OVERVIEW OF COMMUNITY HEALTH

NURSING/PUBLIC HEALTH NURSING

Health
□ WHO defined health as a “ state of complete physical,
mental, and social well-being and not merely the absence of
disease or infirmity”.
 Community
□A c o lle c tio n o f p e o p le w h o in te ra c t w ith o n e a n o th e r a n d w h o s e c o m m o n
in te re s ts o r c h a ra c te ris tic s fo rm th e b a s is fo r a s e n s e o f u n ity o r be lo n g in g.
-A lle n d e r e t a l., 2 009-
□A g ro u p o f p e o p le w h o s h a re s o m e th in g in c o m m o n a n d in te ra c t w ith o n e
a n o th e r, w h o m a y e xh ib it a c o m m itm e n t w ith o n e a n o th e r a n d m a y s h a re a
ge o g ra p h ic b o u n d a ry.
-L u n d y a n d J a n e s , 2 009 -
□A g ro u p o f p e o p le w h o s h a re c o m m o n in te re s ts , w h o in te ra c t w ith e a c h
o th e r, a n d w h o fu n c tio n c o lle c tive ly w ith in a d e fin e d s o c ia l s tru c tu re to
a d d re s s c o m m o n c o n c e rn s
-C la rk, 2 008-
 Definition and Focus of Public Health and Community Health
Public health is the science and art of (1) preventing disease, (2) prolonging life, (3) promoting health
and efficiency through organized community effort for:
1. Sanitation of the environment,
2. Control of communicable diseases,
3. Education of the individual in personal hygiene,
4. Organization of medical and nursing services for the early diagnosis and preventive treatment of
disease, and
5.Development of the social machinery to ensure everyone a standard of living adequate for the
maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright
of health and longevity.
 Public Health Nursing vs Community Health Nursing
□ PHN and CHN have often been interchangeably used in the Philippines while both disciplines serve
the same demographics, their purposes are distinct.
□ Public health nurses provide healthcare to people and communities who are unable to seek
assistance.
□ Community health nursing involves advocacy and policy development to eliminate healthcare
disparities.
COMMUNITY HEALTH NURSING PUBLIC HEALTH NURSING
Deliver health services to individuals, groups, and families. Assessing the population health needs.

Diagnosis is based on the needs of individuals, family, or group. Diagnose and develop policy in relation to community health needs.

Work to promote health and prevent illness in groups and families Plan for community as a whole in order to prevent disease and
with the main goal to increase community health. For example, disability and preserve the health of the community. For example,
meeting with a group of young mothers to provide information on after an illness outbreak, the PHNurse will assess the need and
immunization. develop a program for an immunization clinic.

Implementation based on individual needs. Implementing the plan means the nurse ensures the resources are
available to all who need them within the community.

Evaluate whether health needs were met on the individual, family or Evaluate the health status of the whole community and whether
group level. planned goals and objectives are met.
 Standards of Public Health in the Philippines
1. Assessment
2. Population diagnosis and priorities
3. Outcomes identification
4. Planning
5. Implementation
6. Evaluation
7. Quality of Practice
8. Education
9. Professional practice evaluation
10. Collegiality and professional relationships
11. Collaboration
12. Ethics
13. Research
14. Resource utilization population
15. Leadership
 ROLES OF COMMUNITY HEALTH NURSE
□ utilizes the nursing process in the care of the client in the home setting through home
visits and in public health care facilities; conducts referral of patients to appropriate levels of care when necessary
□ utilizes teaching skills to improve the health knowledge, skills and attitude of the individual, family and
the community and conducts health information campaigns to various groups for the purpose of health promotion and
disease prevention
□ establishes linkages and collaborative relationships with other health professionals,
government agencies, the private sector, non-government organizations and people’s organizations to address health
problems
□ monitors and supervises the performance of midwives and other auxiliary health workers; also initiates the
formulation of staff development and training programs for midwives and other auxiliary health workers as part of their
training function as supervisors
 ROLES OF COMMUNITY HEALTH NURSE
□ influences people to participate in the overall process of community development
□ organizes the nursing service component of the local health agency or local government unit; also, as program
manager, the PHN is responsible for the delivery of the package of services provided by the health program to target clientele
□ participates in the conduct of research and utilizes research findings in practice
 RESPONSIBILITIES OF PUBLIC HEALTH NURSE
Be a part in developing an overall health plan, its implementation and evaluation for communities.
Provide quality nursing services to the four levels of clientele.
Maintain coordination/linkages with other health team members, NGO/ government agencies in the provision of public
health services
Conduct researches relevant to CHN services to improve provision of health care
Provide opportunities for professional growth and continuing education for staff development
 SPECIALIZED FIELDS OF COMMUNITY HEALTH NURSING
□ a unique clinical process which includes an integration of concepts from
nursing, mental health, social psychology, psychology, community networks, and the basic sciences
□ the application of nursing principles and procedures conserving the health of
workers in all occupation
□ the application of nursing theories and principles in the care of the school population
EVOLUTION OF PUBLIC HEALTH NURSING IN THE
PHILIPINES
 HISTORICAL BACKGROUND
□ 1912 The Fajardo Act ( Act No. 2156) created Sanitary Divisions
□ 1914 -School nursing was rendered by a nurse employed by the Bureau of Health in Tacloban, Leyte.
-Reorganization Act No. 2462 created the Office of General Inspection. The office of District Nursing was
organized under this office. It was headed by a lady physician, Dr. Rosario Pastor who was also a nurse. This office was
created due to increasing demands for nurses to work outside the hospital and the need for direction, supervision and
guidance of public health nurses.
□ 1916-1918-Miss Perlita Clark took charge of the public health nursing work. Her staff was composed of one American
nurse supervisor, one American dietitian, 36 Filipino nurses working in the provinces and one nurse and one dietitian
assigned in two Sanitary Divisions.
□ 1917- Four graduate nurses paid by the City of Manila were employed to work in the City Schools. Provinces that
could afford to carry out school health services were encouraged to employ a district nurse.
□ 1918- The office of Miss Clark was abolished due to lack of funds.
 HISTORICAL BACKGROUND
□1 91 9- T h e 1 s t F ilip in o n u rs e s u p e rv is o r u n d e r th e B u re a u o f H e a lth , M is s C a rm e n d e l
R o s a rio wa s a pp o in te d . S h e s u cce e d e d M is s M a b e l D a b b s .

□1 92 3- T w o g o ve rn m e n t S ch o ols o f N u rs in g we re e s ta b lis h e d : Z a m b o a n g a G e n e ra l H os p ita l

S c h oo ls o f N u rs in g in M in d a n a o a n d B a g u io G e n e ra l H o s p ita l in N o rth e rn L u zo n .

□J u ly 1 , 1 92 6- M is s C a rm e n L e og a rd o re s ig n e d a n d M is s G e n a ra S . M a n o n g do , a ra n kin g
s u p e rv is o r o f th e A m e rica n s u p e rvis o r o f th e A m e rica n R e d C ro s s , P h ilip p in e C h a p te r w a s
a p p o in te d in h e r p la ce .
 HISTORICAL BACKGROUND

□1927-The office of District Nursing under the Office of General Inspection, Philippines Health Service was abolished
and supplanted by the Section of Public Health Nursing. Mrs. Genara de Guzman acted as consultant to the Director
of Health on nursing matters
□1928-The 1st convention of nurses was held followed by yearly conventions until the advent of World War
11.Pre-service training was initiated as a pre-requisites for appointment
□1930- The Section of Public Health Nursing was converted into Section of Nursing due to pressing need for
guidance not only in public nursing services but also in hospital nursing and nursing education. The section of
Nursing was transferred from the Office of General Services to the Division of Administration. This office covered the
supervision and guidance of nurses in the provincial hospitals and the two government schools of nursing.
 HISTORICAL BACKGROUND

□ 1933-Reorganization Act No.4007 transferred the Division of Maternal and Child Health of the Office
of Public Welfare Commission to the Bureau of Health. Mrs. Soledad A. Buenafe, former Assistant
Superintendent of Nurses of the Public Welfare Commission was appointed as Assistant Chief Nurse of
the Section of Nursing, Bureau of Health.
□ 1941-Activities and personnel including six public health members of the Metropolitan Division, Bureau
of Health were transferred to the new department. Dr. Mariano Icasiano became the 1st City Health
Officer of Manila. An Office of Nursing was organized with Mrs.Vicenta C.Ponce as Chief Nurse and Mrs.
Rosario A. Ordiz as Assistant Chief Nurse. They occupied their position until their retirement.
□ Dec. 8, 1941-When World War 11 broke out, public health nurses in Manila were assigned to
devastated areas to attend to the sick and the wounded.
 HISTORICAL BACKGROUND
□ 1942- A group of public health nurses, physicians and administrators from the Manila Health
Department went to the internment camp in Capas, Tarlac to receive sick prisoners of war
released by the Japanese Army. They were confined at San Lazaro Hospital and 68 National
Public Health Nurses were assigned to help the hospital staff take care of them.
□ July 1942-Thirty-one nurses who were taken prisoners of war by the Japanese army and
confined at the Bilibid Prison in Manila were released to the then Director of the Bureau of
Health, Dr. Eusebio Aguilar who acted as their guarantor.Many public health nurses joined the
guerillas or went to hide in the mountains during World War 11
□ Feb.1946-Post war records of the Bureau of Health showed that there were 308 public health
nurses and 38 supervisors compared to pre-war when there were 556 public health nurses and
38 supervisors.In the same year Mrs. Genera M.de Guzman, technical assistant in Nursing of the
Dept of Health and concurrent President of the Filipino Nurses Association recommended the
creation of a Nursing Office in the Dept.of Health.
 HISTORICAL BACKGROUND
□ Oct.7, 1947-Executive Order No.94 reorganized government offices and created the Division of Nursing under the Office of
the Secretary of Health. This was implemented on Dec. 16, 1947.Mrs.Genara de Guzman was appointed as Chief of the
Division, with three assistants: Miss Annie Sand for Nursing Education; Mrs.Magdalena C.Valenzuela for Public Health Nursing
and Mrs. Patrocinio J. Montellano for Staff Education.
□ The nursing division was placed directly under the Secretary of Health so that nursing services can be availed of by the
different bureaus and units to help carry out their health programs.
□ At the Bureau of Health, the Section of Nursing Supervision took over the functions of the former Section of
Nursing.Mrs.Soledad Buenafe was appointed Chief and Miss Marcela Gabatin, asst.chief.
□ The newly created Section of Puericulture Center of the Bureau of Hospitals had Mrs.Teresa Malgapo as chief.
 HISTORICALs t BACKGROUND
1 9 48- T h e 1 tra in in g C e n te r o f th e B u re a u o f H e a lth w a s o rg a n iz e d in
c o o pe ra tio n w ith th e P a s a y C ity H e a lth D e p a rtm e n t. T h is w a s h o u s e d a t th e
T a b o n H e a lth C e n te r lo c a te d in a m a rgin a liz e d pa rt o f th e c ity. It w a s la te r
re n a m e d a s D o n a M a rta H e a lth C e n te r. T h e o rig in a l tra in in g s ta ff o f th e
C e n te r h a d D r. T rin id a d A . G o m e z a s C e n te r P h ys ic ia n ; M is s M a rc e la
G a b a tin a s N u rs e S u p e rvis o r; M is s C o n s ta n c ia T u a z o n , M rs . B u g a rin a n d
M is s R a m o s a s N u rs e In s tru c to rs . M is s Z e n a id a Y . P a n lilio , N a tio n a l P u b lic
H e a lth N u rs e , B u re a u o f H e a lth , la te r jo in e d th e s ta ff.
-P h ys ic ia n s a n d n u rs e s u n d e rg o in g p re -s e rvic e a n d in -s e rvic e tra in in g
in p u b lic h e a lth /p u b lic h e a lth n u rs in g a s w e ll a s n u rs in g s tu d e n ts o n a ffilia tio n
w e re a s s ign e d to th e a b o ve tra in in g c e n te r.
 HISTORICAL BACKGROUND
□ 1950- The Rural Health Demonstration and Training Center(RHDTC) was established by the Department of Health through
the initiative of Dr. Hilario Lara, Dean, Institute of Hygiene, now College of Public Health, University of the Philippines.
□ 1953- The office of the Health Education and Personnel Training was established with Dr. Trinidad Gomez as Chief.
-Philippine Congress approved Republic Act No. 1082 or the Rural Health Law.
□ 1957- Republic Act 1891 was approved amending cestions two,three, four, seven and eight of RA 1082 “Strengthening
Health and Dental Services in the Rural Areas”
 HISTORICAL BACKGROUND
□1 9 5 8-1 9 65 – R e p u blic A c t 9 7 7 p a s s e d b y C o n gre s s in 1 9 5 4 w a s
im p le m e n te d . T h is a bo lis h e d th e D ivis io n o f N u rs in g. H o w e ve r it c re a te d
n u rs in g p o s itio n s a t d iffe re n t le ve ls in th e h e a lth o rg a n iz a tio n .
□1 9 6 7 - M rs . Z e n a id a P a n lilio -N is c e w a s a p p o in te d a s N u rs in g P ro g ra m
S u p e rvis o r a n d s e rve d a s c o n s u lta n t o n th e n u rs in g a s pe c ts o f th e 5 s p e c ia l
dis e a s e s : T B , L e p ro s y, V e n e re a l D is e a s e , C a n c e r, F ila ria s is , a n d M e n ta l
H e a lth .
□1 9 7 4- T h e P ro je c t M a n a g e m e n t S ta ff w a s o rg a n iz e d a s pa rt o f th e
P o p u la tio n L o a n II o f th e P h ilip p in e G o ve rn m e n t w ith D r. F ra n c is c o A g u ila r
a s P ro je c t M a n a g e r.
□1 9 7 5 - T h e fu n c tio n s o f th e h e a lth te a m m e m b e rs (m u n ic ip a l h e a lth o ffic e r,
pu b lic h e a lth n u rs e , ru ra l h e a lth m id w ife a n d ru ra l s a n ita ry in s p e c to r w e re
re d e fin e d .
 H IS T O R IC A L B A C K G R O U N D
□1 9 7 6-1 9 86 T h e n u rs in g c o n s u lta n t a n d n u rs in g p ro g ra m s u p e rvis o r o f th e
O ffic e o f th e S e c re ta ry o f H e a lth w h e re in vo lve d in th e R u ra l H e a lth P ra c tic e
P ro g ra m w h ic h re qu ire d m e d ic a l a n d n u rs in g g ra d u a te s to s e rve fo r tw o
m o n th s in th e ru ra l a re a s o f th e c o u n try b e fo re th e ir lic e n s e s c o u ld b e is s u e d
by th e P R C .
□1 9 86- T h e re o rg a n iz a tio n o f th e D e p t. O f H e a lth d u rin g th is p e rio d p la c e d th e
po s itio n o f N u rs in g C o n s u lta n t a t th e B u re a u o f H e a lth a n d M e d ic a l S e rvic e s . It
w a s la te r a b o lis h e d w h e n M rs . M e n d o z a re tire d .
□1 9 87 -1 9 89 –E xe c u tive O rd e r N o . 1 1 9 re o rga n iz e d th e D e p t O f H e a lth a n d
c re a te d s e ve ra l o ffic e s a n d s e rvic e s w ith in th e D e p t. o f H e a lth
 HISTORICAL BACKGROUND
□ 1990-1992 – The number of positions of Nursing Program Supervisors was
increased.
□ May 24, 1999 – Executive Order No. 102 was signed by President Joseph
Ejercito Estrada redirecting the functions and operations of the Dept. of
Health.
□ 2005-2006 The development of the Rationalization Plan to streamline the
bureaucracy further was started and is in the last stages of finalization
THANK YOU!
THAT IN ALL THINGS GOD MAY BE GLORIFIED