I.

One billion people are enjoying better health

and well-being.
A. The Global and National Health Situation - 10 issues demanding attention from the WHO and
health partners in 2019:
Commonly Used Measures to Describe Population’s Health
1. Air Pollution and Climate Change
1. Life Expectancy - In 2019, air pollution is
2. Reduction in child mortality and maternal mortality considered to be the greatest
3. Health Outcomes are highly responsive to healthcare environmental risk to health.
investments. - Burning of fossil fuels is a major
4. Child mortality contributor to climate change.
5. Maternal mortality - Between 2030 and 2050,
6. Five most lethal diseases overtime climate change is expected to
a. Tuberculosis cause 250,000 additional
b. Measles deaths per year due to
c. Malaria malnutrition, malaria, diarrhea
d. Influenza and heat stress.
i. Included is COVID 19
e. Diarrheal Diseases 2. Non-Communicable diseases (NCDs)
B. 10 threats to Global Health - Cancer, diabetes and heart
disease, are responsible for
- The WHO crafted the 13th General Programme of Work over 70% of all deaths
(2019 to 2023) – a five - year development plan. worldwide or 41 million people
- Focuses on the triple billion targets to (15 million of which aged 30
achieve measurable impacts on people’s and 69 dies prematurely).
health. - Five major risk factors for NCDs
- Ensures that by 2023:  Tabacco use
One billion people are benefiting from the  Physical inactivity
UHC.  Harmful use of alcohol
One billion people are better protected from  Unhealth diets
health agencies.  Air pollution.
 - These risk factors exacerbate - It is the ability of bacteria,
mental health issues. parasites, viruses and fungi to
- Suicide is the leading cause of resist medicines.
death among 15 – 19 y.o. - The inability to prevent
infections could seriously
3. Global Influenza Pandemic compromise surgery and
- WHO constantly monitors the procedures such as
circulation of influenza viruses chemotherapy.
to detect potential pandemic - There were around 600,000
strains. cases of tuberculosis resistant
- WHO has set up a unique to rifampicin (the most effective
partnership with all the major first line of drugs against TB).
players to ensure effective and
equitable access to diagnostics, 6. Ebola and other high-threat pathogens
vaccines and antivirals. - WHO’s R and D Blueprint
identifies diseases and
4. Fragile and Vulnerable settings pathogens that have potential
- There are more than 1.6 million to cause a public health
people (22% of the world’s emergency but lack effective
population) live in places where treatments and vaccines.
protracted cases (through a - Priority research and
combination of challenges such development includes EBOLA,
as drought, famine, conflict, and SEVERAL OTHER
population displacement and HEMORRHAGIC FEVERS, ZIKA,
weak health services leave NIPAH, MIDDLE EAST
them without access to basic RESPIRATORY SYNDROME
care. CORONAVIRUS (MERS-CoV)
- Fragile settings is where half of AND SEVERE ACUTE
the key targets in the SDGs, RESPIRATORY SYNDROME (sars)
including on child and maternal and disease X (represents the
health remains unmet. need to prepare for an
5. Antimicrobial Resistance unknown pathogen).
7. Weak primary health care - High numbers occur during the
- PHC is the first point of contact rainy season.
people in a health care system, - An estimated 40% of the world
and ideally should be is at risk for dengue fever.
comprehensive, affordable, - Dengue control strategies aim
community-based care to reduce deaths by 50% by
throughout life. 2020.
- Strong primary health care are
needed to achieve universal 10. HIV
health care coverage. - There are 22 million people
- In October 2018, WHO co- living with HIV being treated
hosted a major global with antiretrovirals, more
conference in Astana, people are being tested, and
Kazakhstan at which countries provided preventive measures
are committed to renew the such as pre-exposure
commitment made in the Alma- prophylaxis.
Ata declaration in 1978. - There are more than 70 million
people who have acquired HIV,
8. Vaccine hesitancy 35 million who have died.
- It is the reluctance or refusal to - Young girls and women aged 15
vaccinate despite the to 24 have been increasing
availability of vaccines – affected by HIV.
threatens reverse progress - In the sub-Saharan Africa there
made in tackling vaccine are 1 in 4 HIV infections.
preventable diseases.
- Vaccination is on of the most C. 10 GLOBAL HEALTH ISSUES TO TRACK IN 2021
cost-effective ways of avoiding
disease. 1. Build Global Solidarity for worldwide health security.
 It prevents 2-3 million 2. Speed up access to COVID-19 tests, medicines and
deaths/year. vaccines.
9. Dengue 3. Advance health for all.
4. Tracking health inequities
 5. Provide global leadership on science and data. 10. Remainder of diseases of the genitorurinary system
6. Revitalize efforts to tackle communicable diseases. 11. All other external causes
7. Combat drug resistance 12. Transport accidents
8. Prevent and treat NCDs and mental health conditions. 13. Remainder of diseases of the digestive system
9. Build back better 14. Diseases of the liver
10. Act in Solidarity. 15. Certain conditions originating in the perinatal period
16. Remainder of diseases of the nervous system
17. Remainder of endocrine nutritional and metabolic
diseases
D. TOP 10 LEADING CAUSE OF MORBIDITY 18. Remainder of diseases of the respiratory system
1. Diarrhea 19. Congenital malformations / deformations and
2. Pneumonia chromosomal abnormalities
3. Bronchiolitis 20. Gastric and duodenal ulcer
4. Influenza (source: https://psa.gov.ph)
5. TB (all forms)
6. Malaria
7. Chickenpox F. Standards of Public Health Nursing in the Philippines
8. Diseases of the Heart
9. Measles 1. Assessment – collection of comprehensive data
10. Dengue pertinent to the health status of populations.
2. Population and diagnosis and priorities - analysis of
assessment data to determine the population diagnoses
E. Top Causes of Death in the Philippines (2024) and priorities.
1. Ischemic Heart diseases 3. Outcomes identification - identification of expected
2. Neoplasms outcomes for a plan that is based on population.
3. Cerebrovascular diseases 4. Planning – development of a plan that reflects best
4. Pneumonia practices by identifying strategies, action plans and
5. Diabetes Mellitus alternatives to attain expected outcomes.
6. Hypertensive Diseases 5. Implementation – implements identified plan by
7. Chronic Lower Respiratory Diseases partnering with others.
8. Respiratory Tuberculosis a. Coordination – coordinates programs, services, and
9. Other heart diseases other activities to implement the identified plan.
 b. Health education and health promotion – employs practice and in the planning and delivery of nursing and
multiple strategies to promote health, prevent public health programs, policies and services.
disease and ensure a safe environment for 15. Leadership – provides leadership in nursing and public
populations. health.
c. Consultation – provides consultation to various
community groups and officials to facilitate the
implementation of programs and services. G. Evolution of Public Health Nursing in the Philippines
d. Regulatory services – identifies, interprets and
implements public health laws, regulations and Pre-colonial era – ancient Filipinos regarded health as
policies. harmonious relationship with the environment, both natural
6. Evaluation – evaluates the health status of the and supernatural.
population.
7. Quality of practice - systematically enhances the quality 1565 : Hospital Real de Manila – first hospital in the
of and effectiveness of nursing practice. Philippines that mainly cares for the King’s soldiers, Spanish
8. Education – attains knowledge and competence that Civilians; founded Gov by Gov. Francisco de Sande.
reflects current nursing and public health practice.
9. Professional practice evaluation – evaluates ones own 1578 – Friar Juan Clement opened a medical dispensary in
nursing practice in relation to professional practice Intramuros for the indigent, called the Hospital de los indios
standards and guidelines, relevant statutes, rules and Naturales.
regulations. 1603 – San Lazaro Hospital – was the reconstruction of the
10. Collegiality and Professional Relationships – establishes Hospital de Naturales, which caters exclusively for patients
collegial partnerships while interacting with with leprosy.
representatives of the population.
11. Collaboration – collaborates with the representatives of 1690 – Dominican Juan de Pergero worked on the
the population, organizations and health human installation of a water system in San Juan del Monte and
services professionals in providing for and promoting Manila.
the health of the population.
12. Ethics – integrates ethical provisions in all areas of 1805 – Francisco de Balmis introduced Smallpox vaccination.
practice.
13. Research – integrates research findings in practice. 1876 – the first medicos titulares were appointed and
14. Resource utilization population – considers factors worked as provincial health officers.
related to safety, effectiveness, cost and impact on
 1876: The first medicos titulares were appointed and  monitors midwives and other auxiliary health
worked as provincial health officers. workers
 Give in-service health education program to the
1888: The University of Santo Tomas opens a two-year, other health team
cirujanos ministrantes course to produce male nurses and  Guides group discussion and helps staff overcome
sanitary inspectors their difficulties in work

1901: The Board of Health of the Philippine Islands was 2. CLINICIAN

created through Act 157, which eventually evolved into the  healthcare provider/ client advocate
Department of Health (DOH).
3. ADVOCATE
1912: The Fajardo Act law created sanitary divisions made  The nurse works on behalf of patients to maintain
up one to four municipalities quality of care and protect patient’s rights

1905: Asociacion de Feminista Filipina founded La Gota de 4. FACILITATOR

Leche: the first center dedicated to the service of mothers
and babies.  uses multi-sectoral linkages (Referral system)
5. TRAINER/ HEALTH EDUCATOR/COUNSELOR
1970: the Philippine health care delivery system was
 Organizes orientation/training of concerned groups
restructured, paving the way for the health care system that
including non-government organization
exists to this day where health services are classified into
 disseminates information to people with emphasis
primary, secondary and tertiary levels.
on health promotion and disease prevention
1991: R.A.7160 or the Local Government Code mandated
the devolution of basic services, including health services, to 6. PLANNER/ PROGRAMMER
local government units and the establishment of a local  Interprets and implements the nursing plan,
health board in every province and city or municipality program policies, memoranda for the concerned
personnel and staff.
H. ROLES AND RESPONSIBILITIES OF A COMMUNITY HEALTH 7. COMMUNITY ORGANIZER
NURSE  Responsible for motivating and enhancing
community participation in terms of planning,
organizing, and implementing and evaluating health
1. MANAGER/SUPERVISOR programs/services
  Initiates and participates in community In September 2020, the United Nations member states adopted
development activities the MDGs to address the need to “combat poverty, hunger, disease,
illiteracy, environmental degradation, and discrimination against
8. HEALTH MONITOR women,” (WHO, 2018).
 Uses symptomatic and objective observation and
Deriving from these global concerns, the United Nations
other forms of data gathering like morbidity,
secretariat along side with the International monetary fund (IMF)
registry, questionnaire, checklist, and anecdo-
and the Organization of Economic Cooperation and Development
report/record to monitor growth and development
came up with eight (8) MDGs, which should be achieved by the year
and health status of individuals, families and
2015.
communities.

MDG 1: Eradicate extreme poverty and hunger.

9. ROLE MODEL
- Targets are halved between 1990 and 2015
 Promotes good example/model of healthful living to o Proportion of the population whose income is
the public and community. less than 1 US dollar.
10. CHANGE AGENT o proportion who suffer from hunger.
 Motivates changes in health behavior of individuals,
families, group and community including lifestyle in MDG 2: Achieve universal primary education.
order to promote and maintain health. - By 2015, children around the globe would be able to
“complete a full course of primary schooling.
11. RESEARCHER
 Participates/assists in the conduct of surveys studies MDG 3: Promote gender equality and empower women.
and researches in nursing and health related
- By 2005, eliminating gender disparity in primary and
subjects
secondary education.
 Coordinates with government and non-government
- By 2015, in all levels of education.
organization of studies/research
II. The HealthCare Delivery System MDG 4: Reduce child mortality.

- Reduce under five mortality rate by 2/3 by the year

A. The Millenium Development Goals
2015.

MDG 5: Improve maternal health.

 - Reduce maternal mortality rate by three quarters; deprivation, adopting the UN Millenium Declaration with
- Increase access to reproductive health measures to 60% specific targets and milestones.
by 2005 and 100% by 2015.
• There were 8 goals and 18 targets from 1990 to 2015,
MDG 6: Combat HIV/AIDS, malaria and other diseases. identified by the UN Secretariat, International Monetary
Fund (IMF), Organization of Economic Cooperation and
- Hamper the spread of HIV/AIDS by 2015
Development; which are identified and selected with time-
- By 2015, reverse the incidence of malaria and
bound and measurable.
Tuberculosis.
• In May 2003 and June 2005, the Philippines submitted its
MDG 7: Ensure environmental sustainability.
progress reports on the MDGs.
- Integrate the principles of sustainable development
• The National Economic and Development Authority (NEDA)
policies and programs;
was the lead agency in preparing reports, in collaboration
- Reverse the loss of environmental resources
with the Multi-Sectoral Committee on International Human
- By 2015, halve the proportion without sustainable
Development Commitments (MC-IHDC) and the Social
access to safe drinking water and basic sanitation;
Development Committee (SDC).
- By 2020, must have achieved a significant improvement
in the lives of at least 100 million informal settlers. • The National Statistical Coordination Board (NSCB) issued
Resolution #10 series of 2004, making the NSCB as
MDG 8: Develop a global partnership for development.
repository od MDG indicators.
- Further develop an open, rule-based, predictable, non-
• Resolution #10 s.2004 – laid the mechanism for the
discriminatory trading and financial system;
continuous improvement of the indicators and localization
- Include a commitment to good governance;
of the MDGs.
- Development and poverty reduction (national and
international). • NSCB reso #6 s. 2005 – became a basis for strengthening the
- Comprehensive dealing of debt problems of developing statistical system at the local level for monitoring and
countries through national and international measures evaluation of local development plans.
in order to make debts sustainable in the long run.

Timelines:
Key MDG achievements
• September 2000 – UN member states affirmed
• More than 1 billion people have been lifted out of extreme
commitments towards reducing poverty and human
poverty (since 1990).
 • Child mortality dropped by more than half (since 1990). Goal 2: Zero Hunger

• The number of out of school children has dropped by more D. The food and agriculture sector offers key solutions for
than half (since 1990). development, and is central for hunger and poverty
eradication.
• HIV/AIDS infections fell by almost 40 percent (since 2000).
Goal 3:: Good Health and well-being

E. Ensuring healthy lives and promoting the well-being for all

B. Sustainable Development Goals
at all ages is essential to sustainable development.
As the timeline for achieving the MDGs came to an end in
Goal 4: Quality education
2015, the United Nations once again adopted the 2030 Agenda for
Sustainable Development. F. Obtaining a quality education is the foundation to improving
people’s lives and sustainable development.
“Ending poverty and other deprivations must go hand-in-
hand with strategies that improve health education, reduce Goal 5: Gender Equality
inequality and spur economic growth – while tackling climate
G. Gender equality is not only fundamental human right, but a
change and working to preserve our oceans and forests.” (SDGS,
necessary foundation for a peaceful, prosperous and
ND).
sustainable world.
• Also known as Global Goals.
Goal 6: Clean water and sanitation
• Adopted by the UN in 2015 as a “universal call to end
H. Clean, accessible water for all is an essential part of the
poverty, protect the planet and ensure that by 2030 all
world we want to live in.
people enjoy peace and prosperity.” (UN).
Goal 7: Affordable and clean energy
• The SDGs have included ending AIDS and discrimination
against women and girls. I. Ensure access to affordable, reliable, sustainable and
modern energy for all.

Goal 8: Decent Work and Economic Growth.

J. Promote sustained, inclusive and sustainable economic

Goal 1: No Poverty
growth, full and productive employment and decent work
C. Economic growth must be inclusive to provide sustainable for all.
jobs and promote equality.
Goal 9: Industry, Innovation and Infrastructure R. Promote peaceful and inclusive societies for sustainable
development, provide access to justice for all and build
K. Build resilient infrastructure, promote inclusive and
effective, accountable and inclusive institutions at all levels.
sustainable industrialization and foster innovation.
Goal 17: Partnership
Goal 10: Reduce Inequalities.
S. Strengthen the means of implementation and revitalize the
L. Reduce inequality within and among countries.
Global Partnership for Sustainable Development
Goal 11: Sustainable Cities and Communities.

M. Make cities and human settlements inclusive, safe, resilient

Key Activities
and sustainable.
Capacity Development/Technical Assistance
Goal 12: Responsible Consumption and Production
Convening/Partnerships/Knowledge Sharing
N. Ensure sustainable consumption and production patterns.
Data Collection and Analysis
Goal 13: Climate Action
Direct Support/ Service Delivery
O. Take urgent action to combat climate change and its
impacts. Normative Support

Goal 14: Life Below Water Policy Advice and Thought Leadership

P. Conserve and sustainably use the oceans, seas and marine Support Functions
resources for sustainable development.

Goal 15: Life on Land

The MDGs vs SDGs
Q. Protect, restore and promote sustainable use of terrestrial
ecosystems, sustainably manage forests, combat
desertification and halt and reverse land degradation and
halt biodiversity loss.

Goal 16: Peace, Justice and Strong Institutions

 MDGs SDGs
Number of 8 17
goals
C. Department of Health
Number of 21 169
1. VISION targets
General scope / Social Economic growth, social
Filipinos are among the healthiest people in Southeast Asia by 2022 focus inclusion & environmental
protection
and Asia by 2040.
target Developing Entire world (rich and
countries, poor)

2. MISSION particularly
the poorest
To lead the country in the development of a productive, resilient, Formulation Produced by a Result of consultation
equitable and people-centered health system. group of experts process

Member UN
3. HISTORICAL BACKGROUND States
Civil society
Other
stakeholders
23 June 1898 - Creation of the Department of Public Works,
-
Education & Hygiene (now the Department of Public Works
& Highways, Department of Education Culture & Sports, and Act Nos. 307, 308 dated December 2,1901, established the
Department of Health, respectively) through the Proclamation of Provincial Municipal Boards respectively completing the health
President Emilio Aguinaldo. organization in accordance with the territorial division of the islands.
September 29, 1898 - General Orders No. 15 established the Board October 26, 1905
of Health for the City of Manila with the primary objective of
The Insular Board of Health proved to be inefficient operationally so
protecting the health of the American soldiers.
it was abolished and was replaced by the Bureau of Health under
July 1, 1901 - a Board of Health for the Philippine Islands was the Department of Interior through Act No. 1487 in 1906 replaced
created through Act No. 157 because it was realized that it was the provincial boards of health with district health officers.
impossible to protect the American soldiers without protecting the
1912
natives.
Act No. 2156 also known as the Fajardo Act, consolidated the of Health and Public Welfare. The Philippine Commonwealth and
municipalities into sanity divisions and established what is known as the Japanese Occupation (1935-1945).
the Health Fund for travel and salaries.
May 31, 1939
1915
Commonwealth Act No. 430 created the Department of Public
Act No. 2468 transformed the Bureau of Health into a commissioned Health and Welfare, but the full implementation was only
service called the Philippine Health Service. completed through Executive Order No. 317,

-This introduced a systematic organization of personnel with January 7, 1941

corresponding civil service grades, and a secure system of civil
Dr. Jose Fabella became the first Department Secretary of Health
service entrance and promotion described as the “semi-military
and Public Welfare in 1941.
system of public health administration”.
October 4, 1947
August 2, 1916
Executive Order No. 94 provided the post war reorganization of the
The passage of the Jones Law also known as the Philippine
Department of Health and Public Welfare.
Autonomy Act,
This resulted in the split of the Department with transfer of the
provided the highlight in the struggle of the Filipinos for
Bureau of Public Welfare and the Philippine General Hospital to the
independence from the American rule.
Office of the President.
-
Another split was created between the curative and preventive
The establishment of an elective Philippine Senate completed an all services through the creation of the Bureau of Hospitals which took
Filipino Philippine Assembly that formed a bicameral system of over the curative services. Preventive care services remained under
government. This ushered in a major reorganization which the Bureau of Health.
culminated in the Administrative Code of 1917 (Act 2711), which
This order also established the Nursing Service Division under the
included the Public Health Law of 1917.
Office of the Secretary.
1932

Act No. 4007 known as the Reorganization Act of 1932, reverted

January 1, 1951
back the Philippine Service into the Bureau of Health, and combined
the Bureau of Public Welfare under the Office of the Commissioner The Office of the President of the Sanitary District was converted
into a Rural Health Unit, carrying out 7 basic health services:
maternal and child health, environmental health, communicable December 2, 1982
disease control, vital statistics, medical care, health education and
Executive Order No. 851 signed by President Ferdinand E. Marcos
public health nursing.
reorganized the Ministry of Health as an integrated health care
Rural Health Act of 1954 (RA 1082) created more rural health units delivery system.
and created posts for municipal health officers, among other
April 3, 1987
provisions.
Executive Order No. 119, “Reorganizing the Ministry of Health by
President Corazon c. Aquino saw a major change in the structure of
February 20, 1958 the ministry. It transformed the Ministry of Health back to the
Department of Health.
Executive Order No. 288 provided for what is described as the “most
sweeping” reorganization in the history of the Department. EO 119 clustered agencies and programs under the Office for
Standards and regulations and Office of Management Services.
An office of the Regional Health Director was created in 8 regions
and all health services were decentralized to the regional, provincial
making and development of procedures. RHUs were made an
October 10, 1991
integral part of the public health care delivery system.
Republic Act 7160 known as the Local Government Code provided
for the decentralization of the entire government.
1970
Under this law, all structures, personnel and budgetary allocations
The Restructures Health Care Delivery System was conceptualized; from the provincial health level down to the barangays were
under this concept the public health nurse to population ratio was devolved to the local government units (LGUs) to facilitate health
1:20,000. service delivery.

May 24, 1999

June 2, 1978 Executive Order No. 102 “Redirecting the Functions and Operations
of the Department of Health” by President Joseph E. Estrada
with the proclamation of martial law in the country, Presidential
granted the DOH to proceed with its rationalization and
Decree 1397 Renamed the Department of Health to the Ministry of
Streamlining Plan which prescribed the current organizational,
Health. Secretary Gatmaitan became the first Minister of Health.
staffing and resource structure consistent with its new mandate,
roles and functions post devolution.
Mandates the department of Health to provide assistance to LGUs, others means by any individual, corporation,
people’s organization, and other members of civic society in association or organization.
effectively implementing programs, projects and services that will
- may be single proprietorship, partnership, corporation,
promote the health and well being of every Filipino; prevent and
cooperative, foundation, religious, non-government organization
control diseases among population at risks; protect individuals,
and others.
families and communities exposed to hazards and risks that could
affect their health; and treat, manage and rehabilitate individuals 2. According to Scope of Services
affected by diseased and disability. a. General – provides services for all kinds of illnesses,
diseases, injuries and deformities.
2005 ongoing.
Clinical Services
Development of a plan to rationalize the bureaucracy in an attempt
to scale down including the DOH. i. Family medicine

ii. Pediatrics
D. CLASSIFICATION OF HEALTH FACILITIES iii. Internal Medicine

iv. Obstetrics and Gynecology

Specific Guidelines v. Surgery

b. Specialty – hospital that specializes in a particular

disease or condition or in one type of patient.
1. According to ownership

a. Government – may be under the national i. Treatment of a particular type of illness or

government, Department of Health, Local for a particular condition requiring a range
Government Units (LGUs), Department of National of treatment
Defense, PNP, DOJ, State Universities and Colleges ii. Treatment of patients suffering from
(SUCs), Government Owned and Controlled diseases of a particular organ or groups of
Corporations (GOCC) and others. organs.
3. Functional Capacity
b. Private – owned, established and operated with
funds through donation, principal, investment or
a. General Hospital
 i. Level 1 certified/eligible medical specialists and other
licensed physicians.
• Qualified medical, allied medical and administrative • Rendering services in the specialties of medicine,
staff headed by a physician duly licensed by PRC. • pediatrics, obstetrics and gynecology, surgery, their
• Bed space for its authorized bed capacity. subspecialties and ancillary services.
• An OR with standard equipment and provision for • General ICU
sterilization of equipment and supplies. • NICU
• A Post Operative Recovery Room. • High Risk Pregnancy Unit (HRPU)
• Maternity Facilities consisting of ward(s), room(s), a • Respiratory therapy services
DR, exclusively for maternity patients and • DOH licensed tertiary clinical laboratory
newborns. • DOH licensed level 2 imaging facility with mobile x-
• Isolation facilities with proper procedures for the ray inside the institution and with capability for
care and control of infectious and communicable contrast examination.
diseases as well as prevention of cross infections.
• Separate dental section / clinic. iii. Level 3
• Blood station. - Has a minimum of all level 2 capacity including, but not
• DOH licensed secondary clinical laboratory with the limited to the following:
services of a consulting pathologist.  Teaching and/ or training hospital with accredited
• DOH licensed level 1 imaging facility with the residency training program for physicians in the four
services of a consulting radiologist. (4) major specialties:
• DOH licensed pharmacy.  Medicine
 Pediatrics
 OB-gynecology
ii. Level 2  Surgery
 Provision of physical medicine and rehabilitation
- has a minimum level 1 capacity, including and not unit.
limited to:  Ambulatory surgical clinic
• Organized staff of qualified and competent  Dialysis facility
personnel with a Chief of Hospital/Medical Director  Blood bank
and appropriate board certified Department Heads.  DOH licensed tertiary clinical laboratory with
• Departmentalized and equipped with the service standard equipment / reagents necessary for the
capabilities needed to support board performance of histopathology examinations.
  DOH licensed level 3 imaging facility with o Dental clinic.
interventional radiology.
b. Specialty Hospitals
c. Trauma Capability of Hospitals b. Category B: Custodial Care Facility

- - assessed in accordance with the guidelines formulated - Provides long term care, including basic human
by the Philippine College of Surgeons (PCS). services like food and shelter to patients with chronic or
i. Trauma-Capable Facility – designated as a mental illness, patients in need of rehabilitation owing
trauma center. substance abuse, people requiring ongoing health and
ii. Trauma-receiving facility – receives trauma nursing care due to chronic impairments and a reduced
patients for transport to the point of care or degree of independence in activities of daily living.
a trauma center.
Examples:
4. OTHER HEALTH FACILITIES • Custodial Psychiatric Care Facility.
• Substance /Drug Abuse Treatment and
a. Category A: Primary Care Facility Rehabilitation Center
- a first contact healthcare facility that offers basic • Sanitarium / Leprosarium
services including emergency service and provision for • Nursing Home
normal deliveries.
c. Category C: Diagnostic / Therapeutic Facility
Subdivided into:
- With in-patient beds – for short stay at the facility, - Facility that examines the human body or specimens from
usually one to three days. the human body (except for laboratory for drinking water
• Infirmary analysis) for the dx, sometimes tx of diseases.
• Birthing home • Examples:
- Without beds – a facility where medicine, medical  Laboratory facility, such as
and/or dental examination / treatment is dispensed.  Clinical laboratory
 HIV Testing Laboratory
o Medical out-patient clinic
 Blood Service Facility
o Medical Facility for Overseas Workers and  Drug Testing Laboratory
Seafarers (OFW Clinic).  NBS Laboratory
  Radiologic Facility, such as but not limited to The Congress shall enact a local government code which
the following: shall provide for a more responsive and accountable local
 Ionizing Machines as X-ray, CT Scan, government structure instituted through a system of
mammography and others. decentralization with effective mechanisms of recall,
 Non-ionizing machines as MRI, UTZ initiative, and referendum, allocate among the different
and others. local government units their powers, responsibilities, and
 Nuclear Medicine Facility – presently resources, and provide for the qualification, election,
regulated by the PNRI embracing all appointment and removal, term, salaries, powers, and
applications of radioactive materials in functions and duties of officials, and all other matters
diagnosis, treatment or in medical research, relating to the organization and operation of the local units.
with the exception of the use of sealed
radiation sources in radiotherapy.
d. Category D: Specialized OPD b. Goals of the LGC

• A facility with highly competent and trained staff that • to provide local government units the opportunity
performs highly specialized procedures on an Outpatient to tap their fullest potentials as self-reliant
basis. communities and as active partners of the national
 Dialysis clinic government in the attainment of national goals;
 Ambulatory surgical clinic • to facilitate faster decision-making at the local
 In-vitro fertilization center level;
 Stem Cell facility • to enhance the participation of ordinary citizens,
 Oncology Chemotherapeutic Center/clinic organized groups, and the poorer sectors in the
 Radiation Oncology Facility conduct of public affairs and the business of
 Physical Medicine and Rehabilitation Center/Clinic. government;
• to deliver basic services more efficiently.
E. Devolution of Health Services c. Rule V (Basic Services and Facilities) of the Local
Government Code of 1991 or RA 7160
1. The Local Government Code of 1991
a. Legal Basis • Definition of Devolution seen under Article 24,
stating that
Section 3 Article X of the 1987 Constitution: “ a. Consistent with local autonomy and
decentralization, the provision for the delivery of
 basic services and facilities shall be devolved from d. Exceptions:
the National Government to the provinces, cities,
municipalities and barangays so that each LGU Article 26. Exceptions
shall be responsible for a minimum set of services
and facilities in accordance with established “ Public works and infrastructure projects and other
national policies, guidelines, and standards.” facilities, programs, services funded by the National
Government under the annual general appropriations act,
• Art. 25. Responsibility of Basic Services and other special laws, and pertinent executive orders and those
Facilities wholly or partially funded from foreign sources, are not
covered by the devolution of basic services and facilities
Barangay under this Rule, except in those cases where the LGU
o b. Health and social welfare services, through concerned is duly designated as the implementing agency
maintenance of barangay health and daycare for such projects, facilities, programs and services.”
centers;
o c. Services and facilities related to general e. Article 28.
hygiene and sanitation, beautification, and solid Period of Devolution
waste collection;
“ The NGAs concerned shall devolve to LGUs the
Municipality responsibility for the provision of basic services and facilities
o c. Subject to the provision of Rule XXIII on local enumerated in this Rule within six (6) months after the
health boards and in accordance with the effectivity of the Code on January 01, 1992.”
standards and criteria of the Department of
Health (DOH), provision of health services f. Article 29.
through: Funding
o g. Construction and maintenance of “Basic services and facilities shall be funded from the share
infrastructure facilities funded by the of LGUs in the proceeds of national taxes, other local
municipality to serve the needs of the residents revenues, and funding support from the NG and its
including, but not limited to: instrumentalities including GOCCs, tasked by law to
Clinics, health centers, and other establish and maintain such services or facilities. Any
health facilities necessary ot carry available fund or resource of LGUs shall be first be allocated
out health services. for the provision of basic services and facilities before using
 such fund or resource for other purposes, unless otherwise • The SC ruled that the just share of the LGUs should not be
provided under these Rules. ” based solely on the national internal revenue taxes but on
all national taxes.
The internal revenue allotment in the LGC shall be
g. FUNCTION OF THE LOCAL HEALTH BOARD understood as pertaining to the allotment of the LGUS
derived from the national budget.
• Propose to the Sangguniang Bayan / Panlalawigan the
• The Supreme Court’s ruling became final and executory on
annual budgetary allocation.
April 10, 2019. Affirming its decision promulgated in July 3,
• Serves as an advisory committee to the Sanggunian. 2018.
• EO 138 signed by Pres. Rodrigo R. Duterte, directing certain
• Creates committees that shall advice local health agencies. functions of the executive branch to be fully devolved to the
LGUs.

2. The Mandanas-Garcia Supreme Court Ruling

3. Devolution’s operation definition
• Refers to the SC’s on the two (2) separate petitions filed by
(1) Congressman Hermilando I. Mandanas and other a. Fully devolved
officials vs Executive Secretary Paquito N. Ochoa, Jr.
et al (GR No. 199802), and Refers to re-devolution of the entire function or
(2) Congressman Enrique T. Garcia, Jr. vs Executive responsibility to the LGUs.
Secretary Paquito N. Ochoa, Jr. et al (G.R. No.
208488). b. Partially devolved
• Challenged the National Government in the computation of
the Internal Revenue Allotment (IRA) shares of LGUs. Refers to the functions that will be shared between the
• Pleaded with the SC to mandate the NG to compute the IRA national and local government.
based on the shares of the LGUs. c. Retained with the DOH
Maintaining the inherent DOH-retained functions.
• On July 03, 2018, The Supreme Court Declared the phrase
“internal revenue” seen in section 284 of the LGC of 1991 F. Primary Health Care
as unconstitutional, favoring the Mandanas-Garcia petition.
4. According to the ALMA ATA Declaration
 Primary Health Care is: 1978 during the First International Conference in Primary
Health Care in Alma Ata, Russia
“is essential health care based on practical, scientifically
sound and socially acceptable methods and technology
President Ferdinand E. Marcos signed Letter of Instruction
made universally accessible to individuals and families in the
(LOI) 949 on October 19, 1979, a year after the Primary
community through their full participation and at a cost that
Health Care Conference.
the community and country can afford to maintain at every
stage of their development in the spirit of self-reliance and
self-determination.”
6. CONCEPTUAL FRAMEWORK (Philippines)
The universal goal of Public Health Care is:
“health for all” by the year 2020. Goal:
Health for all Filipinos and Health in the Hands of the People
Health for all by the year 2000 was a global strategy by the year 2020.
employed for achieving three main objectives:
Mission:
1. Promotion of healthy lifestyles To strengthen the healthcare system by increasing
2. Prevention of diseases opportunities and supporting the conditions wherein people
3. Therapy for existing conditions will manage their own health care

5. WHO Concept:

• Primary Health Care is Primary Health Care (PHC) characterized by partnership and
“is essential health care made universally accessible to empowerment of the people shall permeate as the core strategy in
individuals and families in the community by means the effective provision of essential health services that are
acceptable to them, through their full participation and a t a community based, accessible, acceptable and sustainable, at a cost,
cost that the community and country can afford at every which the community and the government can afford. It is a
stage of development.” strategy, which focuses responsibility for health of the individual, his
family and the community.

The WHO has supported the global implementation of

Primary Health Care which started in September 6 to 12,
It includes the full participation and active involvement of the M – Maternal and child health including responsible
community towards the development of self-reliant people, capable motherhood
of achieving an acceptable level of health and well-being. It also
E – Essential drugs
recognizes the inter-relationship between health and the overall
political, socio-cultural and economic development of society. N - Nutrition

T – Treatment of communicable and noncommunicable diseases

Five Key Elements identified to achieving the goal for “health for S – Safe water and sanitation
all.”

1. Reducing exclusion and social disparities in health (universal

coverage) Key Principles of PHC

2. Organizing health services around people’s needs and • Accessibility, affordability, acceptability, and availability and
expectations (health service reforms). availability

3. Integrating health into all sectors (public policy reforms). • Support mechanisms

4. Pursuing collaborative models of policy dialogues • Multi-sectoral approach

(leadership reforms). • Community participation
5. Increasing stakeholder participation. • Equitable distribution of health resources.

• Appropriate Technology
Essential Health Services using the acronyms (derived from the
Alma Ata Declaration)

ELEMENTS

E – Education for health

L – Locally endemic disease control

E – Expanded program for immunization