COMMUNITY

HEALTH
NURSING 2
ESSENCE OF COMMUNITY ORGANIZING PROCESS

F OCUS ON COMMUNITY ORGANIZING IS TO ACHIEVE SELF-RELIANCE

AIM OF CO is COMMUNITY DEVELOPMENT

CONCEPT OF CO IS TEAMWORK
ELEMENT OF CO IS PARTICIPATION OF PEOPLE\
S TRATEGIERS OF CO ARE TEACHING, TRAINING, AND TRANSFER OF TECH-
NOLOGY
THE COMMUNITY ORGANIZER
-can be a Nurse, social worker, teacher, or a volunteer from a grassroots

ROLES:
• ENABLER –Transforming human resource to their full potential. 
education and training
• ADVOCATE – he represents the best of what the community is and
speaks not his personal views but echoes that of the people, mak-
ing sure their voices are heard.
• FACILITATORS- fostering relationship and linkages among people,
agencies and resources
• CHANGE-AGENT –guides and influences the community in making
decisions to sha[pre their future.
COMPARISON OF TRADITIONAL RESEARCH AND
PARTICIPATORY ACTION RESEARCH IN THE COMMUNITY

POINTS OF TRADITIONAL ACTION PARTICIPATORY ACTION

COMPARISON RESEARCH RESEARCH
Decision TOP-DOWN BOTTOM-UP
Making
Roles • Expert/ nurse-driven • Community-driven process
Process • Premium is placed on the
• Much premium is placed pro-cess
on the data and output
Methodology • Research tools and • Research tools and
methodologies are prede- methodologies and identi-
termined/ prepackaged by fied and developed by the
the nurse-organizer community
COMPARISON OF TRADITIONAL RESEARCH AND
PARTICIPATORY ACTION RESEARCH IN THE COMMUNITY

POINTS OF TRADITIONAL ACTION PARTICIPATORY ACTION

COMPARISON RESEARCH
Output • Upon completion, the • Conclusions and recom-
study is packaged, sub-
mitted to agency, and
published. Recommenda-
tions are made by the re-
searchers based on the
findings of the study.
RESEARCH
mendations are made by
the community. These will
lead to agreed community
action/projects. The whole
research cycle is continuous
until it becomes part of
community life, leading to-
wards community develop-
ment. Communty members
formulate the recommenda-
TOPICS:
 Monitoring and Evaluating
Community Health
Programs Implemented
Evaluation
 

An evaluation plan is a written document

that describes how you will monitor and
evaluate your program, as well as how you
intend to use evaluation results for program
improvement and decision making.
The evaluation plan clarifies how you will
describe the “What,” the “How,” and the “Why
It Matters” for your program.
 The “What” reflects the de-
scription of your program and
how its activities are linked
with the intended effects.
 It serves to clarify the pro-
gram’s purpose and antici-
pated outcomes.
The “How” addresses the process for
implementing a program and provides
information about whether the program
is operating with fidelity to the program’s
design
the “How” (or process evaluation),
along with output and/or short-term out-
come information, helps clarify if
changes should be made during imple-
mentation.
The “Why It Matters” provides the ra-
tionale for your program and the im-
pact it has on public health
This is also sometimes referred to as
the “so what” question. Being able to
demonstrate that your program has
made a difference is critical to program
sustainability.
An evaluation plan is similar to a roadmap. It
clarifies the steps needed to assess the pro-
cesses and outcomes of a program.
It is a dynamic tool (i.e., a “living document”)
that should be updated on an ongoing basis to
reflect program changes and priorities over
time.
serves as a bridge between evaluation and
program planning by highlighting program
goals, clarifying measurable program objec-
tives, and linking program activities with in-
Types of Evaluation
 

Planning
Structure evaluation involves
looking into the manpower
and physical resources of the
agency responsible for com-
munity health interventions.
Formative
Process evaluation is exam-
ining the manner by which
assessment, diagnosis, plan-
ning, implementation, and
evaluation were undertaken
Summative
Outcome evaluation
is determining the
degree of attainment
of goals and objec-
tives
Steps of Program Evaluation
1.Engage stakeholders, including those
involved in program operations; those
served or affected by the program; and
primary users of the evaluation.
2.Describe the program, including the
need, expected effects, activities, re-
sources, stage, and context and logic
model.
3. Focus the evaluation
design to assess the issues of
greatest concern to stakeholders
while using time and resources as
efficiently as possible. Consider
the purpose, users, uses, ques-
tions, methods and agreements.
4. Gather credible evidence to
strengthen evaluation judgments
and the recommendations that fol-
low. These aspects of evidence
gathering typically affect percep-
tions of credibility: indicators,
sources, quality, quantity and lo-
gistics
4. Gather credible evidence to
strengthen evaluation judgments
and the recommendations that fol-
low. These aspects of evidence
gathering typically affect percep-
tions of credibility: indicators,
sources, quality, quantity and lo-
gistics
5. Justify conclusions by linking
them to the evidence gathered and
judging them against agreed-upon
values or standards set by the stake-
holders. Justify conclusions on the
basis of evidence using these five el-
ements: standards, analysis/synthe-
sis, interpretation, judgment and rec-
ommendations.
6. Ensure use and share
lessons learned with these
steps: design, preparation,
feedback, follow-up and dis-
semination.
Documentation
and Reporting
 I. Family Health
Records
II. Community Profile

22
FAMILY HEALTH RECORDS:
 Records are necessary for the continuation of delivery
of family health care services and its evaluation while
evaluation of family health services is necessary to
identify the new and continuing family health needs.
 Family records include information based on factual
events, observation results or measurements taken.
 Health records refer to forms on which information
about an individual and family is noted. Information
varies from socio-economic, psychological, environ-
mental factors etc.
Importance and Uses
 Provides documentation of services that have been ren-
dered and supply data that are essential for program plan-
ning.
 To provide the practitioner with data required for application
of professional services for improvement of family's health
 Records are tools of communication.
 Effective health record shows health problem in the family
and other factors that affect health-standardized sheet/form.
 Records indicate a plan for future.
 Provides baseline data to estimate long-term changes re-
lated to services.
 Provides opportunity for providing evaluation of the situation
Criteria for Recording in Family Health Records

Records should concentrate on the family and

community focus of care.
Family health records should serve as guides
for comprehensive care
show the problem as it develops so that the
change can be identified.
should indicate the expected outcomes and
also the degree to which outcomes are
achieved.
 should have specified actions planned for the family ac-
tions actually taken and distribution of responsibility to
family and other community resources so that necessary
activities are carried out
 record should indicate family response to nursing action
 initial planning and implementation can redefine a prob-
lem the record must show revision in the status of the
problem so that further planning can be done accordingly.
 should possess sufficient uniformity to make recording,
tabulation and collection easy and to permit inter-unit in-
service comparisons and easy reference.
Maintenance of records should require a mini-
mal amount of time
Family records should be quickly available to
the user. Accessibility is not always easy to
achieve.
Family records require reasonable storage
space
Family record system should provide confiden-
tiality of record content
Use of Records
For a Nurse
 Provides basic facts for services. Shows health condition as it is and as
accepted by individual/family
 Provides a basis for analyzing needs, short and long-term planning
 Prevents duplication of services and helps follow up effectively
 Helps the nurse to evaluate care and teaching
 Helps to organize her work in an orderly way and to make effective use of
time
 Serves as a guide to professional growth
 Enables the nurse to judge the quality and quantity of work done
 

For Individual/Family
 Help them to become aware and to recognize their
health needs
 Can be used as a teaching tool too

For the Doctor

 Serves as a guide for diagnosis, treatment and evalua-
tion of services
 Indicates progress
 May be used in research
For the Organization and Community
Helps to assess the health assets and needs of
the community
Helps in making studies for research, legisla-
tive action and planning budget
is legal evidence of the services rendered by
each worker
Provides a justification for expenditure of funds
Types of Records and Reports
Cumulative or continuing records
 This is found to be time saving, economical and also it
is helpful to review the total history of an individual and
evaluate the progress of a long period. (e.g.) child’s
record should provide space for newborn, infant and
preschool data.
 The system of using one record for home and clinic
services in which home visits are recorded in blue and
clinic visit in red ink helps coordinate the services and
saves the time.
Family records
The basic unit of service is the family.
gives the picture of the total services and helps
to give effective, economic service to the family
as a whole.
Separate record forms may be needed for dif-
ferent types of service such as TB, maternity etc.
all such individual records which relate to mem-
bers of one family should be placed in a single
family folder.
The records may be grouped according to:
1. Age of the family member for whom records
are used.
a New born care
Road to health card
Toddler card
Old age or elderly card
Mother-child link card
2. Health care requirement cards as per health condi-
tions and morbidity status
 Pregnant women or antenatal card
 Intra natal card or labor record
 Person with illnesses (e.g. Tuberculosis record, Dia-
betes record, Hypertension case card)
 Drug addicts or alcoholics record
 Any chronic care records
 Immunization record
FILLING OF RECORDS
Different systems may be adopted depending
on the purposes of the records and on the mer-
its of a system. Records could be arranged in
the following ways:
Alphabetically
Numerically
Geographically and
With index cards
REGISTERS
 It provides indication of the total volume
of service and type of cases seen. Cleri-
cal assistance may be needed for this.
Registers can be of varied types such as
immunization register, clinic attendance
register, family planning register, birth
register and death register.
REPORTS
 Reports can be compiled daily, weekly, monthly, quar-
terly and annually.
 Report summarizes the services of the nurse and/or
the agency and may be in the form of an analysis of
some aspect of a service. These are based on records
and registers and so it is relevant for the nurses to
maintain the records regarding their daily case load,
service load and activities. Thus, the data can be ob-
tained continuously and for a long period.
PURPOSES OF WRITING REPORTS
To show the kind and quantity of service
rendered over to a specific period.
To show the progress in reaching goals.
As an aid in studying health conditions.
As an aid in planning.
To interpret the services to the public and
to other interested agencies
C O M M U NI T Y

PROFILE
39
COMMUNITY PROFILE
summary of baseline conditions
and trends in a community and
study area.
It establishes the context for as-
sessing potential impacts and for
project decision-making .
OBJECTIVES
 To investigate the qualities of professional
writing
 To structure and develop a report (Com-
munity Profile) appropriately
 especially the introduction, discussion and
conclusion
 To write an effective purpose statement
 To present tables and figures using Van-
couver style
SKILLS REQUIRED
• Researching
• Planning and organization
• Synthesizing and analyzing information
• Summarizing information
• Writing/communicating clearly
• Having a sense of audience
• Formatting correctly: table of contents, tables,
figures, page numbers, headings
• Working collaboratively
Community profile includes
• Executive Summary
• Table of contents
• Introduction
• Methods
• Results
• Discussion
• Conclusion and recommendations
• References
Executive summary
Gives an overview of the Profile and should stand alone
Is a stand alone document that :
 Identifies the community surveyed and why the survey
was needed (problem)
 States the main objectives/purpose
 Outlines survey type and methods used
Sums up the main findings and conclusions
Outlines the main recommendations
Is written concisely and in your own words
Has no references
Is written last
Has page numbered using roman numerals
Plan the summary
•Begin with the big picture: community, aim,
community characteristics profiled
• Drill down with findings/conclusions from:
demographic data, social indicators, health
status, behaviors
• Finish with recommendations
• Be concise
• Omit details
Table of contents
• Generate using Word
• Number using roman numerals
• Provide page numbers of each
section of the Profile
Introduction
What is the profile about and what will be cov-
ered?
• Purpose/objectives of profile: what you hope
to
achieve by researching the community
• Relevant background information: previous
health, economic, social or environmental
issues/outline of community being profiled
Methods and main categories of information
collection
Scope of profile i.e. what will be covered to
achieve purpose
Appropriate acknowledgement (in-text refer-
encing) Effective purpose statements
Specific, concise and precise Not too general
Goal-oriented: stated in terms of outcomes
Results
What were the findings?
 Systematic presentation of results/findings in relation to
the purpose
 Use of text to describe findings
 Use of graphs and tables where applicable and appro-
priate (remember to refer to these in your text descrip-
tions)
 Appropriate use of headings and titles
 Acknowledgement of sources used
Discussion
What do the findings (results) mean?
 Restate and elaborate on outcome/purpose posed in in-
troduction and link results to this
 Identify any themes and patterns emerging from re-
sults (critically analyze)
 Ask and answer the what, how and why questions
 Make carefully qualified claims: i.e. what does the evi-
dence mean
Conclusion and recommendations
Restates purpose and summarizes main points
from the discussion
Makes recommendations based on the discus-
sion and outlines any limitations with the feasi-
bility of the recommendations
Highlights how the Community Profile can be
used
THANK
YOU !!!