Unit 1: Community Health Nursing
Unit 1: Community Health Nursing
Unit 1: Community Health Nursing
Nursing
Current status, trend, socio-cultural issues and
challenges related to community health nursing
Presented by:
Nisha Dwa
Shushila Pokharel
Current Status:
• Community health nursing has evolved into a focus on care
of individual, families and communities.
• Community health nursing emphasizes on the personal and
environmental health of the total population and not just of
selected individuals.
• Community health nursing focuses on promoting health
related behaviors as well as providing personal health
services to members of populations or communities.
Contd…
• Community health nursing pays attention to the influence of
environment factors (physical, biological and sociocultural) on
the health of populations and priority is given to preventive and
health maintenance strategies rather than curative strategies.
• The nurse today performs demanding tasks to meet the needs of
the society.
• Her job is not only limited to the sick but also to prevent diseases
and to preserve and promote the health of the people.
Contd…
• As a home care nurse, they provide care to the patients at
their home itself.
• Nurses provide antenatal, postnatal and child care services in
the MCH and family planning services.
• The school health nurse renders services to promote and
protect the health of the school children.
Contd…
• They provide primary health care in the community, carry out
immunizations, conduct under five clinics, assess the social,
environmental and nutritional needs of the community.
• Nurses are employed in industries. They carry out the pre-
employment and periodic health checkup, care of sick, first
aid, industrial sanitation, safety and rehabilitation.
Current Trend:
According to Dr. E.G. Mcgaveran, these changes are divided into four
eras from middle of 19th century to middle of 20th century onwards.
• Empirical Era (Upto 1850)
• Basic Science Era (1850 to 1900)
• Clinical Science Era (1900 to 1950)
• Public Health/Community Science Era (1950 onwards)
One more era has been added by W.L. Barton from 1975-2000 AD
and is called as Political Science Era which is Health for All (HFA)
era.
Empirical Era (Upto 1850)
1) Demographic Trends:
• Increased life expectancy leading to greater percentage of
elderly individuals.
• Increased number of elderly individuals has resulted in a
need for greater emphasis on the prevention, diagnosis and
treatment of chronic disease.
2) Technological Trends:
• Technological trends that currently influence health and
health care delivery include such things as the knowledge
explosion, the increased ability to prolong life, environmental
pollution, increased pace of life.
3) Socio-cultural Trends:
• Health is taken as a right rather than a privilege.
• National health insurance policies have been introduced.
• Provisions for hospitalization, ambulatory care, and health
maintenance are provided.
• Health as a positive state rather than the absence of disease.
• Increasing use of mass communication techniques.
4) Economic Trends:
• The rising cost of health care causes the people to seek cost
effective facilities in the community hospitals rather than the
private hospitals.
• Self care by individuals is another consideration in the
provision of health care in today’s economy due to mal-
distribution of health care services.
CHANGING PRACTICES
CENTURY
• World health leaders recognized the need to plan for the
twenty-first century at the 30th world health assembly of the
World Health Organization (WHO), held in 1977.
• At that assembly, delegations from governments around the
world set as a target “that the level of health to be attained by
the turn of the century should be that which will permit all
people to lead a socially and economically productive life”.
• This target goal becomes known as “Health for all by the
year 2000”.
• The following year in Alma-Ata, the joint WHO/UNICEF
International Conference adopted a Declaration on Primary
health Care as the key to attaining the goal of “Health for all
by the Year 2000”.
• At the 34th World Health Assembly in 1981, delegates from
the member nations unanimously adopted a “Global
Strategy” and that same year, the United nations General
Assembly endorsed the “Global Strategy” and urged other
international organizations concerned with community health
to collaborate with World Health Organization.
• The underlying concept of “Health for All by the 2000” was the
health resources should be distributed in such a way that essential
health care services are accessible to everyone.
• As we now know, the lofty goal of health for all around the world
by the 2000 was not reached. That does not mean that the goal
was abandoned.
• With the passing into a new century, the program was renamed
Health for All (HFA). HFA continues to seek “to create the
conditions where people have, as a fundamental human right, the
opportunity to reach and maintain the highest level of health. The
vision of are newer HFA policy builds on the WHO Constitution, the
experience of the past and the needs for the future”.
• Even though the “Health for All by the year 2000” goal was
not reached, some progress was made, overall global health,
as measured by life expectancy at birth, did improve.
Current Issues in
Community Health
Nursing
Ethical issues