📖 WEEK 1: COMMUNITY HEALTH NURSING
(CHN)
1. Concept of Community
A community is not just a group of people living together; it is a group of individuals who share
common culture, values, norms, interests, or goals. In health sciences, the concept of
community is very important because it frames the environment where health behaviors,
illnesses, and interventions occur.
🔹 Types of Communities
1. Geopolitical Community
o Defined by geographical or territorial boundaries (e.g., barangay, city,
municipality).
o Regardless of cultural background, as long as individuals live in the same area,
they are considered a community.
o Example: Living in a coastal town may influence health decisions (e.g., higher
exposure to fishing-related injuries, diet rich in seafood, and vulnerability to
typhoons).
👉 Impact on Health: Where you live determines your exposure to risks, access to
health services, and health-seeking behaviors.
2. Phenomenological Community
o Defined by shared culture, beliefs, interests, or values, not by physical location.
o People may be geographically apart but are considered one community due to
shared identity.
o Example: Overseas Filipino Workers (OFWs) worldwide still form a
“community” because of their shared Filipino values, struggles, and beliefs.
o In the Philippines, a common cultural belief is that “if you can still work, you
are not sick”—which delays medical consultation, often leading to late-stage
diagnoses.
👉 Impact on Health: Beliefs, traditions, and cultural norms heavily influence health-
seeking behaviors and perceptions of illness.
2. Community Health Nursing (CHN)
Definition:
A specialized practice of nursing focused on providing care to individuals, families,
communities, and population groups (IFCP) with the goal of promoting, maintaining, and
restoring health.
🔹 A community is understood as a collection of families, and families are the smallest unit of a
community.
Goal:
Health for all, achieved through nursing care, education, advocacy, and community
participation.
3. Population Groups
Subgroups of a community with common health needs.
Examples: Pregnant women (prenatal care), adolescents (reproductive health), middle-
aged men (risk for cardiovascular disease).
4. Public Health
Public health serves as the umbrella discipline under which CHN operates.
WHO Definition:
Public health is the science and politics of preventing disease, prolonging life, and promoting
health through organized community efforts.
🔹 Public health emphasizes that “health and longevity are a birthright”, meaning access to
health care should be universal.
Objectives of Public Health (PRE-DI, PRO-LI, PRO-HE):
1. Prevent Disease
2. Prolong Life
3. Promote Health
5. Roles of the Community Health Nurse
CHNs assume multiple roles, depending on the situation and the needs of the community:
1. Clinician – Provides direct nursing care.
2. Educator – Teaches preventive and promotive health care (e.g., hygiene, nutrition,
vaccination awareness).
3. Advocate – Ensures clients can access needed services and guides them in availing of
programs (e.g., PhilHealth benefits, maternal services).
4. Manager/Leader – Organizes, supervises, and influences people to achieve health goals.
5. Collaborator – Works with LGUs, DOH, NGOs, and community leaders to improve
health outcomes.
6. Researcher – Conducts community assessments and studies to identify health needs and
evaluate interventions.
6. Public Health Nursing (PHN)
A combination of public health + nursing + social assistance.
Objectives (PRO-HE, IMP-PS, RE, PRE-ILL-DI):
Promote Health
Improve Physical and Social Environment
Rehabilitate
Prevent Illness and Disability
Four Pillars of PHN:
1. Active Community Participation (shared responsibility)
2. Intra and Intersectoral Linkages (collaboration with agencies)
3. Use of Appropriate Technology (affordable, locally available, sustainable)
4. Support Mechanisms (policies, logistics, and referrals)
Functions of PHNs:
Manager
Supervisor
Clinician
Community Organizer
Health Promoter & Educator
Trainer
Researcher
7. Health Care Delivery System (HCDS)
The HCDS includes all organizations, people, and actions whose primary intent is to promote,
restore, or maintain health.
Six Building Blocks of HCDS (WHO Framework):
1. Service Delivery
2. Health Workforce
3. Information Systems
4. Medical Products, Vaccines, Technologies
5. Financing
6. Leadership & Governance
Major Players:
Public Sector – Funded by taxes, includes DOH (national) and RHU (local).
Private Sector – For-profit hospitals, clinics, pharmacies.
R.A. 7160 (Local Government Code of 1991):
Devolved health service delivery to LGUs.
Allows local leaders to make decisions in health, education, and social services.
8. Department of Health (DOH)
Vision (by 2030):
A global leader in health outcomes, competitive healthcare system, and equitable financing.
Mission:
Guarantee equitable, sustainable, and quality health care, especially for the poor.
Goal:
Universal Healthcare (Kalusugang Pangkalahatan).
DOH Roles (LACE):
Leadership in health
Administrator of specific services
Capacity Builder
Enabler
Functions (RP3):
Rehabilitation/Restoration of Health
Protection
Promotion
Preservation of Life
Core Values:
Integrity, Excellence, Compassion, Commitment, Professionalism, Teamwork, Stewardship.
9. Primary Health Care (PHC)
A milestone in health service reform.
Alma Ata Declaration (1978): Health is a basic human right, governments are
responsible for the health of their people.
Philippines:
o 1979: LOI 949 signed by Marcos (adopted PHC).
o 1981: Official launch of PHC.
Goal:
“Health in the hands of the people by 2020.”
Mission:
Strengthen health systems and empower people to manage their own health.
5 A’s of Health Care:
Accessible, Available, Affordable, Acceptable, Adequate.
Focus (PEOPLE):
Partnership with the community
Equitable distribution of health resources
Organized health system
Prevention & promotion focus
Linked multisectorally
Emphasis on appropriate technology
Principles of PHC:
1. 5 A’s
2. Support Mechanisms
3. Multisectoral Approach
4. Community Participation
5. Equitable Distribution
6. Appropriate Technology
Four Pillars (USAI):
Use of Appropriate Technology
Support Mechanisms
Active Community Participation
Intra & Intersectoral Linkages
Elements of PHC (LEMNTS):
Locally endemic disease control
Education for health
Maternal and child health care
Nutrition
Treatment of common diseases & injuries
Safe water & sanitation
Essential Drugs
Expanded Program on Immunization
