HEALTH

● “a state of complete physical, mental, 8 PRINCIPLES OF CHN ADAPTED FROM

and social well-being and not merely the PHN (ANA,2007)
absence of disease or 1. Focus on the community as the
infirmity”(WHO,1958) unit of care
● “a state of well- being in which the - CHN is community focused; it
person is able to use purposeful, is therefore essential to know
adaptive responses and processes the defined community, make a
physically, mentally, map and establish effective
emotionally, spiritually and socially working relationships
(Murray et al .,2009) 2. Give priority to community needs
● “actualization of inherent and acquired - CHN is based on identified
human potential through goal- directed community health nursing needs
behavior, competent self care, and and functions within the total
satisfying relationship with others community health programmes
(Pender et al.,2006) - CHN Nurse has to “marry”
● “a state of aperson that is skills in the nursing process
characterized by soundness or with population focused skills to
wholeness of developed human produce the greatest benefit for
structures and of bodily and mental the majority of the community
functioning (Orem,2001) - Uses assessment tools such as
demographics and vital statistics
COMMUNITY 3. Work with the community as an
● “a collection of people who interact with equal partner of the health team
one another and whose common - Partnership between health
interest or characteristics form the basis workers and community from
for a sense of unity or assessment to evaluation is
belonging(Allender et al.,2009) more likely to produce effective
● “a group of people who share something and sustainable results
in common and interact with one 4. In selecting appropriate activities,
another, who may exhibit a commitment focus on primary prevention
with one another and may share a - Emphasis is given on
geographic boundary” (Lundy and strategies
Janes,2009) 1. To promote optimal
health
COMMUNITY HEALTH NURSING 2. Prevent disease and
(PHILOSOPHY OF CHN) disability
● Philosophy of individual’s right of being 5. Promote a healthful physical and
healthy psychosocial environment
● Philosophy of working together under a - Environmental determinants of
competent leader for the common good health
● Philosophy that people in the 1. Education
community have the potential for 2. Socioeconomic status
continual development and are capable 3. Physical environment
of dealing with their own problems if 4. Working conditions
educated and helped. 5. Social support
● Philosophy of socialism network
(Source, ANA)
 6. Reach out to all who may benefit ● It is possible to predict health behavior
from a specific service given three major interacting
- Health team does not wait for components:
people to come to the health 1. individual perceptions,
facility but goes on active case - 2. modifying factors, and
finding and outreach activities 3. likelihood of action
7. Promote optimum use of
resources ● Shows the direction and flow of the
- Limited health resources are interacting components, each of which
best use for strategies that will is further divided into subcomponents.
produce long term effects, A. The individual perceptions
taking ethical principles into component
consideration 1. perceived susceptibility or
8. Collaborate with others working 2. perceived severity of a specific disease
in the community B. The modifying factors component
- Nurse has to work with a variety Demographic variables (age, sex, race,
of sectors in resolving issues ethnicity),
that affect health 1. Socio-psychological variables
- Community health efforts have (personality, locus of control, social class, peer
to be coordinated among health and reference group pressure)
team members and other 2. Structural variables (knowledge about and
disciplines e.g teachers, social prior contact with disease).
worker, finance and marketing These variables, in conjunction with cues to
experts action (mass media, advice, reminders, illness,
reading material), influence the subcomponent
of perceived threat of the specific disease.
THEORETICAL MODEL/APPROACHES C. Likelihood of action
A. Health Belief Model (HBM) 1. perceived benefits of preventive action
B. Milio’s Framework for Prevention minus perceived barriers to preventive action.
C. Nola Pender’s Health Promotion
D. Lawrence Green PRECEDE- Final Phase
PROCEED MODEL ● All of the components are directed
toward the likelihood of taking
1. PRECEDE = Predisposing, Reinforcing, recommended preventive health action
Enabling Constructs in Educational ● iIndividual perceptions and modifying
Diagnosis and Evaluation factors interact.
2. PROCEED = Policy, Regulatory and ● An individual appraisal of the
Organizational Constructs in preventive action occurs, which is
Educational and Environmental followed by a prediction of the
Development likelihood of action.
HEALTH BELIEF MODEL MILIO’S FRAMEWORK FOR PREVENTION
● Developed by a group of social ● Relate an individual's ability to improve
psychologists to examine why people healthful behavior
did not participate in health screening
programs
6 PROPOSITION SUMMARY functional ability and better quality of
1. Population health deficits’ result from life at all stages of development.
deprivation and/or excess of critical ● The final behavioral demand is also
health resources influenced by the immediate competing
2. Behaviors of populations result from demand and preferences, which can
selection from limited choices derail intended health- promoting
3. Organizational decisions and policies actions.
dictate many of the options available to
individuals and populations and TRANSTHEORETICAL MODEL (TTM)
influence choices ● is a dynamic theory of change based on
4. Individual choices r/t health promotion the assumption that there is a common
or health damaging behaviors are set of change processes that can be
influenced by efforts to maximize applied across a broad range of health
valued resources. behaviors.
5. Alteration in patterns of behavior ● Based on the assumption that behavior
resulting from decision making of a change takes place over time,
significant number of people in a progressing through a sequence of
population can result in social change stages
6. Without concurrent availability of ● Each of the stages is both stable and
alternative health promoting options for open to change
investment of personal resources, health
education will be largely ineffective in STAGES OF CHANGE AND DESCRIPTION
changing behavior patterns. 1. Precontemplation - no intention to take
action
PENDER’S HEALTH PROMOTION MODEL 2. Contemplation - has some intention
● Explores many biopsychosocial factors 3. Preparation - intends to take action
that influence individuals to pursue 4. Action - changed overt behavior for
health promotion activities less than 6 months
● The HPM depicts the complex of 5. Maintenance - change behavior for
multidimensional factors with which more than 6 months
people interact as they work to achieve
optimum health DECISIONAL BALANCE
1. Pros- the benefits of behavior change
2. Cons-the cost of behavior change

HEALTH PROMOTION MODEL PRECEDE - PROCEED MODEL

● Each person has unique ● Provides a model for community
personal/individual characteristics and assessment, health education, planning
experiences that affect subsequent and evaluation P- redisposing
actions. R - einforcing and
● The set of variables for behavioral- E - nabling
specific Cognitions and affect have C - onstructs in
important motivational significance and E - ducational
can be modified through nursing D - iagnosis and
actions. E - valuation
● Health promoting behavior is the
desired behavioral outcome and is the PROCEED
endpoint in the Health Promotion ● A model for implementing and
Model. evaluating health programs based on
● Health promoting behaviors should PRECEDE
result in improved health, enhanced
 P - olicy residence mainly to minimize the
R - egulatory and effects of illness and disability
O - rganizational C ● Patients who may benefit:
- onstructs in 1. Chronically ill
E - ducational and 2. Convalescent patient
E - nvironmental D 3. Elderly
- evelopment 4. Disable who require custodial
care
Predisposing factors 5. High risk pregnant women
● Refer to people characteristics that
motivate them toward health related HOSPICE HOME CARE
behavior ● A homecare specifically rendered to the
Enabling factors terminally ill to:
● Refers to conditions in people and the 1. provide comfort
environment that facilitate or impede 2. improve his/her quality of life
health related behavior 3. provide support to the patient
Reinforcing factors and family as they go through
● Refer to feedback given by support the processes of dying and
person or groups resulting from the grieving
performance of the health related
behavior ENTREPRENURSE
● A project of Dept. of Labor and
ESTABLISHED AND RECOGNIZE FIELDS Employment
OF PRACTICE IN CHN ● To promote nurse entrepreneurship by
1. Public health Nursing - the practice of introducing a home care industry in the
promoting and protecting the health of Phil.
populations using knowledge from AIMS:
nursing, social, and public health 1. Reduce the cost of health care
sciences 2. Maximize employment opportunities
2. Occupational health Nursing - provides 3. Utilize the country’s unemployed
for and delivers health and safety human resources for health services
programs and services to workers, 4. Achievement of MDG on maternal and
worker populations, and community child health
groups.
3. School health nursing - protects and FAITH COMMUNITY NURSING OR
promotes student health, facilitates PARISH NURSING
normal development, and advances ● Practice of the art and science of nursing
academic success. combined with spiritual care
● Focus on health promotion and
EMERGING FIELDS OF COMMUNITY provision of holistic care to the
HEALTH NURSING IN THE PHILIPPINES members of the faith community.
● The nurse may engage in Roles:
1. Home health care 1. Health educator
2. Hospice home care 2. Personal health counselor
● EntrepreNurse 3. Developer and coordinator of support
● Faith community nursing or parish groups
nursing 4. Integrator of faith and healing

HOME HEALTH CARE CONCEPT OF THE COMMUNITY

● Providing nursing care to individuals ● The WHO defines community health
and families in their own places of as: environmental, social, and
 economic resources to sustain emotional ● A healthy city is one that is continually
and physical well being among people creating and improving those physical
in ways that advance their aspirations and social environments and expanding
and satisfy their needs in their unique those community resources that enable
environment. people to support each other in
● A community is a social unit (a group of performing all the functions of life
living things) with commonality such as AIMS:
norms, religion, values, customs, or 1. To achieve a good quality of life
identity. Communities may share a 2. Create a health supportive
sense of place situated in a given environment
geographical area (e.g. a country, 3. Provide basic sanitation and hygiene
village, town, or neighborhood) or in needs
virtual space through communication 4. Supply access to health care
platforms.
● Community health Nursing is the CHARACTERISTICS OF A HEALTHY
synthesis of nursing and public health COMMUNITY
practice applied to promote and protect 1. A shared sense of being a community
the health of the population. It combines based on history and values
all the basic elements of professional, 2. A general feeling of empowerment and
clinical nursing with public health and control over matters that affect the
community practice. community as a whole.
3. Existing structures that allow subgroups
3 TYPES OF COMMUNITIES within the community to participate in
1. Urban - a large community with many decision making in community matters
people and large buildings, a city. 4. The ability to cope with change, solve
2. Suburb - a medium sized community problems and manage conflicts within
near a large city, houses are close the community through acceptable
together, you may see parks and malls means
3. Rural - a community where houses are 5. Open channels of communication and
far apart, there are a smaller number of cooperation among the members of the
people and you may see farms and community
forests 6. Equitable and efficient use of
community resources, with the view
UNIVERSAL TYPE OF COMMUNITY towards sustaining natural resources
1. Formal
2. Informal COMPONENTS OF A COMMUNITY
3. Urban Community development
4. Rural ● Community organization and
5. Global mobilization
6. Sectoral ● Community needs analysis
7. Social space ● Participatory community planning
HEALTH COMMUNITY ● Generation and allocation of
● A healthy community is in the context resources (resource mobilization)
of health promotion defined in Ottawa ● Alliance building and multi-sectoral
charter (WHO,1986) partnership
● “The process of enabling people to Povsonoftechncalandfnancalasssancetir
increase control over, and to improve (ambot unsa ni oy hahahaha)
their health” ● Upgrading of health facilities
● Capacity and capability building
Monitoring and Evaluation @ to spread of diseases causing organisms.
● Documentation of best practices (ex: malaria, diarrhea diseases)
● GIDA Indicators -environment: a clean environment is very vital
to the proper health of a community which
GIDA - DOH minimizes the occurrence and transmission of
● GEOGRAPHICALLY ISOLATED and diseases, unlike a dirty environment which
DISADVANTAGED AREAS: easily leads to outbreak of diseases.
Name of Office: Bureau of Local Health
Development  Social/cultural factors
-tradition beliefs: beliefs or traditions possessed
The objectives of GIDA are the following: by communities greatly affect the health of its
1. To empower communities, local people.
government units (LGUs) and key (ex: FEMALE GENITAL MUTILATION)
stakeholders toward good governance FGM
for health. : reasons given include
2. To generate LGU and community + control over women’s sexuality
commitment to manage and sustain + hygiene
health care. + gender-based factors (removal of ‘male’
3. To strengthen multi sectoral linkages parts
through convergence and efficient use of + cultural identity
resources. + religion
4. To improve access and provision of -economy: a community that is economically
health services. well off has low chances of suffering from
disease breakouts because they have proper
FACTORS AFFECTING COMMUNITY health care and water drainage systems unlike a
HEALTH CAN BE GROUPED INTO: poor community.
 Physical factors -government: since the government involves
-Industrial development: communities that are planning, implementing and provision of
industrially developed are more likely to be community services such as water supply,
affected by numerous diseases due to the toxic medical supplies, and other needs which can
waste products from the industries that are directly affect the community health.
released into water bodies and the atmosphere -community organization: ways in which
and due to congestion of settlement leading to communities organize their resources such as
slum development hence contagious diseases taxes which can be very helpful in control of
compared to areas that are not industrially diseases and supply of sufficient and efficient
developed. (ex: air pollution, water medical care even in times of crisis unlike
contamination from industrial discharge) communities without proper accountability of
-community size: a densely populated or over their taxes which can partly be allocated to the
populated community can easily be attacked by health sector.
communicable diseases. (ex:overcrowding) - education factors: poor education or illiteracy
-geographical location: some communities are affects the health of a community when people
more prone to diseases due to the geographical don’t have education on how they can prevent
location. themselves from diseases. (Ex: health education
(ex:some communities are located in in the use of mosquito treated nets to prevent
swampy areas ARE MORE PRONE TO malaria, health education on the environmental
DISEASES especially during heavy rains they hygiene so as to prevent diseases such as
are affected by floods which can lead @ cholera and trachoma)
manipulation of diseases causing -individual behavior: community health is
organisms if the water is stagnant greatly influenced by individuals, their
personal health, habits etc. and in order to DENSITY:
achieve a healthy community, it takes a team ⦁ Increase population density may increase
work. For instance, proper disposal of waste stress. Similarly, when people are spread out
products from and individuals’ compound, health care provision may become difficult.
clearing all stagnant water in the compound to
prevent harboring of mosquitos, active smokers Negative effects of overcrowding:
to quit smoking to avoid passive smokers thus 1. Easy spread of communicable diseases
preventing lung cancer, abstainance from sexual 2. Increased stress among members of the
activities and for sexually active individuals to community
use protection to prevent the spread of 3. Rapid degradation of housing facilities
HIV/AIDS and STDs etc. Thus, proper 4. Water, air and soil pollution
individual healthy living can greatly promote a
healthy community COMPOSITION:
Health needs vary because of differences
● Community organization 1. Age
● Individual behavior 2. Sex
3. Occupation
Factors affecting health of the 4. Level of education
community:
1. Characteristics of the Population ⦁ Composition of the population often
Population: determines types of health needs. ⦁ A health
⦁ Consists not only of a specialized aggregate, community is one that takes full account of and
but also of all the diverse people, who live provides for differences in age, sex, educational
within the boundaries of the community. level and occupation of each member. All of
⦁ The health of the community is greatly which may affect health concerns. ⦁
influenced by the population that lives in it. Determining a community composition is an
⦁ Different features of the population suggest the important early step in determining its level of
health needs and provide bases for health health.
planning
RAPID GROWTH OR DECLINE:
 Population variables that affect the 1. Rapid Growth-Results in
health of the community increased/extensive demand for services that
1. Size and density may find hard to cope with
2. composition 2. Decline-decrease in economic activity and
3. rate of growth or decline lower government revenue that results to
4. Cultural characteristics decrease in resources accessible to community
5. Mobility 3. Marked decline in population may signal of
6. Social class poorly functioning community.
7. Educational level
SIZE: CULTURAL CHARACTERISTICS:
⦁ Influence the number and size of health care 1. Cultural homogeneity
institutions 2. Multicultural Cultural
⦁ Knowing community size provides important
information for planning CULTURAL DIFFERENCE:
⦁ Concentration of health care institution in o Health needs may vary among sub-
urban areas cultural and ethnic populations.
⦁ Sparsely populated like rural areas have o Cultural differences can create
limited resources resulting to difficulty in conflicting or competing demands for
providing health services resources and services or create inter-
group hostility
 2. LOCATION OF HEALTH SERVICES: -
MOBILITY: When assessing a community, the community
o Feeling of belongingness and health nurse will want to identify the major
participation in community action are health centers and know they are located. Use of
less likely if composed of new and health services depends on availability and
transient residents accessibility.
o Mobility of the population affects 3. GEOGRAPHIC FEATURES: -
continuity of care and availability of Communities have been constructed in every
resources suitable physical environment and that
o Mobility has a direct effect on the health environment certainly can affect the health of a
of a community. community. Injury death, and destruction may
be caused by floods, cyclones, earthquakes
LEVEL OF EDUCATION AND SOCIAL volcanoes…. Etc. recreational activities at lakes,
CLASS: seashores, mountains promote health and
SOCIAL CLASS:  refers to the ranking of wellness.
groups within society by income, education, 4. WELLNESS: - Climate has a direct effect on
occupation, prestige or a combination of these health of a community e.g., extreme heat and
factors. cold)
EDUCATIONAL LEVEL: is a powerful 5. FLORA AND FAUNA: - Poisonous plants
determinant of health-related behavior. Health and disease carrying animals can affect
promotion and preventive health services are community health.
most needed for people with low income and 6. HUMAN MADE ENVIRONMENT: - All
educational levels human influences on environment (housing,
o Affect health status because of dams, farming, types of industry, chemical
differences in living conditions and wastes, air pollution. Etc. ) can influence levels
degree of access to resources and of community wellness.
opportunities
SOCIAL SYSTEM:
In addition to location and population, every
LOCATION: community has a third dimension, a social
Health is affected by: system.
1. Natural and manmade variables ⦁ The various parts of community social system
Geographic features, climate, flora, fauna that interact and influence the system are called
2. Community boundaries Urban or rural social system variable
3. Geographic features Land, water forms ⦁ The patterned series of interrelationships
o Every physical community carries out existing between individuals, groups and
daily existence in a specific geographic institutions and forming a coherent whole
location. The health of a community is (Merriam- Webster dictionary)
affected by this location including the • Social components that affect health
placement of health services, the 1. family, economic, educational
geographic features, plants, animals and communication
animals and the human made 2. Political, legal, religious, recreational and
environment. health system (Allender et al,2009)
SIX LOCATION VARIABLES: Social components that affect health:
1. family,
1. COMMUNITY BOUNDERIES: - To talk 2. economic,
about community in any sense, one must first 3. educational communication
describe its boundaries. It serves as basis for 4. Political,
measuring incidence of wellness and illness and 5. legal,
for determining spread of a disease. 6. religious,
7. recreational and 1. Infectious and sexually transmitted
8. health system diseases
9. (Allender et al,2009) 2. Obesity
3. Poor nutrition
⦁ Although community health nurses must 4. Substance abuse
examine all the system in the community and 5. Smoking
how they interact, the health system is of 6. Teen pregnancy
particular importance to promote the health of 7. Family Planning Program
the community
Where do community Health Nurses
Roles and activities of Community Work?
Health Nurse. (history) Community health nurses work in
⦁ In the past, Albularyu / Manhihilot journeyed ⦁ hospitals,
on foot or carabao’s to the homes of their ⦁ community centers,
neighbors to provide medical services. ⦁ These ⦁ clinics, ⦁ schools and
Manhihilot were crucial to reducing the ⦁ government health agencies.
mortality rates in their communities. ⦁ After the : Community health nurses are important to
Filipino American war, hospitals were built like regions where healthcare is not easily accessible,
San Lazarus so they can travel to remote places and isolated
areas of a city.
What is Community Health Nursing? Example:
Community health nursing is: ⦁ a discipline o PTB program,
that incorporates evidenced based research o Breast feeding program (MBFH)
along with advances in science and new
approaches for improving the health. ⦁ How do you become a community health
Considering the cultural and socioeconomic nurse?
backgrounds of the people in the community to ⦁ To become a community health nurse, you
ensure appropriate interaction and must first work as a registered nurse.
sensitivity when working with them. ⦁ Nursing care should be available to every
Filipino. Throughout the country, there are
What is the role of a community Health entire communities of people prone to chronic
nursing? illnesses, infectious diseases and economic
 The primary role of community health nurses hardships.
is to provide treatment to patients. ⦁ Community health nurses have the ability to
 Additionally, community health nurses offer improve the welfare of individuals and their
education to community members about communities.
maintaining their health so that they can ⦁ They are at the forefront of bringing quality
decrease the occurrence of diseases and deaths. patient care to the most vulnerable and
 They plan educational assemblies, underserved members of society.
 Hand out fliers, ⦁ Example: COVID 19
 Conduct health screenings,
 Dispense medications and What is the goal of community health
 Administer immunizations. nursing?
 Nurses also may distribute health-related The goal of community health nursing is to
items like condoms and pregnancy test promote, protect and preserve the health of the
public. Community health nursing involves
Some health issues that community these basic concepts:
health nurses try to control or eliminate 1. Promote healthy lifestyle
are: 2. Prevent disease and health problems
3. Provide direct care
4.Educate community about managing chronic strategy then focus on improving
conditions and making healthy choices facility-based services
5.Evaluate a community’s delivery of patient  If reason is socio cultural planning team
care and wellness projects may concentrate on providing skills dev
6. Institute health and wellness programs of traditional birth attendant
7. Conduct research to improve healthcare
 Home Delivery
 Birthing Facility
PLANNING COMMUNITY HEALTH ImplementingCommunity Health
INTERVENTIONS: Intervention
Action Phase:
Planning: • Most exciting
o A logical process of decision making to • Deal with the recognized priority health
determine which of the identified health concern
concerns requires more immediate • Enhance the community’s capability in
consideration dealing with common health
o What actions may be undertaken to conditions/problems
achieve goals and objectives • Requires common understanding of goals and
o Involves priority setting, formulating objectives and planned interventions among
goals and objectives and deciding members of implementing group
community intervention
Priority Setting: Nurse’s role:
WHO Criteria To facilitate the process rather than directly
1. Significance of the problem implement the planned intervention
2. Community awareness
3. Ability to reduce risk COMMUNITY ORGANIZING:
4. Cost of reducing risk COMMUNITY ORGANIZING (CO):
5. Ability to identify the target population • A process, consists of steps or activities that
6. Availability of resources instill and reinforce the people’s self- confidence
on their own collective strength and capabilities
• The group make a list of the identified (Manalili,1990)
community health problems or conditions • Each • A process of educating and mobilizing
of the identified problems is treated separately members of the community to enable them to
according to a set of criteria agreed upon by the resolve community problems
group and as suggested by WHO • Teaching the community to apply the nursing
process on its own, utilizing resources that are
Deciding on Community Interventions available thereby allowing the community to be
• What may work for one community may not an active participant in the process of
be effective in another because of inherent development rather than being a passive
differences recipient of care services.
• Group analyzes the reason for people’s health • A social development approach that aims to
behavior and direct strategies to respond to the transform the individualistic, powerless and
underlying causes voiceless poor into
– Dynamic
Example: Reason for preference of home – Participatory
delivery over facility-based delivery should be – Politically responsive communities
identified
 If majority will choose home delivery
because of cost or lack of access, • Characteristics:
– Transformative
– Collective
Goals of CO
1. People empowerment PHASES OF COMMUNITY ORGANIZING:
2. Development of self-reliant community • Pre –entry
3. Improved quality of life (UST, NSTP,20120 1. Involves preparation on the part of organizer
• Building social structures – institutionalizing and choosing a community for partnership
of power a. knowing the goals of the CO activity or
• Building alliances/networking – voice for experience
strong advocacy of issues b. delineates criteria or guidelines for site
• Social transformation selection
c. Making a list of sources of information and
Core Principles in Community Organizing possible facility
1. Community organizing is people centered • Proper selection is crucial.
- People are the means and ends of • Identification of possible barriers, threats,
development and community empowerment is strengths and opportunities at this stage is an
the process and the outcome (Felix,1998) important determinant of the overall outcome of
- It is people centered (Brown,1985) CO.
2. Community organizing is participative Means to identify communities:
- The participation of the community in the 1. initial data gathered through an initial
entire process (assessment, planning, survey
implementation and evaluation) should be 2. Review of records of a health facility
ensure 3. A review of the barangay/municipal profile
- Community is considered as the prime mover 4. Referrals from other communities or
and determinant rather than beneficiaries and institutions or through a series of meetings
recipients of development 5. Consultation from LGU or private
institutions
3. Community organizing is democratic
- It is the process that allow the majority of the  Entry phase
people to recognize and critically analyze their - Formalizes the start of the Organizing process
difficulties and articulate aspirations - Organizer gets to know the community and
- CO should empower the disadvantaged likewise. § Make courtesy call to local formal
population leaders
- A visit to informal leader recognized
4. Community organizing is
developmental Community Integration
- CO should be directed toward changing • Integration with the people
current undesirable conditions -Termed as pakikipamuhay
- Organizer desires changes of the betterment – Establishing rapport with the community by
of the community and believes that the • Living with them
community shares these aspirations and that • Undergo the same experience as they do
these changes can be achieve • Sharing with their aspirations and hard
5. Community organizing is process
oriented  Integration style
• CO objectives: To get to know the people’s
- The community organizing goals of – Culture
empowerment and development are achieved – History
through a process of change – Economy
- Organizers need to diligently and patiently – Leaders
follow the community organizing process to
achieve its goals
– Lifestyle of the people • Spiritual
Manalili, (1990) describes the following styles • Environment
of integration • Gender dimension
1. “Now you see, now You don’t” style as well as the problems and issues that needs
a. Organizer visits the community as per the immediate or long-term solution
schedule but is not able to transcend the “guest”
status. Social analysis is also referred as:
b. Organizer cannot breakdown the barrier 2. -social investigation,
“Boarder” style -community study,
- Organizer rent a room or house in the village -community analysis,
-Does not share the life of the community -community needs assessment,
- Organizer is regarded as a guest 3. -Community D
“Elitist” style
-Organizer lives with the barangay chairman or Identifying potential leaders:
some other prominent person, this makes • Characteristics of potential leader
integration more 1. They represent the target group
2. They possess or display leadership qualities
Activities in Integration 3. They have the trust and confidence of the
• Start where the people are community
• Do house to house visit 4. They express belief in the need to change the
• Seek out and converse with many people current undesirable situation
• Lend a hand in household chores 5. They are willing to invest time
• Participate in social activities
• Participate in direct livelihood production Core Group Formation
• In short “IMMERSION” • Forming a single core group is suggested but
People centered approach in Integration as the community gets better, the 1st group may
1. Pagbabahay-bahay - Occasional home visits decide have a separate group
are an effective way of developing a close • The process of bringing together the most
relationship advanced indigenous leaders among the leaders
2. Huntahan Informal conversation identified during the preliminary social
3. Participation in the production process investigation stages
Organizer participates in in livelihood activities • CO objectives: To ensure the
4. Participation in social activities Help the
organizer and people know Community Organization
• Conducts assembly with the goals of arriving
Social Analysis: at a common understanding of community
Process of gathering, collating and analyzing concerns and formulating a plan of action
data to • If community decide to formalize the
- gain extensive understanding of community organization it must have the ff: characteristics:
conditions, • An organizational name and structure
- help in the identification of problems and • A set bof officers recognized by the
- determine the root cause of problems.
Action /Mobilization Phase
A process of systematically learning and • Refers to implementation of the
analyzing the various structures and forces in the community’s planned programs and projects
community on: • Is the actual community action undertaken to
• Socio-political address and resolve the identified community
• Economic issues and concerns
• Cultural
 • Food Safety Sanitation
Evaluation: • Vermin and Vector Control
• Systematic, critical analysis of the current state • Built Environment
of the organization or projects compared to Monitoring and Evaluating Community
desired or planned goals or objectives Health Programs Implemented
• It is the process of drawing out lessons from Evaluation approaches maybe directed
the activity toward:
• The people should sit down and review what  Structure
happened, whether good or bad  Process
Ask: Did we prepare well?  Outcome
• Did we go to the right person?
• Did we overestimate our strengths? Structure Evaluation
• What did we learn? Etc Involves looking into the manpower and
physical resources of the agency responsible for
Exit and expansion phase community health interventions
• When indicators of success are met, e.g., high
levels of socio-political awareness, sustained Process evaluation
participation, active leaders, clear plans and Examining the manner by which assessment,
goals set by the community diagnosis, planning, imple mentation and
evaluation were undertaken
INDICATIONS OF READINESS FOR EXIT
1. Attainment of the set goals of the Outcome evaluation.
community organizing efforts Determining the degree of attainment of goals
2. Demonstration of the capacity of the and objectives
people’s organization to lead the community in
“The people are the real heroes, while we Types of Evaluation:
ourselves are often childish and ignorant, Formative evaluation
and without this understanding it is • Judgement made about effectiveness of
impossible to acquire even the most nursing interventions as they are implemented
rudimentary knowledge” (Maurer and Smith,2009)
Mao Zedong • This is ongoing and continuing while family
"Preface and nursing care is implemented and family nurse
Postscript to Rural interactions are taking place
Sur
Summative Evaluation:
A people united will never be defeated Determining the end results of family nursing
care and usually involves measuring outcomes
Community Organizing Participatory or the degree to which goals have been achieved
Action Research (Maurer and Smith,2009)
 A community development approach
that allows the community Family Health Record:
(participatory) to : -All records, which relate which relate to
 systematically analyze the members of the family should be placed in a
situation (research), single-family folder.
 plan a solution and -Gives the picture of the total services and §
 Implements project/programs - helps to give effective, economic service to the
(action) utilizing the process of family as a whole
Community - Separate record forms may be needed for
different types of service such as TB, maternity,
• Proper Excreta Disposal etc.
-All such individual records which relate to The term CD was first officially used in
members of one family should be placed in one 1948 at British Colonial Office
single folder Cambridge Conference on Devt of
American Initiative.
Community Profile: The then CDP aimed at helping
-A summary of baseline conditions and trends in British colonies in Africa prepare for
a community and study area. independence by improving local govt
- It establishes the context for assessing and developing their economies. it was
potential impacts and for project decision- initiated on 2nd Oct, 1952 with the aim
making. of promoting better living for the whole
- Developing a community profile involves community in rural areas. The CDP
identifying community issues and attitudes, was also a result of the conclusion
locating notable features in the study area, and drawn from the ‘Grow More Food’
assessing social and economic conditions and enquiry report
trends in the
- Information can be collected both from COREOFCOMMUNITYDEVELOPMENT
primary source Educating
• such as interviews or field Enabling
• such as comprehensive plans or Empowering
newspaper articles
CHARACTERISTICS OF CD
- Focuses on the whole community.
*COMMUNITYDEVELOPMENT* - Emphasizes public participation as self-
“Community Devt is an attempt to bring about a help.
social and economic transformation of village - Uses participatory democracy as a
life through the efforts of the people themselves” model for decision making.
“Community Devt is the process of assisting ELEMENTS OF CD
ordinary people to improve their own -process
communities by undertaking collective action” -method
(Twelvetrees, 1991 -program
-movement
RURALDEVELOPMENT PRINCIPLES OF CD
URBANDEVELOPMENT Self-help and Self-responsibility are required
 CD refers to creation of social services, for successful devt.
human development, community
Participation in public decision-making should
education program and other welfare
be free and open to all citizens.
programs.
Trust is essential for effective working
 The term ‘CD’ used to describe a goal of
relationship.
bringing about social and economic devt
in areas which are underdeveloped. Methods that produce accurate information
 CD can be considered as a goal and about the community are vital to the process.
community organization as the process Understanding and general agreement are the
or the method by which CD can be basis for community change.
achieved. All individuals have the right to be heard in
 CD produces self-reliant, self- open discussion, and the responsibility to respect
sustaining and empowered communities. opposing viewpoints
 CD also known as COMMUNITY
BUILDING PILLARS OF CD
BACKGROUND OF CD -Objectives
- People
- Strategy
 -Technology  To motivate them to solve their problem
To help them build up social and economic
CD V/S CO infrastructure
To train rural unemployed youth
To empower farmers/ laboures to
discourage migration to urban

MAJOR AIMS OF RCD:

RCD:
- infant welfare
- hygiene
- Public health

PROCESS OF RCD:
1. Confirm spread problem by gathering more
PROCESS OFCD
information
2. Examine data from step one
3. Set goals and formulate actions for
improvement
4. Implement actions for improvement
5. Assess progress and refine actors for
improvement
6. Monitor improvements for sustainability

METHODS INVOLVED IN RCD

- PRA is the major and important method in
RCD
- It is intended to enable local communities to
BRANCHES OF CD conduct their own analysis and to plan and take
1. RURALDEVELOPMENT action
2. URBANDEVELOPMENT - The aim of PRA is to help strengthen the
capacity of villagers to plan, make decisions,
I. RURAL COMMUNITY DEVELOPMENT take action towards improving
The term ‘Rural development’ means all round - PLA (Participatory Learning and Action) is
devt of rural areas with a view to betterment of often used interchangeably with PRA
lifestyle and standard of living in all spheres of
II. URBANCOMMUNITYDEVELOPMENT
their life.
 Urban Community Devt in India drives
RCD aims at improving the welfare of rural
its origin from the Rural Community
people and their livelihoods on a sustainable and
Devt Program which commenced on
equitable basis.
2nd Oct. 1952.
 People’s participation is the Centre-piece in
 It requires the urban citizen’s efforts like
RCD
financial support and technical
FUNDAMENTAL OBJECTIVES OF RCD
assistance in areas like sanitation, public
 To teach farmers how to determine their health, education and recreation.
own problems
 To help them acquire knowledge about the
problems
 URBAN BODIES - cohesion
There several types of urban bodies in India - commitment to teamwork
such as Municipality, Notified Area Committee, - trust
Town Area Committee, Special Purpose - psychological safety
Agency, Township, Port Trust, Cantonment - collective efficacy
 Nagarpalika Act came into force on 2. SKILL-BASED COMPETENCIES:
1stJune,1993. - coordination
The 74th amendment made the provisions - communication
relating to Urban Local Govts (Nagarpalika). - conflict resolution
Three-tier structure of Nagarpalika:- - shared leadership
Municipal Corporations, Municipal Council, and - back up behavior
Nagar Panchayat 3.KNOWLEDGE-BASED
COMEPETENCIES
GROUP DEVELOPMENT STAGES: - situation awareness
-Stages group of Development - transactive memory system
 Forming - shared mental models
 Storming
 Norming Collaborative Partnerships – are
 Performing agreements and actions made by consenting
 Adjourning Organizations to share resources to accomplish a
Forming – team acquaintances and establishes mutual goal. Rely on participation by at least
ground rules. Formalities are preserved and two parties who agree to share resources, such as
members are treated as strangers. finances, knowledge and people.
Storming- Members start to communicate their Collaboration and Partnership:
feeling but still view themselves as individuals  Clear Goals – why are we forming a
rather than part of the team. They resist control partnership anyway?
by group leaders and show hostility  Trust – are we willing to depend on one
Norming – People feel part of the team and another? Is decision making
realize that they can achieve work if they accept transparent?
other viewpoints.  Clear roles – what will each of us do?
Performing – The team works in an open  Commitment – are we similarly
and trusting atmosphere where flexibility is the invested in the partnership success?
key and hierarchy is of little importance.
Adjourning – The team conducts an FRAMEWORK FOR “PARTNESHIP”
assessment of the year and implements a plan 0. Delivery – “partnership” who
for transitioning roles and recognizing implement on our behalf or deliver
members contributions. services to us.
1. Leverage Exchange – resources
INTERVENTIONS TO FACILITATE GROUP from another organization that can
GROWTH contribute to your work.
1. Orientation structure, direction 2. Combine Integrate - combine your
2. Process, negotiate and resolve conflicts resources with those of a partner to
3. Awareness of the effects behavior innovative and achieve more efficiently,
4. Application of New Learning ore more effectively than you could do
alone.
TEAMWORK: 3. Transform – multi actor approach to
1. ATTITUDE- BASED COMPETENCIES tackle complex challenges through
systems transformation.
VII. Information Technology and aggregation system that is used for public
Community Health health-related decision making Despite
eHealth is a relatively recent healthcare practice these challenges though, electronic systems are
supported by electronic processes and being adapted and implemented in countries
communication, dating back to at least 1999. around the world.
Usage of the term varies as it just not covers the
“ Internet medicine” as it was conceived during
that time, but also covers “virtually everything WHAT IS E-HEALTH
related to computers and medicine” Definition
 The use of Information and
communication technology (ICT) for
b) Power of data in Information health (WHO,2012)
decision Future  Cost effective way of using ICT in
wisdom health care services, health surveillance,
health literature, health education, and
knowledge Past research.
information E-Health can be considered in any of, but not
data limited to the following:
c) E-Health Situation in the Philippine □ 1. Communicating with a patient through a
teleconference, e mail, SMS
□2. recording, retrieving and mining data in
electronic medical record (EMR)
□3. providing patient teachings with the aid of
electronic tools such as radio, television,
computers, smartphones and tablets

Power of Data and Information

Data:
□ Fundamental elements of cognition
d) Using e-Health in the Community Typically,
(Gudea,2005)
eHealth application uses the
□ Unanalyzed raw facts that do not imply
internet to transmit and store patient data
meaning
either for a provider or payer. These eHealth
Information
applications are used by doctors, hospitals,
When meaning is attributed to data and when
insurance providers to record patient health
data are processed and analyzed, the data
information, called protected health
become information
information (PHI).
Benefits of a well-managed patient
e) Roles of the Community Health Nurse
information system
in e-Health
1. Data are readily mapped, enabling more
The primary role of community health nurses is
targeted interventions and feedback
to provide treatment to patients. They plan
2. Data can be easily retrieved and
educational assemblies, handouts fliers, conduct
recovered
health screenings, dispense medications and
3. Redundancy of data is minimized
administer immunizations. Nurses also may
4. Data for clinical research becomes more
distribute health-related items like condoms and
available
pregnancy tests.
5. Resources are used efficiently
Electronic Health Management Information
Systems (eHMIS) is a facility-based data
In order for information to be valuable, 3. Telemedicine
data must have the ff. characteristic This is to reach and and provide better health
services to geographically isolated and
1. Accuracy disadvantaged areas, to support MDG attainment
Reflects the event as it happened 2. and to disseminate informations to citizens and
Accessibility providers.
Ascertains data availability 4. eLearning
3. Comprehensiveness The use of electronic tools to aid in teaching
Data inputted should be complete 4.
Consistency/reliability Roles of a Community Health Nurse in
Having no discrepancies 5. eHealth
Currency Major Roles of eHealth Nurse in the Philippine
All data must be up to date and timely 6. Community Setting:
Definition 1. Data and Records Manager
Data should be properly labeled Monitor the trends of diseases through the EMR
allowing for targeted interventions for health
E-situation in the Philippine promotion, disease prevention, curative services
 Developing world suffers from or rehabilitation
inadequate health care and medical 2.Change agent
services - Nurses act as change agents by working
2001 closely with the community and implementing
Roughly 2.5 % of the country’s eHealth with them and not for them
population had internet access - Inform and guide the community in selecting
2011 and applying appropriate ICT tools
Steadily increased to 29 % - Collaborate with health leaders,policy
(telecommunication union,2011 makers,stakeholders and other community
health professionals to determine their
Health sector knowledge and awareness on eHealth
1. Begun utilizing ICT to improve services 3.Educator
2. DOH introduced a number of health Provide health education and families
information system that aim to improve the through ICT tools
access of health data such as the 4. Telepresenter
- Electronic Field Health Service In the event that a patient needs to be referred to
Information System a remote medical specialist through telemedicine
- Online National electronic Injury Nurse may need to present the pts. Case noting
Surveillance System salient points for case assessment, evaluation
- Philippine Health Atlas and tx
- Unified Health management 5. Client Advocate
Information System Nurses safeguard patients’ records, ensuring that
- security, confidentiality and privacy of all
Using E-Health in the Community patient information are being upheld.
1. Universal health Care and ICT 6. Researcher
DOH through A.O No. 2010-0036, outlined the Responsible for identifying possible points for
policy directions of Universal Health Care, KP research and developing a framework, based on
Kalusugan Pangkahalahatan data aggregated by the system
Aim:
To attain efficiency by using IT in all aspects of
health care
2. Electronic Medical records
Comprehensive patient records that are stored
and access from a computer or server