Community Health Nursing 6.

Vaccine hesitancy – refusal of vaccine despite the

availability of the vaccine; vaccine is the most
Lesson 1: Global Health Issues effective way to avoid disease.
Global Health Status -Studies describe the state of global 7. Dengue – causes flu like symptoms
health by measuring the burden of disease – the loss of health - 20 %
from all causes of illness and deaths worldwide. - Rainy seasons
- 390 million a year
- WHO 2018 8. HIV (Human Immunodeficiency Virus)
- Anti-retroviral
Top 10 Most Common Health Issues in the Philippines
- Kits
1. Physical Activity and Nutrition - Anti-retroviral drugs
2. Overweight and obese - Preventive measures
3. Tobacco - Its tobacco dependence and not smokers - Example: HPV (Human
4. Substance Abuse Papillomavirus)
- Alcohol and drugs
Lesson 2: Definition and Focus
- “habit forming”
5. HIV/AIDS Community - all the people living in an area or a group or
- Human Immunodeficiency Virus groups of people who share common interests
- Acquired Immunodeficiency Syndrome
6. Mental Health Health – as state of complete physical, mental and social well-
- Acquired through infection, operation, being and not merely the absence of disease or infirmity.
nutritional, and renal failure (WHO)
- Depression: DABDA (Denial, Anger, Nursing - Encompasses autonomous and collaborative care of
Bargaining, Depression, Acceptance) individuals of all ages, families, groups and communities, sick
- Dementia or well and in all settings. It includes the promotion of health,
7. Injury and Violence - 1/3 ages 65 and above falls prevention of illness, and the care of ill, disabled and dying
each year and in order to avoid these, exercise and people. (WHO)
appoint check -ups every 3 months
8. Environmental Quality – Poverty Public Health - Service rendered by a professional nurse with
9. Immunization communities, groups, families, individuals at home, in health
- Influenza and pneumonia are the top centers, in clinics, in schools, in places of work for the
10 causes of death in the Philippines. promotion of health, prevention of illness, care of the sick at
- Vaccinations for seniors and women home and rehabilitation. (Ruth B. Freeman)
10. Access to Health Care
Community Health Nursing - Preventing disease, prolonging
Top 8 Most Common Health Issues in the World Health life, promoting health and efficiency through organized
Organization (WHO) community. Enable every citizen to realize his birth right to
health and longevity. (Dr. C.E. Winslow)
1. Global influenza pandemic
2. Fragile and Vulnerable settings The Standards of Public Health Nursing in the Philippines
- Drought
- Hunger A. Public Health Nurses (PHN)
- Conflict (war) - Found in various health settings
- Population - Are assigned in rural health unit, etc.
- Child and maternal health: assist in - Also in public schools and offices of
the delivery of a baby gov’t agencies.
3. Antimicrobial resistance - Public health nurse I to nurse program
- Anti – biotic Supervisors to chief
- 2017: resistance to peranticine - nurse in Public settings
- Petri dish: anti – biotic - Use various tools
- Uses nursing process
 Red – not resistance
- Technically competent in various
 No/any change of color –
nursing procedures
resistant
B. Qualifications and Functions of Public Health Nurses
4. Ebola and other high-treat pathogens – ebola
a. Qualifications
outbreak
- Licensed to practice
5. Weak primary health care – results to casualties
- Must possess personal qualities and
like outbreaks and mortality rate.
people skills
 b. Functions
- Functions in accordance with the
dominant values of public health nurse.
- Consistent with the Nursing law 2002
and program policies formulated by
DOH
- 6 Functions:
 Management Functions –
deals with budget, supply, and
other financial crisis of the
unit
 Supervisor Function – BHW
(Barangay Health Workers)
example: janitors, Barangay
Nutrition Specialist, guards
 Nursing Function – to
provide nursing care
 Collaborating and
Coordinating Function –
collaborating with barangay
officers and with other
units/department/other part of
the community. Example:
clean up drive
 Health Promotion and
Education Function –
reminding and educating the
community
 Training Function – initiate
your community
Philosophy of Community Health Nursing
CHN Practice guided by the following beliefs:
H – Humanistic values of the nursing profession upheld
U – Unique and distinct component of Health care
M - Multiple factors of health considered
A – Active participation of clients encouraged
N – Nurse considers availability of resources
I – Interdependence among health team members practiced
Roles of the Public Health Nurse
1. Clinician or Health Care Provider – home visit,
utilizes nursing care
2. Health Educator – utilizes KSA (Knowledge, skills,
Attitude)
3. Coordinator and Collaborator – establish with
other health allies/team and other government
agencies.
4. Supervisor – a responsible supervisor of your
unit/team
5. Leader and Change Agent – lead in the
development of the community
6. Manager – organizer, responsible in delivering care
in your community
7. Researcher – participate in the research
Responsibilities of the Public Health Nurse
 Be a part in developing an overall health plan.
 Provide quality nursing services
 Maintain coordination/linkages
 Conduct researches
 Provide opportunities for professional growth
Specialized Fields
 Community Mental Health Nursing – grieving,
depression and other mental health issues
 Occupational Health Nursing
 School Health Nursing – application of Nursing in a
school setting
Lesson 3: Health Care Delivery System
Millenium Development Goals (MDSs)
1. Share of poor people reduced by 50% from 1990-
2015
2. 90% of children in primary school – healthy
immunizes children learns better
3. Promote gender equality and empower women –
equal number of girls and boys started school
4. 17,000 fewer children died each day than in 1990
- Starting from conception (example: a
fetus died because of strangulation by
the umbilical cord, because of no
prenatal check-up)
5. Maternal mortality fell by 45% since 1990
- “mother” mortality
- 2007: when the government started to
prohibit ‘home birth/homedelivery’
- Causes: lack of prenatal check-up,
abortion
- Goal A: reduce by 3 quarters between
1990 – 2015 the maternal mortality ratio
- Goal B: to achieve by 2015 - 2022
Universal Access to Reproductive
Health
- … in order to reduce maternal mortality
rate, women need to have access to a
good quality reproductive health care
and effective intervention
6. Fewer people infected by HIV/AIDS and malaria
each year
- Malaria: in the Philippines, cases of
malaria can still be found in Mt.
Province, Palawan, Pangasinan
 - Target A: to reduce the spread of HIV
and AIDS
- Target B: to achieve universal access of
treatment by HIV, AIDS and to those
who need it. (achieved)
- Free treatment and medication for HIV
and AIDS patients
- Major diseases: TB (Tuberculosis) the
causative agent is a bacteria called
bacterium tuberculosis; 2013 – 9
million new cases, 1.5 million deaths
(Philippines)
- Major Diseases: Human African
Trypanosomiasis – because of “bulate”
- Major Diseases: Dracunculiasis –
because of bite from a “tsetse fly”:
effect – comatose like symptom to until
you’ll fall asleep and die
- Major Disease: Filariasis – causes
elephantiasis (exaggerated enlargement
of the foot)
- To eliminate leprosy (achieved)
7. 2.3 billion people gained access to clean drinking
water
- Target: by 2015, at least half of the
population can have a universal access
to safe drinking water and basic
sanitation.
- Almost 20% of the Philippine
population do not have access to safe
drinking water and basic sanitation
8. Debt service declined foreign aid increase
- Target: provide access to affordable
essential medicine in developing
countries
- Generic Act: an act to promote, require
and ensure the production of an
adequate supply, distribution, use and
acceptance of drugs and medicines
identified by their generic names.
Philippine Department of Health
Vision: The DOH is the leader, staunch advocate and model in
promoting Health for all in the Philippines
Mission: Guarantee equitable, sustainable and quality health
for all Filipinos, especially the poor and shall lead the quest
for excellence in health.
 The DOH shall do this by seeking all ways to
establish performance standards for health human
resources; health facilities and institutions; health
products and health services that will produce the
best health systems for the country. This, in pursuit of
its constitutional mandate to safeguard and promote
health for all Filipinos regardless of creed, status or
gender with special consideration for the poor and the
vulnerable who will require more assistance.
Goal: Health Sector Reform Agenda (HSRA) Health Sector
reform is the overriding goal of the DOH. Support
mechanisms will be through sound organizational
development, strong policies, systems and procedures, capable
human resources and adequate financial resources.
 Rationale for Health Sector Reform: conditions still
seen among the population
 Slowing down in the reduction in the IMR
(Infant Mortality Rate) and MMR (Maternal
Mortality rate)
 Persistence of large variations in health
status across population groups and
geographic areas – you need to know those
people who are in need in your community
regardless of the population
 High burden from infectious diseases
 Rising burden from chronic and
degenerative diseases
 Unattended emerging health risks from
environmental and work-related factors –
example of health risk: landslide,
environmental hazard
 Burden diseases
 Reasons why the above conditions are still seen
among the population
 Inappropriate health delivery system – no
man power, insufficient nurses
 Inadequate regulatory mechanisms for
health services – insufficient policies and
guidelines within the health center / irregular
policies
 Poor health care financing and inefficient
sourcing - poor financing responsibility
 Objectives of the Health Sector
a. Improve the general health status of the
population – conduct ocular survey, do
your assessment and diagnosis, health
teaching, home visits, gain cooperation of
the population
b. Reduce morbidity(pagkakasakit) and
mortality(pagkakamatay) from certain
diseases – conduct survey, house to house
visit and health teaching
c. Eliminate certain diseases as public health
problems – conduct health teaching,
seminar, survey
d. Promote healthy lifestyle and
environmental health – invite the
community to do healthy lifestyles like for
instance – Zumba, walking, jogging,
basketball tournament for the youth in
order to distract them from doing their
habits
e. Protect vulnerable groups with special
health and nutrition needs – children,
obese, elderly and pregnant women are one
 of the people who are in the vulnerable
group.
f. Strengthen national and local health
systems to ensure better health service
delivery – you need to have the connections
and collaborations with the national and
local health system.
g. Pursue public health and hospital reforms
– you need to conduct a study in how you
can contribute to the community how they
can receive treatment from hospital
h. Reduce the cost and ensure the quality of
essential drugs – you need to monitor the
drugs and medications in your rural health
clinic (example: expiration date, how the
drug is stored)
i. Institute healthy regulatory reforms to
ensure quality and safety of health goods
and services – have policies about how to
store the resources and medications of the
clinic
j. Strengthen governance and management
support systems – strengthen the policies
and impose penalties when violated
k. Institute safety nets for the vulnerable and
marginalized groups
l. Expand the coverage of social health
insurance – As a nurse, you need to know
who in your community are Philhealth
dependent
m. Mobilize more resources for health – you
need to know how to responsibly handle
the budget of your clinic
n. Improve efficiency in the allocation,
production and utilization of resources for
health – allocation of budgets