COMMUNITY HEALTH DAY 1

NURSING
OVERVIEW OF THE PUBLIC HEALTH
NURSING IN THE PHILIPPINES

GLOBAL AND NATIONAL HEALTH

SITUATION
 GLOBAL HEALTH STATUS
• Studies describe the state of global health by measuring the
burden of disease – the loss of health from all causes of illness
and deaths worldwide (WHO, 2018).

• Collecting and comparing health data from across the globe is

a way to describe health problems, identify trends and help
decision-makers set priorities.

• Morbidity - refers to an illness or disease

• Mortality - refers to death
TOP 10 THREATS TO GLOBAL HEALTH

1. AIR POLLUTION & CLIMATE CHANGE

• Air pollution is causing the climate to change, and climate

change is also causing air quality to change. Because of
climate warming, the Earth experiences more extreme
weather, such as heat waves and drought, which can
negatively impact air quality.
 TOP 10 THREATS TO
GLOBAL HEALTH

2. NON-COMMUNICABLE DISEASES

The term NCDs refers to a group of conditions that are

not mainly caused by an acute infection, result in long-term
health consequences and often create a need for long-term
treatment and care. These conditions include cancers,
cardiovascular disease, diabetes and chronic lung illnesses.
 TOP 10 THREATS TO GLOBAL
HEALTH

3. GLOBAL INFLUENZA PANDEMIC

• The world will face another influenza pandemic – the only thing we don’t know is
when it will hit and how severe it will be.
• WHO is constantly monitoring the circulation of influenza viruses to detect potential
pandemic strains
• Every year, WHO recommends which strains should be included in the flu vaccine
to protect people from seasonal flu. In the event that a new flu strain develops
pandemic potential, WHO has set up a unique partnership with all the major players
to ensure effective and equitable access to diagnostics, vaccines and antivirals
(treatments), especially in developing countries.
 TOP 10 THREATS TO GLOBAL
HEALTH

4. FRAGILE AND VULNERABLE SETTINGS

• More than 1.6 billion people (22% of the global population) live in places
where protracted crises (through a combination of challenges such as
drought, famine, conflict, and population displacement) and weak health
services leave them without access to basic care. Fragile settings exist in
almost all regions of the world, and these are where half of the key targets in
the Sustainable Development Goals, including on child and maternal health,
remains unmet. WHO will continue to work in these countries to strengthen
health systems so that they are better prepared to detect and respond to
outbreaks, as well as able to deliver high quality health services, including
immunization.
 TOP 10 THREATS TO GLOBAL
HEALTH
5. ANTIMICROBIAL RESISTANCE
• The development of antibiotics, antivirals and antimalarials are some of modern
medicine’s greatest successes. Now, time with these drugs is running out.
Antimicrobial resistance – the ability of bacteria, parasites, viruses and fungi to
resist these medicines – threatens to send us back to a time when we were unable
to easily treat infections such as pneumonia, tuberculosis, gonorrhea, and
salmonellosis.
• Drug resistance is driven by the overuse of antimicrobials in people, but also in
animals, especially those used for food production, as well as in the environment.
WHO is working with these sectors to implement a global action plan to tackle
antimicrobial resistance by increasing awareness and knowledge, reducing
infection, and encouraging prudent use of antimicrobials.
 TOP 10 THREATS TO GLOBAL
HEALTH

6. EBOLA AND OTHER HIGH-THREAT PATHOGENS

• In 2018, the Democratic Republic of the Congo saw two

separate Ebola outbreaks, both of which spread to cities of
more than 1 million people. One of the affected provinces is
also in an active conflict zone. This shows that the context in
which an epidemic of a high-threat pathogen like Ebola erupts
is critical – what happened in rural outbreaks in the past
doesn’t always apply to densely populated urban areas or
conflict-affected areas.
 TOP 10 THREATS TO GLOBAL
HEALTH

7. WEAK PRIMARY HEALTH CARE

• Primary health care is usually the first point of contact people have with their health
care system and ideally should provide comprehensive, affordable, community-
based care throughout life. Health systems with strong primary health care are
needed to achieve universal health coverage. Yet many countries do not have
adequate primary health care facilities.
• In October 2018, WHO co-hosted a major global conference in Astana, Kazakhstan
at which all countries committed to renew the commitment to Primary Health Care
made in the Alma-Ata declaration in 1978. In 2019, WHO will work with partners to
revitalize and strengthen primary health care in countries, and follow up on specific
commitments made by in the Astana Declaration.
 TOP 10 THREATS TO GLOBAL
HEALTH
8. VACCINE HESITANCY
• Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of
vaccines – threatens to reverse progress made in tackling vaccine-preventable
diseases. Vaccination is one of the most cost-effective ways of avoiding disease.
• The reasons for this rise are complex, and not all of these cases are due to vaccine
hesitancy. However, some countries that were close to eliminating the disease have
seen a resurgence.
• The reasons why people choose not to vaccinate are complex; a vaccines advisory
group to WHO identified complacency, inconvenience in accessing vaccines, and lack
of confidence are key reasons underlying hesitancy. Health workers, especially those
in communities, remain the most trusted advisor and influencer of vaccination
decisions, and they must be supported to provide trusted, credible information on
vaccines.
 TOP 10 THREATS TO GLOBAL
HEALTH
9. DENGUE

• Dengue, a mosquito-borne disease that causes flu-like

symptoms and can be lethal and kill up to 20% of those with
severe dengue, has been a growing threat for decades.

• An estimated 40% of the world is at risk of dengue fever, and

there are around 390 million infections a year. WHO’s Dengue
control strategy aims to reduce deaths by 50%.
 TOP 10 THREATS TO GLOBAL
HEALTH

10. HIV
• The progress made against HIV has been enormous in terms of
getting people tested, providing them with antiretrovirals and
providing access to preventive measures such as a pre-
exposure prophylaxis.
• However, the epidemic continues to rage with nearly a million
people every year dying of HIV/AIDS.
• Reaching people like sex workers, people in prison, men who
have sex with men, or transgender people is hugely challenging.
 TOP 10 MOST COMMON HEALTH ISSUES
IN THE PHILIPPINES

1. PHYSICAL ACTIVITY AND NUTRITION

• Research indicates that staying physically active can help prevent or
delay certain diseases, including some cancers, heart disease and
diabetes, and also relieve depression and improve mood. Inactivity often
accompanies advancing age, but it doesn't have to.
• Like exercise, your eating habits are often not good if you live and eat
alone. It's important for successful aging to eat foods rich in nutrients and
avoid the empty calories in candy and sweets.
 TOP 10 MOST COMMON HEALTH ISSUES IN THE
PHILIPPINES

2. OVERWEIGHT AND OBESITY

• Being overweight or obese increases
your chances of dying from
hypertension, Type 2 diabetes,
coronary heart disease, stroke,
gallbladder disease, osteoarthritis,
sleep apnea, respiratory problems,
dyslipidemia and endometrial, breast,
prostate, and colon cancers.
 TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

3. TOBACCO
• Tobacco is the single greatest preventable cause of illness
and premature death and is now called "Tobacco
Dependence Disease."
• Smokers who try to quit are more successful when they have
the support of their physician.
 TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

4. SUBSTANCE ABUSE
• There are 1.8 million current drug users in the Philippines, and 4.8
million Filipinos report having used illegal drugs at least once in their
lives

• Drug abuse affects almost all countries of the world. In the Philippines
it has reached epidemic proportions and is one of the top priorities on
the government's agenda.
TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

5. HIV / AIDS
• As of January 2023, there were 110,736 HIV cases reported in the
Philippines
• These include: a low rate of condom use; unsafe injecting practices
among IDUs; large migration rates; increasing trends in extramarital
and premarital sex; a lack of education and common misconceptions
about HIV/AIDS; and cultural factors that inhibit public discussion of
issues of a sexual nature
 TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

6. MENTAL HEALTH
• Dementia is not part of aging. Dementia can be caused by disease, reactions to
medications, vision and hearing problems, infections, nutritional imbalances,
diabetes, and renal failure. There are many forms of dementia (including
Alzheimer’s Disease) and some can be temporary. With accurate diagnosis comes
management and help. The most common late-in-life mental health condition is
depression. If left untreated, depression in the elderly can lead to suicide. Here’s a
surprising fact: The rate of suicide is higher for elderly white men than for any other
age group, including adolescents.
TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

7. INJURY AND VIOLENCE

• Among seniors, falls are the leading cause of injuries, hospital admissions for
trauma, and deaths due to injury. One in every three seniors (age 65 and older)
will fall each year. Strategies to reduce injury include exercises to improve
balance and strength and medication review. Home modifications can help
reduce injury. Home security is needed to prevent intrusion. Home-based fire
prevention devices should be in place and easy to use. People aged 65 and
older are twice as likely to die in a home fire as the general population.
 TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

8. ENVIRONMENTAL QUALITY
• Even though pollution affects all of us, government studies have
indicated that low-income, racial and ethnic minorities are more likely
to live in areas where they face environmental risks. Compared to the
general population, a higher proportion of elderly are living just over
the poverty threshold.
TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

9. IMMUNIZATION
• Influenza and pneumonia and are among the top 10 causes
of death for older adults. Emphasis on Influenza vaccination
for seniors has helped. Pneumonia remains one of the most
serious infections, especially among women and the very
old.
 TOP 10 MOST COMMON HEALTH
ISSUES IN THE PHILIPPINES

10. ACCESS TO HEALTH CARE

• Seniors frequently don't monitor their health as seriously as they
should.
• Barriers to health care emerged from the discussions: transportation
difficulties, limited health care supply, lack of quality health care,
social isolation, and financial constraints.
 HEALTH

•A state of complete
physical, mental
and social well-
being, not merely
the absence of
disease or infirmity
(WHO, 1948).
 HEALTH AS HUMAN RIGHT
• Essential to WHO – THE RIGHT OF EVERY HUMAN TO HEALTH.

• Health as a human right is grounded in the Universal Declaration of

Human Rights (UDHR)

• UDHR Article 25.1 declares “ Everyone has the right to a standard of

living adequate for the health and well-being of himself and of his
family, including food, clothing, housing and medical care and
necessary social service (UDHR, 1948).
 DEPARTMENT OF HEALTH

• Article II Section 11 and 15 of the 1987 Philippine Constitution,

affirms health as a fundamental human right and recognizes
the obligation of the state to protect and promote the right to
health of all Filipinos (Republic of the Philippines’ Official
Gazette, 1987).

• With this, the DOH was established to lead the health sector
towards assuring quality health care in promoting and
protecting the health of all Filipinos.
 MODELS OF HEALTH
1. CLINICAL MODEL

• The absence of signs and symptoms of disease indicates health.

• Illness would be the presence of conspicuous signs and symptoms of

disease.

• An adult individual who is not particular with his lifestyle choices will only
seek healthcare when chest pain is encountered and begins to suspect a
cardiovascular disease.
 MODELS OF HEALTH
2. ROLE PERFORMANCE MODEL

• Health is indicated by the ability to perform social roles.

• Role performance includes work, family and social roles, with

performance based on societal expectations.

• An employee who reported for work, even if he is febrile, may still be

considered healthy.
 MODELS OF HEALTH
3. ADAPTIVE MODEL

• Health is a dynamic state.

• An individual is considered to be healthy if he was able to

adjust positively to social, mental, and physiological changes.
Illness exists when the person failed to cope or becomes
maladaptive to these changes.
 MODELS OF HEALTH
4. EUDAIMONISTIC MODEL

• Instead of health that simply means the absence of any disease, the
eudaimonistic model views health as well-being. This means it
includes things such as self-awareness, self-actualization, and self-
fulfillment.

• It highlights the interactions between physical, social, psychological

and spiritual facets of life and the environment that leads to goal
attainment that creates meaning and purpose in life.
 DETERMINANTS OF HEALTH AND DISEASE
• Biology – an individuals genetic make up, family history and any physical
and mental health problems developed in the course of life.
• Behaviors – the individual’s responses to internal stimuli and external
conditions.
• Social environment – includes interactions and relationships with family,
friends, co-workers, and others in the community like social institutions.
• Physical environment – is what is experienced by the senses – what is
smelled, touched, heard, and tasted.
• Policies and interventions – have a profound effect on the health of
individuals
 SOCIAL DETERMINANTS HEALTH
• These are conditions in which people are born, grow, live, work and
age; might also be circumstantial elements such as housing, work
conditions and access to recreational activities; circumstances that
influence how an individual will develop sickness, what risk factors they
are exposed to, how they access services; and how they utilized the
appropriate services; and is shaped by the distribution of money, power
and resources at global, national and local levels.

• May also include occupation, circumstances affecting the way in which

people work, income, culture, religion, education, racial and gender
discrimination.
 ONE HEALTH CONCEPT: A FRAMEWORK FOR
COMMUNITY AND PUBLIC HEALTH NURSING

• Recognizing the connection between human, animal and

environmental health
• Calls for a consolidated interaction between human health, veterinary
medicine, and public and environmental health professionals,
clinicians, researchers, and agencies functioning hand in hand for a
worthwhile and sustainable health interventions in addressing
worldwide and environmental health challenges.
• Ex. National Rabies Prevention and Control Program, Avian Influenza
Protection Program, Philippines Inter-agency Committee on Zoonoses
(diseases transmitted to humans from animals).
 PUBLIC HEALTH
• Public health is the science of protecting
and improving the health of people and
their communities. This work is achieved
by promoting healthy lifestyles,
researching disease and injury prevention,
and detecting, preventing and responding
to infectious diseases.

• Protecting the health of the entire

population.
 PUBLIC HEALTH NURSING

• MAJOR GOAL: To preserve the health of the

community and surrounding populations by
focusing on health promotion and health
maintenance of individuals, families, and groups
within the community.
 PUBLIC HEALTH NURSING
• The practice of promoting and protecting the health of the
population using knowledge from nursing, social, and public health
sciences.
• The role of PUBLIC HEALTH NURSING is to promote community
wellness to help prevent disease and reduce health risks in
marginalized communities.
• A Public Health Nurse (PHN) goes into at-risk communities to
provide health education and resources for access to health care.
• A Public Health Nurse doesn’t regularly treat patients but
advocates on their behalf and teaches self-care and prevention.
 COMMUNITY HEALTH
• The field of public health aims to protect and improve health by
addressing the structures and systems that define a place—and by
supporting the people who live and work there in making healthy
choices. Problems are studied, data is collected and resources are gathered to help
solve those problems.

• The workers in this field are the frontline representatives of the health care team.
Often, they are members of the community themselves. They reach out, trying to
immerse themselves with folks who may not see a doctor or specialist regularly and
who might even have some hesitancy dealing with a system that can be confusing,
time-consuming and expensive.
 COMMUNITY HEALTH NURSING
• The specialized field of nursing practice that renders care to
individuals, families, and communities; focusing on health
promotion and disease prevention through people empowerment.

• COMMUNITY HEALTH NURSING, also called PUBLIC HEALTH

NURSING or COMMUNITY NURSING, combines primary health
care and nursing practice in a community setting. Community
Health Nurses (CHN) provide health services, preventive care,
intervention and health education to communities or population.
COMMUNITY HEALTH NURSING

1. MAGLAYA
• - The utilization of the nursing process in the different
levels of clientele- individual, families, population groups
and community concerned with
● promotion of health
● prevention of diseases
● disability & rehabilitation
 COMMUNITY HEALTH NURSING
2. JACOBSON
• CHN is learned practice discipline with the ultimate goal of
contributing, as individual & in collaboration with others, to the
promotion of the client’s optimum level of functioning through teaching
& delivery of care.
• Nursing Function:
● Independent
● Collaborative or Interdisciplinary---Health Team Approach
 COMMUNITY HEALTH NURSING
3. FREEMAN
• Unique blend of nursing & public health practice aimed at developing &
enhancing health capabilities of the people, service rendered by a
professional nurse with the community, groups, families, and individual at
home, in health centers, in clinics, in school, in places of work for the ff:
● Promotion of health
● Prevention of illness
● Care of the sick at home and rehabilitation
- SELF-RELIANCE
 PHILOSOPHY OF CHN

- It is based on the worth & dignity of men.

- This philosophy of care is based on the belief that care

is directed to the individual, the family, and the group
contributes to the health care of the population as a
whole.
HIERARCHY OF NURSING PRACTICE FIELDS

Community &
Public Health
Nursing

Mental Health & Psychiatric

Health Nursing

Mother & Child Health Nursing

Adult Health Nursing

 KEY CONCEPTS OF COMMUNITY AND
PUBLIC HEALTH NURSING
(3) Basic Concepts of PHN
1. The community as a client
2. Health as a goal
3. Nursing as the vehicle or means to achieve its goal.

COMMUNITY – A group of people living in a particular area with common beliefs,

values ang traditions.
Important Attributes of a Community
● Having geographical boundaries
● A shared belief system or culture
 ROLES OF A COMMUNITY & PUBLIC
HEALTH NURSE
BEGINNING PROFESSIONAL NURSE:
1. HEALTH CARE PROVIDER – caring is the essence of nursing
2. MANAGER-LEADER – principles of management to maximize
resources
3. RESEARCHER – keep track of illnesses, submits report
• +++ (PHN)
4. HEALTH EDUCATOR – health instructions
5. PROGRAM IMPLEMENTER – under the local government
6. COMMUNITY ORGANIZER – working with people in the community
7. CLIENT ADVOCATE – ensuring the right to health of the population
LEVELS OF CLIENTELE IN COMMUNITY AND
PUBLIC HEALTH NURSING
1. Individual
2. Family
3. Population Group
4. Community

RA 9173 The Philippine Nursing Law 2002 – a person shall be deemed to be

practicing nursing within the meaning of this Act when he/she singly or in
collaboration with another, initiates and performs nursing services to individuals,
families and communities in any health care setting. It includes but not limited to,
nursing care during conception, labor, delivery, infancy, childhood, toddler, preschool,
school age, adolescence, adulthood and old age.

Nurses are responsible to the promotion of health and prevention of illnesses.

The Intervention Wheel contains
(3) important elements:
A. It is population based

B. It contains three levels of

practice (systems, community,
and individual/family)

C. It identifies and defines 17

public health interventions
 PUBLIC HEALTH INTERVENTION
• Interventions are actions that public health nurses take on behalf of
individuals/families, communities, and systems, to improve or protect health status.
• 1. SURVEILLANCE is “an ongoing, systematic collection, analysis and interpretation
of health-related data essential to the planning, implementation, and evaluation of
public health practice”.
• 2. DISEASE AND HEALTH EVENT INVESTIGATION systematically gathers and
analyzes data regarding threats to the health of populations, ascertains the source of
the threat, identifies cases and others at risk, and determines control measures.
• 3. OUTREACH locates populations of interest or populations at risk and provides
information about the nature of the concern, what can be done about it, and how to
obtain services
 PUBLIC HEALTH INTERVENTION
• 4. SCREENING identifies individuals with unrecognized health risk factors or
asymptomatic disease conditions in populations.
• 5. CASE-FINDING locate individuals and families with identified risk factors and
connects them to resources.
• 6. REFERRAL makes a connection to necessary resources to prevent or
resolve problems or concerns. Follow-up assesses outcomes related to the
utilization of the resources.
• 7. CASE MANAGEMENT is a collaborative process of assessment, planning,
facilitation, care coordination, evaluation, and advocacy for options and services
to meet client needs. It uses communication and available resources to promote
safety, quality of care, and cost-effective outcomes.
 PUBLIC HEALTH INTERVENTION
• 8. DELEGATED FUNCTIONS include: 1) direct care tasks a registered
professional nurse carries out under the authority of a health care practitioner, as
allowed by law, and 2) direct care tasks a registered professional nurse entrusts to
other appropriate personnel to perform.
• 9. HEALTH TEACHING involves sharing information and experiences through
educational activities designed to improve health knowledge, attitudes, behaviors,
and skills.
• 10. COUNSELING involves establishing an interpersonal relationship at an
emotional level, with the goal of increased or enhanced capacity for self-care and
coping.
• 11. CONSULTATION seeks information and generates optimal solutions to
perceived problems or issues through interactive problem-solving
 PUBLIC HEALTH INTERVENTION
• 12. COLLABORATION enhances the capacity to promote and protect health for
mutual benefit and a common purpose. Collaboration involves exchanging
information, harmonized activities, and shared resources.

• 13. COALITION-BUILDING helps promote and develop alliances among

organizations or constituencies for a common purpose. It builds links, solves
problems, and/or enhances local leadership to address health concerns.

• 14. COMMUNITY ORGANIZING is “the process by which people come together to

identify common problems or goals, mobilize resources, and develop and
implement strategies for reaching the objectives they want to accomplish”
 PUBLIC HEALTH INTERVENTION
• 15. ADVOCACY is the act of promoting and protecting the health of individuals
and communities “by collaborating with relevant stakeholders, facilitating access to
health and social services, and actively engaging key decisionmakers to support
and enact policies to improve community health outcomes”.
• 16. SOCIAL MARKETING is a process “that uses marketing principles and
techniques to change target audience behaviors to benefit society as well as the
individual” .
• 17. POLICY DEVELOPMENT places health issues on decision-makers’ agendas,
establishes a plan of resolution, determines needed resources, and results in laws,
rules and regulations, ordinances, and policies. Policy enforcement compels
others to comply with the laws, rules, regulations, ordinances, and policies created
in conjunction with policy development.
 STANDARDS OF PUBLIC HEALTH NURSING PRACTICE
STANDARDS OF CARE

Standard 1 Collects comprehensive data pertinent to the health status

Assessment of population.
Standard 2 Analyzes the assessment data to determine the population
Population diagnosis and priorities.
Diagnosis Priorities
Standard 3 Identifies outcomes for a plan that is based on population
Outcomes diagnosis and priorities.
Identification
Standard 4 Develops a plan that reflects best practices by identifying
Planning strategies, action plans and alternatives to attain expected
outcomes.
Standard 5 Implement the identified plans by partnering with others.
Implementation
a. Coordination Coordinates program, services & other activities to implement the
identified plan
b. Health Employs multiple strategies to promote health, prevent disease &
education ensure a safe environment for the population
and health
promotion
c. Consultation Provides consultation to various community groups & officials to
facilitate
d. Regulatory Identifies, interprets, & implement public health laws, regulation &
activities policies.

Standard 6 Evaluates the health status of the population.

Evaluation
Standard 7 Systematically enhances the quality and effectiveness of nursing
Quality of practice.
Practice
Standard 8 Attains knowledge & competency that reflects current nursing &
Education public health practice.

Standard 9 Evaluates one own nursing practice in relation to professional

Professional nursing standards & guidelines , relevant statutes, rules &
Practice Evaluation regulations.

Standard 10 Establishes collegial partnership while interacting with

Collegiality & representatives of the population, organizations, & health & human
Professional services professionals & contributes to professional development of
Relationship peers, students, colleagues & others.

Standard 11 Collaborates with the representatives of the population,

Collaboration organization & health & human services professionals in providing
for & promoting the health of the population.
Standard 12 Integrates ethical provisions in all areas of practice.
Ethics

Standard 13 Integrates research findings in nursing practice.

Research

Standard 14 Consider factors related to safety effectiveness, cost & impact on

Resource Utilization practice & in the planning & delivery of nursing & public health
Population programs, policies & services.

Standard 15 Provides leadership in nursing & public health.

Leadership
EVOLUTION OF PUBLIC HEALTH
NURSING IN THE PHILIPPINES
 EARLY BELIEFS, PRACTICES AND CARE
OF THE SICK
• Early Filipinos subscribed to superstitious belief and practices in relation to
health and sickness
• Diseases, their causes and treatment were associated with mysticism and
superstitions
• Cause of disease was caused by another person (an enemy of witch) or evil
spirits
• Persons suffering from diseases without any identified cause were believed
bewitched by “mangkukulam”
• Difficult childbirth were attributed to “nonos”
• Evil spirits could be driven away by persons with powers to expel demons
• Belief in special Gods of healing: priest-physician, word doctors,
herbolarios/herb doctors
EARLY HOSPITALS DURING THE SPANISH REGIME

• Religious orders exerted efforts to care for the sick by

building hospitals in different parts of the Philippines:

• Hospital Real de Manila ● San Juan de Dios Hospital

• San Lazaro Hospital ● Hospital de Aguas Santas

• Hospital de Indios
 PROMINENT PERSONS INVOLVED DURING THE
PHILIPPINE REVOLUTION
1. Josephine Bracken – wife of Jose Rizal installed a field hospital in an estate
in Tejeros that provided nursing care to the wounded night and day.
2. Rose Sevilla de Alvaro – converted their house into quarters for Filipino
soldiers during the Phil-American War in 1899.
3. Hilaria de Aguinaldo –wife of Emilio Aguinaldo organized the Filipino Red
Cross.
4. Melchora Aquino – (Tandang Sora) nursed the wounded Filipino soldiers,
gave them shelter and food.
5. Captain Salomen – a revolutionary leader in Nueva Ecija provided nursing
care to the wounded when not in combat.
6. Agueda Kahabagan – revolutionary leader in Laguna also provided nursing
services to her troops.
7. Trinidad Tecson (Ina ng Biak na Bato) – stayed in the hospital at Biac na
Bato to care for the wounded soldiers.
 SCHOOL OF NURSING
1. St. Paul’s Hospital School of Nursing, Intramuros Manila – 1900
2. Iloilo Mission Hospital Training School of Nursing – 1906
● 1909 – Distinction of graduating the 1st trained nurses in the Phils. With
no standard requirements for admission of applicants except their
“willingness to work”
● April 1946 – a board exam was held outside of Manila. It was held in the
Iloilo Mission Hospital thru the request of Ms. Loreto Tupas, Principal of the
school.
3. St. Luke’s Hospital School of Nursing – 1907; opened after four years as a
dispensary clinic.
4. Mary Johnston Hospital School of Nursing – 1907
5. Philippine General Hospital School of Nursing – 1910
 COLLEGE OF NURSING
1.UST College of Nursing – 1st College of Nursing in the Phils: 1877
2.MCU College of Nursing – June 1947 (1st College who offered BSN – 4 year program)
3.UP College of Nursing – June 1948
4.FEU Institute of Nursing – June 1955
5.UE College of Nursing – Oct 1958

1909
• 3 female graduated as “qualified medical-surgical nurses”

1919
• The 1st Nurses Law (Act#2808) was enacted regulating the practice of the nursing profession in
the Philippines Islands. It also provided the holding of exam for the practice of nursing on the
2nd Monday of June and December of each year.
1920
• 1st board examination for nurses was conducted by the Board of Examiners, 93
candidates took the exam, 68 passed with the highest rating of 93.5%-Anna Dahlgren
• Theoretical exam was held at the UP Amphitheater of the College of Medicine and
Surgery. Practical exam at the PGH Library.

1921
• Filipino Nurses Association was established (now PNA) as the National Organization of
Filipino Nurses
• PNA: 1st President – Rosario Delgado
• Founder – Anastacia Giron-Tupas

1953
• Republic Act 877, known as the “Nursing Practice Law” was approved.
1954- RA 1082 (Rural Health Act)- creation of Rural Health Unit in every
municipality
- employment for Municipal Health Officers in the rural health units for each
province such as:
▪ Physicians
▪ Nurses
▪ Midwives
▪ Sanitary Inspectors
▪ Dentist for each Congressional District
1957- amended the Rural Health Act on 8 categories of RHU
corresponding the population size of the municipalities

1958- Regional Health Offices were created as a result of

decentralization

1970- Philippine Health Care Delivery System was

restructured
1991- enactment of the Local Government Code (RA 7160)

- The law mandated devolution of basic services which

includes the following:

● health services to local government units

● establishment of a local health board in every province
and city / municipality.
Sept. 2000- the Philippines signed and adopted the United Nations Millennium
Declaration during the World Summit

- the member nations committed to the attainment of 8 Millennium

Development Goals to reduce child mortality, improve maternal health &
to combat HIV/ AIDS, malaria & other diseases

- DOH directed comprehensive health reforms, Health Sector Reform

Agenda (HSRA) , the implementation of FOURmula One for Health in
2005 (Service Delivery, Health Care Financing, Health Governance and
Health Regulation) & Universal Health Care in 2010.