OVERVIEW OF PUBLIC HEALTH NURSING IN THE
PHILIPPINES
A. GLOBAL AND NATIONAL HEALTH SITUATION
GLOBAL HEALTH SITUATION
 Vaccines: Low trust in vaccination 'a global
crisis‘
 Mental health conditions in conflict situations
are much more widespread than we thought
 1 in 3 people globally do not have access to safe
drinking water – UNICEF, WHO
 Is technology key to improving global health
and education.
 Covid 19 Crisis
LEADING CAUSES OF DEATH BY ECONOMY INCOME
GROUP
NATIONAL HEALTH SITUATION
Philippine Scenario
 In the past 20 years some infectious
degenerative diseases are on the rise.
 Many Filipinos are still living in remote and hard
to reach areas where it is difficult to deliver the
health services they need
 The scarcity of doctors, nurses and midwives
add to the poor health delivery system to the
poor
Vital Health Statistics
 Projected Population: = Both Sexes –
109,933,944
 Life Expectancy:
- Female – 75.9 yrs. Old
- Male – 67.7 yrs. Old
- Both Sexes - 71.7 yrs. Old
 Leading Causes of Morbidity = Most of the top
ten leading causes of morbidity are
communicable disease. These include the
diarrhea, pneumonia, bronchitis, influenza, TB,
malaria and varicella. leading non CD are
heart problem, HPN, accidents and malignant
neoplasms
 Leading Causes of Mortality - The top 10 leading
causes of mortality are due to non CD. Diseases
of the heart and vascular system are the 2 most
common causes of deaths. Pneumonia, PTB and
• Health situation monitoring and analysis
• Epidemiological surveillance/disease prevention
and control
• Development of policies and planning in public
health
• Strategic management of health systems and
services for population health gain
diarrheal diseases consistently remain the 10
leading causes of deaths.
Public health systems are operating within a context of
ongoing changes, which exert a number of pressures on
the public health system. Theses changes include:
 Shifts in demographic and epidemiological
trends in diseases, including the emergence and
re-emergence of new diseases and in the
prevalence of risk and protective factors;
 New technologies for health care,
communication and information;
 Existing and emerging environmental hazards
some associated with globalization;
 Health reforms.
PUBLIC HEALTH
• Dr. C.E. Winslow defines public health as: the
“science and art of preventing disease,
prolonging life, promoting health and efficiency
through organized community effort for the
sanitation of the environment, control of
communicable diseases, the education of
individuals in personal hygiene, the organization
of medical and nursing services for the early
diagnosis and preventive treatment of disease,
and the development of the social machinery to
ensure everyone a standard of living adequate
for the maintenance of health, so organizing
these benefits as to enable every citizen to
realize his birthright of health and longevity”.
• WHO defines public health as: the “art of
applying science in the context of politics so as
to reduce inequalities in health while ensuring
the best health for the greatest number”.
CORE BUSINESS OF PUBLIC HEALTH
 Disease control
 Injury prevention
 Health protection
 Healthy public policy including those in relation
to environmental hazards such as in the
workplace, housing, food, water, etc.
 Promotion of health and equitable health gain.
ESSENTIAL PUBLIC HEALTH FUNCTIONS
• Regulation and enforcement to protect public
health
• Human resources development and planning in
public health
• Health promotion, social participation and
empowerment
 • Ensuring the quality of personal and population
based health services
• Research, development and implementation of
innovative public health solutions
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
 This is a “special 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 programmed for the
promotion of health, the improvement
of the conditions in the social and
physical environment, rehabilitation of
illnesses and disability”.
 One of the famous definitions of
community health nursing comes from
Ruth B. Freeman. It refers to “a service
rendered by a professional nurse with
communities, groups, families,
individuals at home, in health centers,
on clinics, in schools, in places of work
for the promotion of health, prevention
of illnesses, care of the sick at home
and rehabilitation”.
 Public health nursing(PHNs) refer to the
nurses in the local/national health
departments or public schools whether
their official position title is PUBLIC
HEALTH NURSE or SCHOOL NURSE.
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)
 Goal: “To raise the level of citizenry by helping
communities and families to cope with the
discontinuities in and threats to health in such a
way as to maximize their potential for high-level
wellness” ( Nisce, et al)
 Special 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 program for the promotion
of health, the improvement of the conditions in
the social and physical environment,
rehabilitation of illness and disability
( WHO Expert Committee of Nursing)
 A learned practice discipline with the ultimate
goal of contributing as individuals and in
collaboration with others to the promotion of
the client’s optimum level of functioning thru’
teaching and delivery of care (Jacobson)
 A service rendered by a professional nurse to
IFCs, population groups in health centers,
clinics, schools , workplace for the promotion of
health, prevention of illness, care of the sick at
home and rehabilitation (DR. Ruth B. Freeman)
Mission of CHN
 Health Promotion
 Health Protection
 Health Balance
 Disease prevention
 Social Justice
Philosophy of CHN
 “The philosophy of CHN is based on the worth
and dignity of man.”(Dr. M. Shetland)
Basic Principles of CHN
 The community is the patient in CHN,
the family is the unit of care and there are four
levels of clientele: individual, family, population
group (those who share common
characteristics, developmental stages and
common exposure to health problems – e.g.
children, elderly), and the community.
 In CHN, the client is considered as
an ACTIVE partner NOT PASSIVE recipient of
care
 CHN practice is affected by developments in
health technology, in particular, changes in
society, in general
 The goal of CHN is achieved through multi-
sectoral efforts
 CHN is a part of health care system and the
larger human services system.
Standards in CHN
 Theory
 Applies theoretical concepts as basis for
decisions in practice
 Data Collection
 Gathers comprehensive, accurate data
systematically
 Diagnosis
 Analyzes collected data to determine
the needs/ health problems of IFC
 Planning
  At each level of prevention, develops
plans that specify nursing actions
unique to needs of clients
 Intervention
 Guided by the plan, intervenes to
promote, maintain or restore health,
prevent illness and institute
rehabilitation
 Evaluation
 Evaluates responses of clients to
interventions to note progress toward
goal achievement, revise data base,
diagnoses and plan
 Quality Assurance and Professional
Development
 Participates in peer review and other
means of evaluation to assure quality of
nursing practice
 Assumes professional development
 Contributes to development of others
 Interdisciplinary Collaboration
 Collaborates with other members of the
health team, professionals and
community representatives in
assessing, planning, implementing and
evaluating programs for community
health
 Research
 Indulges in research to contribute to
theory and practice in community
health nursing
History of Community Health Nursing
 1919
 Act # 2808 (Nurses Law was created) –
Carmen del Rosario, 1st Filipino Nurse
supervisor under Bureau of Health
 Oct. 22, 1922
 Filipino Nurses Organization (Philippine
Nurses’ Organization) was organized.
 1923
 Zamboanga General Hospital School of
Nursing & Baguio General Hospital were
established; other government schools
of nursing were organized several years
after.
 1928
 1st Nursing convention was held
 1940
 Manila Health Department was created.
 1941
 Dr. Mariano Icasiano became the first
city health officer; Office of Nursing was
created through the effort of Vicenta
Ponce (chief nurse) and Rosario Ordiz
(assistant chief nurse)
 Dec. 8, 1941
 Victims of World War II were treated by
the nurses of Manila.
 July 1942
 Nursing Office was created; Dr. Eusebio
Aguilar helped in the release of 31
Filipino nurses in Bilibid Prison as
prisoners of war by the Japanese.
 Feb. 1946
 Number of nurses decreased from 556
– 308.
 1948
 First training center of the Bureau of Health was
organized by the Pasay City Health Department.
Trinidad Gomez, Marcela Gabatin, Costancia
Tuazon, Ms. Bugarin, Ms. Ramos, and Zenaida
Nisce composed the training staff.
 1950
 Rural Health Demonstration and Training Center
was created.
 1953
 The first 81 rural health units were organized.
 1957
 RA 1891 amended some sections of RA 1082
and created the eight categories of rural health
unit causing an increase in the demand for the
community health personnel.
 1958-1965
 Division of Nursing was abolished (RA
977) and Reorganization Act (EO 288)
 1961
 Annie Sand organized the National
League of Nurses of DOH.
 1967
 Zenaida Nisce became the nursing
program supervisor and consultant on
the six special diseases (TB, leprosy,
V.D., cancer, filariasis, and mental
health illness).
 1975
 Scope of responsibility of nurses and
midwives became wider due to
restructuring of the health care delivery
system.
 1976-1986
  The need for Rural Health Practice
Program was implemented.
 1990- 1992
 Local Government Code of 1991 (RA
7160)
 1993-1998
 Office of Nursing did not materialize in
spite of persistent recommendation of
the officers, board members, and
advisers of the National League of
Nurses Inc.
 Jan. 1999
 Nelia Hizon was positioned as the
nursing adviser at the Office of Public
Health Services through Department
Order # 29.
 May 24, 1999
 EO # 102, which redirects the functions
and operations of DOH, was signed by
former President Joseph Estrada.
 2005-2006
 The development of the Rationalization
Plan to streamline the bureaucracy
further was started and is in the last
stages of finalization.
ROLES AND RESPONSIBILITIES OF A COMMUNITY
HEALTH NURSE
The seven major roles are:
 Clinician
 Educator
 Advocate
 Manager
 Collaborator
 Leader
 Researcher
Other Specific Responsibilities of a Nurse, spelled by the
implementing rules and Regulations 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 families:
 Provision of primary health care services
 Developmental/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, implementation and
evaluation
 Influencing executive and legislative individuals
or bodies concerning health and development
Responsibilities of CHN
 be a part in developing an overall health plan,
its implementation and evaluation for
communities
 provide quality nursing services to the three
levels of clientele
 maintain coordination/linkages with other
health team members, NGO/government
agencies in the provision of public health
services
 conduct researches relevant to CHN services to
improve provision of health care
 provide opportunities for professional growth
and continuing education for staff development
THE HEALTH CARE DELIVERY SYSTEM
WORLD HEALTH ORGANIZATION
 WHO works worldwide to promote health, keep
the world safe, and serve the vulnerable.
 Goal is to ensure that a billion more people
have universal health coverage, to protect a
billion more people from health emergencies,
and provide a further billion people with better
health and well-being.
For universal health coverage, WHO:
 focus on primary health care to improve
access to quality essential services
 work towards sustainable financing and
financial protection
 improve access to essential medicines
and health products
 train the health workforce and advise
on labour policies
 support people's participation in
national health policies
 improve monitoring, data and
information.
For health emergencies, WHO:
  prepare for emergencies by identifying,
mitigating and managing risks
 prevent emergencies and support development
of tools necessary during outbreaks
 detect and respond to acute health
emergencies
 support delivery of essential health services in
fragile settings.
For health and well-being:
 address social determinants
 promote intersectoral approaches for health
 prioritize health in all policies and healthy
settings.
 Through our work, we address:
 human capital across the life-course
 noncommunicable diseases prevention
 mental health promotion
 climate change in small island developing
states
 antimicrobial resistance
 elimination and eradication of high-impact
communicable diseases.
The Eight Millennium Development Goals are as follows:
 Eradicate extreme poverty and hunger
 Achieve universal primary education
 Promote gender equality and empower women
 Reduce child mortality
 Improve maternal health
 Combat HIV/AIDS, malaria and other diseases
 Ensure environmental sustainability
 Develop a global partnership for development
Except for goals 2 and 3, all the MDGs are
health or health-related. Health is essential to the
achievement of these goals and is a major contributor
to the overarching goal of poverty reduction.
Sustainable Development Goals
 The Sustainable Development Goals (SDGs),
otherwise known as the Global Goals, are a
universal call to action to end poverty, protect
the planet and ensure that all people enjoy
peace and prosperity.
 These 17 Goals build on the successes of
the Millennium Development Goals, while
including new areas such as climate change,
economic inequality, innovation, sustainable
consumption, peace and justice, among other
priorities. The goals are interconnected – often
the key to success on one will involve tackling
issues more commonly associated with another.
 The SDGs came into effect in January 2016, and
they will continue to guide UNDP policy and
funding until 2030. As the lead UN development
agency, UNDP is uniquely placed to help
implement the Goals through our work in some
170 countries and territories.
1. End poverty in all its forms everywhere
2. End hunger achieve food security and improved
nutrition and promote sustainable agriculture.
3. Ensure healthy lives and promote well being for
all at all ages.
4. Ensure inclusive and equitable quality education
and promote lifelong learning opportunities for
all.
5. Achieve gender equality and empower all
women and girls.
6. Ensure availability and sustainability
management of water and sanitation for all.
7. Ensure access to affordable, reliable,
sustainable and modern energy for all.
8. Promote sustained inclusive and sustainable
economic growth full and productive
employment and decent work for all.
9. Build resilient infrastructure, promote inclusive
and sustainable industrialization and foster
innovation.
10. Reduce inequality within and among countries.
11. Make cities and human settlement inclusive,
safe, resilient and sustainable.
12. Ensure sustainable consumption and production
patterns.
13. Take urgent action to combat climate change
and its impacts.
14. Conserve and sustainably use the oceans, seas
and marine resources for sustainable
development.
15. Protect, restore and promote sustainable use of
terrestrial ecosystems, sustainably manage
forests, combat desertification, and halt and
reverse land degradation and halt biodiversity
loss.
16. Promote peaceful and inclusive societies for
sustainable development, provide access to
justice for all and build effective, accountable
and inclusive institutions at all levels.
17. Strengthen the means of implementation and
revitalize the global partnership for sustainable
development.
PHILIPPINE HEALTH AGENDA 2016 – 2022
 President Rodrigo Duterte has recently released
the Philippine Health Agenda 2016-2022, which
strengthens the Duterte Health Agenda, “All for
Health towards Health for All”. This health
system, through the Department of Health,
aspires financial protection, better
health outcomes and responsiveness for all
Filipinos.
In order to attain health-related sustainable  With the Philippine Health Agenda 2016-2022,
development goals, the A.C.H.I.E.V.E. strategy we will all ACHIEVE a health system with
is followed: the values of Equity, Quality, Efficiency,
Transparency, Accountability, Sustainability,
 A- Advance quality, health promotion and
Resilience towards “Lahat Para sa Kalusugan!
primary care
Tungo sa Kalusugan Para sa Lahat”.
 C- Cover all Filipinos against health-related
financial risk
UNIVERSAL HEALTH CARE
 H- Harness the power of strategic HRH
development  Also referred to as

 I- Invest in eHealth and data for decision- “Kalusugan Pangkalahatan”

making

 E- Enforce standards, accountability and

transparency

 V- Value all clients and patients, especially the

poor, marginalized, and vulnerable

 E- Elicit multi-sectoral and multi-stakeholder

support for health