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COMMUNITY HEALTH NURSING 1 NCM 104 Global and National Health Situations Global and National Health Situations  National -focuses on the specific conditions, prevalence, and diseases within a particular country or region. It takes into account the local context,...

COMMUNITY HEALTH NURSING 1 NCM 104 Global and National Health Situations Global and National Health Situations  National -focuses on the specific conditions, prevalence, and diseases within a particular country or region. It takes into account the local context, including the prevalence of certain conditions and the cultural, religious and historical factors that shape social care and values.  Global - considers the broader picture, taking into account the worldwide trends, connections, and interdependencies between different nations and cultures. It recognizes the global nature of nationalism and the national nature of globalization.  Global Health  -focuses on the health needs of people around the world. Each regional population has its own global health issues—malaria, malnutrition, or measles, for example—but those issues can affect other populations around the world What is Global Health?  Global Health is the health of populations in a global context.  It transcends national boundaries and involves a wide range of actors. Global Health Challenges 1. Communicable diseases Examples:  COVID-19,  Ebola,  Zika,  Impact on healthcare systems  Role of nurses in prevention and control Global Health Challenges 2. Non-communicable Diseases (NCDs):  Leading causes of death globally (heart disease, stroke, cancer, diabetes)  Risk factors (tobacco use, unhealthy diet, physical inactivity)  Importance of prevention and early detection Global Health Challenges 3. Climate Change and Health:  Impact on physical and mental health  Extreme weather events, air pollution, waterborne diseases  Role of nurses in climate adaptation and mitigation Philippine Health Profile  Overall Health Status: ◦ Life expectancy, infant mortality rate, maternal mortality rate ◦ Comparison to global indicators Leading Causes of Morbidity and Mortality  Top causes of death and illness:  Heart disease, stroke, diabetes, pneumonia, tuberculosis  Implications for nursing practice Health Disparities  Socioeconomic status, geographic location, gender, ethnicity  Impact on health outcomes  Role of nurses in addressing disparities Health System Challenges 1.Underfunding:  Impact on healthcare access and quality  Role of nurses in advocating for increased health budget Health System Challenges 2. Human Resource Shortages Nurse migration, uneven distribution of healthcare workers Strategies to address shortages Health System Challenges 3. Weak Primary Healthcare: ◦ Importance of primary care in preventing diseases. ◦ Strengthening primary healthcare through nursing interventions The Role of Nurses  Advocacy: Promoting health and preventing diseases  Care Provision: Delivering quality care to individuals and communities  Education: Empowering patients and communities  Research: Contributing to evidence-based practice Conclusion Understanding the global and national health landscape is essential for nurses to effectively address the health needs of our population. By working together, we can contribute to improving the health and well- being of Filipinos. Definition and Focus  HEALTH -  The World Health Organization (WHO) defines it as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.  COMMUNITY –  a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging. Definition and Focus  PUBLIC HEALTH - The science and art of preventing disease, prolonging life and improving quality of life through organized efforts for: 1.Sanitation of the environment 2. Control of communicable diseases 3. Education of individuals in personal hygiene 4. Organization of medical and nursing services for the early diagnosis and to ensure everyone a standard of living adequate for the maintenance of health and preventive treatment of disease; and 5. Development of the social machinery Definition and Focus Community Health A field of public health that focuses on studying, protecting, or improving health within a community. Public Health Nursing – the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. focuses on betterment of the community as a whole. Community Health Nursing- the specialized field of nursing practice that renders care to individuals, families, and communities focusing on health promotion and disease prevention through people empowerment. Health promotion and disease prevention are the core of community health nursing practice Sub Fields: a. Occupational Health Nursing b. School Health Nursing c. Correctional Nursing STANDARDS OF PUBLIC HEALTH NURSING  A. Standards of Care  Standard 1 - Assessment  Standard 2 - Population diagnosis priorities  Standard 3 - Outcomes identification  Standard 4 – Planning  Standard 5 - Implementation a. Coordination b. Health education and health promotion c. Consultation d. Regulatory activities  Standard 6 - Evaluation STANDARDS OF PUBLIC HEALTH NURSING  B. Standards of Professional Performance  Standard 7 - Quality of Practice  Standard 8 - Education  Standard 9 – Professional Practice Evaluation  Standard 10 – Collegiality and Professional Relationship  Standard 11 - Collaboration  Standard 12 – Ethics  Standard 13 - Research  Standard 14 – Resource Utilization Population  Standard 15 - Leadership Public Health Interventions  Surveillance  Counseling  Disease and other  Consultation health event  Collaboration investigation  Coalition building  Outreach  Community organizing  Screening  Advocacy  Case finding  Social Marketing  Referral and Follow- up  Policy development and enforcement  Case Management  Delegated functions  Health teaching EVOLUTION OF PUBLIC HEALTH NURSING IN THE PHILIPPINES  1912 - Fajardo Act. (Act No. 2156) created Sanitary Divisions  1914 - School Nursing was rendered by a nurse employed by the Bureau of Health in Tacloban, Leyte. In the same year, Cognization Act No. 2462 created the Office of General Inspection.  1916 -1918 Miss Perlita Clark took charge of the public health nursing work staff was composed.  1919 -The first Filipino nurse supervisor under the Bureau of Health, Miss Carmen del Rosario was appointed  1923 - Three schools of Nursing were established: 1. Zamboanga General Hospital School of Nursing in Mindanao 2. Baguio General Hospital in Northern Luzon 3. Chinese General Hospital School of Nursing EVOLUTION OF PUBLIC HEALTH NURSING IN THE PHILIPPINES  1926- Miss Carmen Leogardo resigned, and Miss Genara S. Manongdo, a ranking supervisor of the American Red Cross - Philippine Chapter, was appointed as her replacement.  1928 - The first convention of nurses was held followed by yearly convention until the adven t of World War II. Pre-service training was initiated as a pre-requisite for appointment.  1933 -Reorganization Act No. 4007 transferred the division of Maternal and Child Health of the Office of Public Welfare Commission to the Bureau of Health.  1947- The newly created Section of Puericulture Center of the Bureau of Hospitals had Mrs. Teresa Malgapo as Chief. EVOLUTION OF PUBLIC HEALTH NURSING IN THE PHILIPPINES  1948 -The first training center of the Bureau of Health was organized in cooperation with Pasay City Health Department. Physicians and nurses undergoing pre-service training in public health nursing as well as nursing students on affiliation were assigned to the above training center.  1953 -Philippine Congress approved Republic Act No. 1082, or the Rural Health Law. It created the 81 Rural Health Units. Each unit had a physician, a public health nurse, midwife, a sanitary inspector, and a clerk driver.  1957 -Republic Act 1891 was approved amending Sections 2, 3, 4, and 8 of R.A. 1082 “Strengthening Health and Dental Services in the Rural Areas and Providing Funds” EVOLUTION OF PUBLIC HEALTH NURSING IN THE PHILIPPINES  1957 Republic Act 1891 was approved amending Sections 2, 3, 4, and 8 of R.A. 1082 “Strengthening Health and Dental Services in the Rural Areas and Providing Funds”  1967 In the merged Bureau of Disease Control and Mental Health, Mrs. Zenaida Panlilio-since was appointed as Nursing Program Supervisor and served as consultant on the nursing aspects of the 5 special diseases: TB, Leprosy, Venereal Disease, Cancer, Filariasis. She was involved in program planning, monitoring, evaluation, and research.  1987 Executive Order No. 119 reorganized the Department of Health and created several offices and services within the Department of Health.  1990-1992 Aside from the usual services for mother and children, these nurses were involved in the following programs: expanded program on immunization, Control of Diarrhea, and control of acute respiratory infections. Roles and responsibilities of a Community and Public Health Nurse  A. Healthcare provider  B. Health Educator  C. Program Implementer  D. Community Organizer  E. Manager / Leader  F. Researcher / Epidemiologist  G. Client Advocate Thank You Standards of Public Health Nursing in the Philippines  ThePhilippine Nursing Association (PNA) sets the standards for public health nursing in the Philippines. Some of the PNA standards for Public Health Nursing  PHNs must have a bachelor's degree in nursing from an accredited program.  PHNs must be licensed to practice nursing in the Philippines.  PHNs must complete continuing education courses in public health nursing. WHO - World Health Organization  The specialized agency of the United Nations responsible for international public health.  WHO plays a crucial role in coordinating international health efforts. WHO, is the directing and coordinating authority on international health within the United Nations system WORLD HEALTH ORGANIZATION Constitution was established on April 7, 1948 Headquarters in Geneva, Switzerland Has 147 country offices Has 6 regional offices ( Africa, the Americas, Eastern Mediterranean, Europe, Southeast Asia, Western Pacific) World Health Assembly (WHA) is the decision – making body of the World Health Organization WORLD HEALTH ORGANIZATION VISION WHO vision of a world in which all peoples attain the highest possible level of health MISSION To promote health, keep the world safe and serve the vulnerable, with measurable impact for people at country level. WHO – CORE VALUES 1. Integrity 2.Professionalism 3.Respect for diversity Core Functions of WHO Providing leadership on matters critical to health and engaging in partnerships where joint action is needed. Setting norms and standards and promoting and monitoring their implementation. Articulating ethical and evidence-based policy options. Providing technical support, catalyzing change, and building sustainable institutional capacity. Shaping the research agenda and stimulating the generation, translation, and disseminating valuable knowledge MILLENIUM DEVELOPMENT SUSTAINABLE DEVELOPMENT GOALS GOALS WORLD HEALTH ORGANIZATIONAL GOALS MILLENIUM DEVELOPMENT GOALS SUSTAINABLE DEVELOPMENT GOALS The Sustainable Development Goals (SDGs) 1. No Poverty 2. Zero Hunger 3. Good Health and Well-being 4. Quality Education 5. Gender Equality 6. Clean Water and Sanitation 7. Affordable and Clean Energy 8.Decent Work and Economic Growth 9. Industry, Innovation, and Infrastructure The Sustainable Development Goals (SDGs) 10. Reduced Inequality 11. Sustainable Cities and Communities 12. Responsible Consumption and Production 13. Climate Action 14. Life Below Water 15. Life on Land 16. Peace, Justice, and Strong Institutions 17. Partnerships for the Goals DEPARTMENT OF HEALTH  The DOH in the Philippines oversees public health services and programs. DEPARTMENT OF HEALTH VISION(2030) “A global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing” DEPARTMENT OF HEALTH MISSION "DOH is committed to nurturing Filipinos to be amongst the healthiest in Asia by 2040 through the development of a productive, resilient, equitable, and people-centered health system." CORE VALUES OF DOH  Patient-focused Care.  Compassion.  Professionalism.  Integrity.  Reliability. Historical Background of DOH 1. Spanish Colonial Period 1577: The health care system in the Philippines began with the arrival of Franciscan friars. Juan Clemente opened a medical dispensary for the indigent in Intramuros. 1578: The Hospital de San Lazaro was established in Manila for patients with leprosy. 1658: The San Juan de Dios Hospital was established, which still operates today. 1690: Dominican Father Juan de Pergero worked toward installing a water system in San Juan City, Metro Manila. Historical Background of DOH 2. American Colonial Period 1805: Manila Smallpox vaccination was introduced by Dr. Francisco de Balmis. 1876: The first Medicos Titulares were appointed by the Spanish government and worked as provincial health officers 1888: A 2- year program consisting of fundamental and dental courses was first offered in the University of Sto. Tomas. Graduates of this program known as Cirujanos Ministrates served as male nurse and sanitation inspectors 1901: The U.S. Philippine Commission, through Act 57, created the Board of Health of the Philippine Islands with a Commissioner of Public Health as its Chief Executive Officer. Historical Background of DOH 2. American Colonial Period 1905: The Bureau of Health was established, replacing the Board of Health. It aimed to improve sanitation, control infectious diseases, and provide health education. 1912: The Fajardo Act created sanitary divisions made up of one to four municipalities. Each sanitation division had a “president” who had to be a physician. 1915: The Philippine General began to extend public health nursing services in the homes of patients by organizing a unit called Social Home Care Service with 2 nurses as staff. Bureau of Health became the Philippine Health Service. Historical Background of DOH 3. Commonwealth Period 1936: The Commonwealth government restructured the health system. The Philippine Health Service was converted into the Department of Public Health and Welfare. 4. Post-World War 1947: After gaining independence from the United States, the department was renamed the Department of Health (DOH). Its role expanded to include broader health services and public health initiatives.. Historical Background of DOH 4. Post-World War 1954: Congress passed R.A.1082 (Rural Health Act) that provided for the creation of Rural health units in every municipality. It also provided employment of physicians to serve as municipal health officers, public health nurses, midwives and sanitation inspectors. It provided for a provincial health officer for each province, and a public health dentist for each congressional district. 1957: RA 1891 amended certain provisions in the rural health act. This law created eight categories of rural health units corresponding to the population size of the municipalities. 1958: Regional offices were like wise created as a result of decentralization. Historical Background of DOH Post-World War 1970”s: the Philippine Health Care Delivery System was restructured, paving the way for the health care system that exists to this day where health services are classified Into primary, secondary, tertiary. a. Primary -Municipal Health Office; Rural Health Units; Health Centers; Barangay Health Stations b. Secondary – Provincial Health Office; District Hospitals; Emergency Hospitals; Provincial Hospital/Provincial Medical Centers c. Tertiary – National Hospitals; National Medical centers and National Specialized Hospitals; Regional Hospitals/Regional Medical centers; Teaching and Training Hospitals Historical Background of DOH 5. Modern Era 1987: Under the reorganization plan of the 1987 Philippine Constitution, the DOH was further restructured to enhance its role in policy-making, regulation, and provision of health services. 1991: RA 7160 The Local Government Code was enacted. This law mandated devolution of basic services, including health services to the local government units and the establishment of a local health board in every province or municipality. 2005: The DOH implemented the FOURmula One (F1) for Health strategy to strengthen the health system, ensuring better health outcomes, more responsive health systems, and more equitable health financing Historical Background of DOH 6 Recent Developments 2012: The Universal Health Care (Kalusugan Pangkalahatan) initiative was launched to provide equitable access to quality health care for all Filipinos. 2019: The Universal Health Care Act was signed into law, aiming to ensure that all Filipinos have access to a comprehensive set of health services without financial hardship. The DOH continues to lead the country's efforts in improving public health, responding to health emergencies, and ensuring that all Filipinos have access to quality health care services. Local Health System and Devolution of Health Services in the Philippines The local health system and devolution of health services in the Philippines are key components of the country's efforts to improve healthcare delivery and make it more accessible to all Filipinos. These initiatives are shaped by the Local Government Code of 1991 (Republic Act No. 7160), which decentralized governance and transferred certain responsibilities from the national government to local government units (LGUs). Local Health System  The local health system in the Philippines is structured to provide primary, secondary, and tertiary health services at various levels of local government.  The system is designed to ensure that health services are delivered efficiently and are accessible to all members of the community. Levels of Local Health System: 1. Barangay Health System: Barangay Health Stations (BHS) 2. Municipal/City Health System: Rural Health Units (RHUs) and City Health Offices (CHOs): Health Centers: 3. Provincial Health System: Provincial Health Offices (PHOs): 4. Regional Health System: Regional Health Offices: Devolution of Health Services  Is a major reform introduced by the Local Government Code of 1991 - which aimed to decentralize governance and improve the efficiency and responsiveness of public services, including health care.  aims to create a more responsive, efficient, and equitable health system by empowering local governments to take a leading role in health care delivery. Key Features of Health Service Devolution 1. Transfer of Responsibilities 2. Funding and Resources 3. Autonomy and Flexibility 4. Capacity Building 5. Monitoring and Evaluation Impact and Challenges of the Devolution of Health Services  Positive Impacts:  improvements in health service delivery at the local level , with more responsive and community-specific health programs  It has also encouraged innovation and local leadership in health.  Challenges:  disparities in the capacity and resources of different LGUs, which can lead to unequal health service provision.  There are also issues with coordination between national and local health authorities, as well as the need for continuous capacity building and resource allocation to support LGUs. Classification of Health Facilities (DOH Administrative Order No. 0012-A)  The Department of Health (DOH) Administrative Order No. 2012-0012-A provides guidelines for the classification of health facilities in the Philippines.  This classification system is designed to standardize the types of services offered by health facilities and ensure quality care.  The facilities are classified into various levels based on the complexity of services they offer and their capabilities LEVELS OF HEALTH FACILITIES 1.General Facilities Category A: Primary Care Facilities Category B: Custodial Care Facility Category C. Diagnostic/Therapeutic Facility Category A: Primary Care Facilities 1. Barangay Health stations 2. Clinics A. Without in patient beds B. With in-patient beds Category B: Custodial Care Facility a. Custodial psychiatric facilities, b. substance/drug abuse treatment and rehabilitation centers, c. sanitaria leprosaria, d. nursing homes Category C. Diagnostic/Therapeutic Facility 1. Laboratory Facility 2. Radiologic Facility 3. Nuclear Medicine Facility 4. Specialized outpatient Facility Laboratory Facility 1. Clinical laboratory 2. HIV testing laboratory 3. Blood Service Facility 4. Drug Testing Laboratory 5. Newborn Screening Laboratory 6 Laboratory for drinking water analysis Philippine Health Agenda: 2010 – 2022  is a strategic framework designed to address the health needs of Filipinos and ensure the achievement of universal health care (UHC).  It serves as a roadmap for the Department of Health (DOH) and its partners in the health sector. Key Goals and Strategies 1. Financial Risk 2.Better Health Protection Outcomes  PhilHealth  Health Service Coverage Delivery  Benefit Expansion Networks  No Balance Billing Public Health Policy Programs  Health Promotion Key Goals and Strategies 3. Responsive Health System  Health Human Resources  Health Information Systems  Health Financing  Governance and Accountability 4 pillars of DOH  F1 – FOURmula One for Health –  A strategic framework for health reforms formulated by DOH using four pillars: 1. 1. 1. Service Delivery 2. Health Care Financing 3. Health Governance 4. Health Regulation DOH Programs a) National Immunization Program b) Women, Men, and Children's Health Development Programs c) HIV/AIDS and STI Prevention d) Emerging and Re-emerging Infectious Disease e) Integrated Helminth Control f) Food and Waterborne Diseases Prevention and Control g) National Dengue Prevention and

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