Laws Affecting Public Health and health conditions of barrio people ,hence help decrease

the high incidence of preventable diseases.

Practice of CHN
R.A. 6425 – Dangerous Drugs Act
- It stipulates that the sale, administration, delivery,
R.A. 7160 – or the Local Government Code
distribution and transportation of prohibited drugs is
- This involves the devolution of powers, functions and
punishable by law.
responsibilities to the local government both rural &
urban. The Code aims to transform local government R. A. 9165 – the new Dangerous Drug Act of 2002
units into self-reliant communities and active partners - This Act repealed Republic Act No. 6425, otherwise
in the attainment of national goals thru’ a more known as the Dangerous Drugs Act of 1972, as
responsive and accountable local government structure amended, and providing funds for its implementation.
instituted thru’ a system of decentralization. Hence, Under this Act, the Dangerous Drugs Board (DDB)
each province, city and municipality has a LOCAL remains as the policy-making and strategy- formulating
HEALTH BOARD (LHB) which is mandated to propose body in planning and formulation of policies and
annual budgetary allocations for the operation and program on drug prevention and control.
maintenance of their own health facilities.
P.D No. 651
Composition of LHB Provincial Level - Requires that all health workers shall identify and
encourage the registration of all births within 30 days
1. Governor- chair
2. Provincial Health Officer – vice chairman following delivery.
3. Chairman, Committee on Health of Sangguniang P.D. No. 996
Panlalawigan - Requires the compulsory immunization of all children
4. DOH representative
below 8 yrs. of age against the 6 childhood immunizable
5. NGO representative
diseases.

P.D. No. 825

City and Municipal Level
- Provides penalty for improper disposal of garbage.
1. Mayor – chair
2. MHO – vice chair S. A. 8749 – Clean Air Act of 2000
3. Chairman, Committee on Health of Sangguniang - a comprehensive air quality management policy and
Bayan program which aims to achieve and maintain healthy air
4. DOH representative for all Filipinos.
5. NGO representative
P.D. No. 856 – Code on Sanitation
- It provides for the control of all factors in man’s
Effective Local Health System Depends on: environment that affect health including the quality of
water, food, milk, insects, animal carriers, transmitters
1. The LGU’s financial capability
of disease, sanitary and recreation facilities, noise,
2. A dynamic and responsive political leadership
pollution and control of nuisance
3. Community empowerment
6758
R.A. 2382 – Philippine Medical Act - Standardizes the salary of government employees
- This act defines the practice of medicine in the including the nursing personnel.
country. R.A. 6675 – Generics Act of 1988
R.A. 1082 – Rural Health Act. - Which promotes, requires and ensures the production
- It created the 1st 81 Rural Health Units. of an adequate supply, distribution, use and acceptance
- amended by RA 1891; more physicians, dentists, of drugs and medicines identified by their generic name.
nurses, midwives and sanitary inspectors will live in the R.A. 6713 – Code of Conduct and Ethical Standards of
rural areas where they are assigned in order to raise the Public Officials and Employees
- It is the policy of the state to promote high standards
of ethics in public office. Public officials and employees R.A. 7719 – National Blood Services Act
shall at all times be accountable to the people and shall - promotes voluntary blood donation to provide
discharges their duties with utmost responsibility, sufficient supply of safe blood and to regulate blood
integrity, competence and loyalty, act with patriotism banks. This act aims to inculcate public awareness that
and justice, lead modest lives uphold public interest blood donation is a humanitarian act
over personal interest.
R.A. 8172 – Salt Iodization Act (ASIN LAW)
R.A. 7305 – Magna Carta for Public Health Workers - This Act requires the addition of iodine to all salt
- This act aims: to promote and improve the social and intended for animal and human consumption in order
economic well-being of health workers, their living and to eliminate micronutrient malnutrition in the country.
working conditions and terms of employment; to
R.A. 7277- Magna Carta for PWD’s
develop their skills and capabilities in order that they
- provides their rehabilitation, self development and
will be more responsive and better equipped to deliver
self-reliance and integration into the mainstream of
health projects and programs; and to encourage those
society.
with proper qualifications and excellent abilities to join
and remain in government service. A. O. No. 2005-0014- National Policies on Infant and
Young Child Feeding:
R.A. 8423
- Created the Philippine Institute of Traditional and 1. All newborns be breastfeed within 1 hr after
Alternative Health Care. birth.
P.D. No. 965 2. Infants be exclusively breastfeed for 6
- Requires applicants for marriage license to receive months.
instructions on family planning and responsible
parenthood. 3. Infants be given timely, adequate and safe
complementary foods
P.D. NO. 79
- Defines, objectives, duties and functions of POPCOM 4. Breastfeeding be continued up to 2 years and
beyond
RA 4073
- advocates home treatment for leprosy EO 51- Phil. Code of Marketing of Breast milk
Substitutes
Letter of Instruction No. 949 - regulates the marketing of infant milk formula, other
- legal basis of PHC dated OCT. 19, 1979 milk products, foods and beverages, as well as feeding
- promotes development of health programs on the bottles and teats
community level
R.A. – 7600 – Rooming In and Breastfeeding Act of
RA 3573 1992
- requires reporting of all cases of communicable - AN ACT PROVIDING INCENTIVES TO ALL GOVERNMENT
diseases and administration of prophylaxis AND PRIVATE HEALTH INSTITUTIONS WITH ROOMING-
IN AND BREASTFEEDING PRACTICES AND FOR OTHER
Ministry Circular No. 2 of 1986
PURPOSES. This law is in promotion of the State policy
- includes AIDS as notifiable disease
to encourage the practice of breastfeeding in the
R. A. 7875 – National Health Insurance Act Philippines
- An act instituting a national health insurance program
R.A. 8976- Food Fortification Law
for all filipinos and establishing the Philippine Health
- Provided the policy on mandatory fortification of
Insurance Corporation for the purpose
staple foods and voluntary fortification of processed
R.A. 7432 – Senior Citizens Act foods or food products
- AN ACT TO MAXIMIZE THE CONTRIBUTION OF SENIOR
R.A. 8980
CITIZENS TO NATION BUILDING, GRANT BENEFITS AND
- promulgates a comprehensive policy and a national
SPECIAL PRIVILEGES AND FOR OTHER PURPOSES
system for ECCD
A.O. No. 2006- 0015
- defines the Implementing guidelines on Hepatitis B
Immunization for Infants

R.A. 7846
- mandates Compulsory Hepatitis B Immunization
among infants and children less than 8 yrs old

R.A. 2029
- mandates Liver Cancer and Hepatitis B Awareness
Month Act (February) A.O. No. 2006-0012
- specifies the Revised Implementing Rules and
Regulations of E.O. 51 or Milk Code, Relevant
International Agreements, Penalizing Violations
thereof and for other purposes.

Blood Bank- a place where supplies of blood or plasma

for transfusion are stored.

Blood Donation- process of collecting, testing,

preparing, and storing blood and blood components

Confirmatory Test. – An analytical test using a device,

tool or equipment with a different chemical or physical
principle that is more specific which will validate and
confirm the result of the screening test.

Insurance - a thing providing protection against a

possible eventuality.

Public Health - is the science of protecting and

improving the health of people and their communities.

Senior Citizen- an elderly person, especially one who is

retired and living on a pension.
ROOMING IN AND BREASTFEEDING ACT Deliveries Outside Health Institutions. — Newborns
delivered outside health institutions whose mothers
OF 2002
have been admitted to the obstetrics department/unit
RA 7600 or “THE ROOMING-IN AND BREASTFEEDING
ACT OF 1992″ AN ACT PROVIDING INCENTIVES TO and who both meet the general conditions stated in
ALL GOVERNMENT AND PRIVATE HEALTH Section 5 of this Act, shall be roomed-in and breast-fed
INSTITUTIONS WITH ROOMING-IN AND
immediately.
BREASTFEEDING PRACTICES AND FOR OTHER
PURPOSES. The State adopts rooming-in as a national Exemptions. — Infants whose conditions do not permit
policy to encourage, protect and support the practice of rooming-in and breast-feeding as determined by the
breast-feeding. It shall create an environment where
basic physical, emotional, and psychological needs of attending physician, and infants whose mothers are
mothers and infants are fulfilled through the practice of either:
rooming-in and breast-feeding.
a) seriously ill;
Breast-feeding has distinct advantages which benefit b) taking medications contraindicated to breast-feeding;
the infant and the mother, including the hospital and c) violent psychotics; or
the country that adopt its practice. It is the first d) whose conditions do not permit breast-feeding and
preventive health measure that can be given to the rooming-in as determined by the attending physician
child at birth. It also enhances mother-infant shall be exempted from the provisions of Sections 5, 6,
relationship. Furthermore, the practice of breast- and 7: provided, that these infants shall be fed
feeding could save the country valuable foreign expressed breastmilk or wet-nursed as may be
exchange that may otherwise be used for milk determined by the attending physician.
importation. Right of the Mother to Breast-feed. — It shall be the
Breastmilk is the best food since it contains essential mother's right to breast-feed her child who equally has
nutrients completely suitable for the infant's needs. It is the right to her breastmilk. Bottlefeeding shall be
also nature's first immunization, enabling the infant to allowed only after the mother has been informed by the
fight potential serious infection. It contains growth attending health personnel of the advantages of breast-
factors that enhance the maturation of an infant's organ feeding and the proper techniques of infant formula
systems. feeding and the mother has opted in writing to adopt
Normal Spontaneous Deliveries. — The following infant formula feeding for her infant.
newborn infants shall be put to the breast of the Continuing Education, Re-education and Training of
mother immediately after birth and forthwith roomed- Health Personnel. — The Department of Health with
in within thirty (30) minutes. the assistance of other government agencies,
a) well infants regardless of age of gestation; and professional and non-governmental organizations shall
b) infants with low birth weights but who can suck. conduct continuing information, education, re-
Deliveries by Caesarian. — Infants delivered by education, and training programs for physicians, nurses,
caesarian section shall be roomed-in and breast-fed midwives, nutritionist-dietitians, community health
within three (3) to four (4) hours after birth. workers and traditional birth attendants (TBAs) and
other health personnel on current and updated FILIPINO CULTURE, VALUES AND
lactation management.
PRACTICES IN RELATION TO HEALTH
Information materials shall be given to all health
CARE OF INDIVIDUAL AND FAMILY
personnel involved in maternal and infant care in health
VALUES OF FILIPINO NURSES
institutions.
Information Dissemination to Pregnant Women. — Work Ethic
During the prenatal, perinatal and postnatal
As a group, Filipino nurses are well liked because they are
consultations and/or confinements of the mothers or hardworking. They place high value on responsibility and
pregnant women in a health institution, it shall be the seldom complain. “Many [Filipino nurses] work nights,
holidays and/or overtime. So, during this time of nursing
obligation of the health institution and the health shortage, one can rely on a Filipino nurse to volunteer to
personnel to immediately and continuously teach, train, cover the shift”. It is not unusual to find Filipino nurses
who work two jobs. The financial rewards, job security,
and support the women on current and updated and personal advancement that U.S. jobs provide to
lactation management and infant care, through Filipino nurses are valued.

participatory strategies such as organization of mother's Spirituality

clubs and breast-feeding support groups and to
Filipino nurses are very religious people. There is a deep
distribute written information materials on such
faith in God that is reflected in the expression of bahala
matters free of charge. na—“it is up to God” or “leave it to God.” This tends to
be incorrectly equated with an expression of fatalism and
a passive acceptance of or resignation to fate. Bahala na
may also apply to acceptance of illness or malady.

Sensitivity
Bottle feeding — the method of feeding an infant using
a bottle with artificial nipples, the contents of which can
Unmarried Filipino nurses recoil at the question, “Are
be any type of fluid. you pregnant?” when they go for a medical checkup.
Breast-feeding — the method of feeding an infant Because the Philippine society considers sexual
directly from the human breast relationships not to occur outside of marriage, it seems
odd to them that they would be questioned, although
Breastmilk — the human milk from a mother. they are aware that this is part of a routine health
assessment. Filipinos are generally sensitive and equally
Expressed breastmilk — the human milk which has sensitive to the feelings of others, so they try to find a
been extracted from the breast by hand or by breast way to say things diplomatically.
pump. It can be fed to an infant using a dropper, a
nasogatric tube, a cup and spoon, or a bottle. Interpersonal Relationships
Formula feeding — the feeding of a newborn with
Filipinos are generally quiet. Very conservative families
infant formula usually by bottlefeeding. It is also called
do not allow their younger members to join the
artificial feeding.
conversation of adults without an invitation. They are
Infant formula — the breastmilk substitute formulated sometimes hesitant to articulate their views, especially if
industrially in accordance with applicable Codex it is different from the majority, as it might indicate
discordance with the team or group. Engaging in
Alimentarius standards, to satisfy the normal nutritional
arguments, especially with someone who is older or
requirements of infants up to six (6) months of age, and
holds an authority position, is considered uncivilized.
adopted to their physiological characteristics.
Filipinos also have difficulty turning down requests from
supervisors to whom they feel obligated.
Respect and Reverence HEALTH BELIEFS, BEHAVIORS, AND PRACTICES

One’s position in society, professional achievements, and Preventive Health

age carry a lot of weight in the Philippine society. Because most of their time is devoted to work, going for
Physicians, lawyers, priests, engineers, teachers, and preventive health checkups takes a backseat. Yet, one
nurses are among the well-respected professionals in the may hear a Filipino extolling the importance of
Philippines. Hence, their opinion is generally accepted preventive health to her patients or clients. Filipino
without question. Filipino values and traditions provide a nurses have a tendency to self-diagnose, self-medicate,
framework for conduct and mode of communication. and seek alternative therapies. In rural areas in the
Philippines, people go for Hilot for relief of pain and
Because of a high regard for the elderly and authority, aches instead of seeking medical attention. In an
Filipinos tend not to oppose or contradict other views for alternative context, Hilot may refer to a practitioner or
fear of embarrassing the other party. “Filipinos generally the practice of chiropractic manipulation and massage
are neither assertive nor aggressive and may often for the diagnosis and treatment of musculoligamentous
appear guarded or reticent. Nurses often misunderstand and musculoskeletal ailments.
this need for passivity and do not appreciate the
culturally induced motivation to maintain harmonious Home Remedies
balance between man and nature”
Three concepts underlie Filipino American health beliefs
Modesty and practices: flushing, heating, and protection. Each
identifies a basic process used to promote good health.
Flushing keeps the body free from debris, heating
Filipino nurses find it uncomfortable to accept even a
maintains a balanced internal temperature, and
well-deserved compliment. For example, if someone
protection guards the body from outside influences.
gives a complement like, “Your dress is beautiful!” the
Although Western and scientific concepts are similar,
answer might be, “Not really. I bought it cheap.” Or if
Filipino theories are founded on different premises.
someone says, “You are so knowledgeable,” the answer
Flushing is based on the notion that the body is a
might be, “Not really, I just happen to know it.” Yet they
container that collects impurities, heating means that
are proud of their accomplishments in a sort of quiet
hot and cold qualities must be balanced in the body, and
way. As a result, many have culture-based barriers to
protection involves safeguarding the body’s boundaries
marketing themselves
from supernatural as well as natural forces.
Language Pain Tolerance

Respect is integrated in the Filipino language. Reference Generally speaking, Filipino nurses have a high tolerance
to the elderly is the use of the third person. Hence, when to pain. For example, one of the author’s sisters has
spoken to assertively in a direct way, Filipinos feel severe arthritis, yet she continues to do housework
offended. There is no gender differentiation in the regardless of her pain. Filipino nurses normally use home
Filipino language. Although they are fully aware of the remedies such as liniments and topical ointments and
male and female genders, their native language is what manage pain before seeking medical care or while under
hinders them from precisely using he or she in spoken medical treatment. Health care providers need to probe
English. Frequently, this leads to confusion. more into the cause and degree of pain from Filipino
patients to elicit more information. The elderly group, in
Close Family Ties particular, is unlikely to complain about their pain
because they do not want to have extra burdens being
imposed on caregivers.
Filipino nurses have strong family ties. While in the
United States, their close friends become their family Privacy
members. As a result, they perpetuate the cultural
burden (as a downside) thus making it more difficult and Filipinos are mostly reserved and private people. As
taking them longer to assimilate into the mainstream patients, they may not readily reveal their personal and
culture of their adopted country. They tend to eat the health information. Women in particular are sensitive to
same food and mingle with individuals of the same ethnic touching another individual as well as being touched.
background. “Young female service providers should practice
discretion with regard to touching older Filipino male Common Perceptions of Filipinos about Mental Illness
patients such as laying one’s hand on the patient’s hand
or shoulder to reassure comfort in moments of distress”  Unwillingness to accept having mental illness,
which leads to the avoidance of needed mental
HEALTH BELIEFS AND PRACTICES ARE health services due to fear of being ridiculed
 Involvement of other coping resources such as
ORIENTED TOWARDS PROTECTION OF THE reliance on family and friends or indigenous
BODY. healers, and dependence on religion which can
diminish the need for mental health services
Flushing  Prioritizing of financial and environmental
needs which preclude the need for mental
The body is thought to be a vessel or container that health services
collects and eliminates impurities through physiological  Limited awareness of mental health services
processes such as sweating, vomiting, expelling gas, or resulting in limiting access
having an appropriate volume of menstrual bleeding.  Difficulty in utilizing mental health services
during usual hours because of the unavailability
Heating of working adult family members
 Mental illness connotes a weak spirit, and may
Adapts the concept of balanced between “hot” and be attributed to divine retribution as a
“cold” to prevent occurrence of illness and disorders. consequence of personal and ancestral
transgression
Protection  Lack of culturally oriented mental health
services
Safeguards the body’s boundaries from outside
influences such as supernatural and natural forces.

Coping Styles  Behaviors - the way in which one acts or

conducts oneself, especially toward others.
Coping styles common among elderly Filipino  Beliefs - an acceptance that a statement is true
Americans in times of illness or crisis include: or that something exists
 Culture - the arts and other manifestations of
 Patience and Endurance (Tiyaga): the ability to human intellectual achievement regarded
tolerate uncertain situations collectively
 Flexibility (Lakas ng Loob): being respectful and  Practices - the actual application or use of an
honest with oneself idea, belief, or method, as opposed to theories
 Humor (Tatawanan ang problema): the capacity relating to it.
to laugh at oneself in times of adversity  Values- the regard that something is held to
 Fatalistic Resignation (Bahala Na): the view that deserve; the importance, worth, or usefulness of
illness and suffering are the unavoidable and something.
predestined will of God, in which the patient,
family members and even the physician should
not interfere
 Conceding to the wishes of the collective
(Pakikisama) to maintain group harmony

Responses to Mental Ilness

Indigenous traits common among elderly Filipino

Americans when faced with illness related to mental
conditions:

 Devastating shame (Hiya)

 Sensitivity to criticism (Amor Propio)
NURSING CORE VALUES AS A across academic and health enterprises. Differences
affect innovation so we must work to understand both
COMMUNITY HEALTH NURSE ourselves and one another. And by acknowledging the
legitimacy of us all, we move beyond tolerance to
CORE VALUES celebrating the richness that differences bring forth.

Mission EXCELLENCE
The National League for Nursing promotes excellence in A culture of excellence reflects a commitment to
nursing education to build a strong and diverse nursing continuous growth, improvement, and understanding. It
workforce to advance the health of our nation and the is a culture where transformation is embraced, and the
global community. status quo and mediocrity are not tolerated.

CORE VALUES

 CARING: promoting health, healing, and hope Core Values – of an organization are those values we
in response to the human condition hold which form the foundation on which we perform
 INTEGRITY: respecting the dignity and moral
work and conduct ourselves
wholeness of every person without conditions or
limitation; Culture – the arts and other manifestations of human
 DIVERSITY: affirming the uniqueness of and intellectual achievement regarded collectively.
differences among persons, ideas, values, and
ethnicities. Ethical – relating to moral principles or the branch of
 EXCELLENCE: co-creating and implementing knowledge dealing with these.
transformative strategies with daring ingenuity.
Excellence – the quality of being outstanding or
CARING extremely good.
A culture of caring, as a fundamental part of the nursing Principles - a fundamental truth or proposition that
profession, characterizes our concern and consideration
serves as the foundation for a system of belief or
for the whole person, our commitment to the common
behavior or for a chain of reasoning.
good, and our outreach to those who are vulnerable. All
organizational activities are managed in a participative
and person-centered way, demonstrating an ability to
understand the needs of others and a commitment to act
always in the best interests of all stakeholders.

INTEGRITY
A culture of integrity is evident when organizational
principles of open communication, ethical decision-
making, and humility are encouraged, expected, and
demonstrated consistently. Not only is doing the right
thing simply how we do business, but our actions reveal
our commitment to truth telling and to how we always
see ourselves from the perspective of others in a larger
community.

DIVERSITY
A culture of inclusive excellence encompasses many
identities, influenced by the intersections of race,
ethnicity, gender, sexual orientation, socio-economic
status, age, physical abilities, religious and political
beliefs, or other ideologies. It also addresses behaviors
 stores/companies, Medical Research
HEALTH-RELATED ENTREPRENEURIAL Consultants/Assistants, Technical Assistance
Consultants/Providers.
ACTIVITIES IN THE COMMUNITY  BUSINESS SECTOR OPPORTUNITIES OR JOB
SETTING OPTIONS - Transcription services (international)
and engage in other non-nursing related
Project EntrepreNurse enterprise.

 Initiative of Department of Labor and

Employment (DOLE) BUSINESS PLANS:
 Introduces HOME HEALTHCARE INDUSTRY IN
 Manage Nurses’ Clinic
THE PHILIPPINES
 Tourism health care services
 FRAMEWORK: FOURmula ONE for HEALTH
 Medical Transcription Services
4 ELEMENTS
 Outsourcing Primary Healthcare Services
 Good Governance  Health care Training management
 Health Financing  Review Center
 Health Regulation  Hospice, domiciliary and health care facilities
 Health Service Delivery  Public health advocacy
GOALS:  Home health care services
 Emergency medical services
 Better Health Outcome  Wellness and fitness management for patients
 Equitable Healthcare Financing  Medical mission management for private
 More responsive healthcare system institutions
LEGAL BASIS:  Periodic physical examination of company
 RA 9173 Article VI Sec 28 workers
 RA 7164 Article V Sec 27
STRATEGY: SOURCES OF REVENUE:
Cooperative:  Senators and Congressman
 500 nurses/cooperative = CITY  Requiring Long Term Care
*RN HEALS= Registered Nurses for Health Enhancement  Government Units
and Local Services  Health Maintenance Organizations
 Elderly (Home for the Aged)
 1000 nurses/ cooperative = PROVINCE  Local and Foreign Donors
 PhilHealth
 Stroke; Handicapped; Debilitated Patients
He also outlines the possible entrepreneurship and job
options for medical practitioners:
AIMS:
 ACADEMIC SECTOR JOB OPPORTUNITIES OR
JOB OPTIONS – Teachers/ professors, Clinical  Reduce the cost of Quality Healthcare
instructors for nurses, Academic research  Employment Opportunities for RN’s
assistants, field coordinators).  Achieve Millennium Development Goal on
 HEALTH SECTOR JOB OPPORTUNITIES OR JOB Maternal and Child Health
OPTIONS -Part time RHU / hospital nurses,
Manage/ operate birthing centers, Manage/
operate care homes for elderly, differently- COLLABORATING AGENCIES:
abled persons and other patients needing
 DOLE: provides all management and direction
chronic care.
and provide financial assistance in the form of
 HEALTH SECTOR JOB OPPORTUNITIES OR JOB
grants to nurses’ cooperatives which the latter
OPTIONS - Part time or fulltime private nurses
will use as a start-up capital. The DOLE through
(in the homes of patients who can afford to
its regional offices shall also assist the nurse
pay), Medical Representative for drug
 organize themselves into cooperativeness or
associations and register themselves with the
appropriate government authority.
 DOH: formulates the Healthcare Returns in
Relation with Project Entreprenurse
 OHNAP: Patient Referral. Lead in the
formulation or reform of health policies in
support of this initiative, including referring
patients to the project’s nurses’
cooperativeness.
 UPCN (UP College of Nursing): research on
IMPACT evaluation of Socioeconomic Effect of
Project Entreprenurse
 PRC-BON: promotes Nurse Entrepreneurship
among country’s Nursing Students and Colleges
in Schools and research on the feasibility of
including nurse entrepreneurship in the BSN
curriculum.
 PNA: Research and formulate costing standards
that our nurses’ coopeartives can use as guide
in fixing the cost of their services.
 DTI: Design and implement an entrepreneurship
development training course for nurses’
cooperatives.

Entrepreneur - a person who organizes and operates a

business or businesses, taking on greater than normal
financial risks in order to do so.

Hospice - a home providing care for the sick or

terminally ill.