Community Health Nursing

2.

Goal: Promotion and maintenance

of health.
Promotes
living
a
healthy
lifestyle.
This is for the attainment of
Physical, mental and psychosocial
being.
Special field of Nursing practice in
a broader setting

3.

4.

CHN is geared towards:

1.
2.
3.
4.
5.
6.
7.

Health
promotion
(healthy
lifestyle)
Disease Prevention
Care of the sick and prevention of
complications
Alleviation of suffering
Facilitate early recovery from
illness
Rehabilitation (bringing the client
to his old lifestyle)
Prevention of disability and death
If death is inevitable, assist family
to accept death.
Professional nurse: Assists client
throughout lifespan.
Health to illness. Womb to tomb.

Community Health Nursing (by WHO)

- is a special field of nursing that
combines the skills in nursing, Public
Health and some paces of social
assistance and functions as a part of
the total public health program for the
promotion of health, improvement of
conditions in the social and physical
environment, rehabilitation of illness
and disability.
The utilization of the nursing process
in the different levels of clienteleindividuals,
families,
population
groups and communities, concerned
with
the
promotion
of
health,
prevention of disease and disability
and rehabilitation. -Maglaya, et al.
Philosophy of CHN
The philosophy of CHN is based on the
worth and dignity on the worth and
dignity of man. - Dr. M. Shetland
Basic Principles of CHN
1.

The community is the patient in

CHN, the family is the unit of care
and there are four levels of
clientele: individual,
family,
population group (those who
share common characteristics,
developmental
stages
and
common exposure to health
problems e.g. children, elderly),
and the community.

In CHN, the client is considered

as
an
ACTIVE partner NOT
PASSIVE recipient of care
CHN practice is affected by
developments
in
health
technology, in particular, changes
in society, in general
The goal of CHN is achieved
through
multi-sectoral
efforts
5. CHN is a part of health care
system and the larger human
services system.

Roles of the PHN

Planner/programmer
- identifies needs/priorities of the
clientele. Formulates nursing health
care plans and municipal health plan.
Nursing provider
- Clinician who is a health care
provider, taking care of the sick
people at home or in the RHU

Counselor/Trainer/Health
Educator who aims towards health
promotion and illness prevention
through dissemination of correct
information;
educating
people.
Identifies and interprets training
needs of the RHNs, Barangay Health
workers amd hilots. It also provides
and arranges learning experiences for
RHMs, affiliates (nursing midwife and
other health workers). It conducts
trainings for RHMs and Hilots on
promotion of health. It organizes
counseling, orientation and training of
concerned groups. It acts as resource
speaker, person on related services. It
participates in the development and
distribution of Information Education
and Communication (IEC) materials.
Its conducts IEC orientation for
groups.
It
conducts
premarital
counseling. It uses TVs, radios, madias
and
etc.
for
health
education
purposes.
- Identifies and interprets training
needs of the RHMs, Barangay Health
Workers and Hilots.
- Formulates appropriate training
program designed for the RHMs,
BHWs and Hilots.
- Provides and arranges learning
experiences
for
RHMs,
affiliates
(nursing and midwife) and other
health workers.
- Conducts training for RHMs and
Hilots on health promotion.
Organizes
counseling/orientation/training
of
concerned groups.
- Acts as a resource speaker/person on
related services.
- Conducts IEC orientation for groups.
- Conducts premarital counseling.
- Use of TUS, radios, medias and
etcetera
for
health
education
purposes.
Service coordinator: provided by the
members of the health team and
other government organizations (GOs)
and non-government organizations
(NGOs)
Coordinates
nursing
process/
program with other health programs

as environmental sanitation, health

education, dental health and mental
health.
Health Monitoring: detects deviations
on the health of the clientele
Role model: provides good example
on the healthful living to the
community
Changer Agent: motivates changes in
the health behavior
Reporter/statistician: prepares and
submits requires reports and records.
It maintains accurate and adequate
and complete recording. It analyzes
reports and records. It prepares
statistical data/charts.
Researcher:
participates
in
the
conduct
of
surveys/studies
and
researches.
It
coordinates
with
government
and
non-government
agenicie for the implementation of the
research.
Community coordinator
Facilitator who establishes multisectoral linkages by referral system
Supervisor/Manager who monitors
and supervises the performance of
midwives. In the event that the
Municipal Health Officer (MHO) is
unable to perform his duties/functions
or is not available, the Public Health
Nurse will take charge of the MHOs
responsibilities.
Other
Specific
Responsibilities of a Nurse, spelled by
the
implementing
rules
and
regulations.
Regulations of RA 7164 (Philippine
Nursing Act of 1991) includes:
Supervision and care of women
during
pregnancy,
labor
and
puerperium
Performance of internal examination
and delivery of babies
Suturing lacerations in the absence
of a physician
Provision of first aid measures and
emergency care

Recommending
herbal
and
symptomatic medsetc.
In the care of the families:
Provision of primary health care
services
Developmental/Utilization of family
nursing care plan in the provision of
care
In the care of the communities:
Community organizing mobilization,
community development and people
empowerment
Case finding and epidemiological
investigation
Planning, implementation and
evaluation
Influencing executive and legislative
individuals or bodies concerning
health and development
Responsibilities of CHN
Be a part in developing an overall
health plan, its implementation and
evaluation
for communities

 Provide quality nursing services to

the three levels of clientele
Maintain coordination/linkages with
other
health
team
members,
NGO/government agencies in the
provision of public health services
Conduct researches relevant to CHN
services to improve provision of health
care

Provide
opportunities
for
professional growth and continuing
education for staff development

all
ages,
families,
groups
and
communities, sick or well, and in all
settings.
Nursing
includes
the
promotion of health, prevention of
illness and the care of ill disabled and
dying people.

Population Age Group:

CHN: organized set of nursing services

or activities that is a part of the total
Community health process for the
promotion of health, prevention and
control of diseases and care and the
rehabilitation of the sick and the
disabled.

0-11 months: Infancy/Immunization

1-4 yo: Toddler and Preschool
5-9 yo: School Age
10-14 yo: Early Adolescence
15-44 yo: Reproductive Age group
45-54 yo: Menopausal Age group
55-64 yo: Retiring Age group
65-79 yo: Elderly
80 & Above: Senescence

In the Philippines, nursing in general

has 3 main fields:
1.
2.
3.

Research
Practice
Education

Utilitarianism: Greatest good for the

greatest number (Ethical Theory)

It is considered as an art because it

combines the skills in nursing and
public health. It is considered as
science because of problem-solving
processes in the promotion of
physical, mental, and social health,
prevention and control of diseases and
prolonging life.

Tool for analyzing and measuring

Community health problems:

Essential services of CHN concerning

community clients:

BP Apparatus
Thermometer
Interview, Observation, Analyzing
data

3 Terms of CHN:

Community (Client)
Health (Goal)
Nursing (Means/Provider)

Community
came from the Latin
word, Communitas meaning, the
same. Also from Communis. Comes
from the combination od Latin word:
com together and munis which
has to do with performing services.

Community: group of people with the

same demographic characteristics,
territory, share common beliefs,
values, needs, risk and number of
other conditions.
Health according to WHO
Nursing: comes from the Latin word,
Nutrix, meaning, to nourish. First
nurses: mothers.
3 Basic concepts of CHN:
According to ICN, Royal College of
Nursing, UK, ANA.

1.

Monitoring health status to

identify CH problems
2. Diagnose and investigate
Community health problems
and
hazards
in
the
community
3. Inform,
educate
and
empower
people
about
health issues.
4. Mobilize
community
partnerships to save health
problems
5. Develop policies and plans in
Public Health
6. Enforced
laws
and
regulations to protect health
and safety
7. Link
people
to
needed
personal services
8. Assure a competent public
and personal health care
work force
9. Evaluate
effectiveness
of
population
based
health
services
10. Research for new insight and
innovative
situations
to
health problems

CHN uses Nursing process to:

ICN:
Nursing encompasses collaborative
and autonomous care of individuals of

Prolong life
Promote health
Efficiency through holistic
and
systematic
and
organized community health
services
Combines skills, knowledge
and theories in the process

Basic elements of CHN

Clientele: Recipient of care

Concern:
Health-Illness
continuum/Spectrum
with
emphasis on the primary
levels of care
Care:
4
dimensions
(preventive,
promotive,
curative, rehabilitative)

Input in Community Health Nursing

1.
2.
3.
4.
5.
6.
7.
8.
9.

Health Education
Direct and Indirect Health
Care
Health
Counseling
and
Guidance
Health Management
Referral
Coordination
of
Health
Services
Community organization of
Health action
Conflict
resolution
and
mediation
Stress management in the
community

Process: CHN involves the application

of theories and knowledge about CHN.
Outcome: the basic outcome is
community health functioning and
ultimately, community health and
development.
SKAV is vital.
Areas of Responsibility
1.
2.

Safe and quality nursing care

Management of resources
and environment
3. Health Education
4. Legal Responsibility
5. Ethico-moral responsibility
6. Personal and professional
development
7. Quality improvement
8. Research
9. Record Management
10. Communication
11. Collaboration and teamwork
Principles:
1.
2.
3.
4.

Recognize individual needs

Continue education program
Maintain accurate records
Supervision
of
Nursing
services
5. Respect customs and veliefs
6. Health
education
is
integrated
7. Collaborate with co-workers
8. Family is the unit of care
9. Utilize indigenous resources
10. Continue evaluation
11. Active
participation
of
clientele in planning
12. Understand objectives
Primary Health Care

Principles:
1.
2.

3.

Major constraints related to attitudes

of:

Essential services must be:

accessible,
available,
affordable, acceptable
Genuine
peoples
participation
is
essential.
Proper education is essential
to identify and solve various
health problems as far as
their
capabilities
and
resources allow.
Community involvement: the
barangay may be mobilized
to
participate
in
health
matters like case reporting,
sanitation,
nutrition
activities,
and
health
education.
It
includes
community organization and
community
development
activities.
(Ex:
Barangay
networking with SK officials)
- Traditional healers as part of
local health personal system.
People involvement is crucial
in PHC.
- PHC relies on people as the
primary resources in health.
- Health for all is impossible
to attain without community
participation.

Health
and
interrelated

development

- Development is a quite for an

improved quality of life for all. It is
multi-dimensional.
Community involvement means that
the community must share the
responsibilities and participate in the:

2.
3.
4.
5.
6.

Defining their health, health

related needs, and problems
Identifying realistic solutions
Organizing the community
for health action
Mobilizing local resources
(like day care centers)
Providing essential health
services
Evaluating results of health
actions

Community Participation:

Conduct
between
health
service and people
Effort should not be from
outside and unfamiliar to
people
Requires the development of
the community to participate
in charting their own health
destiny

Absence of partial will

Bureaucratic set-up makes
him impersonal
Lack of education
Poorly motivated
Political pressure

Health worker

Poorly motivated
Lack of dedication
Indifference
Lack of incentive
Lack of skills in problemsolving, managerial skills,
and community organization

Community

is

- Health being a social phenomenon

recognizes the interplay of political,
socio-cultural and economic factors as
its determinant. Good health therefore
manifest
by
the
progressive
improvements in the living conditions
and quality of life enjoyed by the
community residents.

1.

Administrator:

Indifference
Apathy
Dependence
Resistance to change
Superstitious beliefs
Traditional ways
Values restraint to change

Major strategies of PHC

A.

Elevating
health
to
a
comprehensive
and
situated
national effort
- Desired outcome: support
from parents, families to
make decisions on their
health
Require
expanding
participation
as
service
provider or beneficiary
- Advocacy to National and
local policy

B.
Promoting
and
supporting
community managed health care
C. Increasing efficiencies in the health
sector
- DOH will safeguard and strengthen
the integration of health operation to
maintain the quality of health care
using appropriate technology will
make the services and resources
required for their delivery effective,
affordable, accessible, and culturally
acceptable.

Health
cannot
work
in
isolation. Neither can sector
claim
monopoly
to
the
solution of the community.
Health has become a mutisectoral concern, everybody
works
in
solution
of
community health problems

D. Advancing essential national health

research

Essential national health research is

an integrated strategy for organizing
and
managing
research
using
interserctoral, multidisciplinary and
scientific
approach
to
health
programming and delivery.
Elements or components of Public
Health Care
1.
2.

Health Education
Treatment of locally endemic
diseases
3. Immunization
4. Maternal and child and family
planning
5. Provision of essential drugs
6. Adequate food and proper
nutrition
7. Control
of
communicable
diseases
8. Environment sanitation
9. Provision of medical care and
emergency treatment
10. Dental health program
11. Access or use of hospital
facilities
12. Mental health program

Endemic diseases: Malaria, Dengue

Types of Public Health Care
- Categories of health workers make
up the primary health care team. The
type varies in different community
depending upon:

Available
man
power
resources
Local Health needs and
problems
Political
and
financial
feasibility

PHC Team:

Physician
Nurses
Midwives
Nurse auxillaries
Locally trained community
health workers
Traditional birth attendants
Healers
(Albularyos/Quack
doctors)

Two levels of Primary health care

1.

Village or Barangay health

workers
First
contact
of
the
community
Provide simple curative and
preventive health measures
Work in liason with local
health services
Participants
in
activities
geared towards improvement
of the socio-economic level of
the community


2.

Trained community health

workers, health auxillaries,
volunteers
Intermediate leave health
workers

Traditional Health care:

Outcome

Community

THC: Reliance on health professionals

1.

PHC: Local self-reliance and self-help

2.

Appropriate Technology

Disease oriented
Individual centered
Hospital based

- Method/technique which provides a

socially
and
environmentally
acceptable level of service/quality
product at the least economic cost.

3.

Little knowledge is dangerous.

4.

Primary Health Care

Health oriented
People centered
Community based

Criteria for selection of Technology:

THC vs. PHC

1.
2.
3.
4.
5.
6.

Goal
THC: Absence of disease
PHC: Development/preventive health
care

Strategies of Public Health Care

1.

Focus of care
THC: The sick
2.

PHC: Well/early sick

3.
4.
Setting for

5.

THC: Urban based

6.

PHC: Rural based

Services

7.

THC: Accessible to few

PHC: Accessible to all

8.

People

Reorientation
and
reorganization of the NHC
system
with
the
establishment of functional
support mechanism
Effective preparation and
enabling process for health
action at all levels.
Mobilization of people
Development and utilization
of appropriate technology
Organization of communities
arising from their expressed
needs
Increase opportunities for
community participation in
local
level
planning,
management,
maintaining
and evaluation
Development
of
intrasectoral linkages with other
government
and
private
agencies.
Emphasizing partnership so
that health workers and the
community leaders

4 Cornerstones/Pillar in PHC

THC: Passive participation

1.

PHC: Active participation

2.
3.
4.

Technology
THC:
Modern
motivated.

Effectiveness and safety

Complexity
Cost
Acceptability
Scope of Technology
Feasibility

medicine.

PHC:
Promotive
and
services.
Traditional
Acceptance
of
practitioners.

Active
community
participation
Intasectoral and intersectoral
Use of appropriate technique
Support mechanisms made
available

Doctor
Health community

preventive
medicine.
indigenous

Community (out of the ordinary)

- Latin word: communitas, meaning

common. Ecologically viewed as
special
unit.
Anthropologically
considered as social system

5.

Area of common life such as

village, a town, a district/
even a wider area
Defined as a group with
common territorial base with
a shared sense of common
interests and feeling of
belongingness
Essential that the people
participate in its activities
and acquire a well-feeling
in order to develop a real
community
A community may be limited
to a specific or it may
embrace all people of similar
attitudes and values who
commune in the fellowship
Type of social grouping
occupying
a
certain
geographical area

Demography

Study
of
size,
territorial
distribution and composition of
the population and the changes
wherein.

Population

Number of persons occupying a

certain geographic habitat and
interacting with each other

Sander views the community as a

place, as a collection of people and a
social system.
A.
1.
2.
3.
4.

Viewing the community as a

collection of people
Demographic Characteristics:
Age and population
Educational attainment
Occupational skills
Cultural
and
Ethnic
background

Community as a place
1.
2.
3.
4.
5.

Geographical
location,
physical characteristics
The environment
Channel of communications
Health and health facilities
Resources
and
interrelationships

Community as a system
1.
2.
3.
4.
5.
6.

Structure: Series of agencies,

organization
and
establishment
Set of functions
Persons
charged
with
responsibilities of promoting
the interest of the system
Ideology
of
rationale:
justification
for
the
continuation of the system
Material resources
Linkages with other systems
with in the community

Characteristics of a community
1.
2.
3.
4.

Environment (Physical, sociocultural milleu)

Population
behavior
of
lifestyle (self-responsibility)
Human
Biology
(Characteristics
of
population)
Systems of Health care
(Prevention and promotion)
- Members carry activities
and
bound
to
common
culture
- Locality of Group
Serves as extensions of the
grouping of families
Varies in size and population
diversity and occupation

6.
7.

6.
7.
8.

1.
2.
3.

1.

2.

Rural community: Small population.

Population density is low. Man to land
ratio is small. Peopled by simple folk.
Occupations are usually farming,
fishing, and food gathering.
Urban community: city-density is high.
Large
dense
of
community.
Characterized by a heterogeneity of
culture and a high degree of
specialization and interdependence.
Occupations are non-fishing and nonfarming
Rurban (combination of the two)
Rural Community

2.
3.
4.
5.
6.
7.

Urban Community
1.
2.
3.
4.
5.

Large, diverse interests and

functions
High population density
Rapid culture change
Diversified set of folkways
Do not produce their own
foods

Smaller town with

facilities
Urban in culture
Rural geographically

Source
(income)

latest

Core (People)
-represent the people that
make up the community
-demographics
of
the
population, values, beliefs
and history of the people
8 subsystems
A. Housing (type of housing
facilities
in
the
community,
enough
housing
facilities
available)
B. Education
(ratio
of
health
educators
to
learners, distribution of
educational
facilities,
who utilizes these)
C. Fire and safety (fire
protection illness, fire
prevention
activities,
distribution of these)
D. Politics and government
(political
structures
present
in
the
community,
decisionmaking process. Pattern,
leadership observed)
E. Health (health facilities
and
activities,
distribution
and
utilization,
ratio
of
providers to clientele
served,
priorities
in
health,
programs
developed
F.
Communication
-Systems,
types
of
communication existing,
forms of communication,
be it formal etc.

3.

Health resource characteristics

A. Existing
health
facilities in the area
B. Health manpower in
each facility
4. Health status of the community

# of illness and deaths due to

specific disease

# of births and malnourished

children

Other factors that influence the

occurrence of distribution of
health and diseases.
(Physical condition, rainfall
season, weather climate)
Elements
of
community
1.
2.
3.
4.
5.
6.

2.

Population: total number of

living in a definite geographic
area at a given time
Ecological
characteristics:
sumatotal of the socio-economic
and environmental elements of
the community which have and
important effect on the health
condition of the community.
A. Social Factors:
- Educational level, housing
conditions
- Political set-up, decisionmaking.

Healthy

People are partners in

health care
People work together to
gain goals
Physical
environment
promotes health, safety
and order
Safety
water
and
nutritious food
Families
provide
members
with
basic
needs
Available,
affordable
health care

Healthy Community

4 Characteristics of a community
1.

livelihood

Number of people possessing

time
(home
appliances,
electrical and waterworks,
system connections)

G. Economics
H. Recreation

of

-Number of employed and

unemployed population

Components

Types of community

Small, sharing interest and

function
Low population density
Slow culture change
Unified set of folkways
Produce their own food
Engaged in 1st level of
occupation:
Farming
and
fishing
Predominant
primary
relations
(nuclear
and
extended)

Environmental Sanitation
Facilities

C. Economic Factors:

Housing, shelter and use of space

Safety, security and protection
Distribution of goods and services
Education
Provision of opportunities for
interaction
Transmitting ideas
Employment: means of livelihood
Creating and enforcing laws,
rights and standards of behavior

1.

B.

Rurban Community

Functions:
1.
2.
3.
4.
5.

3rd
level
of
occupation:
commerce and industry
Predominant
secondary
relations (co-workers)

Prompt its members to

have a high degree of
awareness that we are
community
Uses
its
natural
resources while taking
steps to conserve them
for future generations
Openly recognizes the
existence of subgroups
and
welcomes
their
participation
in
community affairs
It is prepared to meet
crises
It is a problem solving
community
Open
Channels
of
communication
that
allows information tyo
flow
among
all

subgroups of its citizens

in all directions.
Seeks to make each of
its
subsystems
resources available to
all members of the
community

An idle man makes a devil workshop

Factors that affect community health
1.

Political influences
- influences social climate in
which people live political
justifications have the power
and authority to regulate the
environment
Ex:
Safety,
oppression,
people
empowerment,
increase of crimes, lack of
safety affect health.

2.

Behavioral influences

- a persons level of functioning is

affected but certain habits that he has
(form of smoking, intake of alcoholic
drinks).
3. Hereditary influences
4. Health
influences

care

delivery

system

5. Environmental influences

Pollution has greatly affected

the health of the people, the
diseases today are largely
man-made

CD due to poor sanitation,

poor
garbage
collection,
smoking,
air
pollution,
utilization of chemicals.

Cutting trees causing flood

and drought

Mans
supply
of
food
continued to threaten
Socio-economic influences

Families from the lower

income groups are the ones
mostly served in public
health
services.
This
is
because people from the
lower income groups tend to
have proportionately greater
number of illness and health
problems that those in the
higher income groups

The
middle
and
upper
income group have pressing
health problems (drug-abuse,
lifestyle disease)

2.
Social
community

Physical environment of the

community
- Clean, purity of the air,
clean
pure
water,
safe
decibels, stimulating climate
and water

of

the

- Stability of the population, provision

made for recreation or socializing
centers,
institutions
within
the
community,
beauty
in
the
surroundings,
tranquility
of
the
neighborhood.
Approaches
Development
1.

to

Community

Welfare Approach
the
immediate
or
spontaneous
response
to
ameliorate the manifestation
of poverty, especially on the
personal level. Assumes that
poverty
is
God-given,
destined, hence the poor
should accept their condition
since they will receive their
just reward in heaven.

2. Modernization Approach
- also referred to as the project
development approach. It introduces
whether resources are lacking in a
given community. It is also considered
a national strategy which adopts the
western
mode
of
technological
development.
It
assumes
that
development consist of abandoning
the traditional methods of doing
things and must adopt the technology
of industrial country. It believes that
poverty is due to lack of education,
lack of resources such as capital and
technology.
3.
Transformatory/Participatory
Approach
The
process
of
empowering/transforming the poor
and the oppressed sectors of society
so that they can pursue a more just
and humane society. It assumes that
poverty is not God-given, rather, it is
rooted in the historical past, and is
maintained
by
the
oppressive
structures in society. Poverty is caused
by
prevalence
of
exploitation,
oppression, domination and other
unjust structures.

capabilities and resources of

the people for the resolution
of their issues and concerns
towards effecting change in
their existing oppressive and
exploitative conditions.
Importance
- is an important tool for community
development and people as this helps
the community workers to generate
people or clients to eventually take
over
the
management
of
a
development programs in the future,
COPAR
maximizes
community
participation, involvement, community
resources
are
mobilized
for
community services.

Principles of COPAR
1.

2.

Pre-entry Phase: initial phase of the

organizing
process
where
the
organizer looks for communities to
serve/help. It is the simplest phase in
terms of actual outputs, activities and
strategies and time spent for it.
Activities include:
1.

2.

COPAR
Definitions:
1.

2.

Social development approach

which aims to transform the
apathetic, individualistic, and
voiceless poor into dynamic,
participatory and political
responsive community.
A collective, participatory,
transformative,
liberative.
Sustained
and
systemic
process of building peoples
organizations by mobilizing
and
enhancing
the

People especially the most

oppressed,
exploited
and
deprived sectors are open to
change, hence the capacity
to change and are able to
bring about change
COPAR should be based on
the interests of the poorest
sectors of society

Progressive cycle of action-reflectionaction which begins with small, local,

concrete issues identified by the
people and the evaluation and
reflection of and on the action taken
by them

3.

Effects of a Healthy Community

1.

environment

Designing
a
plan
for
community
development
including all its activities and
strategies
for
care/development
Designing criteria for the
selection of site
Actually selecting the site for
community care

Entry
Phase:
sometimes
called
preparation phase as it includes the
sensitization of the people on the
critical events in their life, motivating
them to share their dreams, and ideas
on how to manage their concerns and
eventually mobilizing them to take
collective action of these. This phase
signals the actual entry of the
community worker/organizer into the
community. She must be guided by
the following guidelines however:

Recognizes the role of local

authorities by paying them

visits to inform them their

presence and activities
Her
appearance,
speech,
behavior, and lifestyle should
be in with those of the
community residents without
disregard of their being role
models
Avoid
raising
the
consciousness
of
the
community residents

Organization-building Phase: entails

the
formation
of
more
formal
structures and the inclusions of more
formal
procedures
at
planning,
implementing, evaluating communitywide activities. It is at this phase
where the organized leaders or groups
are being given trainings to develop
their AKS in managing their own
concerns or programs.

Critical Steps
Organization
1.

2.

Sustenance/strengthening
Phase:
community organization has already
been established and the community
members
are
already
actively
participating
in
community-wide
undertakings.

3.

Strategies:

4.

Education and training

Networking and linkaging

Developing
secondary
leaders
Implementation of livelihood
projects
in

Building

5.
6.
7.
8.

something on the issue that

has been chosen
The meeting
The role play
Mobilization/action
Evaluation

Peoples

Integration
Immerse
self
with
community:
understand
culture, conduct house to
house visits
Social
investigation:
systematic
process
of
collecting,
collating,
analyzing data to draw a
clear
picture
of
the
community
(community
study, use of questionnaires
like
survey,
community
leaders trained to assist
community workers to do S.I.,
data must be efficiently
collected, confirmation and
validation of community data
should be done regularly)
Tentative program planning:
choose one issue to work on
and begin organizing with
people
Ground work: going around
and motivating the people on
a one on one basis to do

Roles and activities in community

health development

As
recorder/documenter/reporter,
community worker keeps a written
account
of
services
rendered,
observations, conditions, needs, and
problems.
Record refers to forms on which
information pertaining the client is
noted.
Report refers to periodic summaries of
the
services/activities
of
an
organizational/unit or the analysis of
certain phases of its work.