COMMUNITY

HEALTH NURSING
By: MS. CAROLINA D. BARROT, MAN,RN /
MR. JARVIN G. RENOMERON, MAN, MHS, RN

(Mark 10:45)
Discipleship is a lifestyle
Not just a biblical truth
Nor a Christian ideal but a way of life
For the Son of Man also came not to be
served
But to serve and to give His life as a
ransom for many.

COVERAGE FOR LOCAL

BOARD EXAM : CHN

I.

Safe and Quality Care, Health

Education, and Communication,
Collaboration and Teamwork
1. Principles and Standard of CHN
2. Levels of care
3. Types of Clientele
4. Health Care Delivery System
5. PHC as a Strategy

6. Family-based Nursing
Services(Family Health Nursing
Process)
7. Population Group-based Nursing
Services
8. Community-based Nursing
Services/Community Health Nursing
Process
9. Community Organizing
10.Public Health Programs

II.

Research and Quality

Improvement

1.
2.
3.
4.
5.

Research in the Community

National Health Situation
Vital Statistics
Epidemiology
Demography

III. Management of Resources

& Environment and Records
Management

1. Field Health Services And

Information System
2. Target-setting
3. Environmental Sanitation

IV.

Ethico-Moral-Legal Responsibility

1.

Socio-cultural values, beliefs, and

practices of individuals, families,
groups and communities
Code of Ethics for Government
Workers
WHO, DOH, LGU policies on health
Local Government Code
Issues

2.
3.
4.
5.

V.

Personal And Professional

Development
1. Self-assessment of CHN
competencies, importance,
methods and tools
2. Strategies and methods of
updating ones self, enhancing
competence in community health
nursing and related areas.

HISTORY OF CHN

Date Event
1901 - Act # 157 ( Board of Health of the
Philippines) ; Act # 309 ( Provincial and Municipal
Boards of Health) were created.
1905 - Board of Health was abolished;
functions
were transferred to the Bureau of Health.
1912 Act # 2156 or Fajardo Act created the Sanitary
Divisions, the forerunners of present MHOs; male
nurses performs the functions of doctors
1919 Act # 2808 (Nurses Law was created)
- Carmen del Rosario , 1st Fil. Nurse supervisor
under Bureau of Health
Oct. 22, 1922 Filipino Nurses Organization
(Philippine Nurses Organization) was
organized.

 1923 Zamboanga General Hospital School

of Nursing & Baguio General Hospital were
established; other government schools of
nursing were organized several years after.
1928- 1st Nursing convention was held
1940 Manila Health Department was
created.
1941
Dr. Mariano Icasiano became the
first
city health officer; Office of Nursing
was
created through the effort of Vicenta
Ponce (chief nurse) and Rosario Ordiz
(assistant chief nurse)

 Dec. 8, 1941 Victims of World War II were

treated by the nurses of Manila.
July 1942 Nursing Office was created; Dr.
Eusebio Aguilar helped in the release of 31
Filipino nurses in Bilibid Prison as prisoners of
war
by the Japanese.
Feb. 1946 Number of nurses decreased from 556
308.
1948 First training center of the Bureau of Health
was organized by the Pasay City Health
Department. Trinidad Gomez, Marcela Gabatin,
Costancia Tuazon, Ms. Bugarin, Ms. Ramos, and
Zenaida Nisce composed the training staff.

 1950 Rural Health Demonstration and

Training Center was created.
1953 The first 81 rural health units were
organized.
1957 RA 1891 amended some sections of
RA 1082 and created the eight categories
of rural health unit causing an increase in
the demand for the community health
personnel.
1958-1965 Division of Nursing was
abolished (RA 977) and Reorganization Act
(EO 288)

 1961 Annie Sand organized the National

League of
Nurses of DOH.
1967 Zenaida Nisce became the nursing
program
supervisor and consultant on the six
special diseases (TB, leprosy, V.D., cancer,
filariasis, and mental health illness).
1975 Scope of responsibility of nurses and
midwives became wider due to restructuring of
the health care delivery system.
1976-1986 The need for Rural Health
Practice
Program was implemented.
1990- 1992- Local Government Code of 1991 (RA
7160)

 1993-1998 Office of Nursing did not

materialize in spite of persistent
recommendation of the officers, board
members, and advisers of the National
League of Nurses Inc.
Jan. 1999 Nelia Hizon was positioned as
the
nursing adviser at the Office of
Public Health Services through Department
Order # 29.
May 24, 1999 EO # 102, which redirects the
functions and operations of DOH, was
signed by former President Joseph Estrada.

LAWS AFFECTING
PUBLIC HEALTH
AND PRACTICE OF
COMMUNITY
HEALTH NURSING

R.A. 7160 - or the Local Government Code. This

involves the devolution of powers, functions
and responsibilities to the local government
both rural & urban.The Code aims to
transform local government units into selfreliant communities and active partners in the
attainment of national goals thru a more
responsive and accountable local government
structure instituted thru a system of
decentralization. Hence, each province, city
and municipality has a LOCAL HEALTH
BOARD ( LHB ) which is mandated to propose
annual budgetary allocations for the operation
and maintenance of their own health facilities.

Composition of LHB
Provincial Level
1.Governor- chair
2. Provincial Health Officer vice chair
3. Chair , Committee on Health of
Sangguniang Panlalawigan
4. DOH rep.
5. NGO rep.

Composition of LHB
City and Municipal Level
1. Mayor chair
2. MHO vice chair
3. Chair, Committee on Health of
Sangguniang Bayan
4. DOH rep
5. NGO rep

EFFECTIVE LHS
DEPENDS ON:
1. the LGUs financial capability
2. a dynamic and responsive political
leadership
3. community empowerment

R.A. 2382 Philippine Medical Act. This act defines the

practice of medicine in the country.
R.A. 1082 Rural Health Act. It created the 1 st 81 Rural
Health Units.
-amended by RA 1891 ; more physicians,
dentists, nurses, midwives and sanitary inspectors will
live in the rural areas where they are assigned in order
to raise the health conditions of barrio people ,hence
help decrease the high incidence of preventable
diseases

R.A. 6425 Dangerous Drugs Act. It

stipulates that the sale, administration,
delivery, distribution and transportation of
prohibited drugs is punishable by law.
R.A. 9165 the new Dangerous Drug Act of
2002
P.D. No. 651 requires that all health
workers shall identify and encourage the
registration of all births within 30 days
following delivery.

P.D. No. 996 requires the compulsory immunization

of all children below 8 yrs. of age against the 6
childhood immunizable diseases.
P.D. No. 825 provides penalty for improper disposal
of garbage.
R.A. 8749 Clean Air Act of 2000
P.D. No. 856 Code on Sanitation. It provides for the
control of all factors in mans environment that affect
health including the quality of water, food, milk,
insects, animal carriers, transmitters of disease,
sanitary and recreation facilities, noise, pollution and
control of nuisance.

R.A. 6758 standardizes the salary of government

employees including the nursing personnel.
R.A. 6675 Generics Act of 1988 which promotes,
requires and ensures the production of an adequate
supply, distribution, use and acceptance of drugs
and medicines identified by their generic name.
R.A. 6713 Code of Conduct and Ethical Standards of
Public Officials and Employees. It is the policy of the
state to promote high standards of ethics in public
office. Public officials and employees shall at all
times be accountable to the people and shall
discharges their duties with utmost responsibility,
integrity, competence and loyalty, act with patriotism
and justice, lead modest lives uphold public interest
over personal interest.

R.A. 7305 Magna Carta for Public Health

Workers. This act aims: to promote and improve
the social and economic well-being of health
workers, their living and working conditions and
terms of employment; to develop their skills and
capabilities in order that they will be more
responsive and better equipped to deliver health
projects and programs; and to encourage those
with proper qualifications and excellent abilities
to join and remain in government service.
R.A. 8423 created the Philippine Institute of
Traditional and Alternative Health Care.

P.D. No. 965 requires applicants for

marriage license to receive instructions
on family planning and responsible
parenthood.
P.D. NO. 79 defines , objectives, duties
and functions of POPCOM

 RA 4073 advocates home

treatment for leprosy
Letter of Instruction No. 949
legal basis of PHC dated OCT.
19, 1979
- promotes development of
health programs on the
community level

 RA 3573 requires reporting of

all cases of communicable
diseases and administration of
prophylaxis
Ministry Circular No. 2 of 1986
includes AIDS as notifiable
disease

R.A. 7875 National Health Insurance Act

R.A. 7432 Senior Citizens Act
R. A. 7719 - National Blood Services Act
R.A. 8172 Salt Iodization Act ( ASIN
LAW)
R.A. 7277- Magna Carta for PWDs,
provides their rehabilitation, selfdevelopment and self-reliance and
integration into the mainstream of society

A. O. No. 2005-0014- National Policies

on Infant and Young Child Feeding:
1.All newborns be breastfeed within 1 hr
after birth
2. Infants be exclusively breastfeed for 6
mos.
3. Infants be given timely, adequate and
safe complementary foods
4. Breastfeeding be continued up to 2
years and beyond

 EO 51- Phil. Code of Marketing of

Breastmilk Substitutes
R.A.- 7600 Rooming In and
Breastfeeding Act of 1992
R.A. 8976- Food Fortification Law
R.A. 8980- prolmulgates a comprehensive
policy and a national system for ECCD

 A..O. No. 2006- 0015- defines the

Implementing guidelines on Hepatitis B
Immunization for Infants
R.A. 7846- mandates Compulsory Hepatitis
B Immunization among infants and children
less than 8 yrs old
R.A. 2029- madates Liver Cancer and
Hepatitis B Awareness Month Act ( February)

 A.O. No. 2006-0012- specifies the

Revised Implementing Rules and
Regulations of E.O. 51 or Milk Code,
Relevant International Agreements,
Penalizing Violations thereof and for
other purposes

Public Health
- science and art of preventing diasease,
prolonging life, promoting health and efficiency
thru organized community effort for the sanitation
of the environment, control of communicable
diseases, the education of individuals in personal
hygiene, the organization of medical and nursing
services for the early diagnosis and preventive
treatment of diseases and the development of
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 off birth and
longevity ( DR. C.E. Winslow)

Community Health
Nursing
- special field of nursing that combines the
skills of nursing, public health and some
phases of social assistance and functions as
part of the total public health program for the
promotion of health, the improvement of the
conditions in the social and physical
environment, rehabilitation of illness and
disability ( WHO Expert Committee of
Nursing )

CHN
- a learned practice discipline with the ultimate goal
of contributing as individuals and in collaboration
with others to the promotion of the clients optimum
level of functioning thru teaching and delivery of
care ( Jacobson )
- a service rendered by a professional nurse to
IFCs, population groups in health centers, clinics,
schools , workplace for the promtion of health,
preventionof illness, care of the sick at home and
rehabilitation (DR. Ruth B. Freeman)

Concepts
The primary focus of community health
nursing is health promotion.
Community health nurses provide care
necessary to meet the requirements of an
individual all throughout the life cycle.
Knowledge on different fields (biological and
social sciences, clinical nursing, and
community health organizations) is used.
Nursing process in community health nursing
changes based on the needs of the
community.

Goal

To elevate the level health of the multitude.

Worth
and dignity of man.
Philosophy

Principles

1.The need of the community is the basis of

community health nursing.
2.The community health nurse must
understand fully the objectives and policies
of the agency she represents.

3. The family is the unit of service.

4. CHN must be available to all regardless of
race,creed and socioeconomic status
5. The CHN works as a member of the health team
6. There must be provision for periodic evaluation of
community health nursing services
7. Opportunities for continuing staff education
programs for nurses must be provided by the
community health nursing agency and the CHN
as well
8. The CHN makes use of available community
health resources

9. The CHN taps the already

existing active organized groups
in the community
10. There must be provision for
educative supervision in
community health nursing
11. There should be accurate
recording and reporting in
community health nursing
12. Health teaching is the
primary responsibility of the
community health nurse

Standards in CHN
I. Theory
Applies theoretical concepts as basis for
decisions in practice
II. Data Collection
Gathers comprehensive , accurate data
systematically

Standards
III. Diagnosis
Analyzes collected data to determine the
needs/ health problems of IFC
IV. Planning
At each level of prevention, develops plans
that specify nursing actions unique to
needs of clients

Standards
V. Intervention
Guided by the plan, intervenes to promote,
maintain or restore health, prevent illness
and institute rehabilitation
VI. Evaluation
Evaluates responses of clients to interventions
to note progress toward goal achievement,
revise data base, diagnoses and plan

Standards
VII. Quality Assurance and Professional
Development
Participates in peer review and other
means of evaluation to assure quality of
nursing practice
Assumes professional development
Contributes to development of others

Standards
VIII. Interdisciplinary Collaboration
Collaborates with other members of the
health team, professionals and
community representatives in assessing,
planning, implementing and evaluating
programs for community health

Standards
IX. Research
Indulges in research to contribute to theory
and practice in community health
nursing

LEVELS OF CARE/
PREVENTION
1. PRIMARY
2. SECONDARY
3. TERTIARY

Types of Clientele
1. INDIVIDUALS
2. FAMILIES
3. COMMUNITIES
4. POPULATION GROUPS
- Aggregate of people who share common
characteristics, developmental stage or common
exposure to particular environmental factors thus
resulting in common health problems ( Clark,
1995:5) e.g. children . elderly, women, workers etc.

Phil.Health Care
Delivery System
1.PRIMARY LEVEL FACILITIES
2. SECONDARY LEVEL FACILITIES
3. TERTIARY LEVEL FACILITIES

Classify as to what level

the ff. belong

1. Teaching and Training Hospitals

2. City Health Services
3. Emergency and District Hospitals
4. Private Practitioners
5. Heart Institutes
6. Puericulture Centers
7. RHU

THE DEPARTMENT
OF HEALTH
VISION: Health for all Filipinos
MISSION: Ensure accessibility & quality
of health care to improve the quality of
life of all Filipinos, especially the poor.

NATIONAL OBJECTIVES

1. Improve the general health status of the population

(reduce infant mortality rate, reduce child morality rate,
reduce maternal mortality rate, reduce total fertility rate,
increase life expectancy & the quality of life years).
2. Reduce morbidity, mortality, disability & complications
from Diarrheas, Pneumonias, Tuberculosis, Dengue,
Intestinal Parasitism, Sexually Transmitted Diseases,
Hepatitis B, Accident & Injuries, Dental Caries &
Periodontal Diseases, Cardiovascular Diseases,
Cancer, Diabetes, Asthma & Chronic Obstructive
Pulmonary Diseases, Nephritis & Chronic Kidney
Diseases, Mental Disorders, Protein Energy
Malnutrition, Iron Deficiency Anemia & Obesity.

3.Eliminate the ff. diseases as public health

problems:
Schistosomiasis
Malaria
Filariasis
Leprosy
Rabies
Measles
Tetanus
Diphtheria & Pertussis
Vitamin A Deficiency & Iodine Deficiency
Disorders

4. Eradicate Poliomyelitis
5. Promote healthy lifestyle through healthy diet
& nutrition, physical activity & fitness, personal
hygiene, mental health & less stressful life &
prevent violent & risk-taking behaviors.
6. Promote the health & nutrition of families &
special populations through child, adolescent
& youth, adult health, womens health, health
of older persons, health of indigenous people,
health of migrant workers and health of
different disabled persons and of the rural &
urban poor.

7. Promote environmental health and

sustainable development through the
promotion and maintenance of healthy
homes, schools, workplaces,
establishments and communities towns
and cities.

Basic Principles to
Achieve Improvement in
Health
1. Universal access to basic health services
2.
3.
4.

must be ensured.
The health and nutrition of vulnerable
groups must be prioritized.
The epidemiological shift from infection to
degenerative diseases must be managed.
The performance of the health sector
must be enhanced.

Primary Strategies to
Achieve Goals
1. Increasing investment for Primary Health
Care.
2. Development of national standards and
objectives for health.
3. Assurance of health care.
4. Support to the local system development.
5. Support for frontline health workers.

PHC as a Strategy

PRIMARY HEALTH CARE (PHC)

May 1977 -30th World Health Assembly
decided that the main health target of the
government and WHO is the attainment of a
level of health that would permit them to
lead a socially and economically productive
life by the year 2000.
September 6-12, 1978 - First International
Conference on PHC in Alma Ata, Russia
(USSR) The Alma Ata Declaration stated that
PHC was the key to attain the health for all
goal

October 19, 1979 - Letter of

Instruction (LOI) 949), the legal
basis of PHC was signed by Pres.
Ferdinand E. Marcos,
which adopted PHC as an approach
towards the design, development
and implementation of programs
focusing on health development at

 RATIONALE FOR ADOPTING PRIMARY HEALTH CARE:

Magnitude of Health Problems

Inadequate and unequal distribution of
health resources
Increasing cost of medical care
Isolation of health care activities from
other development activities

DEFINITION OF PRIMARY HEALTH

CARE

essential health care made universally

accessible to individuals and families in the
community by means acceptable to them,
through their full participation and at cost that the
community can afford at every stage of
development.
a practical approach to making health benefits
within the reach of all people.
an approach to health development, which is
carried out through a set of activities and whose
ultimate aim is the continuous improvement and
maintenance of health status of the community.

GOAL OF PRIMARY HEALTH CARE:

HEALTH FOR ALL FILIPINOS by the
year 2000
AND HEALTH IN THE
HANDS OF THE
PEOPLE by the year
2020.

An improved state of health and quality of life for

all people attained through SELF-RELIANCE.
KEY STRATEGY TO ACHIEVE THE GOAL:
Partnership with and Empowerment of the people
- permeate as the core strategy in the effective
provision of essential health services that are
community based, accessible, acceptable, and
sustainable, at a cost, which the community and the
government can afford.

OBJECTIVES OF PRIMARY HEALTH

CARE
Improvement in the level of health care of the community
Favorable population growth structure
Reduction in the prevalence of preventable, communicable
and other disease.
Reduction in morbidity and mortality rates especially among
infants and children.
Extension of essential health services with priority given to the
underserved sectors.
Improvement in Basic Sanitation
Development of the capability of the community aimed at selfreliance.
Maximizing the contribution of the other sectors for the social
and economic development of the community.

MISSION:

To strengthen the health care system by

increasing opportunities and supporting
the conditions wherein people will
manage their own health care.
TWO LEVELS OF PRIMARY HEALTH CARE
WORKERS
1. Barangay Health Workers - trained community
health workers or health auxiliary volunteers or
traditional birth attendants or healers.
2. Intermediate level health workers include the Public
Health Nurse, Rural Sanitary Inspector and
midwives.

PRINCIPLES OF PRIMARY HEALTH

CARE

4 A's = Accessibility, Availability,

Affordability & Acceptability,

Appropriateness of health services. The

health services should be present where
the supposed recipients are. They should
make use of the available resources within
the community, wherein the focus would be
more on health promotion and prevention
of illness.

COMMUNITY PARTICIPATION
=heart and soul of PHC

 3. People are the center, object and subject

of development.

Thus, the success of any undertaking that aims at

serving the people is dependent on peoples
participation at all levels of decision-making; planning,
implementing, monitoring and evaluating. Any
undertaking must also be based on the peoples
needs and problems (PCF, 1990)
Part of the peoples participation is the partnership
between the community and the agencies found in the
community; social mobilization and decentralization.
In general, health work should start from where the
people are and building on what they have. Example:
Scheduling of Barangay Health Workers in the health
center

BARRIERS OF COMMUNITY
INVOLVEMENT

Lack of motivation
Attitude
Resistance to change
Dependence on the part of community
people
Lack of managerial skills

4.SELF-RELIANCE
5.Partnership between the community
and the health agencies in the
provision of quality of life.

Providing linkages between the

government
and
the
nongovernment organization and peoples
organization.

6. Recognition of interrelationship
between the health and
HEALTH
development

is not merely the absence of disease. Neither it is only

a state of physical and mental well-being. Health
being a social phenomenon recognizes the interplay of
political, socio-cultural and economic factors as its
determinant. Good Health therefore, is manifested by
the progressive improvements in the living conditions
and quality of life enjoyed by the community residents
(PCF, DEVELOPMENT is the quest for an improved
quality of life for all. Development is multi-dimensional.
It has a political, social, cultural, institutional and
environmental dimensions (Gonzales 1994).
Therefore, it is measured by the ability of people to
satisfy their basic needs.

7. SOCIAL MOBILIZATION
It enhances people participation or
governance, support system provided by
the Government, networking and
developing secondary leaders.

8. DECENTRALIZATION

MAJOR STRATEGIES OF PRIMARY

HEALTH CARE

A. ELEVATING HEALTH TO A
COMPREHENSIVE
AND
SUSTAINED

Attaining Health for all Filipino will require

NATIONAL EFFORTS.
expanding participation in health and health related
programs whether as service provider or beneficiary.
Empowerment to parents, families and communities to
make decisions of their health is really the desired
outcome.

Advocacy must be directed to National and Local

policy making to elicit support and commitment to
major health concerns through legislations, budgetary
and logistical considerations.

B. PROMOTING AND SUPPORTING

COMMUNITY MANAGED HEALTH CARE

The health in the hands of the people

brings the government closest to the
people. It necessitates a process of
capacity building of communities and
organization to plan, implement and
evaluate health programs at their
levels.

C. INCREASING EFFICIENCIES IN THE

HEALTH SECTOR

Using appropriate technology will make

services and resources required for their
delivery, effective, affordable, accessible and
culturally acceptable. The development of
human resources must correspond to the
actual needs of the nation and the policies it
upholds such as PHC. The DOH will continue
to support and assist both public and private
institutions particularly in faculty development,
enhancement of relevant curricula and
development of standard teaching materials.

D. ADVANCING ESSENTIAL
NATIONAL HEALTH RESEARCH

Essential National Health

Research (ENHR) is an integrated
strategy for organizing and
managing research using
intersectoral, multi-disciplinary and
scientific approach to health
programming and delivery.

 FOUR CORNERSTONES/ PILLARS IN

PRIMARY HEALTH CARE
1.
Active Community Participation
2.
Intra and Inter-sectoral Linkages
3.
Use of Appropriate Technology
4.
Support mechanism made available

ELEMENTS OF PRIMARY HEALTH

CARE:

Education For Health

Is one of the potent methodologies

for information dissemination. It
promotes the partnership of both the
family members and health workers in
the promotion of health as well as
prevention of illness.

Locally Endemic Disease

Control

The control of endemic disease

focuses on the prevention of its
occurrence to reduce morbidity
rate. Example Malaria Control
and Schistosomiasis Control

Expanded Program on
Immunization

This program exists to control the

occurrence of preventable illnesses
especially of children below 6 years
old. Immunizations on poliomyelitis,
measles, tetanus, diphtheria and
other preventable disease are given
for free by the government and
ongoing program of the DOH

Maternal and Child Health and

Family Planning
The mother and child are the most
delicate members of the community.
So the protection of the mother and
child to illness and other risks would
ensure good health for the
community. The goal of Family
Planning includes spacing of children
and responsible parenthood.

Environmental Sanitation
and Promotion of Safe
Water Supply
Environmental Sanitation is defined as the
study of all factors in the mans environment,
which exercise or may exercise deleterious
effect on his well-being and survival.
Water is a basic need for life and one factor in
mans environment. Water is necessary for
the maintenance of healthy lifestyle.
Safe Water and Sanitation is necessary for
basic promotion of health.

Nutrition and Promotion of Adequate

Food Supply
One basic need of the family is food. And
if food is properly prepared then one may
be assured healthy family. There are many
food resources found in the communities
but because of faulty preparation and lack
of knowledge regarding proper food
planning, Malnutrition is one of the
problems that we have in the country.

Treatment of Communicable
Diseases and Common Illness
The diseases spread through direct
contact pose a great risk to those who can
be infected. Tuberculosis is one of the
communicable diseases continuously
occupies the top ten causes of death. Most
communicable diseases are also
preventable. The Government focuses on
the prevention, control and treatment of
these illnesses.

Supply of Essential Drugs

This focuses on the information campaign on the
utilization and acquisition of drugs.
In response to this campaign, the GENERIC
ACT of the Philippines is enacted . It includes
the following drugs: Cotrimoxazole, Paracetamol,
Amoxycillin, Oresol, Nifedipine, Rifampicin,
INH(isoniazid) and Pyrazinamide,Ethambutol,
Streptomycin,Albendazole,Quinine

FAMILY HEALTH
NURSING
- that level of CHN practice directed to
the FAMILY as the unit of care with
HEALTH as the goal and NURSING as
the medium, channel or provider of care

Family Case Load

- the no. and kind of families a nurse
handles at any given time
- variable for cases are added or dropped
based on the need for nursing care and
supervision

Types of Families

1. Nuclear
2. Extended
3. Three generational
4. Dyad
5. Single- Parent
6. Step- Parent
7. Blended or reconstituted

Types of Families

8. Single adult living alone

9. Cohabiting/ Living in
10. No- kin
11. Compound
12. Gay
14. Commune

Stages of Family Life

Cycle

1. Newly married couple

2. Childbearing
3. Preschool age
4. Schoolage
5. Teenage
6. Launching
7. Middle-aged ( empty nest retirement)
8. Period from retirement to Death of both
spouses

HEALTH
FAMILY(

TASKS OF THE
Freeman, 1981)

1. recognizing interruptions of health or development

2. seeking health care
3. managing health and non-health crises
4. providing nursing care to the sick, disabled and
dependent member of the family
5. maintaining a home environment conducive to
good health and personal development
6. maintaining a reciprocal relationship with the
community and health institutions

Family Nursing Problem

Arises when the family cannot effectively
perform its health tasks

Nurses Roles in Family

Health Nursing
1. HEALTH MONITOR
2. PROVIDER OF CARE TO A SICK
FAMILY MEMBER
3. COORDINATOR OF FAMILY
SERVICES
4. FACILITATOR
5. TEACHER
6. COUNSELOR

INITIAL DATA BASE FOR

FAMILY NURSING
PRACTICE
Family structure, Characteristics, and
Dynamics

1. Members of the household and relationship

to the head of the family
2. Demographic data age, sex, civil status,
position in the family
3. Place of residence of each member
whether living with the family or elsewhere

4. Type of family structure e.g.

matriarchal or patriarchal, nuclear or
extended
5. Dominant family members in terms of
decision-making, especially in matters
of health care
6. General family relationship/dynamics
presence of any readily observable
conflict between members;
characteristics communication patterns
among members

 Socio-economic and Cultural

Characteristics
1. Income and Expenses
Occupation, place of work and income of
each working members
Adequacy to meet basic necessities
Who makes decisions about money and
how it is spent

2. Educational attainment of each other

3. Ethnic background and religious
affiliation

4. Significant Others role(s)

they play in familys life
5. Relationship of the family to
larger community Nature
and extent of participation of
the family in community
activities

 Home and Environment

1. Housing

Adequacy of living peace

Sleeping arrangement
Presence of breeding or resting sites of
vectors of diseases
Presence of accidents hazards
Food storage and cooking facilities
Water supply source, ownership, portability
Toilet facility type, ownership, sanitary
condition
Drainage system type, sanitary condition

2. Kind of neighborhood, e.g.

congested, slum, etc.
3. Social and health facilities
available
4. Communication and
transportation facilities
available

 Health Status of each Family Member

1. Medical and nursing history indicating
current or past significant illnesses or
beliefs and practices conducive to health
illness
2. Nutritional assessment

Anthropometric data: Measures of nutritional

status of children, weight, height, mid-upper
arm circumference: Risk assessment
measures of obesity: body mass index, waist
circumference, waist hip ratio
Dietary history specifying quality and quantity
of food/nutrient intake per day
Eating/ feeding habits/ practices

3. Developmental assessments of infants,

toddlers, and preschoolers e.g., Metro
Manila
4. Risk factor assessment indicating presence
of major and contributing modifiable risk
factors for specific lifestyles, cigarette
smoking, elevated blood lipids, obesity,
diabetes mellitus, inadequate fiber intake,
stress, alcohol drinking and other substance
abuse

5. Physical assessment
indicating presence of illness
state/s
6. Results of laboratory/
diagnostic and other screening
procedures supportive of
assessment findings

 Values, Habits, Practices on Health

Promotion, Maintenance and Disease
Prevention.
Examples include:

1.
2.
3.

Immunization status of family members

Healthy lifestyle practices. Specify.
Adequacy of:

rest and sleep

exercise
use of protective measures- e.g. adequate
footwear in parasite-infested areas;
relaxation and other stress management
activities

4. Use of promotive-preventive health services

A TYPOLOGY OF NURSING
PROBLEMS IN FAMILY
NURSING PRACTICE

FIRST-LEVEL ASSESSMENT
I.

Presence of Wellness Condition stated as

Potential or Readiness- a clinical or nursing
judgment about a client in transition from a
specific level of wellness or capability to a
higher level. Wellness potential is a nursing
judgment on wellness state or condition based
on clients performance, current competencies
or clinical data but no explicit expression of
client desire. Readiness for enhanced
wellness state is a nursing judgment on
wellness state or condition based on clients
current competencies or performance, clinical
data explicit expression of desire to achieve a
higher level of state or function in specific area
on health promotion and maintenance.

Examples of these are the following:

1. Potential for Enhanced Capability for:
Healthy lifestyle e.g. nutrition/diet,
exercise/ activity
Health Maintenance
Parenting
Breastfeeding
Spiritual Well-being process of a clients
unfolding of mystery through harmonious
interconnectedness that comes from inner
strength/sacred source/GOD (NANDA 2001)
Others,

2. Readiness for Enhanced Capability

for:

Healthy Lifestyle
Health Maintenance
Parenting
Breastfeeding
Spiritual Well-being
Others,

I.

Presence of Health Threats

conditions that are conducive to
disease, accident or failure top
realize ones health potential.

Examples of these are the following:

1. Family history of hereditary

condition, e.g. diabetes
2. Threat of cross infection from a
communicable disease case

3. Family size beyond what family

resources can adequately
provide
4. Accidental hazards
Broken stairs
Sharp objects, poison, and
medicines improperly kept
Fire hazards

5. Faulty nutritional habits or

feeding practices.

Inadequate food intake both in

quality & quantity
Excessive intake of certain
nutrients
Faulty eating habits
Ineffective breastfeeding
Faulty feeding practices

6. Stress-provoking factors
Strained marital relationship
Strained parent-sibling
relationship
Interpersonal conflicts
between family members
Care-giving burden

7. Poor home condition Inadequate living

space
Lack of food storage
facilities
Polluted water supply
Presence of breeding
sites of vectors of
disease
Improper garbage

Unsanitary
waste disposal
Improper
drainage
system
Poor ventilation
Noise pollution
Air pollution

8. Unsanitary food handling and preparation

9. Unhealthful lifestyles and personal habits

Alcohol drinking
Cigarette smoking
Inadequate footwear
Eating raw meat
Poor personal hygiene
Self-medication
Sexual promiscuity
Engaging in dangerous sports
Inadequate rest
Lack of inadequate exercise
Lack of relaxation activities
Non-use of self protection measures

10.Inherent personal characteristics e.g.

poor impulse control
11.Health history which induce the
occurrence of a health deficit, e.g.
previous history of difficult labor
12.Inappropriate role assumption e.g.
child assuming mother's role, father not
assuming his role
13.Lack of immunization/ inadequate
immunization status specially of
children

14.Family disunity
Self-oriented behavior of
member(s)
Unresolved conflicts of
member(s)
Intolerable disagreement
Other

15.Other

III. Presence of Health Deficits

instances of failure in health
maintenance.
Examples include:

1. Illness states, regardless of whether it

is diagnosed or by medical practitioner
2. Failure to thrive/ develop according to
normal rate
3. Disability whether congenital or
arising from illness; temporary

IV.

Presence of stress Points/ Foreseeable Crisis

Situations anticipated periods of unusual
demand of the individual or family in terms of
family resources.

Examples of these include:

1.
2.
3.
4.
5.
6.
7.
8.

Marriage
Pregnancy
Parenthood
Additional member
Abortion
Entrance at school
Adolescence
Divorce

9.
10.
11.
12.
13.
14.

Menopause
Loss of job
Hospitalization of a
family member
Death of a manner
Resettlement in a
new community
illegitimacy

Second Level
Assessment

Focus on determining familys capacity to perform the

a.
b.
c.
d.
e.

health tasks
Statements on family health nursing problem:
Inability to recognize the presence of the condition or
problem
Inability to make decisions with respect to taking
appropriate health action
Inability to provide adequate nursing care to the sick,
disabled , dependent or vulnerable member of the
family
Inability to provide a home environment conducive to
health maintenance or personal development
Failure to utilize community resources for health care

Scale for Ranking Health

Conditions and Problems
according
to
priorities
Criteria:
a. Nature of the condition or problem presented
( wellness state, health deficit, health threat,
forseeable crisis)
b. Modifiability of the condition or problem
( easily, partially, not modifiable)
c. Preventive Potential (high, moderate , low)
d. Salience ( needs immediate attention, not
immediate, not perceived as a problem)

COMMUNITY HEALTH
CARE PROCESS

Assessment
Purpose : To identify the health needs of the people
Planning of nursing actions
Purpose : To act on the determined needs of the
community people
Implementation
Purpose : To achieve the optimum level of health of
the community people
Evaluation
Purpose : To determine the effectiveness of health care
programs

NURSING
PROCEDURES

CLINIC VISIT
- process of checking the clients health
condition in a medical clinic
HOME VISIT
- a professional face to face contact made by
the nurse with a patient or the family to
provide necessary health care activities
and to further attain the objectives of the
agency

 BAG TECHNIQUE
-a tool making of the public health bag
through which the nurse during the
home visit can perform nursing
procedures with ease and deftness
saving time and effort with the end in
view of rendering effective nursing
care

 THERMOMETER TECHNIQUE
-to assess the clients health condition
through body temperature reading
NURSING CARE IN THE HOME
- giving to the individual patient the nursing
care required by his/her specific illness or
trauma to help him/her reach a level of
functioning at which he/she can maintain
himself/herself or die peacefully in dignity

 ISOLATION TECHNIQUE IN THE HOME

-done by :
1. separating the articles used by a client
with communicable disease to prevent the
spread of infection:
2. frequent washing and airing of beddings
and other articles and disinfections of room
3. wearing a protective gown , to be used only
within the room of the sick member
4. discarding properly all nasal and throat
discharges of any member sick with
communicable disease

5. burning all soiled articles if could be or

contaminated articles be boiled first in
water 30 minutes before laundering
INTRAVENOUS THERAPY
- insertion of a needle or catheter into a
vein to provide medication and fluids
based on physicians written prescription
- can be done only by nurses accredited by
ANSAP

PRINCIPLES OF HEALTH
EDUCATION

It considers the health status of the people,

which is determined by the economic and
social conscience of the country.
It is a process whereby people learn to
improve their personal habits and attitudes,
to work responsibly for the improvement of
health conditions of the family, community,
and nation.

 It involves motivation, experience,

and change in conduct and thinking,
while stimulating active interest. It
develops and provides experience
for change in peoples attitudes,
customs, and habits in relation to
health and everyday living.
It should be recognized as the basic
function of all health workers.

 It takes place in the home, in the

school, and in the community.
It is a cooperative effort requiring
all categories of health
personnel to work together in
close teamwork with families,
groups, and the community.

 It meets the needs, interests,

and problems of the people
affected.
It finds means and ways of
carrying out plans by
encouraging individual and
community participation.

 It is a slow, continuous process

that involves constant changes
and revisions until objectives are
achieved.
Makes use of supplementary
aids and devices to help with the
verbal instructions.

 It utilizes community resources by

careful evaluation of the different
services and resources found in the
community.
It is a creative process requiring
methods and techniques with various
characteristics, not following a rigid
and flexible pattern.

 It aims to help people make use of

their own efforts and education to
improve their conditions of living,
It makes careful evaluation of the
planning, organization, and
implementation of all health
education programs and activities.

THE COMMUNITY
HEALTH NURSE

Qualifications
1. Bachelor of Science in
Nursing
2. Registered Nurse of the
Philippines

 Planner/Programmer
1. Identifies needs, priorities, and problems of
individuals, families, and communities
2. Formulates municipal health plan in the absence
of a medical doctor
3. Interprets and implements nursing plan, program
policies, memoranda, and circular for the
concerned staff personnel
4. Provides technical assistance to rural health
midwives in health matters

 Provider of Nursing
Care
1. Provides direct nursing care to sick or
disabled in the home, clinic, school, or
workplace
2. Develops the familys capability to take
care of the sick, disabled, or
dependent member

 Manager/Supervisor
1. Formulates individual, family, group, and
community-centered plan
2. Interprets and implements programs,
policies, memoranda, and circulars
3. Organizes work force, resources,
equipments, and supplies at local level
4. Provides technical and administrative
support to Rural Health Midwives (RHM)
5. Conducts regular supervisory visits and
meetings to different RHMs and gives
feedback on accomplishments

 Community Organizer
1. Motivates and enhances
community participation in
terms of planning, organizing,
implementing, and evaluating
health services
2. Initiates and participates in
community development
activities

 Coordinator of Services
1. Coordinates with individuals, families,
and groups for health related services
provided by various members of the
health team
2. Coordinates nursing program with
other health programs like
environmental sanitation, health
education, dental health, and mental
health

 Trainer/Health Educator
1. Identifies and interprets training needs
of the RHMs, Barangay Health Workers
(BHW), and hilots
2. Conducts training for RHMs and hilots
on promotion and disease prevention
3. Conducts pre and post-consultation
conferences for clinic clients; acts as a
resource speaker on health and healthrelated services
4. Initiates the use of tri-media (radio/TV,
cinema plugs, and print ads) for health
education purposes
5. Conducts pre-marital counseling

 Health Monitor
1. Detects deviation from health
of individuals, families,
groups, and communities
through contacts/visits with
them

 Role Model
1.Provides good
example of healthful
living to the
members of the
community

 Change Agent
1. Motivates changes in health
behavior in individuals,
families, groups, and
communities that also
include lifestyle in order to
promote and maintain health

 Recorder/Reporter/Statistician
1. Prepares and submits required
reports and records
2. Maintain adequate, accurate, and
complete recording and reporting
3. Reviews, validates, consolidates,
analyzes, and interprets all records
and reports
4. Prepares statistical data/chart and other
data presentation

 Researcher
1. Participates in the conduct of
survey studies and researches on
nursing and health-related
subjects
2. Coordinates with government and
non-government organization in
the implementation of
studies/research

Community Organizing

a.
b.
c.

Approaches to community devt.:

Welfare approach
Technological approach
Transformatory approah

Community Organizing
Principles of CO:
1. People esp. the oppressed, exploited and
deprived sectors are most open to change, have
the capacity to change and are able to bring
about change. Hence , CO is based on the ff:
A. Power must reside in the people
B. Devt. is from the people to the people
C. People participation

Principles of CO
2.-must be based on the poorest sectors
of society. The solutions of problems
commonly shared by these sectors must
be focused on collective organizations,
planning and action
3. should lead to self-reliant
communities

THE HRDP-COPAR
PROCESS
1. PRE-ENTRY PHASE
2. ENNTRY PHASE
3. COMMUNITY STUDY/DIAGNOSIS
PHASE/RESEARCH PHASE
4.COMMUNITY ORGANIZATION AND
CAPABILITY-BUILDING PHASE
5. COMMUNITY ACTION PHASE
6. SUSTENANCE AND STRENGTHENING
PHASE

Classify the ff. CO

activities as to phase of
COPAR
each
belong:
1.Conducts community meetings to draw up

guidelines for the organization of CHO

2. Trains BHWs
3. Sets up of linkages/network and referral systems
4. PIME of health services and or community devt.
Projects
5. Provides continuing education to leaders or
residents
6. Trains secondary leaders
7. Selects site for adoption
8. Identifies key leaders

Continued.
9. Develops criteria for site selection
10. Forms the core group
11.Conducts SALT
12.Selects members of the research team
13. Assists the research team in presenting results
during the general assembly
14. Helps the people identifying the community
needs and health problems
15. Facilitates for the formulation and ratification of
the constitution and by-laws of the organization

Public Health Programs

COMPREHENSIVE
MATERNAL AND CHILD
HEALTH PROGRAM
1. EPI (Expanded Program on
Immunization)
2. CDD (Control of Diarrheal
Diseases)
3. CARI
(Control
of
Acute
Respiratory Infections)
4. UFC (Under-Five Clinics)
5. MC (Maternal Care)

6. BF (Breastfeeding)
7. MRP (Malnutrition Rehabilitation
Program)
8. VAD ( Vitamin A Deficiency)
9. IDD/IDA
(Iodine
Deficiency
Disorders/
Iron
Deficiency
Anemia)
10.FP (Family Planning)

EPI (EXPANDED PROGRAM ON

IMMUNIZATION)
TARGET SETTING:
1.INFANTS 0-12 MONTHS
2.PREGNANT AND POST PARTUM WOMEN
3.SCHOOL ENTRANTS/ GRADE 1 / 7 YEARS
OLD
OBJECTIVES OF EPI:
TO
REDUCE
MORBIDITY
AND
MORTALITY RATES AMONG INFANTS AND
CHILDREN
from
SIX
CHILDHOOD
IMMUNIZABLE DISEASE

 ELEMENTS OF EPI:
1. TARGET SETTING
2. COLDCHAIN LOGISTIC MANAGEMENTVaccine distribution through cold chain is
designed to ensure that the vaccine were
maintained under proper environmental
condition until the time of administration.
3. IEC
4. Assessment and evaluation of Over-all
performance of the program
5. Surveillance and research studies

EXPANDED PROGRAM ON
IMMUNIZATION

Vaccine Minimum
Age of 1st
Dose
1. BCG
(Bacillus
Calmette
Guerin)

Birth or
anytime
after
birth
School
entrants

Number
of
Doses
1

Minimum Reason
Interval
Between
Doses
BCG is given
at the earliest
possible age
protects
against the
possibility of
TB infection
from the other
family
members

2. DPT
(Diphtheria
Pertusis
Tetanus)

6 weeks

4 weeks An early start with

3. OPV
(Oral Polio
Vaccine)

6 weeks

4 weeks The extent of

4.
Hepatitis B

6 weeks

4 weeks

5. Measles

9 months

DPT reduces the

chance of severe
pertussis
protection against
polio is increased
the earlier OPV is
given.
An early start of
Hepatitis B reduces
the chance of being
infected and becoming
a carrier.
At least 85% of measles
can be prevented by
immunization at this age.

TETANUS TOXOID IMMUNIZATION

SCHEDULE FOR WOMEN
Vaccin
e

TT1

Minimum Age
Interval
As early as possible
during pregnancy

Percent
Protecte
d
80%

Duration of
Protection

TT2

At least 4
weeks later

80%

Infants born to
the mother will be
protected
from neonatal
tetanus.
Gives 3 years
protection for
the mother from
tetanus.

TT3

At least 6
months
later

90%

Infants born to the

mother will be protected
from neonatal
tetanus.
Gives 5 years protection
for the mother.

TT4

At least
year later

1 99%

Gives 10
protection
for
the
mother

TT5

At least 1 year
later

99%

Dose:0.5ml
Route: Intramuscularly
Site: Right or Left

Gives

lifetime
protection for
the mother.
All infants
born to that
mother
will be
protected.

 UNDER FIVE CLINIC

The first five years of life form the
foundations of the childs physical and mental
growth and development. Studies have shown
the mortality and morbidity are high among this
age group. The Department of Health
established the Under Five Clinic Program to
address this problem.

 PROGRAM OBJECTIVES AND GOALS:

Monitor growth and development of the
child until 5 years of age.
Identify factors that may hinder the growth
and development of the child.

 ACTIVITIES AND STRATEGIES:

Regular height and weight determination/
monitoring until 5 years old.
0-1 year old=monthly
1 year old and above =quarterly
2.
Recording
of
immunization,
vitamins
supplementation,
deworming and feeding.
3. Provision of IEC materials (ex. Posters, charts,
toys) that promote and enhance childs proper
growth and development.
4. Provision of a safe and learning oriented
environment for the child.
5. Monitoring and Evaluation.
1.

 BREASTFEEDING/ LACTATION MANAGEMENT

EDUCATION TRAINING
Breastfeeding practices has been proved to be
very beneficial to both mother and baby thus the
creation of the following laws support the full
implementation of this program:
Executive Order 51
Republic Act 7600
The Rooming-In and Breastfeeding Act of 1992

 PROGRAM
OBJECTIVES
AND
GOALS:
=Protection
and
promotion
of
breastfeeding
and
lactation
management education training

ACTIVITIES AND STRATEGIES:

1.FULL IMPLEMENTATION OF LAWS
SUPPORTING THE PROGRAM
A. EO 51 THE MILK CODE protection and
promotion of breastfeeding to ensure the safe
and adequate nutrition of infants through
regulation of marketing of infant foods and
related products.
(e.g. breast milk
substitutes, infant formulas, feeding bottles,
teats etc. )

B. RA 7600 THE ROOMING IN and

BREASTFEEDING ACT of 1992
=An act providing incentives to government
and private health institutions promoting
and practicing rooming-in and breastfeeding.
=Provision for human milk bank.
=Information, education and re-education drive
=Sanction and Regulation

2.
CONDUCT ORIENTATION/ADVOCACY
MEETINGS TO HOSPITAL/ COMMUNITY.
ADVANTAGES OF BREASTFEEDING:
MOTHER

Oxytocin help the uterus contracts

Uterine involution

Reduce incidence of Breast Cancer

Promote Maternal-Infant Bonding

Form of Family planning Method

(Lactational Amenorrhea)

BABY
Provides Antibodies
Contains Lactoferin (binds with
Iron)
Leukocytes

Contains
Bifidus
factorpromotes growth of the Lactobacillusinhibits the growth of pathogenic
bacilli

POSITIONS IN BF THE BABY:

1. Cradle Hold = head and neck are supported
2. Football Hold
3. Side Lying Position
BEST FOR BABIES
REDUCE INCIDENCE OF ALLERGENS
ECONOMICAL
ANTIBODIES PRESENT
STOOL INOFFENSIVE (GOLDEN YELLOW)
EMPERATURE ALWAYS IDEAL
FRESH MILK NEVER GOES OFF
EMOTIONALLY BONDING
EASY ONCE ESTABLISHED
DIGESTED EASILY
IMMEDIATELY AVAILABLE
NUTRITIONALLY OPTIMAL
GASTROENTERITIS GREATLY REDUCED

 GARANTISADONG PAMBATA (GP)

Garantisadong Pambata is a biannual week long
delivery of a package of health services to children
between the ages of 0-59 months old with the purpose
of reducing morbidity and mortality among under fives
through the promotion of positive Filipino values for
proper child growth and development.
1.

WHAT ARE THE HEALTH SERVICES OFFERED

IN GP AND WHO ARE THE TARGETS?
GP offers the following:
1.1 Routine Health Services:

Health
Service

Dosage

Route of
Target
Administr Population
ation

Vitamin A 200,000 IU Orally by

or 1 capsule drops
capsule
100,000 IU
or cap or
3 drops

12-59
months
old,
nationwide
9-12 month
old infants
receiving
AMV
nationwide

Ferrous
Sulfate
(25
mg.
Elemental
Iron per ml;
30 ml. Bottle
as
taken
home
medicine
with
instructions)

0.3ml(2-6
mos)
once a day
0.6ml(611mos) once
a day

Orally
by
drops

2-11 months old

infants
in
Mindanao
area,
including
evacuation
centers in armed
conflict areas.

Routine
Immunizat
ion
-BCG*
-DPT*
-OPV*
-AMV*
-Hepa B (if
available)

Nationwide

0.05ml
0.5ml
2 drops
0.5ml
0.5ml

Intradermal on right
deltoid
Intramuscularly on
anterior thigh
Orally
Subcutaneously on
deltoid
Intramuscularly

0-11 mos

0-11 mos
0-11 mos
9-11 mos
0-11 mos

Deworming
drug
(if available)
1 tablet Orally
as
single
dose
Weighing

36-59 mos,
nationwide

0-59 mos,
nationwide

 * The child should not have received

megadose of Vit. A above the
recommended dosage within the past 4
weeks except if the child has measles or
signs and symptoms of Vit A. deficiency.
** For any child between 12-23 months,
who missed any of his routine
immunization, the health worker should
give the child the necessary antigen to
complete FIC and shall be recorded as
such.

GARANTISADONG PAMBATA
Sangkap Pinoy

- Vitamin A, Iron and Iodine

-Sources: green leafy and yellow
vegetables, fruits, liver, seafoods, iodized
salt, pan de bida and other fortified
foods.
These micronutrients are not produced
by the body, and must be taken in the
food we eat; essential in the normal
process of growth and development:

a)
b)
c)

Helps the body to regulate itself

Necessary in energy metabolism
Vital in brain cell formation and mental
development
d) Necessary in the body immune system to protect
the body from severe infection.
e) Eating Sangkap Pinoy-rich foods can prevent and
control:
1.
Protein Energy Malnutrition
2.
Vitamin A Deficiency
3.
Iron Deficiency Anemia
4.
Iodine Deficiency Disorder

 BREASTFEEDING
Breast milk is best for babies up to 2
years old. Exclusive breastfeeding is
recommended for the first six months of
life. At about six months, give carefully
selected nutritious foods as supplements.
Breastfeeding provides physical and
psychological benefits for children and
mothers as well as economic benefits for
families and societies.

BENEFITS :
For infants
a.Provides a nutritional complete food for
the young infant.
b.Strengthens the infants immune system,
preventing many infections.
c.Safely rehydrates and provides essential
nutrients to a sick child, especially to
those suffering from diarrheal diseases.
d.Reduces the infants exposure to
infection.

 For the Mother

e. Reduces a womans risk of excessive blood
loss after birth
f. Provides a natural method of delaying
pregnancies.
g. Reduces the risk of ovarian and breast cancers
and osteoporosis.
For the Family and Community
h. Conserves funds that otherwise would be spent
on breast milk substitute, supplies and fuel to
prepare them.
i. Saves medical costs to families and
governments by preventing illnesses and by
providing immediate postpartum contraception.

COMPLEMENTARY FEEDING FOR BABIES 6-11

MONTHS OLD
What are Complementary Foods?

a.foods introduced to the child at the age

6 months to supplement breastmilk
a.given progressively until the child is used to
three meals and in-between feedings at the age
of one year.
Why is there a Need to Give Complementary
Foods?

c. breastmilk can be a single source of

nourishment from birth up to six months of life.

c. The childs demands for food increases as he

grows older and breastmilk alone is not
enough to meet his increased nutritional
needs for rapid growth and development
d. Breastmilk should be supplemented with other
foods so that the child can get additional
nutrients
e. Introduction of complementary foods will
accustom him to new foods that will also
provide additional nutrients to make him grow
well
f. Breastfeeding, however, should continue for
as long as the mother is able and has milk
which could be as long as two years

 How to Give Complementary Foods for

Babies 6-11 Months Old?
a.Prepare mixture of thick lugao/ cooked rice, soft
cooked vegetables. Egg yolk, mashed beans,
flaked fish/chicken/ground meat and oil.
b.Give mixture by teaspoons 2-4 times daily,
increasing the amount of teaspoons and
number of feeding until the full recommended
amount is consumed
c. Give bite-sized fruit separately
d.Give egg alone or combine with above food
mixture

FAMILY PLANNING
The Philippine Family Planning Program is a
national program that systematically provides
information and services needed by women of
reproductive age to plan their families according to
their own beliefs and circumstances.
GOALS AND OBJECTIVES:
Universal access to family planning information,
education and services.
MISSION:
To provide the means and opportunities by which
married couples of reproductive age desirous of
spacing and limiting their pregnancies can realize their
reproductive goals.

TYPES OF METHODS:

A. NATURAL METHODS
1.
Calendar or Rhythm Method
2.
3.
4.
5.

Basal Body Temperature Method

Cervical Mucus Method
Sympto-Thermal Method
Lactational Amennorhea

B. ARTIFICIAL METHODS
I. CHEMICAL METHODS
1.Ovulation suppressant such as PILLS
2. Depo-Provera
3. Spermicidals
4. Implant

II. MECHANICAL METHODS

1.
2.
3.

Male and Female Condom

Intrauterine Device
Cervical Cap/Diaphragm

III. SURGICAL METHODS

1.
Vasectomy
2. Tubal Ligation

WARNING SIGNS
Pills
Abdominal pain ( severe)
Chest pain ( severe)
Headache ( severe)
Eye problems ( blurred vision, flashing
lights, blindness)
Severe leg pain ( calf or thigh )
Others: depression, jaundice, breast lumps

WARNING SIGNS
IUD
*Period late, no symptoms of pregnancy,
abnormal bleeding or spotting
*Abdominal pain during intercourse
*Infection or abnormal vaginal discharge
*Not feeling well, has fever or chills
*String is missing or has become shorter or
longer

WARNING SIGNS

INJECTABLES
Dizziness
Severe headache
Heavy bleeding

WARNING SIGNS
BTL
Fever
Weakness
Rapid pulse
Persistent abdominal pain
Vomiting
Dizziness
Pus or tenderness at incision site
Amenorrhea

WARNING SIGNS
Vasectomy
Fever
Scrotal blood clots or excessive swelling

Nutrition
Goal
To improve the nutritional status,
productivity and quality of life of
the population thru adoption of
desirable dietary practices and
healthy lifestyle

 Objectives
Increase food and dietary energy
intake of the average Filipino
Prevent nutritional deficiency
diseases and nutrition-related
chronic degenerative diseases
Promote a healthy well-balanced
diet
Promote food safety

Nutrition is a state of well-being achieved by

eating the right food in every meal and the
proper utilization of the nutrients by the body.
Proper nutrition is important because :
it helps in the development of the brain, especially
during the first years of the childs life.
It speeds up the growth and development of the body
including the formation of teeth and bones
It helps fight infection and diseases
It speeds up the recovery of a sick person
It makes people happy and productive
Proper nutrition is eating a balanced diet in every meal

Balanced diet is made up of a

combination of the 3 basic
groups eaten in correct amounts.
The grouping serves as a guide
in
selecting
and
planning
everyday meals for the family.

THE THREE (3) BASIC FOOD GROUPS ARE:

1.
Body building food which are rich in
protein and needed by the body for:
< normal growth and repair of worn-out body
tissues
< supplying additional energy
< fighting infections
< Examples of protein-rich food are:
fish;
pork; chicken; beef; cheese; butter; kidney
beans; mongo; peanuts; bean curd; shrimp;
clams

 2. Energy-giving food which are rich in

carbohydrates and fats and needed by the
body for:
< providing enough energy to make the body
strong
< Examples of energy-giving food are: rice;
corn; bread; cassava; sweet potato;
banana; sugar cane; honey; lard; cooking
oil; coconut milk; margarine; butter

 3. Body-regulating food which are rich in

Vitamins and minerals and needed by the
body for:
< normal development of the eyes, skin,
hair, bones, and teeth
< increased protection against diseases
< Examples of body-regulating food are:
tisa; ripe papaya; mango; guava; yellow
corn; banana; orange; squash; carrot

Low Fat Tips

1. Eat at least 3 meals/day
2. Eat more fruits, vegetables, grain and
cereals e.g. rice, noodles and potato
3. If you use butter or margarine, pat it on
thinly
4. Choose low fat substitute i.e. replace
whole milk with skimmed milk, low fat
cheese
5. Become a label reader. Look for foods that
have less than 5 g /100 g of product

6. Eat less high fat snacks and take away

potato chips, sausage rolls or breaded
meats
7. Cut all visible fat from meat, remove skin
from chicken fat drippings and cream
sauces
8. Aim for thin palm-size serving of lean
meat, poultry and fish/ meal
9. Grill, bake, steam, stew, stir fry and
microwave, try not to fry
10. Drink lots of water all day- its a food
quencher

Ambulate

Start by walking for 10 min.

Build up to 30-40 min/day
Go for 3-4 times / week of any exercise
you enjoy

Filipino Food Pyramid

Drink a lot- water, clear broth
Eat most rice, root crops, corn,
noodles, bread and cereals
Eat more vegetables, green salads,
fruits or juices
Eat some fish, poultry, dry beans, nuts,
eggs, lean meats, low fat dairy
Eat a little fats, oils, sugar, salt

IMPORTANT VITAMINS AND

MINERALS

VITAMINS
Vitamin A

FUNCTIONS
Maintain normal vision, skin
health, bone and tooth
growth reproduction and
immune function; prevents
xerophthalmia.
Food sources:
Breastmilk;poultry;eggs; liver;
meat;carrots;squash;
papaya;mango;tiesa;
malunggay;kangkong;
camotetops; ampalaya tops

Thiamine

Help release
energy from
nutrients; support
normal appetite
and nerve
function, prevent
beri-beri.

Riboflavin

Helps release energy from

nutrients, support skin health,
prevent deficiency manifested by
cracks and redness at corners of
mouth; inflammation of the tongue
and dermatitis.

Niacin

Help release energy from nutrients;

support skin, nervous and digestive
system, prevents pellagra.

Biotin

Help energy and

amino acid
metabolism; help in
the synthesis of fat
glycogen.

Pantothenic Help in energy

metabolism.

Folic acid

Help in the formation of DNA

and new blood cells including
red blood cells; prevent anemia
and some amino acids.

Vitamin B
12

Help in the formation of the new

cells; maintain nerve cells,
assist in the metabolism of fatty
acids and amino acids.

Vitamin C

Help in the formation of protein,

collagen, bone, teeth cartilage,
skin and scar tissue; facilitate in
the absorption of iron from the
gastrointestinal tract; involve in
amino acid metabolism; increase
resistance to infection, prevent
scurvy.
Food sources:
Guava;pomelo;lemon;orange;
calamansi; tomato; cashew

Vitamin D

Help in the
mineralization of
bones by enhancing
absorption of
calcium.

Vitamin E

Strong anti-oxidant; help prevent

arteriosclerosis; protect neuromuscular system; important for
normal immune function.

Vitamin K

Involve in the synthesis of blood

clotting proteins and a bone
protein that regulates blood
calcium level.

MINERALS

FUNCTIONS

Calcium

Mineralization of bones and teeth, regulator

of many of the bodys biochemical
processes, involve in blood clotting, muscle
contraction and relaxation, nerve
functioning, blood pressure and immune
defenses.

Chloride

Maintain normal fluid and electrolyte

balance.

Chromium

Work with insulin and is

required for release of energy
from glucose.

Copper

Necessary for absorption and

use of iron in the formation of
hemoglobin.

Fluoride

Involve in the formation of bones

and teeth; prevents tooth decay.

Iodine

As part of the two thyroid hormones,

iodine regulates growth, physical and
mental development and metabolic
rate.
Aids in the development of the brain and
body especially in unborn babies
Food sources:
Seaweeds;squids;shrimps;crabs;
fermented
shrimp;mussels;snails;
dried dilis; fish

Iron

Essential in the formation of blood. It

is involved in the transport and
storage of oxygen in the blood and
is a co-factor bound to several
non-hemo enzymes required for
the proper functioning of cells.
Food sources:
Pork; beef; chicken; liver and other
internal organs; dried dilis; shrimp;
eggs; pechay; saluyot; alugbati

Magnesium

Mineralization of
bones and teeth,
building of proteins,
normal muscle
contraction, nerve
impulse transmission,
maintenance of teeth
and functioning of
immune system.

Manganese

Facilitate many cell

processes.

Molybdenum Facilitate many cell

processes.

Phosphorus Mineralization of bones

and teeth; part of every
Cell; used in energy
transfer and
maintenance of acidbase balance.
Selenium

Work with vitamin E to

protect body compound
from oxidation.

Selenium Work with vitamin E to

protect body compound
from oxidation.

Sodium

Maintain normal fluid and

electrolyte balance,
assists nerve impulse
insulin.

Sulfur

Integral part of vitamins,

biotin and thiamine as well
as the hormone.

Zinc

Essential for normal

growth, development
reproduction and
immunity.

MALNUTRITION
MALNUTRITION
An abnormal condition of the body
resulting from the lack or excess
of one or more nutrients like
protein, carbohydrates, fats,
vitamins and minerals.

PRIMARY CAUSE:
POVERTY

1. Lack of money to buy food

Majority of the victims of malnutrition comes
from families of farmers, fisherfolk, and
laborers who cannot afford to buy nutritious
foods.
2. Lack of food supply
3. Lack of information on proper nutrition and
food values

SECONDARY CAUSES
1. Early weaning of child and improper
introduction of supplementary food
2. Incomplete immunization of babies and
children
3. Bad eating habits
4. Poor hygiene and environmental sanitation:
a.
b.
c.

lack of potable water

lack of sanitary toilet
poor waste disposal

FORMS OF MALNUTRTION
1. Protein-Energy Malnutrition (PEM) is
a nutritional problem resulting from a
prolonged inadequate intake of bodybuilding and/or energy-giving food in
the diet.
Kinds:
a.)MARASMUS
b.) KWASHIORKOR

a) MARASMUS
This child does not get the right amount
and kind of energy food. She/He:
< is always hungry
< has the face of an old man
< is very thin
< easily gets sick
< looks weak
THIS CHILD IS JUST SKIN AND BONES!

b) KWASHIORKOR
This child does not get enough body-building food,
although she/he may be getting enough energy.
She/He:
< has swollen face, hands, and feet
< easily gets sick
< has dry, thin, pale hair
< has sores on the skin
< has thin upper arms
< looks sad
< has dry skin
< is underweight
THIS CHILD IS SKIN, BONES, AND WATER!

CHECKING THE NUTRITIONAL STATUS

WEIGHT
1.1
Weight is a very important indicator of a
persons nutritional status. It is measured in relation
to either AGE or HEIGHT. Normally, a wellnourished child gains weight as she/he grows older.
1.2
On the other hand, a malnourished child
either decreases in weight or maintains his/her
previous weight.
1.3
The nutritional status of a person can also be
checked by looking for specific signs and symptoms
of the different forms of nutritional deficiencies.

 IMPORTANT:
1.1Weigh the child in minimal clothing, with
no shoes, clogs or slippers on; and hands
and pockets free of objects.
1.2The same type of scale should be used
for subsequent weighing.
1.3Observe the proper maintenance of the
weighing scale.
1.4Do not use a bathroom scale to avoid
inaccurate readings of weight.

< BRING THE MALNOURISHED CHILD

TOGETHER WITH THE PARENTS TO THE
HEALTH CENTER FOR PROPER
NUTRITIONAL ADVICE AND TREATMENT.
< VISIT THE MALNOURISHED CHILD
REGULARLY AND MONITOR HIS/HER
WEIGHT.
< ADVISE PARENTS AND THE WHOLE
COMMUNITY ABOUT BETTER NUTRITION
AND PROPER FEEDING ESPECIALLY OF
INFANTS, CHILDREN AND SICK PERSONS.

NUTRITIONAL GUIDELINES

1. Eat a variety of food everyday.

2. Breastfeed infants exclusively from birth to 46 months, and then, give appropriate foods
while continuing breastfeeding.
3. Maintain childrens normal growth through
proper diet and monitor their growth regularly.
4. Consume fish, lean meat, poultry or dried
beans.
5. Eat more vegetables, fruits, and root crops.
6. Eat foods cooked in edible/cooking oil daily.

7. Consume milk, milk products or other

calcium-rich foods such as small fish and dark
green leafy vegetables everyday. Use iodized
salt, but avoid excessive intake of salty foods.
8. Use iodized salt, avoid excessive intake of
salty foods
9. Eat clean and safe food.
10. For a healthy lifestyle and good nutrition,
exercise regularly, do not smoke, avoid
drinking alcoholic beverages.

AIMS AND RATIONALE OF EACH OF THE

GUIDELINES
Guideline No. 1 is intended to give the
message that no single food provides all
the nutrients the body needs. Choosing
different kinds of foods from all food
groups is the first step to obtain a wellbalanced diet. This will help correct the
common practice of confining of choice to
a few kinds of foods, resulting in an
unbalanced diet.

Guidelines No.2 is entitled to promote exclusive

breastfeeding from birth to 4-6 months and to
encourage the continuance of breastfeeding for as
long as two years or longer. This is to ensure a
complete and safe food for the newborn and the
growing infant besides imparting the other benefits
of breastfeeding. The guideline also strongly
advocates the giving of appropriate complementary
food in addition to breast milk once the infant is
ready for solid foods at 6 months. Malnutrition
most commonly occurs between the age of 6
months to 2 years, therefore there is a need to pay
close attention to feeding the child properly during
this very critical period.

Guideline No. 3 gives advise on

proper feeding of children. In
addition, the guideline promotes
regular weighing to monitor the
growth of children, as it is a simple
way to assess nutritional status.

Guidelines No. 4,5,6 and 7 are intended to correct

the deficiencies in the current dietary pattern of

Filipinos. Including fish, lean meat, poultry and dried
beans, which will provide good quality protein and
dietary energy, as well as iron and zinc, key nutrients
lacking in the diet of Filipinos as a whole. Eating more
vegetables, fruits and root crops will supply the much
needed vitamins, minerals and dietary fiber that are
deficient in our diet. In addition, they provide defense
against chronic degenerative diseases. Including
foods cooked in edible oils will provide additional
dietary energy as a partial remedy to calorie deficiency
of the average Filipino. Including milk and other
calcium-rich foods in the diet will serve to supply not
only calcium for healthy bones but to provide high
quality protein and other nutrients for growth.

Guideline No. 8 promotes the use of

iodized salt to prevent iodine

deficiency, which is a major cause of
mental and physical
underdevelopment in the country. At
the same time, the guideline warns
against excessive intake of salty
foods as a hedge against
hypertension, particularly among
high-risk individuals.

Guideline No.9 is intended

to prevent food-borne
diseases. It explains the
various sources of
contamination of our food
and simple ways to prevent it
from occurring.

Finally, Guideline No. 10 promotes

a healthy lifestyle through regular
exercise, abstinence from smoking
and avoiding consumption. If
alcohol is consumed, it must be
done in moderation. All these
lifestyle practices are directly or
indirectly related to good nutrition.

NUTRIENTS IN FOOD
Nutrients are chemical substances present in
the foods that keep the body healthy, supply
materials for growth and repair of tissues, and
provide energy for work and physical activities.
The major nutrients include the
macronutrients, namely; proteins,
carbohydrates and fats; the micronutrients,
namely vitamins such as A, D, E and K, the B
complex vitamins and C and minerals such as
calcium, iron, iodine, zinc, fluoride and water.

Reproductive Health
- a state of complete physical,
mental and social well-being and not
merely the absence of disease/
infirmity in all matters relating to the
reproductive system and to its
functions and processes.

 Basic RH Rights
Right to RH information and health care
services for safe pregnancy and childbirth
Right to know different means of
regulating fertility to preserve health and
where to obtain them
Freedom to decide the number and timing
of birth of children
Right to exercise satisfying sex life

 Factors/ determinants of RH
Socioeconomic conditions education,
employment, poverty, nutrition, living
condition/ environment, family environment
Status of women equal right in education
and in making decisions about her own RH;
right to be free from torture and ill treatment
and to participate in politics
Social and Gender Issues
Biological (individual knowledge of
reproductive organs and their functions),
cultural (countrys norms, RH practices)
and psychosocial factors

 Elements
Maternal and Child Health Nutrition
Family Planning
Prevention and Management of Abortion
Complications
Prevention and Treatment of
Reproductive Tract Infections, including
STDs, HIV and AIDS
Education and Counseling on Sexuality
and Sexual Health

 Elements
Breast and Reproductive Tract Cancers
and other Gynecological Conditions
Mens Reproductive Health
Adolescent Reproductive Health
Violence Against Women
Prevention and Treatment of Infertility and
Sexual Disorders

 Selected Concepts
RH is the exercise of reproductive right with
responsibility
It means safe pregnancy and delivery, the right of
access to appropriate health information and
services
It includes protection from unwanted pregnancy
by having access to safe and acceptable methods
of family planning of their choice
It includes protection from harmful reproductive
practices and violence
It ensure sexual health for the purpose of
enhancement of life and personal relations and
assures access to information on sexuality to
achieve sexual enjoyment

 Goal
To achieve healthy sexual
development and maturation
To achieve their reproductive
intention
To avoid diseases, injuries and
disabilities related to sexuality and
reproduction
To receive appropriate counseling
and care of RH problems

 Strategies
Increase and improve the use of more effective or
modern contraceptive methods
Provision of care, treatment and rehabilitation for
RH
RH care provision should be focused on
adolescents, men and unmarried and other
displaced people with RH problems
Strengthen outreach activities and referral system
Prevent specific RH problems through
information dissemination and counseling of
clients

HEALTH AND SANITATION

Environmental Sanitation is still a health
problem in the country.
Diarrheal diseases ranked second in the
leading causes of morbidity among the
general population.
Other sanitation related diseases :
tuberculosis, intestinal parasitism,
schistossomiasis, malaria, infectious
hepatitis, filariasis and dengue hemorrhagic
fever

DOH thru Environmental Health Services

(EHS)
unit is authorized to act on all issues and
concerns
in environment and health including the very
comprehensive Sanitation Code of the
Philippines (PD 856, 1978).

WATER SUPPLY SANITATION

PROGRAM
EHS sets policies on:
Approved types of water facilities
Unapproved type of water facility
Access to safe and potable drinking
water
Water quality and monitoring surveillance
Waterworks/Water system and well
construction

Approved type of water

facilities
Level 1 (Point Source)- a protected well or
a developed spring with an outlet but
without a distribution system
indicated for rural areas;
serves 15-25 households; its outreach is
not more than 250 m from the farthest
user
yields 40-140 L/ min

Level II ( Communal Faucet

or Stand Posts)
With a source, reservoir, piped distribution
network and communal faucets
Located at not more than 25 m from the
farthest house
Delivers 40-80 L of water per capital per
day to an average of 100 households
Fit for rural areas where houses are
densely clustered

Level III ( Individual House

Connections or Waterworks
System)
With a source, reservoir, piped distributor
network and household taps
Fit for densely populated urban
communities
Requires minimum treatment or
disinfection

ENVIRONMENTAL SANITATION
- the study of all factors in mans
physical environment, which may
exercise a deleterious effect on his
health, well-being and survival.

Includes:
1.1 Water sanitation
1.2 Food sanitation
1.3 Refuse and garbage disposal
1.4 Excreta disposal
1.5 Insect vector and rodent control
1.6 Housing
1.7 Air pollution
1.8 Noise
1.9 Radiological Protection
1.10 Institutional sanitation
1.11 Stream pollution

PROPER EXCRETA AND SEWAGE DISPOSAL

PROGRAM
EHS sets policies on:
Approved types of toilet facilities :
LEVEL I
Non-water carriage toilet facility no water
necessary to wash the waste into receiving space e.g.pit
latrines, reed odorless earth closet.
Toilet facilities requiring small amount of water to
wash the waste into the receiving space e.g. pour flush toilet &
aqua privies

LEVEL II on site toilet

facilities of the water carriage
type with water-sealed and
flush type with septic
vault/tank disposal.

LEVEL III water carriage types of toilet facilities

connected to septic tanks and/or to sewerage
system to treatment plant.

FOOD SANITATION PROGRAM

-sets policy and practical programs to
prevent and control food-borne diseases to
alleviate the living conditions of the
population

HOSPITAL WASTE MANAGEMENT PROGRAM

Disposal of infectious, pathological and other

wastes from hospital which combine them with
the municipal or domestic wastes pose health
hazards to the people.
Hospitals shall dispose their hazardous wastes
thru incinerators or disinfectants to prevent
transmission of nosocomial diseases

PROGRAM ON HEALTH RISK MINIMIZATION DUE

TO ENVIRONMENTAL POLLUTION
Foci:
1. Prevention of serious environmental hazards
resulting from urban growth and industrialization
2. policies on health protection measures
3. researches on effects of GLOBAL WARMING to
health (depletion of the stratosphere ozone layer
which increases ultraviolet radiation, climate
change and other conditions)

NURSING RESPONSIBILITIES AND ACTIVITIES

Health Education IEC by conducting

community assemblies and bench conferences.
The Occupational Health Nurse, School Health
Nurse and other Nursing staff shall impart the
need for an effective and efficient
environmental sanitation in their places of work
and in school.

 Actively participate in the training component of

the service like in Food Handlers Class, and attend
training/workshops related to environmental health.

Assist in the deworming activities for the school

children and targeted groups.
Effectively and efficiently coordinate
programs/projects/activities with other government
and non-government agencies.
Act as an advocate or facilitator to families in the

community in matters of
program/projects/activities on environmental
health in coordination with other members of Rural
Health Unit (RHU) especially the Rural Sanitary
Inspectors.

 Actively participate in environmental

sanitation campaigns and projects in the
community. Ex. Sanitary toilet campaign
drive for proper garbage disposal,
beautification of home garden, parks
drainage and other projects.
Be a role model for others in the
community to emulate terms of cleanliness
in the home and surrounding.

 4. Prevention and Control of

Kidney Disease
5. Program on Mental Health and
Mental Disorders
6. Program on Drug
Dependence/ Substance Abuse

 7.Community-Based Rehabilitation Program

A creative application of the primary health care
approach in rehabilitation services, which involves
measures taken at the community level to use and
build on the resources of the community with the
community people, including impaired, disabled
and handicapped persons as well.
Goal: To improve the quality of life and increase
productivity of disabled, handicapped persons.
Aim: To reduce the prevalence of disability through
prevention, early detection and provision of
rehabilitation services at the community level.

 8. Program on the Elderly/Geriatric

Nursing Services
7 humanitarian issues: family, health,
income, security, employment and labor,
social welfare, education, recreation,
culltural activities and housing

Leading causes of
illness:elderly

Influenza, HPN, diarrhea,

bronchitis, TB, diseases. of the heart,
pneumonia, malaria,
malignant neoplasm, chickenpox

Leading causes of
death:elderly

Diseases of heart and vascular system

Pneumonia, TB, CCOPD
Malignant neoplasms
Diabetes
Nephritis
Accidents

 9. Programs on Blindness, Deafness and

Osteoporosis
Cataract- main causes of blindness
VAD- main cause of childhood blindness; most
serious eye problem of Fil. children below 6 yrs.
old
Osteoporosis special problem in women,
highest bet. 5079 yrs. old, MENOPAUSEmain cause

Prevention of NCD/Role of
Nursing in Health
Promotion And Advocacy

Yosi Kadiri- anti smoking

Edi Exercise/Hataw-regular physical
activity
Tiya Kulit/ Iwas Sakit Diet-low salt, low fat,
high fiber diet
Mag HL exercise, no smoking,
avoidance of alcohol, healthy diet, iwas
stress, watch wt.

Sentrong Sigla Movement ( SSM)

-a certification recognition program which
develops and promotes standards for
health facilities
- Joint effort bet.:
1.DOH provides technical and financial
assistance packages for health care
2. LGUs direct implementers of health
programs & prime developers of health
centers and hospitals making services
accessible to every Filipino

Pillars of SSM

1. Quality Assurance
2. Grant and Technical Assistance
3. Health Promotion
4. Awards

Expected Outcome: SSM

Empowered individuals adopting healthy
lifestyle, improved health-seeking
behavior and well-being & increased
demand for quality health services
Institutions will develop policies, provide
quality services , institute system for
surveillance/ merits and advocate for
laws

Programs: SSM
EPI
Disease Surveillance
CARI
CDD
Nutrition/ Micronutrient Supplementation*Food Fortification :
Rice iron; Oil and sugar Vit. A;
Flour-Vit. A & iron; Salt- iodine

Integrated Management of
Childhood Illness ( IMCI)
Integrates management of most common
childhood problems ( diarrhea,
pneumonia, measles, malnutrition, DHF,
malaria)
Involves family members and community
in the health care process for physical
growth and mental development &
disease prevention

 Programs on Measles.
Chickenpox, Mumps,
Diphtheria, Pertusis, Tetanus
focused on health
information campaigns and
intensive immunization of
children in barangays.

Other CHN Practice

Settings
I. Occupational Health
- the application of public health, medical and
engineering practice for the purpose of
conserving, restoring the health and
effectiveness of workers thru their places of
employment
A. Occupational Health Nursing
- the application of nursing principles and
procedures in providing health service to
employees in their place of work by means of:

 1. prompt and efficient nursing care of the

ill and impaired
2. participation in teaching health and
safety practices on the job
3. cooperation with plant department
administrators
4.keeping the health clinic and staff ready
to handle emergencies
5. advising workers in the utilization of
community and welfare services

Objectives of OHN
To assist, maintain and promote positive
health of laborers and employees thru
early detection and prevention of
occupational diseases and hazards of
industrial processes and by coordinating
and cooperating with activities of other
community health and welfare services

Nurses Role in OHN

1. Assists/participates in developing an adequate
health program for workers and laborers including
sound health education activities
2. Encourages periodic P.E.
3. Cooperates with occupational medical
programs in the prevention of accidents
as
well as in the promotion of good working
atmosphere and relationships in the place of work
4. Helps in teaching others in giving good nursing
care to the sick or handicapped in their own
homes

 II. School Health Nursing

School Health Triad :
1. SERVICE
2. EDUCATION
3. ENVIRONMENT

 Mission of School Health Program:

To maximize potential for learning and

participation in the educational process by
promoting optimum health of school-age
children and adolescents

 School Health Team:

Psychologist/ Counselor
Teacher
Nutritionist
Nurse
Social Workers
Maintenance Personnel

 Targets in SHN

Family
Students
Teachers
Supportive Personnel
Community

 School Health Nurses Roles:

EDUCATOR
CONSULTANT /RESEARCHER
STUDENT, FAMILY AND STAFF
ADVOCATE/CHANGE AGENT
HEALTH SCREENER
HEALTH CARE PROVIDER

 Common Health Concerns of

Schoolchildren:
1.Drug and Alcohol Abuse
2. STDs/STIs
3. Teenage Pregnancies
4. Mental Health
5. Dermatological Disorders- pimples/acne,
fungal infections, allergies
6. Respiratory Conditions- asthma, URTI
7. Nutrition
8. Dental Health

 There was a man who saw a scorpion

floundering around in the water.
He decided to save it by stretching out his
finger but the scorpion stung him.
The man still tried to get the scorpion out of
the water but the scorpion stung him again.
Another man nearby told him to stop saving
the scorpion but the man said, Its the nature
of the scorpion to sting. Its my nature to love,
why should I give up my nature to love just
because its the nature of the scorpion to
sting?