HIGHLIGHTS IN CHN CONCEPTS
o Community organizer
• CHN is based on the recognized needs of
communities, families, groups, and
• RESPONSIBILITIES OF CHN
individuals.
• CHN is a unique blend of nursing and public
health practice, and is oftentimes used
interchangeably the term
• PUBLIC HEALTH NURSING – the practice of
nursing in national and local government
health departments (which include health
centers and rural health units), and public
schools.
o Stands of Public Health Nursing in the
Philippines, 2005
o WHO defined PHN as a special field of
nursing that combines the skills of nsg,
public health and some phrases of social
assistance and functions as part of the
total public health programs for the
promotion of health, the improvement of
the conditions in the social and physical
environment, rehabilitation of illness and
disability.
o According to WHO
- PUBLIC HEALTH
• In the care of the communities:
- The ART OF APPLYING SCIENCE in the
CONTEXT OF POLITICS to REDUCE
INEQUALITIES IN HEALTH ensuring
the best health for the greatest
number
• Objectives of Public Health/major concepts
o 4 P’s
o Promote Health
o Prevent Disease
o Prolong Life
o People participation towards self-
• HEALTH CARE DELIVERY SYSTEM
reliance
• ROLES AND FUNCTIONS OF PHN
o Clinician health care provider
o Health advocator
o Collaborator
o Consultant
o Counselor/health educator
o Researcher
o Case manager
o Role model
o Participates in the development of an
overall health plan, its implementation,
and evaluation for communities.
o Maintains coordination/linkages with
other health team members,
NGO/government agencies in the
provision of PH services
o Initiates and conducts research relevant
to CHN services to improve provision of
health care.
o Engages in such activities that require
the utilization of knowledge and
decision-making skills of a registered
nurse.
o Note: PHN takes charge in absence of
MHO
o In the care of the families:
- Provision of Public health care
services
- Development/utilization of FNC in
the provision of care
o Comm. Organizing, mobilization, comm.
Development and people
empowerment
o Case finding and epidemiological
investigation
o Program planning, implementation, and
evaluation
o Influencing executive and legislative
individuals or bodies concerning health
and development
o (MAGLAYA P. 22)
- PUBLIC HEALTH (Dr. C.E.A.
Winslow/Charles Edward Amory
Winslow)
- "science and art of preventing
disease, prolonging lite, promoting
health and efficiency through
 organized community effort for the
sanitation of the environment,
control of CD, the education of
individuals in personal hygiene, the
organization of medical And
nursing services for the early
diagnosis and preventive
treatment of diseases, and the
development of the social
machinery to ensure everyone a
standard of living adequate for the
maintenance of health, so
organizing these benefits as to
enable every citizen to realize his
birthright of health and longevity."
• 3 CORE FUCNTIONS OF HEALTH CARE
DELIVERY SYSTEM
1. Assessment - is the regular collection
and analysis of health data. These data
are used for program planning and policy
development.
2. Policy Development – involves advocacy
and political action to develop policies in
various levels of decision making.
3. Assurance – is making sure that health
services are effective, available, and
accessible to the people.
• RELATED TO THE CORE FUNCTIONS OF
PUBLIC HEALTH ARE THE 10 ESSENTIAL
HEALTH SERVICES:
1. Monitoring health status to identify
community health problems
2. Diagnosing and investigating health
problems and hazards in the community
3. Informing, educating, and empowering
people about health issues
4. Mobilizing community partnerships to
identify and solve health problems
5. Developing policies and plans that
support individuals, family, and
community efforts
6. Enforcing laws and regulations that
protect health and ensure safety
7. Linking people to needed personal
health services and ensuring the
provision of health care that is otherwise
unavailable
8. Ensuring competent public health and
personal health care workforce
9. Evaluating effectiveness, accessibility,
and quality of personal and population-
based health services; and
10. Researching for new insights and
innovative solutions to health problems
• HEATHCARE DELIVERY (White Book by
Cuevas p.19)
1. PRIVATE SECTOR - (For profit and non-
profit providers) - is largely- market
oriented and where health care is paid
through user fees at the point of service.
- their involvement in maintaining the
people’s health is enormous. This
includes providing health services in
clinics and hospitals, health insurance,
manufacture of medicines, vaccines,
medical supplies, equipment and other
health and nutrition products, research
and development, human resource dev,
and other health-related services
2. PUBLIC SECTOR - is largely financed
through a tax-based budgeting system at
both national and local levels and where
health care is generally given free at the
point of service (although socialized user
fees have been introduced in recent
years for certain types of services.
o PUBLIC SECTOR:
A. Local levels - local health system is now
run by Local Government Units (LGUs)
- the provincial and district hospital
are under the provincial
government.
- the city/municipal government
manages the health centers/ rural
health units (RHUs) and Barangay
health stations (BHSs).
 - In every province, city or
municipality, there is a local health
board chaired by the LOCAL CHIEF
EXECUTIVE
- its function is mainly to serve as
advisory body to the local
executive and the sanggunian or
local legislative council on health-
related matters.
B. National Levels – the DOH is mandated
as the lead agency in health.
- It has a regional field office in every
region and maintains especially
hospitals, regional hospitals, and
medical centers
- It also maintains provincial health
teams made up of DOH
representatives to the local health
board and personnel involved in
CD control specially malaria &
schistosomiasis.
• OTHER NATIONAL LEVEL AGENCIES
PROVIDING HEALTH CARE SERVICES SUCH
AS THE PGH or Phil. Gen Hosp are also part
of this sector.
• Major components of the PHCDS that
constitute the context of CHN:
1. DOH – (ROLES AND FUNCTIONS)
o DOH, in its new role as the national
authority on health providing
technical and other resource
assistance to concerned groups as
mandated by Executive order 102
o FUNCTIONS:
- Leadership in health
- Enabler and capacity builder
- Administrator of Specific Services
- (Its mandate is to develop national
plan, technical standards, and
guidelines on health)
- VISION – The DOH is the leader,
staunch advocate and model in
promoting Health for all in the
Phils.
- MISSION (DOH) – Guarantee
equitable, sustainable, and quality
health for all Filipinos, especially
the poor and shall lead the quest
for excellence in health.
2. HSRA (Health Sector Reform Agenda)
o Goal: Health Sector is the overriding
goal of the DOH (to ensure
affordable access to services of
general interest). Support
mechanisms will be through sound
organizational development, strong
policies, systems and procedures,
capable human resources, and
adequate financial resources.
o The DOH has come up with the
HSRA (Health Sector reform
Agenda) that included the ff
reforms:
1. provide fiscal autonomy to
government hosp.
2. secure funding for priority public
health programs
3. promote the development of
local health systems and ensure
its effective performance
4. strengthen the capacities of
health regulatory agencies; (ex,
FDA, health care research
agencies, disease control and
prevention center)
5. expand the coverage of the
National Health Insurance
Program
3. F1 (FOURmula 1) - is the implementation
framework for health sector reforms under
the current administration.
- 3 GOALS OF F1:
1. Better health outcomes
2. More responsive health systems
3. Equitable health care financing
o The FOUR elements of the strategy are:
 1. Health Financing – the goal of this health
reform area is to foster greater, better,
and sustained investments in health
2. Health Regulation - the goal is to ensure
the quality and affordability of health
goods and services
3. Health Service delivery - the goal is to
improve and ensure the accessibility and
availability of basic and essential health
care in both public and private facilities
and services.
4. Good governance - the goal is to
enhance health system performance at
the national and local levels.
According to Sec of Health, F1 is the guiding
philosophy and strategic approach of the DOH
4. MDG/SDG - The concern is to improve
people's health is universal because there is
a strong correlation between health and
development.
- Poor health is a consequence and
cause of poverty and
underdevelopment.
- Poverty also breeds despair and
turmoil.
- The UNITED NATIONS
spearheaded the formulation of
the MDGs. These 8 GOALS are:
1. Eradicate extreme poverty and
hunger
2. Achieve universal primary
education
3. promote gender equality and
empower women
4. reduce child mortality
5. improve maternal health
6. combat HIV/AIDS, malaria, and
other diseases;
7. ensure development sustainability;
and
8. develop a global partnership for
development
o As 2015 – MDG ended
- January 2016 - an even more
ambitious set of goals to banish a
whole host of social ills by 2030.
- "The 17 Sustainable Development
Goals (SDGs) are our shared vision
of humanity and a social contract
between the world's leaders and
the people," UN Secretary-General
Ban Ki-moon said of the 2030
Agenda for Sustainable
Development adopted
unanimously by 193 Heads of State
and other top leaders at a summit
at UN Headquarters in New York in
September.
- "They are a to-do list for people
and planet, and a blueprint for
success, he added of the 17 goals
and 169 targets to wipe out
poverty, fight inequality and tackle
climate change over the next 15
years.”
- The 2030 Agenda for Sustainable
Development calls on countries to
begin efforts to achieve the 17
SDGs over the next 15 years. The
goals address the needs of people
in both developed and developing
countries, emphasizing that no one
should be left behind. Broad and
ambitious in scope.
- The agenda addresses the three
dimensions of sustainable
development:
- social
- economic
- and environmental
- as well as important aspects
related to peace, justice, and
effective institutions.
o 17 SUSTAINABLE DEVELOPMENT GOALS
(17 GOALS TO TRANSFORM OUR
WORLD)
- No poverty
 - Zero hunger
- Good health and Well-being
- Quality Education
- Gender Equality
- Clear water and Sanitation
- Affordable and clean energy
- Decent work and economic growth
- Industry, innovation, and
infrastructure
- Reduced Inequalities
- Sustainable cities and communities
- Responsible consumption and
production
- Climate change
- Life below water
- Life on land
- Peace, justice, and strong
institutions
- Partnerships for the goals
5. MTPDP (Medium Term Phil. Dev. Plan) 2017
– 2022
o Spells out the priority strategies to meet
the basic needs of the poor
1. To empower the poor and marginalized
2. Push for improved transparency and
accountability in governance
3. Fuel the economy
o (specially, the growth shall be more
inclusive by lowering incidence in the
rural areas, more jobs shall be created,
making individuals, and communities
more resilient, driving innovation, and
building greater trust in government and
in society.)
6. NOH (National Objective for Health)
o Is an important document that reflects
the MDGs/SDG, MTPDP, HSRA and F1 to
bring the health sector to its desired
outcome.
o OBJECTIVED OF HEALTH SECTOR (NOH)
- By Cuevas, et al p.27
A. Improve general health status of the
population
B. Reduce morbidity and mortality from
certain diseases
C. Eliminate certain diseases as public
health problems
D. Promote healthy lifestyle and
environmental health
E. Protect vulnerable groups with special
health and nutrition needs
• Classification of Health Facilities
o Category A. Primary Care Facility - a
first contact health care facility that
offers basic services including
emergency services and provision
for normal deliveries. E.g., health
centers, infirmaries, and birthing
lying-in facilities.
o Category B. Custodial care Facility -
provides long term care, including
food and shelter to clients. With
chronic conditions requiring ongoing
health and nursing care due to
impairment or reduced degree of
independence in activities of daily
living and clients in need of
rehabilitation. E.g., Custodial
psychiatric facilities, drug abuse
treatment and rehab centers,
leprosaria/sanitaria, and nursing
homes.
o Category C. Diagnostic/therapeutic
facility - Facility for the examination
of human body, specimens from the
human body for the diagnosis,
sometimes treatment of disease, or
water for drinking water analysis.
Test covers analysis of specimens.
E.g., Laboratories, Radiologic facility
(ray, CT scan, mammography, MRI,
Ultrasound etc.), Nuclear medicine
facility (Nuclear radioactive
materials in diagnosis, treatment, or
research)
o Category D. Specialized Outpatient
Facility - Performs highly specialized
procedures on an outpatient basis.
E.g., Dialysis clinic, ambulatory
surgical clinic, chemotherapeutic
clinics/center, cancer radiation
facility, Physical medicine, and
rehabilitation clinic (PT).