4.
Concept of Family and the Community
COMMUNITY HEALTH NURSING 2
I. INTRODUCTION
● THE CURRENT POPULATION OF PHILIPPINES IS
110,423,968, BASED ON PROJECTIONS OF THE LATEST
UNITED NATIONS DATA. THE UN ESTIMATES THE JULY
1, 2021 POPULATION AT 111,046,913.
● BECAUSE OF ITS ARCHIPELAGIC NATURE, PHILIPPINES
IS A CULTURALLY DIVERSE COUNTRY.
● Despite having widespread poverty, the Philippines has fared
relatively well in human development index (hdi), particularly in
comparison to other southeast Asian nations. In 2012,
Philippines' economy outpaced the growth of its neighboring
countries with 6.6 percent growth rate.
● According to international insurance.com, healthcare in the
Philippines is considered to be of good quality by international
standards.
● THE WORLD HEALTH ORGANIZATION RANKS THE
EFFICIENCY OF THE FILIPINO HEALTHCARE SYSTEM
60TH IN THE WORLD.
II. CHALLENGES IN PUBLIC HEALTH
FUNCTIONS OF THE FAMILY
● Although with the present availability of vaccination programs of
the government and the access to health care system (philhealth),
yet the emergence of the present global pandemic of covid-19
and the other communicable diseases e.g. Dengue, measles, ptb,
hiv etc. And the non-communicable diseases creates a triple
whammy burden to philippine health care system.
FAMILY
● “the group of persons usually living together and composed of
the head by blood, marriage or adoption. It includes both the
nuclear and the extended family”- (nscb, 2008)
● Sociologists defines, “social unit interacting with larger society”
IN COMMUNITY AND PHN
● The family is considered as the “natural” And fundamental unit
of the society. An institution that involves the majority of the
population.
● The family as a group generates, prevents, tolerates and corrects
health problems within its membership. The family acts as a
basic care provider. It is the family that works to achieve certain
health goals.
● The health problems of the family are interlocking. Illness in one
member affects the entire family and its functioning.
FAMILY AND HEALTH
● The family is the most frequent focus of health decisions and
actions in personal care.
● The family is an effective and available channel for much of the
community health nursing efforts. Improved community health is
realized only through improved health of the family.
III. TYPES OF FAMILIES
● Nuclear family- the family of marriage, parenthood, or
procreation; composed of a husband, wife and their immediate
children- natural, adopted or both”
CHN 2
LECTURE
● Dyad family- consisting only of the husband and the wife,
such as newly married couples and “empty nesters’’.
● Extended family- consisting of three generations, which
may include married siblings and their families and/or
grandparents.
● Blended family- which results from a union where one or
both spouses bring a child or children from a previous
marriage into a new living arrangement.
● Compound family- where a man have more than one
spouse; approved by the philippine authorities only among
muslims by virtue of p.d.no. 1083, also known as the
muslim personal laws of the philippines.
● Cohabiting family- which is commonly described as a
“live- in” Arrangement between unmarried couple who are
called common-law spouses and their child or children from
such an arrangement. Gay or lesbian family are made up of
cohabiting couple of the same sex in a sexual relationship
● Single parent- which results from the death of spouse,
separation, or pregnancy outside of wedlock.
● Procreation
● Socialization of family members
● Status placement (societal rank)
● Economic function (depends on rural and urban status)
� Procreation is the universally accepted
institution for reproductive function and child
rearing.
� Socialization is the process of learning how to
become productive members of the society.
● Specifically, the family meet the needs of individuals
through:
� Physical maintenance. The family provides for
the survival needs (food, shelter, and clothing) of
its dependent members, like the young children
and the aged.
� Welfare and protection. The family supports
spouses or partners by providing companionship
and meeting affective, sexual and socioeconomic
needs.
IV. CHN AND FAMILY
● Community health nursing has long viewed the family as
an important unit of health care. Observing and inquiring
about family interaction enables the nurse to assess the
influence of family members to each other.
● Nursing assessment and intervention must not stop with
the immediate social context of the family, but it must also
consider the broader social context of the community and
society.
● According to friedman et al. (2003), suggests reasons
why it is important for nurses to work with the families
(as a client)
� “the family is a critical resource”
� “in a family unit, any dysfunction that affects one
or more family member will affect the unit as a
whole.”
� “case finding” Involves the whole unit.
� “improving nursing care”. The nurse can provide
better and more holistic care by understanding the
family and its members. Friedman and heinrich
(1981) points out that the family provides
feedback and influence health services.
V. THE FAMILY AS A SYSTEM
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[CHN 2] 4. Concepts of Family in CHN– Prof. Rodel Ninofranco
● The family is more than the sum of its member. The totality of
health among each members applies to the unit as a whole.
● The family is embedded in social systems that have influence on
health (e.g. Education, employment, and housing).
CHARACTERISTICS OF A HEALTHY FAMILY PHASES OF HOME VISIT
Defrain (1999) and montalvo (2004) suggests the following traits of a
healthy family:
● Members interact with each other; they communicate and listen
repeatedly in many contexts;
● They can establish priorities. Members understand that family
needs are priority.
● Healthy family affirms, support and respect each other.
● The members engage in flexible role relationships, share power,
respond to change, support the growth and autonomy of others,
and engage in decision making that affects them.
● The healthy family teaches family and societal values and beliefs
and shares spiritual core. CHARACTERISTICS OF A COMMUNITY
● Healthy families foster responsibility and value service to others.
● Healthy family have a sense of play and humor and share leisure
time.
● Healthy families have the ability to cope with stress and crisis
and grow from problems. They know when to seek help from
professionals.
VI. FAMILY-NURSE CONTACT
The nurse uses the type of family-nurse cnatct that is most suitable to the
purpose or situation at hand:
● The clinic visit (private clinic, health center, bhs, rhu or in
ambulatory clinics) it’s the family who takes initiative of visiting COMMUNITY IN THE PHILIPPINES
the hcw.
● A group conference (e.g. Pregnant mothers, families, group of
parents/ elders, members of the community etc.), may take place
in a health facility or in the community. This is the type of
contact that develops cooperation, leadership, self- reliance and
awareness.
● Telephone- provides easy access either by call or text message.
However, information transmitted is limited and depends on the
service availability.
VII. HOME VISIT OR HOME HEALTH VISIT
● Is a professional and purposeful interaction that takes place in the
family’s residence aimed in promoting, maintain and restoring
the health of the family or its members.
FORMAL COMMUNITY
It has the following advantages:
● It allows firsthand assessment at the home situation: Family
dynamics, environmental factors affecting health, and resources
within the home;
● The nurse is able to seek out previously unidentified health need
(david et al. 2007)
● It gives the nurse an opportunity to adapt interventions according
to family resources (stanhope and lancaster 2010)
● It promotes family participation and focuses on the family as a
unit (maurer and smith 2009)
INFORMAL COMMUNITY
● Teaching family members in the home is made easier by the
familiar environment and the recognition of the need to learn as
they are faced by the actual home situation (maurer and smith
2009)
● The personalized nature of a home visit gives the family a sense
of confidence in themselves and the agency (david et al. 2007)
● Disadvantage is time-consuming and nurses is unable to control
the environment
ETHICS IN HOME VISIT URBAN COMMUNITY
● maintaining a client focus.
● client independence.
● honesty
● privacy and confidentiality
● limits in the intervention
● termination
● pre-visit phase/ planning process
● in-home phase/ initiation/ assessment/ implementation/
termination
● post-visit phase/ follow-up and referral
VIII. COMMUNITY
● the community is a group of people sharing common
geographic boundaries and/ or values and interests. it
functions within a particular sociocultural context, which
means that no two communities are alike.
● it is defined by its geographic boundaries within certain
identifiable characteristics.
● it is made up of institutions organized into a social system
with the institutions and organizations linked in a complex
network having a formal and informal power structure and
communication system.
● A common or shared interest that binds the members
together exists.
● It has an area of fluid boundaries within which a problem
can be identified and solved.
● It has a population aggregate concept.
● In the philippines there is a big difference between rural and
urban communities. These communities differs in terms of a
number of characteristics such as physical environment,
population size and density, economy, culture, political
dynamics, availability and adequacy of social services, and
availability and accessibility of health resources.
IX. TYPES OF COMMUNITY
● Formal communities engage in joint activities and
discussion, help each other, and share information with each
other; they care about their standing with each other.
● Examples of formal communities
� Ecovillages
� Co-housing communities
� Co-ops communities
� Religious communities
● Informal communities consists of a set of personal relations,
social networks, common interest and emotional sources of
motivation.
● Examples of formal communities
� Academic communities
� Recreation communities
� Retirement communities
● Urban communities large in terms of land area &
population, advanced in science & technology, with
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[CHN 2] 4. Concepts of Family in CHN– Prof. Rodel Ninofranco

favorable physical environment and & diverse cultures, and the 6. Community members have access to varied experiences, interaction and
people are engaged in various occupations. communication.
● Characteristics of urban communities 7. The health services are accessible and appropriate.
8. The historical and cultural heritage is promoted and celebrated.
� Advancement in science and technology
9. There is a diverse and innovative economy.
� Many business establishments, recreational centers, 10. There is a sustainable use of available resources for all.
educational and religious institutions
� People are crowded HEALTHY COMMUNITY (MAGLAYA ET.AL 2005)
� Social heterogeneity
● Awareness that “we are community”
� Class extremes ● Conservation of natural resources
� Greater pollution ● Recognition and respect for the existence of sub-groups
● Participation of sub-groups in community affairs
CHARACTERISTICS OF URBAN COMMUNITIES ● Preparation to meet crises
 Many crimes are committed ● Ability to problem-solve
 Family ties tend to be weak ● Communication through open channels resources available to all
 Limited space ● Setting of disputes through legal mechanisms
 Greater impersonality among neighbors ● Participation by citizens in decision making
 Higher standard of living
● Wellness of a high degree among its members (hunt and zurek,
 Informal settlers are rampant
 A lot of hazards and dangers 1997)
 Greater number of separation of spouses and live- in
arrangements HEALTHY COMMUNITYDESIGN CAN PROVIDE MANY
 Major occupations are industrial, administrative and
professional ADVANTAGES:
 Divisions of labor and occupational specialization are very ● Promote physical activity
much common ● Promote a diet free of additives, preservatives, and pesticides
● Improve air quality
RURAL COMMUNITY ● Lower risk of injuries
● Increase social connection and sense of community
● Reduce contributions to climate change
Rural communities usually produce their own food for subsistence
characteristics of rural communities
● Greater personal interaction
● Deep, long-term relationships
● Generally, peace and order exists
● Mutual give and take affairs
● Emphasis of shared values ▪ vernacular is usually spoken

CHARACTERISTICS OF RURAL COMMUNITIES

 Wider area
 Influence of blood relationships in decision making
 Homogenous type of culture
 Belief in supernatural and superstitious beliefs
 Relationship is more personal and informal
 Less pollution
 Few establishments and institutions
 Few goods and services

GLOBAL COMMUNITY
● Global communities it is the international aggregate of nation- states.
● Global communities
� World community
� Common point of view towards issues of human rights, global
warming and climate change, peace and order, socio-
economic conditions as well as disputed issues such as
territorial conflict.

SECTORAL COMMUNITY
● Sectoral communities include the voluntary sector or non-profit sector
● Sectoral communities
� Voluntary, non-profit and non-governmental
� Also called third sector (in contrast to public and private
sector)
� Ngos: Non-governmental organizations

SOCIAL SPACE COMMUNITY

● Social space communities based on social spaces
● Social space communities
� A social space is a physical or virtual space
� Physical: Social center, gathering place, town squares, parks,
pubs, shopping malls

X. CHARACTERISTICS OF A HEALTHY COMMUNITY

1. The physical environment is clean and safe.

2. The environment meets everyone's basic needs.
3. The environment promotes social harmony and actively involves everyone.
4. There is an understanding of the local health and environment issues.
5. The community participates in identifying local solutions to local problems.
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