Concepts of Community

Health and Community

Health Nursing

Presented by:
Harsh Rastogi
Nursing Tutor
M.S. Institute of Nursing
 Outline of the topic
 Introduction- Public Health, Community,
Community Health, Community Health
Nursing
 Concept of Community

 Definition of Community Health Nursing

 Concept of Community Health Nursing

 Philosophy of Community Health Nursing

 Aims and Objectives of Community Health

Nursing
 Scope of Community Health Nursing
 Introduction
 A community may be defined in many different
ways. One definition of community is “a social
group of any size whose members reside in a
specific locality, share government, and often have
a common cultural and historical heritage.”

 Culture, ethnicity, age, gender, sexuality all of

these can be characteristics which define a
community

 The community in which we live and work have a

profound influence on our collective health and
well-being.
 Cont…
 The health of a community is more than the sum
of the health of its individual citizens.
 Community as a field of practice seeks to provide
organizational structure
 Community can influence-
 The spread of disease
 Provide barriers to protect members from
health hazards
 Organize ways to combat outbreaks of
infectious disease
 Promote practices that contribute to individual
and collective health
 Cont…
 Community health nurse work in every
conceivable kind of community agency
 Their duties range from examining infants
in a well-baby clinic, or teaching elderly
stroke victims in their homes to carrying
out epidemiologic research or engage in
health policy analysis and decision
making.
 Combines all basic elements of
professional clinical nursing with public
health and community practice.
 Public Health
 The term public health came in
general use around 1840. it
arose from the need to protect
“the public” from the spread of
communicable diseases.

 Later, it appeared in 1848 in

the name of law, the Public
Health Act in England.

 In 1920, Charles Edward

Armory Winslow, former
professor of public health at
Yale University, gave the oft-
quoted definition of public
health.
 Cont…
 The Science and Art of preventing disease
prolonging life and promoting health and
efficiency through organized community
effort for the sanitation of the
environment, the control of communicable
infections, the education of the individual
in personal hygiene, the organization of
medical and nursing services for early
diagnosis and preventive treatment of
disease and the development of social
machinery, to ensure for every individual
a standard of living adequate for the
maintenance of health, so organizing
these benefits as to enable every citizen
to realize his birth right of health and
longevity.
 Definition of Public Health
 The term public health was defined by
‘C.E.A. Winslow’ (1851) as science & art of
preventing disease, prolonging life &
promoting health & efficiency through
organized community measures such as
control of infection, sanitation, health
education, health education, health services
& legislation, etc.

 Public Health is defined as “the art and

science of preventing disease, prolonging
life and promoting health through the
organized efforts of society” (Acheson,
1988; WHO)
 Cont…
 Activitiesto strengthen public
health capacities and service aim to
provide conditions under which
people can maintain to be healthy,
improve their health and wellbeing,
or prevent the deterioration of their
health.
 Public health focuses on the entire
spectrum of health and wellbeing,
not only the eradication of
particular diseases.
 Cont…
 Many activities are targeted at
populations such as health
campaigns.
 Public health services also include
the provision of personal services to
individual persons, such as
vaccinations, behavioral counseling,
or health advice.
 Current form of Public Health
 Publichealth in its present form, is
combination of scientific principles
(e.g. epidemiology, biostatistics,
laboratory sciences, social sciences,
demography) and skills & strategies
(e.g. epidemiological investigations,
planning and management,
intervention, surveillance,
evaluation) that are directed to the
maintenance & improvement of
health of the people.
 Community Health
 Term community health has replaced
in some countries, the term public
health, preventive health, social
health.
 The word community health has
gained wide acceptance.
 Cont…
 TheEURO symposium(1966); “all
the personal health and
environmental services in any human
community, irrespective of whether
such services were public or private
one.”
 Concept of Community
 A community is a collection of people who share
some important feature of their lives.

 It can be society of people holding common

rights and privileges, sharing interests, living
under same laws and regulations.

 The function of any community includes its

members of collective sense of belonging and
their shared identity, values, norms,
communications and common interests and
concerns.
 Definition of C.H.N.
 “Community Health Nursing is a synthesis
of nursing practice and public health
practice applied in promoting and
preserving the health of populations. The
nature of this practice is general and
comprehensive.
 Cont…
 Itis not limited to a particular age or
diagnostic group. It is continuous
and not episodic. The dominant
responsibility is to the population as
a whole. Therefore, nursing directed
to individuals, families or groups
contributes to the health of the total
population.
 Cont…
 Health promotion, health
maintenance, health education,
coordination and continuity of care
are utilized in a holistic approach to
the management of the health care
of individual, family, group and
community.
 Cont…
 The nurse’s actions acknowledge the need
for comprehensive health planning,
recognize the influences of social and
ecological issues, give attention to
populations at risk and utilize dynamic
forces which influence change.”
(ANA)
 Concept of C.H.N.
 The primary focus of community health
nursing is on the health promotion
 Community health nursing practice is
extended to benefit not only the individual
but the whole family and community
 Community health nurses are generalist in
terns of their practice
 Contact with the client and/or family may
continue over a long period of time.
 Cont…
 The nature of community health
nursing practice requires the current
knowledge
 The dynamic processes of assessing,
planning, provide periodic
measurement of progress, evaluation
and a continuum of cycle until the
termination of nursing is implicit in
the practice of community health
nursing.
 Philosophy of C.H.N.
Philosophy of community health pertains to
underlying ideas and beliefs which govern its
practices. These are as under:
 Philosophy of individuals right of being
healthy
 Philosophy of working together under a
competent leader for common good
 Philosophy that people in the community
have potential for continued development
and are capable of dealing with their own
problems if educated and helped
 Philosophy of socialism.
 Aims of C.H.N.
 To promote health and efficiency
 To prevent and control diseases and
disabilities
 To prolong life by providing basic
needs, well balanced comprehensive
health care services to community at
large through organized community
efforts.
 Objectives of C.H.N.
The objectives of community health nursing are the
same as that of community health which are
achieved by meeting nursing needs of individuals,
families, groups of people and community at large.
 To increase capability of individuals, families,
groups and community to deal with their own
health and nursing problems
 To strengthen community resources
 To control and counteract environment
 To prevent and control communicable and
non-communicable diseases
 Cont…
 To provide specialized services.
 To conduct research and contribute to the
further refinement and improvement.
 To participate in preparing health
personnel to function in community for
community health care services.
 To supervise, guide and help health
personnel in carrying out their function
effectively.
 Nature/Characteristics of C.H.N.
 Community health nursing is an integral part of
community health
 Community health nursing is a specialized field
of nursing
 Community health nursing synthesizes
community health with n nursing
 In community health nursing, the whole
community is the client
 Community health nursing emphasizes on
primary level prevention
 Community health nursing promotes self-care
responsibility
 Cont…
 Community health nursing involves
multidisciplinary team approach
 Community health nursing is working for people,
with people and by people
 Community health nursing is seeking support
from giving support to personnel from other
sectors working for welfare and development in
the community
 Community health nursing is dealing with wide
range of health problems and health needs and
providing need based generalized health services.
 Community health nursing is providing
continuous care and not episodic care
 Scope of C.H.N.
Nursing
care
Occupational
health
Home
nursing care

Domiciliary Geriatric
care
Scope care
of
CHN

Mental School
health health
nursing nursing

MCH &
Rehabilitat family
ion centre planning
services
 Home care
 Extended nursing care services are
received by number of patients at their
home when hospital are overcrowded for
admitting the patients who require indoor
care or when a patient is in need of
isolated treatment.
 Even preventive and promotive services
are provided to the people at their home
to maintain and achieve health.
 Nursing care
The CHN includes nursing care of the family in
sickness and health. The CHN should be able to
 To provide PHC in the community
 To conduct routine antenatal and postnatal
visits and to conduct deliveries when required
 To carry out immunization
 To promote health of the children by
conducting under five clinic and referring
cases who require medical care
 To assess the social environmental and
nutritional needs of the community. And get
the help of social workers to meet these
needs.
 Geriatric care
The number of old people increasing in the
world today. The need of old is different and
they need more care than the younger age
groups. In many countries the old age
people are visited by the nurses and other
health care workers.
 Occupational health nursing
 Occupational nursing is the application of
nursing and public health philosophy and skills to
the relationship of people to their occupation’s
foe the purpose of prevention of disease and
injury and the promotion of optimal health,
productivity and social adjustment.

 OHN identifies health and nursing needs of

workers following health and nursing needs of
workers following health assessment, plans and
implements nursing care within her capabilities,
limitations, means and facilities.
 Cont…
In general, the responsibilities of nursing personnel are being
stated by WHO Technical report series 24 are as follows:
 Carrying out the therapeutic programme designed by
physicians for sick patients including personal services
aimed at hygiene and comfort
 Maintenance of the physical and his family in his recovery
and rehabilitation
 Engaging the patient and his family in his recovery and
rehabilitation
 Carrying out measures for the prevention of diseases
 Instructing people sick or well, in measures promoting
total health (physical and mental)
 Coordinating nursing efforts with other members of
community groups.
 Domiciliary nurse
The areas where domiciliary nursing is
practiced in our country are-
 Maternity services
 Health supervision
 Disease prevention services
 Services for illness and accidents
 The scope for limitless for organizing
domiciliary visits
 Mental health nursing
Many developing countries have mental
health services today. These services
include-
 Early diagnosis and treatment
 Rehabilitation
 Psychotherapy
 Use of modern psychotropic drugs
and after care services
 MHN is yet to be developed in India.
 MCH & family planning
The public health nurse plays a major role in
the MCH and FP services. It consists of-
 Antenatal
 Postnatal
 Childcare services
 Nurse can easily motivate the
mothers to accept the FP methods
and gain their cooperation in
adopting to a small family norms.
 School health nursing
 In general the functions of the school
health nurse are related to
establishment and implementation of
school health policies and
programmes for the protection and
promotion of health of the students,
the maintenance of a school
environment which is conducive to
healthful living.
 Cont…
 The building of components of the
curriculum which have significance
for health; the management of the
health service including screening
programmes and emergency care
services, the handling of special
health problems and relating the
school health problems and relating
the school health programmes to
those of the community.
 Cont…
The SHN renders services-
To prevent diseases
To promote and maintain good health of
the school children’s
The school health programme are
carried out by the PHC
The nurse provides her services in the
area likes.
 Rehabilitation centre
Rehabilitation means restoration of all
treated cases to the highest level of
functional ability.

Nursing is an important component in

the rehabilitation of the disabled.
 Conclusion
Community as a field of practice
seeks to provide organizational
structure a broad set of resources and
the collaborative activities needed to
accomplish the goal of an optimally
healthy community.
The primary focus of community
health nursing is on the health
promotion.
 Cont…
Community health nursing is a
nursing aspect of organized
community health programme and is a
specialized area of professional nursing
practice.
It is a unique blend of nursing and
community health woven into a service
which when properly developed and
implemented can have a tremendous
impact on health.
 References
1. Gulani KK. Community Health Nursing (Principles &
Practices). 2nd ed. Kumar Publishing House; Conceptual
Aspects of Community Health Nursing; p 31-53.
2. Allender JA. Rector C. Warner KD. Community Health
Nursing Promoting and Protecting the Public’s Health. 7th
ed. Wolters Kluvers Health. Introduction to community
health nursing; p 2-17.
3. Bijyalakaskhmi D. A Comprehensive Textbook of
Community Health Nursing. 1st ed. Jaypee digital.
Introduction to community health nursing; p 1-76.
4. Kamalam S. Essentials in Community health nursing
practice. 3rd ed. Jaypee digital. Concepts of health and
theoretical approaches in community health nursing; p 15-
38.
5. Park P., textbook of preventive and social medicine.18th
Edition; Banarsidas Bhanot Publication.