GLOBAL AND NATIONAL HEALTH SITUATIONS 5.
Non-Communicable Diseases
6 Global Health Issues to be Aware of
1. Pandemics
global disease outbreaks
→ ex. COVID-19
2. Environmental Factors
→ “Climate change is thought by many global health experts to be
the greatest threat to human health,”
→ Climate change led to more extreme weather
→
According to World Meteorological Organization (WMO)
○ 11, 000 reported disasters (1970-2019)
○ 2 million deaths, more than 91% of deaths occurred in
developing countries
○ US$ 3.64 trillion
○ Droughts, storms, floods, extreme temperature
→ Storms, flooding, droughts, and air pollution make it easier for
diseases to spread across large groups of people.
→ Ex. Typhoon Odette (2021) – 6 regions affected (Dinagat
islands, Surigao del Norte, Bohol, Cebu, Palawan), 9.9 million
affected, 2.4 million were need of assistance, 28 billion damage,
405 deaths, 66 missing
3. Economic Disparities and Access to healthcare
→ Communities across the world still lack access to basic health
education and health care
Measured thru health Indicators:
1. Data infrastructure
2. Process and outcome measures stratified by subpopulations
3. Process and outcomes measures targeted at specific
subpopulations
4. Process and outcome measures targeted at strategies intended to
reduce inequities
4. Political Factors
→ Based on the leader, if the person with power cares about health
care = will give importance to health
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Such as hypertension, heart diseases, cancer, diabetes, respiratory
diseases
6. Animal health, Food sourcing and Supply
The ever-growing list of global health issues can be overwhelming,
but there are so many ways individuals can make a positive impact
COMMUNITY HEALTH NURSING
PUBLIC HEALTH
Health – WHO defines health as a “state of complete, mental, and
social well-being, not merely the absence of disease or infirmity.”
Determinants of Health
Income and social Status
- Higher income and social status is linked to better health
Education
- Low levels of education are linked to poor health, more stress and
lower self-confidence
Physical Environment
- Safe water, 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, belief, traditions affect health
Genetics
– inheritance plays a part in determining lifespan, healthiness and
developing certain illness
Personal Behavior and Coping Skills
– balanced eating, keeping active, smoking, drinking and how we
deal with life’s stresses affect health
Health Services
– Access and use of services that prevent and treat illness influence
health
Gender
– men and women suffer from different types of diseases at different
ages
Public Health
- “Science and art of preventing diseases, prolonging life,
promoting health and efficiency through organized
community effort for the sanitation of environment, control
of communicable diseases, the education of individuals in
personal hygiene, organization of medical and nursing
services for early diagnosis and preventing treatment of
disease and the development of social machinery to ensure Community Health Nursing
everyone a standard of living adequate for the maintenance - The utilization of the nursing process in the different levels
of health, so organizing these benefits as to enable every of clientele-individuals, families, population groups and
citizen to realize his bright right of health and longevity communities, concerned with the promotion of health,
prevention of disease and disability and rehabilitation
Essential Public Health Functions: (Maglaya, et al).
1. Health Situation Monitoring and analysis -
2. Epidemiological surveillance/ disease prevention and control Concept of CHN
3. Development of policies and planning in public health 1. CHN identifies the need of holistic care approach
4. Strategic management of health systems and services for 2. CHN support that community-based efforts and involvement is
population health gain essential for risk reduction
5. Regulation and enforcement to protect public health 3. It realizes that health promotion and primary prevention are
6. Human resources development and planning in public health major activities in CHN practice
7. Ensuring quality of personnel and population-based health 4. It supports the entire community as well as individual, families
services and aggregates as a focus for CHN
8. Health promotion, social participation and social empowerment 5. It believes in over-all development and well-being of
9. Research, development and implementation of innovative public individuals, families and communities
health
Clients of CHNs
Public Health Nursing
● Individual
“Special field of nursing that combines the skills of nursing, public ● Family
health and some phases of social assistance and function as part of
total public health program for the promotion of health, the ● Population group
improvement of the condition in social and physical environment,
rehabilitation of illness and disability ● Community

COMMUNITY HEALTH NURSING Public Health Nursing Community Health Nursing

Community – group of people who might have different “Whatever the local
characteristics but share geographical location, setting goals or social
interests department of health takes
under its purview – infectious
disease prevention and
eradication, policymaking etc.”
“Has the same goals and
employs the same strategies
(health promotion, prevention
etc), but is primarily organized
around a
geographic area.”

“Sets safety standards to Focuses more on advocating

protect workers and develops for healthcare and medical

school nutrition programs to
ensure kids have access to healthy services to local communities but
foods” can be broader as it encompasses
nursing practice in a variety of
roles, which at times include
independent nursing
Community health
practice
- refers to the health status of a defined group of people, or
community, and the actions and conditions that protect and The practice of nursing in
improve the health of the community.
local/national health

departments (which includes

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 health centers and rural health ● The PHN performs functions and activities in accordance with
units and public schools
the dominant values of public health nurses
Implementers of the local • Management training, supervision, provision of nursing care,
health promotion and education and coordination are consistent
government units’ mandate in with RA 9173 and program policies formulated by DOH
promoting and protecting the • Considers the needs of her/his clients and their available
health of their constituents. resources for heath and health care
● PHN, in coordination with the faculty of colleges of nursing,
STANDARDS OF PUBLIC HEALTH NURSING IN PH (2005) participates in teaching, guidance and supervision of students in
Nursing Service nursing and midwifery for their RLE in the community setting
- Separate and distinct unit of the local health agency/unit ● Participates in the conduct of research and utilizes research
which is composed of nurses, midwives and auxiliaries findings in his/her nursing practice
such as barangay health workers nursing aides and
volunteers. III. Other Components
I. Organization and Management ● Supervision
● A nursing service is organized in a local health agency to ensure ● Interdisciplinary and intersectoral collaboration
the effective delivery of nursing services and nursing component
of public health programs ● Nursing process

● Nursing service is headed by a qualified Chief Nurse (RA 9173) ● Health promotion and health education
1. Has a bachelor’s degree in nursing and a registered nurse in the ● Demonstrating Professional, Responsibility and Accountability
Philippines
2. Has at least 5 yrs. experience in general nursing service
administration EVOLUTION OF PUBLIC HEALTH NURSING IN THE PH
3. Has master’s degree in nursing
4. Member of a good standing of the accredited professional 1898 - The history of public health nursing in the Philippines is
organization of nurses embedded in the history of the Department of Health which was first
established as Department of Public Works, Education and Hygiene
● The Supervising PHN who heads a nursing unit should have 2006 – Present - The Philippine Nursing Act of 2002 was enacted
following qualification: under the Republic Act No. 9173 which entails changes on existing
1. BSN, RN policies under Republic Act No. 7164
2. 5 yrs. Supervisory experience in public health
3. Master’s degree in public health or nursing
4. Member of good standing of the accredited professional org. of
nurses
● The nursing service has a written vision, mission, philosophy,
goals and objectives.
● Formulates/reviews and implements the nursing service plan,
manual of policies and nursing standards.
● Participates for the health agency’s physical facilities,
equipment and supplies and in monitoring their use.
● Participates in the official recruitment, selection, promotion, and
discharge process at all levels involving nursing personnel and
in making decisions involving nurses and midwives and nursing
practice.
● Initiates/strengthens mechanisms within the agency that enhance
nursing and midwifery contribution to the overall community
health goals.

II. Qualification and Function of a PHN

● Graduate of BSN and a RN UNIVERSAL HEALTH CARE LAW
RA 11223: THE UNIVERSAL HEALTH CARE LAW
● Personal and professional competencies:  Signed by Rodrigo Duterte
• Good physical and mental health  Expansion of population, service, and financial coverage
• Interest and willingness to work in the community  Shift to primary care
• Leadership potentials
 All Filipinos guaranteed “equitable access to quality and
• Resourcefulness and creativity
affordable health care goods and services and protected against
• Honesty and integrity
financial risk
• Active membership to professional nursing organizations

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 Ensure every Filipino is healthy, protected from health hazards  Health Technology Assessment
and risks, and has access to affordable, quality and readily  Ethics in public health policy and practice
available health service that is suitable to their need  Health information system
General Objections
 Appropriation
 To progressively realize universal health care through systemic
approach and clear role delineation of stakeholders PHILIPPINE HEALTHCARE DELIVERY SYSTEM
 To ensure equitable access to quality and affordable health care Health System
and protection against financial risk  Interrelated system in which a country organizes available
resources for the maintenance an improvement of the health of
Declaration of Principles its citizens and communities
 Integrated and comprehensive approach  comprises all organizations, institutions and resources devoted to
 Whole of system, whole of government, whole of society producing actions whose primary intent is to improve health
approach Healthcare System – organized plan of health services
 Comprehensive health services without causing financial Healthcare Delivery – rendering health services to people
hardship Healthcare Delivery System - network of health facilities and
 People oriented approach personnel which carries out the task of rendering health care to the
people
Universal Health Care
Philippine Healthcare system Context
 Healthy living, schooling and working environments
 health basic human right
 Primary care provider team for every family
 DOH lead agency
 Healthy spending is predictable not “lahat libre”
 Local government code - devolved the management and delivery
Salient Features of UHC law of health services from National DOH to the LGUs
 Access to healthcare hampered by cost, physical and socio-
FINANCING cultural barriers and workforce crisis
 All Filipinos automatically be member of Philhealth
 Families not registered – assisted by their healthcare provider
 Philhealth ID will not require availing services
 Direct and Indirect Contributors
 Private Sector Financing Agents – offer complementary or
supplementary benefit packages
 Service Coverage - “Preventive, promotive, curative,
rehabilitative and palliative care for medical, dental mental and
emergency health services delivered either as population-based
or individual-based health services.
SERVICE DELIVERY
 Health care provider network (HCPN) - group of primary to
tertiary care providers (public or private), offering people- PHILIPPINE HEALTHCARE DELIVERY
centered and comprehensive care in an integrated manner with  Classification of Hospitals
the primary care provider acting as the navigator and 1. According to ownership – government/private
coordinator. 2. According to scope of services – general/specific
 Primary Care Provider Network refers to a group of public, 3. According to functional capacity – general/specialty/trauma
private or mixed primary care providers as the foundation of capability
HCPN.
 Organization of Local Health Systems: Service Delivery Public Sector
 Province-wide and City-wide Health systems  LGU
 Provincial/ City Health Board  DOH
 Provincial/ City health office  Financed through taxes making healthcare service “free” at point
 Incentives for improving competitiveness of care
HUMAN RESOURCES FOR HEALTH Private Sector
 National Health Human Resource Master Plan  Profit and non-profit providers
 National Health Workforce support system  Services are often not-free
REGULATION • OOP schemes
• Insurance
 Safety and quality
• External funding/grants
 Affordability
 Equity HEALTH WORKFORCE
GOVERNANCE AND ACCOUNTABILITY
 Health Promotion DOH HRH Efforts:
 Evidence-Informed sectoral; policy and planning for UHC • Doctors to the Barrios (DTTB)
• Nurses Deployment Program (NDP), formerly RN-Heals)
 Monitoring and Evaluation
• Rural Health Midwife Placement Program (RHMPP)
 Health Impact Assessment HRH Challenges:
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• Brain Drain Phenomenon:
• 70% of those who stay are in the private sector catering to only 30%
of the
population
• 30% are in the public sector serving the majority
• Largest categories of HRH: nurses and midwives, there is
underproduction in other categories such as doctors, dentists, med
techs etc.
• Less incentives – contractualization, low salary < amount of work

HEALTH INFORMATION SYSTEM

 E-Records
 E-surveillance
 E-medicine

Challenges:
• Computerized systems available but still highly reliant on paper and
pen systems in the frontline
• Telecom infrastructure mostly concentrated in urban areas
• Lack of IT governance and structures

MAJOR CONSTRAINTS ASSESSING ESSENTIAL

MEDICINE:
• Limited availability
• Irrational use
• High costs
*As an effect of the devolution, LGUs are left to budget for essential
medicines which results in great variability in access to such

PHILIPPE HEALTH FINANCING

 Main fund sources

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