BARANGAY

HEALTH SERVICES
1
 HISTORY OF COMMUNITY HEALTH
NURSING
• Community health nursing is the product of countries
responsiveness and growth. Its practice was adapted to
accommodate the needs of a changing society, yet it
has always maintained its initial goal of improved
community health. Community health nursing
development has been influences by changes in
nursing, public health and society that is traced
through several stages.
 Early Home Care Stage
(Before Mid 1800s)
• For many centuries female family members and friends
attended the sick at home. The focus of this care was to
reduce suffering and promote healing. (Kalish, 1986).
The early roots of home care nursing began with
religious and charitable groups
 Early Home Care Stage
(Before Mid 1800s)
• This stage was during these deplorable conditions and
response to them that Florence Nightingale (1820-1910)
began her work. Much of the foundation for modern
community health nursing practice was laid through
 Early Home Care Stage
(Before Mid 1800s)

• Florence Nightingale’s remarkable accomplishments.

Nightingale’s concern for population at risk as well as
her vision and successful efforts at health reform
provided a model for community health nursing today.
 Distinct Nursing (Mid 1800s to 1900)
• The next stage in the development of community
health nursing was the formal organization of visiting
nursing or distinct nursing. Although distinct nurses
primarily care for the sick, they also taught cleanliness
and wholesome living to their patients, even in that
early period. Nightingale referred to them a “health
nurse”. This early emphasis on prevention and health
nursing became one of the distinguishing features of
district nursing and later of public health nursing as a
specialty.
 Problems of District Nursing
• Increased number of immigrants, increased crowded
city slums, inadequate sanitation practices
• Unsafe and unhealthy working conditions
• Nevertheless, nursing educational programs at that
time did not truly prepare district nurses to cope with
their patients, multiple health, and social problems.
 Public Health Nursing Training
(1900-1970)
• By the turn of the century, district nursing had broadened
its focus to include the health and welfare of the public, not
just the poor.
• Lilian D. Wald’s (1867-1940) contributions to the public
health nursing were enormous. Her driving commitment
was to serve needy populations. Wald’s emphasis on illness
prevention and health promotion through health teaching
and nursing intervention as well as her use of
epidemiological methodology established theses actions as
hallmarks of public health nursing practice.
 Community Health Nursing
(1970-Present)
• The emergence of the term community health nursing
heralded a new era while public health nurses
continued their work in public health by the late 1960s
and early 1970s. many other nurses, not necessarily
practicing health, were based in the community. Their
practice settings included community based clinics,
doctor’s office, work sites, schools, etc. to provide a
label that encompassed all nurses in the community.
BRIEF HISTORY OF COMMUNITY
HEALTH NURSING IN THE
PHILIPPINES
1901- Act No.157of the Philippine Commission
created a Board of Health of the Philippines which
also acted as the Board of Health for the City of
Manila. Subsequently, Act of No.309 created
Provincial and Municipal Boards of Health.

1905 - Act No. 1407 (Reorganization Act) abolished

the Board of Health and its function and activities
were taken over by the Bureau of Health under the
Department of Interior.
1906 - District Health Offices headed by District Health
Officers had jurisdiction over health districts.

1912 - The Fajardo Act (Act No. 2156) created Sanitary

Divisions. The President, Sanitary Division (forerunners
of the present Municipal Health Officers) took charge of
two or three municipalities. Where there were no
physicians available, male nurses were assigned to
perform the duties of the President, Sanitary Divisions.
1915 - The Bureau of Health was renamed Philippine
Health Service with a Director of Health as its head. The
Service was placed under the Department of Public
Instruction with the Vice-Governor as the Department
Secretary.

 - Reorganization Act No. 2462 created the Office of

General Inspection. The Office of District Nursing
was organized under this office.
1916-1918– Miss Perlita Clark took charge of the Public
Health Nursing Work.
1918 – the office of “Miss Clark” was
abolished due to “lack of funds”

1919Act # 2808 (Nurses Law was created) – Carmen del

Rosario, 1st Filipino Nurse supervisor under Bureau of
Health
1927 – Office of the District Nursing under the Office of
the General Inspection, Philippine Health Service was
abolished and supplanted by the Section of Public Health
Nursing.
• 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.
1933 – Reorganization Act No. 4007 transferred the
Division of Maternal and Child Health of the Office of
Public Welfare Commission to the Bureau of Health.
1940 – The Manila Health Department was created by
virtue of the new charter of the City of Manila
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.
• 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.
 COMMUNITY HEALTH NURSING

• “ The utilization of 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
 COMMUNITY HEALTH NURSING

• A specialized field of nursing practice

• 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.
 BASIC COMMUNITY HEALTH NURSING

• 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
– Community
 BASIC COMMUNITY HEALTH NURSING

• 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
 BARANGAY HEALTH WORKERS

PHW’s: are members of the health team who are

professionals
• Medical Officer (MO)- Physician
• Public Health Nurse (PHN)- Registered Nurse
• Rural Health Midwife (RHM)- Registered Midwife
 BARANGAY HEALTH WORKERS

• Dentist
• Nutritionist
• Medical technologies
• Pharmacist
• Rural Sanitary Inspector (RSI)- must be a Sanitary
Engineer