EMERGING FIELD OF CHN IN THE PHILIPPINES

1. Home health care

 this practice involves providing nursing care to individuals and families in their own places of residence
mainly to minimize the effects of illness and disability
2. Hospice home care
 homecare rendered to the terminally ill; palliative care is particularly important
3. EntrepreNurse
 A project initiated by the DOLE, in collaboration with the Board of Nursing (BON) in the Philippines,
DOH, PNA, and other stakeholders to promote nurse entrepreneurship by introducing a home
healthcare industry in the Philippines.
 List of nurse cooperatives (as of 2012) found in page 23 of your book by Famorca
 Main purpose: to deliver home health care service
 It aims to:
a. Reduce the cost of healthcare for the countries indigent population by bringing PHC services to poor
and rural areas
b. Maximize employment opportunities for the country’s unemployed nurses
c. Utilizes the country’s unemployed human resources for health for the delivery of public health
services and the achievement of the country’s MDG on Maternal and Child Health (DOLE, 2013) :
transient relief from unemployment
4. Faith Community nursing or parish nursing
 Art and science of nursing combined with spiritual care; provision of holistic care to members of the faith
community

COMPETENCY STANDARDS IN CHN

1. Safe and Quality Nursing Care

 knowledge of health/illness status of the client , sound decision making; safety, comfort, privacy,
administration of medications and health therapeutics and nursing process.
2. Management of resources and environment
 organization of workload; use of financial resources for client care; mechanism to ensure proper functioning
of equipment and maintenance of a safe environment
 have to be efficient and creative
3. Health Education
 assessment of client’s learning needs; development of health education plan and learning materials and
implementation and evaluation of education plan
4. Legal responsibility
 adherence to the nursing laws as well as to the national, local, and organizational policies including
documentation of care given to clients
5. Ethico-moral responsibilities
respect for the rights of the client; responsibility and accountability for own
 decisions and actions; and adherence to the international and national code of ethics for nurses
6. Personal and Professional Development
 identification of own learning needs, pursuit of continuing education; involvement in professional image;
positive attitude towards criticisms and change
7. Quality improvement
 data gathering for quality improvement; participation in nursing audits and rounds; identification and
reporting of solutions to identify problems related to client care
8. Research
 research based formulation of solutions to problems in client care and dissemination and application of
research findings
9. Records Management
 accurate and updated documentation of client care while observing legal imperatives and record keeping
10. Communication
 uses therapeutic communication techniques, identifies verbal and non-verbal cues, responds to client’s
needs, while using formal and informal channels of communications and appropriate information
technology
11. Collaboration and Teamwork
 establishment of collaborative relationship with colleagues and other members of health team
 ROLES AND RESPONSIBILITIES OF A COMMUNITY HEALTH NURSE

1. Health monitor
 detecting deviations from health ion individuals, families, specific population groups and the community as
a whole through contacts and visits with them and with the use of scientific, systematic, valid and reliable
assessment methods and tools
2. Provider of nursing care to the sick and disabled
 provision of care to the sick and disables in various settings and developing the capabilities of individual
clients/ patients, families, specific groups and the community to take care of themselves and of their sick,
disabled and dependent members
3. Health teacher
 health education is one of the most frequently use intervention by the nurse, and every contact with a client
in whatever setting is an opportunity for teaching about health matters with the ultimate objective of
developing capabilities and self-reliance in healthcare.
4. Counselor
 giving appropriate advice and broadening client’s insight about the problem so that appropriate decisions
are made which can lead to a positive resolution of the problem
5. Client/ patient advocate
 an advocate is someone who intercedes and pleads the cause of another. In the role of an advocate, the nurse
protects the interest and welfare of the client when the latter’s health, safety and welfare is threatened by
others; and acts as their eyes, ears and voice; protection of client’s rights
6. Change agent
 changing individuals, family, group or community behavior, including lifestyle and the environment, in
order to promote health
7. Community Organizer
 nurse stimulates and enhances the community participation in planning, organizing, implementing and
evaluating health programs and services, initiates community development activities, develops and
strengthens the community’s capabilities to recognize and manage health and health-related problems

8. Team member
 member of health team that includes traditional health care providers, community health workers, and
volunteers as well as professionals in the health field and related intersectoral teams, and works with them in
close coordination and collaboration to enhance community health
9. Trainer, supervisor, manager
 trainer and supervisor of lower-level health personnel such as midwife, community health workers, and
volunteers and traditional birth attendants (“hilots”) ; manager of a health unit or program of a health agency
(maternal and child health program)

10. Coordinator of health and related services

 coordinate services provided by various members of the health and related intersectoral teams. The objective
of the coordination is to ensure that services are delivered and received as meaningful whole package, not
fragmented
11. Researcher
 planning and conduct of nursing and related studies that contribute to the improvement of nursing health
services, either alone or independently, or in collaboration with other members of the health and
intersectoral teams.
12. Role model
 provide good example of healthful living to the community, to practice and demonstrate what she
preaches in matters that concerns health, like personal and environmental hygiene, proper nutrition,
avoidance of unhealthy habits and a generally healthy lifestyle.

PUBLIC HEALTH NURSING

 Assists clients cope effectively given the different factors and to help clients attain/maintain Optimum
Level Of Functioning (OLOF)

 Public Health Nurses – Are found in various health settings and occupying various positions in the
hierarchy.
  Are assigned in rural health units, city health centers, provincial health offices, regional health
offices, and evening the national office of the Department of Health.
 Are also assigned in public schools and in the offices of government agencies providing health care
services. –
 Occupy a range of positions from Public Health Nurse I to Nurse Program Supervisors to Chief Nurse in
public health settings. –
 Uses various tools and procedures necessary for her to properly practice her profession and deliver
basic health service. –
 Uses nursing process in her practice and is adept in documenting and reporting
accomplishments through records and reports.
 Technically competent in various nursing procedures conducted in settings where she is assigned

 NURSE SUPERVISOR/PUBLIC HEALTH NURSE/PROVINCIAL/CITY LEVEL QUALIFICATIONS:

 BSN graduate, Registered nurse, Master’s Degree in Nursing or Public Health with at least 5 yrs experience
as PHN
 NURSE INSTRUCTOR II QUALIFICATIONS
 BSN , Registered Nurse, with Master’s Degree; 3 years experience as CHN; special training on the functions of
the nurse instructor.
 REGIONAL TRAINING NURSING QUALIFICATIONS:
 BSN, Registered nurse , Master’s Degree/Public health with 6 years experience , 3 years of which are in
training or nursing education.
 REGIONAL NURSE SUPERVISOR/REGIONAL PHN( NURSE V) QUALIFICATIONS :
 BSN; Registered Nurse with at least 5 years experience in CHN, 2 years of which are in
supervisory position, with Master’s degree in Public Health or master of Arts in Nursing , major in
Community Health Nursing Administration and Supervision
 CHIEF NURSE (NURSE VII) SELECTED CUTY HEALTH DEPARTMENT AND HEALTH OFFICES
 BSN,RN, Master’s Degree in Nursing , major in CHN
 With at least 5 years experience in CHN, 3 years of which have been either in supervisory or Assistant
Chief Nurse position, with demonstrated leadership ability.
QUALIFICATIONS AND FUNCTIONS OF THE PUBLIC HEALTH NURSE

A. The PHN has the professional, personal and other qualifications that are appropriate to her/his job
responsibilities:
1. Is a graduate of Bachelor of Science in Nursing (BSN) and a registered nurse (RN).
2. Has the following personal qualities and professional competencies :
 Good physical and mental health;
 Interest and willingness to work in the community;
 Capacity and ability to :
 Relate the practice with ongoing community health and health related activities;
 Work cooperatively with other disciplines and members of the community’
 Accept and take actions needed to improve self and service.
 Analyze combination of factors and conditions that influence of health of populations;
 Apply nursing process in meeting the health and nursing needs of the community and
 Mobilize resources in the community;
 With leadership potential
 Resourcefulness and creativity
 Honesty and integrity; and ,
 Active membership to professional nursing organizations.

B.The PHN performs functions and activities in accordance with the dominant values of public health nurses,
within the profession’s ethicolegal framework and in accordance with the needs of the client and available
resources for health care.
1. The functions and activities of the PHN which are related to:
 Management training
 Supervision
 Provision of nursing care
 Health promotion and education
 Coordination
C. The PHN , in coordination with the faculty of colleges of nursing , participates in teaching , guidance
and supervision of students in nursing and midwifery for their related learning experience (RLE) in the
community setting.
1. Management function:
 the nurse has been trained to lead and manage;
 execution of the( 5) management functions of planning, organizing , staffing , directing and
controlling.
 This function is performed when she organizes the “ nursing service” of the local health agency.
 Another emerging and management function of the PHN is program management.
 The PHN is responsible for the delivery of the package of services provided by the program to the target
clientele.

2. Supervisory function:
 Formulates a supervisory plan and conducts supervisory visits to implement the plan.
 Conducts supervisory visits using a supervisory checklist.

3. Nursing Care function :

 PHN uses her knowledge and skill in the nursing process.
 She does APIE(Assessment, Planning, Implementation, Evaluation);
 Establishes rapport with her client, may it be individual, family or community, in order to ensure good
quality data and to facilitate or enhance partnership in addressing identified health needs and problems.
 Home visits are must activities for PHN, home care should be an area where PHN should be able to devote
some of their time too.
 Referral of patients to appropriate levels of care should be done when indicated.

4. Collaborating and coordinating function :

 This function of the PHN bring activities or group of activities systematically into proper relation or harmony
with each other.
 Actively involve both socially and politically to empower individuals, families and communities as an entity
to initiate and maintain health promoting environments.
 Establishes linkages and collaborative relationships with other professionals, government agencies, the private
sector , non government organizations , people’s organizations to address health problems.

 Identifies person, groups, organizations , other agencies and communities whose resources are available
within and outside the community and which can be tapped in the implementation.

5. Health promotion and education function :

 Uses skills in advocacy for the creation of a supportive environment through policies and
reengineering of the physical environment for healthier actions.
 As an educator, the PHN provides clients with information that allows them to make healthier choices
and practices.
 The PHN are expected to teach on a daily basis as part of their practice.

D. Training function :

 The PHN initiates the formulation of staff development and training programs for midwives and other
auxillary workers.
 The PHN also participates in the training of nursing and midwifery affiliates in coordination with the
faculty of colleges of nursing and midwifery.
 Participates in teaching, guidance and supervision of student affiliates for their RLE in the
community setting.
 Mobilize communities for health actions.

F. Research function :
 Participates in the conduct of research and utilizes research findings in her practice;
 Participate in disease surveillance purpose:
 To measure the magnitude of the problem
  To measure the effect of the control program
HISTORY OF PHN IN THE PHILIPPINES

Good To Know Fact:

 1577 - Franciscan Friar Juan Clemente opened medical dispensary in Intramuros for the indigent
 1690 - Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte and
Manila
 1805 - smallpox vaccination was introduced by Francisco de Balmis, the personal physical of King Charles IV of
Spain
 1876 - first medicos titulares: medicalpractiioner were appointed by the Spanish government
 1888 - 2year courses consisting of fundamental medical and dental subjects was first offered in University of
Santo Tomas.Graduates were known as “cirujanos ministrantes” and serve as male nurses and sanitation
inspectors
 1901 - United States Philippine Commission, through Act 157, created the Board of Health of the Philippine
Islands with a Commissioner of the Public Health as its chief executive officer (now DOH)
 1905 - Founded by the Associacion Feminista Filipina, La Gota de Leche was the first center dedicated to the
service of mothers and babies
 1912 - Fajardo Act of 1912 created sanitary divisions made up of one to four municipalities; each sanitary
division had a president who had to be a physician
 1915 - the Philippine General Hospital (PGH) began to extend public health nursing services in the homes of
patients by organizing a unit called “Social and Home Care Services”
 In addition to puericulture centers, just before the WW2 broke out, municipal and charity clinics were
also setup headed by physicians, nurses or midwives.
 1947 - DOH was reorganized into bureaus: quarantine, hospitals that took charge of the municipal and charity
clinics and health with sanitary division under it.
 1954 congress passed RA 1802 or the Rural Health Act that provided the creation of RHU in every municipality
 1957 enacted the RA 1891 that amended certain provisions of the Rural Health Act; created 8 categories of rural
health units corresponding to the population of the municipalities

 1991- enacted RA 7160 or the Local Government Code, amended the devolution of basic services, including
health services, to local government units and the establishment of a local health board in every province and
city of municipality
 2000 - the Philippines is a signatory to the UN Millennium Declaration adopted during the World Summit in
September 2000.
 The member nations committed themselves to the attainment of the 8 MDGs. DOH committed to
improve maternal health and to combat HIV/AIDS, malaria and other disease

8 MDGS OR MILLENNIUM DEVELOPMENT GOALS

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS and other diseases
7. Ensure environmental sustainability
8. Global partnership for development

 2005 - FOURmula One (F1) for health and Universal Health Care in 2010 (both aim to reform
healthcare with the Health Sector Reform Agenda launched in 1999)
 UHC aims to achieve the health system goals of:
1) better health outcomes
2) sustained health financing
3) responsive health system that will provide equitable access to healthcare.
 Four elements
1) Health financing
2) Health regulation
3) Health service delivery
4) Good governance