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A social group determined by geographic boundaries and/or common values and interest. Its members know and interact with each other. It functions within a particular social structure and exhibit and creates norms, values and social institution. What are the Characteristics? 1. Prompts its members to have a high degree of awareness that we are community. 2. Uses its natural resources while taking steps to conserve them for future generations. 3. Openly recognizes the existence of subgroups and welcomes their participation in community affairs. 4. Prepared to meet crisis. 5. Has open channels communication that allows information to flow among all subgroups of its citizens and in all direction. 6. Seeks to make each of its systems resources available to all members of the community. 7. Has legitimate and effective ways to settle disputes and meet needs that arises within the community. 8. Encourage maximum citizen participation in decision making. 9. Promotes a high level wellness among its members. 10. Is a problem solving community, it identifies, analyzes and organize to meet its own needs. Classification of Community a. URBAN – High – density, a socially homogenous population and a complex structure, non – agricultural occupations; something different from an area characterized by complex interpersonal social relation an urban community. One in which a number of people are not engaged in the collection or production of food. b. RURAL – usually small and the occupation of the people are usually farming, fishing, and food gathering. It is by simple folks characterized by primary group relation well – knit and having a high degree of group feeling. c. RUBAN – a combination or a rural and urban community. Components of a Community a. PEOPLE – the core that makes up the community included is a study of a demographic characteristic of the population as well as the values, beliefs and history of the people. b. SUBSYSTEM OF COMMUNITY o Housing - included the types and characteristics of housing facilities, presence of housing laws / regulations governing the people. o Education – includes laws, regulation, RAT 10 of educators to learners, distribution of education facilities, presence of informal education facilities and activities existing in the community. o Fire and Safety - availability and accessibility of fire protection and safety services and facilities. o Politics and Government – existing political structure, decision – making process or pattern leadership styles observed, etc. o Health – Health Facilities/ Services/ Activities and its availability and accessibility, ratio of provider/ clients served; priorities in programs. o Communication – systems, types or forms of communication existing how it influences community health.
o Economics – occupation, types of economics activities engaged by people. o Recreation – recreational activities/ facilities including types of consumers, appropriateness of recreational activities and consumers. Factors Affecting Community Health o o o o o o Political Socio – cultural Economics Environment Health Care Delivery Heredity
Elements of a Healthy Community a. b. c. d. e. f. People are partners in health care. People work together to attain goals. Physical environment promotes health, safety, order and cleanliness. Safe water and nutritious foods. Families provide members with basic needs. Available, affordable health care. CHAPTER 2 VITAL STATISTICS Vital Statistics The application of statistical method and techniques to the study of the vital facts such as these concerning births, deaths and illnesses. Statistical data which relate to the total numbers of various kinds of biologic or vital events (like births, illnesses, marriages, divorces/ separations, illnesses and deaths) to the size and characteristics of the affected population. Statistics of disease (morbidity) and death (mortality) indicate the state of health of a community and the success or failure of health work. Statistics on population and the characteristics such as age and sex distribution are obtained from the National Statistics Office (NSO), the office charged with registering vital facts in the country. Birth and deaths are registered in the Office of the Local Civil Registrar of the municipality or city. The Local Civil Registrar of municipality is usually the Municipal Treasurer or the Municipal Health Officer. In cities, births and deaths are registered at the City Health Department. Health Indicators A list of information which would determine the health of a particular community like population, crude birth rate, crude death rate, infant and maternal death rates and to tuberculosis death rate.
a. BIRTH – the act or process of being born.
Rates – a relation indicating the number of times a certain event occurs when a certain number of exposures to the risks of occurrence in present in a given period of time. Crude Birth Rates – is only a rough measure of fertility in a population since it makes us of mid – year population (which includes the number of men and women incapable of child – bearing) as its denominator. - Live births per 1000 population.
Total No. It is an index of the obstetrical care needed and received by the women in a community. It limits the occurrence of the event to the portion of the population definitely exposed to it. Crude or General Rates – These rates are referred to the total living population. of deaths under 1 year of age registered in a given calendar year IMR = Total No. Crude Death Rates – is only a rough measure of the force of mortality or the probability of dying in a population because death rates are largely influenced by age and sex composition of the population. MARRIAGES – the institution whereby men and women are joined in a special kind of social and legal dependence for the purpose of founding and maintaining a family. These quantities need not necessarily represent the same entities. Total No. of live deaths registered in a given calendar year CDR = Estimated population as July 1 of same year x 1000 Infant Mortality Rate – Measures the risk of dying during the 1st year of life. Ratio – it is used to describe the relationship between two numerical quantities or measures of events without taking particular considerations to the time or place. d. and puerperium. Total No. although the unit of measure must be the same for both numerator and denominator of the ratio. childbirth. DEATH – the cessation of all physical and chemical processes that invariably occurs in all living things. of deaths maternal causes 3 . a rate shows the relationship between a vital event and those persons exposed to the occurrence of said event. of live births registered in a given calendar year CBR = Estimated population as July 1 of same year x 1000 Crude Death Rate – A measure of one mortality from all causes which may result in a decrease of population. of registered live births of same calendar year . Specific Rates – The relationship is for a specific population class or group. Rates and Ratios Rates – In the Vital Statistics. c. It must be presumed that the total population was exposed to the risk of the occurrence of the event. Crude Birth Rate – A measure of one characteristic of the natural growth or increase of a population. MIGRATION – the transfer of the individual from one locality to another. It is a good index of the general health condition of a community since it reflects the changes in the environmental and medical conditions of a community. x 1000 Maternal Mortality Rate – It measures the risk of dying from causes related to pregnancy. within a given a area and during a specified unit of time. It is evident that the persons experiencing the events (the numerator) must come from the total population exposed to the risk of same event (the denominator).b. Total No.
Specific D. of live births registered of same year x 1000 Neonatal Death Rate – Measures the risk of dying the 1st month of life. May serve as index of the effects of prenatal care and obstetrical management on the newborn. Deaths in specific class or group registered in a given calendar year . of live births registered of same year x 1000 Specific Death Rate – Describes more accurately the risk of exposure of certain classes or groups to particular diseases. To understand the forces of mortality. of deaths in a particular age group registered in a given calendar year . of deaths under 28 days of age registered in a given calendar year . No.R. of Foetal deaths registered in a given calendar year . x 1000 MMR = Total No. of new cases of a particular disease registered during a specified period of time IR = Estimated population as July 1 in same year x100000 4 . FDR= Total No. Total No. Age specific Death Rate = Estimated population as July 1 in same specified class or group of said year No. reveal the problems of public health. Cause specific Death Rate = Estimated population as July 1 in same specified class or group of said year No. irrespective of duration of pregnancy. Sex specific Death Rate = Estimated population as July 1 in same specified class or group of said year x100000 x100000 x100000 x100000 Incidence Rate – Measures the frequency of occurrence of the phenomenon during a given period of time. Deals only with new cases. Death of the product of conception occurs prior to its complete expulsion. of live births registered of same year Foetal Death Rate – Measures pregnancy wastage. of deaths from a specific cause registered in a given calendar year . Specific rates render more comparable and thus. the rates should be made specific provided the data are available for both the population and the event in their specifications. No. of deaths of a certain sex registered in a given calendar year .registered in a given year . NDR= Total No. = Estimated population as July 1 in same specified class or group of said year Examples: No.
of persons acquiring a disease registered in a given year . AR = No. of registered deaths from all causes. of registered cases from same specific disease in same year . 6. exposed to same disease in same year x100 Proportionate Mortality (Death Ratios) – Shows the numerical relationship between deaths from a cause (a groups of causes). This can only be determined following a survey of the population concerned. 3. sex. Family and Community 1. 4. By applying observed specific rates to some standard population. race and any other factors which influence vital events to be made. Deals with total (old and new) number cases. implementation and evaluation of any health programs. and the total no. x 100 Implications of Health Statistics to Individual.Prevalence Rate – Measures the proportion of the population which exhibits a particular disease at a particular time. adjustment for the difference in age. of registered deaths from a specific cause or age for a given calendar year . etc. Serve as bases for determining the success or failure of health services or action. of deaths from all causes in all ages taken together. Health personnel share with the community they serve the responsibility of planning and taking the necessary actions to solve the latter’s health problems. PM = x 100 No. Useful in epidemiological investigations. Not a measure of risk of dying. Two methods: a. 2. Health personnel are expected to be able to maintain accurate and updated statistical records and reports. Provide valuable clues as to the nature of health services or actions needed. b. 5. No. 5 . Vital Statistics is indispensable tool in planning. PR = Total no. By applying specific rates of standard population to corresponding classes or groups of the local population. No. No. Case Fatality Ratio – Index of the killing power of a disease. all ages in same year Adjusted or Standardized Rates – To render the rates of 2 communities comparable. age (or groups of age). new and old cases of a certain disease registered at a given time . No. They serve as index of the health conditions obtaining in a community or population group. of registered deaths from a specific disease for given calendar year CFR = No. of person examined at same given time X100 Attack Rate – A more accurate measure of the risk of exposure. It is influenced by incomplete reporting and poor morbidity data.
2. Transformatory or Participatory Approach 6 . natural disasters and certain circumstances that are beyond the control of people cause poverty. especially on the personal level. Believes that poverty is due to lack of education. Assumes that development consists of abandoning the traditional methods of doing things and must adopt the technology of industrial countries. Focuses as technological approach. Hence the poor should accept their condition since they will receive their just reward in. Believes that bad luck. lack of resources such as capital and technology. Assumes that poverty is God – given. 3. Welfare Approach The immediate and or spontaneous response to ameliorate the manifestation of poverty. Modernization Approach Also referred to as the project development approach.CHAPTER 3 COMMUNITY HEALTH CARE DEVELOPMENT PROCESS Approaches to Community Development 1. Also consider a national strategy which adopts the western mode of technological development. Introduces whatever resources that are lacking in a given community. destined.
Transform the community from oppressed to dynamics one. especially the oppressed and exploited sectors are most open to change and are able to bring about change. community organizations should be based on the following: a. (CO: A Manual of Experiencing PCPD) Transformation of force. COPAR (Community Organizing Participatory Action Research) The Philippine Center for Population and Development in its effort to support the Department of Health in the implementation of Primary Health Care (PHC) designed the Health Resource Development Program (HRDP) to enable the health training institutions e. expression. that enables the individuals. b. develops confidence to take action in respect to them and in doing so extends and develops cooperative and collaborative attitudes and practices in the community. but not making them as subjects of research but rather participants or co – researchers.g. and mobilizing the people to develop their capability and readiness to respond and take action on their immediate needs towards solving their long – term problems. 7 . COPAR mobilized community resources for community services. IMPORTANCE OF COPAR 1. COPAR maximizes community participation and involvement. Power must reside in the people – participation indicate power to cooperate in order to have a good result. Believes that poverty is caused by prevalence of exploitation. (ROSE 1967) A continuous and sustained process of educating with people to understand and develop their critical awareness of their existing conditions working with the people collectively and efficiently on their immediate and long – term problems. transformative and systematic process of building people organizations by mobilizing and enhancing the capabilities and resources of the people for the resolution of their issues and concerns towards effecting change their existing oppressive and exploitative conditions. COPAR is an important tool for community development and people empowerment as this helps the community workers to generate community participation in development activities. PRINCIPLES OF COPAR 1. Voiceless poor into dynamic. participatory and politically responsive community. Along this line. Assumes that poverty is not God – given rather it is rooted in the historical past and is maintained by the oppressive structures in society. 2. Money is not involved in this approach but the things that surround them. COPAR prepares people / client eventually take over the management of a development program in the future. People. participatory. This is also a collective. communities to be responsible for their own health. families. 4. It is used to generate community participation and involvement in health activities and to prepare communities to set up their own health programs. People are the one to solve their problems while the facilitator (nurse) is only to motivate them. schools of medicine. DEFINITION OF COPAR A social development approach that aims to transform the Apathetic. Individual. The process of empowering or transforming the poor and the oppressed sectors of society so that they can pursue a more just and humane society. A phenomenon of interest goals and objectives at the health care worker and the people in their way to health citizenry. (1994 National Rural CO Conference) A process by which a community identifies its needs and subjective. domination and other unjust structures. HRDP sees Community Organizing (CO) as a tool for people’s empowerment to health. nursing and midwifery to effectively implement their community – based health programs. Development is from the people to the people – progress is in the hands of the people. 3.
Use of survey questionnaire is discouraged. Also known as Community Study. b. Participatory and Mass . 3. harvesting. PROCESS/METHODS USED IN COPAR 1. Conduct of house to house visits. understanding deeply the culture. c. COPAR should be for the interest of the poorest sectors of the society. Community workers nowhere should refrain from drinking. history and lifestyle in the community. METHODS OF INTEGRATION a. participating in conversing in jeepneys and others) 8 . cleaning the house etc. b. Data can be more effectively and efficiently collected through informal methods (house to house visits. Consciousness – Raising Through experimental learning is central to the COPAR process because it places emphasis on learning that emerges from concrete action and which enriches succeeding action. b. Conversing with the people where they usually gather such as stores. POINTERS FOR THE CONDUCT OF SOCIAL INVESTIGATION a. fishing. 4.c. economy. excessive drinking has a negative effect on the community worker’s reputation. c. Participation in social activities such as birthday parties. Participation in direct production activities of the people like planting. 2. 3. e. the participatory the powerless and the oppressed.Based Because it is primarily directed towards and biased in favor of the poor. wakes.Oriented Leaders are identified emerged and are listed thru action rather than appointed or selected by some external force or entity. POINTERS IN BUILDING PEOPLE’S ORGANIZATION 1. immerse himself in the poor community. Integration A Community Organizer becoming one with the people in order to: a. dishwashing. d. Community leaders can be trained to initially assist the community worker/organizer in doing social investigation. seasonal rituals and others. While drinking is an effective strategies in integrating with male residents. People’s participation should always be present – participation is essential elements in COPAR. collating and analyzing data to draw a clear picture of the community. weddings. COPAR should lead to self – reliant community and society. Helping out in household chores like cooking. water walls. washing streams and in churchyard. and broom making. 2. fiestas. Group – Centered and Not Leader . planning and actions. 2. local and concrete issues identified by the people and the evaluation and reflection of and on the action taken by them. Progressive Cycle of Action – Reflection – Action Which begins with small. The solutions of problems commonly shared by these sectors must be focused on collective organizations. leaders. Social Investigation A systematic process of collecting.
3. f. The steps in building organizations are done in all or any of the phase of the COPAR process. Reflection Dealing with deeper on going concerns to look at the positive values Community Organizer is trying to build in the organization. 7. 2. activities and strategies and time spent for it. Social Investigation is facilitated is the Community Organizer is properly integrated and has acquired the trust of the people. 9 . Tentative Program Planning Community Organizer to choose one issue to work on in order to begin organizing the people. 8. 3. PHASES OF COPAR 1. Organization The People’s Organization is the result of many successive and similar actions of the people. 6. Problems and issues are discussed. Ground working Going ground and motivating the people on a one on one basis to do something on the issue that has been chosen. Mobilization or Action Actual experience of the people in confronting the powerful and the actual exercise of people power. It is a way of training the people to participate what will happen and prepare themselves for such eventually. 5. Actually selecting the site for community care. 4. Group Meeting People collectively ratifying what they have already decided individually.d. Confirmation and validation of community data should be alone. ACTIVITIES: 1. Pre – entry Phase Is the initial phase of the organizing process where the community organizer looks for communities to serve or help. Is it considered as the simplest phase in terms of actual outputs. Their application and the specific strategies and purpose may vary slightly depending on the phase of the process it is applied. Designing a plan for community development including all its activities and strategies for care or development. Evaluation The people reviewing the steps 1-7 so as to determine whether they were successful or not in their objectives. Secondary data should be thoroughly examined because much of the information might be available. It gives the people time to reflect on the stock reality of life compared to the ideal. The final organizational structure is set – up with elected officers and supporting members. e. 10. 9. The meeting gives the people the collective power and confidence. Designing criteria for the selection of site. Rehearsal / Dry run (Role Play) Means the act out the meeting that will take place between the leaders of the people and the government representative.
) METHODS OF ENTRY PHASE a. Converse people in their usual gatherings. Entry Phase Sometimes called the Social Preparation Phase as it is the activities done. (Consider number of population) b. Maternal Mortality Rate) d. GUIDELINES FOR ENTRY INTO THE COMMUNITY a. Participation in social activities. This phase includes the sensitization of the people on the critical events in their life. 4. OJT) in order for them to manage their concerns or programs. behavior and lifestyle should be in keeping with those of the community residents without disregard of there being role models. evaluating community . Health Condition. speech. The sensitization of the people on the critical events in their life. and attitudes to organize and managing their own problems and programs. Avoid raising the expectations/consciousness of the community residents by adopting a low key profile and approach. (Assess the malnutrition. Motivating them to share their dreams and ideas on how to manage their concerns. ACTIVITIES: 1. Purpose: to develop their knowledge. settlement patterns and available physical resources. Organization Building Phase Entails the formation of more formal structures and the inclusion of more formal procedures of planning. c. Sustenance and Strengthening Phase 10 . geography. e. (main concern for the safety of Health Personnel) f. Participate in household chores. Participate in livelihood activities. Conduct of ocular observations. Infant Mortality Rate.METHODS OF PRELIMINARY SOCIAL INVESTIGATION a. Peace and order situation. terrain. particularly the Provincial Health and/or the Rural Health Unit and other community organization.wide activities. b. c. (there is no rejection within the community) 2. Health Personnel. 3. Health Services. (Not to higher the levels of expectations. And eventually mobilizing them to take collective action on these. This phase signals the actual entry of the community worker / organizer into the community. skills. 3.) c. Depressed Rural Community. It is the phase where the organized leaders or groups are being given trainings (Formal or Informal. d. implementing. 2. noting the accessibility. Use of secondary data from various government officers. Coordination with extension workers from both government and non – government agencies. them visits to inform them of your presence and to orient them on the project objectives. Adequate Facilities. Use of secondary data from other community based health program. (Check BHS. CRITERIA: a. Recognize the role of the local authorities by paying. Distance of secondary Hospital (30 min. c. b. One’s appearance. d. motivating their to share their dreams and ideas on how to manage their concern and eventually mobilizing them to collective actions on those concerns this signals the entry of the community organizing. No strong resistance from the people. b. House to house visits. No similar or free of similar agencies. e.
Implementation of livelihood projects. STRATEGIES: 1. 2. What the outside researcher expects. Assembly. the community should be. Education and training. 5. 3. Networking and linkaging. Make up of quantitative method. Method of data gathering Does not adhere to any standard design. Plan for the actual data gathering. 4. Selection of research committee. CHAPTER 4 ROLES AND ACTIVITIES OF COMMUNITY HEALTH CARE DEVELOPMENT Roles of Community Health Nurse 1. Occurs when the community organization has already been established and the community members already actively participating in community wide undertaking. 2. The Community Assisted by a researcher. the different committees set – up in the organization building phase are already expected to be functioning by way of planning. Dominated by trained outside researcher. At this point. with the overall guidance from the community – wide – organization. (assigned to the committees) Community Based People Organization Participatory Research V. implementing and evaluating their own programs. (talk able their concern of the people in community) 6. 3. CRITICAL ACTIVITIES IN COPAR PROCESS 1. Prioritization of needs. Training on how to gather data. The choice of the problem is based on the Immediate problem situation. 5. 4. Conduct of mobilization on health and development concerns. RECODER / DOCUMENTATION Responsibilities: 11 . Analyze those information gathered. Developing secondary leaders in the community.S Tradition Research Participatory Research The task of identifying what the problem are Involves the community group experiencing the problem Tradition Research Done by the professional or outside researcher. Problem Identification is jointly undertaken by the people who are actors in the situation and by the researcher who is initiating the research process.
Disseminate reports. PURPOSES OF RECORDING AND REPORTING a. “Report should be concise and condensed. b. prevention of illness.a. Train people in making reports. Reports are of the most interest value when they are arranged to that comparison may be made between successive periods of time. CHAPTER 5 INTRODUCTION TO COMMUNITY HEALTHY WORKER COMMUNITY HEALTH WORKER Is one who provides basic community health care services for promotion of health. e. Aids or part in the studying the conditions of the community. Reports are more readily received when presented in an interesting manner. 2. Provide basis for future planning. FORM WHICH: a. c. Schedule for laboratory. Record daily activities. Records our development changes – accomplishments of the health care providers and the client accomplishments. Records Refers to written documents. Reports Refers to periodic summarizes of the services and activities rendered to the community. To interpret the work to the public and other agencies. Keeps a written account of services rendered observations of the conditions of the client. the needs and problem the attitude of the client with the community. b.” EFFECTIVE AND USEFUL REPORTS DEPENDENCE UPON CERTAIN BASIC PRINCIPLES SUCH AS: a. Disseminate any information to the appropriate authority or any agencies. ACTIVITIES RELATED TO THE ROLE AS RECORDED AND REPORTER a. All items should be carefully selected in order to give significant information. Record keeping and filling. b. We must develop the people capabilities to keep their own recording and reporting. d. simple treatment and rehabilitation. b. Measure the services or programs rendered or directed to the client. e. Schedule of Health Center. c. b. REPORTER Responsibilities: a. Assist people in research and community development activity. Disseminate any information which are necessary for the client in the community. Reports of value only when the items included carry a common meaning to all who make all of them. b. c. d. the services rendered 12 . d. To contribute to client’s care. Encourage with people to report in the Health Center.
2. FACILITATOR Helps plans a comprehensive health program with the people. listening is the key to good assessment. Appraises health needs and hazards. EFFICIENT Knowledgeable about everything relevant to his/her practice. FUNCTION OF A HEALTH WORKER 1. e. d. content. has empathy. TACTFUL One who presides over an assembly meeting or discussion in a subtle manner. no favoritism. groups. prevention of illness. method and skills used in Primary Health Care and has a qualities of a good Health Worker. GOOD LISTENER Attentive always available for the participant to voice out their sentiments and needs. 4.utilize the a goal or objectives. 5. Provide continuing guidance and supervisory. 13 . 3. Unbiased and fair in decision making. c. OBJECTIVE Gives fair judgment. has the necessary skills expected from him/her. early treatment of illnesses and rehabilitation. b. COMMUNITY HEALTH SERVICE PROVIDER Carries out health services contributing to the promotion of health. CRITICAL THINKER / ANALYTICAL Decides on the basis of what has been analyzed. FLEXIBLE Able to cope with different situation. has good diction. Always a presence of mind. proper choice of words. open to ideas. no biases. f. one goal / common goal. HEALTH COUNSELOR Provides health counseling including emotional support to individuals. open to suggestions and criticism. QUALITIES OF A HEALTH WORKER a. EMPOWERING AGENT Emphasis on the active role of the client in all aspect of care include client in all aspects of care. OPEN Accepts needs of joint planning and decisions relative to health care in particular situation not resistant to changes. and community. does not embarrass but gives constructive criticisms. g. COORDINATOR Brings into consonance or harmony the community’s health care activity. family.
Keen observer Maintain eye to eye contact. Helps make multiple services which the family receives in the course of health care. Always available for the participant to voice out their sentiments and needs. Participates in planning for the study and in formulation procedures. Consults with and refers to appropriate personnel for any other community services. 2. Act as referral agent and assist client in obtaining the care deserve in the patient. CO – RESEARCHER Provides health with stimulation necessary for a wider or ore complex study or problem. continuous and comprehensive as possible. 8. 5. TRAITS AND QUALITIES OF A HEALTH EDUCATOR 1. MEMBERS OF A TEAM In operating within the team. Information – provision of knowledge.6. 2. lead as well as to follow to share authority as well as to work under. 3. one must be willing to listen as well as to contribute to teach as well as to learn. Knows how to put in sequence or logical order the parts of the session. 4. 7. ASPECTS OF HEALTH EDUCATION 1. how to arranged the activity. process and participants’ behavior. Good Communicator and always validate information Provide the participants with clear and relevant information. Keep an eye on the proceedings. Systematic Put into sequence. Assist in the collection of data. Education – change in knowledge. Health Education is accepted to all levels of public work. 14 . Is one who improves the health of the people by employing various methods or scientific procedures to stimulate arouse and guide people to healthful ways of living. attitude and skills. Coordinated. Good listener Hears what’s being said and what’s behind the words. Knowledgeable about everything relevant to his practice. 3. Efficient Plans with a people according to the needs of the client or community. Suggest areas that need research. Helps interpret findings. has the necessary skills expected of him. HEALTH EDUCATOR Primary responsibility of Community Health Nurse. Acts on the result of the research / study. Communication – exchange of information. ADVOCATOR Representative of the client. Enforces community to do prompt and intelligent reporting of epidemiologic investigation of diseases. 9.
Learn how to count. e. 4. Know your left and right. 4. Provide quick feedback. 7. 11. BASIC SKILLS IN FACILITATING 1. 6. not resistant to change. 3. Tactful Brings about issues in smooth subtle manner. Have a complete understanding of the subject matter. b. Watch your time. recognize and acknowledge your client. and share. 5. Methodologies and strategies must motivate the participants to improve their level of performance. Accepts need for joint planning and decision relative to health care in a particular situation. 10. Develop desirable behavior patterns positive attitude. 6. Develop desirable behavior pattern positive change. 7. a. ideas and criticism. It should facilitate transfer of learning to on the job site. Open Inviting the client to give their reaction. Health Education has to choose specific materials that will bring about the desired output. 12. d. 2. Change Agent Let the client participate in the activities. 3. Good Sense of Humor Knows how to place a touch of humor to keep audience alive. It should allow opportunity to learn at individual and group levels. 9. Knowledgeable Have to knowledge relevant. Creative and Resourceful Use any available resources and evolve participants in the discussion. It should be generate active participation. Does not embarrass but gives constructive criticisms.6. 5. 2. Be open and flexible. Involves participants actively in assuming the responsibility for his own learning. Know your reach and limitations. Allow opportunity to learn at individual and group levels. f. Facilitate. 15 . It should provide quick feedback. Involves participants actively in assuming the responsibility for his own learning. c. Generate active participation of the learner. Good Critical Thinker / Analytical Decides on what has been analyzed. Motivate participants to improve their level of performance like return demonstrations of learners. 8. Teaching and Methodologies / Strategies (Selection and Uses) – appropriate for the participants. Know how to salute. GUIDELINES TO BE EFFECTIVE HEALTH EDUCATOR IN TERMS OF A. In making decisions about methodologies. the health educator has to choose specific methods that will bring about the desired output and the technique should: 1. transfer of learning. Involves people in decision making.
hand – outs. Generate active participation of the learner. chalk. C. B. CHARACTERISTICS OF HEALTH TEACHING PLAN a. Facilitate transfer of learning to on – the – job situation. pad paper. b.METHODS SHOWED a. Uses of a Teaching Plan List of steps and activities and equipments needed in health education session. b. subject matter / topic. objectives. Should be also follow the sequence of that process from pre – training to be continued. c. d. Example: Topic: _____________________________ Goal: ______________________________________________________________________ _________ Venue: ______________________________________________________________________ _______ Participants: ______________________________________________________________________ _ Learning Content Objectives Methodology Time Resources Person E Frame Responsible 16 . methodology and resources to be used during the health teaching. Performance of a behavior that helps resolves a health need or problem. e. Represents a package of education services provided to the participants consumers or even to the students it should be based on participants’ viewpoint. c. Should also include a list of specific actions or abilities that the client may perform at intervals during the education session or at the end of the session. A lesson should be planned by having an outline of what is to be taught and the methods to be used. Provide guide feedback. Helps the health educator recognize and use methods of learning that involves the clients’ active participation. SESSION DESIGN Document which contains the rationale. Time allocation for various activities should also be included. May emphasize a phase of phase of behavior change process that is related to the client’s health need and problems. Preparation of IEC materials Blackboard. f.
THREE WAYS OF HANDLING CONFLICT MY PROPOSAL Move Away Move Against Move Toward o Surrender o Distract o Suppressing Differences o Denial o Sickness o Fragmentation o o o Fighting Back Escalation of feelings of anger Distortion of perception o o o o o 17 o Open confrontation Communication Sort out ideas. a. Know clear definition of your responsibilities. of lecture discussion the client will be able to: 1. Facilities. ________ P of an A 2.) ----------------------------------------------------------------------------------------------------------------------------------------Lecture Discussion / Role Play/ ___ min. b. Money. feelings Brainstorming 4d sol’n Resolution of conflict Through resolution through growth . Mr. Ii is due to different ideas. _______ / Ms. Multi media. viewpoint and opinion. Tapes / film showing. Conflict Management Employing various strategies appropriate for the situation in order to solve with conflict.) O F Conflict Management Skills of a Health Worker Conflict To come into opposition neither weapons as in battle physically as in children’s round and tumble or verbally as quarrel between two persons. Books. Know the different needs of the individual. Magazine. Internet.After __ hrs. Manpower.
No feedback recognition 3. Competition Rivalry Communication Barriers Cultural differences Different values and need Lack of respect TWELVE DIRTY DOZENS 1. Interrole Occurs when an individual belongs to ore than one group simultaneously. If conflict is handled properly this could be a source of couth. 3. Intrasender Originates in the sender who gives conflicting instructions. Unrealistic dead limit / giving irrational order 8. Mix messages 6. 2. Threatening 12. Negative feedback (criticism) 4. Total suppression of differences will lead to physical and psychological sickness. 5. 2. Intersender Arises when an individual receives conflicting message from two or more sources. If conflict is not handled properly this could be a source of psychological decline / decay. needs or capabilities were incompatible with the role requirement. 4. Personal put down (harsh negative criticism) 10. Lecturing or talking by 7. Breaking Promises 11. 6. Favoritism 5. 3. Interperson 18 . Person role The result of disparity between internal and external role. Attacking TYPES OF CONFLICT 1. passive aggression (pretending) 9. have multiple role within the some organization. 4. 5. SOURCES AND CAUSES OF CONFLICT 1. May occur when one’s values. Isolation (ignored) 2.
one neglects one’s own needs to meet the goals of the other party. alternatives explored ramification considered until difficulties are resolved. Requires mutual respect open and honest communication and should decision making process. Resolution. Appropriate when the person is very knowledgeable about. Incomplete explanation of assigned tasks. Competing Power oriented mode that is assertive but cooperative. Also appropriate when the other party is more powerful the issue is important. Because there is an honest and open communication APPROACHES TO CONFLICT RESOLUTION 1. Creates a win – lose situation. Common among people whose positions require interaction with other person who has various roles in the same organization or other organizations. c. Can be used when issue is not critical. Appropriate if the opponent is right more powerful. Intergroup Common where two groups have different goals and can achieve their goals only at the others expensive. Opposite of Accommodating = one is aggressive and pursue ones. Create a lose –lose situation thru unassertive and uncooperative means. STRATEGIES IN CONFLICT MANAGEMENT 1. b. Collaborating Assertive and cooperation. Most effective method in dealing conflict. 7. Comprising Moderates both assertiveness and cooperation. Problem are identified. 6. Reason: a. Accommodating or Cooperating Cooperative but unassertive. 3. Win – Lose Situation 19 . Self – sacrificing . 5. 2. When one has no chance of meeting the goods or the cost of dealing with the conflict is higher than the benefit of the resolution. 8. Avoiding A strategies that allows conflicting parties to calm down. 4. Result to lose – lose situation. Inadequate job description. Also appropriate when one wishes to reduce tension and gain composure. Rapid technological change. Role Ambiguity Condition in which individual don’t know what is expected of them. It contributes to effective problem solving. creates a win – win situation. the issue is more important to someone else. Intragroup conflict Occurs when the group faces a new problem.
conflict if openly surface and honestly faced. majority rule. Method includes the use of position. Collaborating Common goals identified. Lose – Lose Situation Since the anger and resentment of the loser does not disappear but simply goes underground to emerge later as “Backlash” 3. COMMUNITY ASSESSMENT Getting to know the community client 20 . power. CHAPTER 6 HEALTH CARE PROCESS Application COPAR in Community Health Process STEPS: 1. Emphasizes consensus and integrative approaches to decision making. mental and physical power. can improved both planning and implementation. failure to respond. 2. Win – Win Situation Focus on goals. More alternatives are likely to emerge.
reflective of actual reality? Which are needed to be confirmed. Decision – Making Process / Pattern. Plan the data gathering activity. validated. or investigated further? EXAMPLE OF DATA TO BE GATHERED o o o o o o Demographic Data – information about the population: Size. Decide what data are to be gathered. What data need to be researched yet? What are already available? Which of these are fully. Review of Secondary Data – Process of going over recorded information. PLANNING FOR A PROGRAM OF ACTION / PROJECT Includes the following: a. Socio – economic Data – Occupation. Density. Political – Leadership Structure and Style. Actual data gathering. Income Levels of Families. Health Care Delivery System b. Who will gather the data? How will the data be gathered? Tool to be used? Who and how will the data be collated? Analyzed? d. Beliefs people uphold. Preparing a report based on the gathered data. Determine data gathering methods. Land Ownership. Structure / Composition. Distribution. etc. etc. Production Quality. Observation – Process of obtaining data through visual means. Cultural groups. Plan the process of data gathering. Cultural – Values. etc. COPAR Principles and Strategies that could be applied in this phase: (NOTE: Faculty is encouraged to review these concepts by referring to module on COPAR) Integration Social Investigation Ground working People Participation 2. Norms. Environmental – Physical Structures. Community Survey c. Sanitary Conditions. e. Interview – Is a conversation between two individuals in which one seeks information and the other providers it. Determining objectives for care / action 21 . This includes: a. Include here the list of prioritized problems.
Identify what is to be done and what outcomes might be expected from the program / project / services implemented / rendered. There are a variety of activities that may be employed to meet the objectives: Home visits Conferences / Demonstrations Health Service Delivery Group discussion / Education Information Dissemination Consider the following in selecting activities: Consider need / Capabilities of the client Identify target clientele Review traditional activities and select only those not detrimental to health / life / limb. when / where / how / how often should they these be done. CRITERIA FOR SETTING OBJECTIVES: They should be realistically achievable. are within the available potential time and resources. Remember to involve the people / clientele in the planning / implementation / monitoring / evaluation of the plan / program. Should be flexible enough to allow for change. Should be closely coordinated with those of the entire health care team. are accepted and understood by them. 22 . Are within the competence of the implementor / community / care provider. b. c. Identify the persons responsible. Estimate time needed. Select activities and methods / strategies for achieving the objectives. Should be specifically stated. Bear in mind that a balanced program is far more effective than in those which are unbalanced or biased. Develop monitoring and evaluation scheme. Who will take the lead or participate in the implementation of the program plan. Indicates what should be done. e. Determine how much time is needed to accomplish each activity / program / project. Should be closely related to the problems and needs identified and felt by the client. Determine methods / tools / strategies for M & E. who should do it. Allows for modification / substitution / revision of plans / activities / strategies depending on what happens or are needed during the time of implementation. d. etc.
Must include active participation of the people. Self – evaluation Peer evaluation Evaluation by superior Analysis of statistical reports Use of standards Records of tests Case discussion Action – Reflection – Action Session (ARAS? ARFA) 3. Is an essential component of planning and should be built in as the plan of services if constructed. They are interrelated. Is a process that is designed to show the relationship between services rendered and the objectives or purpose of the services / unit / care provider.An internal program care activity concerned to assess whether the resources is being used as intended.A process design to show the relationship. Refers to the mobilization of resources to meet objectives. PROGRAM MONITORING AND EVALUATION Evaluation . from groups to expedite 4. Are vital elements community health care process. Is mainly used to help in the selection and design of future plans / programs / projects. Refers to the actual carrying out of the plan. Monitoring .Improvement and development of the community. . PROGRAM IMPLEMENTATION Essential is the active participation of the people. 23 . Not a record nor count of what was done but of what DIFFERENCE the doing made. Accompanied by utilization of resources.
3. and beliefs. Contributing to the development of new methods. According to World Health Organization (WHO). ROLES AND FUNCTIONS OF THE NURSE IN FAMILY PLANNING 1. it is the uses of a range of fertility regulation to help individuals or couples attain certain objectives such as avoid unwanted birth produce a change in the number of children born. Identifying. 24 . decreases the rate of abortion. regulate the intervals between pregnancies and control time at which birth occurs. how will each method prevents pregnancy. and religious values. Counseling and when appropriate making referral for clients who are in need of information. Contraceptive Education 2. religious. Information regarding Alternatives (assisted) Birth Technologies and Adoption Assistance PRIMARY GOAL OF FAMILY PLANNING 1. to create and sustain new life. Is to reduce the number of unintended pregnancy (Unwanted or earlier the planned). NURSE’S ROLE IN CONTRACEPTIVE EDUCATION 1. COMPREHENSIVE FAMILY PLANNING PROGRAM Should provide: 1. if any will be used their decision should be accordance with their personal. Decreases the number of unintended pregnancy. Contraceptive Education should include whether these methods protects against HIV / STD’s both patterns should be included during the teaching. Genetic Counseling 3. 2. services and programs as well as evaluating existing ones. Parent should consciously decide of whether to have children and which contraceptive method. The ability to conceive and bear children and one’s views towards planning the number and spacing of children are associated with many social.CHAPTER 7 INTRODUCTION TO FAMILY PLANNING Fertility Refers to the ability of the body to reproduce. About Family Planning and its services. information and resources. Provide and interpreting Family Planning instructions. 3. 2. economic and health circumstances. Provide accurate. religious and cultural values for both men and women. Methods of Fertility Enhancement 5. social. It involves a cognitive decisions and behavioral practices that enable a woman to have a wanted pregnancy and avoid an unwanted pregnancy Family Planning Is a the conscious effort of individuals and couples of reproductive age to regulate / limit their fertility through the use of the medically and legally accepted methods of contraception (natural and artificial) according to their beliefs. Help the client with the risks and benefits of each method and determine which method will best fit his / her lifestyle. unbiased information about their various contraceptive methods and correcting misinformation. 2. 3. Infertility Counseling 4.
2. 1. used in conjunction with barrier methods. Periodic Abstinence FOUR BASIC METHODS 1. 2. Those that prevent implantation. LOCAL BARRIERS Barriers methods of contraception are methods that prevent sperm entering the reproductive system spermicides that immobilize and kill sperm.THREE MAIN CATEGORIES Contraceptive methods that are used temporarily to prevents conception. 1. 2. Shaped like a finger the condom is inserted over the erect penis before intercourse. 2. METHODS THAT PREVENT FERTILIZATION 1. DISADVANTAGES OF FAMILY PLANNING 1. The man with draws his penis from a woman’s vagina before he ejaculates so that the sperm released from his penis does not enter her vagina. This can be done by with man by woman. To prevent spilling sperm into the vagina after intercourse the man should hold onto the condom as the penis is carefully with drawn. Woman who uses these methods became more knowledgeable about their bodies. Male Condom Most widely used birth control device in the UN and in the world. Abstinence – refraining 2. WITHDRAWAL Is also called Coitus Interuptus. Calendar Method Basal Body Temperature (BBT) Cervical Mucus Method Symptothermal Method ADVANTAGES OF FAMILY PLANNING 1. These require extended periods of abstinence during each ovulation and require considerable commitment on the part of the couple. Those that prevent fertilization. Coitus interuptus – withdrawal 3. a man may release sperm before he has an orgasm. Do not use petroleum gel. A half – inch space or the pocket should be left at the end to collect the ejaculate and to prevent the condom from tearing during ejaculation. There are problems with using withdrawal as a contraceptives method. Usually acceptable to these who had religious objectives to other methods of contraception. None of these methods provides protection from STD’s or HIV. 3. Those that prevent ovulation. ADVANTAGES: Safe readily available Easy to use Inexperience 25 . provide enhanced protection against STD’s and increase protection against pregnancy. First. 4. 3.
Because it is made of polyurethane. Diaphragm An ordinary spring A flat or Wide – Seal spring Coil spring 4. Female Condom A combination of a diaphragm. Pleasurable (Men and Women) with the presence of the sheath. 5. douches. Prevent transmission of STD’s and HIV. DISADVANTAGES: Should not be used during menses or when a vaginal discharge is noted. 2. it is less likely to tear than the rod condoms. she should wait for at least 6 hours to avoid washing away spermicides. (If woman does.) SAFETY: Not all women can be fitted satisfactorily. Available on the counter. DISADVANTAGES: If the woman is uncomfortable with contraceptive method require touching herself. Vaginal Spermicides ADVANTAGES: 26 . To health Care Provider should check the woman’s ability to insert and remove these devices correctly. they may need to be refitted after pregnancy because of changes is cervical size. Prescriptions should be limited to woman without pap smear. She may not like this method. 3. ADVANTAGES: Women can be in control of contraception. It is soft relubricated. must be fitted by a physician or technician are available only by prescription. It is an alternative for those who are allergic latex. To apply the condom and the need to quickly remove the penis from the vagina after ejaculation MOST PROTECTIVE CONDOM – are those inside of latex. DISADVANTAGES: Decreased sensation the interruption of sexual foreplay. Cervical Caps ADVANTAGES: Easy to use Inexpensive Do not dull sexual sensation and help prevent STD Diaphragm and Caps however. Douching after intercourse is not recommended.
Counselor must work with grief and anticipatory grief issues with the knowledge of a potentially negative outcome a amount of hope and denial usually prevails until the birth of the affected child brings family back to reality. Couples feel uneasy. GENETIC COUNSELING Consists of one or more encounters with the problems and their families with the objective or providing information about their genetic disease. 25% more effective and provide much better protection from STD’s and HIV. Genetic Counseling will start when the physician have the diagnoses about the condition of the baby. Kills organism that cause gonorrhea. Involves adequate performance of parents. b. Spemicides are readily available and relatively inexpensive. Adjust and adapt where they are living. DISADVANTAGES: Intravaginal spermicidal / barrier agents sometimes caused local irritation. even when spermicides are used in the douching solution. Provide vaginal lubrication. The Following Information includes: 27 . and emotionally. trichomoniasis and syphilis. TWO FACTORS A UNIQUE PROCESS a. if used in conjunction with one of the other barrier method. PROBAND Clinically identified person who person who displays the characteristics or features of the disease in question. Also associated with an increased incidence of candidiasis. spiritually. genital herpes. BEST APPROACH IN GENETIC COUNSELING TEAM APPROACH o o o o o A Physician Geneticist Nurse Psychologist Medical Specialist Consist of one or more encounter with the family with objectives of providing information about them genetic disease. Prevents knowledge that they are biologically responsible for their child condition is a burden often too. As a Nurse what Genetic Counseling will you advise to couples who have unwanted pregnancy is abnormal. RESPONSIBLE PARENTHOOD Promote the basic needs of his / her family morally. financially. Sperm may enter the cervix as soon as 15 seconds after ejaculation. DOUNCHES Vaginal irrigations are not a reliable means of contraception.
The risk of figure. INFERTILITY It is inability to conceive after 1 year of any contraceptive method. 1st Degree of Infertility The couple has never conceived despite of unprotected intercourse after 12 months. options. b. options. Two Types: a.a. and provides a framework disease in question. 2nd Degree of Infertility The couple has previously conceived regardless of outcomes that are subsequently unable to conceive unprotected intercourse after 12 months. b. provide and framework for a course of action taken by the individual. The information includes risk figure. 40% = Woman 40% = Men 10% = Both 10% = Undetermined 28 . family and psychosocial family dynamics. c. Typically Genetic Counseling process begins when a clinician refer a family with a genetic disease has been identified its heavy to carry without emotional damage.
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