STANDARD OF PUBLIC HEALTH

NURSING
IN
THE PHILIPPINES
THE PUBLIC HEALTH NURSING IN THE
PHILIPPINES
 created to developed and practice promoting wellness
of the community and protecting the health of every
individual with the help of the nurse’s skills and
 knowledge to serve the community through educating
people about the health issues that might affects
 the individual’s physical, emotional, and spiritual aspect,
also it improve the community safety and
 health and to increase and enhance the access to care
to help and improve their lifestyle and environment.
STANDARD OF CARE
Standard 1 ASSESSMENT
Standard 2
POPULATION DIAGNOSIS PRIORITIES
Standard 3 IDENTIFICATION
Standard 4 PLANNING
Standard 5 IMPLEMENTATION
Standard 6 EVALUATION
Standard 7 QUALITY OF PRACTICE
Standard 8 EDUCATION
Standard 9 PROFESSIONAL PRACTICE
EVALUATION
Standard 10
COLLEGIALITY AND PROFESSIONAL RELATIONSHIPS
Standard 11 Collaboration
Standard 12 ETHICS
Standard 13 RESEARCH
Standard 14 RESOURCE UTILIZATION POPULATION
Standard 15 LEADERSHIP
EVOLUTION OF PUBLIC HEALTH
NURSING IN THE PHILIPPINES
PRE SPANISH ERA BEFORE 1565

 Our ancestors put faith in nature not

only for physical but also for spiritual
sustenance.
Belief in the power of both the
animate and inanimate world was
central to their way of life.
Ailments were believed to be caused by
disharmony with the spiritual world, and
restoring health meant appeasing the gods
through incantations, dances and ritual
offerings that ranged from food, to clothing,
to blood sacrifice.(BABAYLAN)
 THE SPANISH ERA
(1565 – 1898)
 The religious orders exerted their
efforts to care for the sick by building
hospitals in different parts of the
Philippines
 BABAYLAN TO SPANISH FRIARS
 THE EARLIEST HOSPITALS

Hospital Real de Manila (1587 to 1685)

The religious orders exerted their efforts
to care for the sick by building hospitals
in different parts of the Philippines
very first hospital in the Philippines
From Cebu to Manila
 JUAN CLEMENTE

A Lay Brother and Botanist

Concocted medication and salves to apply their
wounds
He was able to raise funds for a simple structure
inside the convent from the community and clergy
The hospital became the Hospital de los Indios
Naturales, more popularly known as Hospital de
Naturales
The friars cared for the sick while also tending to
their spiritual needs. Apart from the hospital, the
facility also housed a free pharmacy where
ointments, oils, herbal remedies and other medical
supplies could be obtained. Through its well-
stocked dispensary, the Hospital de Naturales was
able to supply most of the medical needs of other
hospitals and religious infirmaries
The original structure was destroyed by a fire that
razed Intramuros in 1583 but was rebuilt as a stone
structure with the help of Father Domingo Salazar,
the first archbishop of the Philippines
Juan Fernando de Leon, a Franciscan priest.
Inspired by Fray Clemente, de Leon devoted
himself to hospital work after his recovery. Using his
personal finances, he built an additional ward for
the hospital and ensured its financial upkeep.
Eventually, de Leon founded the Brotherhood of
Santa Misericordia under the Order of St. Francis to
support the facility
Fray Clemente died in 1598 at the age of 74 after
20 years of service to the hospital.

A few years after his death, tragedy struck once

again when the Hospital de Naturales was
destroyed in yet another fire.
HOSPITAL DE LA MISERICORDIA

After the fire of 1603, it was decided that the

original site of the Hospital de Naturales be turned
over to the Brotherhood of Santa Misericordia.

The Hospital de la Misericordia was built for the

care of the sick servants and slaves of the
Spaniards.
Dwindling funds necessitated the transfer of the hospital’s
administration from the Brothers to the Hospitaller Order of
San Juan de Dios. A small infirmary in Bagumbayan began
operations in 1643, which became known as the Hospital
de San Juan de Dios.
The Order of San Juan de Dios maintained the
hospital for over two hundred years until by the
decree of the governor-general and the will of
Queen Isabella of Spain, the management of the
facility was transferred to the Daughters of Charity
on April 14, 1868. A year later, the decree went
into full effect when the Sisters formally took over
the hospital
 HOSPITAL OF SAN GABRIEL

The Chinese population in the Philippines was already

present long before the Spanish

The Dominicans arrived in the country in 1587 upon the

invitation of Manila Bishop Domingo de Salazar who sought
their help to minister and convert the Chinese to the faith

The Dominicans would extend charity to the Chinese,

some of whom fell sick and died in poverty and
abandonment.
It was in 1574 that another smallpox, also called bolotong,

became the first recorded epidemic in the history of the

country. It spread to provinces as far as Cagayan, Samar,
and Leyte and killed over 30,000 Filipinos by the 1760s.

In 1789, a vessel from China traveling to the Ilocos region

was believed to be the probable source of an epidemic
that soon spread to Manila and its neighboring provinces.
 APRIL 15, 1805

 The introduction of the smallpox vaccine

to the Spanish colonies, including the
Philippines, though an expedition led by
Dr. Francisco de Balmis.
 HOSPITAL DE SAN LAZARO

named after the Patron Saint of the Lepers

took care of 150 lepers

But the lepers were received graciously by the hospital,

their arrival becoming an occasion for the clergy and the
community to extend its benevolence to those afflicted by
the disease who are normally treated as outcasts in
society.
San Lazaro Hospital is known today as an institution
for the treatment of communicable and infectious
diseases. It remains one of the tertiary public
hospitals under the supervision of the DOH,
continuing to serve those in need as it has done
for more than 400 years.
AMERICAN REGIME
 1901

The United States Philippine Commission,

through Act 157
created the Board of Health of the
Philippine Islands with a Commissioner of
Public Health as its chief executive officer.
The Board of Health eventually evolved into
what is now Department of Health
1912

Fajardo Act of 1912

created Sanitary Divisions made up of one

to four municipalities.

Each Sanitary division had a president who

had to be a physician
 1915

The Philippine General Hospital began

to extend public health nursing services
in the home of the patients by
organizing a unit called Social and
Home Care Service, with two staff
nurses.
 1916 to 1918

Perlita Clark took charge of public

health nursing work.
 1919

Public health nursing inaugurated its pioneer work in Tondo

Manila when a visiting nurse Balbina Basa was assigned to
make a house to house visit, hold clinic and dispensary
work with special emphasis maternal and child care 176
puericulture nurses assigned in Manila. and provinces
since 1919.
Puericulture centers are semi government agencies partly
financed by private funds and aided by the government.
Maternal and child care is offered
 1923

90 Public Health Nurses assigned in

different province
 1928

First convention of nurses was held

followed by annual conventions until
the advent of World War ll.
 1935

133 positions of public health nurses

assigned in the community with high
infant mortality
JAPANESE ERA
 1941

Public Health Nursing services was

interrupted(1941) The effect of WW II on
December 8, 1941Public Health Nurses in Manila
was assigned to devastated areas to attend to
the sick and wounded civilians caused by
bombing, 12 emergency units were organized;
one of them was sent to Bataan to attend to the
sick and wounded which were left by the
retreating forces of Gen. Douglas MacArthur.
 1942

Group of Public Health Nurses with

Physicians and administrators of Manila
Health Department went to Capas Tarlac to
receive sick prisoners of war released by to
receive sick prisoners of war released by
Japanese army
ERA OF THE REPUBLIC OF THE
PHILIPPINES
 1947

Increased the number of Public Health

Nurses
Reorganization of government offices
under E.O No. 49 s. of 1947 with the transfer
of the Bureau of Public Welfare to the Office
of the Pres., and the department was
renamed Department of Health
 1954

R.A 1082 (Rural Health Unit Act) creation of a rural

health units in every municipality and for the
employment of physicians to serve as municipal
health officers, public health nurses, midwives, and
sanitation inspectors, in the rural health units.
It also provided a provincial health officer for
each province and public for each province and
public health dentist for each congressional
district.
 1957

R.A 1891(an Act Strengthening Health

and Dental Services in the Rural Areas
and Providing Funds
 1975

Formulation of the National Health

Plan and the Restructured Health care
Delivery System
 1982

Under E.O 851,

the Health Education and Manpower

Development Services was created
with the BFAD
 1986

The Ministry of Health became

Department of Health
 1987

The EPI and the National drug Policy,

the implementation of Generic Law of

1988
 1991

R.A. 7160,
The Local Government Code of 1991

was implemented which resulted to devolution

which transferred the power and authority from
the national to local government units. Materials,
supplies, of health centers have to be provided by
the local government units.
 1992

Full implementation of the R.A 7160 or Local Government Code.

Special projects were highlighted like NID (National Immunization Day),
National Micronutrients Campaign (Araw ng Sangkap Pinoy)

Disater Management, Urban Health and Nutrition Project, Traditional

Medicine, Doctors to the Barrio Program,” Let’s Do It!” became a
national battle cry

The National League of Philippine Government Nurses was organized,

government nurses as members
 1993

Primary Health Care as a strategy to attain Health for All

by the year 2000 was in focus supported by the following
slogan,
“23 in “93”,
Health for More in “94”
five in “95”
Go 7 in “1977”
Health Sector Reform Agenda of the Philippine was
launched
 2005

The DOH launched Fourmula One for health

to ensure speed precision
and effectiveness and equity of health care
delivery
 1999

D.O order 209 designated Nelia Hizon, Nurse V1 as

the nursing adviser to look matters affecting nurses
nursing is referred to her.

E.O 102 was signed by President Erap Estrada,

redirecting new functions and operations of the
DOH, wherein most of the nursing positions at the
Central Office were transferred or devolved to
other offices and services.
ROLES OF A COMMUNITY HEALTH
NURSING
ROLES OF THE PUBLIC HEALTH NURSE

Clinician
 Health Educator
 Coordinator/
Collaborator
 Supervisor
 Leader/
Change Agent
 Manager
 Researcher
 CLINICIAN or HEALTH CARE
PROVIDER
Caring is the essence of nursing and has
been widely accepted in all settings.
The use of nursing process applied in the
natural environment of the client
 HEALTH EDUCATOR

Communicating information to help patients

make an informed choice regarding their
health is a key activity in public health work.

It is hoped that awareness will impact

people’s behavior to achieve health in their
own hands.
 COORDINATOR and
COLLABORATOR
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.
 SUPERVISOR

monitors and supervises the performance of

midwives and other auxiliary health workers;
also initiates the formulation of staff
development and training programs for
midwives and other auxiliary health workers
as part of their training function as
supervisors
 MANAGER/LEADER

Community and public health work deals

with competing claims specifically on
utilization of limited resources.

Employs principle of management to

maximize resources effectively and
efficiently
 COMMUNITY ORGANIZER

Working with people in communities and

providing them ownership of their
healthcare needs and to act collectively on
their issues
 RESEARCHER

The nurse is regarded as the health

monitor of the community.

The nurse utilizes research findings to

provide evidence to convince decision
makers to make policies f
Other Specific Responsibilities of a Nurse, spelled by the
implementing rules and regulation of RA 7164 (Philippine
Nursing Act of 1991) includes:

Supervision and care of women during pregnancy, labor

and puerperium

Performance of internal examination and delivery of

babies

Suturing lacerations in the absence of a physician

Provision of first aid measures and emergency care
Recommending herbal and symptomatic meds… etc
IN THE CARE OF THE FAMILY

Provision of primary health care services

Development/Utilization of family nursing

care plan in the provision of care
IN THE CARE OF THE COMMUNITIES

Community organizing mobilization, community

development and people empowerment

Case finding and epidemiological investigation

Program planning, implementing and evaluation

Influencing executive and legislative individuals or bodies
concerning health and development
MILLENIUM DEVELOPOMENTAL
GOALS
 MDGs

are eight goals with measurable targets and

clear deadlines for improving the lives of the
world's poorest people. To meet these goals
and eradicate poverty, leaders of 189
countries signed the historic millennium
declaration at the United Nations Millennium
Summit in 2000.
 Goal 1 have seen the number of hungry people in
the world decrease to fewer than 1 billion, though
the Food and Agriculture Organisation of the
United Nations believes that this number is still
unacceptably high
THREE TARGETS OF GOAL 1
To halve the proportion of people whose daily
income is less than $1.25
To achieve full and productive employment, as
well as decent work for all, including young
people and women
To halve the proportion of individuals suffering
from hunger in the period between 1990 and 2015.
To ensure that children universally – including
both boys and girls – will be able to complete
a full course of primary education by 2015.
There was only one target under
millennium development goal 3:

To eliminate gender disparity in primary

and secondary education by 2005,
and in all levels of education by 2015.
The Millennium Development Goal 4
has only one target:

To reduce the under-five mortality rate

by two-thirds in the period between
1990 and 2015
Undernutrition is estimated to contribute to
more than 33 percent of all deaths in
children under five. So, efforts to improve
household food security and nutrition have
increased the chances of children growing
to adulthood.
Hunger and malnutrition were observed to
increase the incidence and fatality rate of the
conditions that contribute to nearly maternal
deaths.
TARGET OF GOAL 5

To reduce the maternal mortality ratio

by 75 percent

To achieve universal access to

reproductive health
HIV, malaria, and other diseases directly and
indirectly impact food and nutrition security,
rural development, and agricultural
productivity. At the same time, malnutrition
and food and nutrition insecurity can increase
vulnerability to disease.
TARGET OF GOAL 6

To halt by 2015 and have started to reverse the

spread of HIV/AIDS

To achieve global access to treatment for

HIV/AIDS for those who need it by 2010

To have ceased and started reversal of the

incidence of malaria and other major diseases by
2015
TARGETS OF GOAL 6

Target #1: Halt and reversal of the spread of

HIV/AIDS
Target #2: Universal access to HIV/AIDS
treatment
Target #3: Reversal of the incidence of
malaria and other major diseases
It is critical that the natural resources base and
ecosystems are managed sustainably to ensure
that people’s food requirements and other social,
economic, and environmental needs are
sufficiently met.
Climate change, conflicts over access to
resources, and increased water scarcity all pose a
threat to not only environmental sustainability but
also food security.
GOAL 7 TARGETS

To integrate the principles of sustainable

development into every nation’s policies and
programmes, and also reverse the depletion of
environmental resources

To reduce biodiversity loss and achieve a

substantial reduction in the rate of loss by 2010
 To halve the proportion of the universal
population without sustainable access to clean
and safe drinking water and basic sanitation by
2015.

 To achieve substantial improvement in the lives

of a minimum of 100 million slum dwellers by
2020.
Millennium development goal 8 has 6 targets
that seek to develop global partnership for
development

To further develop an open, predictable, rule-based, non-

discriminatory trading and economic system

To address the special needs of the least developed

countries
To address the special needs of
small island developing States and
landlocked developing countries

To deal exhaustively with the debt

problems of developing nations
To provide access to affordable essential
drugs in the developing world – in
collaboration with pharmaceutical
companies
To avail benefits of new technologies,
especially information and communications,
in collaboration with the private sector