Professional Documents
Culture Documents
CHN Notes Summary
CHN Notes Summary
CHN Notes Summary
Twitter: @nursehooman
Facebook: facebook.com/nurse.hooman
o 1877: women’s board of NY mission Community Health Nursing Historical Background in Philippines
established 1st visiting nurses
● 1901- Act 157, est. Board of Health of Philippines
History of Public Health ● 1905- Act 1407, est. Bureau of Health, under Department
of Interior
● Babylonians ● 1912- Fajardo Act (Act 2156) – Sanitary Division,
o Understood need for hygiene forerunner of present Municipal Health Offices; President
o Developed medical skills of Sanitary division took charge of 2 to 3 municipalities.
● Egyptians Philippine General Hospital sent 4 nurses to Cebu
o Developed variety of pharmaceutical ● 1914- School of Nursing rendered by Filipino Nurse
preparations employed by Bureau of Health in Tacloban, Leyte
o Constructed earth privies and public drainage ● 1915- Philippine Health Service; Reorganization Act 2462
system created. Office of Inspector General and Office of District
● Hebrew Mosaic Law Nursing headed by Dr. Rosario Pastor, a nurse and
o Maternal health, communicable disease physician
control, protection of food, water, waste and ● 1915-1918- Ms. Perlita Clark took charge of Public Health
sanitary disposal Nursing Works
● Greeks ● 1919- 1st Filipino Nurse Supervisor was appointed, 84
o Linked health to environment PHN’s assigned in 5 health stations
o Wealthy people value personal cleanliness, ● 1927- Office of District Nursing abolished and changed to
exercise, diet and sanitation Section of Public Health Nursing
● Romans ● 1930- Section for Nursing
o Viewed medicine from a community health and ● 1941- Outbreak of war, PHN’s were assisted to take care
social medicine perspective of sick and wounded
o Emphasized regulation of medical practice ● 1942- 31 nurses as POW’s at Bilibid Prison, released to
o Provision of pure water Director of Bureau and Health, Dr. Eusebio Aguilar
o Sewage systems, public food preparation ● 1948- 1st training center of Bureau of Health organized in
o Women visited and cared for the sick cooperation with Pasay City Health Department
● Christianity ● 1950- Rural Health Demonstration and Training Center by
o Brought idea of personal responsibility DOH
o Started the care for the sick ● 1958-1965- RA 977 abolished Division of Nursing
● Middle Ages o Annie Sand= nursing consultant, Office of
o Poor sanitary conditions Secretary of Health
o Increase in communicable diseases (cholera, ▪ Founded DOH National League of
bubonic plague, smallpox) Nurses Inc.
o Religious convents and monasteries o RA 977created 8 regional offices in country
established hospitals increased to 11 then to 16
o Started movement of health education and
personal hygiene
● Renaissance
o Health practices were influenced by
recognition of human dignity and worth
o Elizabeth Poor Law: established 1601, Primary Health Care (Basic Health Care)
guaranteed medical services to poor and lame
individuals Definition
● Industrial Revolution
o Advances in transportation 1.) World Health Organization: “essential health
o Religious women started to provide nursing care made universally accessible to individuals
care in institutions and homes and families by means acceptable to them,
through full participation and at cost that the
Milestones in history of public health community and country can afford at every
stage of development.”
● 1601- Elizabeth Poor Law
● 1617- Sisterhood of Dames de Charite organized by St. Conceptual Framework
Vincent de Paul
● 1789- Baltimore Health Department ● Goal: Health for all Filipinos and Health in the hands of th
● 1798- Marine Hospital Service, nuns visited poor epoeple by the year 2020
● 1813- Ladies Benevolent Society of Charleston, South ● Mission: to strengthen the health care system by
Carolina founded increasing opportunities and supporting conditions
● 1836- Lutheran deaconesses provided home visits in wherein people will manage their own health care.
Germany ● Concept: Primary Health Care (PHC) characterized by
● 1851- Nightingale visited Kaiserwerth, 3 months of partnership and empowerment of people shall permeate
nursing training as core strategy in effective provision of essential health
● 1855- Quarantine Board, established in New Orleans; services
beginning of tuberculosis campaign in US
● 1859- district nursing established by William Rathbone
Legal Basis
● 1860- Florence Nightingale Training School for Nurses
established in St. Thomas Hospital in London
● 1864- Beginning of Red Cross
Page | 3
Twitter: @nursehooman
Facebook: facebook.com/nurse.hooman
● Letter of Instruction (LOI) 949: signed on Oct. 19, 1979 by g. Establishment of community health
then Pres. Ferdinand E. Marcos organizations
● Historical Background h. Mass health campaigns and community
o 1974- WHO and UNICEF conducted a joint mobilization
study 4.) Self-reliance
o 1975- World Health Assembly passed a a. Community generates support for health care
resolution giving priority to the development of b. Mobilization of health resources
PHC c. Training of community leaders on leadership
o 1977- World Health Assembly decided that and managerial skills
main target of government and WHO is the d. Income-generating projects
attainment of the level of health that would 5.) Recognition of interrelation of health and development
allow or permit them to lead a socially and a. Convergence of health, food, nutrition, water,
economically productive life by year 2000 sanitation and population services
o September 6-12, 1978- 1st International b. Integration of PHC into national, provincial,
Conference on Primary Health Care in Alma municipal and barangay development plan
Ata, USSR 6.) Social Mobilization
o 1979- WHA launched global strategy to attain a. Establishment of effective health referral
health for all system
o 1980- PHC endorsed for implementation by b. Multi-sectoral and inter-disciplinary linkages
respective regional community c. Integration, Education, Communication (IEC)
support using multimedia channels
Why Philippines Adopted PHC d. Collaboration among government agencies,
non-government organizations and community
1.) magnitude of health problems groups
2.) inadequate and unequal distribution of health resources 7.) Decentralization
3.) increased cost of medical care a. Reallocation of budgetary resources
4.) isolation of health care activities from other b. Advocacy for political will and support
developmental activities c. Re-orientation of health profession
1.) Accessibility, acceptability, availability, and affordability of 1.) reorientation and reorganization by local government
health services code of 1991 or RA 7160
a. Health services are delivered where people live 2.) effective preparation and enabling process for health
and work action at all levels
b. Development of indigenous or resident 3.) mobilization of people to know their communities and
volunteer health workers to provide health identify basic health needs
care with an ideal ration of 1:10-20 households 4.) development of utilization of technology
c. Use of low cost, appropriate technology 5.) organization of communities arising from needs
sustainable by community 6.) increase opportunities
d. Combined utilization of traditional medicines
and essential drugs Essential Components of Primary Health Care
2.) Partnership between community and health agencies in
provision of quality, basic and essential health services 1.) Multi-Sectoral Approach
a. Community needs and priorities are basic for a. Intrasectoral linkages
planning health services and activities b. Intersectoral linkages
b. Training curriculum of community health 2.) Community participation
workers I based on community health a. Identify problem
problems and task analysis of community b. Identify solution
health workers c. Mobilizing resources
c. Regular supervision and periodic evaluation of d. Barriers
community health workers’ performance by i. Lack of motivation
health staff to community ii. Indifference on part of community
d. Development of promotive, preventive, curative iii. Resistant to change
and rehabilitative care iv. Bureaucracy of government
e. Recognition of role and traditional healers in v. Lack of managerial skills
delivery of health services vi. Dependence on part of community
3.) Community Participation 3.) Appropriate Technology
a. Awareness building and consciousness raising a. 6 criteria:
on health and developmental issues i. effectiveness and safety
b. Community building and organizing ii. less complex
c. Planning, implementation, monitoring and iii. less costly
evaluation done by community iv. broader scope of technology
d. Community discussions done through small v. acceptability to local culture
group discussions vi. feasibility
e. Selection of community health workers by 4.) Community involvement
community a. Involvement level:
f. Foundation of health committees i. Individual
Page | 4
Twitter: @nursehooman
Facebook: facebook.com/nurse.hooman
ii. Family-monitor growth and ● Health Care System- organized plan of health services
development of child and able to ● Health Care Delivery- rendering services to people
address to problems in government ● Health Care Delivery System- network of health facilities
iii. Community- organizations formed to and personnel which carries out task of rendering health
promote health development care to people
● Philippine Health Care System- complex set of
Concepts of Primary Health Care organizations interacting to provide an array of health
services
1.) PHC represents supplementary health system ● RA 7160
2.) Equip community with capability to solve its own o Local Gov’t Code of 1991
problems by conducting trainings o Provides for decentralization
3.) Come into being only when community recognizes and o Places in local gov’ts to manage health care
accepts problems system
4.) Government officials don’t work in place of community
and vice versa Levels of Health Care Facilities
5.) Community involvement is the heart and soul of PHC
6.) Good health is related to living conditions and lifestyle 1.) Primary level
7.) Provide opportunity to underprivileged majority to a. Composed of barangay, municipal and
develop to an acceptable level medicare health facilities
a. Basic minimalistic needs: b. 1st contact emergency care
i. Food c. rural health units, chest clinics, malaria
ii. Clothing eradication units, schistosomiasis control units,
iii. Shelter and clean environment puericulture units, private clinics, company
iv. Health clincis
v. Education and information d. early symptomatic stage
vi. Security of life 2.) Secondary level
vii. Means of livelihood a. Consists of district health care institutions with
8.) Community must take its role and responsibility to capabilities and facilities for cases with
develop basic needs hospitalization
9.) PHC activities must be in harmony with existing b. Smaller non-departmentalized hospitals
institution including emergency and regional hospitals
10.) PHC activities must be flexible in its application 3.) Tertiary level
11.) Must be related to public health services and technical a. Highly technological and sophisticated services
support levels of public… b. Specialized centers, regional health care
institutions and provincial health care centers
Elements of Primary Health Care
Multi-Sectoral Approach to Health
1.) Education
2.) Locally Endemic Diseases ● Intersectoral
a. Filariasis o Sectors most closely related to health
b. Schistosomiasis o Agriculture, education, public works, local
3.) Essential basic drugs governments, social welfare, population
a. Cotrimoxazole control, private sectors
b. Amoxicillin ● Intrasectoral
c. Rifampicin
d. Isoniazid Restructured Healthcare Delivery System
e. Ethambutol
f. Paracetamol Rationale
g. Pyrazinamide
h. Oresol ● healthcare system serves only small portion of rural
i. Nifedipine population
4.) Maternal and Child Health Care ● diseases do not require sohphistication
5.) Expanded program of immunization ● some problems can be handled by other postiions besides
a. BCG- bacillus calmette guerin MHO (Municipal Health Officer)
b. OPV- oral polio vaccine
c. AMV- anti-measles vaccine Solutions
d. DPT- dyptheria pertussis tetanus
e. Anti-Hep B ● 3 levels of health care provided by RHU (rural health unit)
6.) Nutrition staff, with referral and supervisory system support
a. IDD- iodine deficiency disorder ● redefinition of roles and relationships among RHU staff
b. IDA- iron deficiency anemia ● establishment of satellite health centers in selected
c. PEM- protein energy malnutrition barangays
7.) Treatment of common diseases
8.) Safe water supply and sanitation Features of DOH reorganization
9.) Prevention and control of leading communicable diseases
10.) Promotion of dental health
● 1958- RA 1082
11.) Elderly and disabled’s physical and mental health
o 1st Rural Health Act
The Philippine Healthcare Delivery System
Page | 5
Twitter: @nursehooman
Facebook: facebook.com/nurse.hooman
Population
Health Promotion, Health Maintenance, and Disease Prevention
BHS Midwife BHS
BHW Health Promotion
● 1st use of term, health promotion- 1945, Henry E. Sigerist ▪ Heart of this process is
o Defined 4 major tasks of medicine Empowerment of communities
▪ Promotion of health ▪ Community development helps to
▪ Prevention of illness enhance self-help and social
▪ Restoration of the sick support, to develop flexible system
▪ Rehabilitation for strengthening public
o Sigerist: “Health is promoted by providing a participation in and direction of
good labor condition, education, physical health matters
culture and means of rest and recreation.” o Develop Personal Skills
▪ Concepts used and found in Ottawa ▪ Through providing information,
Charter for Health Promotion which education for health and enhancing
occurred 40 years later life skills
● 1986, WHO, Health and Welfare Canada and Canadian ▪ Enabling people to learn throughout
Public Health Association organized an International life, to prepare themselves for all of
Conference on Health Promotion its stages and to cope with chronic
o later known as Ottawa Charter illnesses and injuries
o Guiding principle in health promotion efforts o Reorient Health Services
currently ▪ Health services are shared among
individuals; community groups,
Ottawa Charter for Health Promotion health service institutions and
government
● “Process of enabling people to increase control over and
to improve their health”
● To reach a state of complete physical, mental and social
well-being , an individual or group must be able to
identify and to realized aspiration; to satisfy needs and to
change and cope with environment
● Health promotion is not just a responsibility of the health
sector, but goes beyond healthy lifestyles to well-being.
● Prerequesite for Health
o Peace
o Shelter
o Education
o Food
o Income
o A stable eco-system
o Sustainable resources
o Social Justice
o Equity
● In order to operationalize the concept of Health
Promotion, the Charter recommended the following areas.
o Build Health Public Policy
▪ Coordinated action that leads to
health, income and social policies
that foster greater equity
o Create Supportive Environment
▪ Societies are complex and
interrelated
▪ Overall guiding principle is the need
to encourage reciprocal maintenance
to take care of each other, our
communities and our natural
environment
▪ Conservation of natural resources
throughout world should be
emphasized as a global
responsibility
▪ Changing patterns of life; work and
leisure leave a significant impact on
health
▪ Systematic assessment of health
impact of rapidly changing
environment, especially in areas of
technology, works, energy
production and urbanization
o Strengthen Community Action
▪ Setting priorities, making decisions,
planning strategies and
implementing