NRCM

Community
0104
Health Nursing

2ND YEAR, 1ST SEMESTER J. B. L &

R.M.A
Overview of PHN in the Philippines
COHN - TOPIC 1

10. Acute Respiratory Infection

Public health nurse
(PRIORITY!) Why do we need to know the reasons people
 To promote and maintain health
die? (WHO, 2020)
 Prevention of diseases
(communicable and non- To improve how people live 1
communicable)
 Rehabilitation at the individual and family level
helps to assess the effectiveness of our health
utilizing the nursing process.
2 systems and direct resources to where they are
Additional: The nurse must recognize the national and needed most.
global health situations; and holistically and
comprehensively discuss the appropriate community health
nursing concepts and actions.
to allow daily counting of deaths, and direct
prevention and treatment efforts. 3
As a community health nurse, awareness of statistical trails
can help better respond to the health needs of the people,
focus on appropriate nursing care plan and offer community
members about maintaining own health to decrease the For inherent fragmentation in data collection
occurrence of diseases and deaths. systems in most low-income countries, where
policymakers still do not know with confidence
A detailed evolution of public health nursing was how many people die and of what causes.
embedded in the history of Department of Health.
Distinguishing roles and responsibilities of public health 4
nurse were given emphasis to work effectively with the
individual and family.

Global population as of Aug 2020 – 7.8 billion THE TOP

DEATH
10 GLOBAL CAUSES OF
Philippines population as of July 2020 – 109,581,070
million
Causes of morbidity and mortality worldwide – chronic  IN 2019, It accounted for 55% of the 55.4
kidney diseases million deaths worldwide.
Life expectancy -among Filipino 71.28  The top global causes of death, in order of total
Growth rate – 0.180% number of lives lost, are associated with THREE
BROAD TOPICS:
10 Leading Causes of Mortality- Philippines 1. CARDIOVASCULAR (ischemic heart
January to December 2019 & 2020 disease, stroke),
1. Ischemic heart diseases 2. RESPIRATORY (chronic obstructive
2. Neoplasms pulmonary disease, lower respiratory
3. Diabetes Mellitus infections)
4. Pneumonia 3. NEONATAL CONDITIONS – birth
5. Hypertensive diseases asphyxia and birth trauma, neonatal
6. Covid-19 virus not identified sepsis and infections, and preterm birth
7. Chronic lower respiratory infections complications.
8. Other heart diseases
9. Respiratory Tuberculosis CAUSES OF DEATH CAN BE GROUPED
10. Remainder of diseases of the Genitourinary INTO THREE CATEGORIES:
system 1. COMMUNICABLE - infectious and
Leading Causes of Morbidity- Philippines 2014 parasitic diseases
1. Tuberculosis other forms 2. MATERNAL, PERINATAL AND
2. Dengue fever NUTRITIONAL CONDITIONS
3. Tuberculosis respiratory 3. NONCOMMUNICABLE
4. Acute watery diarrhea (CHRONIC) AND INJURIES.
5. Influenza
6. Bronchitis
7. Urinary tract Infection
8. Hypertension
9. ALTRI and Pneumonia
Leading causes of death globally

J.B.L and R.M. A 1

  At a GLOBAL LEVEL, 7 of the 10 leading
causes of deaths in 2019 were  People living in a low-income country are far
NONCOMMUNICABLE DISEASES. These more likely to die of a communicable disease
seven causes accounted for 44% of all deaths or than a noncommunicable disease.
80% of the top 10. However, all 
noncommunicable diseases together accounted
 The routine collection and analysis of high-
for 74% of deaths globally in 2019.
quality data on deaths and causes of death, as
well as data on disability, disaggregated by age,
sex and geographic location, is essential for
improving health and reducing deaths and
disability across the world.

1. Ischemic heart disease

2. Stroke
3. Chronic obstructive pulmonary disease
4. Lower respiratory infections (world’s most
deadly communicable disease)
5. Neonatal conditions
6. Trachea, bronchus and lung cancers
7. Alzheimer’s disease (65% women)
8. Diarrheal diseases
9. Diabetes (mostly male)
10. Other diseases- HIV/AIDS, Kidney diseases

Leading causes of death in lower-

middle-income countries 10
The top deadliest diseases

J.B.L and R.M. A 2

 Several of the deadliest diseases are partially  Capacity and ability to:
preventable.
Non-preventable factors include where a person a. relate the practice with ongoing
lives, access to preventive care, and quality of healthcare – community health and related health
risk factors. activities
b. work cooperatively with other
1. Ischemic heart disease, or coronary artery disciplines and members of the
disease - CAD occurs when the blood vessels community
that supply blood to the heart become narrowed. c. accept and take actions needed to
Untreated CAD can lead to chest pain, heart improve self and service
failure, and arrhythmias. d. analyze combination of factors and
2. Stroke - A stroke occurs when an artery in your conditions that influence health of
brain is blocked or leaks; this causes the oxygen- populations
deprived brain cells to begin dying within e. apply nursing process in meeting the
minutes. health and nursing need mobilize
3. Lower respiratory infections resources in the community with
4. Chronic obstructive pulmonary disease leadership potential
5. Trachea, bronchus, and lung cancers
6. Diabetes mellitus
 resourcefulness and creativity,
7. Alzheimer’s disease and other dementias (a
 honesty and integrity,
progressive disease that destroys memory and
interrupts normal mental functions - thinking,  Active membership to professional
reasoning, and typical behavior.) nursing organizations
8. Dehydration due to diarrheal diseases
9. Tuberculosis III. Supervision
10. Cirrhosis (the result of chronic or long-term
scarring and damage to the liver) IV. Interdisciplinary and
intersectoral collaboration
NOTE: A good approach to lowering your risk of any of V. Nursing process
these conditions is to live a healthy lifestyle with good
nutrition and exercise. Avoiding smoking and drinking in VI. Health promotion and health
moderation can also help. For bacterial or viral infections,
proper handwashing can help prevent or reduce your risk.
education
VII. Demonstrating Professional
STANDARDS OF PHN IN THE PH responsibility and
accountability.
developed by the National League of Philippine
Government Nurses in 2005

I. ORGANIZATION AND
MANAGEMENT
II. QUALIFICATIONS AND
FUNCTIONS OF THE PHN
1. A graduate of BSN and RN
2. Has the following personal qualities and
professional competencies

 Good physical and mental health

 Interest and willingness to work in the
community

J.B.L and R.M. A 3

 Date Event
Pre-Spanish Era  No records
Spanish Regime
1577-1898  Bro. Juan Clemente, a Franciscan Friar started public health services through dispensary
in Intramuros for the indigent
1577  Dominican Father, Juan de Pergero start water sanitation in San Juan Manila
 Dr. Francisco de Balmis introduced small pox vaccination
1690  First medicos titular were appointed by the Spanish government course. The medicus
1805 titulares worked as provincial health officers. A 2-year course consisting of fundamental
medical subjects was first offered in the University of santo Tomas. Graduates of this
course known as cirujanos ministrantes served as male nurses and sanitation inspectors.
American Regime
1901-1940  The United States Philippine Commission, through Act 157, created the Board of Health
of the Philippine Islands with a Commissioner of Public Health as its chief executive
officer. The Board of Health eventually
evolved into what is now Department of Health
1901  The Asociacion Feminista Filipina founded La Gota de Leche the first center dedicated to
the service of mothers and children
1905  Fajardo Act of 1912 created Sanitary Divisions made up of one to four municipalities.
Each Sanitary division had a president who had to be a physician
1912  The Philippine General Hospital began to extend public health nursing services in the
home of the patients by organizing a unit called Social and Home Care Service, with two
staff nurses.
1915  Perlita Clark took charge of public health nursing work
1916-1918  Public health nursing inaugurated its pioneer work in Tondo Manila when a visiting nurse
Balbina Basa was assigned to make a house to house visit, hold clinic and dispensary
work with special emphasis maternal and child care
1919  176 puericulture nurses assigned in Manila. and provinces since 1919. Puericulture
centers are semi government agencies partly financed by private funds and aided by the
government. Maternal and child care is offered.
1923
 90 Public Health Nurses assigned in different provinces
1928
 First convention of nurses was held followed by annual conventions until the advent of
1935
World War ll.
 133 positions of public health nurses assigned in the community with high infant
mortality
Japanese Regime  Public Health Nursing services was interrupted
1942- 1945
1941  The effect of WW II on December 8, 1941
 Public Health Nurses in Manila was assigned to devastated areas to attend to the sick and
wounded civilians caused by bombing, 12 emergency units were organized; one of them
was sent to Bataan to attend to the sick and wounded which were left by the retreating
forces of Gen. Douglas MacArthur.
1942  Group of Public Health Nurses with Physicians and administrators of Manila Health
Department went to Capas Tarlac to receive sick prisoners of war released by Japanese
army.
Era of the Republic  Increased the number of Public Health Nurses
of the Philippines
1946 to present  Reorganization of government offices under E.O No. 49 s. of 1947 with the transfer of
1947 the Bureau of Public Welfare to the Office of the Pres., and the department was renamed
Department of Health
1954  R.A 1082 (Rural Health Unit Act) creation of a rural health units in every municipality
and for the employment of physicians to serve as municipal health officers, public health

J.B.L and R.M. A 4

 nurses, midwives, and sanitation inspectors, in the rural health units. It also provided a
provincial health officer for each province and public health dentist for each
congressional district.
1957  R.A 1891(an Act Strengthening Health and Dental Services in the Rural Areas and
1975 Providing Funds
 Formulation of the National Health Plan and the Restructured Health care Delivery
1982 System
 Under E.O 851, the Health Education and Manpower Development Services was created
with the BFAD assumed the function of FDA
1986  The Ministry of Health became Department of Health
1987  The EPI and the National drug Policy, the implementation of Generic Law of 1988 (R.A
6675) were subsequently given importance
1991  R.A. 7160, The Local Government Code of 1991was implemented which resulted to
devolution which transferred the power and authority from the national to local
government units. Materials, supplies, of health centers have to be provided by the local
government units.
1992  Full implementation of the R.A 7160 or Local Government Code. Special projects were
highlighted like NID (National Immunization Day), National Micronutrients Campaign
(Araw ng Sangkap Pinoy), Disater Management, Urban Health and Nutrition Project,
Traditional Medicine, Doctors to the Barrio Program,” Let’s Do It!” became a national
battle cry
1993
 The National League of Philippine Government Nurses was organized, government
nurses as members.
1999
 Primary Health Care as a strategy to attain Health for All by the year 2000was in focus
supported by the following slogan, “23 in “93”, Health for More in “94”, five in “95”,
2005
and Go 7 in “1977”
 Health Sector Reform Agenda of the Philippine was launched
 D.O order 209 designated Nelia Hizon, Nurse V1 as the nursing adviser to look matters
affecting nurses
nursing is referred to her.
 E.O 102 was signed by President Erap Estrada, redirecting new functions and operations
of the DOH, wherein most of the nursing positions at the Central Office were transferred
or devolved to other offices and services.
 The DOH launched Fourmula One for health to ensure
speed
precision, and effectiveness and equity of health care
delivery.

J.B.L and R.M. A 5

 ROLES AND RESPONSIBILITIES OF A CHN Roles and Functions of CH Nurse:
1. Advocate

- defends the rights of the client for self-

determination

- intercedes, supports, pleads or acts as guardian of

the client’s rights to autonomy and free choice for
self-care

2. Supervisor

- provides administrative support

- oversees, monitors and evaluates the function of

the subordinates

3. Counselor

- encourages client to verbalize and express feelings

and concerns

- key task is active listening

4. Educator

- teaches the client to provide skills, knowledge and

attitude

- primary task is to assess readiness to learn

5. Trainer

- provides technical support

- identifies training needs, formulates training

program designs

- arranges and conducts training to provide learning

experiences to subordinates and client’s community.

1. Programmer/Planner
2. Health Educator/Trainer/Counsellor
3. Community Organizer
4. Manager/Supervisor
5. Coordinator of Servicer
6. Provider of Nursing Care
7. Health Monitor
8. Role Model
9. Recorder/Reporter
10. Statistician
Mnemonic:
MGA CHN J.B.L and R.M. A 6
 11. Researcher
12. Change agent

LEVELS OF CLIENTELE
1. Individual

- “point entry”

2. Family

- center of delivery of care.

3. Group

- point of specific care.

4. Community

- point of entire care

IMPORTANT CONCEPTS ON CHN:

1. The primary focus of CHN is on health promotion.

2. Recognized needs of individuals, families and

communities provide the basis for CHN.

3. The family is the unit of service.

4. Contact with the client may continue over a long

period of time which include all ages and all types of
health care.

5. CH nurses are generalists in terms of their practice

throughout life’s continuum –its full range of health
problems and needs.

6. CHN practice is extended to benefit not only the

individual but the whole family and community.

OTHERS: Roles and Functions of CH Nurse:

Planner: e.g. IMCI = Integrated management of
childhood illnesses KEY POINTS
Provider of Nsg Services: direct nursing care of sick;
provides patient continuity of care  population
 morbidity
Manager/Supervisor: formulates individual, family,  mortality
group and community centered care of plan; organize
work force Definition of Terms:
CHN-Community Health Nurse
PHN-Public Health Nurse
Coordinator of Services: coordinates with Morbidity-susceptible to disease
individuals, family, group for health-related services Mortality- susceptible to death
provided by GO’s and NGO’s Life expectancy- life span.
Growth Rate-increase in the number of individuals in a population.
Public Health – the science and art of preventing disease,
Trainer/Health Educator/Counselor: identifies and
prolonging life and promoting health through efficiency through
interprets training needs of RHM’s, BHW’s and hilots; community effort (C.E.Winslow. 1982)
resource speaker; IEC materials Community Health – a discipline concerned with the study and
improvement of the health characteristics of different
communities. J.B.L and R.M. A 7
Health Monitor: detects deviation from health of
Community Health Nursing – diagnosis is based on the needs of
individual, family, group and community through the individuals
contact visits with them; use of systematic and Public health Nursing – diagnose and develop policy in relation to
 The Health Care Delivery System
COHN - TOPIC 2

Introduction human dignity, equality and equity at the global level.

- The commitment of the 191 members states, including the
It is clearly stated in the Philippine Constitution that every Philippines.
Filipino has the fundamental human and constitutional right - To reduce extreme poverty and achieve seven other targets-
to health. The Department of Health is the lead agency now called the Millennium Development Goals
mandated by the government to be responsible for the (MDGs) by the year 2015.
protection and promotion of health to every Filipino. The
Public Health Nurse therefore must fully understand the
DOH vision – “Health for all Filipinos” and mission –
“Guarantee equitable, sustainable and quality health for all
Filipinos especially the poor, and to lead the quest for
excellence in health.”

The Health Care Delivery System has a great

influence on the health of the people and similarly on
the total economic development of our country. In the
Philippines, the health services are provided by the
government and the private sectors. The nurse is an
essential member of the community health team; the Sustainable Development Goals
value of the nurse’s position in the system is very
much overwhelming with the anchored - September 25, 2015 - Building on MDGs, the
responsibilities. Sustainable Development Goals (SDG) [Global
Goals] was launched
- September 2016 - Sustainable Development
Summit ushers in the official launch of the bold
In 1945, the diplomats formed the United Nation and and transformative 2030 Agenda adopted by
discussed the creation of a global organization. The world leaders at the United Nations.
outcome of the discussion was the World Health - The new Agenda calls on countries to begin
Organization. The WHO constitution came into force efforts to achieve 17 Sustainable Development
on April 7, 1948. Since then, April 7, has been Goals (SDGs) over the next 15 years.
celebrated each year as World Health Day - “The seventeen Sustainable Development Goals:
(WHO,2013). The Philippines is a member of the shared vision of humanity and a social contract
Western Pacific Region, which hold office in Manila between the world's leaders and the people,” (UN
(WHO,2007b) Secretary-General Ban Ki-moon)
- “They are a to-do list for people and planet, and a
blueprint for success.” aspiring to achieve a new
set of global goals by 2030 where ‘no one is left
WHO Attainment by all people of the behind’.
highest possible level of health.
(WHO, 2006)

Objective:
The Millennium Development Goal
- September 6-8, 2000 - Millennium Summit
participated by the world leaders of the United
General Assembly
o The result was a resolution entitled
United Nations Millennium Declaration
(UN,2013).
- The collective responsibility: to uphold the principles of

J.B.L and R.M. A 8

 17 Goals to Transform our

World
The SDGs are a call for action by all countries – poor, (Before 1898) Superior Board of Health and Charity
rich and middle-income – to promote prosperity while (1888)
protecting the planet.
2. June 23, 1898 Creation of E. Aguinaldo government of
 Recognize that ending poverty must go hand-in-hand the Department of Public Works,
with strategies that build economic growth and address Education and Hygiene
a range of social needs including education, health,
3. September 29, General order no.15 established the
social protection, and job opportunities, while tackling
1898 Board of Health for the City of Manila
climate change and environmental protection. More
important than ever, the goals provide a critical 4. July 1, 1901 Act no. 157: Board of Health of
framework for COVID-19 recovery. Philippines Island
 While the MDGs achieved significant developments Act no. 307 and 308: provincial and
over the past 15 years, persistent gaps have been municipal boards
evident, and progress has been uneven across regions 5. October 26, Act no. 1407: establishment of Bureau of
and UN member states. 1905 Health
 The MDG Report 2015 concludes that targeted efforts 6. 1912 Act no. 2156 (Fajardo Act): health fund
are needed to fill in the gaps and reach the most for travel and salaries
vulnerable people for many developing countries, 7. 1915 Act no. 2156: from Bureau of Health to
including least developed countries (LDCs), small Philippine Health Service “semi-military
island developing States (SIDS) and other low-income system of public health administration
countries.
8. August 2, Act 2711 which included the Public
o Access to essential medicines at affordable
1916 Health Law 0f 1917
prices remains highly problematic, many
households squeezed out of the market due 9. 1932 Act no. 4007: Reorganization Act of
1932
to high prices and limited availability.
o A major digital divide, with more people 10. May 31, Commonwealth Act no. 430 created the
offline than online and particularly poor 1939 Department of Public Welfare, but was
access in sub-Saharan Africa. only completed through E.O. no. 317,
January 7, 1941
Dr. Jose Fabella became its first secretary
The Philippine Department 11. October 4, E.O no. 94: post war reorganization of
1947 the Department of Health and Public
of Health Welfare (which became Social Welfare
Mission – To guarantee equitable, sustainable, and Administration) and Philippine General
quality health for all Filipinos, especially the poor, and to Hospital to the Office of the President.
lead the quest for excellence in health Another split between curative (Bureau
of Hospitals) and preventive services
Vision – to be a global leader for attaining better (Bureau of Health)
health outcomes, competitive and responsive health Nursing service was also established
care system, and equitable health financing. 12. January 1, Conversion of Sanitary District to Rural
1951 Health Unit, carrying the following
services:
maternal and child health, environmental
health, communicable disease control,
vital statistics, medical care, health
education.
Public health nursing resulted in the
passage of Rural Health Act of 1954 (RA
1082)
13. 1970 Conceptualization of the Restructured
Historical Background Health Care Delivery System (primary,
secondary and tertiary levels of care);
under this concept the public health nurse
1. Pre Spanish Traditional health care (herbs and rituals to population ratio was 1:20,000.
and Dispensary of indigent patients of Manila
14. June 2, 1978 P.D 1937. DOH to Ministry of Health
Spanish periods Medicus Titulares during the Martial Law

J.B.L and R.M. A 9

 Sec. Gatmaitan was the 1st Minister of o City/municipal governments - operate the health
Health Centers/RHUs and BHSs.
15. December 2, E.O 851 reorganized Ministry of Health
1982 as an integrated heath health care Objective for local health
delivery system through the creation of
Integrated Provincial Health Office systems:
combining the public health hospital 1. For effective and efficient delivery of health care
operations under the PHOs services.
16. April 13, E.O no.119: MOH was back in the name 2. Upgrade the health care management and service
1987 Department of Health by President Cory capabilities of local health facilities.
Aquino 3. Promote inter-LGU linkages and cost sharing
17. October 10, R.A 71690 known as the Local schemes including local health care financing
1991 government Code: all structures, systems for better utilization of local health
personnel and budgetary allocations from resources.
the provincial health level down to the 4. Foster participation of the private sector, non-
barangay were devolved to the LGU to government organizations (NGOs) and
facilitate service delivery. From communities in local health systems
provincial to local government development.
(devolution/devolved health sector) 5. Ensure the quality of health service delivery at
18. May 24, E.O 102 “Redirecting the Functions and the local level.
1999 Operations of the DOH” by Pres. Joseph
Estrada 2012 DOH
19. 1999-2004 Development of the Health Reform Original AO 2012-
Agenda Title: 0012; Rules
on New
20. 2005 to Devolvement of plan to rationalize the Classification of Hospitals and Other
present bureaucracy in an attempt to scale down
Health Facilities, July 18, 2012
including the DOH
New DOH Hospital Classifications 2015

Classification of hospital shall be based on Administrative

Local Health System and Order No. 2012–0012, dated July 18, 2012, "Rules and
Regulations Governing the New Classification of Hospitals
Devolution of Health and Other Health Facilities in the Philippines"

Services Classified according to the following:

 Central agency based in Manila. - 1. According to Ownership
administered Philippine health care a) Government (The hospital is created
system by law)
o provided the singular sources of resources, policy  A government health facility may be under
direction, technical and administrative the National Government, DOH, Local
supervision to all health facilities nationwide. Government Unit (LGU), Department of
Justice (DOJ), State Universities and
Colleges (SUCs), Government-owned and
 Local Government Code (Republic Act
controlled corporations (GOCC) and others
7160) - all structures, personnel and
b) Private
budgetary allocations from the  Owned, established, and operated with
provincial health level down to the funds from donation, principal, investment,
barangays were devolved to the local or other means by any individual,
corporation, association, or organization.
government units to facilitate health
service delivery. 2. According to Scope of Services
o Provincial government - operate the hospital a) General Hospital
system & Provincial District Hospitals,

J.B.L and R.M. A 10

  A hospital that provides services for all Operating Room or Theater DOH
kinds of illnesses, diseases, injuries or Guidelines on Cleaning,
deformities Disinfection, and Sterilization of
 It provides medical and surgical care to the Reusable Medical Devices in
sick and injured, maternity, newborn and Hospital Facilities in the
child care. Philippines
o It shall be equipped with the service 4. A post-operative Recovery Room
capabilities needed to support board 5. Maternity Facilities consisting of Ward(s),
certified/ eligible medical specialists Room(s), a Delivery Room, exclusively for
and other licensed physicians
maternity patients and newborns.
rendering services in, but not limited
6. Isolation facilities with proper procedures
to the following:
for the care and control of infection and
 Clinical Services (Family
communicable diseases as well as for the
Medicine, Pediatrics, Internal
prevention of cross infection
Medicine, Obstetrics and
7. A separate dental section/ clinic
Gynecology, Surgery)
8. Provision for blood donation
 Emergency Services
9. A DOH-licensed secondary clinical
 Outpatient Services
laboratory with the services of a consulting
 Ancillary and Support Services
pathologist
(Clinical Laboratory, Imaging
10. A DOH licensed Level 1 imaging facility
Facility, Pharmacy).
with the services of a consulting radiologist
11. A DOH licensed pharmacy
b) Specialty
Specializes in a particular disease or
condition or in one type of patient. b) Level 2 General Hospital
 A specialized hospital may be devoted to  As minimum, all of Level 1 capacity, including but
the treatment of the following: not limited to:
o Treatment of a particular type 1. An organized staff of qualified and competent
of illness or for a particular personnel with Chief of Hospital/Medical
condition requiring a range of Director and appropriate board-certified
treatment Clinical Department Heads
o Treatment of patients suffering 2. Departmentalized and equipped with the
service capabilities needed to support board
from a particular disease of a
certified/ eligible medical specialties and other
particular organ or group of licensed physicians rendering services in the
organs specialties of Medicine, Pediatrics, Obstetrics
o Treatment of patients and Gynecology, Surgery, their subspecialties,
belonging to a group such as and other ancillary services
children, women, elderly or 3. Provision for general ICU for critically ill
others patients
3. According to functional capacity 4. Provision for NICU
5. Provision for HRPU
a) Level 1 General Hospital 6. Provision for Respiratory Therapy Services
7. A DOH licensed tertiary clinical laboratory
• shall have as minimum: 8. A DOH licensed level 2 imaging facility with
mobile X-ray inside the institution and with
1. A staff of qualified, medical, allied medical capability for contrast examinations
and administrative personnel headed by a
physician duly licensed by the PRC.
c) Level 3 General Hospital
2. Bed space for its authorized bed capacity,
in accordance with DOH Guidelines in the As minimum, all of Level 2, including but not limited to:
Planning and Design of Hospitals.  Teaching and/or Training Hospital with
3. An operating room with standard accredited residency training program for
equipment and provisions for sterilization physicians in the four major specialties namely:
of equipment and supplies in accordance Medicine, Pediatrics, Obstetrics and Gynecology,
with: and Surgery
o DOH Reference Plan in the  Provision for physical medicine and rehabilitation
Planning and Design of an unit

J.B.L and R.M. A 11

  Provision for ambulatory surgical clinic Guarantee 1. All life stages and triple burden of disease
 Provision for dialysis facility
 Provision for blood bank  Pregnant, newborn, infant, child, adolescent,
 A DOH licensed level 3 imaging facility with adults, elderly
interventional radiology
Guarantee 2. Services are delivered by networks that
are

d) Specialty Hospitals (same as the  fully functional

previous description)  gate keeping
 Specializes in a particular disease or condition Guarantee 3: services are financed predominantly by
or in one type of patient PhilHealth
A specialized hospital may be devoted to the
treatment of the following:  100% of Filipinos are member
 Treatment of a particular type of  Formal sector premium paid through payroll
illness or for a particular condition
 Non-formal sector premium paid through tax
requiring a range of treatment
subsidy
 Treatment of patients suffering from a
particular disease of a particular Strategy (A.C.H.I.E.V.E.)
organ or group of organs
 Treatment of patients belonging to a  Advance quality, health promotion and
group such as children, women, elderly primary care
or others  Covers all Filipinos against health-related
financial risk
e) Trauma Hospitals  Harness the power of strategic HRH
development
The trauma capability of hospitals shall be assessed in  Invest in eHealth and data for decision making
accordance with the guidelines formulated by the
 Enforce standards, accountability, and
Philippine College of Surgeons
transparency
 Trauma Capable Facility is a DOH licensed
 Value all clients and patients, especially the
hospital designated as a Trauma Center
 Trauma Receiving Facility is a DOH poor, marginalized, and vulnerable
licensed hospital within the trauma service  Elicit multi-sectoral and multi-stakeholder
area which receives trauma patients for support for health
transport to the point of care or a trauma
center Primary Health Care (PHC)

 an essential health care made universally

All for Health
Philippine Health towards Health
accessible to individuals and families in the
community by means acceptable to them
Agenda (2010-2022) for All (Lahat
through their full participation and at a cost
under President Duterte Para sa
that the community and country can afford at
Kalusugan!
every stage of development. (WHO)
Tungo sa Kalusugan Para sa Lahat)
 Declaration: during the First International
Goals Conference on PHC held in Alma Ata, USSR
on September 6-12, 1978 by WHO.
The Health System Aspires for  Goal: “Health for All by the year 2000”.
 Adopted in the Philippines through Letter of
 financial protection Instruction 949 signed by President Marcos on
 better health outcomes October 19, 1979
 responsiveness  Theme: “Health in the Hands of the People by
2020.”
Values
 Concept: characterized by partnership and
 equitable and inclusive to all empowerment of the people that shall
 transparent and accountable permeate as the core strategy in the effective
 uses resources efficiently provision of essential health services that are
 provides high quality services community based, accessible, acceptable and

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 sustainable at a cost which the community and needs with the end in view of providing
the government can afford appropriate solutions leading to self-reliance and
□ Focus of responsibility: health on the self-determination.
individual, his family and the 4. Development and utilization of appropriate
community. technology focusing on local indigenous
□ includes the full participation and resources available in and acceptable to the
active involvement of the community community.
towards the development of self-reliant 5. Organization of communities arising from their
people, capable of achieving an expressed needs which they have decided to
acceptable level of health and well- address and that this is continually evolving in
being. pursuit of their own development.
□ recognizes the interrelationship 6. Increase opportunities for community
between health and the overall political, participation in local level planning,
socio-cultural and economic management, monitoring and evaluation within
development of society. the context of regional and national objectives.
7. Development of intra-sectoral linkages with other
Four cornerstones/pillars government and private agencies so that
in PHC programs of the health sector is closely linked
with those of other socio-economic sectors at the
national, intermediate and community levels.
 February 23-24, 2006, PHC Summit: 8. Emphasizing partnership so that the health
 showcased the various community managed workers and the community leaders/members
health activities that has successfully placed
health in the hands of the people in this country. Elements/Components of
PHC:
view each other as partners rather than merely
providers and receiver of health care respectively
1. Environmental sanitation
1. Active community participation
2. Control of Communicable Diseases
2. Intra and inter-sectoral linkages
3. Use of appropriate technology
2 Levels of PHC workers: 4. Support mechanism made available Types of
3. Immunization PHC workers that vary in different communities
4. Health education depending upon:
5. Maternal and Child Health and Family Planning • Available health manpower resources
6. Adequate Food and Proper Nutrition • Local health needs and problems

Strategies:
Levels of Health Care and Referral • Political and financial feasibility
System: 1. Village or Barangay Health Workers
2. Intermediate level health workers
7. Provision of Medical Care and Emergency
Treatment 1. Primary Level of Care
8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs  The first contact between the community
members and the other levels of health
facility.

1. Reorientation and reorganization of the national 2. Secondary Level of Care

health care system with the establishment of
 Capable of performing minor surgeries and
functional support mechanism in support of the
mandate of devolution under the Local perform some simple laboratory examinations.
Government Code of 1991. 3. Tertiary Level of Care
2. Effective preparation and enabling process for
health action at all levels.  Complicated cases and intensive care requires
3. Mobilization of the people to know their tertiary care and all these can be provided.
communities and identifying their basic health

J.B.L and R.M. A 13

 2. Sustained health financing
3. Response health system by ensuring that all
Filipinos especially the disadvantage group
have equitable access to affordable health care.

UHC’s Three Strategic Thrusts:

1. Financial risk protection through expansion in

The Levels of Prevention enrollment and benefit delivery of the National
Health Insurance Program (NHIP);
PRIMARY SECONDARY TERTIARY 2. Improved access to quality hospitals and health care
PREVENTIO PREVENTION PREVENTION facilities; and
N 3. Attainment of health-related Millennium
Definition An intervention An intervention In intervention Development Goals (MDGs).
implemented implemented after a implemented after a
before there is disease has begun, disease injury is
evidence of a but before it is established To Achieve the three Strategic Thrusts, 6 Strategic
disease or injury symptomatic Instruments shall be Optimized
Intent Reduce or Early identification Prevent sequelae
eliminate risks (through screening) (stop bad things1. Health financing
factors Risk and treatment from getting worse)
reduction) 2. Service delivery
Example Encourage Check body mass Help obese3. Policy standards, and regulations
exercise and index (BMI) at every individuals lose4. Governance for health
healthy eating to well checkup to weight to prevent
5. Human resources for health
prevent identify individuals progression to more
individuals from who are overweight severe 6. Health information
becoming or obese consequences.
overweight
KEY POINTS
The key points may be bulleted like this:
Universal Health Care (UHC)
 Health Care delivery System
 Also referred to as Kalusugan Pangkalahatan  Millennium Development Goal
(KP),  Sustainable Development Goal
 the “provision to every Filipino of the highest  Philippine Health Agenda
possible quality of health care that is accessible,
efficient, equitably distributed, adequately Definition of Terms:
funded, fairly financed, and appropriately used
by an informed and empowered public”. Health care delivery system – an organization of people,
 The Aquino administration puts it as the institutions, and resources to deliver health care services
availability and accessibility of health services to meet the health needs of the people.
and necessities for all Filipinos. Devolution – the transfer of powers held by central
government to a lower level of government
 a government mandate aiming to ensure that
Primary Health Care (WHO) – essential health care
every Filipino shall receive affordable and
made universally accessible to individuals and families in
quality health benefits. the community.
 involves providing adequate resources – health
human resources, health facilities, and health Hazard Alerts:
financing.
Mission and Vision of DOH changes depending on the
Goals and Objectives current health situation of the country.
1. Better health outcome

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