NCM 104: COMMUNITY

HEALTH NURSING 1
NCM 104: COMMUNITY HEALTH NURSING 1

WORLD HEALTH ORGANIZATION

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World Health Organization

• GLOBAL PROGRAMS are defined as partnerships and related
initiatives whose benefits are intended to cut across more than one
region of the world and in which the partners:
• Reach explicit agreements on objectives
• Agree to establish a new (formal or informal) organization
• Generate new products or services
• Contribute dedicated resources to the program.
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• Helping achieve the eight Millennium Development Goals

• In September 2000, world leaders came together at the United

Nations to set far-sighted goals for the health of children and
mothers, gender equality and empowerment of women, literacy,
the environment and a global partnership for development. These
became known as the Millennium Development Goals (MDGs) and
laid a roadmap to a better world.
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• In the same year, the GAVI Alliance (Global alliance for Vaccines
and Immunization) was established to address the urgent need to
boost immunization coverage. It was formed as an alliance in
recognition that the distribution of new and underused vaccines to
low-income countries was dependent on strong partnerships.
• Its mission, to save children’s lives and protect people’s health by
increasing access to immunization in poor countries, recognized not
only the priority of reducing child deaths due to vaccine-
preventable diseases, but also the power of vaccines to provide
life-long protection against debilitating illness and disease.
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• THE EIGHT MILLENNIUM DEVELOPMENT GOALS

• MDG 1: End poverty and hunger
• Vaccines protect children from death and disability, enabling
families to break out of a cycle of poverty and ill health.
• Healthy children free families from the financial burden of medical
care, allowing them to spend more on food and education.
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• MDG 2: Achieve universal primary education

• Healthy, immunized children are better able to attend school and learn.
• Protecting children from infectious diseases enables them to attend
school more regularly.
• Vaccination raises children’s IQ, improves their cognitive development,
physical strength and educational achievements.
• In most countries, girls and boys have the same likelihood of being
vaccinated.
• GAVI’s gender policy recognizes equal
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• MDG 3: Promote gender equality and empower women

• In most countries, girls and boys have the same likelihood of being
vaccinated.
• GAVI’s gender policy recognizes equal access as key to expanding
vaccine coverage and making immunization more equitable.
• Healthy, immunized children frees women’s time for other
activities.
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• MDG 4: Reduce child mortality

• Immunization is among the most successful and most cost-
effective health interventions; saving an estimated two to three
million lives every year1.
• Pneumonia and diarrhea kill between two to three million children
each year. GAVI supports pneumococcal and rotavirus vaccines
against these leading child killers.
• MDG 5: Improve maternal health
• Vaccines benefit women's health.
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• MDG 6: Combat HIV/AIDS, malaria and other diseases

• Vaccinating HIV-positive adults and children can help to protect
them from pneumonia, diarrhea and other diseases.
• Vaccinating children also benefits the non-vaccinated by reducing
disease transmission within the community.
• This is especially important for HIV-positive people who are more
vulnerable to pneumonia and other diseases.
• MDG 7: Ensure environmental sustainability
• MDG 8: Develop a global partnership for development
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4.4 Local Health System &Devolution

of Health Services

• provincial, district and municipal hospital - provincial governments

• rural health units (RHUs) and barangay health stations (BHSs)
• Municipal governments

4.4 LOCAL HEALTH SYSTEM AND DEVOLUTION OF HEALTH SERVICES

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4.5 CLASSIFICATION OF HEALTH FACILITIES

• Administrative Order No. 2012-0012

• New Classification of Hospitals and other Health Facilities

Classification of hospital shall be based on Administrative Order No.

2012–0012, dated July 18, 2012, "Rules and Regulations Governing the
New Classification of Hospitals and Other Health Facilities in the
Philippines"
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• They shall be classified according to the following:

• 1.According to Ownership
• Government – The hospital is created by law.
• A government health facility may be under the National Government, DOH, Local
Government Unit (LGU), Department of Justice (DOJ), State Universities and Colleges
(SUCs), Government-owned and controlled corporations (GOCC) and others.

• Private
• Owned, established, and operated with funds from donation, principal, investment, or other
means by any individual, corporation, association, or organization
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• According to Scope of Services

• General Hospital
• A hospital that provides services for all kinds of illnesses, diseases, injuries or deformities
• It provides medical and surgical care to the sick and injured, maternity, newborn and child care.
• It shall be equipped with the service capabilities needed to support board certified/ eligible
medical specialists and other licensed physicians rendering services in, but not limited to the
following:
• Clinical Services (Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology,
Surgery)
• Emergency Services
• Outpatient Services
• Ancillary and Support Services (Clinical Laboratory, Imaging Facility, Pharmacy)
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• Specialty
• Specializes in a particular disease or condition or in one type of patient
• A specialized hospital may be devoted to the treatment of the
following:
• Treatment of a particular type of illness or for a particular condition
requiring a range of treatment
• Treatment of patients suffering from a particular diseases of a
particular organ or group of organs
• Treatment of patients belonging to a group such as children, women,
elderly or others
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• According to Functional Capacity

• Level 1 General Hospital
• General Hospital shall have as minimum:
•
• 1. A staff of qualified, medical, allied medical and administrative personnel headed by a physician duly licensed by the
PRC

• 2. Bed space for its authorized bed capacity, in accordance with DOH Guidelines in the Planning and Design of
Hospitals

• 3. An operating room with standard equipment and provisions for sterilization of equipment and supplies in
accordance with:
• DOH Reference Plan in the Planning and Design of an Operating Room or Theater
• DOH Guidelines on Cleaning, Disinfection, and Sterilization of Reusable Medical Devices in Hospital Facilities in the
Philippines
• 4. A post-operative Recovery Room
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• 5. Maternity Facilities consisting of Ward(s), Room(s), a Delivery Room, exclusively for

maternity patients and newborns
•
• 6. Isolation facilities with proper procedures for the care and control of infection and
communicable diseases as well as for the prevention of cross infection
• 7. A separate dental section/ clinic
• 8. Provision for blood donation
• 9. A DOH-licensed secondary clinical laboratory with the services of a consulting pathologist
•
• 10. A DOH licensed Level 1 imaging facility with the services of a consulting radiologist
• 11. A DOH licensed pharmacy
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• Level 2 General Hospital

• As minimum, all of Level 1 capacity, including but not limited to:
• 1. An organized staff of qualified and competent personnel with Chief of Hospital/Medical Director and
appropriate board certified Clinical Department Heads
• 2. Departmentalized and equipped with the service capabilities needed to support board certified/
eligible medical specialties and other licensed physicians rendering services in the specialties of
Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, their subspecialties, and other ancillary
services
• 3. Provision for general ICU for critically ill patients
• 4. Provision for NICU
• 5. Provision for Respiratory Therapy Services
• 6. A DOH licensed tertiary clinical laboratory
• 7. A DOH licensed level 2 imaging facility with mobile X-ray inside the institution and with capability for
contrast examinations
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• Level 3 General Hospital

• Teaching and/or Training Hospital with accredited residency training program for physicians in the four major
specialties namely: Medicine, Pediatrics, Obstetrics and Gynecology, and Surgery

• Provision for physical medicine and rehabilitation unit

• Provision for ambulatory surgical clinic

. Provision for dialysis facility

• Provision for blood bank

• A DOH licensed level 3 imaging facility with radiology

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THREE LEVELS OF PRIMARY HEALTH CARE WORKERS

A. VILLAGE OR GRASSROOT HEALTH WORKERS
• first contacts of the community and initial links of health care.
• Provide simple curative and preventive health care measures
promoting healthy environment.
• Participate in activities geared towards the improvement of the
socio-economic level of the community like food production
program.
• Community health worker, volunteers or traditional birth
attendants.
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B. INTERMEDIATE LEVEL HEALTH WORKERS

• represent the first source of professional health care
• attends to health problems beyond the competence of village
workers
• provide support to front-line health workers in terms of
supervision, training, supplies, and services.
• Medical practitioners, nurses and midwives.
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C. FIRST LINE HOSPITAL PERSONNEL

• provide backup health services for cases that require
hospitalization
• establish close contact with intermediate level health workers
or village health workers.
• Physicians with specialty, nurses, dentist, pharmacists, other
health professionals.
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Level of Health Care Facilities

1. Primary Level- includes Rural Health Units (RHUs), sub-centers,
community hospitals, speciality clinics and/or health centers
operated by both government and private entities, and other
health facilities operated by non-government agencies and other
groups.
2. Secondary Level- includes smaller, often non-departmentalized
hospitals that offer a variety of healthcare services which require
moderately-specialized knowledge and technical resources for
adequate case management; includes Provincial and Regional
hospitals.
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3. Tertiary Level- includes healthcare facilities that

offer highly-technological and sophisticated
healthcare services such as those offered by specialty
national hospitals and medical centers.