OVERVIEW OF COMMUNITY

HEALTH NURSING/PUBLIC
HEALTH NURSING
Health
WHO defined health as a “ state of complete
physical, mental, and social well-being and not merely
the absence of disease or infirmity”.
 Community
A collection of people who interact with one another and whose common
interests or characteristics form the basis for a sense of unity or belonging.
-Allender et al.,2009-
A group of people who share something in common and interact with one
another, who may exhibit a commitment with one another and may share a
geographic boundary.
-Lundy and Janes, 2009-
A group of people who share common interests, who interact with each
other, and who function collectively within a defined social structure to
address common concerns
-Clark, 2008-
 Definition and Focus of Public Health and Community
Health
• Public health is the science and art of (1) preventing disease, (2) prolonging life, (3)
promoting health and efficiency through organized community effort for:
1. Sanitation of the environment,
2. Control of communicable diseases,
3. Education of the individual in personal hygiene,
4. Organization of medical and nursing services for the early diagnosis and preventive
treatment of disease, and
5.Development of the social machinery to ensure everyone a standard of living
adequate for the maintenance of health, so organizing these benefits as to enable
every citizen to realize his birthright of health and longevity.
 Public Health Nursing vs Community Health Nursing

PHN and CHN have often been interchangeably used in the Philippines while both
disciplines serve the same demographics, their purposes are distinct.
Public health nurses provide healthcare to people and communities who are unable
to seek assistance.
Community health nursing involves advocacy and policy development to eliminate
healthcare disparities.
COMMUNITY HEALTH NURSING
Deliver health services to individuals, groups, and
families.
Diagnosis is based on the needs of individuals, family, or
group.
Work to promote health and prevent illness in groups
and families with the main goal to increase community
health. For example, meeting with a group of young
mothers to provide information on immunization.
Implementation based on individual needs.
Evaluate whether health needs were met on the
individual, family or group level.
PUBLIC HEALTH NURSING
Assessing the population health needs.
Diagnose and develop policy in relation to community
health needs.
Plan for community as a whole in order to prevent
disease and disability and preserve the health of the
community. For example, after an illness outbreak, the
PHNurse will assess the need and develop a program for
an immunization clinic.
Implementing the plan means the nurse ensures the
resources are available to all who need them within the
community.
Evaluate the health status of the whole community and
whether planned goals and objectives are met.
 Standards of Public Health in the Philippines
1. Assessment
2. Population diagnosis and priorities
3. Outcomes identification
4. Planning
5. Implementation
6. Evaluation
7. Quality of Practice
8. Education
9. Professional practice evaluation
10. Collegiality and professional relationships
11. Collaboration
12. Ethics
13. Research
14. Resource utilization population
15. Leadership
 ROLES OF COMMUNITY HEALTH NURSE
 Clinician or Health Care Provider:
utilizes the nursing process in the care of the 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 Educator: 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
 Coordinator and collaborator: 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
 Supervisor: monitors and supervises the performance of midwives and other
auxiliary health workers; also initiates the formulation of staff development and
training programs for midwives and other auxiliary health workers as part of
 ROLES OF COMMUNITY HEALTH NURSE

Leader and Change Agent:

influences people to participate in the overall process
of community development
Manager: organizes the nursing service component of the local health agency
or local government unit; also, as program manager, the PHN is responsible
for the delivery of the package of services provided by the health program
to target clientele
Researcher: participates in the conduct of research and utilizes research
findings in practice
 RESPONSIBILITIES OF PUBLIC HEALTH NURSE

• Be a part in developing an overall health plan, its implementation and

evaluation for communities.
• Provide quality nursing services to the four levels of clientele.
• Maintain coordination/linkages with other health team members,
NGO/ government agencies in the provision of public health services
• Conduct researches relevant to CHN services to improve provision of
health care
• Provide opportunities for professional growth and continuing education
for staff development
SPECIALIZED FIELDS OF COMMUNITY HEALTH
NURSING
Community Mental Health Nursing: a unique clinical process which
includes an integration of concepts from nursing, mental health, social
psychology, psychology, community networks, and the basic sciences
Occupational Health Nursing: the application of nursing principles
and procedures conserving the health of workers in all occupation
School Health Nursing: the application of nursing theories and
principles in the care of the school population
 EVOLUTION OF PUBLIC
HEALTH NURSING IN THE
PHILIPINES
 HISTORICAL BACKGROUND
1912 The Fajardo Act ( Act No. 2156) created Sanitary Divisions
1914 -School nursing was rendered by a nurse employed by the Bureau of Health in
Tacloban, Leyte.
-Reorganization Act No. 2462 created the Office of General Inspection. The office of
District Nursing was organized under this office. It was headed by a lady physician, Dr. Rosario
Pastor who was also a nurse. This office was created due to increasing demands for nurses to
work outside the hospital and the need for direction, supervision and guidance of public
health nurses.
1916-1918-Miss Perlita Clark took charge of the public health nursing work. Her staff was
composed of one American nurse supervisor, one American dietitian, 36 Filipino nurses
working in the provinces and one nurse and one dietitian assigned in two Sanitary Divisions.
1917- Four graduate nurses paid by the City of Manila were employed to work in the City
Schools. Provinces that could afford to carry out school health services were encouraged to
employ a district nurse.
1918- The office of Miss Clark was abolished due to lack of funds.
 HISTORICAL BACKGROUND
1919- The 1st Filipino nurse supervisor under the Bureau of
Health, Miss Carmen del Rosario was appointed. She
succeeded Miss Mabel Dabbs.
1923- Two government Schools of Nursing were established:
Zamboanga General Hospital Schools of Nursing in Mindanao
and Baguio General Hospital in Northern Luzon.
July 1, 1926- Miss Carmen Leogardo resigned and Miss Genara
S. Manongdo, a ranking supervisor of the American supervisor of
the American Red Cross, Philippine Chapter was appointed in
her place.
 HISTORICAL BACKGROUND
1927-The office of District Nursing under the Office of General Inspection, Philippines Health
Service was abolished and supplanted by the Section of Public Health Nursing. Mrs. Genara de
Guzman acted as consultant to the Director of Health on nursing matters
1928-The 1st convention of nurses was held followed by yearly conventions until the advent of
World War 11.Pre-service training was initiated as a pre-requisites for appointment
1930- The Section of Public Health Nursing was converted into Section of Nursing due to
pressing need for guidance not only in public nursing services but also in hospital nursing and
nursing education.The section of Nursing was transferred from the Office of General Services to
the Division of Administration.This office covered the supervision and guidance of nurses in the
provincial hospitals and the two government schools of nursing.
 HISTORICAL BACKGROUND
1933-Reorganization Act No.4007 transferred the Division of Maternal and
Child Health of the Office of Public Welfare Commission to the Bureau of
Health. Mrs. Soledad A. Buenafe, former Assistant Superintendent of Nurses of
the Public Welfare Commission was appointed as Assistant Chief Nurse of the
Section of Nursing, Bureau of Health.
1941-Activities and personnel including six public health members of the
Metropolitan Division, Bureau of Health were transferred to the new
department. Dr. Mariano Icasiano became the 1st City Health Officer of Manila.
An Office of Nursing was organized with Mrs.Vicenta C.Ponce as Chief Nurse
and Mrs. Rosario A. Ordiz as Assistant Chief Nurse.They occupied their position
until their retirement.
Dec. 8, 1941-When World War 11 broke out, public health nurses in Manila
were assigned to devastated areas to attend to the sick and the wounded.
 HISTORICAL BACKGROUND
1942- A group of public health nurses, physicians and administrators from the
Manila Health Department went to the internment camp in Capas, Tarlac to
receive sick prisoners of war released by the Japanese Army. They were
confined at San Lazaro Hospital and 68 National Public Health Nurses were
assigned to help the hospital staff take care of them.
July 1942-Thirty-one nurses who were taken prisoners of war by the Japanese
army and confined at the Bilibid Prison in Manila were released to the then
Director of the Bureau of Health, Dr. Eusebio Aguilar who acted as their
guarantor.Many public health nurses joined the guerillas or went to hide in the
mountains during World War 11
Feb.1946-Post war records of the Bureau of Health showed that there were
308 public health nurses and 38 supervisors compared to pre-war when there
were 556 public health nurses and 38 supervisors.In the same year Mrs.
Genera M.de Guzman, technical assistant in Nursing of the Dept of Health and
concurrent President of the Filipino Nurses Association recommended the
creation of a Nursing Office in the Dept.of Health.
 HISTORICAL BACKGROUND
Oct.7, 1947-Executive Order No.94 reorganized government offices and created the
Division of Nursing under the Office of the Secretary of Health. This was implemented
on Dec. 16, 1947.Mrs.Genara de Guzman was appointed as Chief of the Division, with
three assistants: Miss Annie Sand for Nursing Education; Mrs.Magdalena C.Valenzuela
for Public Health Nursing and Mrs. Patrocinio J. Montellano for Staff Education.
The nursing division was placed directly under the Secretary of Health so that nursing
services can be availed of by the different bureaus and units to help carry out their
health programs.
At the Bureau of Health, the Section of Nursing Supervision took over the functions of
the former Section of Nursing.Mrs.Soledad Buenafe was appointed Chief and Miss
Marcela Gabatin, asst.chief.
The newly created Section of Puericulture Center of the Bureau of Hospitals had
Mrs.Teresa Malgapo as chief.
 HISTORICAL BACKGROUND
• 1948- The 1st training Center of the Bureau of Health was organized in
cooperation with the Pasay City Health Department. This was housed at the
Tabon Health Center located in a marginalized part of the city. It was later
renamed as Dona Marta Health Center. The original training staff of the
Center had Dr.Trinidad A. Gomez as Center Physician; Miss Marcela
Gabatin as Nurse Supervisor; Miss Constancia Tuazon, Mrs. Bugarin and
Miss Ramos as Nurse Instructors. Miss Zenaida Y.Panlilio, National Public
Health Nurse, Bureau of Health, later joined the staff.
-Physicians and nurses undergoing pre-service and in-service training
in public health/public health nursing as well as nursing students on affiliation
were assigned to the above training center.
 HISTORICAL BACKGROUND
1950- The Rural Health Demonstration and Training Center(RHDTC) was
established by the Department of Health through the initiative of Dr.
Hilario Lara, Dean, Institute of Hygiene, now College of Public Health,
University of the Philippines.
1953- The office of the Health Education and Personnel Training was
established with Dr. Trinidad Gomez as Chief.
-Philippine Congress approved Republic Act No. 1082 or the Rural
Health Law.
1957- Republic Act 1891 was approved amending cestions two,three,
four, seven and eight of RA 1082 “Strengthening Health and Dental
Services in the Rural Areas”
 HISTORICAL BACKGROUND
1958-1965 – Republic Act 977 passed by Congress in 1954 was
implemented. This abolished the Division of Nursing. However it created
nursing positions at different levels in the health organization.
1967- Mrs. Zenaida Panlilio-Nisce was appointed as Nursing Program
Supervisor and served as consultant on the nursing aspects of the 5 special
diseases: TB,Leprosy, Venereal Disease, Cancer, Filariasis, and Mental
Health.
1974- The Project Management Staff was organized as part of the
Population Loan II of the Philippine Government with Dr. Francisco Aguilar
as Project Manager.
1975- The functions of the health team members(municipal health officer,
public health nurse, rural health midwife and rural sanitary inspector were
redefined.
 HISTORICAL BACKGROUND
1976-1986 The nursing consultant and nursing program supervisor of the
Office of the Secretary of Health where involved in the Rural Health Practice
Program which required medical and nursing graduates to serve for two
months in the rural areas of the country before their licenses could be issued
by the PRC.
1986- The reorganization of the Dept. Of Health during this period placed the
position of Nursing Consultant at the Bureau of Health and Medical Services.
It was later abolished when Mrs. Mendoza retired.
1987-1989 –Executive Order No.119 reorganized the Dept Of Health and
created several offices and services within the Dept.of Health
 HISTORICAL BACKGROUND
1990-1992 – The number of positions of Nursing Program
Supervisors was increased.
May 24, 1999 – Executive Order No. 102 was signed by
President Joseph Ejercito Estrada redirecting the functions and
operations of the Dept. of Health.
2005-2006 The development of the Rationalization Plan to
streamline the bureaucracy further was started and is in the
last stages of finalization
 THANK YOU!
THAT IN ALL THINGS GOD MAY BE GLORIFIED