Community

a group of people with common characteristics or interests living together within a

territory or geographical boundary
place where people under usual conditions are found
Derived from a latin word “comunicas” which means a group of people.
Health
OLOF (Optimum Level of Functioning)
Health-illness continuum
High-level wellness
Agent-host-environment
Health belief
Evolutionary-based
Health promotion
WHO definition
Community Health
Part of paramedical and medical intervention/approach which is concerned on the
health of the whole population
Aims:
1. Health promotion
2. Disease prevention
3. Management of factors affecting health
Nursing
Both profession & a vocation. Assisting sick individuals to become healthy and
healthy individuals achieve optimum wellness
Community Health Nursing
“The utilization of the nursing process in the different levels of clientele-individuals,
families, population groups and communities, concerned with the promotion of
health, prevention of disease and disability and rehabilitation.” ( Maglaya, et al)
Goal: “To raise the level of citizenry by helping communities and families to cope
with the discontinuities in and threats to health in such a way as to maximize their
potential for high-level wellness” ( Nisce, et al)
Special field of nursing that combines the skills of nursing, public health and some
phases of social assistance and functions as part of the total public health program
for the promotion of health, the improvement of the conditions in the social and
physical environment, rehabilitation of illness and disability ( WHO Expert
Committee of Nursing)
A learned practice discipline with the ultimate goal of contributing as individuals
and in collaboration with others to the promotion of the client’s optimum level of
functioning thru’ teaching and delivery of care (Jacobson)
A service rendered by a professional nurse to IFCs, population groups in health
centers, clinics, schools , workplace for the promotion of health, prevention of
illness, care of the sick at home and rehabilitation (DR. Ruth B. Freeman)
Public Health
 “Public Health is directed towards assisting every citizen to realize his birth rights
and longevity.”“The science and art of preventing disease, prolonging life and
efficiency through organized community effort for:
1. The sanitation of the environment
2. The control of communicable infections
3. The education of the individual in personal hygiene
4. The organization of medical and nursing services for the early diagnosis and
preventive treatment of disease
5. The development of a social machinery to ensure every one a standard of living,
adequate for maintenance of health to enable every citizen to realize his birth right of
health and longevity (Dr. C.E Winslow)
Mission of CHN
Health Promotion
Health Protection
Health Balance
Disease prevention
Social Justice
Philosophy of CHN
“The philosophy of CHN is based on the worth and dignity on the worth and dignity
of man.”(Dr. M. Shetland)
Basic Principles of CHN
1. The community is the patient in CHN, the family is the unit of care and there
are four levels of clientele: individual, family, population group (those who share
common characteristics, developmental stages and common exposure to health
problems – e.g. children, elderly), and the community.
2. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of
care
3. CHN practice is affected by developments in health technology, in particular,
changes in society, in general
4. The goal of CHN is achieved through multi-sectoral efforts
5. CHN is a part of health care system and the larger human services system.
Roles of the PUBLIC HEALTH NURSE
Clinician, who is a health care provider, taking care of the sick people at home or in
the RHU
Health Educator, who aims towards health promotion and illness prevention through
dissemination of correct information; educating people
Facilitator, who establishes multi-sectoral linkages by referral system
Supervisor, who monitors and supervises the performance of midwives
Health Advocator, who speaks on behalf of the client
Advocator, who act on behalf of the client
Collaborator, who working with other health team member
*In the event that the Municipal Health Officer (MHO) is unable to perform his duties/functions
or is not available, the Public Health Nurse will take charge of the MHO’s responsibilities.

Other Specific Responsibilities of a Nurse, spelled by the implementing rules

and Regulations of RA 7164 (Philippine Nursing Act of 1991) includes:
Supervision and care of women during pregnancy, labor and puerperium
Performance of internal examination and delivery of babies
Suturing lacerations in the absence of a physician
Provision of first aid measures and emergency care
Recommending herbal and symptomatic meds…etc.
In the care of the families:
Provision of primary health care services
Developmental/Utilization of family nursing care plan in the provision of care
In the care of the communities:
Community organizing mobilization, community development and people
empowerment
Case finding and epidemiological investigation
Program planning, implementation and evaluation
Influencing executive and legislative individuals or bodies concerning health and
development
Responsibilities of CHN
be a part in developing an overall health plan, its implementation and evaluation for
communities
provide quality nursing services to the three levels of clientele
maintain coordination/linkages with other health team members, NGO/government
agencies in the provision of public health services
conduct researches relevant to CHN services to improve provision of health care
provide opportunities for professional growth and continuing education for staff
development
Standards in CHN
1. Theory
Applies theoretical concepts as basis for decisions in practice
2. Data Collection
Gathers comprehensive, accurate data systematically
3. Diagnosis
Analyzes collected data to determine the needs/ health problems of IFC
4. Planning
At each level of prevention, develops plans that specify nursing actions
unique to needs of clients
5. Intervention
 Guided by the plan, intervenes to promote, maintain or restore health,
prevent illness and institute rehabilitation
6. Evaluation
Evaluates responses of clients to interventions to note progress toward
goal achievement, revise data base, diagnoses and plan
7. Quality Assurance and Professional Development
Participates in peer review and other means of evaluation to assure
quality of nursing practice
Assumes professional development
Contributes to development of others
8. Interdisciplinary Collaboration
Collaborates with other members of the health team, professionals and
community representatives in assessing, planning, implementing and
evaluating programs for community health
9. Research
Indulges in research to contribute to theory and practice in community
health nursing
PHILIPPINE HEALTH AGENDA 2016-2022
Healthy Philippines 2022
GOALS

The Health System We Aspire For

FINANCIAL BETTER HEALTH

RESPONSIVENESS
PROTECTION OUTCOMES
Filipinos, especially the Filipinos attain the Filipinos feel
poor, marginalized, and best possible health respected, valued, and
vulnerable are outcomes with no empowered in all of
protected from high
disparity their interaction with
cost of health care
the health system
2
VALUES

The Health System We Aspire For

EQUITABLE & INCLUSIVE TRANSPARENT &

TO ALL ACCOUNTABLE

USES RESOURCES PROVIDES HIGH

EFFICIENTLY QUALITY SERVICES
3
 During the last 30 years of Health Sector Reform, we have
undertaken key structural reforms and continuously built on
programs that take us a step closer to our aspiration.

Milestones

Devolution Use of Generics Milk Code PhilHealth (1995)

DOH resources to Fiscal autonomy Good Governance Funding

promote local for government Programs for UHC
health system hospitals (ISO, IMC, PGS)
development
 Persistent Inequities in Health Outcomes

2000
Every year, around A Filipino child born to the Three out of 10
2000 mothers die due poorest family is 3 times children are
to pregnancy-related more likely to not reach his stunted.
complications. 5th birthday, compared to
one born to the richest
family.
5
 Restrictive and Impoverishing Healthcare Costs

Tiisin ko na
lang ito..

Every year, 1.5 million Filipinos forego or delay Php 4,000/month

families are pushed to care due to prohibitive healthcare expenses
poverty due to health and unpredictable user considered
care expenditures fees or co-payments catastrophic for single
income families
6
 Poor quality and undignified care synonymous
with public clinics and hospitals

Limited autonomy Less than hygienic restrooms,

Long wait times to choose provider lacking amenities

Privacy and confidentiality Poor record-keeping Overcrowding &

taken lightly under-provision of care
7
 Lahat Para sa Kalusugan!
Tungo sa Kalusugan Para sa Lahat
 • UNIVERSAL HEALTH
COVERAGE

• STRENGTHEN
IMPLEMENTATION OF
RPRH LAW

Investing in People • WAR AGAINST

DRUGS

• ADDITIONAL
Protection Against FUNDS FROM
Instability PAGCOR
 ATTAIN HEALTH-RELATED SDG TARGETS
Financial Risk Protection | ttain  Health-­Related  SDG  Targets
Goals:  A Better Health Outcomes | Responsiveness
Financial  Risk  Protection,  Better  Health  Outcomes,  Responsiveness
Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience
Values:  Equity,  Efficiency,  Quality,  Transparency

SERVICE  DELIVERY  
NETWORK

3 Guarantees ALL  LIFE  STAGES  &  

TRIPLE  BURDEN  OF  
DISEASE

UNIVERSAL  
HEALTH  
INSURANCE

A C H I E V E
 GUARANTEE #1

ALL LIFE STAGES &

TRIPLE BURDEN OF DISEASE
Services for Both the Well & the Sick
Guarantee 1: All Life Stages & Triple Burden of Disease
Pregnant Newborn Infant Child Adolescent Adults Elderly

First 1000 days | Reproductive and sexual health | maternal, newborn,

and child health | exclusive breastfeeding | food & micronutrient
supplementation | Immunization | Adolescent health | Geriatric Health
| Health screening, promotion & information

NON-
DISEASES OF RAPID
COMMUNICABLE COMMUNICABLE
URBANIZATION &
DISEASES DISEASES & INDUSTRIALIZATION
MALNUTRITION
12
Guarantee 1: All Life Stages & Triple Burden of Disease

NON-
DISEASES OF RAPID
COMMUNICABLE COMMUNICABLE
URBANIZATION &
DISEASES DISEASES & INDUSTRIALIZATION
MALNUTRITION

• HIV/AIDS, TB, Malaria • Cancer, Diabetes, Heart • Injuries

• Diseases for Elimination Disease and their Risk • Substance abuse
• Dengue, Lepto, Factors – obesity, • Mental Illness
Ebola, Zika smoking, diet, • Pandemics, Travel Medicine
sedentary lifestyle • Health consequences of
• Malnutrition climate change / disaster

13
 GUARANTEE #2

SERVICE DELIVERY NETWORK

Functional Network of Health Facilities
Guarantee 2: Services are delivered
by networks that are
FULLY FUNCTIONAL
(Complete Equipment, PRACTICING
Medicines, Health GATEKEEPING
Professional)

COMPLIANT WITH LOCATED CLOSE

CLINICAL PRACTICE TO THE PEOPLE
(Mobile Clinic or Subsidize
GUIDELINES Transportation Cost)

AVAILABLE 24/7 &

ENHANCED BY
EVEN DURING
TELEMEDICINE
DISASTERS
15
 GUARANTEE #3

UNIVERSAL
HEALTH INSURANCE
Financial Freedom when Accessing Services
Guarantee 3: Services are financed predominantly by PhilHealth

• 100%  of  Filipinos are  members

PHILHEALTH  AS  THE  
• Formal  sector premium  paid  through payroll  
GATEWAY  TO  FREE  
• Non-­formal  sector  premium  paid  through  tax  
AFFORDABLE  CARE
subsidy

SIMPLIFY •No  balance  billing  for  the  poor/basic  

PHILHEALTH accommodation  &  Fixed  co-­payment
RULES   for  non-­basic  accommodation

PHILHEALTH  AS  MAIN   • Expand  benefits  to  cover  comprehensive

REVENUE  SOURCE   range  of  services
FOR  PUBLIC  HEALTH   • Contracting  networks of  providers  within  
CARE    PROVIDERS SDNs
17
 Our Strategy
A Advance quality, health promotion and primary care

C Cover all Filipinos against health-related financial risk

H Harness the power of strategic HRH development

I Invest in eHealth and data for decision-making

E Enforce standards, accountability and transparency

Value all clients and patients, especially the poor,
V marginalized, and vulnerable
Elicit multi-sectoral and multi-stakeholder support for
E health
18
A Advance quality, health promotion and primary care

1. Conduct annual health visits for all poor families and

special populations (NHTS, IP, PWD, Senior Citizens)
2. Develop an explicit list of primary care entitlements that
will become the basis for licensing and contracting
arrangements
3. Transform select DOH hospitals into mega-hospitals with
capabilities for multi-specialty training and teaching and
reference laboratory
4. Support LGUs in advancing pro-health resolutions or
ordinances (e.g. city-wide smoke-free or speed limit
ordinances)
5. Establish expert bodies for health promotion and
surveillance and response
C Cover all Filipinos against health-related financial risk

1. Raise more revenues for health, e.g. impose health-

promoting taxes, increase NHIP premium rates, improve
premium collection efficiency.
2. Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with
PhilHealth
3. Expand PhilHealth benefits to cover outpatient diagnostics,
medicines, blood and blood products aided by health
technology assessment
4. Update costing of current PhilHealth case rates to ensure that
it covers full cost of care and link payment to service quality
5. Enhance and enforce PhilHealth contracting policies for
better viability and sustainability
H Harness the power of strategic HRH development

1. Revise health professions curriculum to be more

primary care-oriented and responsive to local and
global needs
2. Streamline HRH compensation package to
incentivize service in high-risk or GIDA areas
3. Update frontline staffing complement standards
from profession-based to competency-based
4. Make available fully-funded scholarships for HRH
hailing from GIDA areas or IP groups
5. Formulate mechanisms for mandatory return of
service schemes for all heath graduates
I Invest in eHealth and data for decision-making

1. Mandate the use of electronic medical records in all health

facilities
2. Make online submission of clinical, drug dispensing,
administrative and financial records a prerequisite for
registration, licensing and contracting
3. Commission nationwide surveys, streamline information
systems, and support efforts to improve local civil
registration and vital statistics
4. Automate major business processes and invest in ware-
housing and business intelligence tools
5. Facilitate ease of access of researchers to available data
E Enforce standards, accountability and transparency

1. Publish health information that can

trigger better performance and
accountability
2. Set up dedicated performance
monitoring unit to track
performance or progress of reforms
 Value all clients and patients, especially the poor,
V marginalized, and vulnerable

1. Prioritize the poorest 20 million Filipinos in all health

programs and support them in non-direct health
expenditures
2. Make all health entitlements simple, explicit and
widely published to facilitate understanding, &
generate demand
3. Set up participation and redress mechanisms
4. Reduce turnaround time and improve transparency
of processes at all DOH health facilities
5. Eliminate queuing, guarantee decent
accommodation and clean restrooms in all
government hospitals
E Elicit multi-sectoral and multi-stakeholder support for health

1. Harness and align the private sector in planning

supply side investments
2. Work with other national government agencies to
address social determinants of health
3. Make health impact assessment and public health
management plan a prerequisite for initiating
large-scale, high-risk infrastructure projects
4. Collaborate with CSOs and other stakeholders on
budget development, monitoring and evaluation
 ATTAIN HEALTH-
SERVICE DELIVERY RELATED SDGs
NETWORK

ALL LIFE STAGES &

TRIPLE BURDEN OF
DISEASE

UNIVERSAL
HEALTH
INSURANCE

Financial Risk Protection

Better Health Outcomes
Responsiveness