How do you define Health?

➢ A place where people under usual

conditions are found
"As a state of complete physical, mental and ➢ The community is the object of
social well-being and not merely the focus care in CHN, with family as the
absence of disease or infirmity" (WHO, unit of service.
1958)
❖ Community Health Nursing
❖ Health is the extent to which an Concept
individual or group is able.. ➢ CHN is a specialized field of nursing
practice that renders care to
➔ To realize aspirations and satisfy individuals, families and
needs communities, focusing on health
➔ To change or cope with the promotion and disease prevention
environment through people empowerment.
➢ CHN as an area of human services
❖ Health is seen as resource for directed toward developing and
everyday life, not the objective of enhancing the health capabilities of
living; it is a positive concept people - either individuals, groups
emphasizing social and personal and communities (Heinrich &
resources and physical capacities Freeman, 1981)
(WHO, 1986)
❖ FACTS OF CHN
Health......
● Focus: promotion and reservation of
➔ It carries the mandate that health is health
a basic human right. ● Area of Content: skills and
➔ It is seen as a spectrum or a knowledge relevant to both nursing
continuum. and public health
➔ The modern concept of health refers ● Clients : general populations
to the optimum level of Individuals, families, communities)
functioning of individuals, families ● Scope: comprehensive and general,
and communities which is influenced not limited to a particular age or
by the ecosystem through a myriad group.
of factors.
★ Characteristics and Features of
What is Community? CHN
➢ A group of people living in a ❖ Includes population- focused
particular area with common beliefs, interventions that seek to improve
valties and traditions. the health and well- being of groups,
➢ Having geographic boundaries and aggregates and communities.
Shared belief System or culture
 ❖ Can be distinguished from other ❖ CHN uses prepayment
fields of nursing in 3 major points: mechanism
focus, approach and
underpinning ✓Funded by taxes of the people
✓Nurse in the community, fundamentally
❖ CHN is developmental committed to attend to patients in
communities regardless of their status since
✓ Thus, health education is a primary all are paying taxes
activity that nurses incorporate in all public
health activities and interventions as an ❖ CHN focuses on preventive
approach to help people acquire knowledge service
and skills and instill health consciousness
among them. ✓Community health nurse are in constant
search of risks that make people vulnerable
❖ CHN is multidisciplinary to disease and implement interventions to
modify and mitigate these-vulnerabilities
✓nurses fosters collaboration with different
professionals and sectors from society ❖ CHN offers comprehensive care
This includes working within and amung
government agencies or departments in a ✓Community nurses cannot choose who
private organizations their patients will be and predict what cases
they will deal with.
❖ CHN is ecology oriented ✓Holistic care is expected in delivering
health services
✓This means that the setting for community
health nurses include homes, school, ❖ Philosophical and Ethical
workplaces, prison and churches. Underpinnings of CHN

❖ CHN promotes social justice ➔ Anchored in the primacy of worth

and dignity of man
✓Community health nurses ensure that ➔ Respect for people's inherent value
people regardless of age, sex, creed on regardless of their background and
religion enjoy healthcare services In their beliefs - considered as the summit
communities of all ethical norms

❖ CHN values consumer ➢ UNESCO (2005) - Client must be

involvement treated with utmost respect and his
right to health enabled through just
✓Considered pártners in health provision of access to healthcare
✓Need for patients to be responsible for ➢ Jean Watson (2009) - caring is the
their own health moral ideal of nursing whereby the
 end is protection, enhancement, and ● T-raining and development as
preservation of human dignity opportunities for continuing staff
education programs
➔ The right to health of all people
enshrined in the UN declaration of ❖ Theoretical Models approaches
1948 is another value in the practice
of CHN ★ Health Belief Model

★ This implies that responsibility for Theoretical model that can be used to guide
health rests primarily on people health promotion and disease prevention
and not on agencies or programs
professionals Used to explain and predict individuals
➔ Thus, the role of nurses when changes in health behaviors
engaging communities is to foster
awareness that will lead people to ✓Key factors that influence health
manage their own health… behaviors as an individual's..

❖ Principles of CHN ➔ perceived threat to sickness

● E-education primary tool and ➔ perceived susceptibility
responsibility ➔ perceived severity
● M-ade available it all regardless of ➔ perceived benefits
race, creed and socio-economic ➔ perceived benefits to action
status ➔ Exposure to factors that prompt
● P-olicies and objectives of the action
agency is fully understood by the ➔ Self-efficacy
nurse
● O-rganizing for health, with the ❖ Milio's Framework for Prevention
family as the unit of service
● W-orks as a member of the health ★ OVERVIEW OF MILIO'S
team (PHN) FRAMEWORK
● E-xisting active organizations are FOR PREVENTION
utilized
● R-ecording and reporting are Μilo (1978) proposed that health deficits
accurate often result from an imbalance between a
● M-onitoring and evaluation of population's health needs and as healin
services is periodically done Mustaning resources.
● E-xisting indigenous resources of
the community is used She stated that diseases associated with
● N-eeds of clienteles is recognized excess occurred in affluent sociales
and serves as basis for CHN (obesity) and diseases that result koos
inadequacies in food, shaifer and water
affect the poor. Thenilore, poor people in
affluent societies experience the least ❖ PRECEDE-PROCEED MODEL
desirable combination of factors, Personal Lawrence Green
and societal pressures affect the range of
health promoting on healthy Samaging PRECEDE
choices available to individuals, Personal
resources include the individual's P-predisposing
awanimees, knowledge, and health beliefs. R-reinforcing
Money and sine am also personal resources E-enabling
C-constructs
She proposed that most human beings E-educational
make the easiest choices available to them D-diagnosis
most of the time. Health promoting choices E-evaluation
must be more readily available and fests
costly than health damaging options for PROCEED
individuals to pain.
P-policy
This theory is prouder than the HBM, It R-regulatory
includes economic, political, and O-organizational
environmental health determinants rather C-Constructs
than just the individual's perceptions E-educational
E-environmental
This theory encourages the nurse to D-development
understand health behaviors in the control
of their societal milieu

❖ Nola Pender's Health Promotion

➔ Her Health Promotion Model

Indicates preventative health
measures and describes nurses'
critical function in helping patients
prevent illness by sat care and bold
alternatives.
Different Fields in Nursing
➢ RA 124 in 1947 an act to provide
Different Fields in Nursing for Medical Inspection of Children
1.School Health Nursing Enrolled in Private Schools,
2.Occupational Health Nursing Colleges and Universities in the
3.Community Mental Health Nursing Philippines.
➢ This law stated that it was the duty
School Health Nursing of the school heads of private
➢ The school nurse visits four to six schools with a total enrolment of 300
schools per month, with each visit or more to provide for a part-or full
lasting for 3 days or more, time physician for the annual
depending on the type of school and medical examination of pupils and
school location and population. students
➢ The school nurse is responsible for ➢ The physicians were to render their
planning and conducting training school health activities at the end of
programs for teachers on health every quarter of each school year to
and nutrition. the Director of Health.
➢ Poverty is associated with
decreased or inferior health care and School Health Services
has been linked to serious health
problems that result in absenteeism ❖ Health Education
and failure in school. ➔ These are culture sensitive and
➢ The school nurse and in the based on the identified educational
absence of the school nurse, the needs of the target population.
well-prepared school teacher,
serving as school health guardian, ★ Areas of concern for health
can effectively manage minor education:
complaints of illnesses, helping
these children to return to or remain 1. Oral Hygiene of the oral health care
in class. program involves the 7 o'clock tooth
➢ There is a need for mental and brushing habit activity.
physical health services for students 2. Injury prevention and developing
of all ages in an effort to improve safety conscious behavior in the use of
both academic performance and the the school playground, while engaging in
sense of well- being. sports, and the like. The MAPEH period is a
good time for the school nurse or teacher to
School health program were defined as: talk with and counsel students about the risk
1. School health services of developing health problems related to
2. School health education physical activity.
3. A healthy school environment to 3. Tobacco Use or Smoking is a major
include both physical and psychosocial problem in this country. Prevention should
aspects of environment (WHO, 1997) be emphasized in young people.
4. Substance Abuse i. Annual Individual Health Assessment
➔ The use of alcohol and other drugs ★ Examination of the eyes, ears,
is associated with problems in nose, throat, neck, mouth, skin,
schools, injuries, violence, and extremities, posture, nutritional
motor vehicle deaths. status, heart and Lungs
★ National Drug Education Program ★ Visual acuity test is done with the
➔ designed to promote collaboration use of Snellen's chart, E-chart or
of other sectors with the school symbol chart.
system by establishing linkages ★ Ball Pen Click Test (Auditory
among government, private and Screening) - test for hearing acuity.
socio civic organizations.
➔ Random drug testing is also ii. Height and weight measurement
carried out as part of this program. ★ done at the beginning and at the
5. HIV and AIDS end of the school year.
➔ School-based HIV and AIDS
Education and prevention iii. Rapid Classroom Inspection
program is an information ★ inspection of the pupils in the
dissemination campaign to educate classroom or while they are in line
the general population on the risks formation outside the classroom.
of HIV and AIDS.
IV. Emergency Care
8 Components of School Health
Programs ➢ Emergencies can include natural
events such as typhoons, floods,
1. Physical Education and earthquakes and man-made
➔ Sedentary lifestyle is associated with disasters, such as hazardous
obesity, hypertension, heart disease material spills, fires, and civil
and diabetes disobedience.
➔ Regular physical activity helps build ➢ Basic first aid equipment should
and maintain healthy bones and be available in all schools.
muscles. ➢ The school nurse and school
health guardians must be
2. Health Services knowledgeable about standard first
★ Health Screening aid.
➔ One of the objectives of the school ➢ EMS activation and Referral
health nursing program in the system should be in place.
Philippines is to detect early signs
and symptoms of illness, disabilities,
and deviations from normal.
3. Nutrition Services 4. Counseling, Psychological, and Social
➔ A variety of foods must be ingested Services
to meet their daily requirement.
★ Diets ➔ Children and teens struggle with
➔ should include a proper balance of depression, substance abuse,
carbohydrates, proteins, and fats conduct disorders, self-esteem,
with sufficient intake of vitamins suicide ideation, eating disorders
and minerals and under or overachievement.
➔ Skipping meals, especially breakfast ➔ Early detection and treatment may
and eating unhealthy snacks prevent untoward consequences.
contribute to poor childhood ➔ It is important for the nurse to be
nutrition. cognizant of the warning signs
★ Food preparation associated with suicide and to
➔ is expected to be undertaken by the recognize and refer at-risk
home economics, feeding teachers, adolescents to appropriate mental
homeroom Parent- Teachers health professionals.
Association on a rotation basis or
both. 5. Healthy School Environment
★ Obesity
➔ Not considered as an eating ★ The healthy school environment
disorder should consist of (WHO, 1997)
➔ Must be of concern to the school
nurse 1. A Physical, psychological, and social
environment
3 Most Common Eating Disorder: 3. Productive interaction between the
i. Anorexia school and community.
➢ Severely restricted intake of food
based on an extreme fear of 6. Health Promotion for School Staff
weight gain
ii. Bulimia ➢ Staff that participate in health
➢ Chaotic eating pattern with promotion increase their health
recurrent episodes of binge eating. knowledge and positively change
not. their attitudes and behaviors
iii. Binge Eating relative to smoking practices,
➢ Out-of-control eating of large nutrition, physical activity, stress,
amounts of food whether hungry or and emotional health.
not.
 maintenance of the highest degree
School Nursing Practice of physical, mental and social
well-being of workers in all
★ A specialty unto itself. occupations
★ School nurses need education in
specific areas, such as: ❖ EVOLUTION OF OCCUPATIONAL
➢ Growth and development HEALTH NURSING IN THE
➢ Public health PHILIPPINES
➢ Mental health nursing
➢ Case management ★ MS. MAGDALENA VALENZUELA
➢ Family theory she instituted the INDUSTRIAL
➢ Leadership NURSING UNIT of the Philippine
➢ Cultural sensitivity to effectively Nurses Association on November
perform their roles. 11, 1950.
★ MS. PERLA GORRES - from the
OCCUPATIONAL HEALTH NURSING Philippine Manufacturing
Company (PMC) served as the first
Occupational Health Nursing is defined as chairperson of the said unit.
a specialty practice that focuses on the ★ MS. ANITA SANTOS was elected as
promotion, prevention, and restoration first president on August 19, 1964.
of health within the context of a safe and She paved the way for the
healthy environment. It includes the modification in the name of the
prevention of adverse health effects from organization to Occupational
occupational and environmental hazards. Health Nurses Association of the
Philippines, Inc. on November 12,
Department of Labor and Employment 1966.
the lead agency on Occupational Safety ★ June 5-6, 1970-first annual
and Health convention was held. September
25, 1979 the organization was
★ They are given RULE MAKING and registered with the Securities and
RULE ENFORCEMENT powers to Exchange Commission.
implement stipulations of the
Philippine Constitution and the ❖ ASSESSMENT AND CONTROL OF
Philippine Labor Code HAZARDS IN THE WORKPLACE

★ The National Profile on HEALTH HAZARDS - are the elements in

Occupational Safety and Health the work environment that can cause
(of the Department of Labor and work- related disease.
Employment Occupational Safety
and Health Center (OSHC) - SAFETY HAZARDS - are the unsafe
defined OSH as a discipline conditions or unsafe acts that significantly
Involved in the promotion and increase the risk of a worker to be injured.
 ii. Provide nursing care to injured or ill
❖ TYPES OF HAZARDS: workers,
1. Biological-infectious hazards - iii. Participate in health maintenance
infectious agents such as bacteria, viruses, examination, to a physician;
fungi. iv. Participate in the maintenance of
2. Chemical hazards - various forms of occupational health and safety by giving
chemical agents. suggestions in the improvement of working
3. Enviro Mechanical hazards - factors environment affecting the health and
that cause accident, injuries, strains or well-being of the workers;
discomfort (eg. Poor equipments) v. Maintain a reporting and records system,
4. Physical hazards - radiation, electricity, and, if a physician is not available, prepare
temperature, and noise and submit an annual medical report, using
5. Psychosocial hazards - anything that form DOLE/BWC/HSD/OH47, to the
causes emotional stress and strain or employer, as required by this Standards.
interpersonal problems.
IMPACT OF LEGISLATION ON
❖ CONTROL MEASURE FOR OCCUPATIONAL HEALTH:
OCCUPATIONAL HAZARD
1. Administrative Control - refers to the • The DOLE possesses legislative and
development and implementation of rule-making powers with regards to the
policies, standards, training, job design and following laws and standards:
the like.
2. Engineering-refers to the adoption of 1. Presidential Decree 442 Philippine
physical, chemical or technological Labor Code on prevention and
Improvements to limit exposure to compensation
hazards. 2. RA 11058 The Administrative Code on
3. Materials Provision - refers to Enforcement of Safety and Health
providing the workers with supplies or Standards.
supplements that can decrease their 3. The Occupational Safety and Health
exposure to hazards Standards
DUTIES OF OCCUPATIONAL HEALTH 4. Executive Order 307 The Occupational
NURSE Safety and Health Center
5. Presidential Decree 626 The
"The duties and functions of the Educational Development Decree
Occupational Health Nurse are: 6. RA 9165 or The Comprehensive Drug
Act
i. In the absence of a physician, to organize 7. RA 8504 of The National HIV/AIDS Law
and administer a health service program 8. RA 856 DOH: Sanitation Code
integrating occupational safety, otherwise, 9. DA: Fertilizer and Pesticide Act
these activities of the nurse shall be in
accordance with the physician;
10. DENR: RA 6969 Toxic Substances 6. Helping patients navigate their way
and Hazardous and Nuclear Waste through the health systems
Control 7. Helping patients talk about their problems
11. RA 9185 or The Comprehensive and access therapeutic activity
Dangerous Drug Act 8. Keeping good records, including
12. RA 6541 of The National Building Code reviewing and monitoring care plans
of the Philippines 9. Liaising with other healthcare
13. RA 9231 or The Special Protection of professionals
Children against Child Abuse, Exploitation 10. Offering practical advice and educating
and Discrimination people about their condition
11. Reporting back on a patient's progress
COMMUNITY MENTAL HEALTH at case conferences
NURSING 12. Reviewing/assessing, planning,
monitoring and responding to a patient's
• Community Mental Health Nurses clinical care needs
● delivers a range of medical and 13. Suicide prevention
nursing therapies as well as 14. Visiting patients in their homes
assistance, to support patient
recovery Who do Community Mental Nurses
Support?
Roles involve:
● Reviewing, treating and ● Those experiencing their first
monitoring patients of all ages mental health crisis
with various conditions like ● People who need support at home
anxiety, depression to eating to prevent a hospital admission
disorders ● People who have been discharged
● Supporting parents, partners and from hospital
other caregivers which include ● Those with long-term mental
establishing strong relationship and illnesses who need ongoing care
helping them develop their and support
confidence as they deliver
day-to-day support
1. Administering medicines/making sure
clients are taking their medicines correctly
2. Aggression reduction
3. Conducting risk assessments and helping
to keep people and their families safe
4. Ensuring legal compliance
5. Helping patients and their families deal
with the stigma around mental health
Concepts of the Community 6. Equitable and efficient use of community
resources, with the view towards sustaining
Types of Communities natural resources

1. Geopolitical Communities (Territorial Components of a Community

Communities) 1. Aggregate of People
2. Location in space
➢ Most traditionally recognized 3. Social System
➢ Defined or formed by both natural
and man- made boundaries and 1. Aggregate of People
include barangays, municipalities, is a community composed of people who
cities, provinces, regions and have similar demographic
nations characteristics such as age, sex, ethnic
background, common activities, concerns or
2. Phenomenological Communities goals
(Functional Communities) 2. Location in Space
the physical location or geographic
➢ Refer to relational, interactive boundaries of a group may define a
groups, in which the place or setting community.
is more abstract, and people share a 3. Social System
group perspective or identity based the relationship of members that forms one
on culture, values, history, interest, another a major dimension of a
and goals. community.

Characteristics of a Healthy Community Factors Affecting Health of A Community

1.People
1. A shared sense of being a community Variables that affect the health of the
based on history and values. Community:
2. A general feeling of empowerment and a. size
control over matters that affect the b. density
community as a whole. c. composition
3. Existing structures that allow subgroups d. rate of growth or decline
within the community to participate in e. cultural characteristics
decision making in community matters f. mobility
4. The ability to cope with change, solve g. social class
problems, and manage conflicts within the h. educational level
community through acceptable means
5. Open channels of communication and 2. Location
cooperation among the members of the Natural factors:
community. a. Geographic features
b. Climate
c. Flora and fauna
COMMUNITY ASSESSMENT ❖ Data Collected for the PATCH
process for health planning
➢ Essential process for
understanding the community, 1. Community profile: demographic,
identifying its needs and educational and economic data.
weaknesses, assets or strengths 2. Morbidity and mortality data, including
that is useful to achieve healthy unique health events.
community 3. Behavioral data focusing on behavioral
➢ Known also Community Health risk factors, such as smoking, drinking, and
Needs Assessment leading a sedentary lifestyle and prevailing
➢ This refers to a state, tribal, local good health practices in the community
or barangay health assessment such as breastfeeding and getting regular
that identifies key health needs exercise.
and issues through systematic, 4. Opinion data from community leaders,
comprehensive data collection such as what they think about the main
and analysis. health problems of the community, their
➢ The data that needs to be causes, and measures that may alleviate or
collected depend on the objectives correct them.
of the community assessment.
➢ Nurse need to collect data on the 3 Community Profile
categories of community health ● It is used to ensure representation
determinants: people, place and of all the stakeholders in the
social system building of the PATCH community
➢ A process by which community team.
members gain an understanding ● Morbidity mortality data.
of the health, concerns, and health ● Unique health events.
care systems of the community by
identifying, collecting , analyzing, ❖ Approaches in conducting
disseminating information on Community Assessment
community assets, strengths,
resources, and needs 1.Comprehensive Needs Assessment.
2. Problem-oriented Assessment.
★ Planned Approach To Community
Health (PATCH) 1. Comprehensive Needs Assessment.
It is a community health planning model
based on Green's PRECEDE model, Here, the nurse gathers information
including quantitative and qualitative about the entire community using a
data. systematic process where data is collected
regarding all aspects of the community to be
able to identify actual and potential health
problems.
2. Problem-oriented Assessment either by driving or riding a vehicle or
● focused on a particular aspect of walking through it.
health ➢ Participant observation is a
● collects information with a certain purposeful observation of formal
community problem in mind, and and informal community activities
then proceeds to gather information by sharing, if possible, in the life of
from the aggregate vulnerable to the the community.
problem.
● This approach is workable when ❖ Example of formal community
the nurse is familiar with the activities:
community such as when a a. Barangay assemblies and school
comprehensive community (parent teacher) meetings.
assessment b. Church meeting

❖ Tools for Community ❖ Example of informal gatherings

Assessment takes place in the following:
a. Sari-sari stores
1. Primary Data b. Community recreational areas.
★ These are data that have not been c. Schools.
gathered before and are collected
by 2. Survey
★ the nurse through observation ➢ It is made up of a series of
(ocular/windshield survey and questions for collection of
participant observation), survey, systematic information from a
informant interview, community sample of individuals or families in a
forum and focus group discussion, community, and may be written or
oral.
2. Secondary Data ➢ It is also appropriate for
★ These are taken from existing data determining community attitudes,
sources. knowledge, health behaviors, and
➢ First gives the nurse a picture of perceptions of health and health
what is already known about the services.
population under study, which may ➢ It is also used by the nurse in
facilitate collection of primary data identifying patterns of utilization
of health services
COLLECTING PRIMARY DATA ➢ It is also an opportunity for making
the members of the community
1. Observation aware of community problems and
➢ Rapid observation of a their effects and more conscious of
community may be done through their capacity to influence decision
an ocular or windshield survey, making about health policies and
 plans, giving them a sense of Secondary Data Resource
empowerment.
1. Registry of Vital Events
3. Informant Interview ★ Act 3753 (Civil Registration Law,
➢ These are purposeful talks with Philippine Legislature enacted in
either key Informants Or ordinary 1930 established the oil registry
members of the community. system in the Philippines and
★ Key Informants requires the registration of vital
➔ Consist of formal and informal events such as births, marriages,
community leaders or persons of and death.
position and influence such as
leaders in focal government, ★ R.A.47160 (Local Government
schools, and business. Code) assigned the function of civil
➔ Interview may be structured where registration to local governments
the nurse directs the talk based mandated appointment of local
on an interview guide (city/municipal) Civil Registrar
➢ The NSO serves as the central
4. Community forum repository of civil registries and
➢ It is an open meeting of the the NSO Administrator and the Civil
members of the community Registrar General of the Philippines.
➢ It is an effective tool in providing ➢ Reliable civil registration and vital
the people with a medium for statistics provide a realistic bags for
expressing their views and program planning implementation
developing their capacity to and
influence decision makers. ➢ Birth and death registries are of
➢ It may also be used as a venue for particular importance to the nurse
Informing the people about since they are sources of fertility
secondary data, for data validation, and mortality data.
and for getting feedback from the
people themselves about ● A facility-based births, the facility
previously gathered data. administrator shall be responsible
for the registration of the event.
5. Focus Group The physician ourse, midwife,
Saturation same question and answer anybody who attended the delivery
has the responsibility for registering
➢ It is made up of a much smaller births that occur outside a facility.
group, usually 6-12 members only.
➢ Its membership is more ● Either pavent, may us register the
homogenous, that is, persons with birth
similar sociocultural or health ● The birth of a child should be
conditions. registered within 30 days from the
occurrence of the birth at the Local
 Civil Registry Office of the city or municipality, district, provincial and
municipality where the birth national)
occurred. ➔ Monitoring and evaluating health
program implementation.
★ Presidential Decree 856
(Sanitation Code: Office of the ➢ The FHSIS (version 2008 is
President, Republic of the composed of recording and reporting
Philippines, 1975) requires a death tools. Records are facility-based,
certificate before burial of the that is they are kept at the Barangay
deceased. Health Station (SHS) or at the
Rural Health Unit (RHU) or health
➔ The physician who last attended center and contain a day to day
the deceased shall be responsible account of activities of health
for preparing the death certificate, workers.
certifying the cause of death, and
forwarding the death certificate to ❖ The FHSIS Manual of Operations
the health officer within 48 hours. lists and describes the following
tools:
2. Health Records and Reports
★ As specified by Executive Order 1. The Individual Treatment Record
No. 352 (Office of the President (ITR)
Republic of the Philippines, 1996). is the building block of the FHSIS. The
The Field Health Service record contains the date, name, address of
Information System (FHSIS) is the the patient, presenting symptoms or
official recording and reporting complaints of the patient on consultation,
system of the Department of and the diagnosis (if available), treatment,
Health and is used by the NSCB to and date of treatment. ITRs are maintained
generate health statistics. at the facility on all patients seen. Health
workers are advised not to rely on
➢ The Field Health Service client-maintained records, like the
Information System is an essential home-based mother's record.
tool in monitoring the health
status of the population at 2. Target Client Lists (TCLs) (For
different levels. monitoring)
are the second building block of the
❖ FHSIS is the basis of the FHSIS. These service records have the
following: following purposes:
➔ Priority setting by local a. To plan and carry out patient care
governments. and service delivery since midwives
➔ Planning and decision making at and nurses use TCLs to monitor
different levels (barangay. target or eligible populations for
particular health services.
b. To facilitate monitoring and ❖ Methods to Present Community
supervision of service delivery Data
activities. Purposes:
c. To report services delivered, thus 1. To inform the health team and
reducing the need to refer back to members of the community of
the ITRs to accomplish reporting. existing health and health-related
d. To provide a clinic-level database conditions in the community in an
that can be accessed for further easily understandable manner.
studies 2. To make members of the community
appreciate the significance and
3. Disease Registries relevance of health information to
➢ Listing of persons diagnosed with their lives.
a specific type of disease in a 3. To solicit broader support and
defined population, participation in the community health
➢ Data collected through disease process.
registries serve as a basis for 4. To validate findings.
monitoring, decision making, and 5. To allow for a wider perspective in
program management. the analysis of data.
6. To provide a basis for better decision
4. Census Data making
➢ It is a periodic governmental
enumeration of the population. ❖ Eight Steps to Community Health
➢ Batas Pambansa Blg. 72 provides Needs Assessment
for a national census of
population and other related data in 1. Identify and engage Stakeholders
the Philippines every 10 years (community)
(Batasang Pambansa, 1980). 2. Define the community
➢ The Philippine Statistical System 3 Collect and analyze data
(PSS) provides statistical (consolidate - tally data)
Information and services to the 4. Select priority community health
public. issues
➢ The NSCB is the policy making 5. Document and communicate
and coordinating body of the PSS, 6. Plan improvement strategies
whereas the NSO is the PSS arm 7. Implement improvement plans
that generates general purpose 8. Evaluate progress
statistics: population, employment,
prices, and family income/
expenditures.
 ❖ Graphs for Presenting Community ❖ COMMUNITY DIAGNOSIS
Data and their Uses
Community diagnosis
1. Bar Graphs ➢ It is the process of determining the
➔ To compare values across health status of the community
different categories of data. and the factors responsible for it.
Ex: Population pyramid is made up of two ➢ The term is applied both to the
horizontal bar graphs representing the age process of determination and to its
structure of the male and female population findings.
➢ It is a quantitative and qualitative
2. Line Graph description of the health of citizens
➔ To have a visual image of trends in and the factors that influence their
data over time or age. This is health.
appropriate for time series. ➢ In this phase, the health worker
For example: makes a judgment about the
➔ The trend of the total fertility rate or community's health. status,
average number of children per resources, and health action
woman in the Philippines from 1973 potential or the likelihood that the
to 2011. community will act to meet health
needs or resolve health problems.
3. Pie chart
➔ To show the percentage ❖ Proposed format by Shuster and
distribution or composition of a Goeppinger and the Omaha
variable such as population or System for Community Diagnosis:
households.
➔ Effective in highlighting the value ➢ Health risk of Specific problem to
of a group in relation to the whole which the community is exposed.
population. ➢ Specific aggregate of the community
with whom the nurse will be working
4. Scatter Plot or Diagram to deal with the risk or problem.
➔ To show the correlation between ➢ Related factors that influence how
two variables. the community will respond to the
➔ The values of both variables in health risk or problem.
subjects are plotted in a graph with
an x-axis and a y-axis.
 ❖ Comparison of Participatory 4 levels of identified problems or areas
Action Research and Traditional of concern:
Investigator- Directed Prevention
Research a. The first and most general level of four
domains:
1. Environmental
2. psychosocial
3. physiological
4. health-related behaviors.

b. The second level consists of problems

❖ Omaha System
or areas of concern under the four
domains.
➢ This is initially designed for clients
in a community setting.
● It is possible that the user of this
➢ Used as a framework for the care
system may encounter a client who
of individuals, families, and
presents an unlisted problem.
communities by nurses, nursing
educators, physicians and health
care other providers.
➢ It is a comprehensive and
research-based classification
system for client problems that exist
in the public domain.

❖ 3 components:
a. Problem classification scheme. c. In the third level, the problem or area
b. Intervention scheme. of concern is classified according to two
c. Problem rating scale for outcomes sets of qualifiers.
Area of concern (health promotion,
a. Problem classification scheme. potential problem, or actual problem)
➔ Client assessment.
➔ Serves as a guide in collecting, d. The fourth and most specific level is
classifying, analyzing, documenting made up of clusters of signs and symptoms
and communicating health needs that describe the actual problems.
and health- related strengths.
 ❖ EPIDEMIOLOGY Time Pattern
➔ May be annual, seasonal, weekly,
Descriptive Epidemiology daily, hourly or any other
➢ The study of the distribution and breakdown of time that may
determinants of health-related influence health condition or disease
states or events in specified
populations, and the application of Place Pattern
this study to the prevention and ➔ Include geographic variations
control of health problems. (urban/rural) and locations such as
➢ Distribution (frequency or pattern) schools or workplace
➢ Determinants (risk factors or Personal Characteristics
causes) ➔ Include demographic factors
➢ Prevention and control which may be related to risk of
Also: Illness, Injury or disability such as
➔ Defining the problem age, sex, marital status, and
➔ Gathering data or information socioeconomic status, behaviors
➔ Analyzing and interpreting and environmental exposures.
➔ Conclusion ❖ Also used to determine the causes
➔ Recommendation and risk factors that influence the
occurrence of health conditions and
Focuses on the frequency and pattern of diseases.
health events in a population Called DETERMINANTS
Include:
Frequency ➔ Demographic characteristics
➔ Refers to the number of health ➔ Genetics
events, such as the number of ➔ Behaviors
cases of pneumonia or DM in a ➔ Environmental exposure
population.
➔ Also refer to the ratio or rate of Analytic Epidemiology
cases in the population to ● provides answers to assess
compare health conditions or whether groups with different rates
disease occurrence across different of health conditions or diseases
populations. differ with these determinants
● These findings provide evidence
Pattern for public health control and
➔ Refers to the occurrence of health prevention measures
conditions or disease by time,
place, and person. Epidemiologic methods are used to
study both communicable and
non-communicable diseases and other
health-related states or events
Communicable diseases
➔ Are spread from one person to ❖ Uses of Epidemiology in Public
another through physical contact Health and Nursing
with an infected person, ➢ For accurate community assessment
contaminated food or water, bites and diagnosis, planning and
from insects or animals capable of evaluating effective community
transmitting the disease, and Interventions
breathing in an airborne virus. ➢ PHN uses epidemiology to describe
the distribution and extent of health
Noncommunicable diseases condition/disease in the population
➔ Are chronic diseases which are the ➢ Identity the risk factors in studying
result of a combination of genetic, natural history of diseases or models
physiological, environmental, and of disease causation
behavioral factors ➢ Monitor diseases/health conditions
rough screening and surveillance
Emerging Infectious Diseases ➢ Evaluate approaches or
interventions that reduce disease
➔ Are infections that have recently risk and promote health
appeared within a population or ➢ Used to describe the health status of
those whose incidence or population groups to determine
geographic range is rapidly priority health programs based on
Increasing or threatens to increase identified community health
in the near future. problems.
➢ Help to understand epidemic or
❖ History of Epidemiology endemic diseases to come up with
prevention and control measures.
➢ 1854-John Snow (Father of Field
Epidemiology) conducted studies of ❖ Levels of Disease Occurrence
cholera outbreaks to discover the
cause of the disease and to prevents Sporadic
its recurrence ➔ Refers to a disease that occurs
❖ Richard Doll and Austin Bradford Infrequently and irregularly
Hill Endemic
➢ 1950-linking lung cancer to smoking ➔ Refers to the constant presence and
and the study of cardiovascular usual prevalence of a disease or
disease among residents. infectious agent in a population
➢ 1980-epidemiology was extended to within a geographic area
the studies of Injuries and violence Hyperendemic
➢ 1990-related fields of molecular and ➔ Refers to persistent, high levels of
genetic epidemiology started disease occurrence
Epidemic ❖ Three models of disease
➔ Refers to an increase, often sudden, causation:
in the number of cases of a disease ● Epidemiological Triad
above what is normally expected in ● Iceberg Principle
that population in that area ● Web of Causation
Outbreak
➔ Caries the same definition of Epidemiologic Triad or Triangle
epidemic, but is often used for a ➔ is the traditional model for infectious
more limited geographic area (communicable) diseases,
Cluster consisting of a: susceptible host,
➔ Refers to an aggregation of cases an external agent and an
grouped in place and time that are environment that brings the host and
suspected to be greater than the agent together.
number expected even though the
expected number may not be known
Pandemic
➔ Refers to an epidemic that has
spread over several countries or
continents, usually affecting a large
number of people

Iceberg Principle
➔ Shows the disease situation where
the problem is subclinical,
unreported or hidden from view
➔ Public health goals is to find out
through screening and early
detection those who are exposed or
affected
❖ Models of Diseases Causation

Example of Risk Factors:

● Unsale water
● Sanitation and hygiene
● Underweight
● Unsafe sex
● High blood pressure
● Tobacco use and alcohol
consumption
Web of Causation ★ Indicator based Surveillance
➔ shows the relationship between ➔ Are routine reporting of cases of
different multiple factors that disease such as notifiable disease
contribute to the cause of a disease surveillance systems
➔ proposes that diseases are caused
by the interaction between genetic ❖ Levels of Prevention
factors and environmental factors,
personal behaviors Primordial Prevention
➔ Seeks to prevent at a very early
stage, even before the risk factors is
present
➔ Includes activities that promote
healthy lifestyles, avoiding the
development of behaviors and
exposure patterns that contribute to
❖ Screening and Surveillance increased risk of disease

Screening (healthy individuals) Primary Prevention

➔ Is the prevention through the control
➔ Is the active search or process of of exposure to risk factors, before
detection for disease or disorders disease development
among apparently healthy people ➔ Relies on epidemiological
➔ Is to identify risk factors and information to Indicate those
diseases in their earliest stage behaviors elther protective and
those that are associated with
Surveillance (Monitoring Diagnose Increased risk
individual) ➔ Health promotion activities are
actions
➔ Is the systematic, ongoing and ➔ designed to promote healthy lifestyle
analytic process of monitoring to and environment
scrutinize disease condition Involves
investigating the distribution and Secondary Prevention
possible causes of diseases and ➔ Is the application of available
condition within the population measures to detect early the disease
or health condition before the onset
★ Event based surveillance of signs and symptoms Screening
➔ For rapid detection, notification, and physical examination for early
verification and assessment of public diagnosis
health events such as cluster of ★ Mammography, cervical screening
disease regular BP monitoring
Tertiary Prevention
➔ Is managing the disease after the ❖ Analytic Observations
diagnosis to slow or stop disease
progression and limit disability or ➔ Aims to understand the quality and
complications the amount of influence and
★ Chemotherapy, rehabilitation, determinants on the occurrence of
regular blood glucose check for DM the disease

❖ Evaluating Interventions TYPES OF ANALYTIC OBSERVATIONS

Population-Based Approach ➢ Cross-sectional

➔ Interventions which attempt to ➔ Examines the relationship between
change socio-cultural or structural health problems and other variables
factors in the community ➔ Used to get baseline data determine
the magnitude the health problem or
High-Risk Approach evaluate medical care
➔ Interventions largeling those persons
who are likely to have Increased ➢ Cohort
Incidence of a disease based on the ➔ Subjects are selected based on
presence of risk factors their exposure status
➔ Followed through time to determine
❖ Types of Studies in Epidemiology their later outcome status

Observational (Nonexperimental) ➢ Case Control

● Descriptive Observation ➔ Is a retrospective study
● Analytic Observations ➔ Subjects are selected based on their
Experimental Study disease status
● Randomized Controlled Trials ➔ Look at the exposures that both
● Field Trials groups may have encountered in the
● Community Trials past

❖ Descriptive Observation ❖ Experimental Study

➔ Control factors to reveal unbiased
➔ Focuses on describing disease relationships between exposures
distribution by characteristics and outcomes
relating to time place and people ➔ Test a hypothesis about a health
➔ Done through review records, problem, disease or disease
routine data collection, ecological treatment in a group of people
surveys ➔ Used to test whether or not a
➔ Examines factors like age, sex, particular Intervention is effective
education, socioeconomic status or against a particular health conditions
availability of health services or disease
 INDIVIDUAL VITAL STATISTICS
❖ Randomized Controlled Trials Individual Records
➔ Are experiments with patients as ➔ Bitte death, montage/divorce
subjects to evaluate a potential cure ➔ Birth Records is a legal
for a disease and prevent death or documents
disability ● Name, Parentage
➔ Used for testing new Interventions or ● Birth date
drugs ● Order of birth
● Legitimacy
❖ Field Trials ● Citizenship
➔ Are experiments done in to "field" ● Nationality
Involving subjects free of the ● Geographic place of Birth
disease or health condition but at a
high risk on contracting them Death Records
➔ In this study, Intervention is listed ➢ Provides documentary proof
whether it reduces the risk of surrounding the death of the
developing the disease or condition person such as time and place and
medical cause of death.
❖ Community Trials ➢ Used for property inheritance rights
➔ Extension of the field trials involving and rights to remarry of surviving
the whole community as the unit of spouse
assignment Ex. Water treatment is
done at the community level through Marriage/Divorce records
water supplies ➔ Needed for social and economic
➔ The intervention can be evaluated programs
by Involving entire communities who ➔ Tax privileges for couples
were assigned the water treatment ➔ Alimony
➔ Change of nationality
VITAL STATISTICS ➔ Right to remarry
➢ Is the study of the characteristics
of human populations Records on Adoption, Legitimation and
Comprises of Important events in human life Recognition
like: ➔ Used for determining rights of
➔ Birth, death, fetal death, marriage, individuals (children, parents,
divorce guardians)
➔ Annulment, judicial separation, ● Individual Vital Records are also
adoption, legitimation and used in program planning (maternal
recognition and emid health services child
immunization programs epidemic
outbreak or investigations and
astètement of causes of accidents
and injuries)
 not from accidental or incidental
POPULATION VITAL STATISTICS causes.
➢ Serve as key demographic Infant Death
variables in the analysis of ➢ is the death of a liveborn infant
population size, growth and who dies before completing its
geographic distribution Population Best year of life
census can show population size Neonatal Death
and growth frends and ➢ death of a liveborn infant who dies
socioeconomic concerns (housing, during the first 25 completed days of
health, education, occupation and life.
income) Perinatal Death
➢ Death of a fetus or newborn infant
VITAL STATISTICS occurring after 22 completed weeks
➢ Analysis and interpretation are (154 days) of gestation (the time
essential in Setting largest and when fetal weight is normally about
evaluating social and economic 500g), but prior to the completion of
plans like: 7 days after birth.
➔ Monitoring of health and
population Intervention programs
➔ Measurement of Important TYPES OF HEALTH INDICATOR AND
demographic Indicators THIER EXAMPLE
Types of Heath Indicators Examples
Definition of Vital Events
Heath status Prevalence, incidence
indicators(morbidity)
Live Birth
➢ Is the complete expulsion or Heath status Crude and specific death
indicators (mortality) rate, maternal mortality,
extraction from its mother of a infant mortality, neonatal
product of conception, irrespective of mortality, postnatal
the duration of the pregnancy, which mortality, child mortality,
offers separation shows evidence of etc.
life. Population Indicators Age-sex structure of the
Fetal Death population, population
➢ Is a death prior to the complete density, migration,
population growth (crude
expulsion from ils mother of a
birth rate, fertility rate)
product of conception. Death is
indicated as separation of the fetus Indicators for the Acess to health programs
prevention of health and facilities, availability
does not breathe. care of health resources
Maternal Death
(facilities, health
➢ Is the death of pregnant womens manpower, finances)
from any course related to or
Risk reduction Causes consulting health
aggravated by the pregnancy, but
indicators provider, infant
 exclusively breastfed for
Number of people examined at that point in
the first 6 months. time

Social and economic Quantity of suspended ➔ Where F Is any number of the bose
indicators particular matter,
hydrocarbons, oxidants. 10 that is used as a multiplier to
Portability of drinking avoid ving decimals as the final
water. value of the Indicator.
➔ Incidence-measures the number of
HEALTH INDICATORS new cases, episodes, or events
➢ These are quantitative measures cuming over a specilled period.
usually expressed as rate or commonly a year within a specified
proportions that describe and population of risk.
summarize various aspects of the
health status of the population FACTOR AFFECTING PREVALENCE
➢ Also used to determine factors INCREASED BY DECREASED BY
that may contribute to a causation
and Contact of diseases, indicates Longer duration of Shorter duration of the
priorities for resource allocation, the disease disease
malfors implementation all health
Prolonged of life of High case-fatality rate
programs, and evaluates outcomes patient without care from disease
on health programs.
Increase in new Descrease in new
MORBIDITY INDICATORS cases cases
➢ Generally based on the disease
In-migration of In-migration of healthy
specific incidence or prevalence cases peopl
for the common and severe
diseases such as malaria, diarrhea Out-migration of Out-migration of cases
and leprosy. healthy people

In-migration of Impoved cure rate of

PREVALENCE PROPORTION (P) susceptible people cases
➢ Measures the total number of
existing cases of disease at a Improved
particular point one divided by the diagnostic facilities
number of people at the point in
time. Incidence
1.Prevalence can be calculated by: ➢ measures the number of new
(P)= NCD/NPE Then x F cases, episodes or events
occurring over a specified period,
Number of existing cases of a disease at a commonly a year within a specified
particular point in time. population at risk.
INCIDENT DENSITY RATE 4.Can be computed as:
➢ Computed using the total (SDR)= N/N then X 1,000
person-time at risk for the entire
cohort as the denominator Number of deaths occurring in the specific
➢ This indicate measures the overage class for a given area and time
Instantaneous role of disease
2.Can be calculated as: Number of person in the specific class of
(ID)= N/S Then x F the population for the same area and time

Number of cases that develop during the Infant Mortality Rate

period ➢ A good Index of health in a
community because infant are very
Sum of person-time at risk sensitive to adverse environmental
conditions.
Mortality Indicators ➢ Thus, a high IMR means low levels
➢ Provide Important information of the of health standards that may be
health status of the people in the secondary to poor maternal health
community and child health care, malnutrition.
➢ Mortality Rate is a measure of the
frequency of occurrence of death 5.It can be calculated as:
in a defined population during a (IMR)=D/N then X 1,000
specified interval
Death under 1 year of age in a calendar
Crude Death Rate (CDR) year
➢ The rate with which mortality occurs
in a given population Number of live birth in the same year
3.is computed as:
(CDR)= N/M then x 1,000 Neonatal Mortality Rate (NMR)
6.It can be calculated as:
Number of death in a calendar year (NMR)= N/N Then X 1,000

Mid year population Number of deaths among those under 28

days of age in a calendar year
• Factors affecting CDR include
➔ Age, sex Number of live births in the same year
➔ composition of the population
➔ the adverse environmental and Postnatal Mortality Rate(PNMR)
occupational conditions.
Specific Death Rate 7.It can be calculated as:
➢ Represents a subset of the (PNMR)= N/N Then X 1,000
population or with particular classes
of death.
Number of deaths among those under 28 POPULATION INDICATOR
days of age to less than 1 year of age ➢ Include not only the population
growth indicators but also other
Number of births in the same year population dynamics that can affect
the age-sex structure of the
➔ Neonatal mortality rate and population and vice versa.
postnatal mortality rate add up
the IMR. The reason for such CRUDE BIRTH RATE(CBR)
division is that the causes of ➢ Measures how fast people are
neonatal deaths, that is, deaths added to the population through
among infants less than 28 old are births.Measure of population
due mainly to prenatal or genetic growth.
factors. 10.It can be calculated as:
(CBR)= NR/MP Then X 1,000
Maternal Mortality Rate
➢ MMR refers to deaths due to complications Number of registered live births in a year
from pregnancy or childbirth.

Midyear population
8.Can be calculated as:s:
(MMR)=ND+NID/T then X 10,000 or ➔ A CBR greater than or equal to
100,000 45/1,000 live births implies high
Number of direct maternal deaths + Number of Indirect
maternal death in a specified time period usually 1 year fertility while
➔ A level less than or equal to
Total number of live births in the same period 20/1,000 live births implies low
Case Fatality Rate (CFR) fertility.
➢ The proportion of cases that end up
fatally. It gives the risk of dying General Fertility Rate (GFR)
among persons afflicted within ➢ A more specific rate than CBR
particular disease since births are related to the
● It is similar to an incidence segment of the population deemed
proportion because it also a to be capable of giving birth, that is
measure of average risk the woman in the reproductive age
9.It can be calculated as: groups.
(CFR)=N/N Then X 100 ➢ Gives a more specific rate than
CBR since births are related to
Number of deaths from a specified cause women of reproductive age
(15-49 yo)
Number of cases of the same disease ➢ High fidelity rafe is indicated by
GFR of 200/1000
➢ Low fertility rate is GFR of
60/1,000 women
11.It can be calculated as:
(GFR)= NR/MW Then X 1,000 Observation of single events or clusters
➢ Surveillance reports of cases of
Number of registered live births in a year communicable disease.
➢ Reviewing exposure information
Midyear population of women 15-49 years from individual case report to look
for common factors can uncover
Population Pyramid infections related to particular
➢ Graphical representation of the exposures.
age sex composition of the ➢ Reviewing laboratory patterns of
population The shape of the pyramid organisms can sometimes detect
provides Insights into the fertility and clusters of diseases.
mortality patterns of the population
as well as the health services. Reports from patients or members of the
community
➢ Another reporting source for
apparent clusters of disease or
health condition is patients or
members of the community.

Factors Affecting Disease Outbreak

Investigation
Conducting Epidemiological
Investigations Disease or health problems
Defining Disease Outbreak ➢ Factors related to the problem itself
➢ One of the core functions of include:
epidemiology is detecting disease ➔ the severity of the illness
outbreaks ➔ the number of cases
➢ Disease Outbreak defined as the ➔ the source, mode or ease of
occurrence of cases of disease in transmission, and
excess of what would normally be ➔ the availability of prevention and
expected in e defined community, control measures.
geographical and or season.
Review of surveillance data Health department
➢ Outbreaks may be detected during ➢ Availability of staff and resources,
regular conduct and timely analysis and competing priorities are also
of surveillance data. some of the factors in deciding to
➢ Such data could reveal an investigate or not.
increased reported cases or an ➢ Some health departments have a
unusual clustering of surveillance by practice of aggressively investigating
time and place. outbreaks
 ➢ while other health departments may PLANNING
lack such experience. ➔ Is a logical process of decision
making to determine which of the
External concerns identified health concerns requires
➢ Other external concerns to more immediate consideration
conducting outbreak investigation (priority setting) and what actions
include: may be undertaken to achieve goals
1. control or prevention of the health and objectives.
problem
2. opportunity to learn or do research, Planning Phase
3. public, political, or ➔ Active participation of the people
➔ To foster participation, the
Steps in Disease Outbreak Investigation community should have genuine
representation in the planning group.
➔ Prepare for field work ➔ Deciding on community
➔ Establish the existence of an representatives will be facilitated if
outbreak the community has been organized
➔ Verily the diagnosis earlier.
➔ Construct a working case
definition Planning Phase involves:
➔ Find cases systematically and 1. Priority setting
record Information 2. Formulating goals
➔ Perform descriptive epidemiology 3. Deciding on Community Interventions
➔ Develop hypotheses
PRIORITY SETTING
Evaluate hypotheses epidemiologically Criteria to Decide on A Community Health
➢ As necessary, reconsider, refine, Concerns for Intervention (Suggested by
and re- evaluate hypotheses WHO).
Compare and reconcile with laboratory ➔ Based on the number of people
and environmental studies affected
1. Implement Control and prevention ➔ Disease-Prevalence rate
measures ➔ Potential Problems estimating the
2. Initiate or maintain surveillance lumber of people at risk of
3. Communicate findings developing the condition

Planning Community Health 1. Significance of the problem

Interventions Under in significance of the problem:
➔ Based on findings during ➔ Based on the number of people
assessment and formulated nursing affected
diagnoses. ➔ Disease-Prevalence rate
 ➔ Potential Problems estimating the manner of reconciling differences of
lumber of people at risk of opinion.
developing the condition ➢ Shuster arid Goeppinger (2004)
suggested a flexible process using
2. The level of community awareness and the nominal group technique
the priority its members give to the health wherein each group member has an
concerns equal voice in decision making,
thereby avoiding control of the
3. Ability to reduce risk process by the more dominant
➔ is related to the availability of members of the group.
expertise. ➢ This technique is appropriate for
brainstorming and ranking ideas,
4. In determining cost of reducing risk when consensus building is desired
➔ The nurse has to consider over making a choice based on the
economic, social, and ethical opinion of the majority.
requisites and consequences of Steps as suggested by Shuster &
planned actions. Goeppinger:
1.From a scale of 1 to 10, 1 being the
5. Ability to identify target population lowest, the members give each criterion a
➔ for the Intervention is a matter of weight based on their perception of its
availability of data resources. degree of importance in solving the
➔ FHSIS, census, survey reports, case problem.
finding or screening tools. 2. From a scale of 1 to 10, 1 being the
lowest each member rates the criteria in
6. Availability of resources terms of the likelihood of the group being
➔ to intervene in the reduction of risk able to influence or change the situation.
entails technological, financial. and 3. Collate the weights and ratings made by
other material resources of the the members of the group
community, the nurse, and the 4. Compute the total priority score of the
health agency. problem by multiplying collated weight and
rating of each criterion.
Priority Setting 5. The priority score of the problem is
● Provides the nurse and the healthy calculated by adding the products obtained
team with a logical means of In step 4.
establishing priority among the 6. After repeating the process on all
identified health concerns. Identified health problems, compare the
● Priority setting process requires the total priority scores of the problems.
joint effort of the community, the 7. The problem with the highest total priority
nurse, and other stakeholders such score is assigned top priority, the next
as the members of the health team. highest is assigned 2nd priority, and so on.
➢ The group defines guidelines for
discussions. particularly on the
Implementing community health ideas for the nurse on how to get started in
interventions partnership and collaboration work:

Importance of Partnership and ★ is essential for nurses to involve

collaboration stakeholders in the process of
➢ The Aim of Partnership and forging partnership and collaboration
collaboration is to get people to work with the community.
together in orde to address problems ★ In working together, the nurse and
or concern that affect them it gives the community face risks Ingethes. It
people the opportunity to learn skills is important therefore, that they need
in group relationship to know and trust each other.

➔ Interpersonal relations PROBLEM —--------- SOLUTION

➔ Critical analysis ➔ Determine how each organization
➔ Decision-making process in the views the problem, how it proposes
context of democratic leadership. to solve the problem and how it
perceives an organizational
★ The community health nurse cannot relationship can help solve the
solve the problems alone. problem.
★ They must work with other people or
groups to increase the probability of ➢ Organizations should agree on the
accomplishing the goals that they kind or level of relationship that will
have set. help best accomplish the group
★ As the saying goes, there is strength goals considering needs and
in numbers. available resources.

The nurse must plan, establish and maintain Community Organizing and Social
an invaluable working relationship with Mobilization
people such as people's organizations,
health organizations, educational Community Engagement
institutions, their local government units, ➔ Both Alma-ata and Astana
financial institutions, religious groups, social declarations emphasized the
civic organizations, sectoral groups and the importance of people's participation
like. in healthcare
● Education
The aim of partnership and collaboration is ● Employment.
to get people to work together in order to ● Sanitation
address problems and concerns that affect ● Access to Services
them. ➔ Social Determinants of Health
➔ Social movement that aims to
Activities involved in Collaboration and transform current realities affecting
Advocacy The following are the general people's health.
Principles of Community Engagement resources) that will enable the
1. Clarity of purpose people to improve their standards
2. Knowledge of living and overall quality of life.
3. Relationships ➢ Community development is the end
4. Respect of Self-Determination goal of community organizing and
5. Partnership all efforts towards uplifting the status
6. Diversiły of the poor and marginalized.
7. Community Assets ➢ Entails a process of assessment of
8. Flexibility/Sharing Control the current situation the identification
9. Commitment of needs
➢ deciding on appropriate s of actions
Community Development courses or response
➔ Is a concept that can be viewed as a ➢ mobilization of resources to address
process and an outcome these needs, and
➢ monitoring and evaluation by the
➢ Process-entails people's active people.
participation in bringing about
solutions to problems collectively Characteristics of Community
identified Development
➢ Outcome-It speaks of a state in • It is a process for implementing change
which people enjoys better health A program of specified activities
through their own efforts or to a • An outcome
broader sense better quality of life. •An ideology of action

➔ Is a practice-based profession and Community Organizing and Social

an academic discipline that Mobilization
promotes participative democracy, ➔ Community organizing work is
sustainable development. rights carried out by the nurse with the
economic opportunity, equality and goal of motivating. enhancing and
social justice, through the seeking wider community
organization, education and participation and decision-making in
empowerment of people within their activities that have the potential to
communities. impact positively on community
➔ As a vital tool of affecting change to health.
improve people's health by fostering ➔ The nurse's efforts are directed
communication and collaboration towards organizing and mobilizing
among Individuals, groups and the people to initiate and sustain
organizations. changes as a group or as an
organization.
➔ The people act not as Individuals but
➢ means improvement access to as members of these groups or
resources (including health organizations.