TRENDS IN

PUBLIC HEALTH:
NATIONAL &
GLOBAL
CHN 2
 At the end of this unit, students are
expected to:
1. Discuss trends of health that affects both
local and global level
2. Describe different threat to wellness
3. Determine role played by nurses in the
local and global healthcare using their
competencies
TRENDS IN COMMUNITY HEALTH
AND COMMUNITY HEALTH
NURSING PRACTICE (Maglaya, 2009)
 1. Health Promotion / Healthy
Lifestyle Directions & Challenges
Rationale /
Bases: CHALLENGES:
Rapid rise of NCD/CVD, CA, Diabetes,
Kidney prob. & COPD Health Promotion
strategy
 CREATIVE OPTIONS AND
INITIATIVES
1. Interventions to
address challenges / issues on
poverty and health
2. Development of healthy
settings
 II. Acute Care / Illness Care
Increasingly Being Delivered in
Home / Community Setting
RATIONALE / BASES
- Early Hospital Discharge due to increasing cost of
hospital care / services, insurance requirements, etc.

- Increasing burden of chronic and palliative care

-By 2010 in the USA, 70 % to 80% illness care will be in

home setting
 ■ CHALLENGES / CREATIVE OPTIONS
■ Expertise / Competence in Specific Areas in Acute Care in
Home Setting

■ Case Management as nucleus of continuum of care w/ the

nurse case manager as orchestrator of services
■ Nurse role varies from monitoring long -term needs to
managing current episode of care

■ Effective use of two- way referral system

■ Enhance potential of families on acute / illness on palliative

care or reduce burden
III.Focus on Care of Population
Aggregates to Promote Healthy
Transitions
RATIONALE / BASES

- Population shift leads to:

:Increasing health problem among elders, ethnic and
marginalized group
:Emphasis on child, adolescent, reproductive /
women’s health

- Increasing scope, magnitude and impact of disaster

around the world
CHALLENGES / CREATIVE OPTIONS
- 1) Expertise / Competence on use of epidemiologic
Approach to care for population group

- Work / Group Approach

- Expertise / competence on Disaster

- Promoting equity to access needed health and

social services

- Use of “Human Becoming “Approach.

 TEN
THREATS TO
GLOBAL
HEALTH
(WHO, 2019)
1. Air pollution and climate change
1. Air pollution and climate change

Air pollution is greatest environmental risk to health (WHO ).

Microscopic pollutants in air penetrate respiratory & circulatory
systems, damaging the lungs, heart & brain

Burning fossil fuels - primary cause of air pollution; major

contributor to climate change.

90% of these deaths are in low- and middle-income countries,

with high volumes of emissions from industry, transport and
agriculture, as well as dirty cookstoves and fuels in homes.
2. Noncommunicable diseases
 2. Noncommunicable diseases
- 70% of all deaths worldwide
- 15 million people dying prematurely, aged
between 30 and 69.
- 5 major risk factors: tobacco, physical inactivity,
use of alcohol, unhealthy diets & air pollution.
- Risk factors exacerbate mental health issues
 2. Noncommunicable diseases
Envt factors linked to urbanization that discourage
people from becoming more active, such as:
- fear of violence and crime in outdoor areas
- high-density traffic
- low air quality, pollution
- lack of parks, sidewalks & sports/recreation facilities
 3. Global influenza pandemic

- 153 institutions in 114 countries are

involved in global surveillance,
response of WHO monitoring of
influenza viruses to detect potential
pandemic strains
4. Fragile and vulnerable settings.
4. Fragile and vulnerable settings.

- Protracted crises (through a combination

of challenges such as drought, famine,
conflict, and population displacement) and
weak health services leave people living in
these areas without access to basic care.

- strengthen health systems

5. Antimicrobial resistance

: rifampicin-resistant TB (RR-TB)
: multi-drug resistant TB (MDR-TB)
: fluoroquinolone antibiotics in E. coli, for
treatment of UTI
: methicillin-resistant Staphylococcus aureus
(MRSA)
 5. Antimicrobial resistance
: N. gonorrhoeae - resistance to sulphonamides,
penicillin, tetracyclines, macrolides,
fluoroquinolones, and early generation
cephalosporins.

: injectable extended-spectrum cephalosporin

(ESC) ceftriaxone - remaining monotherapy for
gonorrhea.
 5. Antimicrobial resistance

: People receiving antiretroviral (ARV) therapy can

acquire HIVDR

: WHO ARV recommends a new drug, dolutegravir,

as preferred first-line treatment for adults, children.
 5. Antimicrobial resistance

: Malaria has partial resistance to artemisinin and

resistance to a number of ACT drugs

: Candida auris, a fungal infections has resistance to

fluconazole, amphotericin B & voriconazole as well
as emerging caspofungin resistance.
 5. Antimicrobial resistance
Leads to :

- prolonged hospital stays

- more expensive
- intensive care
- compromise surgery and chemotherapy.
- risky: Medical procedures, such as surgery,
including caesarean sections or hip
replacements, cancer chemotherapy, organ transplantation,
 6. Ebola & other high-threat pathogens
- WHO’s R&D Blueprint identifies diseases
and pathogens that have potential

- watchlist priority R&D : Ebola, several other

hemorrhagic fevers, Zika, Nipah, MERS-CoV
and SARS & disease X
7. Weak Primary Health Care

Neglect are d/t:

- lack of resources in low- or middle-income
countries
- October 2018, renew commitment to primary
health care made in Alma-Ata declaration (by
WHO in Astana, Kazakhstan)
 8. Vaccine hesitancy
Why people choose not to vaccinate:
complacency
inconvenience in accessing vaccines
lack of confidence

Health workers remain most trusted

advisor.influencer of vaccination decisions
9. Dengue
 10. HIV
Challenge:
Reaching people like sex workers, people in prison, men
who have sex with men, or transgender people

Young girls, women (aged 15–24) - high risk and account

for 1 in 4 HIV infections in sub-Saharan Africa - group
increasingly affected by HIV
 NURSING
COMPETENCY
NURSING COMPETENCY includes core abilities
that are required for fulfilling one's role as a nurse

NCSBN (2005) defines competence as the application of

knowledge, interpersonal decision making, and psychomotor
skills within the context of public health, safety, and welfare
Listed below are the competencies or skills specific to BSN.

1.Apply knowledge of physical, social, natural and health sciences and humanities in the practice
of nursing.
2.Perform safe, appropriate and holistic care to individuals, families, population, groups and
community utilizing nursing process.
3. Apply guidelines and principles of evidence-based practice in the delivery of care.
4. Practice nursing in accordance with existing laws, legal, ethical and moral principles.
5. Communicate effectively in speaking, writing and presenting using culturally-appropriate
language.
6. Report/document client care accurately and comprehensively.
7. Collaborate effectively with inter-, intra- and multi-disciplinary and multicultural teams.
8. Practice beginning management and leadership skills using system approach in the delivery of
client care.
9. Conduct research with an experienced researcher.
10. Engage in lifelong learning with a passion to keep current with national and global
developments in general, and nursing and health developments in particular.
11. Demonstrate responsible citizenship and pride in being a Filipino
12. Apply techno-intelligent care systems and processes in health care delivery.
13. Uphold the nursing core values in the practice of the profession.
14. Apply entrepreneurial skills in the delivery of nursing care.
TO DO : Identify at least 7
competencies. Determine possible
task for each competency and your
role as CH Nurse in the trends.
Submit as a Wordfile.
Thanks!

Any questions?
References:

Maglaya, A, (2009) Nursing Practice in The Community 5th Edition,

Community Health Nursing:
Context and Practice. Marikina: Argonauta Corporation

www.who..org