OVERVIEW OF PUBLIC HEALTH NURSING IN THE PHILIPPINES

INTRODUCTION:

PHN in the Phils. evolved alongside the institutional development of the DOH, the govt agency mandated to protect & promote peoples health and the biggest employer of health workers

Global and Country Health Imperatives

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

Millenium Development Goal

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

1.

2.
3. 4. 5. 6. 7. 8.

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

Evolution of the Public Health Nursing in the Philippines

HEALTH A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO).

DETERMINANTS OF HEALTH
1. 2. 3.

4.
5. 6. 7.

8.
9. 10.

Income & social status Education Physical environment Employment & working conditions Social support networks Culture Genetics Personal behavior & coping skills Health services Gender

The Optimum Level of Functioning of IFG being influenced by several factors in the eco-system

PUBLIC HEALTH
The

art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number.

Essential Public Health Functions:

1. 2. 3. 4. 5. 6. 7. 8. 9.

Health situation monitoring & analysis Epidemiological surveillance/disease prevention & control Development of policies & planning in public health Strategic management of health systems & services for population health gain Regulation & enforcement to protect public health Human resources development & planning in public health Health promotion, social participation & empowerment Ensuring the quality of personal & population based health services Research, development, and implementation of innovative public health solutions

PUBLIC HEALTH NURSING

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

COMMUNITY HEALTH NURSING

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

Public Health Nursing in the Philippines

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

READ: Historical Background of Public Health Nursing

THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

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

The Public Sector

National Level

DOH lead agency in health Regional field office specialty hospitals, regional hospitals, and medical centers Provincial health teams DOH reps Local Health boards involved in communicable disease control PGH Provincial & district hospitals provl govt Health Centers/RHUs & BHSs city/municipal govt Local Health Board chaired by LCE

Local Health system run by LGUs

The Private Sector

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

Philippine Department of Health

The principal health agency in the Philippines Responsible for ensuring access to basic public health services to all Filipinos through the provision of quality health care and regulation of providers of health goods and services

Read: Historical background of the DOH

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

DOH Roles and Functions

1.
2. 3.

Leadership in Health Enabler and Capacity Builder Administrator of Specific Services

1. Leadership in Health

Serve as the national policy & regulatory institution fr. which the LGUs, NGOs, & other members of the health sector involved in social welfare & devt will anchor their thrusts & directions for health Provide leadership in the formulation, monitoring & evaluation of national health policies, plans & programs. The DOH shall spearhead sectoral planning & policy formulation & assessment at the national & regional levels Serve as advocate in the adoption of health policies, plans & programs to address national & sectoral concerns

2. Enabler & Capacity Builder

Innovate new strategies in health to improve the effectiveness of health programs, initiate public discussion on health issues and undertaking and disseminate policy research outputs to ensure informed public participation in policy decisionmaking Exercise oversight function, monitoring & evaluation of national health plans, programs & policies Ensure the highest achievable standards of quality health care, health promotion & health protection

3. Administrator of Specific Services

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

GOAL: Health Sector Reform Agenda

HSRA is the overriding goal of the DOH Support mechanisms will be through sound organizational development, strong policies, systems and procedures, capable human resources and adequate financial resources

Rationale for Health Sector Reform

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

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

Framework for Implementation of HRSA: FOURmula ONE for Health

Designed to implement critical interventions as single package backed by effective management infrastructure and financing arrangements following a sectorwide approach

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

FOURmula ONE components

1.

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

2.

Health regulation the goal is to ensure the quality and affordability of health goods and services

3.

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

4.

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

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

Summary

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

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

thank you!!!