WELLNESS

ILLNESS

MODELS OF HEALTH
Clinical Model
Adaptive Model
Role Performance Model
Eudemonistic Model

Clinical Model

A model of health, wellness, and illness

that narrowly defines health as the
absence of disease.

Adaptive Model
A model of health, wellness, and illness
that views health as adaptation to the
physical and social world in which a
person lives and disease as
maladaptation to this world.

Role Performance
Model
A model of health, wellness, and illness
that views health in functional terms;
here, if a person can function, he or
she is healthy.

Eudemonistic Model
A model of health, wellness, and illness
that focuses on health as well-being,
self-fulfillment, and self-actualization.

DIMENSIONS OF HEALTH

FACTORS AFFECTING
HEALTH

POLITICS

BEHAVIOR

HEALTH CARE DELIVERY

SYSTEMS

HEREDITARY

ENVIRONMENT

SOCIO-ECONOMIC

OPTIMUM LEVEL OF
FUNCTIONING

LEVELS OF PREVENTION

PRIMARY
- prevention or delay of the actual
occurrence of illness or disease.

SECONDARY
- early detection and treatment of the disease

TERTIARY
- prevention of complications of a
disease and rehabilitation of the
individual.

PHILIPPINE HEALTH
CARE
DELIVERY SYSTEM

NATIONAL HEALTH
SITUATION
Population : as of
2010 is 94 Million
Growing at an
annual rate of
1.75%-2.32%
65% of the
population will
be living in urban
areas by 2020

LIFE EXPECTANCY

Female
s:
72.2
years

Males:
66.9 years

LEADING CAUSES OF
MORBIDITY
Diarrheal Diseases
Acute bronchitis
Pneumonias
Influenza
Chickenpox
Hypertension
Dengue Fever

LEADING CAUSES OF MORTALITY

Diseases of the Heart
Diseases of the Vascular System
Pneumonias
Diseases of Respiratory System
Chronic Obstructive Pulmonary Disease (COPD)
Tuberculosis
Accidents and diarrheal diseases
Diabetes Mellitus
Malignant Neoplasm (cancer)
Nephritis, Nephritic syndrome, and nephrosis

COMPONENTS
Department of Health Mandate:
Shall be responsible for the

formulation and development of national health policies, guidelines,

standards

manual of operations for health services and programs

issuance of rules and regulations, licenses and accreditations

promulgation of national health standards, goals , priorities and

indicators

development of special health programs and projects

advocacy for legislation on health policies and programs

PRIMARY FUNCTION
OF DOH
is the promotion , protection, preservation or
restoration of the health of the people
through the provision and delivery of health
services and through the regulation and
encouragement of providers of health goods
and services
(E.O. No. 119, Sec. 3).

VISION

MISSION

GOAL

 framework for implementation of

HSRA
Rationale: Reduction of IMR and MMR

MILLENIUM DEVELOPMENT
GOALS
12345678-

Goals of FOURmula One

Better health outcomes
More responsive health systems
Equitable health care financing

FOUR ELEMENTS

HEALTH FINANCING

Secure more, better and sustained

investments in health

HEALTH REGULATION

quality and affordable health products,

devices, facilities and services,

HEALTH SERVICE DELIVERY

accessibility and availability of basic

and essential health care for all

GOOD GOVERNANCE

To improve health systems

performance at the national and local
levels

PRINCIPLES
Universal accessibility.
Vulnerable groups such as women, children,
and elders are the emphasis of health care
services.
Emphasis on the promotion of healthy
lifestyle due to increase of lifestyle diseases.

OBJECTIVES
Improve general health status
Reduce morbidity, mortality,
disability
Eliminate public health problems
Promote healthy lifestyle
Protect vulnerable groups

LOCAL HEALTH SYSTEM

Local Government Code
People
Boundaries
Heath Facilities
Health Workers

COMMUNITY HEALTH
NURSING

GOAL
Promotion of OLOF thru teaching
and delivery of care

PHILOSOPHY
Based on the WORTH & DIGNITY of
man

PRIMARY FOCUS: Health Promotion

UNIT OF SERVICE: Family
PRIMARY RESPONSIBILITY: Health
Teaching

CORE OF PHN
- Disease control
- Injury prevention
- Health protection
- Healthy public policy
- Promotion of health and equitable health gain

ESSENTIAL FUNCTIONS
-

Health situation and monitoring analysis

Epidemiological surveillance
Development of public health policies
Health systems and services management
Regulation and enforcement to protect public health
Human resources development and planning in
public health
- Health promotion, social participation and
empowerment
- Quality personal and population health services
- Research of public health solutions

PUBLIC HEALTH NURSE

FUNCTIONS
Manager
Supervisor
Care Provider
Collaborator
Coordinator
Health Educator
Trainer
Researcher

CHN PROCESS
ASSESSMENT
PLANNING
IMPLEMENTATION
EVALUATION

ASSESSMENT
Initiate Contact
Demonstrate caring attitudes
Mutual trust & confidence
Collect data from all possible sources
Identify health problems
Assess coping ability
Analyze and interpret data

FIRST LEVEL OF
ASSESSMENT

ASSESSMENT
INITIAL DATA BASE
Family structure, characteristics and
dynamics
Socio-economic and cultural
characteristics
Home and Environment
Health Status of each member
Values and Practices on Health
Promotion and Maintenance

Approved type of water facilities


Level 1
(Point Source)

a protected well or a developed spring with

an outlet but without a distribution system
indicated for rural areas
serves 15-25 households; its outreach is
not more than 250 m from the farthest
user
yields 40-140 L/ min

Level II
(Communal Faucet or Stand Posts)

With a source, reservoir, piped distribution

network and communal faucets
Located at not more than 25 m from the
farthest house
Delivers 40-80 L of water per capital per
day to an average of 100 households
Fit for rural areas where houses are
densely clustered

Level III
(Individual House Connections or Waterworks System)

With a source, reservoir, piped

distributor network and household
taps
Fit for densely populated urban
communities
Requires minimum treatment or
disinfection

Proper Excreta and

Sewage Disposal Program

Level I
Non-water carriage toilet facility no
water necessary to wash the waste
into receiving space e.g. pit latrines,
reed odorless earth closet.
Toilet facilities requiring small
amount of water to wash the waste
into the receiving space e.g. pour
flush toilet & aqua privies

Level II

On site toilet facilities of the water

carriage type with water-sealed and
flush type with septic vault/tank
disposal.

Level III

Water carriage types of toilet

facilities connected to septic tanks
and/or to sewerage system to
treatment plant.

Nature of the Problem

Wellness State
this refers to states of wellness and the
likelihood for health maintenance or
improvement to occur depending on
the desire of the family

Health Threats
these are the conditions that make it
more likely for accidents, disease or
failure to thrive or develop to occur.

Health Deficit
- this refers to conditions of health
breakdowns or advent of illness in
the family

Stress Points or
Foreseeable
Crisis
these are anticipated periods of unusual
demand on the family in terms of time
or resources

Most important in prioritizing family

health problem:

Modifiability of the
Problem

Preventive Potential

Saliency of the Problem

PLANNING
Prioritize needs
Establish goal based on needs &
capabilities of staff
Construct action and Operation plan
Develop evaluation parameters
Revise plan as needed

IMPLEMENTATION
Nursing plan to action
Coordinate care/services
Utilize community resources
Delegate
Supervise/Monitor health service
provided
Provide health education and training
Document responses to Nursing action

EVALUATION
Nursing Audit
Care Outcomes
Performance Appraisal
Estimate cost benefit ratio
Assessment of problems
Identify needed alterations
Revise plans as necessary

NURSING PROCEDURES
CLINIC VISIT
BLOOD PRESSURE MEASUREMENT
HOME VISIT

HOME VISIT

PRINCIPLES
Based on needs of the family
Have purpose or objectivedirectional
Make use of available informationcase follow-up
Practical and flexible
Should involve the family members
No definite rule for frequency

PHASES
Preparatory Phase
Actual Home-visit
Post-Visit

FACTORS INFLUENCING FREQUENCY

Physical, Psychological, Educational Needs
Ability of the Family to recognize needs
Policy of a given agency
Interest, willingness, acceptance of the
family
Evaluation of the past services rendered
Number of personnel involved
Familys knowledge and ability to use their
own resources

BAG TECHNIQUE
tool for ease and deftness to save
and effort
Rationale :
Principle:
Most important in the use of the
bag:

PHN Bag
equipment

- contains basic medications and

articles

Paper Lining
Extra paper for waste bag
Apron
Hand towel
Soap in a soap dish
Thermometer(rectal & oral)
2 pairs of scissors (surgical and bandage)
2 pairs of forceps (curved and straight)
Disposable syringes with needles (g. 23 & 25)
Hypodermic needles g. 19,22,23,25
Sterile dressing
Cotton balls
Cord clamp
Micropore plaster
Tape measure
1 pair of sterile gloves
Babys scale
Alcohol lamp
2 test tubes
Test tube holders
Solutions:
Betadine
Zephiran Solution
Spirit of amonia
Acetic acid
70% alcohol
Hydrogen peroxide
Opthalmic oinment
Benedicts solution

NURSING CARE IN THE

HOME
Principles:
Utilizes a medical plan of care and
treatment
Give maximum comfort and security
Health Education
Recognize dangers
Detect abnormal signs and symptoms
Observe progress of the patient

ISOLATION TECHNIQUE
Should not be mixed
Frequent washing and airing
Protective gown for caregiver
All discharges should be carefully
discarded
If soiled with discharges, boil in water
for 30 minutes before laundering

CLINIC VISIT
Phases:
Pre-consultation
Medical Examination
Nursing Intervention
Post-consultation

TRIAGE
Program-Based Care
Non-Program-Based Care
Emergency Cases

PRIMARY HEALTH CARE

GOAL
Health in the hands of people by
2020.

MISSION
Increasing opportunities where people
can manage their own health care.

THEME
Partnership and Empowerment
towards
self-reliance

STRATEGY
Full participation and active
involvement of the community towards
the development
of self-reliance.

3 MAJOR ASPECTS OF PHC

Promotive
Health education
Preventive
Maternal and Child Care
Immunization
Curative
Treatment of common diseases
Essential Drugs

FOUR PILLARS OF PHC

Active Community Paritcipation

Intra and inter-sectoral linkages
Use of appropriate technology
Support mechanism made available

ESSENTIAL SERVICES
OF PHC

Adequate and safe supply water and basic sanitation

Control of communicable diseases
Immunization
Education on prevailing health problems and
prevention of illness
Maternal and Child health and Family Planning Care
Adequate food and proper nutrition
Provision of medical care and emergency treatment
Treatment of locally endemic disease
Provision of essential drugs and herbal medicines

QUALITIES OF
HEALTH CARE
PROVIDERS
Open
Tactful
Coordinator
Objective

Good listener
Efficient
Flexible
Critical thinker

HEALTH CARE WORKERS AT THE

PRIMARY LEVEL

GRASSROOTS HEALTHCARE WORKERS

or Village Health Workers

PROVIDES SIMPLE CURTIVE

PREVENTIVE HEALTHCARE
MEASURES
PARTICIPATE ON ACTIVITIES THAT
ARE AIMED TO IMPROVE SOCIOECONOMIC STATUS OF THE
COMMUNITY
BHW, VOLUNTEERS, TRADITIONAL

INTERMDIATE-LEVEL HEALTH
WORKERS
First source of professional healthcare
ATTEND TO HEALTH PROBLEMS THAT ARE
BEYOND KNOWLEDGE OF VILLAGE/GRASSROOTS
SUPPORTS FRONT-LINE HEALTH WORKERS IN
TERMS OF SUPERVISION, TRAINING, SUPPLIES
DOCTORS, NURSES, MIDWIVES

LEVELS OF
HEALTH CARE
FACILITIES

PRIMARY LEVEL
Rural Health Units

 Sub-centers
Community Hospitals
Health Centers

SECONDARY LEVEL
Provincial Hospitals
Regional Hospitals

TERTIARY LEVEL
National Hospitals
Medical Centers

TWO-WAY REFERRAL SYSTEM

POPULATION
Rural Health
Station
Midwife
Public Health
Nurse

Barangay
Health
Stations
RHU Midwife
Physician
2nd Level Healthcare
Facility
3rd Level Healthcare
Facility

BHW
Sanitary
Inspector

MULTISECTORAL
APPROACH
TO
HEALTH
Other health-related
systems
(Government/Private)
Ways of the
People
(Cultural)

Community
Health
Environment
(Social , economic ,
physical , etc.)

Health Care
System

HEALTH CARE
PROCESS APPLIED
TO THE FAMILY

FAMILY

PLACE AND RESIDENCE

Patrilocal
Matrilocal
Bilocal
Neolocal
Avunculocal

DESCENT
Patrilineal
Matrilineal
Bilateral

AUTHORITY

Patriarchal
Matriarchal
Egalitarian
Matricentric

SECOND LEVEL OF
ASSESSMENT

FAMILY HEALTH TASKS

Recognizing interruptions of health development
Making decisions about seeking health care/ to
take action
Dealing effectively health and non-health
situations
Providing care to all members of the family
Maintaining a home environment conducive to
health maintenance

FAMILY HEALTH CONDITION

Familys capabilities to maintain health
and prevent illness

FAMILY HEALTH CARE

PLAN
Formulating afamily care
planinvolves the following steps:
1. The prioritized condition/s or
problems
2. The goals and objectives of nursing
care
3. The plan of interventions
4. The plan of evaluating care

FAMILY HEALTH
CARE STRATEGIES

PRE-NATAL CARE

History
Signs and Symptoms of Pregnancy
Check-ups during pregnancy
Immunization
Nutrition
Personal Habits
Others

CARE OF THE NEWBORN

Breastfeeding
Supplementary feeding
Cord care
Bathing
Immunization (EPI)

PARENTING
Responsibilities

ENVIRONMENTAL CARE AND

SANITATION
Cleanliness in the home
Backyard Sanitation

HEALTH EDUCATION

EVALUATION
Evaluation Plan
Standards
Criteria