This PPT helps to gain knowledge about the current trends in Nursing management

2. CURRENT TRENDS,
STANDARDS AND
CHALLENGES IN
COMMUNITY HEALTH
NURSING
Presented By:
Ms. Arpita Saraswat

3. INTRODUCTION
 “Community health refers to the health status of the members of
the community, to the problem affecting their health, and to the
totality of the health care provided for the community”
 Ministry of Health & Family Welfare
 Cabinet Minister
 Dr. Harsh Vardhan

4. OBJECTIVES OF COMMUNITY
HEALTH NURSING
 Increasing the average length of human life.
 Decreasing the rates of mortality and morbidity e.g IMR, MMR etc
 Increasing the physical, mental and social well being of the individual.
 Increasing the ace of adjustment of individual to this environment.
 Providing total health care to enrich the quality of life.

5. CONTINUING..
 Make provision of primary health care services to everyone
irrespective of the areas (rural or urban slums)
 Development of health manpower required to provide proper services
to the community.
 Implementation of effective measures for the surveillance, prevention
and control of major diseases.
 Formulation of health policies and their periodic revision from time to
time.

6. CUR R ENT TR ENDS IN COMMUNITY
HEA LTH NUR SING
Common trends aims at the following:-
 Strengthen the care of community health services the hospital
especially at the district level.
 Providing increasing care for the out -patient and community
based services including social services.
 Increasing responsibilities of families and individual for health.

8. TRENDS IN HEALTH STATUS
 1: Population and Average Annual Exponential Growth Rate
(AAEGR):
 In absolute terms, the population of India has increased by more than
181 million during the decade 2001-2011. Of the 121 crore Indians, 83.3
crore (68.84%) live in rural areas while 37.7 crore (31.16%) live in urban
areas, as per the Census of India’s 2011.
 The current population of India is 1,370,139,352 as of till August
2019, based on the latest United Nations estimates.

9. 2) SEX RATIO
 Sex ratio in India has since shown some improvement.
 It has gone up from 927 females per 1000 males in 1991 census to
933 females per 1000 males in 2001 census and to 940 females per
1000 males in 2011 Census of India.
 Sex Ratio of India is 107.48, i.e., 107.48 males per 100 females in
2019. It means that India has 930 females per 1000 males.

10. 3. Life Expectancy at Birth:
 This has revealed decrease in death rate and the better
improvement of quality health services in India. However,
there are inter-state, male-female and rural urban differences
in life expectancy at birth due to low literacy, differential
income levels and socio-economic conditions and beliefs.
 According to the last census, Indian life expectancy has
merely increased from 60 years in 1992 to 67.9 years in 2012.

11. 4. Crude Birth Rate:
 The CBR is higher (23.7) in rural areas as compared to urban
areas (18.0). However, there are inter-state and rural-urban
differences are quite pertinent.
 UP recorded the highest CBR (28.3) and Goa the lowest
(13.2) recorded higher CBR as compared to the national
average.
 Birth rate, crude (per 1,000 people) in India was reported at
19.01 in 2016.

12. 5. Crude Death Rate:
 The CDR is higher in rural areas (7.7) as compared to urban areas
(5.8). The CDR is higher as compared to national average in respect
of Andhra Pradesh ((7.6), Assam (8.2), Chhattisgarh (8.0), Madhya
Pradesh (8.3), Odisha (8.6), Tamil Nadu(7.6), Uttar Pradesh (8.1),
Puducherry (7.4) and Meghalaya (7.9).
 Delhi (4.2) among the bigger States and Nagaland (3.6) among the
smaller states /UTs recorded the lowest CDR during 2010.
 In 2017, crude death rate for India was 7.33 deaths per thousand
population

13. 6 .Maternal Mortality Ratio (MMR):
 MMR has reduced from 254 per 100000 live births in
2004-06 to 212 per 100000 live births in 2007-09 (SRS), a
reduction of 42 points over a three year period or 14
points per year on an average.
 India has registered a significant decline in Maternal
Mortality Ratio(MMR) recording a 22% reduction in
such deaths since 2013, according to the Sample
Registration System (SRS) bulletin

16. 7. Infant Mortality Rate (IMR):
 The IMR is higher in respect of Female (49) as compared to Male
(46). IMR is also higher in rural areas (51 per 1000 live births) as
compared to urban areas (31 per 1000 live births) during 2010.
 The IMR varied very widely across the states; Kerala with an IMR
of 13 is the best performing state among the bigger States in the
country.
 India has reduced its infant mortality rate (IMR) by 42% over 11
years--from 57 per 1,000 live births in 2006 to 33 in 2017, as per
the latest government data

18. 8. Total Fertility Rate (TFR):
 India’s Total Fertility Rate (TFR) is at 2.5 (SRS-2010) and the target
is to achieve Replacement level of Fertility of 2.1 by 2012. While 21
States and UTs (Andaman & Nicobar Islands, Goa, Tripura,
Chandigarh, Andhra Pradesh, Himachal Pradesh, Jammu &
Kashmir.
 India's total fertility rate (TFR) — the number of children
expected to be born per woman during her entire span of
reproductive period—has reduced from 2.3 in 2016 to 2.2 in 2017.

20. 9. Under-five Mortality Rate:
 The U5 MR declined from 69 in 2008 to 59 in 2010.
However, the Male–Female and Rural-Urban differentials
persists. Kerala with U5MR of 15 in 2010 is the best
performing state in the country.
 Globally, under-five mortality rate has
decreased by 58%, from an estimated rate
of 93 deaths per 1000 live births in 1990 to 39 deaths per
1000 live births in 2017.

23. TRENDS OF COMMUNICABLE
DISEASES
 India is undergoing an epidemiologic, demo-graphic and health transition.
Nevertheless, communicable diseases are still dominant and constitute major public
health issues.
 Despite high disease burden, health system constraints and shortage of funds,
country has achieved noteworthy successes.
 Smallpox and guinea worm have been eradicated; their last cases occurred in the
country in May 1975 and July 1996 respectively.
 Leprosy has been eliminated as a public health problem in 32 states and 83%
districts.

24. CONTINUING..
 Prospects of polio is been eradicated in India.
 Malaria has been reduced to less than 1.5 million cases every year.
 Kala-azar cases reduced to less than 1 per 10k population in 320
of 514 endemic blocks.
 TB mortality has decreased from over 5 lakh deaths every year at
the beginning of programme.

25.  2001 - Nipah Virus(Bangladesh, India)
 2003 - SARS Coronavirus
 2004 - Avian Influenza(H5N1), Thailand,
Vietnam
 2006 - Influenza H5N1(Egypt, Iraq) -
New Human Rhinovirus(USA)
 2007 - Nipah Virus(Bangladesh),
(Australia)
 2009 - Influenza H1N1
 2011 - Crimean Congo Hemorrhagic Fever
(India)
 2018- Nipah Virus (India)
 Ebola
 Marburg
 Dengue
 Yellow fever
 Chikungunya
 Chandipura
 West Nile Virus
 Rift Valley Fever
 Human Monkey Pox
INFECTIOUS DISEASES
EMERGING DISEASES RE –EMERGING DISEASES

27. CURRENT HEALTH PROGRESS IN
HEALTH
 National Cancer Control Programme: (June 2010)
 Under this scheme 27 Regional Cancer Centres (RCCs) including
13 Medical Colleges were assisted. In addition, 57 Institutes including
40 Medical Colleges were assisted under the ‘Development of
Oncology Wing Scheme’.
 Has been revamped and synergized with Diabetes, CVD & stroke
and named as ‘National Program for Prevention and Control of
Cancer, Diabetes, CVD & Stroke’ (NPCDCS).

28. CONTINUING..
 National Mental Health Programme: (2017)
 following are the objectives:
 To ensure the availability and accessibility of minimum mental
healthcare for all in the foreseeable future, particularly to the most
vulnerable and underprivileged sections of the population;
 To promote community participation in the mental health service
development and to stimulate efforts towards self-help in the
community.

29. CONTINUING..
 National Programme for Health Care of Elderly (NPHCE): 2010-11
 Addresses health related problems of elderly people. The programme
has been initiated in 100 identified districts of 21 States during the 11th 5
year plan.
 The important achievements are:
 • MOU has been signed with 19 States.
 • A geriatric OPD has been inaugurated at AIIMS, New Delhi.
 • A training workshop has been organized in which medical specialists
and surgical specialists from 21 districts were trained.

30. CONTINUING..
 National Programme for Prevention and Control of Deafness
(NPPCD):
 The Ministry of Health & Family Welfare, Govt. of India had pilot
phase of NPPCD in un identified 25 districts of 10 states and one
UT in the country.
 The main objective of the program is to train professionals in early
identification, diagnosis, treatment of ear problem, development of
institutional capacity and promote outreach activities and public
awareness.

31. DEVELOPING STANDARDS IN
COMMUNITY HEALTH NURSING
 The Indian Community Health Nursing Standards of Practice
 define the scope and depth of community nursing practice
 establish criteria or expectations for acceptable nursing practice and
safe, ethical care
 support ongoing development of community health nursing
 promote community health nursing as a specialty
 provide the foundation for certification of community health nursing
as a specialty by the Indian Nurses Association
 inspire excellence in and commitment to community nursing practice.

33. CONTINUING..
All community health nurses are expected to know
and use these standards when working in any of
the areas of practice, education, administration or
research.
Nurses in clinical practice will use the standards to
guide and evaluate their own practice. Nursing
educators will include the standards in course
curriculam to prepare new graduates for practice in
community settings.
Nurse administrators will use them to direct policy
and guide performance expectations.

34. CONTINUING..
Nurse researchers will use these standards to guide
the development of knowledge specific to
community health nursing.
 Nurses may enter community health nursing as
new practitioners and require experience and
opportunities for additional learning and skill
development to help them develop their practice.
The practice of expert community health nurses
will extend beyond these standards.

35. CHA LLENEGS IN COMMUNITY
HEA LTH NUR SING
Many challenges influence the overall health of communities.
 Infectious diseases, such as tuberculosis, can spiral out of control in
many urban settings.
 Children's health and well-being are still threatened by preventable
diseases, environmental toxins, violence, accidents, and injuries.
 The complexity of community health and its various problems can
make it difficult for researchers to assess and identify solutions.
 Community-based participatory research(CBPR) is a unique alternative
that combines community participation, inquiry, and action.

36. CONTINUING..
 Cost of medical care. A great majority of the world does not have
adequate health insurance.
 In low-income countries, less than 40% of total health
expenditures are paid for by the public/government.
 The impact, importance, and success of the Affordable Care Act is
still being studied and will have a large impact on how ensuring health
can affect community standards on health and also individual health.

38. CONTINUING..
 Community health tends to focus on a defined
geographical community.
 The success of community health programmes relies upon the transfer
of information from health professionals to the general public using one-
to-one or one to many communication. The latest shift is towards health
marketing.
 The community health nurse is not limited to the care of a particular
age or diagnostic group. It is necessary at this point because it improves
the health status of individuals ,families, groups and the community
through straight approach with them.