UNIT –I community health CHN P.B.Sc ppt.pptx

Community health nursing is a specialized field that combines nursing practice with public health principles to promote the health of populations by working with individuals, families, and communities. These nurses focus on preventive care, health education, and managing chronic diseases in community settings like homes, schools, and local health departments. Their goal is to improve overall community well-being through health promotion, disease prevention, and addressing health inequities by removing barriers to health.

1. Prof. Dr. Anjalatchi Muthukumaran Vice principal and nursing supt Era college of nursing , ELMCH Era university UNIT –I INTRODUCTION TO COMMUNITY HEALTH NURSING P.B.SC-II CHN

2. To Describe the Concepts of community health nursing Total hours -06 LEARNING OBJECTIVES

3. Introduction * Introduction to community health –Concepts, Principles and elements of primary health care. * Introduction to community health nursing. * Concepts of community health nursing –community nursing process. * Objectives, scope and principles of community health nursing. Content of the unit -1

4. Introduction Abbreviation Terminology Definition Aim/goal objectives Concepts Scope Principles Elements Primary health care Summary References To lead for discussion

5. Outline of the topic today

6. Community Its a group of people with common characteristics or interests living together within a territory or geographical boundary place where people under usual conditions are found Derived from a latin word “ comunicas ” which means a group of people Introduction

7. OLOF (Optimum Level of Functioning) Health-illness continuum High-level wellness Agent-host-environment Health belief Evolutionary-based Health promotion WHO definition of health Health

8. Definition of health by WHO

9. Is the fundamental right of every human being. It is the state of integration of the body and mind Health and illness are highly individualized perception. Meanings and descriptions of health and illness vary among people in relation to geography and to culture. Health  – is the state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. (WHO) Health  – is the ability to maintain the internal milieu. Illness is the result of failure to maintain the internal environment.(Claude Bernard) Health – is the ability to maintain homeostasis or dynamic equilibrium. Homeostasis is regulated by the negative feedback mechanism.(Walter Cannon) Health  – is being well and using one’s power to the fullest extent. Health is maintained through prevention of diseases via environmental health factors.(Florence Nightingale) Health – is viewed in terms of the individual’s ability to perform 14 components of nursing care unaided. (Henderson ) Health definition

10. Positive Health  – symbolizes wellness. It is value term defined by the culture or individual. (Rogers) Health  – is a state of a process of being becoming an integrated and whole as a person.(Roy) Health  – is a state the characterized by soundness or wholeness of developed human structures and of bodily and mental functioning.(Orem) Health – is a dynamic state in the life cycle; illness is interference in the life cycle. (King) Wellness – is the condition in which all parts and subparts of an individual are in harmony with the whole system. ( Neuman ) Health – is an elusive, dynamic state influenced by biologic, psychologic , and social factors. Health is reflected by the organization, interaction, interdependence and integration of the subsystems of the behavioral system.(Johnson) Continued

11. Community health assessment

12. Introduction “Community health nursing is a synthesis of nursing practice applied in promoting and preserving the health of the population. Community health implies integration of curative, preventive and promotional health services. The aim of community diagnosis is the identification of community health problems. Remarkable development in public health was successful control of many communicable diseases. Nursing and medical services were strengthened to promote positive health. Now a days more emphasis is focused on the sick to the well person, from the individual to the community. To attain  Health   For All  through  Primary Health Care  led to   the restructuring of the rural health services. At present Public health nurses are called as Community health nurses who are registered nurses (RN) trained to work in public health settings. It includes nursing services in all phase of health services which is organized for the welfare of the community. In 1958 Indian Nursing Council has integrated Community health into basic curriculum in nursing. Community Health Nurse (Village Health Nurse, Sector Health Nurse, and Community Health Nurse) is responsible for her defined area of work in the provision of community health services. Community health nursing introduction

13. Community Health nursing Definition  It is a synthesis of nursing and public health practice applied to promoting and preserving the health of the people. ·Public health: It is the art and science of preventing illness, prolonging life and promoting through organized efforts of the society. ·Community health: It refers to the health status of the members of the community, to the problems affecting their health and to the totality of the health care provided for the community. Terminology

14. Focus on individual health

15. Community Health Part of paramedical and medical intervention/approach which is concerned on the health of the whole population   Aims : Health promotion Disease prevention Management of factors affecting health Definition and aim

16. Aims of Community Health Nursing To promote health and efficiency.  Prevention and control diseases and disabilities.  Need based health care to prolong life. CHN Aim

17. Nursing Both profession & a vocation. Assisting sick individuals to become healthy and healthy individuals achieve optimum wellness Nursing,community meaning

18. “ The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation.” (  Maglaya , et al) Goal: “To raise the level of citizenry by helping communities and families to cope with the discontinuities in and threats to health in such a way as to maximize their potential for high-level wellness” (  Nisce , et al ) Community Health Nursing

19. Special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the 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 ( WHO Expert Committee of Nursing) A learned practice discipline with the ultimate goal of contributing as individuals and in collaboration with others to the promotion of the client’s optimum level of functioning thru’ teaching and delivery of care (Jacobson) A service rendered by a professional nurse to IFCs, population groups in health centers, clinics, schools , workplace for the promotion of health, prevention of illness, care of the sick at home and rehabilitation (DR. Ruth B. Freeman) Continued

20. Community health

21. “ Public Health is directed towards assisting every citizen to realize his birth rights and longevity .”“ The science and art of preventing disease, prolonging life and efficiency through organized community effort for: The sanitation of the environment The control of communicable infections The education of the individual in personal hygiene The organization of medical and nursing services for the early diagnosis and preventive treatment of disease The development of a social machinery to ensure every one a standard of living, adequate for maintenance of health to enable every citizen to realize his birth right of health and longevity (Dr. C.E Winslow) Public Health

22. Public health

23. Definition of chn

24. Health Promotion Health Protection Health Balance Disease prevention Social Justice Mission of CHN

25. “ The philosophy of CHN is based on the worth and dignity on the worth and dignity of man.”(Dr. M. Shetland) Philosophy of CHN

26.  T o Provide antenatal, intra-natal and postnatal, care to ensure safe pregnancy and delivery. To administer Immunization   T o Provide under five children care in village To illustrate Health education throughout community To improve the ability of the community to deal with their own health problems To strengthen the community resources To prevent and control communicable and non-communicable diseases To provide specialized services To conduct research Objectives of Community Health Nursing

27. The  community is the patient in CHN, the family is the unit of care and there are four levels of clientele: individual, family, population group (those who share common characteristics, developmental stages and common exposure to health problems – e.g. children, elderly), and the community. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care CHN practice is affected by developments in health technology, in particular, changes in society, in general The goal of CHN is achieved through multi- sectoral efforts CHN is a part of health care system and the larger human services system. Basic Principles of CHN

28. It should be planned based on the needs of the community.  It is based on identified needs and functions.  Integration of Health education, guidance and supervision with community health nursing services. To provide Health services should be realistic in terms of available resources. To Community is the focus which is the unit of health care services. To Professional relationship with etiquette and dignity   To Community participation is the integral part of the community health services.   To Individual and family members participation in decision making. To Health services must be continuous.   To Proper records and reports are essential.   To Proper evaluation of health services   To provide Health services must be available to all without any different Principles of Community Health Nursing

29. Clinician , who is a health care provider, taking care of the sick people at home or in the RHU Health Educator, who aims towards health promotion and illness prevention through dissemination of correct information; educating people Facilitator, who establishes multi- sectoral linkages by referral system Supervisor, who monitors and supervises the performance of midwives Health Advocator, who speaks on behalf of the client Advocator, who act on behalf of the client Collaborator, who working with other health team member Roles of the PUBLIC HEALTH NURSE

30. *In the event that the Municipal Health Officer (MHO) is unable to perform his duties/functions or is not available, the Public Health Nurse will take charge of the MHO’s responsibilities. Other Specific Responsibilities of a Nurse, spelled by the implementing rules and Regulations of RA 7164 (Philippine Nursing Act of 1991) includes: Supervision and care of women during pregnancy, labor and puerperium Performance of internal examination and delivery of babies Suturing lacerations in the absence of a physician Provision of first aid measures and emergency care Recommending herbal and symptomatic meds…etc. Continued

31. In the care of the families: Provision of primary health care services Developmental/Utilization of family nursing care plan in the provision of care In the care of the communities: Community organizing mobilization, community development and people empowerment Case finding and epidemiological investigation Program planning, implementation and evaluation Influencing executive and legislative individuals or bodies concerning health and development Continued

32. Qualifications Bachelor of Science in Nursing Registered Nurse of the state/central Planner/Programmer Identifies needs, priorities, and problems of individuals, families, and communities Formulates municipal health plan in the absence of a medical doctor Interprets and implements nursing plan, program policies, memoranda, and circular for the concerned staff personnel Provides technical assistance to rural health midwives in health matters Provider of Nursing Care Provides direct nursing care to sick or disabled in the home, clinic, school, or workplace Develops the family’s capability to take care of the sick, disabled, or dependent member Community Organizer Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services Initiates and participates in community development activities Community Health Nurse Roles and Functions

33. Coordinator of Services Coordinates with individuals, families, and groups for health related services provided by various members of the health team Coordinates nursing program with other health programs like environmental sanitation, health education, dental health, and mental health Trainer/Health Educator Identifies and interprets training needs of the RHMs, Barangay Health Workers (BHW), and hilots Conducts training for RHMs and hilots on promotion and disease prevention Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and health related services Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education purposes Conducts pre-marital counseling Continued

34. Health Monitor Detects deviation from health of individuals, families, groups, and communities through contacts/visits with them Role Model Provides good example of healthful living to the members of the community Change Agent Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health Continued

35. Role of community health nurse

36. Recorder/Reporter/Statistician Prepares and submits required reports and records Maintain adequate, accurate, and complete recording and reporting Reviews, validates, consolidates, analyzes, and interprets all records and reports Prepares statistical data/chart and other data presentation Researcher Participates in the conduct of survey studies and researches on nursing and health-related subjects Coordinates with government and non-government organization in the implementation of studies/research Continued

37. She should be a part in developing an overall health plan, its implementation and evaluation for communities She provide quality nursing services to the three levels of clientele She maintain coordination/linkages with other health team members, NGO/government agencies in the provision of public health services She conduct researches relevant to CHN services to improve provision of health care She provide opportunities for professional growth and continuing education for staff development Responsibilities of CHN

38. Theory Applies theoretical concepts as basis for decisions in practice Data Collection Gathers comprehensive, accurate data systematically Diagnosis Analyzes collected data to determine the needs/ health problems of IFC Planning At each level of prevention, develops plans that specify nursing actions unique to needs of clients Intervention Guided by the plan, intervenes to promote, maintain or restore health, prevent illness and institute rehabilitation Standards in CHN

39. Evaluation Evaluates responses of clients to interventions to note progress toward goal achievement, revise data base, diagnoses and plan Quality Assurance and Professional Development Participates in peer review and other means of evaluation to assure quality of nursing practice Assumes professional development Contributes to development of others Interdisciplinary Collaboration Collaborates with other members of the health team, professionals and community representatives in assessing, planning, implementing and evaluating programs for community health Research Indulges in research to contribute to theory and practice in community health nursin Continued

40. The aim of occupational health nurse is to keep the people at work healthy and to prevent them from illness and injury due to the working environment. Special Community Health Nursing Services

41. The aim of occupational health nurse is to keep the people at work healthy and to prevent them from illness and injury due to the working environment. The following are the basic functions of Occupational or Industrial Nurse ·  Identify the occupational Hazards ·  Educate them about the control of the occupational hazards. ·  Initial treatment for the emergencies such as injuries and illnesses. Buy vitamins and supplements ·  Early diagnosis of the occupational or other illnesses and to screen the people at risk. ·  Assist the management in placement of the people in suitable work. ·  Provide advice and supervision of conditions at work which may affect the health such as environmental sanitation. ·  Health Education 1.  Industrial Nursing

42. ·   Assist the doctor for the examination of the employees. ·  Protect and improve the physical and mental health of the workers. Buy vitamins and supplements ·  Provision of first aid and treatment for minor illnesses and injuries. ·  Assess, identify and notify the management regarding the hazards affecting the workers. ·  Conduct health education ·  Home visit to the employees to educate regarding the health and family welfare. ·  Nutrition ·  Communicable Disease prevention ·  Environmental sanitation ·  Protective Measures for the employees Buy vitamins and supplements ·  Medical Check - up and Immunization Role of Nurses in Occupational Health Services

43. In the control of communicable diseases nurses play a vital role in the community level. The following are the nurses role in control of Tuberculosis which an airborne infectious disease affecting the people living in poor living standards and with low immunity. Pulmonary tuberculosis is responsible for the majority 85% of TB infections. ·  Case finding ·  Health Supervision (DOTS) ·  Domiciliary care - Isolation Buy vitamins and supplements ·  Prevention of the spread of infection ·  Drug compliance ·  Nutrition ·  Health Education 2.  Tuberculosis Nursing

44. Leprosy is one of the major health and socio-economic problems in the country. Nurses responsibility in the care of Leprosy patients is divided into the following categories 1.  Nurse - patient relationship - An effective Nurse Patient Relationship enhances the appropriate management of Leprosy cases. Buy vitamins and supplements 2.  Recorder and observer of facts - Accurate observation and correct recording of facts are vital role of a nurse and she has to provide accurate account of health. 3.  Leprosy Nursing

45. 3.  Health Education regarding ·   Leprosy is curable and the deformities are preventable  and must be educated about   the drug compliance. ·  Family Education - about the preventive measures, Isolation of under 15 years children, especially infants from active patients who are infective. ·  Need for assistance and support during the course of illness and recovery stage. ·  Family Education - Educate the family regarding the misconceptions regarding Leprosy Continued

46. ·  The nurse must have interest on the people. ·  Understand the human behavior. ·  Sincere. ·  Empathy. ·  Honest. ·  Charitable. Buy vitamins and supplements ·  Resourceful. ·  She must have observation, communication, interview skills and technical skills. ·  She must have ability to make interpretations, make judgment, and take decisions. Self discipline on emotions and other aspects of behaviour and action. Qualities of a community Health Nurse

47. 1 . General Duties Buy vitamins and supplements ·  Provision of nursing services to the community. ·  Maternal health (Antenatal, Intra natal and postnatal care) ·  Infant and pre-school health ·  Prevention of Communicable diseases. 2. Administrative Duties  - is responsible for   the implementation of policies and programme relating to nursing and midwifery services. Functions of Public Health Nurse

48. 3. Supervisory - To promote harmony and   efficiency within the health teams to improve the quality of life. 4. Educational  - Participating and organizing   In-service training programme . Buy vitamins and supplements 5. Caregiver  - They provide prenatal care   and education for expectant mothers, including information about maternal nutrition, referrals for childbirth classes, and postpartum assistance. 6.   Community Educator  - As educators,   community health nurses focus on presenting materials in a clear and understandable format. They provide information to individuals, families, and communities that create a framework for healthy living and healthy choices. Continued

49. 7. Leader  - Community health nurses use   evidence to implement policy changes and quality-based practices.. 8.  Researcher - As researchers, community   health nurses collect and use evidence to execute positive changes for better health. 9. Advocate  - Advocate on the local, state,   and federal level to provide better access to healthcare, protect funding for public health programs, and reduce or eliminate health disparities. Buy vitamins and supplements 10. Disease prevention specialist -  Community health nurses focus on long-and short- term care for disease prevention. Their work includes averting or controlling the spread of the flu and other communicable diseases. Continued

50. 11. Director and Co- ordinator   - Community   health nurse has to plan and organize and make sure that the work is done as planned and organized. 12. Collaborator  - Community health problems   cannot be solved by single health worker. It involves many people who work together in a team. Healthcare experts say public health has made great strides in the past decades, allowing people to live longer and healthier lives. Continued

51. Primary health care at community level

52. Overview May 1977 -30th World Health Assembly decided that the main health target of the government and WHO is the attainment of a level of health that would permit them to lead a socially and economically productive life by the year 2000. September 6-12, 1978 – First International Conference on PHC in Alma Ata, Russia (USSR) The Alma Ata Declaration stated that PHC was the key to attain the “health for all” goal Primary Health Care (PHC)

53. October 19, 1979 – Letter of Instruction (LOI) 949, the legal basis of PHC was signed by Pres. Ferdinand E. Marcos, which adopted PHC as an approach towards the design, development and implementation of programs focusing on health development at community level. Continued

54. To Magnitude of Health Problems To Inadequate and unequal distribution of health resources Increasing cost of medical care Isolation of health care activities from other development activities Rationale for Adopting Primary Health Care

55. Terminology for phc

56. PHC is a essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at cost that the community can afford at every stage of development. a practical approach to making health benefits within the reach of all people. an approach to health development, which is carried out through a set of activities and whose ultimate aim is the continuous improvement and maintenance of health status Definition of Primary Health Care

57. In community health nursing, primary health care (PHC) is the approach that provides essential, accessible, and affordable health services, focusing on health promotion, disease prevention, treatment, and rehabilitation to individuals, families, and communities as their first point of contact with the healthcare system. Rooted in social justice, it emphasizes community participation, equitable access, and inter- sectoral collaboration to achieve the highest attainable standard of health for everyone. Meaning of phc

58. HEALTH FOR ALL FILIPINOS by the year 2000 AND HEALTH IN THE HANDS OF THE PEOPLE by the year 2020. An improved state of health and quality of life for all people attained through SELF RELIANCE. Goal of Primary Health Care

59. Partnership with and Empowerment of the people  – permeate as the core strategy in the effective provision of essential health services that are community based, accessible, acceptable, and sustainable, at a cost, which the community and the government can afford. Key Strategy to Achieve the Goal:

60. Improvement in the level of health care of the community Favorable population growth structure Reduction in the prevalence of preventable, communicable and other disease. Reduction in morbidity and mortality rates especially among infants and children. Extension of essential health services with priority given to the underserved sectors. Improvement in Basic Sanitation Development of the capability of the community aimed at self- reliance. Maximizing the contribution of the other sectors for the social and economic development of the community. Objectives of Primary Health Care

61. To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care. Mission

62. Accessibility & Affordability:   PHC strives to make healthcare available to all community members, regardless of their socioeconomic status.  Community-Centered:   It involves and empowers individuals, families, and communities to participate in health decisions and take greater control of their own health.  First Point of Contact:   It serves as the initial and ongoing interaction between people and the health system, providing comprehensive care close to their homes.  Holistic Approach:   PHC includes health promotion, disease prevention, diagnosis, treatment, rehabilitation, and palliative care across the lifespan.  Multisectoral Collaboration:   It recognizes that factors outside the health sector influence health and encourages cooperation with other sectors, such as education and housing.  Key Aspects of Primary Health Care in Community Health Nursing

63. Health Education :  Informing the community about health problems and how to prevent and manage them.  Maternal & Child Health:  Providing care for mothers and children, including family planning and immunization.  Nutritional Support :  Promoting proper nutrition and addressing deficiencies like anemia.  Disease Prevention :  Administering immunizations and promoting healthy lifestyles to prevent illness.  Treatment of Common Ailments :  Managing common diseases and providing first aid for injuries.  Services Provided by Community Health Nurses in PHC

64. Surveillance:  Monitoring health conditions and the prevalence of endemic diseases within the community.  Coordination & Referral :  Working with other health workers and referring individuals to specialized services when needed.  Continued

65. Barangay Health Workers – trained community health workers or health auxiliary volunteers or traditional birth attendants or healers. Intermediate level health workers- include the Public Health Nurse, Rural Sanitary Inspector and midwives. Two Levels of Primary Health Care Workers

66. 1 . 4 A’s = Accessibility, Availability, Affordability & Acceptability, Appropriateness of health services. The health services should be present where the supposed recipients are. They should make use of the available resources within the community, wherein the focus would be more on health promotion and prevention of illness. Principles of Primary Health Care

67. 2. Community Participation - heart and soul of PHC 3.People are the center, object and subject of development . Thus, the success of any undertaking that aims at serving the people is dependent on people’s participation at all levels of decision-making; planning, implementing, monitoring and evaluating. Any undertaking must also be based on the people’s needs and problems (PCF, 1990) Part of the people’s participation is the partnership between the community and the agencies found in the community; social mobilization and decentralization. In general, health work should start from where the people are and building on what they have. Example: Scheduling of Barangay Health Workers in the health center Continued

68. Barriers of Community Involvement Lack of motivation Attitude Resistance to change Dependence on the part of community people Lack of managerial skills

69. 4.  Self-reliance Through community participation and cohesiveness of people’s organization they can generate support for health care through social mobilization, networking and mobilization of local resources. Leadership and management skills should be develop among these people. Existence of sustained health care facilities managed by the people is some of the major indicators that the community is leading to self reliance.

70. 5. Partnership between the community and the health agencies in the provision of quality of life. Providing linkages between the government and the nongovernment organization and people’s organization.

71. 6. Recognition of interrelationship between the health and development Health- Is not merely the absence of disease. Neither is it only a state of physical and mental well-being. Health being a social phenomenon recognizes the interplay of political, socio-cultural and economic factors as its determinant. Good Health therefore, is manifested by the progressive improvements in the living conditions and quality of life enjoyed by the community residents (PCF, Development- is the quest for an improved quality of life for all. Development is multidimensional. It has political, social, cultural, institutional and environmental dimensions (Gonzales 1994). Therefore, it is measured by the ability of people to satisfy their basic needs.

72. 7. Social Mobilization It enhances people participation or governance, support system provided by the Government, networking and developing secondary leaders.

73. 8.  Decentralization This ensures empowerment and that empowerment can only be facilitated if the administrative structure provides local level political structures with more substantive responsibilities for development initiators. This also facilities proper allocation of budgetary resources.

74. The eight elements of primary health care are: Health education, Proper nutrition, Safe water and basic sanitation, Maternal and child health care (including family planning), Immunization against major infectious diseases, Prevention and control of locally endemic diseases, Appropriate treatment of common diseases and injuries, and Provision of essential drugs .  These components aim to provide comprehensive healthcare at a community level, as outlined in the Alma-Ata Declaration of 1978.  the 8 elements of primary health care?

75. Health education : Educating the community about health problems and methods to prevent and control them.  Proper nutrition :  Promoting food supply and proper nutrition to address malnutrition.  Safe water and basic sanitation : Ensuring an adequate supply of safe water and access to basic sanitation facilities.  Maternal and child health care , including family planning : Providing essential services to mothers and children and offering family planning options.  Here is a breakdown of each element:

76. Immunization against major infectious diseases : Implementing immunization programs to protect against common infectious diseases.  Prevention and control of locally endemic diseases : Focusing on preventing and controlling diseases that are common in a specific region.  Appropriate treatment of common diseases and injuries : Offering suitable treatment for common ailments and injuries.  Provision of essential drugs : Ensuring the availability of necessary medicines for effective treatment.  Continued

77. Active Community Participation Intra and Inter- sectoral Linkages Use of Appropriate Technology Support mechanism made available Four Cornerstones/Pillars in Primary Health Care

78. Principles of phc

79. Core principles of phc

80. Level of health care

81. Strengthening of phc

82. Comprehensive phc

83. Elements of primary health care

84. 1 . Education for Health Is one of the potent methodologies for information dissemination. It promotes the partnership of both the family members and health workers in the promotion of health as well as prevention of illness. Elements of Primary Health Care

85. The control of endemic disease focuses on the prevention of its occurrence to reduce morbidity rate. Example Malaria Control and Schistosomiasis Control 2. Locally Endemic Disease Control

86. This program exists to control the occurrence of preventable illnesses especially of children below 6 years old. Immunizations on poliomyelitis, measles, tetanus, diphtheria and other preventable disease are given for free by the government and ongoing program of the DOH 3. Expanded Program on Immunization

87. The mother and child are the most delicate members of the community. So the protection of the mother and child to illness and other risks would ensure good health for the community. The goal of Family Planning includes spacing of children and responsible parenthood. 4. Maternal and Child Health and Family Planning

88. Environmental Sanitation is defined as the study of all factors in the man’s environment, which exercise or may exercise deleterious effect on his well-being and survival. Water is a basic need for life and one factor in man’s environment. Water is necessary for the maintenance of healthy lifestyle. Safe Water and Sanitation is necessary for basic promotion of health. 5. Environmental Sanitation and Promotion of Safe Water Supply

89. One basic need of the family is food. And if food is properly prepared then one may be assured healthy family. There are many food resources found in the communities but because of faulty preparation and lack of knowledge regarding proper food planning, Malnutrition is one of the problems that we have in the country. 6. Nutrition and Promotion of Adequate Food Supply

90. The diseases spread through direct contact pose a great risk to those who can be infected. Tuberculosis is one of the communicable diseases continuously occupies the top ten causes of death. Most communicable diseases are also preventable. The Government focuses on the prevention, control and treatment of these illnesses. 7. Treatment of Communicable Diseases and Common Illness

91. This focuses on the information campaign on the utilization and acquisition of drugs. In response to this campaign, the GENERIC ACT of the Philippines is enacted. It includes the following drugs: Cotrimoxazole , Paracetamol , Amoxycillin , Oresol , Nifedipine , Rifampicin, INH (isoniazid) and Pyrazinamide,Ethambutol , Streptomycin,Albendazole,Quinine 8. Supply of Essential Drugs

92. Fundamental function of

93. Primary health center

94. Primary health service

95. 1 . Elevating Health to a Comprehensive and Sustained National Effort . Attaining Health for all Filipino will require expanding participation in health and health related programs whether as service provider or beneficiary. Empowerment to parents, families and communities to make decisions of their health is really the desired outcome. Advocacy must be directed to National and Local policy making to elicit support and commitment to major health concerns through legislations, budgetary and logistical considerations. Major Strategies of Primary Health Care

96. The health in the hands of the people brings the government closest to the people. It necessitates a process of capacity building of communities and organization to plan, implement and evaluate health programs at their levels. 2. Promoting and Supporting Community Managed Health Care

97. Using appropriate technology will make services and resources required for their delivery, effective, affordable, accessible and culturally acceptable. The development of human resources must correspond to the actual needs of the nation and the policies it upholds such as PHC. The DOH will continue to support and assist both public and private institutions particularly in faculty development, enhancement of relevant curricula and development of standard teaching materials. 3. Increasing Efficiencies in the Health Sector

98. Essential National Health Research (ENHR) is an integrated strategy for organizing and managing research using intersectoral , multi-disciplinary and scientific approach to health programming and delivery. 4. Advancing Essential National Health Research

99. The Community Health Nursing Process , involves six main steps: Community Assessment, Nursing Diagnosis, Planning, Implementation, Evaluation, and Re-planning. This systematic method is used by nurses to identify health issues in a community, develop and implement health care plans, and measure the effectiveness of those plans.  Community health nursing process

100. Introduction Definition Step Of Nursing Process Description Of Nursing Process Assessment Nursing Diagnosis Nursing Intervention Nursing Implementation Evaluation Outcome Content

101. Definition of Nursing Process The nursing process is also a standard of practice, which when followed correctly, protects nurses against legal problems related to nursing care.   Definition of Nursing Process The nursing process is a critical thinking process that professional nurses uses to apply the best available evidence to care giving and promoting human functions and responses to health and illness Definition of nursing process

102. The nursing process is goal-oriented method of caring that provides a framework to nursing care. It involves five major steps: Over View of Nursing   Process

103. A  - Assess (what data is collected?) D  - Diagnose (what is the problem?) P  - Plan (how to manage the problem) I  - Implement (putting plan into action)   with Rationale (Scientific reason of the implementations) E  - Evaluate (did the plan work?) According to some theorists, this seven-steps description of the nursing process is outdated and misrepresents nursing as linear and atomic. Continued

104. The nurse completes an holistic nursing assessment of the needs of the individual/ family/community, regardless of the reason for the encounter. The nurse collects subjective data and objective data using a nursing framework, such as Marjory Gordon’s functional health patterns. Methods for data collection Nursing assessments provide the starting point for determining nursing diagnosis. It is vital that a recognized nursing assessment framework is used in practice to identify the patient’s problems, risks and outcomes for enhancing health. The use of an evidence-based nursing framework such as Gordon’s Functional Health Pattern Assessment should guide assessments that support nurses in determination of NANDA-I nursing diagnosis. For accurate determination of nursing diagnosis, useful, evidence-based assessment framework is best practice. Assessing phase-Nursing assessment

105. Client Interview   Physical Examination  Obtaining a health history (including dietary data)    Family history/report Methods of collection

106. The nursing process is a cyclical and ongoing process that can end at any stage if the problem is solved. The nursing process exists for every problem that the individual/family/community has. The nursing process not only focuses on ways to improve physical needs, but also on social and emotional needs as well. Cyclic and dynamic Goal directed and client centred Interpersonal and collaborative Universally applicable Systematic The entire process is recorded or documented in order to inform all members of the health care team. Characteristics of Nursing Process

107. Community Assessment :  The initial phase where nurses collect data about the community's health status, including social, environmental, and health-related factors.  Nursing Diagnosis :   This involves analyzing the collected data to identify specific health problems and unmet needs within the community.  Planning :  Nurses develop goals, objectives, and specific interventions designed to address the identified health problems and improve community well-being.  steps of the Community Health Nursing Process

108. Implementation :  Putting the planned interventions into action to deliver the necessary nursing care to the community.  Evaluation :  Assessing the effectiveness of the implemented plan by measuring whether the goals were achieved and making adjustments as needed.  Re-planning :  Based on the evaluation, the process may cycle back to re-assess, re-diagnose, or modify the plan to ensure continued effectiveness and improvement in community health.  Continued

109. Nursing diagnosis represent the nurse’s clinical judgment about actual or potential health problems/life process occurring with the individual, family, group or community. The accuracy of the nursing diagnosis is validated when a nurse is able to clearly identify and link to the defining characteristics, related factors and/or risk factors found within the patients assessment. Multiple nursing diagnosis may be made for one client. Diagnosing phase-Nursing diagnosis

110. In agreement with the client, the nurse addresses each of the problems identified in the diagnosing phase. When there are multiple nursing diagnosis to be addressed, the nurse prioritizes which diagnosis will receive the most attention first according to their severity and potential for causing more serious harm. For each problem a measurable goal/outcome is set. For each goal/outcome, the nurse selects nursing interventions that will help achieve the goal/outcome . A common method of formulating the expected outcomes is to use the evidence-based Nursing Outcomes Classification to allow for the use of standardized language which improves consistency of terminology, definition and outcome measures. The interventions used in the Nursing Interventions Classification again allow for the use of standardized language which improves consistency of terminology, definition and ability to identify nursing activities, which can also be linked to nursing workload and staffing indices. The result of this phase is a nursing care plan. Planning phase-Nursing care plan

111. The nurse implements the nursing care plan performing the determined interventions that were selected to help meet the goals/ outcomes that were established. Delegated tasks and the monitoring of them is included here as well. Activities ·           pre-assessment of the client-done before just carrying out implementation to determine if it is relevant ·           determine need for assistance ·           implementation of nursing orders ·           delegating and supervising-determines who to carry out what action Implementing Phase

112. The nurse evaluates the progress toward the goals/outcomes identified in the previous phases. If progress towards the goal is slow, or if regression has occurred, the nurse must change the plan of care accordingly . Conversely, if the goal has been achieved then the care can cease. New problems may be identified at this stage, and thus the process will start all over again. Evaluating Phase

113. Summary

114. Thank you