Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
1
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Health Resource Development Program III (HRDP)
The Health Resource Development Program was developed and
sponsored by the Philippine Center for Population and
Development to make health services available and accessible to
depressed and underserved communities in the Philippines.
The Philippine Center for Population and Development
Is a non-stock, non-profit private institution which serves as
a resource center assisting institutions and agencies through
programs and projects geared toward the social human
development of rural and urban communities. This was
formerly the Population Center Foundation.
The PCPD sponsored health training institutions or
hospitals to carry out the program as part of the outreach
activities of these schools or hospitals.
The training institutions developed an effective system of
delivery of the primary health care in depressed
communities and trained the community residents in the
management of their own health concerns.
The PCPD provides funds for health programs while the
school or hospitals has a counterpart to contribute in the
form of service or in kind.
Three Cycles of HDRP
First Cycle (HRDP I)
Trained the faculty, medical/nursing students to provide
health care services to the far-flung barrios because of lack
of manpower for health services at the same time that
similar activities fulfilled the curricular requirements of
students for public health.
The PCPD provides seed money for the income- generating
projects. On the other hand, the community organizer uses
his/her own strategy or method in developing the
community. This is considered to be a short-term service.
Second Cycle (HRDP II)
Uses the same strategy but the program could not be sustained
by the schools or hospitals and the income-generating projects
eventually became a hindrance to the goal of achieving the
health program because the people tended to be more interested
in the income generated by the projects.
Both HRDP I and II have brought about some changes in the
community life of the people.
There was an established basic health infrastructures; basic
health services were increased, there were trained health
workers and organized health groups to take care of the health
needs of the communities
Third Cycle (HRDP III)
The PCDP refined the program which has these unique features:
Comprehensive training of the staff and faculty of the
participating agency in which the community work was
initiated.
Periodic training program and regular assistance to the
participating agency were provided to strengthen the health
outreach program to become community oriented.
Primary Health Care (PHC) as the approach with which
all nursing/medical students, their clinical instructors and
indigenous health workers are to be trained for community
health work and around which all other project inputs will
revolve
Community organizing as the main strategy to be employed
in preparing the communities to develop their community
health care systems and the establishment of community
health organization to manage the community health
programs.
Organizing work in the communities was done in three
phases.
The participating agency worked only in one
community on the first year.
A thorough assessment and summing up of field
experience in the first community is done before the
entry to the three communities on the 7th month.
The experiences in these three communities are
assessed before entering the last three communities on
the 14th month.
Participatory Action Research (PAR) as facilitating
strategy for maximum community involvement, through
collective identification and analysis of community health
problems and collective health action.
Available funds to finance community initiated projects;
thereby enabling the communities to gain hands-on
experience in managing community health projects.
Systematize effort to disseminate information on the HRDP
model through networking so that other five health
institutions can apply the model in various settings. (PCPD,
1992)
It could be noted that the PCPD made a contract with each
participating agency to develop seven communities in the
span of 36 months; thereafter, the institution would develop
one community each year.
Program Objectives and Planned Outputs
HRDP III aimed to develop an effective primary health care
system in underserved communities through the improvement of
the capabilities of health training institutions to provide
community outreach services and to train and to organize
community residents in the management of their health
concerns.
By the end of 36 months, the project would have achieved the
following:
Subgrants must have been given to the participating school
to enable them to undertake outreach activities in
accordance with the HRDP model.
The participating school must have been provided with nine
training programs and regular assistance in developing community-oriented health outreach program.
The participating school must have developed sustainable
community-based health programs.
The HRDP model must have been disseminated to other
health-related organization with HRDP principles integrated
into their plans of community-based health in five
additional sites.
In summary, the goal of HRDP is the delivery of health care to
the far-flung communities which cannot be reached by the
health care agencies. Through the development of available
health care givers and the local residents, the primary health
care can be delivered to the community members.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
2
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
The strategy used was the Community Organizing and Personnel of the Philippine Center of Population and
Participatory Action Research to activate the involvement of Development who sponsored the HRDP III
community members.
Guidelines in the Implementation of HRDP III
Accounting Records
HIRDP IlI maintained separate books, records and documents
and other evidence in accordance with the accepted accounting
principles and procedures.
The accounting records are:
Journal
Ledger
Cash Receipt
Cash Disbursements
Subsidiary Ledger
Paid Cash Voucher
Journal Voucher
Supporting Receipts Invoices and other evidence of
payment.
Counterpart Contribution
The Training School provides a counterpart in cash or in kind
contribution for the program.
Full documentation of the transactions is made and recorded in
the book of accounts.
Purchases involving a cost of five thousand pesos (P5,000) or
less requires a canvas report of at least three suppliers.
Purchases involving, or costs of more than P5,000 but not
exceed
P100,000 requires a formal canvas (written quotation)
All canvass reports whether formal or informal shall be
approved by the Project Director
Procurement of Supplies and Materials
The participating agency procures the needed items or services
only from reputable and dependable suppliers or contractors.
Training and Staff Development
The finance management and the HDR staff undergo the basic
orientation on HRDP.
They attend the financial management workshop and all the
Seminars offered by the PCPD, which are pertinent to the
project.
Financial Review and Audit
The PCPD conducts financial review/monitoring from the
negotiation to the end of the project. It looks over the following
items: (PCPD 1992 p.8-10)
Organizational Structure and Personnel
Records/ Reports
Accounting and Financial Management System
Management Performance and Control
Advance Funds Control
Purchase, Maintenance and Disposal of Equipments
At the period when HRDP III was implemented, the
participating institutions consisted of the following:
De La Salle University, College of Medicine, Dasmarinas,
Cavite.
Lyceum of Cagayan College of Nursing, Cagayan de Oro.
St. Paul's University, College of Nursing, Tuguegarao.
Sacred Heart College of Nursing, Lucena City.
President ––––––––––––––––––––––– Dr. Conrado Lorenzo, M.D.
Vice President ––––––––––––––– Ms. Ma. Socorro Camacho Reyes
Project Director –––––––––————––––– Ms. Antonina Coronel
Project Associate ————————–————– Emma Taguinen
Community Organizer ––––—–––––––––––––– Perfecto Uysingco
Project Accountant –––––––––––––––––––– Mary Ann de la Pena
Project Secretary –––––––––––—–––––––––––––– Virginia Doble
Primary Health Care
The Primary Health Care approach has been practiced in the
Philippines even before 1978 when this was declared by the
World Health Organization in Alma Ata.
The Alma Ata identified Primary Health Care as the "key in
achieving an acceptable level of health throughout the world in
the foreseeable future as part of social development and in the
spirit of social justice." (Declaration of WHO Alma Ata 1978)
The Concept of Primary Health Care
Primary Health Care is a practical approach to the effective
provision of health services that are community based,
accessible and acceptable and sustainable at a cost which the
community and the government can afford.
Letter of Instruction 949, October 19, 1979
It includes the full participation and active involvement of
the community towards the development of a self-reliant
people capable of achieving an acceptable level of health
and well-being. It recognizes the interrelationship between
health and overall socio-economic development.
Ed. for Health 1984
The Director General of the World Health Organization
emphasized that world health will improve only if the
people themselves become involved in the planning,
implementing, and having a say about their own health and
health care.
He reiterated that the health workers must understand the
concept of primary health care and must have a new
outlook. The people must be concerned not only of disease
prevention and control but also for health promotion and
care.
That health workers must all act as facilitators of actions of
individuals, families and communities.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
3
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Thus they should recognize their roles as partners, to find
ways to help individuals and families to be self-reliant.
He also emphasized that both lay persons and health
professionals are essential.
Training and education of health workers are needed to
acquire the necessary skills to carry out the new roles
effectively.
The World Health Organization (1978)
Pointed out that the Primary Health Care is people-oriented.
Its success rests on the people.
It identifies four pillars on which the actions for health for
all must be based:
Political and societal commitment and determination to
move towards health for all as the main social target for
the coming decades.
Community Participation
The active involvement of people and the
mobilization of societal forces for health
development.
Intersectional cooperation between the health section
and other development sectors such as education,
communication, industry, public works, transportation,
and housing.
System Support
To ensure that the essential health care and
scientifically sound affordable health technology
are available to all people.
Objectives of Primary Health Care
To enable the people to seek better health at home, in
schools, in fields and in factories.
To enable the people to prevent injury and diseases,
instead of relying on doctors to repair damages that can
be avoided.
To enable the people to exercise the right and
responsibility in shaping the environment and bringing
about conditions that make it possible and easier to live
a healthy life.
To enable the people and exercise control in managing
health and related systems and to ensure that the basic
pre-requirements for health and access to health care
are available to all people.
Principles and Strategies of Primary Health Care
The Department of Health in the Philippines promulgated
principles and strategies to attain the objectives of Primary
Health Care.
The principles are rules or standards while strategies are the
methods or activities to attain the principles.
Principle 1. Accessibility, Availability, and Acceptability of
Health Services
Strategies:
Health services must be delivered where the people are.
Use the indigenous/resident volunteer workers as health
care providers with a ratio of one community health worker
per 10-20 household.
Use of traditional (herbal) medicine together with the
essential drugs.
Principle 2. Provision of Quality Basic and Essential Health
Services
Strategies:
Training design and curriculum based on community needs
and priorities, task analysis of community health workers
(CHW) are competency based.
Attitudes, knowledge and skills developed are on
promotive, preventive, curative, and rehabilitative health
care.
Regular monitoring and periodic evaluation of CHW
performances by the community and health staff.
Principle 3. Community Participation
Strategies:
Awareness building and consciousness raising on health and
health- related issues.
Planning, implementation, monitoring and evaluation done
through small group meetings (10-12 household clusters).
Selection of community health workers by the community.
Community building and community organizing
Formation of health committees.
Establishment of a community Health Worker Organization
at the parish municipality level
Mass health campaign and mobilization to combat health
problems.
Principle 4. Self-Reliance
Strategies:
Community generates support (eash, kind, labor) for the
health program.
Use of local resources (human, financial, material)
Training of community in leadership and management
skills.
Incorporation of income generating projects, cooperatives,
small scale industries.
Principle 5. Recognition of Interrelationship Between Health
and Development
Strategies:
Convergence of health, food, nutrition/ water, sanitation,
and population services.
Integration of PHC into national, regional, provincial,
municipal, barangay development plans.
Coordination of activities with economic planning,
education, agriculture, industry, housing, public works,
communication and social services.
Principle 6. Social Mobilization
Strategies:
Establishment of an effective health referral.
Multisectoral and interdisciplinary linkages.
Information, education and communication support using
multimedia.
Collaboration between government and non-government
organizations.
Principle 7. Decentralization
Strategies:
Re-allocation of budgetary resources
Re-orientation of health professionals on primary health
care
Advocacy for political will and support from the national
leadership down to the barangay level.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
4
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
All the health workers, students and staff working in the Emphases of Community Organizing in Primary Health Care
communities must be re-oriented on these principles and
The community works to solve their own problems. 0 m
strategies so that they in turn can train the indigenous or
The direction is internal rather than external.
volunteer community health workers to be self-reliant.
The development of the capacity to establish a project is more
important than the project.
The Essential Elements of Primary Health Care
There is a consciousness-raising to perceive health and medical
Education on the prevailing health problems and the methods of
care within the total structure of society.
preventing and controlling diseases.
Participatory Action Research
Prevention and control of local endemic diseases.
Participatory Action Research is an investigation on problems
Promotion of food supply and proper nutrition.
and issues concerning life and environment of the
Adequate and safe supply of water and basic sanitation.
underprivileged by way of research collaboration with the
Maternal-child health including family planning.
underprivileged whose representatives participate in the actual
Immunization against infectious diseases.
research as researchers themselves, doing research of their own
Appropriate treatment of common diseases and injuries.
problem. The objective is to encourage consciousness of the
Provision of essential drugs and herbal medicines.
suffering and develop competence for changing their own
situation, and helping in the organization building by harnessing
Community Organizing and Participatory Action Research (COboth human and natural resources in responding to community
PAR)
needs. (PCPD 1990)
It has been the strategy used by the HRDP III in implementing
PAR is a community-directed process of gathering and
the Primary Health Care delivery in depressed and underserved
analyzing information or an issue for the process of taking
communities to become self-reliant.
actions and making changes. (Partners in Action Research 1997
The HRDP III describes community organizing as a continuous
p.3)
and sustained process of educating the people to let them
The essential element of PAR is participation. The beneficiaries
of the research are the main actors in the research process. It
understand and develop their critical awareness of the existing
enables the community to experience a collective consciousness
conditions; it is working with the people collectively and
of their own situations. PAR involves research, education and
efficiently, discover their immediate and long term problems
actions to empower people to determine the cause of their
and mobilizing the people to develop their capabilities and
problems, analyze these problems and act by themselves in
readiness to respond and take action on their immediate needs
responding to their own problems.
toward the solution of their long-term problems.
The PCPD identified the objectives of Community Organizing:
In PAR - there is an outside researcher, a professional one who
through immersion and integration on the community becomes a
To make people aware of social realities toward the
committed participant and learner in the community.
development of local initiative, optimal use of human,
technical and material resources, and strengthening of
Characteristics of Traditional and Participatory Action
people's capacities.
To form structures that hold the people's basic interests as Research
PAR
oppressed and deprived sectors of the community and as Traditional
Research for purpose of
Research
seek
social
people bound by the interest to serve the people.
identifying
and
meeting
transformation.
To initiate the responsible actions intended to address
individual
needs
within
holistically the various community health and social
existing social system.
problems.
Community problems or
The research problems are
As applied to Primary Health Care Community Organizing is
needs are defined by experts
defined by the community
defined as the process and structures through which members of
or the external researchers to
members themselves who are
the community are tapped to become organized for participation
community
group
and
viewed as "experts of their
in health care and community development activities.
considered neutral or nonown reality."
They organized themselves to get better health care and improve
biased.
their health as part of a larger effort, to increase their power and
The research problem is
The
community
group
achieve greater social and economic equality within a larger
studied by the researchers
undertakes the investigation
social system.
who control the research
or research process from data
As a process, Community Organizing is the sequence of steps
process.
collection
to
analysis.
whereby the members of the community work together to
External researchers work
critically assess and evaluate community conditions to improve
alongside the community
these conditions.
group.
As a structure, it refers to the particular group of community
Recommendations for the
The community formulate
members that work together for common health and healthcommunity are based on the
recommendation
and
an
related problems.
researcher's findings and
action plan based on research
It is the people who organize themselves into a working team
analysis.
outcome.
who can effectively solve their own health problems.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
5
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
It can be seen from the characteristics of PAR that it is the
community members who are experiencing the problem and the
ones defining their own problems. The choice of problem is
based on their immediate situation and not on the outside
researcher. The researcher who is initiating the research process
assists the community but does not dominate the community.
The methodology in PAR is determined by the local culture and
innovativeness of the people. The method of data collection is
through discussion among villagers, direct observations which
are jointly made by the community members and the
researchers.
The result of the study are within the control of the people, they
become aware of the issues and problems that affect them. They
are more capable to change their situations. PAR addresses itself
to the marginalized communities and sectors.
It aims to encourage consciousness of their suffering and
develop competence for changing their situation. It is an attempt
toward organization building, harnessing the human and
material resources of the community in responding to the needs
as discovered in the process.
Participants in PAR
The outside researcher is a professional researcher, who is
committed and a learner; active learner rather than detached. He
goes into an immersion and integration in the community. He
shares his research knowledge to encourage genuine
participation but would never assume a paternalistic
authoritarian attitude but leaves the application of that
knowledge to the people of the community.
Local Researcher and the Community
The local researchers are trained in the process of research and
are made aware of the needs of their people and committed to
do something about them. The local researchers elicit active
participation from community members for collective data
gathering, data analysis and action. They are the link between
the community and the outside resources.
HRDP COPAR Process
Pre-entry Phase
Community consultations / dialogues
Setting of issues / considerations related to site selection
Development of criteria for site selection
Site selection
Preliminary Social Investigation (PSI)
Networking with local government units (LGU's), NGOs, and
other departments within the HRDP-NGO
Entry Phase
Integration with the community
Sensitization of the community / Information campaigns
Continuing social investigation
Core group (CG) formation
Development of criteria for selection of CC members
Defining the roles / functions / tasks of the CG
Coordination/Dialogue/Consultation with other community
organizations
Self-Awareness and Leadership Training (SALT) / Action
planning
Community Study / Diagnosis Phase (Research Phase)
Selection of the research team
Training on data collection methods and techniques /
Capability-building (includes development of data collection
tools)
Planning for the actual gathering of data
Data gathering
Training on data validation (includes tabulation and preliminary
analysis of data)
Community validation
Presentation of the community study / diagnosis and
recommendations
Prioritization of community needs / problems for action
Community Organization and Capability-Building Phase
Community meetings to draw up guidelines for the organization
of the CHO
Election of officers
Development of management systems and procedures, including
delineation of the roles, functions and tasks of officers and
members of the CHO
Team building / Action-Reflection-Action (ARA)
Working out legal requirements for the establishment of the
CHO
Organization of working committees/ task groups
(e.g., education and training, membership of committees)
Training of the CHO officers / community leaders
Community Action Phase
Organization and training of community health workers (CHWs)
Development of criteria for the selection of CHWs
Selection of CHWs
Training of CHWs
Setting up of linkages / network referral systems
PIME of health services / intervention schemes and community
development projects
Initial identification and implementation of resource
mobilization schemes
Sustenance and Strengthening Phase
Formulation and ratification of constitution and by-laws
Identification and development of "secondary" leaders
Setting up and institutionalization of financing scheme for
community health program/ activities
Formalizing and institutionalization of linkages, networks and
referral systems
Development and implementation of viable management
systems and procedures, committees, continuing education/
training of leaders, CHWs, community residents
Continuing education and upgrading of community leaders,
CHWs, and CHO members
Development of medium/long term community health and
development plans.
PIME - Project Implementation, Monitoring, and Evaluation
Health Resource Development Program as Experienced in
Sacred Heart College
The Sacred Heart College, College of Nursing was a subgrantee of the Philippine Center for Population and
Development (PCPD) in the implementation of the Health
Resource Development Program III (HRDP III) in 1992-1995.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
6
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Coordinator of Student Community Immersion
Plans with the other team members on community immersion
program for students.
Supervises students in the community
Monitors performances of students in community.
Coordinates with community group and with staff
Evaluates students' performance.
Health Services Coordinator
Provides health care services with emphasis on promotive and
preventive aspects.
Monitors health-related activities.
Conducts health education to community health workers and
students.
Assists in the preparation of modules and training designs.
Identifies need and problems of community.
Training Coordinator
Prepares training design
Trains community researchers on Participatory Action Research.
Conducts training and monitors performance of trained Health
Workers.
Financial Officer
Sets up project's financial system in accordance with funding
agency.
Conducts internal audit and reviews financial report
Sacred Heart College HRDP III Staff (1998-1995)
Adheres to the cost-sharing scheme.
Project Director (President) –––––– Sr. Ma. Lourdes Versoza, D.C. Bookkeeper
Project Manager (Dean CON) ––––––– Sr. Carmen Jimenez, D.C.
Sees to it that funds are liquidated.
Student Immersion Coordinator ––––––––––––––– Mr. Erwin Co
Prepares quarterly cash flow in consultation with other staff.
Training Coordinator –––––––––––––––– Ms. Adelisa Samaniego Secretary
–––––––––––––––––––– Ms. Vivian Lindog
Maintains project files
Health Services Coordinator –––––––––––––– Ms. Vivian Lindog
Finalizes monthly reports in print form.
Documents the process and proceedings of meetings and
––––––––––––––– Ms. Paulita Abuel
trainings.
Community Organizer ––––––––– Mr. Benjamin Garcia (full-time)
––––––––––––––––––––– Mr. Caezar Jara
–––––––––––––––––––– Ms. Paulita Abuel General and Specific Objectives of SHC for HRDP III
The purpose for which Sacred Heart College of Nursing coFinance Officer ––––––––––––––––––– Sr. Lachmee Fabriga, D.C.
sponsored the HRDP III is to train and organize community
Bookkeeper –––––––––––––––––––––––––––––– Mr. Rey Principe
residents in the management of their health concerns, through
Secretary ––––––––––––––––––––––––––– Mrs. Julieta Penaranda
the training and development of students, staff, and faculty.
General Objectives:
Functions of the HRDP Program Staff
After three years the rural areas which are depressed and
Project Director (Head of the School)
inadequately served by the regular government health
Has command responsibility of the Project; sees to it that the
workers would be able to avail of the health resources, both
project is implemented as planned.
of manpower and services after training and development.
Project Manager (Dean College of Nursing)
Specific Objectives:
Plans and implements staff development.
To expand the health services delivery of the College of
Supervises staff, community and health workers in the
Nursing to a larger number of areas.
implementation of plan.
To build the capacity of the institution to increase the
Helps prepare plan for exposure and immersion of faculty and
involvement of beneficiary communities in the development
students.
and management of sustainable health services delivery.
Establishes linkages with GOs and NGOs.
To develop a scheme for innovative services that would
Submits report to Project Director of Funding Agency.
eventually form a regular part of the curriculum.
Community Organizer
To support the initial community effort in seeking ways to
Coordinates with the community; Organizes barangay units for
sustain health service delivery, and
health clusters.
To review and evaluate past community extension efforts as
Coordinates the project team in planning and implementation of
well as to assess new schemes and thrusts in the
community level project activities.
implementation of plans.
Trains community researchers in Participatory Action Research
Sacred Heart College is a non-profit Catholic Educational
Institution owned and administered by the Company of the
Daughters of Charity of St. Vincent de Paul, Servants of the
Poor. The Daughters of Charity is a society of apostolic life in a
community consecrated to God with vows for the service of the
poor.
Sacred Heart College offers courses in Bachelor of Science in
Education, Bachelor of Arts, Bachelor of Science in Commerce,
Accountancy, Bachelor of Science in Social Work and Bachelor
of Science in Nursing. As a college it has an organized
community extension service.
This invitation of PCPD to co-sponsor the HRDP III was
attractive to the administration so that they would be able to
extend its health services to the poor in far-flung communities of
Lucena City.
The School Administration presented the proposal to the
department heads by January 1992 and the department heads
accepted the proposal for the College of Nursing to spearhead
the project and the other departments would participate in an
appropriate time.
The President of SHC through the recommendation of the Dean
of the College of Nursing appointed the staff from the Faculty of
Nursing so that they can attend the Orientation Seminar.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
7
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
These aims and objectives are part of the proposal.
However, in the beginning, how to go about the program was
still very vague for Sacred Heart College. The need for
orientation and how to implement the program was deemed
necessary.
By February 1992, the PCPD conducted an Orientation
Seminar on HRDP III. The President and other members of the
staff attended the seminar, which oriented the staff on the
mechanics and other requirements of the program, the functions
and responsibilities of the staff, the expectations from the
college and the responsibilities of PCPD towards the college.
Another seminar on the process of Community OrganizingParticipatory Action Research and Primary Health Care was
conducted
—————————insert pages 100-102—————————
Organization Building Phase
The organization building phase signals the start of community
self-management because it entails here the formation of a more
formal structure and the inclusion of more formal procedures of
planning, implementing, monitoring, and evaluating community
wide activities.
Election of CHO Officers
The officers of the community health organization should
be elected by the people, they should not be appointed.
Election may be in the form of secret ballot or by handraising
During election ask persons nominated to respond to
nomination by stating his/her willingness, availability,
limitations, hindrances, etc.
Tasks and job responsibilities of each position should be
well stated during the election.
The basic guidelines defining the roles and function of the
community health organization are as follows:
It is not an organization of the leaders of the people, but
of leaders among and with the people.
There should exist a collective type of collective
leadership, that is, no individual should monopolize
decision-making.
Regular planning, action tetection-action-session
(ARAS) must always become a part of the group
activity.
The CHO should always take the lead in planning
implementing and evaluating of all organizational,
educational and mobilization activities of the people.
The CHO officers / members should act as role models
for all community residents to emulate.
Organize/Train CHW’s and Second Liners
Trainings are done in staggered basis.
CHW's are selected based on their interest to learn and
willingness to serve the community.
Proper scheduling of training should be done among the trainee
to avoid conflict.
Before the conduct of any training, a rehearsal is necessary in
the form of a dry-run.
In the training, use the dialect or local language spoken by the
people. Trainings are those of the ff: BHST, AHST, SHST.
Project implementer should always meet daily at the end of the
day to evaluate the process of the training and its conduct.
PAR is an Active Process
Where the expected beneficiaries of research are the main actors
in the entire research process.
This process acts as the main actor in the entire research
process.
This process is based on a system of discussion, investigation
and analysis. This also enables the community to experience
collective consciousness about the issue(s) at hand.
The output of PAR and Project Management is the creation of
development action plan / project proposal.
Consolidate Community Diagnosis and PAR Results
Community study is a comprehensive documentation of data
about the community gathered through social investigation.
Physical-Geographical Data
Area size and boundaries
Settlement and road patterns
Land use
Climate
Topography and terrain
Physical resources
Demographic data
Population
Family size
Family structure in terms of age, sex and civil status
Social relationship
Origin and migration patterns
Economic Conditions
Sources of livelihoods of community residents
Average incomes
Systems of production, distribution and consumption of
community products
Land and property ownership
Expenditure patterns
Mortality and Morbidity Data
Rates of Mortality and Morbidity
Leading causes of mortality and morbidity
Food Supply and Nutrition
Quality and quantity of food intake per family
Common practices in food handling, preparation and
consumption
Weaving practices
Cultural Patterns, Common Cultural Beliefs and Health
Practices
Rituals that have bearing on health/ common health
practices during illness
Non-health related seasonal rituals and their schedules
Health Services and Facilities
Availability of health centers and staff
Availability of medicines and clinic supplies
Methods of referral system
Sanitation facilities, practices and problems
General condition of the natural environment
Availability of herbs and plants and medicinal properties
Availability of local health resources such as "hilots" and
"herbolarios"
Education
Average level of educational attainment
Educational facilities
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
8
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Community Leadership and Organizations
Existing community organizations - their project and
activities
Existing informal groups
Nature of leadership for each organization/ informal group their qualities and basis for their selection
Leadership styles and practices
Development Agencies
List of government and NGO agencies in the area (past and
present)
Types of programs and services of these agencies
People's perception of these agencies, their participation in
their programs and services, and the benefits they receive
from these programs
Community Problems and Needs
As verbalized by the people
As objectively seen by the project implementers
Formulate Community Health Plan
The community health organization officers and research team
in consultation with the community residents formulate a health
plan based on the consolidated data from community diagnosis
and PAR results. If possible come up first with a short-term
health plan.
Organize Working Committee
To facilitate the easy implementation of any plan, organization/
formation of working committee is of great help. dents to be
recognized
This will also allow the potential of other community residents
to be recognized.
Link with LGU's INGOs for Financial and Technical Assistance
Linkaging and networking from the government and private
sector must be intensified, Seeking help or any form of
assistance is a big help.
Implement / Monitor / Evaluate Health projects
Once a health project is conceived it is important that it is
implemented well. Monitoring during the course of
implementation is necessary to provide direction and control.
Evaluation is also needed to find out the strengths and
weaknesses of the program to its beneficiaries.
Sustenance and Strengthening Phase
This is the last phase when the community can already stand on
its own, thus the people can sustain the program even without
the help from the project implementers. At this time, the trained
leaders and workers take the overall management of the
program. The different committees set up during the
organizational building phase are already expected to be
functioning by way of planning, implementing and evaluating
their programs, with the overall guidance from the community
health organization. Thus, the project implementers prepare the
community for their eventual phase out.
Develop Financial and Management Systems
A well-defined financial and management system and procedure
makes order in the organization.
Assess/Re-plan Community Health Programs
Continuous assessment and re-planning of community health
plan gives direction and helps in attaining the objective.
Problems identified during the course of implementation are
given attention.
Institutionalize Linkages / Network / Referral Points
Institutionalizing linkaging means that permanent structure in
lieu of the NGO should take in the lead role of assisting the
community organization once it phases out of the area. An
objective linkage with service delivery agencies should have
been formalized. This way, basic services could continue even
without the NGO.
Hold Continuing Needs-based Education / Training of Leaders,
CHWs, and Residents
The primary objective of education and training is to unify the
members / residents in the goals / objectives, activities and
methods of the program. The continuing education also help
leaders and workers to get updates thus improving the delivery
of services to its constituents.
Formulate / Ratify Constitution and By-Laws
To make the community health organization more visible and
cohesive, constitution and by-laws need to be formulated and
ratified.
Apply for SEC Registration / LGU Accreditation
For an organization to be secured, it needs to be accredited and
registered with the Security Exchange Commission (SEC). This
will allow the organization to be recognized as such.
Negotiate for Absorption of CHW's LGU
CHWs who were found to be actively working in the delivery of
basic health services are recommended to the LGU to be
absorbed.
Once a CHW is absorbed, it is given a sort of honorarium and
other privileges that the LGU can give. This way, CHW will be
best motivated in doing the job.
Work Towards Affiliating / Federating with other Groups
If there are two or more community-based health programs that
exist in a certain municipality, it is advisable to federate or
affiliate with one another.
Sharing of resources and mobilization scheme will help facilitate
development of communities.
Working with the Members of the Community
Working with the poor people in far-flung communities is a
earning and meaningful experience which is guaranteed to create
a compassionate heart. This is because, the development of the
poor people is a tedious but self-fulfilling experience.
The selection of a depressed and underserved community
preempts difficulties and self-sacrifice on the part of a
community health, worker.
The Community Organizer selected these barrios because the
are deprived of health services, and most of the people are poor,
ic-norant but simple people. The first barrio selected was Barra,
a community which could be reached by riding a jeep from
Sacred Heart College and then riding a banca about 20 minutes
and walking about a kilometer to reach the place. The men are
mostly fishermen and the women engaged in fish vending or
making of Tinapa.
The community organizer and a group of students visited the
families, observed their lifestyle and inquired about their health
concerns.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
9
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
The barangay leaders were met and with the people were asked if they want to be helped in developing their community. Some people
were hesitant and suspicious as to why the students and staff of Sacred Heart College would help them.
This period lasts about three weeks until most of the people accepted the help offered to them.
Once the people accepted the staff and students a General Assembly was scheduled one evening. The purpose was to introduce the
HRDP III its purpose, and objectives and what the people were expected to do so that the program can be launched.
The only expectation from the people was their cooperation and assurance of participating in the meeting and training programs that
would be undertaken so that their knowledge, attitude and skills on health would be improved.
Once the assembly agreed, they recommended some persons who would join the staff and students in making a health survey and
gathering of data, studying and analyzing the data, identifying the problems and find solutions to this problem; in other words, they
were participating in the action research on their own.
This was done after several meetings with the core group or those persons who participated in the research. There were times that only
few, about 4 out of 10 would attend the meetings. Yet the meetings went on so that those who were interested would not lose their
enthusiasm.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
10
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Spot Map
It is a geographical representation of an area or community.
Usually a portion of the earth's surface.
Importance of a Spot Map
Direct the new person in the community. Direct travelers from
one point to another through confusing terrain.
Explain a place by attaching specific types of information.
Entertains and invites exploration.
Purposes of a Spot Map
Present the general picture of the community.
Shows landmarks and boundaries.
Helps identify the subsystem of the community.
Provides direction / guidance gathering data.
Helps identify the possible health or health threats of the
community.
There are three things to consider with titles: content,
placement, and design.
Content
Introduces the reader to the map subject. A map title should
be simple and precise.
Unnecessary words should be omitted from the title.
It is important to avoid abbreviations that the map user
might not understand.
Remember to ensure that the title is understandable to the
audience.
Design
Style of the title should be plain.
Avoid italics or ornate font and type styles. The exception to
this rule is when the map has a theme that would call for an
ornate style. For example, an ornate title could be used in a
map that is showing the early history of the world.
Otherwise, do not make the type style ornate. The map title
should usually be the largest type on a map, and, if possible,
should be limited to one line. A map title in large font
establishes an immediate visual hierarchy and alerts the map
reader where to look first for the information that the map is
displaying.
Placement of the title on the map
Can be placed anywhere on the map as long as it stands out
in the visual hierarchy.
In general, the title is usually placed towards the top of the
map, where the map user is accustomed to seeing titles.
Also, the map title is usually placed above the legend, to
relieve the map user from having to jump back and forth
between the title and the legend.
The rules about the placement of the legend apply to the
map title as well. Remember that captions usually take the
place of map titles when used in a published work like a
book or journal.
The Elements and Characteristics of a Good Spot Map
Title
It indicates the purpose of the map. This includes the name of
the area (Zone, Barangay, City, Country, in CAPITAL
LETTERS.)
It should contain the name of the community specifying the
zone, barangay, town/city, and province.
It should indicate the date in which the map has been made.
Shape inverted triangle
ZONE 4, BLOCK 3, BARANGAY PAGATPAT
CAGAYAN DE ORO CITY
AUGUST 22, 2023
Map Title
Reflects the subject of the map. A good title should include
the geographic name, the layer name, and the indicator
name. A proper map title should be recognizable.
Is an element in a map layout that describes the theme or
subject of a map. The map title should instantly give the North Arrow
It gives a reference point to indicate how a direction of the map
viewer a good idea of what the map is depicting.
corresponds to a direction in the world.
The title of the map should depict applicable information for
Has 4 Cardinal Directions: North, South, West, East
the intended audience, depending on how well they know
the subject before viewing the map.
Cardinal Points
A good title should also give the audience an idea of the
Cardinal means primary, important directions
“What? Where? and When?” of the map.
Placed on the right part of the paper, just slightly below the title,
Map Title Elements (or parts)
drawings, and font size should be smaller than the title
Map titles are often made up of three parts: the geographic
name, the layer name, and the indicator name.
Geographic Name
Is the base area that the map is showing.
Layer Name
Is focusing on the overlying map layer.
Indicator Name
Is what information the map is trying to portray.
"Provo, UT. Theme Park Locations"
"Provo, UT." is the geographic name showing the base
The Map Body
location.
It should have permanent landmarks such as a school, market,
"Theme Park" is the layer (or layers) of interest.
recreational area, houses, church.
"Locations" is the indicator name, explaining that the
There should be clarity. The contents should be clearly presen-..
map is showing the location of theme parks in Provo.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
11
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
..-ted in terms of colors, figrues, and drawing.
Rules to improve clarity:
Avoid overlapping symbols and names
Limit the number of colors on the map.
Limit the number that are consistent with their connotative
meaning
Include only the permanent symbols.
There has to be order. Sequence must be observe in the
map readers view components of the map clearly:
Title
Spatial patterns (SPÃ-SHEL) character of space
Map body
Legend
North arrow
In terms of roads, there should be a clear presentation:
National roads (widest)
Barangay roads
Trails (narrowest)
There has to be boundaries:
Overall boundaries - straight line ————————
Within boundaries - broken line - - - - - - - - - - - - - - Observance of appropriate color utilization:
Blue - water
Green - low elevations
Brown - high elevations
Proper locations of the components:
Title - upper part of the page, large and bold
North Arrow - upper right part of the page
Legend - lower left side of the page
Legend (Or Key)
It is an explanatory list that defines symbols appearing in a map
or chart. (Placed in a box at lower left margin)
A Map Legend is a side table or box on a map that shows the
meaning of the symbols, shapes, and colors used on the map.
The map legend is sometimes called the map key. The map
legend often also has a scale to help the map reader gauge
distances
A map legend shows colors, shapes, and symbols to define a
certain characteristic of the map. On a physical location map,
you might find areas of lakes, rivers, and mountain ranges
highlighted in the map legend for the type of map that's being
used.
Map legends are often found in a top or bottom of a map, with a
color or symbol and a description for what these colors and
symbols mean.
Check your map area, and then consult the map key for a clearer
definition of the part of the map you're seeing.
The map legend's purpose is also to show relationships between
certain things.
You might be in a major metro area and consult the subway
map, as an alternative to taking a bus or car.
The map and its legend can highlight not only the distance but
also the complexity or ease of your trip using a public subway.
This value in highlighting spatial relationships is a key asset to a
printed map legend.
Placed on the left side of the paper, drawing and font size
should be smaller than the title.
Legends
Airport - airplane
Building - houses
Trees - green trees
Roads / Streets - black with lines
National Roads - widest in width
Barangay Road - narrower in width
Lakes / Rivers - color blue
Mountains - color gray
Lower Elevation - in green
Higher Elevations - orange or brown
Materials Needed in Spot Map Making
Directional compass
Colored Pencil/ ballpen
Long Bond Paper
Ruler
Steps in Making a Spot Map
1. Prepare the materials
2. Seek guidance of a permanent residence of the community such
as the Barangay chairman, Barangay health worker, zone leader.
3. Look for a reference point
4. Hold the compass at waist level or a little higher
5. Rotate the compass until the compass needle is box in the
orienting arrow (north direction).
6. Identify and draw the boundaries of the area.
7. Draw the roads from the widest to the narrowest (National road
to Barangay road).
8. Draw the directional arrow
9. Draw the important permanent landmarks and their specific
locations such as :
a. Barangay Hall
b. Barangay Health Center
c. Recreational Area
d. Bodies of water
e. Bridges
f. School
g. Church
10. Identify the individual household
11. Color the contents of the spot map. Color the landmarks.
12. The information must be clear and complete.
13. The spot map must be neat and clear.
14. Enclose with a BORDER.
Reminders:
All symbols must be reflected in the legend
Write the title on the upper middle part of the paper
Write the north arrow on the upper right side of the paper
Write the legend on the lower left side of the paper
Write the BORDER in your paper
Courtesy Call Letter
A behavior marked by polished manners of respect for others.
7 Parts of a Letter
Heading
Contact information, placed at the top of a business letter.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
12
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
Lets the reader identify you and provides a way to contact you.
Lithosphere
If used preprinted letterhead, you have already made heading for
Contains all of the cold, hard solid land of the planet's crust
your letter.
(surface), the semi-solid land underneath the crust, and the
If not, insert your address at the top of the letter, including your
liquid land near the center of the planet.
street address, city, state, and zip code.
The surface of the lithosphere is very uneven. There are high
Do not include your name in your heading since you will sign
mountain ranges like the Rockies and Andes, huge plains or flat
the paper.
areas like those in Texas, Iowa, and Brazil and deep valleys
Date
along the ocean floor.
Write out the month, date, and the year - August 17, 2023
The solid, semi-solid, and liquid land of the lithosphere form
layers that are physically and chemically different. If someone
Addressee Information
were to cut through Earth to its center, these layers would be
Also called “inside address”
revealed like the layers of an onion.
Includes the name of the person whom you're writing, his title,
The outermost layer of the lithosphere consists of loose soil rich
the company, and his full mailing address
in nutrients, oxygen, and silicon.
Salutation
Beneath that layer lies a very thin, solid crust of oxygen and
Is a greeting made up of two parts: a word of welcome such as
silicon.
“Dear”
Next is a thick, semi-solid mantle of oxygen, silicon, iron, and
Avoid using a generic, “To whom It May Concern” or “Dear
magnesium.
Gentlemen” but instead, greet the specific individual as listed in
Below that is a liquid outer core of nickel and iron.
the information.
At the center of Earth is a solid inner core of nickel and iron.
The salutation can be formal (using the reader's title such as
Hydrosphere
Dr., Mr., Ms., followed by his last name)
Contains all the solid, liquid, and gaseous water of the planet. It
Or informal (using the person' first name)
ranges from 10 to 20 kilometers in thickness.
Insert a comma or colon and a line space after the salutation
The hydrosphere extends from Earth's surface downward several
Letter Body
kilometers into the lithosphere and upward about 12 kilometers
Comprised of three part
into the atmosphere.
Use the first paragraph as an introduction to explain why you are
A small portion of the water in the hydrosphere is fresh (nonwriting.
salty). This water flows as precipitation from the atmosphere
Use the following paragraph to lay out your points, providing
down to Earth's surface, as rivers and streams along Earth's
more information and specific details in logical order.
surface, and as groundwater beneath Earth's surface.
Use the final paragraph what step you want your reader to take
Most of Earth's fresh water, however, is frozen.
after reading your letter.
Ninety-seven percent of Earth's water is salty. The salty water
Close this final section with words of appreciation.
collects in deep valleys along Earth's surface. These large
Closing
collections of salty water are referred to as oceans.
Has different elements
Water near the poles is very cold while water near the equator is
Complimentary Close
very warm. The differences in temperature cause water to
This short phrase ends your letter but continues to
change physical states.
communicate your tone.
Extremely low temperatures like those found at the poles cause
Always communicate courtesy and respect, follow with a
water to freeze into a solid such as a polar icecap, a glacier, or
comma.
an iceberg.
Handwritten Signature
Extremely high temperatures like those found at the equator
Insert 2-4 line spaces for a handwritten signature.
cause water to evaporate into a gas.
If letter will be sent electronically, you can insert an email
Biosphere
signature.
Contains all the planet's living things. This sphere includes all of
Typed Signature
the microorganisms, plants, and animals of Earth.
Type your signature and the title.
Within the biosphere, living things form ecological communities
P.S. (Post Script)
based on the physical surroundings of an area.
This element is the most varied. It is also optional.
These communities are referred to as biomes.
When the postscript is short message inserted after the letter
Deserts, grasslands, and tropical rainforests are three of the
closing.
many types of biomes that exist within the biosphere.
It reminds or an extra piece of information for the reader.
Atmosphere
Contains all the air in Earth's system. It extends from less than 1
Four Subsystems of Planet Earth
m below the planet's surface to more than 10,000 km above the
Everything in Earth's system can be placed into one of four
planet's surface.
major subsystems: land, water, living things, or air.
The upper portion of the atmosphere protects the organisms of
These four subsystems are called "spheres."
the biosphere from the sun's ultraviolet radiation. It also absorbs
Each of these four spheres can be further divided into suband emits heat.
spheres.
Liceo de Cagayan University - College of Nursing
Community Health Nursing (NCM-104)
13
Prelim Transes (RLE)
Transcribed by: Bianca Angelica Gerardo
When air temperature in the lower portion of this sphere
changes, weather occurs. As air in the lower atmosphere is
heated or cooled, it moves around the planet.
The result can be as simple as a breeze or as complex as a
tornado.
Interactions Between the 4 Spheres
Although the four systems have their individual identities, there
is important interaction between them. Environmental scientists
study the effects of events in one sphere on the other spheres.
There are ten possible types of interactions that could occur
within the earth system. Four of these interactions are between
the event and each of the 3 earth's spheres.
Figure 1.
ATMOS
HYDRO
Event
EVENT
LITHO
BIO
The double-headed arrows indicate that the cause and effect
relationships of these interactions go in both directions. These
four types of interactions can be illustrated in Figure #1.
The "event <-> hydrosphere" refers to the effects of the event on
the hydrosphere, as well as the effects of the hydrosphere on the
event.
For example, a volcanic eruption in the geosphere may cause
profound direct and indirect effects on the hydrosphere,
atmosphere and biosphere as follows.
(Volcano) On May 18, 1980, Mount Saint Helens, in the
state of Washington, erupted.
This event altered the surrounding environment, and
provided scientists with an opportunity to study the
effects of volcanic eruptions on the lithosphere,
hydrosphere, atmosphere and biosphere.
Such studies are important because volcanic eruptions
will continue to occur, and will have increasing impact
on humans as people continue to settle lands closer to
dormant volcanoes.
Figure 2.
ATMOS
HYDRO
EVENT
Event
LITHO
BIO
In addition to the above four eventsphere interactions, there are
six interactions that occur among the spheres themselves.
Figure 2 illustrates a few of the many interactions resulting from
a volcanic eruption. The ten types of interactions that can occur
within the earth system often occur as a series of chain
reactions.
This means one interaction leads to another interaction, which
leads to yet another interaction—it is a ripple effect through the
earth's spheres.
Volcano>Lithosphere>Atmosphere>Hydrosphere>Biosphere
Volcanoes (an event in the lithosphere) release a large amount
of particulate matter into the atmosphere. These particles serve
as nuclei for the formation of water droplets (hydrosphere).
Rainfall (hydrosphere) often increases following an eruption,
stimulating plant growth (biosphere).
Particulate matter in the air (atmosphere) falls out, initially
smothering plants (biosphere), but ultimately enriching the soil
(lithosphere) and thereby stimulating plant growth (biosphere).
Volcano>Lithosphere>Hydrosphere>Biosphere
Volcanoes (events in the lithosphere) may release a substantial
amount of hot lava (lithosphere), which causes mountain
glaciers (hydrosphere) to melt.
Mudflows (lithosphere) and flooding may occur downstream
from volcanoes and may inundate streamside communities
(biosphere).
Volcano>Lithosphere>Atmosphere>Biosphere>Lithosphere
Volcanoes (events of the lithosphere) release a large amount of
carbon dioxide (atmosphere), the raw material for sugar
production in plants (biosphere).
This may increase photosynthetic production and eventually
increase the amount of biomass, which, after a very long time,
forms coal and oil deposits (lithosphere).
Volcano>Complex Interactions
Volcanoes (lithosphere) may emit large quantities of sulfur
dioxide (atmosphere). When atmospheric sulfur dioxide
combines with water (hydrosphere), sulfuric and sulfurous acid
form.
Rain (hydrosphere) may bring these acids to the Earth,
acidifying soils (lithosphere), lakes and rivers (hydrosphere).
Acidic water leaches nutrients from the soil (lithosphere) into
the water table (hydrosphere), making the soil less fertile for
plants (biosphere), and the subterranean water supply
(hydrosphere) less potable for humans (biosphere).
Acid rain falling on lakes and streams reduces the pH of the
water (hydrosphere), which may result in a decrease in
phytoplankton and zooplankton growth (biosphere).
If photosynthesis is reduced, atmospheric concentrations of
carbon dioxide can build up and stimulate global warming
(atmosphere) which may contribute to increased melting of
glaciers (hydrosphere).