GLOBAL AND NATIONAL HEALTH within a geographically or culturally defined

SITUATIONS group.
1. Air pollution and climate change Public Health Nursing
2. Non-communicable disease
The practice of promoting and protecting the
3. Global influenza disease
health of populations using knowledge from
4. Fragile and vulnerable settings
nursing, social and public health sciences.
5. Antimicrobial resistance
(American Public Health Association, 1996)
6. Iboland and other high-threat pathogens
7. Weak primary Healthcare Community Health Nursing
8. Vaccine hesitancy
9. Dengue Also called public health nursing, combines
10. Human Immunodeficiency Virus (HIV) primary health care and nursing practice in a
community setting.

DEFINITION AND FOCUS

Public Health
- Is a science and art of preventing disease, Evolution of Public Health Nursing in the
prolonging life, promoting health through the Philippines
organized efforts & informed choices of society, • 1577 – first dispensary for indigent
organizations, public and private communities, patients of Manila ran by a Franciscan
and individuals (CEA Winslow) Friar
Public Health • 1876 – Medicos Titulares equivalent to
is the science of protecting and improving the provincial health officers
health of people in their communities by: • 1888 – Superior Board of Health and
 Promoting healthy lifestyles Charity established a hospital system and
a board of vaccination
 Researching disease and
• June 23, 1898 – creation of the Dept. of
injury prevention Public Works, Educ. & Hygiene
 Detecting, preventing and • September 29, 1898 – General Order No.
15 Board of Health for the City of Manila
responding to infectious disease (cdc
(protecting American Soldiers)
foundation org.) Center of Disease Control
• July 1, 1901 – Act No. 157 creation of a
and prevention
Board of Health for the Philippine islands
(protecting Filipinos)
Community Health • Dec 2, 1901 – Insular Board of Health thru
Acts No. 307 and 308
Health status of a defined group of
people/community and the actions and conditions - established the Philippine and
that protect and improve the health of the Municipal Board : health organization
community. It does not focus on a group of in accordance with the territorial
people with the same shared characteristics like division of the islands
age/dx but on all people within the geographical • October 26, 1905 – abolished Insular
location. Board of Health, replaced by Bureau
of Health under the Dept of Interior thru
Community Health
Act No 1407 in 1906
A field of public health that focuses on
• 1912 – Act No 2156 “Fajardo Act”
studying, protecting, or improving health within a
consolidation of municipalities into sanitary
community.
divisions;
Rooted in the collective efforts of individuals
- Health fund for travel & salaries was
and organizations who work to promote health
created
 • 1915 Act No. 2468 transformed Bureau of • Oct 10, 1991 – RA 7160 “Local Govt
Health into Philippine Health Service Code” devolution to LGU; DOH from
implementation to governance
- Health Personnel required of Civil Service
Grades, promotion described as • 1999-2004 – Health Sector Reform
Agenda
“Semi-military system of public health
administration” Roles and Responsibilities of Community
Health Nurse
• August 2, 1916 – passage of Jones
Law/Phil. Autonomy Act…major 1. Management Function
reorganization which culminated to Public
2. Supervisory Function
Health Law of 1917
3. Nursing Care Function
• 1932 – Act No 4007 “Reorganization Act
of 1932” reverted Philippine Service into 4. Collaborating and Coordinating Function
the Bureau of Health
5. Health Promotion and Education Function
• May 31,1939 –Commonwealth Act No.
430 created the Department of Public 6. Training Function
Health and Welfare. Dr. Jose Fabella 7. Research Function
became the first Department Secretary of
Health and Public Welfare in 1941 Competencies Skills and Knowledge of
Community Health Nurse
• Oct 4, 1947 – post war reorganization of
the DOH and Public Welfare 1. Community Health Nursing Process

• Jan 1, 1951 – conversion of the Office of 2. Nursing Procedures during clinic and
the President of Sanitary District into home visits
Rural health Units with 7 basic health
3. Community organizing
services: MCH, environmental health,
communicable disease control, vital 4. Health Promotion and education
statistics, medical care, health
education and public health nursing 5. Surveillance

- Passage of Rural Health Act of 1954 6. Records and reports

( RA 1082)
• Feb 20, 1958 – EO 288 decentralize
governance of health services, Regional Community Health Nursing
Health Director in 8 regions where health
Community Health Nursing is one of the
services were decentralized to regional,
two major fields of nursing in the Phils., the other
provincial and municipal levels
is Hospital Nursing. We generally use the terms
• 1970 - Restructured Health Care Delivery Community Health Nursing
System: Primary, Secondary and Tertiary and Public Health Nursing, and community health
levels of Care nurses and public health nurses interchangeably.
- expanded role of Public Health Nurse 1: Those who work in Rural Health Units (RHUs) or
20,000 Health Centers are Community health nurses and
are officially called Public Health Nurse (PHNs).
• June 2, 1978 – PD 1397 Renamed DOH Occupational Health Nurses (company nurses)
to Ministry of Health (Secretary Gatmaitan, and school health nurses are classified as
first Minister of Health) community health nurses.
• Dec 2, 1982 – creation of Integrated
Provincial Health Office Community Health Nursing highlights the
following important points:
• April 13, 1987 – from Ministry of Health
renamed to DOH 1. The goal of professional practice is the
promotion and prevention of the health of the
population.
2. The nature of practice is comprehensive, environment. Occupational Health nursing is
general, continual and not episodic autonomous, and make independent nursing
judgments in providing occupational health
3. The knowledge base comes from nursing and
services. The foundation for occupational health
public health
nursing practiced is research – based with
4. The different level of clientele – individuals, emphasis on optimizing health, preventing illness
families, and groups and injury, and reducing health hazards
( American Association of occupational Health
5. The practitioner’s recognition of the primacy of Nurses, 1993 in Rogers, 1994: 35)
the population as a whole. Occupational Health Nursing is “aimed at
Community Health Nursing is a assisting workers in all occupations to cope with
actual and potential stresses in relation to their
specialized field of nursing practice. It’s basic
work and work environment. It is primarily geared
knowledge and skills are anchored on nursing
at helping workers attain and maintain optimum
theories and important concepts from the science
level of physical and psychological functioning”
of public health.
( PNA - ANSAP, 1982)
1. Emphasis on the importance of the “ greatest
good for the greatest number” Occupational Health Nurses Association of the
2. Assessing health needs, planning, Phils. (OHNAP) and the Phil. Nurses Association
( PNA) conducts training for its members.
implementing and evaluating the impact of health
services on population groups.
School Health Nursing
3. Priority of health – promotive and disease –
- is primarily determined by the
preventive strategies over curative
characteristics of their clientele – their age,
interventions.
developmental stage, and their common health
4. Tools for measuring and analyzing community
problems and concerns. Aside from
health problems and,
developmental and genetic considerations, health
5. Application of principles of management and
problems of school children are the result of
organization in the delivery of health
economic and environmental (particularly their
services in the community.
home and immediate environment) factors.
The practice of community health nursing is
Other determinants of school health nursing
enhanced by the bodies of knowledge of other
practice include policies and standards of the
academic disciplines such as the social sciences.
Department of Education, Culture, and Sports
Concepts from sociology, psychology,
and the Department of Health and standards of
anthropology, economics, and political science
the nursing profession. And probably more
help nurses understand the health care delivery
important determinants are the socioeconomic
system and their clients, and thus perform their
realities in the school, particularly in public
roles and function better.
schools, and local government units.
In the country, the two most commonly
School Health Nursing aims at promoting the
identified subspecialties of community health
health of school children and preventing health
nursing are: Occupational Health Nursing and
problems that would hinder their learning and
School Health Nursing. These are relatively ‘more
performance of their developmental tasks. Health,
developed’ than other subspecialties because of
in this particular instance is considered as an
the legal requirement for school and companies
important requisite in education. Although School
to provide health services, which include nursing
Health Nursing is primarily concerned with health
services, to their constituents.
concerns in the school setting, it accepts that
health is affected by factors outside the school
Occupational Health Nursing
setting such as poverty, family dynamics and
- is nursing in the workplace; it is the
lifestyle
community health nursing focused on people in
their places of work.
The practice focuses on promotion,
protection, and restoration of workers’ health
within the context of a safe and healthy work
THE HEALTH CARE DELIVERY SYSTEM national health policy-maker and regulatory
institution.
World Health Organization
DOH Vision
UN agency that leads and champions global
health efforts A world-leading health system where Filipinos are
among the healthiest in Asia by 2040 .
The World Health Organization is composed
of three main bodies: DOH Mission
a. The World Health Assembly To lead the country in building a health system
b. The Executive Board that is productive, resilient, equitable, and
c. The Secretariat focused on the needs of its people .
Millennium Development Goals (MDGs) 3 Major rules in health sector
Established in 2000 with targets to be achieved
a. Leadership in health
by 2015, the MDGs comprised eight goals:
b. Enabler and capacity builder
1. Eradicate extreme poverty and hunger c. Administrator of specific services
2. Achieve universal primary education
Philippine Healthcare System
3. Promote gender equality and empower
women A complex set of organizations interacting to
4. Reduce child mortality provide an array of health services.
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other 4 Essential Function of Health System
diseases a. Service provision
7. Ensure environmental sustainability b. Resource generation
8. Develop a global partnership for c. Financing
development d. Stewardship
Sustainable Development Goals (SDGs) Levels of Healthcare Facilities
Adopted in 2015 to be achieved by 2030, the
SDGs build on the MDGs with a broader and a. Primary
more integrated approach encompassing 17 - RHU and BHS include:
goals:  health education
 control of locally endemic diseases
1. No poverty such as malaria, dengue, and
2. Zero hunger  schistosomiasis
3. Good health and well-being  immunization against TB, polio,
4. Quality education measles, and tetanus, among
5. Gender equality others
6. Clean water and sanitation  maternal and child health and
7. Affordable and clean energy family planning
8. Decent work and economic growth  environmental sanitation and
9. Industry, innovation, and infrastructure provision of safe water supply
10. Reduced inequalities  nutrition
11. Sustainable cities and communities  treatment of common diseases
12. Responsible consumption and production  supply of essential drugs
13. Climate action b. Secondary
14. Life below water - Smaller, non-departmentalized hospi
15. Life on land - refer to medical services that are
16. Peace, justice, and strong institutions accessible in some RHUs, infirmaries,
17. Partnerships for the goals district hospitals, and outpatient
THE PHILIPPINE HEALTH departments of provincial hospitals
CARE DELIVERY SYSTEM c. Tertiary
- Highly technological and sophistical
Philippine DOH services
The over-all technical authority on health as it is a - include medical and surgical
diagnostics, treatment, and rehab care
 provided by medical specialists in a  available
hospital setting
Historical background
DEVOLUTION OF HEALTH SERVICES
 September 6-12, 1978 at alma-ata USSR
RA 7160 (Local Government Code of 1991) - Declation by WHO
 October 19, 1979
Aims to transform local government into self-
- Adapt by phil
reliant communities
Elements
Devolved Health Services
a. Barangay
Maintenance of barangay health center LEVEL OF PREVENTION
b. Municipality
Levels of Prevention:
- Implementation of programs and
projects on primary health care, a. Primary Prevention
maternal and child care, and - prevent problems before they start
communicable and non-communicable - e. immunization, public health
disease control services; campaign, anti-drug programs
- Access to secondary and tertiary - goals:
health services  promoting good nutrition
- Purchase of medicines, medical  safety and injury prevention
supplies, and equipment needed to b. Secondary Prevention
carry out the said services - Detecting and addressing problems
c. Province early to minimize impact
Hospitals and other tertiary health services - eg. regular med check ups, screening
d. City for disease, counseling for early signs
All the services and facilities of the of mental health issues
municipality and province - goals:
 assess and treat nutrition
Classification of healthcare facilities
related disorders
a. Primary  diagnose and treat medication
- basic services related injuries
b. Custodial care facility c. Tertiary Prevention
- Provides long-term care - Manage and minimize the impact of
- eg. Rehab, nursing homes existing problems
c. Diagnostic/therapeutic facility - eg. Rehabilitation program for injuries,
- Examinations and lab support group for clinics
d. Specia\lized outpatient facility - goals:
- Performs highly specialized  maintain and improve nutrition
procedures on an outpatient basis  consistency with prescribed
- eg. Dialysis, chemotherapy medication
PRIMARY HEALTH CARE
Primary Health Care
It is an essential health care made universally
accessible to individuals and fam in the
community by means acceptable to them through
the full participation
eg. pag gamit ng mga herbal na gamot
It is:
 accessible
 acceptable
 affordable