overview of public health nursing in the ph

1. OVERVIEW OF PUBLIC
HEALTH NURSING IN
THE PHILIPPINES

2. INTRODUCTION:
 PHN in the Phils. evolved alongside the
institutional development of the DOH,
the gov’t agency mandated to protect
& promote people’s health and the
biggest employer of health workers

3. Global and Country Health
Imperatives
Changes on Public Health System
1. Shifts in demographic & epidemiological trends in
diseases, including the emergence and re-
emergence of new diseases and in the prevalence
of risk and protective factors
2. New technologies for health care, communication,
and information
3. Existing and emerging environmental hazards
some associated with globalization
4. Health reforms

4. Millenium Development Goal
 The global community decided to adopt a common vision of
poverty reduction and sustainable development in Sept. 2000
based on the fundamental values of freedom, equality,
solidarity, tolerance, health, respect for nature, and shared
responsibility
1. Eradicate extreme poverty & hunger
2. Achieve universal primary education
3. Promote gender equality & empowerment
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria & other diseases
7. Environmental sustainability
8. Develop a global partnership for development

5.  The Health Sector Reform Agenda (HRSA)
implemented through FOURmula ONE and
operationalized in the National Objectives
for Health 2005 to 2010 spells out the
program imperatives of the health sector. All
these are in lie with MDG and the Medium-
Term Development Plan of the country

6. Evolution of the Public Health
Nursing in the Philippines
HEALTH
 A state of complete physical, mental, and
social well-being, not merely the absence
of disease or infirmity (WHO).

7. DETERMINANTS OF HEALTH
1. Income & social status
2. Education
3. Physical environment
4. Employment & working conditions
5. Social support networks
6. Culture
7. Genetics
8. Personal behavior & coping skills
9. Health services
10. Gender
The Optimum Level of Functioning of IFG being influenced by
several factors in the eco-system

8. PUBLIC HEALTH
 The “art of applying science in
the context of politics so as to
reduce inequalities in health
while ensuring the best health for
the greatest number.”

9. Essential Public Health Functions:
1. Health situation monitoring & analysis
2. Epidemiological surveillance/disease prevention &
control
3. Development of policies & planning in public health
4. Strategic management of health systems & services
for population health gain
5. Regulation & enforcement to protect public health
6. Human resources development & planning in public
health
7. Health promotion, social participation &
empowerment
8. Ensuring the quality of personal & population based
health services
9. Research, development, and implementation of
innovative public health solutions

10. PUBLIC HEALTH NURSING
 “A special field of nursing that combines the
skills of nursing, public health, and some
phases of social assistance and functions
as part of the total public health
programme for the promotion of health,
the improvement of the conditions in the
social and physical environment,
rehabilitation of illness and disability.”
(WHO)

11. COMMUNITY HEALTH NURSING
 “A service rendered by a professional nurse
with communities, groups, families,
individuals at home, health centers, in
clinics, in schools, in places of work for
the promotion of health, prevention of
illness, care of the sick at home and
rehabilitation.”

12. Public Health Nursing in the Philippines
Public Health Nurses (PHNs)
 Refer to the nurses in the local/national health
departments or public schools whether their official
position title Public Health Nurse or Nurse or school
nurse
Public Health Nursing
 Refers to the practice of nursing in national and
local government health departments (which
includes health centers and rural health units), and
public schools. It is community health nursing
practiced in the public health sector.

13. READ: Historical Background of Public Health
Nursing

14. THE PHILIPPINE HEALTH
CARE DELIVERY SYSTEM
Two Sectors:
 The Public Sector – which is largely financed
through a tax-based budgeting system at both
national and local levels and where health care is
generally given free at the point of service
(although socialized user fees have been introduced
in recent years for certain types of services)
 The Private Sector – (for profit and non-profit
providers), which is largely market-oriented and
where health care is paid through user fees at
the point of service

15. The Public Sector
 National Level
 DOH – lead agency in health
 Regional field office – specialty hospitals, regional
hospitals, and medical centers
 Provincial health teams –DOH reps
 Local Health boards – involved in communicable disease
control
 PGH
 Local Health system – run by LGUs
 Provincial & district hospitals – prov’l gov’t
 Health Centers/RHUs & BHSs– city/municipal gov’t
 Local Health Board – chaired by LCE

16. The Private Sector
 For Profit and Non-profit health providers
 Providing health services in clinics and
hospitals, health insurance, manufacture
of medicines, vaccines, medical supplies,
equipment, and other health and nutrition
products, research and development,
human source development and other
health-related services

17. Philippine Department of
Health
 The principal health agency in the Philippines
 Responsible for ensuring access to basic
public health services to all Filipinos
through the provision of quality health care
and regulation of providers of health goods
and services
Read: Historical background of the DOH

18. DOH Vision: “The Leader of Health for All
in the Philippines”.
Health for All Filipinos and Health in the
Hands of the People by the year 2020
DOH Mission: “Guarantee equitable,
sustainable and quality health for all
Filipinos, especially the poor, and to
lead the quest for excellence in health”.

19. DOH Roles and Functions
1. Leadership in Health
2. Enabler and Capacity Builder
3. Administrator of Specific Services

20. 1. Leadership in Health
 Serve as the national policy & regulatory
institution fr. which the LGUs, NGOs, & other
members of the health sector involved in social
welfare & dev’t will anchor their thrusts & directions
for health
 Provide leadership in the formulation, monitoring
& evaluation of national health policies, plans &
programs. The DOH shall spearhead sectoral
planning & policy formulation & assessment at the
national & regional levels
 Serve as advocate in the adoption of health
policies, plans & programs to address national &
sectoral concerns

21. 2. Enabler & Capacity Builder
 Innovate new strategies in health to improve the
effectiveness of health programs, initiate public
discussion on health issues and undertaking and
disseminate policy research outputs to ensure
informed public participation in policy decision-
making
 Exercise oversight function, monitoring & evaluation
of national health plans, programs & policies
 Ensure the highest achievable standards of
quality health care, health promotion & health
protection

22. 3. Administrator of Specific Services
 Manage selected national health facilities & hospitals
with modern and advanced facilities that shall serve as
national referral centers & selected health facilities at
sub-national levels that are referral centers for local
health systems.
 Administer direct services for emergent health
concerns that require new complicated technologies
that it deems necessary for public welfare; administer
special components of specific programs like TB,
schistosomiasis, HIV-AIDS, in as much as it will
benefit and affect large segments of the population.
 Administer health emergency response services,
including referral & networking system for trauma,
injuries and catastrophic events, in cases of epidemic
and other widespread public danger, upon the
direction of the President and in consultation with
concerned LGU.

23. GOAL: Health Sector Reform Agenda
 HSRA is the overriding goal of the DOH
 Support mechanisms will be through sound
organizational development, strong policies,
systems and procedures, capable human
resources and adequate financial resources

24. Rationale for Health Sector Reform
 Slowing down in the reduction in the IMR and the
MMR
 Persistence of large variations in health status
across population groups and geographic areas
 High burden from infectious diseases
 Rising burden from chronic and degenerative
diseases
 Unattended emerging heath risks from
environmental and work related factors
 Burden of disease is heaviest on the poor

25. This is explained by:
 Inappropriate health delivery system as shown by an
efficient and poorly targeted hospital system,
ineffective mechanism for providing public health
programs on top of health human resources
maldistribution.
 Inadequate regulatory mechanism for health
services resulting to poor quality of health care, high
cost of privately provided health services, high cost
of drugs and presence of low quality of drugs in the
market
 Poor health care financing and inefficient sourcing or
generation of funds for health care

26. Framework for Implementation of HRSA:
FOURmula ONE for Health
 Designed to implement critical interventions
as single package backed by effective
management infrastructure and financing
arrangements following a sectorwide
approach

27. Over-all Goals and Objectives
 The implementation of FOURmula ONE for
Health shall be directed towards achieving
the following end goals, in consonance with
the health system goals identified by the
WHO, the MDGs and the Medium Term
Philippine Development Plan covering
2005-2020
1. Better health outcome
2. More responsive health systems
3. Equitable health care financing

28. FOURmula ONE components
1. Health financing – the goal of this
health reform area is to foster greater,
better and sustained investments in
health. The Philippine Health
Insurance corporation through the
National Health Insurance Program
and the DOH.

29. 2. Health regulation – the
goal is to ensure the
quality and affordability of
health goods and services

30. 3. Health service delivery – the
goal is to improve and ensure
the accessibility &
availability of basic and
essential health care in both
public & private facilities and
services

31. 4. Good governance the
goal is to enhance health
system performance at
the national and local
levels

32. The National Health Insurance Program supports
each off the elements in terms of:
 Financing – as it reduces the financial burden
placed on Filipinos by health care costs;
 Governance – as it is a prudent purchaser of health
care thereby influencing the health care market and
related institutions;
 Regulation – as the NHIP’s role in accreditation and
payments based on quality acts as a driver for
improved performance in the health sector
 Service delivery – as the NHIP demands fair
compensation for the costs of care directed at
providing essential goods and services in health

33. Summary
 Health is an integral part of the development.
The practice of community health nursing is
greatly influenced by its context - the health
of the people, socio-cultural, economic and
political environment and the health care
delivery system

34.  The government has taken a leadership role
in establishing national health objectives and
supporting the public health standards. With
FOURmula ONE for Health as the present
implementation framework of the DOH, it is
yet another concrete manifestation that all
partners in health are working closely
together to ensure acceptable, affordable,
and accessible quality health care for all
Filipino people. The Philippines is probably
the only country in the world with a
constitution that guarantees the right of
people to health

35. thank you!!!