unit -1 introduction of community health nursing, it related to field of nursing, that added introduction of community, community health, and community health nursing and characteristics, and principles.

1. COMMUNITY HEALTHCOMMUNITY HEALTH
NURSINGNURSING
 PREPARED BY:PREPARED BY:
 ABHINAV BHATTABHINAV BHATT

LECTURERLECTURER

2. 22
Community Health DefinitionsCommunity Health Definitions
 CommunityCommunity -- a group of people sharing common needs,a group of people sharing common needs,
interests, resources and environments.interests, resources and environments.
 PopulationPopulation -- a statistical aggregate or subgroup of peoplea statistical aggregate or subgroup of people
with similar or identical characteristics; may or may notwith similar or identical characteristics; may or may not
interact with one another.interact with one another.
 Community HealthCommunity Health NursingNursing -- nursing care that takesnursing care that takes
place outside of acute-care settings; meets its goals byplace outside of acute-care settings; meets its goals by
identifying problems and supporting communityidentifying problems and supporting community
participation in the process of preserving and improvingparticipation in the process of preserving and improving
the health of community. The focus is on the health of thethe health of community. The focus is on the health of the
larger group rather than the health of the individual.larger group rather than the health of the individual.
OrOr

3.  Community health nurses provide preventive,Community health nurses provide preventive,
promotive, curative and rehabilitative services topromotive, curative and rehabilitative services to
the people. They provide these services directlythe people. They provide these services directly
to individual, family or community. They carryto individual, family or community. They carry
out all the activities to render primary health careout all the activities to render primary health care
in the community. So, they are primary carein the community. So, they are primary care
provider.provider.
 Public HealthPublic Health NursingNursing -- subset of Communitysubset of Community
Health Nursing; goal is primarilyHealth Nursing; goal is primarily improvingimproving thethe
health of the entire community.health of the entire community.

4. IntroductionIntroduction
 Community living is an essential feature ofCommunity living is an essential feature of
human being can live in company of otherhuman being can live in company of other
people, help each other and fulfil theirpeople, help each other and fulfil their
physical, social, emotional and spiritualphysical, social, emotional and spiritual
needs.needs.
 The community may very from a smallThe community may very from a small
and simple village setup of 50 to 1000and simple village setup of 50 to 1000
families to a big & complex metropolitanfamilies to a big & complex metropolitan
city like…Delhi.city like…Delhi.

5.  Whatever may be the size and complexityWhatever may be the size and complexity
of community, it influences the health andof community, it influences the health and
well being of its people.well being of its people.
 Many prevailing are existing due toMany prevailing are existing due to
environmental conditions, culturalenvironmental conditions, cultural
practices, biological aspects and resourcepractices, biological aspects and resource
which are available in the community.which are available in the community.
 Exp.- cholera, typhoid, TB, STD, polio etc..Exp.- cholera, typhoid, TB, STD, polio etc..

6.  Main role of community preventing themMain role of community preventing them
and promoting and preserving.and promoting and preserving.
 And focus on all health care facilities.And focus on all health care facilities.

7. COMMUNITYCOMMUNITY
 MEANING AND DEFINITIONMEANING AND DEFINITION
 The word ‘community’ is used in a varietyThe word ‘community’ is used in a variety
of contexts and by the people withof contexts and by the people with
different perspectives.different perspectives.
 Community suggest a shared pattern ofCommunity suggest a shared pattern of
feelings, behaviours and lifestyles togetherfeelings, behaviours and lifestyles together
with close and frequents personalwith close and frequents personal
relationship with others.relationship with others.
--Little wood 1985Little wood 1985

8.  The word has its origin from Latin wordThe word has its origin from Latin word
‘COMMUNIS’.‘COMMUNIS’.
 It’s derived from two Latin words namelyIt’s derived from two Latin words namely
“com and munis”“com and munis”
 In English “com” means “Together”.In English “com” means “Together”.
 ““munis” means “To Serve”munis” means “To Serve”
Means “serve together”Means “serve together”

9. CommunityCommunity
 It means ‘community’ is an organization ofIt means ‘community’ is an organization of
human beings framed for the purposes ofhuman beings framed for the purposes of
serving together.serving together.

10. DEFINITION OF Community.DEFINITION OF Community.
 BY WHO-1947BY WHO-1947
 ““A Community is a social groupA Community is a social group
determined by geographical boundariesdetermined by geographical boundaries
andor common values and interests. It’sandor common values and interests. It’s
members know and interact with eachmembers know and interact with each
other. It functions within a particularother. It functions within a particular
structure and exhibits and creates certainstructure and exhibits and creates certain
norms, values and social institutions.”norms, values and social institutions.”

11.  In other way community health nursing is:In other way community health nursing is:
 Collection of peopleCollection of people
 PlacePlace
 Social systemSocial system

12. Community as collection of peopleCommunity as collection of people
 Community is collection of people who areCommunity is collection of people who are
social, interact with each other formally andsocial, interact with each other formally and
informally with in some type of organizedinformally with in some type of organized
structure for mutual benefit.structure for mutual benefit.
 The organization can be hamlet, village,The organization can be hamlet, village,
neighborhood, town or a city.neighborhood, town or a city.
 People in community make different groupPeople in community make different group
based on variety of common factors whichbased on variety of common factors which
include culture, beliefs, religion, cast etc..include culture, beliefs, religion, cast etc..

13.  The basic fact behind the groupThe basic fact behind the group
identification is their common charactrsticsidentification is their common charactrstics
which create a sense of belongingness.which create a sense of belongingness.

14. Community as a placeCommunity as a place
 Mean specific location, geographic area andMean specific location, geographic area and
boundaries within which group of people withboundaries within which group of people with
common culture, beliefs, mores and customscommon culture, beliefs, mores and customs
etc. live together.etc. live together.
 Geographical areaGeographical area- housing, building- housing, building
,streets, roads, physical and biological,streets, roads, physical and biological
environmentenvironment
 Geographical boundaries- marked by river,Geographical boundaries- marked by river,
roads, mountains etc..roads, mountains etc..

15. Community as social systemCommunity as social system
 Community as social system organizesCommunity as social system organizes
itself to meet the needs of its memberitself to meet the needs of its member
 According toAccording to maslow’s “hierarchy ofmaslow’s “hierarchy of
needsneeds of individual as basis for its growth,of individual as basis for its growth,
development and motivation is equallydevelopment and motivation is equally
applicable to community for its survival,applicable to community for its survival,
growth, development and fulfillment”.growth, development and fulfillment”.
 Community needs are met with by jointCommunity needs are met with by joint
organized efforts of the members of theorganized efforts of the members of the
specific community and larger society ofspecific community and larger society of
which it is a part.which it is a part.

16. Maslow’s Hierarchy of Needs

17. Abraham Maslow
In the 1930’s the psychologist Abraham Maslow designed a pyramid to
explain ‘basic health needs’.

18. Basic Physical Needs
#4. Basic Physical Needs

19. Basic Physical NeedsBasic Physical Needs
 This includes the need forThis includes the need for
 FoodFood
 DrinkDrink
 OxygenOxygen
 SleepSleep
 WarmthWarmth
 Sensory pleasureSensory pleasure
 Maternal behaviourMaternal behaviour
 and Sexual Desire.and Sexual Desire.
 If people are denied any of these needs, they mayIf people are denied any of these needs, they may
spend long periods of time looking for them.spend long periods of time looking for them.

20. Basic Physical Needs
Safety and Security Needs
#6. Safety and Security Needs

21. Safety and Security NeedsSafety and Security Needs
Once a persons basic needs have been met, their nextOnce a persons basic needs have been met, their next
concern is usually forconcern is usually for
 safety and security,safety and security,
 freedom from pain,freedom from pain,
 threat from physical attack andthreat from physical attack and
 protection from danger.protection from danger.

22. Basic Physical Needs
Safety and Security Needs
Love and Social Needs
#8. Love and Social needs

23. Love and Social needsLove and Social needs
 These include:These include:
 a sense of belonginga sense of belonging
 the need for social activitiesthe need for social activities
 friendships and the giving and receiving of love.friendships and the giving and receiving of love.

24. Basic Physical Needs
Love and emotional needs
Safety and Security Needs
Esteem needs
#10. Esteem needs

25. Esteem needsEsteem needs
This includes the need to haveThis includes the need to have
 self respect (involves the desire to haveself respect (involves the desire to have
strength, confidence, independence,strength, confidence, independence,
freedom and achievement) andfreedom and achievement) and
 esteem of others (involves having prestige,esteem of others (involves having prestige,
status, attention, recognition, reputationstatus, attention, recognition, reputation
and appreciation from other people).and appreciation from other people).

26. Basic Physical Needs
Love and emotional needs
Safety and Security Needs
Self-esteem
needs
Self
actualisation
needs
#12. Self actualisation needs
Yes

27. Self actualisation needsSelf actualisation needs
 This is the development of and realisation of a personsThis is the development of and realisation of a persons
full potential.full potential.
 all the other needs in the pyramid have to be achievedall the other needs in the pyramid have to be achieved
before a person can reach this stagebefore a person can reach this stage..
Yes

28. Final thought
‘Health is complete physical, mental
and social well-being and not just the
absence of disease or infirmity
1946 World Health Organisation
Copy of Maslow's Pyramid of Needs .doc

29. Functions of communityFunctions of community
 Utilization of space:-Utilization of space:-
Provides space for housings, shelter, for socialization and recreation.Provides space for housings, shelter, for socialization and recreation.
 Means of livelihood:-Means of livelihood:-
Provide opportunity for employment and sustenance.Provide opportunity for employment and sustenance.
 Protection of its members:- creates and enforces norms andProtection of its members:- creates and enforces norms and
controls for safety and security.controls for safety and security.
 Production & distribution & consumption of goods & services.Production & distribution & consumption of goods & services.
 Socialization & Education of its members.Socialization & Education of its members.
 Participation & communications:-Participation & communications:-
Provides opportunity for interaction amongst members, transmitsProvides opportunity for interaction amongst members, transmits
information, ideas and beliefs and provides support system.information, ideas and beliefs and provides support system.
 Linkage with social system outside community.Linkage with social system outside community.

30. CharacteristicsCharacteristics
 DistinctivenessDistinctiveness
 HomogeneityHomogeneity
 ClosenessCloseness
 Self sufficiencySelf sufficiency
 Sense of belongingness (We feeling)Sense of belongingness (We feeling)
 Solidarity or sense of togethernessSolidarity or sense of togetherness

31. 1 Distinctiveness1 Distinctiveness
 Each community has defined geographicalEach community has defined geographical
boundaries having its beginning and end.boundaries having its beginning and end.
These boundaries are more demarkabaleThese boundaries are more demarkabale
in smaller communities than in largerin smaller communities than in larger
communities.communities.
 Exp- village, town, neighbourhood etc.Exp- village, town, neighbourhood etc.

32. 2 Homogeneity2 Homogeneity
 There is similarity in psychosocialThere is similarity in psychosocial
characteristics of people living in thecharacteristics of people living in the
defined boundaries of the community.defined boundaries of the community.
 Exp.- similarity in language, life style,Exp.- similarity in language, life style,
customs, interest, traditions etc.customs, interest, traditions etc.

33. 3 closeness3 closeness
 The people in the community have face toThe people in the community have face to
face interaction and free communication.face interaction and free communication.
 Exp- mostly in small communities likeExp- mostly in small communities like
hamlet, small village and neighbourhood.hamlet, small village and neighbourhood.

34. 4 self sufficiency4 self sufficiency
 The community provides all such meansThe community provides all such means
and facilities which help in meeting theand facilities which help in meeting the
basic needs of its people.basic needs of its people.
 Exp- space to live, means for livelihood ,Exp- space to live, means for livelihood ,
education, protection and security etc.education, protection and security etc.

35. 5 sense of belongingness5 sense of belongingness
(we felling)(we felling)
 They are “community consciousness.”They are “community consciousness.”

36. 6 solidarity or sense of6 solidarity or sense of
togethernesstogetherness
 There is unity and cohesiveness amongThere is unity and cohesiveness among
the members in the community which isthe members in the community which is
based on their interaction and sense ofbased on their interaction and sense of
belongingness to community.belongingness to community.

37. Structure of communityStructure of community
 PhysicalPhysical

Pattern of settlement (hamlet to bigPattern of settlement (hamlet to big
metropolitan cities)metropolitan cities)

Natural resources (land, river, rainfall, humidity,Natural resources (land, river, rainfall, humidity,
minerals, plants vegetables, forests etc.minerals, plants vegetables, forests etc.

Man made resources-Man made resources-

(supply services, marketing & industrial(supply services, marketing & industrial
facilities,, financial, educational, health andfacilities,, financial, educational, health and
welfare, transport and communication.welfare, transport and communication.
Recreational etc.)Recreational etc.)

38. 
Human resources (physical and intellectualHuman resources (physical and intellectual
power)power)
 Social StructureSocial Structure

Social statusSocial status

Stratification l(evel)Stratification l(evel)

39. CommunityCommunity
WHO DefineWHO Define
““Community as social groupCommunity as social group
determined by geographicaldetermined by geographical
boundaries, common valuesboundaries, common values
and interest”and interest”

40. HealthHealth
WHOWHO
"Health is a state of complete"Health is a state of complete
physical mental and socialphysical mental and social
well-being, and not merely anwell-being, and not merely an
absence of disease orabsence of disease or
infirmity"infirmity"

41. Community HealthCommunity Health
WHO’sWHO’s
““Community health refers to theCommunity health refers to the
health status of thehealth status of the
community, to the problems,community, to the problems,
affecting their health & to theaffecting their health & to the
totally health care provided tototally health care provided to
the community.”the community.”

42. Acc. To AAPHAcc. To AAPH
(African academy of public health)(African academy of public health)
““The art and science ofThe art and science of
maintaining, protecting andmaintaining, protecting and
improving health of theimproving health of the
people through organizedpeople through organized
efforts.”efforts.”

43. (Acc. To(Acc. To C.E.A. WinslowC.E.A. Winslow 1920,)1920,)
Public health is "the science and artPublic health is "the science and art
of preventing disease, prolongingof preventing disease, prolonging
life and promotinglife and promoting healthhealth throughthrough
the organized efforts and informedthe organized efforts and informed
choices of society, organizations,choices of society, organizations,
public and private, communitiespublic and private, communities
and individuals"and individuals"

44. Community healthCommunity health
NursingNursing
ANA’sANA’s
““It is field of practice that synthesizesIt is field of practice that synthesizes
knowledge & skill from nursing &knowledge & skill from nursing &
public health & applied them towardpublic health & applied them toward
preventing, promoting, curative &preventing, promoting, curative &
rehabilitative care to family &rehabilitative care to family &
community.”community.”

45. Acc. To AAPHAcc. To AAPH
““Public health NursingPublic health Nursing synthesizessynthesizes
the body of knowledge fromthe body of knowledge from
public health sciences andpublic health sciences and
professional nursing theories forprofessional nursing theories for
the purpose of improving thethe purpose of improving the
health of entire community.”health of entire community.”

46. Acc. To Archer SE, 1982Acc. To Archer SE, 1982
““Community health Nursing is aCommunity health Nursing is a
synthesis of both public healthsynthesis of both public health
science and nursing science and isscience and nursing science and is
theoretically responsive to ourtheoretically responsive to our
prevailing ideas of social justiceprevailing ideas of social justice
and the methods of distributingand the methods of distributing
health care resources as choosenhealth care resources as choosen
by the community”by the community”

47. Characteristics of Community
Health Nursing
 It is a field of nursing
 It combines public health and nursing
 It focus in population and environment
factors that may impact to people’s health
 It emphasize in health promotion, illness
prevention, and wellness

48.  It involves inter-professional collaboration.
 It promotes client responsibility and self-
care
 It uses aggregate measurement and
analysis

49. Objective of C.H. Nursing
 1. Prevention of disease
 2. Promotion & Maintenance of health.

50. Purpose of C.H. Nursing:
 1. To ascertain the nature & extent of
disease & disability in the community.
 2. To take suitable measures to….
 -Promote healthful living.
 -Prevent Disabilities.
 -Correct re-medical defects.
 -Treat illness & Rehabilitate those and
handicaps.

51. 3. To evaluate the progress and success
of current programmes.
4. To conduct research in community
causes and diseases.
5. To provide the medical & nursing care to
common ill health.
6. To educate the public in prevention of
health hazards.

52. PRINCIPLES OF COMMUNITY
HEALTH NURSING
1. Community health nursing is an
established activity based on recognized
needs.
2. The community health nursing agency
has clearly defined objectives and purpose
for its services.
3. Community health nursing is an integral
part of the community health programme.

53.  Community health nursing services should
be available to people irrespective of age,
sex, creed, and nationality, cultural and
economic resources.
 5. Community health nursing recognized
the family and community as unit of
service.
 6. Community health nursing should
include health education and counseling.

54.  7. Community health nurse should be
qualified as a full-fledged.
 8. Community health nursing service should
be based on the need s of the patient.
 9. The Community health nurse should
function as an important member of the
health team.
 10. The Community health nurse should not
accept gifts or bribes from the patient.

55.  11. The Community health nurse should not
belong to any one section or any political group.
 12. The Community health agency should
provide a continuing education programme for
nurses.
 13. The Community health nursing services
should develop proper guideline, in maintaining
records and reports.
 14. The Community health nurses should
maintain professional relationship with all the
leaders in the community and maintain ethics at
all times.