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
Collaboration and
Documentation
Advocacy

Community
Steps in Program
Organizing and
Evaluation
Social Mobilization.

Roles of the nurse in

Indicators of
the implementation
Evaluation
of Health Program

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

They must work with

other people or groups
The community health As the saying goes,
to increase the
nurse cannot solve the there is strength in
probability of
problems alone. numbers.
accomplishing the goals
that they have set.
 The nurse must plan, establish,
and maintain invaluable working
Importance of relationship with people such us
Partnership people’s organizations, health
and organizations, educational
Collaboration institutions, their local 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 Take time to Don't force

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

The nurse helps the

is one way that
people to attain
nurse can promote
optimal degree of
active 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.

Through this process that

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

The nurse puts It is also the nurse

emphasis on the responsibility to
people's right to decide facilitate the process of
actions what they think weighing the benefits
should benefit of the 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 AND TRAINING
organization and develops PHASE
its capability to attend 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
The process of developing
organizational activities such
community leaders is a
as conduct of meetings,
continuous and sustained
assessment, planning,
process.
implementation, monitoring
and evaluation of activities.
D. INTERSECTORAL COLLABORATION PHASE

The need for

As the organization resources-material,
grows, its needs human, financial-
also grow. will have to 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
Criteria Observed 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
is the analysis of the
and objectively the
effectiveness, quality, scope
relevance, efficiency and
and timeliness of services
effectiveness and impact of
given.
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
Evaluation and likely future outputs, effects and impact.

Terminal • Is undertaken from 6-12 months after the

project completion.

Evaluation • It is a substitute for an ex post evaluation of

the projects with short duration.

Ex post • is undertaken some years after project

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

Decide what to Design Collect

evaluate Evaluation Plan Relevant Data

Make Report/Give
Analyze Data
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 Records and reports can be
collection methods and reviewed and analyzed.
tools and sources of data.

Local officials, community Data collection tools

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

Prior to actual data collection, data

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

Poor quality means incomplete,

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

Evaluator should assess the What do the What do the qualitative The main questions that
quality of data before they figure/statistics mean? data reveal? should be asked are:
start their analysis.
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 the local It should be noted that these
authorities such as the mayor, are the key decision makers in
chair of the Sangguniang the 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
Report/Give prepare for the questions
Feedback that may be asked.
• 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
Tools for following client assessment and health
Documentation needs identified, 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