4) Strategic management of health systems and

services for population health gain

Public Health Nursing in the Philippines
5) Regulation and enforcement to protect public
health
Introduction 6) Health promotion, social participation and
empowerment
7) Ensuring the quality of personal and
Nursing in the Philippines has a deep and enigmatic population based health services
history. This article illustrates the considerable weight 8) Research, development and implementation of
and influence of nursing history while at the same time innovative public health solutions
disclosing the challenges of applying the past to the
present.
Community health - (WHO) defines community health
What is Public Health? as: environmental , social and economical resources to
sustain emotional and physical well being among
people in a way that advances their aspirations and
Public Health satisfies their needs in their unique environment.
● Is a “science and art of preventing disease,
prolonging life, promoting health and efficiency Public health - focuses on the scientific process of
through organized community efforts for the preventing infectious diseases, Community health -
sanitation of the environment, control of focuses more on the overall contributors to a
communicable disease, education of population’s physical and mental health
individuals in personal hygiene, organization of
the medical and nursing service and the Public Health Nursing - The American Public Health
development of the social machinery, which Association defines public health nursing as. “The
will ensure to every individual in the practice of promoting and protecting the health of
community a standard of living adequate for populations using knowledge from nursing, social and
the maintenance of health”.. (C.E. Winslow, public health sciences”.
1920)
● Refers to the health status of the members of
the community, to the problems affecting their Community Health Nursing
health and to the totality of health care
provided for the community (WHO) Community Health Nursing

Core Business of Public Health Community

1. Disease control
2. Injury prevention ● Derived from a latin word “ comunicas” which
3. Health protection means a group of people.
4. Healthy public policy ● A social group determined by geographical
5. Promotion of health and equitable health gain boundaries and/or common values and
interests (WHO)
Essential Public Health Functions ● Local areas over which people are using the
1) Health situation monitoring and analysis same language, conforming to the same
2) Epidemiological surveillance/disease feeling, more or less the same sentiments and
prevention and control acting upon the same attitudes. (Sutherland)
3) Development of policies and planning in public can be viewed
health
Three Ways: 4. The goal of CHN is achieved through
➢ Geographical location multi-sectoral efforts
➢ Social system 5. CHN is part of health care system and the
➢ Collection of people larger human services system

Standards of Public Health Nursing Practice

● A service rendered by professional nurse with
the community, groups, families, and
individuals at home, in health center, in clinics, STANDARDS OF CARE
in schools, and in places of work for the
promotion of health, prevention of illness, care STANDARD 1 - The public health nurse
of the sick at home and rehabilitation (Ruth B. Assessment collects comprehensive
Freeman) data pertinent to the
● The utilization of the nursing process in the health status of the
population
different levels of clientele-individuals, families,
population groups and communities, STANDARD 2 - The PHN analyzes the
concerned with the promotion of health, Population Diagnosis assessment date to
prevention of disease and disability and and Priorities determine the population
rehabilitation.” (Araceli Maglaya, et al). diagnosis and priorities

STANDARD 3 - The PHN identifies the

Goal
Outcome Identification expected outcome for a
”to raise the level of citizen by helping communities plan that is based on
and families to cope with the discontinuities in such a population diagnoses
way as to maximize their potential for high-level and priorities.
wellness” (Nisce, et al)
STANDARD 4 - The PHN develops a
Mission of CHN Planning plan that reflects best
practices by identifying
● Health promotion
strategies- action plans,
● Health protection and alternatives to attain
● Health balance expected outcomes.
● Disease prevention
● Social justice STANDARD 5 - The PHN implements
Implementation the identified plan by
partnering with others
Philosophy
● “The philosophy of CHN is based on the worth a. coordination Coordinates programs,
and dignity of man”. (Dr. M. Shetland) services, and other
activities to implement
Basic Principles of CHN the identified plan
1. The community is the patient in CHN, the
family is the unit of care, and there are four b. Health Employs multiple
education and strategies to promote
levels of clientele:
health health , prevent disease,
- Individual, family, population group promotion and ensure a safe
(those who share common environment for
characteristics, developmental stages, populations.
and common exposure to health
problems – e.g. children, elderly), and c. consultation Provides consultation to
various community
the community
groups and officials to
2. In CHN, the client is considered as an ACTIVE facilitate the
partner, NOT PASSIVE recipient of care implementation of
3. CHN practice is affected by developments in programs and services
health technology, in particular, changes in
society in general d. Regulatory Identifies, interprets, and
 activities implements public health Research research findings in
law , regulation, and practice
policies
STANDARD 14 - The PHN considers
STANDARD 6 - The PHN evaluates the Resource Utilization, factors related to safety,
Evaluation health status of the Population effectiveness, cost, and
population impact on practice and
in planning and delivery
STANDARDS OF PROFESSIONAL of nursing and public
PERFORMANCE health programs,
policies, and services
STANDARD 7 - Quality The PHN systematically
of Practice enhances the quality STANDARD 15 - The pHN provides
and effectiveness of Leadership leadership in nursing
nursing practice and public health.

STANDARD 8 - The PHN attains

Education knowledge and
competency that reflects Roles and Responsibilities of a
current nursing and
Community Health Nurse
public health practice

STANDARD 9 - The PHN evaluates Roles

Professional Practice one’s own nursing
Evaluation practice in relation to 1. Clinician
professional practice
2. Health Educator
standards and
guidelines, relevant 3. Facilitator
statutes, rules, and 4. Supervisor
regulations 5. Health Advocator
6. Collaboration
STANDARD 10 - The PHN establishes
Collegiality and collegial partnerships
professional knowledge while interacting with
representatives of the Other Specific Responsibilities of a Nurse
population, organization,
and health and human
services professionals Spelled by the implementing rules and regulations of
and contributes to the RA 7164 (Philippine Nursing Act of 1991) includes:
professional
development of peers, ● Supervision and care of women during
students, colleagues, pregnancy, labor, and puerperium
and others. ● Performance of internal examination and
delivery of babies
STANDARD 11 - The PHN collaborates
● Suturing lacerations in the absence of a
Collaboration with the representatives
of the population, physician
organizations, and ● Provision of first aid measures and emergency
health and human care
services professionals in ● Recommending herbal and symptomatic
providing for and meds…etc.
promoting the health of
the population In the care of the families:
STANDARD 12 - Ethics The PHN integrates 1. Provision of primary health care services
ethical provision in all
areas of practice 2. Developmental/ Utilization of family nursing
care plan in the provision of care
STANDARD 13 - The PHN integrates
In the care of the communities: ● Health Care Delivery System is the totality of
all policies, infrastructures, facilities,
1. Community organizing mobilization, equipment, product, human resources, and
community development, and people services that address the health needs,
empowerment problems and concerns of the people
● Composed of 2 sectors
2. Case finding and epidemiological investigation a. Public sector - largely financed
3. Program planning, implementation, and through tax-based budgeting system
evaluation at both national and local levels and
where health care is generally given
4. Influencing executive and legislative
free at the point of service
individuals or bodies concerning health and b. Private sector - largely
development market-oriented and where health care
is paid through user fees at the point
of service

World Health Organization

Responsibilities of CHN ● WHO - a specialized agency of the United

Nations that provides global leadership on
health matters
1. Be a part in developing an overall health plan, ● The WHO constitution states that its objective
its implementation and evaluation for is the attainment by all people’s highest
communities possible level of health
2. Provide quality nursing services to the three ● It came into force on April 7, 1948
levels of clientele
3. Maintain coordination/ linkages with other
health team members, NGO/ government
agencies in the provision of public health
services
4. Conduct researches relevant to CHN services
to improve provision of health care
5. Provide opportunities for professional growth
and continuing education for staff development

The Health Care Delivery System

● Health System - consist of all organizations,

people, and actions whose primary intent is to
promote, restore, or maintain health
● It has 6 building blocks:
1. Service delivery
2. Health workforce
3. Information Millennium Development Goals (MDGs)
4. Medical products (vaccines and
technologies)
5. Financing ● There were goals that all 19 UN Member
6. Leadership and governance States have agreed to try to achieve by the
stewardship year 2015.
● The united Nations Millennium Declaration,
signed in September 2000, committed world
 leaders to combat poverty, hunger, disease, underpinned by 13 targets that cover a wide spectrum
illiteracy, environmental degradation, and of WHO’s work.
discrimination against women. 1. No poverty
● The MDSs were derived from this Declaration, 2. Zero hunger
and had specific targets and indicators. 3. Good health and well being
● A common vision of poverty reduction and 4. Quality education
sustainable development in response to the 5. Gender equality
global and country health trends. 6. Clean water and sanitation
● Imperatives: 7. Affordable and clean energy
- Shifts in demographic and 8. Decent work and economic growth
epidemiological trends in disease 9. Industry, innovation and infrastructure
- New technologies for healthcare, 10. Reduced inequality
communication and information 11. Sustainable cities and communities
- Existing and emerging environmental 12. Responsible consumption and production
hazards 13. Climate action
- Health norms 14. Life below water
15. Life on land
Millenium Development Goals (MDGs) 16. Peace and justice, strong institutions
- 2005 - 2015 is based on the fundamental 17. Partnership to achieve the goal
values of freedom, equality, solidarity,
tolerance, health, respect for nature and Note: It has 15 years lifespan; 2016 marks the 1st year
shared responsibility. of its implementation

● 8 MDGs
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/ AIDS, malaria, and other
diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development

Sustainable Development Goals (SDG)

● Also known as the “Global Goals”

● Are the blueprint to achieve a better and more
sustainable future for all.
● They address the global challenges we face,
including those related to poverty, inequality,
climate change, environmental degradation,
peace and justice.
● The 17 goals are all interconnected, and in
order to leave no one behind, it is important
that we achieve them all by 2030.

17 SDG’s
Health has a central place in SDG 3 “Ensure healthy
lives and promote well-being for all at all ages”,
 Summary

● The Global Challenge for Government

Transparency: The Sustainable Development
Goals (SDG) 2030 Agenda
● In 2015, nations agreed with the United Nation
that they can change the world for the better
● This will be accomplished by bringing together
their respective governments, businesses,
media, institutions of higher education, and
local NGOs to improve the lives of the people
in their country by the year 2030

Standards of Public Health Nursing Practice

Standards of Care

▪ STANDARD 1 Assessment
The public health nurse collects
comprehensive data pertinent to the health
status of the population.
▪ STANDARD 2 Population Diagnosis and The PHN attains knowledge and competency
Priorities that reflects current nursing and public health
practice
The PHN analyzes the assessment data to
determine the population diagnosis and
priorities
▪ STANDARD 9 Professional Practice Evaluation
The PHN evaluates one’s own nursing
▪ STANDARD 3 Outcome Identification practice in relation to professional practice
standards and guidelines, relevant statutes,
The PHN identifies the expected outcome for
rules, and regulations
a plan that is based on population diagnoses
and priorities
▪ STANDARD 11 Collaboration

▪ STANDARD 4 Planning The PHN collaborates with the

representatives of the population ,
The PHN develops a plan that reflects best organizations, and health and human
practices by identifying strategies ., action services professionals in providing for and
plans , and alternative to attain expected promoting the health of the population
outcomes Planning
▪ STANDARD 10 Collegiality and professional
relationships
▪ STANDARD 5 Implementation The PHN establishes collegial partnerships
The PHN implements the identified plan by while interacting with representatives of the
partnering with others population, organization, and health and
1. Coordination – Coordinates programs, human services professionals and contributes
services, and other activities to to the professional development of peers,
implement the identified plan students, colleagues, and others
2. Health education and health promotion
▪ STANDARD 12 Ethics
– Employs multiple strategies to
promote health , prevent disease, and The PHN integrates ethical provisions in all
ensure a safe environment for areas of practice
populations.
3. Consultation – Provides consultation ▪ STANDARD 13 Research
to various community groups and
officials to facilitate the implementation The PHN integrates research findings in
of programs and services practice
4. Regulatory activities – Identifies, ▪ STANDARD 14 Resource Utilization
interprets, and implements public population
health laws , regulations, and policies
The PHN considers factors related to safety ,
effectiveness, cost, and impact on practice
▪ STANDARD 6 Evaluation and in planning and delivery of nursing and
public health programs , policies, and services
The PHN evaluates the health status of the
population
STANDARD 15 Leadership
▪ STANDARD 7 Quality of Practice
The PHN provides leadership in nursing and
The PHN systematically enhances the quality
public health
and effectiveness of nursing practice

Health Care Delivery System

▪ STANDARD 8 Education
 Philippine Department of Health

Health Sector Reform Agenda

◼ DOH - Is the national agency mandated to lead
The five major reforms contained in the HSRA:
the health sectors toward assuring quality
health care for Filipinos
1. Provide fiscal autonomy to government
– national government’s biggest health care hospitals
provider
2. Secure funding for priority public health
– exercises regulatory powers of health programs
facilities and product
3. Promote the development of local health
– takes the lead in the formulation of systems and ensure its effective
policies and standards related to health performance
facilities, health products and health
human resource 4. Strengthen the capacities of health
regulatory agencies
◼ Major Role of DOH
5. Expand the coverage of the National
– Leader in health Health Insurance Program

– Enabler and capacity builder Framework for Implementation for of HSRA :

FOURmula ONE for Health - it is the strategy for
– Administrator of specific services
implementing health reforms
◼ Vision
▪ Spells out the program imperatives of the health
– The DOH is the leader, staunch advocate sector
and model in promoting HEALTH FOR ALL
in the Philippines ▪ Intends to implement critical interventions as a
single package backed by effective management
◼ Goal infrastructure and financing arrangements
following a sectoral approach
• Overriding goal of the DOH is the Health Sector
Reform Agenda. Goals of FOURmula ONE for Health

◼ Mission ▪ Better health outcomes

Guarantee equitable, sustainable, and ▪ More responsive health systems

quality health for all Filipinos, especially the
poor and shall lead the quest for excellence
▪ Equitable health care financing
in health.

✔ by making services available ▪ National Objectives for Health - provides the

road map for stakeholders in health and
health-related sectors to intensify and harmonize
✔ By arousing community awareness
their efforts to attain its vision and mission
✔ By mobilizing resources
Principles

✔ By promoting the means to better health

▪ Universal access to basic health services must
 be ensured. practitioners, traditional/alternative providers,
caregivers, household
▪ The health and nutrition of vulnerable groups
must be prioritized. • Core referral hospital(s): District Hospital or
Provincial Hospital
▪ The epidemiologic shift from infectious to
degenerative diseases must be managed. • End referral hospital(s): Higher level hospitals

▪ The performance of the health sector must be Guiding Principles for ILHZs
enhanced
1. Voluntary actions for mutual benefits
Goals and Objectives
2. Flexible forms of organization
◼ Improve the general health status of the
population. 3. Results -oriented

◼ Reduce morbidity and mortality from 4. Sustained and evolutionary

certain diseases
5. Purposive and developmental
◼ Eliminate certain diseases as public health
problems 6. Universal and non –partisan

◼ Promote healthy lifestyle and environment

health
Devolution of Health Services

◼ Protect vulnerable groups with special ◼ RA 7160 a.k.a. Local Government Code
health and nutrition needs
• One of the significant laws that radically
Local Health System changed the landscape of health care
delivery

◼ LHS - A health system at the sub-national level • Aims to transform local government units
into self-reliant communities and active
(Dorotan, et al) The core element of local or
partners in the attainment of national goals
district health system is the integrated primary
through more responsive and accountable
health care and the first referral hospital serving a
local government structure instituted
well-defined population (Segall, 2003).
through a system of decentralization
Inter-Local Health Zone
◼ 1993- Health services were devolved or
transferred from the DOH to the LGU - all
∙ Any form of organized arrangement for
provincial, district and municipal hospitals to the
coordinating the operations of an array and
provincial governments and the rural health units
hierarchy of health providers and facilities
(RHUs) and barangay health stations (BHSs) to
serving a common population within a local
the municipal governments
geographic area under the jurisdictions of more
than one local government (DOH, CY 2006)
∙ Composition of an ILHZ Levels of Health Care and Referral System

• Primary Health Care Providers (Barangay ◼ PRIMARY HEALTH CARE

Health Station, Rural Health Unit, health
centers, community hosp., private ✔ Health services offered at this level are to
 individuals in fair health and to patients with ◼ Classification of Hospitals
diseases in the early symptomatic stage
◼ General Hospital - provides services
✔ Primary care is devolved to the cities and for all kinds of illnesses and injuries,
the municipalities. or deformities.

◼ Specialized Hospital – offers services

✔ It is the health care provided by center
for a specific disease or condition or
physicians, public health nurses, rural
type of patient.
health midwives, BHWs, traditional healers.
Classification of other Health Facilities :
◼ SECONDARY LEVEL OF CARE
1. Category A Primary Health Care Facility- a first
✔ Service offered to patients with
contact health care facility that offers basic
symptomatic stages of disease which
services including emergency services and
require moderately specialized knowledge
provisions to normal deliveries .
and technical resources for adequate
A. Without in patient beds like health
treatment
centers, clinics, and dental facilities
B. Within patients beds- a short stay
✔ Is given by physicians with basic health facility where the patients on the
training. average one or two days before
discharge . ex. Lying –in , birthing
✔ This is usually given in health facilities homes
either owned or government operated such
as infirmaries, municipal, and district
hospitals, OPD of provincial hospitals. 2. Category B Custodial Care Facility – health
facility that provides long term care including the
✔ Capable of performing minor surgeries and basic services like food, shelter, to patients with
perform some simple laboratory chronic conditions . ex. Custodial psychiatric
examinations. facilities, substance/ drug abuse treatment and
rehabilitation . sanitaria/ leprosaria, nursing
◼ TERTIARY LEVEL OF CARE homes

✔ Are the highly technological and 3. Category C. Diagnostic/ Therapeutic Facility – a

sophisticated services offered by medical facility for the examination of the human body,
centers and large hospitals. These are specimens from human body for the diagnosis,
specialized national hospitals. sometimes treatment of disease, or water
drinking analysis. Ex. A patient needs to give a
✔ Services are for clients afflicted with sputum specimen to check for TB.
diseases which seriously threaten their
health & which require highly technical and FURTHER CLASSIFICATION:
specialized knowledge, facilities and
personnel to treat effectively. o Laboratory Facility - such as, but no
limited to the ff.
✔ Note: Advances in health sciences and
services have brought about the a) Clinical Laboratory
development of different types of health
facilities . DOH Administrative Order b) HIV Testing Center
2012-0012 ( Rules and Regulation
c) Blood Service Facility
Governing the new Classification of
Hospital and other Health Facilities in the d) Drug Testing Laboratory
Philippines )
e) Newborn Screening Laboratory
 f) Laboratory for drinking water Definition
analysis - Primary Health care an essential health care
o Radiologic Facility - such as X-ray , CT scan , made universally acceptable to individuals and
Mammography, MRI, ultrasonography families in the community by means
acceptable to them through their full
o Nuclear Medicine facility - a facility regulated by participation and at a cost that the community
the Philippine Nuclear Research and country and afford at every stage of
Institute utilizing radioactive materials in development in the spirit of self-reliance and
diagnosis, treatment , or medical research. self-determination (WHO)

GOALS
4. Category D Specialized Out patient Facility - a
facility that performs highly specialized
procedures on an out patient basis . ex dialysis, Universal goal of PHC = "HEALTH FOR ALL" by the
cancer radiation facility, rehabilitation centers year 2000
● To have an acceptable level of health for all
people of the world through community and
PRIMARY HEALTH CARE individual self reliance.

● Sept. 6-12, 1978 - health workers from around The policy agenda of " health for all by the year 2000"
200 countries attended the INTERNATIONAL technically was a global strategy employed for
CONFERENCE FOR PRIMARY HEALTH achieving 3 main objectives:
CARE @ Alma Ata, USSR ● Promotion of healthy lifestyle
● INITIATED by WHO and United Nations ● Prevention of diseases
Children’s Fund ● Therapy for existing conditions
● Altogether the partici[ants expressed the need
for concerted efforts by all government and President Ferdinand Marcos signed LOI 949 with the
health and development workers for the theme " Health in the Hands of the People by 2020".
protection and promotion by health of all
people 8 ESSENTIAL ELEMENTS OF FAMILY HEALTH
● The Alma Ata declaration on Primary Health CARE
Care emerged from the said conference

1. Education for health

ALMA ATA DECLARATIONS - This is one of the potent
methodologies for information
1. Health is a basic fundamental right dissemination. It Promotes the
2. There exist global burden of health inequalities partnership of both the family
among population members and health workers in the
3. Economic and social development is of basic promotion of health as well as
importance for the attainment of health for all prevention of illness
4. Government have a responsibility for the 2. Locally endemic Disease Control
health of their people - The Control of endemic disease
focuses in the prevention of its
Legal Basis occurrence to reduce morbidity rate
- PHC was adopted in the Philippines by Virtue (example Malaria control and
of letter if Instruction (LOI) 949 of 1979 schistosomiasis control)
- Philip[pines the 1st country in asia to meet the 3. Expanded Program on Immunization
challenge of PHC - This program exists to control the
occurrence of preventable illnesses
especially of children below 6 years
old. Immunizations on poliomyelitis,
 measles, tetanus, diphtheria, and acquisition of drugs. In response to
other preventable disease are given this campaign, the GENERIC ACT of
for free by the government on going the Philippines is enacted. It includes
program of the DOH the following drugs: Cotrimoxazole,
4. Maternal and Child Health and family Paracetamol, Amoxycillin, Oresol,
Planning Nifedipine, Rifampicin, INH (isoniazid)
- The mother and child are the most and Pyrazinamide, Ethambutol,
delicate members of the community. Streptomycin, Albendazole, Quinine
So the Protection of the mother and
child to illness and other risks would
PRINCIPLES OF STRATEGIES
ensure good health for the community
- The Goal of family planning includes
spacing of children and responsible 1. ACCESSIBILITY, AFFORDABILITY,
parenthood ACCEPTABILITY, AND AVAILABILITY (botika ng
5. Environmental Sanitation and Promotion of bayan, Ligtas tigdas Pilipinas)
safe water supply
- Environmental sanitation is defined as 2. SUPPORT MECHANISM (Resources for essential
the study of all factors in the man’s services comes from 3 entities:People, Government,
environment, which exercises and Private sectors)
deleterious effects on his well-being
and survival. Water is a basic need for 3. MULTISECTORAL APPROACH (exemplified
life and one factor in man’s through intrasectoral and intersectoral linkages)
environment. Water is necessary for
the maintenance of a healthy lifestyle. 4. COMMUNITY PARTICIPATION (Individuals,
Safe water and sanitation is necessary families, and communities are not recipients of care
for abacus promotion of health but active participants in achieving their health goals)
6. Nutrition and Promotion of Adequate Food
Supply 5. EQUITABLE DISTRIBUTION OF RESOURCES –
- One basic need of the family is food. (PHC advocates for care that is community based and
And if food is properly prepared then preventive in orientation)
one may be assured of a healthy
family. There are many food resources 6. APPROPRIATE TECHNOLOGY
found in the communities but because
of faulty preparation and lack of 4 A’S
knowledge regarding proper food
planning, Malnutrition is one of the
problems that we have in the country. Accessibility
7. Treatment of Communicable Diseases and - Refers to the physical distance of a health
Common Illness facility or the travel time required for people to
- The diseases spread through direct get needed or desired services. This requires
contact pose a great risk to those who the existence of a facility within reasonable
can be infected.Tuberculosis is one of distance from the catchment population or the
the communicable diseases that people they serve
continuously occupies the top ten - WHO – health facilities should be accessible
causes of death. Most communicable within 30 mins from the communities.
diseases are also preventable. The - Barangay Health Stations (BHS) are facilities
Government focuses on the intended to provide accessible health services
prevention, control and treatment of in a community level
these illnesses.
8. Supply of Essential Drugs
- This focuses on the information
campaign on the utilization and
Affordability members of the health team and among health
- Not only for consideration of the individual or agencies
family’s capacity to pay for basic health ● Team approach is utilized by the personnel of
services. It is also the matter of whether the a health center in dealing with health
community or government can afford these conditions and problems.
services. ● Two-way referral system – necessary for
- WHO – to determine the affordability of clients to get the needed and desired care
healthcare is the out-of-pocket expenses for
health care. This is the actual cost of the Intersectoral linkages
family for health care services. ● “the population is sick because they are poor”
- Philippines health insurance is covered by –This statement implies that illness or health is
PhilHealth a result of economic gains or the lack thereof.
● Health is a multisectoral concern. Health
Acceptability programs should not be taken in isolation from
- Health care offered is in consonance with the the overall development agenda of society.
prevailing culture and traditions of the ● Encompass the communication, cooperation
population and collaboration between the health sector
and other sectors of society like education,
Availability public works, agriculture and local govt
- Is a question of whether the basic health officials.
services required by the people are offered in
the health care facilities or is provided on a
COMMUNITY PARTICIPATION
regular and organized manner

● Is an educational empowering process in

SUPPORT MECHANISM which people, in partnership with those who
are able to assist them, identify the problems
● Resources for essential health services come and the needs and increasingly assume
from three major entities: responsibilities themselves to plan, manage,
○ The People, Government and the control and assess the collective actions that
Private sectors (NGO, socio-civic and are proved necessary.
faith groups)
● Health programs and projects provide better True/ Active Participation
outputs when these three entities are involved ● people should be knowledgeable about their
● Multisectoral approach is necessary to own health problems
efficiently utilize the resources from the three ● should identify the needs for their solution or
major entities reduction and
● draw out plans of actions according to the
priority and the resources available; organize
MULTISECTORAL APPROACH
and implement the programs and monitor and
control their progress and periodically evaluate
● Diseases are outcomes of multiple interrelated for getting the feedback and do
factors, PHC requires Communication, reprogramming
Cooperation, and Collaboration within and
among various sectors.
EQUITABLE DISTRIBUTION OF HEALTH
● This is exemplified through intersectoral and RESOURCES
intrasectoral linkages

● PHC advocates for care that is community

Intrasectoral Linkages
based and preventive in orientation.
● Refers to communication, cooperation and
● Philippines has oversupply of medicine (due to
collaboration within the health sector: among
people not believing in medicine) and nursing
 graduates (other occupation, did not take or 4. Simplicity – technology that requires readily
want to take board exam) available simple materials that involves a simple
● Govt health care employees (29% = Dr; 26% process. Example ORS
= RN)
● Impression: graduates of health-related 5. Acceptability- technology is effective only when it is
college programs wants to work abroad used by those who need it ( culture is an important
consideration in determining appropriateness of
*NTP = National Tuberculosis Program technology , education is essential for adoption.

Two Programs of DOH to ensure distribution of 6. Feasibility and Reliability- technology must be
manpower to the rural areas: easy to apply considering the peoples ’ natural settings
like the home ,school, workplace , and community
● Doctor to the Barrios (DTTB) Program – ,supplies must be constantly available ex. DSSM
DTTB volunteers are fielded to manage the
RHU of 5 th o 6 th class municipalities for 2 7. Ecological Effects – effects on ecology are RA
years and have the option to be absorbed with 8423 Traditional and Alternative Medicine Act of 1997
competitive compensation by the DOH and – created the Philippine Institute of Traditional and
LGU Alternative Health Care

● Registered Nurses Health Enhancement

MAJOR STRATEGIES
and Local Service (RN HEALS ) –
deployment of nurses for 1 year to address the
inadequate nursing workforce in rural 1. Elevating health to a comprehensive and
communities sustained national effort
2. Promoting and supporting community
managed health care
APPROPRIATE TECHNOLOGY 3. Increasing efficiency in health sector
4. Advancing essential national health research
- refers to the technology that is suitable to the
community that will use it . To better capture its
essence, the terms “ people’s technology “ and
1. ELEVATING HEALTH TO A COMPREHENSIVE
indigenous technology “ are also used in AND SUSTAINED NATIONAL EFFORT
reference to appropriate technology.
- Ex) to rehydrate pts in indigenous
communities, use Oresol ● Attaining health for all Filipinos will require
expanding participation in health and
health-related programs whether as service
CRITERIA FOR APPROPRIATE TECHNOLOGY provider or beneficiary. Empowerment to
parents, families and communities to make
1. Safety - technology results in minimal risks to the decisions of their health is the desired
users and that the intended positive outcome far outcome.
outweigh its unintended negative effects . ● Advocacy must be directed to national and
local policy making to elicit support and
2. Effectiveness- technology should accomplish what commitment to major health concerns through
is meant to accomplish ex. medicinal plants legislations, budgetary and logistical
considerations
3. Affordability – measures for health promotion and
disease prevention are cost effective in comparison to 2. PROMOTING AND SUPPORTING COMMUNITY
treatment of diseases. 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

3. INCREASING EFFICIENCY IN HEALTH

SECTOR
Cd
● 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 Department of Health (DOH) continue to
support and assist both public and private
institutions particularly in faculty development,
enhancement of relevant curricula and
development of standard teaching materials

4. ADVANCING ESSENTIAL NATIONAL HEALTH

RESEARCH

● Essential National Health Research (ENHR)

is an integrated strategy for organizing and
managing research using intersectoral,
multidisciplinary and scientific approach to
health programming and delivery.

LEVELS OF PREVENTION

● Primary Prevention—intervening
before health effects occur, through.
● Secondary Prevention—screening to
identify diseases in the earliest.
● Tertiary Prevention—managing
disease post diagnosis to slow or stop