MODULE 2 ACTIVITY DOCUMENT

[insert your name here]

[insert your affiliation here]
Enero, Giovanni N. – Western Leyte College of Ormoc City

OVERVIEW
As the world continues to face challenges in terms of health needs and
problems, Public Health Nurses become an important and visible component
of an increasingly complex health system. Management and leadership skills
among public health nurses are vital in the delivery of public health services,
the ultimate goal of which is to promote wellness, prevent disease and
reduce health risks in the population. The DOH, in its Administrative Order
No. 2020-0040 provided guidelines classifying Individual-Based and
Population-Based Primary Care Service Packages
to realize this goal. Although our Public Health Nurses have been known to be
performing individual-focused and population-based interventions, the times
call for a greater need to be involved in public health nursing practice at the
community and systems level.

This module introduces a framework that serves to guide the management

and delivery of public health services, the Ten Essential Public Health
Services in which population-based models and public health nursing
competencies were grounded. To enhance the population- based practice at
the individual, community, and systems level, the module gives special
attention to strengthening competencies in the project management cycle
and financial management.

MODULE 2. ACTIVITY DOCUMENT | 1

Enero, Giovanni N. – Western Leyte College of Ormoc City

MODULE OUTCOMES
At the end of the module, the learner will be able to:
1. Utilize the Ten Essential Public Health Services as a framework to
guide the management and delivery of public health nursing
services.
2. Apply population-based models in managing public health
nursing intervention programs and services.
3. Enhance public health nursing competencies essential for
improving population health.
4. Strengthen competencies in the project management cycle to
improve care for the population.
5. Develop financial management competency of public health nurses.
6. Demonstrate application of the models in a selected public health program.

MODULE TOPICS
1. Public Health Services and Core Competencies of Public Health
Professionals
2. Public Health Nursing as Population-Based Practice
3. Integrated Services and Continuum of Care

MODULE ACTIVITIES
To complete this module, you are required to complete the 40 contact
hours, divided into 36 hours of asynchronous sessions and 4 hours of
synchronous sessions.

Typically, asynchronous sessions are conducted through UPCN Open Learning, a virtual learning
environment (VLE) based on MOODLE. However, due to ongoing server issues, the course site
remains inaccessible.

As a result, participants must complete the module materials and activities using the provided
documents in place of the VLE activities. Completion of these activities is mandatory to fulfill
the course requirements. The Professional Regulation Commission (PRC) requires all
participants to complete synchronous, asynchronous, and face-to-face activities to qualify for the
credited 45 CPD units.

ACCESS TO THE MODULE 2 MATERIALS

Access the Module 2 Handout through this link:
https://drive.google.com/file/d/1WyyB2A3Kc549qMx6EUqfW14U-UA1vYUI/view?usp=sharing

Access the Learning Materials (e.g. lecture videos, slides) through this link:
https://drive.google.com/drive/folders/1pkAL0tB3yM2rLrHk7MW61wDuDCMACoqM?
usp=sharing

MODULE 2. ACTIVITY DOCUMENT | 2

Enero, Giovanni N. – Western Leyte College of Ormoc City

With the COVID 19 pandemic running for almost two years now, the world is experiencing an unprecedented crisis,
challenging health systems and changing the dreams of people. To date, there seem to be no signs of abating as variants
of concern keep diminishing the effectiveness of vaccines. As high-income countries reached their targets for the priority
groups and general population in no time, low to middle-income countries struggle to control rising cases and deaths,
desperately almost begging for vaccines to protect the frontline health workers who are of the COVID 19 battle. The
reports on waning immunity of the vaccines and the threat of the delta variant placed the high-income countries in the
position of protecting their fully-vaccinated population by protecting them with boosters or additional doses. Again, the
low-to-middle economies will seem to be left empty-handed. What does this situation tell us? It gives us the best
illustration of health inequity.

Health inequity is the reason why the Ten Essential Public Health Services came to be. The framework which had its
beginnings in the early 90’s aims to protect and promote the health of people in all communities. It highlights the call to
address systemic and structural barriers for everyone to have a fair opportunity and choice to achieve health and well-
being.

To successfully deliver essential public health services, a health system requires competent public health professionals.
The Core Competencies of Public Health Professionals provide a framework for workforce development and guide
public health organizations in determining the competencies and skills needed to address their organizational needs.

LEARNING OBJECTIVES
At the end of this session, you will be able to:
1. Describe the Ten Essential Public Health Services as a framework to strengthen the public health system towards
improving health outcomes.
2. Explain the origin, core functions, and purposes of the Ten Essential Public Health Services.
3. Describe the core competencies for public health professionals

LEARNING RESOURCES
View the lecture of Associate Professor Luz Barbara P. Dones on Public Health Services and Core Competencies
of Public Health Professionals in this link:
https://drive.google.com/file/d/1x9IHdxf1jAsuCvQznA40JUCwm3y6u1QC/view?usp=sharing

In her presentation, she emphasized several key areas:

● Definition and purpose of public health
● Core functions of public health: assessment, policy development and assurance
● The 10 Essential Public Health Services as a framework to strengthen public health systems
● Core competencies of public health professionals

After viewing the lecture, read/ browse through the resources below and work on the activity that follows.
1. The 10 Essential Public health Services (2020). Public Health National Center for Innovation
Retrieved from: https://phnci.org/uploads/resource-files/EPHS-English.pdf
This is the original document.

2. Core Competencies for Public Health Professionals (June 2014). Council on Linkages Between Academia Public
Health Practice
Retrieved from: http://www.phf.org/resourcestools/Documents/Core_Competencies_for_Public_Health_Profe ssionals_2014June.pdf
This original document provides a summary table of the core competencies of public health professionals discussed per domain. The table
also specifies the core competencies according to career stages described in tiers.

3. Modified Core Competencies for Public Health Professionals (June 2017). Council on Linkages Between
Academia Public Health Practice
Retrieved from: https://www.phf.org/resourcestools/Documents/Modified_Core_Competencies.pdf

MODULE 2. ACTIVITY DOCUMENT | 3

Enero, Giovanni N. – Western Leyte College of Ormoc City
ACTIVITY 1. Reflecting the essential health services in day-to-day public health activities.

Instruction: Below are scenarios that you usually encounter as you carry out your daily public health tasks.
● Identify which of the 10 Essential Public Health Services will address each scenario
● Specify the core competencies needed to carry out the public health service

1. An ambulant vendor selling assorted street food past the gate of a public school where people, especially
students patronize the cheap, deep-fried and ready-to-eat food and sugary drinks.
Essential Public Health Service Involved:
Inform, educate, and empower people about health issues.
This means helping the community, especially the students and the vendor, understand
the health risks of consuming and selling unsafe or unhealthy food.

Core Competencies Needed:

Health education and communication skills – to talk to the vendor and students in a
respectful and understandable way about healthy food choices and safety.
Community engagement – to build trust and cooperation among vendors, school staff,
and local health workers.
Cultural sensitivity and empathy – to understand that the vendor is just trying to
make a living and might not be fully aware of the health risks.

Reflection:
In situations like this, it's important to approach with care, not criticism. As public health
professionals, we’re not just there to point out what’s wrong, but to guide and support.
We can suggest healthier food options, explain the importance of food safety, and even
link the vendor to programs that can help them improve their livelihood while still
protecting the health of students.

2. A returning Overseas Filipino Worker (OFW) from the Middle East was given a welcome
party by his family after going on a 2-week self-isolation and negative RT- PCR. Within a
week from the party, three of the visitors showed up in the health center with mild to
moderate COVID symptoms. The OFW was asymptomatic.
Essential Public Health Service Involved:
Diagnose and investigate health problems and health hazards in the
community.
This means the health team needs to look into the situation to trace the possible source
of the infection, monitor the people exposed, and prevent the virus from spreading
further.

Core Competencies Needed:

Epidemiological investigation skills – to trace who might have been exposed and
when symptoms started.
Surveillance and data analysis – to monitor the spread and understand patterns.
Effective communication – to calmly explain the situation to the family and community
without causing panic.
Compassion and cultural sensitivity – to handle the issue gently, since it's a family
celebration and emotions may be involved.

Reflection:
In this kind of situation, it’s important to remember that people just want to celebrate
safely but sometimes, the virus still finds its way in. As public health workers, we need to
respond quickly but kindly, guiding families on what to do next, helping with contact

MODULE 2. ACTIVITY DOCUMENT | 4

Enero, Giovanni N. – Western Leyte College of Ormoc City

tracing, and reminding them of health protocols—not with blame, but with care. It’s
about protecting the community while respecting the emotions and traditions of the
people involved.

3. A group of elderly persons is seated outside the health center waiting for their turn to have
their BP and blood glucose taken. They were arguing whether it is better not to eat rice to
reduce their blood sugar.
Essential Public Health Service Involved:
Inform, educate, and empower people about health issues.
This is a great opportunity to share correct information about diabetes, healthy eating,
and how to manage blood sugar in a way that fits their lifestyle.

Core Competencies Needed:

Health promotion and communication skills – to explain complex health ideas (like
balanced diet and portion control) in ways that are easy to understand.
Cultural competence – especially since rice is a staple food in Filipino meals.
Patience and empathy – to listen to their concerns and guide them without judgment
or confusion.
Knowledge in nutrition and chronic disease prevention – to give practical advice
they can actually follow.

Reflection:
These situations remind us that health teaching doesn't always happen inside classrooms
or seminars—it happens in everyday conversations, even while people wait in line. As
public health professionals, we need to be approachable and ready to turn casual chats
into learning moments. It’s not about scaring people with big medical terms—it’s about
meeting them where they are, answering their questions with kindness, and helping
them make better choices, one step at a time.

4. A parent and her teenage son were seen arguing over the son’s refusal to wear a helmet
while riding his bike around the neighborhood.
Essential Public Health Service Involved:
Educate and empower people about health issues.
This is a teachable moment to help both the parent and the teen understand the
importance of safety, especially injury prevention, in everyday activities like biking.

Core Competencies Needed:

Health education and risk communication – to explain the dangers of biking without
a helmet in a way that teens can relate to.
Youth engagement skills – to connect with young people and make them feel heard
instead of scolded.
Conflict resolution and communication – to help both parent and child find common
ground.
Understanding of injury prevention and safety – to provide solid facts and real-life
examples.

Reflection:
Teenagers often think they’re invincible—and it’s normal for them to push boundaries.
But as public health workers, we can gently step in and help guide them toward safer
habits without making them feel attacked. Sometimes, it just takes one real story or a
friendly reminder to change someone’s mind. It’s not about forcing rules—it’s about

MODULE 2. ACTIVITY DOCUMENT | 5

Enero, Giovanni N. – Western Leyte College of Ormoc City

helping people understand why those rules can save lives. And if we approach these
situations with respect and patience, we can really make a difference.

5. The barangay captain confronted the people who were caught throwing their trash in the
canal.
Essential Public Health Service Involved:
Develop policies and plans that support individual and community health
efforts.
This situation involves more than just reminding people—it’s about creating clear rules
and promoting responsible behavior to keep the environment clean and the community
healthy.

Core Competencies Needed:

Community organization and mobilization – to involve residents in keeping their
surroundings clean.
Advocacy and policy development skills – to help implement barangay ordinances
that protect the environment and promote health.
Environmental health knowledge – to explain how improper waste disposal leads to
diseases like dengue or cholera.
Communication and leadership – to address issues firmly but respectfully, and
encourage community participation.

Reflection:
This is a reminder that public health isn’t just about hospitals and clinics—it’s also about
clean streets, safe water, and healthy surroundings. Sometimes, change starts with
uncomfortable conversations. The barangay captain may have raised his voice out of
concern, but this could be a chance to educate, not just reprimand. If we can work with
leaders and residents together, we can turn these moments into community efforts that
protect everyone's health—not just today, but for the future.

MODULE 2. ACTIVITY DOCUMENT | 6

Enero, Giovanni N. – Western Leyte College of Ormoc City

Public health nursing is a principal and a major component of the public health workforce of the Philippine health care
system. Public health nurses do not only provide individual-focused health services but are responsible for much of the
community-level health activities as partners of local health officials at the barangay level. The inadequate number of
public health workers, especially nurses, coupled with a lack of resources to deliver much-needed health services to a
population straining from the effects of a pandemic can overwhelm the health system to its breaking point. Our
experience with the COVID-19 pandemic has taught us great lessons on public health and public health nursing practice-
focus on the greater good for the population, the importance of health promotion and disease prevention, the need to
continuously assess and monitor the health status of the population, formulate and enforce policies considering social
and economic consequences, create a wide network for collaborative and coordinated public health effort and the need to
value research and evidence to guide overall efforts to quell the pandemic.

Throughout history, public health nursing and public health nurses played major roles in stepping into times of crisis,
providing care and innovation that has saved lives and reduced suffering. We cite Florence Nightingale during the
Crimean War and the disastrous influenza pandemic, Clara Barton during the American Civil War, Anne Caroline
Maxwell during the Spanish-American War, and Lillian Wald, who was a major force for social reform and public health
and an international crusader for human rights. Public health nurses served as the most important frontline care providers
during the world’s recent outbreaks- H1N1 Swine Flu, Ebola, SARS, and MERS. And now, the COVID 19 pandemic
puts the nurses back into the limelight, stepping up in improving public health during times of crisis. As always.

LEARNING OBJECTIVES
At the end of this session, you will be able to:
1. Discuss public health nursing as a population-based practice
2. Describe public health nursing competencies essential for improving population health
3. Describe the application of the Public Health Interventions Model (PHI) at the community and systems-level
practice
4. Describe public health nursing intervention categories and practice applications
5. Demonstrate application of the model in a selected health program

LEARNING RESOURCES
View the lecture of Associate Professor Luz Barbara P. Dones on Public Health Nursing: A Population-based
Practice in this link:
https://drive.google.com/file/d/17iNxnQd0U6BRtBWTCv-gJWcHH4j2XON7/view?usp=drive_link

Her presentation focuses on the following topics:

● Public health: population-based practice and population-based approach
● Public health nursing as a population-based practice
● Core competencies of Public Health Nurses
● Public Health Intervention Model (PHI)
● Public health Nursing Intervention Categories
● The 2012 National Nursing Core Competency Standards
● The Philippine Professional Nursing Practice Standards and Advanced Practice in Nursing

After viewing the lecture, read/ browse through the resources below and work on the activity that follows.
1. Quad Council Coalition (2018). Community/Public Health Nursing (C/PHN) Competencies
Retrieved from: https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:edc1e09d-e9cf-427c-b1c0-5021ee84e7f8

This article describes the different public health nursing core competencies in each of the eight (8) domains according to the level of mastery
or tiers.
The 8 domains are: 1) Assessment and Analytic Skills, 2) Policy Development and Program Planning Skills, 3) Communication Skills, 4)
Cultural Competency Skills, 5) Community Dimensions of Practice Skills, 6) Public Health Science Skills, 7) Financial Planning and
Management and Planning Skills, 8) Leadership and Systems Thinking Skills.

MODULE 2. ACTIVITY DOCUMENT | 7

Enero, Giovanni N. – Western Leyte College of Ormoc City
The 3 Levels of Mastery or Tiers are: Tier 1 apply to generalist community/ public health nurse; Tier 2 apply to community/public health
nurse with management and supervisory responsibilities and Tier 3 apply to community/public health nurse at an executive or senior
management level and leadership level

2. Keller LO, Stroschein S, Lia-Hoagberg B, Schaffer MA. (1998). Population-Based Public Health Nursing
Interventions Model: A Model from Practice
Retrieved from: https://www.academia.edu/10620680/Population_Based_Public_Health_Nursing_Interventio ns_A_Model_from_Practice?
email_work_card=view-paper

This article describes the Public Health Nursing Intervention (PHI) Model to clarify the public health nursing practice at the community and
systems level. The PHI identifies 17 interventions and provides practice examples at the individual, community, and systems level.

3. Keller LO, Stroschein S, Lia-Hoagberg B, Schaffer MA. (2004) Population-Based Public Health Interventions:
Practice-Based and Evidence-Supported Part I. Public Health Nursing Vol 5 No 3, pp 207-215
Sept/Oct2004Public Health Nursing Vol 5 No 3, pp 207- 215 Sept/Oct 2004.
Retrieved from: https://cpb-us-e2.wpmucdn.com/sites.up.edu/dist/1/131/files/2013/03/Keller-et-al.-Part-I.pdf

ACTIVITY 2. Reflecting on the required public health nursing core competencies needed for an effective
COVID-19 response in your work setting.

COVID-19 exposed the weaknesses in our public health system. Public Health Nurses as frontliners are
expected to carry on with the delivery of the essential public health services.
1. Are there essential public health services that are not being delivered effectively because of the
pandemic? Identify which aspect/s of the essential public health service is/are weak.
2. Given the specific weakness/es, what public health nursing interventions will be able to address such
weakness/es.
3. If you have a nurse in the BHS, RHU, and PHO, differentiate the public health nursing interventions
each nurse will carry out. Remember that the nurse in the BHS is considered Tier 1 and will carry out
individual-focused interventions; the nurse in the RHU is Tier 2 and will carry out community-focused
interventions and the nurse in PHO is Tier 3 and will perform systems-focused interventions

MODULE 2. ACTIVITY DOCUMENT | 8

Enero, Giovanni N. – Western Leyte College of Ormoc City

1. Are there essential public health services that were not delivered effectively
during the pandemic? What aspect was weak?

Yes, during the height of the pandemic, some essential public health services were not
delivered as effectively as they should have been. One key weakness was in “linking
people to needed health services”. Many people, especially in far-flung areas, struggled
to access regular health check-ups, immunizations, and maintenance medications because
of lockdowns, fear of exposure, and overwhelmed health workers.

Another weak aspect was “educating and empowering people”. With so much
misinformation about COVID-19 spreading, some people didn’t know what to believe or
follow. This led to vaccine hesitancy, panic, and non-compliance with health protocols.

2. What public health nursing interventions can address these weaknesses?

To fix these gaps, we need to go back to strong community engagement and health
education. Nurses can:

 Conduct house-to-house visits (if safe) or barangay-based health education

sessions to answer questions about vaccines and COVID-19.
 Work with barangay officials and volunteers to help connect patients to services,
like scheduling for teleconsultations or arranging transportation for check-ups.
 Use social media and local radio stations to spread correct and easy-to-
understand health information.

We need to meet people where they are—physically and emotionally—and guide them
with patience and compassion.

3. What would a nurse do at each level (BHS, RHU, PHO)?

 BHS Nurse (Tier 1 – Individual-focused):

o Provides one-on-one health teaching during clinic visits or home visits.
o Follows up with patients who missed vaccinations or check-ups.
o Builds trust with families by listening to their concerns about COVID-19 and
encouraging healthy behavior.
 RHU Nurse (Tier 2 – Community-focused):
o Organizes barangay health education campaigns.
o Coordinates with barangay captains to identify high-risk areas.
o Gathers community data to plan mass vaccination drives or outreach clinics.
 PHO Nurse (Tier 3 – Systems-focused):
o Develops policies or guidelines for COVID-19 response in the province.
o Ensures smooth coordination between RHUs and BHSs.
o Monitors and evaluates how health programs are being implemented and looks
for ways to improve them.

Reflection:

COVID-19 taught us that public health nursing is not just about treating illness—it’s about
building connections, communicating clearly, and staying strong even in
uncertain times. Each nurse, whether at the barangay, municipal, or provincial level, plays
an important role in keeping our communities safe and informed.

SUPPLEMENTAL READINGS
To enhance your understanding and complement what you learned, read the resources in the following link:
MODULE 2. ACTIVITY DOCUMENT | 9
Enero, Giovanni N. – Western Leyte College of Ormoc City
● 2012 National Nursing Core Competency Standards
Retrieved from: https://www.prc.gov.ph/uploaded/documents/Nursing%20Core%20Competency%20Standards%202012.pdf

This is a monograph produced by the Professional Regulatory Board of Nursing (PRBON) which describes the core competency standards of
entry-level nurses performing roles as a beginning provider of care, manager and supervisor, and researcher.

● Philippine Professional Nursing Practice Standards (2017)

Retrieved from: https://www.prc.gov.ph/sites/default/files/2017-22.PDF

This is another monograph from the Professional Regulatory Board of Nursing that describes the nursing practice standards to promote, guide, and
direct professional nursing practice. The nursing standards will be used by the individual nurses, the public, the employers, the regulatory boards,
the academe, and other stakeholders.

MODULE 2. ACTIVITY DOCUMENT | 10

Enero, Giovanni N. – Western Leyte College of Ormoc City

Over the years, the Philippines demonstrated great strides in health outcomes improvement as a result of health sector
reforms to achieve universal health coverage. In 2010, the government pursued UHC as its priority under the program
Kalusugan Pangkalahatan. These reforms concluded with the passage of Republic Act No 11223 better known as the
Universal Health Care Act. The UHC Law adopts a whole-of-system, whole-of-government, whole-of- society, people-
centered approach to improve overall health system performance. Although the law intends to address the health
inequities confronted by the health care system, there remain to be challenges that disrupt integrated services and the
continuum of care.

LEARNING OBJECTIVES
At the end of this session, you will be able to:
1. Discuss the challenges in ensuring integrated services and a continuum of care in the Philippines
2. Describe possible solutions to address the problems identified in securing integrated services and continuum of
care
3. Apply strategic responses to identified problems (e.g. maternal and neonatal health, NCDs, pandemic influenza)

LEARNING RESOURCES
View the lecture of Dr. Carlo Irwin Panelo on Integrated Services and Continuum of Care in this link:
https://docs.google.com/presentation/d/1lkl4Zmfk_-_5Iu_U13wKy6QTF3ljiBz_/edit?
usp=drive_link&ouid=112509942284019465918&rtpof=true&sd=true

He highlights the following aspects:

● Health care system challenges in improving health outcomes
● UHC as a response to address fundamental system challenges
● Implications of major provisions of UHC Act to the health system

After viewing the lecture, read/ browse through the resources below and work on the activity that follows.
1. Republic Act No. 11223 (Universal Health Care Act)
Retrieved from: http://www.congress.gov.ph/legisdocs/ra_17/RA11223.pdf

2. Implementing Rules and Regulations of the Universal Health Care Act (RA No 11223)
Retrieved from: https://www.philhealth.gov.ph/about_us/UHC-IRR_Signed.pdf

3. An Introduction to the Philippine Universal Health Care Law

Retrieved from: https://thinkwell.global/wp-content/uploads/2020/05/PH-UHC-Law-Series_Brief-1.pdf

This article provides a brief but concise discussion about the UHC Act, its major provisions and a summary of the intended changes to the
health system features.

MODULE 2. ACTIVITY DOCUMENT | 11

Enero, Giovanni N. – Western Leyte College of Ormoc City

ACTIVITY 3. Reflecting on the implications of UHC Law to public health nursing practice.

One of the major provisions of the UHC Act is illustrated in the changes in the health system features on the
health workforce. Can you reflect on the possible implications on the training and primary care certification
for public health nurses?

Features Before UHC Law UHC Law mandates

Health Workforce
Training General undergraduate training as Undergraduate and graduate training and
default primary care training, but curricula designed and realigned to focus on
with recognized inadequacies primary care competencies
Primary Care No required certification to Certification based on primary care
certification practice primary care competencies required for primary care
providers

Reflection: Implications of UHC Law on Training and Primary Care Certification for
Public Health Nurses

The Universal Health Care (UHC) Law brings big changes to how we prepare and support
public health nurses. Before the UHC law, most of us relied on our general nursing education
and learned primary care while already on the job. But now, with the UHC law, there’s a
stronger push to realign training to focus on primary care competencies—meaning,
nurses must be better equipped from the start to handle real-life health concerns at the
community level.

This is a good step forward. It means future nurses will be trained not just to provide care,
but to understand the full picture of public health—prevention, health promotion, early
detection, and managing common illnesses in the community. We will need more
targeted and practical training that prepares nurses to become effective primary care
providers, especially in far-flung and underserved areas.

Another big change is the requirement for primary care certification. Before, anyone
could be assigned to primary care work even without specific certification. With the new law,
nurses will now need to prove their competency in primary care through certification.
While this may seem like an extra step, it’s actually a way to ensure better quality of care
and help the public feel more confident in the services they’re receiving.

Final Thoughts:

This change pushes us to grow as professionals. It also gives us the opportunity to level up
our skills, serve our communities better, and contribute more meaningfully to the health
system. As public health nurses, we are not just caregivers—we are frontliners in prevention
and health promotion. The UHC law reminds us that we are essential, and we must be ready.

MODULE 2. ACTIVITY DOCUMENT | 12