Community Health Nursing

Module 2: UNIVERSAL HEALTH CARE

UNIVERSAL HEALTH CARE (UHC), ALSO REFERRED TO Target : Ensure that, by 2015, children everywhere,
AS KALUSUGAN PANGKALAHATAN (KP) boys and girls alike, will be able to complete a full course of
primary schooling
Universal Healthcare GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER
WOMEN
 is the “provision to every Filipino of the highest Target : Eliminate gender disparity in primary and
possible quality of health care that is accessible, secondary education preferably by 2005 and to all levels of
efficient, equitably distributed, adequately funded, education no later than 2015
fairly financed, and appropriately used by an informed GOAL 4: REDUCE CHILD MORTALITY
and empowered public” Target : Reduce by two-thirds, between 1990 and 2015, the
 It is a government mandate aiming to ensure that under-five mortality rate
every Filipino shall receive affordable and quality Target : Reduce by three-quarters, between 1990 and 2015,
health benefits. This involves providing adequate the maternal mortality ratio
resources – health human resources, health facilities,
and health financing. GOAL 5: IMPROVE MATERNAL HEALTH
UHC’S THREE THRUSTS GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER
DISEASES
1. FINANCIAL RISK PROTECTION Target : Have halted by 2015 and begun to reverse the spread
Protection from the financial impacts of health care is attained of HIV/AIDS
by making any Filipino eligible to enroll, to know their Target : Have halted by 2015 and begun to reverse the
entitlements and responsibilities, to avail of health services, incidence of malaria and other major diseases
and to be reimbursed by PhilHealth with regard to health care
expenditures. GOAL 7: ENSURE ENVIRONMENTAL SUSTAINABILITY
2. IMPROVED ACCESS TO QUALITY HOSPITALS Target : Integrate the principles of sustainable development
AND HEALTH CARE FACILITIES into country policies and programmes and reverse the loss of
shall be achieved in a number of creative approaches. First, environmental resources
the quality of government-owned and operated hospitals and Target : Halve, by 2015, the proportion of people without
health facilities is to be upgraded to accommodate larger sustainable access to safe drinking water
capacity, to attend to all types of emergencies, and to handle Target: By 2020, to have achieved a significant improvement in
non- communicable diseases. the lives of at least 100 million slum dwellers
 The Health Facility Enhancement Program (HFEP) GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR
shall provide funds to improve facility preparedness for trauma DEVELOPMENT
and other emergencies. The aim of HFEP was to upgrade 20%
of DOH- retained hospitals, 46% of provincial hospitals, 46% of Field Health Service Information System (FHSIS)
district hospitals, and 51% of rural health units(RHUs) by end FHSIS
of 2011. • It is a network of
3. ATTAINMENT OF HEALTH-RELATED MDGS It is intended to address the short term needs of DOH and LGU
Further efforts and additional resources are to be applied on staff with managerial or supervisory functions in facilities and
public health programs to reduce maternal and child mortality, program areas.
morbidity and mortality from Tuberculosis and Malaria, and It monitors health service delivery nationwide.information
incidence of HIV/AIDS. Localities shall be prepared for the
emerging disease trends, as well as the prevention and control OBJECTIVES OF FHSIS
of non- communicable diseases.  To provide summary data on health service delivery
and selected program accomplishment indicators at
 The organization of Community Health Teams (CHTs) the barangay, municipality/ city, and district, provincial,
in each priority population area is one way to achieve regional and national levels.
health-related MDGs. CHTs are groups of volunteers,  To provide data which when combined with data from
who will assist families with their health needs, other sources, can be used for program monitoring
provide health information, and and evaluation purposes.
 RNheals nurses will be trained to become trainers  To provide a standardized, facility-level data base that
and supervisors to coordinate with community-level can be accessed for more in-depth studies.
workers and CHTs. By the end of 2011, it is targeted  To minimize the recording and reporting burden at the
that there will be 20,000 CHTs and 10,000 RNheals. service delivery level in order to allow more time for
 Another effort will be the provision of necessary patient care and promote activities.
services using the life cycle approach. These services
include family planning, ante-natal care, delivery in IMPORTANCE OF FHSIS
health facilities, newborn care, and the Garantisadong  Helps local government determine public health
Pambata package. priorities.
 Basis for monitoring and evaluating health program
Better coordination among government agencies, such as implementation.
DOH, DepEd, DSWD, and DILG, would also be essential for  Basis for planning, budgeting, logistics and decision
the achievement of these MDGs. making at all levels.
 Source of data to detect unusual occurrence of a
MILLENIUM DEVELOPMENT GOALS disease.
 Needed to monitor health status of the community.
GOAL 1: ERADICATE EXTREME POVERTY AND HUNGER
 Helps midwives in following up clients.
GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION
ACHIEVE UNIVERSAL PRIMARY EDUCATION  Documentation of RHM/PHN day to day activities. on
Community Health Nursing
Module 2: UNIVERSAL HEALTH CARE

COMPONENTS OF FHSIS to higher level. The source of data for this component
1. Individual Treatment Record (ITR) is dependent on the records.
2. Target Client List (TCL)
3. Summary Table THE MONTHLY FORM
4. The Monthly Consolidation Table (MCT) • Program Report (M1) The Monthly Form contains
selected indicators categorized as maternal care,
INDIVIDUAL TREATMENT RECORD (ITR) childcare, family planning and disease control.
 The fundamental building block or foundation of the • Morbidity Report (M2) The Monthly Morbidity Disease
Field Health Service Information System is the Report contains a list of all diseases by age and sex.
INDIVIDUAL TREATMENT RECORD. The Midwife uses the form for the monthly
 This is a document, form or piece of paper upon consolidation report of Morbidity Diseases and is
which is recorded the date, name, address of patient, submitted to the PHN for quarterly consolidation.
presenting symptoms or complaint of the patient on
consultation and the diagnosis (if available), treatment THE QUARTERLY FORM
and date of treatment. • Program Report (Q1) The Quarterly Form is the
municipality/city health report and contains the three-
TARGET CLIENT LIST (TCL) month total of indicators categorized as maternal
First is to plan and carry out patient care and service delivery. care, family planning, child care, dental health and
Such lists will be of considerable value to midwives/nurses in disease control
monitoring service delivery to clients in general and in • Morbidity Report (Q2) The PHN uses the form for the
particular to groups of patients identified as “targets” or Quarterly Consolidation Report of Morbidity Diseases
“eligibles” for one or another program of the Department to consolidate the Monthly Morbidity Diseases taken
from the Summary Table.
TARGET CLIENT LIST (TCL)
• The second purpose of Target Client Lists is to THE ANNUAL FORMS (A-BHS, A1, A2 & A3)
facilitate the monitoring and supervision of service ABHS Form is the report of midwife which contains data on
delivery activities. demographic, environmental and natality.
• The third purpose is to report services delivered.
• The fourth purpose of the Target Client Lists is to The report of nurse at the RHU/MHC are the
provide a clinic-level data base which can be
accessed for further studies Annual Form 1 which is the report on vital statistics:
demographic, environmental, natality and mortality.
TARGET CLIENT LISTS TO BE MAINTAINED IN THE FHSIS Annual Form 2 is the report that lists all diseases and their
• 1. Target Client List for Prenatal Care occurrence in the municipality/city. The report is broken down
• 2. Target Client List for Post-Partum Care by age and sex.
• 3. Target Client List of Under 1 Year Old Children Annual Form 3 is the report of all deaths occurred in the
• 4. Target Client List for Family Planning municipality/city. The report is also broken down by age and
• 5. Target Client List for Sick Children sex.
• 6. NTP TB Register
• 7. National Leprosy Control Program Form 2-Central HEALTH INDICATORS
Registration Form • Fertility
• Crude Birth Rate (CBR) - Overall total reported births
SUMMARY TABLE Morbidity-Illnesses affecting the population group
The Summary Tables is a form with 12-month columns • Incidence Rate (IR)-reported new cases affecting the
retained at the facility (BHS) where the midwife records population group
monthly all relevant data. The Summary Table is composed of: • Prevalence Rate (PR)-determine sum total of new +
old cases of diseases per percent population
(1) Health Program Accomplishment this can serve as proof of • Mortality-Reports causes of deaths
accomplishments to show LGU officials whenever they visit the - Crude Death Rate (CDR)-overall total reported
facility. death
(2) Morbidity Diseases the source of ten leading causes of - Maternal Mortality Rate (MMR)-maternal deaths
morbidity for the municipality/city. This summary table will help due to maternal causes
the nurse and MHO to get the monthly trend of diseases. - Infant Mortality Rate (IMR)-# of infant deaths (0-
12 months) or less than 1 year old
THE MONTHLY CONSOLIDATION TABLE (MCT) - Neonatal Mortality Rate (NMR)-# of deaths
The Consolidation Table is an essential form in the FHSIS among neonates (newborn 0-28 days, < 1 month)
where the nurse at the RHU records the reported data per
- Swaroops Index (SI)-deaths among individual in
indicator by each BHS or midwife.
the age group of 50 and above
 " This is the source document of the nurse for the
Quarterly Form.
 " The Consolidation Table shall serve as the Output
Table of the RHU as it already contains listing of BHS
per indicator.

FHSIS REPORTING
 These are summary data that are transmitted or
submitted on a monthly, quarterly and on annual basis
Community Health Nursing
Module 2: UNIVERSAL HEALTH CARE