Introduction &

Overview of Public
Health Nursing in
The Philippines
Community • A group of people living in a
particular area with common
beliefs, values and traditions
(Nies et, Al)
• A collection of people who
interact with one and whose
common interests or
characteristics form the basis
for a sense of unity or belonging
(Allender et. Al)
PUBLIC HEALTH
• the science and art of 3 P’s:
• Preventing disease, Prolonging life, Promoting health and
efficiency through organized community effort for the:
✓ sanitation of the environment
✓ control of communicable disease
✓ education of individuals in personal hygiene
✓ the organization of medical and nursing services for the early
diagnosis and preventive treatment of disease
✓ the development of the social machinery to insure everyone a
standard of living adequate for the maintenance of health, so
organizing these benefits as to enable every citizen to realize his
birthright of health and longevity. (C.E. Winslow)
GOAL OF PUBLIC HEALTH

• “For people to attain

their birthrights of
health and longevity”
PUBLIC HEALTH NURSING
• first term used before CHN
• Field of professional practice in nursing
and in public health in which technical
nursing, interpersonal, analytical and
organization skills are applied to
problems of health as they affect the
community.
• Refers to the practice of nursing in
national and local government health
departments (which includes Health
Centers and RHU) and public schools
PUBLIC HEALTH NURSING
• It is community health nursing practiced in
the public sector
• “A 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)
 Community Health Nursing
• The utilization of the nursing process in
the different levels of clientele-
individuals, families, population groups
and communities, concerned with the
promotion of health, prevention of
disease and disability and rehabilitation
(Maglaya, et al)
Community Health Nursing
• Specialized field of nursing practice
that renders care to individuals,
families and communities; focusing
on health promotion and disease
prevention through people
empowerment (Nies et, Al)
• The synthesis of nursing practice
and public health practice applied to
promoting and preserving the health
of populations (ANA, 1980).
 Community Health Nursing
• Some definitions indicates CHN is
broader than PHN because it
encompasses “nursing practice in
a wide variety of community
services and consumer advocate
areas, and in variety of roles, at
times inducing independent
practice, CHN is certainly not
confined to PHN agencies.”
(Jacobson)
Health

• is a state of complete
physical, mental and
social well-being and
not merely the
absence of disease or
infirmity (WHO).
Classifications of a Community
1. Rural communities
2. Urban communities
3. Suburban or the
capitals
Characteristics of a Healthy Community
• Awareness that “we are community”
• Conservation of natural resources
• Recognition of and respect for the existence of
subgroups
• Participation of subgroups in community affairs
• Preparation to meet crises
• Ability to solve problems
• Communication through open channels
• Resources available to all
• Settling of disputes through legitimate mechanisms
• Participation by citizens in decision-making
• Wellness of a high degree among its members
Philosophy of
Community Health Nurse
• Based on the worth and
dignity of men.
• Philosophy of care is based
on the belief that care
directed to the individual,
the family, and the group
contributes to the
healthcare of the
population as a whole
Goals of Community Health Nurse

• To assist the individual, family and

community in attaining their highest
level of holistic health which is
attained through multidisciplinary
effort and to promote reciprocally
supportive relationship between
people and their physical and social
environment
 Principles of
Community Health Nursing
• Based on recognized needs of individuals,
families, groups and communities.
• Community Health Nurse must understand
fully the objectives and policies of the agency
she represents.
• The family is the unit of care
• Must be available to all regardless of race,
creed, and socioeconomic status
 Principles of
Community Health Nursing
• Community Health Nurse makes use of
available health resources
• There must be provision for educative
supervision
• Community Health Nurse utilizes the
already existing active organized groups in
the community.
• There should be accurate recording and
reporting
 Three Basic Concepts of Community
and Public Health Nursing
• Community as a client
• Health as a goal
• Nursing as the vehicle
or means to achieve its
aims.
Levels of Clientele in
Community Health Nursing
1. INDIVIDUAL
• Specific person / client in
various stages of health or
illness
2. FAMILY
• The Family -Group of people
affiliated by consanguinity,
affinity, or co-residence.
• Basic unit of society
Levels of Clientele in
Community Health Nursing
3. POPULATION GROUPS
• A group of people sharing the
same characteristics,
developmental stage or common
exposure to particular
environmental factors thus
resulting in common health
problems.
Levels of Clientele in
Community Health Nursing
• COMMUNITY
• Vulnerable groups or those at risk of
developing certain health or health
related problems.
• A broad term for fellowship or organized
society.
• A group of people sharing common
geographic boundaries and or
common values and interests
• The group which functions within a
particular socio-cultural context and
varying physical environment
Standards of Public Health Nursing
in the Philippines
Standard 1: Assessment
• collects comprehensive data
pertinent to the health status of
population
Standard 2: Population and Diagnosis
and Priorities
• analyses the assessment data to
determine the population diagnosis
and priorities.
Standard 3: Outcomes
Identification
• identifies expected
outcomes for a plan that is
based on population
diagnoses and priorities
• Standard 4: Planning
• develops a plan that reflects
best practices by identifying
strategies
• Standard 5: Implementation
• implements the identified plan by partnering with
others.
• Coordination- coordinates programs, services
and other activities to implement the identified
plan
• Health Education and Health Promotion-employs
multiple strategies to promote health, prevent
disease and ensure a safe environment for
population
• Consultation- provides consultation to various
community groups and officials to facilitate the
implementation of programs and services.
• Regulatory Activities- identifies, interprets, and
implements public health laws, regulations and
policies
• Standard 6: Evaluation
• evaluates the health status of the
population
• Standard 7: Quality of Practice
• systematically enhances the
quality and effectiveness of
nursing practice.
• Standard 8: Education
• attains knowledge and
competency that reflects current
nursing and public health
practice.
• Standard 9: Professional Practice Evaluation
• evaluates one’s nursing practice in relation to
professional practice standards and
guidelines, relevant, statutes, rules and
regulations

• Standard 10: Collegiality and Professional

Relationship
• Establishes collegial partnerships while
interacting with representatives of the
population, organizations, and health and
human services professionals and
contributes to the professional development
of peers, students, colleagues, and others.
• Standard 11: Collaboration-
• collaborates with the representatives
of the population, organizations, and
health and human services
professionals in providing for and
promoting the health of the
populations
• Standard 12: Ethics
• integrates ethical provisions in all
areas of practice.
• Standard 13: Research
• integrates research findings in
practice
• Standard 14: Resources Utilization
Population
• considers factors related to safety,
effectiveness, cost, and impact on
practice and in planning and
delivering of nursing and public
health programs, policies, and
services
• Standard 15: Leadership
• provides leadership in nursing and
public health
 Roles and
Responsibilities
of a Community
Health Nurse
Programmer/Planner
✓Identifies the needs and concerns of
individuals, groups, families, and the
community
✓Formulates health plans, especially in
the absence of a community
physician
✓Interprets and implements nursing
plans and programs
✓ Assists other health team members
in implementing health programs in
the setting
Health Educator/Trainer/ Counsellor
✓Acts as resource speaker on
health and health-related
services
✓Advocates health programs in
the community through
dissemination of IEC or
Information Education and
Communication materials
✓Conducts advocacy educations
concerning premarital,
breastfeeding, and immunization
counsellings
Health Educator/Trainer/ Counsellor
✓Organizes orientation/ training of
concerned groups like pregnant
mothers
✓Identifies and interprets training
needs of health team members
and formulate appropriate training
program for them
✓Conducts and facilitates
necessary training or educational
orientation to other health team
members in the community
Community Organizer
✓Promotes self- reliance of
community and emphasizes
their involvement and
participation in planning,
organizing, implementing and
evaluating of health services
✓ Initiates and implements
community development
activities
Coordinator of services
✓Coordinates health services with
concerned individuals and
families through the community
health team members,
government organizations and
non- government organizations
✓Coordinates nursing plans and
programs with other health
programs
Provider of Nursing Care
✓Renders direct care to various
clients with different needs, may
it be at home, in school, clinics or
work settings
✓Involves the family in the care of
the sick or dependent individual,
i.e., sick child
Health Monitor
✓Monitors and detects the presence
of health concerns in the
community through contacts or
home visits.
✓Utilizes various effective data
gathering techniques in keeping an
eye on the health status of all
recipients of care.
✓ Records and reports health status
and presence of health problems in
the community
Researcher ✓Follows a systematic process of
monitoring the health status of the
community through the conduct of
surveys and home visits
✓Conducts researches concerning
the health of the community
✓Coordinates with government and
non- government organizations in
the conduct and implementation of
studies
Statistician /Recorder/Reporter
✓Records data systematically and
ensures its validity through accurate and
complete data gathering
✓Reports prepared reports to concerned
organizations i.e. government
organization for immediate necessary
plans or programs
✓Consolidates and reviews reports
efficiently.
✓Analyzes and interprets consolidated
data for monitoring the development in
the health matters of the whole
community
Change Agent
✓Promotes and motivates change in
the community in their health
practices and lifestyle behaviors
for them to promote and maintain
good health, be knowledgeable
and has the initiative in accessing
health services
✓Inculcates self- reliance to brought
about development and
improvement in the community
Role Model
✓Provides good example of
healthful living to the
members of the community
 Evolution of Public
Health Nursing in the
Philippines
Pre-Spanish Era - no records
Health Care During Spanish Regime
The religious orders exerted their efforts to
care for the sick by building hospitals in
different parts of the Philippines. The earliest
hospitals were:
❖Hospital Real de Manila (1577) – it was
established mainly to care for the Spanish
king’s soldiers, but also admitted Spanish
civilians; founded by Gov. Francisco de
Sande.
Health Care During Spanish Regime
❖(1577) Bro. Juan Clemente, a Franciscan Friar
started public health services through dispensary in
Intramuros for the indigentDominican Father, Juan
de Pergero start water sanitation in San Juan Manila
❖San Lazaro Hospital (1578) – founded by Brother
Juan Clemente and was administered for many
years by the Hospitalliers of San Juan de Dios; built
exclusively for patients with leprosy
❖Hospital de Indios (1586) – established by the
Franciscan Order; service was in general supported
by alms and contributions from charitable persons
Health Care During Spanish Regime
❖Hospital de Aguas Santas (1590) –
established in Laguna; near a medicinal
spring, founded by Brother J. Bautista of the
Franciscan Order.
❖San Juan de Dios Hospital (1596) – founded
by the Brotherhood of Misericordia and
administered by the Hospitaliers of San Juan
de Dios; support was delivered from alms and
rents; rendered general health service to the
public.
Health Care During Spanish Regime
❖(1690) Dr. Francisco de Balmis introduced
small pox vaccination
❖( 1805) First medicos titular were
appointed by the Spanish government
course. The medicus titulares worked as
provincial health officers. A 2-year course
consisting of fundamental medical
subjects was first offered in the University
of santo Tomas. Graduates of this course
known as cirujanos ministrantes served as
male nurses and sanitation inspectors.
American Regime
❖(1901) The United States Philippine Commission,
through Act 157, created the Board of Health of
the Philippine Islands with a Commissioner of
Public Health as its chief executive officer. The
Board of Health eventually evolved into what is
now Department of Health
❖(1905) The Asociacion Feminista Filipina founded
La Gota de Leche the first center dedicated to the
service of mothers and children
❖(1912) Fajardo Act of 1912 created Sanitary
Divisions made up of one to four municipalities.
Each Sanitary division had a president who had to
be a physician
American Regime
❖(1915) The Philippine General Hospital began to
extend public health nursing services in the home
of the patients by organizing a unit called Social
and Home Care Service, with two staff nurses.
❖ (1916-1918) Perlita Clark took charge of public
health nursing work
❖(1919) Public health nursing inaugurated its
pioneer work in Tondo Manila when a visiting
nurse Balbina Basa was assigned to make a
house to house visit, hold clinic and dispensary
work with special emphasis maternal and child
car
American Regime
❖176 puericulture nurses assigned in Manila. and
provinces since 1919.
❖Puericulture centers are semi government agencies
partly financed by private funds and aided by the
government. Maternal and child care is offered.
❖(1923) 90 Public Health Nurses assigned in different
provinces
❖(1928) First convention of nurses was held followed by
annual conventions until the advent of World War ll.
❖(1935) 133 positions of public health nurses assigned
in the community with high infant mortality.
Japanese Regime
❖Public Health Nursing services was interrupted
❖(1941) The effect of WW II on December 8,
1941Public Health Nurses in Manila was assigned
to devastated areas to attend to the sick and
wounded civilians caused by bombing, 12
emergency units were organized; one of them was
sent to Bataan to attend to the sick and wounded
which were left by the retreating forces of Gen.
Douglas MacArthur.
❖(1942) Group of Public Health Nurses with
Physicians and administrators of Manila Health
Department went to Capas Tarlac to receive sick
prisoners of war released by Japanese army.
Era of the Republic Philippines
❖Increased the number of Public Health Nurses
❖(1947) Reorganization of government offices under
E.O No. 49 s. of 1947 with the transfer of the Bureau
of Public Welfare to the Office of the Pres., and the
department was renamed Department of Health
❖(1954) R.A 1082 (Rural Health Unit Act) creation of a
rural health units in every municipality and for the
employment of physicians to serve as municipal
health officers, public health nurses, midwives, and
sanitation inspectors, in the rural health units. It also
provided a provincial health officer for each province
and public health dentist for each congressional
district
Era of the Republic Philippines
❖(1957) R.A 1891(an Act Strengthening Health
and Dental Services in the Rural Areas and
Providing Funds
❖(1975) Formulation of the National Health Plan
and the Restructured Health care Delivery
System
❖(1982) Under E.O 851, the Health Education and
Manpower Development Services was created
with the BFAD assumed the function of FDA
❖(1986) The Ministry of Health became
Department of Health
Era of the Republic Philippines
❖(1987) The EPI and the National drug Policy,
the implementation of Generic Law of 1988
(R.A 6675) were subsequently given
importance
❖(1991) R.A. 7160, The Local Government Code
of 1991was implemented which resulted to
devolution which transferred the power and
authority from the national to local government
units. Materials, supplies, of health centers
have to be provided by the local government
units.
Era of the Republic Philippines
❖(1992) Full implementation of the R.A 7160
or Local Government Code. Special projects
were highlighted like NID (National
Immunization Day), National Micronutrients
Campaign (Araw ng Sangkap Pinoy),
Disaster Management, Urban Health and
Nutrition Project, Traditional Medicine,
Doctors to the Barrio Program,” Let’s Do It!”
became a national battle cry
❖The National League of Philippine
Government Nurses was organized,
government nurses as members.
Era of the Republic Philippines
❖(1993) Primary Health Care as a strategy to
attain Health for All by the year 2000was in focus
supported by the following slogan, “23 in “93”,
Health for More in “94”, five in “95”, and Go 7 in
“1977”
❖Health Sector Reform Agenda of the Philippine
was launched(1999) D.O order 209 designated
Nelia Hizon, Nurse V1 as the nursing adviser to
look matters affecting nursesnursing is referred
to her
 Era of the Republic Philippines
• E.O 102 was signed by President Erap
Estrada, redirecting new functions and
operations of the DOH, wherein most of the
nursing positions at the Central Office were
transferred or devolved to other offices and
services.
• (2005) The DOH launched Fourmula ONE for
health to ensure speed precision, and
effectiveness and equity of health care
deliver
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