safety of the school
o Referrals and follow-ups of pupils and personnel
 School nurses manage the school clinic, monitors, and evaluates health
programs and projects

References:

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  Chatters, L. (2000). Religion and Health: Public Health Research and Practice. Annual Review of Public Health. Vol. 21:335-367
(Volume publication date May 2000). https://doi.org/10.1146/annurev.publhealth.21.1.335
 Five (5) Benefits of Interprofessional Collaboration in Healthcare. https://tigerconnect.com/blog/5-benefits-of-interprofessional-
collaboration-in-healthcare/
 Maglaya, et. Al (2009). Nursing Practice in the Community (Fifth Edition). Argonauta Corporation. School Nursing, page 42-43.
 The Philippine Health System at a Glance. https://www.doh.gov.ph/sites/default/files/basic-page/chapter-one.pdf
 World Health Organization, Regional Office for South-East Asia (2020). The Philippines health system review. Health systems in
transition. Vol-8, Number-2

Prepared by:

NCM 104/ CHN (Theory) Lecturers