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Community Health and Develop Men 2

Community Health and Develop Men 2

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Published by: Benjie Mananzan on Jul 07, 2011
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What Community Development Is? Principle: PHC & Ethicolegal Aspect
CONCEPT: Primary Health Care History of Primary Health care May 1977- The 30th World Health Assembly adopted resolution WHA 30:43. This resolution decided that the main social target of governments and WHO should be the attainment by all the people of the world by the year 2000 a level of health that will permit them to lead a socially and economically productive life. September 12, 1978- International conference on primary health care was held in this year at Alma Ata. USSR. The conference came up with what is known popularly as the Alma Ata Declaration, Which represents a global ideal, a new vision about how to achieve world health. The declaration stated that primary health care is the key to attaining the health for all goal. 1979- The World Health Assembly launched the Global Strategy for Health for All. October 19, 1979- The President of the Philippines Issued letter of Instruction 949 which mandated the ministry of health to adopt Primary Health care as an approach towards design, development, and implementation of programs, which focus health development at the community level DEFINITION OF PRIMARY HEALTH CARE The Alma Ata Conference defines PHC as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to, Through their full participation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and selfdetermination. It forms as integral part of both the country’s health system, of which it is the central function and the main focus and of the overall social and economic development of the community. GLOBAL GOAL OF PHC The Global goal as stated in the Alma Ata declaration is Health For all by the year 2000 through self reliance. The health for all goals does not mean however that nobody will be sick or disabled anymore. Nor does it mean that health care professionals will provide care for everybody in the country or the world for all their existing ailments. What it means is that health begins at home, schools and in the work place.

Basic Concept of PHC: 1. 2. 3. 4. 5. Health is related to social structure. Health and development are interrelated People participation is essential. Community organizing is the core in PHC. Use of appropriate technology.

PHC PRINCIPLES AND STRATEGIES 1. Accessibility, Availability, Affordability and Acceptability of Health services. Strategies: a. Health services delivered where the people are b. Use of indigenous/resident volunteer health worker as a health care provider with a ration of one community health worker per 10-20 households c. Use of Traditional medicine with essential drugs 2. Provision of quality, basic and essential health services Strategies: a. Training design and curriculum based on community needs and priorities b. Attitudes, knowledge and skills developed are on promotive, preventive, curative and rehabilitative health care. c. Regular monitoring and periodic evaluation of community health worker performance by the community and health staff. 3. Community Participation Strategies: a. Awareness-building and consciousness raising on health and healthrelated issues. b. Planning, implementation, monitoring and evaluation done through small group meetings(10-20 households cluster). c. Selection of community health workers by the community. d. Formation of health committees e. Establishment of a community health organization at the parish or municipal level. f. Mass health campaigns and mobilization to combat health problems. 4. Self-Reliance Strategies: Community generates support (cash,labor) for health programs a. Use of local resources (human,financial,material) b. Training of community in leadership and management skills. c. Incorporation of income generating projects, cooperatives and small scale industries. 5. Recognition of the interrelationship of health and development Strategies:

d. 8 Essential Health Services in Primary Health Care (ELEMENTS) 1. Social Mobilization Strategies: a. early diagnosis. communication and social services. Information. c. reallocation of budgetary resources b. Specific protection. 8.Safe water and sanitation Theoretical Framework for CHN Practice  Nursing Process: Assessment. Advocacy for political will and support from the national leadership down to the barangay level. Multi sectoral and interdisciplinary linkage b. Coordination of activities with economic planning. 7. education.a. food. 6. Specific Population group and Community  Approach to Nursing Care Delivery: Risk and Team approach. housing. 4. nutrition. Family. sanitation and population services b. The proposed theoretical framework defines the following: . c. public works. regional. Convergence of health. 5. Reorientation of health professionals on PHC c. 6. 3. Collaboration between government and non governmental organizations. 7. municipal and barangay development plans. prompt treatment and rehabilitation  Levels of Clientele: Individual. Establishment of an effective health referral system. agriculture. industry. communication support using multimedia. water. E – Education for Health L – Locally endemic disease control E – Expanded program for immunization M – Maternal and Child Health including responsible parenthood E – Essential drugs N – Nutrition T – Treatment of communicable and non-communicable diseases S . education. Decentralization strategies: a. Integration of PHC into national. provincial. Intervention and Evaluation  Levels of Prevention: Health promotion. 2.

The focus of care is on individual and the objective of nursing care is either promotion and maintenance of health. Priorities for care.It is not possible for a community health nurse to provide service to levels of clientele in the community who may need or demand nursing care. specific population group or the community at large. The focus of care is the family as a total functioning units which is more than the sum of its part. rearing and care of children until they are mature and ready to starts lives on their own . which is preventive. The objectives of care. Approach to health care delivery – The community health nurse is part of health team with specific roles and functions in the achievement of goal of community health development. applied to the four levels of clientele. ranked according to five levels and addressed to an individual. family. family.1. The family undertakes certain basic functions in all social classes and cultures through changing times and throughout the family life cycle. B. It is also the primary mediating agent between the individual and his society. LEVELS OF CLIENTELE The 4 levels of clientele in CHN practice: A. 5. 3. prevention of disease. Family – is the basic unit of society. 4. early diagnosis and treatment of a suspected ailment. who should receive care in the face of limited time and resources. Procreation. 2. It is part of a larger system encompassing communities and cultures. The level of clientele of the community health nurse – Care may be focused on and delivered to an individual client/patient. recovery and rehabilitation or peaceful and dignified death. Methodology for practice – The nursing process.  The Framework provides direction and guidelines to the community health nurse in terms of who or to whom she is giving care. To identify prioritize of care she/he should utilize the risk approach. a specific population group or the community as a whole. Individual – the CHN provide care to specific client/patients in various conditions of health and illness from healthy well to the dying and from all age group. She/he works in cooperation and coordination with other members of the health team. These function include the following: 1. why or the actions and intervention measures and the how of providing care and delivering nursing services.

disability. 4. Socialization of family members. interaction. accident or failure to realize one’s health potential • Health deficits: instances of failure in health maintenance (disease. 5. Satisfying the family member’s psychosocial needs for love. Maintenance of order and discipline. Structural-Functional Initial Data Base • Family structure and Characteristics • Socio-economic and Cultural Factors • Environmental Factors • Health Assessment of Each Member • Value Placed on Prevention of Disease First Level Assessment • Health threats: conditions that are conducive to disease. 11. Promoting and ensuring the well being and overall development of the members and the family as a whole. Provision of education to the young. Assigning roles. 9. Placement of members in the larger society. 8. 6. Development of a sense of family loyalty and maintenance of family. shelter. clothing. Developmental Stages of Family Development Stage 1 – The Beginning Family Stage 2 – The Early Child-bearing Family Stage 3 – The Family with Preschool Children Stage 4 – The Family with School Age Children Stage 5 – The Family with Teen-agers Stage 6 – The Family as Launching Center Stage 7 – The Middle-aged Family Stage 8 – The Aging Family 2. acceptance and belonging and self actualization. establishing standard of communication. Provision of food. 10. 3. 7.2. tasks and responsibility to the family members to ensure effective operation of household. Models: 1. developmental lag) • Stress points/ Foreseeable crisis situation: anticipated periods of unusual demand on the individual or family in terms of adjustment or family resources . Allocation and management of family resources to meet family needs. relationship and behavior. health care and other essentials of living.

school health nursing and occupational health nursing are subspecialties in CHN practice. Vulnerable Groups: • Infants and Young Children • School age • Adolescents • Mothers • Males .Second Level Assessment: • Recognition of the problem • Decision on appropriate health action • Care to affected family member • Provision of healthy home environment • Utilization of community resources for health care Problem Prioritization: • Nature of the problem Health deficit Health threat Foreseeable Crisis • Preventive potential High Moderate Low • Modifiability Easily modifiable Partially modifiable Not modifiable • Salience High Moderate Low Family Service and Progress Record C. communicable disease cases and disabled.  In the care of specific population groups the nurse utilizes the group approach. are at risk of developing or have already developed certain defined health problems. identifying the common health and nursing needs of the members and addressing them for the whole group. street children.  Midwifery. Other population include the elderly population. preventive. out of school youth. and whom the nurse delivers and whom the nurse delivers health promotive. Specific population group  Community health nurses directs and focus their activities to certain population groups with common unique health needs. curative or rehabilitative nursing services.

families and specific population groups. like individuals and families.  These activities defined as health promotion and specific protection: . also go through stages of growth and development towards maturity. health of a community is influenced by many factors – physical. As with individuals. Primary Prevention  the core of the public health efforts. such as a town. Communities. cultural. developing or fully developed. A community health nurse assigned in a particular community. mental health. specific protection 3. Thus. Mortality and morbidity are broad indicator of a community sate of health. Prompt treatment 5. and the basic sciences • Occupational Health Nursing The application of nursing principles and procedures in conserving the health of workers in all occupations • School Health Nursing The application of nursing theories and principles in the care of the school population D. in cooperation and coordination with other members of the health team as well as relevant intersectoral teams. as well as healthy and unhealthy/sick communities. community networks. economic and political factors. Community At this level of care the community as a whole is the client/patient to whom the nurse delivers nursing services addressed to community-wide health problems. psychology.Primary Prevention II.Secondary Prevention III. Early diagnosis 4. communities which are underdeveloped. consist of activities which are undertaken before the disease strikes. we have primitive and progressive communities. Health Promotion 2.Tertiary Prevention Objectives and Focus of activities 1.     LEVELS OF PREVENTION IN PUBLIC HEALTH Level of prevention I. municipality has the whole community as her client/patient. biological.• Old People Specialized Fields: • Community Mental Health Nursing A unique clinical process which includes an integration of concepts from nursing. social. social psychology. Rehabilitation A.

with the objectives of halting its progress. an injury or a calamity has already exacted its damage and ill effects.  Specific protection refers to activities which protect people from specific and known potential or actual threats to health such certain disease and accidental injuries. It involves providing education and guidance on hygiene . nutrition.  The adverse or undesirable unwanted outcomes can be of any of the following: Death Disability Disease/illness Accident/injury Decline in quality of life Disaster. exercise. preventing or reducing its complications and bringing about cure. The level or degree of risk varies from        . shortening its duration. undesirable and adverse outcome of level of clientele. APPROACH TO NURSING CARE DELIVERY A. sleep and rest. mental or social well being. natural or man made Negative effects on human relationships. This explains and justifies the conduct of screening programs and periodic checkups such as pap smear. periodic such as x-ray exam. group or community unity and stability  Risk refers to an increased probability of occurrence of an unwanted. B. Risk Approach to Health Care  Refers to the early recognition of risk factors associated with adverse or undesirable unwanted outcomes in level of clientele and taking the necessary anticipatory or compensatory intervention measures to reduce. family. The objective of rehabilitation is to restore the patient to an optimum level of functioning physically. use of tobacco. psychologically. The objective of this is to prevent the development of disease /health problems. totally eliminate or cope with the probability of occurrence of the adverse or undesirable unwanted outcomes. minimizing its severity. alcohol and drugs. guidance on sexuality and relationship and other matters that affect health. socially and economically within the constraints imposed by the disability. C. with consequent disability or loss of function in varying degrees. Secondary Prevention  includes the activities for early diagnosis and prompt treatment of disease or health problem which has not been prevented. The objective is to enable the level of clientele to maintain health and realize full potential for development. Tertiary prevention  consist of activities which are done when the disease process. Health promotion Consist of activities aimed at maintaining or enhancing people’s physical.

No level of clientele has a zero risk at any unwanted. nursing auxiliary. Nursing team – Is part of the health team and is responsible for planning and implementation of nursing services. Ex: reducing blood cholesterol through proper diet and exercise 2. 1. The team may composed of professional nurses.  The risk factors to 4 of the major health problems in the world today.refers to measures taken in order to be ready to cope with the probability of occurrence of an unwanted outcome in instances where the risk factors cannot be modified or too late to be modified. low. The nurse sustains a cooperative relationship with co-workers in nursing and other fields. Anticipatory actions. . Pneumonia 4. Osteoporosis  Intervention Measures: There are 2 kinds of intervention methods 1. high and very high. moderate. community health workers. 2. Nutritionist. Environmental E. Biological C. orderlies. Risk factor can be causes or signals which are observable or identifiable prior to the event they are associated with. 1. B. Heart disease/heart attacks/stroke 3. practical nurses. Compensatory actions. health educators. HIV infection/ AIDS 2.refers to the health promotive and preventive measures which are taken to lower or reduce the risk of occurrence of the untoward outcome. social workers. volunteers and family members. Team Approach to health care  The concept of teamwork is stipulated in the International Council of Nurses (CN) Code of ethics in its section on nurses and co-workers which states. Psycholosocial D.  Risk factor is any characteristic or circumstances of level of clientele is known to be associated with increased risk of developing the untoward outcome and problem.the level of clientele and ranges from very low. Behavioral  A factor may be specific to one or more adverse.  There are 3 types of team that are of relevance to CHN practice: The nursing team. trained traditional birth attendants. undesirable adverse outcome. Risk factor can be any of the following types: A. unwanted outcome. Health team – is composed of people coming from various disciplines in the health field who work together to promote the health of clients. Genetics B. Health team and Intersectoral team.

organized and dynamic method of providing care to the clients/ patients. systematic.  Commonly agreed and understood goals and plan of action  Effective leadership  A clear division of labor and appropriate allocation of responsibilities among members  Supportive.  Provision for periodic evaluation of the team’s functioning. behavioral and environmental problems. collaborative and cooperative relationship among the members of team. retraining and continuing education for team members  THE NURSING PROCESS • • • It is a logical. confidence and respect among the various members of the team. sanitary inspector and laboratory technician are some of the heath team. systematic pattern to reflect a sequential progress from one phase to another: a) Assessment phase b) Planning phase c) implementation phase d) Evaluation phase ASSESSMENT PHASE o Assessment is considered the foundation of the nursing process and is intended to collect and analyze information about the client in order to identify his health/nursing needs and problem which could include physical. Sectors which directly or indirectly affect community health are education.  An attitude of mutual trust. industry. 3. Intersectoral team – consist of professional worker from various disciplines outside of health fields but whos work has relevant to and impact on community health. Essential Elements of TEAMWORK. family a specific population group or a community. One of the significant developments in the 1970 was the adoption and use of the nursing process as the basic methodology of the profession. agriculture. whether the client is an individual. There are 4 distinct phases of the nursing process which are ordered in logical.pharmacist.  Open and honest communication among the members of the team  Recognition of the responsibility of each professional group represented in the team to safeguard its own practice  Appropriate use of available resources so as to achieve the goals of the team. community organizer.  Training. and related law enforcement agency and mass media. psychological. • . the police.

Nursing diagnosis refers to the effects of these diseases and pathological condition. among them. when to do it and who will do it. reports and other relevant documents. family. IMPLEMENTATION PHASE o The implementation of the plan of care is the “doing” phase of the nursing process. they have to be analyzed so that the client needs and problem can be identified. While giving care there is continual data collection and analysis and subsequent validation and modification of the care plan as needed. how to do it. friends. o A nursing diagnosis is a clear. o Methods of data collection include physical. syndrome. o Medical diagnosis refers to disease. survey or community environment and analysis of records. concise and definitive statement of the client problem and its etiology which can be modified by nursing intervention. disordered physiological and psychological functioning. The plan of care is viewed as the core focus of the nursing process which provides direction to nursing activities. abnormal organ system. • PLANNING PHASE o Planning is deciding in advance what to do.o Various source of information may be employed such as the client. the nurses organization of her work and the physical environment within which the care takes place. resources available. other health worker and secondary sources such as records and reports. EVALUATION PHASE o This phase of nursing process involves the collection of objective and subjective data which indicate whether the objectives of nursing care were achieved or not. o The end result of data is a statement of nursing problem or what is referred to as nursing diagnosis. observation. relatives. o The result is a mass of objective and subjective data about the client. o In this phase the nurse applies his knowledge and skills from nursing and relevant discipline in an integrated manner. interview. o The 4 components of Planning process:  Prioritizing problems  Setting goals and objectives  Identifying nursing actions which will meet the objectives set  Formulating a plan for evaluating care. o Once the data has been collected. which problem s were solved and which ones • • . or the actual giving of care to the client. o A number of factors may affect the actual provision of care. taking a nursing history.

Community Organizing Participatory Action Research (COPAR) . reimplemented.is a continuous and a sustained process of: 1. Educating the people . Development and implementation of a specific project less important than the development of the capacity of the community to establish the project 4.to work collectively and effectively on their immediate and long term problems 3. Emphasis of COPAR: 1. and reevaluated. Direction is established internally and externally 3.develop their capability and readiness to respond. Community working to solve its own problem 2. Structure: .need to be reassessed and which part of the nursing care plan needs to be replanned. Mobilizing with people .to understand and develop their critical consiousness 2. Working with people .the sequence of steps whereby members of a community come together to critically assess to evaluate community conditions and work together to improve those conditions.refers to a particular group of community members that work together for a common health and health related goals. Consciousness raising involves perceiving health and medical care within the total structure of society Importance of COPAR: • COPAR maximizes community participation and involvement . take action on their immediate needs towards solving the long term problems The process and structure through which members of a community are/or become organized for participation in health care and community development activities Process: .

• No serious peace and order problem. • Coordinate with local government and NGOs for future activities. Pre-Entry Phase . Criteria for Initial Site Selection • Must have a population of 100-200 families.• • • • COPAR could be an alternative in situations wherein health interventions in Public Health Care do not require direct involvement of modern medical practitioners COPAR gets people actively involved in selection and support of community health workers Through COPAR. • Make long/short list of potential communities. . Identifying Potential Barangay • Do the same process as in selecting municipality. Site Selection • Initial networking with local government. Identifying Potential Municipalities • Make long/short list. Choosing Final Barangay • Conduct informal interviews with community residents and key informants. • Formulate plans for institutionalizing COPAR. community resources are mobilized for selected health services COPAR improves both projects effectiveness during implementation Phases of COPAR Process: 1. • Do ocular survey of listed communities. • Revise/enrich curriculum and immersion program. Acitivities include: Preparation of the Institution • Train faculty and students in COPAR. • Coordinate participants of other departments. • No similar group or organization holding the same program.is the intial phase of the organizing process where the community organizer looks for communities to serve and help. • Consult key informants and residents. • Economically depressed. • No strong resistance from the community. • Conduct preliminary special investigation.

Develop community profiles for secondary data. adopt a low-key profile. Develop survey tools. • Her appearance. Identifying Host Family • House is strategically located in the community. Is crucial in determining which strategies for organizing would suit the chosen community. Success of the activities depend on how much the community organizers has integrated with the commuity. behavior and lifestyle should be in keeping with those of the community residents without disregard of their being role model. • Neighbors are not hesitant to enter the house. Guidelines for Entry • Recognize the role of local authorities by paying them visits to inform their presence and activities.• • • • • • Determine the need of the program in the community. • No member of the host family should be moving out in the community. Take note of political development. Choose foster families based on guidelines.sometimes called the social preparation phase. Pay courtesy call to community leaders. • Avoid raising the consciousness of the community residents. speech. 2. results relayed through community assembly . • Respected by both formal and informal leaders. Entry Phase .establishing rapport with the people in continuing effort to imbibe community life. • Should not belong to the rich segment. Activities in the Entry Phase o Integration .  living with the community  seek out to converse with people where they usually congregate  lend a hand in household chores  avoid gambling and drinking o Deepening social investigation/community study   verification and enrichment of data collected from initial survey conduct baseline survey by students.

. OJT) to develop their style in managing their own concerns/programs. • Conduct of mobilization on health and development concerns.never or hardly consulted 3. implementing.approach by key persons Isolates . implementing and evaluating their own programs. Key Activities • Training of CHO for monitoring and implementing of community health program. Organization-building Phase Entails the formation of more formal structure and the inclusion of more formal procedure of planning. • Linkaging and networking. Key persons . and evaluating community-wise activities. Key Activities o Community Health Organization (CHO)  preparation of legal requirements  guidelines in the organization of the CHO by the core group  election of officers Research Team Committee Planning Committee Health Committee Organization Others Formation of by-laws by the CHO o o o o o 4. At this point. • Identification of secondary leaders. the different committees setup in the organization-building phase are already expected to be functioning by way of planning. with the overall guidance from the community-wide organization. informal.approached by most people Opinion leader . It is at this phase where the organized leaders or groups are being given training (formal.Core Group Formation • Leader spotting through sociogram. Sustenance and Strengthening Phase Occurs when the community organization has already been established and the community members are already actively participating in community-wide undertakings.

• Implementation of livelihood projects .

Interdependence Strategies Reasons 1. empowerment and community participation 1. 2. Health promotion 1. personnel and facilities Community based approach to health Principle of interdependence 1. ESSENTIAL HEALTH SERVICES IN PRIMARY HEALTH CARE The Alma Ata report on PHC outlined 8 essential elements to be emphasized in PHC. Interdisciplinary community health 3. Appropriate participation technology democratize health sector 3. The acronym ELEMENTS is used to present these. Community based health programs upholds empowerment Equity. 4. Health becomes the responsibility of many sectors 2. 4. empowerment 3. These shall comprise the initial and continuing care at the point of entry into health system. The list of essential elements is a modification of the basic health services of earlier times. Equity 2. Community participation 4. Intersectoral 2. 2. To facilitate easy recall of these. Education for health Locally Endemic Diseases Control Expanded Program of Immunization Maternal and Child health including Responsible parenthood . 1.THE PRINCIPLES. Equity and 4. Universal coverage through social health insurance (phil health) Social financing by expanding philhealth coverage and tapping other sources Devolution of health offices. STRATEGIES AND RATIONALE stated in the Alma Ata Declaration can be summarized as follows: Principles 1. 3. Health becomes the responsibility of the people. PHC is the key and preventive care approach to 2. 3. Health becomes the responsibility of all professionals 3.

7. Confidentiality. Ex: to decide or to refuse treatment 3. Nonmaleficence. to apply measures for the benefit for the benefits of the sick: maximize good and minimize harm. Respect for Autonomy – The ability to decide: adequate information. 8. Essential drugs Nutrition Treatment of communicable and Non communicable Diseases Safe Water and Sanitation ETHICOLEGAL ASPECTS OF NURSING PRACTICE IN THE COMMUNITY Guided by a number of legal and ethical principles centered on the welfare of clients and protection of their rights. 3. Role Fidelity Some applications: 1.Fairness. CHN is composed of 3 major concepts: COMMUNITY (client) HEALTH (goal) NURSING (means) COMMUNITY as the Client/patient  At this level of care the community as a whole is the client/patient to whom the nurse delivers nursing services addressed to community. intervention must be done 2. Right to be informed about condition and treatments. 4. Right to safe and quality. Right to privacy Finally! Do not only deliver health services but HUMANIZE the health care delivery system. Other Universal Ethical Principles are: Veracity.5. Beneficence. Right to accurate or adequate information to make an informed decision. “ equals must be treated equally and un-equals must be treated unequally. Ethical practice is characterized by 3 major principle: 1. Justice. Ex: Update client on the latest development of health care. .Act of mercy and Charity. 6. Professional practice is legal if the practitioner works in accordance with the law. intellectual competence: power to act upon your decision and respect for the individual autonomy for others: self determination 2.

Mortality and Morbidity statistics are broad indicators of a community’s state of health. rehabilitative – tertiary health care services 4. development of progress and working together to achieve their goal. Health education. 05. Community is influence by many factors like physical. s. These knowledge. health counseling and guidance. health management and supervision. 2. ethnic or cultural ties.2008. Records management . economic and political factors.  This system approach to community health care is enhanced by CHED Memorandum Curricula No. conflict resolution and mediation and stress management in the community. intervening and evaluating. Input. Process: Community health nursing involves the application of theories and knowledge about community health and professional nursing. Clientele: The 4 main clientele of CHN are individual. 3. same aspiration of peace. Nursing inputs in CHN. cultural. b. Outcome: Community health functioning and ultimately. Direct and indirect care. prolong life and promote health and efficiency through holistic. requiring nursing students and nurses to posses competency in the following areas of responsibility: 1. a. and are committed to their group’s well being. social. systematic and organized community health activities. The following are the basic elements of community health nursing using a system framework: 1. Promotive – primary health care services c. Ethico-moral responsibility 6. Safe and quality nursing care 2. skills and even attitude are vital in every stage of the community health nursing process. Preventive – Primary. Personal and professional development 7. Management of resources and environment 3. community health and development. interest. Quality improvements 8.  Collection of families constitute a community. 6. planning. family. Concern: Community heath nursing is concerned with the client along the total health illness continuum with emphasis on the primary level of care. community health nursing has the following dimensions of care. Legal responsibility 5. population groups and community. Community can also refer to a group of people who share a common needs. Curative – secondary health care services d. community organization for health action.relating. Research 9. secondary and tertiary level of prevention. Health education 4. 5. referral. Care: With its focus on primary health care. biological. Community health nursing uses the nursing process to prevent disease. coordination of health services. assessing.

hospital. The state.  2 basic Components of a Concept of Health (Kass) 1. The following community health care paradigm integrates the health sector. mental and social well being and not merely the absence of disease or infirmity (WHO). 2.  WHO(1995) “ Governments have a responsibility for the health of their people by providing adequate health and social measures. health education.10. health deserves to a top national priority. community organization and participation. Wholeness – simultaneous functioning of the different components of the ability to self-heal.  Congressional Commission on health (1993) Health as a fundamental right. individuals. preventive care.  The key strategies for the achievement of the community health goal are: health promotion. families and communities share the responsibility for health and as responsibility of all sectors. Community Health Care Paradigm Health Sector Health provider Community Other sector Primary Health Care health promotion preventive care health education Community organization and participation Health Development  The above paradigm follows the emerging approach of engaging the community in the decision-making process in health and community participation in primary health care.  Health – a state of complete physical. . health and other social services available to all people at affordable cost”.  The health sector in the community health includes the multidisciplinary health providers. well workingness – identifies the physical ability of components of the body to function. Phil. Communication 11. community as client and other sector (e.g. Public and private clinics. section 11 “ The state shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods. primary health care. Constitution and By laws: Article 13. government and non-government organization. health and development. Collaboration and Teamwork RIGHT TO. AND RESPONSIBILITY FOR HEALTH HEALTH  Is a basic human right  Article 1.

health is defined as well being. . which defined as “ meeting the needs of the present generation without compromising the ability of the future generations to meet their own needs. The community health goal is Health and Development which are connected to each other. not merely the absence of disease and development Means sustainable development of the community. As the key to development.

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