Community and Public Health Nursing (Reviewer) - NCM 104 - University of La Salette

UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY NCM 104 Reviewer- Community a...

UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY NCM 104 Reviewer- Community and Public Health Nursing By: Jericho G. Ferrer, BSPH, CGV, MSPH-Candidate Topic: Introduction to Community and Public Health Nursing Health- defined as multi-dimensional. A state of Complete Physical, Mental, and social well being and not merely the absence of the disease or infirmity (WHO, 1995). The Goal of Public Health in general and Community Health Nursing in Particular is HEALTH Community - The Group of People who shares something in common and interact with one another, who may exhibits a commitment with one another and may share a geographical Boundary (Lundy and Janes, 2009) LEVELS OF CLIENTELE 1. Individual 2. Family 3. Population Groups 4. Community Public Health: Science and Art of : - Preventing Diseases - Prolonging life - Promoting Health and Efficiency through organized community effort Public Health Nursing - Practice of Promotion and Protecting the health of Populations using Knowledge from nursing, social, and Public Health Sciences. Community Health - Organized health effort at the community level through government and Privat efforts Community Health Nursing - Specialized field of Nursing practice that renders care to all level of Clientele; focusing on health promotion and disease prevention through people empowerment Primary Health Care- Tool in the delivery of Health Care Services Community Health Nurse/ Public Health Nurse - A professional Specialized in the field of Nursing practice that renders care to all level of Clientele; focusing on health promotion and disease prevention through people empowerment  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY Health Promotion- Primary focus of CHN Practice ROLES OF THE NURSE IN HEALTH PROMOTION 1. Advocate- Speak/write in favor off/support 2. Enabler- Reassure/ Something makes possible 3. Mediator- Acts as an Intermediary, referring patients to other referrals ROLES AND RESPONSIBILITIES OF COMMUNITY HEALTH NURSE 1. Case Manager- Assist Clients to make decisions about appropriate health care services 2. Advocate- Seeks to promote an understanding of Health 3. Teacher- Apply teaching-learning principles to facilitates behavioral changes 4. Partner and Collaborator- established and maintains valuable working relationships with people 5. Health Planner/Programmer- Identifies the needs, priorities, and problems; formulates nursing health plan 6. Community Organizer- Motivates and Enhance community participation in terms of planning, organizing, implementing and evaluating health programs 7. Health Educator/ Trainer- Identifies and Interprets training needs of RHM, BHW’s, and Hilots 8. Case Finder- Identifies and follow-up periodically cases especially to at risk 9. Recorder/Reporter/Statisticians- Prepares and submits required records 10. Epidemiologist- Collects data on health problem 11. Community Leader- Being a leader or role model and respected in the community RESPONSIBILITIES OF THE CHN 1. Develops an Overall Health Plan 2. Provide Quality Nursing Services 3. Maintain Coordination/linkages 4. Conducts Researches relevant to CHN services 5. Provide opportunities for professional growth and continuing education\ WORLD HEALTH ORGANIZATION (WHO) - A global Health organization - April 7, 1948 declared as “World Health Day” and founding day for WHO - Headquarters located in Geneva, Switzerland - Has 147 country offices - 6 world regional offices (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, Western Pacific) - PHILIPPINES is a member of the Western Pacific Region, Office is located in Manila THE MILLENIUM DEVELOPMENT GOALS September 6-8, 2000: World Leaders in UN General Assembly participated in the Millenium summit United Nations Millenium Declaration- Resolution of the summit which The World Leaders Recognizes the collective responsibility to uphold these principles: 1. Human Dignity, 2. Equality, 3. Equity at the Global Level.  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY The UN Millenium Declaration was signed in September 2000, which combats: 1. Poverty 5. Environmental Degradation 2. Hunger 6. Discrimination against woman 3. Diseases 4. Illiteracy The Millenium Development Goals are the following: 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, and Malaria and other diseases 7. Ensure Environmental Sustainability 8. Global Partnership among the people SUSTAINABLE DEVELOPMENT GOALS (2030) - Adopted by the United Nations General Assembly in September 15, 2015 - Also known as the GLOBAL GOALS UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY Evolution of Public Health Nursing in the Philippines: A Detailed Summary Pre-Spanish Era: There are no available records about public health during this period. Spanish Regime (1577–1898): In 1577, Bro. Juan Clemente initiated public health services with a dispensary in Intramuros, Manila. The positions of district, provincial, and national health officers were established to structure public health efforts. American Regime (1898–1946): 1901: Act No. 157 created the Philippine Board of Health, followed by Act No. 309 which established provincial and municipal Boards of Health. 1905: The Board of Health was replaced by the Bureau of Health under the Department of Interior. 1906: District Health Offices were created, headed by District Health Officers with jurisdiction over various districts. 1912: Four nurses from the Philippine General Hospital were sent to Cebu to care for mothers and babies, while St. Paul’s Hospital School of Nursing assigned nurses to home visits in Manila. 1915: The Office of District Nursing, led by Dr. Rosario Pastor, was established to meet growing demands for nurses in homes and public health. 1916–1918: Ms. Perlita Clark headed public health nursing with a team of American and Filipino nurses, but the office was abolished in 1918 due to budget constraints. 1919: Ms. Carmen del Rosario became the first Filipino Nurse Supervisor with a team of 84 public health nurses (PHNs). 1923: Public health nursing expanded, with 90 nurses deployed across provinces. Japanese Regime (1941–1945): During World War II, public health nurses in Manila served devastated areas and attended to the wounded, while others joined the guerrilla forces or hid in the mountains. 1946: After the war, there was an increase in the number of public health nurses. Mrs. Genara de Guzman recommended the creation of a nursing office within the Ministry of Health.  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY Era of the Republic of the Philippines (1946–present): 1947: Reorganization of government offices under Executive Order No. 94. 1954: The Rural Health Unit Act (RA 1082) was passed, allowing for the employment of nurses in rural health units to improve the health of rural populations. 1975: The National Health Plan and the Restructured Health Care Delivery System were introduced to improve health services. 1986: The Ministry of Health reverted to being the Department of Health. 1990–1992: The Local Government Code of 1991 (RA 7160) resulted in the "devolution" of public health services, transferring authority to local governments. 1996: The Primary Health Care strategy was introduced to achieve “Health for All by 2000.” 1999: Department Order No. 29 appointed Mrs. Nelia F. Hizon as the Nursing Adviser. Later, Executive Order No. 102 shifted many nursing roles from the central Department of Health to other offices. 1999–2004: The Health Sector Reform Agenda (HSRA) was developed, focusing on health delivery improvement. 2005: The Department of Health launched "FOURmula One for Health," a strategy to streamline health services and promote efficiency.  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY GLOBAL HEALTH SITUATIONS HEALTH CARE SYSTEM - COVID-19 Pandemic uncovered critical vulnerabilities in health system - Inadequate access in health system is a health threat - Challenges in health care systems vary across countries A. Mental Health and Substance abuse - Mental Health concern increased due to COVID-19 pandemic - Substance abuse cause 8 million deaths per year resulting to 1.3% of the global disease burden B. Infectious disease, malnutrition, and food safety - The increasing scope of infectious diseases warrants the improvement of the quality of services in healthcare delivery - Malnutrition affects around 29% of the world's population and remains a significant concern - among children. Malnutrition has been linked to various socioeconomic factors, including limited - access to healthy foods and a general lack of awareness of healthy diets. C. Food adulteration in Honey Industry eBook - The globalization of food production and supply has increased the extent and speed of transmission of foodborne pathogens. D. Sexual and Reproductive Health - The significant challenges in sexual and reproductive health rights (SRHRs) include gender-based violence, inadequate comprehensive sexuality education, early marriage, teenage pregnancy, maternal health, sexually transmitted infections, infertility, unsafe abortion, reproductive cancers, and poor access to SRHR services. E. Environmental pollution and climate change - Environmental Pollution: Threatens humans, wildlife, and their habitats - Climate Change: Humanity’s most significant health threat in the intermediate term F. Cancer and Diabetes - Cancer: It is globally a leading cause of death - Diabetes: It is a debilitating condition severely affecting people, healthcare systems, and the economy  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY NATIONAL HEALTH SITUATION Philippines Population - In 2023, the Philippines has an estimates population of 117,337,368 at mid year - Equivalent of 1.46% of the total of world population - Ranked number 13 in the list of countries by population 10 LEADING CAUSES OF MORBIDITY The top three causes of death in the country from January to December of 2022 were ischemic heart diseases, neoplasms, and cerebrovascular diseases. 4. Deaths due to diabetes mellitus recorded 39,193 cases or 6.3 percent share, making it the fourth leading cause of death. 5. Deaths due to hypertensive diseases, which ranked fifth, recorded 35,641 cases or 5.7 percent 6. Pneumonia 7. Chronic Lower Respiratory Diseases NOTE: 8. Other Heart Diseases LIFE EXPECTANCY: 9. Genitourinary Diseases FEMALE - 76 years 10. Respiratory Tuberculosis Male - 67 years PHILIPPINE HEALTH CARE DELIVERY SYSTEM - Totality of all policies, infrastructures, facilities, equipment, products, human resources, and services that address the health needs, problems and concerns of all people DEPARTMENT OF HEALTH - Main governing body of health services in the Philippines - Provides Guidance and technical assistance to LGU’s through CHC in each 17 regions Provincial Governments- Responsible for provincial and district hospitals Municipality and City Government- In charge in Primary Care Facilities Private sectors- composed of Profit and Non-profit agencies NOTE: - 30% Filipinos utilized Private health Facilities - 60% of the national health expenditures goes to private sectors - Private Sectors Employs 70% of Health Professionals in the Philippines  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY Financing of Health Services 1. Government 2. Private Sources 3. Social Health Insurances Philippine Health Insurance Corporation (PhilHealth) – created by the National Health Insurance Act (R.A. 7875) - A tax-exempt government corporation attached to the DOH for policy coordination and Guidance - Aims for universal health coverage of all Filipino citizens (Congress of the Republic of the Philippines, 1995) Philippine Department of Health VISION - “To make Filipinos among the healthiest in Southeast Asia by 2022 and in Asia by 2040.” Philippine Department of Health MISSION - “To lead the country in the development of a productive, resilient, equitable, and people-centered health system” (DOH, 2019). MAJOR ROLES OF DOH 1. Leader in Health (EO 102, series of 1999) 2. Enabler and Capacity Builder (Office of the President, 1999) 3. Administrator o Specific Services (Office of The President, 1999) LEVELS OF PUBLIC HEALTH CARE DELIVERY  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY LOCAL HEALTH SYSTEM AND DEVOLUTION 1. Rural Health Unit (RHU) - Known as the HEALTH CENTER - Primary level health facility in the municipality/City - It focuses on o Preventive and promotive health services o Supervisions of BHS o 1 RHU: 20,000 Population 2. Barangay Health Station - First Contact health care facility, offering basic health care services - Satellite station of RHU  UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY RURAL HEALTH UNIT PERSONNEL 1. Municipal Health Officer (MHO) - Rural Health Physician: Heads the health services at the municipality level Roles and Functions NOTE: (R.A.7305) 1. Administrator of RHU Ratio of MHO to population 2. Community Physician 3. Medico-Legal officer of the Municipality 1 MHO : 20,000 Populations NOTE: (R.A.7305) Ratio of PHN to population 2. Public Health Nurse (PHN) 1 PHN : 10,000 Populations Roles of PHN’s 1. Supervise and guides all RHMs in the municipality (DOH, 2001) 2. Prepares the FHSIS (Field Health Service Information System) quarterly and annual reports of the municipality for submission to the Provincial Health Office (DOH, 2011) 3. Utilizes the nursing process in responding to health care 4. Collaborates with the other members of the health team, government agencies, private businesses, NGOs, and people’s organizations to address the community’s health problems. Nurse Deployment Project (NDP)- launched to augment efforts of PHNs in their areas of jurisdiction UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY UNIVERSITY OF LA SALETTE, INC. Dubinan East, Santiago City, Philippines, 3311 COLLEGE OF NURSING, PUBLIC HEALTH AND MIDWIFERY