• DEFINTION AND MEANING OF COMMUNITY

• The word ‘’ community has its origin from

Latin word ‘’communes’’ the word community
is used in many different ways in a wide variety
of situations and therefore many definition
have come up.

• The WHO expert committee on community

health nursing as a community is a social
group determined by geo-graphical 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, norms, values
and social institutions’’.

• Definition of health

• The WHO in 1946 defines ‘’ health is a state of

complete physical ,mental and social wellbeing
and not merely the absence of disease or
infirmity’’
• COMMUNITY HEALTH

• The definition given by WHO expert

committee was ‘’ the community health refers
to the health status of the members of the
community to the problems affecting their
health and to the totality of health care
provide for the community.
• Concept of community health
• Community health is art and science of taking care of
health in all its aspects of life which includes promotion
and preservation of health prevention of diseases
through.
 Maintaining good sanitation, potable water supply.
 Providing health education to self care, nutrition etc.
 Controlling communicable and non-communicable
diseases.
 Organizing proper medical and nursing services
 Improving the standard of living with help of other
sectors
 Active involvement of beneficiaries and people
• Concept of community health: cont...
• Health of a person gets influenced by various
factors:
1. internal hereditary to environment
2. family
3. neighbour hood
4. society
5. age and sex composition of the community
socio demographic factors etc.
• Concept of community health: cont...
• community health tries to maintain, protect
and improve of the health status of population
groups and community unlike individual
patients health at the hospital.
• it aims at improving the health of a community
by improving access to medical care,
sanitation, health teaching, immunization,
healthy life style adaptation, to public health
communications and medical campaigns
• Aims of community health

1. Health promotion
2. Disease prevention
3. Management of factors affecting health
• Principles of community health.
1. Health care should be shaped around the life
patterns of the population..
2. Primary health care should be an integral part
of the national health system. Health
organization at all levels should be designed in
support of the needs of the peripheral level.
3. Health care activities should be fully
integrated with the actives of other sectors
involved in community development.
• Principles of community health. cont....

4. The local population should be actively involved

in the decision making upon the local needs
requiring solutions, formulation and
implementation of health care actives.

5. The health care offered should place a maximum

reliance on available community resources and
should remain within the cost limitations relevant
to each country.
• Principles of community health.cont....
6. Health care should be an integrated approach
of preventive, primitive, curative and
rehabilitative services for the individual family
and community.

7. The majority of interventions should be at the

peripheral practice level by the workers
suitably trained for performing them.
• COMMUNITY HEALTH NURSING

• Definition and meaning

• Community health nursing practice is

synthesis of nursing practice and public health
practices which in general and comprehensive
services are provided and not initiated to a
particular case and diagnostic group.
• Definition and meaning

• According to WHO expert committee

community health nursing comprises the skills
of nursing improvement of the conditions in
the social and physical environment, the
prevention of illness and disability and
rehabilitation.
• Definition of community /public health nurse
• An European conference on nursing
administration 1959 defined a public health
nurse as “the nurse mostly concerned directly
with giving health education and care too
individuals and their families in community’’
• The specific nursing activates performed by
the nurse will vary according to community
needs and the structure of health care agency.
• Definition of community/public health nurse
• A qualified public health nurse is one who has
undergone training in basic general midwifery
and public health nursing or any graduate
nurse or post graduate nurse.
• Purpose of community health nursing
• to improve community health through the
selective application for nursing and public
health measures, within the frame work of the
total community health effort.
• Aims of community health nursing
1. To increase the capability of families, groups and
community to cope health and illness problems.
2. To support and supplement efforts of other
professionals in restoration and preservation of
health.
3. To control or counteract physical and social
environmental conditions that threaten health or
decrease the enjoyment of life.
4. To contribute to the refinement and improvement of
nursing practice and of public health practice and
service.
5. To promote, preserve and restore health when it is
impaired , minimize suffering and distress and to
promote quality living.
• OBJECTIVES.
General objectives of community health nursing
1. To increase capability of individuals families,
groups and community to deal with their own
health and nursing problems.
2. To strengthen community resources and to
make people to best utilize them
3. To promote measures to control and protect
environment
4. To prevent and control communicable and non
communicable diseases
OBJECTIVES.CONT...
6. To provide specialized services for mothers,
children, adults, workers elderly,
handicapped and eligible couples etc.
7. To conduct research and contribute to the
further refinement and improvement of
community health nursing practice.
8.To participate in preparing health personnel to
function at the level of the community
9. To supervise guide and help health personnel
n carrying out their functions effectively
• Specific objectives of community health nursing
1. Provide antenatal, intra-natal and postnatal care to
ensure safe pregnancy delivery and puerperium for
the mother and child.
2. Perform developmental assessment.
3. Advice on nutrition child care treatment of minor
ailments.
4. Organize clinics for treating adults and children
5. Minor ailments and referral of major illness.
6. To promote general awareness/health
consciousness.
7. Provide facilities for family planning.
8. Teach the correct use of common medicines and
drugs.
• Specific objectives of community health nursing:cont...
8. Explain and promote the use of local health services,
advising people to seek health care from safe qualified
heath personnel.
9. Promote projects in the community that will improve
life for the people
10. Teach and demonstrate healthy ways of living
11. Assist in the prevention and control of communicable
diseases.
12. Visit people n their own homes and villages to identify
health needs and priorities, and deal with them
effectively.
Specific objectives of community health nursing:cont...

13. Promote the health of school children

14. Promote the health of the industrial workers
15.Maintain and promote the health of the elderly and
handicapped.
16. Work in close cooperation with government and
other local organizations to promote health and
welfare of communities.
• Philosophy of community health nursing
• Philosophy is an attitude towards life and
reality.
• Philosophy of community health nursing
Philosophy is an attitude towards life and reality.
The philosophy of community health nursing derives from
acceptance of certain concepts and facts as a
foundation for working with people.
1. The essential dignity and worth of the individual
2. Each individual possess potentialities and resources for
managing their own lives
3. The importance of freedom to express ones
individuality.
4. The great capacity for growth within all social beings
5. The right of an individual for basic necessities
6. The need for individuals to struggle and strive to
improve their life and environment
7. The right of the individual to be helped in times of need
and crisis.
• Characteristics of community health nursing
1. It is a field of nursing:
• Comprehensive, quality nursing care at all the levels with
their participation and willingness is best provided in
community health nursing.
2. It combines public health with nursing :
 The principle, concepts, strategies from basic nursing
practice are incorporated to provide priority of preventive
and health promotive strategies
 apply concepts of epidemiology and its methods for various
diseases
 controls or prevents influence of environmental factors on
health
 applies principles underlying management and organization
to community health
 and applies knowledge in public health policy analysis and
development.
• Characteristics of community health nursing: cont...
3. It is population –focused:
• Concerned with the personal and environmental
health of the population groups.
• The population oriented focus requires the
observation of relationships.
4. It emphasizes wellness:
• It deals with both well and ill persons, but emphasis
is given on positive health or wellness to prevent
health problems and promoting health.
• They identify high risk groups and institute
preventive programmes.
• A wellness emphasis requires taking initiative and
making sound judgments.
• Characteristics of community health nursing: cont...
5. It involves interdisciplinary collaboration:
• Coordination and cooperation with team members
promotes a great effort in dealing with health aspects
of community.
• Community health nursing maintains a good team
effort.
• 6. It promotes clients responsibility and self care:
• Consumer participation is promoted when clients are
treated as partners on the health care team.
• Community health nursing encourages for expressed
felt need, active participation and self responsibility for
self care at various levels of health and illness.
• Factors influencing community health nursing
1. Population in the area
2. Size of the area Transport and communication facilities
3. Number and qualifications of other personnel
4. General health needs of the people
5. Socio- economic conditions, education etc,
6. Previous experience of qualified health personnel.
• SCOPE OF COMMUNITY HEALTH NURSING
1. Community health nursing services at center:
2. Provides primary health care in the community.
3. Conducts routine antenatal and postnatal
services.
4. Conducts deliveries when required.
5. Corries out immunization services.
6. Promotes health of the children by conducting
under five clinics and referring cases who
require medical care.
7. Assess the social ,environmental and nutritional
needs of community and get the help of social
workers to meet these needs.
SCOPE OF COMMUNITY HEALTH NURSING: cont...
2. Industrial nursing services:
Nurses are employed in industries.
There is a provision for appointment of
medical and nursing staff in factories where
500 or more workers are employed.
The broad areas of nursing in this are pre-
employment examination and periodic health
checkups, care of sick, first aid, industrial
sanitation and safety etc.
SCOPE OF COMMUNITY HEALTH NURSING: cont...

3.School health nursing :

1. The school health nurse renders services to promote and
protect the health of the school children.

2. She provides her services in areas like:

 health education
 detection of diseases
 immunization
 first aid
 dental health
 school sanitation
 maintenance of health records
 follow up and referral services.
SCOPE OF COMMUNITY HEALTH NURSING: cont...

4. Domiciliary nursing services:

The areas where domiciliary nursing is practiced
maternity services and services for illness and
accidents at the home setting.
• SCOPE OF COMMUNITY HEALTH NURSING: cont...

5.Mental health nursing services:

Many developing countries have mental health
supervision and disease prevention service
today.
These services include early diagnosis and
treatment, rehabilitation, psychotherapy, use
of modern psychotropic drugs.
• SCOPE OF COMMUNITY HEALTH NURSING: cont...

6. MCH and family planning:

The public health nurse plays a major role in
the MCH and family planning services.
It comprises antenatal, postnatal and child
care services.
• SCOPE OF COMMUNITY HEALTH NURSING: cont...

7. Rehabilitation centers:

1. Rehabilitation means restoration of all

treated cases to the highest level to function
ability.
2. Nursing is an important component in the
rehabilitation of the disabled at the
community level.
• SCOPE OF COMMUNITY HEALTH NURSING: cont...

8. Geriatric nursing services:

1. Monitor and ensure the quality care for elderly.
2. Understands the trends in ageing while planning
and providing care.
3. Educates elderly to be more and more self
dependent personal hygiene, nutrition,
prevention of infections.
4. Helps the elderly to cope up with the changes in
their physical and mental ability.
5. Maintain accurate record of care given to the
elderly.
6. Historical development of community health
9. International health agencies :
• Plays a role in collecting health related data
and takes active part in programme planning,
Implementation and evaluation
• Qualities of a community health nurse
1. The CHN is in direct contact with people of different ideas,
beliefs, superstitions, customs and culture about health. She
must therefore possess special qualities which will enable her to
work successfully. she should be:
2. sympathetic, empathetic and understanding
3. respectful, tolerant and patient.
4. tactful, observant and co-operative
5. able to adjust and work freely with different people at different
situations in the community.
6. appreciate the effort of all people and correct their mistakes
tactfully.
7. create good interpersonal relationship with colleagues and
other health workers and client.
8. trustworthy, punctual and sincere with her work
• Setting for community health nursing practice
1. Homes
2. Ambulatory service
3. Schools
4. Occupational/Industrial Setting
5. Residential Institutions
6. Community at large
7. Voluntary organization ( national and
international)
8. Various centers (PHC, CHC, District hospitals
maternity centers and urban health centers)
• Duties of a community health nurse
1. Home visiting
2. Running child welfare clinic
3. Running family planning clinic or assisting
4. Assist in running ANC and PNC clinic
5. Conducts school health services
6. Carries out or assist the PHN in inspection of day
care centers
7. Collection of information or data from the
community
8. Health education
9. Record keeping
• Role of community health nurse
1. Health care provider:
• The community health nurse (CHN) provides direct care in
community.

2. Health educator:
1. Educates individual family and community to follow principles
and techniques of proper prevention of communicable diseases.
2. Teachers the modes of spread, prevention and control of genetic
and infectious diseases.
3. Teaches about diet in quantity and quality
4. Teaches the personal, family and community hygiene.
5. Teaches the handling and first aid techniques for emergencies like
drawing, snakes bite, dog bite etc.
6. Trains the traditional birth attendants for normal delivery and
safe delivery in communise.
• Role of community health nurse:cont...

3.Collaborator:
• CHN works with the collaboration of other health team
of govt. or NGOs in community.
• She works with doctors, nurse vaccinators, TBA,
midwives, and LHVs etc. in the community.

4. Counsellor:
CHN conducts the counselling for individuals, families
and community in prevention of social and mental
problems, for motivation of family planning,
vaccination and for removing the unhealthy behaviour
by folk ways.
• Role of community health nurse:cont...
5. Advocate:
1. Plans and leads for installation of facilities of health care in
suitable and required places.
2. Participates at the district level meeting and talk to
administrators for the favour of folks for solution of health care,
social and financial problems available in his or her
constituency.
Role of community health nurse:cont...
6. Researcher:
1. CHN work hard for searching new methods of care
and application of new technology
2. She finds the social and economical problems in
community, which makes hindrance for care cure.
3. She searches for causes of illnesses .
4. She collects the statistical data and analyzes that data.
5. After analysis she reports to higher authorities for
remedies in feedback.
6. She writes the research papers on different issues and
problems in community.
• Role of community health nurse:cont...
7. Manager:
1. Organizes and manages various programmes
of health and assume leadership of nursing
team for supervision of nursing and other
staff.
2. Being a CHN of one specific community or
village, she gives her plan to district health
office for national immunization and family
planning programs etc.
Role of community health nurse:cont...
8. Evaluator:
1. CHN after implementation of any project or
health programme evaluates the success or
outcome of that project or programme.
2. She does the surveillance for diseases.
3. She evaluates the special health programmes in
the community
4. She evaluates the effectiveness any programme
or drugs’ or teaching or vaccination in
community.
• Role of community health nurse:cont...

9. Consultant:
1. She advice is taken before starting of any health care
programme in community.
2. she renders the services for prevention of diseases
and promotion of health in the community.
• Functions of community health nurse
1. Planning identifying execution and evaluation of care.
2. Providing comprehensive care to the individual, families
and groups by teaching counselling and guidance.
3. Demonstrates and teaches skilled nursing care to family
members of sick, chronically ill in the home.
4. Cares for the chronically ill, handicapped & disabled in
the community.
5. Provides assistance to the families in improving
environmental conditions.
6. Helps the families in the adjustment of social, emotional
aspects of health .
7. Provides preventive health care services like
immunization, supplementary nutrition etc,
• Functions of community health nurse:cont...

9. Renders treatment and follow up care of

mentally ill & elderly people.
10. Development and utilization of other branches
of health for welfare of community.
11.Organizing planned group classes regarding the
sanitation, nutrition child care family welfare
services and parent, craft to the various members
in the community.
12.Supervises the work of MPHW, visitors and Dias.
13.Conducts epidemiological investigations TB, STD
& leprosy etc.
• Functions of community health nurse:cont...

14.She co-ordinates her work with other member of health

team.
15.She revises the plan, programmes in her area and
collects the vital statistics, conducts research to study the
existing health problems, evaluates effectiveness of
various health problems.
16. She trains & conducts orientation and in-services
training classes in her area to the nursing students and
other nursing staff.
17.She acts as a co-consultant or between individuals and
the community.
18. She acts as a consultant and talk on behalf of the
individual or family with village leaders and other
members of the health team.
• Functions of community health nurse:cont...

19. She plans the budget, gets the equipment required,

organizes PHC and to its associated health centers,
20. She manages various health programmes
&campaigns in the area.
21. He act as a administrator at different levels to
evaluate and puts into practice to improve quality &
quantity of the total community.