MOHAMMED RAFI M

Asst Professor, Dept of Community Health Nursing

ACON, Varanasi
INTRODUCTION TO COMMUNITY
HEALTH NURSING
Health: Is state of complete physical, mental, and social well-
being and it is not merely the absence of disease or infirmity
(WHO, 1978).

Community: A group of people who share common interests,

who interact with each other, and who function collectively
within a defined social structure to address common
concerns.
Examples of some communities:
– Citizens of a town
– Group of farmers
– Prison community
– Tiny village
– Professional nurses
Three Types of Communities

1. Geographic = city, town, neighborhood

2. Common-interest = church, professional organization,

people with mastectomies

3. Community of solution = group of people who come

together to solve a problem that affects all of them.

Nursing: encompasses autonomous and collaborative care of individuals of all ages,
families, groups and communities, sick or well and in all setting. Nursing includes the
promotion of health, prevention of illness, and the care of ill, disabled, and dying people.
Advocacy, promotion of a safe environment, research, participation in shaping health policy
and in patient and health systems management, and education are also key nursing roles
(ICN, 2002).

Neighborhood: A smaller, more homogeneous group than a community that involves

interaction and a level of identification with others living near-by.

Population: The general public or society or a collection of communities.

Aggregates: Populations with some common characteristic that frequently have common
concerns, but may not interact with each other to address those concerns.
Public Health:
"Science and art of preventing disease, prolonging life, promoting
health and efficiency through organized community effort.
Aims:
1. The sanitation of the environment.
2. Control of communicable diseases.
3. The education of individuals in personal hygiene.
4. The organization of medical and nursing services for the early diagnosis
and preventive treatment of diseases.
5. The development of social machinery to ensure everyone a standard of living
adequate for the maintenance of health.
so organizing these benefits as to enable every citizen to realize his birthright off
birth and longevity” (Charles Edward A. Winslow, 1920)
Community Health:
The identification of needs and the protection and improvement of
collective health within a geographically defined area.

Community Health Nursing:

Special field of nursing that combines the skills of nursing,
public
health and some phases of social assistance and functions as part
of the
total public health program for the promotion of health, the
improvement of the conditions in the social and physical environment,
rehabilitation of illness and disability ( WHO Expert Committee of
Nursing )
Community Health (CH) vs Public Health (PH)

• CH : “identification of needs and the protection

and

improvement of collective health within a geographically

defined area”

•PH : “activities that society to assure

the
undertake conditions in which people can be

healthy”
The mission of community health nursing:
 The primary mission of community health nursing is improving
the overall health of the population through health promotion,
illness prevention, and protection of the public from a wide
variety of biological, behavioral, social and environmental
threats.
 "promote the good life" all of Its social,
in psychological, physical, and
cultural, (Uosukainen,2001) economic aspects
HISTORICAL DEVELOPMENT OF COMMUNITY HEALTH NURSING
Concept of Health
 Health: holistic state of well-being, including soundness of
mind, body, and spirit
 Wellness: health plus the capacity to one’
s
develop potential, leading to a fulfilling and
productive life
 Illness: state of being relatively unhealthy
Characteristics of CHN:
1. The client or “unit of care” is the population.
2. The primary obligation is to achieve the greatest good for the greatest number of
people or the population as a whole.
3. The processes used by public health nurses include working with the client(s) as an
equal partner.
4. Primary prevention is the priority in selecting appropriate activities.
5. Selecting strategies that create healthy environmental, social, and
economic conditions in which populations may thrive is the focus.
6. There is an obligation to actively reach out to all who might benefit from a
specific activity or service.
7. Optimal use of available resources to assure the best overall improvement in the
health of the population is a key element of the practice.
8. Collaboration with a variety of other professions, organizations, and entities is the
most effective way to promote and protect the health of people.
COMPONENT OF COMMUINTY HEALTH PRACTICE
› Community health practice can be best understood by examining six
basic components, which, when combined, encompass its services
and programs. These components are:
1. Promotion of health.
Includes all efforts that seek to move people closer to optimal well-
being or higher levels of wellness .
The goal of health promotion:
 Is to enable people to exercise control over their well-being and
ultimately improve their health.
 Is to raise levels of wellness for individuals, families, populations, and
communities.
2. Prevention of health problems.
 Prevention of health problems constitutes a major part of community health
practice.
 Prevention means: Anticipating and averting problems or discovering them as
early as possible to minimize potential disability and impairment.
Three Levels of prevention:
1 Primary prevention: Action taken prior to the occurrence of health
problems and directed toward avoiding their occurrence. Primary
prevention includes health promotion, health protection, and illness
prevention.
2 Secondary prevention: The early identification and treatment of
existing health problems.
3 Tertiary prevention: Activity aimed at returning the client to the highest
level of function and preventing further deterioration in health.
3. Treatment of disorders.
 It focuses on the illness end of the continuum and is the remedial
aspect of community health practice.
 This occurs by three methods :
1. Direct service to people with health problem.
2. Indirect service that helps people to obtain treatment.
3. Development programs to correct unhealthy conditions.

4. Rehabilitation.
 The fourth component of community health practice, involves efforts
to reduce disability and , as much as possible, restore function.
 People whose handicaps are congenital or acquired through illness
or accident e.g:.Stroke, .Heart condition,.Amputation, Mental illness.
5. Evaluation.
The process by which that practices is analyzed,
judged, and improved according to established goals
and standards.

6. Research.
Is systematic investigation to discover facts affecting
community health and community health practice,
solve problems, and explore improved methods of
health services
Community Health Nursing Roles:
A. Client-oriented roles
B. Delivery-oriented roles
C. Population-oriented roles
A. Client-oriented Roles
1. Caregiver
Uses the nursing process to provide direct nursing intervention to individuals, families, or
population groups
2. Educator
Facilitates learning for positive health behavior change
3. Counselor
Teaches and assists clients in the use of the problem solving process
4. Referral Resource
Links clients to services to meet identified health needs
5. Role Model
Demonstrates desired health-related behaviors
6. Advocate
Speaks or acts on behalf of clients who cannot do so for themselves
7. Primary Care Provider
Provides essential health services to promote health, prevent illness, and deal with existing
health problems
8. Case Manager
Coordinates and directs the selection and use of health care services to meet client needs,
maximize resource utilization, and minimize the expense of care
B. Delivery-oriented Roles
1. Coordinator/Care Manager
Organizes and integrates services to best meet client needs in
the most efficient manner possible
2. Collaborator
Engages in shared decision making regarding the nature
of health problems and potential solutions to them
3. Liaison
Provides andmaintains connections andcommunication
between clients and health care providers or among providers
 C. Population-oriented Roles
1. Case Finder
 Identifies clients with specific health problems or conditions
 Geared toward awareness of population-level problems
2. Leader
Influences clients and others to take action regarding identified health problems
3. Change Agent
Initiates and facilitates change in individual or client behaviors or conditions or
those affecting population groups
4. Community Developer
Mobilizes residents and other segments of the population to take action regarding
identified community health problems or issues
5. Coalition Builder
Promotes the development and maintenance of alliances of individuals or groups of
people to address a specific health issue
6. Researcher
Conducts studies to explain health-related phenomena and to evaluate
the
QUIRIES?????
THANK YOU!!!!!