National Health Situations 7.

High level malnutrition

8. Malaria, Schistosomiasis and goiter are
❖ The health problems of our country remains the
still endemic
same over the past 30 years, the leading causes
9. Incidence of HIV infection and AIDS is
of death are preventable. Added to the situation
slowly increasing not only in males and
is the emergence of life style diseases.
females but in infant and children
10. High rate of disability
A. Positive aspect:
11. Poor environmental sanitation and new
1. Filipinos are healthier today
threat of degradation
2. Life expectancy rises (Male = 68.81 :
12. Under - funding / overspending for
Female = 74.43)
health care by individual, family and
3. Decline in mortality rate
government
4. Certain diseases (Poliomyelitis and
13. Low coverage and support level existing
Neonatal Tetanus) are nearing
compulsory national insurance system
eradication due to immunization
14. Rising and prohibitive cost of drugs and
5. Increase awareness of the families and
hospitalization
community in health and disease
15. Rapid turn over and mal - distribution of
6. Use of herbal medicine is slowly
health and human resources
gaining ground
16. Inadequate basic service coverage in
7. Increase access to safe water
many areas exacerbate by the
8. Improve child survival and development
occurrence of natural and man made
service including the establishment of
disaster
baby friendly hospital and breast feeding
promotion
❖ According to Philippine Health Statistics total
9. Fast growing number of health initiative
population in 2015 is 100, 979, 303. There was a
to solve equitable distribution of health
47% increase in the population from 1995 -
facilities and human resources
2015.
10. DOH has become responsive in
providing quality health services
10 Leading Causes of Mortality (2016)
11. Multi - sectoral and multidisciplinary
1. Ischemic Heart Disease
participation in health care development
2. Neoplasms
3. Pneumonia
B. Negative Aspect
4. Cerebrovascular Disease
1. Fast growing population
5. Hypertensive Diseases
2. Urban dwellers exposed to risk factors
6. Diabetes Mellitus
e.g. smoking, stress, high risk living
7. Other Heart Diseases
associated with more dominated
8. Respiratory Tuberculosis
lifestyle related illness
9. Chronic Lower RTI's
3. Increasing mortality rate from cancer,
10. Diseases of the Genitourinary system
cardiovascular disease, accidents and
chronic degenerative diseases
10 leading Causes of Morbidity (2015)
4. Slow reduction in fertility and close
1. Acute Respiratory Infection
spacing of birth 2. Hypertension
5. Many infants and children still suffer 3. Pneumonia
and die from communicable diseases 4. Urinary Tract Infection
5. Bronchitis
(diarrhea and pneumonia which are 6. Influenza
preventable) 7. Acute Watery Diarrheal
6. Death related to pregnancy and 8. TB Respiratory
childbirth remains to be leading causes 9. Dengue Fever
10. TB other Forms
of female death
Definition and Focus Health as Human Right
❖ The enjoyment of the highest attainable standard
Nursing
of health is one of the fundamental rights of
➢ is a profession aimed at helping the population
every human being without distinction of race,
achieve better health thru their own hands.
religion, political belief, economic and social
conditions.
❖ As a science, it relies heavily on an
❖ It is grounded in the Universal Declaration of
understanding that the key towards genuine
Human Rights proclaimed in Paris on Dec. 10,
development is investing in the health and
1948. UDHR Article 25.1 declares: Everyone
healthcare of the people regardless of age, sex,
has the right to a standard of living adequate for
gender, religion and color.
the health and well - being of himself and of his
family, including food, clothing, housing and
Health
medical care and necessary social services.
➢ is a shared reality.
➢ it enables the people to achieve their full
Components of the right to health:
potential.
1. Availability
➢ is a complex reality
2. Accessibility
➢ a state of complete physical, mental and social
3. Acceptability
well - being and not merely the absence of
4. Quality
disease or infirmity.
Models of Health
Social
1. Clinical Model / Medical Model
➢ means relating to living together in organized
● Health is the absence of signs and
groups or similar close aggregates.
symptoms of disease and illness refers
➢ refers to units of people in communities who
to its presence.
interact with one another.
2. Role Performance Model
● The individuals' ability to perform
Social health
societal roles.
➢ connotes community vitality and is a result of
3. Adaptive Model
positive interaction among groups within the
● Health is a dynamic state.
community, with emphasis on health promotion
4. Eudaimonistic Model
and illness prevention.
● An elevated level of wellness suggests
optimal health and illness is reflected by
❖ In the mid 1980's WHO defines health as the
a lack of vitality. (Exuberant well being)
extent to which an individual or group is able on
5. Health - Illness Continuum Model
the one hand, to realize aspirations and satisfy
6. High Level Wellness Model
needs; and, on the other hand, to change or cope
7. Health Belief Model
with the environment. Health is therefore, seen
8. Needs - Fulfillment Model
as a resource for everyday life, not the objective
of living; it is a positive concept emphasizing
social and personal resources and physical
capacities.

Dimensions of Health
1. Physical - structure and function
2. Social
3. Role
4. Mental (emotional & mental)
5. General perceptions of health status
Determinants of Health and Disease for the maintenance of health, so organizing
1. Biology these benefits as to enable every citizen to
➢ is the individual's genetic make - up, realize his birth right of health and longevity.
family history, and any physical and
mental health problems developed in the According to WHO:
course of life. ❖ public health is the art of applying science in the
2. Behavior context of politics so as to reduce inequalities in
➢ are the individual's responses to internal health while ensuring the best health for the
stimuli and external conditions. greatest number.
3. Social environment
➢ include interactions and relationships Community Health (Stanhope and Lancaster, 1992)
with family, friends, co - workers and ❖ the meeting of collective needs through
others in the community. identifying problems and managing interactions
4. Physical environment within the community itself and between the
➢ is what is experienced by the senses community and large society.
5. Policies and interventions ❖ is part of paramedical and medical intervention /
➢ can have a profound effect on the health approach which is concerned on the health of the
of individuals, groups, and communities. whole population.

Social Determinants of Health Aims:

➢ are conditions in which people are born, grow, 1. Health promotion
live, work and age; might also be circumstantial 2. Disease prevention
elements such as housing, work conditions and 3. Management of factors affecting health
access to recreational activities, circumstances
that influence how an individual will develop 3 common characteristics / dimensions of community
sickness, what risk factors they are exposed to, health:
how they access services, and is shaped by the 1. Status
distribution of money, power and resources at ➢ the physical component, frequently
global, national and local levels. measured by mortality and morbidity
rates, life expectancy rates and risk
1. Health care access factors profile.
2. Economic conditions 2. Structure
3. Social and environmental issues ➢ community health services and
4. Cultural practices resources
3. Process
❖ A framework for Community and Public Health ➢ effective community functioning or
Nursing is: ONE HEALTH CONCEPT problem solving, promotion of effective
community action or wellness
Public Health (Dr. Charles Edward Winslow)
● the science and art of preventing disease, Status
prolonging life, promoting health and efficiency ● Vital statistics - live births, neonatal deaths,
through organized community effort for the infant deaths, maternal deaths
sanitation of the environment, control of ● Disease incidence and prevalence of leading
communicable diseases, the education of causes of mortality and morbidity
individuals in personal hygiene, the organization ● Health risk profiles of selected aggregates
of medical and nursing services for the early ● Functional ability levels
diagnosis and preventive treatment of disease,
and the development of the social machinery to
ensure everyone a standard of living adequate
Structure Place
● Health facilities such as hospitals, nursing ● Geopolitical boundaries
homes ● Local or folk name for area
● Health - related planning groups ● Size in square miles, blocks or census tracts
● Health manpower such as physicians, dentists, ● Transportation avenues
nurses ● History
● Health resource utilization patterns such as bed ● Physical environment such as land use patterns
occupancy rate and patient / provider visits and condition of housing

Process People or Person

● Commitment, Articulateness, Effective ● Number and density
communication, Participation, Conflict ● Demographic structure
containment and accommodation, machinery for ● Informal groups
facilitating participant interaction ● Formal group
● Linking structures
Public Health Nursing
❖ According to the World Health Organization Function
Expert Committee of Nursing, Public Health ● Production, distribution and consumption of
Nursing is a special field of nursing that goods and services
combines the skills of nursing, public health and ● Socialization of new members
some phases of social assistance and functions ● Maintenance of social control
as part of the total public health programme for ● Adapting to on - going and expected change
the promotion of health, the improvement of the ● Provision of mutual aid
conditions in the social and physical
environment, rehabilitation of illness and Community Health Nursing
disability. ❖ According to Ruth B. Freeman it refers to a
service rendered by a professional nurse with
Community communities, groups, families, individuals at
❖ Hanchett, 1979 in Stanhope and Lancaster, 1992 home, in health centers, in clinics, in schools, in
defines community as a group of people in place of work for the promotion of health,
relationship with each other. prevention of illness, care of the sick at home
❖ The World Health Organization Expert and rehabilitation.
Committee of Nursing Public Health Nursing ❖ is a unique blend of nursing and public health
(1974) defines community as a social group practice aimed at developing and enhancing the
determined by geographic boundaries and / or health capabilities of people, either singly as
common values and interests. Its members know individuals or collectively as families, special
and interact with one another. It functions within populations or communities. It involves the
a particular social structure and exhibits and entire spectrum of health services for the
creates norms, values and social interactions. community.

Dimensions of Community: According to American Nurses Association

1. People - the community residents (1973)
2. Place - the spatial and time dimensions ❖ CHN is a synthesis of nursing practice and
3. Functions - the aims and activities of the public health practice applied to promoting and
community preserving the health of populations. The nature
of this practice is general and comprehensive. It
is not limited to a particular age or diagnostic
groups. The dominant responsibility is to the
population as a whole. Therefore, nursing
directed to individuals, families or groups contributes to Standards of Public Health Nursing in the
the health of the total population Philippines
➔ Was founded by the National League of
According to Tinkham and Voorhies (1972) Philippine Government Nurses in 2005.
❖ CHN is that field of nursing in which the family ➔ Differentiated public health nursing and
and community are patients. Its primary focus is community health nursing in one area (setting of
on the prevention of disease and the promotion work as dictated by funding).
and maintenance of the highest level of health ➔ The government is the employer of public health
and well- being. nurses both the national and local health
agencies.
❖ Community Health Nursing is the synthesis of ➔ The position title or designation was given by
nursing and public health practice applied to the Civil Service Commission (Public Health
promote and protect the health of the population. Nurse)
It combines all the basic elements of
professional, clinical nursing with public health According to standards of Public Health Nursing in the
and community practice. Philippines:
Public Health Nurse
Characteristics and Features of Community and ➢ refers to the nurses in the local / national health
Public Health Nursing (CPHN) departments or public schools.
1. CPHN is developmental
2. CPHN promotes social justice Public Health Nursing
3. CPHN values consumer involvement ➢ refers to the practice of nursing in national and
4. CPHN uses prepayment mechanism local government health departments (health
5. CPHN focuses on preventive services. centers & RHU's) and public schools. It is
6. CPHN offers comprehensive care. community health nursing practiced in the
7. CPHN is multidisciplinary public sector.
8. CPHN is ecology oriented
Evolution of Public Health Nursing in the
Philippines
Philosophical and Ethical Underpinnings ❖ The history of public health nursing in the
Philosophical Philippines is embedded in the history of DOH
1. Worth and dignity of man - Margaret Shetland which was first established as Department of
2. Caring is the moral ideal of nursing whereby the Public Works, Education and Hygiene in 1898.
end is protection, enhancement, and preservation ❖ Republic Act No. 1082 or the Rural Health
of human dignity - Jean Watson Law
3. Responsibility for health rest primarily on ➢ It created the first 81 RHU's. Each unit
people and not on agencies or professionals - had a physician, a public health nurse, a
Aristotle midwife, a sanitary inspector and a clerk
4. Social justice driver.

Ethical
Roles and Responsibilities of a Community
1. Beneficence and nonmaleficence
2. Veracity and Public Health Nurse
3. Fidelity 1. Health Monitor
4. Autonomy ● detects deviations from health by
individuals, families, groups, or the
community through her contact / visit
with them and with the use of systematic
 and objective observation and other personnel in the health agency as well as
forms of data gathering. community health workers and manager
2. Provider of Nursing Care to the sick or / administrator of a unit / program of the
disabled / Health Care Provider agency.
● provides nursing care to the sick / 9. Supervisor / Manager
disabled in the home, clinic, school or ● the nurse also participates in the
place of work. planning and evaluation of the total
● develops the families capability to take program of the health agency.
care of its sick, disabled or dependent 10. Planner / Programmer
members. ● the nurse identifies needs, priorities and
3. Health Teacher / Counselor / Trainer / Health problems; formulates nursing
Educator component of health plans; interprets
● is one of the most frequently used and implements nursing plan, program
interventions of the nurse. policies; and provide technical
● Every contact of the client, be it in the assistance to midwives in health matters.
home, clinic, school or place of work 11. Recorder /Reporter / Statistician
must be seen as an opportunity for ● the nurse prepares and submits required
teaching about health promotion, disease reports and records; maintains adequate,
prevention, care of the sick at home and accurate recording and reporting;
rehabilitation. reviews, validates, consolidates,
4. Coordinator of Services to the individuals and analyzes and interprets all records and
family reports; prepares statistical data for
● with the nurse holistic view of the presentation or display
family and her prolonged contact with it, 12. Researcher / Epidemiologist
she is in a position to coordinate health ● participates / assists in the conduct of
services provided by various members surveys and studies on nursing and
of the health team so that they are health related subjects; and coordinates
delivered and received as a meaningful with government and non - government
whole / package based on needs, not as organizations in the implementation of
fragmented bits and pieces. studies / research.
5. Community Organizer 13. Program Implementer
● takes active participation in stimulating ● requires that programs initiated by the
and enhancing community participation national government thru the DOH are
in planning, organizing, implementing executed at all levels
and evaluating health programs and
services and initiating community The Health Care Delivery System
development activities. 1. World Health Organization
6. Change Agent ❖ Millennium Development Goals:
● this involves individual, family, groups ➔ Eradicate extreme poverty and hunger
and community's health behavior, ➔ Achieve universal primary education
including lifestyles in order to promote ➔ Promote gender equality and empower
and maintain health. (Client Advocate) women
7. Role Model ➔ Reduce child mortality
● the nurse is expected to provide a good ➔ Improve maternal health
example or model of healthful living to ➔ Combat HIV / AIDS, malaria and other
the public / community. diseases
8. Supervisor / Manager/ Leader ➔ Ensure environmental sustainability
● the nurse functions as trainer and ➔ Develop a global partnership for
supervisor to lower level health development
 Philippine Department of Health
The 17 Sustainable Development Goals for the period Vision: The DOH is the leader, staunch advocate and
2016-2030 are: model in promoting Health for all in the Philippines.
1. End poverty in all its forms everywhere
2. End hunger, achieve food security and improved Mission: Guarantee equitable, sustainable and quality
nutrition, and promote sustainable agriculture health for all Filipinos, especially the poor and shall lead
3. Ensure healthy lives and promote well-being for the quest for excellence in health.
all at all ages
4. Ensure inclusive and equitable quality education DOH
and promote life-long learning opportunities for ➢ is a government agency that is responsible for
all the health problems of the Filipino people under
5. Achieve gender equality and empower all the virtue of Executive Order (EO) 119.
women and girls ➢ responsible for the promotion, protection,
6. Ensure availability and sustainable management preservation and restoration of health of the
of water and sanitation for all people.
7. Ensure access to affordable, reliable, sustainable,
and modern energy for all RA 7160 - The Local Autonomy Code
8. Promote sustained, inclusive and sustainable ➢ devolution of the health services, the local
economic growth, full and productive government units were granted more power,
employment and decent work for all authority and resources.
9. Build resilient infrastructure, promote inclusive
and sustainable industrialization and foster EO 503
innovation ➢ Transfer of personnel assets and liabilities and
10. Reduce inequality within and among countries records of devolved government agencies.
11. Make cities and human settlements inclusive,
safe, resilient and sustainable
12. Ensure sustainable consumption and production
patterns
13. Take urgent action to combat climate change and
its impacts (in line with the United Nations
Framework Convention on Climate Change)
14. Conserve and sustainably use the oceans, seas
and marine resources for sustainable
development
15. Protect, restore and promote sustainable use of
terrestrial ecosystems, sustainably manage
forests, combat desertification, and halt and
reverse land degradation and halt biodiversity
loss
16. Promote peaceful and inclusive societies for
sustainable development, provide access to
justice for all and build effective, accountable
and inclusive institutions at all levels
17. Strengthen the means of implementation and
revitalize the global partnership.