Public Health Nursing - Midterms PDF

Aspect Public Health Nursing Community Health Nursing Definition Focuses on the health of populations through disease prevention, health promotion, and policy. Provides health services, education, and advocacy within communities, focusing on prevention and health maintenance. Primary Goals Pr...

Aspect Public Health Nursing Community Health Nursing Definition Focuses on the health of populations through disease prevention, health promotion, and policy. Provides health services, education, and advocacy within communities, focusing on prevention and health maintenance. Primary Goals Prevention of disease, prolonging life, and promoting health through organized efforts. Promoting health, preventing disease, and maintaining health within a community setting. Approach Population-based, addressing health issues at the community or global level. Individual and community-focused, addressing health needs of specific populations. Key Activities Surveillance, policy development, health education, and program implementation. Direct care, health education, community assessments, and advocacy. Work Setting Government agencies, non-profits, international organizations. Local health departments, schools, community clinics, homes. Scope Broad, covering a wide range of public health issues and populations. Specific, often focusing on particular communities or population groups. Target Population Entire populations or large segments of populations. Specific communities or groups within a larger population. Key Focus Areas Epidemiology, environmental health, global health, health policy. Maternal and child health, school health, occupational health, environmental health. Role of Nurses Developing and implementing public health policies, conducting research, and health promotion. Providing direct patient care, health education, and community advocacy. --------------------------------- ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------- Aspect Public Health Nursing Example Community Health Nursing Example Focus on Prevention Implementing a national vaccination program to prevent influenza. Organizing a community flu shot clinic and educating residents on prevention. Health Education Launching a country-wide campaign to educate the public on the dangers of smoking. Conducting workshops at local community centers on healthy eating habits. Population Health Developing policies to reduce obesity rates across the country. Initiating a weight management program for a local community group. Community Assessment Conducting a survey to identify health risks in urban areas nationwide. Performing door-to-door surveys to assess health needs in a rural village. Policy Development and Advocacy Advocating for legislation to improve air quality standards. Working with local government to pass a policy for smoke-free public spaces. Collaboration and Partnerships Partnering with international organizations to combat a global health crisis. Collaborating with local schools and businesses to promote health initiatives. Research and Data Analysis Analyzing national health data to track the spread of infectious diseases. Using community health data to identify trends and plan local health programs. Access to Health Services Developing programs to increase access to primary care across the country. Setting up mobile clinics to provide care in underserved areas. Health Promotion Organizing a national heart health campaign to reduce cardiovascular diseases. Running a local fitness program to encourage physical activity among residents. --------------------------------- ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------- **Public Health Nursing** **Prevention** **Epidemiology** **Policies** **Surveillance** **Community outreach** **Organized efforts** **Population health** **Education** **Community Health Nursing** **Community-based** **Advocacy** **Risk reduction** **Education** **Nursing care** **Utilizing resources** **Resource assessment** **Service delivery** **Engagement** **History of Community Health Nursing in the Philippines** **Introduction** The history of community health nursing in the Philippines is a fascinating journey of growth, adaptation, and resilience. It reflects the broader social, economic, and medical trends that have shaped the country\'s healthcare system over the years. **Early Beginnings** **Spanish Colonial Period (1565-1898)** During the Spanish colonial period, healthcare was primarily provided by religious orders, particularly the Franciscans and Dominicans1. They established hospitals and dispensaries to care for the sick, with notable institutions like San Lazaro Hospital1. **American Colonial Period (1898-1946)** The American colonial period brought significant changes to the healthcare system. The establishment of the Board of Health in 1901 and the creation of the Bureau of Health in 1905 marked the beginning of formal public health efforts2. **Early 20th Century Developments** **Sanitary Divisions (1912)** The Fajardo Act of 1912 created the Sanitary Divisions, which were the forerunners of modern municipal health offices2. Male nurses were employed to perform the functions of doctors in rural areas2. **Nurses Law (1919)** The Nurses Law of 1919 formalized nursing education and practice in the Philippines2. This act laid the foundation for the professionalization of nursing and the establishment of nursing schools2. **Establishment of Nursing Schools (1923)** The establishment of nursing schools, such as the Zamboanga General Hospital School of Nursing and Baguio General Hospital, further advanced the training and education of nurses2. **Mid-20th Century Expansion** **Rural Health Units (1950s)** In the 1950s, the Philippine government established Rural Health Units (RHUs) to provide primary health care in rural areas2. These units played a crucial role in improving access to healthcare for underserved populations. **Professional Organizations** The formation of professional organizations, such as the Filipino Nurses Organization (now the Philippine Nurses Association), provided support and advocacy for nurses working in community settings2. **Modern Developments** **Local Government Code of 1991** The Local Government Code of 1991 decentralized health services to local government units (LGUs), enhancing community-level healthcare delivery2. This devolution aimed to make health services more accessible and responsive to local needs. **Technological Advancements** Technological advancements, such as electronic health records and telehealth, have transformed community health nursing, enabling nurses to deliver care more efficiently and reach underserved populations. **Global Health Initiatives** Community health nurses in the Philippines participate in international health initiatives, disaster relief efforts, and global health education programs, addressing health disparities and improving health outcomes worldwide. **SPECIALIZED FIELD IN COMMUNITY HEALTH NURSING AND PUBLIC HEALTH NURSING** **School Health Nursing, Occupational Health Nursing, and Mental Health Nursing** **Concepts and Comparison** -------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------ **Aspect** **School Health Nursing** **Occupational Health Nursing** **Mental Health Nursing** **Definition** Focuses on the health and well-being of students in educational settings. Promotes and maintains the health and safety of workers in various industries. Specializes in the care of individuals with mental health conditions. **Primary Goals** Promote health, prevent disease, and manage health issues in schools. Prevent work-related injuries and illnesses, promote healthy work environments. Provide care, support, and treatment for mental health disorders. **Key Activities** Health education, screenings, immunizations, managing chronic conditions. Risk assessment, health surveillance, employee health education, ergonomics. Mental health assessments, counseling, crisis intervention, medication management. **Work Setting** Schools, colleges, and universities. Workplaces, industrial sites, corporate settings. Hospitals, mental health clinics, community health centers, private practices. **Target Population** Students, school staff, and sometimes families. Employees and employers. Individuals with mental health issues, their families, and communities. **Health Focus Areas** Immunizations, mental health, chronic disease management, health promotion. Occupational safety, ergonomics, chronic disease prevention, wellness programs. Anxiety, depression, substance abuse, schizophrenia, bipolar disorder. **Collaboration** Works with teachers, parents, school administrators, and healthcare providers. Collaborates with employers, safety officers, occupational therapists, and healthcare providers. Teams up with psychiatrists, psychologists, social workers, and family members. **Policy and Advocacy** Develops and advocates for school health policies. Ensures compliance with occupational health and safety regulations. Advocates for mental health policies and patient rights. **Research and Data Analysis** Uses data to improve school health programs. Conducts research to identify workplace health risks and improve safety. Utilizes research to enhance mental health care practices and interventions. **Health Promotion** Promotes healthy lifestyles and preventive measures among students. Promotes workplace wellness and preventive health practices. Promotes mental health awareness and preventive strategies. -------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------ **School Health Nursing** Mnemonic: SCH -- School Care Health School-based health services Care coordination Health education and promotion **Occupational Health Nursing** Mnemonic: WORKS -- Workplace Occupational Risk Knowledge Safety Workplace health promotion Occupational safety Risk assessment Knowledge dissemination Safety Programs **Mental Health Nursing** Mnemonic: MIND -- Mental Intervention Nurture Diagnosis Mental health assessments Intervention and counseling Nurture patient well-being Diagnosis and treatment management **THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM** World Health Organization (WHO) Definition:The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Established on April 7, 1948, and headquartered in Geneva, Switzerland, the WHO\'s primary role is to coordinate and direct international health efforts, set health standards, and promote health and well-being globally. Purpose:The WHO\'s overarching purpose is to promote health, keep the world safe, and serve the vulnerable. It works to ensure that people worldwide achieve the highest possible level of health, regardless of geographical location or socioeconomic status. Key Purposes: - To ensure universal health coverage. - To protect people from health emergencies. - To promote health and well-being. World Health Organization (WHO) in Nursing Definition:The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Established on April 7, 1948, and headquartered in Geneva, Switzerland, the WHO\'s primary role is to coordinate and direct international health efforts, set health standards, and promote health and well-being globally. Purpose:The WHO\'s overarching purpose is to promote health, keep the world safe, and serve the vulnerable. It works to ensure that people worldwide achieve the highest possible level of health, regardless of geographical location or socioeconomic status. Key Purposes:To ensure universal health coverage,To protect people from health emergencies,To promote health and well-being. Functions in Nursing:The WHO plays a crucial role in nursing by providing guidance, standards, and support to improve nursing practices globaly.  Here are some key functions: 1.Setting Standards and Guidelines-develops and disseminates international standards and guidelines for nursing education, practice, and ethical conduct. Example: The WHO\'s \"Global Strategic Directions for Strengthening Nursing and Midwifery\" sets the agenda for nursing practices worldwide. 2.Capacity Building and Education-Provides training programs and resources to enhance the skills and knowledge of nurses. Example: Initiatives like the \"Nursing Now\" campaign, in collaboration with the International Council of Nurses, focus on empowering nurses with the skills necessary to lead in healthcare. 3.Health Policy Development-Works with governments and health organizations to develop policies that support nursing and midwifery services. Example: The WHO collaborates with countries to integrate nursing into national health policies and frameworks. 4.Advocacy and Leadership-Advocates for the recognition of nursing as a critical component of healthcare systems. Example: WHO\'s efforts to raise the profile of nurses and midwives through global campaigns and recognition programs. 5.Research and Data Collection-Conducts research and collects data to inform evidence-based nursing practices and policies. Example: WHO publishes reports and studies on global nursing trends, workforce statistics, and health outcomes. 6.Emergency Response and Preparedness-Provides training and resources for nurses to respond effectively to health emergencies and disasters. Example: The WHO\'s emergency training programs for nurses preparing them to handle pandemics and natural disasters. 7.Promoting Health and Wellness-Initiates programs to promote health and wellness among populations through nursing interventions. Example: WHO\'s initiatives on maternal and child health, immunization programs, and chronic disease prevention. **Mnemonic for Functions: SCARE PR** **Standards** **Capacity Building** **Advocacy** **Research** **Emergency Response** **Policy Development** **Promoting Health** ** Millennium Development Goals (MDGs)** **Introduction** The Millennium Development Goals (MDGs) were a set of eight international development goals established following the Millennium Summit of the United Nations in 2000. They were designed to address some of the most pressing issues facing the world, including poverty, hunger, disease, gender inequality, and environmental degradation. The MDGs were intended to be achieved by 2015. **The Eight Millennium Development Goals** **1.Eradicate Extreme Poverty and Hunger** Goal: Halve the proportion of people living on less than \$1.25 a day and achieve full and productive employment for all, including women and young people. Purpose: Reduce poverty and hunger to improve the overall standard of living. **2.Achieve Universal Primary Education** Goal: Ensure that all boys and girls complete a full course of primary schooling. Purpose: Provide all children with access to education, which is essential for personal and societal development. **3.Promote Gender Equality and Empower Women** Goal: Eliminate gender disparity in primary and secondary education, preferably by 2005, and at all levels of education no later than 2015. Purpose: Empower women and girls through equal access to education and opportunities. **4.Reduce Child Mortality** Goal: Reduce by two-thirds the under-five mortality rate. Purpose: Improve child health and reduce preventable deaths. **5.Improve Maternal Health** Goal: Reduce the maternal mortality ratio by three-quarters and achieve universal access to reproductive health. Purpose: Enhance maternal health and reduce the number of deaths during childbirth. **6.Combat HIV/AIDS, Malaria, and Other Diseases** Goal: Halt and begin to reverse the spread of HIV/AIDS, achieve universal access to treatment, and reduce the incidence of malaria and other major diseases. Purpose: Control and reduce the prevalence of life-threatening diseases. **7.Ensure Environmental Sustainability** Goal: Integrate sustainable development principles into country policies, reverse the loss of environmental resources, reduce biodiversity loss, and halve the proportion of people without access to safe drinking water and basic sanitation. Purpose: Promote sustainable use of natural resources and ensure a healthy environment. **8.Develop a Global Partnership for Development** Goal: Address the needs of least developed countries, develop fair trade systems, deal comprehensively with developing countries\' debt, provide access to affordable essential drugs, and make new technologies available. Purpose: Strengthen global partnerships to support development efforts. **Achievements and Challenges** Achievements: Significant progress was made in areas such as reducing extreme poverty, increasing primary school enrollment, promoting gender equality, and improving access to clean drinking water. Challenges: Despite the successes, many targets were not fully met, particularly in regions affected by conflict and instability. Issues such as maternal health, child mortality, and environmental sustainability continued to face significant challenges. **Legacy and Transition to SDGs** The MDGs laid the foundation for the Sustainable Development Goals (SDGs), which were adopted in 2015. The SDGs build on the MDGs and aim to address a broader range of issues with more ambitious targets by 2030. **Sustainable Development Goals (SDGs) ** Introduction The Sustainable Development Goals (SDGs) are a set of 17 global goals established by the United Nations in 2015. These goals aim to address the world\'s most pressing challenges, including poverty, inequality, climate change, environmental degradation, peace, and justice1. The Philippines, like many other countries, has committed to achieving these goals by 2030. The 17 Sustainable Development Goals (SDGs) **1.No Poverty** Goal: End poverty in all its forms everywhere. Philippine Example: The Pantawid Pamilyang Pilipino Program (4Ps) provides conditional cash transfers to poor families to improve their health, nutrition, and education1. **2.Zero Hunger** Goal: End hunger, achieve food security and improved nutrition, and promote sustainable agriculture. Philippine Example: The Department of Agriculture\'s \"Masagana 99\" program aims to increase rice production and ensure food security1. **3.Good Health and Well-being** Goal: Ensure healthy lives and promote well-being for all at all ages. Philippine Example: The Universal Health Care (UHC) Act provides all Filipinos with access to affordable and quality health services1. **4.Quality Education** Goal: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. Philippine Example: The Alternative Learning System (ALS) provides non-formal education to out-of-school youth and adults1. **5.Gender Equality** Goal: Achieve gender equality and empower all women and girls. Philippine Example: The Magna Carta of Women ensures the protection and promotion of the rights of Filipino women1. **6.Clean Water and Sanitation** Goal: Ensure availability and sustainable management of water and sanitation for all. Philippine Example: The \"Water for All\" program aims to provide clean and safe drinking water to rural communities1. **7.Affordable and Clean Energy** Goal: Ensure access to affordable, reliable, sustainable, and modern energy for all. Philippine Example: The National Renewable Energy Program promotes the use of renewable energy sources like solar and wind power1. **8.Decent Work and Economic Growth** Goal: Promote sustained, inclusive, and sustainable economic growth, full and productive employment, and decent work for all. Philippine Example: The Department of Labor and Employment (DOLE) implements programs to create job opportunities and improve working conditions1. **9.Industry, Innovation, and Infrastructure** Goal: Build resilient infrastructure, promote inclusive and sustainable industrialization, and foster innovation. Philippine Example: The Build, Build, Build program aims to develop infrastructure projects to boost economic growth1. **10.Reduced Inequality** Goal: Reduce inequality within and among countries. Philippine Example: The Pantawid Pamilyang Pilipino Program (4Ps) helps reduce poverty and inequality by providing financial assistance to poor families1. **11.Sustainable Cities and Communities** Goal: Make cities and human settlements inclusive, safe, resilient, and sustainable. Philippine Example: The \"Green Building Code\" promotes sustainable urban development and reduces the environmental impact of buildings1. 12.Responsible Consumption and Production Goal: Ensure sustainable consumption and production patterns. Philippine Example: The \"Zero Waste Management\" program encourages waste reduction, recycling, and proper disposal1. 13.Climate Action Goal: Take urgent action to combat climate change and its impacts. Philippine Example: The National Climate Change Action Plan (NCCAP) outlines strategies to mitigate and adapt to climate change1. 14.Life Below Water Goal: Conserve and sustainably use the oceans, seas, and marine resources for sustainable development. Philippine Example: The \"Biodiversity Conservation and Management\" program protects marine ecosystems and promotes sustainable fishing practices1. 15.Life on Land Goal: Protect, restore, and promote sustainable use of terrestrial ecosystems, manage forests, combat desertification, and halt biodiversity loss..Philippine Example: The National Greening Program (NGP) aims to reforest denuded areas and promote biodiversity1. 16.Peace, Justice, and Strong Institutions Goal: Promote peaceful and inclusive societies, provide access to justice for all, and build effective, accountable, and inclusive institutions. Philippine Example: The \"Peace and Development Framework\" addresses conflict and promotes peacebuilding in conflict-affected areas1. 17.Partnerships for the Goals Goal: Strengthen the means of implementation and revitalize the global partnership for sustainable development. Philippine Example: The Partnership Framework for Sustainable Development (PFSD) supports national development goals and the 2030 Agenda1. **[Philippines\' Health Care Delivery System]** -------------------------------------- ----------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- **Component** **Major Functions** **Characteristics** **Structure** **Policy and Legal** Develop and enforce health policies and regulations. Establishes the legal framework for health services. Includes the Department of Health (DOH), legislation like the Universal Health Care (UHC) Act. **Governance and Leadership** Provide strategic direction, oversight, and coordination of the health system. Ensures effective management and accountability. Headed by the Secretary of Health, with regional and local health offices. **Finance and Payment** Manage financial resources, health insurance schemes, and funding allocation. Ensures sustainable and equitable funding for health services. Includes PhilHealth for insurance, DOH budgeting, and local government funding. **Management** Ensure efficient operation, resource allocation, and administrative support. Facilitates smooth delivery of health services and coordination among providers. Hospital management teams, administrative departments, and health program managers. **Human Resources** Recruit, train, and retain health professionals; manage workforce policies. Builds a competent and motivated health workforce. Includes medical schools, training programs, DOH Human Resource Bureau, and local health units. **Service Provision** Deliver preventive, curative, and rehabilitative health services to the population. Directly impacts patient care and health outcomes. Comprises barangay health stations, rural health units, district hospitals, provincial hospitals, and tertiary care facilities. **Immunizations and Logistics** Manage supply chain for vaccines and medical supplies; implement immunization programs. Ensures availability and timely distribution of essential health commodities. Includes National Immunization Program, warehouses, and distribution networks. **Provider-to-Provider Interaction** Facilitate communication and collaboration among health care providers. Ensures continuity of care and efficient patient referral systems. Referral systems, inter-hospital communication protocols, and specialist networks. -------------------------------------- ----------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------- ----------------------------------------------------------- ------------------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- **Component** **Roles** **Functions** **Goals** **Examples** Department of Health (DOH) National health policy-maker and regulatory body. Develops health policies, implements national health programs, regulates health services and products. Ensure access to quality health care, improve health outcomes, protect public health. Implementation of the Universal Health Care (UHC) Act, regulation of pharmaceutical companies. Local Government Units (LGUs) Manage local health services and facilities. Provide primary health care services, manage local health programs, enforce health regulations. Ensure community health, provide accessible health services, implement local health initiatives. Barangay Health Centers, Municipal Health Offices, Provincial Hospitals. PhilHealth National health insurance provider. Administers health insurance coverage, reimburses health care providers, manages health insurance funds. Achieve universal health coverage, reduce out-of-pocket health expenses, improve financial protection. Universal Health Care coverage for all Filipinos. **Private Health Sector** Deliver private health services and facilities. Provide health care services, operate private hospitals and clinics, offer specialized medical treatments. Improve health service quality, expand health care options, contribute to health sector growth. St. Luke\'s Medical Center, Makati Medical Center, private clinics and specialty hospitals. **Public Health Sector** Deliver public health services and programs. Implement public health programs, provide preventive services, manage disease control and surveillance. Protect population health, prevent disease outbreaks, promote health and wellness. National Immunization Program, Disease Surveillance Systems, Health Promotion Programs. **Educational Institutions** Train and educate health professionals. Provide medical and health education, conduct health research, offer professional development programs. Produce skilled health workforce, advance health knowledge, support health sector innovation. University of the Philippines College of Medicine, Ateneo School of Medicine and Public Health. **Non-Governmental Organizations (NGOs)** Support health programs and provide specialized services. Offer health services, conduct health advocacy, implement community health projects. Enhance community health, support vulnerable populations, advocate for health rights. Philippine Red Cross, Gawad Kalinga Community Health Programs. **Traditional and Alternative Health Care** Offer complementary and alternative health care services. Provide traditional healing practices, offer alternative therapies, promote holistic health approaches. Integrate traditional medicine with modern health care, offer diverse health options, promote wellness. Traditional healers, acupuncture clinics, herbal medicine practitioners. **Research Institutions** Conduct health research and innovation. Perform health research, develop new health technologies, contribute to evidence-based health policies. Advance medical knowledge, improve health care practices, support health policy development. Philippine Council for Health Research and Development, Research Institute for Tropical Medicine. --------------------------------------------- ----------------------------------------------------------- ------------------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- **[Composition of  Local Health Boards in the Philippines:]** ----------------------------------- ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ **Component** **Provincial Health Board** **City Health Board** **Municipal Health Board** **Chairman** Governor City Mayor Municipal Mayor **Vice-Chairman** Provincial Health Officer City Health Officer Municipal Health Officer **Committee Chair** Chairman of the Committee on Health of the Sangguniang Panlalawigan Chairman of the Committee on Health of the Sangguniang Panlungsod Chairman of the Committee on Health of the Sangguniang Bayan **Private Sector Representative** Representative from the private sector or non-governmental organizations involved in health services Representative from the private sector or non-governmental organizations involved in health services Representative from the private sector or non-governmental organizations involved in health services **DOH Representative** Representative of the Department of Health in the province Representative of the Department of Health in the city Representative of the Department of Health in the municipality ----------------------------------- ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ **Levels of  Health Care Facilities in the Philippines** ----------------------------------- ----------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------- ------------------------------------------------------ **Level of Health Care Facility** **Roles** **Functions** **Goals** **Examples** Primary Level Provide basic health services and initial patient care. Health promotion, disease prevention, basic medical care, immunizations, maternal and child health services. Improve community health, prevent common diseases, provide  accessible health care. Barangay Health Centers, Rural Health Units Secondary Level Offer specialized medical care and support services. Diagnose and treat more complex health conditions, perform minor surgeries, provide inpatient and outpatient care. Provide comprehensive health care services, support primary level facilities. District Hospitals, Provincial Hospitals Tertiary Level Provide highly specialized medical care and advanced treatment. Advanced diagnostic services, major surgeries, specialized treatments for severe and complex conditions. Deliver top-level medical services, offer advanced treatments and procedures, conduct medical research. National and Regional Hospitals, Specialty Hospitals ----------------------------------- ----------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------- ------------------------------------------------------ **Primary Health Care Workers in the Philippines:** ----------------------------------- ------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- --------------------------------------------------------------- ------------------------------------------------------------- **Primary Health Care Worker** **Roles** **Functions** **Training/Qualifications** **Examples** Barangay Health Workers (BHWs) Provide basic health services, assist in community health programs. Conduct home visits, health education, immunizations, monitor health status. Basic training in primary health care, community health work. Community Health Workers in barangays. Rural Health Midwives Provide maternal and child health services in rural areas. Prenatal care, deliveries, postnatal care, family planning services. Licensed midwives with training in maternal and child health. Midwives working in Rural Health Units (RHUs). Barangay Nutrition Scholars (BNS) Promote nutrition and implement community nutrition programs. Nutrition education, growth monitoring, supplementary feeding programs. Training in nutrition, basic health education. Community volunteers focused on nutrition programs. Rural Health Physicians Provide medical care and oversee health services in rural health units. Diagnose and treat illnesses, manage health programs, supervise health staff. Licensed medical doctors with public health training. Doctors working in Rural Health Units (RHUs). Public Health Nurses Coordinate and provide public health services at the community level. Immunizations, disease surveillance, health education, maternal and child health care. Registered nurses with public health training. Nurses in Municipal Health Offices and Rural Health Units. Sanitary Inspectors Ensure environmental health and sanitation in communities. Inspect food establishments, water quality monitoring, enforce sanitation laws. Training in sanitation and environmental health. Sanitary inspectors working under Municipal Health Offices. ----------------------------------- ------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- --------------------------------------------------------------- ------------------------------------------------------------- **Types Primary Health Care Workers in the Philippines:** ----------------------------- ------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- **Aspect** **Village/Grassroots Health Workers** **Intermediate Workers** **Health Personnel of First-Line Hospitals** **Roles** Provide basic health services at the community level. Offer more specialized health services and support. Provide comprehensive medical care and specialized services. **Functions** Basic health education, immunizations, maternal and child health, sanitation. Diagnose and treat common illnesses, conduct health screenings, manage health programs. Advanced diagnostics, specialized treatments, surgeries, inpatient and outpatient care. **Training/Qualifications** Basic training in primary health care, community health work. Professional training in nursing, midwifery, or general medical practice. Advanced medical degrees, specialized training, and certifications. **Examples** Barangay Health Workers (BHWs), Barangay Nutrition Scholars (BNS), Barangay Health Aides. Rural Health Midwives, Public Health Nurses, Sanitary Inspectors. Physicians, Specialists, Surgeons, Registered Nurses, Medical Technologists. **Work Setting** Barangay Health Centers, Rural Health Units (RHUs). Rural Health Units (RHUs), Municipal Health Offices. District Hospitals, Provincial Hospitals, Tertiary Hospitals. **Goals** Improve basic health outcomes, increase accessibility to health services. Enhance community health, reduce incidence of common diseases, improve maternal and child health. Provide comprehensive medical care, improve health outcomes for complex conditions, support community health facilities. **Patient Ratio** 1:1,000 - 1:2,000 (varies by region) 1:500 - 1:1,000 (varies by region) 1:200 - 1:500 (varies by hospital and region) ----------------------------- ------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- **Restructured Health Care Delivery System** ----------------------------------------- ------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------- Component Roles Functions Goals Service Delivery Networks (SDNs) Coordinate and integrate health services across different levels. Ensure continuity of care, reduce fragmentation, improve access to health services. Provide seamless and efficient health care delivery, reduce patient \"zigzagging.\" Primary Health Care (PHC) Provide basic health services and preventive care. Health promotion, disease prevention, immunizations, maternal and child health services. Improve community health, increase accessibility to health services, prevent common diseases. Secondary Health Care Offer specialized medical care and support services. Diagnose and treat more complex health conditions, perform minor surgeries, provide inpatient and outpatient care. Provide comprehensive health care services, support primary health care facilities. Tertiary Health Care Provide highly specialized medical care and advanced treatment. Advanced diagnostics, major surgeries, specialized treatments for severe and complex conditions. Deliver top-level medical services, offer advanced treatments and procedures, conduct medical research. PhilHealth National health insurance provider. Administer health insurance coverage, reimburse health care providers, manage health insurance funds. Achieve universal health coverage, reduce out-of-pocket health expenses, improve financial protection. Local Government Units (LGUs) Manage local health services and facilities. Provide primary health care services, manage local health programs, enforce health regulations. Ensure community health, provide accessible health services, implement local health initiatives. Private Health Sector Deliver private health services and facilities. Provide health care services, operate private hospitals and clinics, offer specialized medical treatments. Improve health service quality, expand health care options, contribute to health sector growth. Non-Governmental Organizations (NGOs) Support health programs and provide specialized services. Offer health services, conduct health advocacy, implement community health projects. Enhance community health, support vulnerable populations, advocate for health rights. Educational Institutions Train and educate health professionals. Provide medical and health education, conduct health research, offer professional development programs. Produce skilled health workforce, advance health knowledge, support health sector innovation. Traditional and Alternative Health Care Offer complementary and alternative health care services. Provide traditional healing practices, offer alternative therapies, promote holistic health approaches. Integrate traditional medicine with modern health care, offer diverse health options, promote wellness. ----------------------------------------- ------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------- **Composition and population ratio of Rural Health Units (RHUs) in the Philippines:** ------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------- **Component** **Composition** **Population Ratio** Rural Health Unit (RHU) Municipal Health Officer, Public Health Nurse, Midwife, Sanitary Inspector1 Serves a population of approximately 20,000 Barangay Health Station (BHS) Barangay Health Workers (BHWs), Barangay Nutrition Scholars (BNS) Serves a population of approximately 5,000 District Hospital Physicians, Surgeons, Registered Nurses, Medical Technologists Serves a population of approximately 200,000 (varies by region) ------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------- **Two-Way Referral System in the Philippines** The two-way referral system in the Philippines is designed to ensure that patients receive the appropriate level of care at the right time. It involves the transfer of patients between different levels of health care facilities, such as from primary care (Barangay Health Centers) to secondary care (District Hospitals) and tertiary care (Provincial and National Hospitals), and vice versa. **Key Components:** Primary Health Care (PHC): Provides basic health services and preventive care. Secondary Health Care: Offers specialized medical care and support services. Tertiary Health Care: Delivers highly specialized medical care and advanced treatment. **Functions:** Referral In: Patients are referred from lower levels (PHC) to higher levels (secondary or tertiary) for specialized care. Referral Out: Patients are referred back to lower levels for follow-up care and continued management. **Goals:** 1.Ensure continuity of care. 2.Improve access to specialized health services. 3.Optimize the use of health care resources. 4.Enhance patient outcomes. Mnemonics for Two-Way Referral System To remember the two-way referral system, you can use the mnemonic: \"PHC to SHC to THC and back\". PHC: Primary Health Care to SHC: Secondary Health Care to THC: Tertiary Health Care **Inter-Local Health System** The Philippine Inter-Local Health System (ILHS) is a framework designed to improve the delivery of health services by fostering collaboration among local government units (LGUs). This system aims to create Inter-Local Health Zones (ILHZs), which are clusters of municipalities and cities working together to provide comprehensive health care services1. Key Components: Inter-Local Health Zones (ILHZs): Clusters of municipalities and cities within a defined geographical area1. Core Referral Hospital: A central hospital within the ILHZ that provides advanced medical care and serves as the main referral center1. Primary Health Facilities: Rural Health Units (RHUs) and Barangay Health Stations (BHS) that offer basic health services and preventive care1. Functions: Coordination and Integration: Ensures seamless coordination and integration of health services across different levels of care2. Resource Sharing: Facilitates the sharing of resources, such as medical personnel, equipment, and supplies, among LGUs2. Capacity Building: Enhances the capacity of health facilities and personnel through training and development programs2. Improved Access: Increases access to health services for residents within the ILHZ2. Goals: Enhance Health Outcomes: Improve the overall health outcomes of the population served by the ILHZ2. Financial Protection: Provide financial protection against the costs of ill health, especially for the poor2. Efficient Use of Resources: Optimize the use of health care resources to ensure sustainability and efficiency2. Mnemonics for Inter-Local Health System To remember the key components of the ILHS, you can use the mnemonic: \"ILHZ: Core + Primary\". ILHZ: Inter-Local Health Zone-Core: Core Referral Hospital-Primary: Primary Health Facilities (RHUs and BHS)