Ethico-Legal Aspects in Community Health Nursing PDF

VII. Ethico-Legal Aspects Considerations in the Community Health Nursing A. Ethical Considerations in Community Health Nursing Practice Practice of a profession is guided by a number of legal and ethical principles that are primarily centered on the welfare of clients and the protect...

VII. Ethico-Legal Aspects Considerations in the Community Health Nursing A. Ethical Considerations in Community Health Nursing Practice Practice of a profession is guided by a number of legal and ethical principles that are primarily centered on the welfare of clients and the protection of their rights. Professional practice is legal if the practitioner works in accordance with the law or does not violate its provision. What is legal may not be necessarily ethical. 3 Major Principles of Ethical Practice in the Community includes: 1. Right to be informed Concepts Inform the client about his/her condition and treatment or any health intervention that needs to be done. Patients are entitled to accurate and adequate information that helps clients for decision making. Nurse Responsibility: O Respect the client’s decision and his/her refusal and should not affect the latter’s access to other health services. 2. Right to safe and quality care Patient has the right to receive proper and updated care of his/her condition. Nurse Responsibility: o Update himself/herself on the latest development in health care and in the nursing profession. o Read new books, professional journals, manuals and other related materials. o Attend seminars and conferences that would enrich her/his professional practice. 3. Right to privacy and confidentiality Nurses should make sure that the clients’ medical records are treated privately and confidentially. Concept of Distributive Justice in Health Care System “Fair, equitable and appropriate distribution” of services and resources such as medicines. Allocation of resources in the LGU is based on the decision of the local council and chief executive. Distribution of health goods and services is in the hands of the Health Center Staff. Since resources are limited, Health Center staff is guided by the principle of “Equity”, that is, the scarce resources should be given to the one who is in greater need B. Public Health Laws: The Legal Aspects in the practice of Community health Nursing. 1. Magna Carta for Public Health Workers ▪ Republic Act no. 7305 – “ ▪ Aims to: ▪ To promote and improve the social and economic well-being of health workers, their living and working conditions and terms or employment. ▪ To develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs. ▪ To encourage those with proper qualifications and excellent abilities to join and remain in government service.  2. National Voluntary Blood Services Program ▪ Republic Act 7719 is otherwise known as the "Blood Services Act of 1994". ▪ Vision: “A network of modernized national and regional blood centers operating on a fully voluntary, non- remunerated blood donation system” ▪ Mission: Ensure adequate, safe and accessible blood supply by: Promoting voluntary blood donation as a way of life for every qualified healthy Filipino Establishing a new blood service and upgrading existing ones Organizing association of blood donors and training medical practitioners on national blood use ▪ Who can donate? o Weigh more than 45 kilograms (100 lbs.) for 250 ml. of donated blood o 50 kilograms (110 lbs.) for 450 ml. of donated blood o In good health o Aged 16-65 years of age (for ages 16 & 17, parental consent is needed) o Blood pressure in safe range - 90- 160 mmHg systolic; 60-100mmgHg diastolic o Hemoglobin is at least 125 g/l (12.5 g/dl) ▪ Conditions that can prevent you from donating blood o Diabetes o Cancer o Hyperthyroidism o Cardiovascular diseases o Severe psychiatric disorder o Epilepsy / convulsions o Severe bronchitis & other lung disorders, such as TB o AIDS, Syphilis & other sexually transmitted diseases (past or present) o Malaria o Kidney & liver diseases, such as Hepatitis o Prolonged bleeding o Use of prohibited drugs 3. Sanitation code of the Philippines ▪ Presidential Decree no. 856 of 1978. ▪ It includes guidelines regarding the Environmental, Water supply and sanitation program, Proper excreta and sewage disposal program, Food sanitation program and Hospital Waste management program. 4. Clean Air Act of 1999 ▪ Republic Act No. 8749, otherwise known as the “Philippine Clean Air Act” ▪ A comprehensive air quality management policy and program which aims to achieve and maintain healthy air for all Filipinos. Lifted from: Department of Environment and Natural Resources. (2003, August). ▪ All potential sources of air pollution (mobile, point and area sources) must comply with the provisions of the law. All emissions must be within the air quality standards. ▪ Mobile sources refer to vehicles like cars, trucks, buses, jeepneys, tricycles, motorcycles, and vans. ▪ Point sources refer to stationary sources such as industrial firms and the smokestacks of power plants, hotels, and other establishments. ▪ Area sources refer to sources of emissions other than the above. These include smoking, burning of garbage, and dust from construction, unpaved grounds, etc.  5. Clean Water Act of 2004 ▪ Republic Act no. 9275 ▪ “An Act Providing for a Comprehensive Water Quality Management and for Other Purposes”, also known as the Philippine Clean Water Act of 2004 (CWA), was signed by former President Gloria Macapagal-Arroyo on March 22, 2004. ▪ Aims to protect the country's water bodies from pollution from land-based sources (industries and commercial establishments, agriculture and community/household activities) 6. Generic Act of 1978 ▪ Republic act no. 6675 ▪ An act to promote, require and ensure the production of an adequate supply, distribution, use and acceptance of drugs and medicines identified by their generic names. ▪ The law aims to promote, require, and ensure the labeling, prescribing, and dispensing of medicines using their generic names. 7. National Health Insurance Act of 2013 ▪ Old law: Republic Act no 7875 otherwise known as the “National Health Insurance Act of 1995” ▪ Amended law Republic Act no. 10606. ▪ The law aims to provide mandatory health insurance coverage to all Filipinos. ▪ Who are qualified as dependents? o Legitimate spouse who is not a member. o Child or children - legitimate, legitimated, acknowledged and illegitimate (as appearing in birth certificate) adopted or stepchild or step children below 21 years of age, unmarried and unemployed. o Children who are twenty-one (21) years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support, as determined by the Corporation; o Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012; o Parents with permanent disability regardless of age as determined by PhilHealth, that renders them totally dependent on the member for subsistence. o Parents who are sixty (60) years old or above, not otherwise an enrolled member, whose monthly income is below an amount to be determined by PhilHealth in accordance with the guiding principles set forth in the NHI Act of 2013. 8. Laws of Notifiable Disease ▪ Old law: Republic Act 3573 or also known as “The Reporting of communicable Disease Act” ▪ Amended Law: Republic Act no. 11332 or also known as “Mandatory reporting of notifiable diseases and health events of Public health concern act”. ▪ An act providing policies and prescribing procedures on surveillance and response to notifiable diseases, epidemics, and health events of public health concerns, and appropriating funds therefor, repealing for the purpose of Republic Act no. 3573, otherwise known as reporting of communicable diseases. 9. Senior Citizen related Laws ▪ Republic Act No. 9994 an act granting additional benefits and privileges to senior citizens, further amending republic act no 7432. ▪ Republic Act 9257 amended republic act no. 7432 otherwise known as “Expanded Senior Citizen Act of 2010”.  10. Comprehensive Dangerous Drug Act of 2002 ▪ Republic act no. 9165, an act instituting the comprehensive dangerous drugs act of 2002, repealing Republic act no. 6425, otherwise known as the “Dangerous Drugs act of 1972”. 11. Cheaper Medicine Law ▪ Republic Act No. 9502'Universally Accessible Cheaper and Quality Medicines Act of 2008" ▪ An Act Providing for Cheaper and Quality Medicines, Amending for the Purpose Republic Act No. 8293 or The Intellectual Property Code, Republic Act No. 6675 or the Generics Act of 1988, and Republic Act No. 5921 or The Pharmacy Law and for Other Purposes. 12. Save the Children Law ▪ Republic Act no. 7610 or otherwise known as "Special Protection of Children Against Abuse, Exploitation and Discrimination Act." ▪ An act providing for stronger deterrence and special protection against child abuse, Exploitation and discrimination, providing penalties for its violation and for other purposes. 13. VAWC Law ▪ Republic act no. 9262 or otherwise “Anti-Violence Against Women and their Children Act of 2004” ▪ An act defining violence against women and their children, providing for protective measures for victims, prescribing, penalties therefore, and for other purposes. ▪ Violence in terms of: 1. Physical Violence 2. Sexual Violence 3. Psychological Violence 4. Economic abuse 14. Philippine Disaster Reduction and Management Act ▪ Republic Act no. 10121. ▪ An Act strengthening the Philippine Disaster Risk Reduction and management system, providing for the National Disaster risk reduction and management framework and institutionalizing the national disaster risk reduction and management plan, appropriating funds and for other purposes. 15. Rooming-in and Breastfeeding Act of 1992 ▪ Republic Act 7600. ▪ An act providing incentives to all government and private health institutions with rooming-in and breastfeeding practices and for other purposes. ▪ Republic Act no. 10028, which is the amendment of R.A. no. 7600, An Act expanding the promotion of Breastfeeding. 16. Mild Code ▪ Executive order no. 51 or otherwise known as "National Code of Marketing of Breast milk Substitutes, Breast milk supplement and Other Related Products." ▪ The law aim of the Code is to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breastfeeding and by ensuring the proper use of breast milk substitutes and breast milk supplements when these are necessary, on the basis of adequate information and through appropriate marketing and distribution 17. The Responsible Parenthood and Reproductive Health Act of 2012  ▪ Republic Act no.10354 ▪ An Act providing for a National Policy on Responsible Parenthood and Reproductive Health. 18. National Immunization Program ▪ Republic Act 101521 otherwise known as “Mandatory Infants and Children Health Immunization Act of 2011”. ▪ “An act providing for mandatory Basic immunization services for infants and Children, Repealing for the Purpose of presidential Decree No. 996 as amended.” ▪ Mandatory basic immunization shall be given for Free at any government hospital and health center to infants and children up to five (5) years of age. 19. Children Safety on Motorcycles Act ▪ Republic Act No. 10666 otherwise known as “Children’s Safety on Motorcycles Act of 2015”. ▪ “An Act providing for the safety of children aboard motorcycles. 20. Children’s Emergency Relief and Protection Act of 2016. ▪ Republic Act No. 10821 ▪ “An act mandating the provision of emergency relief and protection for children before, during, and after disasters and other emergency situations.” 21. The Child and Youth Welfare Code ▪ Presidential Decree No. 603 otherwise known as "Child and Youth Welfare Code". ▪ It shall apply to persons below twenty-one years of age except those emancipated in accordance with law. "Child" or "minor" or "youth" as used in this Code, shall refer to such persons”. 22. Tobacco Regulation Law ▪ Republic Act No. 9211 also known as: “The Tobacco Regulation Act of 2003”. ▪ An Act regulating the packaging, use, sale, distribution and advertisements of tobacco products and for other purposes. ▪ “An omnibus law regulating smoking in public places, tobacco advertising, promotion and sponsorship, and sales restrictions, among other requirements.” Understanding the culture, health care beliefs, and practices of Filipinos is important, as it affects the way nurses assess the needs and provide care for their clients. Please read and understand the topic below. A. Family Solidarity Solidarity - is an awareness of shared interests, objectives, standards, and sympathies creating a psychological sense of unity of groups or classes. It refers to the ties in a society that bind people together as one. Commonly termed as the “Pusong Pinoy” or the “Bayanihan Spirit”. Bayanihan is a core essence of the Filipino culture. It is helping out one’s neighbor as a community, and doing a task together, thus lessening the workload and making the job easier. It is also called the ‘community spirit’ and best exhibited when people wish to move locations in the rural area. B. Filipino Family Values a. Communication Filipinos are fond of non-verbal communications. They use hand gestures, pursing of lips, raising of eyebrows and their eyes to communicate. They are less dependent on spoken words. When responding to a request or a favor, Filipinos generally struggle with saying “no” for fear of hurting other people's feelings (www.international.gc.ca). b. Helping Others and Gratitude (Pakikisama at Utang na Loob) Filipinos get along with different kinds of people. They can easily adjust to any situation and are flexible. This trait fosters cooperation, good and helpful deeds. When their neighbors are in trouble, they will help them in whatever they can. They also do not let their family members go through hard times alone, instead, they help each other. (Goyola, 2019) Gratitude is a Filipino trait that shows a sense of duty and responsibility. Filipinos know how to repay other people. When someone helps us, we return the favors with goodness. (Goyola, 2019) c. Respect One of the precious things’ Filipinos have is that they are respectful. Young, youth, people in all ages know how to show respect and courtesy. Some ways to show them are the use of “Po at Opo”, “Pagmamano” or putting the back of an elder’s hand on your forehead, and calling our older siblings or elders Ate or Kuya. (Goyola, 2019) d. Independence e. Service f. Trust B. Filipino Family Culture and Traditions. Health Beliefs and Behaviors: Indigenous Health Beliefs Concept of Balance (Timbang) This concept is central to Filipino self-care practices and is applied to all social relationships and encounters. According to this principle, health is thought to be a result of balance, while illness due to humoral pathology and stress is usually the result of some imbalance. Rapid shifts from “hot” to “cold” cause illness and disorder. Illustrated below are a range of humoral balances that influence Filipino health perceptions: o Rapid shifts from “hot” to “cold” lead to illness o “Warm” environment is essential for maintaining optimal health o Cold drinks or cooling foods should be avoided in the morning o An overheated body is vulnerable to disease; a heated body can get “shocked” o When cooled quickly, it can cause illness o A layer of fat maintains warmth, protecting the body’s vital energy o Imbalance from worry and overwork create stress and illness o Emotional restraint is a key element in restoring balance o A sense of balance imparts increased body awareness (Adapted from Becker, 2003). Health Beliefs and Behaviors: Theories of Illness Physical and mental health and illness are viewed holistically as an equilibrium model. In contrast, other explanatory models may include mystical, personalistic and naturalistic causes of illness or disease (Anderson, 1983; Tan, 1987; Tompar-Tiu & Sustento-Seneriches, 1995). Mystical Causes are often attributed to experiences or behaviors such as ancestral retribution for unfinished tasks or obligations. Some believe that the soul goes out from the body and wanders, a phenomenon known as Bangungot, or that having nightmares after a heavy meal may result in death. Personalistic Causes are associated with social punishment or retribution from supernatural forces such as evil spirit, witch (Manga ga mud) or sorcerer (mangkukulam). The forces cast these spells on people if they are jealous or feel disliked. Witch doctors (Herbularyo) or priests are asked to counteract and cast out these evil forces through the use of prayers, incantations, medicinal herbs and plants. For protection the healer may recommend using holy oils, or wearing religious objects, amulets or talismans (anting anting). Naturalistic Causes include a host of factors ranging from natural forces (thunder, lightning, drafts, etc.) to excessive stress, food and drug incompatibility, infection, or familial susceptibility. Health Beliefs and Behaviors: Basic Logic of Health and Illness The basic logic of health and illness consists of prevention (avoiding inappropriate behavior that leads to imbalance) and curing (restoring balance); it is a system oriented to moderation. Parallel to this holistic belief system is the understanding of modern medicine with its own basic logic and principles for treating certain types of diseases. These two systems co-exist, and Filipino older adults use a dual system of health care (Anderson, 1983; Mc Bride, 2006; Miranda, Mc Bride & Spangler, 1999). Health Beliefs and Behaviors: Health Promotion/Treatment Concepts Health beliefs and practices are oriented towards protection of the body. 1. Flushing - The body is thought to be a vessel or container that collects and eliminates impurities through physiological processes such as sweating, vomiting, expelling gas, or having an appropriate volume of menstrual bleeding. 2. Heating - Adapts the concept of balance between “hot” and “cold” to prevent occurrence of illness and disorders. 3. Protection - Safeguards the body’s boundaries from outside influences such as supernatural and natural forces. Health Beliefs and Behaviors: Health Behaviors Response to Illness Filipino older adults tend to cope with illness with the help of family and friends, and by faith in God. Complete cure or even the slightest improvement in a malady or illness is viewed as a miracle. Filipino families greatly influence patients’ decisions about health care. Patients subjugate personal needs and tend to go along with the demands of a more authoritative family figure in order to maintain group harmony. Before seeking professional help, Filipino older adults tend to manage their illnesses by self-monitoring of  symptoms, ascertaining possible causes, determining the severity and threat to functional capacity, and considering the financial and emotional burden to the family. “Seeking medical advice from family members or friends who are health professionals is also a common practice among Filipino older adults and their family members, especially if severe somatic symptoms arise.” They may even resort to utilizing traditional home remedies such as alternative or complementary means of treatment. They may discuss their concern with a trusted family member, friend, spiritual counselor or healer (Yeo, 1998). Seeking medical advice from family members or friends who are health professionals is also a common practice among Filipino older adults and their family members, especially if severe somatic symptoms arise (Anderson, 1983). Coping Styles Coping styles common among elderly Filipino Americans in times of illness or crisis include: 1. Patience and Endurance (Tiyaga): the ability to tolerate uncertain situations 2. Flexibility (Lakas ng Loob): being respectful and honest with oneself 3. Humor (Tatawanan ang problema): the capacity to laugh at oneself in times of adversity 4. Fatalistic Resignation (Bahala Na): the view that illness and suffering are the unavoidable and predestined will of God, in which the patient, family members and even the physician should not interfere 5. Conceding to the wishes of the collective (Pakikisama) to maintain group harmony Responses to Mental Illness Indigenous traits common among elderly Filipino Americans when faced with illness related to mental conditions: o Devastating shame (Hiya) o Sensitivity to criticism (Amor Propio) Common Perceptions of Filipinos about Mental Illness Unwillingness to accept having mental illness, which leads to the avoidance of needed mental health services due to fear of being ridiculed Involvement of other coping resources such as reliance on family and friends or indigenous healers, and dependence on religion which can diminish the need for mental health services Prioritizing of financial and environmental needs which preclude the need for mental health services Limited awareness of mental health services resulting in limiting access Difficulty in utilizing mental health services during usual hours because of the unavailability of working adult family members Mental illness connotes a weak spirit, and may be attributed to divine retribution as a consequence of personal and ancestral transgression Lack of culturally oriented mental health services Though such coping mechanisms, perceptions and traits may help elderly Filipino Americans adjust initially to their illnesses, these tactics also pose barriers and impede implementation of necessary treatment intervention in a timely fashion.  Objectives: At the end of this lesson, you are expected to be able to do the following: 1. Explain the importance of New Technologies Related to Public Health Electronic Information. 2. Practice using the Public Health Electronic Information system. New Technologies Related to Public Health Electronic Information The future of healthcare is shaping up in front of our very eyes with advances in digital healthcare technologies, such as artificial intelligence, VR/AR, 3D- printing, robotics or nanotechnology. We have to familiarize with the latest developments in order to be able to control technology and not the other way around. The future of healthcare lies in working hand-in-hand with technology and healthcare workers have to embrace emerging healthcare technologies in order to stay relevant in the coming years (https://medicalfuturist.com). The presence of new technology plays a vital role in information dissemination since most people now have an easy access to information whenever they want to. Search engines like google search makes health information just one click away to all who seeks it. Some websites also offer comprehensive health information for both government and private institutions. Such websites include: www.who.int The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution, which establishes the agency's governing structure and principles, states its main objective as "the attainment by all peoples of the highest possible level of health.” It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide. The website includes information about the World Health Organization programs and activities. The website will provide all available information to all its readers including latest health trends and updates regarding health matters like world health news, latest vaccines creations and medical updates. www.doh.gov.ph The website is a dedicated web for the Department of Health of the national government that includes all the information regarding the Department of Health programs, activities and latest updates. It is a useful electronic information system that will help you, students, to research information about the Philippine Health System and the Government's health projects and activities. www.worldometer.info The worldometer website is a useful electronic information system if you are looking for information regarding statistics like World population, life expectancy and even the census of the COVID19 pandemic. It will give you a real time statistics update from time to time all over the world. Nursing Core Values as a Community Health Nurse Mission: The National League for Nursing promotes excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community. CORE VALUES CARING: promoting health, healing, and hope in response to the human condition INTEGRITY: respecting the dignity and moral wholeness of every person without conditions or limitation; DIVERSITY: affirming the uniqueness of and differences among persons, ideas, values, and ethnicities. EXCELLENCE: co-creating and implementing transformative strategies with daring ingenuity. CARING A culture of caring, as a fundamental part of the nursing profession, characterizes our concern and consideration for the whole person, our commitment to the common good, and our outreach to those who are vulnerable. All organizational activities are managed in a participative and person-centered way, demonstrating an ability to understand the needs of others and a commitment to act always in the best interests of all stakeholders. INTEGRITY A culture of integrity is evident when organizational principles of open communication, ethical decision-making, and humility are encouraged, expected, and demonstrated consistently. Not only is doing the right thing simply how we do business, but our actions reveal our commitment to truth- telling and to how we always see ourselves from the perspective of others in a larger community. DIVERSITY A culture of inclusive excellence encompasses many identities, influenced by the intersections of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious and political beliefs, or other ideologies. It also addresses behaviors across academic and health enterprises. Differences affect innovation so we must work to understand both ourselves and one another. And by acknowledging the legitimacy of us all, we move beyond tolerance to celebrating the richness that differences bring forth. EXCELLENCE A culture of excellence reflects a commitment to continuous growth, improvement, and understanding. It is a culture where transformation is embraced, and the status quo and mediocrity are not tolerate  Health-Related Entrepreneurial Activities in the Community Setting There is a growing trend in nursing to seek a more independent practice in health care delivery and services through entrepreneurship. In 1986, Susan Hartley of the ANA posted a letter to the editor in the American Journal of Public Health requesting information on nurse entrepreneurs with the stated goal of “developing a list of nurse entrepreneurs as part of a continuing effort to describe the delivery of nursing services” and to “gather data and resource people to support lobbying efforts to achieve payment systems for nursing” Entrepreneur as “one who organizes, manages, and assumes the risks of a business or enterprise” (merriam-webster.com, 2012). Entrepreneurial nurse is one who is willing to take on that role within a health care or social context. Common examples of nurse entrepreneurs include: - legal consultants - forensic nurses - owners of home health care agencies - authors, and nurse consultants in a variety of areas ❖ For the community/public health nurse, these and many other options offer the independence to provide services in perhaps a new and innovative way. ❖ For health care to continue to respond to the changing environment, the innovators are often the ones who have the courage to test those new methods. Suggestions to promote entrepreneurship ( Elango, Hunter, and Winchell (2007) 1. Seek local resources to develop business skills. 2. Do not be constrained by current resources. 3. Build an active network within the community. 4. Understand the importance of entrepreneurship. 5. Mobilize professional resources at the state and national level. 6. Assume an active role in public policy. Five (5) steps to promote entrepreneurship from the National Nurses in Business Association, Inc.(NNBA) (similar to Elango) 1. Review your business options and determine what you enjoy doing. 2. Determine if there are enough clients (customers) for the business to make a profit doing what you enjoy. 3. Obtain the knowledge needed to provide the service. 4. Obtain the business knowledge needed to start and operate the business sale. 5. Start and grow the business. Suggestions for the development of a business plan (2006). Patricia Bemis, president of the NNBA a. The business plan should include the description of the business; marketing strategies; competitive analysis, design, and development plan; operations and management plan; and financial factors. b. Choosing a name and the correct colors for promotional materials. - The name should be easily spelled and pronounced, elicit a positive emotional response from the customer, and be short and to the point. - Meaning of color and the important role it plays in the success of your business - She cautions that the psychology of color and contrast is vital to your overall business plan and should be carefully selected. REFERENCES Available in the library: Nursing Practice in the Community 4th edition, by Araceli S. Maglaya, RN, PhD., 2005 Community Health Nursing Services in the Department of Health – Philippines, 9th edition by Community Health Nursing Section, National League of Government Nurses Inc., 2000. Community Health Management Manual for Nursing Students, Community Exposure, Book 1, by Lydia Capistrano – Viet, RN, MAN, 2004. Community Health Nursing: The Basics of Practice by Salvacion G. Bailon – Reyes, 2006 Health Care Practice in the Community by Erlinda Castro – Palaganas, RN, Ph. D., First Edition, 2003. Community Organizing Participatory Action Research for Community Health Development by Sr. Carmen E. Kimenez, D.C., BSE, BSN, MA, Ed.D, 2 nd Edition, 2002. Public Health Nursing in the Philippines by National League of Philippine Government Nurses, Incorporated 10th Edition, 2007. The Basics of Community Health Nursing: A study Guide for Nursing Students and  Local Board Examinees by Monica H. Gesmundo, RN, MAN, 2010 Other references of the teacher (not in the library): https:www.DOH.gov.ph https:www.who.int https:www.worldpopulationreview.com https:www.worldometers.info https:www.investopedia.com https:www.cancer.com www.barrowgroup.com https:www.sciencedirect.com https://rojosonwritingsonhospitaladministration-wordpress-com.cdn.ampproje ct.org https://medicalfuturist.com https://www.who.int/news-room/fact-sheets/detail/family-planning-contracepti onhttp://popcom.gov.ph/ https://www.unicef.org/regional_action_plan_new_born_infants.pdf https://study.com/academy/lesson/legal-issues-in-nursing-concepts-and-term s.html https://www.makatimed.net.ph/news-and-exhibits/news/do-you-believe-in-the se-pinoy- health-superstitions https://www.who.int/news-room/fact-sheets/detail/family-planning-contracepti on