Community Health Nursing

Community Health Nursing

• Integrates nursing practice with public health to improve the health of populations.
• Emphasizes community health, providing care to individuals, families, and groups within the community context.
• Focuses on three main areas: health promotion, illness prevention, and care for the sick at home.

Levels of Clientele

• Individuals
• Families
• Populations
• Communities

Subspecialties

• School Nursing
• Occupational Health Nursing
• Community Mental Health Nursing
• Public Health Nursing

Public Health Nursing

• Combines nursing skills and public health principles with elements of social assistance.
• Aims to promote health, improve social and physical environments, and assist in rehabilitation.
• Defined by Dr. C.E. Winslow as the art and science of preventing diseases and promoting health and efficiency.

Public Health Nurse

• Works in local/national health departments or public schools.
• Typically starts at Salary Grade 15.

Roles and Functions of a Public Health Nurse

• Planner/Programmer: Identifies health needs and priorities.
• Nursing Care Provider: Delivers nursing care in home, clinic, school, or workplace settings.
• Manager/Supervisor: Implements nursing plans and encourages community health problem solving.
• Community Organizer: Fosters participation and initiates development activities.
• Service Coordinator: Collaborates for health service delivery.
• Health Educator/Counselor: Conducts health training and informs communities on health-related issues.
• Health Monitor: Tracks health status through contact and observation.
• Role Model: Exemplifies healthy living standards.
• Change Agent: Motivates behavior change in health practices.
• Reported/Recorder/Statistician: Documents interventions and analyzes health data.
• Researcher: Gathers data through various assessment methods.

Philippine Health Care Delivery System

• Department of Health (DOH) focuses on health leadership, capacity building, and specific service administration.
• Vision: Filipinos to be among the healthiest in Southeast Asia by 2022, Asia by 2040.
• Mission: Develop a resilient, equitable, people-centered health system.
• Goal: Implement Health Sector Reform Agenda (HSRA).

Framework for HSRA Implementation

• FOURmula ONE for Health (2005-2010) aims at better health outcomes and responsive health systems.
• Four Elements:
  • Health Financing: Ensure sustainable health investment (PHILHEALTH).
  • Health Regulation: Maintain quality and affordability of health services.
  • Health Service Delivery: Enhance accessibility to essential health care.
  • Good Governance: Improve health system performance across levels.

Primary Health Care (PHC) in the Philippines

• Established via Letter of Instruction (LOI) 949 on October 19, 1979, themed "Health in the Hands of the People".
• Centers on community empowerment and accessible health services.

Components of PHC

• Education for health
• Disease control and treatment
• Expanded immunization program
• Maternal and child health
• Essential drugs
• Nutrition
• Sanitation

Levels of Primary Health Care Providers

• Village/Barangay Health Workers: Trained community health volunteers.
• Intermediate Level Health Workers: Includes public health nurses and rural health physicians.

Levels of Healthcare and Referral Systems

• Primary Level of Care: Personnel provide basic health services at local health facilities.
• Secondary Level of Care: Basic health training physicians handle minor surgeries and serve as referral centers.
• Tertiary Level of Care: Specialists address complex cases in advanced medical facilities.

Levels of Prevention

• Primary Prevention: Focuses on preventing disease transmission (e.g., vector control, immunization).
• Secondary Prevention: Targets early detection and intervention post-infection (e.g., screenings, health exams).
• Tertiary Prevention: Aims to reduce morbidity post-disease onset through rehabilitation efforts.

Field Health Services and Information System (FHSIS)

• Collects and analyzes health service delivery data across various levels for program monitoring and evaluation.
• Aims for data accuracy and reduced reporting burdens for healthcare providers.

Public Health Programs - Family Health

• Maternal Health Program: Includes antenatal registration, immunization, disease treatment, and health teachings.

Immunization Policies

• EPI LAW (PD 996): Advocates concurrent vaccinations on the same day and outlines essential guidelines for immunization practices.
• RA 10152 (2011): Mandates basic immunization services for children; emphasizes the importance of vaccinations despite common contraindications.

Family Planning

• Overall Goal: Provide universal access to family planning services.
• Aims to reduce infant, neonatal, under-five, and maternal mortality rates.
• Methods: Consists of sterilization (female and male), contraceptive pills, male condoms, and injectables, each with specific advantages and disadvantages.### Lactating Amenorrhea Method (LAM)
• Temporary birth control method for breastfeeding women based on natural infertility
• Universally accessible with no additional family planning resources needed
• Supports maternal and child health and nutrition
• Effective only for up to 6 months postpartum
• Effectiveness decreases with mother-child separation
• Maintaining full breastfeeding might be challenging for 6 months

Mucus/Billing Methods

• Involves abstaining from intercourse during fertile days to prevent pregnancy
• Applicable for any reproductive-age woman without unusual medical conditions

Basal Body Temperature Method

• Identifies fertile and infertile periods through daily temperature recording
• Temperature reduces by 0.5°F before ovulation and rises by 1.0°F during ovulation

Sympto-thermal Method

• Combines observations of cervical mucus, basal body temperature, and other ovulation signs for cycle tracking

Two Day Method

• Based on daily checking of cervical secretions to identify fertility
• Usable by women with any cycle length
• Minimal cost and immediate reversibility
• Requires male partner participation and may be unreliable for women with unusual cervical secretions

Standard Days Method

• Color-coded cycle beads help track fertile and infertile days
• No health side effects; promotes self-awareness and education on reproduction
• Applicable for pregnancy avoidance or achievement
• Not suitable for women with cycles shorter than 26 days or longer than 32 days

Environmental Health

• Branch of public health focused on preventing illness through environmental management and behavior change
• Addresses exposure to disease-causing agents

Health and Sanitation Laws in the Philippines

• PD 856: Sanitation Code
• RA 6969: Toxic Substances and Hazardous Waste Control Act
• RA 8749: Clean Air Act
• RA 9003: Ecological Solid Waste Management Act
• RA 9275: Clean Water Act

Environmental Sanitation

• Studies factors in the environment affecting health, well-being, and survival

Water Supply Facilities

• Level 1: Point source (protected well/spring) serving 15-25 households
• Level 2: Communal faucet systems delivering shared water supply
• Level 3: Individual house connections for waterworks systems
• Unapproved facilities include open dug wells and unimproved springs

Proper Excreta and Sewage Disposal Program

• Level 1: Non-water carriage facilities (pit latrines, earth closets)
• Level 2: Water carriage types with small water use
• Level 3: Connected to sewage systems or treatment plants

Food Sanitation Program

• Inspections for food sources, sanitation permits, and health certifications for food handlers
• Administrative Order no. 1-2006 mandates modern stool analysis methods

Four Rights in Food Safety

• Right Source: Purchase fresh, unspoiled food; check expiry dates; boil water for safety
• Right Preparation: Prevent cross-contamination; wash raw vegetables and hands before cooking
• Right Cooking: Cook food thoroughly at correct temperatures; eat promptly
• Right Storage: Store food correctly to ensure safety and freshness; discard suspicious food

General Guidelines for Herbal Medicine

• Use the correct plant, part, dosage, and duration; stop if adverse reactions occur
• Consult a physician if no improvement is observed after use

Selected Herbal Plants and Uses

• Lagundi: Used for cough and asthma; preparation involves boiling leaves
• Ulasimang Bato: Used for lowering uric acid; can be consumed fresh or as decoction
• Bayabas: Used for wound cleaning and oral infections; leaves boiled for solution
• Bawang: Used for cholesterol; consumed raw or prepared in dishes
• Yerba Buena: For body pains; leaves boiled and solution divided for consumption
• Sambong: For swelling; leaves boiled and administered in portions
• Ampalaya: Used for diabetes; leaves prepared and taken before meals
• Niyug-niyugan: For ascaris; seeds consumed after meals
• Tsaang Gubat: For stomachaches; leaves prepared into a solution
• Akapulko: For skin infections; juice applied topically

Conclusion

• Proper understanding of family planning methods, environmental health policies, food safety practices, and herbal medicine can contribute to overall health awareness and community well-being.