The College of Maasin

Nisi Dominus Frustra

College of Nursing and Allied Health Sciences

INTRODUCTION TO COMMUNITY
HEALTH NURSING
FUNDAMENTAL CONCEPTS OF COMMUNITY HEALTH
NURSING

NOREEN V. BORRES, RN., MANc

HEALTH (WHO, 1958)
“ STATE OF COMPLETE PHYSICAL , MENTAL, AND
SOCIAL WELL-BEING AND NOT MERELY THE
ABSENCE OF DISEASE OR INFIRMITY”
◦ Social Health – community vitality and a result of
positive interaction among groups within the
community, with emphasis on health promotion and
illness prevention.
COMMUNITY

◦collection of people who interact with one

another and whose common interest or
characteristics form the basis for a sense of
unity or belonging. (Allender et al, 2009)
 POPULATION AGGREGATES

◦A group of people ◦Are subgroups

having common or
personal and subpopulations
environmental that have some
characteristics or all common
characteristics
of the people in a
or concerns.
defined community.
 2 Main Types of Communities
PHENOMENOLOGICAL(functional)

◦Relational , interactive
GEOPOLITICAL(territorial)
groups, in which the place
◦Defined or formed by or setting is more abstract,
both natural and and people share a group
man-made boundaries perspective or identity
based on culture, values,
history, interests, goals.
Neighborhood – small units in the community, and
people often identify more closely with

◦There is high level of cohesiveness, cooperativeness,

and comradery in neighborhoods

◦Neighborhood based initiatives empower

participants with a sense of ownership and
involvement and offer a mechanism for directly
targeting resources to at-risk populations
 Classifications of Neighborhoods
◦INTEGRAL ◦PAROCHIAL

The individuals in People in this setting

also have face-to-face
this setting have
contacts, but there is
frequent an absence of ties to
face-to-face the larger community.
contacts.
Classifications of Neighborhoods

◦ DIFFUSE ◦ STEPPING-STONE
Neighbors within this This type of
type of environment neighborhood is
interact infrequently with characterized by a
each other and have few rapid membership
ties with the larger turnover and families
community. who have a weak
sense of identity with
the neighborhood.
Classifications of Neighborhoods

◦TRANSITORY ◦ANOMIC
Members of this kind A completely
of neighborhood fail disorganized
to participate in or neighborhood.
identify with the local
community.
 HEALTH AS A
HUMAN RIGHT
Right of every human to health (WHO)
“ The enjoyment of the highest attainable
standard of health is one of the fundamental
rights of every human being without
distinction of race, religion, political belief
,economic or social condition”.
-Dr. Ghebreyesus, WHO Director –General , 2017
 Article II, Section 15, 1987 Philippine
Constitution

◦declares that “The State shall protect and

promote the right to health of the people
and instill health consciousness among
them”.
 These are interconnected and
indispensable components

Right To Health : Components

1.AVAILABILITY adequate for all

health facilities , services and goods are

2. ACCESSIBILITY made possible and obtainable for everyone

3. ACCEPTABILITY respect for the medical ethics, culturally

appropriate and gender sensitive

4. QUALITY health facilities , commodities and services must be in

accordance with medical and scientific standards
MODELS
OF
HEALTH
1. CLINICAL MODEL
◦ absence of s/sx of disease and illness

2. ROLE PERFORMANCE MODEL

◦ individual’s ability to perform his societal
roles
3. ADAPTIVE MODEL
◦ health is a dynamic state

4. EUDAIMONISTIC MODEL
◦ an elevated level of wellness that suggests
optimal health and wellness is reflected by a
lack of vitality
DETERMINANTS OF HEALTH AND DISEASE

◦ GENETIC (BIOLOGICAL)
◦LIFESTYLE ( BEHAVIORAL AND SOCIO-CULTURAL)
◦ SOCIAL ENVIRONMENT
◦ PHYSICAL ENVIRONMENT
◦ POLICIES AND INTERVENTIONS
 Determinants of Health & Disease
Determinants How?
1. Income & social status Higher income and social status – better
health
2. Education Low education levels – poor health

3. Physical environment Safe water, clean air, safe houses, roads –

good health
4. Employment & Employed – better health
working conditions
5. Social support Greater support – better health
networks
 Determinants of Health

Determinants How?
6. Culture Customs & traditions, beliefs – affect health

7. Genetics Inheritance plays a part in determining

lifespan/healthiness

8. Personal behaviour & How one deals with life affect health
coping skills
9. Health services Access and use of service influences health

10. Gender Suffer different types of diseases at different ages

 Health is a social
phenomenon where
various determinants
interplay with each other
 ONE HEALTH CONCEPT
- framework for community and public health nursing

◦APPROACH : the most effective way to

respond to the threats of emerging
infectious disease (EID) is to recognize the
connection between human, animal and
environmental health)
 ONE HEALTH CONCEPT
- framework for community and public health nursing

◦calls for CONSOLIDATED interaction between

human health, veterinary medicine, and public &
environmental health professionals, clinicians,
researchers, and agencies functioning conjointly for a
worthwhile and sustainable health interventions in
addressing worldwide and environmental health
challenges.
HEALTH IN THE PHILIPPINE CONTEXT :
a call for nursing action
◦Health, rarely, is encountered as a premium
concern , it is often valued last.
◦ TASK : to mainstream health in the community
and raise people’s value for healthcare
Community and Public Health Nurses

◦ called to share their expertise regarding

population - based approaches to
healthcare for groups of inidividuals across
health care settings.
Hierarchy of Nursing Practice Fields
RECALL: Three Key Concepts Of Community And
Public Health Nursing (CPHN)

CLIENT : Community
GOAL : Health
VEHICLE : Nursing
 COMMUNITY HEALTH NURSING

• specialized field in nursing practice that

renders care to individuals , families and
communities; focusing on health
promotion and disease prevention
through people empowerment.
 Preventive Approach to
Health
HEALTH PROMOTION - activities done
to enhance resources directed at
improving well-being

DISEASE PREVENTION - activities

done to protect people from disease
and its effects
Preventive Approach to
Health

THREE LEVELS OF PREVENTION

BY LEAVELL AND CLARK (1958)

•PRIMARY – prevention of problems before

they occur
•SECONDARY – early detection and
intervention
•TERTIARY – correction and prevention of
deterioration of a disease state ; to restore an
individual to its optimal level of functioning
 PRIMARY EXAMPLES:
•Health Education :
Focus DIET, EXERCISE,
• improving ENVIRONMENTAL
HAZARDS, ACCIDENT
over-all health PROTECTION,
• health IMMUNIZATION,
promotion ASSESSMENT OF RISKS
FOR INJURY/ILLNESS
• prevention of
illness/ injury
 SECONDARY EXAMPLES:

Focus : •Health Screening and

diagnostic procedures
• early •Regimen for treatment of
identification of illness
illness
• Promotion of regular
• treatment for health care examinations
existing health across the life span
problems
 TERTIARY EXAMPLES:

Focus : •Health Education to

• return to optimum reduce or prevent
level of wellness complications of
after an illness or disease
injury • Referral to
• prevention of rehabilitation
recurrence of services
problems
Basic Principles of CPHN
• In CHN, the client is considered as an
ACTIVE partner NOT PASSIVE
recipient of care.

• The community is the patient in CHN

and the family is the unit of care.
 WORTH and DIGNITY OF MAN
- primacy on which the practice of
community and public health nursing is
anchored . ( Margaret Shetland)
- respect for people’ s inherent value
regardless of their background and beliefs
Fields of Community & Public Health Nursing
• FAITH COMMUNITY NURSING (or Parish Nursing, Congregational
Nursing) - focuses on the intentional care of the spirit as well as on
the promotion of wholistic health and prevention or minimization of
illness within the context of a faith community

• CORRECTIONAL NURSING – providing healthcare to those

incarcerated in the criminal justice system in a variety of settings
such as jails, prisons, remand centers and juvenile detention.

• OCCUPATIONAL HEALTH NURSING - provides for and delivers health

and safety programs and services to workers, worker populations,
and community groups.

• SCHOOL NURSING- protects and promotes student health, facilitates

normal development, and advances academic success.
 Characteristics and Features of CPHN
•developmental
•multidisciplinary
•ecology oriented
•promotes social justice
•values consumer involvement
•uses prepayment mechanism
•focuses on preventive service
•offers comprehensive care
 Roles of the Community and Public Health
Nurse
1. Healthcare Provider
2. Health Educator
3. Program Implementer
4. Community Organizer
5. Manager/ Leader
6. Researcher / Epidemiologist
7. Client Advocate
Many of these roles may
overlap and the Community
Health Nurse may perform
several roles at the same
time.
Competency Standards in Public Health Nursing

• Analytic Assessment Skills

• Policy Development / Program Planning Skills
• Communication Skills
• Cultural Competency Skills
• Community Dimensions Of Practice Skills
• Public Health Sciences Skills
• Financial Planning And Management Skills
• Leadership And Systems Thinking Skills
Levels of Clientele
Community

Population
Group

The
Family

The
Individual
 Public Health (C.E.Winslow)

“Is the science and art of

preventing disease, prolonging
life, and promoting health and
efficiency through organized
community effort.”
Goal of Public Health
To improve the health of the
public by promoting health
lifestyles, preventing disease
and injury, and protecting the
health of communities.
 “through organized
community effort”
- key phrase in the definition of
public health
 CORE PUBLIC HEALTH FUCTIONS
1. Assessment- collection , analysis ,
information sharing about health conditions,
risks and resources in a community
2. Policy Development – use of information
gathered during assessment to develop local
and state health policies and to direct
resources toward those policies
3. Assurance – availability of necessary health
services throughout the community
 Essential Public Health Services (CDC , 2014)
1. Monitor health status to 5. Develop policies and plans that support
identify and solve community individual and community health efforts.
health problems. 6. Enforce laws and regulations that
2. Diagnose and investigate protect health and ensure safety.
health problems and health 7. Link people to needed personal health
hazards in the community. services and assure the provision of
health care when otherwise unavailable.
3. Inform , educate , and
empower people about 8. Assure a competent public health and
health issues. personal health care workforce.
4. Mobilize community 9. Evaluate effectiveness , accessibility ,
partnerships and actions to and quality of personal and
identify and solve health population-based health services
problems. 10. Research for new insights and
innovative solutions to health problems.
PUBLIC HEALTH INTERVENTION WHEEL

Describes the breadth and

scope of public health
nursing process and has
become recognized as the
framework for community
and public health nursing
practice
 PUBLIC HEALTH WORKERS
• Rural Sanitary Inspector (RSI)-must be a sanitary engineer
• Pharmacist
• Medical Technologist
• Nutritionist
• Dentist
• Rural Health Midwife (RHM)-Registered Midwife
• Public Health Nurse (PHN)-Registered Nurse
• Medical Health Officer (MHO)-Physician
 RHU Personnel Ratio
•Rural Sanitary Inspector (RSI)-
1 : 20,000 population
•Rural Health Midwife (RHM)-
1 : 5,000 population
•Public Health Nurse (PHN)
1: 20,000 population
•Medical Health Officer (MHO)
1 : 20,000 population
Rural Health Units (RHU)
Barangay Health Station (BHS)
 The College of Maasin
Nisi Dominus Frustra
College of Nursing and Allied Health Sciences

EXPANDING FIELDS OF
COMMUNITY HEALTH
NURSING PRACTICE
 COMMUNITY HEALTH NURSING
- “ the synthesis of nursing practice and public
health practice applied to promoting and preserving
the health of populations” (ANA, 1980)
 COMMUNITY HEALTH NURSING

PUBLIC HEALTH NURSING

OCCUPATIONAL HEALTH NURSING
CORRECTIONAL HEALTH NURSING
SCHOOL HEALTH NURSING
 2. OCCUPATIONAL HEALTH NURSING
“ Everyone has the right to work , to free choice of
employment , to just and favorable conditions of
work”. - Article 23 , United Nations Universal
Declaration of Human Rights
- promotion of occupational safety and health (OSH)
Department of Labor and Employment – lead
government agency on OSH
 2. OCCUPATIONAL HEALTH NURSING
- the specialty practice that focuses on the promotion,
prevention and restoration of health within the context of a
safe and healthy .
-prevention of adverse health effects from occupational and
environmental hazards
-provides for and delivers occupational and environmental
health and safety programs and services to clients
 OCCUPATIONAL HEALTH NURSING: ELEMENTS
1. NURSING SCIENCE
2. MEDICAL SCIENCE
3. OCCUPATIONAL HEALTH SERVICES
4. EPIDEMIOLOGY
5. BUSINESS AND ECONOMICS (theories,
concepts and principles)
6. SOCIAL AND BEHAVIORAL SCIENCES
7. ENVIRONMENTAL HEALTH
8. LEGAL AND ETHICAL ISSUES
 OCCUPATIONAL HEALTH STRATEGIES: ASSESSMENT
AND CONTROL OF HAZARD IN THE WORKPLACE

- to IDENTIFY health hazards and safety hazards

beginning with risk anticipation and assessment by creating
a job-safety analysis
HEALTH HAZARDS- elements that can cause work
–related disease to the worker
SAFETY HAZARDS- unsafe conditions or unsafe acts that
significantly increase the risk of worker to be injured
 CATEGORIES OF HEALTH HAZARDS IDENTIFIED BY THE
OCCUPATIONAL HEALTH TEAM:

1. Administrative Control
2. Engineering
3. Material Provision
4. Supplementation
FUNCTIONS OF AN OCCUPATIONAL HEALTH WORKER
Source: Lie A, Baranski B, Husman K, Westerholm P (2002) Good practice in occupational health services: A contribution to workplace health.

1. Identification and assessment of the health risk in the workplace.

2. Surveillance of work environment factors and work practices that

affect workers’ health, including sanitary installations, canteens and
housing, when such facilities are provided by the employer.

3. Participation in the development of programmes for the improvement

of working practices, as well as testing and evaluating health aspects
of new equipment.

4. Advice on planning and organization of work, design of workplaces,

choice and maintenance of machinery, equipment and substances
used at work.
FUNCTIONS OF AN OCCUPATIONAL HEALTH WORKER
Source: Lie A, Baranski B, Husman K, Westerholm P (2002) Good practice in occupational health services: A contribution to workplace health.

5. Advice on occupational health, safety and hygiene, and on ergonomics and individual and
collective protective equipment.

6. Surveillance of workers’ health in relation to work.

7. Promoting the adaptation of work to the worker.

8. Collaboration in providing information, training and education in the fields of

occupational health, hygiene and ergonomics.

9. Contribution to measures of vocational rehabilitation.

10. Organisation of first aid and emergency treatment.

11. Participation in the analysis of occupational accidents and occupational diseases.

FRAMEWORK AND SCOPE OF OCCUPATIONAL HEALTH NURSING PRACTICE
*Department of Labor and Employment: Rule 1965.04 Amended Occupational Safety and Health Standards (OSHS) 1996

1. Organize and administer health service program integrating

occupational safety in the absence of a physician.
2. Provide nursing care to injured/ill workers.
3. Participate in health maintenance examination.
4. Participate in maintenance of occupational health and safety .
5. Maintain a reporting and records system and prepares annual
medical report to the employer.
 LEVELS OF PREVENTION IN OCCUPATIONAL HEALTH NURSING

1. PRIMARY – health promotion and disease

prevention
2. SECONDARY – early diagnosis, tx ,
interventions and attempts to limit disability
3. TERTIARY –rehabilitation and restoration of
the worker to an optimal level of functioning
 LEGAL MANDATES IN OCCUPATIONAL HEALTH
1. Presidential Decree (P.D.) 442 – Philippine Labor Code
2. Administrative Code on Enforcement of Safety and Health Standards
3. Occupational Safety and Health Standards
4. Executive Order (E.O.) 307- Creation of the Occupational Safety and Health Center under the
Employees Compensation Commission
5. PD 626- Employees Compensation and State Insurance Fund
6. R.A. 9165- Comprehensive Drugs Act
7. R.A. 6969- Toxic Substance Act
8. R.A. 9231- Special Abuse , Exploitation and Discrimination Act
9. R.A. 11058- Strengthening Compliance with Occupational Safety and Health Standards Act of
2017
CLASSIFICATION AND NUMBER OF OCCUPATIONAL HEALTH PERSONNEL
Source : Republic Act 11058 (2018)

FIRST AIDER OH NURSE OH DENTIST OH PHYSICIAN

NUMBER OF WORKERS MEDIUM MEDIUM MEDIUM

MEDIUM TO
LOW RISK TO HIGH LOW RISK TO HIGH LOW RISK LOW RISK TO HIGH
HIGH RISK
RISK RISK RISK
1 to 9 1 - - -
10 to 50 1 - - -
51 to 99 1 - 2PT - -
100 to 199 2 2PT 1FT - 1PT - 1PT
200 to 500 3-5 1FT 1PT 1PT 2PT
501 to 2000 6-20 1FT 1PT 1FT 2PT 2PT or 1FT
>2000 >20 1FT /shift 1FT 1 FT and 2 PT
Every 100 workers or a 1 - - -
fraction thereof
Every 250 workers or a - 1FT - -
fraction thereof
Every 500 workers or a - - 1FT 1 FT or 4 PT
fraction thereof
CLASSIFICATION AND NUMBER OF OCCUPATIONAL HEALTH PERSONNEL
• Part Time = 4 hrs/ day, 3 days / week
• Full Time = 8 hrs/day. 6 days / week
• OH Personnel shall be placed in the shift with the highest number of
workers
• For OH Dentist = alternatively , establishments can enter into a
Memorandum of Agreement (MOA) for dental services for workers ,
provided that the requirements for dental facilities are met.
• For OH physicians = if more that 1 PT physician is required , a
physician must be present in all work days of the establishment.
 3. SCHOOL HEALTH NURSING
TRADITIONAL SCHOOL HEALTH PROGRAMS ADDITIONAL COMPONENTS OF SCHOOL HEALTH
PROGRAMS
1. SCHOOL HEALTH SERVICES
1. HEALTH PROMOTION FOR SCHOOL
2. SCHOOL HEALTH EDUCATION PERSONNEL

3. A HEALTHY SCHOOL 2. SCHOOL-COMMUNITY PROJECTS AND

OUTREACH
ENVIRONMENT (including physical
3. NUTRITION AND FOOD SAFETY
and psychosocial aspects of
4. PHYSICAL EDUCATION AND RECREATION
environment)
5. MENTAL HEALTH ( counselling and social
supports)
 EIGHT
COMPONENTS
OF SCHOOL
HEALTH
PROGRAMS
 EMERGING FIELDS OF
COMMUNITY AND PUBLIC
HEALTH NURSING IN THE
PHILIPPINES
 HOME HEALTH CARE
•Providing nursing care to individuals and families in their own
residence to minimize the effects of illness and disability.
 HOSPICE HOME CARE
•for terminally ill patients
• palliative care is important
FUNCTION/ TASK
• provide comfort to the terminally ill patient
• improve his/her quality of life
• provide support to the patient and family as they go through
the processes of dying and grieving
 FAITH COMMUNITY NURSING OR PARISH NURSING

• the art and science of nursing combined with spiritual care

• can either be paid or unpaid positions
• FOCUS : health promotion and provision of holistic care to
members of the faith community
• recognizes spirituality as the core of practice of nursing.
FAITH COMMUNITY NURSING OR PARISH NURSING
 FAITH
COMMUNITY
NURSING
 CORRECTIONAL NURSING
•specialized subset of forensic nursing
FUNCTIONS:
• maintenance of a safe environment
• promotion of health among inmates
• dealing with both acute and chronic conditions
In the Philippines , major concerns include preventing the spread of tuberculosis , skin infections
due to overcrowding and lack of ventilation.
 ENTREPRENEURSHIP IN NURSING
•encourages nurses to pursue independent practice and establish
singly or in collaboration health care related business establishments.
-child wellness clinics
- maternity clinics
-wound care centers
-training organizations
 ENTREPRENURSE
–launched in 2013 , an initiative of
DOLE, in collaboration with
BON-PRC, DOH, PNA, UPCN,
OHNAP and other government and
non-government entities
 ENTREPRE-NURSE
1.to reduce the cost of health care for the country’s indigent
population by bringing primary health care services to poor
rural communities,
2.to maximize employment opportunities for the country’s unemployed
nurses and
3.to utilize the country’s unemployed human resources for health for
the delivery of public health services and the achievement of the
country’s Sustainable Development Goals on maternal and child
health, consistent with the FOURmula Plus One for Health framework
of the Department of Health.
 HEALTH PROMOTION, RISK
REDUCTION and CAPACITY
BUILDING STRATEGIES
HEALTH PROMOTION
• any combination of health education and
related organizational , economic and
environmental supports for behavior of
individuals , groups or communities
conducive to health. (Green and Kreuter,1991)

• behavior that is motivated by the desire to

increase well-being and to reach the best
possible health potential. (Parse,1990)
HEALTH PROTECTION
• behaviors in which one engages
with the specific intent to prevent
disease , to detect disease in the
early stages or to maximize health
within the constraints of disease.
(Parse ,1990)

•
RISK AND HEALTH
RISK – the probability that a
specific event will occur in a
given time

RISK FACTOR – exposure that is

associated with a disease
Criteria for Establishing a Risk Factor
1. The frequency of the disease varies
by category or amount of the factor

2. The risk must precede the onset of

the disease

3. The association of concern must not

be due to any source of error
RISK ASSESSMENT
-A systematic way of distinguishing the
risks posed by potentially harmful
exposures

- 4 MAIN STEPS:
1. hazard identification
2. risk description
3. exposure assessment
4. risk estimation
Two types of Risks

•MODIFIABLE – individual has some

control

•NON-MODIFIABLE – one has little or

no control
 RISK REDUCTION

• a proactive process in which

individuals participate in behaviors
that enable them to react to actual
or potential threats to their health
RISK COMMUNICATION

• the process through which the

public receives information
regarding possible or actual
threats to health
DIET AND HEALTH
 DIET

• one of the most modifiable of risk

factors
•
 Overweight and Obesity
• alarmingly increasing in the country

• OBESITY – android or apple-shaped type

• WAIST-TO-HIP RATIO

• WHR of =/> 1.0 (men) =/> 0.85 (women)

android or apple-shaped obese

How to calculate WHR
•Stand up straight and breathe out. Use
a tape measure to check the distance
around the smallest part of your waist,
just above your belly button. This is your
waist circumference.

•Then measure the distance around the

largest part of your hips — the widest
part of your buttocks. This is your hip
circumference.

•Calculate your WHR by dividing your

waist circumference by your hip
circumference.
 Health risk Women Men

Low 0.80 or lower 0.95 or lower

Moderate 0.81–0.85 0.96–1.0

High 0.86 or higher 1.0 or higher

e.g. Female with waist= 30in. , hips 38 in.

WHR = ?
CALORIES IN

CALORIC BALANCE EQUATION

10 NUTRITIONAL GUIDELINES FOR FILIPINOS
 DAILY NUTRITIONAL GUIDE PYRAMID
- A tool that helps users translate
the Recommended Energy
and Nutrient Intakes (RENIs) for
Filipinos into the kinds and
amounts of foods to eat each
day.
DAILY NUTRITIONAL GUIDE PYRAMID
Foods eaten away from home is
associated with an increased
likelihood of overweight
PORTION DISTORTION
PHYSICAL ACTIVITY
AND HEALTH
SLEEP
PROCESSES THAT REGULATE THE NEED FOR
SLEEP:
1.Number of hours we are awake
2. Circadian biological clock (in the brain) – the
suprachiasmatic nucleus-
-circadian rhythm
 SLEEP HYGIENE
1. AVOID caffeine and nicotine close to
bedtime.
2. AVOID alcohol as it can cause sleep
disruptions.
3. Retire and get up the same time every day.
4. Exercise regularly . Finish all exercise and
vigorous activity at least 3 hours before bedtime.
5. Establish a regular, relaxing bedtime routine.
6. Create a dark , quiet, cool sleep environment.
7. Have comfortable beddings.
8. Use the bed for sleep only.
9.Avoid large meals before bedtime.
 TOBACCO
AND
HEALTH RISK
• SMOKING CESSATION IS
AN IMPORTANT STEP IN
ACHIEVING OPTIMUM
HEALTH
QUIT SMOKING TIMELINE
WITHDRAWAL SYMPTOMS INTERVENTION
 GOING “COLD TURKEY”
• "Cold turkey" describes the abrupt cessation
of a substance dependence and the
resulting unpleasant experience, as
opposed to gradually easing the process
through reduction over time or by using
replacement. medication
 Some steps to quit smoking
(American Cancer Society)

1. Make the decision to quit.

2. Set a date to quit and choose a plan.
3. Deal with the withdrawal.
4. Staying off tobacco is a lifelong process-
remind yourself of the reasons why you quit.
 MPOWER (WHO Tobacco Free Initiative, 2012)

- a strategy used in the implementation and

management of tobacco control
•M – monitor tobacco use and prevention
policies
•P- protect people from tobacco smoke
•O- offer help to quit tobacco use
•W- warn about the dangers of tobacco
•E - enforce bans on tobacco advertising.
promotion and sponsorship
•R- raise taxes on tobacco
 R.A. 9211
Tobacco Regulation Act of 2003
• Prohibits smoking in
public places and sale
of tobacco products to
minors

• May 31 – World No
Tobaccco Day
 Executive Order 26
• signed on May 16, 2017
• smoking is prohibited in “enclosed” public
places and public utility vehicles regardless if
they are moving or stationary and is allowed
only in designated smoking areas
• Selling, distribution and purchasing of tobacco
products from minors are also prohibited
• Ordering, instructing or compelling of a minor to
use, light up, buy, sell, distribute, deliver and
promote tobacco products will likewise be
prohibited.
Red Orchid Award

• Red Orchid Awards was

conceptualized to combat
tobacco use and to work for a
tobacco-free environment ,
whether by the local
government units, government
offices or government hospitals
ALCOHOL CONSUMPTION
AND
HEALTH
OTTAWA CHARTER
FOR HEALTH
PROMOTION
• Organized by the WHO

• the first International Conference

on Health Promotion held in
Ottawa , Canada on November
17- 21, 1986

• Calls for a commitment on health

promotion to achieve the goal of
health for all by year 2000 and
beyond
 THREE BASIC STRATEGIES
1. Advocacy for health to provide the
conditions and resources essential for
health
2. Enabling all people to attain their full
health potential
3. Mediating among the different sectors
of society in efforts to achieve health
 Five PRIORITY Action Areas
to support the three strategies

1. Build Healthy Public Policy

2. Create Supportive
Environments
3. Strengthen Community Actions
4. Develop Personal Skills
5. Reorient Health Services
6. Moving Into the Future
 HEALTH EDUCATION
- The process of changing people’s knowledge,
skills and attitudes for health promotion and risk
reduction.

- Nurses Role:
- - to empower people so that they are able to
achieve optimum health and prevent disease by
bringing about lifestyle changes and reducing
exposure to health risks in the environment.
 PATIENT EDUCATION
- a series of planned teaching-learning activities
designed for individuals , families or groups with
an identified alteration in health

- PURPOSE: to aid the client in coping with the

event, to prevent complications or deterioration
of the client’s condition or to prevent
transmission of the disease.
 Basic Principles That Guide
The Effective Nurse Educator
1. Message – clear, understandable
2. Format – most appropriate strategy to
match the objectives of the activity and the
characteristics of the learner
3.Environment – conducive environment
that would create a therapeutic and supportive
relationship with the learner
 Basic Principles That Guide
The Effective Nurse Educator
4. Experience –positive and meaningful
learning experiences
5. Participation- involving the learner in
discussions and other activities, soliciting
feedback, role playing and return demonstration
6. Evaluation- objective feedbacking to
the learner through quizzes, individual
conferences.
al
 ▪ group of persons united by ties of
FAMILY
marriage , blood or adoption,
–a unit of constituting a single household,
service in interacting and communicating with
community and each other in their respective social
public health roles.
nursing
▪ “ natural’ and fundamental unit of
society
Types of
Families

1. STRUCTURE:
  FAMILY OF PROCREATION-
Types of refers to the family you yourself
Families created.

2. FUNCTIONAL

 FAMILY OF
ORIENTATION-refers to the
family where you came from.
  PATRIARCHAL – full authority on the father or any male
Types of member of the family e.g. eldest son, grandfather
 MATRIARCHAL – full authority of the mother or any female
Families member of the family, e.g. eldest sister, grandmother
 EGALITARIAN- husband and wife exercise a more or less
Y amount of authority, father and mother decides
 DEMOCRATIC – everybody is involved in decision
IT
making
OR

 AUTOCRATIC- both parents rule the family with absolute

authority
TH

 LAISSEZ-FAIRE- “full autonomy”

AU

 MATRICENTRIC- the mother decides/takes charge in

absence of the father (e.g. father is working overseas)
3.

 PATRICENTIC- the father decides/ takes charge in

absence of the mother
 4. DESCENT
Types of - cultural norms, which affiliate a person with a
particular group of kinsman for certain social purposes
Families
• PATRILINEAL (Agnatic) – affiliates a
person with a group of relatives who are
related to him though his father
• BILATERAL- both parents
• MATRILINEAL (Uterine) – related
through mother
Types of 5. RESIDENCE
Families

• PATRILOCAL – family resides / stays with

/ near domicile of the parents of the
husband
• MATRILOCAL – live near the domicile of
the parents of the wife
FAMILY LIFE
CYCLE
▪ Based on the Philippine Constitution, Family Code with
focus on religious, legal, and cultural aspects of the
definition of family.
▪ Section 1
▪

The Filipino The state recognizes the Filipino

Family family as the foundation of the
nation. Accordingly, it shall
strengthen its solidarity and actively promote
its total development.
 THE FILIPINO FAMILY

▪Section 2
▪ -Marriage, as an inviolable social
institution, is the foundation of family and
shall be protected by the state.

THE FILIPINO
▪Section 3
FAMILY
The state shall defend –
-the right of spouses to found a family in
accordance with their religious
convictions and the demands of
responsible parenthood
 THE FILIPINO FAMILY

-the right of children to assistance including proper

care and nutrition, and special protection from all
forms of neglect, abuse, cruelty, exploitation and
other conditions prejudicial to their development

THE FILIPINO
FAMILY -the right of the family to a family living wage
income

-the right of families or family associations to

participate in the planning and implementation of
policies and programs of that affect them
 ▪Section 4
▪ The family has the duty to care for
its elderly members but the state
THE FILIPINO may also do so through just
FAMILY
programs of social security
 expressly states that :

Executive Order “Marriage is a special

No. 209 contract of permanent union
between man and woman
FAMILY CODE entered into in accordance
OF
THE PHILIPPINES with the law for the
establishment of conjugal
and family life”
The basic social units of Philippine
society are the nuclear family
▪ 1. The influence of kinship is felt in all
segments of social organizations

CHARACTE ▪ 2. Extensions of relationships and descent

RISTICS OF patterns are bilateral
A FILIPINO
FAMILY ▪ 3. Kinship circles is considerably greater
because effective range often includes the
third cousin
 ▪ 4. Kin group is further enlarged by a finial,
spiritual or ceremonial ties. Filipino
marriage is not an individual but a family
affair.
CHARACTE
RISTICS OF ▪ 5. Obligation goes with this kinship
A FILIPINO system
FAMILY
▪ 6. Extended family has a profound effect
on daily decisions
 ▪ 7. There is a great degree of equality
between husband and wife

▪ 8. Children not only have to respect

CHARACTE their parents and obey them, but also
RISTICS OF have to learn to repress their
A FILIPINO aggressive tendencies
FAMILY
▪ 9. The older siblings have something
of authority of their parents.
 ▪ HOSPITALITY
▪ FATALISM : An attitude of "what goes
around, comes around" or "come what may." We
OTHER FILIPINO have a tendency to surrender our future to fate. We
CHARACTERISTI often accept bad news or circumstances without
CS trying to stop or change them. This can sometimes
be helpful in adversity, but it can also keep us from
finding ways out of situations

▪CRAB MENTALITY