NCM 104: COMMUNITY HEALTH NURSING (INDIVIDUAL AND FAMILY)

Module 8:

Ethical Considerations in Community Health Nursing

Public Health Laws

Module Content:

A. Magna Carta for Health Worker

B. Sanitation Code

C. Clean Air Act

D. Generic Act

E. National Health Insurance Act (PhilHealth)

F. National Blood Services Act

G. Laws on Notifiable Disease

H. Senior Citizen Laws

I. Revised Dangerous Drugs Law

J. Act on Cheaper Medicine

K. Save the Children

L. Violence Against Women

M. Disaster Risk Reduction Management

Rooming-In and Breastfeeding Act of 1992 (Milk Code)

O. Responsible Parenthood and Reproductive Health Law of 2012

P. Mandatory Infant and Children Health Immunization Act of 2011

Q. Children safety on Motorcycles Act of 2015

R. Children’s Emergency Relief and Protection Act of 2016

S. Child and Youth Welfare Code of the Philippines

T. Tobacco Regulation Act of 2003 (RA 9211)

U. Other related Laws

PD 856 Code on Sanitation

was promulgated in 1975 and one of its chapter on Industrial Hygiene provides the standards and guidelines for the

protection and promotion of workers' health.

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RA 8749 Philippine Clean Air Act

The Act provides for the creation of a national program of air pollution management focusing primarily on pollution

prevention; for the promotion of mass media communication in order to create social awareness and active

participation in air quality planning and monitoring.

RA 7719 National Blood Services Act

Steps in donating?

1. Register → Physical Exam → Blood Donation → Snacks

Who can donate?

1. Blood should be given out of one’s own free will & shall therefore not receive payment for it

2. Both men and women are accepted as donors

3. One must at least be 110 lbs. or 50 kgs.

4. One’s blood pressure should fall under: systolic (90-160 mmHg); diastolic (60-100 mmHg)

5. Hgb at least 125g/L or not anemic

6. Ages 18-65 y.o.; if 16-17 y.o., one can donate but with parental consent

7. Blood donor must be in generally good health condition

8. People with tattoos, acupuncture, surgery and ear piercing may donate 1 year after the procedure.

Preparation before blood donation

1. Have enough rest and sleep

2. Eat light meals and avoid fatty foods

3. Drink plenty of fluids

4. No alcohol intake for 24 hours before

5. No medication for at least 24 hours before

What to do after blood donation?

1. Apply pressure at the punctured site

2. If there is swelling and discoloration at the punctured site, apply cold compress for 24 hours then hot compress for

the next 24 hrs. If there is dizziness, just lie down with feet elevated. Drink plenty of fluids preferably something sweet.

It will pass in a few minutes.

3. Avoid stooping down. Avoid strenuous activities.

4. Rest for about 5-19 minutes, Eat healthy meals.

5. Increase fluid intake like water and juice.

6. If one still does not feel well, please inform the Red Cross Blood Center.

7. Avoid smoking 1 hour and drink alcohol 24 hours after.

Every blood donor should know that?

1. Blood donation takes 10-12 minutes

2. By drinking fluids, volume extracted can be replenished in 24 hours

3. Blood donation lessens blood viscosity making circulation function more effectively.

RA 7875 National Health Insurance Act (PhilHealth)

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 This Act seeks to:

a) provide all citizens of the Philippines with the mechanism to gain financial access to health services;

b) create the National Health Insurance Program, hereinafter referred to as the Program, to serve as the means to help

the people pay for health care services;

c) prioritize and accelerate the provision of health services to all Filipinos, especially that

segment of the population who cannot afford such services; and

d) establish the Philippine Health Insurance Corporation, hereinafter referred to as the Corporation, that will

administer the Program at central and local level.

RA 3573 Mandatory Reporting of Notifiable Diseases and Health Events of Public Concern Act

Epidemiology – branch of medical science that treats epidemics; the study of the distribution and determinants of

disease frequency in man

Incidence – the number of new cases occurring in a defined population during a specified period of time

Prevalence – refers to all current cases (old & new) existing at a given point of time, or over a period of time in a given

population

Sporadic – diseases only occur rarely and largely without a geographic focus

Endemic diseases occur at a constant level within a population

Epidemic describes diseases that’s widespread; affect greater number of people than is usual for the locality or one

that spreads to areas not usually associated with the disease.

Pandemic is an epidemic of worldwide proportions.

RA 7305 Magna Carta for Public Health Workers

The Magna Carta of Public Health Workers (RA 7305) was enacted to ensure that health workers are properly

compensated, thereby helping to promote better delivery of quality health care service.

RA 9211 Tobacco Regulation Act of 2003

To combat the youth tobacco epidemic, the Philippines implemented tobacco control legislation (Republic Act No.

9211) in 2003 that included prohibiting the sale of tobacco products to those aged <18 years, placing text warning
7
labels on tobacco products, and prohibiting tobacco smoking in public places

RA 6675 Generic Acts of 1988

An Act to Promote, Require and Ensure the Production of an Adequate Supply, Distribution, Use and Acceptance of

Drugs and Medicines Identified by their Generic Names.

RA 9994 Expanded Senior Citizens Act of 2010 (amending RA 7432 & RA 9257)

- Entitled to 20% senior citizen discount and exempted from the value added tax on applicable goods and services for

their exclusive user. These privileges apply to both cash and credit card payments

List of Senior Citizen Benefits

1. Income tax exemption for minimum wage earners

2. Training fee exemption on socio – economic programs

3. Free medical and dental sercice4s in government facilities

4. Free flu and pneumococcal vaccinations for indigent senior citizens

5. Scholarship and financial assistance for seniors’ education in public and private schools

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 6. Retirement benefits from SSS, GSIS and Pagibig

7. Express lanes for senior citizens

8. Discounts in special programs

Senior Citizen or elderly @ least 60 years of age

RA 9165 Comprehensive Dangerous Act of 2002 (repealing RA 6425 Dangerous Drugs Act of 1972)

Dangerous Drugs Board – the policy making and strategy formulating body in planning and formulations of policies and

programs on drug prevention and control

Philippines Drug Enforcement Agency – under the Office of the President, serves as the implementing arm of the

Dangerous Drugs Board

RA 9502 Universally Accessible Cheaper and Quality Medicines Act of 2008 – intended to achieve universally accessible and

cheaper and quality medicines by pursuing an effective competition policy in the pharmaceutical sector

RA 10121 An Act Strengthening the Philippine Disaster Risk Reduction and Management System

providing for the National Disaster Risk Reduction and Management Framework and Institutionalizing the National

Disaster risk Reduction and management Plan, appropriating funds therefor and for other purposes

Disaster – a serious disruption of the functioning of a community or society involving widespread human, material,

economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope

using its own resources.

Emergency – unforeseen or sudden occurrence, esp. danger, demanding immediate action.

Disaster Management Cycle

1. Risk Reduction – mitigation/prevention; the outright avoidance of adverse impacts of hazards and related disasters

(DOST)

2. Readiness – preparedness; the knowledge a d capacities developed by governments, professional response and

recovery organizations, communities and individuals to effectively anticipate, respond to and recover from the impact

of likely, imminent or current hazard events or conditions. (DILG)

3. Response – provision of emergency services and public assistance during or immediately after a disaster in order to

save lives, reduce health impacts, ensure public safety and meet the basic subsistence needs of the people affected.

(DSWD)

4. Recovery – rehabilitation (NEDA)

National Disaster Risk Reduction and Management Council -

Chair: Department of National Defense

Office of the Civil Defense – the implementing arm of the NDRRMC

RA 9262 Violence Against Women refers to any act or a series of acts committed by any person against a woman who is his

wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom

he has a common child, or against her child whether legitimate or illegitimate, within or without the family abode,

which result in or is likely to result in physical, sexual, psychological harm or suffering, or economic abuse including

threats of such acts, battery, assault, coercion, harassment, or arbitrary deprivation of liberty.

RA 11188 Save the Children:

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 An Act providing special protection of the children in situations of

armed conflict and providing penalties for violations.

RA 10028 THE EXPANDED BREASTFEEDING PROMOTION ACT OF 2009” AN ACT EXPANDING THE PROMOTION OF

BREASTFEEDING, AMENDING FOR THE PURPOSE REPUBLIC ACT NO. 7600

Rooming – in and Breastfeeding Act of 1992 (Milk Code)

The Philippine Milk Code of 1986 or Executive Order 51 - A LAW IMPOSING STRICT FORMULA MILK MARKETING IN

THE PHILIPPINES

Ten steps to successful breastfeeding

Critical management procedures

1. (a) Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health
Assembly resolutions.

(b) Have a written infant feeding policy that is routinely communicated to staff and parents.

(c) Establish ongoing monitoring and data-management systems.

2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding. Key clinical practices

3. Discuss the importance and management of breastfeeding with pregnant women and their families.

4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as

possible after birth.

5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.

6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.

7. Enable mothers and their infants to remain together and to practice rooming-in 24 hours a day.

8. Support mothers to recognize and respond to their infants’ cues for feeding.

9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.

10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

RA 10354 Responsible Parenthood & Reproductive Health Law

4 Pillars: (1) Responsible Parenthood, (2) Respect for Life, (3) Birth Spacing, and (4) Informed Choice

Gender equality refers to the principle of equality between women and men and equal rights to enjoy conditions in

realizing their full human potentials to contribute to, and benefit from, the results of development, with the State

recognizing that all human beings are free and equal in dignity and rights. It entails equality in opportunities, in the

allocation of resources or benefits, or in access to services in furtherance of the rights to health and sustainable human

development among others, without discrimination.

Gender equity refers to the policies, instruments, programs and actions that address the disadvantaged position of

women in society by providing preferential treatment and affirmative action. It entails fairness and justice in the

distribution of benefits and responsibilities between women and men, and often requires women-specific projects and

programs to end existing inequalities. This concept recognizes that while reproductive health involves women and

men, it is more critical for women’s health.

Reproductive Health (RH) refers to the state of complete physical, mental and social well being and not merely the

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absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.

This implies that people are able to have a responsible, safe, consensual and satisfying sex life, that they have the

capability to reproduce and the freedom to decide if, when, and how often to do so. This further implies that women

and men attain equal relationships in matters related to sexual relations and reproduction.

Elements of Reproductive Health:

1. Family planning information and services which shall include as a first priority making women of reproductive age

fully aware of their respective cycles to make them aware of when fertilization is highly probable, as well as highly

improbable;

2. Maternal, infant and child health and nutrition, including breastfeeding;

3. Prescription of abortion and management of abortion complications;

4. Adolescent and youth reproductive health guidance and counseling;

5. Prevention, treatment and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually

transmittable infections (STIs);

6. Elimination of violence against women and children and other forms of sexual and gender-based violence;

7. Education and counseling on sexuality and reproductive health;

8. Treatment of breast and reproductive tract cancers and other gynecological conditions and disorders;

9. Male responsibility and involvement and men’s reproductive health;

10. Prevention, treatment and management of infertility and sexual dysfunction;

11. Reproductive health education for the adolescents; and

12. Mental health aspect of reproductive health care.

− Makes family planning methods accessible to all Filipino woman without cost

− Family Planning– fertility awareness

− BEMONC / CEMONC Comprehensive Emergency Obstetrical Newborn Care – functions performed by SBA (skilled

birth attendants – doctor, nurse, midwife) in the community level

✓ Assist NSD

✓ Emergency functions: (BEMONC)

✓ Parenteral antibiotics without doctor’s order

✓ Parenteral oxytocin – for bleeding

✓ Parenteral anticonvulsant

✓ Imminent breach delivery

✓ Manual removal of placenta

✓ Removal of retained parts

✓ Injection of corticosteroids (dexamethasone) in preterm labor – Philippines only

✓ Performance of EINC – Philippines only

✓ CEMONC – Blood transfusion + CS delivery

✓ MNCHN (Maternal Neonatal Child Health and Nutrition)

✓ Rapidly reduce maternal and neonatal mortality

✓ AO 0029-2008

✓ Aligned with MDGs – service delivery network

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 − Adolescence – any person between 10-19 years old

− Human sexuality must be taught in school – DepEd conducts the Syllabus

1. RA 9288 – NB Screening

− Basic – 6 diseases; Expanded – 28 diseases

2. RA 11210 – Expanded Maternity Leave Act

− 105 paid days (previous: 60 days)

− Can extend another 15 days without pay, 7 days can be passed to the husband

3. MDGs (2000-2015)

− 4 th goal – reproductive and child health → ENC, KMC (kangaroo mother care), HMB (human milk bank)

− 5 th goal – maternal health → decrease Maternal Death Rate by 75%

4. SDGs (2015-2030)

− 3 rd goal – reproductive and child health → to lessen maternal deaths by 70-100,000

5. AO 0012-2012

− Nurse can now put up a birthing clinic

RA 10152 Mandatory Infant & Children Health Immunization Act of 2011

- An act providing for mandatory basic immunization services for infants and children repealing for the purpose

PRESIDENTIAL DECREE NO. 996 ( Compulsory Basic Immunization for Infants and children below 8 years of age)

- children under 5 years old.

- This shall be given free at any government hospital or health centers

The mandatory immunization for all infants and children provided under this Act shall cover the following vaccine –

preventable diseases:

(1) Tuberculosis; (2) DPT (Diphtheria, Pertussis, Tetanus); (3) Poliomyelitis; (4) MMR; (5) Hepatitis B; (6) H. Influenza

type B (Hib)

Vaccine against Hepatitis-B, meanwhile, should be administered to an infant without 24 hours after birth. Subsequent

doses shall be completed according to the recommended

schedule as provided by the DOH.

RA 10666 Children Safety on Motorcycles Act of 2015

AN ACT PROVIDING FOR THE SAFETY OF CHILDREN ABOARD MOTORCYLES

- it is illegal to operate a two-wheeled motorcycle on public roads if a child is on board, specifically if there’s a heavy

volume of vehicles, there’s a high density of fast moving vehicles, or where there’s a speed limit of more than 60 kph is

imposed

What are the roads covered by the law?

• all public roads nationwide such as but not limited to national highways, provincial roads, and municipal and

barangay streets.

• roads where there is a heavy volume of vehicles

• there is a high-density of fast moving vehicles, or where a speed limit of more than 60 kph is imposed.

What type of motorcycles are covered by the law?

This covers any two-wheeled motor vehicles having one or two riding saddles

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 Are all children covered by the law? What are the exemptions?

- below 18 years old- However, a child may be allowed to board a motorcycle on public roads if:

1. the child passenger can comfortably reach his/her feet on the standard foot peg of the motorcycle

the child’s arms can reach around and grasp the waist of the motorcycle rider

2. the child is wearing a standard protective helmet or gear.

Are children allowed to ride in front of the rider?

Sitting in front of the rider is not allowed.

How about medical emergencies?

The law does not apply to cases where the child to be transported requires immediate medical attention

What are the penalties for violators?

First Offense – P3,000 fine; Second Offense – P5,000 fine; Third Offense – P10,000 fine and a one-month suspension of

driver’s license

Violation beyond the third time – Automatic revocation of driver’s license

Who will enforce the law?

The DOTr – Land Transportation Office (LTO) is the lead implementing agency of the Act.

The LTO also has the authority to deputize members of the PNP, MMDA, and LGUs to carry out enforcement functions

and duties.

RA 10821 Children’s Emergency Relief and Protection Act of 2016

- mandates national and local government agencies to establish and implement a Comprehensive Emergency Program

that will prioritize the protection of children and pregnant and lactating mothers during and after emergencies and

disaster situations

PD 603 Child and Youth Welfare Code of the Philippines

All children shall be entitled to the rights herein set forth without distinction as to legitimacy or illegitimacy, sex, social

status, religion, political antecedents, and other factors.

It shall apply to persons below twenty-one years of age except those emancipated in accordance with law.

RA 7877 Anti – Sexual Harassment Act

Under RA 7877, work, education, or training related sexual harassment is... A person who directs or induces another

person to commit any act of sexual harassment or who cooperates to commit the act, without which the said act

would not have been committed, will also be held liable under the law.

RA 8423 Herbal Medicines

mandates the Philippine Institute of Traditional and Alternative Health Care (PITAHC) “to improve the quality and

delivery of health care services to the Filipino people through the development of traditional and alternative health

care and its integration into the national health care

Lagundi cough Sambong Diuretic

Ulasimang Bato uricosuric agent Ampalaya Anti- diabetic

Bayabas Wash wound Niyog-niyogan Anti – Parasitis

Bawang anti - hypertensive Tsaang Gubat Anti – spasmod

Yerba Buena analgesic Akapulko Anti- fungal

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RA 3753 Civil Registrar Law

. It has for its purpose the establishment of a civil register in the Philippines wherein act, events, legal instruments and

court decrees concerning the civil status of persons shall be recorded.

RA 7160 Devolution of Health Services

Public health service was one of the national functions devolved to local government units. The Department of Health

(DOH), the sole provider of health-related services, was transformed into a technical authority providing technical

support and assistance to local health units.

RA 6713 Code of Conduct & Ethical Standards for Public Officials & Employees

An act establishing a code of conduct and ethical standards for public officials and employees, to uphold the time-

honored principle of public office being a public trust, granting incentives and rewards for exemplary service,

enumerating prohibited acts and transactions and providing penalties for violations

R.A. 1082 Rural Health Act. An Act Strengthening Health and Dental Services in the Rural Areas

• It created the 1st 81 Rural Health Units.

• amended by RA 1891; more physicians, dentists, nurses, midwives and sanitary inspectors will live in the rural areas

where they are assigned in order to raise the health conditions of barrio people ,hence help decrease the high

incidence of preventable diseases

There shall be in each province a Provincial Health Officer, and in each congressional district, a Public Health Dentist:

Provided, however, That a congressional district having a population of over one hundred fifty thousand shall have an

additional Public Health Dentist

PREPARED BY:

Luzvimida G. Villanueva, RN

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