Context of the local public health organization The capability of the public health system is influenced by dedsion. s made by the local chief executive and couna1, especially those oo budgetary allocation. How the: budget is <let. ermined and the degree of participation of the health center staff in the preparation of the hea Jth budget vary from one LGU to another. A number,,f management activities in the LGUs such as hiring of personnel and purchasing are centralized. The degree of pa. rticipat fon (and satisfac..-tion) of the health center staff vane$ from one organizatio n to another. In wme LG Us. non-gov ernment organizations (NGOs), people's orgaoii1. ations and even halikbayan s (returning Filipinos) are active in hea Jth an. d bea1th-relatecl endeavo rs. l,ocal Hcallh Boards, tov, are active in some LG Us but not 'in others. There arc oilier factors that affect the delivery of health services and implemenlalio n of public health program s. Since health centers are usually located in the town proper, the residents of far-flung barangays find it difficult to go to town for consultntion. Travel time is long and tr:insportation cost is high.. Although there arc baranga y health stations (IHl S), t. he needed medicines and supplies are not always available. To make thin~,; worse, thl!re is no efficient communication system that links t J1e main health centers to the BHSs and far-fiuog catchment areas. ·niese factors, in addilion to client-re lated factors pose as Lhreats or as chal Jenges to the public health system. THE PHN AS A MANAGER AND SUPERVISOR The following di..o;cussion of managem ent issues and concerns does not pertain to a specific public health organization. It is premised on the following realities and professional beliefs: {1) under a devolved sct-up, the major decision-makers in he,ilth nrc t J1c elected local officials whose term of office is three years (a mayor may be re­ elected twice);(:. <) m<Jst LG Us do not hnvc ndcquotc resources for health; (3) there are LGUs with outst:mdi ng performance in health despite their meager resources while there ::in' others 1h;11 p Prform poorly in he::ilth care delivery: (4) nursing has a unique contribution in pnhlic health: and. (5) the p'rimary responsibi Lity of nurses is the provi:,;km of nun. in)!, <;. ire aml hcallh services lo their clients--individuals, fnmilies, populntfon groups,Lnd communitie s. Planning Nurses porticiputc i. n planning for the whole local health organization. A component of lhc orj!. nniw1ion's plan is a nursing unit plan. 111ere are different types of plans that PHNs tire exposed to, nnd participate in--strategic plan, operational plan, program plnn,rncl nu~ing care plan. TI1is chapter is just concerned with the first two. A strategic phtn is o long-range plan which contains an organizational vision and mission, guidin11, principles, broad strategic objectives, and specific tactics, projects or activities for achieving the brond objectives (Goet~ch :rnd Davis, 2000:78) In strategic plrmning. l'HNs participate in reviewing the organiza tion·s !-trenglhs, weakness, opportuniti c,; and lhrc. il'> (SWOT); and in fo. rmulaling its beliefs, mission, vision nn. d goal. Altho\1gh strategic planning is a function and responsibility of all managers in ao organizatio n. the initiative usually comes from top managem ent. Nu. rscs particip Rte in strategic planning to articulate their aspirations and unique contribution to the 422 