COMMUNITY HEALTH NURSING

Mrs. Irene R. Mina

Encoded by: Kyna Cathleen M. Galolo

physical, mental and social

INTRODUCTORY CONCEPTS OF well-being and longevity consistent
COMMUNITY HEALTH with available knowledge and
NURSING resources at a given time and place.
(Hanlon)
CONCEPTS OF PUBLIC
● is the art of applying science in the
HEALTH, PUBLIC HEALTH
context of politics so as to reduce
NURSING, AND COMMUNITY
inequalities in health while
HEALTH NURSING
ensuring the best health for the
PUBLIC HEALTH greatest number. It points to the
fact that public health is a core
● a science and art of preventing element of the government’s
disease, prolonging life, promoting attempts to improve and promote
health and efficiency through the health and welfare of their
organized community effort for the citizens. (WHO)
sanitation of the environment,
control of communicable diseases, PUBLIC HEALTH NURSING
the education of individuals in
● The practice of nursing in national
personal hygiene, the organization
and local government health
of medical and nursing services for
department, and public schools.
the early diagnosis and preventive
● It is community health nursing
treatment of disease, and the
practiced in the public sector.
development of the social
(Standard of Public Health Nursing
machinery to insure everyone a
in the Philippines, 2005)
standard of living adequate for the
● is a special field of nursing that
maintenance of health, so
combines the skills of nursing,
organizing these benefits as to
public health and some phases of
enable every citizen to realize his
social assistance and functions as
birthright of health and longevity.
part of the total public health
(Dr. Charles Edward Winslow)
programme for the promotion of
● is dedicated to the common
health, the improvement of the
attainment of the highest level of
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conditions in the social and physical
environment, rehabilitation of
illness and disability.(WHO Expert
Committee of Nursing)
COMMUNITY HEALTH
NURSING
● is a unique blend of nursing and
public health practice woven into a
human service that when properly
developed and applied has a
tremendous impact on human well
being. Its responsibilities extend to
the care and supervision of
individuals and families in their
homes, in places of work, in schools
and clinics. It is one of the basic
services of the health departments.
● is the utilization of the nursing
process in the different levels of
clientele concerned with the
promotion of health, prevention of
disease and disability and
rehabilitation. (Maglaya, Araceli)
● Broader sense
● Includes CHN in both public and
private sectors
● is a learned practice discipline with
the ultimate goal of contributing, as
individuals and in collaboration
with others, to the promotion of the
Mrs. Irene R. Mina
client’s optimum level of
functioning through teaching and
delivery of care. (Jacobson)
HISTORY OF COMMUNITY
HEALTH NURSING
● The history of Public Health
Nursing is embedded in the history
of the Department of Health which
was first established as the
Department Public Works,
Education and hygiene in 1898.
1912
● he Fajardo act (Act NO. 2156)
created the sanitary divisions
● -PGH sent 4 nurses to Cebu to take
care of mothers and their babies.
1914
● School nursing was rendered by a
nurse employed by the Bureau of
Public Health in Tacloban, Leyte.
● Two nurses, Mrs. Casilang
Eustaquio and Mrs. Matilde Azurin
were employed for MCH and
sanitation
1916 - 1918
● Ms. Perlita Clark took charge of the
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Mrs. Irene R. Mina
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Public Health Nursing work. 1927

1917 ● The office of District Nursing under

the Office of General Inspection of
● Four graduate nurses paid by the Health Service was abolished and
city of Manila were employed to replaced by the Section of Public
work in the city division. Health Nursing with Mrs. Genara
de Guzman as consultant to the
1918
Director of Health.
● The office of Miss Clark was
1928
abolished due to lack of funds.
● First convention of nurses was held
1919
until the advent of World War II.
● Ms. Carmen del Rosario, the first
1930
Filipino nurse supervisor was
appointed under the Bureau of ● Conversion of Section of Public
Health. Health Nursing into Section of
Nursing
1923
1933
● Two government schools of nursing
were established ● Reorganization Act 4007
○ Zamboanga General transferred the Division of Maternal
Hospital School of Nursing and Child Health of the Office of
○ Baguio General Hospital Public Welfare Commission to the
Bureau of Health.
July 1, 1926
1941
● Ms. Carmen resigned and Ms.
Genara Manongdo, ranking ● Transferring of activities and
supervisor of American Red Cross personnel of the Metropolitan
replaced her. Division and Bureau of Health
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transferred to a new department
with Dr. Mariano Icasiano as City
Health Officer of Manila; also and
Office of Nursing was established
with Mrs. Vicenta C. Ponce as Chief
Nurse and Mrs. Rosario A. Ordiz
as her assistant.
December 8, 1941
● Health nurses in Manila were
assigned to devastated areas to
attend to the sick and wounded
during World War II.
1942
● A group of health nurses, doctors
and administrators from the Manila
Health Department went to the
internment camp in Capas, Tarlac
to receive sick prisoners of war by
the Japanese army. They were
confined at San Lazaro Hospital and
sixty-eight National Public Health
Nurses took care of them.
July 1942
● Thirty-one nurses taken prisoners of
war by the Japanese army and jailed
in Bilibid Prison in Manila were
released to the Director of the
Mrs. Irene R. Mina
Bureau of Health, Dr. Eusebio
Aguilar, their guarantor. Public
Health Nurses joined guerillas
during the World War II.
February 1946
● Comparison of war records of the
Bureau of Health: a. 308 public
nurses and 38 supervisors (post
war), b. 556 nurses and 38
supervisors (pre-war). Mrs. Genara
M. de Guzman, technical assistant
in Nursing of the Department of
Health recommended the creation
of a Nursing Office of the DOH.
October 7, 1947
● Executive Order (EO) NO. 94
reorganized government offices and
created the Division of Nursing
under the Office of the Secretary of
Health implemented on December
16, 1947. Mrs. Genara de Guzman
was appointed as Chief of the
Division with three assistants: Ms.
Annie Sand (Nursing Ed.), Mrs.
Magdalena C. Valenzuela (Public
Health Nursing) and Mr.
Patrocinio Montellano for Staff
Education.
● The Nursing Division was placed
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directly under the Secretary of
Health for bureaus and units to
help carry out health programs. At
the Bureau of Health, the Section of
Nursing Supervision took over the
former function of the Section of
Nursing. Mrs. Soledad Buenafe was
appointed Chief
● with Ms. Marcela Gabatin as
assistant Chief. The newly created
Section of Puericulture Center of
the Bureau of Hospitals had Mrs.
Teresa Malgapo as Chief.
1948
● The first training Center of the
Bureau of Health was organized in
cooperation with Pasay Cit Health
Department housed at the Tabon
Health Center which was later
renamed as Doña Marta Health
Center. The staff consisted of Dr.
Trinidad A. Gomez, Center
Physician; Ms. Marcela Gabatin,
Nurse Supervisor; Ms. Constancia
Tuazon, Mrs. Bugarin and Ms.
Ramos as Nurse Instructors, later
on joined by Ms. Zenaida Panlilio,
National Public Health Nurse of
the Bureau of Health.
1950
Mrs. Irene R. Mina
● The Rural Health Demonstration
and Training Center (RHDTC) was
established by the Dept. of Health
through Dr. Hilario Lara, Dean of
the Institute of Hygiene, now
College of Public Health,
University of the Philippines. Dr.
Amansia Mangay (Mrs. Andres
Angara), a Doctor of Public Health
graduate of Harvard was chosen to
be Chief of the RHDTC. Dr.
Antonio N. Acosta, former
Physician of the Manila Health
Dept. was Medical Training Officer.
The first Supervising Training
Nurse was Ms. Marta Obaña with
Ms. Jean Bactat, Mrs. Mary Velono
and Mrs. Natividad B. Asuque as
Nurse Instructor.
1953
● The office of the Health Ed. and
Personnel Training was established
with Dr. Trinidad Gomez as Chief.
Four nurse instructors were
recruited, two from the Manila
Health Dept, Mrs. Venancia
Cabanos and Mrs. Damasa Torrejon
and two from the BOH, Ms.
ZenaidaY. Panlilio and Ms. Leonora
Liwanag (first graduates of the
 COMMUNITY HEALTH NURSING
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University of the Philippines,
College of Nursing to join the
BOH).
● Republic Act No. 1082 or the Rural
Health Law created the first 81
Rural Health Units. Among the
first public health nurses assigned to
the Rural units were two graduates
of class 1952 of the Philippine
General Hospital School of
Nursing, Miss Florida B. Ramos
(Mrs. Martinez) and Ms. Lydia
Amurao (Mrs Cabigao).
1957
● Republic Act 1891 was approved
amending Sections II, III, IV, VII
and VIII of the R.A. 1082. This
second Rural Health Act created 8
categories of rural health units based
on population.
1958 - 1965
● R.A. 977 passed by the Congress in
1954 abolished the Division of
Nursing, creating nursing positions
at different levels. Ms. Annie Sand
was appointed Nursing Consultant
under the Office of the Secretary of
Health.
● Two nurses of the former Bureau of
Mrs. Irene R. Mina
Hospitals worked with the Nursing
consultant: Ms. Rosita Furia for
Hospital Nursing Service, and Ms.
Eva Obsequio for Nursing
Education. Mrs. Rosita Villanueva
and Mrs. Juanita Hospitals vice Ms.
Furia and Ms. Obsequio when they
retired.
● The Department of Health
National Leagues of Nurses, Inc
was founded by Ms. Annie Sand in
1969 and became its President and
Adviser. The Reorganization Act
embodied in EO 288, Series of
1959 de-centralized and integrated
health services creating 8 Regional
Health offices in the country.
● At the Regional level two
supervising positions for nurses
were created: Regional Nurse
Supervisor and Regional Public
Health Nurse.
● The Supervising Public Health
Nurses (SPHN) at the Provincial
Health supervised the public health
nurses at the Rural Health Units as
well as the Chief Nurses in
Hospitals.
● The reorganization of 1959 also
merged two Bureaus in the Dept. of
Health: The Bureau of Health (in
charge of preventive programs)
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Mrs. Irene R. Mina
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merged with Bureau of Hospitals Orais and later Mrs. Constancia

(curative programs and Asinas
regulatory/licensing functions) to
form the Bureau of Health and November 1971
Medical Services.
● Mrs. Josefina A. Mendoza,
● In the merged Bureau of Health and
Supervising Nurse Instructor,
Medical Services, Nursing program
Office of the Health Education and
supervisors were appointed for the
Personnel Training succeeded Ms.
different programs. In the Maternal
Annie Sand as Nursing Consultant.
and Child Health Division, Ms.
Later, Mrs. Nelida K. Castillo,
Saturnina Latorre, Mrs. Fe Bacaloso
former Nurse Instructor at San
and later Mrs. Rosario Zaraspe,
Lazaro Hospital and counterpart to
Mrs. Isabel Pascua and Mrs. Emilia
Ms. Helen Filmore, WHO
Briones. In the occupational Health
consultant of Pediatric Nursing was
Division, Mrs. Felisa V. Chanco was
appointed Nursing Program
nurse in charge of Occupational
Supervisor, Office of the Secretary
Health Nursing.
of Health
1967
1974
● In the Bureau of Disease Control,
● The Project Management Staff was
Mrs. Zenaida Panlilio-Nisce was
organized as part of Population
appointed as Nursing Program
Loan II of the Philippine
Supervisor and served as consultant
Government with Dr. Francisco as
on 5 diseases: TB. Leprosy, Venereal
Project Manager. Experts on
Diseases, Cancer and Filariasis; and
different fields were recruited and
Mental Health.
Mrs. Nelida Castillo joined the PMS
● At the Office of Health Education
staff. Her position as Nursing
and Personnel Training, the nurses
Program Supervisor, Office of the
were Mrs. Josefina A. Mendoza,
Secretary of Health was taken over
Supervising Nurse Instructor, Ms.
by Mrs. Zenaida Nisce, Nursing
Carmen Panganiban, Ms. Virginia
Program supervisor Bureau of
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Disease Control. Ms. Julita Yabes,
faculty member of the Institute of
Hygiene (now College of Public
Health) University of the
Philippines served as consultant on
nursing matters in the Project
Manage Staff.
1975
● As a result of the restructuring of
the health care delivery system based
on the findings of the Operations
Research (WHO assisted)
conducted in the province of Rizal
the functions of the health team
were redefined.
1976 - 1986
● The Nursing Consultant and
Nursing Program Supervisor of the
Office of the Secretary of Health
were involved in the Rural Health
Practice Program which required
medical and nursing graduates to
serve for two months in rural areas
before the licenses could be issued
by the Professional Regulatory
Commission.
1986
Mrs. Irene R. Mina
● The reorganization of the
Department of Health during this
period placed the position of
Nursing Consultant at the Bureau
of Health and Medical Services later
abolished when Mrs. Mendoza
retired. Mrs. Zenaida Nisce
remained as Nursing Program
Supervisor of the Office of the
Secretary of Health.
● The other nursing positions at the
Central Office were at the National
Family Planning Service. Among
these nurses were Miss Leonora
Liwanag, Ms. Virginia Orais, Mrs.
Vilma Paner, Mrs. Sarah Austria
and Mrs. Leticia Daga, Mrs. Nelia
Hizon joined the NFPS when Miss
Liwanag retired.
1987 - 1989
● Executive Order No. 119
reorganized the Department of
Health and created several offices
and services within the Department
of Health.
1990 -1992
● The number of positions of
Nursing Program Supervisors
(Nurse VI) was increased as there
 COMMUNITY HEALTH NURSING
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were three or more appointed in
each service. In the Maternal and
Child Health Services Mrs. Emilia
Briones and Mrs. Nilda Silvera and
Mrs. Vicenta Borja. Mrs. Asucena
Alcantara and Mrs. Lucila Agripa
later joined them.
● In the non-communicable Disease
Control Service (NCDCS), the first
two Nursing Program Supervisors
were Mrs. Gloria Temelo and Miss
Gilda Estipona who were with the
cardiovascular and cancer control
programs respectively. In 1989, Mrs.
Carmen Buencamino joined the
Occupational Health Division.
When these three nurses retired one
after another, their positions were
taken over by Miss Ma. Thelma
Bermudez, Ms. Frances Prescilla
Cuevas and Mrs. Ma. Theresa
Mendoza.
● The three nurses at the
Communicable Disease Control
Service, Mrs. Zenaida P. Nisce, Mrs.
Carolina A. Ruzol and Mrs.
Zenaida Recidoro participated in
the planning, training, monitoring,
supervision and evaluation of
diseases. At the Community Health
Service, the Nursing Program
Supervisor was Mrs. Patrocinio
Mrs. Irene R. Mina
Ferrera. At the Department of
Health Administrative Service there
were four Public Health Nurses and
one Senior Public Health Nurse
assigned at the Medical
Examination Division and
Infirmary (MEDI) formerly called
the Physical Examination Division.
January 1999
● Department Order No. 29
designated Mrs. Nelia F. Hizon,
Nurse VI, then the President of the
National League of Philippine
Government Nurses as Nursing
Adviser
May 24, 1999
● Executive Order No. 102 was
signed by the President Joseph
Ejercito Estrada redirecting the
functions and operations of the
DOH
2005 - 2006
● The development of the
rationalization plan to streamline
(simplify) the bureaucracy (official
procedure) was started and is in the
last stages of finalization
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HISTORICAL DEVELOPMENT OF
COMMUNITY HEALTH NURSING
IN THE PHILIPPINES
Before (1898)
● Traditional health care practices
especially the use of herbs and
rituals for healing were practiced. In
1876, Medicos Titulares, equivalent
to provincial health officers were
already existing. In 1888, a Superior
Board of Health and Charity was
created by the Spaniards which
established a hospital system and a
board of vaccination.
June 23, 1898
● Shortly after the proclamation of
the Philippine independence from
Spain. The Department of Public
Works, Education and hygiene was
created by a decree signed by Pres.
Emilio Aguinaldo. However, this
was short live because of the
American invasion.
September 29, 1898
● With the primary objective of
protecting the health of the
American soldiers, General Orders
Mrs. Irene R. Mina
No. 15 established the Board of
Health for the City of Manila.
July 1, 1901
● because it was realized that it was
impossible to protect the American
soldiers without protecting the
natives, a board of Health for the
Philippine Islands was created
through Act No. 157. It became an
Insular Board of Health when Act
Nos. 307, 308 dated December 2,
1901 established the Provincial and
Municipal boards respectively. The
Insular Board of Health proved to
be inefficient operationally so it was
abolished and replaced with the
Bureau of Health under the
Department of Boards of Health.
1912
● Act No. 2156 also known as the
Fajardo act, consolidated
municipalities into sanitary
divisions and established the Health
Fund for travel and salaries.
1915
● Act No. 2468 transformed the
Bureau of Health into a
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commissioned service called the
Philippine Health Service.
August 2, 1916
● The passage of the Jones Law also
known as the Philippine Autonomy
Act provided the highlight in the
struggle of the Filipinos for
independence from the American
Rule. The establishment of an
elective Philippine Senate
completed an all Filipino Philippine
Assembly which majored in
reorganization, culminating the
Administrative Code of 1917 (Act
2711), which included the Public
Health Law of 1917.
1932
● Because of the need to coordinate
public health, Act No. 4007 known
as the Reorganization Act of 1932
reverted back the Philippine Service
into Bureau of Health, and
combined the Bureau of Public
Welfare under the Office of the
Commissioner of Health and Public
Welfare. The Philippine
Commonwealth and the Japanese
Occupation (1935- 1945)
Mrs. Irene R. Mina
May 31, 1939
● Commonwealth Act No. 430
created the Department of Public
Health and Welfare but the full
implementation was only completed
through Executive Order no. 317,
January 7, 1941. Dr Jose Fabella
became the First Department
Secretary of Health and Public
Welfare Act in 1941.
1942
● During the period of the Japanese
occupation reorganizations and
issuances for the health and welfare
of people were instituted.
October 4, 1947
● Executive Order No. 94 provided
for the post war reorganization of
the Department of Health and
Public Welfare which resulted in the
split of the Department and transfer
of the Bureau of Public Welfare
(became Social Welfare
Administration) and the Philippine
General Hospital to the office of the
President.
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January 1, 1951
● The office of the President of the
Sanitary District was converted into
a Rural Health Unit, carrying out
seven basic Health services: maternal
and child health, environmental
health, communicable disease
control, vital statistics, medical care,
health education and public health
nursing. The impact of the
community was so strong that it
resulted in the passage of the Rural
Health Act of 1954 (RA 1082).
This Act created more health units
and created posts for municipal
health.
February 20, 1958
● Executive Order No. 288 provided
for what is described as the “most
sweeping” reorganization in the
History of the Department. This
came about as an effort to
decentralize governance of health
services.
1970
● The Restructured Health Care
Delivery System was conceptualized.
It classified health services into
Mrs. Irene R. Mina
primary, secondary and tertiary
levels of care. Under this concept
the ration of a nurse to a
population is 1: 20,000. The
expanded role of the public health
nurse was highlighted
June 2, 1978
● With the proclamation of martial
law in the country, Presidential
Decree 1397 renamed the
Department of Health to the
Ministry of Health with Sec.
Gatmaitan as its first Minister of
Health.
December 2, 1982
● Executive Order No. 851 signed by
President Ferdinand Marcos
reorganizes the Ministry of Health
as an integrated health care delivery
system through the creation of the
Integrated Provincial Health
Officers.
April 13, 1987
● Executive Order No. 119,
“Reorganizing the Ministry of
Health” by President Corazon C.
Aquino saw a major change in the
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structure of the ministry. EO 119
clustered agencies and programs
under the Office for Public Health
Regulations and Office of
Management Services. The Field
Offices were composted of the
Regional Health Offices and
National Health Facilities. The
latter was composed of National
Medical Centers, Special Research
Centers and Hospitals.
October 10, 1991
● Republic Act 7160 also known as
the Local Government Code
provided for the decentralization of
the entire government. Under this
law, all structures, personnel and
budgetary allocations from the
provincial health level down to the
barangays were devolved to the
Local Government Units to
facilitate health service delivery.
May 24, 1999
● EO No. 102, “Redirecting the
Functions and Operations of the
Department of Health” by
President Joseph Estrada granted
the DOH to proceed with its
Rationalization and Streamlining
Mrs. Irene R. Mina
Plan which prescribed the current
organizational, staffing and resource
structure consisted with its new
● mandate. EO 102 mandates the
Department of Health to provide
assistance to local government units,
people’s organization, and other
members of the civic society in
implementing programs, projects
and services which promote the
health and well-being of every
Filipino.
1999 - 2004
● Development of the Health Sector
Reform agenda which describes the
major strategies, organization and
policy changes and public
investments needed to improve the
way health care is delivered,
regulated and financed.
2005 - ongoing!
ROLES OF A COMMUNITY
HEALTH NURSE
a) Client-oriented roles
CAREGIVER
● Provides a continuous and
comprehensive to the family, group
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of people, and community at large.
● Emphasizes more on promotive and
preventive healthcare.
● Approaches the family and
persuades them to implement
promotive and preventive measures.
● Care during illness is beneficial
gaining acceptance, trust, and
confidence.
● Also provides care during illness for
which usually the family members
come forward to seek help.
● As care is given, the nurse educates
and helps the family members to
develop their abilities and overcome
their barriers so that they can take
care of their health and nursing
needs, promote their health, and
prevent illness.
EDUCATOR
● Educates the individual, family,
groups of people, and the
community at large.
● Health education thus given
focuses on promoting health,
preventing illness and aspects related
to care during illness and
rehabilitation and disability
prevention.
● The nurse conducts planned health
Mrs. Irene R. Mina
education sessions for organized
community groups e.g., school
children, antenatal mothers, eligible
couples, elderly, etc.
● Health education for the family is
planned and implemented as part of
the family care plan.
● Involved in giving
incidental/casual/spontaneous
health education according to the
situation. (Washing of hands before
the child eats)
COUNSELOR
● Helps individuals, families, and the
community at large to recognize and
understand their problems to be
solved, find solutions within
resources and implement feasible
and acceptable solutions.
REFERRAL RESOURCE
● Explores community resources in
terms of money, manpower,
material, agencies, etc.
● Makes use of these resources in
helping individuals, family groups,
and communities to meet their
health and nursing needs.
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ROLE MODEL
● Helping a person develop by seeing
and following your example
● Encouraging reflective practice and
increasing their self awareness
● Providing strategies to overcoming
obstacles
● Being a supportive role by providing
encouragement or emotional help
● Empowering a person to develop
their own career into the future
CASE MANAGER
● Coordinates and directs the
selection and use of health care
services to meet client needs,
maximize resource utilization, and
minimize the expense of care.
● Work with the multidisciplinary
health care team to measure the
effectiveness of the case
management plan and to monitor
outcomes.
b) Delivery-oriented roles
COORDINATOR
● Coordinates health services with
concerned individuals and families
through the community health
Mrs. Irene R. Mina
team members, government
organizations and non- government
organizations
● Coordinates nursing plans and
programs with other health
programs
COLLABORATOR
● Seldom practice in isolation. They
must work with many people,
including: the clients, physician
teachers, social workers,
nutritionist, psychologist, city
planners, other nurses, health
educators, physical therapist,
occupational therapist,
epidemiologist, etc. to solve patient
care problems and to provide the
optimal quality level of care to the
patient or group of patients.
LIAISON
● Fosters the relationship between
patients and the facilities providing
their care.
● Establish patients' eligibility for
care, communicating with families,
and interacting with a wide range of
staff members, from admissions
coordinators to case managers to
physicians.
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● Arranging care for patients, assisting client return to health.

patients in appointments, liaising
with healthcare staff for patient
health matters, ensuring consumer
rights, and following up on
insurance claims for patients.
c) Population-oriented roles
CASE FINDER
● Involves identifying individual cases
or occurrences of specified diseases
COMMUNITY MOBILIZER
or other health-related conditions
requiring services.
LEADER
● Focuses on affecting change, thus
the nurse becomes an agent of
change.
● Seek to initiate changers that
positively affect people’s health.
COALITION BUILDER
● Influences others to work together
to accomplish a specific goal.
CHANGE AGENT
● Acts as a change agent when
assisting others, that is, clients, to
make modifications in their own
behavior. Nurses also often act to
make changes in a system such as
clinical care, if it is not helping a
● Promotes and motivates change in
the community in their health
practices and lifestyle behaviors for
them to promote and maintain
good health, be knowledgeable and
has the initiative in accessing health
services
● Inculcates self- reliance to brought
about development and
improvement in the community
● Promotes self- reliance of
community and emphasizes their
involvement and participation in
planning, organizing, implementing
and evaluating of health services
● Initiates and implements
community development activities
● Creates temporary or permanent
alliances of individuals or groups to
achieve a specific purpose.
Coalitions have the advantage of
fostering community wide problem
solving and collaborative policy and
program development.
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POLICY ADVOCATE
● A person or group of people who
work for and argue on behalf of
policy formation or changes in
policy that influence the health of
population groups.
SOCIAL MARKETER
● Applies the commercial marketing
technologies to the analysis,
planning, execution and evaluation
of programs designed to influence
the voluntary behavior of target
audiences to improve their personal
welfare or that of their society.
● Encourages certain personal
behaviors by mothers or
interpersonal behaviors between a
mother and others—for example, to
encourage nurses to support a
mother’s choice to start
breastfeeding within 1 hour of birth
RESEARCHER
● Explores phenomena observed in
the world with the intent of
understanding, explaining and
ultimately controlling them.
● Follows a systematic process of
monitoring the health status of the
Mrs. Irene R. Mina
community through the conduct of
surveys and home visits
● Conducts researches concerning the
health of the community
● Coordinates with government and
non- government organizations in
the conduct and implementation of
studies
FUNCTIONS OF A PUBLIC
HEALTH NURSE
PROVISION OF HEALTH AND
NURSING CARE
● Utilizes the nursing process in the
care of client in the home setting
through home visits and in public
health care facilities; conducts
referral of patients to appropriate
levels of care when necessary.
HEALTH EDUCATION
● Utilizes teaching skills to improve
the health knowledge, skills and
attitude of the individual, family
and the community and conducts
health information campaigns to
various groups for the purpose of
health promotion and disease
prevention.
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COORDINATION &
COLLABORATION
● Establishes linkages and
collaborative relationships with
other health professionals,
government agencies, the private
sector, non-government
organizations and people’s
organizations to address health
problems
SUPERVISION
● Monitors and supervises the
performance of midwives and other
auxillary health workers; also
initiate the formulation of staff
development and training programs
for midwives and other auxillary
health workers as part of their
training function as supervisor.
LEADER AND CHANGE AGENT
● Influences people to participate in
the overall process of community
development.
MANAGEMENT
● Organizes the nursing service
component of the local health
agency or local government unit;
Mrs. Irene R. Mina
and as program manager, the PHN
is responsible for the delivery of the
package of services provided by the
health program to the target
clientele.
RESEARCHER
● Participates in the conduct of
research and utilizes research
findings in practice
LEVELS OF CLIENTELE
INDIVIDUAL
● sick or well individuals in the home
and health center.
● Considered as the entry point in
working with the family.
FAMILY
● Two or more persons bound
together by blood, marriage, or
adoption.
POPULATION GROUP
● A group of people sharing the same
characteristics, developmental stage,
or common exposure to particular
environmental factors thus resulting
in community health problems.
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Mrs. Irene R. Mina
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COMMUNITY to parents

● group of people sharing common UNIFIED WHOLE

geographic boundaries and/or
common values and interests. ● Operates as a single entity
● No two communities are the same.
HOLON
● Exerts a strong influence on health
of individuals, families and ● something that is both a part and a
communities. whole e.g. an individual is
autonomous, but also part of a
CONCEPTS OF AN INDIVIDUAL,
family, which is part of an extended
HIS RIGHTS, AND THE
family, which is part of the
DETERMINANTS OF HEALTH
community.
BASIC CONCEPTS IN LOOKING
DIMORPHIC
AT AN INDIVIDUAL
● existing in two different forms
ATOMISTIC
DIMORPHISM
● divided into separate elements
● the occurrence in an animal species
HOLISTIC
of two distinct types of individuals
● relating to a study of the whole
instead of a separation into parts
ANTHROPOLOGICAL

ANTHROPOLOGY
PERSPECTIVES IN
UNDERSTANDING AN ● the holistic and scientific and social
INDIVIDUAL study of humanity.
BIOLOGICAL ANTHROPOLOGICAL
BIOLOGICAL ● relating to the study of humankind.
● related by consanguinity, especially
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ESSENTIALISM (SOCIOLOGY)
● the view that all members of certain
groups of people (such as those of
the same race, gender, age or sexual
orientation) have common, essential
traits inherent to the defining
feature of the group.
CONSTRUCTIONISM
● (in social science) the idea that
people learn about, or perceive the
world by constructing mental
models
CULTURE
● the arts, customs, lifestyles,
background, and habits that
characterize a particular society or
nation.
● the beliefs, values and behavior and
material objects that constitute a
people’s way of life.
● in anthropology - any knowledge
passed from one generation to the
next
PSYCHOLOGICAL
PSYCHOSEXUAL
● involving the psychological aspects
Mrs. Irene R. Mina
of the sexual impulse
SIGMUND FREUD
● (Surname of German origin) an
Austrian neurologist,
psychotherapist, and founder of
psychoanalysis-(oral-birth to 1 year,
anal-1-3 years, phallic-3-6 y,
latent-6-puberty – libido inactive,
genitals-puberty to death-maturing
sexual interests)
PSYCHOSOCIAL
● relating to the interrelation of social
factors and individual thought and
behavior.
ERIK ERIKSON (8 STAGES)
● trust vs mistrust, autonomy vs
shame and doubt, initiative vs guilt,
industry vs inferiority, identity vs
confusion, intimacy vs isolation,
generativity vs isolation, integrity vs
despair
● described the impact of social
experience across the whole lifespan
● interested in how social interaction
and relationships played a role in the
development and growth of human
beings
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BEHAVIORISM
● an approach to psychology focusing
on observable behavior, denying any
independent significance for mind,
and usually assuming that behavior
is determined by the environment.
SOCIOLOGICAL
SOCIAL LEARNING
● theorized by Albert Bandura
● posits that people learn from one
another via observation, imitation
and modelling.
1. Family and kinship
2. Social groups
SOCIOLOGICAL
● pertaining to sociology
SOCIOLOGY
● is the study of society, patterns of
social relationships, social
interaction and culture of everyday
life. It is a social science that uses
various methods of empirical
investigation and critical analysis to
develop a body of knowledge about
Mrs. Irene R. Mina
social order, acceptance, and change
or social evolution.
THE INDIVIDUAL AS A CLIENT
● Individual is a single human being, a
person, a distinct indivisible entity.
● The CHN deals with individuals;
sick or well on a daily basis.
● Since the health problems of
individuals are intertwined with
those of the other members of the
family and community,
● Individuals are considered as the
entry point in working with the
family and community.
THE RIGHTS OF AN
INDIVIDUAL
Article III: Bill of Rights
1987 PHILIPPINE CONSTITUTION
ARTICLE III, BILL OF RIGHTS
Section 1. No person shall be deprived of
life, liberty, or property without due
process of law, nor shall any person be
denied the equal protection of the laws.
Section 2. The right of the people to be
secure in their persons, houses, papers, and
effects against unreasonable searches and
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seizures of whatever nature and for any
purpose shall be inviolable, and no search
warrant or warrant of arrest shall issue
except upon probable cause to be
determined personally by the judge after
examination under oath or affirmation of
the complainant and the witnesses he may
produce, and particularly describing the
place to be searched and the persons or
things to be seized.
Section 3. (1) The privacy of
communication and correspondence shall
be inviolable except upon lawful order of
the court, or when public safety or order
requires otherwise, as prescribed by law.
(2) Any evidence obtained in violation of
this or the preceding section shall be
inadmissible for any purpose in any
proceeding.
Section 4. No law shall be passed abridging
the freedom of speech, of expression, or of
the press, or the right of the people
peaceably to assemble and petition the
government for redress of grievances.
Section 5. No law shall be made respecting
an establishment of religion, or prohibiting
the free exercise thereof. The free exercise
and enjoyment of religious profession and
worship, without discrimination or
Mrs. Irene R. Mina
preference, shall forever be allowed. No
religious test shall be required for the
exercise of civil or political rights.
Section 6. The liberty of abode and of
changing the same within the limits
prescribed by law shall not be impaired
except upon lawful order of the court.
Neither shall the right to travel be impaired
except in the interest of national security,
public safety, or public health, as may be
provided by law.
Section 7. The right of the people to
information on matters of public concern
shall be recognized. Access to official
records, and to documents and papers
pertaining to official acts, transactions, or
decisions, as well as to government research
data used as basis for policy development,
shall be afforded the citizen, subject to such
limitations as may be provided by law.
Section 8. The right of the people,
including those employed in the public and
private sectors, to form unions,
associations, or societies for purposes not
contrary to law shall not be abridged.
Section 9. Private property shall not be
taken for public use without just
compensation.
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Section 10. No law impairing the
obligation of contracts shall be passed.
Section 11. Free access to the courts and
quasi-judicial bodies and adequate legal
assistance shall not be denied to any person
by reason of poverty.
Section 12. (1) Any person under
investigation for the commission of an
offense shall have the right to be informed
of his right to remain silent and to have
competent and independent counsel
preferably of his own choice. If the person
cannot afford the services of counsel, he
must be provided with one. These rights
cannot be waived except in writing and in
the presence of counsel.
(2) No torture, force, violence, threat,
intimidation, or any other means which
vitiate the free will shall be used against
him. Secret detention places, solitary,
incommunicado, or other similar forms of
detention are prohibited.
(3) Any confession or admission obtained
in violation of this or Section 17 hereof
shall be inadmissible in evidence against
him.
(4) The law shall provide for penal and civil
sanctions for violations of this section as
Mrs. Irene R. Mina
well as compensation to the rehabilitation
of victims of torture or similar practices,
and their families.
Section 13. All persons, except those
charged with offenses punishable by
reclusion perpetua when evidence of guilt
is strong, shall, before conviction, be
bailable by sufficient sureties, or be released
on recognizance as may be provided by law.
The right to bail shall not be impaired even
when the privilege of the writ of habeas
corpus is suspended. Excessive bail shall not
be required.
Section 14. (1) No person shall be held to
answer for a criminal offense without due
process of law. (2) In all criminal
prosecutions, the accused shall be
presumed innocent until the contrary is
proved, and shall enjoy the right to be
heard by himself and counsel, to be
informed of the nature and cause of the
accusation against him, to have a speedy,
impartial, and public trial, to meet the
witnesses face to face, and to have
compulsory process to secure the
attendance of witnesses and the production
of evidence in his behalf. However, after
arraignment, trial may proceed
notwithstanding the absence of the
accused: Provided, that he has been duly
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notified and his failure to appear is
unjustifiable.
Section 15. The privilege of the writ of
habeas corpus shall not be suspended
except in cases of invasion or rebellion,
when the public safety requires it.
Section 16. All persons shall have the right
to a speedy disposition of their cases before
all judicial, quasi judicial, or administrative
bodies.
Section 17. No person shall be compelled
to be a witness against himself.
Section 18. (1) No person shall be detained
solely by reason of his political beliefs and
aspirations.
(2) No involuntary servitude in any form
shall exist except as a punishment for a
crime whereof the party shall have been
duly convicted.
Section 19. (1) Excessive fines shall not be
imposed, nor cruel, degrading or inhuman
punishment inflicted. Neither shall death
penalty be imposed, unless, for compelling
reasons involving heinous crimes, the
Congress hereafter provides for it. Any
death penalty already imposed shall be
reduced to reclusion perpetua.
Mrs. Irene R. Mina
(2) The employment of physical,
psychological, or degrading punishment
against any prisoner or detainee or the use
of substandard or inadequate penal
facilities under subhuman conditions shall
be dealt with by law.
Section 20. No person shall be imprisoned
for debt or non-payment of a poll tax.
Section 21. No person shall be twice put in
jeopardy of punishment for the same
offense. If an act is punished by a law and
an ordinance, conviction or acquittal under
either shall constitute a bar to another
prosecution for the same act.
Section 22. No ex post facto law or bill of
attainder shall be enacted.
Appendix B
PHILIPPINE PATIENT’S BILL OF
RIGHTS
1. The patient has the right to considerate
and respectful care irrespective of
socio-economic status.
2. The patient has the right to obtain from
his physician complete current information
concerning his diagnosis, treatment and
prognosis in terms the patient can
reasonably be expected to understand.
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When it is not medically advisable to give
such information to the patient, the
information should be made available to an
appropriate person on his behalf. He has
the right to know by name or in person,
the medical team responsible for
coordinating his care.
3. The patient has the right to receive from
his physician information necessary to give
informed consent prior to the start of any
procedure and/or treatment. Except in
emergencies, such information for
informed consent should include but not
necessarily limited to the specific procedure
and or treatment, the medically significant
risks involved, and the probable duration of
incapacitation. When medically significant
alternatives for care or treatment exist, or
when the patient requests information
concerning medical alternatives, the patient
has the right to such information. The
patient has also the right to know the name
of the person responsible for the procedure
and/or treatment.
4. The patient has the right to refuse
treatment/life – giving measures, to the
extent permitted by law, and to be
informed of the medical consequences of
his action.
5. The patient has the right to every
Mrs. Irene R. Mina
consideration of his privacy concerning his
own medical care program. Case
discussion, consultation, examination and
treatment are confidential and should be
conducted discreetly. Those not directly
involved in his care must have the
permission of the patient to be present.
6. The patient has the right to expect that
all communications and records pertaining
to his care should be treated as
confidential.
7. The patient has the right that within its
capacity, a hospital must make reasonable
response to the request of patient for
services. The hospital must provide
evaluation, service and/or referral as
indicated by the urgency of care. When
medically permissible a patient may be
transferred to another facility only after he
has received complete information
concerning the needs and alternatives to
such transfer. The institution to which the
patient is to be transferred must first have
accepted the patient for transfer.
8. The patient has the right to obtain
information as to any relationship of the
hospital to other health care and
educational institutions in so far as his care
is concerned. The patient has the right to
obtain as to the existence of any
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professional relationship among
individuals, by name who are treating him.
9. The patient has the right to be advised if
the hospital proposes to engage in or
perform human experimentation affecting
his care or treatment. The patient has the
right to refuse or participate in such
research project.
10. The patient has the right to expect
reasonable continuity of care; he has the
right to know in advance what
appointment times the physicians are
available and where. The patient has the
right to expect that the hospital will
provide a mechanism whereby he is
informed by his physician or a delegate of
the physician of the patient’s continuing
health care requirements following
discharge.
11. The patient has the right to examine
and receive an explanation of his bill
regardless of source of payment.
12. The patient has the right to know what
hospital rules and regulation apply to his
conduct as a patient.
DETERMINANTS OF HEALTH
Mrs. Irene R. Mina
● Many factors combine together to
affect the health of individuals and
communities. Whether people are
healthy or not, is determined by
their circumstances and
environment.
● To a large extent, factors such as
where we live, the state of our
environment, genetics, our income
and education level, and our
relationships with friends and
family all have considerable impacts
on health, whereas the more
commonly considered factors such
as access and use of health care
services often have less of an
impact.
DETERMINANTS OF HEALTH
● are a range of factors that influence
the health status of individuals or
populations. At every stage of life,
health is determined by complex
interactions between social and
economic factors, the physical
environment and individual
behavior. They do not exist in
isolation from each other.
● The social determinants of health
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Mrs. Irene R. Mina
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are the conditions in which people
are born, grow, live, work and age.
These circumstances are shaped by
the distribution of money, power
and resources at global, national
and local levels.
● The social determinants of health
are mostly responsible for health
inequities - the unfair and avoidable
differences in health status seen
within and between countries.
The determinants of health include:
● The social and economic
environment, the physical
environment, and the person’s
individual characteristics and
behaviors.
● The context of people’s lives
determines their health, and so
blaming individuals for having poor
health or crediting them for good
health is inappropriate. Individuals
are unlikely to be able to directly
control many of the determinants
of health.
INCOME AND SOCIAL STATUS
richest and poorest people, the
greater the differences in health
EDUCATION
● low education levels are linked with
poor health, more stress and lower
self-confidence.
PHYSICAL ENVIRONMENT
● safe water and clean air, healthy
workplaces, safe houses,
communities and roads all
contribute to good health.
EMPLOYMENT AND WORKING
CONDITIONS
● people in employment are healthier,
particularly those who have more
control over their working
conditions
SOCIAL SUPPORT NETWORKS
● greater support from families,
friends and communities is linked to
better health.

● higher income and social status are

CULTURE
linked to better health.
● The greater the gap between the ● customs and traditions, and the
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beliefs of the family and community

all affect health.

GENETICS

● inheritance plays a part in

determining lifespan, healthiness
and the likelihood of developing
certain illnesses.

PERSONAL BEHAVIOR AND

COPING SKILLS

● balanced eating, keeping active,

smoking, drinking, and how we
deal with life’s stresses and
challenges all affect health.

HEALTH SERVICES

● access and use of services that

prevent and treat disease influences
health

GENDER

● Men and women suffer from

different types of diseases at
different ages.