Community

health nursing

Neethu Vincent

Asst.professor
Community Health

COMMUITY HEALTH
The community health refers to the health status of the
members of the community to the problems affecting their
health and to the totality of health care provided for
community.

WHO
CONCEPT OF COMMUNITY
HEALTH
– Maintaining good sanitation ,potable water supply
– Providing health education to self care ,nutrition etc,
– Controlling communicable and non communicable
disease
– Organizing proper medical and nursing services
– Improving the standard of living with the help of other
sectors
– Active involvement of beneficiaries and people
Health of the people in a community depends on
concrete and cooperative efforts of people
residing in a community.
The organized efforts of community as a whole
can improve the health of the members of the
community.
Organized governmental efforts in the health field
can improve the health status of the community.
Both affected and non affected people comes
under community health concern.
PHILOSOPHY OF COMMUNITY
HEALTH
 Philosophy of individual rights of being healthy
 Philosophy of working together under a competent leader
for the common goal.
 People in the community have potential for continued
development and are capable of dealing with their own
problems if educated and helped.
 Philosophy of socialism- sharing.
AIMS OF COMMUNITY HEALTH

– To reduce mortality, morbidity, and disability

– To improve nutritional status
– To improve life expectancy.
– Health promotion
– Disease prevention
– Management of factors affecting health
 GENERAL GOAL OF COMMUNITY HEALTH

– To promote health and efficiency

– Prevent and control disease & disability
– Prolong life by providing need based well balanced
comprehensive health care services to community through
organized community efforts.
 OBJECTIVES
1.To increase the capability of the community to deal with
their own health problems.
2. To prevent and control communicable and non
communicable disease
3. To provide specialized services.
4. To strengthen community resources.
5. To control and counter act environment.
6. To conduct research.
7. To prepare health personal.
8. Increasing the average span of human life
9. Decreasing the mortality rate , particularly infant
mortality rate, and maternal mortality rate
10. Increasing physical ,mental, and social well being
of individual
11. Increasing the place of adjustment of the individual
to his environment
12. Providing total health care to enrich quality of life
DETERMINANTS OF COMMUNITY HEALTH

Human biology
Environment
Life style
Health and allied resources
Human biology
Include age, race, genetic inherence, & self concept.
Environment
Include physical, biological, &and social components of environment.
Life style
Include way of living, knowledge, attitude, practice etc acquired through formal &
informal education.
Health and allied resources
Include health services, socio economic conditions, education, food, agriculture,
industry rural- urban development, communication, transportation, political
system,& health related services.
 Community health indicators

Represent the health of the community

Include mortality indicators, morbidity indicators, disability
indicators, life expectancy of health, nutritional status, social and
maternal indicators, indicators pertaining to health care delivery
system socio economic indicators, environmental indicators,&
quality of life.
Scope of community health
– Focused on health as influenced by social and
community structure.
– Well established methods for assessment, planning,
implementation, and evaluation of health programs
as well as health assessment of the community.
– Offer higher education facilities
– Well educated personals in community health discipline
plans, administer, and evaluate all health program
– Included as an important subject for nursing and medicine
curriculum.
– High influence in improvement of health of the
community.
– Advanced technical assistances are implemented to stand
in equal position with other discipline.
PRINCIPLES OF COMMUNITY HEALTH
– Health care should be shaped around the life patterns of the
population. It should serve and should meet the needs of the
community
– Should be an integral part of the national health system . health
organization at all levels should be designed in support of the need
of the peripheral level, especially as related to technical ,supply,
supervisory and referral agencies.
– Health care activities should be integrated with the activities of
other sector involved in community development
– Local population should be actively involved in the formulation
– The health care offered should place a maximum reliance on
available community resources and should remain within the cost
limitation relevant to each country
– Health care should integrated approach of preventive ,curative
and rehabilitative services for the individual , family and
community. The balance between these services would vary
according to community needs and might will change over time.
– The majority of interventions should be undertaken at the most
peripheral practice level of the health services by workers most
suitably trained for performing these activities.
 Community Health Nursing

Community health nursing is the synthesis of nursing and public

health practice applied for promoting and preserving the health of
people . A N A -1980
Community health nursing is a learned practice with ultimate
goal of contributing individuals and in collaboration with others to the
promotion of optimum functioning through and delivery care.
(Margret J Jacobson)
Purpose of Community Health
Nursing

– To improve community health through the

selective application for nursing and public
health measures within the frame work of
the total community health effort
Aims of Community Health nursing
– To increase the capability of families ,groups and communities to cope
health and illness problems
– To support and supplement the efforts of other professionals in
restoration and preservation of health
– To control or counteract as much as possible physical and social
environmental conditions that threaten health or decrease the enjoyment
of life
– To contribute to the refinement and improvement of nursing practice
and of public and of public health practice and service.
– To promote and preserve health ,to restore health when it is impaired ,
minimize suffering and distress and to promote quality living
 Objectives
– 1. To increase the capability of community to deal with their own health problems.
– Provision of adequate information pertaining to their health problems,health issues can
increase the community’s capability to deal with the health problems in a effective
manner
– People can be taught “how to care for themselves” through education,guidance and
supervision.
– eg: Helping young mothers to give care to the children in meeting their physiological,
safety, love and security needs so as to have normal growth and development of
children.
– Continuous need based health education not only improves health knowledge and skills
but also helps in developing positive attitude which brings change in health behavior.
2.To strengthen community resources

– Community resources include manpower ,money material their

development, distribution their utilization.
– Resources need to be strengthened ,distributed and utilized
properly.
– For this purpose an intersectoral approach is regarded,
wherein,there is need for a strong political, legal and
administrative support.
3.To prevent and control and protect environment
– It includes environment protection measures and changing reaction to environment
when some protection measures are not feasible.
– Protection measures are as follows:
– i. Safe drinking water
– ii. Clean air and soil
– iii. Safe disposal of refuse and excreta
– iv. Good social security and safety
– Changing reactions
– i. Mass Immunizations
– ii. Mass screening
– iii. Mass prophylactic treatment
– 4. To prevent and control communicable and non-communicable
diseases
– This includes application all the three levels of preventive measures i.e:
– 1) Primary level
– 2) Secondary level
– 3) Tertiary level
– 5.To provide specialized services for mothers , children,adults, workers,
elderly, handicapped and eligible couples etc
– It provides specialized services for mothers,children,workers,elderly,
handicapped and eligible couples,etc.
6.To conduct research
– To conduct research to build up knowledge and contribute to
further refinement and improvement of community health
practice.
7.To prepare Health personnel
– To prepare health personnel in the community for community
health care services.
– Ultimate aim of community health care services is to reduce
morbidity, mortality and disability, improve nutritional status and
increase life-expectancy at birth.
CONCEPT OF COMMUNITY HEALTH NURSING

The conceptual elements of community health nursing practice include:

1)Community
2)Community health
3)Community as a patient
4)Community participation
1)Community :
A community is a social group determined by geographical boundaries and
common values and interest.
Its members interact with each other
The community has three dimensions
-interpersonal relationship
-residence in a common locality
-solidarity, sentiments and activities
So community health nurse should observe the different views of the community .
2)Community health
Has three common characteristics
– Status
– Structure
– Process
status indicate the physical, emotional and social components of community
health.
structure include community health services, resources, and quality of
community structure.
process indicates the effective community efforts towards wellness.
3)Community as a patient
The location of practice is the community but focus of care is the
individual or family.
4)Community participation
Community health nursing practice aims at change in the behavior of the
community for the promotion of health and wellness of the whole
community.
 Principles of Community Health Nursing
1) Community health nursing is community focused, it is there for
essential to know the defined community, make a map and
establish effective working relation ship.
2) Community health nursing is based on identified community
health nursing needs and functions within total community health
programs.
3) Health education, guidance and supervision are an integral part of
community health nursing.
4) Health services should be realistic in terms of available resources.
5)The health worker is responsible to the authorized health authority and
functions within the policies, general goals and objectives set by the health
agency.
6) Effective health workers irrespective of position or place of work , function
as a team.
7) In community health, community and the family are in focus rather than the
individual as the unit of health care.
8) Professional relationship and etiquette are essential in community health
services
9) Community involvement is an integral part of community heath services.
10)Individual and family participate fully in all decision making relating to attainment of
health.
11) Continues services are effective services and community health nurse must provide
continues health services.
12) Well developed system of records and reports is essential for community health
services.
13) Periodic and continues appraisal & evaluation of health situations and health services
are basic to community health.
14)Health services should be available and accessible to all without any discrimination.
15) Health worker should be nonpolitical& nonsectarian in her relationship.
16) Health worker should maintain professional dignity and must never accept any gift or
bribe.
Philosophy of community health nursing

1. Philosophy of individual’s right of being healthy.

2. Philosophy of working together under a competent leader for the common
goal.
3. Philosophy that people in the community have potential for continued
development and are capable for dealing with their own problems if educated
and helped.
4. Philosophy of socialism.
Characteristics of Community Health Nursing

– It is a field of nursing
– It combines public health with nursing
– It is population focused
– It emphasizes wellness
– It involves interdisciplinary collaboration
– It promotes clients responsibility and self care
Factors Influencing Community Health Nursing

– Population in the area

– Size of the area
– Transport and communication facilities
– Number an qualifications of other personnel
– General Health needs of the population
– Socio-economic conditions , education etc
– Previous experience of qualified health personnel
Scope of community Health Nursing

– 1. Community health nursing services at centre

– 2. Industrial nursing services
– 3. School health nursing
– 4. Domiciliary nursing services
– 5. Mental health nursing services
– 6.MCH and family planning
– 7.Rehabilitation centre
– 8. Geriatric nursing services
– 9. International health agencies
Nature of community health nursing
– Community health nursing is an integral part of
community health.
– Community health nursing is a specialized field of
nursing.
– Community health nursing synthesizes community
health with nursing.
– In community health nursing the whole community is
the client.
– Community health nursing emphasizes on primary level of
prevention.
– Community health nursing promotes self care
responsibility.
– Community health nursing involves multi-disciplinary
team approach.
– Community health nursing is working for people, with
people and by people.
– Community health nursing is dealing with wide
range of health problems and health needs and
providing need based generalized health services.
– Community health nursing is providing continues
care.
– Community health nursing is seeking support from
and giving support to personnel from other sectors
working for the welfare and development in the
community.