Professional Documents
Culture Documents
Community
The word community comes from the Latin word, ‘communitas’ which means as
common. A “group of people with a common characteristic or interest living
together within large society” or a “body of persons or nations having a common
history or common social, economic, and political interest.
Community development
A process whereby the efforts of government are united with those of the people to
improve the social, cultural and economic conditions in communities
Julius Nyerere,
4. Empower themselves
persuasive approach
enforcement approach
team approach
Intersectorial approach
PERSUASIVE APPROACH
The persuasive approach implies convincing people through dialogue and educate them to
change or modify their health behavior. community health nurse make use of this approach
in all types of nursing interventions related to health promotion and specific protection,
early recognition, diagnosis and treatment and disability limitation and rehabilitation.it is
through education that self-care competencies of individual, family and community can be
developed which is essential to achieve the goal of health for all.
ENFORCEMENT APPROACH
The enforcement implies the use of more coercive measures such as use of legislation e.g.
prohibition of drug abuse ,child abuse, immunization as a condition to school admission
etc. and the use of authority e.g. giving strict instructions or orders to do certain things
especially when it is a question of life and death during emergency situations such as child
labor, acute bronchopneumonia etc. Community health nurses make use of such measures
in life threatening emergency situations.
TEAM APPROACH
Community health is a problem solving process and a team approach is very necessary to
deal with varied and complex health needs & problems at large. It is just not possible for
any one profession or discipline to provide such care. community health nursing is one of
the professions & community health nurses along with auxiliary nurses and female health
supervisors help to meet nursing needs of the community as a whole. other members of the
team who are usually there include physicians, clinical specialists, public health engineers,
health statistians, epidemiologists, health educationalists, counselors, social workers,
clinical psychologists, pharmacologists, lab technicians, village health workers. Community
health nurses working in the community health settings needs to identify the health teams
and their roles, functions and team dynamics so as to participate effectively in providing
compressive health care services to people in the community & accomplish community
health goals and aims.
COMMUNITY INVOLVEMENT
Health of the individuals living in a defined community is not only their right' but
also their responsibility to take care of their own health & also of the community at
large. Without people's help, participation or cooperation, it is neither possible to
make health care services accessible & acceptable to them nor it is feasible to
achieve community health goals and aims.
It may depend upon their socio economic &cultural aspects, health attitude, health
knowledge etc. It ranges from true or active participation (i.e people are
knowledgeable & have a positive attitude & get involved in planning &
implementing their health care)to passive recipient of care provided i.e the major
responsibility of community involvement lies with health personnel who directly
deal with people at the community level. They need to encourage and promote them
for their participation.
Community health nurse working with individuals, families, groups within the
community as a whole for community health nursing services need to mobilize,
encourage, organize & prepare them to take greater interest & responsibilities,
develop self reliance for their own health matters.
INTERSECTORIAL APPROACH
Health of people at large cannot be attained by health sector alone because there are many
factors which affect people's health but they are not under the purview of the health sector
e.g food production and distribution, water, sanitation, housing, environmental protection
and education etc. each one is dealt by separate sector and socio economic development &
health.it is felt necessary to have proper coordination between the health & all other
sectors concerned at all levels. Health workers including community health nurses working
at the grass root level for primary health care need to identify these sectors and coordinate
with them to provide desired services which serve as entry points for the development &
implementation for primary care services .community health nurses can also educate on
:nutritional status of the family, food storage through programs in the agriculture & health
economics ,proper use & maintenance of houses & the areas surrounding them through
respective programs etc.
A worker endeavors to help the people to learn skills which reinforce these attitudes
and promote attitude-change.
The community worker has to create and sustain with persons and groups many
relationships which are both simultaneous and independent of one another.
The worker has to maintain relationships with each without arousing mistrust or
jealousy when persons or groups may expect to receive his exclusive attention or
loyalty.
The form of initial contact may be unstructured, the worker making a habit of being
around and accessible in a community meeting place to watch the passersby and
enjoy their company, until such time as both curiosity and familiarity prompt the
first exchange of greeting, comment, or inquiry.
Contact may be made through a group, structured to afford the community the help
of the worker in solving some pressing need.
Systematic discussion
The second step in the sequence of method comes when the people ask the worker
to help them resolve their problems and meet their needs. By helping people to
express themselves they can better focus feelings and there by define more
precisely the cause of their discontent.
The degree of help required, and the time needed to move toward remedial action.
Depends on the social structure and values as well as on the sophistication of the
community and its capacity to grow in community consciousness.
Beyond the initial stages lies the task of analyzing the nature of the needs and
problems, assessing what is required to deal with them and deciding which
resources can be used for the purpose.
Systematic discussion is necessary to establish what the community felt needs are,
and which are to be given priority in the light of objective analysis.
The worker does offer only a point of view and not a decision for the people.
Everyday worker will independently have made some preliminary investigation of
the community in which he is to work, and have taken steps to inform himself of
basic data on the community.
Native wisdom, the know-how which comes from intimate and long acquaintance
with the local environment and climate, has too often been ignored by community
development workers coming from outside the community with their imagined
superior technical knowledge.
By persuasion, they can try to establish more modest targets and help to plan the
execution of a project in manageable stages of development.
The worker is aware that in the community development process, the educational
experience of the people and their growth and development, both as persons and as
a community, in terms of cooperation and the maturation of their common
relationships, is more important than the content of the program or projects
undertake.
Insofar as he can, a worker should guard against the possibility of protecting people
from learning through painful experience. The workers tend to be are subject to
pressure from above to achieve certain targets.
The work will be done without a damage to community self-esteem if workers help
people to plan carefully: to phase the execution of a project: and to make a kind of
decision about what they want to do what would comprehend the discipline of the
situation, requiring completion of a task within a reasonable time and with a
reasonable outlay of effort to which no one can reasonably object.
No work can guarantee success. With our present limited knowledge of human
behavior and its motivation, the worker and the people must live in imperfect
knowledge of themselves.
Conclusion of Project
Conclusion and evaluation constitute the fourth step in the sequence. This action
turn. Provides the seed for a further undertaking of community action.
The workers daily routine should be seen in terms of the should process of
community development. Such perspective is enhanced by the skill of record-
keeping by his professional relationship with his supervision or supervising
committee, and by the concurrent evaluation which both afford.
The workers skill in leading, stimulating and supporting group discussion, his work
in committee, his relationship with people in the community- all contain the
ingredient of evaluation.
In fact, the method is made complex in application. Some of the complicating factors
include the personality of the worker, the groups the particular profile of the
community, the alternative choices of action facing the community to meet their
needs and problems.
We also need to consider other factors, such as context and form, organizational and
administrative, which we may term community development strategy.
Strategies
Collaborative Strategies
Education Strategy
Process Strategy
Leadership Strategy
Collaborative Strategies
There are two major problem with community development are
Outside workers making decision about what would be best for the community
The community development strategies are aimed to solve the problem of outsiders
deciding what should happen within the community. The collaborative participation
opens communication and helps reduce resistance to change created by the
community development program.
Because of the many different kinds of community action each type of action
research has its validity. It is important in choosing the type of action research best
suited to the needs of any particular community action.
Education Strategy
According to the gains to be expected from community action are in terms of the
value as an educational experience rather than in terms of any specific
achievements in administrative change.
The community worker helps people critically reexamine the society in which they
find themselves, to understand the ways in which they various political and
administrative and also more specific skills that may be relevant to their self-chose
projects.
Process Strategy
It is this transmission of skills from community workers to citizens individually and
collectively that supposedly leads to achievement and strengthening of popular
power.
Leadership Strategy
All citizen organizations to be effective require both a large membership and a
dynamic cadre of leaders. There is the need for a clearly articulated program of
political education that challenges capitalist hegemony so that other alternatives
can be discussed.
In order to increase the local capacity for independent community action, and to
discourage dependence on government, people need some basic skills and
knowledge.