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COMMUNITY HEALTH NURSING (1)

Primary strategies to achieve goals
1. Increasing investment for primary health care
2. Development of national standards and objectives for health
3. Assurance of health care
4. Support to the local system development
5. Support for frontline health workers.

National Health Plan
Blueprint covering the period of 1995-2020

Health Sector Reform Agenda
Overriding goal of DOH

Fourmula one for health
Framework for implementation of HSRA

National objectives for health
It reflects MDG, MTPDP, HSRA and F1 vision and mission goals objectives

Health sector reform agenda
Reform areas:
1. Local health system development.
2. Hospital reforms
3. Public health program reforms
4. Health regulatory reform.
5. Social health R.A. 7875(PHILHEALTH)

SLOGAN for HSRA
TSK( tulong sulong sa kalusugan)
3 pillars:
1. Pagtutulunga/ mutual assistance
2. Pagsulong/ moving forward
3. Kalusugan para sa lahat/ health for all

FOURMULA 1 for health
Goals:
Better health outcome
More equitable health care financing
More responsive health system

Components:
Health financing
Health regulation
- Regulation of health services. Regulated.
Health service delivery
- Availability being accessible
Good governance in health

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-potical will.

Millieum Development Goals(MDGs)
Eradicate extreme provety and hunger
Achieve universal primary education
Promote gender quality and empower women
Reduce child mortatlity.
Improve maternal health
Combat HIV/AIDS, malaria, etc.
Ensure environmental sustainability
Develop global partnership for development.

Medium Term Philippine Devt Plan (MTPDP)
2004-2010
Spells out priority strategies to meet basic needs of the poor:
o Reduction of cost of medicines
o Expansion of health insurance
o Strengthening national and local health systems
o Improvement of health care management
o Improvement of health care productivity
o Establishment of drug treatment and rehabilitation corners.

Sentrong Sigla Movement
Main component
Certification and recognition program
(award)
Key strategies:
o Certification/recognition program - CRP
o Continuous quality improvement COI
Goals: Quality Heatlh
Objectives: better and more effective collaboration between DOH and LGUs(devolution)
DOH: as provider of technical and financial assistance packages for health care
LGU: prime developers of health systems and direct implementers of health programs
Pillars:
o Quality assurance
o Grants and technical assistance
o Awards
o Health promotion

2007 Philippine Health Situation
Pop. - 88.6million
91,868,309 projection population as of Aug. 2007
Life expectancy at birth 2004
Male 67.5
Median age 32
Depedency ratio 69

Leading cause of morbidity (2007)
1. Acute lower RTI and pneumonia
2. Diarrheas
3. Bronchitis /bronchiolitis

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4. Influenza
5. Hypertension
6. TB respiratory
7. Heart disease
8. Malaria
9. Chicken pox
10. Measles

Esperanza Cabral sec. of DOH

Mortality(2007)
1. Heart disease
2. Vascular system disease
3. Cancer
4. Accidents
5. Pneumonia
6. Tuberculosis
7. Ill defined and unknown cause of mortality
8. Chronic lower respiratory diseases
9. Diabetes
10. Prenatal conditions

Infant mortality
Bacterial sepsis
Maternal mortality
Other complication orelated to pregancny occulting in the course of labor
Lifestyle related disease
9 fil dies every hour
Dm biggest catastrophe the world has ever seen
Cancer is the most dreaded
Infectious and communicable disease
Sars, HIV, H1N1
74% were males

Health Care Delivery Systems
Public sector
o Government through taxes
Private sector
o Non government



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Municipal
Chairman of the board - MAYOR
Vice chair municipal health officer
Committee on Sangunian Sangbayan
DOH representative
NGO representative

Provincial
Governor
Provincial health officer
Committee on sangunian Sanlalawigan
DOH representative
NGO representative

Baranggay 3-5 km
Midwife

Municipal - 5000
Doctor, complete

Doctor
1:20000
Nurse
1:20000
Sanitary inspector
1:20000
Med tech
1:20000
Midwife
1:5000
Dentist
1:50000

Levels of primary health workers
1. Village/grassroots/barangay health workers
2. Intermediate level health workers
3. Health personnel of the 1
st
hospital facility

Levels of health facility
Primary
o First contact
o Icasiano
o Private practitioners
o Puericulture centers
o RHU
Secondary
o Simple lab., simple surgery
o City health services
o Emergency and district hospitals
Tertiary
o Complicated cases and tertiary care
o Lung Center

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o FEU NRMF

Primary Health Care
Essential health care made universal accessible to the family
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
Concept: partnership and empowerment of the people

Key strategies (SAPAC)
Self reliant
Active community participation
PARTNERSHIP WITH PEOPLE
Availability and accessibility
Community focus

First international conference on primary health care
September 6-12 ,1978
Alma Ata
150 members

Legal Basis:
Letter of instruction 949
October 19, 1979

Four cornerstone/Pillars in primary health care
Active community participation
Intra and inter-sectoral linkages
Use of appropriate technology
Support mechanism made available

PHC-essential services/Components
HOME ELEMENTS:
o Hospital as center for wellness
o Oral and dental health
o Mental health
o Elderly Care
o Education for health
o Local endemic disease prevention and control
o Expanded program on immunization
o Maternal child health family planning
o Essential drug
o Nutrition
o Treatment of communicable diseases and accidents
o Safe water and sanitation

DOH PROGRAM
Dental health program
Osteoporosis prevention
Health Education and community organizing
Primary health care
Reproductive health care

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Older persons health service
Guidelines for good nutrition
Respirator y infection control
Alternative health care
Maternal and child care
Sentrong sigla movement

Halamang Gamot/ Herbal Medicine
Decoction except bawang. Akapulko and niyog niyogan

Bayabas/Guava
o Diarrhea
o Toothache
o Washing wound
Ulasimang Bato/Peporni/Pancit Pancitan/
o Lowers uric acid
o Rheumatism
o Gout
Bawang/Garlic
o HPN
o Lowers cholesterol
o Toothache
Lagundi/five leave Chaster tree
o Asthma
o Fever
o Cough
Yerba Buena/pepermint
o Muscle pain
o Arthritis
o Rheumatism
o Cough
o Headache
Sambong/Camphor
o Anti edema
o Diuretic
o Anti Eurilitiasis(BATO)
Akapulko/ Ringwrom bush
o Antifugal
o Anti ringworm
Niyog niyogan/ Yesterday today and tomorrow
o Parasitism
o Anti-helmintic
o Ascariasis
Tsaang Gubat/Wild tea
o Stomach ache
o Diarrhea

Amplaya/ Bitter gourd
o Lowers blood sugar

Reminders:
When Boiling dont cover

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One kind of plant
No insecticide
Use clay pot
Stop if case of untoward reaction/ allergy occurs

Acupressure
Life is the result of Qi or life energy
When there is an imbalance of YIN and Yang forces, there is illness.
Yin feminine and negative
Yang masculine and positive
TSUN measurement

DONTS
Pregnant
Full of stomach
Heart illness

Acupuncture
Stimulating specific anatomic points called HSUEH

DONTS
Hemophilia
Pregnant
Heart illness

Aroma therapy
Based on olfactory stimuli used to help balance the DOSHAS, the mediators between physiologic and
psychologic process
Done often at night to induce sleep
Use of essential oils of plants of threat symptoms























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LEGISLATIONS OF HEALTH
E.O. 102 Redirecting function and operation of DOH
E.O 851 Reorganizing DOH
P.D. 568 Restructured HCDC
R.A. 4226 Hospital licensure
R.A. 7875 PHILHEALTH
R.A. 1082 Rural health unit act
R.A. 1054 Free emergency medical and dental treatment for employees
R.A. 8344 Penalizing hospital and clinics requiring deposit of payment
PD 654 Registration of death and birth in the Pphilippines
LOI 949 PHC
R.A 7160 Devolution code
R.A. 6758 Salary standard decision law
R.A. 7305 Magna Carta for health workers
R.A. 7277 Magna Carta for disabled person
R.A. 1080 Conversion of bar and board exam as civil service eligibility
LOI 000 Compulsory membership to personal association accredited by
R.A 7432 Senior citizen act
R.A. 9257 EXPANDED Senior citizen Act of 2003
R.A. 8353 Anti rape law
R.A. 7877 Anti sexual harassment act of 1995
R.A. 9262 Anti Violence Against Women and Children
E.O 209 Family code of the Philippines
RA. 3573 Reporting of communicable disease
R.A. 4073 Liberalzing treatment of leprosy
R.A. 1136 Tb Law
R.A. 7719 National blood service act
PD No. 965 Family planning and responsible parenthood before marriage and license
R.A. 6365 National population policy
R.A. 7610 Special protection on child abuse
PDA 856 Sanitation code
R.A. 8749 Clean air act
R.A. 6969 No entry of nuclear and hazardous waste in the country
R.A. 9211 Anti tobacco smoking campaign
PD 996 EPI below 8 years old
Proclamation
6
Universal child immunization of UN
Proclamation
46
Polio eradication through immunization
PD 773 Knockout polio
RA 7846 Heap b
R.A. 9288 Newborn screening
R.A. 8972 Salt iodization nation wide
R.A. 8172 Asin law of the Phil
R.A. 8504 Prevention of AIDS and control
R.A. 8980 ECCD act of the Phil.
R.A. 7600 Breast feeding act and rooming in

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EO 51 Milk code of the Phil.
R.A.8976 Food fortification Act
R.A. 6675 Generic Act law
R.A. 6425 Dangerous drug act
R.A. 9165 Comprehensive drug act of 2002
R..A. 8423 Traditional and alternative medicine
PP 1407 March 3 1993 declares april 21 and may 19 1993 and every 3
rd
Wednesday of
January and February there after for 2years as national immunization day
RA. 7875 National health insurance act
R.A. 7885 Corneal transplantation act
RA 8191 National diabetic act
RA 8504 Aids prevention and control act
RA. 9173 Philippine nursing act of 2002
RA. 9255 Act allowing illegitimate children to use surname of their father



Quality of PHN positions
Supervising, PHN/ nurse supervisor at provincial level
o BSN, RN, MAN/ MPH and 5 years exp.
Nurse instructor II
o 3 years of exp, RN, MSN, special training for on nurse instructor
Regional training nurse
o BSN, RN, MAN, MPH, 6 years exp and 3 years of which is training for nursing
education
Nurse V
o BSN, RN, MAN, CHN administration and super vision 5 years exp in CHN 2 years of
which is supervisory position
Nurse VI / program supervisor
o BSN, RN MPH, MAN major in CHN administration and supervision 7 years exp
training.
Chief Nurse / Nurse VII
o RN, BSN, MPH, MAN major in CHN administration and supervision, 5 years exp in
CHN and 3 years of which either supervisory position or assistant chief nurse with
leadership ability.
Assistant Chief Nurse
o BSN, RN, MPH or MAN major in CHN administration and supervisor, 5 years exp in
CHN and 3 years of which is either supervisory position or assistant chief nurse with
leadership ability
Occupational Health Nurse
o BSN, RN, preferably with training units in occupational health nursing