 PUBLIC HEALTH NURSE  Program management

(reports on program accomplishments is

o Nursing has responded to advances in a documentation of her management
medical sciences, modern technology, skills.)
changing health care delivery system,
technological and social forces.  FUNCTION OF PUBLIC HEALTH NURSE

o Public health nurses are found in various 1. SUPERVISORY FUNCTION

 The public health nurse is the
health settings and occupying various
supervisor of the midwives and other
positions in the hierarchy. Public health
auxiliary health workers
nurse can be seen in:
 Formulates a supervisory plan and
 RHU
conducts supervisory visits
 City Healthcare Centers
 Agencies policies in a manner that
 Provincial Health Offices
improves performance and promotes
 Regional Health Offices
job satisfaction.
 National Health Office (DOH)
 Provides a checklist
 Public schools
 The supervisory identifies the
 Government agencies
problem within the agency and
address the problem by providing
o Have broad roles and functions that is
solution.
dependent on the position description.

Sentrong Sigla Program has develop

o Uses various tools and procedures necessary
supervisory package.
for her to properly practice her profession
and deliver basic health service.
2. NURSING CARE FUNCTION
 USES THE ADPIE:
 QUALIFICATIONS AND FUNCTIONS
 Assessment
 Diagnosis
o The standard of public health nursing in the
 Planning
Philippines, they developed the
 Implementation
NATIONAL LEAGUE OF PHILIPPINE
 Evaluation
GOVERNMENT OF NURSES in 2012.
 Establishes rapport to the client
(individual, family or community) to
QUALIFICATIONS:
ensure good quality data to facilitate
 Must be professionally qualified and
and enhanced partnership in
licensed to practice
addressing identified health needs
 Must possess personal qualities and
and problem.
“people skills”
 Uses her knowledge and skill in the
 Functions within the ethico-legal
nursing process
framework of the nursing profession
 Home visits- visible manifestation of
 Consistent with the Nursing Law 2002
a nurses caring function.
and program policies formulated by the
 Referral of patients to appropriate
Department of Health and Local
levels of care
government health agencies.
 During assessment, nurse
encounters a problem that is
 MANAGEMENT FUNCTION
beyond the scope of nursing
1 nurse in the municipality
and thus referral is done.

 Planning
 Organizing
 Staffing
 Directing
 Controlling
3. COLLABORATING AND
COORDINATING FUNCTION
 Bring activities or group of activities
systematically
 Establishes linkages and
collaborative relationships with the
health professionals, government
agencies, the private sectors, non
government organization, peoples
organization to address health
problems.
 The nurse identifies groups, persons,
organizations, other agencies and
communities, whos resources are
available within and outside the
community.
 LINKAGES to various groups in the
community
4. HEALTH PROMOTION AND
EDUCATION FUNCTION
 Understands the multidimensional
nature of health will help enable the
nurse to plan and implement health
promoting intervention for individual
and communities.
 Uses her skills in advocacy for the
creation of a supportive environment
through policies and re-engineering
of the physical environment for
healthier actions.
 Provides clients with information
5. TRAINING FUNCTION
 Formulate, does assessment,
evaluates training outcomes
 Participates in the training itself
 Initiates PROGRAMS that could
help develop the workers (midwives
and BHW)
6. RESEARCH FUNCTION
 Conduct of research and utilizes
research findings in her practice
 Disease surveillance is a research
activity of the nurses
 Participates in the conduct of
research and utilizes research
findings in her practice.
 DISEASE SURVEILLANCE
- surveillance is an integral part to
any programs. It is important in
monitoring the progress of the
disease reduction initiatives such as
eradication of poliomyelitis,
elimination of neonatal tetanus and
other diseases that are usually
communicable and non
communicable diseases.
Purpose:
 To measure the magnitude of
the problem
 To measure the effect of the
control program.
 FUNCTION OF A PUBLIC HEALTH
NURSE IN A CITY HEALTH OFFICE
 PUBLIC HEALTH NURSE II
 Works in a health center
 First contact of the patient
 Provides health education to the
public giving pre and post clinical
lectures.
 Performs home visits or follow-up
cases
 Prepare and submit the necessary
reports required of her which are
done weekly, monthly and
quarterly.
 Frontline health worker
 Prime mover to all programs and
activities
 PUBLIC HEALTH NURSE III
 Same functions but differs from the
PHN II
 Acts as the nurse-in-charge of PHN
II (supervises, coordinates and
evaluates the work of the co-nurses)
 Interprets policies and participate in
planning health programs and
activities that involves nursing
service.
 PUBLIC HEALTH NURSE V
 “Supervising Public Health
Nurse”
 Assigned in a health center with a
lying-in clinic
  Supervise and coordinates the work
of nurses, midwives and other
health personnel.
 Guides the co workers in carrying
out activities, ensuring that they
used correct procedures and
techniques. Participate in program
planning and guidance, to student
trainees and affiliates.
 Attends meeting and seminar for her
own career growth and for the
improvement of health services.
 Evaluate the performance of her
staff and analyze records and
reports
 PUBLIC HEALTH VI
 “Nurse Program Supervisor”
 Manages and oversees the
performance of a group of nurses
assigned in a number of health
centers covered by a particular
district or area.
 Performs consultations and
objective assessment and
evaluation of nursing programs,
problems and services.
 Consolidates and evaluates,
analyzes the necessary weekly,
monthly, quarterly and annual
reports of the health center.
 Studies and evaluates the
performance ratings of nurses
 Initiates meetings, discussions
and conferences. To provide joint
planning, to stimulate activities
among nurses and other health
personnel.
 Conducts program orientation to
pre-service and in-service nurse
trainees and students.
Coordinates with other health
discipline in implementation of
program.
 Likewise acts as a nursing
consultant on technical matters
 COMPETENCIES, SKILLS AND
KNOWLEDGE
 Community health nursing process
 Nursing procedures during clinic and
home visits
 Community or organizing
 Health promotion and education
 Surveillance
 Records and reports
THE PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
“A public health nurse does not function in a
vacuum.”
- A nurse is a member of a team, working within the
system. In order for that nurse to function
effectively, she has to understand the healthcare
delivery system wherein she is working. It
influences her status and functions. The nurse needs
to properly relate with the dynamics of the political,
organizational structure surrounding her position in
the health care delivery system.
 HEALTH CARE DELIVERY SYSTEM:
MAJOR PLAYERS:
 Public sector
- financed through a tax-based budgeting
system at both national and local levels.
- healthcare is generally given for free at
the point of service.
- National and local government
agencies providing health services.
- Department of Health (DOH) is
mandated as the lead agency in health.
Philippine General Hospital (part of
DOH sector)
- run by Local Government Units
(LGUs). LGUs are now in charge of the
local health system.
- The provincial and district hospitals are
under the provincial government.
- The city or municipal government,
manages the health centers or rural
health units and barangay health stations.
 Private sector
- market-oriented and where health care
is paid through user fees at the point of
service.
- includes for profit- and non profit
health providers
- providing health services in clinical
and hospitals, health insurance,
manufacture of medicines, vaccines,
medical supplies, equipment and other
health and nutrition products, research
and development, human resource
 development and other health-related
services.
 LOCAL HEALTH SYSTEM
Was over 40 years after post war
independence, the Philippine Healthcare
System was administered by a central
agency based in Manila. This agency
provided the singular sources of resources,
policy direction, technical and
administrative supervision to all health
facilities nationwide.
 Post war: central agency based in
Manila
 MAJOR SHIFT- 1991: passage of
the Local Government Code also
known as Republic Act 7160.
Under this law, all structures,
personal and budgetary allocation
from the provincial health level
down to the barangays were
devolved to the local government
units to facilitate health service
delivery.
 Local health services emerged
 OBJECTIVES OF THE LOCAL HEALTH
SYSTEM
1. Establish local health systems for
effective and efficient delivery of health
care services.
2. Upgrade the health care management
and service capabilities of local health
facilities.
3. Promote inter-LGU linkages and cost
sharing schemes including local health
care financing systems for better
utilization of local health resources.
4. Foster participation of the private, sector,
non-government organizations (NGOs)
and communities in local health systems
development.
5. Ensure the quality of health service
delivery at the local level.
 INTER LOCAL HEALTH SYSTEM
 Supported by the DOH inorder to
ensure quality of health care service
at the local level.
 Provide quality equitable and
accessible health care
 Creation of an Inter Local Health
System (ICHS) by clustering
municipalities into Inter Local
Health Zone (ILHZ)
 Defined population within a
defined geographical area
 Central referral hospital
 Rural Health Units and
Barangay Health Station
Stakeholders of Inter-Local
Health System:
 LGUs
 Department of Health
 Philippine Health Insurance
Cooperation (PHIC)
 Communities
 Non-government
Organization (NGOs)
private sector
 EXPECTED ACHIEVEMENT
1. Universal coverage of health insurance
2. Improved quality of hospital and Rural
Health Units (RHU) service.
3. Effective referral system
4. Integrated planning
5. Appropriate health information system
6. Improved Drug Management System
7. Developed human resources
8. Effective leadership through Inter-LGU
corporation
9. Financially visible or self sustaining
hospitals
10. Integration of public health and curative
hospital care
11. Strengthened cooperation between LGU
and health sectors.
 UNIVERSAL HEALTH CARE ACT
 The act will automatically enroll Filipino
citizens into the National Health Insurance
Program and expand PhilHealth coverage
to include free medical consultations and
laboratory tests.
 GUIDING PRINCIPLES
 Financial and administrative autonomy
(LGUs)
 Strong political support
 Strategic synergies and partnerships
 Community participation
 Equity of access to health services by the
population, especially the poor
 Affordability of health services
 Appropriateness of health programs
 Decentralized management
 Sustainability of health initiatives
 Upholding of standards of quality health
service
 COMPOSITION
1. People
- According to WHO, the ideal health
district would have a population size
between 100, 000- 500, 000 for optimum
efficiency and effectiveness.
2. Boundaries
- clear boundaries between zone
- determine the accountability and
responsibility of health service providers.
3. Health facilities
- District or provincial hospitals, RHUs,
barangay health stations.
4. Health workers
- The DOH, district hospitals, RHU,
barangay health stations, private clinic,
volunteer health workers, non government
organization and community based
organization is needed to deliver
comprehensive health services. Together
they form the INTER LOCAL HEALTH
ZONE TEAM to plan joint strategies for
district health care.
 PRIMARY HEALTH CARE
 Describe during the First International
Conference in Alma Ata, USSR on
September 6-12, 1978 by WHO
 Goal was “Health for All by the year
2000”
 Adopted in the Philippines through
letter of instruction 949 signed by
President Marcos on October 19,
1979.
 “HEALTH IN THE HANDS OF THE
PEOPLE BY 2020”
 ELEMENTS/COMPONENTS OF
PRIMARY HEALTH CARE
1. Environmental sanitation
2. Control of Communicable Diseases
3. Immunization
4. Health Education
5. Maternal and Child Health and Family
Planning
6. Adequate Food and Proper Nutrition
7. Provision of Medical Care and Emergency
Treatment
8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs
 STRATEGIES FOR PRIMARY
HEALTHCARE
 Reorientation and reorganization of the
national health care system under the
local government code of 199.
 Effective preparation and enabling
process
 Mobilization of the people to know their
communities and identifying their self
needs, leading to self reliance and self
determination
 Development and utilization of
appropriate technology focusing on local
indigenous resources available in and
acceptable to the communities.
 Organization of communities
 Increase opportunities for community
participation
 Development of intra-sectoral linkages
with other government and private
agencies
 Emphasizing partnership
The framework for meeting the goal
of primary health care is
organizational strategy.
 FOUR CORNERSTONES/PILLARS
1. Active community participation
2. Intra and inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made availble
 TYPES OF PRIMARY HEALTH CARE  TERTIARY LEVEL OF CARE
WORKERS - rendered by specialists in health
 Available health manpower resources facilities including medical centers and
 Local health needs and problems as well as regional and provincial
 Political and financial feasibility hospitals and specialized hospitals.
- referral center for secondary care
PRIMARY HEALTH CARE TEAM IS facilities
COMPOSED OF - complicated cases requires tertiary
 Physician level of care
 Nurse
 Midwives
 Nurse oxillaries
 Local trained community health worker
 Traditional birth attendant
 Healers

 TWO LEVELS OF PRIMARY HEALTH

CARE WORKERS
1. Village or Barangay Health Workers
- BHW, trained community health
workers or health auxillary volunteers or
traditional birth attendant, healer
2. Intermediate level Health Workers
- intermediate level healh workers.
General medical practioners
- public health nurse
- rural sanitary inspectors
- midwives
 LEVELS OF HEALTH CARE AND
REFERRAL SYSTEM
 Primary Level of Care
- cities and the municipalities
- provided at the barangay health stations
and rural health units.
- Usually the first contact between the
community members and the other levels
of health facility.
 LEVELS OF HEALTH CARE SERVICES
 Health problems that are beyond the
capability of PHC units and beyond the
competence of PHC workers are referred
to an intermediate health facility, usually
a Rural health Unit (RHU).
 The higher the level, the more qualified
the health personnel and the more
sophisticated the health equipment.
 Team planning by health personnel in
the same level and the various health
levels will be essential for the
effectiveness and efficiency of health
services.
 Teamwork entails joint planning,
implementation, and evaluation of
community’s activities.

 SECONDARY LEVEL OF CARE

- given by physicians with basic health
training
- serves as a referral center for the
primary health facilities.
- is given at government operated or
privately owned
- capable of performing minor surgeries
and perform some simple laboratory
examination.