ENTREPRE

NURSE
Year launched:2010
 APPROACH
Financing Care
Contracting
Organizing Delivery
Cooperative
Target geography
Rural
Target Population
General population
Target income level
Bottom 20%
Lower-middle income (20-40%)
Health focus
Primary care
PARENT ORGANIZATIONS
PHILLHEALTH
Government
Cooperatives Development Authority (CDA)
Department of Labor and Employment (DOLE) Region XI
Department of Health
Not-for-profit
Philippine Nurses Association (PNA)
 Summary

EntrepreNurse is a project initiated by the

Department of Labor and Employment (DOLE) to
facilitate nurse entrepreneurship by giving
opportunities to unemployed licensed nurses to
create cooperatives servicing health care needs of
the rural poor communities.
 PROGRAM GOALS

An initiative of DOLE, in collaboration with BON-

PRC, DOH, PNA, UPCN, OHNAP and other
government and non-government entities to
promote nurse entrepreneurship by introducing a
home health care industry in the Philippines.
 KEY PROGRAM COMPONENTS
In collaboration with Department of Health (DOH) and Philippine Health
Corporation, the project aims to engage unemployed nurses on
cooperatives and entrepreneurial management of nurses clinics that
offers reduced cost of primary and home health care services to indigent
or poor rural communities. These cooperatives can also market diagnostic
services and community based pharmacies like Botika ng Barangay.
The selection of areas must consider the business viability of
entrepreneurship. The business program design should be based on
actual needs of the community. EntrepreNURSE nurses shall organize
among themselves as an institution and/or organization (cooperative)
manning and running a business enterprise; all risk and benefits are
equally divided. The cooperatives deploy licensed nurses to poor rural
communities with little or no access to basic health care and with
substantial populations of sick, elderly and disabled patients on a one
nurse per month per village basis.
 The nurses will act both as health educator and
health care provider. Their services will be
compensated no less than P1,000 (approximately
USD 23) per visit by the local government unit
(LGU), PhilHealth, health maintenance
organizations (HMOs), by the patients themselves
on a per visit basis, or from grants from local and
foreign donors. Currently, DOLE is also providing
assistance in the form of grants to 5 piloted
cooperatives established in five provinces of
Region 11.
 The idea that nurses could engage in the independent
practice of nursing is allowed in both Republics Acts
7164 and 9173 which regulate the practice of
nursing, but somehow, something got lost in the
translation and all our nurses were encouraged to
achieve their dreams by working abroad. Project
Entreprenurse, an initiative of the Department of
Labor and Employment piloted in Davao, aims to
change the outlook of nurses in the country and help
them recognize that nurse entrepreneurship is a
viable option for them. Faced with bleak prospects of
formal employment in the local jobs market and
dwindling opportunities abroad, the nurses of Davao
have answered the call of the DOLE to engage in
nursing-related businesses for themselves, such as
 Nearly 500 nurses in Region 11 have now banded
together to form nurses cooperatives and are busy
complying with the requirements for registration with
the Cooperative Development Authority as a
cooperative.
After registration, they will be assisted by MASICAP to
put together business plans that they can use to ask
for grants from government and non-government
sources. Among the potential sources of revenues for
the cooperatives are the local government units,
Philhealths capitation fund, foreign donors and
migrant Filipino organizations abroad.
The DOH will be a critical partner as source of data
on the status of health services delivery in poor rural
communities. total support by Governor Rodolfo del
 PREVENTION
OF BLINDNESS
PROGRAM
 VISION:

All Filipinos enjoy the right to sight by year

2020
 MISSION:
The DOH, Local Health Unit (LGU) partners and
stakeholders commit to:
Strengthen partnership among and with stakeholder to
eliminate avoidable blindness in the Philippines;
Empower communities to take proactive roles in the
promotion of eye health and prevention of blindness;
Provide access to quality eye care services for all; and
Work towards poverty alleviation through preservation
and restoration of sight to indigent Filipinos.
 GOAL:

Reduce the prevalence of avoidable blindness in

the Philippines through the provision of quality
eye care.
General Objective No. 1: Increase
Cataract Surgical Rate from 730 to
2,500 by the year 2010

Specific:
Conduct 74,000 good outcome cataract surgeries by 2010;
Ensure that all health centers are actively linked to a
cataract referral center by 2008;
Advocate for the full coverage of cataract surgeries by
Philhealth;
Establish provincial sight preservation committees in at
least 80% of provinces by 2010;
Mobilize and train at least one primary eye care worker
per barangay by 2010;
 Mobilize and train at least one mid-level eye
care health personnel per municipality by 2010;
Improve capabilities of at least 500
ophthalmologists in appropriate techniques and
technology for cataract surgery;
Develop quality assurance system for all
ophthalmology service facilities by 2008; and
Ensure that 76 provincial,16 regional and 56
DOH retained hospitals are equipped for
appropriate technology for cataract surgery.
General objective no 2: Reduce visual impairment
due to refractive errors by 10% by the year 2010

1.Institutionalize visual acuity screening for all sectors

by 2010;
2.Ensure that all health centers are actively linked to
a referral center by 2008;
3.Distribute 125,000 eye glasses by 2010;
4.Ensure that the hospitals and of health centers have
professional eye health care providers by 2010;
5. Ensure establishment of equipped refraction centers
in municipalities by 2008; and
General objective no 3: Reduce the prevalence of
visual disability in children from 0.3% to 0.20% by the
2010

1.Identify children with visual disability in

the community for timely intervention;
2.Improve capability of 90% of health
worker to identify and treat visual disability
in children by 2010; and
3.Establish a completely equipped
primary eye care facility in municipalities
Interventions/Strategies employed or
Implementation by the DOH

1. Advocacy and Health Education

Thisincludes patient information and education,
public information and education and intersectoral
collaboration on eye health promotion and the
nature and extent of visual impairments
particularly its risk factors and complications and
the need/urgency of early diagnosis and
management.
2. Capability Building
Thiscomponent shall focus on ensuring the
capability of national and local government health
facilities in delivering the appropriate eye health
care services especially to the indigent sector of
the population. Program shall provide training for
coordinators at regional and provincial levels; will
ensure the availability of and access to training
programs by program implementers.
3. Information Management
The program shall develop an information
management system for purposes of reporting
and recording. As far as practicable, this system
shall consider and will build on any existing
mechanism. The system shall be national in
scope, although the mechanism shall consider
the regional and local needs and capabilities .
4. Networking, Partnership Building and
Resource Mobilization
An important component of the program is networking

and partnership building to ensure that services are
available at the local level. This shall include public-
private and public-public partnership aimed at building
coalition and networks for the delivery of appropriate eye
health care services at affordable cost especially to the
indigent sector. This component shall also focus on
ensuring that the highest appropriate quality services
are made available and accessible to the people.
7. Service Delivery
Service delivery for the prevention of Blindness Program

shall be covered by the principle of best practice. In
collaboration with the local government units and
stakeholders, the program shall develop systems and
procedures for the integration and provision of services at the
community level. This means primary eye prevention
concentrating on health education, advocacy and primary
eye interventions; Secondary prevention; screening/early
detection/basic management/ counseling, referral and/or
definitive care and tertiary prevention: management of
complications, continuing care and follow up including
rehabilitation.
The following areas will be the priority
areas for services to be provided by the
National Prevention of Blindness Program:
a.Cataract Surgeries
b. Errors of Refraction
c. Childhood Blindness
Cataract
Cataract, the opacification of the normally clear lens of
the eye, is the most common cause of blindness
worldwide. It is the cause in 62% of all blindness in the
Philippines and is found mostly in the older age groups.
The only cure for cataract blindness is surgery. This is
available in almost all provinces of the country;
however there are barriers in accessing such services.
Interventions will therefore consist of increasing
awareness about cataract and cataract surgery; as well
as improving the delivery of cataract services. The
parameter used worldwide to monitor cataract service
delivery is the Cataract Surgical Rate.
Errors of Refraction
Errors of refraction is the most common
cause of visual impairment in the country
(prevalence is 2.06% in the population).
Errors of refraction are corrected either with
spectacle glasses, contact lenses or
surgery. The services to address the
problem of EOR are provided mainly by
optometrists. However, the provision of the
eyeglasses or lenses (who should provide,
how is it provided, etc.) has to be
addressed.
Childhood Blindness

The prevalence of blindness among children

(up to age 19) is 0.06% while the
prevalence of visual impairment in the
same age group is 0.43%. The problem of
childhood blindness is the highly
specialized services that are needed to
diagnose and treat it. However, screening
of children for any sign of visual impairment
can be done by pediatricians, school clinics
 Future Plan/Action:
Development of Service Package for Prevention Blindness
Program
Development of Clinical Practice Guidelines for Prevention
Blindness Program
Development of Strategic Framework and a Five Year Strategic
Plan for Prevention Blindness Program (2012-2016)
Continue conduct of promotion and advocacy activities and
partnership with National Committee for Sight Preservation,
Specialty Societies and other stakeholders on PBP
Creation of PBP Registry System
Ensure the implementation of the National Prevention of
Blindness Program
 PERSONS WITH
DISABILITIES
HEALTH AND WELLNESS PROGRAM
FOR PERSONS WITH DISABILITIES
 BACKGROUND
Persons with disabilities (PWDs), according the UN
Convention on the Rights of Persons With Disabilities,
include those who have long-term physical, mental,
intellectual or sensory impairments which ininteraction
with various barriers may hinder their full and effective
participation in society on an equal basis with others.
The International Classification of Functioning, Disability
and Health (ICF) refers to disability as an umbrella term
covering impairments, activity limitations, and
participation restrictions. An impairment is a problem in
body function or structure; an activity limitation is a
difficulty encountered by an individual in executing a
task or action; while a participation restriction is a
 The ICFs definition of disability denotes a
negative interaction between a person (with a
health condition) and his or her contextual factors
(environmental and personal factors). A
comprehensive approach in interventions is then
necessary for persons with disabilities (PWDs) as
it entails actions beyond the context of health, but
more on helping them to overcome difficulties by
removing environmental and social barriers (WHO,
2013).
 The mandate of the DOH to come up with a national health
program for PWD was based on Republic Act No. 7277, An Act
Providing for the Rehabilitation and Self-Reliance of Disabled
Persons and Their Integration into the Mainstream of Society
and for Other Purposes or otherwise known as The Magna
Carta for Disabled Persons and the Implementing Rules and
Regulations (IRR) of RA 7277.
This document stipulated that the DOH is required to: (1)
institute a national health program for PWDs, (2) establish
medical rehabilitation centers in provincial hospitals, and (3)
adopt an integrated and comprehensive program to the Health
Development of PWD, which shall make essential health
services available to them at affordable cost. In response to
this, the DOH issued Administrative Order No. 2006-0003,
which specifically provides the strategic framework and
operational guidelines for the implementation of Health
Programs for PWDs.
 VISION:

A country where all persons with disability,

including children and their families, have
full access to inclusive health and
rehabilitation services.
 MISSION

A program designed to promote the highest

attainable standards of health and wellness
for PWDs by fostering a multi-sectoral
approach towards a disability inclusive
health agenda.
 OBJECTIVES
To address barriers and improve access and reasonable
accommodations of PWDs to health care services and
programs.
To ensure the accessibility, availability, appropriateness and
affordability of habilitation and rehabilitation services for
PWDs, including children with disabilities.
To ensure the development and implementation of policies
and guidelines, health service packages, including financing
and provider payment schemes for health services of PWDs.
To enhance capacity of health providers and stakeholders in
improving the health status of PWDs.
 To strengthen collaboration and synergy with and
among stakeholders and sectors of society to
improve response to a disability inclusive health
agenda through regular dialogues and
interactions.
To provide the mechanism in facilitating the
collection, analysis and dissemination of reliable,
timely and complete data and researches on
health-related issues of PWDs in order to develop
and implement evidence-based policies and
Action Framework for the Health and Wellness
Program of Persons with Disabilities

The Action Framework for the Health and Wellness

Program of Persons with Disabilities is adapted from
the three major objectives of the WHO Global Disability
Action Plan 2014-2021. As applied in the country,
program actions or interventions shall focus on the
following areas: 1) removal of barriers and
improve access to health services and programs;
(2) strengthening and expansion of
rehabilitation, habilitation, assistive technology,
and community-based rehabilitation; (3)
strengthen collection of relevant and
 Action Area 1:Removal of barriers and improve access to
health services and programs.People with disabilities, including
children, encounter a range of attitudinal, physical and systemic
barriers when they attempt to access health care such as physical
barriers related to the architectural design of health facilities or
health providers lack of adequate knowledge and skills in providing
services for persons with disabilities, among many others.
Action Area 2: Strengthening and expansion of
rehabilitation, habilitation, assistive technology, and
community based rehabilitation.Habilitation and rehabilitation
are sets of measures that assist individuals, who experience or are
likely to experience disability, to achieve and maintain optimal
functioning, in interaction with their environments. Encompassing
medical care, therapy and assistive technologies, they should begin
as early as possible and be made available as close as possible to
where people with disabilities live.
Action Area 3: Strengthening
collection of relevant and
internationally comparable disability
data and support disability
researches.Data is needed to strengthen
health care systems, as it informs policy
and interventions. These can be collected
through dedicated disability surveys, or
disaggregating data from other data