Chapter-2.pdf

Chapter 2 Concept of the Community TYPES OF COMMUNITIES 1. Activist Community Activivist communities stand out for the action that they take. They are usually founded around...

Chapter 2 Concept of the Community TYPES OF COMMUNITIES 1. Activist Community Activivist communities stand out for the action that they take. They are usually founded around a cause. Globally, activist communities also unify its members with a shared sense of purpose and identity. Early stages of activist communities can be exiting and ambitious to watch as they blastinto public awareness in a significant way to create the impactthey desire. 2. Brand Community Is a community with a specific business objective lead by an executive sponsor, where a company creates a space for people with a common sense of identity to participate in ongoing, shared experience. 3. Impact Community They are often a source of quiet power rather than being loud and attention drawing. Imact communities are the ones which are most familiar with our day to day lives but also the ones which have rarely paid much attention to. They are parent teacher association, our neighbors watch, and churches. They are support groups, book clubs and our online groups. They are a constant and consistent presence providing us with a much needed sense of belonging, and sometimes they only exist to gather people together. CHARACTERISTICS OF A HEALTHY COMMUNITY A healthy organism has all its body parts contributing to its well-being by carrying out their specific functions. In the same manner, all systems of a community need to function effectively and work together to maintain the health of the community. A healthy community has mechanism that assure all citizens a decent way of life in all aspects (Rabinowitz, 2012). Certain observable traits allow health workers to ascertain whether an individual or a family is healthy. A community likewise, may be observed for evident traits that indicate its health. Characteristics of a healthy community include (adapted from Hunt, 1997; Duhl, 2002):  A shared sense of being a community based on history and values. Despite the presence of subgroups, members of the community have the feeling of belonging and that they make up one community. Recognition and respect for these subgroups makes this possible.  A general feeling of empowerment and control over matters that affect the community as a whole.  Existing structures that allow subgroups within the community to participate in decision making in community matters.  The ability to cope with change, solve problems, and manage conflicts within the community through acceptable means.  Open channels of communications and cooperation among the members of the community.  Equitable and efficient use of community resources with the view towards sustaining natural resources. A healthy community is, in fact, the context of health promotion defined in the Ottawa Charter (WHO, 1986) as “the process of enabling people to increase control over, and to improve their health.” Further, the charter states, “To reach the state of complete physical, mental and social well-being, an individual or group must be able to identify and realize aspirations, to satisfy needs, to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just a responsibility of the health sector, but goes beyond healthy life-styles to well- being.” The Ottawa Charter was one of the documents that paved the way for the Healthy Settings movement. Healthy initiatives, such as the Healthy Cities movement, have been undertaken in different parts of the world (WHO, 2012a). A healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources that enable people to mutually support each other in performing all the functions of life and developing to their maximum potential. It aims to:  achieve a good quality of life  create a health-supportive environment  provide basic sanitation and hygiene needs  supply access to health care. Being a healthy city does not depend on existing structures, but the commitment to improve the city environment and create the necessary networks for health (WHO, 2012b). The Philippines is a member nation of the WHO Western Pacific Region, which has advocated for the Healthy Cites and Healthy Islands movement, especially because of rapid economic, environmental, and social changes (WHO WPR, 2010). Health is affected by many factors that cannot be controlled by individuals all by themselves. Effectively functioning systems within the community go a long way toward health promotion, disease prevention, and access to resources needed for health. Knowing that a healthy community is essential to health promotion gives the community health nurses further motivation in their work. ELEMENTS OR COMPONENTS OF PRIMARY HEALTH CARE HC ELEMENT Health Education Communicable Disease Control Expanded Program on Immunization Locally Endemic Disease Treatment Environmental Sanitation Maternal and Child Health and Family Planning Essential Drug Provision Nutrition and Adequate Food Provision Treatment of Emergency Cases and Provision of Medical Care FACTORS AFFECTING HEALTH OF THE COMMUNIT Y A community has three features: people, location, and social system (Allender et al., 2009; Hunt, 2009). Factors related to these features affect the health status of the community. 1. Characteristics of the Population Population variables that affect the health of the community include size, density, composition, rate of growth or decline, cultural characteristics, mobility, social class, and educational level (Allender et al., 2009).  People move from one place to another for various reasons, such as to start a family, to take a new job, or to join another family member. Again, the feeling of belongingness and participation in community action are less likely when a large segment of the community is composed of new or transient residents. The level of education and social class affect health status because of differences in living conditions and degree of access to resources and opportunities. In addition, different social classes display distinctive health problems (Allender et al., 2009). 2. Location of the Community The health of the community is affected by both natural and man-made variables related to location. Natural factors consist of geographic features, climate, flora, and fauna. Community boundaries, whether the community is urban or rural, the presence of open spaces, the quality of the soil, air, and water, and the location of health facilities are influenced by human decisions and behavior (Benson, 1980; Allender et al., 2009). Geographic features consist of land and water forms that influence food sources and prevalent occupations in the community. Geography plays an important role in disasters, such as earthquakes, landslides, and floods. Air, water, and soil pollution poses health hazards to the population. Outdoor air pollution is attributed to transport and manufacturing activities, which occur in concentration in urban areas, especially the National Capital Region. The use of solid fuel (wood, charcoal, and biomass residues like stalks, leaves and agricultural by-products), which lead to indoor pollution, is more prevalent among low-income households in rural areas (Arcenas, 2009). A great portion of water pollution from domestic sources id contributed by the National Capital Region and Region 4A (CALABARZON). Soil pollution is mainly attributed to mining, industries, farming, and household activities (Asio et al., 2009). The first three affect rural areas, whereas household activities have a greater effect in urban areas. 3. Social Systems within the Community A social system is the patterned series of interrelationships existing between individuals, groups, and institutions and forming a coherent whole (Meriam-Webster Online Dictionary, 2012b). Social system components that affect health include the family, economic, educational, communication, political, legal, religious, recreational, and health systems (Allender et al., 2009). While carrying out several roles simultaneously, an individual serves as a part of several social system components at the same time. One may be a son or daughter in the family, a nurse employed in a hospital, a church member, a member of a neighborhood basketball team, and a citizen all at one time. As in other systems, the composites parts of the social system of the community affect and interact with one another. During these interactions, patterns and communications transpire, which form the basis of organization. Organizations within the social system can be formal or informal (Allender et al., 2009). A government agency, bank, and a school are examples of formal organizations, whereas neighborhood friends and volunteers in a barangay clean –up drive are examples of informal organizations. Organizations that have interactions and linkages and that carry out similar functions form community systems or subsystems (Allender et al., 2009). For example, health centers, private clinics, hospitals, health laboratories, and drugstores are elements of health system of a community. ROLES AND ACTIVITIES OF COMMUNITY HEALTH NURSE Roles of the Public Health Nurse 1. Clinician or health care provider  utilizes the nursing process in the care of the client in the home setting through home visits and in public health care facilities ; conducts referral of patients to appropriate level of care when necessary. 2. Health Educator  utilizes teaching skills to improve the health knowledge, skills, and attitudes of the individual, family and the community, and coducts health information campaigns to various groups for the purpose of health promotion and disease prevention. 3. Coordinator and Collaborator  establishes linkages and collaborative relationships with other health professionals, government agencies, private sector, non- government organizations and people’s organizations to address health problems 4. Supervisor  Monitors and supervises the performance of midwives and otherauxillary health workers ; also initiates the formulation of staff development and training programs for the midwives and other auxillary health workers as part of their training function as supervisors 5. Leader and Change Agent  Influences people to participate in the overall process of community developement 6. Manager  Organizes the nursing service component of the local health agency of local government unit.  As a program manager, the PHN is responsible for the delivery of the package of services provided by the health program to the target clientele 7. Researcher  Participates in the conduct of research and utilizes research findings in practice. 8. Others