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.
Some of these inequalities are due to location, with rural areas seeing
the highest physician deficit. Other inequalities are the result of income gaps,

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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
requires addressing the factors that disproportionately affect low-income
areas.

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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. 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

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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%20decre

asing.

➢ 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.
➢ 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.

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➢ 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.
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.

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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
• 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

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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.
• 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.

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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.

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

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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.

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.

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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.

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.

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• 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
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.

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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
• 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.

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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.

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).

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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.

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.

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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.

✓ 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.

Nurse, Nurse Inspiration, Nurse Humor, pinterest.ph

✓ Suturing lacerations in the
absence of a physician

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✓ 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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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

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

For IFSU use only.