INTRODUCTION TO

COMMUNITY HEALTH NURSING

FOR BASIC NURSING STUDENT SET 6

KANO STATE COLLEGE OF NURSING & MIDWIFERY

SCHOOL OF NURSING, MADOBI.

BY:
NURUDDEEN YUSHA’U ZAREWA

JUNE, 2022
 Lesson Objectives
2

At the end this lesson the student should be able to:
Define a community and explain the concepts of a
healthy community
Define community Health Nursing
Discuss the history of community health nursing
Outline the elements, objectives, philosophy and
principles of community health nursing
List the settings for community health nursing
practice
Explain the roles of a community health nurse

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 Introduction
3

Community Health Nursing (CHN) is a specialized area of

nursing practice with peculiar conceptual and theoretical
underpinnings from basic life sciences, nursing theories
and practice, public health sciences, community dynamics,
and information communication technology in modern
times.
community health nurse draws on the knowledge from
these diverse areas and develops competencies in health
promotion, anticipates and works with communities to
prevent and manage deviations from health of
people/populations and facilitate community action for
change

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 Introduction cont..
4

Community health nursing practice is implemented within group

actions to improve the health status of the individuals and families
and populations
To be able to conduct appropriate assessment, make relevant
diagnoses and implement relevant interventions to meet the health
needs of the individual, family and community, the nurse need to
acquire sound knowledge in relevant subject areas and MUST;
 understand the basic principles and theories of community health
nursing
 be able to apply nursing knowledge to resolve community health
challenges and meet the needs of consumers of health throughout
the life span

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 What is community?
5

 Community is from a Latin word “COMMUNIS” which

means “common”.
 A community is a social group determined by geographical
boundaries and / or common values and interests. Its
members know and interact with each other. It functions
within a particular structure and exhibits and creates
certain norms, values and social institution.”
 Community is a collection of people.
 Community is a place.
 Community is a social system.
 Community is a highly important habitat of man.

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 Main features of a community
6

A community has three features, location, population and

social system.
Location: every physical community carries out its daily
existence in a specific geographical location. The health of the
community is affected by this location, including the
placement of the service, the geographical features…
Population: consists of specialized aggregates, but all of the
diverse people who live with in the boundary of the
community.
Social system: the various parts of communities’ social
system that interact and include the heath system, family
system, economic system and educational system.

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 Types of Community
7

Geographic communities
They shares physical space, so that residents come
into contact with each other by virtue of proximity,
rather than intent.
A community often is defined by its geographic
boundaries and thus is called a geographic
community.
A city, town, or neighbourhood is a geographic
community.
 

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 Types of Community
8

Communities of interest: are sometimes referred to

as "communities within communities". A collection of
people, even if they are widely scattered geographically,
can have an interest or goal that binds the members
together.
Members of these communities choose to associate
with each on the basis of a common interest.
For example, members of an international nursing
professional organization, NANMN and women who
have had mastectomies are all common-interest
communities etc.
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 Types of Community
9

Community of solution (problem solving community)

This is a type of community encountered frequently in
community health practice in which a group of people
come together to solve a problem that affects all of them.
The shape of this community varies with the nature of
the problem, the size of the geographic area affected, and
the number of resources needed to address the problem.
For example, a water pollution problem may involve
several communities whose agencies and personnel must
work together to control upstream water supply,
industrial waste etc.

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 Healthy Community
10

World Health Organization (2009) defined a healthy

community as “one that is continually creating and
improving those physical and social environments
and expanding those community resources that
enable people to mutually support each other in
performing all functions of life and in developing
their maximum potential”

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 Characteristics of a Healthy Community
11

1. The physical environment is clean and safe.

2. The environment meets everyone’s basic needs.
3. The environment promotes social harmony and
actively involves everyone.
4. There is an understanding of the local health and
environment issues.
5. The community participates in identifying local
solutions to local problems.

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 Characteristics of a Healthy Community
12

6. Community members have access to varied

experiences, interaction and communication.
7. The health services are accessible and appropriate.
8. The historical and cultural heritage is promoted and
celebrated.
9. There is a diverse and innovative economy.
10. There is a sustainable use of available resources for
all.

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 Factors determining health of the community
13

Environmental factors
Socio-economic factors
Culture factors
Lifestyle of its members
Religious factors
Political factors

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 Community Health Nursing (CHN)
14

 Community Health Nursing is a synthesis of nursing practice

and public practice applied in promoting and preserving the health
of the population.
 The nature of this practice is general and comprehensive. It is 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 care directed to individuals, families or groups
contributes to the health of the total population.
 Health promotion, health maintenance, health education, co-
ordination and continuity of care are utilized in a holistic approach to
the management of the health care of individual, family, group and
community.

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 Element of CHN
15

CHN comprises of 6 basic elements

1. Health promotion: It includes all effort that seeks to move
people closer to optimal wellbeing or higher level of wellness. It
is the combination of educational and environmental support for
action and condition of living that is conducive to health.
2. Disease prevention: This involves collective effort of
individuals to deal with any factor or circumstances that may
hinder wellbeing and to ensure improved lifestyle that is not
detrimental to health.
3. Treatment of Disorders: It focuses on the illness end
continuum and is the remedial aspect of community health
practice. It can either be by direct service to people with health
problems or an indirect service.

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 Element of CHN cont..
16

4. Rehabilitation: It involves effort which seeks to reduce

disabilities as much as possible and to restore function.
5. Evaluation: It involves the process by which the practice
is analyzed, judged, and improved according to the
established goals and standard. Evaluation helps to solve
problem and provide direction for future health care
planning.
6. Research: It is a systematic investigation of which helps
to discover factors affecting community health and
community health practices, solve problems and explore
improved methods of health services.

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 History of CHN
17

 Community health nursing is the product of

centuries of responsiveness and growth.
 Four general stages mark the development of public
health or community health nursing:
1. The early home care stage
2. The district nursing stage
3. The public health nursing stage
4. The community health nursing stage

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 Early Home Care Stage
18

Before mid 1800’s

For many centuries female family members and friends
attended the sick at home. The focus of this care was to
reduce suffering and promote healing. The early roots of
home care nursing began with religious and charitable
groups.
This stage was in the midst of these deplorable conditions
and response to them that Florence Nightingale (1820 -
1910) began her work.
Nightingale’s concern for population at risk as well as her
vision and successful efforts at health reform provided a
model for community health nursing today.

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 District Nursing Stage
19

Mid 1800 to 1900

The next stage in the development of community health
nursing was the formal organization of visiting nursing
or district nursing.
The work of district nurses focused almost exclusively on
the care of individuals.
District nurses recorded temperatures and pulse rates
and gave simple treatments to the sick poor under the
immediate direction of a physician. They also instructed
family members in personal hygiene, diet and healthful
living habits and the care of the sick.

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 Public Health Nursing Stage
20

1900 to 1970
By the turn of the century, district nursing had broadened its
focus to include the health and welfare of the general public,
not just the poor.
This new emphasis was part of a broader consciousness about
public health.
Lillian D. Wald’s (1867-1940) contributions to public health
nursing were enormous. Her driving commitment was to
serve needy populations.
The public health nursing stage was characterized by service
to the public with the family targeted as a primary unit of
care.

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 Community Health Nursing Stage
21

1970 to present
The emergence of the term community health nursing heralded a
new era while public health nurses continued their work in public
health by the late 1960s and early 1970s.
Many other nurses, not necessarily practicing public health, were
based in the community.
The confusion was laid in distinguishing between public health
nursing and community health nursing. The terms were being used
interchangeably and yet, had different meanings for many in the
field in 1984.
It was concluded in 1985 that community health nursing was the
broader term referring to all nurses practicing in the community
regardless of their educational preparation

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 Development of CHN (summary)
22

STAGES FOCUS NURSING SERVICES INSTITUTIO

ORIENTATI EMPHASIS NAL BASE
ON (AGENCIES)
Early home Sick poor Individual Curative Lay & religious
care stage orders
(before mid
1800)
District Sick poor Individual Curative; Voluntary;
Nursing stage beginning of some
(1800-1900) preventive government
Public Health Needy public Families Curative; Government;
Nursing stage preventive some
(1900-1970) government
Emergence of Total Populations Health Many kinds;
CHN (1970- community promotion; some
present) illness independent
prevention practice
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 Objectives of CHN
23

a. To increase capability of individuals, families, and

groups and community to deal with their own
health and nursing problems.
b. To strengthen community resources.
c. To control and counteract environmental problems.
d. To prevent and control communicable and non-
communicable diseases .
e. To provide specialized services for mothers,
children, adults, workers, elderly handicapped and
eligible couples etc.

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 Objectives of CHN cont..
24

f. To conduct research and contribute to the further

refinement and improvement of community health
nursing practice.
g. To participate in preparing health personnel to
function in community for community health care
services.
h. To supervise, guide and help health personnel in
carrying out their functions effectively.

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 Philosophy of CHN
25

1. Philosophy of individual’s right of being healthy.

2. Philosophy of working together under a competent
leader for the common good.
3. Philosophy that people in the community have
potential for continued development and are
capable of dealing with their own problems if
educated and helped.
4. Philosophy of socialism.

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 Principles of CHN
26

1. Community health nursing practice is community focused, so

it important for a nurse to defined community , make a map,
and established working good relationship.
2. Community health nursing services based on needs of
community peoples and all health programmes should be
concerned with solution of health problem and resources
available .
3. Health services should be suitable to the budgets and they
should be practical.
4. Health services should be available in all areas of community
and provide all people without partiality.

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 Principles of CHN cont..
27

5. Professional relationship and proper etiquettes are

essential in community health services.
6. Community health nurse should have job satisfaction and
she can receive in- services training for continuous education
and for improvement of knowledge .
7. Professional interest should be developed and maintained
8. All the health team members should be guided by highly
skilled and educated nurse supervisor.
9. Health worker must maintain professional dignity.
10. Nurse should maintain professional cumulative records.

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 Settings for CHN Practice
28

 Homes (rural and poor urban families)

 Ambulatory service settings
 Rural areas
 Schools
 Occupational health setting
 Residential institutions
 The community at large

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 Scope of CHN
29

1. Education such as Health education and various

cadre in the colleges
2. Practice such as: school health nurse,
Occupational health nurse, Home visit Nurse, MCH
and family planning, Mental health nursing
services, Geriatric nursing services, Rehabilitations
services etc.
3. Research
4. Administration

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 Who is a Community Health Nurse?
30

A Community Health Nurse is a Nurse who adds

public health knowledge and skills that address the
needs and problems of communities and aggregates
and focuses care on communities and vulnerable
populations.
Community health nurses provide care to
individuals, families and communities.
They are committed to social justice, health
promotion, health protection, disease prevention
and facilitation of healing.

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 Who is a Community Health Nurse?
31

Community health nurses integrate community

involvement and knowledge about the entire
population with personal, clinical understandings of
the health and illness experiences of individuals and
families within the population.
He/she also provides assistance to pregnant women,
elderly, homeless or disabled by directing them to
social services.

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 Roles of Community Health Nurse
32

Provider of PHC / clinician

Care provider to the sick person at home
Advocate
Educator
Sensitized observer
Change agent
Organizer/manager
Leadership
Collaborator
Researcher

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