Overview of Public Health Nursing in The Philippines

13/09/2023
Overview of Public
Health Nursing in the
Philippines
Katreena Ness J. Olila, RN, LPT
Reno Richard C. Ramirez, RN
Global and National Health Situation

CORONAVIRUS DISEASE (COVID-19) IN THE PHILIPPINES
❑ The COVID-19 is an infectious disease caused by a
new strain of coronavirus. This new virus and disease
were unknown before the outbreak began in Wuhan,
China, in December 2019.
❑ On 30 January 2020, the Philippine Department of
Health reported the first case of COVID-19 in the
country with a 38-year-old female Chinese national.
❑ On 7 March, the first local transmission of COVID-19
was confirmed.
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Philippines Department of Health- COVID-19 Tracker from
https://doh.gov.ph/covid19tracker (August 11, 2023)

Philippines Department of Health- COVID-19 Tracker from
https://doh.gov.ph/covid19tracker (August 11, 2023)
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Philippines Department of National COVID-19 Vaccination Dashboard from
https://doh.gov.ph/covid19-vaccination-dashboard (March 19, 2023)

• POLIO OUTBREAK IN THE PHILIPPINES
• On 19 September 2019, an outbreak of polio was declared in the
Philippines which might put the children at risk of lifelong paralysis.
• The Philippine DOH and partners are working together on
comprehensive outbreak response, including mass polio immunization
rounds “Sabayang Patak Kontra Polio” from October 2019.
• All children, regardless f whether they are covered by the mass
immunization campaign or not, should be vaccinated according to the
routine immunization schedule.
❑ No Polio Virus Type 1 (cVDPV1) and Type 2 (cVDPV2) was reported
recently.
❑ Total number of Type 2 cases reported in 2020 remains one and 12 in
2019.
❑ Total number of Type 1 cases reported in 2019 is only 2 and none in
2020.
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TWENTY LEADING CAUSES OF MORTALITY as of July 31, 2022
Data from Philippine Statistics Office
https://psa.gov.ph/content/2022-causes-deaths-philippines-preliminary-31-july-2022

Ten Leading Causes Of Mortality (2021) in Region 10
Data From Https://Ro10.Doh.Gov.Ph/Health-statistics/Fhsis-reports
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Ten Leading Causes Of Morbidity (2021) in Region 10
Data From Https://Ro10.Doh.Gov.Ph/Health-statistics/Fhsis-reports

TOP 10 Most Common Health Issues in the Philippines
1. Physical Activity & Nutrition
2. Overweight & Obesity
3. Tabacco
4. Substance Abuse
5. HIV/AIDS
6. Mental Health
7. Injury & Violence
8. Environmental Quality
9. Immunization
10. Access to Health Care
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HEALTH
“Health is the state of complete

physical, mental, and social well being,
not merely the absence of disease or
infirmity” – WHO
Public Health
• “science and art of preventing disease, prolonging
life, promoting health and efficiency through
organized community effort”- CE Winslow, 1920
• According to CE Winslow, Public Health is a science and
art of 3 P’s
➢ Prevention of Disease
➢ Prolonging life
➢ Promotion of health and efficiency through
organized community effort
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Community Health
• Part of paramedical and medical intervention/
approach which is concerned on the health of the
whole population
• AIMS:
✓ health promotion
✓ disease prevention
✓ management of factors affecting health
Public Health Nursing
• “specific field of nursing that combines the skills of

nursing, public health and some phases of social
assistance and functions as part of the total public
health programme for the promotion of health, the
improvement of the conditions in the social and
physical environment, rehabilitation of illness and
disability.” – WHO
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Public Health Nursing

• refers to the practice of nursing in national and local
government health departments (which includes
health centers and rural health units), and public
schools.
Community Health Nursing

• “The utilization of the nursing process in the
different levels of clientele-individuals, families,
population groups and communities, concerned with
the promotion of health, prevention of disease and
disability and rehabilitation.” - Maglaya, et al
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• A science of Public Health combined with Public
Health Nursing Skills and Social Assistance with the
GOAL: of raising the level of health of the citizenry,
to raise optimum level of functioning of the citizenry.
– WHO

• “a service rendered by a professional nurse
with communities, groups, families, individuals
and home, in health centers, in clinics, in
schools, in places of work for the promotion of
health, prevention of illness, care of the sick at
home an rehabilitation.” – Ruth B. Freeman
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Standards of Public Health Nursing in

the Philippines
The Standards of Public Health Nursing in the

Philippines developed by the National League
of Philippine Government Nurses in 2005
described the qualification and functions of a
Public Health Nurse.

the Philippines
QUALIFICATIONS AND FUNCTIONS OF A PUBLIC HEALTH NURSE
A. The PHN has the professional, personal and other qualifications that
are appropriate to his/her job responsibilities.
➢ a graduate of BS in Nursing and a Registered Nurse (RN)
➢ has the following personal qualities and professional
competencies:
a) Good physical and mental health
b) Interest and willingness to work in the community
c) Capacity and ability to:
✓ relate the practice with ongoing community health and
health related activities
✓ work cooperatively with other disciplines and members of
the community
✓ accept and take actions needed to improve self and
service
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the Philippines
c) Capacity and ability to:
✓ analyze combination of factors and conditions that
influence health of population
✓ apply nursing process in meeting the health and
nursing needs of the community and
✓ mobilize resources in the community
d) With leadership potential
e) resourcefulness and creativity
f) honesty and integrity
g) Active membership to professional nursing organizations.

the Philippines
B. The PHN performs functions and activities in accordance with the
dominant values of public health nurses, within the profession’s
ethicolegal framework and in accordance with the needs of the client
and available resources for health care.
C. The PHN, in coordination with the faculty of college of nursing,
participates in teaching, guidance and supervision of students in
nursing and midwifery for their related learning experience (RLE) in
the community setting.
D. The PHN participates in the conduct of research and utilizes
research findings in his/her nursing practice.
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the Philippines
QUALIFICATIONS AND FUNCTIONS OF A PUBLIC HEALTH NURSE
❖ Management function
❖ Supervisory function
❖ Nursing care function
❖ Collaborating and coordinating function
❖ Health promotion and education function
❖ Training function
❖ Research function
Evolution of Public Health Nursing in

the Philippines
HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES BASED ON SOCIO-
POLITICAL PERIODS:
A. Pre-American Occupation ( up to 1898 )
B. American Military Government ( 1898-1907)
C. Philippine Assembly (1907-1916)
D. The Jones Law (1916-1936)
E. The Commonwealth (1936-1941)
F. Japanese Occupation ( 1941-1945)
G. Post World War II (1945-1972)
H. Post EDSA revolution (1986 to present)
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the Philippines
A. PRE-AMERICAN OCCUPATION
➢ 1577- Public health began at the old Franciscan Convent in
Intramuros where Fr. Juan Clemente put up dispensary for
treating indigents in Manila.
➢ San Juan de Dios Hospital
➢ During Spanish Time
✓ Creation of Vaccinators to prevent smallpox
✓ Creation of Board of Health
✓ First medical school in the Philippines- UST
✓ School of Midwifery
✓ Public Health Laboratory
✓ Forensic Medicine

the Philippines
HOSPITAL BEFORE THE AMERICANS CAME TO PHILIPPINES
❑ General Hospitals
1. San Juan de Dios Hospital
2. Chinese General Hospital
3. Hospicio de San Jose in Cavite
4. Casa dela Caridad in Cebu
5. Enfermeria de Sta. Cruz in Laguna
❑ Contagious Hospitals
1. San Lazaro Hospital
2. Hospital de Palestina in Camarines Sur
3. Hospital delos Lesporosos in Cebu
4. Hospital de Argencina in Manila for smallpox and cholera
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the Philippines
B. AMERICAN MILITARY GOVERNMENT
➢ Control of epidemics such as cholera, small pox and plague
➢ Fight against communicable diseases such as common cold, Hepa
A-D, chickenpox, SARS, flu, mumps, malaria, herpes, STD, measles
➢ Projects and activities:
1. Garbage crematory
2. First sanitary ordinance and rat control
3. Cholera vaccine was first tried
4. Confirmed that plague in man comes from infected rat
5. Opened the UP College of Medicine
6. Establishes Bureau of Science

the Philippines
C. PHILIPPINE ASSEMBLY
➢ Hygiene and Physiology were included in
curriculum of public elementary school
➢ Anti-TB campaign was started
➢ Philippine Tuberculosis Society was
organized
➢ Opening of PGH (Phil. Gen. Hospital)
➢ Use of anti-typhoid vaccine was initiated
➢ Dry vaccine against small pox was first use
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the Philippines
D. JONES LAW YEARS
➢ Retrogression rather than progression in so far as the

health was concern
✓ Increase Crude Death Rate
✓ Increase Infant Mortality Rate
✓ Increase Morbidity
➢ Increase deaths from smallpox, cholera, typhoid,
malaria and TB

the Philippines
D. JONES LAW YEARS
➢ Re-organized happened (reorganized the health service and
encouraged effective supervision)
✓ Study the cause and prevalence of typhoid fever
✓ Schick test was used to determine the causes of diphtheria
✓ Campaign against Hookworm was launched
✓ Anti-dysentery vaccine was first tried
✓ First training course for sanitary inspector was given
✓ Women and child labor law was passed
✓ Mechanisms of transmission of dengue fever through
Aedes aegyti was studied
✓ Establishment of School of Hygiene and Public Health
✓ National Research Council of the Philippines was organized
✓ BS in Education Major in Health Education was opened in UP
✓ (PPHA) Philippine Public Health Association was organized
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the Philippines
E. COMMONWEALTH PERIOD
➢ The epidemiology of life threatening disease was studied-
diphtheria, yaws, dengue
➢ Research in the field of health was promoted
➢ UP School of Public Health was established
➢ Development of Maternal and Child Health (MCH)
➢ 1939 – Creation of Dept. of Public Health and Welfare
– Dr. Jose Fabella as the First secretary
➢ 1940 – Bureau of Census and Statistics was created to gather vital
statistics
➢ In spite of development
• Inequitable distribution of health services remained a problem
• 80% of those who died were never given medical attention

the Philippines
F. JAPANESE OCCUPATION/WORLD WAR II
➢ During this time, all public health activities were
practically paralyzed.
➢ Increase incidence of TB, veneral dses, malaria,
leprosy and malnutrition.
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the Philippines
G. POST WORLD WAR II
➢ Philippine Independence
➢ Completion of a research on
Dichlorodiphenyltricholorothanel (DDT) – as larvicidal/
insecticide to control malaria
➢ Introduction of one-infection method for gonorrhea with
penicillin
➢ Manila was selected as Headquarters for World Health Organization -
Western Pacific Office
➢ Strengthening Health and Dental services in rural areas
(per municipalities with 5,000-10,000 population)
✓ 1 Municipal Health
Officer
✓ 1 Public Health Nurse
✓ 1 Midwife
✓ 1 Sanitary Inspector

the Philippines
H. MARTIAL LAW YEARS
➢ Creation of National Economic
Development Authority
➢ Department of Health was renamed as
Ministry of Health (MOH)
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the Philippines
Accomplishments during this period:
1. Formulation of National Health Plan
➢ Construction of Tertiary Hospital
✓ Philippine Heart Center
✓ Lung Center
✓ Kidney Center
✓ Lungsod ng Kabataan / Phil. Childrens
Medical Center
➢ Adaptation of the Primary Health Care
- Philippines was the first country to implement
the Primary Health Care

the Philippines
Accomplishments during this period:
1. Formulation of National Health Plan
➢ Launching of Operation Timbang and
Mothercraft Nationwide program providing
supplementary food for infants, pre-school and
school children.
✓ NUTRIBUN- bread with vitamins
2. Progress in Public Health research

➢ RITM- Research Institute for Topical
Medicine
➢ PCHRD- Philippine Council for Health
Research and Development
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the Philippines
I. EDSA REVOLUTION
➢ From Ministry of Health, it was renamed again

as Department of Health
➢ Increase in life expectancy slowed down
➢ Increased incidence of malnutrition
➢ Declined practice of family planning

the Philippines
J. AQUINO ADMINISTRATION
➢ 1987 Constitution- more provisions on health making
comprehensive health care available
➢ Major activities:
✓ Milk Code- promotes and protect breastfeeding
✓ Universal child and mother immunization
✓ RA. 6725- Act prohibiting discrimination against women
✓ NESS- National Epidemic Surveillance System
✓ RA. 6675- National Drug Policy and Generics Act
✓ RA. 7170- Organ Donation Act
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the Philippines
K. RAMOS ADMINISTRATION
➢ “Health in the Hands of People” and “Let's DOH it” –by Sen Juan
Flavier
➢ Memorable initiative during leadership of Flavier:
• National Immunization Day
✓ BCG (Bacille Calmette-Guérin (BCG) is a live strain of
Mycobacterium bovis developed by Calmette and Guérin
for use as an attenuated vaccine to prevent tuberculosis
and other mycobacterial infections.)
✓ DPT (diphtheria, pertussis(whooping cough)
and tetanus)
✓ OPV –Oral Polio Vaccine
✓ MMR- Immunization shot against measles, mumps, and
rubella (also called German measles)

the Philippines
K. RAMOS ADMINISTRATION
➢ Memorable initiative during leadership of Flavier:
• Promotion of Traditional Medicine- Herbal Medicine
• Yosi Kadiri
• Araw ng Sangkap Pinoy- aimed to prevent Vitamin A,
Iron and Iodine deficiency
• Voluntary Blood Donation Program
• Kung Sila'y Mahal Mo Magplano- Family Planning
Program
• Doctors to the Barrio
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Roles and Responsibilities of a

Community Health Nurse
• The main focus of community health nurse is health
promotion.
• The recipient of care of community public health
nursing practice is extended not only to the
individual but also to benefit the whole family and
community.
• Community health nurses are generalists in terms of
their practice through life’s continuum.
Roles and Responsibilities of a

Community Health Nurse
• Continuity of care with the client, family or and the
community extends for a longer time involving individuals of
all ages and health needs.
• The nature of nursing practice in the community needs the
knowledge of biological and social sciences, ecology, clinical
nursing, and community organizing, for it to be effective.
• This field of nursing practice utilizes a dynamic process
(assessment, planning, implementation, and evaluation) in
the provision of continuous care until termination is implicit.
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Roles and Functions of a Community

Health Nurse
Roles Functions
• Identifies priorities and problems of individuals,

families and community.
• Formulates nursing component of health plans.

In doctorless area, she/he is responsible for the
formulation of the municipal health plan.
1. Planner/
Programmer • Interprets and implements the nursing plan,
program policies, memoranda and circulars for
the concerned staff/ personnel.
• Provides technical assistance to rural health

midwives in health matters like target setting,
etc.

Health Nurse
Roles Functions
• Provides direct nursing care to the sick, disabled

in the home, clinic, school or place of work.
2. Provider of
• Develops the family’s capability to take care of
Nursing Care
the sick, disabled or dependent member.
• Provides continuity of patient care.
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Health Nurse
Roles Functions
➢ Formulates individual, family, group and community

centered care plan.
➢ Interprets and implements program policies,
memoranda and circulars.
➢ Organizes work force, resources, equipments and
supplies and delivery of health care at local levels.
3. Manager/
➢ Requisitions, allocates, distributes materials
Supervisor
(medicine and medical supplies, records and reports
equipment.)
➢ Provides technical and administrative support to
Rural Health Midwife (RHM)
➢ Conducts regular supervisory visits and meetings to
different RHMs and gives feedback on
accomplishments/performances.

Health Nurse
Roles Functions
➢ Responsible for motivating and

enhancing community participation
in terms of planning, organizing and
4. Community implementing and evaluating health
Organizer programs/services.
➢ Initiates and participates in

community development activities.
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Health Nurse
Roles Functions
➢ Coordinates with individuals, families, and

groups for health and related health
services provided by various members of
health team and other Government
Organizations (Gos) and Non-Government
5. Coordinator of
Organizations (NGOs).
Services
➢ Coordinates nursing program with other
health programs as environmental
sanitation, health education, dental health
and mental health

Health Nurse
Roles Functions
➢ Facilitates training for BHWs

➢ Organizes orientation/training of concernes
groups including non-government organizations
➢ Acts as a resource speaker/person on health and
health related services
6. Trainer/Health ➢ Participates in the development and distribution
Educator/Counselor of Information Education and Communication
(IEC) materials
➢ Initiates the use of tri-media: radio/TV and
cinema plugs, print ads, and other indigenous
resources for health education purposes.
➢ Conducts pre-marital counseling
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Health Nurse
Roles Functions
➢ Detects deviation from health of
individuals, families, groups of the
community through contact/visits with
them.
➢ Uses symptomatic and objective
7. Health Monitor observation and other forms of data
gathering like morbidity, registry,
questionnaire, checklist, and anecdo-
report/record to monitor growth ad
development and health status of
individuals, families and communities.

Health Nurse
Roles Functions
➢ provides good example/model of healthful living to
8. Role model
the public/community.
➢ motivates changes in health behavior of individuals,
9. Change Agent families, group and community including lifestyle in
order to promote and maintain health.
➢ prepares and submits required reports and records
10. Recorder/ ➢ Maintains adequate, accurate and complete

Reporter/ recording and reporting.
Statistician
➢ reviews, validates, consolidates, analyzes and
interprets all records and reports.
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Health Nurse
Roles Functions
➢ prepares statistical data/charts and other

10. Recorder/ data presentations for display and for
Reporter/Statistician presentation in staff meetings
conferences and seminars/workshops.
➢ participates/assists in the conduct of

surveys studies and researches on nursing
and health related subjects
11. Researcher
➢ coordinates with government and non-
government organization in the
implementation of studies/research.
Emerging Fields of CHN in the

Philippines
• Community Mental Health Nursing – a

unique clinical process which includes an
integration of concepts from nursing, mental
health, social psychology, psychology,
community networks, and the basic sciences
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Philippines
Functions of the School Nurse
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Philippines
Occupational Health Nursing
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Philippines
Entreprenurse
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Aims of Entreprenurse
Thank you and God bless!
30

Overview of Public Health Nursing in The Philippines

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13/09/2023

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

Global and National Health Situation

“Health is the state of complete

Public Health Nursing

• “specific field of nursing that combines the skills of

Public Health Nursing

Community Health Nursing

Community Health Nursing

Community Health Nursing

Standards of Public Health Nursing in

The Standards of Public Health Nursing in the

Standards of Public Health Nursing in

Standards of Public Health Nursing in

Standards of Public Health Nursing in

Standards of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

➢ Retrogression rather than progression in so far as the

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

2. Progress in Public Health research

Evolution of Public Health Nursing in

➢ From Ministry of Health, it was renamed again

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Evolution of Public Health Nursing in

Roles and Responsibilities of a

Roles and Responsibilities of a

Roles and Functions of a Community

• Identifies priorities and problems of individuals,

• Formulates nursing component of health plans.

• Provides technical assistance to rural health

Roles and Functions of a Community

• Provides direct nursing care to the sick, disabled

• Provides continuity of patient care.

Roles and Functions of a Community

➢ Formulates individual, family, group and community

Roles and Functions of a Community

➢ Responsible for motivating and

➢ Initiates and participates in

Roles and Functions of a Community

➢ Coordinates with individuals, families, and

Roles and Functions of a Community

➢ Facilitates training for BHWs

Roles and Functions of a Community

Roles and Functions of a Community