COMMUNITY

DEVELOPMENT
NCM 220B: Nursing Leadership and
Management (RLE)
Dexter P. Cendaña, R.N. [dexterpc@[Link]]

Notes
 Notes COMMUNITY DEVELOPMENT

I. CHN
A. Concepts B. Principles C. Roles of the Nurse
II. PHC
A. Elements/Components
B. Health Care Delivery System
C. Levels of Clientele
D. Levels of Primary Health Facility
E. Two Types of Primary Health Care
III. Community Diagnosis
A. Elements
B. Process
1. Collecting, organizing and synthesizing data
2. Analyzing and interpreting health data
3. Formulation of Community Health Nursing Diagnoses
C. Steps
1. Determining the Objectives
2. Defining the Study Population
3. Determining the Data to be collected
4. Collecting the Data
5. Developing the Instrument
6. Actual Data Gathering
7. Data Collation
8. Data Presentation
9. Data Analysis
10. Identifying Community Health Nursing Problems
11. Priority-setting
D. Categories of Health Problems
E. Prioritizing Health Problems
IV. COPAR
A. Phases
1. Pre-entry
2. Entry
3. Organization-building
4. Sustenance and strengthening
V. Community Organizing
A. Approaches
B. Principles
C. Stages
1. Community analysis
2. Design and initiation
3. Implementation
4. Program maintenance-consolidation
5. Dissemination-reassessment
VI. DOH
A. Vision
B. Mission
C. Objectives
D. Basic Principles
E. Programs
VII. Evaluation of Care and Services
VIII. FHSIS
A. Objectives
B. Components
1. Treatment Record
2. Target/Client Lists
3. Tally/Reporting Forms
4. Output Reports

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 Notes COMMUNITY DEVELOPMENT

I. CHN
COMMUNITY =
▪ a group of people sharing common geographic boundaries and common values and interests.

HEALTH =
▪ state of complete physical, mental and social well-being, not merely the absence of disease or infirmity
▪ W.H.O. - optimum level of individuals, families and communities

NURSING =

✓ FOCUS: promotion and preservation of the health of populations

✓ NATURE OF PRACTICE: comprehensive, general, continual and not episodic
✓ KNOWLEDGE BASED: from nursing and public health
✓ LEVELS OF CLIENTELE: individuals, family, population groups and community as a whole

PUBLIC HEALTH NURSING

• the science and art of preventing disease, prolonging life and efficiency to enable every citizen to realize his birthright of health and
longevity (Winslow)
• dedicated to the common attainment of the highest level of physical, mental and social well-being and longevity
GOAL: contribute to the most effective total development and life of the individual and his society. (Hanlon)

A. CONCEPTS
▪ a learned practice discipline
Ultimate Goal: contribute to the promotion of client’s optimum level of functioning through teaching and
delivery of care. (Jacobson)
▪ a service rendered by a professional nurse with the community, groups, families and individuals
GOAL: promotion of health, prevention of illness, care of the sick at home and rehabilitation (Freeman)
▪ philosophy is based on the worth and dignity of man. (Shetland)
▪ primary focus of community health nursing practice = HEALTH PROMOTION
▪ practice is extended to benefit not only the individual but the whole family and community
▪ community health nurses are GENERALISTS

B. PRINCIPLES
▪ community health nursing is based on recognized needs of communities, families, groups and individuals
▪ the community health nurse must understand fully the objectives and policies of the agency she represents
✓ unit of service = FAMILY
✓ Community health nursing must be available to all
✓ primary responsibility of the community health nurse = HEALTH TEACHING
✓ The community health nurse works as a member of the health team
✓ There must be periodic evaluation
✓ Opportunities for continuing staff education program must be provided
✓ Make use of available community health resources
✓ Utilize existing active groups in the community
✓ Educative supervision
✓ Accurate recording and reporting
▪ ULTIMATE GOAL: Raise the level of health of the citizenry

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 Notes COMMUNITY DEVELOPMENT

C. ROLES OF THE NURSE IN COMMUNITY HEALTH NURSING

1. Clinician focus on the health of the individuals on the larger context of the community

2. Advocate promote self-care and self-determination

3. Collaborator brings together strengths and weaknesses of people involved toward a common goal

4. Researcher utilizes data to predict future phenomenon and modify interventions

5. Counselor key tasks include listening and providing feedback and information

oversees all aspects of care to facilitate delivery of cost-efficient care; to individualize and coordinate
6. Case Manager care

7. Educator provide knowledge, skills and attitudes that people need to make appropriate choices or decision

8. Hospice Care providing care skills in a home and other settings and balancing client’s needs

II. PHC
PRIMARY HEALTH CARE
✓ essential health care made universally acceptable to individuals and families in the community
✓ by means acceptable to them and through their full participation
✓ at a cost that the community and country can afford at every stage of development

LEGAL BASIS:
✓ Letter of Instruction 949
✓ President Ferdinand Marcos
✓ October 19, 1979
✓ First International Conference on Primary Health care
▪ Alma Ata, USSR
▪ September 6-12, 1978
▪ Sponsored by the World Health Organization and UNICEF

Five (5) Principles of Primary Health Care (PHC):

• Social equity
• Nation-wide coverage/wider coverage
• Self- reliance
• Intersectoral coordination
• People’s involvement (in planning and implementation of programs)

A. ELEMENTS/COMPONENTS
E Education for Health
L Locally Endemic Disease Control
E Expanded Program on Immunization
M Maternal and Child Health
E Essential Drugs and Elderly Care
N Nutrition
T Treatment of CD and Non-CD
S Sanitation: Water and Environment

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 Notes COMMUNITY DEVELOPMENT

B. HEALTH CARE DELIVERY SYSTEM

✓ one component of this factor is the primary health care which is a partnership approach
✓ Goal: Effective provision of health services that are community-based and accessible
✓ Components:
a. Promotive
b. Preventive
c. Curative
d. Rehabilitative

C. LEVELS OF CLIENTELE
✓ Individual, Family, Community, Population Group → Sick or Well

D. LEVELS OF PRIMARY HEALTH FACILITY

1. PRIMARY
• client in Fair health and with early symptoms of illness
• Barangay Health Center (BHC), City Health Office (CHO), Municipal Health Office (MHO), Lying-in Clinics, Puericulture
Center, Community Hospitals
2. SECONDARY
• patient in symptomatic stage of an illness and requires moderately specialized knowledge/facilities
• Provincial Hospitals, District Hospitals, Municipal Hospitals, Emergency Hospitals
3. TERTIARY
• Patients seriously threaten and requires highly technical facilities and knowledge
• National Hospitals, Teaching/Training Hospitals, Regional Hospitals
(SPECIALTY HOSPITALS)

E. TWO TYPES OF PRIMARY HEALTH CARE WORKERS

1. Village/Grassroot workers
• trained individuals
✓ BHW, TBA, Trained hilot, Trained Dentist, Trained Nutritionist
2. Intermediate Health Care Workers
• Professional Groups
✓ RH Physicians, RH Nurse, RH Midwife, RH Dentist, Medtech, Nutritionist, Sanitary Inspector

Ratio to Population

1 Physician = 20,000

1 Nurse = 20,000

1 Med Tech = 20,000

1 Sanitary Inspector = 20,000

1 Dentist = 50,000

1 Midwife = 5,000

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 Notes COMMUNITY DEVELOPMENT

III. COMMUNITY DIAGNOSIS

✓ a process by which the nurse collects data about the community in order to identify factors which may influence the deaths
and illnesses of the population to formulate a community health nursing diagnosis and develop and implement community
health nursing interventions and strategies
✓ done to come up with a profile of local health situation
✓ will serve as a basis of health programs and services to be delivered to the community
✓ starts with determining the health status of the community

TWO TYPES OF COMMUNITY DIAGNOSIS

1. Comprehensive Community Diagnosis
• aims to obtain general information about the community
2. Problem-Oriented Community Diagnosis
• type of assessment responds to a particular need

A. ELEMENTS:
1. Demographic Variables
• Total population & Geographical distribution including Urban-Rural index & Population Density
• Age & Sex composition
• Selected vital indicators e.q. Growth rate, CBR, CDR & Life expectancy rate
• Patterns of migration
• Population projection

Note: Population groups that need special attentions:

▪ Indigenous people
▪ Socially dislocated groups as a result of disasters, calamities & development programs

2. Socio-economic & Cultural Variables

a. Social indicators
▪ Communication network
▪ Transportation system
▪ Educational level
▪ Housing conditions
b. Economic indicators
▪ Poverty level income
▪ Employment rate
▪ Types of industry present in the community
▪ Occupation common in the community
c. Environmental indicators
▪ Physical/geographical/topographical characteristics
▪ Water supply
▪ Waste disposal
▪ Air, Water and Land pollution
d. Cultural factors
▪ Variables that may break up people into groups within the community e.q.
• Ethnicity
• Social class
• Language
• Religion
• Race
• Political orientation
▪ Cultural beliefs and practices that affect health
• Concepts about Health and Illness

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 Notes COMMUNITY DEVELOPMENT

3. Health & Illness Patterns

▪ Leading cause of mortality
▪ Leading cause of morbidity
▪ Leading cause of infant mortality
▪ Leading cause of maternal mortality
▪ Leading cause of hospital admission
4. Health Resources
▪ Manpower resources
▪ Material resources
5. Political/Leadership Patterns
▪ Reflects the action potential of the state and its people to address the health needs and problems of the community
▪ Mirrors the sensitivity of the government to the people’s struggle for better lives

PROCESS OF COMMUNITY DIAGNOSIS

1. Collecting, organizing & In order to identify the different factors that may directly or indirectly influence the
synthesizing data health of the population

2. Analyzing & interpreting health Seek explanations for the occurrence of health needs and problems of the
data community

3. Formulation of Community Health Will become the bases for developing and implementing community health nursing
Nursing Diagnoses interventions and strategies

STEPS IN CONDUCTING COMMUNITY DIAGNOSIS

1. DETERMINING THE OBJECTIVES the nurse decides on the depth and scope of the data she needs to gather.

2. DEFINING THE STUDY POPULATION the nurse identifies the population group to be included in the study.

3. DETERMINING THE DATA TO BE the objectives will guide the nurse in identifying the specific data she will collect, and
COLLECTED will also decide on the sources of these data.

the nurse decides on the specific methods depending on the type of data to be
4. COLLECTING THE DATA generated.
Ocular survey, interview, and records review
instruments/tools facilitate the nurse’s data-gathering activities.
Most common instruments:
5. DEVELOPING THE INSTRUMENT ▪ survey questionnaire
▪ interview guide
▪ observation checklist
the nurse supervises the data collectors by checking the filled-up instruments in
6. ACTUAL DATA GATHERING terms of completeness, accuracy and reliability of the information collected.
the nurse is now ready to put together all the information.
7. DATA COLLATION a. Numerical data
b. Descriptive data
will depend largely on the type of data obtained.
8. DATA PRESENTATION a. Descriptive- narrative reports
b. numerical data- table or graphs
aims to establish trends and patterns in terms of health needs and problems of the
9. DATA ANALYSIS community.

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 Notes COMMUNITY DEVELOPMENT

10. Identifying Community Health

Health Status Problems
Nursing Problems
Increased/decreased morbidity, mortality fertility or reduced capability for
wellness
Health Resources Problems
Lack of or absence of manpower, money, materials or institutions
necessary to solve health problems
Health Related Problems
Existence of social, economic, environmental and political factors that
aggravate the illness-inducing situations in the community

11. Priority-setting
Nature of the condition/problem presented
Classified as health status, health resources or health related problems
Magnitude of the problem
Severity of the problem which can be measured in terms of the proportion
of the population affected by the problem
Modifiability of the problem
Probability of reducing, controlling or eradicating the problem
Preventive potential
Probability of controlling or reducing the effects posed by the problem
Social concern
Perception of the population or the community as they are affected by the
problem and their readiness to act on the problem

CATEGORIES OF HEALTH PROBLEMS

▪ a gap between actual and achievable health status; instances of failure in health maintenance
▪ possible precursors of health deficit:
✓ History of repeated infections or miscarriages
✓ No regular health check-up
1. HEALTH Examples:
DEFICIT ▪ ILLNESS states, diagnosed or undiagnosed
▪ Failure to thrive/develop
▪ Disability
o Transient (aphasia or temporary paralysis after a CVA)
o Permanent (leg amputation secondary to diabetes, blindness from measles,
lameness from polio)

conditions that are conducive to disease, accident or failure to realize one’s potential
Examples:
• Family history of hereditary disease
2. HEALTH • Threat of cross infection
THREAT • Accident hazards
• Faulty eating habits
• Poor environmental sanitation
• Unhealthy lifestyle/personal habits

anticipated periods of unusual demand on the individual or family in terms of adjustment/family resources
Examples:
• Marriage
• Pregnancy
3. FORESEEABLE
• Parenthood
CRISIS • Divorce or separation
• Loss of job
• Menopause
• Death

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 Notes COMMUNITY DEVELOPMENT

PRIORITIZING HEALTH PROBLEMS

categorized into health deficit, health threat and foreseeable crisis

Health deficit 3
1. NATURE OF THE
Health threat 2
PROBLEM Foreseeable crisis 1

refers to the probability of success in minimizing, alleviating or totally eradicating the problem through
intervention
2. MODIFIABILITY OF
Easily modifiable 2
THE PROBLEM Partially modifiable 1
Not modifiable 0

refers to the nature and magnitude of future problems that can be minimized or totally prevented if
intervention is done on the problem under consideration
3. PREVENTIVE
High 3
POTENTIAL Moderate 2
Low 1

refers to the family’s perception and evaluation of the problem in terms of seriousness and urgency of
attention needed
4. SALIENCE A serious problem, immediate attention needed 2
A problem, but not needing immediate attention 1
Not a felt need / problem 0

IV. COPAR
Importance:
COPAR is an important tool for community development and people empowerment as this helps the community workers to generate
community participation in development activities. COPAR prepares people/clients to eventually take over the management of a
development program(s) in the future. COPAR maximizes community participation and involvement; community resources are mobilized for
community services.

Principles:
1. People, especially the most oppressed, exploited and deprived sectors are open to change, have the capacity to change, and are
able to bring about change.
2. COPAR should be based on the interest of the poorest sector of society.
3. COPAR should lead to a self-reliant community and society.

Phases of the COPAR Process

Preparation of the Institution

• Train faculty and students in COPAR.
• Formulate plans for institutionalizing COPAR.
• Revise/enrich curriculum and immersion program.
• Coordinate participants of other departments.
1. Pre-Entry Phase
Site Selection
• Initial networking with local government.
• Conduct preliminary special investigation.
• Make long/short list of potential communities.
• Do ocular survey of listed communities.

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 Notes COMMUNITY DEVELOPMENT

Criteria for Initial Site Selection

• Must have a population of 100-200 families.
• Economically depressed.
• No strong resistance from the community.
• No serious peace and order problem.
• No similar group or organization holding the same program.

Identifying Potential Municipalities

• Make long/short list.

Identifying Potential Barangay

• Do the same process as in selecting municipality.
• Consult key informants and residents.
• Coordinate with local government and NGOs for future activities.

Choosing Final Barangay

• Conduct informal interviews with community residents and key informants.
• Determine the need of the program in the community.
• Take note of political development.
• Develop community profiles for secondary data.
• Develop survey tools.
• Pay courtesy call to community leaders.
• Choose foster families based on guidelines.

Identifying Host Family

• House is strategically located in the community.
• Should not belong to the rich segment.
• Respected by both formal and informal leaders.
• Neighbours are not hesitant to enter the house.
• No member of the host family should be moving out in the community.

Guidelines for Entry

• Recognize the role of local authorities by paying them visits to inform their presence and
activities.
• Her appearance, speech, behavior and lifestyle should be in keeping with those of the
community residents without disregard of their being role model.
• Avoid raising the consciousness of the community residents; adopt a low-key profile.

Activities in the Entry Phase

• Integration - establishing rapport with the people in continuing effort to imbibe community
life; living with the community; seek out to converse with people where they usually
congregate; lend a hand in household chores; avoid gambling and drinking
2. Entry Phase
• Deepening social investigation/community study verification and enrichment of data
collected from initial survey; conduct baseline survey by students, results relayed through
community assembly

Leader Spotting Through Sociogram.

Key persons - approached by most people
Opinion leader - approach by key persons
Isolates - never or hardly consulted

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 Notes COMMUNITY DEVELOPMENT

Entails the formation of more formal structure and the inclusion of more formal procedure of planning,
implementing, and evaluating community-wise activities. It is at this phase where the organized leaders
or groups are being given training (formal, informal, OJT) to develop their style in managing their own
concerns/programs.

Key Activities
• Community Health Organization (CHO)
3. Organization- - preparation of legal requirements
building Phase - guidelines in the organization of the CHO by the core group
- election of officers
• Research Team Committee
• Planning Committee
• Health Committee Organization
• Others
• Formation of by-laws by the CHO

Occurs when the community organization has already been established and the community members
are already actively participating in community-wide undertakings. At this point, the different
committee’s setup in the organization-building phase is already expected to be functioning by way of
planning, implementing and evaluating their own programs, with the overall guidance from the
community-wide organization.
4. Sustenance and
Strengthening Key Activities
Phase • Training of CHO for monitoring and implementing of community health program.
• Identification of secondary leaders.
• Linkaging and networking.
• Conduct of mobilization on health and development concerns.
• Implementation of livelihood projects.

V. COMMUNITY ORGANIZING
✓ a process whereby the community members develop the capability to assess their health needs and problems, plan and implement
actions to solve these problems, put up sustain organizational structures which will support and monitor implementation of health
initiatives by the people
✓ Purpose: Empowerment or building the capability of people for future community action

A. Approaches to community development:

a. Social changes
▪ Building up social organizations (relationships, structure and resources)
b. Change in ideology
▪ Knowledge, beliefs and attitude
c. Change agents
▪ Capacity to influence others by setting a good example.
B. Principles:
1. Welfare approach
• People esp. the oppressed, exploited and deprived sectors are most open to change, have the capacity to change
and are able to bring about change. Hence, CO is based on the ff:
a. Power must reside in the people
b. Development. is from the people to the people
c. People participation
2. Technological approach
• must be based on the poorest sectors of society. The solutions of problems commonly shared by these sectors must
be focused on collective organizations, planning and action
3. Transformatory approach
• should lead to self-reliant communities
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 Notes COMMUNITY DEVELOPMENT

COMMUNITY ORGANIZING STAGES

Stage 1. Community analysis

✓ the process of assessing and defining needs, opportunities and resources involved in initiating community health action.
✓ maybe referred to as community diagnosis, community needs assessment, health education planning and mapping

5 Components of Community Analysis

1. Demographic, social and economic profile of the community derived from secondary data.
2. Health risk profile (social, behavioural and environmental risks)
▪ Behavioural- dietary habits and other life style concerns like alcohol, tobacco and drugs
▪ Social indicators- exposure to long term unemployment, low education and isolation.
3. Health/wellness out comes profile (morbidity/mortality data)
4. Survey of current health promotion programs.
5. Studies conducted in certain target groups

Steps in Community Analysis

1. Defining the community Determining the geographic boundaries of the target community

2. Collecting data

3. Assessing community Entails an evaluation of the driving forces which may facilitate or impede the advocated
capacity change

4. Assessing community
barriers

5. Assessing readiness to Community interest

change Perception on the importance of the problem

6. Synthesis data and set Provide a community profile of the needs and resources and will become the basis for
priorities designing prospective community interventions for health promotion

Stage 2. Design and Initiation

Steps in Design and Initiation

1. Establish a core planning ▪ Requirements:

group and select a local ▪ Select 5-8 member in charge for core planning and management of the program
organizer. ▪ With management skills, good listener and conflict resolution skills.

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 Notes COMMUNITY DEVELOPMENT

▪ This activate the community participation.

Types:
a. Leadership board council - existing local leaders working for a common cause
b. Coalition - linking organizations and groups to work on community issues.
c. “lead” or official agency - a single agency takes the primary responsibility of a
2. Choose an organizational
liaison for health promotion activities in the community.
structure. d. Grass-roots - informal structures in the community like the neighbourhood
residents.
e. Citizens panels - a group of citizens (5-10) emerge to form a partnership with the
government agency.
f. Networks and consortia - network develop because of a certain concerns

3. Identify, select and recruit ▪ As much as possible different groups, organizations sectors should be represented.
organizational members. ▪ Chosen representative have power for the group they represents

4. Define the organization ▪ This will specify the what, who, where, when and extent of the organizational
mission and goals. objectives.

5. Clarify roles and

responsibilities of people ▪ This is done to establish a smooth working relationship and avoid overlapping of
involved in the responsibilities.
organization.
▪ Active involvement in planning and management of programs may require skills
6. Provide training and development training.
recognition. ▪ Recognition of the programs accomplishment and individuals contribution to the
success of the program and boost morale of the members.

Stage 3. Implementation
✓ putting the design plan into action.

a. Generate broad citizen participation

▪ How? Organizing task force, who, with appropriate guidance can provide the necessary support.
b. Develop a sequential work plan
▪ Activities should be planned sequentially. Often, times has to be modified as events unfold. Community members may
have to constantly monitor implementation steps.
c. Use comprehensive, integrated strategies
▪ Generally the program utilize more than one strategies that must complement each other.
d. Integrate community values into the programs, materials and messages.
▪ The community language, values and norms have to be incorporated into the program.

Stage 4. Program maintenance – consolidation

✓ the program at this point has experienced some degree of success and has weathered through implementation problems, the
organization and program is gaining acceptance in the community.

a. Integrate intervention
▪ This can be affected through implementation problems.
activities into community ▪ The organization and program is gaining acceptance in the community.
networks

▪ A positive environment is a critical element in maintaining cooperation and

b. Establish a positive
preventing fast turnover of members.
organizational culture. ▪ This is a result of good group process based on trust, respect, and openness.

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 Notes COMMUNITY DEVELOPMENT

▪ It should be expected that volunteers may leave the organization.

c. Establish an ongoing
▪ This requires a built in mechanisms for continuous recruitment and training of new
recruitment plan. members.

▪ Continuous feedback to the community on results of activities enhances visibility and

d. Disseminate results. acceptance of the organization.
▪ Dissemination of information is vital to gain and maintain community support.

Stage 5. Dissemination - reassessment

✓ continuous assessment is part of the monitoring aspect in the management of the program

a. Update the community ▪ Is there a change in leadership, resources and participation?

analysis. ▪ This may necessitate reorganization and new collaboration with other organizations.

▪ Quantitative and qualitative methods of evaluation can be used to determine

b. Assess effectiveness of
participation, support and behavior change level of decision making and other
interventions/programs. factors deemed important to the program.

▪ This may mean revision of goals and objectives and development of new strategies.
c. Chart future directories and
▪ Revitalization of collaboration and networking may be vital in support of new
modifications. ventures.

▪ Some organization die because of the lack of visibility.

d. Summarize and disseminate
▪ A dissemination plan may be helpful in diffusion of information to further boost
results. support to the organization’s endeavour.

VI. DEPARTMENT OF HEALTH (DOH)

The Department of Health (DOH) is the principal health agency in the Philippines. It is responsible for ensuring access to basic
public health services to all Filipinos through the provision of quality health care and regulation of providers of health goods and
services. ([Link]

VISION: Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040

MISSION: To lead the country in the development of a productive, resilient, equitable and people-centered health system for
Universal Health Care

NATIONAL HEALTH OBJECTIVES

✓ Improve the general health status of the population
✓ Reduce morbidity, mortality, disability and complications
✓ Eliminate the following diseases as public health problems (schistosomiasis, malaria, filariasis, leprosy, rabies, measles,
tetanus, diphtheria, pertussis, vitamin A and iodine deficiency)
✓ Eradicate poliomyelitis
✓ Promote healthy lifestyle
✓ Promote health and nutrition of families and special populations
✓ Promote environmental health and sustainable development

BASIC PRINCIPLES TO ACHIEVE IMPROVEMENT IN HEALTH

▪ Ensure universal access to basic health services
▪ Epidemiological shift from infectious to degenerative disease must be managed
▪ Enhance the performance of the health sector
▪ Ensure the prioritization of the health and nutrition of vulnerable groups

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 Notes COMMUNITY DEVELOPMENT

PRIMARY STRATEGIES TO ACHIEVE HEALTH GOALS

▪ Support for frontline health workers and local system development
▪ Assurance of health care
▪ Increasing investment for primary health care
▪ Development of national standards and objectives for health

DOH PROGRAMS

D Dental health program

O Osteoporosis prevention

Health education and community organizing

- Herbal medicine
H - Health Emergency Preparedness and Response Program
- National Voluntary Blood Services Program
- Botika ng Barangay

P Primary health care

R Reproductive health: Family Planning Program

O Older persons health service
G Guidelines for good nutrition: Food fortification
R Respiratory Infection Control

A Alternative health care

Maternal and child care

- Basic Emergency Obstetric Care (BEMOC)
- Infant and Young Child Feeding
- Newborn Screening
- Expanded Program on Immunization
M
- Management of Childhood Illnesses
- Micronutrient Supplementation = “Araw ng Sangkap Pinoy”, Garantisadong Pambata, Child Week
- Dental Health
- Early Child Development
- Child Health Injuries

S Sentrong Sigla Movement

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EVALUATION OF CARE AND SERVICES PROVIDED

include the physical settings, instrumentalities and conditions through which nursing care is given
Components:
▪ Philosophy
1. STRUCTURAL
▪ Objectives
ELEMENTS ▪ Building
▪ Organizational structure
▪ Financial resources (budget, equipment, staff)
steps of the nursing process ( assessment, planning, implementing and evaluating)
Components:
▪ Taking the family health database
▪ Performing physical examination
2. PROCESS ▪ Making a nursing diagnosis
ELEMENTS ▪ Determining nursing goals
▪ Writing a nursing care plan
▪ Performing nursing interventions
▪ Coordination of services
▪ Measuring success of nursing actions
changes in the client’s health status that result from nursing interventions
Components:
▪ modification of signs and symptoms
3. OUTCOME ▪ Knowledge
ELEMENTS ▪ Attitude
▪ Satisfaction
▪ Skill level of client
▪ Compliance with treatment regimen

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 Notes COMMUNITY DEVELOPMENT

Field Health Services and Information System (FHSIS)

Recording and reporting system (vital statistics, notifiable disease, services provided to family and
community)

OBJECTIVES:
✓ To provide summary of data on health services delivery and selected program accomplished indicators at the barangay,
municipality/city, district, provincial, regional and national levels.
✓ To provide data which when combined with data from other sources, can be used for program monitoring and evaluation
purposes.
✓ To provide a standard, facility level data base which can be accessed for a more in-depth studies.
✓ To ensure that the data reported to the FHSIS are useful and accurate and are disseminated in a timely and easy to use fashion.
✓ To minimize the recording and reporting burden at the service delivery level in order to allow more time for patient care and
promotive activities.

COMPONENTS:
1. Treatment Record
• The fundamental building block or foundation of the FHSIS
• This is the document, form or pieces of paper upon which the presenting symptoms or complaints of the patient on consultation
and the diagnosis (if available), treatment data and date of treatment is recorded.
• This record will be maintained as part of the system or records at each BHS/BHC/RHU/MHC, or hospital outpatient by facility on all
patients seen.

Rx Diagnosis
Date Name Address Complaint
(if available)

2. Target/Client Lists
• Constitute the second “building block” of the FHSIS and are intended to serve four purposes.
a. to plan and carry out patient care and service delivery – the midwife/nurse does not have to go back to individual
patient/family records as frequently in order to monitor patient treatment or services to beneficiaries.
b. to facilitate the monitoring and supervision for services.
c. to report services delivered.
d. to provide a clinic-level data base which can be accessed for further studies.

e.g. Target client list for Expanded program on Immunization

Client list for pre-Natal care
List for TB Symptomatic
3. Tally/Reporting Forms
• Are prepared and submitted:
a. either monthly or quarterly, weekly, several annually, and in some instance, every few minutes as relevant events occur.
b. by the unit/person responsible for the service/activity being provided and sent directly to the Provincial Health Office.

4. Output Reports
• Will be produced at the PHO (or alternate date processing site in the province) from the data reported in the FHSIS disseminated
down to the RHU/MHC and up through the DOH system to the Regional Health Office.
• The objective in designing the output formats is to make the reports useful for monitoring/management purposes at each level of
DOH Management.

Reporting Unit – as any DOH health care facility that renders/delivers public care-related services to targeted beneficiaries.
• BHS/BHC → RHU / MHC (Main Health Center)
• PH (Provincial Hospital) / CHO (City Health Office)
• RH (Regional Hospital) including Medical Centers → processed by a microcomputer.

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