SCHOOL OF NURSING

SECOND SEMESTER, SCHOOL YEAR 2023 – 2024

NCM 104 - COMMUNITY HEALTH NURSING LECTURE

RESOURCE UNIT WEEK 1

PROGRAM VISION:

Congruent with the institution’s core values, Excellence, Integrity, Compassion,

Resilience and Fidelity, and through its functions in EDUCATION, MEDICAL
SERVICES, and RESEARCH, the School of Nursing similarly envisions producing
socially responsible healthcare professionals adhering to global standards.

PROGRAM MISSION:

The School of Nursing is committed to maintaining the highest academic standards in

nursing practice through the development of competent, caring and compassionate
nurse practitioners imbued with the highest ethical, moral and social standards.

Course title : COMMUNITY HEALTH NURSING (Individual and Family)

Course code : NCM 104

Course Credit : Theory: 2 UNITS (36 HOURS); RLE: SKILLS LAB- 1 UNIT (51 HOURS); Clinical -1 unit (51
hours)

Placement : SECOND YEAR, FIRST YEAR

Pre-requisite : NCM 101, NCM 102, NCM 103

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WEEK I
TOPIC I: THE HEALTH CARE DELIVERY SYSTEM

LEARNING OBJECTIVES:
1. Explain the factors that influence the health care delivery system
2. Critiquing the Philippine health care delivery system in terms of the different levels
of services
3. Compare the Health care delivery system between health system, health care system
4. Monitor how the health care delivery system paradigm helps the health condition of
the people
5. Link the pyramid to achieve our country’s vision, mission and goal
6. Review how the WHO affects health issues in the Philippines
7. Integrating the Millennium Development Goals and the targets of the health related
MDG’s in the health care delivery system
8. Explain the Sustainable Development Goals and its effect on the people

HEALTH CARE DELIVERY SYSTEM

 A nation’s health care delivery system has a tremendous impact not only on the health
of its people but also on their total development, including their socioeconomic status.
A discussion of the health care delivery system often involves issues of cost and
challenges. Nations go through a struggle to overcome multiple forces in efforts to
advance the nation’s health within the context of their financial and political situations.

 Anderson and Mc Earlane (2011) emphasized the role of the following factors in shaping
21st century health that further influence health care delivery system:

FACTORS THAT INFLUENCE HEALTH CARE DELIVERY SYSTEM

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1. Health care reforms: is for the most part governmental policy that affects health care
delivery in a given place. Health care reform typically attempts to:
A. Broaden the population that receives health care coverage
through either public sector insurance programs or private sector
insurance companies
B. Expand the array of health care providers consumers may choose
among.
C. Improve the access to health care specialist
D. Improve the quality of health care
E. Give more care to citizens
F. Decrease the coat of health care
2. Demographics: is the study of a population based on factors such as age, race, and sex. It also
refers to socio-economic information expressed statistically, also including employment,
education, income, marriage rates, birth and death rates and more factors.
3. Globalization: it is the interaction and integration among nations which is driven by
international trade.
4. Poverty and growing disparities: There are a wide variety of types of economic inequality,
most notably measured using the distribution of income ( the amount of money people are
paid) and the distribution of wealth )n the amount of wealth people own)
5. Social disintegration: it is the tendency for society to decline or discharge overtime, perhaps
due to the lapse or breakdown of traditional social support systems.

 The health care delivery system in the Philippines beginning with the WHO as this
specialized agency of the United Nations (UN) provides global leadership on health
matters.
In the Philippines, health services are provided by the:
A. Government
B. Private sector- for profit and nonprofit agencies.

 With the latter frequently referred to as non-governmental organizations or NGOs.

On the National level, direction is set by the Department of Health (DOH) . By virtue of the
mandate of the local Government Code (R.A. 7160), local government units (LGUs) should have
an operating mechanism to meet the priority needs and service requirements of their
communities. Basic health services are regarded as priority services, for which LGUs are
primarily responsible.

Health System

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  Consist of all organizations, people, and actions whose primarily intent is to promote,
restore, or maintain health.
HEALTH CARE DELIVERY SYSTEM:
 It is the totality of all policies, infrastructures, facilities, equipment, products, human
resources, and services that addresses the health needs, problems and concerns of all
people.
Health Care System – an organized plan health services (Miller Keane, 1987).
Health Care Delivery – rendering health care services to the people.
Health Care Delivery System (Williams-Tungpalan, 1981) – the network of health facilities and
personnel, which carries out the task of rendering health care to the people.
Philippine Health Care System – is a complex of organizations interacting to provide an array of
health services (Dizon, 1977)

Health System has 6 building blocks or components

1. Service Delivery
2. Health workforce
3. Information
4. Medical products, vaccines, and technologies
5. Financing
6. Leadership and governance or stewardship

 The nurse is an essential member of the health workforce in the country. For all the
nurse to work efficiently within the health care delivery system, an understanding of the
dynamic relationships among its components is needed.

 The DOH serves as the main governing body of health services in the country.
 The DOH provides guidance and technical assistance to LGUs through the Center for
Health Development in each of the 17 regions.
 Provincial government is responsible for administration of provincial and strict hospitals.
 Municipal and city governments are in charge of primary care through rural health units
(RHUs) or health centers.
 Satellite outposts known as barangay health stations (BHSs) provide health services in
the periphery of the municipality or city.
 As mentioned earlier, the Local Government Code mandated the devolution or
decentralization of basic health services.
 This means that LGUs have the autonomy and responsibility to plan and implement
basic health services (primary care) on behalf of their constituents.
 This is a mandate for LGUs Depending on the capability and political will of the
municipality /city government, higher levels of services may be provided.

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  This sector provides all levels of services and accounts for a large segment of health
service providers in the country.
 About 30% of Filipinos utilize private health facilities.
 An estimated 60% of the national health expenditure goes to the private sectors.
 This sector also employs more than 70% of the health professionals in the Philippines
(Romualdez, 2011)

Financing of health services is provided by three major groups:

A. Government (national and local)
B. Private sources
C. Social health insurance
 The National Health Insurance Act of 1995 (R.A. 7875) created the Philippine Health
Insurance Corporation (Phil Health). It is a tax-exempt government corporation attached
to the DOH for policy coordination and guidance, and aims for universal health coverage
of all Filipino citizen.
 In the Philippines health care system is complex set of organizations interacting to
provide an array of health services. ([Link]/.../...).

Components of the Health Care Delivery System as mandate of the Department of Health
(DOH) is to be responsible for the following:
[Link] and development of national health policies, guidelines, standards
[Link] of operations for health services and programs;
3. issuance of rules and regulations, licenses and accreditations;
[Link] of national health standards, goals, priorities and indicators;
[Link] of special health programs and projects and advocacy for legislation on health
policies and programs.
The Primary Function of the Department of Health:
a. promotion
b. protection
c. preservation
d. restoration of the health of the people through the provision and delivery of health
services and through the regulation and encouragement of providers of health goods and
services (E.O. No. 119, Sec. 3).

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 A. Paradigm

National - Tertiary
Health Services
Medical Centers
Teaching &
training
Hospitals
Regional Health
Services
Regional Medical
Centers - Secondary
and Training Hospitals
Provincial / City Health Services
Provincial / City Hospitals

Emergency / District Hospitals

Rural Health Unit - Primary

Community Hospitals and Health Centers
Private Practitioners / Puericulture Center

Barangay Health Station

FIGURE 1. THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

(Community Health Nursing Services in the Philippine Department of Health, 2000)
The pyramid is a graphic representation of our country’s vision and goal to achieve
Health for all Filipinos and Health in the Hands of the People by the year 2020, with the mission
to ensure accessibility and quality of life of all Filipinos, especially the poor.

THE HEALTH CARE DELIVERY SYSTEM

A. WHO - World Health Organization

Specialized agency of the United Nation provides global leadership on health matters.
 The WHO constitution came into force on April 7, 1948. Since then, April 7 has been
celebrated each year as -World Health Day (WHO, 2013a). With its headquarters in
Geneva, Switzerland, WHO has 147 country offices and 6 world regional offices for

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 Africa, the Americas, Eastern Mediterranean, Europe, Southeast Asia, and the Western
Pacific.
 The Philippines is a member of the Western Pacific Region, which holds office in Manila
(WHO, 2007b).
 The WHO constitution states that its objective is the attainment by all peoples of the
highest possible level of health (WHO, 2006).

Core Functions:
1. Providing leadership on matters critical to health and engaging in partnerships where joint
action is needed.
2. Shaping the research agenda and stimulating the generation, translation and disseminating
valuable knowledge
3. Setting norms and standards and promoting and monitoring their implementations.
4. Articulating ethical and evidence based policy options.
5. Proving technical support, catalyzing change, and building sustainable institutional capacity

WHO strategy on research has 5 goals;

[Link] in reference to capacity building to strengthen national health research systems
[Link] to focus research on priority health needs particularly in low-and middle income
countries
[Link] to promote good research practice and enable the greater sharing of research
evidence tools, and materials
4. Translation to ensure that quality evidence is turned into products and policy
[Link] to strengthen the research culture within WHO and improve the
management and coordination of WHO research activities
In the past decade, WHO has worked as a partner of the Philippine DOH in the development
and provision of services towards the attainment of health-related Millennium Development
Goals (MDGs).

1. THE MILLINEUM DEVELOPMENT GOALS

 September 6-8, 2000- Millennium Summit. World leaders in the UN assembly
participated.
 United Nations Millennium Declaration. The world leaders recognized their collective
responsibility to uphold the principles of human dignity, equality, and equity at the
global level.

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  The declaration expressed the commitment of the member states is to reduce poverty
and achieve the 7 other targets. Now called Millennium Development Goals (MDGs) by
the year 2015.

MILLENNIUM DEVELOPMENT GOALS

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-mmr n rh
6. Combat HIV/AID, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development

2. SUSTAINABLE DEVELOPMENT GOALS

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  Known as the Global Goals are a universal are a collection of 17 global goals set by the
United Nations Assembly in 2015 for the year 2030. The SDGs are part of Resolution 701
of the United Nations General Assembly
 They are the blueprint to achieve a better and more sustainable future for all. They
address the global challenges we face, including those related to poverty, inequality,
climate, environmental degradation, prosperity, and peace and justice.
 The goals interconnect and in order to leave no one behind, it is important that we
achieved each goal and target by 2030

17 GLOBAL GOALS (SUSTANAINABLE GOALS)

1. No poverty-end poverty in all its forms everywhere

2. Zero hunger-food security n improved nutrition 17
3. Good health and well being
4. Quality Education
5. Gender equality
6. Clear water and sanitation

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7. Affordable and Clean energy
8. Decent Work and economic growth
9. Industry, Innovation, and infrastructure
10. Reduces inequalities
11. Sustainable cities and communities
12. Responsible consumption and production
13. Climate action
14. Life below water
15. Life on land
16. Peace justice and strong institution
17. Partnership for the goals

END OF WEEK 1 TOPIC

Prepared by: MARILYN M. SANTOS, PhD, MAN.

Signature over printed name

August 5, 2023

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