Public health nurses (PHNs) in the Philippines play a vital role in advancing Universal Health Care and Primary Health Care by serving as frontline leaders in community engagement, health promotion, and policy implementation. Despite their contributions, they face persistent challenges, including workforce shortages, wage disparities, hospital-centric education, and fragmented governance. Drawing from a reflexive narrative of community-based practice and organizational experience, this article situated the evolving role of PHNs within broader health systems transformation. The National Association of Public Health Nurses, Inc. (NAPHNI) established a unified platform for advocacy, leadership development, and recognition of advanced practice roles. Policy reforms such as a National Nursing Workforce Plan, passage of the Comprehensive Nursing Bill, and competitive compensation were imperative to empower PHNs. Strengthening public health nursing was discovered to be crucial in achieving health equity and a resilient healthcare system in the Philippines.

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs.

A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data.

A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken.

Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

Achievement of Universal Health Care (UHC) in the Philippines requires capable health workers who can navigate changes and lead in the local implementation of health system reforms. Public health nurses are in a strategic position to lead in UHC implementation as they constitute the largest cadre of health workers in the public health setting, and core concepts of UHC intersect with principles of public health nursing practice. This paper aims to describe the development and implementation of a leadership training program for public health nurses in the Philippines, in response to UHC. Document reviews of training reports and evaluations, including course site data analytics, and evaluation of the training program were done for the four cohorts of the course. The University of the Philippines Manila College of Nursing, with support from the Department of Health, responded to the increased demand of the Philippine health system for public health nurses with strong foundations and advanced skills by designing and offering a leadership development course specific to PHNs. From November 2019 to March 2022, a total of 183 participants from 17 regions completed the training. With the COVID-19 pandemic and dynamic changes in governance, the experiences of the project highlighted the need for flexibility in delivering the training program, updating module contents according to the latest developments, and improving course duration and evaluation. Barriers to course engagement and completion must be addressed for PHNs, their workplaces, clients, and the health system to benefit the most from the training.
Nurses, Public Health ; Universal Health Care ; Nursing

PURPOSE: The purpose of this study was to develop a suicide prevention nursing competency program for visiting nurses, and to examine the effect of this program on suicide prevention-related knowledge, attitudes, and behaviors.METHODS: A total of 66 visiting nurses were recruited from 10 public health centers and divided equally into the experimental and control group. For the experimental group, the suicide prevention nursing competency program was provided twice a week for 120 minutes across 3 weeks. Participants were asked questions related to suicide prevention knowledge, attitudes, and behaviors at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, a t-test, repeated measure ANOVA, and Friedman test.RESULTS: There were significant differences in knowledge and behaviors at the measured time periods, and significant differences in attitudes and behaviors between the two groups. There were also significant interactions between groups and times in attitudes and behaviors. These results suggest that the effects of the program were persistent until the 1-month follow-up.CONCLUSION: The developed suicide prevention nursing competency program is effective in evidence-based education for visiting nurses to increase suicide prevention-related knowledge, attitudes, and behaviors.
Education ; Follow-Up Studies ; Home Health Nursing ; Nurses, Community Health ; Nursing ; Public Health ; Suicide

BACKGROUND AND OBJECTIVES: Nationwide social inequalities of oral anticoagulation (OAC) usage after the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) have not been well identified in patients with atrial fibrillation (AF). This study assessed overall rate and social inequalities of OAC usage after the introduction of NOAC in Korea.METHODS: Between January 2002 and December 2016, we identified 888,540 patients with AF in the Korea National Health Insurance system database. The change of OAC rate in different medical systems after the introduction of NOAC were evaluated.RESULTS: In all population, overall OAC use increased from 13.2% to 23.4% (p for trend <0.001), and NOAC use increased from 0% to 14.6% (p for trend <0.001). Compared with pre-reimbursement (0.48%), the annual increase of OAC use was significantly higher after partial (1.16%, p<0.001), and full reimbursement of OAC (3.72%, p<0.001). Full reimbursement of NOAC (adjusted odds ratio, 2.10; 95% confidence interval, 2.04–2.15) was independently associated with higher OAC use. However, the difference of overall OAC usage between tertiary referral hospitals and nursing or public health centers increased from 17.9% in 2010 to 36.8% in 2016. Moreover, usage rate of NOAC was significantly different among different medical systems from 37.2% at the tertiary referral hospital and 5.5% at nursing or public health centers.CONCLUSIONS: Introduction of NOACs in routine practice for stroke prevention in AF was associated with improved rates of overall OAC use. However, significant practice-level variations in OAC and NOAC use remain producing social inequalities of OAC despite full reimbursement.
Anticoagulants ; Atrial Fibrillation ; Humans ; Insurance ; Korea ; National Health Programs ; Nursing ; Odds Ratio ; Public Health ; Socioeconomic Factors ; Stroke ; Tertiary Care Centers

This paper describes the COVID-19 response efforts through strategic partnerships of a nursing school in the Philippines. The roles of the academe through teaching as well as continuing education and community extension services programs were particularly harnessed. Existing academe-government-community partnerships were leveraged, and personal networks mobilized to provide support on risk communication, community engagement, and capacity building. Challenges and limitations encountered serve as points for improving the academe's strategies and activities. The lessons from this undertaking highlight the crucial role of nursing schools as relevant resources in COVID-19 pandemic response initiatives. Partnerships and networks built prior to the pandemic are instrumental in providing the space and opportunities for faculty and student nurses to aid in strengthening the local response. Recommendations are outlined to enhance current roles, strategies, and activities of the academe in the COVID-19 pandemic and lay future directions for Philippine nursing schools given the increasing incidence and severity of disasters in the country.
Public Health Nursing ; Disaster response ; Disaster nursing ; COVID-19

In this paper, I reflect on caring and witnessing through engaged ethnography of an urban poor community during the onset of the COVID19 pandemic. The urban poor are individuals and families who live below the poverty line in metropolitan areas, many of whom have little or no political voice and are insufficiently protected by social networks and other institutions. In March 2020, the government placed Metro Manila under Enhanced Community Quarantine to control the spread of COVID19. This left many an urban poor community in Metro Manila to struggle even more against an already precarious existence. By standard, nurses render different levels of care for urban poor clients in almost all health care settings. In public health nursing, we come in close contact to the realities of our clients when we see them in health centers, in the community, or whenever we do our home visits. Now, caring for vulnerable and marginalized groups such as the urban poor has changed due to minimum public health standards of wearing masks, physical distancing, handwashing, and enforcement of lockdowns. As a nurse, an academic, and as a student of anthropology, I came up for self-review while doing an article for a popular social news network derived from a virtually engaged ethnography. While this novel method requires you to see the world through the eyes of the “other,” and generates bioethical dialogue and awareness of personal biases in addressing ethical considerations and challenges, it gives voice and fulfills our roles as client advocates. In May 2020, the article was published with the urban poor organization and its partners as my coauthors. I borrowed from anthropology to arrive at a greater understanding of the socio-cultural effects and political implications of COVID19 to one of the most vulnerable nursing clientele – the urban poor.
Public Health Nursing ; Ethics, Research ; COVID-19

PURPOSE: It is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs' daily practice.METHODS: Semistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.RESULTS: The participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.CONCLUSION: The application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.
Community Health Nursing ; Education ; Grounded Theory ; Nurses, Public Health ; Public Health Nursing ; Public Health

PURPOSE: This study was conducted to examine the relationships among the perceptions and practice of taegyo (a traditional set of practices and beliefs related to healthy fetal development) and maternal-fetal attachment in pregnant women.METHODS: The participants were 136 pregnant women who visited a public health center or maternity hospital for prenatal care. The collected data were analyzed using descriptive statistics, the t-test, analysis of varience, and Pearson correlation coefficients with SPSS version 22.0.RESULTS: The mean age of the pregnant women was 32.24±3.99 years. The mean scores for perceptions of taegyo, practice of taegyo, and maternal-fetal attachment were 3.96±0.53, 3.74±0.64, and 3.94±0.49, respectively. Perceptions of taegyo were significantly correlated with the practice of taegyo (r=.72, p<.001), and maternal-fetal attachment (r=.55, p<.001). A significant correlation was also found between the practice of taegyo and maternal-fetal attachment (r=.65, p<.001).CONCLUSION: Perceptions of taegyo affected the practice of taegyo, and had a positive effect on maternal-fetal attachment. These findings suggest that primary care nurses at hospitals and public health centers should provide nursing intervention programs to improve the perceptions of taegyo, the practice of taegyo, and maternal-fetal attachment.
Female ; Hospitals, Maternity ; Humans ; Maternal-Fetal Relations ; Nursing ; Pregnant Women ; Prenatal Care ; Primary Health Care ; Public Health

PURPOSE: This study is a descriptive survey to identify emotional labor and job stress recognized in the course of administrative work, and how these affect the professional quality of life of public health nurses according to the employment type.METHODS: Data was collected through a survey of public health nurses conducted from Dec. 2018 to Jan. 2019 (N=232).RESULTS: The emotional labor of public health nurses was 3.27 out of 5 and full-time public health nurses had the highest scores. The job stress score was moderate at 2.45 out of four. The job stress of full-time nurses was also the highest. Among the sub-divisions of professional quality of life, compassion satisfaction was 3.55 out of five, while secondary traumatic stress was moderate at 2.48 and exhaustion at 3.01. Factors affecting compassion satisfaction were shown to be employment types and exhaustion. Factors affecting secondary traumatic stress were exhaustion, job stress and emotional labor. Factors affecting exhaustion were secondary traumatic stress and compassion satisfaction.CONCLUSION: The results of this study shows that full-time public health nurses in charge of nursing organizations at public health centers have extreme difficulty with excessive role responsibilities, resulting in high emotional labor intensity and high job stress.
Compassion Fatigue ; Empathy ; Employment ; Nurses, Public Health ; Nursing ; Public Health ; Quality of Life