CHN CONCEPTS

R.A. 7160 - or the Local Government Code 

 This involves the devolution of powers, functions and responsibilities to the local
government both rural & urban. The Code aims to transform local government units
into self-reliant communities and active partners in the attainment of national goals
thru’ a more responsive and accountable local government structure instituted thru’
a system of decentralization. Hence, each province, city and municipality has a
LOCAL HEALTH BOARD (LHB) which is mandated to propose annual budgetary
allocations for the operation and maintenance of their own health facilities.

    Composition of LHB 

        Provincial Level 

1. Governor- chair
2. Provincial Health Officer – vice chairman
3. Chairman, Committee on Health of Sangguniang Panlalawigan
4. DOH representative
5. NGO representative

        City and Municipal Level 

1. Mayor – chair
2. MHO – vice chair
3. Chairman, Committee on Health of Sangguniang Bayan
4. DOH representative
5. NGO representative

        Effective Local Health System Depends on: 

1. The LGU’s financial capability

2. A dynamic and responsive political leadership
3. Community empowerment

R.A. 2382 – Philippine Medical Act. 

 This act defines the practice of medicine in the country.

R.A. 1082 – Rural Health Act. 

 It created the 1st 81 Rural Health Units.

 amended by RA 1891; more physicians, dentists, nurses, midwives and sanitary
inspectors will live in the rural areas where they are assigned in order to raise the
health conditions of barrio people ,hence help decrease the high incidence of
preventable diseases

R.A. 6425 – Dangerous Drugs Act 

 It stipulates that the sale, administration, delivery, distribution and transportation of

prohibited drugs is punishable by law.

R.A. 9165 – the new Dangerous Drug Act of 2002 

P.D. No. 651 

 Requires that all health workers shall identify and encourage the registration of all
births within 30 days following delivery.

P.D. No. 996 

 Requires the compulsory immunization of all children below 8 yrs. of age against the
6 childhood immunizable diseases.

P.D. No. 825 

 Provides penalty for improper disposal of garbage.

R.A. 8749 – Clean Air Act of 2000 

P.D. No. 856 – Code on Sanitation 

  It provides for the control of all factors in man’s environment that affect health
including the quality of water, food, milk, insects, animal carriers, transmitters of
disease, sanitary and recreation facilities, noise, pollution and control of nuisance.

R.A. 6758 

 Standardizes the salary of government employees including the nursing personnel.

R.A. 6675 – Generics Act of 1988 

 Which promotes, requires and ensures the production of an adequate supply,

distribution, use and acceptance of drugs and medicines identified by their generic
name.

R.A. 6713 – Code of Conduct and Ethical Standards of Public Officials

and Employees 

 It is the policy of the state to promote high standards of ethics in public office. Public
officials and employees shall at all times be accountable to the people and shall
discharges their duties with utmost responsibility, integrity, competence and loyalty,
act with patriotism and justice, lead modest lives uphold public interest over personal
interest.

R.A. 7305 – Magna Carta for Public Health Workers 

 This act aims: to promote and improve the social and economic well-being of health
workers, their living and working conditions and terms of employment; to develop
their skills and capabilities in order that they will be more responsive and better
equipped to deliver health projects and programs; and to encourage those with
proper qualifications and excellent abilities to join and remain in government service.

R.A. 8423 

 Created the Philippine Institute of Traditional and Alternative Health Care.

P.D. No. 965 

 Requires applicants for marriage license to receive instructions on family planning

and responsible parenthood.

P.D. NO. 79 

 Defines, objectives, duties and functions of POPCOM

RA 4073 

 advocates home treatment for leprosy

Letter of Instruction No. 949 

 legal basis of PHC dated OCT. 19, 1979

 promotes development of health programs on the community level

RA 3573 

 requires reporting of all cases of communicable diseases and administration of

prophylaxis

Ministry Circular No. 2 of 1986 

 includes AIDS as notifiable disease

R.A. 7875 – National Health Insurance Act 

R.A. 7432 – Senior Citizens Act 

R. A. 7719 - National Blood Services Act 

R.A. 8172 – Salt Iodization Act (ASIN LAW) 

R.A. 7277- Magna Carta for PWD’s \

 provides their rehabilitation, self development and self-reliance and integration into
the mainstream of society

A. O. No. 2005-0014- National Policies on Infant and Young Child

Feeding: 

1. All newborns be breastfeed within 1 hr after birth

2. Infants be exclusively breastfeed for 6 months.
3. Infants be given timely, adequate and safe complementary foods
4. Breastfeeding be continued up to 2 years and beyond

EO 51- Phil. Code of Marketing of Breast milk Substitutes 

R.A. - 7600 – Rooming In and Breastfeeding Act of 1992 

R.A. 8976- Food Fortification Law 

R.A. 8980 

 promulgates a comprehensive policy and a national system for ECCD

A.O. No. 2006- 0015 

 defines the Implementing guidelines on Hepatitis B Immunization for Infants

R.A. 7846 
  mandates Compulsory Hepatitis B Immunization among infants and children less
than 8 yrs old

R.A. 2029 

 mandates Liver Cancer and Hepatitis B Awareness Month Act (February)

A.O. No. 2006-0012 

 specifies the Revised Implementing Rules and Regulations of E.O. 51 or Milk Code,
Relevant International Agreements, Penalizing Violations thereof and for other
purposes
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
o Applies theoretical concepts as basis for decisions in practice
2. Data Collection
o Gathers comprehensive, accurate data systematically
3. Diagnosis
o Analyzes collected data to determine the needs/ health problems of IFC
4. Planning
o At each level of prevention, develops plans that specify nursing actions unique
to needs of clients
5. Intervention
o Guided by the plan, intervenes to promote, maintain or restore health,
prevent illness and institute rehabilitation
6. Evaluation
o Evaluates responses of clients to interventions to note progress toward goal
achievement, revise data base, diagnoses and plan
7. Quality Assurance and Professional Development
o Participates in peer review and other means of evaluation to assure quality of
nursing practice
o Assumes professional development
o Contributes to development of others
8. Interdisciplinary Collaboration
o Collaborates with other members of the health team, professionals and
community representatives in assessing, planning, implementing and
evaluating programs for community health
9. Research
o Indulges in research to contribute to theory and practice in community health
nursing
 Rabies Awareness month- March,
 There are 6 principles of community organizing such as principle of leadership, principle of evaluation,
principle of structure, principle of needs, principle of participation and principle of communication.
 Dependency ratio compares the number of economically dependent with the economically productive group
in population
 There are 4 core business of public health these are disease control, health protection, health public policy
and injury prevention.
 Primary prevention is directed to the healthy population, focusing on prevention of emergence of risk factors
and removal of the risk factors or reduction of their levels. Operation Timbang is done to identify members of
the susceptible population who are malnourished.
 C. E Winslow, the goal of Public Health is for the people to attain their bright rights of health and longevity.
 RA 9288- NBS
 N the EPI, fever up to 38.5 degrees C is not a contraindication to immunization. Mild acute respiratory tract
infection, simple diarrhea and malnutrition are not contraindication either.
 Health regulation aims to ensure quality and affordability of health services. Health financing aims to sustain
investments in health. Health service delivery aims to improve and ensure accessibility and availability of
basic and essential health care. Good governance aims to enhance the performance of the health sector.
 here are four pillars of primary health care, these are the active community participation, support mechanism
made available, use of appropriate technology and intro and intra-sectoral linkages.
 Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to infants aged 6 to 12
months. 10,000 IU is the dose for pregnant women
