CHAPTER 1

OVERVIEW OF PHN IN THE PHILIPPINES

Global and country health imperatives
1. Shifts in demographic and epidemiological
trends in diseases
2. New technologies for health care,
communication, and information
3. Existing and emerging health hazards
4. Health reforms

The Philippines has poor performance in reducing

infant and maternal mortality

Epidemiologic shift while it is still contending

with the burden of communicable diseases, it is
also at the same time contending with noncommunicable diseases
Health

State of complete physical, mental, and social well

being, not merely the absence of disease or infirmity
Determinants of Health
1. Income and social status
2. Education
3. Physical environment
4. Employment and working conditions
5. Social support networks
6. Culture
7. Genetics
8. Personal behaviour and coping skills
9. Health services
10. Gender
Public Health

Science and art of preventing disease through

organized community effort for the sanitation of the
environment to ensure everyone a standard of living
adequate for the maintenance of health

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
Core business of public health:
1. Disease control
2. Injury prevention
3. Health protection
4. Healthy public policy
5. Promotion of health and equitable health gain
Public health nursing

Special field of nursing that combines the skills of

nursing and public health and functions as part of the
total public health programme for the promotion of
health and the improvement of the conditions in the
social and physical environment

Practice of nursing in the local/ national government

health departments and public schools
Community health nursing

Service rendered by a professional nurse with

clienteles at home, in health centers, and other
places for the promotion of health and prevention of
illness

Encompasses PHN
*The Standards differentiated PHN and CHN only in one area:
setting of work as dictated by funding
Public health nurses

Nurses in the local/ national health departments and

public schools regardless of their official position
titles
CHAPTER II
THE PHILLIPPINE HEALTH CARE DELIVERY SYSTEM
Sectors of PHCDS:
1. Public Sector largely financed through a taxbased budgeting system
2. Private sector largely market-oriented
Roles and Functions
According to E.O. 102:
1. Leaderhip in health
a. Serve a the national policy and
regulatory institution

b.

2.

3.

Provide leadership in the formulation

and monitoring of national health
policies and plans
c. Serve as advocate in the adoption of
health policies and plans
Enabler and capacity builder
a. Exercise oversight functions and
monitoring and evaluation of national
health plans and programs
b. Ensure the highest achievable
standards of quality health care and
health promotion
Administrator of specific services
a. Manage selected national health
facilities and hospitals with modern and
advanced facilities
b. Administer direct services for emergent
health concerns
c. Administer health emergency response
services

Vison
Health for all in the Philippines
Mission
Guarantee equitable, sustainable and quality health for all
Filipinos, especially the poor and shall lead the quest for
excellence in health
Goal: Health Sector Reform Agenda (HSRA)
Support mechanisms will be through sound organizational
development and strong policies
Rationale for health sector reform
1. Slowing down in the reduction in the infant mortality
rate and the maternal mortality rate
2. Persistence of large variations in health status
3. High burden from infectious diseases
4. Rising burden from chronic and degenerative
diseases
5. Unattended emerging health risks
6. Burden of disease is heaviest on the poor
Reasons for the above conditions:
1. Inappropriate health delivery system
2. Inadequate regulatory mechanisms for health
services
3. Poor health care financing and inefficient souring or
generation of funds for healthcare
Implications:
1. Poor coverage of public health and primary care
services
2. Inequitable access to personal health care services
3. Low quality and high costs of both public and
personal health care
Goals of FOURmula ONE for health:
1. Better health outcomes
2. More responsive health systems
3. Equitable health financing
Four elements of strategy:
1. Health financing foster greater, better and
sustained investments in health
2. Health regulation ensure the quality and
affordability of health goods and services
3. Health service delivery improve and ensure the
accessibility and availability of basic and essential
health care
4. Good governance enhance health system
performance at the national and local levels
National Health Insurance Program (NHIP) supports in terms
of:
1. Financing reduces the financial burden
2. Governance prudent purchaser of healthcare
3. Regulation accreditation and payments based on
quality acts
4. Service delivery fair compensation for the costs of
care
Inter local health system
A system of health care similar to a district health system in
which clients and healthcare providers participate together in
providing quality equitable and accessible healthcare with

inter local government unit (ILGU) partnership as the basic

framework
Composition of the Inter-local health zone:
1. People ideal health district wuld have a population
size between 1000,000 and 5000,000
2. Boundaries determine the accountability and
responsibility of healthcare providers
3. Health facilities
4. Health workers the right unit of health providers
Primary Healthcare

Essential healthcare made universally accessible to

individuals and families in the community by means
acceptable to them through their full participation
and at the cost that the community and country can
afford at every stage of development

Characterized by partnership and empowerment of

the people
Types of primary healthcare workers:
1. Village or baranggay health workers trained
community health workers
2. Intermediate level health workers general medical
practitioners or their assistants
Levels of healthcare and referral system
1. Primary level of care
a. Healthcare provided by center physicians
and public health nurses at the baranggay
health stations and rural health units
2. Secondary level of care
a. Given by physicians with basic health
training
b. Referral center for the primary health
facilities
c. Minor surgeries and minor laboratory
examinations
3. Tertiary level of care
a. Medical centers and regional and provincial
hospitals
b. Referral center for the secondary care
facilities
c. Complicated cases and intensive care
CHAPTER 3
THE PUBLIC HEALTH NURSE
Qualifications:
1. Professionally qualified and licensed
2. Must possess personal qualities and people skills
3. Physically, mentally, and emotionally strong
4. Leadership, resourcefulness, and creativity
5. Interest, willingness, and capacity to work with
people
Functions:
1. Management function
a. Planning, organizing, staffing, directing, and
controlling

b.

2.

3.

4.

5.

6.

7.

Organizes the nursing service of the local

health agency
c. Program management delivery of the
package of services provided by the
program to the target clientele
Supervisory function
a. Formulates a supervisory plan and conducts
supervisory visits to implement the plan
b. Supervisory checklist
Nursing care function
a. Caring for the client toward health
promotion and disease prevention
b. Adpie
c. Establishes rapport with client
d. Home visits
e. Referral of patients to appropriate levels of
care
Collaborating and coordinating function
a. Involved socialy and politically to empower
clients as an entity to initiate and maintain
health promoting environments
b. Establishes linkages and collaborative
relationships with other health professionals
c. Identifies resources available within and
outside the community in which can be
tapped in the implementation of healthcare
Health promotion and education function
a. Advocacy for the creation of a supportive
environment
b. Provides clients with information that allows
them to make healthier choices and
practices
c. Solid knowledge base, not only of theories
and models of the teaching/ learning
process but of general principles of
teaching/learning
Training function
a. Initiates the formulation of staff
development and training programs for
midwives and other auxiliary workers
b. Participates in the training of nursing and
midwifery affiliates in coordination with the
faculty of colleges of nursing and midwifery
Research function
a. Disease surveillance
b. Continuous collection and analysis of data of
cases and deaths
c. Measure the magnitude of the problem
d. Measure the effect of the control program