NCM 104 Community Health Nursing I Self-Instructional Manual PDF

College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082)...

College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 UNIVERSITY OF MINDANAO College of Health Sciences Education Program Bachelor of Science in Nursing Physically Distanced but Academically Engaged Self-Instructional Manual (SIM) for Self-Directed Learning (SDL) Course/Subject: NCM 104 – Community Health Nursing I Name of Teacher: Joyce D. Cajigal, RN THIS SIM/SDL MANUAL IS A DRAFT VERSION ONLY; NOT FOR REPRODUCTION AND DISTRIBUTION OUTSIDE OF ITS INTENDED USE. THIS IS INTENDED ONLY FOR THE USE OF THE STUDENTS WHO ARE OFFICIALLY ENROLLED IN THE COURSE/SUBJECT. EXPECT REVISIONS OF THE MANUAL. 1  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 TABLE OF CONTENTS Pages Title page 1 Table of Contents 2 Quality Assurance Policy 3 Instruction Proper 8 Big Picture 1. Overview of Public Health Nursing in the Philippines 8 Big Picture 2. The Health Care Delivery System 16 Big Picture 3. The Family 33 Big Picture 3. The Family Nursing Process 38 Big Picture 4. Records In Family Health Nursing Practice 56 Big Picture 4. DOH Programs Related to Family Health 59 Big Picture 4. Ethical Considerations in Community Health Nursing 73 Big Picture 4 Filipino Culture, Values, And Practices In Relation To 79 Health Care Of Individual And Family Big Picture 4 Nursing Core Values as a Community Health Nurse 80 2  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Course Outline: NCM 104 – Community Health Nursing Course Coordinator: Joyce D. Cajigal Email: [email protected] Student Consultation: By appointment Mobile: 0922-9950751 Phone: (082) 300-5456/300-0647 Local 117 Effectivity Date: June 2020 Mode of Delivery: Blended (On-Line with face to face or virtual sessions) Time Frame: Lecture: 54 hours; Lab.: 102 hours Student Workload: Expected Self-Directed Learning Requisites: None Credit: 4 units (2 units lecture and 2 units laboratory) Attendance Requirements: A minimum of 95% attendance is required at all scheduled Virtual or face to face sessions. Course Outline Policy Areas of Concern Details Contact and Non-contact Hours This 2-unit course self-instructional manual is designed for Blended Learning Mode of Instructional delivery with scheduled face to face or virtual sessions. Including the face to face or virtual sessions, the expected number of hours will be 36 for the lecture components and 108 hours for the laboratory (Online Laboratory Exercises). The face to face sessions shall include the summative assessment tasks (exams) since this course is vital foundations of a BS - Nursing students. Assessment Task Submission Submission of assessment tasks shall be on 3rd, 5th, 7th and 9th week of the term. The assessment paper shall be attached with a cover page indicating the title of the assessment task (if the task is performance), the name of the course coordinator, date of submission and name of the student. The document should be emailed to the course coordinator. It is also expected that you already paid your tuition and other fees before the submission of the assessment task. 3  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 If the assessment task is done in real time through the features in the Blackboard Learning Management System, the schedule shall be arranged ahead of time by the course coordinator. Turnitin Submission (if To ensure honesty and authenticity, all assessment necessary) tasks are required to be submitted through TURNITIN with a maximum similarity index of 30% allowed. This means that if your paper goes beyond 30%, the students will either opt to redo her/his paper or explain in writing addressed to the course coordinator the reasons for the similarity. In addition, if the paper has reached more than 30% similarity index, the students may be called for a disciplinary action in accordance with the University’s OPM on Intellectual and Academic Honesty. Please note that academic dishonesty such as cheating and commissioning other students or people to complete the task for you have severe punishments (reprimand, warning, expulsion). Penalties for Late Assignments The score of the assessment item submitted after the / Assessments designated time on the due date, without an approved extension of time, will be reduced by 5% of the possible maximum score for that assessment item is late. However, if the late submission of assessment paper has a valid reason, a letter of explanation should be submitted and approved by the course coordinator. If necessary, you will also be required to present/ attach evidences. Return of Assignments/ Assessment tasks will be returned to you two (2) Assessments weeks after the submission. This will be returned by email or via Blackboard portal. For the group assessment task, the course coordinator will require some or few of the students for online or virtual sessions to ask clarificatory questions to validate the originality of the assessment task submitted and to ensure that all the group members are involved. Assignment Resubmission You should request in writing addressed to the course coordinator his/her intention to resubmit an assessment task. The resubmission is premised on the student’s failure to comply with similarity index and other reasonable ground such as academic 4  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 literacy standards or other reasonable circumstances e.g. illness, accidents, financial constraints. Re-marking of Assessment You should request in writing addressed to the Paper and Appeal program coordinator your intention to appeal or contest the score given to an assessment task. The letter should explicitly explain the reasons/points to contest the grade. The program coordinator shall communicate with the students on the approval and disapproval of the request. If disapproved by the course coordinator, you can elevate your case to the program head or the dean with the original letter of request. The final decision will come from the dean of the college. Grading System All culled from the Black Board sessions and traditional contact A. Lecture Component Class Participation 40% Assignments 5% Quizzes 10% Recitation 10% Requirements 15% Examinations 60% 1st formative assessment 10% 2nd formative assessment 10% 3rd formative assessment 10% Final Exam 30% TOTAL 100% B. Skills laboratory Examinations 60% First Exam 10% Second Exam 10% Third Exam 10% Final Exam 30% Class Participation Total Quizzes 10% Total Recitation 10% Return Demonstration 20% TOTAL 40% Skills Laboratory Tentative Final Grade 100% x 40% Total Clinical Exposure Grade 100% x 60% RLE Final Grade 100% x50% Lecture Final Grade 100%x 50% Final Grade 100% 5  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Submission of the final grades shall follow the usual University system and procedures. Preferred Referencing Style Used APA 6th Edition. Student Communication You are required to create a umindanao email account which is a requirement to access the BlackBoard portal. Then, the course coordinator shall enroll the students to have access to the materials and resources of the course. All communication formats: chat, submission of assessment tasks, requests etc. shall be through the portal and other university recognized platforms. You can also meet the course coordinator in person through the scheduled face to face sessions to raise your issues and concerns. For students who have not created their student email, please contact the course coordinator or program head. Contact Details of the Dean Ofelia C. Lariego, RN, MAN Email: [email protected] Phone: 082-3050645 loc. 117 Contact Details of the Program Dennis C. Padernilla, RN, MN Head Email: [email protected] Phone: 082-3050645 loc. 117 Students with Special Needs Students with special needs shall communicate with the course coordinator about the nature of his or her special needs. Depending on the nature of the need, the teacher with the approval of the program head may provide alterative assessment task or extension of the deadline of submission of the assessment tasks. However the alternative assessment tasks should still be in the service of achieving the desired course learning outcomes. Online Tutorial Registration You are required to enroll in a specific tutorial time for this course via the www.cte.edu.ph portal. Please note that there is a deadline for enrollment to the tutorial. Help Desk Contact Dean- CHSEOfelia C. Lariego [email protected] Phone: (082)305-0640/300-0647 Local 117 Program Head: Dennis C. Padernilla, RN MN [email protected] Phone: 082-3050645 loc. 117 6  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Library Contact Brigida E. Bacani [email protected] Phone. No. 305-06-45 loc. 140 LIC Help Desk: 0951-376-6681 Website: http://library.umindanao.edu.ph Facebook page: https://www.facebook.com/UM-Learning- and- Information-Center-Davao-City-962331877193048/ Course Information – see/download course syllabus in the Black Board LMS CC’s Voice: Hi! Hello! Welcome to the NCM 104/L – Community Health Nursing. By now, I am confident that you really wanted to become a Registered Nurse and that you have visualized yourself as part of the health care team, taking care of the well and sick clients in any health care setting. CO Community Health Nursing is a nursing field which deals with concepts, theories, principles and techniques for providing basic care in terms of health promotion, disease prevention, restoration and maintenance and rehabilitation at the individual and family level. In this course you are expected to know and understand the different health needs and problems of people; the rationale behind the Department of Health’s different strategies and programs; how to interpret and apply them. These will help and guide you in your community health practice. Let us begin! Big Picture I. OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES Week 1-2: Unit Learning Outcomes (ULO): At the end of the unit, you are expected to: a. Discuss the overview of public health nursing in the Philippines b. Define terms related to community health. c. Discuss the focus of public health. d. Apply the competency standards of nursing practice in the Philippines in community health nursing practice. e. Outline the historical development of public health nursing in the Philippines. 7  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Big Picture in Focus: ULO 1. Discuss the global and National Health Situations and outline the evolution of public health nursing in the Philippines. Metalanguage Community - Defined as “ 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” (Allender et al., 2009, p. 6). Health -A state of complete physical, mental, and social well- being and not merely the absence of disease or infirmity. (WHO, 1958). Public Health -Is defined as “The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort Community Health - Part of paramedical and medical intervention/approach which is concerned on the health of the whole population. Public Health Nursing- Is a special field of nursing, public health and some phases of social assistance and functions as part of the total public health program for the promotion of health, the improvement of the condition in the social and physical environment, rehabilitation of illness and disability. Individual - Is defined as a specific person or client in various stages of health or illness who is given the appropriate nursing intervention by the community health nurse and other members of the health team as the condition warrants. Family - is a group of persons usually living together and composed of the head and other persons related to the head by blood , marriage or adoption.(National Statistical Coordination Board NSCB,2008). Population group - those who share common characteristics, developmental stages and common exposure to health problems. Essential Knowledge I. OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES 8  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Public Health - “The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort for: a. The sanitation of the environment b. The control of communicable infections c. The education of the individual in personal hygiene d. The organization of medical and nursing services for the early diagnosis and preventive treatment of disease e. The development of a social machinery to ensure everyone a standard of living, adequate for maintenance of health to enable every citizen to realize his birth right of health and longevity (Dr. C.E Winslow). Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. Three primary functions of public health(Institute of Medicine US 1988) 1. Assessment-regular collection, analysis, and information sharing about health conditions, risks, and resources in a community. 2. Assurance – Focuses on the availability of necessary health services throughout the community. It includes maintaining the ability of both public health agencies and private providers to manage day to day operations and having the capacity to respond to critical situations and emergencies. 3. Policy Development- Use of information gathered during assessment to develop local and state health policies and to direct resources toward those policies. Essential Public Health Functions (WHO 2003, Regional Office for the Western Pacific Region) 9 Essential Public Health Functions 1. Health situation monitoring and analysis. 2. Epidemiological surveillance/ disease prevention and control. 3. Development of policies and planning in public health. 4. Strategic management of health systems and services for population health gain. 5. Regulation and enforcement to protect public health. 6. Human resources development and planning in public health. 7. Health promotion, social participation, and empowerment. 8. Ensuring the quality of personal and population -based health service. 9. Research, development, and implementation of innovative public health solutions. Aims of Community Health a. Health promotion b. Disease prevention c. Management of factors affecting health 9  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Philosophy of CHN § “The philosophy of CHN is based on the worth and dignity of man.”(Dr. M. Shetland) Basic Principles of CHN 1. The community is the patient in CHN, the family is the unit of care and there are four levels of clientele: a. Individual b. Family c. Population group (those who share common characteristics, developmental stages and common exposure to health problems – e.g. children, elderly), d. Community 2. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 3. CHN practice is affected by developments in health technology, in particular, changes in society, in general. 4. The goal of CHN is achieved through multi-sectoral efforts 5. CHN is a part of health care system and the larger human services system. Goal of CHN Multidiscipli- nary effort Highest level Promote reciprocally of holistic supportive health relationship between people & their Individual, physical & social family & environment community Standards of Public Health Nursing in the Philippines Standards of Public Health Nursing Practice (ANA 2007) Standards of Care Standard 1. Assessment The public health nurse collects comprehensive data pertinent to the health status of populations. Standard 2. Population diagnosis and The public health nurse analyzes the assessment data to priorities determine the population diagnosis and priorities. Standard 3. Outcomes Identification The public health nurse identifies expected outcomes for a plan that is based on population diagnoses and priorities. Standard 4. Planning The public health nurse develops a plan that reflects best 10  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 practices by identifying strategies, action plans, and alternative to attain expected outcomes. Standard 5. Implementation The public health nurse implements the identified plan by partnering with others. a. Coordination Coordinates programs, services and other activities to implement the identified plan. b. Health education and Employs multiple strategies to promote health, prevent health promotion disease, and ensure a safe environment for populations. c. Consultation Provides consultation to various community groups and officials to facilitate the implementation of programs and services. d. Regulatory activities Identifies, interprets, and implements public health laws, regulations, and policies. Standard 6. Evaluation The public health nurse evaluates the health status of the Population. Standards of professional performance Standard 7. Quality of practice The public health nurse systematically enhances the quality and effectiveness of nursing practice. Standard 8. Education The public health nurse attains knowledge and competency that reflects current nursing and public health practice. Standard 9. Professional practice evaluation The public health nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulation Standard 10. Collegiality and professional The public health nurse establishes collegial partnerships Relationships while interacting with representatives of the population, organizations and health and human services professionals, and contributes to the professional development of peers, students, colleagues and others. Standard 11. Collaboration The public health nurse collaborates with the representatives of the population, organizations, and health and human services professionals, in providing for and promoting the health of the population. Standard 12. Ethics The public health nurse integrates ethical provision in all areas of practice. Standard 13. Research The public health nurse integrates research findings in practice. Standard 14. Resource utilization population The public health nurse considers factors related to safety, effectiveness, cost, and impact on practice and in the planning and delivery of nursing and public health programs, policies, and services. Standard 15. Leadership The public health nurse provides leadership in nursing and public health. Evolution of Public Health Nursing in the Philippines History of Public Health Nursing in the Philippines Year Event 11  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 1577 Franciscan Friar Juan Clemente opened a medical dispensary in Intramuros (the old walled city of Manila) for the indigent. 1690 Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte (now San Juan City, Metro Manila). 1805 Smallpox vaccination was introduced by Dr. Francisco de Balmis, the personal physician of King Charles IV of Spain who came to the Philippines. 1876 The medicos titulares worked as provincial health officer. 1888 A 2 year course consisting of fundamental medical and dental subjects was first offered in the University of Santo Tomas, graduate of this course known as cirujanos ministrantes served as male nurses and sanitation inspectors. 1901 The United States Philippine Commission, through Act 157, created the Board of Health of the Philippine Islands, with a Commisioner of Public Health as its chief executive officer. The Board of Health eventually evolved into what is now the Department of Health. 1912 § Act # 2156 or Fajardo Act created the Sanitary Divisions, the forerunners of present MHOs; male nurses performs the functions of doctors 1915 § The Philippine General Hospital began to extend public health nursing services in th homes of patients by organizing a unit called Social and Home Care Services with two nurses as staff. 1919 § Act # 2808 (Nurses Law was created) – Carmen del Rosario, 1st Filipino Nurse supervisor under Bureau of Health 1947 § The department of Health was reorganized into bureaus: quarantine hospitals that took charge of municipal and charity clinics, and health with the sanitary division under it. The reorganization also placed the administration of city health departments at the bureau level. 1954 § Congress passed R.A. 1082 or the Rural Health Act that provided for the creation of a rural health unit in every municipality. Furthermore , R.A. 1082 provided for the employment of physicians to serve as Municipal Health Officers, public health nurses, midwives , and sanitation inspectors in the rural health units. It also provided for a provincial health officer for each province and a public health dentist for each congressional district. 1957 § RA 1891 amended some sections of RA 1082 and created the eight categories of rural health unit causing an increase in the demand for the community health personnel. 1958 § Regional Health offices were created as a result of decentralization efforts. 1970 § The Philippine health care delivery was restructured, paving the way for the health care system that that exist to this day where health services are classified into primary, secondary, and tertiary levels. 1991 § To enable local governments to attain their fullest development as self reliant communities and make them more effective partners in the attainment of national goals, RA 7160 or the Local Government Code was enacted. The law mandated devolution of basic services , including health services, to local government units and the establishment of a local health board in every province and city or municipality. 1999 § The Department of Health has directed efforts toward comprehensive reforms in health care with the Health Sector Reform Agenda, its implementation framework FOURmula One(F1) for Health in 2005, and Universal Health Care in 2010. Universal Health Care aims to achieve the health system goals of better health 12  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 outcomes, sustained health financing, and responsive health system that will provide equitable access to health care. 2000 § The Philippine is a signatory to the United Nations Millenium Declaration adopted during the world summit in September 2000. The member nations committed themselves to the attainment of the 8 Millenium Development Goals(MDG’s). Roles and Responsibilities of a Community Health Nurse Community health nursing is not fundamentally different from that of clinical nursing confined to the four corners of the hospital. It also promotes wellness and prevents disease through education and health teaching, provides comfort and care through its delicate nursing care interventions, and emphasizes curative and rehabilitative interventions through individualized efficient approaches. But its peculiarity involves not only caring for single client but also extending thru the entire family and the community. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 1. Clinician – the emphasis is on the wellbeing of the population or individuals in the broader sense of the community. Provides health care to the sick and disabled in order to alleviate sickness, pain, impiarment, and premature death, among others. 2. Advocate – Speaks or acts for those who are unable to speak/ act for themselves. Advocates for self-care and self - determination. 3. Collaborator – puts together the strengths and weaknesses of individuals involved for a common purpose. She works with people in the community toward a common goal and relies on collective or mutual decision making. 4. Consultant – catalyst to bring change, encouraging people understand processes and behaviors, and allowing them to make decisions. 5. Counselor – listens and provides feedback and information, enhances and guides people’s own decision making skills, and explores feelings and attitudes towards knowing themselves and their decisions. 6. Educator- acts as a health educator, one of her most significant roles as Community Health Nurse. The CHN provides the knowledge, skills and attitudes require by the community members for self-efficacy in decisions - making and empowerment. Enables the individual to make informed decisions, identifies populations at risk, and explores learning strategies. 7. Researcher- utilizes data to predict future phenomenon and modify interventions. Reliable research foundation allows nurses to anticipate potential health problems and interventions. Identify research problems, works with data, and conducts research. 8. Case manager- coordinates care in a system that consist of various programs that have different policies, services and mission in order to prevent the gaps in services and breakdown in the care system. Self-Help: You can also refer to the sources below to help you further understand the lesson. 1. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 13  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 2. Castro, Cecilia (2012). Community health nursing & community health development. 1st Edition. Educational Publishing House, Ermita, Manila. 3. Introduction to Public Administration A Reader 2nd Edition National College of Public Administration & Governance University of the Philippines Diliman, Quezon City, 2003 4. Nursing Practice in the Community – Maglaya 4th Ed. 5. www.slideshare.netjobitonio primary health care. Let’s Check Activity 1. Matching Type. Instruction: Match column A (Description) with column B (Roles & Functions of CHN) Column A Column B _____1. G Provide knowledge and attitude. A. Counsellor _____2. B Bring together strengths and weaknesses. B. Collaborator _____3. C Focus on health teachings. C. Clinician _____ A 4. Key tasks include listening & providing D. Advocate Information. E. Case Manager G _____5. Providing Care Skills F. Researcher _____6. D Promote self -care & Self- determination G. Educator _____7. Predict future phenomenon & modify F H. Consultant Interventions. _____8. E Oversees the training of midwives. _____9. F Prepares documents reports. _____10. F Undertakes demographic and epidemiological surveys. _____11. E Refers cases to other members of the health care team. _____12. H Catalyst to bring change. _____13.Strengthens A and guides people’s own decision making skills. _____14. C Providing nursing care to the sick. _____15. G Assisting in making decisions. Let’s Analyze Activity 2. Identification: Write all the answers in CAPITAL letters on the space provided in each statement. __________1. R. A 7160 This law mandated the devolution of basic services, including health services, to local government units. __________ Carmen Del Rosario- 1919 2. 1st Filipino Nurse supervisor under Bureau of Health. __________ Family 3. Refers to a group of people affiliated by consanguinity, affinity, or co-residence. __________ R.A 1082 - Rural Health Act4. The republic act passed by Congress which provided for the creation of a rural health unit in every municipality. __________ 5. Introduced the Smallpox vaccination. Dr. Francisco de Balmis 14  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 __________ Public Health 6. The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort. __________ 7. A collection of people who interact with one another and whose common Community interests or characteristics form the basis for a sense of unity or belonging. __________ Health 8. A state of complete physical, mental, and social well-being and not merely the Franciscan Friar Juan absence of disease or infirmity. Clementes__________ 9. Opened a medical dispensary in Intramurous for the indigent. __________10. Standard of care where in the public health nurse collects comprehensive data Assessment pertinent to the health status of populations. __________11. Education Standard of professional performance where in the public health nurse attains knowledge and competency that reflects current nursing and public health practice. __________12. Standard of care where in the public health nurse identifies expected outcomes Outcome Identification for a plan that is based on population diagnoses and priorities. __________13. Evaluation Standard of care where in the public health nurse evaluates the health status of the Population. R.A 2156 or __________14.This Fajardo Act Republic Act created the Sanitary Divisions. Dr. M.__________15. Shetland “The philosophy of CHN is based on the worth and dignity of man”. In a Nutshell Activity 3. Essay (Credit will be given not only for the content, but also for the organization and presentation of the essay and use of grammar, punctuation, and spelling.) 1. Discuss the Global and National health Situations. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 2. Outline the evolution of Public Health in the Philippines. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Q&A List 15  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Do you have question for clarification? Questions Answers 1. 2. 3. 4. Keywords Index Health Community Health Health promotion Public Health nursing Community Individual Primary prevention Disease prevention Public health Family Secondary prevention Population Community health Nursing Assessment Tertiary prevention Planning Big Picture II. THE HEALTH CARE DELIVERY SYSTEM Week 3-4: Unit Learning Outcomes (ULO): At the end of the unit, you are expected to: a. Discuss how the World Health Organization(WHO) affects health issues in the Philippines and around the world. b. Enumerate the Millennium Development Goals (MDGs) and the health objectives of the MDGs. c. Describe the method of provision of health care in the Philippines in terms of various levels of services. d. Explain how the Department of Health (DOH) provides health leadership in the Philippines. e. Relate the strategic thrusts of Universal Health Care to the current health situation and the goal and objectives of Universal Health Care. Big Picture in Focus: ULO 2. Describe the Philippine Health Care Delivery System and identify the Government health programs. Metalanguage World Health Organization - specialized agency of the United Nations(UN) provides global leadership on health matters. Department of Health(DOH) - is the national agency mandated to lead the health sector towards assuring quality health care for all Filipinos. Devolution - refers to the act by which the national government confers power and authority upon the various LGUs to perform 16  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 specific functions and responsibilities (Congress of the Republic of the Philippines,1991). Primary Care Facility - health care facility that offers basic services including emergency services and provision for normal deliveries. Custodial Care facility - a health facility that provides long term care, examples are psychiatric facilities, nursing homes, etc. Diagnostic /therapeutic facility - a facility for the examination of the human body, specimens from the human body for the diagnosis, sometimes treatment of the disease, or water for drinking water analysis. Specialized outpatient facility - a facility that performs highly specialized procedures on an outpatient basis. Examples are dialysis clinic, rehabilitation center/clinic ambulatory surgical clinic. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. Primary Health Care - defined as essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development. Primary prevention - relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Secondary Prevention - refers to early detection and prompt intervention during the period of early disease pathogenesis. Tertiary prevention - targets population that have experienced disease injury and focuses on limitation of disability and rehabilitation. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. Universal Health Care (UHC) - also referred to as Kalusugan Pangkalahatan (KP), is the “provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public”. Essential Knowledge 17  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 II.THE HEALTH CARE DELIVERY SYSTEM A. World Health Organization Philippine Department of Health 1. The MILLENIUM DEVELOPMENT GOALS in THE PHILIPPINES A Universal Development Framework https://www.undp.org/content/undp/en/home/sdgoverview/mdg_goals/mdg1/ MDG1 Eradicating extreme poverty and hunger Targets: 1. To halve the proportion of people whose daily income is less than $1.25 2. To achieve full and productive employment, as well as decent work for all, including young people and women 3. To halve the proportion of individuals suffering from hunger in the period between 1990 and 2015. MDG2 Achieving universal primary education Target: 1. To ensure that children universally – including both boys and girls – will be able to complete a full course of primary education by 2015. MDG3 Promoting gender equality and empowering women 18  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Target: 1. To eliminate gender disparity in primary and secondary education by 2005, and in all levels of education by 2015. MDG 4: Reduce child mortality Target: 1. To reduce the under-five mortality rate by two-thirds in the period between 1990 and 2015. MDG 5: Improve maternal health Targets: 1. To reduce the maternal mortality ratio by 75 percent. 2. To achieve universal access to reproductive health. MDG 6: Combat HIV/AIDS, Malaria and other major diseases Targets: 1. To halt by 2015 and have started to reverse the spread of HIV/AIDS 2. To achieve global access to treatment for HIV/AIDS for those who need it by 2010 3. To have ceased and started reversal of the incidence of malaria and other major diseases by 2015. MDG7 Ensuring environmental sustainability Targets: 1. To integrate the principles of sustainable development into every nation’s policies and programmes, and also reverse the depletion of environmental resources 2. To reduce biodiversity loss and achieve a substantial reduction in the rate of loss by 2010 3. To halve the proportion of the universal population without sustainable access to clean and safe drinking water and basic sanitation by 2015. 19  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 MDG8 Developing a global partnership for development Targets: 1. To further develop an open, predictable, rule-based, non-discriminatory trading and economic system. 2. To address the special needs of the least developed countries. 3. To address the special needs of small island developing States and landlocked developing countries. 4. To deal exhaustively with the debt problems of developing nations. 5. To provide access to affordable essential drugs in the developing world – in collaboration with pharmaceutical companies. 6. To avail benefits of new technologies, especially information and communications, in collaboration with the private sector. Retrived from: https://www.mdgmonitor.org/millennium-development-goals/ https://www.who.int/topics/millennium_development_goals/about/en/ 2. Sustainable Development Goals The Sustainable Development Goals ( SDGs), also known as the Global Goals, were adopted by all United Nations Member States in 2015 as a collective call for action to end poverty, protect the world and ensure security and prosperity for everyone by 2030. The 17 SDGs are integrated — that is, they understand that intervention in one area will have an effect on outcomes in others, and that development must be balanced. https://sustainabledevelopment.un.org/content/documents/23366Voluntary_National_Review_2019_Philippines.pdf 20  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 B. Philippine Department of Health 1. Mission-Vision VISION Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040. MISSION To lead the country in the development of a productive, resilient, equitable and people-centered health system, 2. Historical Background (Philippine Department of Health) Year Events September 10, 1898 Americans assembled a military Board of Health. with its formal organization. September 29,1898 Upon its creation, Dr. Frank S. Bourns is assigned as president while Dr. C. L. Mullins is assigned as assistant surgeon. The purpose of this Board of Health was to care for injured American troops but as the hostilities between Filipinos and Americans waned in 1901, a civilian Board of Health was now deemed appropriate with Dr. L. M. Maus as the first health commissioner. 1900 200,222 lives including 66,000 children were lost; three percent of the Population was decimated in the worst epidemic in Philippine health history. In view of this, the Americans organized and erected several institutions, including the Bureau of Governmental Laboratories, which was built in 1901 for medical research and vaccine production. 1905 The Americans, led by Dean Worcester built the UP College of Medicine and Surgery with Johns Hopkins University serving as a blueprint, at the time, one of the best medical schools in the world. 1909 Nursing instruction was also begun at the Philippine Normal School. In terms of public health, the Americans improved on the sewer system and provided a safer water supply. 1915 The Bureau of Health was reorganized and renamed into the Philippine Health Service. During the succeeding years leadership and a number of health institutions were already being given to Filipinos, in accordance with the Organic Act of 1916. On January 1, 1919, Dr. Vicente De Jesus became the first Filipino to head the Health portfolio. 1933 After a reorganization, the Philippine Health Service reverted to being known as the Bureau of Health. It was during this time that it pursued its official journal, The Health Messenger and established Community Health and Social Centers, precursors to today's Barangay Health Centers. as Governor-General Frank Murphy was assuming the post of United 1936 States High Commissioner, he would remark that the Philippines led all oriental countries in terms of health status. When the Commonwealth of the Philippines was inaugurated, Dr. Jose Fabella was named chief of the Bureau of Health. In 1936, Dr. Fabella reviewed the Bureau of Health's organization and made an inventory of its existing facilities, which consisted of 11 community and social health 21  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 centers, 38 hospitals, 215 puericulture centers, 374 sanitary divisions, 1,535 dispensaries and 72 laboratories. 1940 the Bureau of Health was reorganized into the Department of Health and Public Welfare, still under Fabella. During this time, the major priorities of the agency were tuberculosis, malnutrition, malaria, leprosy, gastrointestinal disease, and the high infant mortality rate. When the Japanese occupied the Philippines, they dissolved the National Government and replaced it with the Central Administrative Organization of the Japanese Army. Health was relegated to the Department of Education, Health and Public Welfare under Commissioner Claro M. Recto. 1944 President Manuel Roxas signed Executive Order (E.O.) No. 94 into law, calling for the creation of the Department of Health. Dr. Antonio C. Villarama as appointed Secretary. A new Bureau of Hospitals and a Bureau of Quarantine was created under DOH. Under E.O. 94, the Institute of Nutrition was created in 1948 to coordinate various nutrition activities of the different agencies. February 20, 1958 Executive Order 288 provided for the reorganization of the Department of Health. This entailed a partial decentralization of powers and created eight Regional Health Offices. Under this setup, the Secretary of Health passed on some of responsibilities to the regional offices and directors. 1975 to the mid- four specialty hospitals were built in succession. The first three eighties institutions were spearheaded by First LadyImelda Marcos. The Philippine Heart Center was established on February 14, 1975 with Dr. Avelino Aventura as director. Second, the Philippine Children's Medical Center was built in 1979. Then in 1983, the National Kidney and Transplant Institute was set up. This was soon followed by the Lung Center of the Philippines, which was constructed under the guidance of Health Minister Dr. Enrique Garcia. June 2, 1978 With a shift to a parliamentary form of government, the Department of Health was transformed into the Ministry of Health with Dr. Clemente S. Gatmaitan as the first health minister. April 13, 1987 the Department of Health was created from the previous Ministry of Health with Dr. Alfredo R. A. Bengzon as secretary of health. December 17, 2016 Health Secretary Paulyn Jean Rossel-Ubial announced that in 2017 the government will start paying the hospital bills and medicines of poor Filipinos. She said that the Department of Health (DOH) is capable of taking care of the hospital bills and medicines of poor Filipinos owing to its bigger budget starting in 2017. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 3. Local Health Systems & Devolution of Health Services 22  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 R.A. 7160 or Local Government Code was enacted to bring genuine and meaningful local autonomy. This will enable local governments to attain their fullest development as self-reliant communities and make them more effective partners in the attainment of national goals. R.A.7160 provided for the creation of the Provincial Health Board and the City/ Municipal Health Boards, or Local health Boards. Provincial Governor/Mayor -Chairman of the Board Provincial/City//Municipal Health Officer -Vice chairman Members of the Board - Composed of the chairman of the committee on health of the Sanggunian, a representative from the private sector or NGO involved in health services, and a representative of the DOH (Congress of the Republic of the Philippines,1991). Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 3.1 Functions of the local health boards: 1. Proposing to the Sanggunian annual budgetary allocations for the operation and maintenance of health facilities and service within the province/city/municipality. 2. Serving as an advisory committee to the Sanggunian on Health matters; and 3. Creating committees that shall advise local health agencies on various matters related to health service operations. 4. Classification of Health Facilities (DOH AO – 0012A) Classification of hospital based on Administrative Order No. 2012–0012, dated July 18, 2012, "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines". Department of Health, Republic of the Philippines Hospitals Other Health Facilities General A. Primary Care Facility Level 1 B. Custodial Care Facility. Level 2 Level 3 C. Diagnostic / Therapeutic Facility (teaching/training) Specialty D. Specialized outpatient facility 23  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 New Classification of general hospitals(Department of Health, Republic of the Philippines,2012) Hospital Level 1 Level 2 Level3 Clinical Services for Consulting Specialist in: Level 1 plus: Level 2 plus: inpatients Medicine Departmentalized clinical Teaching/ training with Pediatrics Services accredited residency Obstetrics -Gynecology training program in four Surgery major clinical services. Emergency & outpatient Respiratory unit Physical medicine and services rehabilitation unit Isolation facilities General ICU Surgical/maternity High risk pregnancy Ambulatory surgical clinic facilities Dental Clinic NICU Dialysis clinic Ancillary Services Secondary clinical Tertiary clinical laboratory Tertiary clinical laboratory laboratory with histopathology Blood station Blood bank First-level X-ray Second level X-ray with Third level X-ray mobile unit Pharmacy Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 5. Philippine Health Agenda 2016-2022please refer to https://www.doh.gov.ph/sites/default/files/basicpage/Philippine%20Health%20Agenda_Dec1_1. pdf C. Primary Health Care (PHC) 1. Brief History of Primary Health Care May 1977. The 30th World Health Assembly adopted resolution which decided that the main social target of governments and of WHO should be the attainment by all the people of the world by the year 2000 a level of health that will permit them to lead a socially and economically productive life. September 6-12, 1978. International Conference in PHC was held in this year at Alma Ata, USSR (Russia) October 19, 1979. The President of the Philippines (Ferdinand Marcos) issued Letter of Instruction (LOI) 949 which mandated the then Ministry of Health to adopt PHC as an approach towards design, development, and implementation of programs which focus health development at the community level. 2. Legal Basis Alma Ata Declaration 24  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care (PHC), Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic), 6-12 September 1978 October 19, 1979 – Letter of Instruction (LOI) 949, the legal basis of PHC was signed by Pres. Ferdinand E. Marcos, which adopted PHC as an approach towards the design, development and implementation of programs focusing on health development at community level. 3. Goal of Primary Health Care HEALTH FOR ALL FILIPINOS by the year 2000 AND HEALTH IN THE HANDS OF THE PEOPLE by the year 2020. 4. Elements The following are the eight (8) essential elements of primary health care: E- Education for Health This is one of the potent methodologies for information dissemination. It promotes the partnership of both the family members and health workers in the promotion of health as well as prevention of illness. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. L- Locally Endemic Disease Control The control of endemic disease focuses on the prevention of its occurrence to reduce morbidity rate. Example Malaria control and Schistosomiasis control E- Expanded Program on Immunization This program exists to control the occurrence of preventable illnesses especially of children below 6 years old. Immunizations on poliomyelitis, measles, tetanus, diphtheria and other preventable disease are given for free by the government and ongoing program of the DOH M- Maternal and Child Health and Family Planning The mother and child are the most delicate members of the community. So the protection of the mother and child to illness and other risks would ensure good health for the community. The goal of Family Planning includes spacing of children and responsible parenthood. E- Environmental Sanitation and Promotion of Safe Water Supply Environmental Sanitation is defined as the study of all factors in the man’s environment, which exercise or may exercise deleterious effect on his well-being and survival. Water is a basic need for life and one factor in man’s environment. Water is necessary for the maintenance of healthy lifestyle. Safe Water and Sanitation is necessary for basic promotion of health. N- Nutrition and Promotion of Adequate Food Supply One basic need of the family is food. And if food is properly prepared then one may be assured healthy family. There are many food resources found in the communities but 25  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 because of faulty preparation and lack of knowledge regarding proper food planning, Malnutrition is one of the problems that we have in the country. T- Treatment of Communicable Diseases and Common Illness The diseases spread through direct contact pose a great risk to those who can be infected. Tuberculosis is one of the communicable diseases continuously occupies the top ten causes of death. Most communicable diseases are also preventable. The Government focuses on the prevention, control and treatment of these illnesses. S- Supply of Essential Drugs This focuses on the information campaign on the utilization and acquisition of drugs. In response to this campaign, the GENERIC ACT of the Philippines is enacted. It includes the following drugs: Cotrimoxazole, Paracetamol, Amoxycillin, Oresol, Nifedipine, Rifampicin, INH (isoniazid) and Pyrazinamide, Ethambutol, Streptomycin, Albendazole, Quinine 5. Principles & Strategies Primary health care is run with the following principles: 1. 4 A’s = Accessibility, Availability, Affordability and Acceptability, Appropriateness of health services. The health services should be present where the supposed recipients are. They should make use of the services available within the community, with a greater emphasis on health promotion and disease prevention. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 2. Community Participation Community participation is the heart and soul of primary health care. 3. People are the center, object and subject of development. The success of any undertaking that aims at serving the people is dependent on people’s participation at all levels of decision-making; planning, implementing, monitoring and evaluating. Any undertaking must also be based on the people’s needs and problems (PCF, 1990) Part of the people’s participation is the partnership between the community and the agencies found in the community; social mobilization and decentralization. In general, health work should start from where the people are and building on what they have. Example: Scheduling of Barangay Health Workers in the health center Barriers of Community Involvement Lack of motivation Attitude Resistance to change Dependence on the part of community people Lack of managerial skills 4. Self-reliance Through the involvement of the community and the cohesion of people’s organization support for health care can be created through social mobilization, networking and mobilization of local resources. Leadership and management skills should be established among these people. Existence of sustained health care facilities managed by the people is some of the major indicators that the community is leading to self - reliance. 26  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 5. Partnership between the community and the health agencies in the provision of quality of life. Providing linkages between the government and the non-government organization and people’s organization. 6. Recognition of interrelationship between the health and development Health is defined as not just the absence of disease. It’s not about a state of physical and mental well-being. Health as a social phenomenon recognizes the interplay of political, socio-cultural and economic factors as its determinant. Good Health therefore, is manifested by the progressive improvements in the living conditions and quality of life enjoyed by the people. Development is the quest for an improved quality of life for all. Development is multidimensional. It has political, social, cultural, institutional and environmental dimensions (Gonzales 1994). It is then measured by the ability of people to meet their basic needs. 7. Social Mobilization Enhances people’s participation or governance, support system provided by the government, networking and developing secondary leaders. 8. Decentralization This ensures empowerment and that empowerment can only be promoted if the institutional system provides local level political structures with more practical roles for development initiators. It also accounts for the correct distribution of financial resources. Major Strategies 1. Elevating health to a comprehensive and sustained national effort ü Health for all Filipinos would entail greater involvement in health and health-related services, whether as service provider or as a beneficiary. Empowerment of parents, families and communities to make decisions of their health is the desired outcome. ü Advocacy must be directed to national and local policy making, to elicit support and commitment to major health concerns through legislations, budgetary and logistical considerations. 2. Promoting and supporting community managed health care Health in the hands of the people takes the government closer to the people. It takes a capacity building mechanism for communities and organizations to plan, implement and evaluate health services at their levels. 3. Increasing efficiency in health sector Appropriate technology would make services and resources needed to provide them, effective, affordable, accessible and culturally acceptable. The development of human resources must correspond with the actual needs of the nation and the policies it upholds such as PHC. 4. Advancing essential national health research Essential National Health Research (ENHR) is an integrated strategy for organizing and managing research using intersectoral, multi-disciplinary and scientific approach to health programming and delivery. 27  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Reference: Introduction to Public Administration A Reader 2nd Edition National College of Public Administration & Governance University of the Philippines Diliman, Quezon City, 2003 www.slideshare.netjobitonio primary health care D. Levels of Prevention 28  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 Level 1 Primary Prevention Activities Prevention of problems before they occur Example: Immunization Level 2 Secondary Prevention Activities Early detection and intervention Example: Screening for sexually transmitted disease Level 3 Tertiary Prevention Activites Correction and prevention odf deterioration of a disease state Example: Teaching Insulin administration in the home The three levels of prevention Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. E. Universal Health Care(UHC) ADMINISTRATIVE ORDER NO. 2010 - 0036 Universal Health Care (UHC), - also referred to as Kalusugan Pangkalahatan (KP), is the “provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public”. It is a government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits. This involves providing adequate resources – health human resources, health facilities, and health financing. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. GOAL AND OBJECTIVES: 29  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 The implementation of Universal Health Care is directed towards ensuring the achievement of the health system goals of: 1. better health outcomes, 2. sustained health financing and, 3. responsive health system by ensuring that all Filipinos, especially the disadvantaged group, have equitable access to affordable health care.(DOH,2010) UHC’s Three Thrusts The attainment of the goal of UHC is through the pursuit of three strategic thrusts: 1. Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP); 2. Improved access to quality hospitals and health care facilities; and 3. Attainment of health-related Millennium Development Goals (MDGs). To achieve the three strategic thrusts six (6) strategic instruments shall be optimized: 1. Health Financing - instrument to increase resources for health that will be effectively allocated and utilized to improve the financial protection of the poor and the vulnerable sectors 2. Service Delivery - instrument to transform the health service delivery structure to address variations in health service utilization and health outcomes across socio-economic variables 3. Policy, Standards and Regulation - instrument to ensure equitable access to health services, essential medicines and technologies of assured quality, availability and safety 4. Governance for Health - instrument to establish the mechanisms for efficiency, transparency and accountability and prevent opportunities for fraud 5. Human Resources for Health - instrument to ensure that all Filipinos have access to professional health care providers capable of meeting their health needs at the appropriate level of care 6. Health Information - instrument to establish a modern information system that shall: a. Provide evidence for policy and program development b. Support for immediate and efficient provision of health care and management of province-wide health systems. Self-Help: You can also refer to the sources below to help you further understand the lesson. 1. Famora, Z., et.al. (2013). Nursing care of the community: A comprehensive text on community and public health nursing in the Philippines. 1st Edition C & E Publishing, Inc. 2. Castro, Cecilia (2012). Community health nursing & community health development. 1st Edition. Educational Publishing House, Ermita, Manila. 3. Introduction to Public Administration A Reader 2nd Edition National College of Public Administration & Governance University of the Philippines Diliman, Quezon City, 2003 4. Nursing Practice in the Community – Maglaya 4th Ed. 30  College of Health Sciences Education 3rd Floor, DPT Building Matina Campus, Davao City Telefax: (082) Phone No.: (082)300-5456/300-0647 Local 117 5. www.slideshare.netjobitonio primary health care. Let’s Check Activity 1. Matching type: Match Column A with Column B A B ______1. Health Promotion A. Local Government Code ______2. Curative Care B. Primary concern of hospital ______3. Dr. Rosario Pastor C. Primary concern of health centers ______4. Devolution D. Essential health care ______5. Primary health care E. Group of people sharing a common geography ______6. Chairman of the Provincial Local F. Services rendered by the nurse at Health Board home, health centers, etc. for health promotion and disease prevention ______7. I A RA 7160 G. Tool in the delivery of health care ______8. Public Health H. Biggest provider of health care nationwide ______9. Community I. Transfer of power to LGU’s ______10. H Alma Ata Declaration J. Goal of CHN ______11. Head of the Municipal Health Board K. Governor ______ 12. Department of Health L. Mayor ______13. Preventive care M. 1st nurse supervisor under the Bureau of Health ______14. M Carmen del Rosario N. Head of office of District Nursing in 1915 ______15. Primary Health Care O. Primary health care as key to attain “Health in the Hands of the People in 2020” Let’s Analyze Activity 2. Identify the level of disease prevention. Write the letters only. A. Primary Prevention B. Secondary Prevention C. Tertiary Prevention __________1. A Sex Education among the youth _________2. C Breastfeeding classes to mothers _________3.OperationTimbang B _________4. C Management of Epidemics _________5. B Conducting sputum microscopy _________6. A Male Circumcision _________7. B Use of mosquito nets and repellants _________8. A Colostomy support group _________9. C Passive ROM Exercises for a trauma patient _________10. C Crutch walking _________11. B Teaching how to use a condom _________12. B Belly dancing for middle-aged people _________13. B Surgical handwashing _________14. B