 Institute health regulatory reforms
 Strengthen health governance and management support
COMMUNITY HEALTH NURSING
Prof. Michael Bryann Sta.Maria-Flores BSN, RN, RM, MAN(c)
Roles of the DOH:
1. Leadership in health
 Serve as the national policy and regulatory institution
 Provide leadership in the formulation, monitoring and
evaluation of the national health policies, plans and
programs
 Serve as advocate in the adoption of health policies,
plans and programs
2. Enabler and capacity builder
 Innovate new strategies in health
 Exercise oversight functions and monitoring and
evaluation of national health plans, program and
policies
 Ensure the highest achievable standards of quality
health care, promotion and protection
3. Administrator of specific services
 Manage selected national health facilities and
hospitals with modern and advanced facilities
 Administer direct services for emergent health
concerns that require new complicated technologies
Vision: The DOH is the leader, staunch advocate and model in
promoting Health for All in the Philippines
Mission: Guarantee equitable, sustainable quality health for all
Filipinos, especially the poor and shall lead the quest for excellence
in Health.
Goal: Health Sector reform Agenda (HSRA)
Rationale for HSRA:
 Slowing down in the reduction of Infant Mortality and
Maternal Mortality Rates
 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 health risks from environmental and
work related factors
 Burden of disease is heaviest on the poor
Framework for the Implementation of HSRA: FOURmula One for
Health
Goals of FOURmula ONE for Health:
1. Better health outcomes
2. More responsive health systems
3. Equitable health care financing
Elements of the Strategy:
1. Health financing – to foster greater, better and sustained
investments in health
2. Health regulation – to ensure quality and affordability of
health goods and services
3. Health service delivery – to improve and ensure the
accessibility and availability of basic and essential health
care in both public and private facilities and services
4. Good governance – to enhance health system
performance at the national and local levels
Roadmap for All Stakeholders in Health: National Objectives for
Health 2005 – 2010
National Objective for Health: sets the target and the critical
indicators, current strategies based on field experience, and laying
down new avenues for improved interventions.
Objectives of the Health Sector:
 Improve general health status of the population
 Reduce morbidity and mortality from certain diseases
 Eliminate certain diseases as public health problems
 Promote healthy lifestyle and environmental health
 Protect vulnerable groups with special health and
nutrition needs
 Strengthen national and local health systems to ensure
better health service delivery
 Pursue public health and hospital reforms
 Reduce the cost and sure the quality of essential drugs
bryannflores.multiply.com
systems
 Institute safety nets for the vulnerable and marginalized
groups
 Expand the coverage of social health insurance
 Mobilize more resources for health
 Improve efficiency in the allocation, production and
utilization of resources for health
PRIMARY HEALTH CARE
LOI 949 – signed by President Marcos with an underlying theme:
“Health in the Hands of the People by 2020”
Concept of PHC - characterized by partnership and empowerment
of the people that shall permeate as the core strategy in the
effective provision of essential health service that are community
based, accessible, acceptable and sustainable at a cost which the
community and the government can afford
Elements/Components of Primary Health Care:
Education for Health
Locally Endemic and Communicable Disease Control and Treatment
Expanded Program on Immunization
Maternal and Child Health and Family Planning
Essential drugs
Nutrition
Treatment (Medical care and Emergency treatment)
Sanitation of the Environment
Strategies of Primary Health Care
1. Reorientation and reorganization of the national health
care system
2. Effective preparation and enabling process for health
action at all levels
3. Mobilization of the people to know their communities and
identifying their basic health needs
4. Development and utilization of appropriate technology
5. Organization of communities
6. Increase opportunities for community participation
7. Development of intra-sectoral linkages
8. Emphasizing partnership
Four Cornerstones/Pillars in Primary Health Care
1. Active community participation
2. Intra-intersectoral linkages
3. Use of appropriate technology
4. Support mechanism made available
Types of Primary Health Care workers depend upon:
 Available health manpower resources
 Local health needs and problems
 Political and financial feasibility
Two levels of primary health care workers:
1. Village or Barangay Health workers
2. Intermediate level health workers
Levels of Health Care and Referral System
1. Primary level of Care – health care provided by center
physicians, PHN, Rural Health Midwives, barangay health
workers and others at the barangay health station and
rural health units
2. Secondary level of care – given by physicians with basic
health training; given in health facilities which are privately
owned or government operated such as infirmaries,
municipal and district hospitals and OPD of provincial
hospitals; serves as the referral center for primary health
facilities
3. Tertiary level of care – care rendered by specialists in
health facilities including medical centers as well as
regional and provincial hospitals and specialized hospitals
Functions of the PHN:
1. Management function
2. Training Function
3. Supervisory function
4. Health care provider/ Nursing care function
5. Health promotion and education function
Page 1
 6. Collaborating and coordinating function 1. Refer patient if he needs further management
7. research function following the 2-way referral system
2. Accompany the patient when an emergency referral
COMMUNITY HEALTH NURSING PROCESS is needed
Assessment
 Initiate contact VII. Prescription/dispensing
 Demonstrate caring attitudes 1. Give proper instructions on drug intake
 Mutual trust and confidence
 Collect data from all possible sources VIII. Health education
 Identify health problems 1. Conduct one-on-one counseling with the patient
 Assess coping ability 2. Reinforce health education and counseling messages
 Analyze and interpret data 3. Give appointments for the next visit

Planning Nursing Action Blood pressure measurement

 Prioritize needs Procedure:
 Establish goals based on needs 1. Preparatory phase
 Construct action and operation plan  Introduce self to client
 Develop evaluation parameters  Make sure client is relaxed and has rested for at least 5
minutes
 Revise plan as needed
Implementation of planned care  Explain the procedure
 Put nursing care plan to action  Assist to a seated or supine position
 Coordinate care/ services
2. Applying the BP cuff and stethoscope
 Utilize community resources
 Bare client’s arm
 Delegate
 Apply cuff around upper arm 2-3 cm above brachial artery
 Supervise/monitor health services provided
 Keep manometer at eye level
 Provide health education and training
 Keep arm level with his heart by placing it on a table or a
 Document responses
chair arm or by supporting it
 Palpate brachial pulse correctly just below or slightly
Evaluation of Care and Services Rendered
medial to the antecubital area
 Nursing audit
3. Obtaining the BP reading by using palpatory method
 Care outcomes
 While palpating the brachial or radial pulse, close valve or
 Performance appraisal
pressure bulb and inflate cuff until pulse disappears
 Estimate cost benefit ratio
 Note point at which pulse disappeared – palpated systolic
 Re-assessment of problems
BP
 Identify needed alterations
 Deflate cuff fully
 Revise plans as necessary
 Wait 1-2 minutes before inflating cuff again
NURSING PROCEDURES
Obtaining the BP reading by auscultation
 Place earpieces of stethoscope in ears and stethoscope
Clinic visit – patient visits the Health center to avail of the services
head over the brachial pulse
thereto offered by the facility primarily for consultation on matters
 Use the bell of the stethoscope to auscultate pulse
that ailed them physically
 Watching the manometer, inflate the cuff rapidly by
pumping the bulb until the column reaches 30 mmHg
Standard procedures performed during clinic visits:
above the palpatd SBP
I. Registration/ Admission
1. Greet client and establish rapport  Deflate the cuff slowly at a rate of 2-3 mmHg per beat
2. Prepare the family record or retrieve records of old  While the cuff is deflating, listen for pulse sounds
clients (Korotkoff sounds) (1st clear tapping sound – Systolic BP
3. Elicit and record the client’s chief complaint and and disappearance of sound – Diastolic BP
clinical history 4. Recording BP and other guidelines
4. Perform physical examination on the client and  For every visit, take the mean of 2 reading, obtained at
record it accordingly least 2 minutes apart
 If first visit, repeat procedure with other arm. Subsequent
II. Waiting time BP readings should be performed on the arm, with a
1. Give priority numbers to clients higher BP reading
2. Implement the “first come, first served” policy except
for emergency cases Home visit – family nurse contact which allows the health worker to
assess the home and family situations in order to provide the
III. Triaging necessary nursing care and health related activities
1. Manage program-based cases (like the IMCI)
2. Refer all non-program based cases to the physician Purpose of Home Visit:
3. Provide first aid treatment to emergency cases and 1. To give nursing care to the clients
refer to the next level when necessary 2. To assess living conditions of the patient and his family
and their health practices
IV. Clinical evaluation 3. To give health teachings regarding prevention and control
1. Validate clinical history and physical exam of diseases
2. Nurse arrives at evidence-based diagnosis and 4. To establish close relationships between the health
provides rational treatment based on DOH programs agencies and the public
3. Inform the client on the nature of the illness, 5. To make use of the inter-referral system and to promote
appropriate treatment and prevention and control the utilization of community services
measures

V. Laboratory and other diagnostic examinations Principles involve in Preparing for a Home visit:
1. Identify a designated referral laboratory when 1. Must have a purpose or objective
needed 2. Should make use of all available information about a
patient
VI. Referral system 3. Should consider and give priority to needs of clients

bryannflores.multiply.com Page 2
 4. Should involve the clients  Health risk profile
5. Should be flexible  Health/wellness outcome profile
 Survey of current health promotion programs
Guidelines to consider regarding the Frequency of Home Visits  Studies conducted in certain target groups
1. Needs of the client Steps in community analysis
2. Acceptance of the family  Define the community
3. Policy of a specific agency  Collect data
4. Other health agencies and personnel involved in care of  Assess community capacity
family  Assess community barriers
5. Past services given to families  Assess readiness for change
6. Ability of clients to recognize own needs
 Synthesis of data and set priorities
Steps in conducting home visits
2. Design and initiation
1. Greet the patient and introduce yourself
 Establish a core planning group and select a local
2. State the purpose of the visit
organizer
3. Observe the patient and determine the health needs
 Choose an organizational structure
4. Put the bag in a convenient place then proceed to perform
 Identify, select and recruit organizational
the bag technique
members
5. Perform nursing care needed and give health teachings
6. Record all important data, observation and care rendered  Define the organization mission and goals
7. Make an appointment for a return visit  Clarify roles and responsibilities of people
involved in the organization
Bag Technique: too by which the nurse, during her visit will enable  Provide trainings and recognition
her to perform a nursing procedure with ease and deftness, to save
time and effort 3. Implementation
 Generate broad citizen participation
Public Health Bag: an essential and indispensable equipment of a  Develop a sequential work plan
public health nurse which she has to carry along during her home  Use comprehensive integrated strategies
visits  Integrate community values

Principles of Bag Technique: 4. Program maintenance – consolidation

1. Minimize, if not prevent the spread of infection  Integrate intervention activities into community
2. Saves time and effort of the nurse networks
3. Should show effectiveness of total care given to an  Establish a positive organizational structure
individual or family  Establish an ongoing recruitment plan
4. Can be performed in a variety of ways  Disseminate results

Important points to consider in the use of the bag technique:
1. The bag should contain all necessary articles, supplies and
equipments that will be used
2. The bag and its contents should be cleaned very often,
supplies replaced and ready for use anytime
3. The bag and its contents should be well-protected from
contact with any article in the paitent’s home.
4. The arrangement of the contents of the bag should be the
one most convenient for the user, to facilitate efficiency
and avoid confusion
Nursing care in the Home
Principles in Nursing Care:
1. Nursing care utilizes a medical plan of care and treatment
2. Performance of nursing care utilizes skills that would give
maximum comfort and security to the individual
3. Nursing care given at home should be used as a teaching
opportunity to the patient or to any responsible member
of the family
4. Performance of nursing care should recognize dangers in
the patient’s over-prolonged acceptance of support and
comfort
5. Nursing care is a good opportunity for detecting abnormal
signs and symptoms, observing patients attitude towards
care given and the progress of the patient
5. Dissemination – reassessment
 Update the community analysis
 Assess effectiveness of interventions/programs
 Chart future directories and modifications
 Summarize and disseminate results
GUIDE ON HOW TO DO AN EFFECTIVE COMMUNITY DIAGNOSIS
Community Diagnosis: an in-depth process of finding out the
profiles, health status of the community and the factors affecting
the present status
Contents:
1. Introduction
1.1 Rationale – accurate, valid, timely and relevant
information on the community profile and health problems are
essential so that resources can be maximized
1.2 Purpose – to analyze the data in order to develop
responsive intervention strategies that address the root cause
of the problem
1.3 Statement of Objective – what are to be accomplished
to attain the study
1.4 Methodology and tool used – a description of the
adoption, construction and administration of instruments
1.5 Limitation of the study – state any limitations that exist
in the reference or given population or area of assignment

COMMUNITY ORGANIZING 2. Target Community Profile

Maglaya DOH 2.1 Geographical Identifiers – historical background,
1. Preparatory Phase Community Analysis location, boundaries, population, physical features, climate,
2. Organizational Phase Design and Initiation spot map
3. Education and training Implementation 2.2 Population Profile – Total estimated population of
4. Collaboration Phase Program Maintenance- Barangay, Population Density,
Consolidation 2.3 Socio-demographic Profile – total population of
5. Phase Out Dissemination families surveyed, number of households, age and sex
Reassessment distribution, sex ratio, dependency ratio, civil status, types of
families, religious distribution, place of origin, length of
1. Community analysis residency
5 components 2.4 Socio-economic indicators – educational attainment,
 Demographic, social and economic profile of the literacy rate, occupation, income, housing, ventilation
community derived from secondary data

bryannflores.multiply.com Page 3
 2.5 Environmental indicators – Water supply, excreta Epidemiology: study of occurrences and distribution of diseases
disposal, garbage disposal, pet ownership, domestic animals as well as the distribution and determinants of health state or
2.6 Health profile – food storage, infant feeding practices, events in a specified population, and the application of this
immunization, community facilities, health seeking behaviors, study to the control of health problems
communication resource and family planning
2.7 Morbidity and mortality data – leading cause of Uses of Epidemiology:
morbidity, mortality, infant mortality and maternal mortality 1. Study the history of the health population and the rise and
fall of diseases and changes in their character
3. Analysis of Data 2. Diagnose the health of the community
3.1 Identification of health problems 3. Study the work of health services with a view of improving
3.2 Prioritized problems identified them
4. Estimate the risk of disease, accident, defects and the
4. Action plan based from prioritized problem identified chances of avoiding them
4.1 Intervention strategies 5. Identify syndromes by describing the distribution and
association of clinical phenomena in the population
5. Conclusion 6. Complete the clinical picture of chronic disease and
describe their natural history
6. Recommendation 7. Search for causes of health and disease by comparing the
experience of groups
Community Diagnosis
1. Preparation of Community Diagnosis Epidemiologic triangle: Agent, Host and Environment
a. Identify barangay to survey or required by the health Agents of disease:
center  Nutritive elements in excess or in deficiencies
b. Ocular survey  Chemical agents
c. Community assembly  Physical agents
2. Conduct of survey proper using the format/survey form  Infectious agents
a. Random sampling or saturation Host Factors (intrinsic factors) – influence exposure,
b. Guidelines in filling survey form susceptibility or response to agents
c. Data collection techniques  Genetics
3. Make graph or chart of each data gathered  Age
4. Data analysis and interpretation  Sex
5. Preparation of action plan /project plan  Ethnic group
HEALTH PROMOTION AND EDUCATION  Physiologic functioning
 Immunologic experience
Ottawa charter for Health Promotion
 Inter-current or pre-existing disease
 Human behavior
Health promotion – process of enabling people to increase control
Environmental factors (extrinsic factors) - influence existence
over and to improve their health
of the agent, exposure or susceptibility to agents
 Physical environment
Prerequisite for Health:
 Biologic environment
 Peace
 Socio-economic environment
 Shelter
Preventive strategies :
 Education
1. Change the people’s behavior to manipulate the
 Food
environment and reduce their exposure to biological and
 Income
non-biological disease agents
 A stable eco-system 2. manipulate the environment and prevent production or
 Sustainable resources presence of disease agents
 Social justice 3. Increase man’s resistance or immunity to disease agents
 Equity Patterns of Occurrence and Distribution of Disease:
1. Sporadic occurrence – intermittent occurrence of a few
isolated and unrelated cases in a given locality
2. Endemic occurrence – continuous occurrence throughout
a period of time
To Operationalize concept of health promotion, the Charter 3. Epidemic occurrence – unusually large number of cases in
recommended the following action ares: a relatively short period of time
 Build Health Public policy 4. Pandemic – simultaneous occurrence of epidemic of the
 Create supportive environment same disease in several countries
 Strengthen community action Outline of Plan for Epidemiological Investigation:
 Develop personal skills 1. Establish fact of presence of epidemic
 Reorient health services 2. Establish time and space relationship of the disease
3. Relations to characteristic of the group of community
WHO Principles of Health Promotion: 4. Correlation of all data obtained
1. Involves the population as whole in the context of their Steps in Outbreak Investigation:
everyday life 1. Prepare for field work
2. It is directed towards actions on the determinants or 2. Establish existence of an outbreak
causes of health 3. Verify diagnosis
3. It combines diverse, but complementary methods or 4. Define and Identify cases
approaches 5. Perform descriptive epidemiology
4. It aims particularly at effective and concrete public 6. Developing hypotheses
participation 7. Evaluate hypotheses
5. It is primarily a societal and political venture and not a 8. Refine hypotheses and execute additional studies
medical service 9. implement control and prevention measures
10. Communicate findings
Health Education – any combination of learning experience 11. Follow-up Recommendations
designed to facilitate voluntary adoptions of behaviors conducive to National Epidemic Sentinel Surveillance System (NESSS)
health  Hospital based information system that monitors the
occurrence of infectious diseases with outbreak potential
EPIDEMIOLOGY

bryannflores.multiply.com Page 4
  Serves as a supplemental information system of the Dept  Population census
of Health  Registration of vital data
Objectives:  Health survey
 To provide early warning on occurrence of outbreaks  Studies and research
 To provide program managers, policy makers, and Rate – shows the relationship between a vital event and those
public administrators, rapid, accurate and timely persons exposed to the occurrence of said event, within a given
information so that inventive and control measures area and during a specified unit of time
can be instituted Ratio – used to describe the relationship between 2 numerical
NESS DATA shows: quantities or measures of events without taking particular
 Trends of cases across time considerations to the time of place
 Demographic characteristics of cases Crude or general rates – referred to the total living population
 Estimates of case fatality ratio Specific rate – the relationship is for a specific population class
 Clustering of cases in a geographical area or group
 Information to formulate hypotheses for disease causation Presentation of Data:
Diseases under surveillance (NESSS)  Line or curved graphs – shows peaks, valleys and
Laboratory diagnosed seasonal trends
 Cholera  Bar graphs – for comparison of data
 Hepatitis A  Area diagram or pie charts – shows relative
 Hepatitis B importance of parts to the whole
 Malaria Functions of the Nurse:
 Typhoid fever  Collects data
Clinically diagnosed  Tabulates data
 Dengue Hemorrhagic fever  Analyzes and interprets data
 Diphtheria  Evaluates data
 Measles  Recommends redirection and or strengthening of
 Meningococcal disease specific areas of health programs as needed
 Neonatal tetanus FIELD HEALTH SERVICES AND INFORMATION SYSTEM
 Non-neonatal tetanus Objectives:
 Pertussis  To provide summary of data on health service delivery
 Rabies and selected programs
 Leptospirosis  To provide data which can be used for program monitoring
 Poliomyelitis and evaluation purposes
Under surveillance system:  To provide a standardized, facility level data base which
1. Acute flaccid paralysis can be accessed for a more in-depth study
2. Measles  To ensure that the data reported are useful and accurate
3. Maternal and neonatal tetanus  To minimize recording and reporting burden at the service
4. Paralytic shellfish poisoning delivery level
5. Fireworks and related injury Components:
6. HIV/AIDS 1. Family treatment record – fundamental building block or
Importance of outbreak investigation: foundation of the FHSIS
 Control and prevention measure 2. Target client list – second building block
 Severity and risk to others 3. Reporting forms
 Research oppurtunities 4. Output reports
Reporting Units:
 Public, political or legal concerns
 Barangay Health Stations/ Barangay Health Centers
 Program consideration
 Rural Health Units or Main Health Center
 Training
Sources:  Provincial hospital or City Health Office
 Surveillance data  Regional Hospital
SCHOOL NURSING
 Medical practitioner
Objectives: To promote and maintain the health of the school
 Affected persons/ groups
populace by providing comprehensive and quality nursing care
 Concerned citizens
Functions:
 Media
1. School Health and Nutrition Survey
Functions of the Epidemiology Nurse:
2. Putting up a functional School Clinic
1. Implement public health surveillance
3. Health assessment
2. Monitor local health personnel conducting disease
4. Standard vision testing for school children
surveillance
5. Ear examination
3. Conduct and/ or assist other health personnel in outbreak
6. Ht and wt measurement and nutritional status
investigation
determination
4. Assist in the conduct of rapid surveys and surveillance
7. Medical referrals
during disasters
8. Attendance to emergency cases
5. Assist in the conduct of surveys, program evaluations and
9. Student health counseling
other epidemiologic studies
10. Health and nutrition education activities
6. Assist in the conduct of training course in epidemiology
11. Organization of School-Community Health and Nutrition
7. Assist the epidemiologist in preparing the annual report
Councils
and financial plan
12. Communicable disease control
8. Responsible for inventory and maintenance of
13. Establishment of Data bank on school health and nutrition
epidemiology and surveillance unit equipment
activities
14. School plant inspection
VITAL STATISTICS
15. Rapid classroom inspection
 Systematic study of vital events such as births, illnesses, 16. Home visitation
marriages, divorces, separation and deaths OCCUPATIONAL HEALTH NURSING
Use of Vital Statistics: Primary focus: Mission of occupational health and safety is “to
 Indices of the health and illness status of a community assure every working man and woman in the country is safe and in
 Serves as bases for planning, implementing, monitoring healthful working conditions”
and evaluating community health nursing programs and Essential Components:
services 1. Health promotion and prevention
Sources of Data:

bryannflores.multiply.com Page 5
 2. Worker and workplace health hazard assessment and 11. Inform, teach and counsel the woman on important MCH
surveillance messages:
3. Injury and illness investigation  birth registration
4. Primary care  importance of breastfeeding
5. Case management  Newborn Screening for babies delivered in RHU or at
6. counseling home within 48 hours up to 2 weeks after birth
7. Management administration  Schedule when to return for consultation for post partum
8. Legal/ethical monitoring visits
9. Research 1st visit 1st week post partum preferably 3-5 days
10. Community orientation 2nd visit 6 weeks post partum
Issues in Occupational Health Nursing
A. Categories of Workplace Hazards
 Physical hazards
 Chemical hazards FAMILY PLANNING
 Biologic hazards Goal: Provide universal access to family planning information and
 Mechanical hazards services wherever and whenever these re needed
 Psychosocial hazards
Vaccin Minim # of Minimu Route, Storag Type/ form
B. Work-related Injuries and Illnesses
e um Dos m Dosage, e of vaccine
C. Worker’s compensation
age at es interval Site temp
PUBLIC HEALTH PROGRAMS
1st betwee
FAMILY HEALTH
dose n doses
Aims to:
1. Improve the survival, health and well-being of mothers and the BCG Birth 1 ID 2-8 C Freeze
unborn through a package of services for the pre-pregnancy, or 0.05 ml in dried, live
prenatal, natal and postnatal packages. anyti Right body attenuated
2. Reduce morbidity and mortality rates for children 0-9 years. me arm of ref bacteria
3. Reduce mortality from preventable causes among adolescents after
and young people. birth
4. Reduce mortality and morbidity among Filipino adults and DPT 6 3 4 weeks IM 2-8 C D–
improve their quality of life. weeks 0.5 ml in weakened
5. Reduce morbidity and mortality of older persons and improve Thigh body toxin
their quality of life (vastus of ref P – killed
Maternal Health Program lateralis) bacteria
Strategic thrusts for 2005-2010 T – toxin
 Launch and implement the Basic Emergency Obstetric Care OPV 6 3 4 weeks Oral -15 to Live
or BEMOC strategy in coordination with the DOH. weeks 2 drops -25C attenuated
 Improve the quality of prenatal and postnatal care Mouth (freez virus
er)
 Reduce women’s exposure to health risks through the
institutionalization of responsible parenthood and Hepa At 3 6 wks IM 2-8 C RNA
provision of appropriate health care package to all women B birth interval 0.5 ml in recombina
of reproductive age from 1st Thigh body nt
dose to (vastus of ref
 LGUs, NGOs and other stakeholders must advocate for
2nd lateralis)
heatlh through resource generation and allocation for
dose, 8
health services to be provided for the mother and the
wks
unborn
interval
A. Antenatal Registration
from
Prenatal Visits Period of Pregnancy
2nd to
1st visit As early as possible before 4 months
3rd dose
or during the 1st trimester
nd
Measl 9 1 SQ -15 to Freeze
2 visit During the 2nd trimester
rd
es mont 0.5 ml -25C dried, live
3 visit During the 3rd trimester
hs Outer (freez attenuated
Every 2 weeks After 8th month until delivery part of er) virus
B. Tetanus Toxoid Immunization upper
 A series of 2 doses of TT vaccination must be received by a arm
woman one month before delivery to protect the baby
from neonatal tetanus FP Aims to contribute to:
 3 booster dose shots are needed to complete the five  Reduced infant deaths
doses following the recommended schedule to provide full  Neonatal deaths
protection for both mother and child
 Under-five deaths
 mother is then called as a “fully immunized mother”
 Maternal deaths
C. Micronutrient supplementation:
Objectives:
Vit A: 10,000 IU 2x a week starting on 4th month of pregnancy
 Addresses the need to help couples and individuals
Iron: 600mg/400ug tablet daily
achieve their desired family size within the context of
D. Treatment of Diseases and other conditions
responsible parenthood and improve their reproductive
E. Clean and Safe Delivery
health to attain sustainable development
1. Do a quick check upon admission for emergency signs.
 Ensure that quality FP services are available in DOH
2. Make the woman comfortable/
retained hospitals, LGU managed health facilities, NGOs
3. Assess the woman in labor.
and private sector
4. Determine the stage of labor.
Strategies:
5. Decide if the woman can safely deliver.
 Focus service delivery to urban and rural poor
6. Give supportive care throughout labor.
7. Monitor and manage labor.  Reestablish the FP outreach program
8. Monitor closely within one hour after delivery and give supportive  Strengthen FP provision in regions with high unmet needs
care.  Promote frontline participation of hospitals
9. Continue care after one hour postpartum.  Mainstream modern natural family planning
10. Educate and counsel on Family Planning and provide Family  Promote and implement CSR strategy
Planning Method if available and decisions made by the woman. Different Family Planning Methods:
1. Female sterilization

bryannflores.multiply.com Page 6
 2. Male sterilization  False contraindications: malnutrition, low-grade fever,
3. Pills mild respiratory infections, and other minor illnesses and
4. Male condom diarrhea
5. Injectibles Management of CHILDHOOD ILLNESSES
6. Lactational amenorrhea method (LAM) Methods:
7. Mucus/ Billings Method  Assess the patient
8. Basal Body temperature  Classify the disease
9. Two-day method  Treat the patient
10. Symptothermal method  Counsel the patient
11. Standard days method
Misconceptions about Family Planning Methods: Color Presentation Classification of Level of
 Some family planning methods cause abortion Disease Management
 Using contraceptives will render couples sterile Green Mild Home Care
 Using contraceptive methods will results to loss of Yellow Moderate Managed at the RHU
sexual desire Pink Severe Urgent Referral in
CHILD HEALTH PROGRAMS Hospital
 Infant and young child feeding NUTRITION PROGRAM
 Newborn screening Goal: Improve the quality of life of Filipinos through better nutrition,
 Expanded program on immunization improved health and increased productivity
 Management of childhood illnesses Strategies:
 Micronutrient supplementation 1. Food based interventions for sustained improvements in
 Dental health nutritional status
 Early child development 2. Life-cycle approach with strategic attention to 0-3 year old
 Child health injuries children, adolescent females and pregnant/lactating
National Plan iof Action for 2005-2010 for Infant and Young Child women
Feeding 3. Geographical focus to needier areas
Programs and projects:
Goal: Reduce child mortality rate by 2/3 by 2015 1. Micronutrient Supplementation – “Araw ng Sangkap
Objective: To improve health and nutrition status of infants and Pinoy”
young children 2. Food Fortification
Outcome: To improve exclusive and extended breastfeeding and 3. Essential maternal and child health service package
complementary feeding 4. Nutrition information, communication and education
Key messages on infant and young child feeding 5. Home, school and community food production
 Initiate breastfeeding within 1 hour after birth 6. Food assistance includes center based complementary
 Exclusive for the first 6 months of life feeding for wasted/stunted children and pregnant women
 Complemented at 6 months with appropriate foods, 7. Livelihood assistance
excluding milk supplements
 Extend breastfeeding up to 2 years and beyond.
Breastfeeding benefits ORAL HEALTH PROGRAM
To Infants: Goal: Reduce the prevalence rate of dental caries and periodontal
 Provides a nutritional complete food for the young infant diseases by the end of 2010 among general population
 Strengthens infants’ immune system Objectives:
 Safely rehydrates and provides essential nutrients  Increase proportion of Orally Fit Children under 6 y/o to
 Reduces infants exposure to infection 80% by 2010
 Increase IQ points  Control oral health risks among the young people
 Improve the oral health conditions of pregnant women by
To Mother: 20% and older persons by 10% every year until 2010
 Reduces woman’s risk of excessive blood loss after birth
 Provides natural methods of delaying pregnancies Classification of Oral Interventions:
 Reduces the risk of ovarian and breast cancers and  Preventive services
osteoporosis  Curative/treatment services
 Promotive services
To Household and the Community:
 Conserve funds that would be spent on breastmilk ADOLESCENT HEALTH PROGRAM
substitute
 Saves medical cost to families Essential health care package for the Adolescent and Youth:
1. Management of illness
EPI 2. Counseling on substance abuse, sexuality and
Reproductive tract infections
3. Nutrition and diet counseling
Principles in Vaccinating Children: 4. Mental health
5. Family planning and responsible sexual behavior
 It is safe and immunologically effective to administer all
6. Dental care
EPI vaccines on the same day at different sites of the body.
 Measles vaccine should be given as soon as the child is
ADULT MEN AND WOMEN
9m/o.
 Vaccination schedule should not be restarted from
Essential health care package for the Adult Male and Female:
beginning even if interval exceeds recommended interval.
1. Management of illness
 Moderate fever, malnutrition, mild respiratory infection,
2. Counseling on substance abuse, sexuality and
cough, diarrhea and vomiting are not contraindications to
Reproductive tract infections
vaccination.
3. Nutrition and diet counseling
 Absolute contraindications: DPT 2 or DPT3 to a child who 4. Mental health
had convulsions or shock within 3 days after DPT 5. Family planning and responsible sexual behavior
administration; BCG to immunosuppressed clients 6. Dental care
 Giving doses of a vaccine at less than the recommended 4 7. Screening and management of lifestyle related and other
weeks interval may lessen antibody response degenerative diseases

bryannflores.multiply.com Page 7
PHILIPPINE REPRODUCTIVE HEALTH  Community organizer – community health development
and empowerment of the people by raising their levels of
Main objectives: awareness regarding non communicable diseases
 Reducing maternal mortality rate  Health trainer – provides technical assistance in the
 Reducing child mortality rate assessment of the skills of auxiliary health workers in NCD
 Halting and reversing spread of HIV/AIDS prevention and control
 Increasing access to reproductive health information and  Researcher – provides valuable information for prevention
services and control
Risk factor Cardio- Diabetes Cancer Respiratory
10 Element of RH: vascular conditions
1. Family planning dse
2. Maternal and Child Health and Nutrition Smoking    
3. Prevention and Management of Reproductive Tract Infections Diet    
4. Adolescent Reproductive Health Physical    
5. Prevention and Management of Abortion and its complications inactivity
6. Prevention and Management of Breast and Reproductive Tract Obesity    
Cancers and other gynecologic principles Alcohol    
7. Education and counseling on Sexuality and Sexual Health Increased BP    
8. Violence against Women and Children Bld glucose    
9. Prevention and management of Infertility and Sexual Dysfunction Bld lipids    
10. Men’s Reproductive Health
Risk Factor Key area for Prevention
FAMILY NURSING ASSESSMENT:
Elevated blood Promote proper nutrition:
Steps:
lipid  limit intake of fatty, salty and
1. Data Collection
High intake of preserved foods
2. Data Analysis
3. Family Nursing Diagnoses
fatty foods  increase intake of vegetables and
Inadequate intake fruits
Criteria for Prioritization of Family health problems:
1. Nature of the problem
of dietary fiber  avoid high calorie low nutrient value
2. Modifiability of the problem food
3. Preventive potential  start developing healthy habits in
4. Salience children
Overweight and Encourage more physical activity and exercise:
Family Nursing Care Plan: Blueprint of the care that the nurse obesity  Moderate physical activity of at least
designs to systematically minimize or eliminate the identified health Sedentary 39 minutes for most days
and family nursing problems lifestyle  Integrate physical inactivity and
Features: exercise into regular activities
1. Focuses on actions to solve or minimize existing problems  Encourage walking as exercise
2. Product of a deliberate systematic process Smoking Promote smoke-free environment:
3. Relates to the future  Smoking cessation for active smokers
4. Based upon health and nursing problems  Prohibit smoking inside living areas
5. Means to an end  Avoid smoke-filled places
6. Continuous proess  Advocate for implementation of
policies and Clean Air Act
Qualities:  Support Policies that limit access of
1. Based on a problem youth to cigarettes
2. Realistic Excessive use of Discourage excessive drinking of alcoholic
3. Prepared jointly with the family alcohol beverages
4. In written form Hyperlipidemia, Early diagnosis and prompt treatment
Steps in Developing FNCP HPN, DM
1. Prioritize the Health Conditions and Problems
2. Define Goals and Objectives of Care
3. Select Appropriate Nursing Interventions NATIONAL PREVENTION OF BLINDNESS PROGRAM
4. Develop Evaluation Plan VISION 2020: Right to Sight is global initiative to eliminate
NON-COMMUNICABLE DISEASE PREVENTION AND CONTROL avoidable blindness by year 2020
Goal: Reduce the toll of morbidity, disability and premature deaths Vision: All Fililpinos enjoy the right to sight by year 2020
due to chronic, non-communicable lifestyle related disease Mission: The DOH, Local Health Units, partners and stakeholders
Key intervention Strategies: commit to:
1. Establishing program direction and infrastructure 1. Strengthen partnership among and with stakeholders to
2. Changing environments eliminate avoidable blindness in the Philippines
3. Changing lifestyle 2. Empower communities to take proactive roles in the
4. Reorienting health services promotion of eye health and prevention of blindness
4 Major non-communicable diseases: 3. Provide access to quality eye care services for all
 Cardiovascular diseases 4. Work towards poverty alleviation through preservation
 Cancer and restoration of sight to indigent Filipinos
 Chronic obstructive pulmonary disease Goal: Reduce the prevalence of avoidable blindness in the
 Diabetes mellitus Philippines through the provision of quality eye care
Role of the PHN in NCD prevention and control: 5 preventable/treatable conditions causing blindness:
 Health advocate – PHN promotes active community  Cataract
participation in NCD prevention and control; helps people  Refractive errors and low vision
towards optimal degree of independence in decision  Trachoma
making and in asserting their right to a safer and better  Onchocerciasis
community  Childhood blindness
 Health educator – concerned with promoting health as MENTAL HEALTH AND MENTAL DISORDERS
well as reducing behavior-induced disease, focuses on Four Facets as public health burden:
establishing or inducing changes in personal and group
attitudes and behavior that promote healthier living
 Health care provider

bryannflores.multiply.com Page 8
  Defined burden – burden currently affecting persons with  Public information campaign on health and
mental disorders and is measured in terms of prevalence environmental hazards arising from mismanagement
and other indicators such as quality of life of hospital shall be the responsibility of hospital
 Undefined burden – portion of the burden relating to the administration
impact of mental health problems to persons other than  DOH HWM guidelines/policies shall be guided by
the individual directly affected existing legislative health and environmental
 Hidden burden – refers to the stigma and violations of protection laws policies on waste management
human rights  Local ordinances regarding the collection and disposal
 Future burden – refers to the burden in the future relating techniques shall be institutionalized
from the aging of the population, increasing social SENTRONG SIGLA
problems and unrest inherited from the existing burden  Joint effort of the DOH and LGU
Pointers for Having Mental Health:  Aims to promote availability of quality health services
 Maintain good physical health in health centers and hospitals and to make these
 Undergo annual medical exam services accessible to every Filipino
 Develop and maintain a wholesome lifestyle  Main component is the certification recognition
 Avoid smoking, substance abuse and excessive alcohol program that develops and promotes standards for
 Have a realistic goal in life health facilities
 Have a friend whom you can confide and ventilate your Guiding Principles
problems  Recognition for achieving good quality shall be the main
 Don’t live in the past and avoid worrying about the future incentive in SS certification
 Live one-day at a time  Quality improvement is an unending process
 Avoid excessive stress  Focus shall be on core public health programs that are
 Develop and sustain solid spiritual values most beneficial to the people
COMMUNITY DIAGNOSIS  Quality improvement is a partnership that empowers all
Types: stakeholders
1. Comprehensive Community diagnosis  DOH shall give purposive technical assistance to targeted
2. Problem Oriented Community diagnosis health facilities
Steps:  Assessment for certification shall involve other
1. Determining Objectives stakeholders in order to provide objectivity and varying
2. Defining Study Population perspective into the process
3. Determining Data to be Collected GOALS:
4. Data Collecting Methods Long-term: Institutionalize within the health sector the leadership,
5. Developing the Instrument processes, knowledge, attitudes and skills and organizations to
6. Actual Data Gathering generate continuous quality improvement in health care
7. Data Collation Intermediate: To improve quality of health care in outpatient health
8. Data Presentation facilities, hospitals and public health services in communities
9. Data Analysis Specific goal: To improve the quality of out-patient health care and
10. Identifying Community Health Nursing Problems of public health services in communities
11. Priority-Setting Level and Scope of Certification:
Criteria for prioritization of COMMUNITY Problems: 1. Basic SS certification – minimum input, process and output
1. Nature of the problem standards
2. Magnitude of the Problem 2. Specialty awards – second level quality standards
3. Modifiability of the Problem 3. Award for Excellence – highest level quality standards
4. Preventive Potential 4 Pillars of SSM
5. Social concern 1. Quality Assurance Pillar
Environmental Sanitation: study of all factors in man’s physical 2. Grants and Technical Assistance Pillar
environment, which may exercise a deleterious effect on his 3. Health Promotion Pillar
health, well-being and survival 4. Award Pillar
Approved types of water facilities: HERBAL MEDICINE
Level I – Point source Herbal plant Uses
Level II – Communal faucet system or stand-posts Sambong Anti-edema, diuretic, anti-urolithiasis
Level III – Waterworks System or Individual House connections Akapulko Anti-fungal, Ringworm, athlete’s foot, scabies,
Approved types of Toilet facilities: Tinea Flava
Level I – non-water carriages (pit latrines, reed odorless earth Niyug-niyogan Anti-helminthic
closet) and with water (pour flush toilets and aqua privies) Tsaang Gubat For Diarrhea and Stomachache
Level II – on site toilet facilities water sealed and flush type with Ampalaya Lower blood sugar levels
septic vault/tank disposal facilities Lagundi For cough, fever, asthma, dysentery, colds
Level III – toilet facilities connected to septic tanks and/or to and pain, skin diseases, headache,
sewerage system to treatment plant rheumatism, sprain, insect bites, aromatic
FOOD SANITATION PROGRAM bath for sick patients
Four rights in Food Safety: Ulasimang bato Lowers uric acid
 Right source Bayabas Washing wounds, diarrhea, toothache
 Right preparation bawang For hypertension and toothache
 Right cooking Yerba buena For pain, rheumatism, arthritis, cough and
 Right storage cold, swollen gums, toothache, menstrual and
HOSPITAL WASTE MANAGEMENT PROGRAM gas pain, nausea and fainting, insect bites and
Policies: pruritus
 All newly constructed/authorized and existing
government and private hospitals shall prepare and
implement a Hospital Waste Management (HWM) Reminders on the Use of Herbal Medicine:
program as a requirement for registration/renewal of 1. Avoid the use of insecticides
licenses 2. Use a clay pot and remove cover while boiling at low heat.
 Use of appropriate technology and indigenous 3. Use only the part being advocated
materials for HWM system shall be adopted 4. follow accurate dose of suggested preparation.
 Training of all hospital personnel involved in waste 5. Use only one kind of herbal plant for each type of
management shall be part of hospital training symptom or sickness.
program

bryannflores.multiply.com Page 9
 6. Stop giving the herbal medication in cases of untoward
reactions.
7. If signs and symptoms are not relieved after 2-3 doses,
consult a doctor.
HEALTH EMERGENCY PREPAREDNESS AND RESPONSE PROGRAM
Legal mandate: Presidential Decree no. 1566. Strengthening the
Philippine Disaster Control Capability and Establishing the National
Program on Community Disaster Preparedness
Disaster – serious disruption of the functioning of a society, causing
wide spread human, material or environmental losses which exceed
the ability of the affected society to cope
Emergency – as any occurrence, which requires an immediate
response
Hazards – any phenomenon, which has the potential to cause
disruption or damage to humans and their environment
Risk – the level of loss or damage that can be predicted from a
particular hazard affecting a particular place at a particular time
from the point of view of the community
Classifications of disaster according to its cause:
1. Natural disaster – force of nature
2. Human generated/manmade disaster
Classification of disasters according to onset:
1. Acute or sudden impact events
2. Slow or chronic genesis
Contributing Factors to disaster occurrence and severity:
1. Human vulnerability resulting from poverty and social
inequality
2. environmental degradation resulting from poor land use
3. Rapid population growth especially among the poor
General Principles of Disaster Management
1. The first priority – protection of people who are at risk
2. Second priority – protection of critical resources and
systems on which communities depend
3. Disaster management must be an integral function of
national development plans and objectives
4. Disaster management relies upon an understanding of
hazard risks
5. Capabilities must be developed prior to impact of a
hazard.
6. Disaster management must be based upon
interdisciplinary collaboration
7. Disaster management will only be as effective as the
extent to which commitment, knowledge and capabilities
can be applied.
Principles of Emergency Preparedness:
1. It is the responsibility of all
2. Should be woven into the community and administrative
levels of both government and non-government
organizations
3. Emergency preparedness is an important aspect of
emergency management
4. Emergency preparedness is connected to other aspects of
emergency management
5. Should concentrate on process and people rather than
documentation
6. Emergency preparedness should not be done in isolation
7. Emergency preparedness should not concentrate only on
disasters but integrate prevention and response strategies
for any scale of emergency
8. Hospitals play a very vital role in the management of
emergencies
9. Main objective is to decrease mortality, morbidity and to
prevent disability
10. Every hospital should have a regularly updated disaster
plan
Purpose of the Disaster Plan:
1. To Provide policy for effective response to both internal
and external disaster situations
2. Identify hospital capability to handle mass casualty
bryannflores.multiply.com
3. Identify responsibilities of individuals and departments in
the event of a disaster situation
4. Identify standard operating guidelines for emergency
activities and responses
NATIONAL VOLUNTARY BLOOD SERVICES PROGRAM
RA 7719 – Blood Services Act of 1994
Objectives:
 To promote and encourage voluntary blood donation by
the citizenry
 To provide adequate, safe, affordable and equitable
distribution of supply of blood and blood products
 To mobilize all sectors of the community to participate in
mechanisms for voluntary and non-profit collection of
blood
Vision: Envision network of modernized national and regional
blood centers operating on a fully, voluntary, non-remunerated
blood donation system
Mission: Ensure adequate, safe and accessible blood supply by:
a. promoting voluntary blood donation as a way of life
b. establishing new blood service facilities and upgrading
existing ones
c. organizing association of blood donors and training
medical practitioners on national blood use
Eligible Blood Donors must:
 Weigh more than 45 kg for 250ml of donated blood; 50 kg
for 450ml of donated blood
 Be in good health
 Be aged 16-5 yrs of age
 Have BP in safe range 90-160 mmHg systolic and 60-100
mmHg diastolic
 Have HGB at least 12.5g/dL
BOTIKA NG BARANGAY
Goal: To promote equity in health by ensuring the availability
and accessibility of affordable, safe and effective quality
essential drugs to all, with priority for marginalized,
underserved, critical and hard to reach areas.
Objectives:
 To Rationalize the distribution of common drugs and
medicines among intended beneficiaries
 To serve as mechanism for the DOH to establish
partnership with LGU and Community Organizations
 Optimize involvement of the Barangay Health
workers addressing the Health needs of the
community
STANDARDS OF PUBLIC HEALTH NURSING IN THE PHILIPPINES
2006
Public health nursing – practice of nursing in local/national health
departments; community health nursing practiced in the public
sector
Community health nursing – broader than public health nursing
because it encompasses “nursing practice in a wide variety of
community services and consumer advocate areas and in a variety of
roles
Public health nurses – refers to nurses in the local health
departments whether their official position is Public Health Nurse or
Nurse or School Nurse
Nursing service – separate and distinct unit of the local health
agency which is composed of nurses, midwives and auxiliaries such
as barangay health workers, nursing aides and volunteers
Standard – desired and achievable level of performance against
which actual practice is compared
Criterion – objective, measurable, relevant and flexible indicator
related to performance, behavior, circumstances or clinical status
I. Organization and Management
A. A nursing service is organized in a local health agency to ensure
the effective delivery of nursing services and nursing component of
public health programs
B. The nursing service is headed by a qualified chief nurse (RA 9173)
Page 10
C. The nursing service has a written vision, mission, philosophy,
goals and objectives.
D. The nursing service formulates/reviews and implements the
nursing service plan, manual of policies and nursing standards.
E. The nursing service participates in planning for the health
agency’s physical facilities, equipment and supplies and in
monitoring their use.
F. The nursing service participates in the official recruitment,
selection, promotion and discharge process at all levels involving
nursing personnel and in making decisions involving nurses and
midwives and nursing practice.
G. The Nursing service initiates/ strengthens mechanisms within the
agency that enhance nursing and midwifery contribution to the
overall community health goals.
II. Qualifications and Functions of the PHN
A. The PHN has the professional, personal and other qualifications
that are appropriate to his job responsibilities ( a graduate of BSN
and a registered Nurse,RN)
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.
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 experiences (RLE) in
the community setting.
D. The PHN participates in the conduct or research and utilizes
research findings in his/her nursing practice
III. Supervision
A. The PHN supervises midwives within her catchment area in
accordance with the agency’s policies and in a manner that improves
performance and promotes job satisfaction
1. The PHN formulates a supervisory plan.
2. The PHN conducts supervisory visits to implement the
supervisory plan
3. The PHN regularly monitors and evaluates midwives and
nursing auxiliaries’ performance in the implementation of public
health programs.
4. The PHN initiates and participates in activities to
promote his/her supervisees’ personal and professional growth.
5. The PHN initiates and participates in developing policies
and guidelines that promote good performance in nursing and
midwifery services.
A. The PHN recognizes the role of a healthy lifestyle in the different
health programs.
B. The PHN plans, conducts and evaluates health promotion and
health education activities properly.
C. The PHN demonstrates knowledge and skills on how to advocate
for healthy public policy, creating supportive environment,
strengthening community action and developing client’s personal
skills
D. The PHN actively works to build capacity for health promotion
among the midwives, volunteer health workers and community
partners.
VII. Demonstrating Professional Responsibility and Accountability
A. The PHN recognizes that her/his personal attitudes, beliefs,
assumptions, feelings and values about health have potential effects
on his professional actions and interventions.
B. The PHN accepts accountability for his actions and engages in
nursing practice that is ethical, safe, acceptable and evidence-based.
C. The PHN protects his professional autonomy, assumes
responsibility for professional development and contribute to the
professional development of thers.
D. The PHN institutes changes/ improvements in service delivery and
management of health facility to improve client’s access and use of
public health nursing services.
E. The PHN maintains links and collaboration with other professional
nurses and nursing groups to strengthen his/her nursing practice
F. The PHN maintains links and collaboration with government
agencies and non-government organizations.
G. The PHN conducts and/or facilitates in various training activities
for public health nurses, midwives, barangay health workers, nursing
aide and volunteers.

IV. Interdisciplinary and Intersectoral Collaboration

A. The PHN establishes linkages and collaborative relationships with
other health professionals, government agencies, the private sector
(businesses) non-government organizations and people’s
organizations to address the community’s health problems
B. The PHN collaborates with other health care providers,
professionals and community representatives in assessing, planning,
implementing and evaluating programs for community health.

V. Nursing Process
A. The PHN establishes a working relationship to help ensure good
quality data and to facilitate on enhance partnership in addressing
identified health needs and problems.
B. The PHN systematically collects data that are appropriate and
accurate.
C. The PHN recognizes the broad impact of certain factors on the
client’s health and nursing problems and their readiness or
willingness to do something about their problems.
D. The PHN analyzes data collected about the community, family
and individual to determine the diagnoses.
E. the PHN formulates a nursing/ community diagnosis/
F. The PHN develops jointly with the client a nursing care plan or
program plan for the priority nursing problems.
G. The PHN implements the nursing care plan/program plan to
promote, maintain or restore health, to prevent illness, to effect
rehabilitation and to improve the capability of clients.
H. The PHN evaluates the responses of his clients to interventions in
order to revise data base, diagnose and plan and to formulate
recommendations.

VI. Health promotion and Health education

bryannflores.multiply.com Page 11