Community involvement, community participation, community leaders and their roles, role of community health nurse

1. Community involvement and role of
community health nurse
BY MSRADHA RANA
(STUDENT OF RAJKUMARIAMRIT
KAURCOLLEGEOFNURSING)

2. Introduction
The health of individuals living in a defined
community is not only their “right” but also
their “responsibility” to take care of their
own health and also of community at large.
Community involvement and participation is
recognised as one of the crucial supportive
approach for the successful implementation

3. Definition
Community involvement is defined as the type of
community participation in which the community is
involved in all aspects of a programme.

4. Importance of community involvement
1. For successful health services
2. Opportunity to people to identify health needs
3. Active involvement of community
4. Community to identify available resources
5. To make informed decisions

5. 6. Sense of responsibility and accountability to the
community
7. Community to develop self realiance And social control

6. Communityhealthworkers
Communityhealthworkers(CHWs)arefrontlinepublichealth
workerswhohaveacloseunderstandingofthecommunitythey
serve.Thistrustingrelationshipenablesthemtoserveasalink
betweenhealthservicesandthecommunitytofacilitateaccess
healthservicesandimprovethequalityandculturalcompetenceof
servicedelivery.

7. Communityhealthworkerstypicallyhavedeeprootsorsharedlife
experiencesinthecommunitiestheyserve.Theysharesimilarvalues,ethnic
backgroundandsocio-economicstatusandusuallythesamelanguageasthe
peopletheyserve.

8. Functionsof communityhealthworkers
Linkingpeopletohealthcare/socialserviceresources
Providinginformalcounseling,supportandfollow-up
Advocatingforlocalhealthneed
Makinghomevisitstochronicallyillpatients,pregnantwomenandnursing
mothers,individualsathighriskofhealthproblemsandtheelderly
Helpingpeopleunderstandtheirhealthcondition(s)anddevelopstrategiesto
improvetheirhealthandwellbeing

9. Helpingindividuals,families,groupsandcommunitiesdevelop
theircapacityandaccesstoresources,includinghealth
insurance,food,housing,qualitycareandhealthinformation

10. Services participation
 For Children
1. Immumization and vitaminAprophylaxis
2. Ironfolicacidsupplementationtochildwithanemia
3. Dewormingtopreventhookworminfestation
4. Managementtof diarrhoealdiseases= preparationof ORS,increasingfluids,normaldiet, recognisewhentoseek
medicalhelp.
5. Helpprevent deathsduetopneumonia

11. For Mothers
1. Immunization
2. Preventionand treatmentofanemia
3. Antenatalcareandearlydetectionofmaternalcomplications
4. Feliverybytrainedpersonnel
5. Promotuonof institutionaldeliveries
6. Birthspacing

13. Examples of community involvement
ASHA (accredited social health activist)
Village health guide
Anganwadi workers
Birth attendents

14. Asha
• Honorary trained community healthcare
volunteer
• A link between community and rural
healcare system
Roles
1. Create awareness
2. Counsel for safe delivery, breastfeeding etc
3. Mobilization of community and resources
4. Primary medical care for minor ailments

15. Village health
guides

16. Functions of village health guides
Villagehealthguidesisapersonwithanaptitude forsocialserviceandisnota
fulltimegovt.Functionary.Sheshouldbeapermanentresidentoflocal
community.Thereis1villagehealthguideover1000population
Theyprovidesimpletreatmentforcommonminorailments,firstaidduring
accidentandemergency,caretomotherAndchildincludingfamilyplanning,
healtheducationetc.

17. Anganwadi workers
• Is under ICDS scheme, 1 over a population of
1000
• Selected from the community, undergoes training
in various aspects of health, nutrition, child
development etc.
Roles
1. Promote and encourage community participation
2. Provide minor ailments treatment
3. Care to mother and child
4. First aid during emergency, accidents etc

18. Birthattendents
• Works under supervision and guidance of
female healcare worker.
Roles
1. personal and skillful care during perinatal period
2. Health education on childcare, immunization,
nutrition, family planning etc

19. Activitiesof dai
 Looking FortheregistrationofantenatalmothersinherVillage.
 AttendingweeklyprenatalclinicsandassistANM
 EnsurethatEverypregnantwoManintheareaattendtheprenatalclinicsAtleast3timesI.e3rd,7th and9th months
 TrytoensureTTimmunizationofantenatalmothersofherarea
 ShouldensurethateveryantenatalmothersistakingFesupplimemts
 Reportanyabnormalitiesinthepregnancyifany,reporttonearbyPHC
 Properpreparationsfordelivery

20.  Ifshefindsanyabnormalitiesduringthelabour,,shemustseekmedicalaidwithoutanydelay
 Whenshereceivesacallfordelivery,shemust
1. Watchprogressofdeliverycarefully
2. AllowlabortoprogressNormallywithoutanyunnecessaryInterference
 SheshouldEnsurethecompleteimmunizationofthebabiesinherarea
 SheshouldmotivatetheeligiblecouplesforcontraceptionAndtoundergosterilisation
 ReportallbirthsanddeathsofherareatotheANM.

21. Role of community healthnurse

22. There are inumerable roles which are performed by community
health nurses working in various community health settings.

23. Care provider

24. Itincludesactivitiesfortheprovisionofdirect
nursingcare
ShealsosuperviseguidesandteachesCommunity
participants,familytoaccesstotheavailable
healthcareservices

25. Educator

26. Sheeducatesindividual,familiesand
communitynotonlywhentheyaresickbut
alsowhentheyarewellbutrequirehelpto
promotehealthandpreventillnesswithThe
helpof communityparticipants

27. Leader

28. Sheleadsthegroupbygivingthemdirections,
ensuringbiwaycommunicationwiththecommunity
participants,providingsupervisionandguidance
andbycoordinatingtheiractivitiesand
infrastructure.

29. Change agent

30. Sheisabletomakeothersmoreeffectiveby
increasingtheircapacityto
1. Copeupwiththeirhealthproblems
2. Providecaretothemselves

31. Advocate

32. Asanadvocate,CHNstandsbetweentheindividual/
family/communityandvariousspecialisedservices.She
pleadsfortheircausebyspeaking,actingontheirbehalf.She
explainstothemaboutthevariousservicesavailableand
guidethemhowtoutilizetheservices.

33. Councillor

34. Communityhealthnursehelpsthecommunitytofind
thesolutionstotheirproblems.Asacouncillor,She
helpsthecommunitytorecogniseandunderstand
theirproblemstobesolved,identifythesolutions
withinresources Andimplementthesolutionwith
helpofcommunityparticipants

35. Observer

36. Thecommunityhealthnurseobserveandreportthe
environmentalandhomeconditionofthe
communitytobeserved.Allhealthservicestothe
communityrelyonobservationskillsofnurse.

37. Manager

38. Asamanager,sheplans,organises,coordinates,
supervise,guidesanddirectsVarioushealth
programswiththeteammembers,andcommunity
participants.Ifthereisanyproblemwhichshe
identify,ifnecessaryshehavetoreportittothe
higherauthorities.

39. Evaluator

40. Onceanyhealthservices/programisimplemented,
itistheresponsibilityofthecommunityhealth
nursetomonitorandevaluatetheplantomakesure
whetheritisproceedinginitsdirectionornot.

41. Adviser

42. ThereareSomepracticalsituationswhichrequire
regularActionsintheformofadvisestobegivento
thecommunity.Eg.Regularintakeofiron
supplementsbytheantenatalmother’s.

43. Collaborator

44. Communityhealthproblemscannotbesolvedbya
singlehealthworker.Itinvolvescommunity
participantswithwhomshe workstogetherasa
team.Eachmemberintheteamhasa uniquerole
andspecificresponsibilitiesinmeetinghealthneeds
andpromotingcommunityparticipation.

45. RefErer

46. Makingrefferalsofcommunitypeoplewhoisin
needofmedicalhelpthatcan’tbefulfilledinthe
communitysettingsandneedstoreferredtothe
highercentresisanessentialpartofcommunity
healthnursing.

47. Research

48. Topic=Remuneration Systems of Community Health Workers in India and Promoted
Maternal Health Outcomes: A Cross-Sectional Study
Author=Hannah j. Kohen Et Al. Bmc health services Researcher

49. Background:Thisstudyassessedtheassociationofremuneration
systemsofpaid-for-performanceAccreditedSocialHealthActivists
(ASHAs)andsalariedAnganwadiworkers(AWWs)onseven
maternalhealthoutcomesinfourstatesinIndia:AndhraPradesh
(AP),Chhattisgarh,Odisha(Orissa),andUttarPradesh(UP).

50. Methods:Thecross-sectionalstudysurveyedmothersofchildrenaged6-23months.
Atotalof3455motherswereselectedviamultistageclustersampling.Thesevenhealth
outcomesrelatedtothecommunityhealthworker(CHW)visitswere:institutional
delivery,completeimmunization,exclusivebreastfeedingforsixmonths,timely
introductionofcomplementaryfeeding,continuedbreastfeedingduringchild'sillness,
handwashing,andawarenessofNutritionandHealthDays(NHDs).

51. Results:Theresultsvariedbystate.MotherswhoreceivedASHAvisitswere
significantlylesslikelytohaveaninstitutionaldelivery,timelyintroductionof
complementaryfeeding,awarenessofNutritionandHealthDays(NHDs),proper
handwashing,andexclusivebreastfeedingforthefirstsixmonthsinatleastoneof
thefourstates.Conversely,AWW'shomevisitswerepositivelypredictiveofthe
followinghealthoutcomesincertainstates:completeimmunizationforindexchild,
continuedbreastfeedingduringthechild'sillness,handwashing,andawarenessof

52. Conclusions:ASHAs'homevisitswerenotmorestronglyassociatedwithhealth
outcomesforwhichtheywerepaidthanoutcomesforwhichtheywereunpaid.
AWWs'homevisitswerepositivelyassociatedwithawarenessofNHDs,and
associationsvariedforotherrecommendedhealthbehaviors.Furtherresearchcould
elucidatethecausesforsuccessesandfailuresofCHWprogramsindifferentstatesof
India.