Implementing Plan

of Action for
Community Health
NCM 104
Learning Outcome

Use appropriate strategies/approaches to plan community

health programs and nursing service.

Document client’s responses/ nursing care services

rendered and processes/ outcomes of the nurse client
working relationship.

Ensure completeness, integrity, safety, accessibility and

security of information.

Adhere to protocol and principles of confidentiality in

safekeeping and releasing of records and other
information.
 Contents
Importance of
Partnership and
Collaboration

Activities involved in
Tools for Documentation Collaboration and
Advocacy

Steps in Program Community Organizing

Evaluation and Social Mobilization.

Roles of the nurse in the

Indicators of Evaluation implementation of
Health Program

Designing and
Types of Evaluation implementing evaluation
Plan
 Importance of Partnership and Collaboration

They must work with other

The community health nurse people or groups to increase
As the saying goes, there is
cannot solve the problems the probability of
strength in numbers.
alone. accomplishing the goals that
they have set.
 The nurse must plan, establish, and
maintain invaluable working relationship
Importance of with people such us people’s
Partnership and organizations, health organizations,
educational institutions, their local
Collaboration government units, financial institutions,
religious groups, social civic
organizations, sectoral groups and the
like.
 The aim of partnership and
collaboration is to get people to
work together in order to address
problems and concerns that affect
them.
 Activities involved in
Collaboration and Advocacy
The following are the general
ideas for the nurse on how to
get started in partnership and
collaboration work:
It is essential for nurses to
involve all stakeholders in
the process of forging
partnership and
collaboration with the
community.
In working together, the nurse
and the community face risks
together. It is important
therefore, that they need to
know and trust each other.
Determine how each organization
views the problem, how it proposes to
solve the problem and how it
perceives an organizational
relationship can help solve the
problem.
Organization should agree on
the kind or level of
relationship that will help
beast accomplish the group
goals considering needs and
available resources.
5. When organizations have agreed on the type of organizational relationship,
ground rules that will become the basis for a decision-making. The following
are the most important point:

Listen Take Don't force

Listen to what has Take time to listen Don't force

to say, points of to people who voice organizations to
agreement can only different opinions or give up their
be reached if there's concern. Keep an identities.
an exchange of open mind. Try to Remember,
information. identify points of organization work
unity from diverse together for a
opinions. common good.
They do not work
together just so they
can outdo each
other.
 Advocacy work

The nurse helps the

is one way that nurse
people to attain
can promote active
optimal degree of
community
independence in
participation.
decision making.
Advocacy works involves the
following (Kohnke, 1982)
Informing the people about the
rightness of the cause

• The nurse conveys the

problem to the people,
shows how it affects them
and describes what
possible actions they can
take.
 Thoroughly discussing with the people, the nature of
alternatives, their content and possible consequences.

While discussing the Through this process that the

alternatives, the community's
needs and problems are
amplified in eventually
become the basis of decision
making.
nurse and the people can
agree with one relevance and
inappropriateness of the
actions to be taken to solve
the problem.
Supporting people's right to make a choice and to act on
their choice

The nurse puts emphasis on It is also the nurse

the people's right to decide responsibility to facilitate
actions what they think the process of weighing the
should benefit of the benefits and losses of the
community. alternatives.
Influencing Public Opinion

The nurse appears the decision made

by the people by getting powerful
individuals and groups to listen,
support and make substantial changes
to solve the problem.
Community Organizing and Social
Mobilization
Community Organizing and Social
Mobilization
• Community organizing work is carried out by the
nurse with the goal of motivating, enhancing and
seeking wider community participation and
decision-making in activities that have the potential
to impact positively on community health.

• The nurse’s efforts are directed towards organizing

and mobilizing the people to initiate and sustain
changes as a group or as an organization.

• The people act not as individuals but as members

of these groups or organization.
 Community Organizing
Is a process whereby community members develop the
capability to:
• Assess their health needs and problems 
• Plan and implement actions to solve these
problems 
• Put up and sustain organizational structures 
• Support and monitor implementation of health
initiatives by the people
 Phases of
Community
Organizing
A. PREPARATORY PHASE

• The activities in the preparatory phase

include area selection, community
profiling, entry in the community and
integration with the people. 
A. PREPARATORY PHASE
1.Area Selection- choosing and prioritizing areas for community development.

2.Community Profiling-
• A community profile provides an overview of demographic characteristic, community and health
related services and facilities.
• It will serve as an initial database of the community and provide the basis for planning and
programming of organizing activities.

3. Entering the community an integration with the people.

• Establishing rapport and integrating with them will be much easier if one is able to understand,
accept or imbibe their community life.
B. ORGANIZATIONAL
PHASE
• The organizational phase consists of
activities leading to the formation of a
people’s organization.
B. ORGANIZATIONAL PHASE
1. Social preparation- The integration works paves the way for the nurse to introduce into the
community and signals the beginning of the social preparation phase.

2. Spotting and developing potential leaders- As a result of living and being with the people,
nurse comes to know who among them had deep concern and understanding of the conditions of
the community.

3. Core Group for Formation- The core group will identify potential leaders who will be tasked
with laying down the foundation of the strong people’s organization.

4. Setting up the community organization- This organization will facilitate wider participation in
collective action on community problems. When the organization is formed, the nurse makes
sure that there is maximum participation of members in all its activities.
The purpose of this is to C. EDUCATION
strengthen the organization and AND
develops its capability to attend TRAINING
PHASE
to the community's basic health-
care needs.
C. EDUCATION AND TRAINING
PHASE

1. Conducting Community Diagnosis

• The community diagnosis is done to come up with a profile of

local health situation that will serve as a basis of health programs
and services to be delivered to the community.
• The nurse helps the community to identify, analyze and
understand implication of the data that they have been collected.
 
2. Training of the Community Health Workers

• The community decides on the role of community health workers, they are
expected to perform the competences and personal qualities they should possess.
• The nurse facilitates and conduct of training needs assessment to determine the
level of health skills and knowledge the trainees possess and the result of the
assessment will serve as the basis for the health skills training curriculum which
will focus on their required competences.
3. Health Services and Mobilization

• The organization takes the lead in undertaking activities that will

solve problems in the community is confronted with.

• Engaging them in collective word gives the people opportunities to

test and strengthen collective spirit and at the same time, build and
enhance their confidence.
 4. Leadership Formation Activities

Leaders learn a lot by engaging in

actual organizational activities
The process of developing
such as conduct of meetings,
community leaders is a
assessment, planning,
continuous and sustained process.
implementation, monitoring and
evaluation of activities.
D. INTERSECTORAL COLLABORATION
PHASE

The need for resources-

As the organization
material, human,
grows, its needs also
financial-will have to
grow.
be sourced externally.
E. PHASE-OUT

• As the organization in the community assume greater responsibility in managing

their health care needs,
• the nurse gradually prepares for a turnover of work and develops a plan for
monitoring and subsequent follow-up of the organization's activities until the
community is ready to full this disengagement and phase-out.
 Roles of the nurse in the implementation of Health
Program
• Conducts regular visits to priority households under the National
Household Targeting System for Poverty Reduction (NHTS-PR)
• Prepares health status reports of families based on the NHTS-PR
priority households
• Plans for appropriate interventions on the identified health concerns of
families
 Roles of the nurse in the implementation of
Health Program

• Assists in the conduct of regular monitoring and evaluation of various

health programs
• Assists in the conduct of disease surveillance
• Maintains Barangay Health Stations
• Conduct health education and training
• Assists in the preparation of reports on clinic and community
activities.
Designing and Implementing
Evaluation Plan

•  In designing an evaluation

plan, the PHN should specify
the criteria and corresponding
evaluation tool for each
objective.
The table below serve as a guide to ensure that the evaluation
plan does not miss an important point.

Sample Form in Designing an Evaluation Plan

Objective Criteria for Evaluation
Evaluation
     
 Sample Evaluation Checklist
Direction: What does check mark on the appropriate column and write significant explanatory notes on the Remarks column.

  Check if Observed  
Criteria Remarks
Yes No
1. The client takes prescribed anti-malarial drugs correctly      
2. Each family member sleeps under a mosquito net.      
3. The family eliminates the breathing and resting sites of the mosquito vector      
4. The family takes care of family member with malaria correctly.      

For example, if the PHN is going to evaluate the

response of the family on the community malaria
prevention and control program, the nurse should
prepare a checklist similar to the one shown:
Designing and Implementing Evaluation Plan

If the evaluator would like the measure the knowledge of the client, relevant questions
should be asked.

If the objective of nursing intervention is to increase the knowledge of the mother on

nutrition of the children, then the questions that will be asked should be specific to the
identified criterion.

In preparing a list of questions to be asked, the evaluator should make sure that the
questions are clear and very easy to understand.
Designing and Implementing Evaluation Plan

• After the collection and analysis of data/information, the nurse should

give clients feedback on the result of evaluation.
• Giving feedbacks serves many purposes, among which are motivates
and reinforce positive behaviors, enhances client’s self-image and
increases client’s awareness of the need to improve their repertoire of
coping behaviors.
• There is a lot of the evaluation and feedback session should be
properly documented.
 Evaluation

It is defined as the process of

determining systematically and
is the analysis of the effectiveness,
objectively the relevance,
quality, scope and timeliness of
efficiency and effectiveness and
services given.
impact of activities in the light of
their objectives (UN, 1978).
 Types of Evaluation
Ongoing • Is the analysis during the implementation of the
activity, of its continuing relevance, efficiency and
effectiveness and present and likely future outputs,
Evaluation effects and impact.

Terminal • Is undertaken from 6-12 months after the project

completion.
• It is a substitute for an ex post evaluation of the
Evaluation projects with short duration.

Ex post • is undertaken some years after project completion

when full program/project benefits and impact are
expected to have been realized (UN 1978) .
Evaluation
Steps in Program Evaluation
There are six steps in program evaluation:

Decide what to Design Collect Relevant

evaluate Evaluation Plan Data

Report/Give
Analyze Data Make Decisions
Feedback
Decide What To Evaluate:

• The WHO suggested five dimensions of

program performance that could be evaluated:
relevance, progress, effectiveness, impact and
efficiency.
• The questions that need to be answered at these
points are what should be evaluated? what
indicator should be used?
 Design Evaluation Plan

Designing an evaluation plan

means specifying data collection Records and reports can be
methods and tools and sources of reviewed and analyzed.
data.

Local officials, community

Data collection tools include
leaders and program
questionnaires or interview
implementers can also be
schedules and checklist
interviewed.
 Sample Evaluation Plan Format
What to Data/Information Data Collection Sources of
Evaluate and Needed Methods/Tools Data/Informatio
Evaluation n
Indicators

       
 
 
 
Collect Relevant Data

Prior to actual data collection, data

The evaluator’s primary aim is the
collection methods and tools should be field
generation of accurate and reliable data.
tested and data collector should be trained.

Poor quality means incomplete, inaccurate

or inconsistent or simply unbelievable. This
Evaluators are sometimes faced with poor
problem can be prevented or at least
quality of available data.
minimized, if this concern is addressed
during the program planning stage.
 Analyze Data

Evaluator should assess the
quality of data before they
start their analysis.
What do the figure/statistics
mean?
What do the qualitative data
reveal?
The main questions that
should be asked are:
Is the program relevant?
Is it progressing in accordance with the
program plan?
Is it effective? Is it efficient?
Did it make a significant impact on the
beneficiaries and the community?
Do the benefits outweigh the problems
created (if there are)?
What are the lessons that could be
learned from the program?
Make Decisions
• If the interventions or program
was effective and efficient, this
could be continued and/or
applied to another client or
group, given similar
circumstances.
Make Decisions
If the interventions or program was effective and
efficient, this could be continued and/or applied to
another client or group, given similar circumstances.

The positive evaluation results serve as a go-

signal to start the next phase.

If the program is not relevant, the elevator should

recommend its modification or termination.
 Report/Give Feedback

The result of the program

evaluation should be submitted to
It should be noted that these are
the local authorities such as the
the key decision makers in the
mayor, chair of the Sangguniang
local health system.
Bayan Committee on health, and
to the local health board.
Report/Give Feedback
• An executive summary should be prepared for them.
• It should be contained a brief description of the focus and procedures
of the evaluation, summary and interpretation of evaluation results,
locations and recommendations.
• The nurses and the other health workers must be prepared to make a
presentation to the Sangguniang Bayan or to the local health board.
 • If the nurse will be asked to make a
presentation, the nurse should
prepare good visual aid, rehearse
and prepare for the questions that
Report/Give may be asked.
Feedback
• A good written report and an
impressive oral presentation can
influence decision makers
positively.
 • The nurse should document all the things that
he/she did.
• Documentation should include the following
Tools for client assessment and health needs identified,
Documentation interventions, client response the
interventions, outcome of intervention in the
future plan of care.
Tools for Documentation
• Documentation is an important component of the nursing process. It
serves a number of functions among which are:

• It serves as a proof of that thinking and decision-making that nurses do.

• It could protect the nurse from a lawsuit
• It gives decision makers an idea of the workload of nurses
• It provides information that could be used in research and quality assurance
activities for training in purposes
END