COMMUNITY HEALTH PUBLIC HEALTH NURSING

NURSING It is a special field of nursing that combines the

skills of nursing, public health and some phases
of social assistance (World Health Organization)
It is synthesis of nursing practice and public
health applied to promoting and preserving the Functions as part of the total public health
health of populations programme for the promotion of health, the
(ANA,1980) improvement of the conditions, in the social and
physical environment, rehabilitation of illness
Focus of the community health nursing is the and disability
community as a whole, with nursing care of According to Dr. C.E Winslow, public health is
individuals, families and groups being provided the science and art of:
within the context of promoting and preserving
the health of the community (Association of - Preventing diseases
Community Health Nursing Educators, 1990)
- Prolonging life
According to Ruth B. Freeman, it refers to a - Promoting health and efficiency
service rendered by a professional nurse with
communities, group, families, individuals at
home, in health centers, in clinics, in schools, in
PUBLIC HEALTH NURSE
places of work for the: Refers to the nurses in the local/national
health departments or public schools whether
- Promotion of health their official position title is public Health
- Prevention of illness Nurse or Nurse school nurse
- Care of the sick at home and rehabilitation Starts with a Salary Grade 15
Four Levels of Clientele Roles & Functions
Individuals Planner/Programmer
Family Identifies the health needs, priorities and
Population problems of individuals, families, and community
Community
Nursing Care Provider
Subspecialties
School Nursing Provides nursing care to the sick, disabled in
the home, clinic, school, or place of work
Occupational Health Nursing
Community Mental Health Nursing Manager/Supervisor
Public Health Nursing
Formulates and implements nursing plan for
COMMUNITY – BASED NURSING individual, family, group, community
It is a philosophy of care in which the care is Leads and encourages them to address their
provided as clients and their families move health needs and solve their health problems
among various service outside of hospitals.
@RNurseGuides
Community Organizer Good physical and mental health
Motivates and enhances community participation Interest and willingness to work in the community
Initiates and participates in community Capacity and ability to:
development activities Relate the practice with on-going community
health and health related activities
Service Coordinator
Work cooperatively with other disciplines and
Collaborates with individuals, families, and members of the community
groups for health and health services
Accept and take actions needed to improve
Health Educator/Counselor/Trainer self and service
Conducts health teaching, training and counseling Analyze combination of factors and conditions
Trains and educates rural health midwives Acts as that influence health of populations
a resource speaker on health and health related Apply nursing process in meeting the health
services and nursing needs of the community
Health Monitor Mobilize resources in the community
Monitors the status of the individuals, families With leadership potential
and groups through various contacts Resourcefulness and creativity
Role Model Active membership to professional nursing
organizations
Sets as good example of healthful, living to the
individuals, families, and community
Change Agent
Motivates changes in the health behavior of
individual, families and community
Reported/ Recorder/Statistician
Records every nursing interventions
Updates existing data base
Makes statistical analysis of data for
interpretation
Researcher
Uses observation, interview, survey questionnaire,
physical exam, and other methods in the
assessment of individuals, families, and community
Qualifications of Public Health Nurses
Graduate of Bachelor of Science in Nursing and a
Registered Nurse
@RNurseGuides
PHILIPPINE
HEALTH CARE DELIVERY SYSTEM
RN2024
Public Sector Goal
Department of Health Health Sector Reform Agenda (HSRA)
Health Sector reform is the overriding goal of
Serve as national policy and DOH
regulatory institution.
Leadership in
Health
Provide leadership in
formulation, monitoring, and FRAMEWORK
evaluation of national FOR THE IMPLEMENTATION OF HSRA
policies, plans and programs.
Serve as advocate in the FOURmula ONE for Health (2005-2010)
adoption of health policies,
plans and programs
Innovate new strategies in
Goals of the FOURmula One of Health
health Better Health Outcomes
Exercise oversight functions More responsive health systems
Enabler and and monitoring and evaluation Equitable health care financing
Capacity of national health plans,
programs, and policies
Ensure the highest achievable Four Elements of the Strategy
standards of quality health
care, health promotion, and
health protection
1. Health Financing
To foster greater, better and sustained
Manage selected national investments in health (PHILHEALTH)
health facilities and hospitals
Administrator with modern and advanced
of specific facilities 2. Health Regulation
Administer direct services for
Services emergent health concerns To ensure the quality and affordability of
that require new complicated health goods and services
technologies
Administer health emergency
response
3. Health Service Delivery
To improve and ensure the accessibility
and availability of basic and essential
Vision health care
Filipinos are among the healthiest people in
Southeast Asia by 2022, and Asia by 2040 4. Good Governance
To enhance health system performance
Mission at the national and local levels.
To lead the country in the development of a
productive, resilient, equitable and people-
centered health system
@RNurseGuides
LOCAL
HEALTH SYSTEM
Health Facilities
District or provincial hospital and other health
services deciding to work together as an
integrated health system
RA 7160 - Local Government Code
All structures, personnel, and budgetary Health Workers
allocations from the provincial health level Right unit of health providers is needed to deliver
down to the barangays were DEVOLVED to the comprehensive health services.
Local Government Units to facilitate health
service delivery

Objectives of Local Health System

Establish local health system
Upgrade the health care management and
service capabilities of local health facilities
Promote inter-LGU linkages and cost sharing
schemes
Foster participation of the private sector, non-
government organizations and community

Inter Local Health System

It is a system of health care similar to a
district health system
System that is being espoused by the DOH in
order to ensure quality of health care service
Composition of Inter-Local Health Zone
People
Ideal health district would have a population size
between 100,000 to 500,000 for optimum
efficiency and effectiveness
Boundaries
Clear boundaries between inter Local Health
Zones determine the accountability and
responsibility of health service providers
@RNurseGuides
PRIMARY
HEALTH CARE (PHC)
RN2024
Levels of Primary Health Care Worker
Adopted in the Philippines through: 1. Village/Barangay Health Workers
Letter of instruction (LOI) 949 Refers to trained community health workers or
Signed by President Marcos on October 19, 1979 health auxiliary volunteer or a traditional birth
Underlying theme: attendant or healer
“Health in the Hands of the People by 2020” 2. Intermediate Level Health Workers
Characterized by partnership and empowerment General medical practitioners or their assistants.
of the people that shall permeate as the core E.g. Public Health Nurse, Rural Sanitary
strategy in the effective provision of essential Inspectors and Midwiwes, Rural Health
health services that are community- based, Physician
accessible, acceptable, and sustainable at a
cost, which the community and the government Levels of Health Care and Health Referral System
can afford.
1. Primary Level of care
Elements/Components of PHC Devolved to the cities and municipalities
Health care provided by center physicians,
E Ducation for health public health nurses, rural health midwiwes,
barangay health workers, traditional healers
L ocally Endemic and Communicable Disease
Control and Treatment Examples
E xpanded Program on Immunization Barangay Health Stations
M Aternal and Child Health and Family
Planning
Rural Health Unit
Community Hospitals
E Ssential Drugs Health Centers
Puericulture Center
N Utrition
T Reatment (Medical and Emergency Care, 2. Secondary Level of Care
Non Communicable Diseases and Mental
Health) Secondary care is given by physicians with
S Anitation of the Environment basic health training
Serves as a referral center for the primary
health facilities
Four Cornerstones/Pillars in Primary Health Care Capable of performing minor surgeries and
perform some simple laboratory examinations
Active community participation
Intra and inter-sectoral linkages Examples
Use of appropriate technology Emergency/District Hospitals
Support mechanism made available Provincial/City Health Services
Provincial/City Hospitals
@RNurseGuides
 3. Tertiary Level of Care Examples
Tertiary care is rendered by specialists in health Mental Health
facilities Crutch Walking
Referral center for the secondary care facilities Physical Therapy
Complicated cases and intensive care requires
tertiary care
Examples
Regional Health Services
Regional Medical Centers and Training Hospitals
National Health Services
Medical Centers
Teaching and Training Hospitals

Levels of Prevention
Primary Prevention
Focuses on health promotion and disease
prevention
Examples
Immunization
Promotion of Healthy Lifestyle (Proper Diet &
Exercise)
Secondary Prevention
Focuses on early detection of disease and
prompt treatment for individual experiencing
health problems
Examples
Breast-Self Examination
Diagnostic Test (AFB test)
Cancer Signs & Symptoms (CAUTION US)
Tertiary Prevention
Rehabilitation (prevent further disability)
Restore client’s optimum level of functioning

@RNurseGuides
COMMUNITY Constructing a Plan of Action
Choosing from among the possible courses of
HEALTH NURSING PROCESS action
Selecting the appropriate types of nursing
1. Assessment intervention
This provides: Identifying appropriate and available resources
An estimate of the degree to which a family, Developing an Operational Plan
group or community is achieving the level of
health possible for them Establish priorities, phase, and coordinate
Identifies specific deficiencies or guidance needed activities
Estimates the possible effects of nursing Development of evaluation parameters is done
interventions in the planning stage
Health Deficit 3. Implementation
A gap between actual and achievable health Involves various nursing interventions which
status have been determined by the goals/objectives
Failure in health maintenance that have been previously set
Already developed the disease or disability, Carrying out of nursing procedures
developmental lag. Documentation is done at this phase
Health Threat
Condition that promote disease or injury and
4. Evaluation
prevent people from realizing their health Three Classic Frameworks
potential Structural elements
Foreseeable Crisis Process elements
Anticipated periods of unusual demand on the Outcome elements
individual/family in terms of resources and
adjustment
Wellness Potential
This refers to states of wellness and the
likelihood for health maintenance or improvement
to occur depending on the desire of the family
2. Planning
Goal Setting
Initial step
Declaration of purpose/ intent that gives essential
direction to action
@RNurseGuides
MANAGEMENT FUNCTIONS OF THE Evaluating
COMMUNITY HEALTH NURSE Involves upon actions to determine their
effectiveness in order to make decisions
Planning regarding future action
Includes assisting the organization in Documenting the progress by comparing
establishing a vision for the future achievements against a performance standard
Deciding what must be done and what the
organization wants to achieve

Organizing
Helps to determine how a manager implements
planning to achieve the stated goals
Major concerns
Analysis of the systems
Analysis of functions
Assigning job responsibilities
Implementation
Directing
Includes conveying to the workers what has
occurred in the planning and organizing phases

Coordinating
Linking people on the health care team together
to function in such a way that objectives are
achieved
Controlling
Process that measures and corrects the activities
of the people and establishes standards so that
objectives are met
Step
Establishing standards
Measuring performance criteria
Correcting deviations from normal
@RNurseGuides
NURSING Identify a designated referral laboratory when
PROCEDURES needed
6. Referral System
CLINIC VISIT Refer the patient if he needs further
Standard Procedures management following the two-way referral
system
1. Registration/Admission
Accompany the patient when an emergency
Greet the client and establish rapport referral is needed
Prepare family record (New Client)
Retrieve record (Old Client) 7. Prescription/Dispensing
Elicit and record the client’s chief complaint
Give proper instruction on drug intake
and clinical history
Perform physical exam on the client 8 . Health Education
2. Waiting time Conduct one-on-one counseling with the
patient
Give Priority numbers to clients Reinforce health education and counseling
Implement “first come, first served” policy messages
except for emergency cases Give appointments for the next visit
3. Triaging BLOOD PRESSURE MEASUREMENT
Manage program-based cases 1. Preparatory Phase
Manage according to Protocols Introduce self to client
Refer all non-program based cases to the Make sure the client is relaxed and has rested
for 5 minutes
physician Client should not have smoked or ingested
Provide first-aid treatment to emergency cases caffeine within 30 minutes before BP
measurement
4. Clinical Evaluation Explain the procedure
Assist to seated or supine position
Validate clinical history and physical exam
Nurse arrives at the evidence-based diagnosis 2. Applying the BP cuff and stethoscope
and provides rational treatment based on DOH Bare client’s arm
programs Apply cuff around the upper arm 2-3 cm
Inform the client on the nature of the illness, above the brachial artery
appropriate treatment and prevention and control Apply cuff snugly with no creases
Keep the manometer at eye level
measures Keep arm level with his/her heart by placing
5. Laboratory and other Diagnostic it on a table or a chair arm or by supporting
it with examiner’s hand.
Examinations
@RNurseGuides
If the client is in recumbent position, rest arm at
his/her side
Palpate brachial pulse correctly just below
or slightly medial to the antecubital area
3. Obtaining the BP Reading by using
Palpatory Method
While the branchial or radial pulse is located and
palpated, close pressure bulb and inflate cuff
until pulse disappears
Note point at which pulse disappears (palpated
systolic BP)
Deflate cuff fully
Wait for 1-2 minutes before inflating cuff again
4. Obtaining the BP by Auscultation
Place earpieces of stethoscope in ears and head
(diaphragm) of stethoscope over the branchial
pulse
Use the bell side of the stethoscope; however,
for obese persons, use diaphragm
Watching the manometer, inflate the cuff rapidly
by pumping the bulb until it reaches 30mmHg
above the palpated SBP
Deflate the cuff slowly at a rate 2 to 3 mmHg
per beat
While the cuff is deflating, listen for pulse
sounds.
1st Clear tapping sound (Korotkoff Phase
I: Systolic BP)
Disappearance of sound (Korotkoff Phase
V: Diastolic BP
5 . Recording of BP and other Guidelines
For every visit, take the mean of 2 reading,
obtained at last 2 minutes apart
If first visit, repeat procedure with other arm.
Subsequent BP readings should be performed
on the arm, with a higher BP reading
@RNurseGuides
HOME
VISIT P olicy of a Specific agency

Professional family-nurse contact O ther health agencies involved

Allow the health worker to assess the home and
family situations in order to provide the P ast services given to family

A
necessary nursing care and health related
activities bility to recognize own needs

PRINCIPLES STEPS IN CONDUCTING HOME VISITS

Home visit must have a purpose or objective 1. Greet the patient and introduce self
Planning should: 2. State the purpose of visit
Make use of all available information 3. Observe the patient and determine health
Involve the individual and family needs
Give priority to the essential needs 4. Put the bag in a convenient place then
proceed to perform the bag technique
PURPOSES 5. Perform the nursing care needed and give
health teachings
To give nursing care to the clients 6. Record all important data, observation, and
To assess living conditions of the patient and his
family care rendered
To give health teaching regarding the prevention 7. Make appointment for a return visit
and control of diseases
To establish close relationship between health
agencies and public
To make use of inter referral system

FACTORS INFLUENCING
FREQUENCY OF HOME VISITS
NAPOPA
N eeds of the (most important)

A cceptance of the family 2nd most

important
@RNurseGuides
 BAG
TECHNIQUE
Important Points to Consider
in the Use of the Bag
The bag used:
Contain all the necessary articles, supplies,
and
A tool by which the nurse will enable her to: Equipment that will be used to answer
Perform a nursing procedure with ease and emergency needs
deftness Be cleaned very often, the supplies replaced,
Save time and effort and ready for use any time
Be well protected from contact with any article
Public Health Bag
An essential and indispensable equipment of a
public health nurse which she has to carry
EPIDEMIOLOGY
along during her home visits Study of the occurrence and distribution of
health conditions such as disease, death,
deformities or disabilities on human
Principles of bag Technique populations.
Minimize if not prevent the spread of any The nurse measures the frequency and
infection distribution of health conditions using Vital
Saves time and effort statistics.
This should show the effectiveness of total care
given to an individual or family Important Concepts related to
Can be performed in a variety of ways Epidemiology:
depending on the agency’s policy or home
situation or as long as principles of avoiding 1. The Multiple Causation Theory (the wheel, the
transfer of infection is always observed web, the ecologic triad)
2. Natural History of Disease
A. Pre-pathogenesis or susceptibility
B. Pathogenesis which has 3 substages:
a. Pre-symptomatic
b. Discernible lesions
c. Advanced Disease
3. Level of Prevention of Health Problems
4. Concept of Causality and Association
The Epidemiological Approach
1. Descriptive Epidemiology
Concerned with disease distribution and
frequency
@RNurseGuides
 2. Analytical Epidemiology
Attempts to analyze causes or determinants of
disease through hypothesis testing
3. Intervention or Experimental
Epidemiology
Answers questions about the effectiveness of new
methods for controlling diseases or for improving
underling conditions
4. Evaluation Epidemiology
Attempts to measure the effectiveness of different
health services and programs

@RNurseGuides
VITAL Crude Birth Rate
STATISTICS A measure of one characteristic of the natural
growth or increase of population
Refers to the systematic study of vital events such Crude Death Rate
as births, illnesses, marriages, divorces, separation
and deaths A measure of one mortality from all causes
Morbidity (Disease) and Mortality (Death) which may result in a decrease of population
Indicate the state of health of a community Maternal Mortality Rate
and the success of failure og health work Measures the risk of dying from causes related
to pregnancy, childbirth and puerperium
Uses of Vital Statistics Index of the obstetrical care needed and
Indices of the health and illness status of a received by women in a community
community Fetal Death Rate
Serves as bases for planning, implementing,
monitoring and evaluating CHN programs and Measures pregnancy wastage
services Death of the product of conception occurs prior
to its complete expulsion, irrespective of
Sources of Data duration of pregnancy
Population census
Neonatal Death Rate
Registration of Vital Data
Health survey Measures the risk of dying 1st month
Studies and researches
Attack Rate
Comparison between Rates and Rations More accurate measure of the risk of exposure
Rate Case Fatality Ratio
Shown the relationship between vital event and
those persons exposed to the occurrence of said Index of a killing power of a disease and is
event within a given area and during a specified influenced by incomplete reporting and poor
unit of time morbidity data
Ratio Incidence Rate
is used to describe the relationship between two Measures the frequency of occurrence of the
numerical quantities or measure of events without phenomenon during a given period of time
taking particular considerations to the time or place
New cases
Infant Mortality Rate Prevalence Rate
Good index of the general health condition of a Measures the proportion of population which
community exhibits a particular disease at a particular time
New and old cases
FHSIS
FIELD HEALTH SERVICES AND
INFORMATION SYSTEM
Objectives
To provide summary of data on health services
delivery
To provide data that can be used for program
monitoring and evaluation purposes
To provide a standardized, facility level
database which can be accessed for more in-
depth studies
To ensure that the data are useful and accurate
To minimize the recording and reporting burden
at the service delivery level
Components
Family Treatment Record
Fundamental building block of FHSIS
Target Client List
Second building block of FHSIS
Reporting Forms
Only mechanism through which data are
routinely transmitted from one facility to
another
Prepared and submitted either monthly or
quarterly
Output Reports
Objective in designing the output formats: Make
the reports useful for monitoring or management
purposes

@RNurseGuides
PUBLIC HEALTH
PROGRAMS
FAMILY HEALTH
MATERNAL HEALTH PROGRAM
1. Antenatal Registration
PRENATAL VISITS PERIOD OF PREGNANCY
1st Visit As early in pregnancy as possible
2nd Visit During 2nd trimester
3rd Visit During 3rd trimester
Every 2 weeks After 8th month of pregnancy until delivery

2. Tetenus Toxoid Immunization

VACCINES INTERVAL PROTECTION DURATION
TT1 As early as possible during pregnancy - -
TT2 After 4 weeks 80% 3 years
TT3 After 6 months 95% 5 years
TT4 After 1 year 99% 10 years
TT5 After 1 year 99% Lifetime

3. Micronutrient Supplementation
VITAMINS DOSE SCHEDULE
Vitamin A 10,000 IU Twice a week starting on the 4th month of pregnancy
Daily (Starting 5th month of pregnancy up 2 months
Iron/Folic acid 60mg/400ug tablet postpartum)
4. Treatment of Diseases and Other Conditions Schedule when to return for consultation for
5. Clean and Safe Delivery post-partum visits
6. Health Teachings: 1st Visit – 1st week postpartum preferably 3-5 days
Birth registration 2nd Visit – 6 weeks postpartum
Importance of breastfeeding 7. Support to Breastfeeding
Newborn screening between 48 hours up 2 8. Family Planning Counseling
weeks after birth Proper spacing of birth (3 to 5 years interval)
@RNurseGuides
 FAMILY Advantages
PLANNING Permanent method of contraception
Does not interfere with sex
Overall Goal: To provide universal access to Results in increased sexual enjoyment
family planning information and services No effect on breastfeeding
wherever and whenever these are needed No known long term side effects or health risks
AIMS TO REDUCE Disadvantages
Infant deaths Infection or bleeding
Neonatal deaths Increase risk for ectopic pregnancy
Under-five deaths Requires physical examination
Maternal deaths Reversal surgery is difficult
OBJECTIVES Do not protect against sexually transmitted
diseases
Addresses the need to help couples and
individuals achieved their desired family size
within context of responsible parenthood
2. MALE STERILIZATION
Also known as Vasectomy
Ensure that quality FP services are available in Permanent method wherein the vas deferens
DOH retained hospitals, LGU managed health is tied and cut or blocked through a small
facilities, NGOs and private sector opening in the scrotal skin

FAMILY PLANNNG METHODS

1. FEMALE STERILIZATION
Also known as Bilateral Tubal Ligation
Safe and simple surgical procedure which
provides permanent contraception for women
who do not want more children
Involves cutting or blocking of two fallopian
tubes.

Advantages
Very effective in 3 months after the procedure
Permanent, safe, simple and easy to perform
Can be performed in a clinic
Person will not lose his sexual ability and
ejaculation
@RNurseGuides
Disadvantages May decrease sensation, making sex less
May be uncomfortable due to slight pain and enjoyable
swelling 2-3 days after the procedure
Reversibility is difficult and expensive 5. INJECTABLES
Bleeding may result in hematoma formation Contain synthetic hormone, progestin that
suppresses ovulation, thickens cervical mucus
3. PILL and changes uterine lining.
Contains hormones – estrogen and progesterone Advantages
Advantages Reversible
No need for daily intake
Safe as proven through extensive studies Does not interfere with sexual intercourse
Convenient and easy to use Has no estrogen-related side effects
Reduces gynecologic symptoms such as painful
menses and endometriosis
Does not interfere with sexual intercourse
6. LACTATING AMENORRHEA METHOD/LAM
Temporary introductory postpartum method of
Disadvantages postponing pregnancy based on physiological
infertility experienced by Breastfeeding women
Often not used correctly and consistently,
lowering its effectiveness Advantages
Has side effects such as nausea, dizziness or LAM is universally available to all postpartum
breast tenderness breastfeeding women
Can suppress lactation No other FP commodities are required
It contributes to improve maternal and child
4. MALE CONDOM health and nutrition
Thin sheath of latex rubber made to fit on a
man’s erect penis to prevent the passage of Disadvantages
sperm cells and sexually transmitted disease Short term FP method which is effective only
into the vagina for a maximum of 6 months
Advantages The effectiveness of LAM may decrease if a
mother and child are separated for extended
Safe and has no hormonal effect periods
Protects against microorganisms during Full or nearly full BF may be difficult to
intercourse maintain up to 6 months
Encourages male participation in family planning
7. MUCUS/BILLING METHODS
Disadvantages
Abstaining from sexual intercourse during
May cause allergy for people who are sensitive fertile days prevents pregnancy
to latex or lubricant
@RNurseGuides
Advantages No health related side effects associated
Can be used by any woman of reproductive Incurs very little or no cost
age as long as she is not suffering from an Immediately reversible
unusual disease or condition that results in Promote male partner involvement in FP
extraordinary vaginal discharge
Disadvantages
Disadvantages Needs cooperation of the husband
Cannot be used by woman with medical Can become unreliable for women who have
conditions that would make pregnancy conditions that cause abnormal cervical
dangerous secretions
8. BASAL BODY TEMPARATURE
Identifies the fertile and infertile period of a
woman’s cycle by daily taking and recording of
the rise in body temperature during and after
ovulation.
Before ovulation:
Temperature decreases 0.5 °F
During ovulation: 11. STANDARD DAYS METHOD
Temperature increases 1.0°F Couples use color coded cycle beads to mark
the fertile and infertile days of the menstrual
9.SYMPTO-THERMAL METHOD cycle
Identifies the fertile and infertile days of the
menstrual cycle as determined through a Advantages
combination of observations made on the cervical No health related side effects associated with
mucus, basal body temperature recording and its use
other signs of ovulation Increases self-awareness and knowledge of
human reproduction
10. TWO DAY METHOD Can be used either to avoid or achieve
Simple fertility awareness based method of FP pregnancy
that involves: Enhances self-discipline, mutual respect
Can be integrated in health and family planning
Cervical secretions as an indicator of fertility services
Women checking the presence of secretions
everyday Disadvantages
Advantages Cannot be used by women who usually have
Can be used by women with any cycle length menstrual cycle between 26 and 32 days long
@RNurseGuides
MISCONCEPTIONS ABOUT
FAMILY PLANNING
Causes abortion
Will render couples sterile
Will result to loss of sexual desire

ROLES OF PUBLIC HEALTH NURSE

ON FP PROGRAM
Provide counseling
Provide packages of health services
Ensure the availability of FP supplies and logistics

@RNurseGuides
CHILD Outcome
HEALTH PROGRAMS To improve exclusive and extended breastfeeding
and complementary feeding
Goal Key Messages on Infant and
To reduce morbidity and mortality rates (for children
0-9yrs) Young Child Feeding
Programs IInitiate breastfeeding within 1hour after birth
Infant and Young Child Feeding Exclusive for the first 6 months of life
Newborn Screening Complemented at 6 months with appropriate
Expanded Program on Immunization food
Management of Childhood illnesses
Micronutrient Supplementation Extend Breastfeeding up to 2 years and beyond
Dental health Exclusive breastfeeding
Early Child Development means giving a baby only breast milk, and no
Child Health Injuries other liquids or solids, not even water.

INFANT & YOUNG CHILD Complementary feeding

fEEDING after six months of age all babies require other
foods to complement breast milk.
Complementary foods should be:
Timely
Adequate
Safe
Properly fed

When not to breastfeed:

AIDS
Goal
Reduce child mortality rate by 2/3 by 2015
Objective
To improve health and nutrition status of infants
and young children

@RNurseGuides
LAWS 4. Expanded Breastfeeding
Act of 2010
THAT PROTECT INFANT AND
YOUNG CHILD FEEDING Exclusive breastfeeding for the first 6 months.

1. Milk Code
EO 51
Products covered by Milk Code consist of breast
milk substitutes, including infant formula; other milk
products, food and beverages, including bottle-fed
complementary foods.

2. Rooming-In and Breastfeeding Act

of 1992
RA 7600
To promote room-in and to encourage. Protect and
support the practice of breastfeeding.
Compliance to the law is ensured through one of
the 10 steps to Mother Baby Friendly Hospitals
wherein the mother and the baby should be
. for 24 hours.
together
3. Food Fortification Law
RA 8976
The law requires a mandatory food fortification of
staple foods – rice, flour, edible oil and sugar and
voluntary food fortification of processed food or
food products

@RNurseGuides
EPI LAW
(PD 996) Diarrhea
Vomiting

PRINCIPLES: ABSOLUTE CONTRAINDICATIONS

It is safe and immunologically effective to DPT 2 or DPT 3 to a child who has had
administer all EPI vaccines on the same day at convulsions or shock within 3 days the previous
different sites of the body dose.
Measles Vaccine should be given as soon as Patients with neurologic disease should not be
the child is 9 months old. If the child is living in given vaccines containing whole cell pertussis
an endemic area, give the vaccine as early as Live vaccines like BCG vaccine must not be given
6 months. If given at 9 months = 85% to individuals who are immunosuppressed due to
protection; if given at one year and older = a malignant disease.
95%
Vaccine schedule should not be restated
Giving doses less than the recommended
interval may lessen the antibody response
No extra must be given to children/ mother
who missed a dose of DPT/Hepa-B/OPV/TT
Strictly follow the principle of never, ever
reconstituting the freeze dried vaccines other
than the diluents supplied with the
One Syringe, One Needle per child during
vaccination

RA 10152 (2011)
An act providing for mandatory basic immunization
services for infants and children.
FALSE CONTRAINDICATIONS
Malnutrition
Low Grade Fever
Mild Respiratory Infections
Cough
@RNurseGuides
EPI
VACCINE MINIMUM AGE AT 1ST DOSE DOSES INTERVAL
BCG At birth 1
PENTAVALENT 6 weeks 3 4 weeks
OPV 6 weeks 3 4 weeks
HEPA B At birth 1 6 weeks from 1st dose
MEASLES 9 months 1
MMR 12 months 1
IPV 14 weeks 1

VACCINE DOSAGE ROUTE SITE

BCG 0.05 mL ID Right deltoid region

DPT 0.5 mL IM Upper outer portion of thigh (Vastus lateralis)
OPV 2-3 drops ORAL Mouth
HEPA B 0.5 mL IM Upper outer portion of thigh (Vastus lateralis)
MEASLES 0.5 mL SQ Outer portion of upper arm

VACCINE

@RNurseGuides
NUTRITION Objectives
To increase the proportion of orally fit children
PROGRAM under 6 years old 80% by 2010
To control oral health risk among the young
Goal people
improve quality of life of Filipinos through better To improve the oral health conditions of
nutrition, improved health, and increased pregnant women by 20% and older persons by
productivity 10% every year until
2010
Common Nutritional Deficiencies CLASSIFIACTION OF ORAL INTERVENTIONS
Vitamin A Promotive
Iron Service Health education
Iodine
Oral examination
Preventive
Programs and Projects Treatment Oral hygiene
Pit & Fissure Sealant
Micronutrient Supplementation Program
Food Fortification Fluoride Utilization Program
Essential maternal and Child Health Service
Package Curative Permanent Filling Gum
Treatment
Nutrition Information, Communication, and Treatment
Education Atraumatic Restorative
Treatment
Home, School and Community Food Production Temporary Filling
Food Assistance
Extraction
Livelihood Assistance
Treatment Post Extraction

ORAL
HEALTH PROGRAMS
Drainage of Localized Oral
abscesses

Goal
Reduce the prevalence rate of dental caries and
periodontal diseases from 92% in 1998 to 85% and
from 78% in 1998 to 60% by 2010 among general
population

@RNurseGuides
PHILIPPINE
REPRODUCTIVE HEALTH
Goal
Better Quality Life among Filipinos

Main Objectives
Reducing Maternal Mortality Rate
Reducing Child Mortality
Halting and Reversing spread of HIV/AIDS
Increasing access to reproductive health
information and services

Elements
Family Planning
Maternal and Child Health Nutrition Prevention
and Management of Reproductive Tract Infection
Adolescent Reproductive Health
Prevention and Management of Abortion and its
Complications
Prevention and Management of Breast and
Reproductive Tract Cancers and other
Gynecological Conditions
Education and Counselling on Sexuality and
Sexual Health
Men’s Reproductive Health and Involvement
Violence against Women and Children
Prevention and Management of Infertility and
Sexual Dysfunction

@RNurseGuides
ENVIRONMENTAL
HEALTH AND SANITATION Outreach must not be more than 250 meters
from the farthest user
Environmental Health Yield or discharge is generally from 40 to 140
It is a branch of public health that deals with the liters per minute
study of preventing illness by managing the Generally adaptable for rural areas where the
environment and changing people’s behavior to houses are thinly scattered
reduce exposure to biological and non-biological LEVEL II (Communal Faucet System or
agents of disease or injury Stand –posts)
Health and Sanitation Laws System composed of a source of reservoir, a
piped distribution network and communal
PD 856 – Sanitation Code of the Philippines faucets
RA 6969 – toxic Substances and hazardous and Located not more than 25 meters from the
Nuclear Waste Control Act of 1990 farthest house
Designed to deliver 40-80 liters of water per
RA 8749 – Clean Air Act of 1999 capital per day
RA 9003 – Ecological Solid Waste Management Average households: 100
Act of 2000 One faucet per 4 to 6 households
Suitable for rural areas where houses are
RA 9275 – Clean Water Act 2004 clustered densely to justify a simple-piped
system
ENVIRONMENTAL
SANITATION LEVEL III (Waterworks System or
Individual House Connections)
Study of all factors in man’s physical environment, NAWASA, Maynilad
which may exercise a deleterious effect on his
health well - being and survival 2. Unapproved type of water facility
The Development of Health through the Open drug wells
Environment and Occupation Health Office Unimproved springs
(EOHO) has set some policies on the following Wells that need priming
areas:
1. Approved Types of Water Supply Facilities 3.Access to sage and potable drinking water
LEVEL 1 (Point Source) 4. Water quality and monitoring surveillance
Protect well or developed spring with an outlet Disinfection of water supply sources is
but without a distribution system required on the following:
Serves around 15 to 25 households
@RNurseGuides
 Newly constructed water supply facilities
Water supply facility that has been
repaired/improved

5. Waterworks/water system and well

construction

Well sites shall require the prior approval of

the Secretary of Health or his duly authorized
representative
Well construction shall comply with sanitary
requirements of the Department of Health
Water supply system shall supply safe and
potable water in adequate quantity

@RNurseGuides
FOOD
SANITATION PROGRAM
Always buy pasteurized mild and fruit juices
Wash vegetables well if to be eaten raw such
Food Establishments shall be appraised as lettuce, cucumber, tomatoes & carrots
as to the following sanitary conditions: Wash hands kitchen utensils before and after
Inspection/approval of all food source, containers, preparing foods
transport vehicles Sweep kitchen floors to remove food droppings
Compliance to sanitary permit requirements for all
food establishment
Provision of updated Health certificate for food Right Cooking
handlers, cooks and cook helpers Cook food thoroughly (temperature on all parts
of the food should reach 70 degrees
DOH’s Administrative Order no.1 centigrade
2006 requires all laboratories to use Formalin Eat cooked food immediately
Ether Concentration Technique (FECT) instead of
the direct fecal smear in the analysis of stools of Wash hands thoroughly before and after eating
food handlers.
Right Storage
Food Establishment shall be rated as follows:
All cooked food should be left at room
CLASS A – Excellent temperature for not more than two hours
CLASS B – Very Satisfactory Use tightly sealed containers for storing food
CLASS C – Satisfactory Store food under hot conditions (at least or
above 60°C) or in cold conditions (below or
Four Rights in Food Safety equal to 10°C) if you can plan to store it for
Right Source more than 4 to 5 hours
Always buy fresh meat, fish fruits & vegetables Do not overburden the refrigerator by filing it
with too large quantities of warm food
Look at the expiry dates of processed food
Food should be reheated to at least 70
Avoid buying canned goods with dents, bulges, degrees centigrade
deformation, broken seals and improper seams
Rule in Food Safety: “When in doubt, throw it
Boil water for at least 2 minutes (running out!”
boiling)
Right Preparation
Avoid contact between raw food and cooked
food @RNurseGuides
SENTRONG SIGLA (SS) Scope and structure of the SS
CERTIFICATION Quality Standards (Level I)
Primary function:
Goal Provide basic public health services
Quality Health Care, Services, and Facilities Facility and System Standards
Ensure that the health facility is appropriately
Level and Scope of Certification equipped with sufficient manpower, adequate
1. Basic SS Cerfitication logistics and organized procedures to
efficiently and effectively promote core public
Minimum input, process and output standards for health programs
integrated public health services for 4 core
programs, facility system, regulatory functions and
basic curative services Integrated Public Health Function Standards

2. Specialty Awards Ensure that the health facility and staff

promote public health programs and prevent
Second level quality standards for selected 4 core and control public health problems through
public health programs direct patient/client care

3. Awards for Excellence Basic Curative Function Standards

Highest level quality standards for maintaining Ensure that the health facility and staff provide
Level 2 standards for the 4 core public health basic curative services that consist of primary
programs and level 2-facility system for at least 3 level outpatient and emergency care
consecutive years.
Regulatory Function Standards
The SS Certification validity of certification is
every two years. Ensure that the health facility and staff support
and provide an environment to prevent, reduce
Facilities which did not progress to a and control risks and hazards to the community
level of certification but maintained
current certification are: Scope and Structure of SS Quality
Standards (Level II)
Given stickers to confirm the renewal of the
validity of seal 1. Local Health System Development
No other incentives given for mere renewal of SS Goal:
status To strengthen local health system development
Facilities that slide back; seal will not 2. Integrated Public Health Functions
be removed but not issued an SS covering 5 core public health programs:
sticker Integrated Women’s Health
Child Care
@RNurseGuides
Prevention and Control of Infectious Disease
Integrated Prevention and Control of Lifestyle
Related Diseases
Environmental Health

@RNurseGuides
10 HERBAL MEDICINES PREPARATION:
BY DOH Clean the leaves thoroughly and chop
Measure two cups of water and boil on a low
fire for 15 minutes
General guidelines for the use
Use the table on the amount of leaves to be
of medicinal plants used
Be sure that the right king of plant is used LEAVES
according to the intended purpose
AGE FRESH DRIED
Use the plant part suggested
Use according to the dosage and direction Adult 6 tbsp. 4 tbsp.
recommended 7- 12 y/o 3 tbsp. 2 tbsp.
Use only one kind of medicinal plant at a time 2 – 6 y/o 1 1⁄2 tbsp. 1 tbsp.
Stop the use of the plant if there is any
untoward reaction or if side effects occur DOSAGE:
If there are no signs of improvement after two Divide the solution into three parts. Drink one part
or three administration of the drug, consult a each in the morning, noon and night For fever,
physician drink each part every four hours
In boiling the plants, use enamel were or clay
pots, not aluminum ware. Clean the pots very
well before and after boiling the plant YERBA BUENA
Use only the prescribed part of the plant ( Mentha cordifolia Opiz ex Fresen )
Avoid the use of insecticides For pains of the body

HERBAL PLANTS
LAGUNDI ( Vitex negundo )
For cough and asthma

PREPARATIONS:
Cleanse thoroughly and chop the leaves, then
boil in two glasses of water for 15 minutes.
@RNurseGuides
 Do not cover the pot; allow to cool and strain
For adults, six tbsp. of fresh leaves or four tbsp. TSAANG GUBAT
of dried leaves should be used ( Ehretia microphylla Lam )
For patients 7-12 years old, use half the adult For stomachache
dose
DOSAGE:
Divide the boiled solution into three parts and
drink on part each in the morning, afternoon
and evening, squeeze the fresh leaves and
place on the painful part

SAMBONG
( Blumea balsamifera )
For swelling. Diuresis, Anti-urolithiasis
PREPARATIONS:
Cleanse thoroughly and chop leaves and boil
in two glasses of water for 15 minutes
Do not cover the pot; keep cooking and strain
For adults, six tbsp. of fresh leaves or four
tbsp. of dried leaves should be used
For patients 7-12 years old, use half the adult
dose
DOSAGE:
Divide in two parts and drink one part every
PREPARATIONS: four hours
Cleanse thoroughly and chop leaves, boil in
two glasses of water for 15 minutes NIYUG-NIYUGAN
Do not cover the pot; keep boiling and strain ( Quisqualis indica )
For adults, use six tbsp. fresh leaves or four For ascaris
tbsp. dried leaves
DOSAGE:
Divide the boiled solution into three parts and
drink one part each in the morning, afternoon
and evening, Squeeze the fresh leaves and
place on the painful part.
@RNurseGuides
PREPARATIONS:
Use newly-opened, mature and dried nuts
AKAPULKO ( Cassia alata )
Infected skin, skin irritation and scabies
ADMINISTRATION:
Eat the seeds two hours after supper
DOSAGE:
Adult 8-10 seeds
7-12 y/o 6-7 seeds
6-8 y/o 5-6 seeds
4-5 y/o 4-5 seeds PREPARATION:
Squeeze enough leaves
BAYABAS ( Psidium guajava ) ADMINISTRATION:
For cleansing or wounds, mouth infections and Apply the juice of the leaves on affected parts
swollen gums twice a day

ULASIMANG BATO
( Peperomia pellucida )
Lower uric skin; for arthritis or gout

PREPARATIONS:
Clean thoroughly and chop leaves
Boil two glasses of leaves in four glasses of PREPARATIONS:
water on a low fire
Salad: Clean leaves thoroughly, Eat three times
ADMINISTRATION: a day with meals

Clean wounds with the solution two times a Decoction: Clean leaves thoroughly and boil 1
day. To use as a mouthwash, use a lukewarm 1⁄2 glasses of leaves in two glasses of water
solution for 15 minutes. Divide into three parts and take
three times a day.
@RNurseGuides
BAWANG ( Allium sativum ) PREPARATION:
Clean the leaves thoroughly and chop. Measure
To lower cholesterol level two cups of leaves in two glasses of water,
Boil for 15 minutes on low fire. Drink 1⁄2 glass
three times a day before eating

PREPARATION:
Saute or boil; may be infused (five minutes); be
mixed with vinegar
ADMINISTRATION AND DOSAGE:
Eat two clove of garlic with meals three times a
day

AMPALAYA
( Momordica charantia )
For diabetes mellitus (mild-insulin dependent)

@RNurseGuides
HEALTH EMERGENCY PREPAREDNESS It should concentrate on process and people
AND RESPONSE PROGRAM rather than documentation
Main objective:
Goal Decrease mortality, morbidity and prevent
disability
Promoting health emergency preparedness among
the general public and strengthening the health HAZARDS
sector capability and response to emergencies
disaster. Any phenomenon, which has the potential to
cause disruption or damage to humans and their
Legal Mandate environment
Presidential Decree No 1566 (1978) General Principles:
First priority: protection of the people who
Strengthening the Philippine Disaster Control are at risk
Capability and Establishing the National Program on
Community Disaster Preparedness Second priority: protection of critical
resources and systems on which communities
Republic Act No 7160 (Local Gov’t Code depend
of 1991) Disaster management must be an integral
Transfer of responsibilities from the national to the function of national development plans and
local government units (LGUs) objectives
Disaster management relies upon an
Disaster and Health Emergency Management understanding of hazard risks
DISASTER Capabilities must be developed prior to the
impact of a hazard
It a serious disruption of the functioning of a
society, causing widespread human, material or Disaster Management must be based upon
environmental losses which exceed the ability of interdisciplinary collaboration
the affected society to cope, using only its own
resources. Major Risks to be Considered
Classification of Disaster according to 1. Natural risks
its cause E.g. flood, earthquake, cyclones
1. Natural Disaster 2. Technological risks
2. Human generated/Man-made
Chemical, radiological, other events caused by
EMERGENCY the failure of the socio-technical systems
Requires an immediate response 3 . Epidemics
It is the responsibility of all 4. Societal risks
It should be woven into the community and Caused by social exclusion, extreme poverty
administrative levels and group violence.
@RNurseGuides
NATIONAL VOLUNTARY Requirements before donating
BLOOD SERVICES PROGRAM Weigh more than 45 kg (100 lbs) for 250 ml of
donated blood; 50kg (110 lbs) for 450 ml of
RA 7719 – Blood Services Act 1994 donated blood
Objectives Be in good health
To promote and encourage voluntary blood Be aged 16-65 years (for ages 16 & 17, parental
Objectives
donation by the citizenry and to instill public consent is need)
consciousness of the principle that blood donation Systolic BP =90-160 mm Hg
is a humanitarian act. Diastolic =60-100 mm Hg
To provide adequate, safe, affordable and Hemoglobin at least 12.5g/dL
equitable distribution of supply of blood and blood
products Contraindications
To mobilize all sectors of the community to Diabetes
participate in mechanisms for voluntary and non- Cancer
profit collection of blood
Hyperthyroidism
Vision Cardiovascular disease
Severe psychiatric disorder
Envision a network of modernized national and Epilepsy/convulsions
regional blood centers operating on a fully Severe bronchitis
voluntary, non- remunerated blood donation AIDS/ Syphilis and other STI (past & present)
system Malaria
Kidney and Liver disease
Mission Prolonged bleeding
Ensure adequate, safe and accessible blood supply Use of prohibited drugs
by:
Promoting voluntary blood donation
Blood extracted for Donation
Whole blood and red cell concentrates
Establishing new blood service facilities
Shelf-life to 5 weeks
Organizing association of blood donors and
training medical practitioners on national blood Plasma
use Can be stored frozen for 12 months
Considerations after blood donation:
Leave the adhesive dressing on your arm for
at least 3 hours but not more than twelve (12)
hours.
Bruising or discoloration may occur and will
disappear in a few days

@RNurseGuides
Avoid carrying heavy objects with your donating
arm
Do not smoke for the next 2 hours
Avoid alcohol intake for the next 12 hours
Eat regular meals and increase fluid intake following
your donation

@RNurseGuides
BOTIKA Submission of a barangay socio-economic
profile and health profile including a master list
NG BARANGAY of indigents, if available
Commitment form a licensed pharmacist to
Goal supervise Botika ng Barangay operations
To promote equity in health by ensuring the Identification and selection of at least 2
availability and accessibility of affordable safe and accredited Barangay Health Workers or
effective quality essential drugs to all, with priority Community Volunteer Health workers trained as
for marginalized, underserved, critical and hard to botika ng barangay Aides
reach areas. Availability of a botika ng barangay space

Objective
To rationalize the distribution of common drugs
and medicines among intended beneficiaries
To serve as mechanism for the DOH to
establish partnership with Local Government
Units (LGUs)
To optimize involvement of the Barangay Health
Workers addressing the health need of the
community

Criteria for Establishing a Botika

ng Barangay
Managed or operated by an established
community organization or cooperative which is
duly recognized as a
judicial body
Service or coverage area a barangay that is far
flung, depressed, and hard to reach area as
defined in the Magna Carta for public Health
Workers implementing Rules and Regulations
Community-sourced funds at least 1/3 of the
initial capital requirements
Local government unit/other government
officials-sourced funds at least 1/3 of the initial
capital requirement
@RNurseGuides
COMMUNITY ORGANIZING Process/Methods used in COPAR
PARTICIPATORY ACTION RESEARCH

COPAR
Progressive Cycle of Action Reflection Action
Begins with small, local and concrete issues
identified by the people and the evaluation and
reflection of and on the action taken by them
Definition Consciousness Raising
The strategy used by the health Resource
Development Program (HRDP) III in implementing Emphasis on learning that emerges from
primary health care delivery in depressed and concrete action and which enriches succeeding
undeserved communities for them to become action
self-reliant
It is collective, participatory, transformative, COPAR is participatory and mass-based
liberate, sustained & systematic process of Primarily towards and biased in favor of the
building people’s organizations by mobilizing poor, the powerless and the oppressed
and enhancing the capabilities and resources of
the people for the resolution of their issues and COPAR is group-oriented not leader-oriented
concerns towards effecting change in their
existing oppressive and exploitative conditions Leaders are identified, emerge and are tested
(National Rural CO conference, 1994) through action
Rather than appointed or selected by some
Importance external force or entity

Tool for community development & people

empowerment
Community Organizing
Prepares people/clients to eventually take over Continuous and sustained process of educating
the management of a development programs in the people let them understand and develop
the future their critical awareness of the existing
Maximizes community participation and conditions
involvement
PRINCIPLES Objectives
People, especially the most oppressed, To make the people aware of social realities
exploited and deprived sectors are open to towards the development of local initiative,
change, have the capacity to change, and are optimal use of human, technical and material
able to bring about change resources
Based on the interests of the poorest sectors To form structures that uphold the people’s
of society basic interests as oppressed and deprived
Should lead to self-reliant community and sections of the community and as people bound
society by the interest to serve the people
@RNurseGuides
Emphasis Conduct ocular observations, noting the
accessibility, geography , terrain, settlement
Members of the community work to solve their patterns and available physical resources
own problems
Direction is internal rather than external Networking with local government units
Development of the capacity to establish a (LGUs) NGO and other departments
project is more important than the project
There is consciousness-raising with regard to 2. Entry phase
the situation of health care delivery within the
total structure of society. Integration with community residents
Deepening Social Investigation
Information Dissemination
COPAR PROCESS Core Group (CG) Formation
1. Pre – Entry Phase
Done before going to the community Development of criteria for the selection
of CG members
Activities:
Community consultations/dialogues Respected member of the community
related to site selection Belongs to the poor sector of society
Must be responsible, committed and willing to
Setting of issues/considerations related work for social change and social
to site selection transformation
Development of criteria for site selection Must be willing to learn
Socio-economically depressed and Must be able to communicate; can express
underserved community with majority of the oneself in a group
population belonging to the poor sector Defining the roles/functions/tasks of the
Health services are inaccessible CG
Community is in poor health status Delivery of basic health services
The area must have relative peace and order Coordination/dialogue/consultation with other
Acceptance of the program by the community community organizations
Site selection Self-Awareness and Leadership Training
(SALT)
Preliminary Social Investigation (PSI)
Use of secondary data from various This will help each one discover his/her
potentials and talents and discover
government offices, particularly the Provincial opportunities for growth and
Health Office and / or RHU development of the entire community
Use of secondary data from other community
based health programs
Coordination with extension workers form
both GO and NGO
@RNurseGuides
3. Community Study/Diagnosis Initial identification and implementation of
phase/Research phase resource mobilization schemes
Selection of the research team 6. Sustenance & Strengthening Phase
Training on data collection methods and Formulation and ratification of constitution and
techniques by-laws
Planning for the actual data gathering Identification and development of secondary
Data Gathering leaders
Community Validation Formalizing and institutionalizing of linkages,
Presentation of Community Diagnosis and networks, and referral system
recommendation Setting up and institutionalizing financing
Prioritization of Community Needs/Problems scheme for the community health
for action program/activities
Development and implementation of viable
4. Community Organization & Capacity committees, management system and
Building Phase procedures
Community Meetings Continuing Education of community leaders,
Election and induction of CHO officers CHWs and CHO members and community
Development of management systems and residents
procedures Develop medium and long-term community and
Team building Activities /Action-Reflection- development plans
Action Session (ARAS)
Organization of the Working Committees 10 CRITICAL ACTIVITIES IN COPAR
Training of CHO officers/ Community Leaders
1. Integration
5. Community Action Phase Establishing rapport with the people in a
continuing effort to imbibe community life and
Organization and training of Community Health undergoing the same experience as the people
Workers (CHW) and sharing their hopes, aspirations and
Development of criteria for the selection of CHWs hardships towards building mutual trust and
Selection of CHWs cooperation
Training of CHWs 2. Social Investigation
Process of systematically learning and
Setting up linkages, networks, and referral analyzing the various structures and forces in
systems the community
Project implementation, Monitoring, and Objectives
Evaluation (PIME) of health services intervention Gather data on the geographic, economic,
schemes and community development projects political and socio-cultural situation of the
community
@RNurseGuides
 Identify the classes and sectors present in the 9. Reflection
community Analyzing the finished mass action, its good
and weak points identified
3. Planning
Determine the correct approach and method 10. Organization
of organizing This facilitates wider participation and
Provide a basis of planning and programming collective action on community problems
of organizing activities

4. Ground Working
Also termed as Agitation
This entails going around and motivating
people on a one-to-one basis to do
something about community issues.
5. Community Meeting
Ratification of what has been already decided
The meeting gives a sense of collective power
and confidence
6. Role play
This is means of acting out the meeting or the
activity that will take place between the people
and the group targeted by the mobilization

7. Social Mobilization
This refers to the activities undertaken by the
community through the people’s organization
to solve problems confronting the community
8. Evaluation
The process of discovering by the people the
way something has been accomplished, what
has been left out and what remains to be
done.

@RNurseGuides
PARTICIPATORY
ACTION RESEARCH
Active process where the expected beneficiaries of research are the main actors in the entire research
process
It is combination of education, research and action
Purpose is the empowerment of the people

Characteristics of Traditional and Participatory Action Research

TRADITIONAL PARTICIPATORY
Research has the purpose of identifying and Research seeks social transformation
meeting individual needs within existing social
system
Research problems are defined by the
Community problems or needs are defined by community members themselves who are viewed
experts or researchers external to the community as experts of their own reality
group and considered neutral or non-biased
Research problem is studied by the researchers Community group undertakes the investigation
who control the research process on research process from data collection to
analysis. External researcher work alongside the
community group

Recommendations for the community are based Community formulates recommendations and an
on researcher’s findings and analysis action plan based on research outcome

@RNurseGuides