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PROFESSIONAL ETHICS IN COMMUNITY HEALTH

1.0 PROFESSIONAL ETHICS IN COMMUNITY HEALTH PRACTICE

1.1 DEFINE ETHICS AND ETIQUETTE

Ethics: A branch of philosophy that deals with questions of morality, focusing on what is good or
bad, right or wrong. Ethics involves the systematic reflection on moral principles and values that
govern the conduct of individuals and groups.
Etiquette: The conventional rules of personal behavior and polite conduct that reflect social norms
and respect within a specific context or profession. While ethics relates to moral principles,
etiquette involves manners and proper behavior in professional settings.

DEFINATION OF PROFESSIONAL ETHCS

PROFESSIONAL ETHICS: Refers to the ethical standards and expectations that guide the
professional conduct of community health workers. These standards include maintaining integrity,
confidentiality, and patient welfare above all else.
In the other word, professional ethics can be defined as a set of moral principles and standards that
guide behavior and decision-making in a professional context. In community health, it dictates
how health workers should act to uphold the integrity of their profession and the well-being of
their clients.
IMPORTANCE OF ETHICS IN COMMUNITY HEALTH
PROMOTES TRUST: Ethical practices help build trust between health professionals and the
community, which is essential for effective health interventions.
ENSURES QUALITY OF CARE: Adherence to ethical standards ensures that patients receive
respectful, competent, and compassionate care.
PROTECTS PATIENT RIGHTS: Ethics provide a framework for protecting the rights and dignity
of patients, ensuring informed consent, confidentiality, and fair treatment.
GUIDES PROFESSIONAL CONDUCT: It helps professionals navigate complex situations,
ensuring decisions are made in the best interest of patients and the community.
DIFFERENCES BETWEEN ETHICS, MORALS, AND LAWS
Ethics vs. Morals:
Ethics are generally defined as a system of moral principles that apply to a specific group or
profession, whereas morals are personal beliefs about right and wrong.

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Ethics are externally imposed (often by a professional body), while morals are internal beliefs
shaped by culture, religion, and personal experiences.
Ethics vs. Laws:
Laws are rules and regulations enforced by the government that dictate what is legally right or
wrong. While ethics are guidelines based on moral principles.
Breaking a law can lead to legal consequences, while breaching ethics may result in professional
disciplinary actions but not necessarily legal action.
Example: A legal action might be permissible under the law (e.g., not providing a certain level
of care due to resource constraints), but it may still be considered unethical.

1.1.1 BRIEF HISTORY OF ETHICS

Ancient Roots: The concept of ethics can be traced back to ancient civilizations, including Greek
philosophy with notable figures such as Socrates, Plato, and Aristotle. They laid the foundation
for ethical thought by exploring the nature of virtue, justice, and the good life.
Religious and Cultural Influence: Throughout history, various religions and cultures have
contributed to the development of ethical frameworks. For example, the Hippocratic Oath,
originating in ancient Greece, established ethical standards for medical practice.
Modern Ethics: In contemporary times, ethics has evolved to address complex issues in various
fields, including healthcare, law, business, and technology. Ethical guidelines and codes of conduct
have been established by professional bodies to regulate behavior and decision-making within
professions.

1.2 PROFESSIONAL ETHICS REQUIRED OF A COMMUNITY HEALTH

PRACTITIONER
Community health practitioners are expected to uphold high ethical standards to ensure the well-
being of patients and the community. Key professional ethics include:
CONFIDENTIALITY: Keeping patient information private and only sharing it when necessary
for the patient's care, confidentiality can also means Respecting the privacy of patients by
safeguarding their personal and medical information. This principle ensures that sensitive
information is not disclosed without the patient’s consent, except where legally required or
necessary to prevent harm.
PRIVACY: Protecting the personal space and information of patients. This involves conducting
consultations and examinations in private settings and respecting patients’ rights to control their
personal health information.

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INTEGRITY: Demonstrating honesty, transparency, and accountability in all professional

interactions and decisions. Integrity involves maintaining a high standard of moral and ethical
conduct, even when faced with challenging situations.
RESPECT FOR CLIENTS: Treating all patients with dignity, respect, and without
discrimination. This includes valuing their rights, beliefs, and autonomy, and ensuring that their
voices are heard and considered in their care.
PATIENCE: Exhibiting understanding, empathy, and patience when dealing with patients,
particularly those who may be distressed, confused, or non-compliant. Patience helps build trust
and rapport, essential for effective community health practice.
COMPASSION: Showing kindness and concern for the welfare of patients, especially those in
vulnerable situations. Compassion drives health practitioners to go beyond basic care and strive to
meet the emotional and psychological needs of their patients.
PROFESSIONALISM: Upholding the standards and expectations of the community health
profession through continuous learning, adherence to guidelines, and maintaining a professional
demeanor in all interactions.

2.0 EVOLUTION AND PRINCIPLES OF ETHICS

2.1 EVOLUTION OF ETHICS

ANCIENT CIVILIZATIONS AND ETHICAL THOUGHT:
In early human societies, ethical guidelines were established as a way to maintain order and address
conflicts. Moral codes in civilizations like ancient Egypt, Mesopotamia, and India included rules
on justice, fairness, and the treatment of others.
Ancient Egypt: The “Ma'at” principle, which emphasized truth, balance, and justice, was central
to Egyptian society. Ethical behavior was seen as necessary to maintain social order.
Ancient Indian Texts: Such as the “Vedas” and “Upanishads”, emphasized duties (Dharma) and
morality in interpersonal relations and governance.

GREEK PHILOSOPHY AND THE BIRTH OF SYSTEMATIC ETHICS:

Socrates (470-399 BC):
Socratic ethics focused on self-knowledge and the belief that knowing what is good will lead
individuals to act accordingly. His famous principle was that "an unexamined life is not worth
living."

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In community health, this translates to health practitioners needing self-awareness and knowledge
to provide ethically sound care.
Plato (428-348 BC):
Plato’s ethics revolved around the idea of the good' and the just.' He believed that ethical behavior
came from achieving a balanced and harmonious soul, where reason rules over desires.
In modern healthcare, this could mean balancing personal beliefs with professional ethics,
ensuring the welfare of patients is prioritized.
Aristotle (384-322 BC):
Aristotle introduced “virtue ethics”, emphasizing developing good character traits like courage,
honesty, and patience.
For health practitioners, this means cultivating virtues that promote patient welfare and building
trust within the community.

RELIGIOUS INFLUENCE ON ETHICS:

Judaism, Christianity, and Islam played significant roles in shaping ethical norms. These religions
emphasize compassion, care for the vulnerable, honesty, and justice.
Islamic Medical Ethics: Stresses the importance of compassion (rahmah), justice (adl), and the
prohibition of harm (la darar wa la dirar), which align with modern ethical principles.
Christian Ethics: Rooted in the teachings of love and care for one's neighbor, this has influenced
the establishment of hospitals and charitable care.

MODERN ETHICAL THEORIES:

Kantian Ethics (18th Century):
Proposed by Immanuel Kant, it focuses on duty and the moral law. Kant believed that actions
should be guided by a sense of duty, regardless of the consequences.
In healthcare, this translates into following rules and ethical guidelines (such as confidentiality)
even if it might not lead to the best outcome in some situations.
Utilitarianism (19th Century):
Jeremy Bentham and John Stuart Mill argued that the best action is the one that maximizes
happiness for the greatest number of people.
This principle is frequently applied in public health policies, where decisions (like vaccinations
or resource allocation) are made based on what benefits the largest portion of the community.

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CONTEMPORARY ETHICS:
Medical Ethics has become a specialized field, with a focus on patient rights, informed consent,
bioethics (handling advanced medical technologies like genetic engineering), and global health
justice.
Case Study: The HIV/AIDS pandemic in the 1980s led to significant discussions around
medical ethics, patient confidentiality, and public health policy, particularly when it came to
testing, disclosure, and stigma reduction.

2.2 PRINCIPLES OF ETHICS

Principle 1: Autonomy
Autonomy is the principle that patients have the right to make decisions about their own health
care without coercion. This is based on the respect for the individual's freedom and capacity to
decide what is best for their health.
Autonomy must be protected in community health by ensuring that patients are informed of their
options, the risks, and benefits of any treatment, and allowing them to choose freely.
Application of auutonomy in Community Health:
Informed Consent: Community health extension workers (CHEWs) must provide clear
information about treatments or health interventions and seek consent before proceeding.
Case Study: In antenatal care, CHEWs must explain all screening options to pregnant
women, allowing them to make autonomous decisions about which tests they wish to undergo.

Principle 2: Beneficence
Beneficence refers to actions that promote the well-being of others. It requires healthcare
professionals to act in ways that benefit their patients, preventing harm and promoting good health
outcomes.
For CHEWs, beneficence means actively working to improve health in the community, whether
through treatment, education, or advocacy for better living conditions.
Application of Beneficence in Community Health:
Health Education: A community health worker promoting hygiene practices in a rural area is an
example of beneficence acting to prevent illness.

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Case Study: In vaccination campaigns, health workers should not only administer
vaccines but also educate communities on the benefits, ensuring that they are acting in the
community's best interests.

Principle 3: Non-Maleficence
Non-maleficence is the principle of “do no harm.” Health practitioners must ensure that their
actions, treatments, or interventions do not cause unnecessary harm to patients or communities.
This principle covers physical harm, psychological harm, and even harm caused by negligence or
omission.
Application of Non-Maleficence in Community Health:
Ethical Prescriptions: Community health workers must prescribe treatments that are safe and
avoid harmful side effects. For instance, not over-prescribing antibiotics to avoid antibiotic
resistance.
Case Study: If a CHEW identifies an outdated or incorrect medical practice in the
community, they have an ethical duty to correct it to prevent harm, even if this involves challenging
traditional practices.

Principle 4: Justice
Justice in healthcare means ensuring fairness in the distribution of resources and services. It also
involves treating all patients equally, regardless of their background or status.
In community health, justice ensures that vulnerable or marginalized groups receive the same level
of care as everyone else.
Application of Justice in Community Health:
Equitable Distribution: CHEWs must ensure that limited resources (like vaccines or medical
supplies) are distributed fairly, not favoring any group over another.
Case Study: During an epidemic, CHWs should prioritize at-risk groups (e.g., elderly,
immunocompromised individuals) to ensure fairness in protecting the most vulnerable.

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3.0 PROFESSIONAL RESPONSIBILITIES AND LIMITATIONS OF A COMMUNITY

HEALTH PRACTITIONER

3.1 PROFESSIONAL RESPONSIBILITIES AND LIMITATIONS

Community Health Extension Workers (CHWs) play a critical role in delivering healthcare
services at the grassroots level. However, their responsibilities are guided by ethical codes and
professional limitations to ensure they provide quality care within their scope of practice.

ESSENTIAL MORAL PRINCIPLES AND CODES THAT SHOULD GUIDE THE

COMMUNITY HEALTH EXTENSION WORKER (CHEW)

1. Leadership and Its Limitations

Definition: Leadership refers to the ability of a community health worker to influence and guide
individuals or groups toward achieving health goals.
Application of leadership in Community Health:
As a CHEW, you are often seen as a leader within the community. This leadership role involves
being a source of guidance and information, advocating for health-related changes, and acting as
a bridge between the community and healthcare providers.
Limitations:
A CHEW should not overstep their boundaries or make decisions beyond their competence. For
example, a CHEW can educate on health practices but must refer complex medical cases to trained
physicians.
Example: A CHEW can encourage hygiene and sanitation practices but should not administer
medical treatments beyond first aid without proper referral to a physician.

2. The Right to Human Dignity

Explanation: Every individual has an inherent right to dignity, meaning they should be treated
with respect and worth regardless of their socio-economic status, ethnicity, or health condition.
Application of the right to human dignity in Community Health:
Community health extension worker (CHEW) must ensure that all patients are treated with the
utmost respect. This includes recognizing their needs, listening attentively, and treating them with
compassion.

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Example: A community health worker addressing a patient’s concern with patience and without
discrimination, even if the patient comes from a disadvantaged background.

3. Lateness and Absenteeism

Explanation: Lateness or absenteeism refers to consistently arriving late to work or failing to
show up for work without valid reasons.
Ethical Impact:
For Community Health Extension Worker (CHEW)’s, punctuality is essential as delays in
providing healthcare services can directly affect patient outcomes. Being late or absent may mean
that community members are left without timely care or education on health issues.
Example: If a CHEW consistently arrives late for a vaccination campaign, it can delay the entire
process, putting vulnerable groups like children and elderly people at risk of illness.

4. Patient/Customer Rights to Confidentiality and Privacy

Explanation:
Confidentiality: Ensuring that all patient information (medical, personal, or otherwise) is kept
private and is only shared with authorized individuals when necessary.
Privacy: Giving patients control over their own personal health information and respecting their
right to withhold certain information if they choose.
Application in Community Health:
CHEWs must maintain confidentiality when dealing with sensitive information, such as HIV
status, family planning details, or any health condition.
Example: If a CHEW is aware of a patient’s HIV status, they must not disclose this information
to anyone without the patient’s explicit consent.

5. Proper Dressing
Explanation: Professional attire is an essential part of maintaining respect and professionalism in
healthcare settings.
Application of proper dressing in Community Health:
Community Health Extension Worker (CHEW)’s should present themselves in a manner that
reflects their role as health educators and providers. This includes wearing appropriate attire (such
as uniforms or official clothing), maintaining personal hygiene, and avoiding overly casual or
inappropriate clothing.

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Example: Wearing a clean and well-maintained uniform not only boosts the CHW’s credibility
but also reassures the community members about the care they are receiving.

6. Respect for Leaders and Clients

Explanation: Showing respect to leaders, whether they are community leaders, health supervisors,
or patients, is a key ethical principle for Community Health Extension Worker (CHEW).
Application of respect for leaders and clients in Community Health:
Respect for clients means listening to their concerns, responding to their needs, and valuing their
input in decision-making about their health.
Example: Even if a CHEW disagrees with a community elder or patient, they must respond
politely and professionally, working to resolve the issue without confrontation.

7. Respect for Colleagues

Explanation: Just as respect is due to patients and leaders, colleagues in the healthcare field also
deserve respect.
Application of respect for colleagues in Community Health:
This involves maintaining professionalism when interacting with colleagues, collaborating
effectively in teams, and resolving conflicts amicably.
Example: A Community Health Extension Worker (CHEW) may need to work with a nurse or
doctor during a vaccination campaign. Respectful communication and coordination are essential
for the success of the project.

8. Adultery or Fornication with Clients and Clients’ Relatives

Explanation: Engaging in romantic or sexual relationships with clients or their relatives is strictly
unethical and unprofessional.
Application in Community Health:
This behavior breaches the trust between the healthcare worker and the patient. It compromises
the objectivity and neutrality required in healthcare provision.
Example: A community health extension worker (CHEW) must maintain a strictly professional
relationship with all clients to avoid conflicts of interest or ethical violations.

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9. Stealing/Pilfering
Explanation: Taking property, medical supplies, or resources that do not belong to you is
unethical and can have legal consequences.
Application in Community Health:
Community Health Extension Worker (CHEW) have access to medical supplies and resources.
They must not misuse or take advantage of this for personal gain.
Example: Stealing medications or healthcare supplies meant for the community undermines trust
and disrupts healthcare delivery.

LIMITATIONS OF A COMMUNITY HEALTH WORKER

While Community Health Extension Worker (CHEW) have important responsibilities, there are
limitations to their roles:

1. Scope of Practice:
Community Health Extension Worker must not perform medical procedures or treatments beyond
their training. They should always refer patients with complex medical issues to doctors or
specialized healthcare providers.
Example: A CHEW can offer first aid or administer vaccinations but must refer cases like surgery
or serious illness to a hospital.

2. Authority:
A Community Health Extension Worker’s (CHEW) are not authorized to make legal decisions or
represent patients in matters beyond their professional role.
Example: A CHEW cannot make decisions regarding a patient's legal guardianship or financial
matters.

3. Legal Boundaries:
A Community Health Extension Worker (CHEW) must work within the laws and regulations
governing healthcare practice. They should avoid engaging in illegal activities like administering
treatments without certification or licenses.
Example: A CHEW cannot prescribe medication without proper authorization.

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4.0 LEGAL ASPECTS OF COMMUNITY HEALTH PRACTICE

4.1 LEGAL ASPECTS OF COMMUNITY HEALTH PRACTICE

Community health practitioners must operate within a legal framework that governs their
professional conduct. This framework not only protects the rights of patients but also defines the
responsibilities and limitations of health workers. Legal issues in healthcare can encompass
everything from patient consent to malpractice and negligence. Understanding these legal aspects
is crucial for maintaining ethical standards and ensuring accountability in community health.

4.1.1 Implications of Law in Community Health Practice

The Law of the Federation of Nigeria (LFN), particularly CAP C19 ACT 2004, is a critical
piece of legislation that outlines the legal framework for healthcare professionals, including
community health workers.

Key Legal Aspects for Community Health Workers

1. Patient Consent and Autonomy

Explanation: Consent is the legal process by which a patient agrees to receive treatment or refers
to the patient’s right to make decisions about their healthcare without coercion or undue influence.
Application in Community Health:
CHEWs must obtain “informed consent” before performing any procedure or providing care. This
involves explaining the purpose, benefits, and risks of any intervention.
For minors or individuals unable to provide consent, the legal guardians' consent is required.
Example: Before conducting health screenings, a community health extension worker (CHEW)
should explain the process to the patient and ensure they willingly agree to participate.

2. Duty of Care and Negligence

Explanation: The “duty of care” is a legal obligation that requires healthcare providers to provide
services that meet an established standard of care. If this duty is breached, it can lead to negligence.
Then what is Negligence?

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Negligence occurs when a healthcare worker fails to provide the standard care expected in a given
situation, resulting in harm to the patient.
Application in Community Health:
Community Health Extension Worker’s (CHEW) are legally obligated to provide competent care
that meets professional standards. Negligence could arise from failing to refer a patient to a hospital
when needed or administering incorrect treatments.
Example: If a community health worker fails to refer a patient with severe symptoms to a medical
doctor and the patient's condition worsens, this could be considered negligence.

3. Confidentiality and Privacy Laws

Explanation: Confidentiality is the legal requirement for healthcare workers to keep a patient’s
health information private unless they are given consent to share it or there is a legal requirement
to disclose it (e.g., public health reporting).
Breaching patient confidentiality can result in legal actions against the healthcare provider.
Application in Community Health:
A Community Health Extension Worker (CHEW) must protect the personal health information of
their clients, ensuring that records, test results, and medical histories are not disclosed to
unauthorized individuals.
Example: A CHEW should not share a patient’s HIV status without their consent, even with other
health workers, unless absolutely necessary for treatment purposes.

4. Licensing and Registration Laws

Explanation: Licensing and registration are legal requirements for all healthcare practitioners to
ensure they meet the necessary qualifications and maintain professional standards.
Practicing without proper registration or a valid license is illegal and can result in criminal charges
and the loss of the right to practice.
Application in Community Health:
A Community Health Extension Worker’s (CHEW) must ensure that they are duly registered with
relevant health authorities and possess valid licenses e.g. Community Health Practice
Registration Board of Nigeria (CHPRBN). This guarantees that they are legally recognized to
practice and are held accountable to professional bodies.
Example: A CHEW must renew their license with (CHPRBN) regularly and ensure they meet the
continuing education requirements to remain in good standing.

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5. Public Health Laws and Regulations

Explanation: Public health laws govern how health services are delivered, particularly in response
to community-wide issues such as disease outbreaks, vaccinations, sanitation, and health
promotion.
These laws ensure that healthcare providers and the public adhere to practices that prevent the
spread of diseases and protect community health.
Application in Community Health:
A Community Health Extension Worker (CHEW) must work within the framework of public
health laws, such as those related to vaccination campaigns, quarantine measures, and sanitation
guidelines.
They must follow national protocols during disease outbreaks to protect both individuals and
communities.
Example: During an outbreak of a communicable disease like cholera, a CHEW is required to
follow public health laws regarding containment measures, even if this means limiting individual
freedoms (e.g., quarantining infected individuals).

4.1.2 The Implications of Law of the Federation of Nigeria (LFN) CAP C19 ACT 2004 and
Its Limitations

What is CAP C19?

The CAP C19 Act refers to Nigeria’s legal framework governing healthcare practice, especially
as it pertains to medical and health professionals. This Act outlines the registration and practice
regulations for health practitioners in Nigeria and stipulates the standards required for delivering
healthcare services. It defines legal responsibilities, practice standards, and the consequences of
professional misconduct.
Key Provisions of CAP C19 ACT 2004:
1. Regulation of Practice: CAP C19 outlines the conditions under which healthcare providers,
including community health workers, can operate. It regulates standards to ensure that healthcare
is provided safely, competently, and ethically.

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2. Disciplinary Actions: The Act outlines disciplinary actions for misconduct, including
professional negligence, ethical violations, or failure to comply with registration and licensing
requirements.

3. Patient Rights: The Act emphasizes the rights of patients to receive quality care, including their
right to informed consent, confidentiality, and access to healthcare services without discrimination.

4. Professional Standards: It ensures that all healthcare practitioners adhere to standardized care
protocols and guidelines established by governing bodies such as the Medical and Dental Council
of Nigeria and the Community Health Practitioners Registration Board of Nigeria.

Limitations of CAP C19 Act 2004:

1. Scope of Authority:
The Act applies primarily to registered healthcare providers. However, in rural and underserved
areas, there may be health workers operating without proper licensure due to a lack of enforcement.
This limits the full application of the law.

2. Geographical Reach:
The effectiveness of the CAP C19 Act may be limited in remote areas where healthcare
infrastructure is lacking, and regulatory bodies have limited oversight.

3. Evolving Healthcare Challenges:

The healthcare landscape is constantly evolving, especially with the introduction of new medical
technologies. The Act may not fully cover emerging ethical issues related to modern medical
advancements such as genetic testing or telemedicine.

5.0 REGISTRATION AND LICENSING

5.1 DEFINITIONS OF LICENSE AND LICENSING

License: A license is an official or legal permission given to an individual to practice a particular
profession. In community health, a license certifies that the individual has met the necessary
qualifications and is authorized to provide healthcare services.

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Licensing: Licensing is the process of granting permission to an individual or an organization to

engage in an activity after ensuring they have met the required standards. In the context of
community health, it refers to the process through which health professionals obtain the legal
authorization to practice.

5.2 DEFINITION OF REGISTRATION

Registration: Registration is the process of formally recording the names and details of qualified
individuals on an official list. For community health workers, registration involves being recorded
in a government or professional body’s registry, which allows them to practice within a legal
framework.

5.3 THE RATIONALE AND PROCEDURE FOR REGISTRATION AND LICENSING

RATIONALE FOR REGISTRATION AND LICENSING

Registration and licensing of community health practitioners are essential for maintaining
professional standards and ensuring public safety. The rationale includes:

1. Ensuring Competency: Registration and licensing ensure that only individuals who have the
necessary training, education, and qualifications are allowed to practice.
2. Accountability: By registering with a recognized health body, practitioners become
accountable for their actions and are subject to professional codes of conduct and discipline.
3. Legal Compliance: Practicing without proper registration or licensing is illegal in many
countries, including Nigeria. It helps to regulate the profession and protect the public from
unqualified or incompetent practitioners.
4. Professional Recognition: Registered and licensed practitioners are recognized as
professionals in their field and can access various benefits such as career advancement, further
training, and the ability to specialize.

PROCEDURE FOR REGISTRATION AND LICENSING

1. Educational Requirements: The individual must complete an accredited training program in

community health or a related field.

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The training program should be recognized by relevant regulatory bodies like the **Community
Health Practitioners Registration Board of Nigeria (CHPRBN).
2. Application Process: The graduate applies for registration by submitting their academic
qualifications, proof of internship (if required), and other supporting documents to the regulatory
board.
3. Examination: In some cases, applicants may need to pass a licensure examination (National
Examination) to demonstrate their competency and knowledge of the field.
4. Issuance of License: Once the application is approved, the practitioner is issued a license, which
allows them to legally practice in the field of community health.
5. Continuing Professional Development (CPD): In order to maintain their license, practitioners
may need to engage in ongoing professional development, attend refresher courses, and
periodically renew their license.

5.4 REQUIREMENTS AND BENEFITS OF REGISTRATION

REQUIREMENTS FOR REGISTRATION

1. Completion of Accredited Training: The individual must have completed an approved

program in community health, usually from an accredited college or university.
2. Submission of Necessary Documents: The applicant must submit their academic transcripts,
proof of internship or clinical training, and any additional certifications.
3. Licensure Exam (where applicable): The practitioner may be required to pass a licensing
examination to prove their proficiency.
4. Payment of Registration Fees: A fee is often required during the registration process, which
covers administrative costs.
5. Adherence to Ethical Standards: The individual must agree to adhere to the professional code
of ethics and conduct set by the regulatory body.

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BENEFITS OF REGISTRATION

1. Legal Right to Practice:

Once registered, a practitioner has the legal right to practice community health. They are protected
under the law and can offer services without fear of legal repercussions.
2. Professional Credibility:
Registration gives practitioners credibility, ensuring they are recognized as legitimate and
qualified healthcare professionals.
3. Career Advancement:
Being registered can open up opportunities for further training, specialization, and career growth.
Registered practitioners can also move into supervisory or leadership roles.
4. Access to Professional Resources:
Registered practitioners have access to resources, networking opportunities, and training programs
that are often offered through professional organizations.
5. Protection for Practitioners:
Registration ensures that practitioners have access to legal protection and support in cases where
their professional conduct is questioned or they face legal challenges.

5.5 EFFECTS OF NON-REGISTRATION AND DEREGISTRATION

EFFECTS OF NON-REGISTRATION

1. Inability to Practice Legally:

A community health worker who is not registered cannot legally practice. Offering healthcare
services without registration is illegal and can lead to fines, imprisonment, or both.
2. Lack of Professional Recognition:
Non-registered practitioners may not be taken seriously in their profession. They may miss out on
job opportunities, promotions, and other benefits.
3. No Legal Protection:
Unregistered practitioners are vulnerable to legal actions if something goes wrong in their practice,
as they are not recognized by the regulatory authorities.

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4. Limited Career Growth:

Without registration, career advancement opportunities are limited. They will not be able to move
into leadership roles or pursue further specialization

EFFECTS OF DEREGISTRATION

1. Loss of License to Practice:

Practitioners who are deregistered lose the legal right to practice, either temporarily or
permanently, depending on the nature of the offense.
2. Professional Consequences:
Deregistration may result from unethical behavior, incompetence, or criminal activity. This can
tarnish the practitioner's reputation and future career prospects.
3. Legal Consequences:
A deregistered practitioner who continues to practice can face serious legal consequences,
including fines, imprisonment, or both.
4. Difficulty in Re-registration:
Once deregistered, it may be difficult to regain registration. The individual may need to undergo
retraining, pass examinations, or meet additional requirements before being reinstated.

6.0 CONCEPTS OF MORALITY, DUTY, AND LIABILITY

6.1 DEFINITIONS OF MORALITY, DUTY, AND LIABILITY

1. MORALITY
Definition: Morality refers to the principles concerning the distinction between right and wrong
or good and bad behavior. It encompasses the norms, values, and beliefs that guide individuals and
communities in making ethical decisions.

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Application in Community Health:

In community health, morality influences how health practitioners interact with clients, make
decisions about care, and navigate ethical dilemmas. It provides a framework for assessing the
rightness or wrongness of actions within the healthcare context.

2. DUTY
Definition: Duty is a moral or legal obligation that requires individuals to act in a certain way. In
healthcare, duty encompasses the responsibilities health practitioners have toward their patients,
colleagues, and society.
Application in Community Health:
Community health workers have a duty to provide care to their clients, maintain professional
standards, respect patient confidentiality, and uphold the ethical principles of the profession.

3. Liability
Definition: Liability refers to the state of being responsible for something, especially in terms of
legal obligations. In healthcare, liability can arise from negligence, malpractice, or breaches of
duty.
Application in Community Health:
Community health practitioners may face liability for their actions or omissions if they fail to meet
the standard of care expected in their profession, leading to harm to a patient.

6.2 ISSUES RELATING TO MORALITY, DUTY, AND LIABILITY

1. Socially Acceptable Standards of Practice

Morality in community health is guided by socially acceptable standards of practice, which reflect
the ethical norms and values of the community. These standards help ensure that practitioners
provide care that aligns with societal expectations.
Application in the Community Health:
Community health workers must be aware of these standards and strive to meet them in their daily
practice, adapting their approaches to respect cultural beliefs and values.

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2. Difference Between Law and Morality

Law refers to the system of rules that are created and enforced through social or governmental
institutions. Morality, on the other hand, is based on personal beliefs and societal norms regarding
right and wrong.
Key Differences:
Enforcement: Laws are enforceable through legal systems, while morality is enforced by social
norms and personal conscience.
Changeability: Laws can change based on political and societal shifts, while moral principles may
evolve based on cultural and personal values.
Application in the Community Health:
Community health practitioners must navigate situations where legal obligations may conflict with
their moral beliefs, ensuring that they adhere to both legal standards and ethical principles.

3. Similarities Between Law and Morality

Despite their differences, law and morality often overlap. Both serve to regulate behavior and
protect the welfare of individuals and society.
Commonalities:
Both law and morality promote the concepts of justice, fairness, and respect for individuals’ rights.
Many laws are based on moral principles, and violations of laws can be seen as moral failures.
Application in the Community Health:
Community health workers should strive to uphold both legal and moral standards in their practice,
recognizing that their actions impact not only individual patients but also the broader community.

4. Types of Duty
1. Absolute Duty: An obligation that must be fulfilled without exception. For example, a
community health worker has an absolute duty to maintain patient confidentiality.
2. Contractual Duty: Duties established through agreements, such as a service contract between
a health practitioner and a client.
3. Delegable Duty: Responsibilities that can be transferred to another party. For instance, a
community health worker may delegate tasks to a trained assistant while retaining overall
responsibility.

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4. Legal Duty:
Obligations enforced by law. Community health workers have a legal duty to report suspected
cases of abuse or neglect.

5. Moral Duty: Obligations based on ethical beliefs and values. Community health practitioners
may feel a moral duty to advocate for vulnerable populations.

6. Negative and Positive Duty:

Negative Duty: The obligation to refrain from harming others (e.g., not disclosing patient
information without consent).
Positive Duty: The obligation to take action to benefit others (e.g., providing care to patients in
need).

5. Definition of Responsibility
Definition: Responsibility refers to the state or fact of having a duty to deal with something or
having control over someone. In healthcare, it encompasses the obligations health practitioners
have toward their patients, the community, and the healthcare profession.
Application in the Community Health:
Community health workers must understand their responsibilities in providing quality care,
maintaining professional standards, and upholding ethical principles.

6. Differences between Duty and Responsibility

Duty vs. Responsibility:
Duty: An obligation to perform a specific task (e.g., administering medication).
Responsibility: A broader term encompassing the overall obligation to ensure patient care and
safety (e.g., ensuring that medication is administered safely and correctly).

7. Breach of Duty
A breach of duty occurs when a practitioner fails to fulfill their legal or moral obligations, which
can result in harm to a patient.

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Application in the community health:

Community health workers must recognize situations where a breach of duty may occur, such as
failing to follow protocols or neglecting patient care. This can lead to legal liability and ethical
repercussions.

8. TYPES OF LIABILITY
Strict Liability: Responsibility that does not require proof of negligence or fault. For example, if
a community health worker's actions directly cause harm to a patient, they may be held strictly
liable.
Vicarious Liability: Legal responsibility imposed on one party for the negligent actions of
another. Employers can be vicariously liable for the actions of their employees in the course of
their work.
Criminal Liability: Occurs when a practitioner violates a law, resulting in criminal charges. For
instance, fraudulent billing practices can lead to criminal liability.
Civil Liability: Involves legal responsibility for causing harm or injury to another person, leading
to civil lawsuits for damages. Community health workers can be held civilly liable for malpractice.
Derivatives, Several, Joint Liability:
Derivatives Liability: Arises when a third party is liable due to the actions of the primary tortfeasor.
Several Liability: Each party is independently liable for their actions.
Joint Liability: Multiple parties can be held liable together for a single act of negligence.

9. Professional Consequences of Liability

Liability can have severe professional consequences for community health workers, including loss
of licensure, fines, and damage to reputation.
Application in the community health:
Community health workers must adhere to ethical and legal standards to mitigate the risk of
liability, ensuring they provide competent and safe care.

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6.3 TYPES OF DAMAGES

Definition of Damages
Damages refer to the monetary compensation awarded to a person who has suffered loss or injury
due to the wrongful act of another party. In the context of community health, damages can arise
from malpractice, negligence, or breaches of duty.

TYPES OF DAMAGES

1. Compensatory Damages: Designed to compensate the victim for losses incurred, including
medical expenses, lost wages, and pain and suffering.
2. Punitive Damages: Awarded to punish the wrongdoer for particularly egregious conduct and
deter future misconduct. These are not common in healthcare cases but can occur in instances of
gross negligence.
3. Special Damages: Quantifiable losses that can be specifically calculated, such as medical bills
or lost income due to an injury.
4. General Damages: Non-quantifiable losses, such as pain and suffering or emotional distress,
that do not have a specific dollar amount attached.

Conclusion

Understanding the concepts of morality, duty, and liability is essential for community health
practitioners. By recognizing their responsibilities and the legal implications of their actions, they
can better navigate ethical dilemmas, uphold professional standards, and provide quality care to
their clients.

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