CBHC

COMMUNITY BASED HEALTH CARE (CBHC)
CBHC is health care for all people of all ages who need health care
assistance at home or work place. Community care services include home
support, nursing care, physiotherapy and other rehabilitation services. e. a
nurse visits an elderly person at home to help with medication, a home
support worker helps a child in a wheel chair with personal care such as
bathing.
Community based health care is a health care, for the community and by
the community, working together to achieve health for all. It promotes self-
care, independence and family support networks.
CBHC tries to prevent disease and promote health from inside the
community rather than from outside. It means health care which the
people themselves feel they need and can supply from their own resources.
It’s a health care where people themselves take the responsibility for their
own health i. at the individual, family and the community level. It does not
just involve people caring for their health needs by direction from
professional health workers.
As compared to outreach health care, CBHC comes from within the

community. Outreach health care comes to the community from outside. It
does not belong to the community, although it is generally appreciated by
the community but when it stops, its influence tends to subside quickly.
Community based health care tackles poverty directly (head-on)/ face to
face.- it does this through empowerment, and through partnership it
enables communities to share their skills and resources, to each other’s
benefits.
Special features which make CBHC different from standard

medical care
1. CBHC encourages ownership by the community.
The community participates, becomes partner and eventually owns

the programme. Whereas standard medical care is provided by
Doctors and health workers to the people. Therefore CBHC is a
genuine partnership of health workers with the community members.
2. CBHC responds to the needs of the people.
Standard medical care starts with planners, projects and governments,

whereas CBHC starts with the people, helps them identify their needs, and
works together with them to find answers.
3. CBHC leads to self- reliance.
Standard medical care often introduces two unwanted side effects; a

dependence on medicine and dependence on doctors. CBHC aims to bring
about healthy, self-reliant communities- through this people become armed
with knowledge so they depend less on outsiders.
4. CBHC helps to encourage community life.

In CBHC traditional practices are encouraged unless they are proved to be
harmful, new ideas are introduced with a lot of sensitivity. In CBHC the aim
of the health worker is always to build up confidence and dignity and never
to cause offence or humiliation.
5. CBHC moves to where the people live.
6. CBHC aims for a new community order.
As community takes initiatives, as health standards improve and as other

forms of development emerge, a new order starts to take shape. And this
is based on: Justice. Where the rich are no longer allowed to exploit the
poor, nor the strong allowed to oppress the weak. Equity. Where all have
sufficient, and the differences between the rich and the poor are reduced.
Unity. Where individuals and community groups learn mutual respect and
whereby working towards a common goal, they overcome tribal, ethnic and
other differences.
Community Based Health Care emphasizes on health in the

following ways:
 CBHC is involved more in health care than in medical care. It opposes

the use of drugs for every health problem. Instead it emphasizes
that well-being is largely brought about through healthy living
patterns and enlightened attitudes.
CBHC emphasizes appropriate cure. Most health workers use too many
medicines and injections many of which are unnecessary and others even
harmful. Community Based Health Care tries to ensure that a rational list
of essential, life-saving drugs are always available, affordable and
appropriately used.
 CBHC follows a comprehensive and integrated model of health care,

and aims to include the following:
1. Health education.
2. Mother and child health services
3. Diagnostic and curative care,
4. Control of infectious diseases,
5. Adequate nutrition,
6. Immunization.
7. Improvement in water supply and sanitation,
8. Referral systems,
9. Monitoring and evaluation and
10. Effective management.
HEALTH PROMOTION
Health promotion is the process of enabling people to increase control over,

and to improve, their health. To reach a state of complete physical, mental
and social well-being, an individual or group must be able to identify and to
realize aspirations, to satisfy needs, and to change or cope with the
environment. Health is therefore, seen as a resource for everyday life, not
the objective of living. Health is a positive concept emphasizing social and
personal resources, as well as physical capacities. Therefore, health
promotion is not just the responsibility of the health sector, but goes
beyond healthy life-styles to well-being.
Principles of Health promotion
These health promotion principles are based on concepts from social

models of health and key priorities identified from national and
international health promotion documents:
Address the wider determinants of health: Health is influenced by

more than genetics, individual lifestyles and the provision of health care.
Socioeconomic, cultural and environmental factors are also critical.
Base activities on the best available data and evidence, both with respect
to the need for intervention in a particular area and the likely effectiveness
of the interventions chosen.
Act to reduce inequalities in health: Aim to ensure every individual,

family and community group has the opportunity to benefit from living,
learning and working in a health-supporting environment.
Ensure active consumer and community participation: Encourage

people to identify and positively respond to events, services and
environments affecting their health.
Empower individuals to understand and address the impact of their

environments and their health compromising behaviors.
Motivation: in health education, motivation is an important factor. It is
the need for incentives in a first step in learning to change.
To tell an overweight woman to reduce her weight because she might

develop cardiovascular disease or reduce her life span, may have a little
effect, but to tell her that reducing her weight might help her look more
charming and beautiful. On this she might accept the health advice.
Comprehension: in health education one must know the level of

understanding, education and literacy of people whom the teaching is
directed to. One barrier of communication is using words which cannot be
understood. In health education, health educator; nurse, clinical officer or
community health worker, should always communicate in language people
understand and never use words which are strange and new to the people.
Teaching should be within the mental capacity of the audience.
Reinforcement: In health education, repetition at intervals is necessary

because not many people can learn all that is new in a single period. If
there is no reinforcement, there is a high possibility of the individuals going
back to pre-awareness stage. If the message is repeated in different ways
people are likely to remember it.
Learning by doing: learning is an action process and not a memorizing

event, people will learn better by doing it. Known- to unknown: in health
education, the teaching / information must proceed from what is known to
what is not known, from simple to the more complicated, from the easy to
more difficult. Start health education from where the people are and with
what they understand, then you can proceed to the new knowledge.
Setting an example: the health educator should set a good example in
the things he is teaching. If he is explaining the hazards of smoking, he will
be successful if he himself is smokes, same applies to family size; if the
educator has a big family size he may not be in a position to educate
people to have a small size family.
Good human relations: sharing of information, ideas and feelings

happen most easily between people who have good relationship

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COMMUNITY BASED HEALTH CARE (CBHC)

As compared to outreach health care, CBHC comes from within the

Special features which make CBHC different from standard

1. CBHC encourages ownership by the community.

The community participates, becomes partner and eventually owns

2. CBHC responds to the needs of the people.

Standard medical care starts with planners, projects and governments,

3. CBHC leads to self- reliance.

Standard medical care often introduces two unwanted side effects; a

4. CBHC helps to encourage community life.

5. CBHC moves to where the people live.

6. CBHC aims for a new community order.

As community takes initiatives, as health standards improve and as other

Community Based Health Care emphasizes on health in the

 CBHC is involved more in health care than in medical care. It opposes

 CBHC follows a comprehensive and integrated model of health care,

2. Mother and child health services

3. Diagnostic and curative care,

4. Control of infectious diseases,

7. Improvement in water supply and sanitation,

9. Monitoring and evaluation and

10. Effective management.

Health promotion is the process of enabling people to increase control over,

Principles of Health promotion

These health promotion principles are based on concepts from social

Address the wider determinants of health: Health is influenced by

Act to reduce inequalities in health: Aim to ensure every individual,

Ensure active consumer and community participation: Encourage

Empower individuals to understand and address the impact of their

To tell an overweight woman to reduce her weight because she might

Comprehension: in health education one must know the level of

Reinforcement: In health education, repetition at intervals is necessary

Learning by doing: learning is an action process and not a memorizing

Good human relations: sharing of information, ideas and feelings

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