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01 NCM 104 (PALICPIC) (1)

WEEK # 1
MFFP | Sept. 29, 2022
Global and National Health Situations
A. Philippines Health Agenda 2010-2022
a. Rationale
b. Goal & Objectives
c. Strategic Thrust
Definition and Focus
A. Public Health
B. Community Health
C. Public Health Nursing
Community Health Nursing (CHN)
a. Concept and Definition
b. Principles of Community and Public Health
c. Distinguish feature of community health nursing
d. Levels of Clientele in the community
e. Framework for Community Health nursing
f. Ethico-legal aspects of CHN
Black for PowerPoint, red for audio lecture, blue for book
So for the Philippine health situation, according to the W
H. O, has made a significant investment and advances in
health in recent years, there is a rapid economic growth
and strong country capacity that has been distributed or
that have been distributed to Filipinos living longer and
healthier. However, not all the benefits of these growth
have reached the most vulnerable groups and the health
system remains fragmented. Now for the Philippine health
situation. There is what we call the health policies and the
systems as well as the as the strategic agenda. So health
policies and systems the government's vision for
Philippines as we just see that DOH into the Philippine
health agenda 2016 to 2022. Under the motto, “all for
health, towards health for all” this is the universal health
coverage, where the platform for health and development
in the Philippines is seen. And this is driven by action
within and outside the health sectors. Now, reducing
health inequities is singled out as the most important that
result of three health guarantees. So we have ensuring
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financial protection for the poorest people. Second is
improving health outcomes with no disparities, and third
is building health service delivery networks for more
responsiveness. So these three are the basic health
guarantees under your Philippine health agenda 2016 to
2022 with the motto again, all for health, towards health
for all. Cooperation for health under the Philippine health
situation states that the global vision of the world in 2030
That's basically eight years from now is spelled out in the
SDG or sustainable development goals that align to the
Philippines 25 Year Vision AmBisyon Natin 2040. So if you
go through the DOH programs mayda hira 25 year plan
para ha aton. that's what we call this AmBisyon Natin
2040 . So each year mayda target an DOH and for the first
few years hine na program han DOH they call it the
Millennium Goals. Basically they started in the year 2000.
And when the time pass on most likely and Millennium
Goals has coverage of at least six years. The moment that
it was completed, it was reevaluated and it was
reformatted into SDG which means Sustainable
Development Goals. So the year that we are in right now,
sulod na kita han SDG. Okay, so most likely, according to
DOH an MDG or Millennium Development Goals according
to them and according to their reports, all of the goals and
objectives set during that time were met.
So your mnemonics for this one is SPPOU.
WEEK # 1
MFFP | Sept. 29, 2022
and accountable. And fourth is provides high quality
services. So take note of the goals and values of the
Philippine health agenda program of the DOH
Now, we move on to the Philippine health agenda of 2016
to 2022 aiming for healthy Philippines 2022. So, goals, this
is the one I mentioned earlier “all for health, towards
health for all” goals, the health system, we aspire for three
areas, financial protection, better health outcomes and
responsiveness, financial protection of course, especially
this is centered on the group or the part of the population
where the poor the marginalized and the vulnerable group
of the society are protected from high cost of health care.
So basically didi masulod an mga philhealth, second,
better health outcomes this is to attain the best possible
health outcomes with no disparity meaning no matter
what your socio economic status is dapat equal an health
services to everyone, especially to those who most need
the health service. Okay, so regardless kun riko ka or pobre
ka dapat may equal services, but of course with
prioritization. Anyway, the third one is responsiveness, ine
nga health system, the one reason why we are discussing
it is for you to know the health problems of the DOH and
to aspire you to really make a difference when you
become nurses in the future. Okay, the third one is
responsiveness. Filipinos feel respected, valued and
empowered with the health system,
what are the values, one is equitable and inclusive to all.
Second is uses resources efficiently third is transparent
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*kindly check the 2 pdf sent by Ma’am Palicpic in the
Digital Billboard for the full reference*
So this is still centered on the three goals, the financial risk
protection, better health outcomes and responsiveness.
And this centers also in good values equality, quality,
efficiency, transparency, accountability, sustainability
and resilience. Now, we have three guarantees for this
one. The first is all life stages and triple burden of disease
this service is for both the well and the sick. The second
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MFFP | Sept. 29, 2022
one is service delivery network where functional network
of health facilities are offered. And third is the universal
health insurance. There is financial freedom when
accessing services.
Guarantee #1: All Life Stages & Triple Burden of Disease
Services for Both the Well & the Sick
Is the science and art of preventing disease,
prolonging life, and promoting health and efficiency through
organized community effort for:
So, this is centered in the following areas:
 The sanitation of the environment;
 The control of communicable infections;
 The education of the individual in a personal
 The organization of medical and nursing services
for the early diagnosis and preventive treatment of
 The development of the social machinery to ensure
everyone a standard of living adequate for the
maintenance of health, so organizing these
benefits as to enable every citizen his birth-right of
health and longevity.
Key phrase in this definition is through organized
community effort
Guarantee #2: Service Delivery Work
Functional Network of Health Facilities
So basically, public health is a whole concept where we
care holistically to the people in the community in terms
of preventing disease, prolonging life and promoting
health and efficiency. And what areas are these three
functions centered amo an mga areas nga na mention.
Public Health, the key phrase in this definition is through
an organized community effort. So it has to be community
3 Primary Functions
Guarantee #3: Universal Health Insurance
Financial Freedom when Accessing Services
1. Assessment - regular collection, analysis and
information sharing about health conditions, risks
and resources in a community
This is when we do our data collection. There is also
the analysis and information sharing about the
health condition, the risks and resources in the
2. Assurance - focuses on the availability of necessary
health services throughout the community
to make use of the necessary health services
3. Policy Development - use of information gathered
during assessment to develop local and state health
policies and to direct resources toward those
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WEEK # 1
MFFP | Sept. 29, 2022
the use of information gathered, when you have
your assessment for the local government to
develop certain health policies. So makikit-an niyo it
flow on how the health care delivery system is seen
in the community. Mag kakamayada health policies
based on the needs of the community. So this is how
your functions follow from one function to the other
end to the next.
So, basically, your primary prevention is to prevent
the problem from occurring. And take note that in
primary prevention may ada difference an general ha
specific, when we say general we talk about the
general topics we have exercise, diet, shelter,
hygiene, for specific more specific effect ha person
like immunization, filtration, water purification and
so on and so forth. Primary prevention is disease
prevention, preventing the problem to occur.
Extends the realm of public health to include organized
health efforts at the community level through both
government and private efforts.
Okay. So basically, community health is a broader
approach. Public health is more specific kay ma co
consider an public health as a subset of community health.
Meaning when you do community Health Nursing broad
hiya an iyo approach or an iyo target population is the
whole of the community where you assess the community
as a whole.
So, again that community health broad public health
subset are more specific than the community, community
health, the whole of the community public health can be
individual families or a certain age group.
Preventive Approach to Health
 Health Promotion - activities enhance resources
directed at improving well-being.
Disease Prevention - activities protect people from
disease and the effects of disease.
Rehabilitation – you manage the disease or to
prevent the recurrence of the disease.
3 Level of Prevention (Leavell and Clark 1958)
Primary Prevention
Activities directed at preventing a problem before it
occurs by altering susceptibility or reducing exposure
for susceptible individuals.
Secondary Prevention
Refers to early detection and prompt intervention
during the period of early disease pathogenesis.
Implemented after a problem has begun but before
the signs and symtoms appear and targets those
populations who have risk factors.
Ex: Mammography, NBS, Sputum exam for TB,
STD Screening
Also directed toward prompt intervention to prevent
worsening conditions of the affected population
(Ex: Giving Oresol to prevent dehydration in
Secondary prevention is to intervene, the moment that
the disease has already started before mag manifests an
imo patient han signs and symptoms meaning na expose
an imo patient hito nga certain type of disease, that
secondary prevention and also the early detection or
prompt intervention han imo disease pathogenesis
example, in terms of early diagnosis, mammography, so
ngatanan nga diagnostic exam falls under secondary. So
any procedure that will help us diagnose a case or a
condition of the patient falls under the secondary
prevention, the moment that we have the confirmatory
diagnosis of the patient before again manifests in signs
and symptoms, that's also considered as your secondary
prevention. Other screening or other examples for
secondary prevention are newborn screening, sputum
exam, and STD screening
2 Elements:
a. General Health Promotion (EX: Good Nutrition,
adequate shelter, regular exercise)
b. Specific Protection (Ex: Immunization, Water
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an example naman for your secondary prevention where
you're going to implement or to intervene ha disease
process, nga dire pa masyado sugad ka severe is also
considered a secondary prevention example is when your
patient is experiencing diarrhea, so secondary prevention
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MFFP | Sept. 29, 2022
to prevent dehydration or malnutrition for severe diarrhea
mahatag ka hin orisol so nonpharmacologic.
According to ANA-practice of promoting and
protecting the health of populations using
knowledge from nursing, social and public health
ANA elaborated - is population-focused, with the
goals of promoting health and preventing disease
and disability for all people through the creation of
conditions in which people can be healthy.
Tertiary Prevention
Targets population that have experienced disease
or injury and focuses on limitation of disability and
This focuses more on the rehabilitation and prevention of
recurrence of the disease. Meaning natabo na an imo
disease nag worsen na hiya an imo nala is to prevent
complication and the recurrence of it.
According to ANA-the synthesis of nursing practice
and public health practice applied to promoting and
preserving the health of populations (individuals,
families and groups)
Is considered to be broader and more general
specialty area that encompasses subspecialties
that include PHN, school nursing, occupational
health nursing, etc.
Ex: Insulin injection of a diabetic patient, OT and
PT for patients with spinal cord injury, passive
range of motion for stroke patients, support group
with cancer patients, Anonymous group may be
alcoholic drugs cigarette smoking.
this is more specific than public health or deeper
PHN – Is a component or subset
Frequently been described as the synthesis of
public health and nursing practice.
According to Freeman - defined as a field of
professional practice in nursing and in public health
in which technical nursing, interpersonal,
analytical, and organizational skills are applied to
problems of health as they affect the community.
Basically, holistic approach an imo PHN
In the Philippines-seen as a subspecialty nursing
practice generally delivered within "official" or
governmental agencies.
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Preventive approach to health
Characterized by being population or aggregate-
Developmental nature
consumers of CHN services (paid through taxes)
Similar yet distinctive ideologies, visions or
philosophies of nursing.
CHN - global or umbrella term
Is synonymous or interchangeable with community
health nursing.
Distinguishing Features of CHN
CHN nurses care for different levels of clientele
Level of Clientele in the Community
Sick or well on a daily basis
People who consult at the health center and receive
health services such as prenatal supervision, wellchild follow ups, morbidity service
Clients with chronic diseases like DM and
Home follow ups, school health consultation,
workplace visit-conference
Basic unit of society
Basic unit of care in CHN
Individuals must belong to family
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MFFP | Sept. 29, 2022
It may contribute knowingly or unknowingly to the
development of health and nursing problems of its
Locus of decision making on health matters
It is the source of most solid support and care to its
Also known as aggregate or community
Group of
people who
share common
characteristics, developmental stage or common
exposure to particular environmental factors on
consequently common health problems
d. Participation of subgroups in community affairs
e. Preparation to meet crises
f. Ability to problem-solve
g. Communication through open channels
h. Resources available to all
i. Setting of disputes through legitimate mechanisms
j. Participation by citizens in decision making
k. Wellness of a high degree among its members
Framework for Community Health Nursing
This is group of people sharing common
geographic boundaries
Example: barangay
Also regarded as organism with own stages of
Community characteristics:
a. Defined by geographic boundaries within certain
identifiable characteristics
b. Made up of institutions organized into a social
A common or shared interest
Has an areas with fluid boundaries ]
e. Has a population aggregate concept
Difference between rural and urban
a. Physical environment
b. Population size and density
C. Economy
d. Culture
e. Political dynamics
f. Availability and adequacy of social services
g. Availability and accessibility of health resources
Characteristics of a HEALTHY Community:
a. Awareness that "we are community"
b. Conservation of natural resources
c. Recognition of, and respect for, the existence of
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Diagram 1. Framework for the Community Health Nursing
So basically the Community health nursing practice centers
on the philosophies and beliefs, the principles, processes
and the roles and functions han imo mga public health
nurses. At the same time an imo levels of clientele on the
other box amo an imo target population or an imo
beneficiary kun baga so that includes your individual,
family, population group meaning the entire community, at
the same time an factors affecting your health nursing
practice includes your economic, sociocultural, political,
and environmental. This happens the community na affect
an imo mga factors ha imo levels of clientele at the same
time an imo gin tatagan hin health services an imo gehapon
levels of clientele making the cycle complete in terms of
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MFFP | Sept. 29, 2022
health care delivery system. So basically, ha usa nga dako
nga community, the members of the community individuals,
families and population group they live together in the
community where the public health nurses or the members
of the public health cater health services to this specific
community, may it be your primary, secondary or tertiary
prevention na mga services and the cycle goes on an on
and that’s what we call your health care delivery system
In the practice our profession, PHNs have a very important
role to play. They do not only deliver needed health
services, they also humanize the health care delivery
system as well.
Don’t stick to what other people are doing.
Ethico-legal Aspect of Nursing Practice in
the Community
Professional practice is legal if the practitioner
works in accordance with the law or does not violate its
provisions. However, what is legal may not necessarily
be ethical.
Ethical practice is characterized by
3 Major Principles
a. Respect for autonomy
- Right to decide for ones own health
b. Beneficence
- Doing good
C. Justice
Client's Rights in a health care setting
a. Right to be informed about his/her condition and
treatment or any health intervention that need to be
b. Right to accurate and adequate information to
make an informed decision.
Right to refuse and access other health services.
d. Right to safe and quality care.
e. Right to privacy and confidentiality.
Ethical Principle
a. Distributive justice - meaning fair, equitable and
appropriate distribution of services and resources such as
b. "Need" is dictated not only by one's health condition but
also by the lack of personal resources.
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