NCM113 LEC 3.

COMMUNITY HEALTH NURSING PROCESS

1.2 Purpose of community assessment

OUTLINE 1. Identify strengths and deficiencies in relation to
1. Components of community preventive health practices.
1.1. Why assess the community? 2. Determine if structural or process characteristics
1.2. Purpose of community assessment within this system impede preventive health programs.
1.3. Methods for assessing [@] Who are the formal or informal leaders?
1.4. Tools/Sources for assessing community [@] How is the system being implemented
health needs [@] What about the processes they are
1.5. Factors to consider in assessment implementing.
2. What is community diagnosis? 3. Improve the quality of preventive and health promotive
2.1. What is it all about? activities when deficiencies are identified.
2.2. OF community diagnosis 1.3 Methods for assessing
2.3. Comprehensive community diagnosis 1. Community assessment tool
2.4. Elements of a comprehensive community ○ Used to obtain a comprehensive community
diagnosis profile.
2.4.1. Demographic variables 2. Analyze available statistics
2.4.2. Socio-economic and cultural ○ Census tract data
variables ○ Vital statistics
2.4.3. Health and illness patterns ○ Health statistics
2.4.4. Health resources 3. Carry out survey
2.4.5. Political/Leadership patterns ○ Why is there a need to conduct surveys?
2.5. Problem- oriented community diagnosis ○ A community survey is a systematic study
3. Two types of data and how summarize data designed to collect data about a community’s
4. Priority setting functioning.
5. Planning cycle ○ This process, though timely and consuming, can
6. Conducting community diagnosis (Factors to provide essential data for health programming.
consider) ○ Ways:
7. Tools in Community Assessment ■ Personal interviews
7.1. Demography ■ Telephone interviews
7.2. Vital statistics ■ Questionnaires
7.3. Epidemiology [@] Conduct house to house surveys
8. Theories of disease causation 4. Conduct focus interviews
8.1. Supernatural theory ○ The focus group discussion or interview is a
8.2. Ecological theory qualitative approach to learning about population
8.3. Germ theory subgroups with respect to conscious,
8.4. Multiple causation theory semi-conscious, unconscious psychological and
LEGENDS cultural characteristics and processes.
5. Conduct research
No logo - From PPT [@] - Prof’s Notes [$] - From Book
○ To document the effectiveness of nursing service
and to identify cause-and-effect relationships.
1.Components of community assessment ○ Can help identify community needs and to
● This will include all of the components of a community propose interventions strategies that best meet
assessment and how to do it properly. these needs.
1.1 Why assess the community? 6. Contact key informants
○ Can help community nurses understand why
1. Every community has patterns of functioning that there is resistance to certain health programs,
either contribute to or detract from its state of health. how to reduce resistance to change, and with
2. Recognizing these patterns is imperative in order to whom nurses might work to enhance their
anticipate community response to health action and to productivity.
influence the direction of health programming.

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
○ Directors of housing projects, clergy, 2.1 What is it about?
professionals in other health agencies, local 1. Data about community ⇒ Health of the population.
politicians, owners of long-established 2. The data collected is collectively analyzed and
businesses, unofficial community spokesperson. explanations are sought for the occurrence of health
[@] What are the dynamics and needs and problems of the community.
relationships that can be observed in the 3. The community health nursing diagnoses are derived
community? and become the bases for developing and
[@] How do the community leaders implementing community health nursing interventions
engage the community and strategies that improve health and quality life of
[@] May be formal or informal the community
7. Observe, listen, analyze 4. The community diagnosis is a reflection of the health
○ “What the environment looks like when the nurse status of the community
drives in the locality, how families are dressed 5. Community participation in community assessment is
when they are seen in the clinic settings, and who essential
relates to whom during community meetings [@]Make them feel involved and empowered
provide clues about a community’s state of
health.” 2.2 Two types of Community Diagnosis
[@] More on observation, no need to 1. Comprehensive community diagnosis
provide questionnaires 2. Problem-based
1.4 Tools/Sources for Assessing Community Health Needs 2.3 Comprehensive Community Diagnosis
1. Literature review ● Aims to obtain general information about the
2. National and local policy documents community.
3. Demographic and epidemiological data 2.4 Elements of a Comprehensive Community Diagnosis
4. Focus group transcripts ● Demographic Variables
5. Previously conducted community surveys ● Socio-economic and Cultural Variables
6. Participant observation data ● Health and illness patterns
7. Community leaders and experts documents ● Health resources
8. Survey results of community members ● Political/Leadership patterns
1.5 Factors to Consider in Assessment 2.4.1 Demographic variables
1. Communication ● Total population and geographical distribution
[@] May depend on who we are talking to including urban-rural index and population density
2. Personal space ● Age and sex composition
[@] Provide a space wherein the participants are ● Selected vital indicators such as growth rate, crude
able to express their ideas birth rate, crude death rate and life expectancy at birth
3. Reactions to authority ● Patterns of migration
[@] Not to react or argue ● Population projections
4. Social organization 2.4.2 Socio-economic and cultural variables
[@]Organizations that help the community; their
programs and how they ask participation from the ● Social indicators
community ○ Communication network (whether formal or
5. Perception of time informal)
[@] Mindful that people in the community are busy, ■ Transportation system including road
doing household activities, work, other livelihood networks (accessibility and means of
[@] People in community are engaged on their transportation)
work or jobs ■ Educational level (average educational
attainment)
2. Community Diagnosis ■ Housing conditions (common materials
● Community diagnosis or community assessment or used)
situational analysis is a process [@] light materials or concrete?
[@]letting them fill up the questionnaire or form [@] Is the size enough for the family members?
and bring them to a higher level. Being involved in [@] Is it conducive for living?
assessing the barrier. Identifying the strengths in
the planning and identification of solutions and
programs that may improve their health.

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
● Economic indicators 2.4.3 Health and illness patterns
○ Poverty level income ● Leading causes of mortality
○ Unemployment and underemployment rates ● Leading causes of morbidity
○ Proportion of salaried and wage earners to total ● Leading causes of infant mortality
economically active population ● Leading causes of maternal mortality
○ Types of industry present in the community ● Leading cause of hospital admission
○ Occupation common in the community
[@] Are there factories in the community? 2.4.4 Health resources
● Environmental indicators ● Manpower resources
○ Physical / geographical / topographical ○ Categories of health manpower available
characteristics of the community ○ Geographical distribution of health manpower
■ Land areas that contribute to vector ● Manpower-population ratio
problems ○ Distribution of health manpower according to
[@]Identifying if malaria is common to that health facilities (hospitals, rural health units, erc.)
place. ○ Distribution of health manpower according to
■ Terrain characteristics that contribute to to type of organization (government,
accidents or pose as geohazard zones non-government, health units, private)
■ Land usage in industry (ratio of rural to ○ Quality of health manpower
urban areas) ○ Existing manpower development/policies
■ Climate/season ○ Material Resources
○ Water supply ○ Health budget and expenditures
■ Population with access to safe, adequate ○ Sources of health funding
water supply ○ Categories of health institutions available in the
■ Source of water supply community (brgy health centers)
[@] Is it from a portable water supply or ● Hospital bed-population ratio
natural sources like wells? ○ Categories of health services available)
○ Waste disposal 2.4.5 Political/leadership patterns
■ % population served by daily garbage ● Power structures in the community (formal or
collection system informal)
■ % population with safe excreta disposal [@] What are the issues and events in that area? Do
system (how many have access to toilets) they have tribes there?
■ Types of waste disposal and garbage ● Attitudes of the people toward authority
disposal system ● Conditions/events/issues that cause social
○ Air, water and land pollution conflict/upheavals or that lead to social bonding and
■ Industries within the community having unification
health hazards associated with it ● Practices or approaches that are effective in settling
■ Air and water pollution index issues and concerns within the community
[@] People may encounter respiratory 2.5 Problem Oriented Community Diagnosis
hazards because they are exposed to gas or
etc. ● Type of assessment that responds to a particular need
● Cultural factors ● Records review-data may be obtained by reviewing
○ Variables that may break up the people into those that have been compiled by health or non-health
groups within the community such as: agencies from the government or other sources
■ Ethnicity ● Surveys and observations- can be used to obtain
■ Social class qualitative and quantitative data
■ Language ● Interviews can yield first-hand information
■ Religion ● Participant Observation is used to obtain qualitative
■ Race data
■ Political orientation ○ The process:
● Cultural beliefs and practices that ○ Collecting
affect health ○ Organizing
● Concepts about health and illness ○ Synthesizing
○ Analyzing
○ Interpreting

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
To facilitate data collation, the nurse must develop
categories for classification of responses making sure
that the categories are mutually exclusive and
exhaustive.
1. Data Presentation - will depend on the type of data
obtained
● Descriptive data is presented in narrative
reports
● Numerical data may be presented into
table or graphs
Steps in Conducting Community Diagnosis 2. Data Analysis
1. Determining the Objectives - the nurse decides on the - Aims to establish trends and patterns in
depth and scope of data she needs to gather terms of health needs and problems of
2. Defining the Study Population - The nurse identifies the the community
population group to be included in the study - It allows for comparison of obtained data
3. Determining the data to be collected - the nurse is with standard values
guided by the objectives in identifying the specific data 3. Identifying the Community Health Nursing
she will collect. She also decides on the sources of Problems
these data Categories of Health Nursing Problems
4. Collecting the Data - the nurse decides on the specific ● Health Status Problems - may be
methods depending on the type of data to be described in terms of increased or
generated decreased morbidity, mortality or fertility
○ Methods of Collecting Data ● Health-related problems - may be
■ Records review - data may be obtained by described in terms of the existence of
reviewing those that have been compiled by social, economic, environmental and
health or non-health agencies from the political factors that aggravate the
government or other sources illness-inducing situations in the
■ Surveys and Observations - can be used to community.
obtain both qualitative and quantitative data
4. Priority Setting
■ Interviews - can yield first hand information
● Criteria in Priority Setting
■ Participant observation - is used to obtain
○ Nature of the Problem Presented - the problems
qualitative data
are classified by the nurse as health status,
5. Developing the Instrument
health resources or health related problems
○ Most common instruments are:
○ Magnitude of the Problem - refers to the severity
■ Survey questionnaire
of the problem which can be measured in terms
■ Interview guide
of the proportion of the population affected by
■ Observation checklist
the problem
6. Actual Data Gathering
○ Modifiability of the Problem - refers to the
○ The nurse supervises the data collectors by
probability of reducing, controlling or eradicating
checking the filled-up instruments in terms of
the problem
completeness, accuracy and reliability of the
○ Preventive Potential - refers to the probability of
information collected.
controlling or reducing the effects posed by the
7. Data Collation
problem
○ Social concern - refers to the perception of the
population or the community as they are affected
3. There are two types of data that may be generated: by the problem
● Numerical Data - table and graphs 4. Report Back to the Community
● Descriptive Data

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
5. Determine the best way to address the needs that 7. Tools in Community Assessment
were identified
● It is essential that the community have 7.1 Demography (Why study demography?
input in the decision ● Knowing the population size allows the comparison of
6. Plan and implement the selected strategies population changes over time
The following summarizes the concepts of ● Helps rationalize the health programs or interventions
planning: to be provided
● Planning is futuristic ● Assists in finding reasons why or how population or
● Planning is change-oriented groups is influenced by a variety of factors resulting in
● Planning is continuous and dynamic process vulnerability to ill health
● Planning is flexible ● Focuses on three human event
● Planning is a systematic process ○ Changes in population size
5. The Planning Cycle ○ Population composition or structure
● Tools that can be used ○ Distribution of population in space
● Literature review ○ Methods of measuring population size
● National and local policy documents ■ Natural increase
● Demographic and epidemiological data ■ Rate of Natural Increase
● Focus groups ■ Absolute Increase
● Previously conducted community surveys ■ Relative Increase
● Participant observation ○ Methods of measuring population composition
● Community leaders and expert ■ Sex composition
● Surveys of community members ■ Age composition
6. Conducting Community Diagnosis ● Median age
● Factors to consider ● Dependency ratio
○ Communication [@] how many are there in a working age
■ Whether the culture values direct, explicit group
communication or prefers to communicate ■ Age and sex composition
indirectly or implicitly [@] Can be presented into a population pyramid
○ Personal space ○ Distribution of Population in Space
■ The amount of space required between ■ Urban-rural distribution
people so that they feel comfortable and not ■ Population density
that their space is being invaded ■ Crowding Index
○ Reaction to Authority 7.2 Vital Health Statistics and Health Indicators
■ Whether cultural rules prohibits speaking ● Use of Vital Statistics
openly to persons in authority ,or saying ○ Indices of the health and illness status of a
what they want to hear community
○ Social organization ○ Serves as bases for planning, implementing,
■ The strength or flexibility of familial and monitoring and evaluating community health
acquaintance ties nursing programs and services
○ Perception of time ● Essential Concepts
■ Does the culture perceive punctuality and ○ Rates
time efficiency as important or polite? Is ■ Shows the relationship between a vital
time perceived as less important than event and those persons exposed to the
relationships and interaction? occurrence of said event, within a given
area and during a specified unit of time

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
■ Is used to describe the relationship 2. Enabling - may favor the development of the
between two numerical quantities or disease
measures of events without taking 3. Precipitating - exposure to a specific disease
particular considerations to the time or agent or noxious agent may be associated with
place the onset of a disease or state
○ Ratios 4. Reinforcing - repeated exposure and unduly hard
○ Crude or General Rates work may aggravate an established disease or
○ Specific Rate state
○ Fertility rates ○ Theories of disease causation
■ Crude birth rate ■ Supernatural Theory
● A measure of one characteristic of the ● In early times, disease was thought
natural growth or increase of a to be brought about by wrath of Gods
population or due to the evil force of the
● General fertility rate Demons
○ Mortality Rate ■ Ecological Theory
■ Crude Death Rate ● In 463 BC, Hippocrates, who is
● A measure of one mortality from all considered to be the first
causes which may result in a decrease epidemiologist, advised people to
of population search the environment for the
■ Specific Mortality Rate cause of disease
● Deaths in a specific class/group ■ Germ Theory
● Cause of death rate ● Henle-Koch Postulates
● Infant mortality rate ○ Each disease will be caused by a
● Maternal mortality rate germ
● Proportionate mortality rate ○ Without that germ, the disease
● Swaroop’s Index will not be caused
● Case Fatality Rate ○ By introducing that germ, that
[@] Severity of a certain disease disease can be caused in
○ Morbidity Rates animals experimentally
■ Incidence Rate ○ And that germ can be isolated
■ Prevalence Rate from that sick animal
7.3 Epidemiology experimented with
● Purpose of epidemiology ■ Multiple Causation Theory
○ Understand disease causation ● Agent, host and environmental
○ Explain local disease pattern factors will act and interact
○ Describe natural history of disease synergistically an act as joint
○ Provide data for logical planning, implementation independent partners in causing the
and evaluation of health, programs and measures disease
● Cause of a disease ○ Interplay of the agent-host-environment in
○ Sufficient - cause inevitably produces the disease disease causation
(e.g. chronic cigarette smoking) ○ Agent - an element, substance, force, or a
○ Necessary - disease cannot develop in its situation which may server as stimulus to initiate
absence (e.g. TB Bacilli) or perpetuate a disease process
[@] a person may not get TB if not exposed to TB ■ Biologic agent - living organisms such as
Bacilli. virus, bacteria, animals
● Factors in causation ■ Nutritive agent - a substance providing
1. Predisposing - may create a state of nourishment, an excess or lack of which
susceptibility to a disease agent leads to disease

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 NCM113 LEC 3. COMMUNITY HEALTH NURSING PROCESS
■ Mechanical agent - forces resulting in 7. REFERENCES
tearing, crushing and penetration ● Molo J. (2021) CHN2 Module 3
■ Physical agent - forces of the physical
environment such as temperature,
atmospheric pressure, noise, radiation, or
light
■ Psychological agent - events/situations
that lead to anxiety
■ Chemical agent - a substance, man-made
or natural, with inherent capacity to destroy
life or impair health

[@] As healthcare professionals we need to know where we

should cut the chain.Susceptible: Patient with
comorbidities etc. Portal of entry of covid 19:Nose. MOT:
droplets. Portal of exit: Mouth

○ Host - an organism, simple or complex, capable

of being infected by a specific agent, here
specifically, a human being
■ Possession of HOST FACTORS can
increase one’s susceptibility
● Genetic endowment
● Age, sex, marital status, occupation
● race/ethnicity, religion
● Family size, social class membership
● Nutritional state and constitution
● Intercurrent infection
● Human behavior
● Personality type
● Resistance
○ Environment - the sum total of all external
conditions and influences
■ Community Reactions
● Sporadic
○ sometimes, lacks consistency
● Endemic
● Pandemic
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 NCM113 MODULE 6: PUBLIC HEALTH

[@] Access to healthcare facilities

○
■ For example in Mindanao, there are only
OUTLINE
level 3 hospitals meaning tatlong
1. What is Public Health hospitals lang ang kaya
2. What is Primary Health Care mag-accommodate ng health care (e.g
2.1. Factors that Affect the Community Health with ventilator) so na-imagine if
2.2. WHO Definition nag-breakout doon, mas mahihirapan
2.3. Components of Primary Health Care unlike in Manila na maraming hospitals
2.3.1. Adequate Nutrition ■ *One way to solve this issue is to
2.3.2. Health Education establish primary health care facilities in
2.3.3. Provision of Essential Drugs areas without one
2.3.4. MCH/FP ■ *Pag walang primary health care, lahat
2.3.5. Treatment of Common Disease dadagsa sa hospital, nadapa lang pupunta
2.3.6. Communicable Disease Control na sa agad sa St. Lukes,
2.3.7. Sanitation and Safe Water Supply makikipag-siksikan siya sa mga may
3. Why is Primary Health Care Important covid kahit nadapa lang
4. Social Determinants of Health ● [@] Making sure that there are structures and
4.1. Alma Ata Declaration accessible resources
5. Goal of Health System: Decentralization 2.2 WHO DEFINITION
6. Sustainable Development Goals
● Service delivery
LEGENDS ○ Comprehensive, promotive, protective,
No logo - From PPT [@] - Prof’s Notes [$] - From Book preventive, curative, rehabilitative, and palliative
care throughout the life course, strategically
prioritizing key health care services aimed at
1. WHAT IS PUBLIC HEALTH individuals and families
● Helping or providing nursing interventions to the ○ [@] Yung interventions given
community ○ [@] Services available to those who needs it
● Promotion and prevention ○ [@] Examples: Contraceptives, vaccines, School
2. WHAT IS PRIMARY HEALTH CARE health programs, sexual health, nutrition,
● A broader term which derives from core principles adolescent health
articulated by the World ● Policy
Health Organization which describes an approach ○ Addressing the broader determinants of health
to health policy and service provision that includes through evidence-informed public policies and
both services delivered to individuals (Primary actions all sectors (non health situations that
care services) and population - level “Public may affect health)
health-type” functions/interventions. ○ [@] Gusto maging policy analyst, making sure na
○ [@] It will affect the whole barangay kasi proper and in line with the goal
interconnected sila ○ [@] Policy analyst - people who make sure that
○ [@] Community prioritization applies like how it there are certain policies that will check and
does within the ER, triaging. create policies to fill the gaps in the health care
● Well-positioned to respond to rapid economic, system
technological, and demographic changes all of which ○ [@] All throughout the lifespan, sinusundan natin
impact health and well being sila dahil yun ang role ng primary health care
2.1 FACTORS THAT AFFECT THE COMMUNITY HEALTH that's why we develop certain policies to start or
improve new projects
● [@] Crowded town
● [@] Lack of resources upon conducting voluntary ● Advocacy
actions (e.g. vaccination sites) : community resources ○ empowering indiv, families, and communities to
● [@] Health care standards: If poor sanitation, mas optimize their health as advocates for policies
probable yung communicable diseases as co-developers of health and social services
● [@] Geographical and Socio Economic factors and as self-carers and care-givers to others
○ [@] Is this community na mayaman, mahirap, is ○ [@] Where health education is developed as well
this community na bahain or malapit sa taal as knowledge
volcano?

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 NCM113 MODULE 6: PUBLIC HEALTH
■ [@] Empowerment of families and ○ [@] Surveillance systems - people in the
health care workers community, do census based on certain cases
○ [@] Nurses are trained as part of the advocacy. (ex. measles)
○ [@] ESUs - Epidemiologic Surveillance Unit
(contact tracing)
○ [@] endemic diseases in the country
● Sanitation and safe water supply
○ [@] Supply for drinking and panligo
○ [@] WASH Programs (WAter, Sanitation and
Hygiene)+ NCDs
○ [@] Coordination with leaders to improve water
sanitation; educate the community how to proper
hand wash; hygiene

2.1.1 THERE ARE DIFFERENT LEVEL OF HOSPITAL

DEPENDING ON THE CAPACITY AND THE LEVEL OF
TECHNOLOGY
Figure No.1. “Components of PHC” ● [@] Pag district hospi : primary health care lang puro
[@] Basic health care needs generalized doctors no special doctors ( no thoracic
[@] Strengthens essential healthcare needs surgeon, puro ob and other general doctors) with 30
bed capacities
2.3 COMPONENTS OF PRIMARY HEALTH CARE
● [@] Secondary level hospital - provincial and municipal
● Adequate nutrition level, larger, has more technology, but is smaller than
○ [@] BNS - Barangay Nutrition Specialist; assess tertiary level hospitals.
and monitor the nutritional needs of the senior ● [@] Immunization is free pag galing sa health care
citizens center
○ [@] Clients at risk for malnutrition: children,
2.3.1 ADEQUATE NUTRITION
elderly and sick
○ [@] Programs in school: Feeding program ● [@] We follow nutri need throughout the lifespan
○ [@] Dapat yung mga pagkain nakalagay sa likod ● [@] Monitoring of the nutritional status of
yung nutritional values (ex. Fortified with children(feeding program sa school), pregnant women,
vitamins) and elderly
● Health Education ● [@] Kaya nga meron tayong barangay nutritionist
○ [@] Use of social media to educate people especially sa mga bata, low-under five mortality (onti
● Provision of essential drugs lang namamatay five years below) - indicator that a
● Immunization country is not weak, and indicator for healthy
○ [@] EPI - Expanded Program for Immunization (something)
○ [@] NIP schedule 2.3.2 HEALTH EDUCATION
○ [@] Required: OPV, BCG, MMR, DPT, MCV (free ● [@] Not just in the hospital, if you have campaign sa
vaccines) community, that is also a health education
○ [@] Recommended: Jap encephalitis, Flu vacc ● [@] Seminar or workshop type
○ [@] Free: Pneumo vaccine - senior citizens 2.3.3 PROVISION OF ESSENTIAL DRUGS
○ [@] SBV - HPV vaccine for grade 4
● [@] For common diseases such as hypertension,
○ [@] COVID 19 - LGU
pneumonia, tuberculosis, etc.
● MCH/FP
○ [@] Contraceptives ● [@] These are hyupertensive drugs, HIV drugs, EPV
○ [@] TB- TB DOTS drugs.
○ [@] HIV ● [@] Pero yung mga over the counter drugs, hindi siya
○ [@] Hypertension - amlodipine libre so kailangan under pa rin siya ng isang programa
● Treatment of common disease like HIV program or TB kaya libre makukuha sa health
○ [@] Non-communicable diseases: hypertension, center
diabetes 2.3.4 MCH/ FP (MATERNAL AND CHILD HEALTH AND FAMILY
○ [@] foley catheter care, ngt insertion, colostomy PLANNING
● Communicable disease control ● [@] Free sa health care center

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 NCM113 MODULE 6: PUBLIC HEALTH
● [@] Men and women can access resources and info
about family planning and programs
● [@] Common metrics to know if the healthcare system
for MCH is well: maternal mortality rate and under-five
mortality/morbidity rate
2.3.5 TREATMENT OF COMMON DISEASE
● [@] Know which cases of comm members u have no
knowledge about, example sepsis. Walang enough
knowledge sa sepsis, kaya dalhin sa ospital
2.3.6 COMMUNICABLE DISEASE CONTROL
● [@] We have agencies that are present to do
surveillance
● [@] Surveillance: Meaning “case finding”, like CCTV,
workers act to monitor and analyze patients’ cases.
This is also a prevention measure. - chinicheck yung
cases ng mga sakit sa population
● [@] Having a system to check or study on trends and
characteristics of the disease to know if there is a
chance to spread( etong brgy na to maraming nagka
dengue…… alam agad ng nag susurveillance na meron
outbreak)
● [@] Preventive measure
2.3.7 SANITATION AND SAFE WATER SUPPLY
● [@] The cleanliness of the water will affect the health
of the community
● [@] This is because of the water-borne communicable
disease that are present in the water
● [@] WASH program is (water, sanitation and hygiene)
Ensuring safe access to clean water.
3. WHY IS PRIMARY HEALTH CARE IMPORTANT?
● Primary health care is well-positioned to respond
economic, technological, and demographic changes,
all of which impeach health and well-being
○ [@] Should be flexible according to the needs of
the community
○ [@] Need to keep up with new technological
advances/innovations (ex. use of RT-PCR in
tuberculosis becuase it can also detect rifampicin
resistance; so pwede na rin ichange yung drug na
ibibigay sa patient)
● PHC approach draws in a wide range of stakeholders
of stakeholders to examine and change policies to
address the social, economic, environmental, and
commercial determinants of health and well-being
○ [@] When you say stakeholders, they are your key
actors from implementers down to tayo (normal
people). Involved as a functioning member of
society. Lahat tayo stake holder
○ [@] Evaluators and decision-makers
○ [@] Kaya may gobyerno especially we are in a
democratic country (e.g sila yung nag-iimplement
ng policies during COVID, they represent the
interests of the comm members)
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○ [@] BHWs are not nursing graduates, some are
midwives pero mostly mga volunteers lang. We are
devolved or decentralized.
4. SOCIAL DETERMINANTS OF HEALTH
● Social Determinants of Health (SDH) are the conditions
in which people are born, grow, work, live, and age, and
the set of wider set of forces and systems shaping the
conditions of daily life
○ Economic stability
○ Social and community context
○ Neighborhood and Environment
○ Health Care
○ Education
● Aside from health factors we have to look at
non-health factors such as educational attainment, the
type of healthcare system, neighborhood, environment,
social and community context, working conditions,
household condition, economic stability - may affect
health indirectly
● [@] If we have primary healthcare we are responding to
the health needs in an equal and efficient way.
● [@] Tayo as a nurse na nasa primary health care alam
na kaya pa solusyonan yung problems sa center if
dengue yung problem
Figure No.2 “Social Determinants of Health”
● Levels of Hospital
○ (differ in human resources, types of services,
number of beds, technology)
○ Primary hospital
■ general hospital, district hospital, they cover
cases na essential, general
○ Secondary hospital
■ municipal hospital, provincial hospital
■ Mas malaki, mas marami beds and meron
sya technology like xray oxygen tank,
defibrillator, compared sa primary hospital
○ Tertiary hospital
■ may MRI, CT scan, more diagnostic tech, lab,
may specialist. Ex. oncologists, repro doctors
 NCM113 MODULE 6: PUBLIC HEALTH
PAHINGA MUNA, ADHARA!
4.1 ALMA ATA DECLARATION
● Alma - Ata declaration wants the healthcare system to
be devolved meaning we expect or we assume na yung
healthcare system will respond to the needs. Dahil daw
i-ddevolved mas kilala yung mga nakatira sa paligid
and mas macoconsider yung iba-ibang needs. Kaya
mapapansin na iba yung health care management sa
Pasig and other cities/regions (e.g pagalingan ng
mayor this COVID-19 kasi sila yung in-charge and if not
handled properly by the LGUs, mas lalala yung
situation)
● [@] Strengthened family healthcare
○ Health for All/ Universal Healthcare
■ [@] Meaning dapat lahat may access sa basic
healthcare needs and it should be free. Hindi
dapat ma-burden yung mga tao sa
pag-access ng health care. Equal
distribution.
○ Primary Health Care
■ [@] Dapat free and di mabuburden yung mga
tao sa pag avail
○ Health a Fundamental Human Right
■ [@] No one will be denied. Must be present sa
community dahil walang pera or walang
insurance, di mo na ba ba bibigyan ng health
care service? HINDI. Bigyan padin kasi it is a
human right.
○ Universal healthcare
■ SDG 2023
○ Equity
■ Always has equity value in all provisions of
health (equitable quality care)
■ Same services; no differences in private and
public
■ Underserved community should have access
○ Appropriate Technology
■ For the more efficient primary health care;
should invest in appropriate technology
○ Inter-sectoral Approach
■ Continued partnership and collaboration
must apply
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■ [@] Hindi lang siya problem ng DOH dapat
continuous yung partnership and
collaboration ng DOH and LGUs
■ [@] PPP - Private Public Partnership
■ [@] Common collaborations: health sector
and education
○ Community in Participation
■ [@] Isa sa problem yan this pandemic kasi
hindi natin alam yung projects nila for
covid-19. We are all just passive kasi yung
iba di rin naman pumupunta sa kanila.
■ [@] Dapat naaaya natin or nassteer ang
community to engage in participation; we
should all do our parts as well
● Alma Ata, 1978:
○ The international Conference on Primary Health
Care calls for urgent action by all governments, all
health and development workers, and the world
community to protect and promote the health of all
the people of the world by the year 2000
● Alma Ata Declaration
○ Immunization against major infectious disease
■ [@] Expanded program for immunization
(EPI)- for 5 major diseases before primary
school
■ [@] Merong ibang recommended na vaccines
such as yung dengue, HPV. Iba yung
recommended sa mandatory. (Itong 5 major
disease, nakukuha na agad yan ng mga bata)
■ [@] Dengvaxia - naging controversial dati
kaya bumaba yung population na
nagpapa-vaccine
○ Health Education and promotion
○ Maternal and Child health care
■ Buntis is always part if screen and
surveillance
■ Monitor for their nutrition in health care
centers
○ Nutritional promotion and food supply
■ Dito aside from the barangay, meron din itong
follow-up sa school like feeding programs
kapag may malnourished ng program:
noodles fortified w/ vitamins and minerals
○ Immunization against Major infectious diseases
○ Provision and Control of locally endemic diseases
○ Appropriate treatment of common diseases and
injuries
○ Provision of essential drugs
■ Libre mga senior citizen ng pneumonia
vaccine sa health center yearly
○ Safe water and sanitation
5.GOAL OF HEALTH SYSTEM: DECENTRALIZATION
● Community-level and localization/decentralization
● Treating individuals and community as key actors in
the production of their own health and well being is
 NCM113 MODULE 6: PUBLIC HEALTH
critical for the understanding and responding to the ○ [@] Private hospitals should collaborate with the
complexities of our changing world LGU
○ [@] Meaning if we are devolved daw, we can ● Strengthening systems at the community and
equipped peripheral health facility level contributes to building
● Primary health care has been proven to be a highly resilience, which is critical for withstanding shocks to
effective and efficient way to address the main causes the health system.
and risks of poor health and well-being today, as well ○ [@] Not just the hospitals, other facilities such as
as handling the emerging challenges that threaten laboratories, lying-in clinics, pharmacies,
health and well-being tomorrow streetlights, roads, food sources, covid testing.
○ [@] Primary health care fails due to the lack of ■ [@] Molecular testing
proper use, staffing, and equipment. ● Five Principles of primary health care are
■ *The Covid pandemic have been handled in a ○ Accessibility
intersectoral manner, multiple departments ○ Public participation
of the government are involved in the ○ Health promotion
decision making of the health policies and ■ Health education
guidelines ○ Appropriate skills and technology
○ [@] The DOH are advisors for those decision ○ Intersectoral cooperation
makers in the government ■ [@] Partnership and collaboration
○ [@] E.g DOH is not centralized. Unlike in DEPED, ■ [@] IATF - mas lumalabas na mabigat yung
centralized yan. Lahat ng suweldo ng teachers sa economic response so si DOH ang
public school, galing lahat yan sa DEPED. But nagiimplement pero wala sila wall so
compared it to our nurses na willing pumunta sa magyeyes nalang kasi may corruption na din
barrio, walang masyadong may gusto na nangyayari
● Quality primary health care reduces total healthcare 6.SUSTAINABLE DEVELOPMENT GOALS
and improves efficiency by reducing hospital ● Collection of 17 global goals designed to be a
admissions “blueprint to achieve a better and more sustainable
○ [@] Very efficient yung sa UK kasi meron silang future for all”.
NHS (National Health Service) kaya maganda yung ○ Watch videos on youtube:
quality of care na napprovide sa patients; hindi ka ■ Laudato Si' animation | CAFOD
basta basta makakapunta sa hospital, kailangan ■ CAFOD channel - 3rd video:
pa dumaan sa NHS para mabigyan ka ng services https://youtu.be/o3Lz7dmn1eM
○ [@] Hindi nagkakaroon ng health care costs kasi ■ How covid 19 will affect sustainable
hindi severe sakit and hindi nasa tertiary health development goals / Global Citizen Explains
care facility https://www.youtube.com/watch?v=SmhEhq
○ [@] Na ttriage agad LAn8A
■ Triage means the assignment of degrees of ● SDG 2030
urgency to wounds or illnesses to decide the ○ Set in 2015 by the United Nations General
order of treatment of a large number of Assembly and intended to be achieved by the year
patients or casualties 2030
○ [@] Maliit lang yung time nila sa hospital ○ The 17 goals are all interconnected, and in order to
○ [@] Different levels of hospitals leave no one behind, it is important that we
■ Primary - <50 bed capacity achieve them all by 2030. Each SDG has target list
■ Secondary - District/general hospital ( and indicators
surgery, labs) ○ This agenda builds on the Millennium
■ Tertiary - big hospitals with complete Development Goalls which are 8 goals that UN
equipment and facilities member states signed in Sep 2000 to achieve
● Addressing increasingly complex health needs calls for targets to combat poverty, hunger, disease,
a multisectoral approach that integrates illiteracy, environmenttal degradation and
health-promoting and preventive policies, solutions discrimination against women by 2015
that are that are responsive to communities, and health ○ They address the global challenges we face,
services that are people-centered including those related to poverty, inequality,
○ [@] Multisectoral approach - usually dahil climate change, environmental degradation, peace
desentralize multi sector share with LGU; you have and justice.
representatives from department of energy,
department of health, etc.

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 NCM113 MODULE 6: PUBLIC HEALTH

PAHINGA MUNA, ADHARA!

HINGA MUNA, ADHARA!AHINGA MUNA, ADHARA!

Figure No.3 “Sustainable Development Goals”

Voluntary National Review 2019 (Philippine Development

plan)

Sustainability and Emphasizes the For education

inclusivity are synergies between - Alternative
both goals and government and Learning ● Partnership and Collaboration
principles that non- government System (for ○ To get to people to work together in order to
guide our actions out of school address problems or concerns that affect them
development youth ○ The fundamental core of good partnerships is
strategies the ability to bring together diverse resources in
ways that can together diverse resources in
For employment - To reduce For the climate ways that can together achieve more: more
Green Jobs Act inequality -the - Project impact, greater sustainability, increased value to
Incentivizes Conditional cash NOAH all
enterprises to Transfer provides exemplifies ○ The importance of partnership has been
offer jobs using targeted the recognized fully by the UN, by the business and
green production intervention to partnership by all leading institutions in international
practices; Mentor disadvantaged between the development
Me program of families;helping academe and ● Organizational relationship
DTI disadvantaged government in ○ Networking
municipalities. providing ■ CECAP program (Cervical Cancer
-4p’s timely weather Prevention Program) - they do training to
information health care centers or municipalities to do
for disaster cervical screening tests. If nakatrain na sila
preparedness; ng ilang group, kelangan nila magtrain ulit
ban on single ng another group (networking).
plastic use ○ Coordination
■ *Talk with an organization for you to deliver
For Peace justice and strong institutions - Bangsamoro a goal. Meaning di necessarily involved in
Law the implementation. Just facilitators.
■ [@] Indirect - teachers will screen and lists
To ensure effective of partnership - the Philippines has the people without vaccines
been conducting the Official Development Assistance ■ [@] School based programs: immunizations
Portfolio Review (teachers yung mag screen/sino yung may
- For monitoring and evaluation of SDG’s need but yung mag gagawa talaga yung
outcomes mga healthcare workers)
○ Collaboration
PPA

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 NCM113 MODULE 6: PUBLIC HEALTH
■ *Working together towards one
goal/outcome. The one who lead does
goals.
■ [@] Merged work (nutritionist, dentist and
nurse)
○ Coalition or multi-sector collaboration
■ [@] Kapag kelangan mo na iinvolve yung
ibang dept na di similar sayo. Example:
Rescue during natural disaster (flood). Di
lang heathcare providers need, need din ng
NDMMRC, and etc.

*PLEASE DO NOT REMOVE THIS PIC MUNA. TABLE FORM

PAHINGA MUNA, ADHARA!

● Partnership in SDG Era

○ Built on an understanding of the
interconnectedness of the prosperity of
business, society and the environment
○ All societal sectors (including business)
recognized as key development actors and part
of the solution.
■ *Play a role for our economy

Partnership Spectrum
-1st level (One direction)
○ Essential need for collaboration across societal ● LEVERAGE/EXCHANGE
sectors and need for holistic approach to tackle ○ One partner contributes to the work of
systemic challenges another, or partner exchanges resources,
○ Longer term investment required for to allow one or both partners to deliver
transformational and systemic change - this is a more.
very complicated phase, making sure that ■ [@] Exchanges of goods etc
everyone understand this is vague since there is ■ [@] Values and resources that it
many factors to consider creates in terms of partnership
○ Need for innovative approaches with greater ○ Often transactional, one way transfer or
long term potential to tackle complexity but reciprocal exchange of skills, knowledge,
greater risk of failure funding etc.
○ Emergent planning based on the coalescing of ○ Involves negotiation to maximize the
interests and local resources around particular gains of both sides
issues

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 NCM113 MODULE 6: PUBLIC HEALTH
○ VALUE CREATED ● APA citation guide. (2016).
■ Organisational value - Corporate http://www.bibme.org/citation-guide/apa/
Social Responsibility (CSR) ● Lipson, C. (2011). Cite right: A quick guide to citation
○ Applicable when: Each partner has styles – MLA, APA, Chicago, the sciences, professions,
something that is more valuable to the and more (2nd ed). United States of America: The
other than to themselves, resulting in net University of Chicago Press, Ltd., London.
gain on exchange. ● Ferraro, A. (Photographer). (2014). Liberty enlightening
○ [@] Giving a resource, corporate social the world [digital image]. Retrieved from
responsibility (magbibigay ng mga https://www.flickr.com/photos/afer92/
resources, charity) 14278571753/in/set-72157644617030616
2nd level
● COMBINE/INTEGRATE
○ Two or more partners combine their
resources to together deliver more than
each could deliver alone.
○ Characterized by co-generation, mutual
accountability, and innovative approaches
○ VALUE CREATED
■ Organisational Value
■ Mission Value
○ Applicable when: bringing together
complementary resources results in new
approaches delivering value to all.
○ [@] example is the combination and
integration of DOH and LGU
○ [@] COVAX facilities - idaan lahat ng
donations sa COVAX tapos sila na mag
didistribute

3rd level
● TRANSFORM
○ *Example: IATF
○ Multiple actors work together through
collective actions to tackle complex
challenges usually through system
transformation.
○ Involves multiple actors bringing together
unique and complementary resources, all
essential pieces of a jigsaw puzzle.
○ Requires multi-stakeholder dialogue to
understand the system and engage the
players required to make interventions.
○ Value created:
■ Organisational value
■ Mission value (contribute to
COVID response)
○ Applicable when: An issue is sufficiently
complex that a systems approach is
required to tackle it.
○ [@] Working on one goal
○ [@] Systemic goal
CITATION
● Please use APA format for in-text citations (Guiyab,
2021)
REFERENCES
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 NCM113 SCOPE OF NURSING PRACTICE
● The Philippine Board of Nursing is an administrative
body under the Professional Regulation Commission
OUTLINE
that regulates the practice of nursing in the
1. Code of Ethics of the Filipino Nurse Philippines
1.1. Nursing Code of Ethics
1.2. Philippine Board of Nursing 1.2.1 BOARD OF NURSING BOARD RESOLUTION NO. 220
1.2.1. Board of Nursing Board SERIES OF 2004
Resolution no. 220 series of
● Promulgation of the code of ethics for registered
2004
FIlipino nurses. (Roles and responsibilities of the
1.3. Qualification of Board Members
nurse)
2. Laws affecting Nursing Practice
● Its three primary purpose is to:
2.1. Legal Responsibilities of Nursing
1. Provide regulatory standards in the practice of
Students
Nursing by implementing the Nurse Practice Act
2.1.1. Liability for the Work of Nursing
and by lobbying to Congress any proposed
Students
amendment to any laws with direct relationship to
2.1.2. Charting Done by Nursing
the practice of nursing.
Students
2. Ensure public safety by administering the
2.1.3. Incident Report
Philippine Nursing Licensure Exam (PNLE) to
3. Laws affecting CHN Practice
graduates of nursing schools prior to practice of
LEGENDS Registered Nursing in the Philippines.
No logo - From PPT [@] - Prof’s Notes [$] - From Book ● [@] Has the jurisdiction to close down a
school that does not produce high quality
nurses.
1. CODE OF ETHICS OF THE FILIPINO NURSE 3. Maintain high standards of nursing education by
● A written set of guidelines issued by an organization to adulting performance of Philippine Nursing
its workers and management to help them conduct Schools.
their actions.
● It is a guidelines for carrying out nursing
responsibilities in manner consistent with quality in
nursing care and the ethical obligations of the
profession

1.1 NURSING CODE OF ETHICS

● Almost all codes of ethics for nurses in the world
agree on:
○ Practice competence
○ Protection of patient confidentiality
○ Nondiscrimination of patients
■ [@]treat patients equally even if their
beliefs are different than ours
○ Ethical accountability of nurses

1.2 PHILIPPINE BOARD OF NURSING Figure No.1: “Board of Nursing”

● (PRC Professional Regulation Commission) The
Professional Regulation Commission (Filipino: 1.3 QUALIFICATION OF BOARD MEMBERS
Komisyon sa Pamamalakad ng mga Propesyonal), ● Any person who qualifies as Chairman or member of
otherwise known as the PRC, is a three-man the Board shall automatically resign from any
commission attached to the office of the President of teaching position in any school, college or university
the Republic of the Philippines. Its mandate is to and/or review program for the local employment in
regulate and supervise the practice of the the Government or any subdivision, agency, or
professionals who constitute the highly skilled instrumentality thereof, including government-owned
manpower of the country. As the agency-in-charge of or controlled corporations or their subsidiaries.
the professional sector, the PRC plays a strategic role ● He/she shall not have any pecuniary interest in or
in developing the corps of professionals for industry, administrative supervision over any institution
commerce, governance, and the economy.
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 NCM113 SCOPE OF NURSING PRACTICE
offering basic nursing education programs, including ○ Section 16. Oath
review classes. ○ Section 17. Issuance of Certificate of
○ [@] No outside hobbies or lifestyles. Registration/Professional License and
Professional Identification Card
2. LAWS AFFECTING NURSING PRACTICE ○ Section 18. Fee for Examination and
● [@] MOTHER LAW: RA 9173: The Philippine Nursing Registration
Act of 2002 ○ Section 19. Automatic Registration of Nurses
○ Senate Bill #2292 ○ Section 20. Registration by Reciprocity
○ Signed on 10/21/2002 by Gloria Macapagal ○ Section 21. Practice Through
Arroyo Special/Temporary Permit
○ Aim: To provide a sound general and ○ Section 22. Non-registration and
professional foundation for the practice of Non-issuance of Certificates of Registration
nursing through quality nursing education. Professional License or Special/Temporary
○ Purpose - Law that will regulate the: Permit
[@] all areas of nursing ○ Section 23. Revocation and suspension of
■ Education Certificate of Registration Professional
■ Training License and Cancellation of
■ Examination Special/Temporary Permit
■ Registration ○ Section 24. Re-issuance of Revoked
● [@] how to register when you Certificates and Replacement of Lost
already pass the boards Certificates
■ Practice of the Nursing ■ [@] if a malpractice was
profession committed
● [@] practice when you are
already RN ● ARTICLE V - Nursing Education
[@]Curriculum
● ARTICLE III - Organization of the Board of Nursing [@] Qualifications of a professor
[@] Paano sila mag-qualify, mga sahod and pano
○ Section 25. Nursing Education Program
matatanggal sa board of nursing ○ Section 26. Requirement for Inactive Nurses
○ Section 3. Creation and Composition of the Returning to Practice
Board ○ Section 27. Qualifications of the Faculty
○ Section 4. Qualifications of the Chairperson
and Members of the Board ● ARTICLE VI - Nursing Practice
○ Section 5. Requirements Upon Qualification [@] How are we going to practice as nurses
as Member of the Board of Nursing [@]What is allowed and what is not allowed.
○ Section 6. Term of Office ○ Section 28. Scope of Nursing
○ Section 7. Compensation of the Board ○ Section 29. Qualification of Nursing Service
Members Administrators
○ Section 8. Administrative Supervision of the
Board, Custodian of its Records, Secretariat ● ARTICLE VII - Health Human Resources
and Support Services Production, Utilization and Development
○ Section 9. Powers and Duties of the Board. [@]Manpower, salary, benefits,, funding for
○ Section 10. Annual Report comprehensive nursing specialty program
○ Section 11. Removal or Suspension of Board [@]May ongoing bill that allows nurses to have
Members specialty
○ Section 30. Studies for Nursing Manpower
● ARTICLE IV- Examination and Registration Needs, Production, Utilization and
[@] About the board exam; how to apply
Development.
[@]Commit medical malpractice ○ Section 31. Comprehensive Nursing Specialty
[@]Grounds for suspension or revoke of license Program
○ Section 12. Licensure Examination ○ Section 32. Salary
○ Section 13. Qualifications for Admission to ○ Section 33. Funding for the Comprehensive
the Licensure Examination Nursing Specialty Program
○ Section 14. Scope of Examination ○ Section 34. Incentives and Benefits
○ Section 15. Ratings

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 NCM113 SCOPE OF NURSING PRACTICE
● ARTICLE VIII - Penal and Miscellaneous Provisions ● [@] No RLE orientation, no duty (Policy)
○ Section 35. Prohibitions in the Practice of 5. Performance should be assessed frequently to
Nursing determine their strengths and their weaknesses.
○ [@] Indicates nursing malpractices ● [@] Being assessed by the CI helps you
○ [@] Limitations for nurses improve and progress as a student nurse
○ [@] Sanctions and Penalties 6. Frequent conferences with the students will reveal
their problems, which they may want to bring to
2.1. LEGAL RESPONSIBILITIES OF STUDENTS the attention of their instructors or vice-versa.
Discussions of these problems will iron out doubts
● Responsible for acquiring the knowledge and skills and possible solutions may be provided.
necessary to become a safe practitioner
○ [@] as a nursing student you are responsible to 2.1. 2 CHARTING DONE BY NURSING STUDENTS
becoming a responsible practitioner ● When a nurse or a clinical instructor countersigns the
○ [@] knowledge is important for decision making charting of a nursing student, she attests that she has
in certain situations personal knowledge of information and that such is
● Included in this knowledge and skill development is the accurate and authentic. Anyone who countersigns
awareness of ethical principles and the process of without verification commits herself to possible legal
ethical decision making. risk.
○ [@]Ex: Only one incubator and 2 premature ○ [@] Ask clinical instructor to countersign
babies, kanino mo ibibigay? Ethical-decision ○ [@] You are legally at risk if you copy the CI’s sign
making
● Must act as reasonably prudent persons, equivalently 2. 1. 3 INCIDENT REPORT
with education and experience, when performing ● The primary purpose of an incident report is to
nursing duties. document and prevent possible consequent injuries.
● Must perform only those tasks that they are competent Classifying an event as an incident does not imply
to perform that someone made a mistake, it only means that
○ [@] Even as student nurses. something unusual happened.
○ [@] you must be competent to a task ○ [@] For documentation, help the future to prevent
○ [@] Being a nursing student is not an excuse if consequent injury
you commit a mistake ○ [@] When creating an incident report, just narrate
● Under the Philippine Nursing Act of 2002 R.A. 9173, what happened
nursing students do not perform professional nursing.
○ [@]under clinical instructors
● They are to be supervised by their clinical instructors. 3. LAWS AFFECTING CHN PRACTICE
○ [@] when performing a procedure, you must first ● Republic Act 7305 Magna Carta for Public Health
call your clinical instructor Workers
○ [@] Bible of public health nurse (regardless of any
2.1.1 LIABILITY FOR THE WORK OF NURSING STUDENTS kind)
● Under the Philippine Nursing Act of 2002 R.A 9173,
nursing students do not perform professional nursing. PAHINGA MUNA, ADHARA!
● In order that the errors committed by the nursing
students will be avoided/minimized , the following
measures should be taken:
1. Nursing students should always be under the
supervision of their Clinical Instructors.
● [@] Don’t initiate an action when the CI is not
around; Call another CI or nurse on duty
2. They should be given assignments that are in
the level of their training, experience and
competency.
3. They should be advised to seek guidance
especially if they are performing a procedure for
the first time.
4. Should be oriented to the policies of the nursing
unit where they are assigned
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 NCM113 SCOPE OF NURSING PRACTICE

FIGURE INSERTS
● For figures or photo inserts, please use “In Line With
Text” wrapping and position it to fit the size of the
column. Also, make sure that the text or image can be
seen with the final size.

CITATION
● Please use APA format for in-text citations (Guiyab,
2021)
REFERENCES
● APA citation guide. (2016).
http://www.bibme.org/citation-guide/apa/
● Lipson, C. (2011). Cite right: A quick guide to citation
styles – MLA, APA, Chicago, the sciences, professions,
and more (2nd ed). United States of America: The
University of Chicago Press, Ltd., London.
● Ferraro, A. (Photographer). (2014). Liberty enlightening
the world [digital image]. Retrieved from
https://www.flickr.com/photos/afer92/
14278571753/in/set-72157644617030616

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