COMMUNITY HEALTH NURSING
deliveries health and safety programs and services to witness
PHILOSOPY – is a philosophy of care that is characterized
by collaboration. Continuity of care client and family,
responsibility also care and preventive health care.
THEORIES MODEL APROACH
1. Social learning theory – emphasizes the importance of
observing, modeling and imitating the behavior, attitude
and the emotional of the others.
2. Social cognitive theory – used in psychology education
and communication. The portion of an individual
knowledge can be directly related of serving others.
3. Social action theory – is a critical theory that holds the
society is a contraction of interactions and meaning give it
by its members.
4. Health beliefs model – is a heretical model that can be
used to guide health promotion and disease prevention
programs. It is use to explain and predict individual
changes in health behavior. It is one of the most widely
used models for understanding health behavior.
5. Theory of reason action – a person’s behavior is
determined by their intention to perform the behavior and
that is intention is, in turn, a function of their attitude
toward the behavior and subjective norms.
6. Theory of planned behavior – is a psychological theory
that links beliefs to behavior. Maintains that three
components, namely, attitude, subjective, norms, and
perceived behavioral control, together shape an
individual’s behavioral intentions.
MILOS FRAMEWORK FOR PREVENTION
Nancy Milio - developed a framework for prevention that
includes concept of community-oriented population.
Milo stated that behavior patterns of population and
individuals that population are resolved of habitual
selection, from limited sources, from limited choices.
NOLA PENDER’S HEALTH PROMOTION MODEL
- Is to have as a positive dynamic health state not merely
the absence of disease. Health promotion is directed at
increasing a client’s level of well-being. It describes the
multidimensional nature of persons as they interact within
the environment to pursue health.
LAWRENCE AGREEANCE RECIEVED MODEL
- It is cause benefit evaluation framework propose in 1974.
By Lawrence W. Green, that can help health program
planners, policy makers and other evaluation analyze
situation and design health program efficiently.
 There are different fields we have core health nursery
perform a critical role within the school health
program by addressing the major health problems,
experience by children.
 Corners can help the students and their families get
occurred to health insurance coordinate care by
communicating between the family health and
healthcare providers. And educate families on what
health care services are available.
OCCUPATIONAL HEALTH NURSE – Provides for
population.
COMMUNITY DEVELOPMENT
 Community development is a process where people come
together to take action on what’s important to them.
 At its heart, community development is rooted in the
belief that all people should access to health, well-being,
wealth, justice and opportunity.
 Community development is fundamentally based on the
values of human rights, social justice, equality and respect
for diversity.
 Is also understood as a professional discipline, and is
defined by the International Association for Community
Development as “a practice-based profession and an
academic discipline that promotes participative
democracy, sustainable development, rights, economic,
opportunity, equality and social justice, through the
organization, education and empowerment of people
within their communities, whether these be of locality.
Identity or interest, in urban and rural settings”.
 Seeks to empower individuals and groups of people with
the skills they need to effect change within their
communities. These skills are often created through the
formation of social groups working for a common agenda.
Community developers must understand both how to
work with individuals and how to affect communities’
positions within the context of larger social institutions.
WHAT IS THE PURPOSE OF COMMUNITY
DEVELOPMENT?
 Its key purpose is to build communities based on
justice, equality and mutual respect. Community
development involves changing the relationships between
ordinary people and people in positions of power, so that
everyone can take part in the issues that affect their lives.
 The community development approach is a way of
working with communities and people to set agendas
and organize. Community development is a long-term
value-based process which aims to address imbalance in
power and bring about change founded on social justice
equality and inclusion.
WELFARE APPROACH
 The immediate and or spontaneous response to ameliorate
the manifestation of poverty, especially on the personal
level.
 Assumes that poverty is God give; destined, hence the
poor should accept their conditions since they will receive
their just reward in heaven
 Believes that poverty is caused by bad luck, natural
disasters and certain circumstances which are beyond the
control or people.
MODERNIZATION APPROACH
 Also referred to as the project development approach
 Introduces whatever resources are lacking in a given
community.
 Also considered a national strategy which adopts the
western models of technological development
 Assumes that development consist of abandoning the
traditional methods of doing things and must adopt the
technology of industrial countries.
 Believes that poverty is due to lack of education, lack of
resources such as capital and technology.
TRANSFORMATORY APPROACH
 Also refer to as the participatory approach
 The process of empowering or transforming the poor and
the appressed sectors so that they can pursue a more just
and humane society.
 Assumes that poverty is not God given, rather it is rooted
in the historical past and is maintained by oppressive
structures in society.
 Believes that poverty is caused by prevalence of
exploitation oppression, domination and other unjust
structures.
COMMUNITY DEVELOPMENT
 Resource from the process of community organizing
it is a process and an end in itself.
 Continuing and related process of community
organizing. Once a community has been organized
and prepared and action.
COMMUNITY DEVELOPMENT FOLLOWS:
 Empower of individual and groups of people with the
skills need to advocate on their own behalf improve their
lives in behalf communities with access resources.
 So, there is a partnership continuity health development.
WE HAVE STRATEGIES:
1. Partnership building provincial, municipal, and barangay
given to support community based on efforts and
initiatives of community as a whole.
2. Building up of capacities of LGO, DOH, NGO, and their
various truths in their partnership.
3. Enabling and mobilize their resources and produce
sustainable and justify distributed improvement.
4. Provision of grants or additional resource for the
priorities, communities to pursue health development
projects that are locally identified and responsive or
humid to community needs and problems.
MAIN FEATURES OF MAJOR PARTNERSHIP TO
COMMUNITY HEALTH DEVELOPMENT
1. Community based as it is applied in a conservative way
not on a sectoral manner.
2. Focused on 10 basic needs.
3. Application of convergence that is related to intersectoral
collaboration
4. Application of focus
5. Setting of information with community participation
ISSUES IN THE COMMUNITY HEALTH PROGRAM
THE INITIAL ASSESSMENT OF BCHD
EXPERIENCES FROM 1991-1993 IN COORDINATION
WITH POH ARE THE FOLLOWING:
1. All groups to be expect keep partners in barangay level
PCHD implementation need to perform their rules and
task actively in line with attaining an integrated an
effective field action.
2. At the provincial and municipal levels mechanism which
will allow regular interactions for enhancing the learning
process among the partner organization need to be
establish
3. Resource sharing and the partnership is important not
only for an improve community level PCHD
implementation but for eventual intersectoral health.
4. DOH has to have a more dynamic enough, beyond
providing grants and technical assistant with should
actively involve not only CHN’s but other central office-
based units particularly the RHU
5. Together with giving attentions to improve their skills in
facilitating a community, directed implementation of
health focus projects and activities NGO need to render
assistant in developing competence of DOH and NGO
pursuing participatory development.
6. Devolution of health facilities and services from DOH to
NGO challenges to render more significant attentions to
the youth of the community health development approach.
7. Reassessment of the process a methods and tools used the
generating data to community planning at peers in order.
8. We have the rule of the barangay council in community
health development as to be given attention
9. In addition to their health services provider rules
volunteer’s community health workers need to be
regarded and supported as leader and organizers for
health.
FEATURES OF COMMUNITY HEALTH PROJECTS
1. Existing of chief mobilizer
2. Presence of intersectoral in structure that extend technical
assistant of financial support.
3. Deviation, visioning, planning, participation of the
members
4. Activities as starting point that eventually expanses to
non-health activities such as generating projects and
sustainability through mobilization especially financing.
PRINCIPLES AND PRACTICES OF COMMUNITY
HEALTH DEVELOPMENT
 Must be a learning process
 Must develop proact leadership and expertise
 Must develop inter agency coordination and linkages
 Must be avail to influence the exist in the barangay
development plan.
 Must be sustainable of resource access generation
 Must be gender oriented of environment and should be
address deeper issues of justice and equity.
 Should naturally move beyond one issue, one project, one
barangay prospective into broader sectoral concern
METHODS AND ACTIVITIES IN COMMUNITY
DEVELOPMENT
1. Self-help work 2. Building partnership and organizational environment
2. Outreach so that programs and health gains are sustained- this
3. Local action group, lobbying capacity or competence to continue delivering a
4. Peer work particular program through a network of agency, in
5. Festivals and events addition to or instead of, the agency which initiated the
6. Information program.
7. Advocacy
8. Group work
9. Network building 3. Building problem solving capability - The ability or
10. Pump priming initiatives of the community with small capacity to identify health issues and develop appropriate
grants. mechanisms to address them, either building on the
experience for the particular program, or as an activity in
Community development – is a process developing social it’s own right.
capital it is process that emphasizes the importance of working
with people as they defined their own goals. PARTNERSHIP BUILDING – union between the people
and community various stakeholders
Community development theory – is a process design to
create condition of economic and social progress for the whole COMMUNITY ORGANIZING PARTICIPATORY
security within each active participation. ACTION RESEARCH (COPAR)
Self-reliance – is the major and goal of community - A social development approach that aims to transform the
development it is on this previous primary health care is apathetic individuals and voiceless poor into dynamic,
consider an approach community development participatory and politically responsive community
Social capital – is a key indicator of the building of the - A collective participatory, transformation, liberative,
healthy communist list through collective and beneficial sustained and systematic process of building people’s
interaction and accomplishment. organizations by mobilizing and enhancing the capabilities
and resources of the people for the resolution of their issues
Social Capital is characterized by the following: and concerns towards effective change in their existing
1. The existing of community network formal and informal oppressive and exploitative conditions.
2. Civic engagement (particularly in network) - A process by which a community identity its needs and
3. Local identity and sense of solidarity and equality with objectives develops confidence to take action in respect to
other community networks them and in doing so extends and develops cooperative and
4. Norms and trust reciprocal health and support collaborative attitudes and practices in the community.
LOW SOCIAL CAPITAL –If there is low social capital in - A continuous and sustained process of educating the people
the neighborhood or the community is will not be possible or to understand and develop their critical awareness of their
thus people toward work together for the common good. existing conditions, working with the people collectively and
Community development process will be much easier to efficiently on their immediate and long term problems and
develop with highly levels of social capital. mobilizing the people to develop their capability and readiness
CAUSES OF LAW SOCIAL CAPITAL to respond and take action on their immediate needs toward
solving their long term problems.
1. The human capital required for social capital’s core
building blocks is absent self- esteem, trust, IMPORTANCE OF COPAR
communication skills.  COPAR is an important toll for community development
2. There are inadequate levels of material wellbeing; people and people empowerment as this helps community
are struggling for survival workers to generate community participation in
3. There is inadequate in physical infrastructure such as development activities. COPAR prepares people/clients to
places to meet, public spaces, telephones, and newspaper. eventually take over the management of a development
4. The human, economic and physical infrastructure pre- participation and involvement; community resources are
requisites are present but there have been no opportunities mobilized for community services.
to develop the networks and interconnections between
people. PRINCIPLES OF COPAR
CAPACITY BUILDING 1. People especially the most oppressed exploited and
deprived sectors are open to change, have the capacity to
1. Building health infrastructure to deliver health
change and are able to bring about change.
promotion - The capacity or ability to deliver particular
program responses to particular health problems. 2. COPAR should be based on the interest of the poorest
sectors of the society
3. COPAR should lead to a self-reliant community and
society.
PROCESS OR METHODS USED
A progressive cycle of ARAS which begins with small, local
and concrete issues identified by the people and the evaluation
and reflection of and on the action taken by them
Consciousness raising through experiential learning in central
to the COPAR process because it places emphasis on learning
that emerges from concrete action and which enriches
succeeding action
COPAR is participatory and mass based because it is
particularly directed towards and unbiased in favor of the
poor, the powerless and the oppressed.
COPAR is grouped centered and not leader-oriented
leaders are identified emerge and are tested through action
rather than appointed or selected by some external face or
entity…
PHASES OF COPAR PROCESS
Pre-Entry Phase
- Initial/simplest phase of the organizing process where the
community/organizer looks for community to serve/help.
- It is considered the simplest phase in terms of actual
outputs, activities and strategies and time spent for it.
ACTIVITIES INCLUDES:
1. Designing a plan for community development including
all its activities and strategies for care/development.
2. Designing criteria, the site selection:
2.1. Community should be depressed
2.2. No duplication of services rendered
2.3. No peach and order problem
2.4. No strong resistance from the community people
2.5. With increase rate of morbidity and mortality rate
3. Actual selection the site for community care:
prioritization
4. Identification of potential leaders.
Population Characteristics
 A population is a group of individuals of the same
species living in the same geographical area, and
usually able to breed together. The study of human
populations is called demography.
 The study of the other organism’s populations is
population ecology.
 Population information about plants and animals is
used in park planning, setting hunting & fishing
limits and identifying endangered species.
5 Important Characteristics of Population
1. Population Size and Density- Total size is generally
expressed as the number of individuals in a
population.
2. Population dispersion or spatial distribution-
Dispersion is the spatial pattern of individuals in a
population relative to one another.
3. Age structure- In most types of populations,
individuals are of different age. The proportion of
individuals in each age group is called age structure
of that population. The ratio of the various age groups
in a population determines the current reproductive
status of the population, thus anticipating its future
4. Natality (birth rate)- Population increase because of
natality. It is simply a broader term covering the
production of new individuals by birth, hatching, by
fission, etc. The natality rate may be expressed as the
number of organisms born per female per unit time.
In human population, the fatality rate is equivalent to
the birth-rate.
5. Mortality (death rate)- Mortality means the rate of
death of individuals in the population.
Community location means a public or private elementary,
a church, a public library, a public playground, or a public
park.
What is the social system of the community?
 In sociology, a social system is the patterned
network of relationships constituting a coherent
whole that exist between individuals, groups, and
institutions. It is the formal structure of role and
status that can form in a small, stable group.
 Community as a social system means that members
of the same community are functionally related
with each other. This means they have their own
role to play and they love doing their work. All the
part are linked with each other and they make an
integrated whole.
Community Health Nurse Roles and Functions
 Identifies needs, priorities, and problems of individuals,
families, and communities.
 Formulates municipal health plan in the absence of a
medical doctor.
 Interprets and implements nursing plan, program policies,
memoranda, and circular for the concerned staff
personnel.
 Community health nurses create programs that promote
community health and collect data to identify community
needs.
Community Health Nurse Responsibilities
 Medical treatment.
 Rehabilitation.
 Health education.
 Advocacy.
 Research.
 Collaboration with other healthcare workers and with
government agencies.
Introduction
Epidemiology and Community health are two inseparable
words in public health system. This is because they deal with
prevention of disease, promotion of health and efficiency
through organized community efforts. Epidemiology deals
with the frequencies and types of illnesses and injuries that
affect population while community health deals with the
services that aim at protecting the health of the community.
The knowledge of pattern, distribution and
frequencies of diseases and how it affects the community is
the major concern of every health organization. In fact, the
success of epidemiology and community health activities
relies greatly on effective transfer of information from health
professional to general public. Thus health information
management is the most veritable tool for the achievement of
the desired goals of health for all.
Epidemiology Definition
The word epidemiology is derived from Greek terms-
"epi"-upon, among, "demos" -people, district, "logos" -study,
word, discourse. Epidemiology literally is the study of
something that affects population. Jekel, Elmore and Katz
(1996) defined epidemiology as the study of factors that
determine the occurrence and distribution of disease in a
population
Onwasigwe (2004) views epidemiology as the study of the
causes, distribution, determinants and deterrent of diseases,
injuries and other health related condition in human
population. Epidemiology deals with the frequencies and types
of illnesses and injuries in group of people and with factors
that influence their distribution. In summary, epidemiology is
the study of factors that affect health of population
Epidemiology therefore serves as
 cornerstone of methodology of public health research
 evidenced based medicine.
 Means of identifying risk factors for diseases and
determining optimal treatment approaches to clinical
practice.
Uses of Epidemiology
It is used in:
i. Studying the history of diseases in population in
terms of profile, time & trends.
ii. Determining the most common causes of death,
diseases and disability.
iii. Community diagnosis in terms of morbidity, and
mortality rates and ratio.
iv. Determining the effective control method of disease
when known.
v. provision of data for proper planning and evaluation
of health services
vi. identifying deficiencies in ongoing programs vii)
identifying the priority areas for medical research
Basic Definitions in Epidemiology
Epidemics - the occurrence of the disease or groups of
illnesses of similar nature clearly in excess of the expected rate
for the place and time.
Pandemic -an epidemic usually affecting a large proportion of
the populations occurring over a wide geographic area.
Endemic - this refers to the constant presence of a disease or
infectious agent within a given geographic area or population
group.
Sporadic - it the scattered about disease with cases occurring
irregular, haphazardly from time to time and generally
infrequently.
Exotic- disease imported into a country, malaria in United
Kingdom.
Epidemiology of disease
 This is the prerequisites for infection occurrence
 Agent
 Reservoir (man, animals)
 Route of exit from the reservoir
 Channel of transmission-(air, water, formities)
 Pathogen's capacity for survival
 Routes of entry (respiratory route, mouth)
 Host susceptibility-(mechanical protection of skin
alchemical, inflammatory response, immunity)
How Epidemiology is related to community health
 Provide basic knowledge of disease trends and
distribution, causes and contributing factors.
 For planning health programmes procurement drugs
 Advocacy
 Research
 Monitoring and evaluation.
COMMUNITY HEALTH
This is made up of two words- community and health.
Community- is a group of individuals who are bound in time
and space, dependent on each other and having common goals.
Health - According to WHO in 1986 health is defined as the
extent to which an individual or group is able, on the one hand
to realize aspirations and satisfy needs and on the other hand
to change or cope with the environment.
Community health is simply referred to as the health status of
group of people and the actions and conditions to promote,
protect and preserve their health.
 However, park (2004), defined community health as the
health status of the members of community, and the
problems affecting their health as well as the totality of
health care provided to the community.
 In broader sense community health implies integration of
curative, preventive and promote health services
rendered to individual living in the same location.
 The emphasis of community health is centered on two
things namely: community diagnosis and community
treatment.
 This therefore implies that the entire community is
regarded as patient requiring diagnosis and treatment.
Community Diagnosis
Community diagnosis generally refers to the
identification and quantification of health problems in a
community as a whole in terms of mortality and morbidity
rates and ratios, and identification of their correlates for the
purpose of defining those at risk or those in need of health
care.
Community Diagnosis:
Steps in Implementation Phase
1. Determine the objectives
2. Define the study population
3. Determine the data to be collected
4. Collecting the data
5. Developing the instruments
6. Actual data gathering
7. Data collection & Data summarization
8. Data Presentation
9. Data Analyses
10. Problem identification
11. Priority-setting

Health Threats- conditions which are conductive to disease,

accident or failure to realize one’s health potential.
Health Deficit- instances of failure in health maintenance.
Foreseeable Crisis- anticipated periods of unusual demand on
the individual/family or community in terms of
adjustment/family resources.
Modifiability- refers to the probability of success in
minimizing, alleviating, or totally eradicating the problem
through interventions.
Preventative Potential- refers to the nature and magnitude of
future problems that can be minimized or totally prevented if
intervention is done on the problem under consideration.
Salience- refers to the person’s perception and evaluation of
the problem in terms of seriousness and urgency of attention
needed.