Historical developments of community health nursing in the world


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Historical developments of community health nursing in the world

  1. 1. HISTORICALDEVELOPMENTS OFCOMMUNITY HEALTHNURSING IN THE WORLDwww.drjayeshpatidar.blogspot.comwww.drjayeshpatidar.blogspot.in
  2. 2. HISTORICAL DEVELOPMENTS OFCOMMUNITY HEALTH NURSING IN THEWORLD:-ANCIENT PERIOD:- The history of publichealth and public health nursing can be tracedfar back in the past. In earliest times peoplestruggled for their survival by devising theirown methods to deal with life events such asbirths, deaths etc.www.drjayeshpatidar.blogspot.in
  3. 3. HISTORICAL DEVELOPMENTS OFCOMMUNITY HEALTH NURSING IN THEWORLD:- people were concerned about diseases and hadsome knowledge of its treatment. Medical cartewas given by religious leaders or priests whowere revered by the society.Record history of ancient civilization such asBabylonian, Hebrew, greek and roman revealsthat they possessed knowledge of personalhygiene, community responsibility and medicine.www.drjayeshpatidar.blogspot.in
  4. 4. HISTORICAL DEVELOPMENTS OFCOMMUNITY HEALTH NURSING IN THEWORLD:- They had well developed system ofenvironmental sanitation such as safewater supply, drainage and sewagedisposal system. They also hadunderstanding of contagious nature ofdiseases.www.drjayeshpatidar.blogspot.in
  5. 5. HISTORICAL DEVELOPMENTS OFCOMMUNITY HEALTH NURSING IN THEWORLD:- This resulted in rigid public healthmeasures like isolation of thesick, quarantine of the families and sometimes of the communities. The philosophy of the time was that theindividual should provide for the basicneeds for himself and his familywww.drjayeshpatidar.blogspot.in
  6. 6. HISTORICAL DEVELOPMENTS OFCOMMUNITY HEALTH NURSING IN THEWORLD:- his responsibility included the provison offood,shelter and clothing and care in caseof illness. The community responsibilitywas to protect the individual and hisfamily against illness that might be due tocommunal life.www.drjayeshpatidar.blogspot.in
  7. 7. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN BRITAIN:- The development of modern public healthand nursing took place from the middle of19th century both in England and Americaand various other countries as a result ofoccurance of great epidemics of bubonicplague, leprosy, small pox, cholera etc.www.drjayeshpatidar.blogspot.in
  8. 8. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN BRITAIN:- During 18th century and early 19thcentury England faced industrial revolutionwhich created tremendous social impactsin terms of socio-economicimbalance, exploitation ofworkers, slums, overcrowding, poorsanitation, broken families, childabuse, maternal and child healthproblems.www.drjayeshpatidar.blogspot.in
  9. 9. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN BRITAIN:- During 19th century inspite of the actbeing passed and implemented to improvethe environmental sanitation, thesediseases continued to occur time andagain in the western world. This wasbcause of the fact that epidemiology ofthe diseases were not fully understood.www.drjayeshpatidar.blogspot.in
  10. 10. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN BRITAIN:- Ms. Florence Nightingle has beenrecognized as one of the foremestpioneers in the public health and publichealth nursing movements in England.She is acclaimed as the founder of modernnursing. She began her work whennursing services which were establishedby religious order, had withered away withthe decline of church power and influencewww.drjayeshpatidar.blogspot.in
  11. 11. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN BRITAIN:- She began her work when nursingservices which were established byreligious order, had withered away withthe decline of church power and influence.Florence Nightingle created an atmosphereof dignity and self respect for nursing.www.drjayeshpatidar.blogspot.in
  12. 12. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- In America, similar developments tookplace in the field of public health andpublic health movement gainedmomentum in 1850, when lemuelShattuck, a publisher and bookseller, submitted a report on sanitaryconditions of Massachusetts to itslegislature and also published the same.www.drjayeshpatidar.blogspot.in
  13. 13. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- In his report he put forward specificrecommendations regarding a systemof sanitary inspection, collection ofvital statistics school healthprogramme.www.drjayeshpatidar.blogspot.in
  14. 14. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- In 1872, American health association, anational level profession organization ofcommunity health workers wasestablished. This association initiatesvarious public health campaigns and hasconsistently worked for improvingstandars of community health services.www.drjayeshpatidar.blogspot.in
  15. 15. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- The field of public health bradend underthe influence of scientific advances inmicrobiology, social and behavioralsciences. Thus in late 19th century and atthe beginning of 20th century a newconcept began to take impetus that statehas the direct responsibility for the healthof people.www.drjayeshpatidar.blogspot.in
  16. 16. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- Public health activities not only includedthe activities of improved sanitation andcontrol of communicable diseases butaalso preventive and promotive services tomothers,children,school children,workersand elderly.www.drjayeshpatidar.blogspot.in
  17. 17. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- The need for the application of principlesof personal hygiene, care and healthteaching was felt in all these public healthservices for controlling mortality andmorbidity among mothers, children andworkers etc. and improve and promotetheir health.www.drjayeshpatidar.blogspot.in
  18. 18. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- This phase of public health gave origin topublic health nursing. During this period,the foundation of district nursing throughprivate, voluntary efforts was laid.www.drjayeshpatidar.blogspot.in
  19. 19. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- By 1890, twenty one such organizationsexisted in USA. In 1893, Lillian wald, thepioneer in public health nursing, foundedthe hennery street settlement, which grewin to a well organized health centre withvisiting nurse services for the surroundingcommunity.www.drjayeshpatidar.blogspot.in
  20. 20. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- The rockfellers foundation of new yorkestablished in 1913, adepted public healthas one of its field of interest. Thisfoundation assisted in establishment ofschools of public health in united statesand other countries.www.drjayeshpatidar.blogspot.in
  21. 21. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- The American red cross society, thecommon wealth fund and keloggfoundation were the other volutary andprivate bodies which were very active inthe development of public health andpublic health nursing services.www.drjayeshpatidar.blogspot.in
  22. 22. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- During the early part of 20thcentury, there were specialized nurses inthe field of public healthy like nurses inmaternal and chil;d health, veneraldiseases, other communicablediseases, tuberculosis control etc.www.drjayeshpatidar.blogspot.in
  23. 23. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- public health had entered a newera. Itwas faced with new emergent healthproblems which were more serious butchronic and degenerative such ascardiovasculardiseases, cancer, stroke, mental illnessand metasbolic disorders.www.drjayeshpatidar.blogspot.in
  24. 24. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- Thus public health deal with wide range ofhealth problems and its activities movedbeyond the traditional basic seven serviceswhich included communicable diseasecontrol, environmentalsanitation, maternal and childhealth, health education, medical andnursing care, nutrition, & vital statistics.www.drjayeshpatidar.blogspot.in
  25. 25. HISTORY OF PUBLIC HEALTHAND PUBLIC HEALTH NURSINGIN AMERICA:- The field of public health, broadend,increasing emphasis was given on primaryhealth care and preventive and promotiveservices, further as a result of ALMA Atadeclaration of the “ goal of health forall’ through primary health care by WHOand UNICEF in 1975.www.drjayeshpatidar.blogspot.in
  26. 26. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- ANCIENT PERIOD:- The development ofpublic health nursing in India startedmuch later as compared to developedcountries of the west. But public health inIndia was in practice much before itsdevelopment in western countries.www.drjayeshpatidar.blogspot.in
  27. 27. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- The Indian history revealed its publichealth practice as early as 5000BC. Theperiod can be classified as vedic periodand post vedic period. During the vedicperiod the sacred books Upanishads andVedas- especially the atharvedadocumented all the knowledge aboutmedicine,personal hygiene,prevention ofsickness etc.www.drjayeshpatidar.blogspot.in
  28. 28. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- The post vedic period (500BC to 700)started with the rise ofBuddhism, Buddhism emboied theprinciples of nonviolence, helping thesick,poor and needy people, selfdiscipline,self education, charity towardsall men etc.www.drjayeshpatidar.blogspot.in
  29. 29. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- BRITISH PERIOD ( 18TH century to1947):- The british had estabilished itsrule in India in 1757 by establishing civiland military services. In 1859, theadministration of India was taken over bythe crown from east India company.www.drjayeshpatidar.blogspot.in
  30. 30. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- In 1859, a royal commission which cameto India to study theproblem, recommended to establishsanitary commission of five persons eachin Bengal, Bombay and madras.www.drjayeshpatidar.blogspot.in
  31. 31. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- In1896, following the out break ofepidemic of plague, aplague commissionwas set up to investigate itsepidemiological aspects. As result ofinvestigation and suggestion,www.drjayeshpatidar.blogspot.in
  32. 32. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- In1912, the local government bodieswere made responcible to execute varioushealth services according to over all plansand directions of central government.www.drjayeshpatidar.blogspot.in
  33. 33. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- In 1939 some very importantdevelopments took place. The madraspublic health act was passed for the firsttime in the country. The first rural healthtraining centers was established at singurnear Calcutta with the support ofRockfeller Foundations.www.drjayeshpatidar.blogspot.in
  34. 34. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- In 1943, health survey and developmentcommittee existing health conditions andhealth organization in the country and tomake recommendations about thedevelopments in future.www.drjayeshpatidar.blogspot.in
  35. 35. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- DEVELOPMENT SINCEINDEPENDENCE( 1947ONWARDS):-Before India attained independence on15th august 1947, some of the provincesand princely states of India were parted toconstitute Pakistan.www.drjayeshpatidar.blogspot.in
  36. 36. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- This effected change in demographic,Political and socio-economic aspects. Atthe same time, a large number of peoplefrom Pakistan migrated to India.www.drjayeshpatidar.blogspot.in
  37. 37. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- The government of India at that timefaced a large number of socio-economicand public health problems. But becauseof new constitutional policies and theenthusiastic attitude of politicalleaders, administrators and the people ingeneral, the government could manage toovercome initial difficulties,implementstrict public health measures to preventepidemics.www.drjayeshpatidar.blogspot.in
  38. 38. HISTORICAL DEVELOPMENT OFPUBLIC HEALTH NURSING ININDIA:- planning commission was constituted tophelp government to plan out integrateddevelopment plan for the entire countrywith in the available resourses for adefined period of five years for its socoi-economic progress. The planningcommission has been responsible for ten “five year plans”.www.drjayeshpatidar.blogspot.in
  39. 39. COMMUNITY HEALTH NURSINGISSUES:- The professional issues challengingcommunity health nursing . first of allempowered community health nursesneed to be able to address the followingquestions.www.drjayeshpatidar.blogspot.in
  40. 40. COMMUNITY HEALTH NURSINGISSUES:- who is assessed by community healthnurses: the individual, family, group, orcommunity ? what do community health nurses assess? what nursing diagnosis do communityhealth nurses use ?www.drjayeshpatidar.blogspot.in
  41. 41. COMMUNITY HEALTH NURSINGISSUES:- what types of nursing interventions docommunity health nurses use in practice? differ with differences in client focus ? how do interventions differ withdifferences in client focuswww.drjayeshpatidar.blogspot.in
  42. 42. COMMUNITY HEALTH NURSINGISSUES:- how is community health nursingevaluated for quality ofcare, cost, effectiveness, and outcomesassessment?www.drjayeshpatidar.blogspot.in
  43. 43. COMMUNITY HEALTH NURSINGISSUES:- ASSESSMENT:- the previously listedquestions, which challengecommunity health nurses suggestthat there may be wide variety ofareas that are consideredappropriate and necessary forassessment in community healthnursing.www.drjayeshpatidar.blogspot.in
  44. 44. COMMUNITY HEALTH NURSINGISSUES:- DIAGNOSIS:- with the lake of clarity interms of nursing assessment in communityhealth nursing, it follows that nursingdiagnosis in community health nursing isequally undevelopedwww.drjayeshpatidar.blogspot.in
  45. 45. COMMUNITY HEALTH NURSINGISSUES:-Muecke (1984) critiques the concept ofcommunity health diagnosis andproposes the following steps to identifythe community of concern identification of the health risk of thecommunity.www.drjayeshpatidar.blogspot.in
  46. 46. COMMUNITY HEALTH NURSINGISSUES:- specification of the characteristics of thecommunity and its environment that areetiologically associated with the risk specification of the health indicators thatverify the risk.www.drjayeshpatidar.blogspot.in
  47. 47. COMMUNITY HEALTH NURSINGISSUES:-GOALS:- goeppingere (1984) examines theprinciples issues of community helth nursingfrom the perspective of the following questions what are the goals of community health nursingpractice ? what are the target system that communityhealth nurses intend to change ? in what setting do community health nursespracticewww.drjayeshpatidar.blogspot.in
  48. 48. COMMUNITY HEALTH NURSINGISSUES:- INTERVENTIONS:- A major nursingintervention issue is that of themeasurement of costs of communityhealth nursing in the home health caresetting. Kovner categorizes alternatives into four models. Per visit, acuity ofcare, hourly, and by diagnosis.www.drjayeshpatidar.blogspot.in
  49. 49. COMMUNITY HEALTH NURSINGISSUES:- The setting for community health nursingpractice leads to a question of weathercommunity health nursing is settingspecific. Is it community- oriented becauseit emphasizes the collective need ? threenewer and related delopments in nursingcommunity setting have been the nursingentrepreneurship, and parish nursing.www.drjayeshpatidar.blogspot.in
  50. 50. COMMUNITY HEALTH NURSINGISSUES:-EVALUATION:- measurement of the outcomesof community health nursing care leads toavariety of questions and issues. what are the consequences of organizing carearound reimbursement guidelines rather than atheory- based approach? what level of focus of community health nursingis most cost-effective: individual, families, groupor communities?www.drjayeshpatidar.blogspot.in
  51. 51. COMMUNITY HEALTH NURSINGISSUES:- what are the effects of changes inreferral patterns, level of illness of clientsreferred,intensity of servicesrequired, and quality of servicesdelivered ? what measures of patient outcomes interms of behavioral or functionalchanges can be used to evaluate theinterventions of community healthnurses ?www.drjayeshpatidar.blogspot.in
  52. 52. COMMUNITY HEALTH NURSINGISSUES:- what are the effects of differentmanagement procedures for specifictypes of clients ? what is the effect of variousmanagement structures and types ofagencies on the way home care isdelivered ?www.drjayeshpatidar.blogspot.in
  53. 53. CURRENT ISSUES school nurses have played a significantpart in school health programs. They needto be flexible, creative, and involved inrevising their role to fit with newdirections, otherwise, the role of theschool nurse may be jeopardized.Economic justification for services isnecessary and therefore, the value of theschool nurse must be ascertained.www.drjayeshpatidar.blogspot.in
  54. 54. CURRENT ISSUES National health objectives for the year2000 seek to increase school- basededucation to prevent humanimmunodeficiency virus infection, alcoholand other drug use, tobaccouse, injury, and sexually transmitteddiseases.www.drjayeshpatidar.blogspot.in
  55. 55. CURRENT ISSUES Health education has proven to beeffective at reducing risk behaviorsassociated with the leading causes ofdeath, that is heartdiseases, cancer, stroke, C.O.P.D. unintentional injuries, AIDS.etc.responsibility needs to be a fundamentalcomponent of health care reform.www.drjayeshpatidar.blogspot.in
  56. 56. TRENDS IN COMMUNITYHEALTH NURSINGThe major forces for shapingnursing’ role in the health careenvironment are considered to be. Shifting payment system. increased proportion of the agedpopulation. increased competition amonghealth care providers.www.drjayeshpatidar.blogspot.in
  57. 57. TRENDS IN COMMUNITYHEALTH NURSING increased complexity of client needs andseverity of client conditions. government intervention in costcontainment.www.drjayeshpatidar.blogspot.in
  59. 59. SCOPE OF COMMUNITY HEALTHNURSINGAreas of activities of community health fallsin to four catagories described below. those areas where activities must be ona community basis the supervision of food, water and milksupply of a community basis.www.drjayeshpatidar.blogspot.in
  60. 60. SCOPE OF COMMUNITY HEALTHNURSING those areas dealing with preventableillness, disabilities or premature death. communicable diseases includinginfestations, for examplediphtheria, pertusis, tetanus, TB, measles, poliomyelitis, worm infestation etc.www.drjayeshpatidar.blogspot.in
  61. 61. SCOPE OF COMMUNITY HEALTHNURSING nutritional deficiences for example theconditions of mal-nutrition likemarasmus, kwashiorkor, night-blindness, goiter, nutritional anaemia etc. substance abuse, for example drug abuseand other substances abuse like alcohol. Mental health and illness i.e. disorders ofemotion, personality, behaviour etc.www.drjayeshpatidar.blogspot.in
  62. 62. SCOPE OF COMMUNITY HEALTHNURSING Occupational health includes prevention andtreatment of occupational illness & hazards. Non-communicable diseases and conditionslike cancer, cardio- vasculardiseases, diabetes and accidents. Dental healthwww.drjayeshpatidar.blogspot.in
  63. 63. SCOPE OF COMMUNITY HEALTHNURSING Maternal & child health Rehabilitation of victims of accidents andillness. Problem of old agewww.drjayeshpatidar.blogspot.in
  64. 64. SCOPE OF COMMUNITY HEALTHNURSINGThose areas of health , medical and nursingwhich need organized official leadership. providing facilities for undergraduates, postgraduates and continuingeducation programmes in concernedfields promoting of equitable distribution ofhealth man power and facilities research. www.drjayeshpatidar.blogspot.in
  65. 65. HEALTH TECHNOLOGYDEFINITION:-Health technologies are evidence-based when they meet well-definedspecifications and have beenvalidated through controlled clinicalstudies or rest on a widely acceptedconsensus by experts.www.drjayeshpatidar.blogspot.in
  66. 66. HEALTH TECHNOLOGYHEALTH TECHNOLOGY ASSESSMENT(HTA)Basic HTA Orientations Technology-oriented assessments Problem-oriented assessments Project-oriented assessmentswww.drjayeshpatidar.blogspot.in
  67. 67. PURPOSES OF HTA Regulatory agencies such as the Foodand Drug Administration (FDA) aboutwhether to permit the commercial use(e.g. marketing) of a drug, device orother technologywww.drjayeshpatidar.blogspot.in
  68. 68. PURPOSES OF HTA Clinicians and patients about theappropriate use of health careinterventions for a particular patient’sclinical needs and circumstances Health professional associations aboutthe role of a technology in clinicalprotocols or practice guidelineswww.drjayeshpatidar.blogspot.in
  69. 69. PURPOSES OF HTA Health care payers, providers, andemployers about whether technologiesshould be included in health benefitsplans or disease managementprograms, addressing coverage (whetheror not to pay) and reimbursement (howmuch to pay)www.drjayeshpatidar.blogspot.in
  70. 70. PURPOSES OF HTA Hospitals, health care networks, grouppurchasing organizations, and otherhealth care organizations about decisionsregarding technology acquisition andmanagementwww.drjayeshpatidar.blogspot.in
  71. 71. HEALTH TECHNOLOGYASSESSMENT PROGRAM (HTA)The primary goals are to make: Health care safer by relying on scientificevidence and a committee of practicingclinicians Coverage decisions of state agencies moreconsistent State purchased health care more costeffectivewww.drjayeshpatidar.blogspot.in
  72. 72. OHTACCRITERIA :- Technology must improve the nethealth outcome and/or safety forpatients and/or providers orimprove health systems efficiency. Technology must be at least asbeneficial as any establishedalternativewww.drjayeshpatidar.blogspot.in
  73. 73. OHTAC1. Technology must be licensed by HealthCanada and have received otherapplicable licensing or approvals fromappropriate governmental or regulatorybodies (e.g. the Canadian Nuclear SafetyCommission).www.drjayeshpatidar.blogspot.in
  74. 74. HEALTH TECHNOLOGIES ANDDECISION MAKING: How evidence (particularly HTA-basedevidence) is produced and used indecision making. How aspects of health-care systemsfacilitate or impede the implementation ofdecisions.www.drjayeshpatidar.blogspot.in
  75. 75. Thank youwww.drjayeshpatidar.blogspot.in