Daisy B.

Itchock
ØCommunity a group of people with common
characteristics or interests living together
within a territory or geographical boundary
place where people under usual conditions
are found derived from a latin word
“comunicas” which means a group of people.
Øplace where people under usual conditions
are found.
• n the 6th
Global Conference on Health Promotion in
2005 the UNs affirmed its recognition that the
enjoyment of the highest standard of health is
one of the fundamental rights of every human
being
• , is
considered as the goal of public health in
general, and CHN, in particular.
üIt is an important prerequisite (and
consequence) of development.
üBy promoting health and preventing disease,
CHNs therefore, contribute to the country’s
economic and social development.
• is a state of complete physical, mental and
social well-being and not merely the absence
of disease or infirmity .
• “An integral method of functioning which is
oriented toward maximizing the potential
which the individual is capable.
• It requires that the individual maintain a
continuum of balance and purposeful
direction within the environment where he is
functioning”. .
Ø “ A quality of life, involving social, emotional,
mental, spiritual and biological fitness on the part
of the individual, which results from adaptations to
the environment. (Rene Dubos)

Ø Florence Nightingale looked into health and illness

in relation to the environment – ventilation, noise,
light, cleanliness, diet and restful bed.
ü She prescribed ways to improve health by
manipulating the environment.
• part of paramedical and medical intervention/
approach which is concerned on the health of
the whole population.
:
1. health promotion
2. disease prevention
3. management of factors affecting health
Ø The diagnosis and treatment of human
responses to actual or potential health
problems (ANA, 1980).
Ø Nursing, together with public health, is one of
the helping professions in the health care
system which operates at three levels of
clientele – individuals, families or groups, and
communities
ØIt operates within the realm of health care
both independently and interdependently.
ØThe objective of nursing is to assist clients to
achieve, maintain, or recover a high level of
functioning.
ØAssisting sick individuals to become healthy
and healthy individuals achieve optimum
wellness (Henderson)
Ø“a synthesis of nursing knowledge and
practice and the science and practice of public
health, implemented via a systematic use of
the nursing process and other processes to
promote health and prevent illness in
population groups. “ (Clark)
Øas an art - the practice of CHN, entails active
interaction and partnership between the
nurse and the client.
Ø Such partnership recognizes the autonomy of
both parties and the potential of each one in
enriching their relationship.
ØAs science- Community health nurses should
use practice-based and evidence-based
methods and tools.
ØThey also need to engage in generating
evidence to support their practice through
research
ØIt refers to “a service rendered by a
professional nurse with communities, groups,
families, individuals at home, in health centers,
in clinics, in schools, in places of work for the
promotion of health,, prevention of illness,
care of the sick at home and rehabilitation.”
(Ruth B. Freeman).
Ø“nursing practice in a wide variety of
community services and consumer advocate
areas, and in a variety of roles, at times
including independent practice…community
nursing is certainly not confined to public
health nursing agencies.” ( Jacobson).
Ø “The utilization of the in the
different levels of clientele-individuals,
families, population groups and communities,
with the
and
” - Maglaya, et al
Øa specialized field of nursing practice
Øa science of Public Health combined with
Public Health Nursing Skills and Social
Assistance with the goal of
, to raise optimum level
of functioning of the citizenry
• 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
, the improvement of the conditions in
the social and physical environment,
rehabilitation of illness and disability
v( WHO Expert Committee of Nursing)
Øby helping communities and families cope
with discontinuities in health and threats
ØMaximize their potential for high level of
wellness
Ø Promote reciprocally supportive relationship
between people and their physical and social
environment.
 wherein is
the of the
communityhealth nurse, who is a in
terms of practice.
E – ducation as primary tool and responsibility
M – ade available to all regardless of race, creed and socio-economic
status
P – olicies and objectives of the agency is fully understood by the nurse
O – rganizing for health, with the family as the unit of service
W – orks as a member of the health team (PHN)
E – xisting active organizations are utilized
R – ecording and reporting are accurate
M – onitoring and evaluation of services is periodically done
E – xisting indigenous resources of the community is used
N – eeds of clienteles is recognized and serves as basis for CHN
T – raining and development as opportunities for continuing staff
education programs
• “The philosophy of CHN is based on the worth
and dignity of man.”(Dr. M. Shetland)
• Health Promotion
• Health Protection
• Health Balance
• Disease prevention
• Social Justice
1. Promotion of health and prevention of disease
goals of professional practice.
2. CHN practice is comprehensive, general, continual,
and not episodic
3. There are different levels of clientele:
ü Individuals,
ü families
ü and population groups
vPractitioner recognizes the primacy of the
population as a whole
4. The nurses and the client have greater control
in making decisions related to health care and
they collaborate as equal
5. The nurse recognizes the impact of the
different factors on health and has a greater
awareness of his/her client’s lives and situations.
Ø CHN practice is affected by developments in
health technology, in particular, changes in
society, in general
Ø The goal of CHN is achieved through multi-
sectoral efforts
ØCHN is a part of health care system and the
larger human services system.
ØThe community is the patient in CHN, the
family is the and there are
individual, family,
population group (those who share common
characteristics, developmental stages and
common exposure to health problems – e.g.
children, elderly), and the community.
ØIn CHN, the client is considered as an ACTIVE
partner NOT PASSIVE recipient of care
1.Promotion of health and prevention of diseases are the goals of
professional practice;
2.Community health nursing practice is comprehensive, general,
continual and not episodic;
3.There are different levels of clientele-individuals, families and
population groups and the practitioner recognizes the primacy of the
population as a whole;
4.The nurse and the client have greater control in making decisions
related to health care and they collaborate as equals;
5.The nurse recognizes the impact of different factors on health and
has a greater awareness of his/her clients’ lives and situations.
1. Client-oriented roles
üCaregiver
üEducator
üCounselor
üReferral resource
üRole model
üCase manager
2. Delivery-Oriented roles
üCoordinator
üCollaborator
üliaison
3. Population-oriented roles
üCase finder
üLeader
üChange agent
üCommunity mobilizer
üCoalition builder
üPolicy advocate
üSocial marketer
üresearcher
• be a part in developing an overall health plan, its
implementation and evaluation for communities
• provide quality nursing services to the four levels of
clientele
• maintain coordination/linkages with other health
team members, NGO/government agencies in the
provision of public health services
• conduct researches relevant to CHN services to
improve provision of health care
• provide opportunities for professional growth
and continuing education for staff development
Ø Science of Public Health (core foundation in
CHN),
ØPublic Health Nursing Skills and
ØSocial Assistance Functions
1. The health care delivery system, with its CHN subsystem;
= The private for profit and non-profit providers
= and public which is largely financed through a tax-based
budgeting system at both national and local levels
2. The clients:
ü Individual
ü Family
ü Population group
ü community
3. which is the goal of the health care
delivery system (HCDS)
4. The economic, sociocultural, political and
environmental factors that affect the HCDS, the
practice of CHN and people’s health
1 – sick or well – on a daily basis. Since the
health problems of individuals are intertwined with those
of the other members of the family and the community,
they are also considered as an “entry point” in working
with these clients.

2. - a collection of people who are integrated,

interacting and interdependent. Family members interact
with each other and the action of one affects the other
members.
3. - a group of people who share
common characteristics, developmental stage or
common exposure to particular environmental
factors, and consequently common health problems,
issues and concerns.
Ø Allender and Spradley(2001) identified populations
“aggregates’ with developmental needs and those
that are vulnerable . Population groups are the
usual targets or beneficiaries of social services and
health programs.
4. - a group of people sharing
common geographic boundaries and/or
common values and interests within a specific
social system. This social system includes health
system, family system, economic system,
educational system, religious system, welfare
system political system, recreational system,
legal system and communication system
1.Income and social status. Higher income and social status are linked to
better health.
2.Education. Low education levels are linked with poor health, more stress
and lower self- confidence.
3.Physical environment. Safe water and clean air, healthy work places, safe
houses, communities and roads all contribute to good health.
4.Employment and working conditions. People in employment are healthier,
particularly those who have more control over their working conditions.
5.Social support networks. Greater support from families, friends and
communities is linked to better health.
6.Culture, Customs and traditions, and the beliefs of the family and
community all affect health.
7.Genetics. Inheritance plays a part in determining lifespan,
healthiness and the likelihood of developing certain illnesses.
8.Personal behavior and coping skills. Balanced eating, keeping active,
smoking, drinking, and how we deal with life’s stresses and challenges
all affect health.
9.Health services. Access the use of services that prevent and treat
diseases influence health.
10.Gender. Men and women suffer from different types of diseases at
different ages.
Øthe term used before for Community Health
NursingAccording to
is a science & art of 3 P’s  
üPrevention of Disease  
üProlonging life
üPromotion of health and efficiency through
organized community effort
• The “science and art of preventing disease, prolonging
life, promoting health and efficiency through organized
community effort for the sanitation of the environment,
control of communicable diseases, the education of
individuals in personal hygiene, the organization of
medical and nursing services for the early diagnosis and
preventive treatment of disease, and the development of
the 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 the ”
Dr. C.E. Winslow
Ø “art of applying science in the context of politics so as to reduce
inequalities in health while ensuring the best health for the greatest
number”. WHO
Today public health could be defined in terms of its

1) Assessment is the regular collection and analysis of health data.

These data are used for program planning and policy development.
2) Policy development involves advocacy and political action to
develop policies in various levels of decision making.
3) Assurance is making sure that health services are effective, available
and accessible to the people (Institute of Medicine, 1988 in Clark
• Health and longevity as birthrights
• Longevity – average lifespan or life expectancy
3 P’s:
ØPromote health
ØPrevent Disease
ØProlong Life
• Environmental Sanitation
• Health Education
• Prevention of Communicable Diseases
• Medical Services
• Nursing Services
• Vital Statistics
• Public Health Laboratories
• Maternal and Child Health Services
• Teaching
• Management
• Critical Thinking
• Physical Caregiving
• Application of the Nursing Process
• Application of the Epidemiological Process
• Documentation
Ø A “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 programme 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)
Ø The Standards of Public Health Nursing in the Philippines 2005..
Ø refers to the practice of nursing in national and local government
health departments (which includes health centers and rural health
units), and public schools. It is community health nursing practiced
in the public sector.
▪ Public Health Nurses – refer to the nurses in
the local/national health departments or public
schools whether their official position title is
PHN, Nurse or School Nurse.
▪ Public Health Nursing – practice of nursing in
national and local government health
departments (which include health centers and
rural health units), public schools.
 , who is a health care provider, taking
care of the sick people at home or in the
RHUHealth
who aims towards health promotion
and illness prevention through dissemination
of correct information; educating people
who establishes multi-sectoral
linkages by referral system
who monitors and supervises the
performance of midwives
 who speaks on behalf of
the client
• who works with other health
team member
• *In the event that the Municipal Health Officer
(MHO) is unable to perform his duties/functions
or is not available, the Public Health Nurse will
responsibilities
ØManager > Planner, Programmer, Supervisor,
Coordinator of services
ØHealth Care Provider > Direct nursing care
ØResearcher > Epidemiologist, Health Monitor,
Recorder, Statistician
ØCommunity Organizer > Change Agent
ØTrainer > Health Educator, Counselor Role
Model1
1.Monitoring health status to identify community
health problems;
2.Diagnosing and investigating health problems and
hazards in the community;
3.Informing, educating and empowering people
about health issues;
4.Mobilizing community partnerships to identify and
solve health problems;
5.Developing policies and plans that support
individual, family and community efforts;
6.enforcing laws and regulations that protect health
and ensure safety;
7.linking people to needed personal health services
and ensuring the provision of health care that is
otherwise unavailable;
8.ensuring competent public health and personal
health care workforce;
9.evaluating effectiveness, accessibility and quality of
personal and population-based health services; and,
10.researching for new insights and innovative
solutions to health problems
1. I ndividual
2. F amily
3. C ommunity
• Provision of primary health care services
• Developmental/Utilization of family nursing
care plan in the provision of care.
• Community organizing mobilization,
community development and people
empowerment
• Case finding and epidemiological investigation
• Program planning, implementation and
evaluation
• Influencing executive and legislative
individuals or bodies concerning health and
development
 :
1. Disease control
2. Injury prevention
3. Health protection
4. Health public policy including those in relation
to environmental hazards such as in the
workplace, housing food, water, etc.
5. Promotion of health and equitable health
gain
ØCODES
• C ontrol of Communicable Diseases
• O rganization of Medical and Nursing Services
• D evelopment of Social Machineries
• E ducation of IFC on personal Hygiene→
Health Education is the essential task of every
health worker
• S anitation of the environment
Ø
•  I nformation: to share ideas to keep
population group knowledgeable and aware
• E ducation: change within the individual

üK nowledge
üA ttitude
üS kills
• C ommunication: interaction involving 2 or
more persons or agencies

üMessage
üSender
üReceiver
1. Socio-economic: Employment / Education / Housing
2. Environment: Air / Food / Water Waste / Urban/Rural /
Noise / Radiation / Pollution
3. Political: Safety / Oppression / People Empowerment
4. Behavior: Culture / Habits / Mores / Ethnic Customs
5. Heredity: Genetic Endowment / Familial / Ethnic / racial
6. Health Care Delivery System: Promotive / Preventive /
Curative / Rehabilitative
Ø PHW’s: are members of the health team who are
professionals namely
ü Medical Officer (MO)-Physician
ü Public Health Nurse (PHN)-Registered Nurse
ü Rural Health Midwife (RHM)-Registered Midwife-
ü Dentist
ü Nutritionist
ü Medical Technologist
ü Pharmacist
ü Rural Sanitary Inspector (RSI)-must be a sanitary engineer
 -Deliver health services to
individuals, groups, and families
-Diagnosis is based on the needs of
individuals, family, or group
-Work to promote health and
prevent illness in groups and families
with the main goal being to increase
community health. For example,
meeting with a group of young
mothers to provide information on
immunizations.
- the need and develop a program
• -Assessing the populations health
needs
• -Diagnose and develop policy in
relation to community health
needs.
• -Plan for the community as a
whole in order to prevent disease
and disability and preserve the
health of the community. For
example, after an illness outbreak,
the public health nurse will assess
for an immunization clinic.
- Implementation is based on
individual needs. For example,
a new diabetic who is a
kinesthetic learner would be
taught how to give insulin
injections by practicing with
an orange.
-Evaluate whether health
needs were met on the
individual, family or group
level
-Implementing the plan
means the nurse ensures
the resources are available
to all who need them
within the community.
-Evaluate the health status
of the whole community
and whether planned
goals and objectives were
met.
• Public health nursing is an umbrella term that
encompasses community health nursing.
• Both have the main goal of promoting,
preserving, and maintaining the community’s
health
 • Boundaries between these two concepts exist
in relation to the level of assessment.
• Public health nurses are trained and educated
to assess the population overall.
üWhereas the community health nurse's
knowledge lies within assessing the needs of
individuals and families within the population
that they work.
• Awareness “we are a community”
• Conservation of natural resources
• Recognition & respect for the existence of subgroups
• Participation of SG in community affairs
• Preparation to meet crises
• Ability to solve problems
• Open communication (open channels)
• Resources available to all
• Setting of disputes thru legitimate mechanism
• Participation by citizens in decision-making
• Wellness of a high degree among its members