I.
IMPORTANT CONCEPTS IN COMMUNITY HEALTH NURSING
A. Primary goal of professional practice is health promotion and preservation of the health of
the population.
B. Nature of practice is comprehensive, general, and continual.
C. Knowledge base comes from nursing and public health.
D. Different levels of clientele include the individual, family, population groups, and
community.
E. Dominant responsibility is to the population as a whole.
II. OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES
A. Health- state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity (WHO)
B. Public Health
 science and art of preventing disease, prolonging life, promoting health and efficiency
through organized community effort to ensure everyone a standard of living adequate
for the maintenance of health to enable every citizen to realize his birthright of health
and longevity (C.E. Winslow)
 art of applying science in the context of politics so as to reduce inequalities in health
while ensuring the best health for the greatest number (WHO)
 Core business of public health
 Disease control
 Injury prevention
 Health protection
 Public health policy implementation
 Health promotion and equitable health gain
C. Public Health Nursing
 special field of nursing that combines the skills of nursing and public health and some
phases of social assistance and functions as part of the total public health for the
promotion of health, improvement of conditions and social environment, rehabilitation
of illness, and disability
III. LAWS AFFECTING PUBLIC HEALTH NURSING
Laws
Description
RA 1082
The first Rural Health Act,
implemented in 1953, which
called for employment of more
doctors, nurses, midwives and
sanitary inspectors in rural
areas
RA 1891
Improved the health and dental
services in the rural areas
RA 8423
Created the Philippine Institute
of Traditional and Alternative
Care
RA 7305
Magna Carta for Public Health
Workers; which aims to
promote and improve the social
and economic well-being of
health workers
RA 6758
Standardized salaries of
government employees which
included the nursing personnel
RA 3573
Declared that all communicable
diseases should be reported to
the nearest health station
RA 6365
RA 4073
RA 6425
RA 8749
RA 7160
RA 6675
RA 6713
PD 651
PD 856
PD 825
PD 996
PD 965
Ministry
Circular
No. 2 in
1986
Administrat
ive Order
No.114 s.
1991
Established a National Policy
on Population and created the
Commission of Population
Liberalized the treatment of
leprosy; advocated home
treatment of leprosy cases
The Dangerous Drug Act, which
states that the sale,
administration, delivery,
distribution and transportation
of prohibited drugs is
punishable by law
The Clean Air Act
The Local Government Code
where the responsibility for the
delivery of basic services and
facilities of the national
government has been
transferred to local government
The Generics Act of 1988,
which ensures production of
adequate supply of drugs and
medicines identified by their
generic name
Code of Conduct and Ethical
Standards for Public Officials
and Employees
Requires that all health workers
shall identify and encourage the
registration of all births within
30 days following delivery
Sanitation Code; which controls
all factors in man’s environment
that affect health
Provides penalty for improper
disposal of garbage
Requires compulsory
immunization of all children
below 8 years of age against
the 6 childhood immunizable
diseases
Requires applicants for
marriage license to receive
instruction on family planning
and responsible parenthood
Includes Acquired Immune
Deficiency Syndrome (AIDS) as
a notifiable disease
Revised/updated the roles and
functions of the Municipal
Health Officers, Public Health
Nurses and Rural Health
Midwives
Letter of
Instruction
No. 949
The legal basis of primary
health care
IV. THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM
A. Department of Health
Vision
o The DOH is the leader, staunch advocate, and model in promoting health for all in the
Philippines.
Mission
o To guarantee equitable, sustainable and quality health for all Filipinos, especially the
poor, and to lead the quest for excellence in health.
Goal: Health Sector Reform Agenda (HRSA)
o 5 major reforms:
1. provide fiscal autonomy to government hospitals
2. secure funding for priority public health programs
3. promote development of local health systems and ensure its effective
performance
4. strengthen capacities of health regulatory agencies
5. expand coverage of the National Health Insurance Program
Roadmap for All Stakeholders in Health: National Objectives for Health 2005-2010
1. Improve the general health status of the population
2. Reduce morbidity, mortality, disability and complications
3. Eliminate certain diseases as public health problems
4. Promote healthy lifestyle and environmental health
5. Protect vulnerable groups with special health and nutrition needs
6. Strengthen national and local health systems
7. Pursue public health and hospital reforms
8. Reduce cost and ensure quality of essential drugs
9. Institute health regulatory reforms
10. Strengthen health governance
11. Institute safety nets for vulnerable and marginalized groups
12. Expand coverage of health insurance
13. Mobilize more resources for health
14. Improve efficiency of resources for health
B. Local Health System
Objectives
1. Establish effective and efficient delivery of health care services
2. Upgrade health care management and service capabilities of local health
facilities
3. Promote inert-LGU linkages and cost sharing schemes for better utilization of
local health resources
4. Foster participation of private sector, NGOs and communities in local health
systems development
5. Ensure quality of health service delivery at the local level
C. Primary Health Care
Goal
 Health for All Filipinos and Health in the Hands of the People by the year 2020
Mission
 To strengthen the health care system wherein people will manage their own health
care
Elements of PHC
 Environmental sanitation








Control of communicable diseases
Immunization
Health education
Maternal and child health and family planning
Adequate food and proper nutrition
Provision of medical care and emergency treatment
Treatment of locally endemic diseases
Provision of essential drugs
4 Pillars in PHC
 Active community participation
 Intra and intersectoral linkages
 Use of appropriate technology
 Support mechanism
Two levels of PHC workers
 Village or Barangay Health Workers
 Intermediate level health workers
Levels of health care and referral system
Tertiary
Secondary
Primary
V. THE PUBLIC HEALTH NURSE
A. Qualifications
 Bachelor of Science in Nursing graduate
 Registered Nurse in the Philippines
 Professional competence
 Personal qualities and “people skills”
B. Functions
 Manager
 Teacher
 Supervisor
 Trainer
 Clinician
 Researcher
 Collaborator and
coordinator
VI. THE COMMUNITY HEALTH NURSING PROCESS
A. Assessment
Two major levels of assessment
1. First level- existing and potential health conditions and/ or problems are identified
(categories of health problems/ conditions)
2. Second level- definition of the nature or type of nursing problem that the family
encounters in performing health tasks (typology of nursing problem)
Steps
1.
2.
3.
4.
Initiate contact.
Demonstrate caring attitudes.
Develop mutual trust and confidence.
Collect data.
5. Identify health problems.
6. Assess coping ability.
7. Analyze and interpret data.
B. Planning
Steps
1. Prioritize needs.
2. Establish goals.
3. Construct action and operation plan.
4. Devise evaluation parameters.
5. Revise plan as needed.
Family Nursing Care Plan
-blueprint of the care that the nurse designs to systematically minimize or eliminate the
identified health and family nursing problems
C. Implementation
Steps
1. Put nursing plan to action.
2. Coordinate care / services.
3. Utilize community resources.
4. Delegate and supervise.
5. Monitor health services provided.
6. Provide health education and training.
7. Document responses to nursing action.
D. Evaluation
Steps
1. Nursing audit.
2. Care outcomes.
3. Performance appraisal.
4. Estimate cost benefit ratio.
5. Assessment problems.
6. Identify needed alterations.
7. Revise plans as necessary.
Three classic framework/ standards from which nursing care is delivered
1. Structural 2. Process 3. Outcome
Quality assurance- process of ensuring that client’s receive the agreed-upon level of care
based on the standards
VII. COMMON NURSING PROCEDURES
A. Clinic Visit- process of checking the clients’ health condition in a medical clinic where
the nurse assists the client as well as the physician in the whole course of examination.
B. Home Visit- professional face to face contact made by a nurse with the patient or the
family to provide necessary health care activities and to further attain the objective of the
agency.
Steps
1. Greet patient and introduce self.
2. State purpose of visit.
3. Observe patient and determine health needs.
4. Put bag in a convenient place and perform bag technique.
5. Perform nursing care.
6. Document necessary data.
7. Make appointment for a return visit.
D.
E.
F.
G.
H.
C. Bag Technique- a tool making use of a public health bag through which the nurse,
during his/her home visit, can perform nursing procedures
Steps
1. Place bag on table lined with clean paper.
2. Ask for a basin of water or glass of drinking water.
3. Open bag and take out towel and soap.
4. Wash hands with soap and water, towel dry.
5. Take apron from bag and put it on.
6. Put out all necessary articles needed for specific care.
7. Close bag and put it in one corner of working area.
8. Perform necessary care and treatment.
9. Perform after care and handwashing.
10. Open bag and return all things used after cleaning them.
11. Remove apron and place inside the bag.
12. Fold lining and place inside bag
13. Document necessary data. Give health teachings.
14. Make appointment for next visit.
Thermometer Technique
Nursing Care in the Home
Isolation Technique in the Home- process of separating the articles used by a client with
communicable disease to prevent the spread of infection.
Intravenous Therapy
Community Organizing- process of change involving “people empowerment” for future
community action
Stages of Community Organizing
1. Community Analysis
Steps:
a. Define community
b. Collect data
c. Assess community capacity
d. Assess community barriers
e. Assess readiness for change
f. Synthesize data and set priorities
2. Design and Initiation
Steps
a. Establish a core planning group and select a local organizer
b. Choose an organizational structure
c. Identify, select, and recruit organizational members
d. Define organization mission and goals
e. Clarify roles and responsibilities
f. Provide training and recognition
3. Implementation
Activities
a. Generate broad citizen participation
b. Develop sequential work plan
c. Formulate and use comprehensive, integrated strategies
d. Integrate community values into the programs, materials, and messages
4. Program Maintenance and Consolidation
Activities
a. Integrate intervention activities into community networks
b. Establish a positive organizational culture
c. Establish an ongoing recruitment plan
d. Disseminate results
5. Dissemination- Reassessment
Activities
a. Update community analysis
b. Assess effectiveness of interventions/ programs
c. Chart future directories and modifications
d. Summarize and disseminate results
I. Health Promotion- process of enabling people to increase control over and to improve
their health
J. Health Education- process whereby knowledge, attitude and practice of people are
changed to improve individual, family and community health
VIII. DEMOGRAPHY, EPIDEMIOLOGY, AND VITAL STATISTICS
A. Demography
 science which deals with the study of the human population’s size, composition and
distribution in space
1. Census- official and periodic enumeration of the population
2. Sample survey- demographic information is collected from a sample of a given
population
3. Registration Systems- collected by the civil registrar’s office which deal with the
recording of vital events in the community
4. Population Distribution
a. Urban- rural distribution- proportion of the people living in urban compared to
the rural areas
b. Crowding index- describes the ease by which a communicable disease will be
transmitted from one host to another susceptible host
c. Population density- determines how congested a place is
B. Vital Statistics- systematic study of vital events such as births, illnesses, marriages,
divorce, separation and death
1. Rate- relationship between a vital event and those persons exposed in a given area
in a specified time
2. Ratio- relationship between 2 numerical quantities without consideration to place or
time
3. Crude/ General Rates- total living population
4. Specific Rates- measures relationship of event for a specific population class or
group
5. Herd Immunity- represents the immunity and susceptibility levels of individuals
comprising the population
- # of total contacts developing a disease with maximum incubation period/ total # of
susceptible individuals
6. Common Vital Statistical Indicators
 Crude birth rate- measure of one characteristic of the natural growth or increase
of a population
 Crude death rate- measure of one mortality from all causes which may result in
a decrease of population
 Infant mortality rate- measures risk of dying during the first year of life
 Maternal mortality rate- measures risk of dying from causes related to
pregnancy, childbirth and puerperium
 Fetal death rate- measures pregnancy wastage
 Neonatal death rate- measures risk of dying during the 1st month of life
 Specific death rate- describes more accurately the risk of exposure of certain
classes or groups to particular diseases
 Incidence rate- measures the frequency of occurrence of the phenomenon
during a given period of time

Prevalence rate- measures proportion of the population which exhibits a
particular disease at a particular time
 Proportionate mortality rate- shows numerical relationships between deaths
from all causes, age, etc. and total number of deaths from all causes in all ages
 Case fatality rate- index of a killing power of disease
7. Data Presentation
 Line/ curve
 Bar graphs
 Area Diagram (Pie chart)
8. Functions of the nurse in vital statistics
 Collects data
 Tabulates data
 Analyzes and interprets data
 Evaluates data
 Recommends redirection and/or strengthening specific areas of health programs
as needed
C. Epidemiology- study of the occurrence and distribution of health conditions such as
disease, death, deformities or disabilities and determinants of health states in a specific
population
1. Epidemiologic Triangle
Host
Agent
Environment
2. Patterns of Disease Occurrence and Distribution
 Epidemic
 Endemic
 Sporadic
 Pandemic
3. Outline for Epidemiological Investigation
 Establish fact of presence of epidemic
 Establish time and space relationship of a disease
 Relate cases to characteristic of the group of community
 Correlate of all data obtained
4. Functions of the Epidemiology Nurse
 Implement public health surveillance
 Monitor local health personnel conducting surveillance
 Conduct/ assist in outbreak investigation
 Assist in conduct of surveillance during disasters
 Assist in conduct of surveys, program evaluations, and other epidemiologic
studies
 Assist in conduct of training course in epidemiology
 Assist epidemiologist in preparing annual report and financial plan
 Conduct inventory and maintenance of epidemiology and surveillance unit
equipment
IX. FIELD HEALTH SERVICE AND INFORMATION SYSTEM
 a database of health services delivery and programs accomplished at the barangay,
municipal/ city, district, provincial, regional, and national levels
 Components
1. Family treatment record
2. Target client list
3. Reporting forms
4. Output records
X. PUBLIC HEALTH NURSING IN SCHOOLS AND WORK SETTING
A. School Nursing -public health nursing that focuses on the promotion of health and
wellness of the pupils/students, teaching, and non-teaching personnel of the schools
Duties and Responsibilities
 Health advocacy
 Health teaching and nutrition assessment
 Supervision of the health and safety of school
 Referrals and follow-up
 Home visits
 Community outreach
 Recording and reporting
 Monitoring and evaluation
B. Occupational Health Nursing- public health nursing that focuses on preservation and
restoration of health of the workers and working populations.
Duties and Responsibilities
 Health promotion and prevention
 Health hazard assessment and surveillance
 Injury and illness investigation, analysis and prevention
 Primary care
 Case management
 Counseling
 Management and administration of health services
 Legal/ethical monitoring
 Research
 Community orientation
XI. PUBLIC HEALTH PROGRAMS
A. Maternal Health Program
Goal: To improve the survival, health and well-being of mothers and unborn through a
package of services.
Strategic Thrust for 2005-2010:
 Launch the Basic Emergency Obstetric Care (BEMOC)
 Improve quality of prenatal and post natal care
 Reduce women’s exposure to health risk by giving appropriate health package
 Mobilizing LGUs, NGOs, stakeholders for health for resource generation
Essential Health Service Packages
 Antenatal Registration
PRENATAL
PERIOD OF PREGNANCY
VISISTS
1st Visit As early in the pregnancy as possible;
before 4 mos, or during the first trimester

Tetanus Toxoid Immunization
2nd Visit
During the 2nd trimester
3rd Visit
During the 3rd trimester
Every 2
weeks
After 8 months of pregnancy until delivery
VACCINE
TT1
MINIMUM
PERCENT DURATION OF
AGE/INTERVAL PROTECTED PROTECTION
As early as
possible
TT2
4 wks later
80%
3 years
TT3
6 mos later
95%
5 years
TT4
1 year later
99%
10 years
TT5
1 year later
99%
lifetime



Micronutrient Supplementation
 Iron= 60mg/400mg tab 1 tab OD
 Vitamin A= 10, 000 IU/ cap 1 cap twice a week staring on the 4th month of
pregnancy
Treatment of Diseases and Other Conditions
Clean and Safe Delivery
 Ensure clean hands, cord, surface.
 Register each birth to the civil registry.
 Birth certificate should be filled out by the attendant at birth.
 Enroll all newborns in Under Five clinic and issue a Growth Monitoring Chart.
B. Family Planning Program
Goal: To provide universal access to family planning information and services
Objectives:
 Help couple achieve their desired family size within the context of responsible
parenthood and improve their RH
 Ensure that quality FP services are available
Family Planning Methods
 Female Sterilization
 Male Sterilization
 Pills
 Male Condoms
 Injectables
 Lactating Amenorrhea Method
 Mucus/ Billings/ Cervical Method
 Basal Body Temperature
 Sympt0- thermal Method
 Two-day Method
 Standard days Method
C. Child Health Program
Goal: To reduce morbidity and mortality rates for children 0-9 years
Strategic thrusts for 2005-2010:
 Develop local capacity to deliver essential health packages to children
 Implement programs and projects that favor the disadvantaged population
 Apply the Reaching Every Barangay (REB) strategy for immunization
 Intensify health education and information campaigns
 Enhance medical, nursing, and midwifery education with cost-effective life-saving
strategies
 Pursue implementation of laws, and policies for the protection of newborns, infants
and children
Child health programs:
 Infant and Young Child Feeding
Key Concepts
 Initiate breastfeeding within 1 hour after birth
 Exclusive breastfeeding on the first 6 months of life and nothing else
 Complemented at 6 mos with appropriate foods
 Extend breastfeeding up to 2 years and beyond
 Newborn Screening
 Congenital Hypothyroidism
 Congenital Adrenal Hyperplasia
 Galactosemia
 Phenylketonuria
 G6PD Deficiency
 Expanded Program on Immunization
Vaccine
Minimum No. of Dose Route Site
age at 1st doses
dose
Birth or
1
0.05
ID
R/L
anytime
cc
deltoid
after birth
(0-1 year)
BCG
School
entrants
(Grade 1)
1
0.1
CC
ID
DPT
6 weeks
3
0.5 cc
IM
OPV
6 weeks
3
2 gtts oral
Hepa B
1
Hepa B
2
At birth (1 ½
mo)
3
0.5 cc
IM
Interval
R/L
deltoid
4 weeks
4 weeks
TARGET
PREPARATION
DOSE
Infants
(6-11 MOS)
100, 000 IU
1 dose only
Children
21-71 MOS
200, 000 IU
1 capsule
every 6 mos
Deltoid 6 weeks
Thigh (1st to
2nd dose)
6 weeks (1 ½
mo)
8 weeks
(2nd to
3rd dose)
14 weeks
(3 ½ mo)
Hepa B
3
Measles 9-12 months

1
0.5 cc SQ
Deltoid
Thigh
Gluteal
Integrated Management of Childhood Illnesses
 Elements of the IMCI case management process
1. Outpatient health facility
2. Referral health facility

3. Appropriate home management
Two age categories
1. Young infants age 1 week up to 2 months.
2. Children age 2 months up to 5 years
DANGER SIGNS




Convulsions
Lethargy/Unconsciousness
Inability to drink/ breastfeed
Vomiting
Assess MAIN SYMPTOMS
 Cough/ difficulty breathing
 Diarrhea
 Fever
 Ear Problems
Assess NUTRITION, IMMMUNIZATION STATUS and
POTENTIAL FEEDING PROBLEMS
Check for OTHER PROBLEMS
CLASSIFY CONDITION &
IDENTIFY TREATMENT ACTIONS
PINK
YELLOW
Urgent Referral
 Prereferral treatments
 Advise parents
 Refer child
Treat at Outpatient facility
 Treat local infection
 Oral drugs
 Teach caretaker
 Follow up
GREEN
Home Management
Counsel caretaker:
 Home treatment
 Feeding & fluids
 When to return
 Follow up
REFERRAL FACILITY




Micronutrient Supplementation
Dental Health
Early Child Development
Child Health Injuries
D. Nutrition Program
Goal: To improve the quality of life of Filipinos through better nutrition, improved health
and increased productivity
Programs and Projects:
 Micronutrient Supplementation
 Food Fortification
 Essential Maternal and Child Health Packages
 Nutrition IEC campaigns
 Home, School, and Community Food Production
 Food Assistance
 Livelihood Assistance
E. Oral Health Program
Goal: To reduce the prevalence rate of dental caries and periodontal diseases from 92%
in 1998 to 85% and from 78% in 1998 to 60% by end of 2010 among general population
Objectives:
 To increase the proportion of orally fit children under 6 years old to 80% by 2010



To control oral health risks among the young people
To improve the oral health conditions of pregnant women by 20% and older persons
by 10% every year until 2010
Basic services: preventive, curative
F. Philippine Reproductive Health
Objectives:
 Reduce maternal mortality rate
 Reduce child mortality
 Halt and reverse spread of HIV/ AIDS
 Increase access to reproductive health information and services
10 Elements:
 Family Planning
 Maternal and Child Health and Nutrition
 Prevention and Management of RTIs including STDs and HIV/AIDS
 Adolescent Reproductive Health
 Prevention and Management of Abortion and its Complications
 Prevention and Management of Breast and Reproductive Tract Cancer and other
Gynecological Conditions
 Education and Counseling on Sexuality and Sexual Health, Men’s Reproductive
Health and Involvement
 Violence Against Women and Children
 Prevention and Management of Infertility and Sexual Dysfunction
G. Sentrong Sigla
Goals
 Long term: Institutionalize within the health sector the leadership, processes,
knowledge, attitudes, skills and organizations to generate continuous quality
improvement in healthcare.
 Intermediate: (2003-2007) Improve the quality of health care in outpatient health
facilities, hospitals, and public health services in the community
 Specific: Improve the quality of out patient health care (public and private) and of
public health services in the community
Level and Scope of Certification
 Basic Sentrong Sigla Certification
 Specialty Awards
 Award for Excellence
H. 10 DOH Approved Herbal Medicines





I.
Lagundi
Yerba Buena
Sambong
Tsaang gubat
Niyug-niyogan





Bayabas
Akapulko
Ulasimang-bato
Bawang
Ampalaya
National Voluntary Blood Services Program: Legal Basis RA 7719
Vision: A network of modernized national and regional blood centers operating on a
fully voluntary, non-remunerated blood donation system
Mission: Ensure adequate, safe and accessible blood supply by:
 Promoting voluntary blood donation as a way of life for every qualified healthy
Filipino
 Establishing new blood service and upgrading existing ones
 Organizing association of blood donors and training medical practitioners on
national blood use
J. Botika ng Barangay: Drug outlet managed by a legitimate community organization,
NGO, and LGU licensed by BFAD
Goal: Promote equity in health by ensuring the availability and accessibility of affordable,
safe, and effective quality essential drugs to all, with priority for marginalized,
underserved, critical, and hard to reach areas
Objectives:
 To rationalize distribution of common drugs and medicines among intended
beneficiaries
 To serve as mechanism for the DOH to establish partnership with LGUs and
community organization
 To optimize involvement of BHW addressing the health need of the community
XII. ENVIRONMENTAL HEALTH AND SANITATION
A. Environmental Health: branch of public health that deals with the study of preventing
illness by managing the environment and changing people’s behavior to reduce exposure
to biological and non-biological agents of disease and injury (John Tomarro)
B. Environmental Sanitation: study of all factors in a man’s physical environment which
may exercise a deleterious effect on his well-being and survival
C. Environmental and Occupational Health Office (EOHO): agency responsible for the
promotion of healthy environmental conditions and prevention of environmental related
diseases through appropriate sanitation strategies
D. Major Environmental Health and Sanitation Programs
1. Water Supply and Sanitation Program
Policies:
 Approved types of water supply:
Level
Description
1
Point
source
Communal
faucet
system/
stand posts
Waterworks
system/
individual
house
connections
2
3

Distance from
farthest user
Not more than
250 meters
Not more than
25 meters
Yield/
discharge
40-140 L/
min
40-80 L/
capita per
day
Not specified
Not
specified
Unapproved type of water supply: doubtful sources such as open dug wells,
unimproved spring, wells that need priming, etc.
 Access to safe and potable drinking water
 Water quality and monitoring surveillance
 Certifcation of potability of an existing water source issued by the Secretary of
Health or duly authorized representative
 Disinfection of water supply sources
 Waterworks/ water system and well construction
 Requires approval of the Secretary of DOH/ his duly authorized representative
 Shall comply with sanitary requirements of DOH
 Shall supply safe and potable water in adequate quantity
 Readily available water to consumers through water pipe direct to homes
 Adequate pressure and volume in the water system distribution line
2. Proper Excreta and Sewage Disposal System
Policies:
 Approved types of toilet facilities
 Level I
-non water carriage toilet facility
-toilet facilities requiring small amount of water to wash the waste into receiving
space
 Level II
-water-sealed and flush-type with septic vault/tank disposal facilities
 Level III
-water carriage facilities connected to septic tanks and/or sewerage system to
treatment plant
3. Food Sanitation Program
Policy:
 Food establishments shall be monitored.
 4 Rights in Food Safety
 Right source
 Right cooking
 Right preparation  Right storage
4. Hospital Waste Management
Policies:
 All newly constructed and existing govt and private hospitals shall prepare and
implement a Hospital Waste Management System.
 Use of appropriate technology and indigenous materials shall be adopted.
 Training of personnel in hospital waste management shall be an essential part of
hospital training program.
 Public information campaign on health and environmental hazard arising from
mismanagement shall be the responsibility of the hospital admin.
 DOH Hospital Waste Management Program policies and guidelines shall be based
on existing legislative law.
 Local ordinances regarding collection and disposal techniques shall be
institutionalized.
XIII. NON-COMMUNICABLE DISEASE PREVENTION AND CONTROL
A. Integrated Community Based Non-communicable Disease Prevention and Control
Program
Goal: To reduce the toll of morbidity, disability, and premature deaths due to chronic,
non-communicable lifestyle related disease
Key intervention strategies
 Establishing program direction and infrastructure
 Changing environments
 Changing lifestyle
 Reorienting health services
B. Roles of the Nurse in NCD Prevention and Control
 Health advocate
 Health educator
 Healthcare provider
 Community organizer
 Health trainer
 Researcher