NCM 113: COMMUNITY HEALTH NURSING 2
CONCEPT OF COMMUNITY HEALTH
1nd SEMESTER, SY: 2022-2023
LECTURER: MRS. WINNIE THERESA LAGSIC
TYPES OF COMMUNITY
1. URBAN COMMUNITY- Large in terms of land area and
population, advanced in science and technology, with
favorable physical environment and diverse cultures,
people are engaged in various occupations.
2. RURAL COMMUNITY- Usually produce their own food
for subsistence.
3. SUBURBAN COMMUNITY- It is located near the outskirts
of a large town or city.
CHARACTERISTICS OF URBAN COMMUNITY
 Advancement of urban communities
 Many business establishments, recreational centers,
educational and religious institutions
 People are crowded
 Social heterogeneity
 Class extremes
 Greater pollution
 Many crimes are committed
 Family ties tend to be weak
 Limited space
 Greater impersonality among neighbors
 Higher standard of living
 Shortage of employment
 Informal settlers are rampant
 A lot of hazards and dangers
 Greater number of separation of spouses and live-in
arrangements
 Major occupations are industrial, administrative and
professional
 Divisions of labor and occupational specialization are
very much common
 National Statistics Coordination Board (NSCB) redefined
an area as urban barangay that has:
o A population of at least 5,000 or more
o At least one business establishment with a
minimum of one hundred employees or five or
more establishments with a minimum of ten
employees.
o Five or more facilities within the 2-kilometer
radius from the barangay hall
o All barangays in NCR are classified as urban
communities (NCSB, 2013).
CHARACTERISTICS OF RURAL COMMUNITIES
 Greater personal interaction
 Deep, long-term relationships
 Mutual give and take affairs
 Emphasis of shared values
 Vernacular is usually spoken
 Wider area
OUTLINE BY: SHAMERA M. BUAH
PRE-MIDTERMS
 Influence of blood relationships in decision making
 Homogenous type of culture
 Belief in supernatural and superstitious beliefs
 Relationship is more personal and informal
 Less pollution
 Few establishments and institutions
 Few goods and services
CHARACTERISTICS OF SUBURBAN COMMUNITIES
 Homes are close together
 The majority of people depend the work in the cities
 People living in suburbs work in the city and have
transportation to get to work
CHARACTERISTICS OF A HEALTHY COMMUNITY
 Awareness that “we are a community”
 Conservation of natural resources
 Recognition of and respect for the existence of
subgroups
 Participation of subgroups in community affairs
 Preparation to meet crises
 Ability to solve problems
 Communication through open channels
 Resources available to all
 Settling of disputes through legitimate mechanisms
 Participation by citizens in decision-making
 Wellness of a high degree among its members
COMPONENTS OF A COMMUNITY
1. Effective Community Leadership
 Healthy communities have, and develop, public leaders
who work together to enhance the long-term future of
the community.
 Community leadership must be responsive, honest,
efficient, enlightened, fair and accountable. It should
have the ability to bring the community together to
participate in open, neutral dialogue on important
issues.
 Leaders should be representative of their community
and be able to envision an economically secure,
environmentally sound and socially viable future.
 Leaders should understand the challenges facing the
community and be able to take advantage of
opportunities within the community and in cooperation
with neighboring ones.
 Leadership should empower community members to
assist in resolving issues.
2. Informed Citizen Participation
 In a healthy community, citizens actively participate
through voting in local elections, serving on local boards.
Attending public hearings, and being involved in civic
organizations and community activities.
 NCM 113: COMMUNITY HEALTH NURSING 2
CONCEPT OF COMMUNITY HEALTH
1nd SEMESTER, SY: 2022-2023
LECTURER: MRS. WINNIE THERESA LAGSIC
 The increasing complexity of municipal operations is
limiting the ability of government to meet community
needs, escalating the importance of active citizen
involvement and volunteerism.
 All sectors within a community (public, private, non-
profit) must each take responsibility for the
community’s civic education and exchange information
with the public.
 All citizens need to develop knowledge and skills to
contribute to community life. Shared problem solving
and planning for the future as a community increases
local pride and commitment.
3. Sense of Community
 A sense of community is an intangible yet vital
component of healthy community. It encompasses
elements such as image, spirit, character and pride,
along with processes such as communication, intergroup
relations, and networking.
 A community is made up of different people with
different interest, experiences and backgrounds. These
characteristics may divide a community into natural
groups but there must be cooperation among them if the
community is to work well as a unit.
 Increased communication and understanding of
different perspectives among groups within the
community as a whole is an important factor in
establishing a sense of community.
 Villages, towns, and cities with a sense of community
include those wherein all members: contribute to hold a
common vision for the future; respect and celebrate
their heritage, diversity, and resources; share
information, and; develop and sustain an abundance of
social networks and relationships.
4. Fostering Healthy Families, Individuals, and Youth
 Most communities face a variety of challenging social
issues, such as substance abuse, domestic abuse,
poverty, and other concerns related the elderly, youth,
and families. Addressing these concerns effectively takes
the coordinated efforts of the public, private, and
nonprofit sectors.
 Support services such as adequate child day care,
comprehensive after-school, youth, teen, and senior
programs, preventative health and substance abuse
programs, parenting and family support programs, and
effective human service networks help strengthen the
social fabric of a community.
 Aided by effective communication, compassionate
leadership, active citizen participation, and inter-group
cooperation, a comprehensive package of supportive
OUTLINE BY: SHAMERA M. BUAH
PRE-MIDTERMS
services will enable a community to nurture healthy
community members.
5. Lifelong Education and Learning
 Education is a lifelong endeavor, much more extensive
than just the K-12 school system. It starts at home,
continues through childhood and the teen years, and
progresses throughout adult life.
 People of all ages need to develop knowledge and skills
in order to improve the quality of their own lives and
those of their families, and to contribute more
effectively to community life.
 Programs of higher education and lifelong learning
provide local businesses with a pool of trained
employees.
 Other formal and informal learning opportunities allow
community members to discover hidden talents and
develop an array of interests and skills.
 Lifelong learning allows citizens to manage their lives
more effectively in a changing economy and to
participate in increasingly complex municipal
operations with greater knowledge and skill.
6. Community Services, Facilities, and Utilities
 A community provides many essential facilities and
services to its members- public facilities such as
municipal buildings, schools, parks, pathways and trails,
roads, libraries, a recycling center, and cemeteries, and
services and utilities such as police, fire, ambulance,
highway maintenance, information dissemination, and
possibly water, and sewer. These key functions
consume the majority of tax dollars and sharply
influence the community’s quality of life.
7. Recreational and Cultural Heritage
 Recreational and cultural activities nurture the body and
soul of a community- individual and team sports,
outdoor activities, art, crafts, music, dance, theater,
holidays, festivals, and celebration.
 Recreational opportunities allow community members
to experience and appreciate the community’s diversity
of natural and human resources.
 Cultural activities reflect and build a community’s
positive sense of itself and strengthen the fabric of social
interactions within the community.
8. Working Landscape and the Natural Environment
 Natural resources and historical assets of a community
contribute significantly to the quality of life for residents
and play an integral part in defining community
character.
 The lakes, streams, rivers, walking trails, working farms,
forests, clean air, historic buildings and ruin, special
 NCM 113: COMMUNITY HEALTH NURSING 2
CONCEPT OF COMMUNITY HEALTH
1nd SEMESTER, SY: 2022-2023
LECTURER: MRS. WINNIE THERESA LAGSIC
places, wildlife, and open land help determine a
community’s personality and contribute to the everyday
pleasures of community life.
 A successful community recognizes the importance of
these assets and take appropriate measures to assure
their continuance.
9. Economic Vitality
 The private, public and non-profit sectors are all
important in attracting new investment and in
developing new businesses that suit the character of the
community and meet its needs.
 The need to sustain successful workplaces is an
important factor to the health of a community.
 The more often money circulates within the community
before leaving, the more community benefits.
 A healthy community includes access to a variety of
environmentally sound businesses, industries, and
institutions that provide reasonable wages and benefits
to workers, engage in family-friendly policies, provide
workers with opportunities to develop marketable skills,
and contribute to the overall wellbeing of the
community.
10. Growth and Development
 A community can more effectively manage its growth
through the prudent use of local zoning districting and
ordinances and planning regulations that guide how land
is divided, used, and developed.
 These tools allow the community to regulate the
development of residential areas, commercial districts,
and the village centers.
 These are key considerations in managing growth while
maintaining community character.
 Another important factor in the development of a
healthy community is the diversity of the housing. This
encompasses availability, affordability, and location, all
which affect the lives of community members, especially
the elderly, disabled, and low-income families.
11. Transportation
 A community’s strategic location and economic
importance bring many people to live, work, and shop
here.
 Roads get most of us where we need and want to go, and
most people drive their own cars for convenience.
However, more vehicles sharing the roads results in
increase highway maintenance, air pollution, and traffic
congestion.
 Alternatives to automobile travel can include pedestrian
and bicycle travel, broadband/internet based ordered
OUTLINE BY: SHAMERA M. BUAH
PRE-MIDTERMS
and delivered goods and services, and bus and rail
transportation.
FACTORS AFFECTING HEALTH OF THE COMMUNITY
1. People
 Population variables that affect the health:
o Size and Density – influence the number and
size of health care institutions.
 Effects of overcrowding – easy spread
of communicable disease, increased
stress among members of the
community, rapid degradation of
housing facilities, water, air and soil
pollution.
 Sparsely populated area has limited
resources resulting in difficulty
providing health services.
o Composition – health needs vary because of
composition like age, sex occupation, level of
education and other variables. (E.g. a
community with a large number of women of
reproductive age and young children has
different needs compared to a community
with a large number of elderly people.
o Rate of growth or decline
 Rapid population growth usually results
from migration from rural areas to the
city. This results in increase demands
for services that existing health care
institutions may find hard to cope with
instability or economic changes such as
closure of an industrial area. This means
decreases in economic activity and
lower government which in turn
decreases resources accessible to the
community.
o Cultural Characteristics – this refers to
whether members of the community belong
to a similar cultural group.
 Feeling of belongingness and
participation in community action are
more readily achieved in a culturally
homogenous population.
 Providing care to a multicultural
community is more challenging,
requiring cultural competence on the
part of the nurse and other members of
the health team.
 NCM 113: COMMUNITY HEALTH NURSING 2
CONCEPT OF COMMUNITY HEALTH
1nd SEMESTER, SY: 2022-2023
LECTURER: MRS. WINNIE THERESA LAGSIC
o Mobility – movement from one place to
another to start a family, to take a new job,
etc.
 Feeling of belongingness and
participation in community action are
less likely when a large segment of the
community is composed of new or
transient residents.
o Social class and educational level – affect
health status because of difference in living
conditions and degree of access to resources
and opportunities.
 Different social classes display
distinctive health problems.
2. Location
 The health of the community is both affected by the
natural and manmade variables related location.
 Natural factors
o Geographical features – land and water forms
influence food sources and prevalent
occupations in the community. Plays an
important role in disasters such as
earthquakes, landslides and floods.
o Climate – rainy and dry season. The effects of
climate change on human health are
evidenced by seasonal disease.
 Flora – is all of the plant life present in a
particular region or time. Have
medicinal properties. However, some
plants have ill effects as allergens and
sources of toxic substances.
 Fauna – is all of the animal life present
in a particular region or time. Food
source. However, animals may also
serve as reservoirs and vectors of
infectious disease and parasites.
o Geographical boundaries – a clear
demarcation of community boundaries is
necessary since they are the basis for
determining the catchment area of
community health workers.
 Health problems in urban community:
higher population results to:
Congestion
Concentrated poverty and
slum formation
Greatest exposure to health
risk and hazards leading to
violence
OUTLINE BY: SHAMERA M. BUAH
PRE-MIDTERMS
Traffic injuries
Obesity
o Rural areas – characterized by wide open
spaces and low density but inequities in
resources and economic opportunities hinder
rural development.
3. Social System
 The patterned series of interrelationships existing
between individuals, groups, and institutions and
forming a coherent whole.
 Components of social system:
o Family
o Economic
o Educational
o Communication
o Political
o Legal
o Religious
o Recreational
o Health systems – considered of central
importance precisely because of its role in
community health promotion and
maintenance and risk reduction.
ROLES AND ACTIVITIES OF A COMMUNITY HEALTH NURSE
1. Planner
 Identifies needs, priorities and problems of individuals,
families and communities.
 Formulates nursing component of health plans. In
doctorless area, she is responsible for the formulation of
the municipal health plan.
 Interprets and implements the nursing plan, program
policies, memoranda and circulars for the concerned
staff/personnel.
 Provides technical assistance to RHM in health matters
like target setting, etc.
2. Provider of Nursing Services: direct nursing care of risk;
provides patient continuity of care
 Provides direct nursing care to sick, disabled in the
home, clinic, school or place of work.
 Develops the family’s capability to take care of the sick,
disabled or dependent member.
 Provides patient continuity of care.
3. Manager/Supervisor
 Formulate individual, family, group and community
centered care of plan;
 Interprets and implements programs, policies,
memoranda and circulars
 Organize work force, resources, equipment and supplies
and delivery of health care at local levels.
 NCM 113: COMMUNITY HEALTH NURSING 2
CONCEPT OF COMMUNITY HEALTH
1nd SEMESTER, SY: 2022-2023
LECTURER: MRS. WINNIE THERESA LAGSIC
 Requisitions, allocates, distributes materials (medicine
and medical supplies, records, and reports equipment)
 Provides technical and administrative support to RHM
 Conducts regular supervisory visits and meetings to
different RHMs and gives feedback on
accomplishments/performances
4. Community Organizer
 Responsible for motivating and enhancing community
participation in terms of planning, organizing and
implementing and evaluating health program or
services.
 Initiates and participates in community development
activities.
5. Coordinator of Services
 Coordinates with individuals, family, group for health
related services provided by GO’s and NGO’s
 Coordinates nursing program with other health
programs as environmental sanitation, dental health and
mental health
6. Trainer/health educator/counselor
 Identifies and interprets training needs of RHM’s, BHW’s
and hilots;
 Resource speaker; EIC materials (information education
and communication)
 Formulates appropriate training program designs for
RHM, BHW, and hilots
7. Health Monitor
 Detects deviation from health of individual, family, group
and community through contact visits with them;
 Use of systematic and objective observation and other
forms of data gathering like morbidity, registry,
questionnaire, checklist, etc.
8. Recorder/reporter/statistician
 Prepares and submits records and reports
 Maintain adequate, accurate and complete recording
and reporting
 Reviews, validates, consolidates, analyze and interprets
all records and reports
 Prepares statistical data/charts and other data
presentation for display and for presentation in staff
meetings conferences and seminars/workshops
9. Researcher
 Participates/assists in conduct of surveys studies and
researchers on nursing and health related subjects
 Coordinates with government a no-government
organization in the implementation of studies/research
OUTLINE BY: SHAMERA M. BUAH
PRE-MIDTERMS
OTHER SPECIFICS RESPONSIBILITES OF A NURSE
IMPLENTING OF RA 7164 (Phil. Nursing Act of 1991)
1. Supervision and care of women during pregnancy,
labor, and puerperium
2. Performance of internal examination and delivery of
babies
3. Suturing lacerations in the absence of the physician
4. Provision of first aid measures and emergency care
5. Recommending herbal and symptomatic meds
6. In the care of families:
a. Provision of primary health care services
b. Developmental/utilization of family nursing
care plan in the provision of care
7. In the care of the community:
a. Community organizing mobilization,
community development and people
empowerment
b. Case finding and epidemiological investigation
c. Program planning, implementation and
evaluation
d. Influencing executive and legislative
individuals or bodies concerning health and
development
e. 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 take charge of the MHO’s
responsibilities