CHAPTER I

OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES

Learning Outcomes:
At the end of the lesson, the students will:
 Integrate relevant principles of social, physical, natural, and health
sciences and humanities in a given health and nursing situation.
 Discuss appropriate community health nursing concepts and actions
holistically and comprehensively.

INTRODUCTION TO GLOBAL AND NATIONAL HEALTH SITUATIONS

I. GLOBAL
What is global health?
The understanding of health care in an international and
interdisciplinary perspective is known as global health. It encompasses the
study, research, and practice of medicine with a goal of increasing global
health and health care equity. Epidemiology, sociology, economic inequality,
public policy, environmental variables, cultural studies, and other
disciplines are all considered in global health programs.

1. PANDEMICS

"A pandemic is essentially a global epidemic," explains Dan Epstein, a

spokesman for the Pan American Health Organization, a regional office of
the World Health Organization.
Pandemics are global disease epidemics, to put it simply. HIV,
influenza, Severe Acute Respiratory Syndrome (SARS), Ebola, and other viral
dangers are examples of pandemics that highlight our vulnerability to
widespread diseases, many of which start in animals.
Every year, new pandemic threats emerge that are unresolved, and
detecting symptoms may take place after an individual has already been
infected. These problems must be addressed at their root, which includes
health education, responsible farming practices, and the conditions that
drive viruses to spread.

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2. ENVIRONMENTAL FACTORS

Climate change and air pollution are two of the most pressing
environmental challenges. But, in what ways will these difficulties have a
direct impact on human health? In most cases, the solution is found in the
availability of water and sanitation.
Diseases are more easily spread across large groups of people when
basic survival needs are interrupted by destructive storms, flooding,
droughts, and air pollution. The immediate response is to supply resources
such as bottled water, sanitation technology, and education, but global
health must also prioritize environmental concerns prevention in the first
place.
In most cases, the remedy lies in the availability of water and
sanitation. “Many global health specialists believe that climate change is the
greatest threat to human health,” Macpherson says. “Global initiatives to
reduce human-caused climate change are gaining traction.”
He cites legislation in China, India, the United States, and several
European countries as examples. They're enacting policies that will restrict
existing car use and individual household energy consumption on a broad
scale while also promoting industry advancement toward environmentally
friendly methods.
According to Macpherson, “such improvements will have enormous
health benefits for individuals who reside in urban centers, which account
for more than half of the world's population.” “They must be implemented as
quickly as possible.”

3. ECONOMIC DISPARITIES AND ACCESS TO

HEALTH CARE

Despite constant advancements in medicine, communities all across

the world continue to lack basic health knowledge and treatment. As a
result, they must deal with terrible realities such as STDs, high child
mortality rates, and basic nutrition. All of these problems might be solved by
lowering the inequities that divide these groups.

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Some of these inequalities are due to location, with rural areas seeing
the highest physician deficit. Other inequalities are the result of income
gaps, with individuals and families simply unable to afford health care that
would otherwise be unavailable.
To address these economic obstacles, global health professionals must
look for ways to include underrepresented communities in public health
discussions, encourage physicians to practice in rural areas, and implement
policies that lower barriers and improve access to health care.

4. POLITICAL FACTORS

When foreign politics enters the picture, insufficient access to health

care becomes even worse. Average individuals become more vulnerable to
diseases as battles inside or between states damage vital infrastructure for
transportation, water, sanitation, and garbage. As a result, they look for
ways to get out of harmful situations that threaten their safety.
Diseases can spread swiftly as a result of refugee travel, but
organizations like the WHO emphasize that isolating these huge groups of
people is not the solution. Instead, they concentrate on enhancing refugee
health care access by coordinating efforts across borders to support policies
that link short-term humanitarian response to long-term health-care access
improvements.

5. NONCOMMUNICABLE DISEASES

Non-communicable diseases (NCDs) such as heart disease, stroke,

cancer, and diabetes account for 70% of all fatalities globally. Genetic,
physiological, environmental, and behavioral factors all have a role.
Education can help people recognize and improve lifestyle variables
such poor diets, inactivity, cigarette use, and alcohol intake, which can lead
to NCDs. However, there is a link between household income and the
prevalence of NCDs.
Low- and middle-income countries account for about three-quarters of
all NCD-related fatalities worldwide. Reducing the global prevalence of NCDs

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requires addressing the factors that disproportionately affect low-income

areas.
6. ANIMAL HEALTH, FOOD SOURCING, AND
SUPPLY

Human and animal health are inextricably linked. The most obvious
link is found in the food chain, where humans raise, process, and consume
food on a huge scale. Animals are used for transportation, draught power,
and clothing in impoverished countries. Animal health is clearly a factor in
human health in these cultures.
Irrigation, pesticide use, and waste management are all agricultural
activities that can affect animal health, making disease transmission a
worry at every stage of the food supply chain. Veterinary medicine must be
included in any endeavor to enhance global health because diseases
originating from animals or animal products play such an important role in
disease transmission.
The World Health Organization (WHO) is one of the most well-known
organizations dedicated to improving global health, but it is not the only
one. Initiatives to build alliances between formerly disassociated fields are
being spearheaded by researchers and leaders in a range of fields.
Source: https://www.sgu.edu/blog/medical/what-is-global-health/

Why is global health important?

 Global health is becoming increasingly important in both global
security and the security of every country's population. It is vital to
think about health in a global framework as the globe and its
economies become increasingly globalized, including substantial
international travel and business. Almost every week brings news of
the emergence or re-emergence of an infectious disease or other health
danger somewhere around the world.

Emerging issues in Global Health

 The number of people dying from non-communicable diseases like
heart disease, stroke, and trauma is increasing around the world. At
the same time, deaths from infectious diseases including malaria,
tuberculosis, and vaccine-preventable diseases are on the decline.

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Many poor countries today face a "dual burden" of disease: they must
continue to prevent and control infectious diseases while also dealing
with non-communicable diseases and environmental health hazards.
More attention will be needed to address non-communicable diseases,
mental health, substance addiction problems, and, particularly,
injuries as social and economic situations in developing nations
change and their health systems and monitoring improve (both
intentional and unintentional). Some countries are starting to
implement programs to deal with these concerns.
Source: https://www.healthypeople.gov/2020/topics-objectives/topic/global-health#:~:text=Emerging

%20Issues%20in%20Global%20Health,%2Dpreventable%20diseases%2C%20is%20decreasing.

 However, the present virus that is sweeping the globe has left everyone
bewildered. The advent of CoVID-19 has shook the world health-care
system to its core. We were not properly prepared or equipped to
prevent the sickness from spreading. The flood of patients requiring
rapid medical assistance was overwhelming, especially for those
working in the hospital. With 23.3 million cases worldwide and more
than 800,000 deaths to date, this illness is a significant health
catastrophe that will not go away anytime soon.

 This pandemic has taken a toll on our health-care personnel, who

have been on the frontlines since the beginning, fighting an unseen
struggle. They are still striving to execute their jobs while being
mentally, physically, and emotionally weary.

II. NATIONAL

PhilHealth Coverage

 The number of Filipinos covered by PhilHealth increased from 93.4

million in 2016 to 104.49 million Filipinos in 2018, translating to a
population coverage of 98 percent. Out of this, 34.5 million were
indigents enrolled from the DSWD’s list of beneficiaries under the
National Household Targeting System for Poverty Reduction (NHTS-
PR). In addition, 9.4 million senior citizens were provided with
mandatory coverage, as provided for in Republic Act No. 10645
(Expanded Senior Citizens Act of 2010). Sin tax revenues continue to
shoulder the premium of members under these categories.

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 The No Balance Billing (NBB) policy allows PhilHealth members under

the Indigent and Senior Citizen categories to pay nothing more in
excess of PhilHealth case rates when confined at government health
facilities.
 On April 4, 2018, the DOH issued the Implementing Rules and
Regulations for Republic Act No. 10932, or the Anti-Hospital Deposit
Law. The law, which was enacted last August 2017, increases
penalties for the refusal of hospitals and medical clinics to administer
appropriate initial medical treatment in emergency or serious cases.
 In 2019, President Rodrigo Duterte signed the Universal Health Care
(UHC) Bill into law (Republic Act No. 11223) that automatically enrolls
all Filipino citizens in the National Health Insurance Program and
prescribes complementary reforms in the health system.
This gives citizens access to the full continuum of health services they
need, while protecting them from enduring financial hardship as a
result.
Source: https://www.who.int/philippines/news/feature-stories/detail/uhc-act-in-the-
philippines-a-new-dawn-for-health-care

Cultural and Health Ethnic Disparities and Culturally Competent Care

Culturally competent care is seen as foundational for reducing

disparities. Culturally competent care respects diversity as well as the
cultural factors that can affect health and health care, such as language,
communication styles, beliefs, attitudes, and behaviors. A lack of conceptual
clarity around cultural competence persists both in practice and among
researchers. Cultural competence is defined, conceptualized, and
operationalized in a variety of ways. This variance leads to disagreement
around the training needed for providers to attain cultural competence. The
populations to which the term cultural competence applies are also ill-
defined. Often, the term cultural competence is applied only to racial and
ethnic minority populations. This narrow application omits other
marginalized groups who may be ethnically and racially similar to a provider
but nonetheless at risk for stigmatization or discrimination, or who have
differences in health care needs that result in health disparities. This
broader concept may be termed “diversity competence.”
In addition to provider education and training, changing clinical
environments can also be key to improving culturally competent care.
Changes in provider knowledge, attitudes, and skills are necessary, but for
those gains to translate into culturally competent behaviors the structures
and culture of health care systems and organizations must also change. 

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Interpretation and significance of outcomes differ by priority population.

Access is important to all priority populations. However, individuals with
disabilities may face multiple barriers, such as transportation to facilities
and accessibility of exam rooms and their contents.
The concept of cultural competence overlaps with several other
concepts related to providing high-quality, appropriate care. (Please refer to
figure below). Conducting a systematic review requires clarity about whether
interventions fall inside or outside of the inclusion criteria. The criteria are
built to provide a specified scope of cultural competence.

Butler M, McCreedy E, Schwer N, et al. Improving Cultural Competence to Reduce Health Disparities
[Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Mar. (Comparative
Effectiveness Reviews, No. 170.) 1, Introduction. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK361130/

DEFINITION

Public Health
The Centers for Disease Control and Prevention (CDC 2020) defines
public health as the science of promoting healthy lifestyles, researching
diseases and injury prevention, and detecting, preventing, and responding
to infectious diseases in order to protect and improve the health of people
and communities.
Public health is directed towards assisting every citizen to realize his
birth rights and longevity “the art and science of preventing disease,
prolonging life and promoting health and efficiency through the organized
efforts of society” (Winston, 1920) for:
 The sanitation of the environment
 The control of communicable diseases
 The education of the individual in personal hygiene

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 The organization of medical and nursing services for the early

diagnosis and preventive treatment of disease.
 The development of a social machinery to ensure everyone a
standard of living, adequate for maintenance of health to enable
every citizen to realize his birth right of health and longevity (Dr. C.
E. Winslow).

The World Health Organization's ultimate objective is to promote

improved health and well-being in a sustainable manner, while also
improving integrated public health systems and eliminating inequities. The
public health approach to achieving this aim entails collaborating with other
sectors to address the broader determinants of health.

Core Public Health Functions

Assessment: Regular collection, analysis, and
information sharing about health conditions, risks, and
resources in a community.

Policy development: Use of information gathered

during assessment to develop local and state health
policies and to direct resources towards those policies.

Assurance: Focuses on the availability of necessary

health services throughout the community. it includes
maintaining the ability of both public health agencies
and private providers to manage day to day operations
and the capacity to respond to critical situations and
emergencies.

From Institute of Medicine: The future of public health, Washington DC, 1988, National
Academy Press

In 1994, the American Public Health Association drafted a list of 10

essential public health services, which the US Department of Health and
Human Services later adopted. The updated list of essential services (CDC,
2014).

Essential Public Health Services

 Monitor health status to identify and solve community health
problems.
 Diagnose and investigate health problems and health hazards in the
community.
 Inform, educate, and empower people about health issues.
 Mobilize community partnerships and actions to identify and solve
health problems.
 Develop policies and plans that support individual and community
health efforts.
 Enforce laws and regulations that protect health and ensure safety.
 Link people to needed personal health services and assure the
provision of health care when otherwise unavailable.
 Assure a competent public health and personal health care
workforce.

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 Evaluate effectiveness, accessibility, and quality of personal and

population- based health services.
 Research for new insights and innovative solutions to health
problems.
From Centers for Disease Control and Prevention, Office of the Director, Office of the Chief of Public Health Practice, National
Public Health Performances Standards Program: 10 essential public health services, 2014. Retrieved from:
https://www.cdc.gov/nphpsp/essentialservices.html.

Public Health Interventions

Public Health Nurses focus on the care of individuals, groups,

aggregates, and populations in many settings, including homes, clinics,
worksites, and schools.

The Public Health Intervention Model was initially proposed in the late
1990s by nurses from the Minnesota Department of Health in the USA to
describe the breadth and scope of public health nursing practice (Keller et
al., 1998). This model was later revised and termed as intervention wheel
(Keller et al., 2004) and it has become increasingly recognized as a
framework for community and public health nursing practice.

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Source: Minnesota Department of Health Center for Public Health Nursing.

Public Health Interventions and Definitions

Public Health
Intervention Definition

Surveillance Describes and monitors health events through ongoing and

systematic collection, analysis, and interpretation of health data for
the purpose of planning, implementing, and evaluating public
health intervention.

Disease and other Systematically gathers and analyzes data regarding threats to the
health event health of populations, ascertains the source of the threat, identifies
investigation cases and other at risk, and determines control measure.

Outreach Locates population of interest or populations at risk and provides

information about the nature of the concern, what can be done
about it, and how services can be obtained.

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Screening Identifies individuals with unrecognized health risk factors or

asymptomatic disease conditions.

Case Finding Locates individuals and families with identified risk factors and
connects them with resources.

Referral and Assists individuals, families, groups, organizations, and/or

Follow-up communities to identify and access necessary resources to prevent
or resolve problems or concerns.

Case Management Optimizes self-care capabilities of individuals and families and the
capacity of systems and communities to coordinate and provide
services.

Delegated Carries out direct care tasks under the authority of a health care
Functions practitioner as allowed by law.

Health Teaching Communicates facts, ideas, and skills that change knowledge,
attitudes, values, beliefs, behaviors and practices of individuals,
families, systems, and/ or communities.

Counseling Establishes an interpersonal relationship with a community, a

system, and a family or individual, with the intention of increasing
or enhancing the capacity of self-care and coping.

Consultation Seeks information and generates optional solutions to perceived

problems or issues through interactive problem solving with a
community system and family or individual.

Collaboration Commits two or more persons or organizations to achieve a common

goal by enhancing the capacity of one or more members to promote
or protect health.

Coalition Building Promotes and develops alliances among organizations or

constituencies for a common purpose.

Community Helps community groups to identify common problems or goals,

organizing mobilize resources, and develop and implement strategies for
realizing the goals they collectively have set.

Advocacy Pleads someone’s cause or acts on someone’s behalf, with a focus

on developing the community, system, and individual or family’s
capacity to plead their own cause or act on their behalf.

Social marketing Utilizes commercial marketing principles and technologies for

programs designed to influence the knowledge, attitudes, values,
beliefs, behaviors, and practices of the population or interest.

Policy Places health issues on decisions makers’ agendas, acquires a plan

development and of resolution, and determines needed resources, resulting in laws,
enforcement rules, regulations, ordinances, and policies. Policy enforcement
compels others to comply with laws, rules, regulations, ordinances,
and policies.

Source: Modified from Keller LO, Strohschein S, Lia-Hoagberg B, Schaffer MA: Population-based public health interventions: practiced-based
and evidenced-supported. Part I, St. Paul, MN, 2004a, Minnesota Department of Health, Center of Public Health Nursing.

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Community Health
Community health is a field of public health that focuses on studying,
protecting, or improving health within the community. It is a multi- sector
and multi- disciplinary collaborative enterprise that uses public health
science, evidenced- based strategies, and other approaches to engage and
work with communities, in a culturally appropriate manner, to optimize the
health and quality of life of all people who live, work or are otherwise active
in a defined community or communities (Goodman et. Al., 2018).
Community health covers a wide range of healthcare interventions,
including health promotion, disease prevention and treatment. It also
involves management and administration of care.

Public Health Nursing (PHN)

Public Health Nursing as defined by the American Public Health
Association (APHA) is the practice of promoting and protecting the health of
populations using knowledge from nursing, social and public health
sciences. The term public health nursing was invented by Lilian Wald
(1893) to put emphasis on the community value of the nurse whose work
was built upon an understanding of all the problems that invariably
accompanied the ills of the poor.
Public health nursing is a systematic process by which:
 The health and health care needs of the population are assessed
in order to identify subpopulations, families, and individuals
who would benefit from health promotion or who are at risk of
illness, injury, disability, or premature death.
 A plan of intervention developed with the community to meet
identified needs that take into account available resources, the
range of activities that contribute to health and the prevention
of illness injury, disability, and premature death.
 The plan is implemented effectively, efficiently and equitably.
 Evaluations are conducted to determine the extent to which the
intervention has an impact on the health status of individuals
and the population.
 The results of the process are used to influence and direct the
current delivery of care, deployment of health resources, and
the development of local, regional, state, and national health
policy and research to promote health and prevent disease.

Community Health Nursing (CHN)

“The utilization of the nursing process in the different levels of
clientele- individuals, families, population groups and communities,
concerned with the promotion of health, prevention of disease and disability
and rehabilitation”. (Maglaya, et al 2017)
The goal is to raise the level of citizenry by helping communities and
families to cope with the discontinuities in and threats to health in such a
way to maximize their potential for high- level wellness” (Nisce, et al)
Community Health Nursing is a special field of nursing that combines
the skills of nursing, public health and some phases of social assistance and

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functions as part of the total public health program for the promotion of
health, the improvement of the conditions in the social and physical
environment, rehabilitation of illness and disability (WHO Expert Committee
of Nursing).
Jacobson defined CHN as a learned practice of discipline with the
ultimate goal of contributing, as individual and in collaboration with others,
to the promotion of the client’s optimum level of functioning through
teaching and delivery of care.
A service rendered by professional nurse to individuals, families and
communities, population groups in health centers, clinics, schools,
workplace for the promotion of health, prevention of illness, care of the sick
at home and rehabilitation (Dr. Ruth B. Freeman).

Mission of CHN
 Health promotion
 Health protection
 Health balance
 Disease prevention
 Social justice

Philosophy of CHN
 The philosophy of CHN is based on the worth and dignity of
man. (Dr. M. Shetland)

Basic Principles of CHN

1. The community is the patient in CHN, the family is the unit of
care and there are four levels of clientele: Individual, family,
population group (those who share common characteristics,
developmental stages and common exposure to health
problems), and the community.
2. In CHN, the client is considered as an active partner not passive
recipient of care.
3. CHN practice is affected by developments in health technology,
in particular, changes in society, in general
4. The goal of CHN is achieved through multi- sectoral efforts
5. CHN is a part of health care system and the larger human
services system.

Standards of Public Health Nursing in the Philippines

1. Theory
 Applies theoretical concepts as basis for decisions in practice.
2. Data Collection
 Gathers comprehensive, accurate data systematically.
3. Diagnosis
 Analyzes collected data to determine the needs/ health
problems of Individuals, families and communities.
4. Planning

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 At each level of prevention, develops plans that specify nursing

actions unique to needs of clients.
5. Intervention
 Guided by the plan, intervenes to promote, maintain or restore
health, prevent illness and institute rehabilitation.
6. Evaluation
 Evaluates responses of clients to interventions to note progress
toward goal achievement, revise data base, diagnosis and plan.
7. Quality Assurance and Professional Development
 Participates in peer review and other means of evaluation to
assure quality of nursing practice.
 Assumes professional development.
 Contributes to development of others.
8. Interdisciplinary Collaboration
 Collaborates with other members of the health team,
professionals and community representatives in assessing,
planning, implementing and evaluating programs for
community health.
9. Research
 Indulges in research to contribute to theory and practice in
community health nursing.

Evolution of Public Health Nursing in the Philippines

Date Significant Events

1901 Act # 157 (Board of Health of the Philippines); Act # 309

(Provincial and Municipal Boards of Health) were created.

1905 Board of Health was abolished; functions were transferred

to the Bureau of Health.

1912 Act # 2156 or Fajardo Act created the Sanitary Divisions,

the forerunners of present Municipal Health Offices; male
nurses perform the functions of doctors.

1919 Act # 2808 (Nurses Law was created)- Carmen del Rosario,
1st Filipino Nurse supervisor under Bureau of Health.

Oct. 22, 1922 Filipino Nurses Organization (Philippine Nurses

Organization) was organized.

1923 Zamboanga General Hospital School of Nursing and Baguio

General Hospital were established; other government
schools of nursing were organized several years after.

1928 1st Nursing convention was held.

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1940 Manila Health Department was created.

1941 Dr. Mariano Icasiano became the first city health officer;
Office of Nursing was created through the effort of Vicenta
Ponce (chief nurse) and Rosario Ordiz (assistant chief
nurse).

Dec. 8, 1941 Victims of World War II were treated by the nurses of

Manila.

July 1942 Nursing Office was created; Dr. Eusebio Aguilar helped in
the release of 31 Filipino nurses in Bilibid Prison as
prisoners of war by the Japanese.

Feb. 1946 Number of nurses decreased from 556- 308

1948 First training center of the Bureau of Health was organized

by the Pasay City Health Department. Trinidad Gomez,
Marcela Gabatin, Costancia Tuazon, Ms. Bugarin, Ms.
Ramos, and Zenaida Nisce composed the training staff.

1950 Rural Health Demonstration and Training Center was

created.

1953 The first 81 rural health units were organized.

1957 RA 1891 amended some sections of RA 1082 and created

the eight categories of rural health unit causing an
increase in the demand for the community health
personnel.

1958-1965 Division of Nursing was abolished (RA 977) and

Reorganization Act (EO 288).

1961 Annie Sand organized the National League of Nurses of

DOH.

1967 Zenaida Nisce became the nursing program supervisor and

consultant on the six special diseases (TB, Leprosy, V.D.,
Cancer, Filariasis, and Mental illness).

1975 Scope of responsibility of nurses and midwives became

wider due to restructuring of the health care delivery
system.

1976- 1986 The need for Rural Health Practice Program was
implemented.

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1990- 1992 Local Government Code of 1991 (RA 7160)

1993-1998 Office of Nursing did not materialize in spite of persistent

recommendation of the officers, board members, and
advisers of the National League of Nurses Inc.

Jan. 1999 Nelia Hizon was positioned as the nursing adviser at the
Office of the Public Health Services through Department
Order # 29.

May 24, 1999 EO # 102, which redirects the functions and operations of
DOH, was signed by former President Joseph Estrada.

ROLES AND RESPONSIBILITIES

OF A COMMUNITY HEALTH
NURSE

 Clinician, who is a health

care provider, taking care
of the sick people at home
or in the RHU.

 Health Educator, who

aims towards health
promotion and illness
prevention through
dissemination of correct
information; educating
people.

 Facilitator, who
establishes multi- sectoral
linkages by referral
system.

 Supervisor, who monitors

and supervises the
performance of midwives.

 Health Advocator, who

speaks on behalf of the
client.

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 Advocator, who act on behalf of the client.

 Collaborator, who working with other health team member.

Other Specific Responsibilities of a Nurse, spelled by the implementing

rules and Regulations of RA 7164 (Philippine Nursing Act of 1991)
includes:

 Supervision and care of women during pregnancy, labor and

puerperium.

 Performance of internal examination and delivery of babies.

 Suturing lacerations in the absence of a physician

 Provision of first aid measures and emergency care
 Recommending herbal and symptomatic medications.

In the care of the families:

 Provision of primary health care services
 Development/ utilization of family nursing care plan in the provision
of care.

In the care of the communities:

 Community organizing mobilization, community development and
people empowerment
 Case finding and epidemiological investigation
 Program planning, implementation and evaluation
 Influencing executive and legislative individuals or bodies concerning
health and development.

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REFERENCES :

Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.

Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.

Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.

Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.
https://www.officialgazette.gov.ph

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RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

ACTIVITY 1.1: POSITION PAPER

Instructions: Make a Position Paper on the topic below, attach
additional sheet if needed. This activity sheet may also be
downloaded and can be submitted/ turned in online via LMS or
Google class.

Topic: “Global and National Health Situations: Year 2020”

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ACTIVITY 1.2: SITUATIONAL ANALYSIS

Instructions: Analyze the statements carefully, answer the questions
briefly, attach additional sheet if needed. This activity sheet may
also be downloaded and can be submitted/ turned in online via LMS
or Google class.

1. Select one community health nursing role and describe its

application in meeting the need of a community client.
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2. Describe a real situation in which you, as a community health

nurse would combine the roles of a leader, collaborator and
health educator. Discuss how each of these roles might be
played.
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CHAPTER II
THE HEALTH CARE DELIVERY SYSTEM

Learning Outcomes:
At the end of the lesson, the students will:
● Assume responsibility for lifelong learning, own personal development,
and maintenance of competence.
● Engage in advocacy activities to influence health and social care
service policies and access to services.

WORLD HEALTH ORGANIZATION

The World Health Organization (WHO) aims to build a better, healthier

future for people all over the world. WHO was established on April 7, 1948-
a date which was celebrated as World Health Day every year.
Its primary role is to direct and coordinate international health within
the United Nations system. The main areas of work are health systems,
health through the life-course, non-communicable and communicable
diseases, preparedness, surveillance and response, and corporate services.
Its core function is to direct and coordinate international health work
through collaboration. WHO partners with countries, the United Nations
System, international organizations, civil society, foundations, academia,
and research institutions.

Millennium Development Goals

In September 2000, world leaders came together at the United Nations

Headquarters in New York to adopt the United Nations Millennium
Declaration. The declaration committed nations to a new global partnership
to reduce extreme poverty and set out a series of eight time-bound targets

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with a deadline of 2015- that have become known

as Millennium Development Goals (MDGs).

The 8 Millennium Development Goals

1. Eradicate extreme poverty and

hunger.
The global mobilization behind the
Millennium Development Goals has
produced the most successful anti-
poverty movement in history. The
MDG target of reducing by half the
proportion of people living in
extreme poverty was achieved in
2010, well ahead of the 2015
deadline.

2. Achieve universal primary

education
Considerable progress has been made in expanding primary
education enrolment since 1990, particularly the adoption of
the MDGs in 2000. The global number of out-of-school
children has fallen considerably since 1990, however, the
pace of improvement has been insufficient to achieve
universal primary enrolment by 2015.

3. Promote gender equality and empower women

Much progress has been made towards women’s and girl’s
equality in education, employment and political
representation, but still many gaps remain.

4. Reduce child mortality

Substantial progress in reducing child mortality has been
made, but more children can be saved from death due to
preventable causes.

5. Improve maternal health

Maternal survival has significantly improved since the
adoption of the MDGs.

6. Combat HIV/ AIDS, malaria, and other diseases

The number of people newly infected with HIV continues to
decline in many regions around the world. Access to
antiretroviral therapy has increased at a remarkable pace,
averting millions of deaths. Unfortunately, knowledge of HIV
and HIV prevention remains low among your people.

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7. Ensure environmental sustainability

Deforestation has slowed, but global greenhouse gas
emissions continue their upward trend.

8. Develop a global partnership for development

Official development assistance to least developed countries
increased significantly over the MDG season.

Sustainable Development Goals and the 2030 Agenda. ied.eu

Philippine Department of Health

The Department of Health (DOH) is the principal health

agency in the Philippines. It is responsible for ensuring
access to basic public health services to all Filipinos
through the provision of quality health care and regulation
of providers of health goods and services.

Mission and Vision

Vision
Filipinos are among the healthiest people in Southeast Asia by 2022,
and Asia by 2040

Mission
To lead the country in the development of a productive, resilient,
equitable, and people-centered health system.

Historical Background

Year Event

1947 Executive Order No. 94, series of 1947, the Bureau of Public
Welfare to the Office of the President and the Department
was renamed Department of Health (DOH).

1987 The re-organization under Executive Order No. 119, which

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placed under the Secretary of Health five offices headed by an

undersecretary and an assistant secretary, these offices are:
Chief of Staff, Public Health Services, Hospital and Facilities
Services, Standard and Regulations, and Management
Service.

1992 The full implementation of Republic Act No. 7160 or Local

Government Code. The DOH changed its role from one of
implementation to one of governance.

1999 The functions and operations of the DOH was directed to

become consistent with the provisions of Administrative Code
1987 and RA 7160 through Executive Order 102.

Local Health System and Devolution of Health Services

The Philippine health system is characterized as a dual health system

composed of the public sector and the private sector. The public sector is
largely financed through a tax-based budgeting system, where health
services are delivered by government facilities run by the National and local
governments. The private sector, consisting of profit and non-profit health
care providers, is largely market-oriented where healthcare is generally paid
for through user fees at the point of service (Department of Health, 2005).

Local Government Code of 1991 (LGC)

● Devolution- refers to the act by which the national government

confers power and authority upon the various LGUs to perform
specific functions and responsibilities.
● The main feature of LGC is the relinquishing of responsibilities of
the national government in favor of local government units in the
provision of the public good.
● To efficiently deliver the devolved tasks, the LGUs were given
increased powers to mobilize their own resources.
● Aim: To improve the health status of the Filipino people through
greater and more effective coverage of national and local public
health services especially for the poor. And reduce the financial
burden on individual families.

Classification of Health Facilities

Hospitals Other Health Facilities
General a. Primary Care Facility
● Level 1
b. Custodial Care Facility
● Level 2
● Level 3 (Teaching/ Training)
Specialty c. Diagnostic Facility

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d. Specialized Out- Patient Facility

CLASSIFICATION OF GENERAL HOSPITALS

GENERAL LEVEL 1 LEVEL 2 LEVEL 3
Clinical services Consulting Level 1 plus all: Level 2 plus all:
for inpatients Specialists in:
Departmentalized Teaching/ training
Medicine
clinical services with the accredited
Pediatrics
residency training
OB-GYNE
program in the 4
Surgery
major clinical
services
Emergency and Out- Respiratory unit Physical Medicine
patient services and Rehabilitation
Unit
Isolation Facility General ICU Ambulatory Surgical
Clinic
Surgical/ maternity High Risk Pregnancy Dialysis Clinic
Facility Unit
Dental Clinic NICU Tertiary lab with
histopathology
Ancillary Services Secondary Clinical Tertiary Clinical Blood bank
Laboratory Laboratory
Blood station Blood station 3rd level X-ray
1 Level X-ray
st
2 Level of X-ray with
nd

the mobile unit

Pharmacy

CLASSIFICATION OF OTHER HEALTH FACILITIES

A B C D
Primary Care Custodial Care Diagnostic/ Specialized Out-
Facility Facility Therapeutic Patient Facility
Facility
With in-patient beds Psychiatric Care Laboratories: Dialysis Clinic (DC)
● Infirmary/ Facility ● Clinical LAB
Dispensary ● Blood service
● Birthing Facility Ambulatory
Home ● Drug test Lab
Surgical Clinic
● NB Screening
Lab
● Water Lab
Without beds: Drug abuse Ionizing machines as In- vitro
● Medical out- Treatment and X-ray, CT scan, fertilization (IVF)
patient clinic Rehabilitation mammography for Centers
● OFW clinics Center and others
● Dental Clinics
Sanitarium Non- ionizing Radiation oncology
Leprosarium machines as facility
ultrasound, MRI,
and others
Nursing Home Nuclear medicines Oncology Center
Clinic

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Philippine Health Agenda 2016- 2022

Goals

The Health System We Aspire For:

● Financial Protection
Filipinos, especially the poor, marginalized, and vulnerable are
protected from the high cost of health care.

● Better Health Outcomes

Filipinos attain the best possible health outcomes with no
disparity.

● Responsiveness
Filipinos feel respected, valued, and empowered in all of their
interaction with the health systems.

Values
The Health System We Aspire For:
● Equitable and inclusive to all
● Transparent and accountable
● Uses resources efficiently
● Provides high-quality services

Motto
● “All for health towards health for all.”
Strategy
● Advance quality health promotion and primary care
● Cover all Filipinos against health-related financial risk
● Harness the power of strategic HRH development
● Invest in eHealth and data for decision-making
● Enforce standards, accountability and transparency
● Value all clients and patients, especially the poor, marginalized, and
vulnerable
● Elicit multi-sectoral and multi-stakeholder support for health

Primary Health Care (PHC)

Definition
● Primary Health Care (PHC) is essential health care made universally
accepted to individuals and families in the community by means
acceptable to them through their full participation and at a cost that

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the community and country can afford, in the spirit of Self and Self
determination.
● The Declaration of Alma-Ata was adopted at the International
Conference on Primary Health Care (PHC). There are 8 essential
elements of PHC based on Alma Ata: essential health care based on
practical, scientifically sound, and socially acceptable methods and
technology made universally accessible to individuals and families in
the community by means acceptable to them.

History

● May 1977. The 30th World Health Assembly adopted a resolution

which decided that the main social target of the governments and of
WHO should be attained by all people in the world by the year 2000 a
level of health that will permit them to lead a socially and
economically productive life.
● September 6-12, 1978. International Conference in PHC was held
this year at Alma Ata, USSR (Russia).
● October 19, 1979. The President of the Philippines (Ferdinand
Marcos) issued Letter of Instruction (LOI) 949 which mandated the
then Ministry of Health to adopt PHC as an approach towards design,
development, and implementation of programs that focus health
development at a community level.

Elements of Primary Health Care

1. Health Education
One of the potent methods for information dissemination. It
enriches the partnership of both the family and the health
worker in the promotion of health as well as prevention of
illness.

2. Treatment of Locally Endemic Diseases

The control of endemic disease focuses on the prevention of
their occurrence to reduce the morbidity rate.

3. Expanded Program on Immunization

This program exists to control the occurrence of vaccine-
preventable illnesses especially of children below 5 years old.
Immunizations on Poliomyelitis, measles, tetanus, diphtheria,
pertussis, and tuberculosis other preventable disease are given
for free by the government and is an ongoing program of the
DOH.

4. Maternal and Child Health and Family Planning

The mother and the child are considered the most delicate
members of the community. Hence, the protection of the

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mother and the child from illness and other risks would ensure
good health for the community. The goal of family planning
includes spacing and limiting the number of children and
responsible parenthood.

5. Provision of Essential Drugs

This focuses on the information campaign on the utilization and
acquisition of drugs. In response, the GENERIC ACT of the
Philippines is enacted.

6. Nutrition and Promotion of Adequate Food Supply

One basic need of the family is food, its preparation & choices.
And if food is properly prepared then one may be assured a
healthy family. There are many food resources found in the
communities however, faulty preparation and lack of knowledge
regarding food planning, malnutrition is one of the problems
that we have in the country.

7. Treatment of communicable and non-communicable diseases

Diseases spread through direct or indirect contact and pose a
great risk to people who are infected. Most of these diseases are
preventable. This program focuses on the prevention, control,
and treatment of these illnesses.

8. Environmental Sanitation and Promotion of Safe Water Supply

Environmental Sanitation is defined as the study of all factors
in the man’s environment, which exercise or may exercise
deleterious effects on his well-being and survival. Water is a
basic need for life and one factor in man’s environment. Water
is necessary for the maintenance of health. Safe water and
sanitation are necessary for basic health promotion.

Goals
The ultimate goal of PHC is “better health for all”. WHO identified five
key elements to achieving that goal:
● Reducing exclusion and social disparities in health (universal coverage
reforms).
● Organizing health services around people’s needs and expectations
(service delivery reforms).
● Integrating health into all sectors (public policy reforms).
● Pursuing collaborative models of policy dialogue (leadership reforms);
and
● Increasing stake holder’s participation`

Seven Principles and Strategies (DOH)

PHC is run with the following principles:

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1. 4 A’s (Accessibility, Availability, Affordability and Acceptability,

Appropriateness of Health Services
Health care services should be accessible to the community people.
They should make use of available resources within the community,
wherein the focus would be more on health promotion and prevention
of illness.

2. Community Participation
Community participation is the heart and soul of primary health care.

3. People are the center, object, and subject of development

The success of the undertakings is based on the community’s
participation in all levels of decision making; planning, implementing,
monitoring, and evaluating. All of which must be based on the
people’s needs and problems (PCF, 1990)

4. Self- reliance
Through community participation and cohesiveness of people’s
organizations, they can generate support for health care through
social mobilization, networking, and mobilization of local resources.
Leadership and management skills should be developed among these
people. The existence of sustained health care facilities managed by
the people is some of the major indicators that the community is
leading to self- reliance.

5. Partnership between the community and the health agencies in the

provision of quality life
Providing linkages between the government and the non- government
organization and people’s organization.

6. Recognition of interrelationship between the health and

development
● Health is defined as not merely the absence of disease. Neither is
it only a state of physical and mental well- being. Health being a
social phenomenon recognizes the interplay of political, socio
cultural and economic factors as its determinant. Good health
therefore, is manifested by the progressive improvements in the
living conditions and quality of life enjoyed by the community.
● Development is the quest for an improved quality of life for all.
Development is multidimensional. It has political, social, cultural,
institutional, and environmental dimensions (Gonzales 1994).

7. Social Mobilization
It enhances people’s participation or governance, support system
provided by the government, networking, and developing secondary
leaders.

8. Decentralization

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This ensures empowerment and that it can only be facilitated if the

administrative structure provides local-level political structures with
more substantive responsibilities for development initiators. This also
facilities the proper allocation of budgetary resources.

Levels of PHC Delivery in the Philippines

1. Primary
● Municipal Health Office
● Rural Health Unit
● Health Centers
● Barangay Health Stations

2. Secondary
● Provincial Health Office
● District Hospitals
● Emergency Hospitals
● Provincial Hospitals/Provincial Medical Centers

3. Tertiary
● National Hospitals
● National Medical Centers & National Specialized Hospitals
● Regional Hospitals/Regional Medical Centers
● Teaching & Training Hospitals
Levels of Prevention
The goal of health care professionals is to promote health, preserve
health, to restore health when it is impaired, and minimize suffering and
distress. Prevention is one of our tools to achieve this goal. Successful
prevention depends upon a knowledge of causation, dynamics of
transmission, identification of risk factors and risk groups.

Universal Health Care (UHC)

● Republic Act No. 11223

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● An act instituting universal health care for all Filipinos prescribing

reforms in the Health Care Systems, and appropriating funds therefor
● This act shall be known as the “Universal Health Care Act”.
● Declaration of principles and policies- It is the policy of the state to
protect and promote the right to health of all Filipinos and instill
health consciousness among them. Towards this end, the state shall
adopt:
a. An integrated and comprehensive approach to ensure that all
Filipinos are health literate, provided with healthy living
conditions, and protected from hazards and risks that could
affect their health.
b. A health care model that provides all Filipinos access to a
comprehensive set of quality and cost-effective, promotive,
preventive, curative, rehabilitative, and palliative health services
without causing financial hardships, and prioritizes the needs of
the population who cannot afford such services.
c. A framework that fosters a whole-of-system, whole government,
and whole-of-society approach in the development,
implementation, monitoring, and evaluation of health policies,
programs, and plans.
d. A people-oriented approach for the delivery of health services
that are centered on people’s needs and well-being, and
cognizant of the differences in culture, values, and beliefs.

REFERENCES
Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.
Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.
Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.
Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.

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https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.
https://www.officialgazette.gov.ph

RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

ACTIVITY 2: QUIZ- MULTIPLE CHOICE

Instructions: Choose the letter of the BEST answer and write on the space
provided before the number.
_____1. Which of the following activities reflect primary prevention in a
school health nursing?
a. Screening for malnutrition
b. Monitoring school population for signs of measles during an
outbreak.
c. Conducting an information drive on healthy eating habits and
regular exercise
d. Applying first-aid to a student who sustained a cut during a cooking
class
_____2. Treat a wide range of conditions and age groups. Provide
diagnostic, medical, surgical and emergency care services.
a. Specialty hospitals
b. Long term care facilities
c. General hospitals
d. Hospice
_____3. The nurse is delivering influenza shots to senior residents during a
health fair at the local mall. What kind of preventative measures does the

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nurse take?
a. Primary Prevention
b. Secondary Prevention
c. Tertiary Prevention
d. Quaternary Prevention
_____4. What is the goal of tertiary prevention?
a. Educate to prevent diseases from occurring in the first place
b. Early detection and treatment
c. Blood pressure and cholesterol screenings
d. Prevent future occurrences and increase life expectancy
_____5. Be a disease/injury occurs, avoidance or preventive is necessary.
a. Primordial prevention
b. Primary prevention
c. Secondary prevention
d. Tertiary prevention
_____6. What is universal health care?
a. A type of health care in which everyone, regardless of their income,
race, age, pre-existing ailments, gender, or wealth, is covered.
b. A sort of accidental insurance plan in which everyone, regardless of
poverty, ethnicity, age, pre-existing conditions, gender, or wealth,
receives health coverage.
c. A type of health care in which all people are covered regardless of
their income, race, age, pre-existing conditions, gender, or wealth.
d. All of the above
_____7. Which of the following is NOT one of the UN Millennium
Development Goals?
a. To eradicate extreme poverty and hunger
b. To achieve universal primary education
c. To completely end gender inequality
d. To ensure environmental sustainability
_____8. Which of the following conditions do not promote poverty
alleviation?
a. Microfinance for persons who are disadvantaged
b. Debt moratorium
c. Universal primary education
d. Absence of price monitoring on basic commodities
_____9. Which of the following factors makes universal education less
likely?
a. Investing in teacher education and teaching materials
b. Free school meals are available
c. Fees at public schools should be eliminated.
d. Creating "girl-friendly" educational environments
_____10. Which of the following situations does not strengthen global
development partnerships?
a. Tariff reductions by wealthy countries on agricultural imports from

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developing countries
b. Access to Information and Communications Technology (ICT) is
being made more widely available (ICT)
c. Immigrants from underdeveloped nations are subjected to strict
immigration rules.
d. Debt relief schemes aimed at poor countries by creditor countries

CHAPTER III
FAMILY NURSING PROCESS

Learning Outcomes:
At the end of the lesson, the students will:

 Assess with the individual and family one’s health status/

competence.
 Formulate with the client plan of care to address the health
conditions, needs, problems, and issues based on priorities.
 Implement safe and quality interventions with the client to address
the health needs, problems, and issues.
 Provides safe, appropriate and evidenced based nursing interventions
in the different categories of health care.
 Evaluate with the client the health status/ competence. Institute
appropriate corrective actions to prevent or minimize harm arising
from adverse effect.

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FAMILY HEALTH NURSING PROCESS

Definition of Family

 Basic unit in society, and is shaped by all forces around it. These
forces include values, beliefs, and customs of society which influence
the role and function of the family (invades every aspect of the life of
the family).
 Is a unit of interacting persons bound by ties of blood, marriage or
adoption. Constitute a single household, interacts with each other in
their respective familial roles and create and maintain a common
culture.
 An open and developing system of interacting personalities with
structure and process enacted in relationships among the individual
members regulated by resources and stressors and existing within the
larger community (Smith and Maurer, 1995).

Types of Family

There are many types of family. They change overtime as a

consequence of birth, death, migration, separation, and growth of family
member.

A. STRUCTURE

1. NUCLEAR- a father, a mother with child/ children living together but

apart from both sets of parents and other relatives.
2. EXTENDED- composed of two or more nuclear families economically
and socially related to each other. Multigenerational, including
married brothers and sisters, and the families.
3. SINGLE PARENT- divorced or separated, unmarried or widowed male
or female with at least one child.
4. BLENDED/ RECONSTITUTED- a combination of two families with
children from both families and sometimes children of the newly
married couple. It is also remarriage with children from previous
marriage.
5. COMPOUND- one man/ woman with several spouses.
6. COMMUNAL- more than one monogamous couple sharing resources.
7. COHABITING/ LIVE-IN- unmarried couple living together
8. DYAD- husband and wife or other couple lying alone without children.
9. GAY/ LESBIAN- homosexual couple living together with or without
children.
10. NO- KIN- a group of at least two people sharing a relationship
and exchange support who have no legal or blood tie to each other.
11. FOSTER- substitute family for children whose parents are
unable to care for them.

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FUNCTIONAL TYPE:

1. FAMILY OF PROCREATION- refers to the family you yourself created.

2. FAMILY OF ORIENTATION- refers to the family where you came
from.

B. Decisions in the Family (Authority)

1. PATRIARCHAL- full authority on the father or any male member of

the family e.g. eldest son, grandfather
2. MATRIACHAL- full authority of the mother or any female member of
the family, e.g. eldest sister, grandmother
3. EGALITARIAN- husband and wife exercise a more or less amount of
authority, father and mother decides.
4. DEMOCRATIC- everybody if involve in decision making.
5. AUTHOCRATIC-
6. LAISSEZ- FAIRE- “full autonomy”
7. MATRICENTRIC- the mother decides/ takes change in absence of the
father (e.g. father is working overseas)
8. PATRICENTRIC- the father decides/ takes charge in absence of the
mother

C. DECENT (cultural norms, which affiliate a person with a person with

a particular group of kinsman for certain social purposes)

1. PATRILINEAL- affiliates a person with a group of relatives who are

related to him through his father.
2. BILATERAL- both parents
3. MATRILINEAL- related through mother
D. RESIDENCE

1. PATRILOCAL-family resides/ stays with/ near domicile of the parents

of the husband.
2. MATRILOCAL- live near the domicile of the parents of the wife.

ROLES AND FUNCTION OF THE FAMILY:

Ackerman States that the Function of Family are:

1. Insuring the physical survival, thereby insuring man’s species.
2. Transmitting the culture, thereby insuring man’s humanness
 Physical functions of the family are met through parents
providing food, clothing and shelter, protection against danger
provision for bodily repairs after fatigue or illness, and through
reproduction.
 Affectional function- the family is the primary unit in which the
child tests his emotional reactions

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 Social functions- include providing social togetherness, fostering

self-esteem and a personal identity, providing opportunity for
observing opportunity for observing and learning social and
sexual roles, accepting responsibility for behavior and
supporting individual creativity and initiative.

Universal Function of the Family by Doode

1. REPRODUCTION- for replacement of members of society: to
perpetuate the human species.
2. STATUS PLACEMENT of individual in society
3. BIOLOGICAL and MAINTENANCE OF THE YOUNG and dependent
members
4. Socialization and care of the children;
5. Social control

THE FAMILY AS A UNIT OF CARE

Rationale for Considering the Family as a Unit of Care

 The family is considered the natural and fundamental unit of society
 The family as a group generates, prevents, tolerates and corrects
health problems within its membership
 The health problems of the family members are interlocking.
 The family is the most frequent focus of health decisions and action in
personal care.
 The family is an effective and available channel for much of the effort
of the health worker.

THE FAMILY AS THE CLIENT

Characteristics of a Family as a Client

 The family is a product of time and place

 A family is different from other family who lives in another
location in many ways.
 A family who lived in the past is different from another family
who lives at present in many ways.

 The family develops its

own lifestyle
 Develop its own
patterns of
behavior and its
own style in life.
 Develops their
own power system
which either be:

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a. Balance- the parents and children have their own areas of

decisions and control
b. Strong Bias- one member gains dominance over the
others

 The family operates as a group

 A family is a unit in which the action of any member may set of
a whole series of reaction within a group, and entity whose
inner strength may be its greatest single supportive factor when
one of its members is strength may be its greatest single
supportive factor when one of its members is stricken with
illness or death.

 The Family accommodates the needs of the individual members.

 An individual is unique human being who needs to assert his or
herself in a way that allows him to grow and develop.
 Sometimes, individual needs and group needs seem to find a
natural balance;
a. The need for self- expression does not over shadow
consideration for others.
b. Power is equitably distributed.
c. Independence is permitted to flourish.

 The family relates to the community

 Family develops a stance with respect to the community;
a. The relationship between the families is wholesome and
reciprocal; the family utilizes the community resources
and in turn contributes to the improvement of the
community.
b. There are families who feel a sense of isolation from the
community. Families who maintain proud, “we keep to
ourselves” attitude. Families who are entirely passive
taking the benefits from the community without either
contributing to it or demanding changes to it.

FAMILY HEALTH NURSING

Family Health Nursing Process is a systematic approach to help family
to develop and strengthen its capacity to meet its health needs and solve
health problems. The main objective or goals are health promotion,
prevention from disease and control of health problems. There are different
phases of the Family health nursing process.

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Assessment

Nursing
Evaluation
Diagnosis
Family
Health
Nursing
Process

Implementat
Planning
ion

Step 1: ASSESSMENT PHASE

 First major phase of nursing process in family health nursing.
 Involves a set of action by which the nurse measures the status
of the family as a client. Its ability to maintain wellness,
prevent, control or resolve problems in order to achieve health
and wellness among its members.
 Data about present condition or status of the family are
compared against the norms and standards of personal, social,
and environmental health, system integrity and ability to resolve
social problems.
 The norms and standards are derived from values, beliefs,
principles, rules or expectation

Two Major Types of Assessment:

1. First Level Assessment- a process whereby existing and

potential health conditions or problems of the family are
determined.
2. Second Level Assessment- defines the nature or type of
nursing problem that family encounters in performing health
task with respect to given health condition or problem and
etiology or barriers to the family’s assumption of the task.

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Data Collection Method: Select Appropriate Method

a. OBSERVATION
 Done through use of sensory capacities
 The nurse gathers information about the family’s state
of well-being and behavioral responses.
 The family’s health status can be inferred from the
signs and symptoms of problem areas:
 Communication and interaction patterns
expected, used, and tolerated by family
members
 Role perception/ task assumption by each
member including decision making patterns
 Conditions in the home and environment

b. Physical Examination
 Significant data about the health status of individual
members can be obtained through direct examination
through IPPA, measurement of specific body parts and
reviewing the body systems
 Data gathered from PA form substantive part of first
level assessment which may indicate presence of
health deficits (illness state).

c. Interview
 Productivity of interview process depends upon the use
of effective communication techniques to elicit needed
response problems encountered.
 Provisions of models for phrasing interview questions
utilization of deliberately chosen communication
techniques for an adequate nursing assessment.
 Confidence in the use of communication skills.
 Being familiar with and being competent in the use of
type of question that aim to explore, validate, clarify,
offer feedback, encourage verbalization of thought and
feelings and offer needed support or reassurance.
 TYPES:
1. Completing health history of each family member
 Health history determines current health
status based on significant Past Health
History e.g. developmental
accomplishment, known illnesses,
allergies, restorative treatment, residence
in endemic areas for certain diseases or
sources of communicable diseases.
 Family health history e.g. genetic history
in relation to health and illness.

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 Social history e.g. Intra- personal and

inter- personal factors affecting the family
member social adjustment or vulnerability
to stress and crisis
2. Collecting data by personally asking significant
family members or relatives questions regarding
health, family life experiences and home
environment to generate data on what wellness
condition and health problem exist in the family
(first level assessment) and the corresponding
nursing problems for each health condition or
problem (2nd level assessment)

d. Records Review
 Gather information through reviewing existing records
and reports pertinent to the client
 Individual clinical records of the family members,
laboratory and diagnostic reports, immunization
records reports about home and environmental
conditions.

e. Laboratory/ Diagnostic Test

 Another method of data collection is through
performing laboratory tests, diagnostic procedures, or
other tests of integrity and functions carried out by the
nurse

5 Types of Data in Family Nursing Assessment (Initial Data Base)

A. Family Structure, Characteristics and Dynamic
 Members of the household and relationship to the head of
the family
 Demographic data- age, sex, civil status position in the
family.
 Place of residence of each member- whether living with
the family or elsewhere.
 Type of family structure (matriarchal or patriarchal,
nuclear or extended).
 Dominant family members in terms of decision- making,
especially in matters of health care.
 General family relationship/ dynamics- presence of any
obvious/ readily observable conflict between members;
characteristics, communication/ interaction pattern
among members.

B. Socio- economic and Cultural Characteristics

 Income and expenses:
a. Occupation, place of work and income of each working
member

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b. Adequacy to meet basic necessities (food, clothing,

shelter
c. Who makes decision about money and how it is spent.
 Educational attainment of each member.
 Ethnic background and religious affiliation
 Significant others and the roles they play in the family
 Relationship of the family to a larger community- nature
of the activity and the extent of participation to
community activities.

C. Home and Environment

 Housing
a. Adequacy of living space
b. Sleeping arrangement
c. Presence of breeding or resting sites of vectors of
disease (e.g. mosquitoes, roaches, flies, rodents etc.)
d. Professional accident hazards
e. Food storage and cooking facilities
f. Water supply: source, ownership sanitary condition
g. Garbage/ refuse disposal: Type and sanitary condition
h. Drainage system: Type, sanitary condition
 Kind of neighborhood (congested slum).
 Social and health facilities available.
 Communication and transportation facilities available.

D. Health Status of Each Family Member

 Medical and nursing history indicating current or past
significant illnesses or beliefs and practices conducive to
health and illness.
 Nutrition assessment (specially for vulnerable or risk, at-
risk members)
a. Anthropometric data: measures nutritional status of
children- weight, height, mid- upper arm
circumference
b. Dietary history specifying quality and quantity of food/
nutrient intake per day
c. Eating/ feeding habits/ practices.
 Developmental assessment of infants, toddlers and
preschoolers
 Risk factor for assessment for assessment indicating
presence of major and contributing modifiable risk factors
diseases/ illnesses.
 Physical assessment indicating presence of illness state/s
(diagnosed or undiagnosed) by a medical practitioner.
 Results of laboratory/ diagnostic and other screening
procedures supportive of assessment findings.

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E. Values, Habits, Practices on Health Promotion, Maintenance

and Disease Prevention such as:
 Immunization status of family members.
 Healthy lifestyle practices.
 Adequacy of:
a. Rest and sleep
b. Exercise/ activities
c. Use of protective measures
d. Use of relaxation and other stress management
activities
 Use of promotive- preventive health services

Family Data Analysis

Utilizing the data gathered during family assessment, the nurse
goes through data analysis. Data gathered are sorted out, and
classified or grouped by the type of nature (wellness state, health
threats, health deficits or stress points of foreseeable crisis).
Steps:
1. Sorting of data for broad categories
2. Clustering of related cues to determine relationship among data.
3. Distinguish relevant data. This will help in deciding what
information is pertinent to the situation at hand and what
information is pertinent to the situation at hand.
4. Identifying patterns such as physiologic functions, developmental,
nutritional dietary, coping/ adaptation or communication patterns.
5. Compare patterns with norms or standards of health, family
functioning and assumption of health task.
6. Integrating results of comparisons to determine signs and
symptoms or cues of specific well state, health deficit, health
threats, foreseeable crises/ stress points and their underlying
causes or associated factors.
7. Making conclusions about the reasons for the existence of the
health condition or problem, or risk for non- maintenance of
wellness state/s which can be attributed to non-performance of
family tasks.

STEP 2. FAMILY NURSING PROBLEM AND NURSING DIAGNOSIS

The end result of two major types of assessment.

Family Nursing Problem

Described as the inability to perform specific health task and the
reasons (etiology) as to why the family cannot perform such task.
 Consists of 2 parts: Main category of problem (comes from an
unattained health task) and specific problems (statement of
contributory factors for the existence of the main problem.
 Example:
General: Inability to utilize resources of health care due to lack of
adequate family resources, specifically

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a. Financial resources
b. Manpower resources
c. Time
 The more specific the problem definition is, nursing
diagnosis becomes more useful in determining the
nursing intervention. Therefore, as many as 3 or 4 levels
of problem definition can be stated.

Typology of Nursing Problems in Family Nursing Practice

1. First Level of Assessment- process whereby existing potential health

conditions/ problems of the family are determined.
a. Presence of wellness condition- stated as “potential or
readiness”- a clinical or nursing judgment about a client in
transition from a specific level of wellness or capacity to a higher
level.
b. Presence of Health Deficits- instances of failure in health
maintenance.
 Illness state, regardless of whether it is diagnosed or
undiagnosed by a physician.
 Failure to thrive or live according to normal rate.
 Disability whether congenital or arising from illness.
c. Presence of Health Threats- conditions that are conducive to a
disease, accident or failure to realize one’s health potential.
 Family history of a hereditary condition/ disease
 Threat of cross infection from a communicable disease
case
 Family size beyond what family resources can adequately
provide.
 Accident hazards
 Faulty/ unhealthy nutritional or eating habits or feeding
techniques.
 Inadequate food intake both in quality and
quantity
 Excessive intake of certain nutrients
 Faulty eating habits
 Ineffective breastfeeding
 Faulty feeding techniques
 Stress- provoking factors
 Strained marital relationship
 Strained parent- sibling relationship
 Interpersonal conflicts between family members
 Care- giving burden
 Poor home/ environmental condition/ sanitation
 Inadequate living space
 Lack of food storage facilities
 Polluted water supply

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 Presence of breeding or resting sites of vectors of

diseases
 Improper garbage/ refuse disposal
 Poor lighting and ventilation
 Noise pollution
 Air pollution
 Unsanitary food handling and preparation
 Unhealthy lifestyle and personal habits/ practices
 Alcohol drinking
 Cigarette/ tobacco smoking
 Walking barefooted or inadequate footwear
 Eating raw fish or meat
 Poor personal hygiene
 Self-medication/ substance abuse
 Sexual promiscuity
 Engaging in dangerous sports
 Inadequate rest/ sleep
 Lack of/ inadequate exercise/ physical activity
 Non-use of self-protection measures
 Inherent personal characteristics- poor impulses control
 Health history which may induce the occurrence of
health deficit
 Inappropriate role assumption
 Lack of immunization/ inadequate immunization status
specially of children.
 Family destiny

d. Presence of Stress Points/ Foreseeable

Anticipated periods of unusual demand on the individual or
family in terms or adjustment/ family resources.
 Marriage
 Pregnancy, labor, puerperium
 Parenthood
 Additional member
 Abortion
 Entrance at school
 Adolescence
 Divorce or separation
 Menopause
 Loss of job
 Hospitalization of a family member
 Death of a loved one
 Resettlement in a new neighborhood
 Illegitimacy

2. Secondary Assessment
Defines the nature or type of nursing problems that the family
encounters in performing health.

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I. Inability to recognize the presence of the condition or problems due

to:
a. Lack or inadequate knowledge
b. Denial about the existence or severity of the problem as a result of
fear to its consequences specifically;
 Social stigma, loss of respect by peers or significant others
 Economic/ cost implications
 Physical consequences
 Emotional/ psychological issues or concerns
c. Attitude/ philosophy in life which hinders recognition/ acceptance
of a problem.
d. Others

II. Inability to make decisions with respect to taking appropriate

health action due to:
a. Failure to comprehend the nature/ magnitude of the problem/
condition.
b. Low salience of the problem / condition
c. Feeling of confusion, helplessness and/ or resignation brought by
perceived magnitudes/ severity of the situation or problem.
d. Lack of/ or inadequate knowledge/ insight as to alternative courses of
action to take.
e. Inability to decide which action to take among the list of alternatives
f. Conflicting opinions among family members/ significant others
regarding action to take.
g. Lack of/ or inadequate knowledge of community resources for care
h. Fear of consequences of action specially:
 Social consequences
 Economic consequences
 Physical/ psychological consequences
i. Negative attitude towards the health problem- negative attitude meant
one that interferes with rational decision making.
j. Inaccessibility of appropriate resources for care, specifically:
 Physical inaccessibility
 Cost constraints of economic/ financial inaccessibility
k. Lack of trust/ confidence in the health personnel/ agency
l. Others

III. Inability to provide adequate nursing care to sick, disabled,

dependent or vulnerable/ at- risk member of the family due to:
a. Lack of/ inadequate knowledge about the disease/ health condition
(nature, severity, complications, prognosis and management)
b. Lack of/ inadequate knowledge about the child development and care
c. Lack of the necessary facilities, equipment and supplies for care
d. Lack of inadequate knowledge and skill in carrying out the necessary
interventions/ treatment/ procedure/ care
e. Inadequate family resources for care, specifically:

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 Absence of responsible member

 Financial constraints
 Limitations/ lack of physical resources
f. Significant person’s unexpressed feelings which disable his/ her
capacities to provide care.
g. Philosophy in life which negates/ hinders caring the sick, disabled,
dependent, vulnerable/ at-risk members
h. Member’s preoccupation with own concerns/ interests
i. Prolonged disease or disability progression with exhausts supportive
capacity of family members
j. Altered role performance specifically;
 Role denial/ ambivalence
 Role strain
 Role dissatisfaction
 Role conflict
 Role confusion
 Role overload
k. Others

IV. Inability to provide a home environment conducive to health

maintenance and personal development due to:
a. Inadequate family resources specially:
 Financial constraints/ limited financial resources
 Limited physical resources
b. Failure to see benefits (specifically long-term ones) of investment in
home environment improvement
c. Lack of/ inadequate knowledge of importance of hygiene and
sanitation
d. Lack of/ inadequate knowledge of preventive measures
e. Lack of skill in carrying out measures to improve home environment
f. Ineffective communication patterns within the family
g. Lack of supportive relationships among family members
h. Negative attitude/ philosophy in life which is not conducive to health
maintenance and personal development
i. Lack of/ inadequate competencies in relating to each other for mutual
growth and maturation
j. Family’s preoccupation with current problem or condition
k. Others

V. Failure to utilize community resources for health care due to:

a. Lack of/ inadequate knowledge of community resources for health
care
b. Failure to perceive the benefits of health care/ services
c. Lack of trust/ confidence in the agency/ personnel
d. Previous unpleasant experience with health worker
e. Fear of consequences of action (preventive, diagnostic, therapeutic,
rehabilitative), specifically:
 Physical/ psychological consequences

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 Financial consequences
 Social consequences
f. Unavailability of required care/ service
g. Inaccessibility of required care/ service due to:
 Cost constraints
 Physical inaccessibility
h. Lack of/ inadequate family resources, specifically:
 Manpower resources
 Financial resources
i. Feeling of alienation/ lack of support from the community
j. Negative attitude/ philosophy in life which hinders effective/
maximum utilization of community resources for health care
k. Others

STEP III: PLANNING

The step in the process which answers the following questions:
a. What is to be done?
b. How is to be done?
c. When it is to be done?

 It is the phase where the health care provider formulates the

Family Nursing Care Plan.

Steps in developing a Family Nursing Care Plan (FNCP)

1. Prioritize problems
2. Goals and objectives of the nursing care plan
3. Plan of intervention
4. Plan of evaluating care

1. Prioritizing Health Problems

a. Nature of the Problem- categorize problems into wellness state,
health threat, health deficit, or foreseeable crisis.
b. Modifiability of the Problem/ Condition- refers to the probability of
success in enhancing, improving, minimizing, alleviating or totally
eradicating the problem through intervention.
c. Preventive Potential- refers to the nature and magnitude of future
problems that can be minimized or totally prevented intervention is
done on the problem under consideration.
d. Salience- refers to the family’s perception and evaluation of the
problem in terms of seriousness and urgency of attention needed or
family readiness.

CRITERIS WEIGHT
1. Nature of the Problem 1
Scale:
Health Deficit/ Wellness State 3
Health Threat 2

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Foreseeable Crisis 1
2. Modifiability of the Problem 2
Scale:
Easily Modifiable 2
Partially Modifiable 1
Not Modifiable 0
3. Preventive Potential 1
Scale:
High 3
Low 2
Moderate 1
4. Salience 1
Scale:
A condition/ problem needing 2
immediate attention
A condition/ problem not needing 1
immediate attention
Not perceived as a problem or 0
condition needing change

 Scoring
1. Decide a score for each criterion
2. Divide the score by the highest possible score and multiply by the weight.
Formula:
Score X weight
Highest Score
3. Sum up the score of all criteria. The highest score is 5 equivalent to total weight.

 Factors affecting priority setting:

The nurse considers the availability of the following factors in determining
the modifiability of a health condition or problem.
1. Current knowledge, technology and interventions
2. Resources of the family- physical, financial and man power
3. Resources of the nurse- knowledge, skills and time
4. Resources of the community- facilities and community organization or
support

 Factors in Deciding Appropriate Score for Preventive potential:

1. Gravity or severity of the problem- refers to the progress of the
disease/ problem, indicating extent of damage on the patient/ family.
Also includes prognosis, reversibility of the problem.
2. Duration of the problem- refers to the length of time the problem has
been existing
3. Current management- refers to the presence and appropriateness of
intervention exposure of any high-risk group

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FAMILY NURSING CARE PLAN

It is the blueprint of care that a nurse designs to systematically
minimize or eliminate the identified family health problems through explicitly
formulated outcomes of care (goals and objectives) and deliberately chosen
set of interventions/ resources and evaluation criteria, standards, methods
and tools.

Characteristics of a Family Nursing Care Plan

1. It focuses on actions which are designed to solve or alleviate the
existing problem.
2. It is a product of deliberate systematic process.
3. The FNCP as with other plans related to the future.
4. It revolves around the identified health problems.
5. It is a means to an end and not an end in itself.
6. It is best kept in written form

Desirable Qualities of Family Nursing Care Pan

1. It should be based on the definition of the problem.
2. A good plan is realistic, meaning it can be implemented with
reasonable chance of success.
3. It should be consistent with the goals and philosophy of the health
agency.
4. It is drawn/ identified with the family.
5. It is kept in a written form.

Setting/ Formulating Goals and Objectives

 This will set the direction of the plan
 This should be stated in terms of client outcomes whether at the
individual, family, or community level.
 The mutual setting of goals which is the cornerstone of effective planning
consists of:
a. Identifying possible resources.
b. Delineating alternative approaches to meet goals.
c. Selecting specific interventions.
d. Operationalizing the plan- setting of priorities.

Goals
 It is a general statement of the condition or state to be brought about
by specific courses of action.

Cardinal principles in Goal Setting:

a. It must be jointly formulated with the family. This will ensure
the family’s commitment to their realization.
b. Basic to the establishment of mutually acceptable goal in the
family’s recognition and acceptance of existing health needs and
problems.

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Barriers to Joint Goal Setting

a. Failure on the part of the family to perceive the existence of the
problem.
b. Sometimes, the family perceives the existence of the problem
but does not see it as serious enough to warrant attention.

Characteristics of Goals and Objectives

 Specific
 Measurable
 Attainable
 Realistic
 Time bound

Objective
 Refers to a more specific statement of desired outcome of care.
 They specify the criteria by which require immediate attention and
results can be observed in a relatively short period of time.

Types of Objective

1. Short Term or Immediate Objective

 Formulated for problem situation which require
immediate attention and results can be observed in a
relatively short period of time.
 They are accomplished with few Health care provider-
family contacts and are relatively less resources.
2. Medium or Intermediate Objective
 Objective which is not immediately achieved and is
required to attain the long ones.
3. Long Term or Ultimate Objective
 This requires Health Care Provider- family contacts and
an investment of more resources.

Plan of Action/ Interventions

Its aim is to minimize all the possible reasons for causes of the
family’s inability to do certain task.

It is highly dependent into 2 Major Variables:

1. Nature of the problem
2. The resources available to solve the problem

Typology of interventions:
1. Supplemental- the HCP is the direct provider of care
2. Facilitative- HCP removes barriers to needed services
3. Developmental- improves client’s capacity

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1. Categories of Intervention
 Promotive
 Promotion of healthy behaviors and improving the
determinants of Life.
 Preventive
 It is geared toward providing the preventive services
through a community health center concerned with
health promotion.
 It takes an active role to improve the health of the
population.
 Curative
 It is the primary function of the hospital and concerned
with providing patient care.
 It refers to any type of care given to the patients with the
main intent of fully resolving an illness by the health care
team: physicians, nurses, dieticians….
 Rehabilitative
 Mam paki add po yung kulang

2. Tools of Public Health Nurse

 Bag technique
 Tool by which the nurse, during her visit will enable her to
perform a nursing procedure with ease and deftness, to save
time & effort.
 Principles of Bag Technique
 Minimize, if not prevent the spread of infection
 Saves time and effort of the nurse
 Should show effectiveness of total care given to an
individual or family
 Can be performed in a variety of ways
 Important Points to Consider in the use of Bag Techniques
 The bag should contain all necessary articles, supplies
and equipment’s that will be used
 The bag and its contents should be cleaned very often,
supplies replaced and ready for use anytime
 The bag and its contents should be well-protected from
contact with any article in the patient’s home.
 The arrangement of the contents of the bag should be
the one most convenient for the user, to facilitate
efficiency and avoid confusion.

 Public Health Bag

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 Traditional tool used by the nurse during home & community

visits to be able to provide care safely & efficiently.

 Contents of the Public Health Bag:

 Top: extra paper for making waste bag, Plastic/linen
lining, plastic lining, 1 pair of sterile gloves
 Front: Thermometer (oral/rectal), 2 test tubes, test tube
holders
 Center: @ hand towel, soap in a soap dish, cotton balls,
baby’s scale, tape measure, sterile dressing, micropore
plaster, 2 pairs scissors (surgical & bandage), 2 pairs of
forceps (curved & straight), cord clamp, disposable
syringes with needles (g.23 & 25).
 Rear:70% alcohol, betadine, Hydrogen peroxide, Ze phiran
ophthalmic ointment, spirit of ammonia, benedicts
solution, acetic acid.

3. Types of Family Nurse Contacts

 Family nurse-relationship is developed through family-nurse contacts,
which may take the form of a clinic visit, group conference, telephone
contact, written communication or home visit (David et al.,2007).
 The nurse uses the type of family-nurse contact that is most suitable
to the purpose or situation at hand.

1) Clinic visit
 Patient visits the health center: barangay health station, Rural
health Unit or in Ambulatory clinic or Private clinic.
 The major advantage is the family’s readiness to participate in
the health care process and the Nurse maximizes resources
available & has greater control over the environment, &
lessened distractions (David et al.,2007).

2) Home visit
 Family nurse contact which allows the health worker to assess
the home and family situations in order to provide the necessary
nursing care and health related activities.
 Phases of Home Visits:
a) Pre-visit
 The nurse contacts the family’s willingness for a
home visit and sets an appointment with them.
 Purpose of Home visits: (David et al.,2007)
 To have more accurate assessment of family’s
living conditions and adapt interventions
accordingly.

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 To assess living conditions of the patient and

his family and their health practices
 To educate the family regarding health
promotion, disease prevention and control of
health problems.
 To prevent spread of infection among family
members and within the community.
 To provide supplemental interventions for the
sick, disabled or dependent family member
and whenever guide the family on how to give
care in the future.
 To provide family with greater access to
health resources in the community by
establishing a close relationship with them
providing information and making referral as
necessary.
 Principles Involved in Preparing for a home visit:
 Must have a purpose or objective
 Should make use of all available
information about a patient
 Should consider and give priority to needs
of clients
 Should involve the clients
 Should be flexible
 Guidelines to consider regarding the Frequency of
Home Visits:
 Needs of the client
 Acceptance of the family
 Policy of a specific agency
 Other Health agencies
 Past services given to families
 Ability of clients to recognize own needs

b) In-home phase
 This phase begins as the nurse seeks permission
to enter and last until he or she leaves the
family’s home.
 It consists of the initiation, implementation and
termination.
 Initiation: it is the customary to knock or
ring the door bell and at the same time
loud but not threatening voice say “Tao
po”. The nurse enters the home and
acknowledges family members and
introduce him/herself

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building/establishing rapport by making

short conversation and states the purpose
of visit.
 Implementation: It involves the application
of the nursing process-assessment,
provision of direct nursing care as needed
and evaluation.
 Assessment: consist of techniques of
interview, physical examination and
simple diagnostic examination that
can be done at home like fasting
blood sugar using a glucometer.
 Physical care, health teachings and
counseling are provided to the family
as needed according to plan.
c) Post-visit phase
 The nurse has returned to the health facility.
 It involves documentation of the visits during which
the nurse records events that transpired during the
visit, including personal observations and feelings
of the nurse about the visit.

3) Group Conference
 Conferences conducted to mothers (mother’s class) in
neighborhood provides an opportunity for initial contact
between nurse and target families of the community.
 This type of family-nurse contact is appropriate in developing
cooperation, leadership, self-reliance and/or community
awareness among group members.

4) Telephone calls
 With the use of landline/mobile/cellphones provide an easy
access between the nurse/health worker and the family that
cultivates the family’s confidence in health agency.
 It provides the nurse and the family opportunities to contact
each other through calls or short messaging service if there is a
need to communicate with the clinic or health center
 Information transmitted through telephone is limited.
 Accurate information usually requires face-to-face contact.

5) Written Communication
 Used to give specific information to families such as instructions
given to parents through school children.
 This type of family-nurse contact may reach many families
being a one-way method requiring literacy and interest, the

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nurse is not certain if the information reach the intended

recipient.

IV. IMPLEMENTATION
Actual performance of planned interventions to solve health problems.

V. EVALUATION
 Determine whether goals and objectives are met.
 Determine whether nursing care rendered to the family are effective
 Determine the resolution of the problem or the need to re-assess,
re-plan, and re- implement nursing interventions

According to Alfaro- LeFevre:

Evaluation is being applied through the steps of the nursing process:
a. Assessment- changes in health status
b. Diagnosis- if identified family nursing problems were resolved,
improved or controlled
c. Planning- are the interventions appropriate and adequate
enough to resolve identified problems.
d. Implementation- determine how the plan was implemented,
what factors aid in the success and determine barriers to the
care.

Types of Evaluation:
 Ongoing Evaluation- analysis during the implementation of the
activity, its relevance, efficiency and effectiveness.
 Terminal Evaluation- undertaken 6-12 months after the care
was completed.
 Ex- post Evaluation- undertaken years after the care was
provided.

Steps in Evaluation:
1. Decide what to evaluate
 Determine relevance, progress, effectiveness, impact and
efficiency.
2. Design the evaluation plan
 Quantitative- a quantifiable means of evaluation which
can be done through numerical counting of the evaluation
source.
 Qualitative- descriptive transcription of the outcome
conducted through interview to acquire an in-depth
understanding of the outcome.
3. Collect relevant data that will support the outcome
4. Analyze the data
 What does the data mean?
5. Make decisions

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 If interventions are effective, interventions done can be

applied to other client/ group with similar circumstances,
but be designed to meet the individual needs of client/
group.
 If ineffective, give recommendations
6. Report/ give feedbacks

Dimensions of Evaluation
1. Effectiveness- focused on the attainment of the objectives.
2. Efficiency- related to cost whether in terms of money, effort or
materials.
3. Appropriateness- refer its ability to solve or correct the existing
problem, a question which involves professional judgment.
4. Adequacy- pertains to its comprehensiveness.

ACTIVITY 3.1: QUIZ

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Activity 3.2: FAMILY HEALTH ASSESSMENT

Viet, Lydia Capistrano. (2004) Family Health Management Manual for Nursing Students. Trinitas Publishing Inc.

Instructions: Interview at least one family in your neighborhood (preferably your parents)
and fill up the family assessment guide form. This form may also be downloaded and can
be submitted/ turned in online via LMS or Google class.
Family Assessment Guide

Family Name: ________________________________________________________________________

Address: _____________________________________________________________________________
I. Demographic Data
Household No.: ________________ Barangay House No.:
________________
II. Family Data
Length of residency: _____________ Family Size: _______________
Place of origin: Religion:
Husband: _______________________ Husband: _____________________
Wife : ___________________________ Wife: __________________________

Family Members Chart:

Family Ag Se Civil Position Relationshi Educationa Occupatio
Members e x Status In the p l n
Family To Family Attainment
Head

III. Family Characteristics

Type of Family Structure
a. Extended ___________ d. Nuclear ___________
b. Matriarchal __________ e. Patriarchal ___________
c. Dominant Family Member ____________

General Family Relationship/ Dynamics

Criteria Statu Additional Information
s
Observable conflicts between family
members
Characteristics of communication
Interaction patterns among members

Family Dietary Habits

What did you eat yesterday? (24 hours dietary recall)
Breakfast: _____________________________________________________________________________
Lunch:

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_________________________________________________________________________________
Supper:
________________________________________________________________________________

Monthly Family Income Source

Husband:
______________________________________________________________________________
Wife: __________________________________________________________________________________
Others: ________________________________________________________________________________
Monthly Family Income (check bracket)
Below php 5,000.00 _____ Above 20,000.00- 30,000.00 _____
Above 5,000.00- 10,000.00 _____ Above 30,000.00- 40,000.00 _____
Above 10,000.00- 15,000.00 _____ Above 40,000.00- 50,000.00 _____
Above 15,000.00- 20,000.00 _____ More than 50,000.00 _____

Family Health Status/ Health History

Father: ________________________________________________________________________________
Mother:
________________________________________________________________________________
Children: ______________________________________________________________________________

Felt Family Needs

(Identify and rank according to priority)
1. ____________________________________ 6.
_____________________________________
2. ____________________________________ 7.
_____________________________________
3. ____________________________________ 8.
_____________________________________
4. ____________________________________ 9.
_____________________________________
5. ____________________________________ 10.
____________________________________

IV. Home and Environment

a. Is your lot owned? Yes__________ No__________
b. Is your house owned? Yes__________ No__________
c. Type of housing materials (check all that applies)
________ wood _________ mixed Others, specify ______________
________ concrete _________ makeshift
d. Is the living space adequate? Yes ___________ No ___________
e. What are the appliances owned by the family?
_______________________________________________________________________________
f. Type of garbage disposal (check all that applies)
_____ collected _____ burning
_____waste segregation _____ burying
_____feeding to animals _____ throw in the river/ sewer
_____open dumping _____ others, specify
g. Type of waste disposal
_____flush _____ water- sealed

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_____wrap and throw _____pit privy

_____ other, specify ___________________________
h. Type of drainage system
_____open _____closed
i. Source of water supply
_____owned _____shared
_____bought _____others, specify ____________________
j. Drinking water storage
_____refrigerated _____covered _____uncovered
k. Containers used
_____plastic pitchers _____jars, clay pots
_____bottles _____others, specify
____________________
l. Food storage/ Cooking facilities
_____ covered _____ uncovered _____ stove
_____ refrigerator _____ cabinet _____ pots/ pans, etc
m. Common household pets found at home
________________________________________________________________________________
n. Are there breeding sites of insects, rodents, etc. present? _____Yes _____ None
o. Pets/ animals kept in the yard/ home (enumerate all)
________________________________________________________________________________
p. Are there accident hazards present? _____ Yes _____ None

V. Health and Health Practices

a. Common illnesses encountered for the last 6 months and the treatment applied.
________________________________________________________________________________
________________________________________________________________________________
b. Whom do you consult for health- related problems?
_____ manghihilot _____ albularyo
_____midwife _____ nurse
_____ doctor _____ Health Center
_____ Barangay health Worker _____ others, specify _____________________
c. For problems other than health, whom do you consult?
_____ family members _____relatives
_____ friends _____ Barangay officials
_____ priest _____ others, specify ____________________
d. Immunization status of family members
________________________________________________________________________________
________________________________________________________________________________
e. Have you had adequate
1. Rest and sleep? _____ Yes _____No
2. Exercise? _____ Yes _____No
3. Relaxation activities? _____ Yes _____ No
4. Stress management activities _____ Yes _____ No

VI. Environment
Kind of neighborhood
Social and Health facilities available
Communication and transportation

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facilities

VII. Awareness of community organization

a. Are you aware of existing organizations in the community? _____ Yes _____No
b. Name all the organization/s you know.
________________________________________________________________________________
________________________________________________________________________________
c. Are you a member of any of these organizations? _____Yes _____No
d. Are you aware of its activities and projects? _____ Yes _____ No
e. How are you involved in its activities?
_____ attend meetings _____ give donations
_____ planning _____ evaluation
_____implementation _____ others, specify
f. Name 3 formal and informal leaders of the community whom you think can lead the
people?
1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
ACTIVITY 3.2: PREPARING FAMILY HEALTH CARE PLANS
Instructions: Prepare a family nursing care plan together with the concerned family for the
top priority problem. Use the table below. You may attach additional sheet if needed. This
activity sheet may also be downloaded and can be submitted/ turned in online via LMS or
Google class.

Family Name

Family Health Goals and Interventio Methods of Resources Evaluation

Nursing Assessment Objectives n Methods Nursing Required
Problems Family
Contact

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REFERENCES
Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.

Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.

Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.

Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.

For IFSU use only.

 63

https://www.officialgazette.gov.ph

RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

CHAPTER IV
DOH PROGRAM RELATED TO FAMILY HEALTH

Learning Outcomes:
At the end of the lesson, the students will:
 Manage resources efficiently and effectively.
 Apply management and leadership principles in providing direction to
manage community based program.
 Evaluate specific components of health programs and Nursing.

The Department of Health (DOH) is the principal health agency in the

Philippines. It is responsible for ensuring access to basic public health
services to all Filipinos through the provision of quality health care and
regulation of providers of health goods and services.

a. Expanded Program on Immunization

Rationale:
The Expanded Program on Immunization (EPI) was established in
1976 to ensure that infants/ children and mothers have access to routinely
recommended infant/ childhood vaccines. Six vaccines- preventable
diseases were initially included in the EPI: tuberculosis, poliomyelitis,
diphtheria, tetanus, pertussis, and measles. In 1986, 21.3 % “fully
immunized” children less than fourteen months of age based on the EPI
Comprehensive Program Review.

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Program Objectives/ Goals:

Over-all Goal:
 To reduce the morbidity and mortality among children against the
most common vaccine- preventable diseases.

Specific Goals:
 To immunize all infants/ children against the most common vaccine-
preventable disease.
 To sustain the polio- free status of the Philippines.
 To eliminate measles infection.
 To eliminate maternal and neonatal tetanus.
 To control diphtheria, pertussis, hepatitis b and German measles.
 To prevent extra pulmonary tuberculosis among children.

Mandates:
Republic Act No. 10152 “Mandatory Infants and Children Health
Immunization Act of 2011”, signed by President Benigno Aquino III in July
26, 2010. The mandatory includes basic immunization for children under 5
including other types that will be determined by the Secretary of Health.

Strategies:
 Conduct of Routine Immunization for Infants/ Children/ Women
through the Reaching Every Barangay (REB) strategy.
REB strategy, an adaptation of the WHO- UNICEF Reaching Every
District (RED), was introduced in 2004 aimed to improve the access to
routine immunization and reduce drop-outs. There are 5 components of the

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strategy, namely: data analysis for action, re- establish outreach services,
strengthen links between the community and service, supportive
supervision and maximizing resources.

 Supplemental Immunization Activity (SIA)

Supplementary immunization activities are used to reach children
who have not been vaccinated or have not developed sufficient immunity
after previous vaccinations. It can be conducted either national or sub-
national in selected areas.

 Strengthening Vaccine- Preventive Diseases Surveillance

This is critical for the eradication/ elimination efforts, especially in
identifying true cases of measles and indigenous with polio virus.
Procurement of adequate and potent vaccines and needles and syringes to
all health facilities nationwide.

Status of Implementation/ Accomplishment

a. Polio Eradication
 The Philippines has sustained its polio- free status since
October 2000.
 There is an on- going polio mass immunization to all children
ages 6 weeks up to 59 months old in the 10 high risk areas for
neonatal tetanus. These areas are the following: Abra, Banguet,
Isabela City and Basilan, Lanao Norte, Cotabato City,
Maguindanao, Lanao Sur, Marawi City and Sulu.

b. Measles Elimination
 4 rounds of mass measles campaign were conducted: 1998,
2004, 2007 and 2011.
 Implemented the 2- dose measles- containing vaccine (MCV) in
2009
MCV 1(monovalent measles) at 9-11 months old
MCV 2(MMR) at 12- 15 months old
 A supplemental immunization campaign for measles and rubella
(German measles) was done in 2011. This was dubbed as
“Iligtas sa Tigdas ang Pinas” 15.6 million (84%) out of the 18.5
million children ages 9 months to 8 years old were given 1 dose
of the measles- rubella (MR) vaccine between April and June
2011.

c. Maternal and Neonatal Tetanus Elimination

 Three (3) rounds of IT vaccination are currently on going in the
10 highest risk areas. Women ages 15-40 years old regardless
of their TT immunization will receive the vaccine during these
rounds. This is funded by the Kiwanis International through
UNICEF and World Health Organization

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d. Control of other common vaccine- preventable diseases

(Diphtheria, Pertussis, Hepatitis B and Meningitis/ Encephalitis
secondary to H. influenza type B)
 Hepatitis B Control
Republic Act No. 10152 has been signed. It is otherwise known
as the “Mandatory Infants and Children Health Immunization
Act of 2011, which requires that all children under five years old
be given basic immunization against vaccine- preventable
diseases. Specifically, this bill provides for all infants to be
given the birth dose of Hepatitis- B vaccine within 24 hours of
birth.

b. Integrated Management of Childhood Illnesses (IMCI)

IMCI is an integrated approach to child health that focuses on the
well-being of the whole child. IMCI aims to reduce death, illness and
disability and to promote improved growth and development among children
under five years of age. IMCI include curative and preventive elements that
are implemented by families and communities and by health facilities. The
strategy was developed by World Health Organization and UNICEF and is
used by most countries in the world.

Focus:
 Improving case management skills of health workers
 Improving over-all health systems
 Improving family and community health practices

Benefits of the IMCI

1. Addresses major child health problems because it systematically
addresses the most important causes of children’s illness and death.
2. Responds to demands.
3. Promotes prevention as well as cure because IMCI emphasizes
important preventive interventions such as immunization and
breastfeeding.
4. Is cost- effective- most cost- effective interventions in low and middle-
income countries (World Bank).
5. Promotes cost- saving.
6. Improves equity- IMCI improves inequity in global health care.

Principles of the IMCI Case Management Guidelines

 All sick children aged up to 5 years are examined for general danger
signs and all sick young infants are examined for very severe disease.
These signs indicate immediate referral or admission to hospital.
 The children and infants are then assessed for main symptoms. For
older children, the main symptoms include: cough or difficulty
breathing, diarrhea, fever and ear infection. For young children, local
bacterial infection, diarrhea and jaundice. All sick children are
routinely assessed for nutritional and immunization and deworming
status and other problems.

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 Only a limited number of clinical signs are used

 A combination of individual signs leads to a child’s classification
within one or more symptom groups rather than a diagnosis.
 IMCI management procedures use limited number of essential drugs
and encourage active participation of caretakers in the treatment of
children.
 Counseling of caretakers on home care, correct feeding and giving of
fluids, and when to return to clinic is an essential component of IMCI.

Steps in the IMCI Case Management Process

1. Assess the child’s illness
2. Classify the illness based on signs
3. Identify treatment
4. Treat the child
5. Counsel the caretaker
6. Follow-up

c. Essential Intrapartum and Newborn Care (EINC)

Essential Intrapartum and Newborn Care (EINC) is a package of
evidenced- based practices recommended by the Department of Health
(DOH), Philippine Health Insurance Corporation (Phil Health), and the World
Health Organization (WHO) as the standard of care in all births by skilled
attendants in all government and private settings.
It is a basic component of the DOHs Maternal, Newborn and Child
Health and Nutrition (MNCHN) strategy. The EINC practices for newborn
care constitute a series of time- bound, chronologically- ordered, standard
procedures that a baby receives at birth. At the heart of the protocol are four
time- bound interventions: immediate drying; skin to skin contact followed
by clamping of the cord after 1-3 minutes; non- separation of baby from
mother; and breastfeeding initiation.
a. Immediate drying
 Using a clean, dry cloth, thoroughly dry the baby, wiping the
face, eyes, head, front and back, arms and legs.
b. Skin-to-skin contact
 If a baby is crying and breathing normally, avoid any
manipulation, such as routine suctioning, that may cause
trauma or introduce infection.
 Place the newborn prone on the mother’s abdomen or chest
skin-to-skin.
 Cover newborn’s back with a blanket and head with a
bonnet. Place identification band on ankle.
c. Proper cord clamping and cutting
 Clamp and cut the cord after cord pulsations have stopped
(typically at 1-3 minutes).
 Put ties tightly around the cord at 2 centimeters from the
newborn’s abdomen.
 Cut between ties with sterile instrument.

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
Observe for oozing blood.

Do not milk the cord towards the newborn.

After cord clamping, ensure oxytocin 10 IU IM is given to the
mother
d. Non-separation of baby from the mother and breastfeeding
initiation
 Observe the newborn. Only when the newborn shows feeding
cues (e.g., opening of mouth, tonguing, licking, rooting),
make verbal suggestions to the mother to encourage her
newborn to move toward the breast (e.g. nudging).
 Counsel on positioning and attachment
 When the baby is ready, advise the mother to:
 Make sure the newborn’s neck is neither flexed nor
twisted.
 Make sure the newborn is facing the breast, with the
newborn’s nose opposite her nipple and chin touching
the breast.
 Hold the newborn’s body close to her body.
 Support the newborn’s whole body, not just the neck
and shoulders.
 Wait until her newborn’s mouth is opened wide.
 Move her newborn onto her breast, aiming the infant’s
lower lip well below the nipple.
 Look for signs of good attachment:
 Mouth wide open
 Lower lip turned outward
 Baby’s chin touching breast
 Suckling is slow, deep with some pauses
 If the attachment or suckling is not good, try
again and reassess.
Notes:
 Health workers should not touch the newborn unless there is a
medical indication.
 Do not give sugar water, formula or other prelacteals.
 Do not give bottles or pacifiers.
 Do not throw away colostrum.

d. Newborn Screening Program

The Comprehensive Newborn Screening

(NBS) Program was integrated as part of the
country’s public health delivery system with
the enactment of the Republic Act No. 9288
otherwise known as Newborn Screening Act
of 2004. The Department of Health (DOH)
acts as the lead agency in the
implementation of the law and collaborates

Figure 2. footprint Computer Icons Clip art- clipart-

library.com For IFSU use only.
 69

with other National Government Agencies (NGA) and key stakeholders to

ensure early detection and management of several congenital metabolic
disorders, which is left untreated, may lead to mental retardation and/ or
death. Early diagnosis and initiation of treatment, along with appropriate
long-term care help ensure normal growth and development of the affected
individual.

Vision
The National Comprehensive Newborn Screening System envisions all
Filipino children will be born healthy and well, with an inherent right to life,
endowed with human dignity; and reaching their full potential with the right
opportunities and accessible resources.

Mission
To ensure that all Filipino children will have access to and avail of
total quality care for the optimal growth and development of their full
potential.

Goal
To reduce preventable deaths of all Filipino newborns due to more
common and rare congenital disorders through timely screening and proper
management.

e. BEmONC/ CEmONC
1. Basic Emergency Obstetrics and Newborn Care (BEmONC)
Provider is a capable health facility that can either be a primary/
district hospital, RHU or BHS/ Lying-in clinic with complete
complement of BEmONC trained personnel (doctor, nurse and
midwife) operating 24/7 or on- call basis after regular office/ clinic
hours. These health facilities can perform the following six (6) signal
obstetric functions:
 Parenteral Administration of oxytocin in the third stage of labor
 Parenteral administration loading dose of anti- convulsants
 Parenteral administration of initial dose of antibiotics
 Performance of assisted deliveries (Imminent Breech Delivery)
 Removal of retained products of conception
 Manual removal of retained placenta

2. Comprehensive Emergency Obstetric and Newborn Care

(CEmONC) services, are the interventions provided to pregnant
women and newborns experiencing fatal complications, including
severe bleeding, infection, prolonged or obstructed labor, eclampsia,
and asphyxia in the newborn. CEmONC interventions include safe
blood transfusion, providing oxytocin and antibiotics, performing
cesarean sections, manual removal of the placenta, assisted vaginal
delivery, abortion and resuscitation of the newborn.

f. WHO Mental health Gap Action Programme (mhGAP)

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Mental, neurological, and substance use disorders are common in all

regions of the world, affecting every community and age group across all
income countries.
The WHO Mental Health Gap Action Programme (mhGAP) aims at
scaling up services for mental, neurological and substance use disorders for
countries especially with low- and middle- income. The programme asserts
that with proper care, psychological assistance and medication, tens of
millions could be treated for depression, schizophrenia, and epilepsy,
prevented from suicide and begin to lead normal lives- even when resources
are scarce.

REFERENCES
Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.

Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.

Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.

Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.

For IFSU use only.

 71

https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.
https://www.officialgazette.gov.ph

RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

ACTIVITY 4.1: Create an Information Education Material

Instructions:
 Select a topic from the different DOH programs.
 Work with your team pre- assigned by your instructor.
 The IEC material component are as follows:
a. Clearly Define your Purpose
To verbally and visually represent the data and to help your target audience to
clearly understand the information you would like to present.
b. Process
i. Know your subject. Become a content expert. Do thorough
research on your topic.
ii. Plan the “story” of your IEC material. What specific part would you
want to include. Develop contents/ facts, choose layman’s terms
as possible for audience to better understand its contents.
iii. Think visual: identify ways to convert text to images using charts,
graphs, diagrams, pictures and other elements. Consider color
scheme, readable font types, and structure.
iv. Create your IEC material using an application of your choice.
v. Go back and consider Knowledge. Be sure that the intended
messages are well communicated.
vi. Proofread and refine. Work with your teammates and have friends,
family, or experts review your work before you submit.
vii. Finalize and submit.
Rubrics:
Criteria Score Exceptional Admiral Marginal Unacceptable
___Appropriate ___Most details ___Few details ___No details to
details support support main idea. support main idea. support main idea.
main idea. ___Accurate ___Lacking accurate ___Information is
___Accurate and information for information. not accurate
Content 50% detailed almost all subject ___Inadequate ___Information does
information matter. information is not not support the
___Information ___Information is clearly supportive of visual’s purpose.
adequately mostly adequate visual’s purpose.
supports purpose and supportive of

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of visual. visual’s purpose.

___Topic and title ___Topic and title ___Topic and title ___Topic and title
clear and easily are mostly clear difficult to identify are not clearly
identified. and easily identified ___Main idea not identified
___Main idea is ___Main idea is clearly stated. ___No main idea
Focus 20% clearly appropriate appropriate to topic ___Few illustrations ___Illustrations do
to topic ___Most complement not complement
___All illustrations illustrations purpose of visual purpose of visual
complement complement
purpose of visual. purpose of visual

Visual 20% ___Outstanding ___Adequate use of ___Inappropriate use ___Little attempt to

Appeal use of color, color of color, design, and use color, design
design, and space ___Design is space. and space
___Original and adequate ___Design lacks appropriately
creative design ___Overall design is creativity. ___Design is dull
___Overall design mostly pleasing and ___Lack of ___Project has
is pleasing and harmonious. harmonious design sloppy appearance
harmonious. in presentation
___Free of ___Mostly free of ___Frequent ___Too frequent
grammatical errors grammatical errors grammatical errors grammatical errors
___Words are ___Most words are ___Presentation is ___Distractive
Mechanics 10% legible and legible and illegible and elements make
pertinent to topic pertinent to topic confusing illustration
ineffective

Score_______________________ + Bonus Score _____________________= Final Score__________________________

Career Opportunities in Education and Training

Copyright. Texas Education Agency, 2015. All rights reserved

CHAPTER V
ETHICAL CONSIDERATIONS IN COMMUNITY HEALTH NURSING

Learning Outcomes:
At the end of the lesson, the students will:
 Apply ethico- legal considerations when providing safe, quality and
professional nursing care.
 Adhere to establish norms of conduct based on the Philippine Nursing
Law and other legal, regulatory and institutional requirements
relevant to safe nursing practice.

PUBLIC HEALTH LAWS

The Magna Carta of Public Health Workers

 Republic Act No. 7305
Title:
 This Act shall be known as the “Magna Carta of Public Health Workers”
Definition:
 For purposes of this Act, “health workers” shall mean all persons who are engaged
in health and health-related work, and all persons employed in all hospitals,
sanitaria, health infirmaries, health centers, rural health units, barangay heath
stations, clinics and other health related establishments owned and operated by
the Government or its political subdivisions with original charters and shall
include medical, allied health professional, administrative and support personnel
employed regardless of their employment status.
Declaration of Policy and Objective:
 The state shall instill health consciousness among our people to effectively carry

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out the health programs and projects of the government essential for the growth
and health of the nation. Towards this end, this Act aims:
a. To promote and improve the social and economic well- being of the health
workers, their living and working conditions and terms of employment.
b. To develop their skills and their capabilities in order that they will be more
responsive and better equipped to deliver health projects and programs.
c. To encourage those with proper qualifications and excellent abilities to join
and remain in government service.

Official Gazette of the Philippines. Magna Carta for Health Workers.

https://www.officialgazette.gov.ph

Sanitation Code
 Presidential Decree No. 856, series of 1975
Title:
 The title of this Code is “Code on Sanitation of the Philippines”.
Purpose:
 To prescribe sanitation requirements for food establishments and refuse
collections and disposal system of cities and municipalities.
Features:
 Empower the Department of Health with the following powers and functions:
a. Undertake the promotion and preservation of the health of the people and
raise the health standards of individuals and communities throughout the
Philippines.
b. Extend maximum health services to the people in rural areas and provide
medical care to those who cannot afford it by reason of poverty.
c. Develop, administer and coordinate various health activities and services
which shall include public health, preventive, curative and rehabilitative
programs, medical care, health and medical education services.
d. Upgrade the standard of medical practice, the quality of health services and
programs to assure the people of better health services.
e. Assist local health agencies in developing health programs including medical
care, and promote medical and public health research.
f. Issue permits to establish and operate government and private hospitals,
clinics, dispensaries, schools of nursing, midwifery, and other paramedical
course, puericulture centers, clinical laboratories and blood banks.
g. Prescribe standards rates of fees for health, medical, laboratory, and other
public health services.

Official Gazette of the Philippines. Presidential Decree No. 856, s. 1975.

https://www.officialgazette.gov.ph

Clean Air Act

 Republic Act No. 8749
Title:
 Otherwise known as the “Philippine Clean Air Act”.
Definition:
 A comprehensive air quality management policy and program which aims to
achieve and maintain healthy air for all Filipinos.
Guiding Principles:
 Protect and advance the right of the people to a balanced and healthful ecology in
accord with the rhythm and harmony of nature.
 Promote and protect the global environment while recognizing the primary
responsibility of local government units to deal with environmental problems.
 Recognize that the responsibility of cleaning the habitat and environment is
primary area- based.
 Recognize that “polluters must pay”.
 Recognize that a clean and healthy environment is for the good of all and should

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therefore be the concern of all.

Department of Health 2020. Clean Air Act (2003). https://www.doh.gov.ph

Lifted from: Department of Natural Resources. (2003, August). Primer
on the Clean Air Act. Diliman: DENR- Public Affairs Office

Generic Act
 Republic Act No. 6675
Title:
 This Act shall be known as the “Generics Act of 1988”.
Definition:
 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.
Statement of Policies: It is hereby declared the policy of the State:
 To promote, encourage and require the use of generic terminology in the
importation, manufacture, distribution, marketing, advertising and promotion,
prescription and dispensing of drugs.
 To ensure the adequate supply of drugs with generic names at the lowest possible
cost and endeavor to make them available for free to indigent patients.
 To encourage the extensive use of drugs with generic names through rational
system of procurement and distribution.
 To emphasize the scientific basis for the use of drugs, in order that health
professionals may become more aware and cognizant of their therapeutic
effectiveness.
 To promote drug safety by minimizing duplication in medications and/ or use of
drugs with potentially adverse drug interactions.

Official Gazette of the Philippines. Republic Act No. 6675.

https://www.officialgazette.gov.ph

National Health Insurance Act (PhilHealth)

 Republic Act No. 7875
Title:
 This act shall be known as the “National Health Insurance Act of 1995”
Definition:
 An act instituting a national health insurance program for all Filipinos and
establishing the Philippine Health Insurance Corporation for the purpose. It is an
integrated and comprehensive approach to health development which shall
endeavor to make essential goods, health and other social services available to all
people at affordable cost. Priority is given for the needs of the underprivileged,
sick, elderly, disabled, women, and children. Likewise, it shall be the policy of the
state to provide free medical care to paupers.

Department of Health. 2020. Republic Act No. 7875.

https://www.doh.gov.ph

National Blood Service Act

 Republic Act No. 7719
Title:
 This act shall also be known as the National Blood Service Act of 1994.
Description:
 The Act promotes voluntary blood donation to provide sufficient supply of safe
blood and to regulate blood banks. This act aims to inculcate public awareness
that blood donation is a humanitarian act.

Department of Health. 2020. Republic Act No. 7719.

https://www.doh.gov.ph

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Laws on Notifiable Disease

 Republic Act No. 11332, series of 2019
Title:
 This act is otherwise known as “Mandatory Reporting of Notifiable Diseases and
Health Events of Public Health Concern Act”.
Description:
 The Department of Health (DOH) urged all private and public health workers,
especially at the municipal, provincial and barangay levels, to report all public
health threats and emergencies to the DOH to continuously promote the welfare
of the people. The new law aims to protect people from public health threats
through the efficient and effective disease surveillance of diseases of public health
concern.

Department of Health. 2020. Implement Republic Act 11332 to Prevent Epidemics.

https://www.doh.gov.ph

Senior Citizen Law

 Republic Act No. 9994
Title:
 This Act shall be known as the “Expanded Senior Citizens Act of 2010”.
Description:
 An Act granting additional benefits and privileges to Senior Citizens, further
amending Republic Act No. 7432, as amended, otherwise known as “An Act to
Maximize the Contribution of Senior Citizens to Nation Building, grant benefits
and special privileges and for other purposes’.
 It is the declared policy of the state to promote a just and dynamic social order
that will ensure the prosperity and independence of the nation and free the people
from poverty through policies that provide adequate social services, promote full
employment, a rising standard of living and an improved quality of life.

Official Gazette of the Philippines. Republic Act No. 9994.

https://www.officialgazette.gov.ph

Revised Dangerous Drugs Law

 Republic Act No. 9165
Title:
 This Act shall be known as “Comprehensive Dangerous Drugs Act of 2002”.
Description:
 An act instituting the Comprehensive Dangerous Drugs Act of 2002, repealing
Republic Act No. 6425, otherwise known as the Dangerous Drugs Act of 1972.
The policy safeguards the integrity of its territory and the well- being of its
citizenry particularly the youth, from the harmful effects of dangerous drugs on
their physical and mental well- being, and to defend the same against acts or
omissions detrimental to their development and preservation.

The Lawphil Project. Republic Act No. 9165.

https://www.lawphil.net

Act on Cheaper Medicine

 Republic Act No. 9502, series of 2008
Title:
 This Act shall be known as the “Universally Accessible Cheaper and Quality
Medicines Act of 2008”.
Description:
 An act providing for cheaper and quality medicines, amending for the purpose
Republic Act No. 8293 or the Intellectual Property Code, Republic Act No. 6675 or
the Generics Act of 1988, and Republic Act of 5921 or the Pharmacy Law, and for
other purposes.

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 The policy also shall adopt appropriate measures to promote and ensure access to
affordable quality drugs and medicines for all.

Aumento IP Law Firm. Republic Act No. 9502.

https://www.aumentolaw.com.ph

Save the Children’s Act

 Republic Act No. 11188, series of 2018
Title:
 This Act shall be known as the “Special Protection of Children in Situations of
Armed Conflict Act”.
Description:
 It shall be the policy of the state to provide special protection to children in
situations of armed conflict from all forms of abuse, violence, neglect, cruelty,
discrimination and other conditions prejudicial to their development, taking into
consideration their gender, cultural, ethnic and religious background.

Official Gazette of the Philippines. Republic Act No. 11188.

https://www.officialgazette.gov.ph

Violence Against Women’s Act

 Republic Act No. 9262, series of 2004
Title:
 Republic Act 9262 is known as “The Anti- Violence against Women and their
Children Act of 2004.
Description:
 This Act recognized the need to protect the family and its members particularly
women and their children from violence and threats to their personal safety and
security. It also includes any act of gender- based violence that result or is likely
to result in physical, sexual, or psychological harm or suffering to women
including threats or acts, coercion, or arbitrary deprivation of liberty whether
occurring in public or private life.

Department of Health. 2020. Violence Against Women.

https://www.doh.gov.ph

Disaster Risk Reduction Management

 The National Disaster Risk Reduction Management Plan fulfills the requirement of
RA No. 10121 of 2010, which provides the legal basis for policies, plans and
programs to deal with disaster. The NDRRMP covers four thematic areas; (1)
Disaster Prevention and Mitigation, (2) Disaster Preparedness, (3) Disaster
Response, (4) Disaster Rehabilitation and Recovery. The framework envisions a
country of “safer, adaptive and disaster resilient Filipino communities towards
sustainable development.

National Disaster Risk Reduction and Management Plan (NDRRMP).

https://www.ndrrmc.gov.ph

Rooming- in and Breastfeeding Act of 1992 (Milk Code)

 Republic Act No 7600
Title:
 Otherwise known as “The Rooming- in and Breastfeeding Act of 1992”
Description:
 An act providing incentives to all Government and Private Health Institutions with
rooming- in and breastfeeding practices. Provisions include the right of the
mother to breastfeed and the right of the infant to receive breast milk. The
regulations cover the establishment and operation of human milk banks and the
donation of human milk.

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Word press. Republic Act No. 7600.

https://www.women4breastfeeding.wordpress.com

Responsible Parenthood and Reproductive Health Law of 2012

 Republic Act 10354
Title:
 The act is also known as “The Responsible Parenthood and Reproductive Health
Act of 2012”
Description:
 An act providing for a National Policy on Responsible Parenthood and
Reproductive Health. It recognizes and guarantees the human rights of all
persons including their right to equality and nondiscrimination of these rights,
the right to sustainable human development, the right to health which includes
reproductive health, the right to education and information, and the right to
choose and make decisions for themselves in accordance with their religious
convictions, ethics, cultural beliefs, and the demands of responsible parenthood.

The Philippine Commission on Women. Republic Act 10354.

https://www.pcw.gov.ph

Mandatory Infants and Children Health Immunization Act of 2011

 Republic Act No. 10152
Title:
 This Act shall be known as the “Mandatory Infants and Children Health
Immunization Act of 2011”.
Description:
 An act providing for mandatory basic immunization services for infants and
children, repealing for the purpose Presidential Decree No. 996, as amended. The
mandatory basic immunization for all infants and children provided under this
act shall cover the following vaccine preventable diseases: Tuberculosis;
Diphtheria, Tetanus and Pertussis; Poliomyelitis; Measles; Mumps; Rubella or
German Measles; Hepatitis B; H. Influenza type B (HIB); and such other types as
may be determined by the Secretary of Health in a department circular. The
mandatory basic immunization shall be given for free at any government hospital
or health center to infants and children up to five (5) years of age.

Official Gazette of the Philippines. Republic Act No. 10152.

https://www.officialgazette.gov.ph

Children Safety on Motorcycles Act of 2015

 Republic Act No. 10666
Title:
 This Act shall be known as “Children’s Safety on Motorcycles Act of 2015”.
Description:
 An act providing for the safety of children aboard motorcycles, it is a proactive
and preventive approach to secure the safety of passengers, especially children, by
regulating the operation of motorcycles along roads and highways. Provisions
include; it shall be unlawful for any person to drive two (2)- wheeled motorcycle
with a child on board on public roads where there is heavy volume of vehicles,
there is a high density of fast moving vehicles or where a speed limit is more than
60/ kph is imposed, unless: the child passenger can comfortably reach his/ her
feet on the standard foot peg of the motorcycle, the child’s arms can reach around
and grasp the waist of the motorcycle rider, and the child is wearing a standard
protective helmet referred to under RA No. 10054.

Official Gazette of the Philippines. Republic Act No. 10666.

https://www.officialgazette.gov.ph

Children’s Emergency Relief and Protection Act of 2016

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 Republic Act No. 10821

Title:
 This Act shall be known as the “Children’s Emergency Relief and Protection Act”.
Description:
 An Act mandating the provision of emergency relief and protection for children
before, during and after disasters and other emergency situations when the
children are gravely threatened or endangered by circumstances that affect their
survival and normal development.
 The Department of Social Welfare and Development (DSWD) shall formulate a
comprehensive emergency program for children, taking into considerations
humanitarian standards for their protection.

Official Gazette of the Philippines. Republic Act No. 10821.

https://www.officialgazette.gov.ph

Child and Youth Welfare Code of the Philippines

 Presidential Decree No. 603
Title:
 The Code shall be known as the “Child and Youth Welfare Code”.
Description:
 It shall apply to persons below twenty-one years of age except those emancipated
in accordance with the law. “Child” or “minor” or “youth” as used in this code,
shall refer to such persons. All children shall be entitled to the rights herein set
forth without distinction as to legitimacy or illegitimacy, sex, social status,
religion, political antecedents, and other factors.

Official Gazette of the Philippines. Presidential Decree No. 603.

https://www.officialgazette.gov.ph

Tobacco Regulation Act of 2003

 Republic Act 9211
Title:
 This Act shall be known as the Tobacco Regulation Act of 2003.
Description:
 An act regulating the packaging, use, sale, distribution and advertisements of
tobacco products and for other purposes. The purpose of this act is to promote a
healthful environment, inform the public of the health risks associated with
cigarette smoking and tobacco use, regulate and subsequently ban all tobacco
advertisements and sponsorships, regulate the labeling of tobacco products,
protect the youth from being initiated to cigarette smoking and tobacco use by
prohibiting the sale of tobacco products to minors, assist and encourage Filipino
tobacco farmers to cultivate alternative agricultural crops to prevent economic
dislocation, and create an inter- agency committee on tobacco (IAC- Tobacco) to
oversee the implementation of this act.

Official Gazette of the Philippines. Republic Act No. 9211.

https://www.officialgazette.gov.ph

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REFERENCES
Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.

Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.

Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.

Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.
https://www.officialgazette.gov.ph

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Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.
https://www.officialgazette.gov.ph

RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

Activity 5: CRITICAL THINKING EXERCISES

Instructions:
 Read each question carefully and choose the best answer.
 Write the letter of your answer and the rationale or justification in the space provided
after the choices. This activity sheet may also be downloaded and can be submitted/
turned in online via LMS or Google class.

1. As an epidemiologist, the nurse is responsible for reporting cases or

notifiable diseases. What law supports this mandate?
a. Act 3573 c. RA 1054
b. RA 3753 d. RA 1082
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

2. A person, 10 years old, is having fever, cough and other COVID like
symptoms, further he/she thought that he/she may have been exposed to
the virus, he/she was advised to stay home, get rest and hydrated, avoid
public/ crowded areas, and contact a health care professional immediately.
What specific law best applies to this situation?
a. Presidential Decree No. 603 c. Republic Act No. 10821
b. Republic Act No. 10152 d. Republic Act No. 11332

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________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. Maria just delivered to a healthy baby boy and was placed on her bare
chest to maintain skin to skin contact, she was advised to breastfeed her
child, however after the first try, the baby has difficulty of latching and
sucking. It is then possible to use formula milk or bottle feed the newborn
baby as mandated by RA No. 7600.
a. True
b. False
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

CHAPTER VI.
FILIPINO CULTURE, VALUES, AND PRACTICES IN RELATION TO
HEALTH CARE OF INDIVIDUAL AND FAMILY

Learning Outcomes:
At the end of the lesson, the students will:
 Exemplify love for the country in the service of the Filipinos and
family.
 Customize nursing interventions based on Philippine culture and
values.

A. Family Solidarity

Families are bound together in love and solidarity.

Every individual family is called to be rich expression of
that love and solidarity and a witness of the same to
the world. Further, the human person participates in
the broader human family by his own nature.
Participation to be more meaningful needs to be
practiced and chosen. The willingness to practice
participation while striving for social justice is the
Familysolidarity.org social virtue of solidarity (Sirico, 2010).
Family solidarity is directed towards a concrete other and is based on
free choice, albeit often accompanied by a strong sense of personal duty.
Solidarity can be expressed in the family when there is recognition that

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being a family caregiver is a role that all members of the family should
possess (Meulen et al., 2012).

B. Filipino Family Values

The Filipino family consists of many traditional values that have been
treasured and passed on for many generations already.

1. Paggalang (Respect)

The English translation of paggalang

means to be respectful or to give
respect to a person.
 Filipinos are accustomed to use the
words “po”, “opo”, and “ho” when they
are conversing with older people.
Using these words is customary in the
Philippines and it shows a sign of
respect if you do so.
 Paggalang can also be shown to elders by kissing their hands
before leaving/ to say good bye and
seeksa.blogspot.com
upon arrival/ to greet them.
 Younger members of the family can show respect toward older
siblings by calling them kuya (older brother) or ate (older sister)
and adding (younger siblings).
2. Pakikisama (Helping Others)
 Pakikisama has the connotation of
getting along in general.
 There is a general yearning to be
accepted and well-liked among
Filipinos. This applies to one and his
or her friends, colleagues, boss, and
even relatives. This desire is what
steers one to perform pakikisama.
 The word pakikisama literally
translates to “helping others”. Therefore, this trait usually
flicker.com
fosters general cooperation and
performing good or helpful deeds,
which can lead to others viewing you in a favorable light.

3. Utang na Loob (Debt of Gratitude)

 Utang na Loob means to pay your debt with gratitude.
 With utang na loob, there is usually a system of obligation.
When this value is applied, it imparts a sense of duty and
responsibility on the younger siblings to serve and repay the
favors done to them by their elders.

4. Pagpapahalaga sa Pamilya (Prioritizing Family)

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 Pagpapahalaga sa Pamilya. In other words; putting importance

on your family.
 This implies that a person will place a high regard on their
family and prioritize that before anything else.

5. Hiya (Shame)
 Hiya means shame.
 This controls the social behaviors and interactions of a Filipino.
It is the value that drives a Filipino to be obedient and
respectful to their parents, older siblings, and other authorities.
 This is also a key ingredient in the loyalty of one’s family.

C. Filipino Family Culture and Tradition

For Filipinos, traditions in their home
and in their families, are important. They
usually set aside a specific day for certain
celebration like festivals, birthday parties,
reunions, etc. Also, every gathering is
dedicated to keeping up with each other over a
sumptuous food.
Filipinos love to hold celebrations and
fiestas. Among the few examples include
Masskara Festival in Bacolod, Davao has its
Kadayawan Festival, Marinduque has its Theculturetrip.com

Moriones Festival, and Baguio has its Panagbenga Festival.

Filipinos have the longest Christmas celebrations that as early as
August, Christmas songs and jingles are being played in the malls or in the
restaurants. The mood becomes festive, with many people shopping and in
good spirits. Christmas celebrations last until around the first or second
week of January.
Filipinos love to eat. Aside from breakfast, lunch and dinner, Filipinos
manage to squeeze in a little meal in between, too. Usually the eat every
hour or every three hours, they savor every bite.
Filipinos love to sing. As a part of recreation, Filipinos spend some
quality time with their families or friends singing or belting out on old songs.

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CHAPTER VII
NURSING CORE VALUES AS A COMMUNITY HEALTH NURSE

Learning Outcomes:
At the end of the lesson, the students will:
 Demonstrate caring as the core of nursing, love of God, love of
country, and love of people.
 Manifest professionalism, integrity and excellence.

CARING

Promoting health, healing and hope in response to the human

condition. A culture of caring, as a fundamental part of the nursing
profession, characterizes our concern and consideration for the whole
person, our commitment to the common good, and our outreach to those
who are vulnerable. All organizational activities are managed in a
participative and person- centered way, demonstrating an ability to
understand the needs of others and a commitment to act always in the best
interests of all stakeholders.

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INTEGRITY

Respecting the dignity and moral wholeness of every person without

conditions or limitation. A culture of integrity is evident when
organizational principles of open communication, ethical decision making,
and humility are encouraged, expected, and demonstrated consistently. Not
only is doing the right thing simply how we do business, but our actions
reveal our commitment to truth telling and to how we always see ourselves
from the perspective of others in a larger community.

DIVERSITY

Affirming the uniqueness of and difference among persons, ideas,

values and ethnicities. A culture of inclusive excellence encompasses many
identities, influenced by the intersections of race, ethnicity, gender, sexual
orientation, socio- economic status, age, physical abilities, religious and
political beliefs, or other ideologies. It also addresses behaviors across
academic and health enterprises. Differences affect innovation so we must
work to understand both ourselves and one another. And by acknowledging
the legitimacy of us all, we move beyond tolerance to celebrating the
richness that differences bring forth.

EXCELLENCE

Co- creating and implementing transformative strategies with daring

ingenuity. A culture of excellence reflects a commitment to continuous
growth, improvement, and understanding. It is a culture where
transformation is embraced and the status quo and mediocrity are not
tolerated.

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REFERENCES
Books :
Allender, Judith Ann A., Rector, Cherie., & Warner, Kristine D. (2010). Community Health
Nursing: Promoting and Protecting the Public’s Health 7th Edition. Wolters Kluwer Health
Lippincott Williams & Wilkins.

Maglaya, Araceli S., (2009). Nursing Practice in the Community 5 th Edition. Argonauta Corp.
Marikina City.

Sines, David., Bent, Sharon A.,Fanning, Agnes., Farrelly, Penny., Potter, Kate., Wright,
Jane. (2013). Community and Public Health Nursing. 5th Edition. John Wiley & Sons Ltd.

Winchester, M. S., Knapp, C. A., & Belue R. (2018). Global Health Collaboration Challenges
and Lessons. Springer Briefs in Public Health. Retrieved from
https://doi.org/10.1007/978-3-319-77685-9.

E- Resources
Department of Health (2020). Universal Health Care Act. Retrieved from
https://www.doh.gov.ph

Department of Health (2020). Family Health Programs. Retrieved from

https://www.doh.gov.ph

For IFSU use only.

 87

Official Gazette of the Republic of the Philippines. Magna Carta for Health Workers.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Presidential Decree No. 856, s. 1975.
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9502 (2008).
https://www.officialgazette.gov.ph

Official Gazette of the Republic of the Philippines. Republic Act No. 9241 No. 9241 s. 2004.
https://www.officialgazette.gov.ph

RNpedia (2020). Community and Public Health Nursing. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/#

World Health Organization. (2020). Millennium Development Goals (MDGs). Retrieved from
https://www.sho.int/data/gho/Indicator-metadataregistry/Imr-details/3197-82k

Official Gazette of the Philippines. Republic Act No. 9211.https://www.officialgazette.gov.ph

Muelen, Ruud ter et al. (2012). Family Solidarity and Informal Care: the Case of Care for
People with Dementia. https://www.pubmed.ncbi.nlm.nih.gov

ACTIVITY 6.1: SOCIO-DRAMA (Video Presentation)

Instructions:
 Make a 3- 5 minutes socio drama (video presentation).
 Brainstorm/plan with your group on the plot, scene, and how you will accomplish
the Socio-drama task assigned to you.
 Filipino Values and Community Health Nurse Core Values are the main topics and
should be depicted in your output.
 You will be graded based on the following criteria:

Criteria Weight Exceptional Admirable Acceptable Attempted

Understanding 40% ___Factual ___Factual ___Factual ___Information
the topic information is information is information is is inaccurate
accurate mostly somewhat ___Presentation
___Indicates a accurate accurate is off topic
clear ___Good ___Fair
understanding understanding understanding
of the topic of topic of topic

Cooperation 30% ___Accepts ideas ___Accepts ___Unwilling ___Group does

of others; able most ideas to compromise work together
to compromise without ___Few ___One person
___All members negative members does all the
contribute comments; contribute work.
able to
compromise
___Some
members
contribute

Overall 30% ___Shows ___Shows ___Unsure of ___Portrayal

For IFSU use only.

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Presentation confidence some responsibility stalls.

___Informative confidence ___Somewhat ___Lacks
___Entertaining; ___Present informative information
engages some ___Engages ___Audience
audience information audience bored
___speaks ___Engages intermittently ___Mumbles
loudly and Audience ___Hard to ___Body
clearly ___Can be hear language is
___Appropriate heard ___Some lacking;
use of body ___Some use movement inappropriate
language body language

Assigned Score __________ + Beyonder (Bonus) __________= Final Score _____

PDFfiller. Rubrics for Ethics Skit or Role Play. Texas Education

Agency, 2013. Pdffiller.com

For IFSU use only.