NLE Community Health Nursing — Philippine Health Care Delivery System & DOH ProgramsExam Answer Templates

Marks

1

Topic

Devolution and Local Government Code (RA 7160)

Difficulty

easy

Template Id

T1

Examiner Tip

A 1-mark question tests whether you know the single defining fact. Include the RA number and year in every law-based answer — it confirms accuracy and shows legal literacy, which examiners reward even in Very Short Answers.

Model Answer

Devolution refers to the transfer of basic health service delivery from the national Department of Health (DOH) to Local Government Units (LGUs) under RA 7160 (Local Government Code of 1991).

Question Type

very_short_answer

Answer Structure

• One sentence: Define devolution with its legal basis (RA 7160, 1991) and identify the transferring body (DOH) and the receiving body (LGUs).

Scoring Breakdown

Common Mark Deductions

• Writing only 'transfer of services to the local government' without specifying LGUs or citing RA 7160.
• Confusing devolution with decentralisation without the legal reference.
• Omitting the year 1991 — the year is part of the complete citation examiners expect.

Key Phrases To Include

• transfer of basic health services
• Local Government Units (LGUs)
• RA 7160
• Local Government Code of 1991

Marks

1

Topic

Primary Health Care — Alma-Ata Declaration

Difficulty

easy

Template Id

T2

Examiner Tip

The exact phrase 'Health for All by the Year 2000' and the year '1978' are the two facts being tested here. Memorise both as a single unit — they appear together in virtually every NLE question on PHC history.

Model Answer

The goal of Primary Health Care (PHC) as declared at the International Conference in Alma-Ata (1978) is 'Health for All by the Year 2000.'

Question Type

very_short_answer

Answer Structure

• One sentence: Name the conference, the year (1978), and state the exact goal phrase.

Scoring Breakdown

Common Mark Deductions

• Stating only 'Health for All' without specifying 'by the Year 2000' — the complete phrase is needed.
• Writing 'Alma-Ata Declaration of 1979' — the conference was 1978; 1979 was when the Philippines adopted PHC via LOI 949.
• Confusing Alma-Ata with any other declaration or conference.

Key Phrases To Include

• Health for All by the Year 2000
• Alma-Ata
• 1978
• International Conference on Primary Health Care

Marks

2

Topic

Universal Health Care Law — RA 11223

Difficulty

medium

Template Id

T3

Examiner Tip

For 2-mark questions, ensure each feature is clearly numbered or separated. Examiners mark point by point — a blended paragraph risks them missing your second point, costing you a mark.

Model Answer

RA 11223 (Universal Health Care Act, 2019) has two key features: (1) Automatic PhilHealth enrollment — all Filipino citizens are automatically enrolled in the National Health Insurance Program without the need for voluntary registration; and (2) Classification of members into Direct Contributors (those who pay premiums, e.g., employed individuals) and Indirect Contributors (those whose premiums are subsidised by the government, e.g., indigents and senior citizens).

Question Type

short_answer

Answer Structure

• Feature 1 (1 mark): Automatic PhilHealth enrollment of ALL Filipino citizens — state this clearly.
• Feature 2 (1 mark): Distinction between Direct Contributors and Indirect Contributors — define both briefly.

Scoring Breakdown

Common Mark Deductions

• Listing two general features without correctly naming the Direct/Indirect Contributor distinction — this is the most commonly tested feature.
• Writing 'voluntary enrollment' instead of 'automatic enrollment' — this is the exact opposite of what the law provides.
• Omitting the year 2019 or the RA number when the question context requires identification of the law.

Key Phrases To Include

• automatic enrollment
• National Health Insurance Program
• Direct Contributors
• Indirect Contributors
• subsidised by the government
• RA 11223
• 2019

Marks

2

Topic

Referral System — Two-Way Referral

Difficulty

easy

Template Id

T4

Examiner Tip

The word 'distinguish' demands a clear contrast. Place the two definitions side-by-side or in separate, clearly labelled sentences so the examiner can instantly identify both points without hunting through your paragraph.

Model Answer

Upward referral occurs when a client's health needs exceed the capacity of the primary-level facility (BHS or RHU), and the nurse refers the client to a higher-level facility (secondary or tertiary hospital) for specialised care. Back-referral (downward referral) occurs when the client has received specialist care at the higher-level facility and is referred back to the primary facility (RHU or health center) for continuing care, follow-up, and rehabilitation within the community.

Question Type

short_answer

Answer Structure

• Upward referral (1 mark): Direction is primary → secondary/tertiary; reason is needs beyond primary capacity.
• Back-referral (1 mark): Direction is secondary/tertiary → primary; purpose is continuing care and follow-up.

Scoring Breakdown

Common Mark Deductions

• Describing only upward referral and not defining back-referral — both directions are required for full marks.
• Using the term 'downward referral' without explaining that it means the client returns to primary care — direction alone is not enough.
• Failing to mention the purpose of each referral type (e.g., 'specialised care' for upward; 'continuity' for back).

Key Phrases To Include

• upward referral
• back-referral
• exceed capacity
• specialised care
• continuing care
• follow-up
• continuity of care
• two-way referral system

Marks

3

Topic

Primary Health Care — Essential Elements (ELEMENTS mnemonic)

Difficulty

easy

Template Id

T5

Examiner Tip

When asked to name elements from a mnemonic, include the expansion of the letter AND a brief clarifying phrase. This demonstrates you know both the label and its meaning — and protects you if the examiner awards a mark for the explanation rather than just the keyword.

Model Answer

Three essential elements of Primary Health Care (PHC) are: 1. Education for health — providing communities with information on health promotion and disease prevention. 2. Locally endemic disease control — identification, prevention, and management of diseases prevalent in the local community (e.g., malaria, schistosomiasis). 3. Essential drugs — ensuring access to a supply of safe, effective, quality medications at an affordable cost within the community.

Question Type

short_answer

Answer Structure

• Element 1 (1 mark): Name the element correctly and provide a brief one-phrase explanation.
• Element 2 (1 mark): Name the second element correctly and provide a brief one-phrase explanation.
• Element 3 (1 mark): Name the third element correctly and provide a brief one-phrase explanation.

Scoring Breakdown

Common Mark Deductions

• Listing only the letter/keyword without a brief explanation — some examiners require at least a phrase to confirm the student understands the element.
• Confusing the elements (e.g., writing 'endemic disease' as 'infectious disease control') — use the exact terms from the ELEMENTS mnemonic.
• Repeating the same element in different words to fill three lines instead of giving three distinct elements.

Key Phrases To Include

• ELEMENTS mnemonic
• Education for health
• Locally endemic disease control
• Expanded Program on Immunization
• Maternal and child health
• Essential drugs
• Nutrition
• Treatment of communicable and non-communicable diseases
• Safe water and sanitation

Marks

3

Topic

DOH — Roles and Functions

Difficulty

medium

Template Id

T6

Examiner Tip

These three role categories are the official DOH mandate. Use the exact role titles — 'Leadership,' 'Enabler and capacity-builder,' and 'Administrator' — as labels before explaining each. Examiners match your keywords against a marking rubric; using the official terms maximises your mark.

Model Answer

The Department of Health (DOH) performs three major roles in the Philippine health care delivery system: 1. Leadership in health — the DOH sets national health policies, standards, and strategic direction for the entire health sector, including LGUs and the private sector. 2. Enabler and capacity-builder — the DOH provides LGUs and other health stakeholders with technical assistance, training, financial support, and guidelines to strengthen local health systems. 3. Administrator of specific services — the DOH directly operates DOH-retained hospitals and specialty centers, manages national health programs, and oversees emergency preparedness and disaster response at the national level.

Question Type

short_answer

Answer Structure

• Role 1 — Leadership in health (1 mark): Policy-making and standard-setting function.
• Role 2 — Enabler and capacity-builder (1 mark): Technical and financial support to LGUs.
• Role 3 — Administrator of specific services (1 mark): Direct operation of retained hospitals and national programs.

Scoring Breakdown

Common Mark Deductions

• Using vague phrases like 'the DOH manages health' without specifying the three official role categories.
• Describing the DOH as a direct service provider at the RHU level — this is incorrect post-devolution; the DOH retained only specific hospitals and national programs.
• Listing only two roles and not mentioning all three.

Key Phrases To Include

• Leadership in health
• Enabler and capacity-builder
• Administrator of specific services
• national health policy
• standard-setting
• technical assistance
• DOH-retained hospitals
• Local Government Units

Marks

3

Topic

Referral System — Two-Way Referral and Nurse's Role

Difficulty

medium

Template Id

T7

Examiner Tip

Case-study questions test application, not just recall. Structure your answer in two parts: (1) the clinical decision and its rationale, and (2) the nurse's action/documentation. Examiners award marks for each part independently — ensure both are visible in your answer.

Model Answer

The appropriate action is an upward referral. Because the client's condition (gestational hypertension) exceeds the management capacity of the BHS (a primary-level facility), the nurse/midwife initiates an upward referral to a secondary-level facility (e.g., district or provincial hospital) where an obstetrician can provide specialised care. Documentation responsibility: The nurse prepares a completed referral form/slip that includes: (1) the client's identifying data, (2) pertinent assessment findings (gestational hypertension, vital signs, obstetric history), (3) interventions already given at the BHS (e.g., health teaching, initial BP management), and (4) the reason for referral. This referral slip accompanies the client and ensures continuity of care between the primary and secondary facility.

Question Type

case_study

Answer Structure

• Identify referral type (1 mark): Upward referral from primary (BHS) to secondary level, with rationale (gestational hypertension exceeds BHS capacity).
• Action taken (1 mark): Referral to secondary-level facility (district/provincial hospital) for obstetrician care.
• Documentation (1 mark): Completion of referral form including client data, findings, interventions given, and reason for referral.

Scoring Breakdown

Common Mark Deductions

• Stating 'refer to the hospital' without specifying the level of care (secondary) or type of facility.
• Omitting the nurse's documentation responsibility entirely — this is a distinct mark-earning point.
• Describing the nurse giving all care at the BHS without recognising that upward referral is needed — this shows failure to apply the referral system.

Key Phrases To Include

• upward referral
• exceeds capacity of primary-level facility
• secondary-level facility
• referral form/slip
• continuity of care
• assessment findings
• interventions already given
• reason for referral

Marks

3

Topic

FHSIS — Recording and Reporting System

Difficulty

medium

Template Id

T8

Examiner Tip

For questions asking you to name and describe recording tools, always include: (1) the abbreviation, (2) the full name, and (3) a one-phrase description of its function. This three-part formula shows thorough knowledge and earns marks at every sub-point of the rubric.

Model Answer

The Field Health Services Information System (FHSIS) is the official DOH recording and reporting system for health services at the local (RHU/health center) level. It provides data for health planning, monitoring of program implementation, and management decision-making at all levels of the health system. Three main recording tools at the RHU: 1. Individual Treatment Record (ITR) — the basic building block; records every client consultation at the facility, including the client's history, diagnosis, and treatment given. 2. Target Client Lists (TCLs) — program-specific tracking lists (e.g., prenatal TCL, EPI/under-1 TCL, family planning TCL, TB TCL) that ensure every registered program client is monitored and no client is missed for follow-up. 3. Summary/Monthly Consolidation Table — consolidates data from ITRs and TCLs into monthly facility-level statistics that are reported to the municipal health office and onward to the DOH.

Question Type

short_answer

Answer Structure

• Definition of FHSIS (1 mark): Official DOH recording/reporting system; purpose is data for planning, monitoring, and program management.
• Tool 1 (0.5 mark): Individual Treatment Record — basic building block, records every consultation.
• Tool 2 (0.5 mark): Target Client Lists — tracks program-specific clients to ensure follow-up.
• Tool 3 (0.5 mark): Summary/Monthly Consolidation Table — consolidates data for reporting.
• Note: Tools together earn the remaining marks; all three must be mentioned for full credit.

Scoring Breakdown

Common Mark Deductions

• Confusing FHSIS with PhilHealth or any other system — FHSIS is specifically the DOH recording/reporting system.
• Naming only the ITR and failing to mention TCLs and the Summary Table — all three are standard NLE test points.
• Describing FHSIS vaguely as 'a system of recording' without identifying its purpose (planning, monitoring, program management).

Key Phrases To Include

• FHSIS
• official DOH recording and reporting system
• Individual Treatment Record (ITR)
• basic building block
• Target Client Lists (TCLs)
• program-specific tracking
• Summary/Monthly Consolidation Table
• health planning and monitoring

Marks

2

Topic

DOH — Sentrong Sigla Quality Assurance Program

Difficulty

medium

Template Id

T9

Examiner Tip

For 2-mark definition-plus-significance questions, always use a two-sentence structure: sentence one defines the concept, sentence two explains why it matters. Examiners follow this exact pattern when marking.

Model Answer

Sentrong Sigla (SS) is the Department of Health's quality-assurance and certification program for primary-level health facilities such as Rural Health Units (RHUs) and health centers. It uses a seal-of-approval/certification system to recognise facilities that meet established DOH quality standards, and it provides awards, grants, and technical assistance as incentives for continuous quality improvement. Its significance lies in driving better-quality local health services at the LGU level, where most Filipinos first access care, thereby reinforcing the DOH's role as a standard-setter and enabler rather than a direct service provider.

Question Type

short_answer

Answer Structure

• Definition (1 mark): DOH quality-assurance/certification program for RHUs and health centers; uses a seal-of-approval system.
• Significance (1 mark): Promotes quality standards at LGU health facilities; incentivises improvement through awards and technical assistance.

Scoring Breakdown

Common Mark Deductions

• Translating 'Sentrong Sigla' as just 'health center' — it is the name of the quality certification movement, not a type of facility.
• Failing to mention the incentive mechanism (awards, grants, technical assistance) which distinguishes it from simple accreditation.
• Confusing Sentrong Sigla with PhilHealth accreditation — they are different processes.

Key Phrases To Include

• Sentrong Sigla
• DOH quality-assurance
• certification program
• RHUs and health centers
• seal of approval
• quality standards
• awards and technical assistance
• quality improvement

Marks

2

Topic

Universal Health Care — Population vs Individual-Based Services

Difficulty

medium

Template Id

T10

Examiner Tip

Differentiation questions require you to highlight the contrast, not just define two things separately. Use a connector phrase like 'on the other hand' or 'in contrast' to signal the contrast — this helps examiners see you are answering a differentiation question, not two separate definition questions.

Model Answer

Under RA 11223 (UHC Act, 2019), population-based health services are health interventions that benefit an entire community or population rather than a specific individual, such as health promotion campaigns, disease surveillance, vector control, and safe water provision; these are financed by the national and local governments. Individual-based health services, on the other hand, are services directed at specific individuals, such as consultations, laboratory tests, medicines, and hospitalisation; these are primarily financed through PhilHealth benefit packages.

Question Type

short_answer

Answer Structure

• Population-based services (1 mark): Benefit the community/population as a whole; examples (health promotion, surveillance, vector control); financed by government.
• Individual-based services (1 mark): Directed at specific individuals; examples (consultations, labs, hospitalisation); financed through PhilHealth.

Scoring Breakdown

Common Mark Deductions

• Defining the two categories without giving any examples — examples are expected to confirm conceptual understanding.
• Omitting the financing mechanism (government vs PhilHealth) — this is the key differentiating factor under RA 11223.
• Reversing the financing sources (e.g., saying PhilHealth funds population-based services).

Key Phrases To Include

• population-based health services
• individual-based health services
• RA 11223
• financed by national/local government
• financed through PhilHealth
• health promotion
• disease surveillance
• consultations
• hospitalisation

Marks

2

Topic

Levels of Health Care and Facilities

Difficulty

easy

Template Id

T11

Examiner Tip

When asked to enumerate AND give examples, set up a numbered list format. Examiners mark down the list — if your pairing is wrong, you still get partial credit for the correct part. Never blend all three levels into one paragraph for enumeration questions.

Model Answer

The Philippine health care system has three main levels (primary, secondary, and tertiary), with the community level sometimes cited as a fourth: 1. Primary level — first point of contact; example: Barangay Health Station (BHS) or Rural Health Unit (RHU). 2. Secondary level — general specialist care; example: District hospital or Provincial hospital. 3. Tertiary level — highly specialised care; example: Philippine General Hospital (PGH) or a DOH-retained medical center.

Question Type

short_answer

Answer Structure

• Primary level + example (0.5 mark each component): BHS or RHU.
• Secondary level + example (0.5 mark each component): District or Provincial hospital.
• Tertiary level + example (0.5 mark each component): PGH or DOH specialty center.
• Note: Award marks for correct level name paired with an appropriate facility example.

Scoring Breakdown

Common Mark Deductions

• Naming four levels but placing the wrong facility at the wrong level (e.g., PGH at secondary) — matching the level to the correct facility type is the test.
• Listing only the level names without any facility examples when examples are explicitly asked for.
• Confusing BHS with a secondary-level facility.

Key Phrases To Include

• primary level
• secondary level
• tertiary level
• Barangay Health Station
• Rural Health Unit
• district hospital
• provincial hospital
• Philippine General Hospital
• first point of contact

Marks

5

Topic

Primary Health Care — Comprehensive Overview

Difficulty

hard

Template Id

T12

Examiner Tip

For 5-mark long-answer questions, use clear section headings or Roman numerals. Examiners in the NLE typically follow a 5-point marking rubric, awarding one mark per major section. If your answer has visible, labelled sections, the examiner can immediately locate and award each mark without guessing. Aim for 1.5–2 pages of structured, organised content.

Model Answer

I. Definition of Primary Health Care Primary Health Care (PHC) is defined as essential health care made universally accessible to individuals and families in the community, at a cost the community and country can afford, through their full participation and self-reliance. It is the cornerstone of the Philippine community health nursing practice. II. Historical Foundation PHC was established globally through the Alma-Ata Declaration, adopted at the International Conference on Primary Health Care held in Alma-Ata (Almaty), USSR, in 1978, with the visionary goal of 'Health for All by the Year 2000.' The Philippines formally adopted the PHC framework through Letter of Instruction (LOI) 949, signed by President Marcos in 1979, with community participation as its central and underlying theme. III. Key Principles / Pillars of PHC The PHC framework rests on four key principles: 1. Accessibility, availability, affordability, and acceptability (the '4 As') — health services must be physically reachable, consistently available, financially feasible, and culturally acceptable to the community. 2. Community participation — community members are active partners in planning and implementing health programs, not passive recipients of care. 3. Intersectoral coordination — health improvement requires collaboration across multiple sectors beyond health, including agriculture, education, water and sanitation, housing, and local governance. 4. Appropriate technology — the use of health interventions and equipment suited to the local conditions, resources, and cultural context of the community. IV. Essential Elements of PHC (ELEMENTS mnemonic) E — Education for health L — Locally endemic disease control E — Expanded Program on Immunization (EPI) M — Maternal and child health, including family planning E — Essential drugs N — Nutrition T — Treatment of communicable and non-communicable diseases S — Safe water and sanitation V. Community Health Nurse's Role within PHC The community health nurse is the primary implementer of PHC at the RHU and BHS level. The nurse functions as: (1) a health educator — the core PHC function, providing health teaching to individuals, families, and communities; (2) a care provider — delivering direct nursing services including maternal and child health, immunisation, and disease management; (3) a manager and supervisor — overseeing Barangay Health Workers (BHWs), coordinating programs, and maintaining FHSIS records; and (4) an advocate and community organiser — mobilising community participation, which is the cornerstone of PHC.

Question Type

long_answer

Answer Structure

• Section I — Definition (1 mark): Accurate, complete definition of PHC including universality, affordability, and community participation.
• Section II — Historical foundation (1 mark): Alma-Ata Declaration (1978), LOI 949 (1979), goal 'Health for All by the Year 2000.'
• Section III — Key principles/pillars (1 mark): 4 As, community participation, intersectoral coordination, appropriate technology — at least 3 of 4 required for the mark.
• Section IV — Essential elements (1 mark): At least 5 of the 8 ELEMENTS correctly named.
• Section V — Nurse's role (1 mark): At least 3 roles correctly identified and briefly explained (health educator, care provider, manager, advocate).

Scoring Breakdown

Common Mark Deductions

• Writing a very long introduction without reaching the substance — examiners mark sections, not length. A long preamble that never defines PHC will lose the first mark.
• Confusing LOI 949 (Philippine adoption, 1979) with the Alma-Ata Declaration (international, 1978) — these are two separate events.
• Using only the ELEMENTS mnemonic letters without expanding them — the expansion is required to show understanding.
• Omitting the nurse's role entirely — in a 5-mark comprehensive question, the nurse's application component is always worth 1 mark.
• Writing in continuous prose for a list-based question (like ELEMENTS) — examiners expect a structured list; dense paragraphs make it easy to miss individual elements.

Key Phrases To Include

• essential health care
• universally accessible
• community participation
• Alma-Ata Declaration
• 1978
• LOI 949
• 1979
• Health for All by the Year 2000
• 4 As — accessibility, availability, affordability, acceptability
• intersectoral coordination
• appropriate technology
• ELEMENTS mnemonic
• health educator
• community organiser
• Barangay Health Workers

Marks

5

Topic

Devolution — RA 7160 and LGU Responsibilities

Difficulty

hard

Template Id

T13

Examiner Tip

A 5-mark question that says 'discuss' expects you to cover multiple dimensions: what, why, who, and so what (implication). Use the WIIS formula — What is it (definition), Impact (effects), Implementation (who does what), and So what (significance for nursing practice). This naturally generates 5 distinct scorable points.

Model Answer

I. RA 7160 and Devolution Republic Act 7160, the Local Government Code of 1991, enacted the devolution of basic health services from the Department of Health (DOH) to Local Government Units (LGUs). Devolution means the formal and permanent transfer of authority, responsibility, and resources for service delivery to LGUs. This was one of the most transformative reforms in Philippine public health administration. II. Impact on the DOH's Role Before RA 7160, the DOH was both the national policy-maker and the primary direct service provider. After devolution, the DOH shifted its primary function to: (1) Leadership in health — formulating national health policies and standards; (2) Enabler and capacity-builder — providing LGUs with technical assistance, training, and financial support; and (3) Administrator of specific retained services — directly operating DOH-retained hospitals, specialty centers, and national programs (e.g., disease surveillance, national immunisation programs). The DOH is no longer the frontline service provider; that role transferred to LGUs. III. Responsibilities of LGUs at Different Levels 1. Provincial LGUs — responsible for operating and managing provincial hospitals and district hospitals, which serve as secondary-level referral facilities for the municipalities within the province. 2. City and Municipal LGUs — responsible for establishing and operating Rural Health Units (RHUs) and health centers as the primary entry points of care. They employ public health nurses, midwives, physicians, and sanitary inspectors. 3. Barangay LGUs — support the operation of Barangay Health Stations (BHS), the most peripheral primary-level facility, and organise Barangay Health Workers (BHWs). IV. Implications for Community Health Nursing The community health nurse in the Philippines most commonly works within this devolved structure, employed by the city or municipal LGU at the RHU level. The nurse's accountability is primarily to the local health office and LGU, not to the DOH directly. This also means health delivery quality can vary significantly between LGUs depending on local government commitment and resources, which is why the DOH's capacity-building role remains critical. V. RA 11223 (UHC Act, 2019) and Refinement of Devolution The Universal Health Care Act of 2019 (RA 11223) built upon devolution by integrating LGU health services into province-wide and city-wide health systems, ensuring coherent and coordinated delivery from the BHS up to the provincial hospital, with the RHU as the primary care gateway and coordinator.

Question Type

long_answer

Answer Structure

• Section I — Definition and context of devolution under RA 7160 (1 mark): Correct RA number, year, and meaning of devolution.
• Section II — Impact on DOH's role (1 mark): Shift from direct provider to policy-maker/enabler/administrator; at least 2 of 3 DOH roles mentioned.
• Section III — LGU responsibilities by level (2 marks): Provincial LGU (hospitals — 0.5 mark); City/Municipal LGU (RHUs — 0.5 mark); Barangay (BHS/BHWs — 0.5 mark); integration under UHC or consequence for nursing (0.5 mark).
• Section IV — Implication for community health nursing (1 mark): Nurse works within devolved structure at RHU/LGU; accountability to local health office.

Scoring Breakdown

Common Mark Deductions

• Stating that the DOH 'still runs all hospitals' — this is incorrect; only DOH-retained hospitals remain under the DOH.
• Describing LGU responsibilities without differentiating by LGU level (provincial vs municipal vs barangay) — the differentiation is the core of the question.
• Not connecting devolution to the community health nurse's daily working reality — application is expected in 5-mark questions.
• Writing fewer than 1 page — a 5-mark long-answer in NLE-equivalent exams typically requires comprehensive, multi-section coverage.

Key Phrases To Include

• RA 7160
• Local Government Code of 1991
• devolution
• transfer of basic health services
• Local Government Units
• policy-maker and standard-setter
• enabler and capacity-builder
• DOH-retained hospitals
• provincial hospitals
• Rural Health Units (RHUs)
• Barangay Health Stations
• Barangay Health Workers
• RA 11223
• province-wide and city-wide health systems

Marks

3

Topic

PhilHealth — RA 7875 and RA 11223 Contributor Categories

Difficulty

medium

Template Id

T14

Examiner Tip

When a question references a case/scenario AND asks you to identify a law, address both parts — the applied explanation AND the legal citation. Examiners allocate marks for each distinct element. A brilliant explanation of contributors that omits RA 7875 will score only 2 out of 3.

Model Answer

Under RA 11223 (Universal Health Care Act of 2019), all Filipino citizens are automatically enrolled in the National Health Insurance Program (PhilHealth/NHIP). Members are classified into two categories: 1. Direct Contributors — members who have the capacity to pay and are required to pay monthly premiums. This includes employed workers (whose contributions are shared with their employer), self-earning individuals, Overseas Filipino Workers (OFWs), and other individuals with capacity to pay. 2. Indirect Contributors — members whose premiums are fully subsidised by the national government. This includes indigent persons, senior citizens, persons with disability (PWDs), and other sponsored and vulnerable population groups. PhilHealth (National Health Insurance Program) was originally created under Republic Act 7875 (National Health Insurance Act of 1995). RA 11223 strengthened and expanded NHIP by mandating automatic enrollment and expanding benefit coverage.

Question Type

case_study

Answer Structure

• Direct Contributors defined (1 mark): Pay premiums; examples — employed, self-earning, OFWs.
• Indirect Contributors defined (1 mark): Premiums subsidised by government; examples — indigents, senior citizens, PWDs.
• Legal basis of PhilHealth (1 mark): RA 7875 (National Health Insurance Act of 1995) created PhilHealth/NHIP.

Scoring Breakdown

Common Mark Deductions

• Confusing RA 7875 (creates PhilHealth, 1995) with RA 11223 (UHC Act, 2019) — both are frequently tested in the same question.
• Describing Indirect Contributors as 'those who don't pay' without stating that their premiums are subsidised by the national government — the subsidy mechanism is the key fact.
• Omitting examples for each contributor type — examples are expected to confirm you understand who belongs in each category.

Key Phrases To Include

• Direct Contributors
• Indirect Contributors
• premiums
• subsidised by the national government
• automatic enrollment
• RA 11223
• RA 7875
• National Health Insurance Act of 1995
• indigents
• senior citizens
• Overseas Filipino Workers

Marks

2

Topic

Community Health Nurse — Roles and Functions

Difficulty

easy

Template Id

T15

Examiner Tip

When asked to 'list' roles, use a numbered list and keep descriptions brief but present. The examiner is checking that you know (1) the role name AND (2) its basic function. Lead with the role title, then add a short phrase — this format makes it easy to award both sub-points of each mark.

Model Answer

The community health nurse in the Philippine health care delivery system performs the following roles: 1. Care provider — delivers direct nursing care to individuals, families, and communities at the clinic, home, and community level. 2. Health educator — provides health teaching on disease prevention, health promotion, and community health programs; this is the core PHC function of the nurse. 3. Manager and supervisor — manages the RHU nursing service, supervises Barangay Health Workers (BHWs) and midwives. 4. Coordinator and collaborator — links clients with referral facilities and other sectors to ensure continuity of care. 5. Recorder and reporter — maintains FHSIS records (ITR, TCLs, Monthly Reports) and ensures accurate health data reporting. 6. Advocate and community organiser — mobilises community participation, which is the cornerstone of PHC.

Question Type

short_answer

Answer Structure

• Any 4 roles correctly named and briefly described (0.5 mark each) OR 2 roles with fuller description (1 mark each) depending on rubric.
• For a 2-mark question: 4 correctly named roles = full marks; each role requires its name and a minimum one-phrase description.

Scoring Breakdown

Common Mark Deductions

• Listing role titles without any description — if the rubric requires a brief description, titles alone may earn zero.
• Listing overlapping or duplicate roles (e.g., 'educator' and 'teacher') instead of distinct role categories.
• Omitting 'health educator' — this is the PRIMARY and most frequently tested nurse role in PHC; its omission is a significant gap.

Key Phrases To Include

• care provider
• health educator
• manager and supervisor
• coordinator and collaborator
• recorder and reporter
• advocate and community organiser
• Barangay Health Workers
• FHSIS
• community participation