Community involvement and role of community health nurse

Community involvement, community participation, community leaders and their roles, role of community health nurse

1. Community involvement and role of community health nurse By ms R adha Rana ( Student of Rajkumari Amrit Kaur college of nursinG)

2. Introduction The health of individuals living in a defined community is not only their “right” but also their “responsibility” to take care of their own health and also of community at large. Community involvement and participation is recognised as one of the crucial supportive approach for the successful implementation of community health services.

3. Definition Community involvement is defined as the type of community participation in which the community is involved in all aspects of a programme.

4. Importance of community involvement For successful health services Opportunity to people to identify health needs Active involvement of community Community to identify available resources To make informed decisions

5. 6. Sense of responsibility and accountability to the community 7. Community to develop self realiance And social control

6. Community health workers Community health workers (CHWs) are frontline public health workers who have a close understanding of the community they serve. This trusting relationship enables them to serve as a link between health services and the community to facilitate access health services and improve the quality and cultural competence of service delivery.

7. Community health workers typically have deep roots or shared life experiences in the communities they serve. They share similar values, ethnic background and socio-economic status and usually the same language as the people they serve.

8. Functions of community health workers Linking people to health care/social service resources Providing informal counseling, support and follow-up Advocating for local health need Making home visits to chronically ill patients, pregnant women and nursing mothers, individuals at high risk of health problems and the elderly Helping people understand their health condition(s) and develop strategies to improve their health and well being

9. Helping individuals, families, groups and communities develop their capacity and access to resources, including health insurance, food, housing, quality care and health information

10. Services participation For Children Immumization and vitamin A prophylaxis Iron folic acid supplementation to child with anemia Deworming to prevent hookworm infestation Managementt of diarrhoeal diseases= preparation of ORS, increasing fluids, normal diet, recognise when to seek medical help. Help prevent deaths due to pneumonia

11. For Mothers Immunization Prevention and treatment of anemia Antenatal care and early detection of maternal complications Felivery by trained personnel Promotuon of institutional deliveries Birth spacing

12. Examples of community involvement ASHA (accredited social health activist) Village health guide Anganwadi workers Birth attendents

13. Asha Honorary trained community healthcare volunteer A link between community and rural healcare system Roles Create awareness Counsel for safe delivery, breastfeeding etc Mobilization of community and resources Primary medical care for minor ailments

14. Village health guides

15. Functions of village health guides Village health guides is a person with an aptitude for social service and is not a full time govt. Functionary. She should be a permanent resident of local community . There is 1 village health guide over 1000 population They provide simple treatment for common minor ailments, first aid during accident and emergency ,care to mother And child including family planning, health education etc.

16. Anganwadi workers Is under ICDS scheme, 1 over a population of 1000 Selected from the community, undergoes training in various aspects of health, nutrition, child development etc. Roles Promote and encourage community participation Provide minor ailments treatment Care to mother and child First aid during emergency, accidents etc

17. Birth attendents Works under supervision and guidance of female healcare worker. Roles personal and skillful care during perinatal period Health education on childcare, immunization, nutrition, family planning etc

18. Activities of dai Looking For the registration of antenatal mothers in her Village. Attending weekly prenatal clinics and assist ANM Ensure that Every pregnant woMan in the area attend the prenatal clinics Atleast 3 times I.e 3 rd , 7 th and 9 th months Try to ensure TT immunization of antenatal mothers of her area Should ensure that every antenatal mothers is taking Fe supplimemts Report any abnormalities in the pregnancy if any, report to nearby PHC Proper preparations for delivery

19. If she finds any abnormalities during the labour,, she must seek medical aid without any delay When she receives a call for delivery, she must Watch progress of delivery carefully Allow labor to progress Normally without any unnecessary Interference She should Ensure the complete immunization of the babies in her area She should motivate the eligible couples for contraception And to undergo sterilisation Report all births and deaths of her area to the ANM.

20. Role of community health nurse

21. There are inumerable roles which are performed by community health nurses working in various community health settings.

22. Care provider

23. It includes activities for the provision of direct nursing care She also supervise guides and teaches Community participants, family to access to the available healthcare services

24. Educator

25. She educates individual, families and community not only when they are sick but also when they are well but require help to promote health and prevent illness with The help of community participants

26. Leader

27. She leads the group by giving them directions , ensuring biway communication with the community participants, providing supervision and guidance and by coordinating their activities and infrastructure.

28. Change agent

29. She is able to make others more effective by increasing their capacity to Cope up with their health problems Provide care to themselves

30. Advocate

31. As an advocate, CHN stands between the individual/ family/community and various specialised services. She pleads for their cause by speaking , acting on their behalf. She explains to them about the various services available and guide them how to utilize the services .

32. Councillor

33. Community health nurse helps the community to find the solutions to their problems. As a councillor, She helps the community to recognise and understand their problems to be solved, identify the solutions within resources And implement the solution with help of community participants

34. Observer

35. The community health nurse observe and report the environmental and home condition of the community to be served. All health services to the community rely on observation skills of nurse.

36. Manager

37. As a manager, she plans, organises, coordinates, supervise, guides and directs Various health programs with the team members, and community participants. If there is any problem which she identify, if necessary she have to report it to the higher authorities.

38. Evaluator

39. Once any health services/ program is implemented, it is the responsibility of the community health nurse to monitor and evaluate the plan to make sure whether it is proceeding in its direction or not.

40. Adviser

41. There are Some practical situations which require regular Actions in the form of advises to be given to the community. Eg. Regular intake of iron supplements by the antenatal mother’s.

42. Collaborator

43. Community health problems cannot be solved by a single health worker. It involves community participants with whom she works together as a team. Each member in the team has a unique role and specific responsibilities in meeting health needs and promoting community participation.

44. RefErer

45. Making refferals of community people who is in need of medical help that can’t be fulfilled in the community settings and needs to referred to the higher centres is an essential part of community health nursing.

46. Research

47. Topic= Remuneration Systems of Community Health Workers in India and Promoted Maternal Health Outcomes: A Cross-Sectional Study Author= Hannah j. Kohen Et Al. Bmc health services Researcher

48. Background : This study assessed the association of remuneration systems of paid-for-performance Accredited Social Health Activists (ASHAs) and salaried Anganwadi workers (AWWs) on seven maternal health outcomes in four states in India: Andhra Pradesh (AP), Chhattisgarh, Odisha (Orissa), and Uttar Pradesh (UP) .

49. Methods :  The cross-sectional study surveyed mothers of children aged 6-23 months. A total of 3455 mothers were selected via multistage cluster sampling. The seven health outcomes related to the community health worker (CHW) visits were: institutional delivery, complete immunization, exclusive breastfeeding for six months, timely introduction of complementary feeding, continued breastfeeding during child's illness, handwashing, and awareness of Nutrition and Health Days (NHDs).

50. Results :  The results varied by state. Mothers who received ASHA visits were significantly less likely to have an institutional delivery, timely introduction of complementary feeding, awareness of Nutrition and Health Days (NHDs), proper handwashing, and exclusive breastfeeding for the first six months in at least one of the four states. Conversely, AWW's home visits were positively predictive of the following health outcomes in certain states: complete immunization for index child, continued breastfeeding during the child's illness, handwashing, and awareness of NHDs.

51. Conclusions : ASHAs' home visits were not more strongly associated with health outcomes for which they were paid than outcomes for which they were unpaid. AWWs' home visits were positively associated with awareness of NHDs, and associations varied for other recommended health behaviors. Further research could elucidate the causes for successes and failures of CHW programs in different states of India.