INTRODUCTION OF COMMUNITY HEALTH NURSING IN MALAWI

The presentation highlights the genesis of community health nursing

1. INTRODUCTION TO COMMUNITY HEALTH NURSING

2. Definition of terms COMMUNITY is from a Latin word “COMMUNIS” which means “common”. A community is a social group determined by geographical 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, values and social institution.”

3. Community is a collection of people. Community is a place. Community is a social system. Community is a highly important habitat of man. Health is related to individual, but concerted and cooperated effort to people in the community is needed for individuals health.

4. Health A state of complete physical, mental and social wellbeing not merely the absence of disease and infirmity- WHO It includes other dimensions such as physical, emotional, social, intellectual, spiritual and occupation Health is dynamic in nature which results in a person’s ability to adapt to his or her environment

5. Definition of Community Health Refers to health status of a defined group of people, and the actions and the conditions both private and public to protect, promote and preserve their health It can also be defined as a field within public health concerned with the study and improvement of the health of biological communities. Example: Community health tends to focus on geographic areas rather than people with shared characteristics.

6. Community Health Nursing A special field in nursing that combines the skills of nursing, public health and some phases of social assistance and some functions as part of total public health program for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability .

7. is a synthesis of nursing practice and public practice applied in promoting and preserving the health of population. The nature of this practice is general and comprehensive. It is not limited to a particular age or diagnostic group. It is continuous and not episodic. The dominant responsibility is to the population as a whole

8. Therefore, nursing directed to individuals, families or groups contributes to the health of the total population. Health promotion, health maintenance, health education, co-ordination and continuity of care are utilized in a wholistic approach to the management of the health care of individual, family, group and community.

9. Concepts of community health nursing Concepts of community health nursing involves: Healthful community. Empowerment for health promotion. Prevention of premature death Prevention of diseases, illness and disability. Promotion and maintenance. Rehabilitation

10. Philosophy of Community Health Nursing Philosophy of individual’s right of being healthy. Philosophy of working together under a competent leader for the common good. Philosophy that people in the community have potential for continued development and are capable of dealing with their own problems if educated and helped. Philosophy of socialism.

11. Objectives of Community Health Nursing: To increase capability of individuals, families, and groups and community to deal with their own health and nursing problems. To strengthen community resources. To control and counteract environmental problems. To prevent and control communicable and non-communicable diseases . To provide specialized services for mothers, children, adults, workers, elderly handicapped and eligible couples etc.

12. To conduct research and contribute to the further refinement and improvement of community health nursing practice. To participate in preparing health personnel to function in community for community health care services. To supervise, guide and help health personnel in carrying out their functions effectively.

13. CHN as a science ANA defines CHN as a synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations It uses scientific knowledge , methods and tools to gather knowledge It has theoretical grounding and uses logical reasoning

14. It has specific language or terminology eg ( outreach, growth monitoring) It observes and describes phenomena in real life It synthesizes, classifies and organizes facts

15. CHN as a Science cntd Empirical verification of statements and assumption- its statements are based on scientific knowledge , supported by research

16. Public Health Public health is defined as the science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency through organized community efforts focused towards: Maintaining a sanitary environment Controlling communicable diseases Providing education regarding principles of personal hygiene

17. Public health ctd Organizing medical and nursing services for early diagnosis and treatment of disease Developing social machinery to ensure every one a standard of living adequate for health maintenance , so organizing these benefits as to enable every citizen to realize his birth right of health and longevity

18. CHN VS PUBLIC HEALTH CHN PUBLIC HEALTH -Deliver health services to individuals, groups, and families  -Diagnosis is based on the needs of individuals, family, or group -Work to promote health and prevent illness in groups and families with the main goal being to increase community health. For example, meeting with a group of young mothers to provide information on immunizations. -Implementation is based on individual needs. For example, a new diabetic who is a kinesthetic learner would be taught how to give insulin injections by practicing with an orange. -Evaluate whether health needs were met on the individual, family or group level.   -Assessing the populations health needs -Diagnose and develop policy in relation to community health needs. -Plan for the community as a whole in order to prevent disease and disability and preserve the health of the community. For example, after an illness outbreak, the public health nurse will assess the need and develop a program for an immunization clinic. -Implementing the plan means the nurse ensures the resources are available to all who need them within the community. -Evaluate the health status of the whole community and whether planned goals and objectives were met.  

19. Characteristics of Community Health Nursing A specialty field of nursing, CHN adds public health knowledge and skills that address the needs and problems of the communities and aggregates and focuses care on communities and vulnerable populations. CHN is grounded in both public health nursing and nursing science. Recognition of the specialty continues with a greater awareness of the important contributions made by CHN to improve the health of the public

20. Characteristics of Community Health Nursing ctd CHN combines nursing science with public health science to formulate a community based and population focused practice. During the first 70 years of 20th century in (1900 – 1970), community health nursing was known as public health nursing (Shah, 2010).

21. HOW CHN DIFFERS FROM OTHER SPECIALITIES It is nursing without walls- it is practiced in the hospital as well as outside the hospital it is community focused, family and group oriented Its nurses are specialized The nurse has advanced physical assessment skills, prepared to exercise independent and corroborative judgment in management of patients/clients

22. Emphasizes on the health of the population as a whole CHN adresses Both personal and environmental aspects of health Community health factors that facilitate health living eg peace stability, social life etc

23. CHN enters and practices within the environment in which people live CHN philosopy and scope of practice focuses on providing preventive health of individuals and groups within the community Community health nursing is general and comprehensive, and not limited to a particular age group or diagnosis

24. Community health nurse works with clients across life span (individuals, families, groups) The CHN is committed to improve health the health of the community by identifying subgroups who are at high risk of illnesses, disability and premature death and directing resources towards these groups (e.g. advocating for condoms for the people who work on road constructions)

25. Words like ‘client’ or ‘consumer’ rather than patient are used in CHN because they reflect sense of wellness The words denote active and independent relationship in contrast to passivity denoted to the client The clients participate in assessing needs, planning and implementing preventive health care

26. Community health nursing synthesizes nursing and public health practice