A. Healthy Community 1. Prompt its members to have a high degree of awareness that we are community. 2.

Uses its natural resources while taking steps to conserve them for future generations. 3. Openly recognizes the existence of subgroups and welcomes their participation in community affairs. 4. Is prepared to meet crisis. 5. Is a problem-solving community; it identifies, analyzes & organizes to meet its own needs. 6. Has an open channel of communication that allows information to flow among all subgroups of its citizens in all directions. 7. Seeks to make each of its systems resources available to all members of the community. Functions of a community a) To provide shelter, housing and regulate the use of space. b) To provide employment, means of livelihood c) To provide protection, safety and security d) To facilitate the distribution of goods and services e) To ensure the education of children and newcomers. f) To provide opportunities for interaction g) To ensure the transmission of information, ideas and beliefs h) To create and enforce rules or standards of behavior. B. Components of a Community The Core represents the people that make up the community 2. Eight (8) Subsystems of the community a. Housing Education These includes laws, regulations, facilities, who utilizes these, what informal educational facilities and activities exist in the community
1.

b. c.

d.

e.

f. g.

Fire and Safety fire protection facilities and fire prevention activities, distribution of these. Politics and government political structures present in the community, decision-making process / pattern leadership style observed, etc Health health facilities and activities: distribution, utilization, ratio of providers to clientele served; priorities in health, programs developed, etc. Communication systems, types of communication existing, forms of communication, be it formal or informal, etc. Economics occupation, types of economic activities, income, etc. Recreation recreational activities/facilities: type, consumers, appropriateness to consumers, etc.

Elements of A Healthy Community 1. People are partners in health care 2. People work together to attain goals 3. Physical environment promotes health, safety, order and cleanliness 4. Safe water and nutritious food. 5. Families provide members with basic needs 6. Available, affordable health care Factors that affect community health 1. Political 2. Socio-economic 3. Heredity 4. Environment 5. Behavior 6. Health Care Delivery System

C.

Health Statistics Definition of Terms Vital Statistics is the application of statistical methods and techniques to the study of vital facts, such as those concerning births, deaths and illness. Health Indicators A list of information which would determine the health of a particular community like population, crude birth rate, crude death rate, infant and maternal death rates, neonatal death rates and tuberculosis death rate Rate a relation indicating the number of times a certain number of exposures to the risks of occurrence are present in a given period of time. A figure that describes the probability of occurrence of some event. Ratio a figure that indicates the relative size of two numbers. Population an aggregate or group of people under study. Midyear Population the population of the area under study as of July 1 (mid-year) of a calendar year. Examples of health indicators 1. Fertility / Birth Rates 2. Mortality / Death Rates 3. Morbidity / Sickness Rate

Implications of Health Statistics to Individual, Family and Community Vital statistics, which is concerned mainly with the study of births, illnesses and death occurring in a defined population for a specified time period, is an indispensable tool in planning, implementation, and evaluation of any health program. They serve as indices of the health program They serve as indices of the health conditions obtaining in a community or population group, provide valuable clues as to the nature of health services or actions needed and serve as basis for determining the success or failure of such services / actions. Heath personnel share with the community they serve the responsibility of planning and taking the necessary actions to solve the latters health problems. Further more, they are expected to be able to maintain accurate and updated statistical records and reports D. Community Health Development Process Community Development - a process designed to create conditions of economic and social progress for the whole community with its active participation and the fullest possible reliance on the communitys initiative Approaches to Community Development a. Welfare/Dole=Out Approach b. Modernization Approach c. Participatory Approach Community Health Care Process a. Assessing Community Needs 1. Methods of Assessment 2. Data needed for Community Diagnosis

b. Community Diagnosis - the process of community diagnosis consists of collecting, organizing, synthesizing, analyzing and interpreting health data Types of Community Diagnosis a. Problem Oriented Assessment type of assessment that responds to a particular need. b. Comprehensive Assessment aims to obtain general information about the community. Steps in the Community Diagnosis Process a. Determining the objectives b. Defining the study population c. Determining the data to be collected d. Collecting the data e. Developing the Instrument f. Actual data gathering g. Data collation h. Data presentation i. Data analysis j. Identifying the Community Health Nursing Problems k. Priority-setting Categories of Community Health Problems a. Health status problems described in terms of increased or decreased morbidity, mortality, or fertility b. Health resource problems described in terms of lack of or absence of manpower, money, materials or institutions necessary to solve health problems c. Health related problems described in terms of existence of social, economic, environmental and political factors that aggravate the illness-inducing situations in the community Application of Public health tools in community health nursing

Demography a. Population Size Natural increase = no. Of births no. of deaths Rate of natural increase = crude birth rate crude death rate b. Population composition - Sex composition - Age composition - Age and sex composition c. Population distribution Urban rural Crowding index Population density Role and Activities in Community Health Care Development a. recorder b. reporter c. documentor d. Researcher Qualities of a Community Health Worker 1. Open minded 2. Tactful 3. Objective 4. Good listener 5. Efficient 6. Flexible 7. Critical thinker Functions of a community health worker 1. Community Organizer 2. Educator 3. Health Care Provider

Guidelines in Conducting a Community Health Teaching 1. Choosing a Topic Choose a topic that is significant and relevant to the community at a particular period Involve the community in choosing the topic they want to learn The teaching must begin with what the people know and what they do at present. Correct notions and practices can be reinforced and wrong ones corrected 2. When and Where to Hold Sessions Consult the people about the most convenient schedule that will not disrupt them from their usual activities Find a place that is most accessible to all participants. The Barangay Hall or the house of a participant or leader may be used 3. Preparation of materials Make sure that all visual aids are ready for use and are arranged in order. This will also guide you in the teaching proper Illustrations must be close to the day-to-day experiences of your audience. Make it as simple as possible 4. Review or Dry-Run So that you will already have a feel of what is going to happen. This will also give you a chance to check on your visuals and to prepare for possible questions, which may be asked during the actual teaching session. Make sure that all words and spoken, are clear and simple

5. Groundworking Inform the target participants individually, if possible, at least a week before your scheduled activity. Give the time, date, place and the topic to be discussed and what to bring, if any. This will help them prepare 6. Teaching Proper Make the session and as simple as informal as possible Use words that are easy to understand and as familiar to them Make sure that the participants hear, see and understand the message that is being shared with them. Talk, write or present the message clearly and simply Use as few words as possible. Encourage participation. Ask questions Demonstrate procedures and have participants demonstrate back what you have taught. Listen and pay attention to what the people tell you. Encourage them to speak freely. Do not stop, interrupt or begin to argue with them. It is also good to summarize. Get feedback from the participants after each health teaching. 7. Evaluation / Reflection After conducting the community health teaching, look back to what had just transpired

Records vs Reports Health Records are written information about the health of the people. These includes records of: Births Deaths Illnesses or injuries Other health activities Health reports are the information you write and send to your health team and barangay council The monthly report consists of: a. A health report containing the following information: Number of births and deaths Kinds and number of illnesses or injuries Other health activities Comments of the community committee b. Drugs and supplies report containing the following information: Name of item (medicine, gauze, cotton, etc.) Number of item used during the month Number of item remaining Number of item needed for next supply Helping Out in the health Center As a Community health worker, you must remember that you are a member of a team. Each member has a special skills and responsibilities and must work together with the team to make sure that health care reaches the people in the community You must keep in touch with the other members of the health team in the Health Center You should try to know well the other community health workers, especially at the Health Center. In this way, you will be able to:

o Keep them informed about your problems in the community and discuss and solve these with them o Call on them for help when needed o Increase your knowledge and skills as Health Worker through sharing of information The Health Center is also a place for holding regular team meetings where: New problems are identified and solved Progress can be evaluated Relationships can grow among members How and When to Refer a Patient Seek medical help at the first sign of a dangerous disease. Do not wait until the person is very serious before referring her/him to the hospital. Ask the person or her/his relatives what happened and examine her/him carefully and completely. Write down your findings, if possible, on your logbook. Accompany the sick person to the hospital. Inform the doctor about the patients history; your findings and what first aid measures or medicines were given to the patient. A community Health Worker must attend to persons who are dangerously sick or injured in an accident and need immediate care. Situations that need immediate care: Loss of consciousness Severe pain in the belly Shock A woman in labor Convulsion Dehydration Poisoning Too much bleeding

 Fracture/dislocated bones Snake bite

The Community Health Plan Planning skills are useful not only for the Community Health Workers, but also for the community. Involving the community in the planning process helps the people to: Learn about their own health and the health of the community. Become willing and capable of making decisions about their health. Become more committed to support and value their plans Become self-reliant because once the skills have been learned and practiced, the community will be able to take the initiative in planning their own programs and activities. The Community Health Worker gathers information about the community, the people and the common illnesses in the community. In doing this, she/he gets to know the people better, and in the process, gains their confidence. Stages of Health Planning 1. Identifying and understanding the problem Meetings and discussions with individuals and groups in the community are useful in helping people understand the problems they face. As members of the community learn more about their problems, they will be able to organize themselves into action. 2. Planning

 For a program to succeed, the community must know clearly what they want to do and how they are going to do it. On a basis of the information gathered, people can work out which problems they will try to solve first. They can then identify the steps in solving this problem. They also identify resources (human and material) that can be used in solving the health problem. These resources can come from the community or from outside. Some examples of the many kinds of resources within the community 1. Places to hold meetings, discussions and training, sessions (school, barangay hall, and other) 2. Labor from able-bodied people 3. Transportation (jeeps, bicycles, and boat) to carry or ferry materials for projects. Some examples outside the community: 1. Drilling materials for well construction 2. Seedlings for reforestation from the Department of Environment and Natural Resources. 3. Implementation In implementing plan, it is important to remember 3 things What will be done Who will do the task? When will it be undertaken A timeframe is useful in checking whether the program is progressing as scheduled. A copy of the timeframe can be put up in the barangay hall or in a place where people can see it Assigning tasks:

 Make sure that as many people participate as possible. Setting target dates: Be realistic when setting target dates for various tasks. People will be disappointed if they set a schedule that is too short for the actual completion of the assigned task. 4. Monitoring Hold regular meetings to review programs and see if the program is progressing as scheduled Look into the problem if there is a delay in the implementation of the program As a Community Health Worker, keep in touch with people and give them encouragement. 5. Evaluation At the end of the program, a final meeting can be held to know if the program has been successful or not. Discussing such questions will help the people evaluate and learn from their mistakes as well as successes; and identify alternatives / recommendations for future actions. How to Mobilize the Community? Health programs and projects should not be imposed on the community. The people should participate from the beginning in identifying their problem and in deciding what steps to take to solve this problem. You need the peoples active involvement to mobilize a community. As a Community Health Worker, you educate people to develop critical awareness of existing conditions and work with people to solve their problems. The main reason for creating awareness is to challenge the people to take action so that they can improve their situation.

 As a facilitator, the Community Health Worker is expected to mobilize the peoples interest and participation The benefit of active community participation: It raises the peoples morale and feeling of self-worth. It promotes a sense of belonging to the community. It makes people committed to health work because they: Take responsibility for their own health Become more aware of the changed needed Increase their knowledge and skills on health and health-related issues It contributes to the wider development of the community and improves the quality of life. It enhances the delivery of health services by strengthening the links between the community and the health team