Community Health Nursing 2

(Family, Population Group and

Community as Clients)
NSG 122
 Grading System
Long Exams: 30%
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Quizzes/Individual & Group Activities

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Individual & Group Projects: 40%

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Requirements/Assignments: 20%
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Attendance/Class Participation: 10%

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 Classroom Policies
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Arriving within 15 minutes after the class has already started, a student is considered
late.
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Arriving beyond 15 minutes after the class has already started, a student is considered
absent.
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If a quiz is scheduled for that day, a considered absent student will not be allowed to
take that particular quiz(even if he/she attends the class), and there are no special
quizzes allowed.
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Any student who, for unavoidable cause is obliged to be absent from class, must obtain
an explanation letter signed by a parent or guardian and noted by the Dean.
Absence due to illness must be supported by a parent’s letter and a medical certificate
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within 3 days after absence.

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Projects and requirements must be submitted on or before the set deadline. After the
deadline, no requirements will be accepted.
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Use of mobile phones and other gadgets during class is strictly not allowed unless
stipulated by the instructor.
A student who is not wearing complete uniform will be considered absent.
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 Brief History Primary Health Care
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September 6-12, 1978- health leaders from around 200
countries attended the International Conference for Primary
Health Care held at Alma Ata, USSR initiated by the WHO and
United Nations Children’s Fund.
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Alma Ata Declaration on Primary Health Care made the
following declarations:
– Health is a basic fundamental right.
– There exists global burden of health inequalities among
populations.
– Economic and social development is of basic
importance for the full attainment of health for all.
– Governments have a responsibility for the health of their
people.

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The PHC strategy was later adopted in the
Philippines by virtue of Letter of Instruction(LOI)
949 0f 1979.
Philippines- the first country in Asia to embark on
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meeting the challenge of PHC.

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 What is Primary Health Care?
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Is essential health care based on practical,
scientifically sound and socially acceptable
methods and technology made universally
accessible to individuals and families in the
community through their full participation and at
cost that the community and country can afford to
maintain at every stage of their development in
the spirit of self-reliance and self-determination.

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 8 essential health services listed in
Alma Ata Declaration
E- Education for health
L- Locally endemic disease control
E- Expanded program for immunization
M- Maternal and child health including responsible
parenthood
E- Essential drugs
N- Nutrition
T- Treatment of CD and NCD
S- Safe water and Sanitation

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 Key Principles of Primary Health
Care
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4 As: Accessibility, affordability, acceptability and
availability
Support mechanisms
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Multisectoral approach
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Community participation
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Equitable distribution of health resources

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Appropriate technology
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 The 4As of PHC
1. Accessibility- refers to physical distance of a
health facility or the travel time required for people
to get the needed or desired health services.
*WHO guidelines states that facilities must be
within 30 minutes from the communities to be
considered accissible.
*Barangay Health Stations(BHSs)- are facilities
intended to provide accessible health services at
the community level.

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2. Affordability- a matter of wether the community
or the government can afford services, not only in
consideration of the individual and family’s
capacity to pay for basic health services.
*out-of-pocket expenses- one of the factors in
determining affordability of health care.

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3.Acceptability- means that the health care
offered is in consonance with the prevailing
culture and traditions of the population.

4.Availability- a question whether the basic health

services required by the people are offered in the
health care facilities or is provided on a regular
and organized manner.

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 Support Mechanisms
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Resources for essential health services come from
three major entities:
1.People themselves
2.Government
3.Private Sector

*Health programs and projects provide better

outputs when these three entities are
involved.

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 Multisectoral approach
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PHC requires communicatiion, cooperation, and
collaboration within among various sectors. This
is exeplified through intrasectoral and
intersectoral linkages.
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Intrasectoral linkages- refer to communication,
cooperation, and collaboration withing the health
sector: among members of the health team and
among health agencies.
Example: two-way referral system
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Intersectoral Linkages- encompass the
communication, cooperation, and collaboration
between the health sector and other sectors of
society like education, public works, agriculture, and
local government officials.
Example: Rabies Prevention and Control
Program- which requires collaborative effort
effort among the Department of Health(DOH),
Department of Agriculture(DA), Department of
Education(DepEd), and LGUs.

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 Community Participation
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It is an educational and empowering process in
which people, in partnership with those who are
able to assist them, identify the problems and
needs and increasingly assume responsibilities
themselves to plan, manage, control, and assess
the collective actions that are proved necessary.

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 Equitable distribution of health
resources
DOH Programs to ensure equitable distribution of
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manpower to the rural areas:

1.Doctor to the Barrios(DTTB) Program- deployment
of doctors to municipalities that are without doctors.
They manage Health Centers in unserved,
economically depressed municipalities.
2.Registered Nurses Health Enhancement and Local
Services(RN HEALS)- training and development
program for unemployed nurses; deployed to
unserved, economically depressed municipalities.
Update: Nurse Deployment Project(NDP) under
HRH

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 Appropriate Technology
Technology- “applied science”
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Health technology- includes tools, drugs,

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methods, procedures and techniques.

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Refers to the technology that is suitable to the
community that will use it. The terms “people’s
technology” and “indigenous technology” are also
used in reference to appropriate technology.

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Criteria for appropriate health technology
Safety
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– This means that the technology results in minimal risk to the user and that the intended positive outcomes of the use of technology
far outweigh its negative unintended negative effects.

Effectiveness
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– The technology should accomplish what is meant to accomplish.

Affordability
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– Measures for health promotion and disease prevention are cost effective in comparison to treatment of diseases.

Simplicity
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– The technology that requires readily available simple materials and that involves a simpler process in its use can be more easily
adopted by the people in the community

Acceptability
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– Technology is effective only when it is used by those who need it.

– Culture- an important consideration in determining the appropriateness of a technology.

Feasibility and reliability

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– Must be easy to apply considering the people’s natural settings

– Supplies must be constantly available

Ecological effects
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– Important consideration in choosing or rejecting a particular technology

Potential contribute to individual and community development

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– Appropriate technology promotes self-sufficiency on the part of those using it.

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 Primary Health Care Vs. Primary
Care
PHC
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– strategy for the delivery of health programs.

– Focus: community, family, and individual
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Primary Care
– refers to the first contact of a person with a
health professional
– Performed and managed by a personal
physician collaborating with other health
professionals and utilizing consultation or
referral as appropriate.

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 Differences between PHC and
Primary Care
Point of Comparison Primary Health Care Primary Care
Focus Client Family and community Individual
Focus of Care Promotive and preventive Curative, provided by health
through community professionals
participation
Decision-making process Community Health worker driven
centered/consultative-
participative
Outcome self-reliance/self-help Reliance on health
professionals to
restore/regain health
Setting for services Rural-based satellite clinics, Mostly urban-based:
community health centers, hospitals, clinics
health posts that are
accessible to all
Goal Development and preventive Absence of disease
care

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 Learning Activities
1.Choose a specific Public Health Program(PHC).
2.Identify its goals, objectives, and strategies for
implementation.
3.Analyze the program’s goals and objectives based on the
key principles of PHC:
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Accessibilty,affordability, acceptability, and
availability
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Support mechanisms
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Multisectoral approach
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Community participation
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Equitable distribution of health resources
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Appropriate technology

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