COMMUNITY

HEALTH
NURSING
Prepared by:
A. L. De Ramos RN., MAN
COMMUNITY HEALTH NURSING:
AN OVERVIEW
What is a community?
•a group of people with common
characteristics or interests living
together within a territory or
geographical boundary
•place where people under usual
conditions are found
 What is health?

• as defined by the
World Health Organization (WHO), is
"a state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity."
What is community health ?

• part of paramedical and medical

intervention/ approach which is
concerned on the health of the
whole population
Aims:
1. health promotion
2. disease prevention
3. management of factors affecting health
 What is nursing?

• assisting sick individuals to become

healthy and healthy individuals
achieve optimum wellness
• Public Health Nursing: the term
used before for Community
Health Nursing
 Public Health
According to Dr. C.E. Winslow
-is the science and art of 3P’s
1.preventing disease,
2.prolonging life,
3.promoting health and efficiency,
through organized community effort for:
. sanitation of the environment
. control of communicable diseases
 Public Health
a. education of individuals in personal
hygiene
b. organization of medical and nursing
services for the early diagnosis and
preventive treatment of disease
c. development of the social machinery
to ensure everyone a standard of
living adequate for the maintenance
of health, so organizing these benefits
as to enable every citizen to realize
his birthright of health and longevity
(Hanlon,1960 p23)
 Public Health
● Art of applying science in the context of
politics so as to reduce inequalities in
health while ensuring the best health for
the greatest number
-WHO
Core Business of Public
Health
● Disease control
● Injury prevention
● Health protection
● Healthy public policy including those in
relation to environmental hazards such as in
the workplace, housing, food, water, etc.
● Promotion of health and equitable health
gain
 What is Community Health
Nursing?
• “The utilization of the nursing process
in the different levels of clientele-
individuals, families, population groups
and communities, concerned with the
promotion of health, prevention of
disease and disability and
rehabilitation.”
-Maglaya, et al
 What is COMMUNITY
HEALTH NURSING (CHN)
According to WHO?
• the synthesis of nursing and
public health practice applied to
promote and protect the health of
population.
• It combines all the basic elements of
professional, clinical nursing with
public health and community
practice.
 COMMUNITY HEALTH
NURSING (CHN)
• a specialized field of nursing practice
• ​ a science of Public Health combined with
Public Health Nursing Skills and Social
Assistance with the goal of raising the
level of health of the citizenry, to raise
optimum level of functioning of the
citizenry
-WHO Expert Committee of Nursing
 CHN Goal
• To raise the level of health of the citizenry
achieved through multi-sectoral efforts
• Objectives:
1. To participate in the development of an
over all health plan for the community.
2. To provide quality nursing services to
individuals, families & communities.
 MISSIONS OF C.H.N
• Health Promotion – actions related to
lifestyles and choices that maintains /
enhances a population’s health.
• Health Protection – includes activities
designed to detect or prevent illness
or alter disease processes
• Health Balance – state of well being that
results from a healthy interaction between
a person’s body, mind, spirit and
environment.
• Disease Prevention – activities designed to
protect people from disease and its
consequence.
• Social Justice – all people have a right to
certain “basics” of life and health
protection
 A. INFLUENCES OF
ANCIENT CULTURES ON
PUBLIC HEALTH
• . EGYPTIAN CIVILIZATION (ca 3000 BC)
Built irrigation canal and granaries for storage
of food.
• Practice of prophylaxis by the medicine man
and high priest
• Emphasis on personal hygiene, cleanliness
within & outside the body
• Sanitation measures ( removal of refuse and
crude fumigation in times of epidemics)
Hebrews (c.a. 1400 BC)
•Founders of public hygiene
•Moses “father of Sanitation”
•Mosaic Health Code pertained to every
aspect of individual, family & community
hygiene, included:
a. Principles of personal hygiene (rest,
sleep, hours of work, cleanliness)
b. Environmental sanitation
1.Inspection of food
2.Methods of disposal of excreta
3.Detecting and reporting diseases
4.Practice of isolation, quarantine,
fumigation and disinfection
5.Detailed instructions on the correct way of
hand washing
•
Greeks (ca. 600 BC) Hippocrates – “Father
of Medicine” > exponent of the science of
preventive medicine > introduced the
philosophy of the interrelationship between
physical and mental health ( “A healthy mind
dwells in a healthy body”)
•
Romans (ca. 50 BC)
•Contributed to the field of sanitation
(building of Aqueducts, purification of water
supply)
• Appointing of public health medical officers
• Establishment of hospitals which
emphasized both preventive and curative
aspects of care
 B. DEVELOPMENT OF
PUBLIC HEALTH
NURSING AS A WORLD
MOVEMENT
1. Early Christian Period (1 st century)
• order of Deaconesses
• Phoebe a friend of St Paul and the first
Deaconess and visiting nurse
- organized visiting of the sick
- called visiting nurses
- forerunner of CHN
- endeavored to practice the corporal works of
mercy (feeding the hungry, caring for the sick,
burying the dead)
2. Middle Ages (500-1500)
* Beguines of Flanders- worked as nursing
sister in the hospital, but also gave care to
the sick in their homes, staying with the
dying and consoling the families of the
bereaved.
•
3. Renaissance (1500-1700)
St Vincent De Paul- introduced modern
principles of visiting nurse and social
services
•taught that indiscriminate giving was
harmful
•emphasized the concept of helping people
help themselves
• organized the daughters of charity
primarily for the care of the sick at home
• maintained the family is the unit of the
service
• recognized the importance of supervision
of those who render service to the sick
• Early 19 th century
Pastor Theodor Fliedner- German Lutheran
pastor, went tour to raise funds when the main
industry of his community failed, came back with
money and ideas for a program social work.
Fredericka Munster Fliedner- a wife pastor
organized women society for visiting nursing the
sick poor in their homes
Couple recognized the need for preparing the
training those who care for the sick , organized
a hospital school of nursing in Germany (
Kaiserswerth Institute for the training of
Deaconesses)
Development of Modern
PHN
• William Rathbone - father of modern
district nursing with the encouragement of
florence Nightingale
- organized a training school for nurses in
the liverpool
Royal Infirmary which provided training for
hospital nurses, private duty nurses and
district nurse.
 Development of modern
Nursing
1. Characterized by clean-up measures in
the control of communicable disease
• Removal of refuse Clean-up campaign of
prison and asylums
• Improvement of working conditions of
women and children
1. Period of Scientific Control of
Communicable Diseases(1890-1910) -
Application of bacteriology and
immunology
2. Period of health education (1910-
present) - Characterized by education for
prevention of diseases with active
cooperation of the individual in the health
action
 PHN in USA
1. Lillian Wald - Conceived the idea of
establishing a neighborhood nursing
service for the sick poor in the lower east
side of New York To her “the home visit
should be like that of really interested
friend, rather than that of an impersonal
paid visitors
2. Teacher College of University of
Columbia (1912) -offered the first course
of study of PHN
3. National Organization PHN
- organized in 1912 to upgrade the practice
of PHN through standardization of policies
regarding the function and qualification of
PHN.
PHN in THE Philippines
1. Pre- Spanish Era- no records
2. Spanish Regime (1591-1898)
Bro. Juan Climente (1577)
●Started Public Health Services though a
dispensary in Intramuros
●Started water sanitation
●Introduced small pox vaccine
●Creation of position of district, provincial,
national health officers
3. American Regime (1898- 1942)
●1898 creation of board of the Health for
Physician
●1899 appointment of the first commissioner of
health
●1901 - Creation of Board of Health for City of
Manila, Provincial and Municipal Boards of
Health
●1905 abolition of the board of health, creation
of bureau of health under Department of
interior
● 1906 – abolition of Board of Health;
creation of Bureau of Health
● 1912 -PHN started in Cebu w/ 4
graduate nurses who dealt primarily in
MCH services
● 1915 – BOH was renamed Philippine
Health Service with Director of Health as
head
-PHN began in Manila with 2 nurses who
offered follow-up care of OB patients and
environmental sanitation services
● 1928 – First convention of Nurses
● 1930 – Section of PHN was converted to
Section of Nursing 1933
– Reorganization act 4007 – Division of Mat.
& Child Health of the office of Public
welfare commission was transferred to
Bureau Of Health
4. Japanese Regime (1942-1945)
PHN services were interrupted
 5. Era of the Republic of the Philippines
(1946 to present)
●1947 DOH was divided into 3 bureaus
a. Hospital
b. Quarantine
c. Health
May 18, 1954 – RA 1082 (RHU Act)
was passed, implemented in July of the same
year, provided for the employment of health
personnel, including nurses, who would man
the RHUs and help raise the health conditions
of the rural population.
June 1957 – RA 1891 (An Act Strengthening
Health and Dental Services in the Rural
Areas and Providing Funds Thereof) was
approved; created eight(8) categories of RHUs
corresponding to 8 population groups to be
served.
1975 – Formulation of the National Health
Plan and the restructured Health Care
Delivery System.

1982 – E.O 851 Health Educ. And

Manpower Dev. Service was created and
Bureau of Food and Drugs assumed the
functions of the Food and Drug Admin.
 1986 – Min. of Health became DOH again
1987 – reorganization E.O – 119. Secretary
Of Health covered 5 offices:
. Chief of Staff
. Public Health Services
. Hospital & Facilities Services
. Standard & regulations
. Management Service
1991 – Rep. Act 7160 Local
Government Code passed &
implemented
1992- Devolution transferred authority to
LGU by virtue of the Local Government
Code.
•Appointments of RHU/City Health
Department personnel (including nursing
personnel) have to be approved by the
mayor. Material supplies of health center
have to be provided by the LGUs.
• Nat. Immunization Day
• Nat. Micronutrient Campaign (Araw ng
Sangkap Pinoy)
• Disaster Management
• Urban Health and Nutrition project
• Traditional Medicine
• Doctors to the Barrios
• Program became a national battle cry.
Let’s DOH it
1996 – Primary Health Care as strategy to
attain Health for All by the year 2000
1999 – Creation of the National Health
Planning Committee (NHPC) And
establishment of Inter-Local Health Zone
1999 – 2004 = Health Sector Reform
Agenda of the Phils.
2005 – DOH launched Fourmula One for
Health to ensure speed, precision and
effective coordination towards improving the
efficiency, effectiveness and equity of Health
Care delivery.
DOH Plans, Programs &
Projects
VISION: Health for all Filipinos and Health in
the hands of people by 2020.
MISSION: Ensure accessibility and quality
of health care to improve the quality of life of
all Filipinos, especially the poor.
THANK YOU
&
GOD BLESS!