Community Health Nursing 2 Midterm Exam, October 2024 PDF

1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Health Assessment Tools COMMUNITY ASSESS...

1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Health Assessment Tools COMMUNITY ASSESSMENT Community assessment is a process that identifies a NECESSARY WHEN: community's strengths, resources, assets, and needs. ◦ No Available Information It's a comprehensive process that involves collecting, ◦ Needs to collect data from a particular community analyzing, and sharing information about the community. ◦ Reveals a particular health problem USES OF SURVEY COLLECTING PRIMARY DATA ◦ A survey is also useful in determining the following: OBSERVATION community attitudes, knowledge, health behaviors and It is an act of extracting information from subjects being perception of health and services. studied ◦ A survey is used to identify patterns of utilization of health ◦ OCULAR SURVEY OR WINDSHIELD SURVEY services (Maurer & Smith, 2009) ▪ This involves rapid observation of a community and ◦ A survey is an opportunity for making the community more performed either by walking through it, driving or riding aware of community problems and their effects and more in a vehicle. conscious of their capacity to influence the decision ▪ This give the nurse a chance to observe: making about health policies & plans, giving them a sense ▫ PEOPLE: Spot vulnerable groups and peoples of empowerment appearance. SURVEYS IN ASSESSMENT ▫ ENVIRONMENT: Terrain, Homes, Housing Density & ◦ In COMPREHENSIVE NEEDS assessment: Cleanliness, Vegetation, Street Animals ▪ Data collected is about a “random sample of a ▫ FACILITIES/COMMUNITY RESOURCES: Health population.” Facilities, Barangay Halls, School, Places Of Worship, ◦ In PROBLEM-ORIENTED assessment: Open Spaces ▪ “Purposive sampling” is indicated where the sample ▪ The nurse talks to people to know their perception of population consists of the population “healthy community” and their “community facilities” ▪ Susceptible to the problem being studied. (Eg. Mother ◦ PARTICIPANT OBSERVATION with young children) ▪ Purposeful observation of formal and informal INFORMANT INTERVIEW community activities by sharing in the life of the A purposeful talk with either key informant or ordinary community. members of the community. ▫ FORMAL: community activities are barangay ◦ KEY INFORMANT assemblies, school parent-teacher meeting, church ▪ Formal: persons of position and leaders or as leaders in meeting. local government ▫ INFORMAL: gatherings are in variety of setting such ▪ Informal: community leaders or persons of position and as sari-sari store, community recreation area or influence, such as schools and business schools ◦ INTERVIEW ▪ Helps in determining the following in a community: ▪ Structured: is where the nurse directs the talk based on ▫ Values an interview guide ▫ Belief ▪ Unstructured: is where the informant guides the talk. ▫ Norms COMMUNITY FORUM ▫ Priorities Community Forum is an open meeting of the members of the ▫ Concerns community ▫ Power or Influence Structures ◦ PULONG-PULONG SA BARANGAY: is an illustration of a ▪ Suits community organizing and participatory research. community forum, this offers the nurse an information SURVEY regarding community perceptions on their needs, health A made of series of questions for systematic collection of and health care information from a sample of individuals or families in a Community Forum is good in providing folks with a medium of community conveying their views and developing their capability to ◦ Time consuming influence decision makers ◦ Expensive The forum is set in coordination with the leaders of the public ◦ Written or Oral if the community forum is initiated by the nurse. ◦ They are the barangay leaders or other informal leaders. Kath Venus 1 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 The community forum can be used for data gathering. ◦ If death occurred without medical attention: the nearest Also, it can be used as a venue for informing the people relative or any person who has knowledge of the death about secondary data, for data validation and for getting ◦ In the absence of a health officer: the death should be feedback from the public about previously gathered data. reported to the mayor, municipal secretary or any member FOCUS GROUP of the Sangguniang Bayan, who shall issue the death Assessment of health needs of specific groups certificate for the purposes of burial. ◦ Focus group is made up of much smaller group usually 6-12 Registration of death shall be made within 30 days from the member only occurrence of death at the Local Civil Registry Office of the Membership is more homogeneous which is person with city or municipality. similar sociocultural or health conditions Fetal deaths are registered following the same process ◦ GUIDELINES IN THE CLASSIFICATION OF DATA COLLECTING SECONDARY DATA ▪ Reckoning of Vital Events: All vital events are registered REGISTRY OF VITAL EVENTS and reported by place of occurrence, not by place of ACT 3753 (Civil Registration Law, Philippine Legislature) residence. ◦ Enacted in 1930 ▪ Reckoning of Age: age is recorded as of last birthday ◦ Established the civil registry system in the Philippines ▪ For Neonatal Death: In the first day of life (day zero), ◦ Requires the registration of vital events such as births, age at death should be recorded in units of completed marriages and deaths minutes or hours of life. For the succeeding days until RA 7160 (Local Government Code) the 27th completed days of life, age at death should be ◦ Assigned the function of civil registration to local recorded in days governments HEALTH RECORDS AND REPORTS ◦ Mandated the appointment of Local (city/municipal) Civil Executive Order No. 352 (Office of the President, Republic of registrars the Philippines, 1996), the Field Health Service Information NATIONAL STATISTICS OFFICE System (FHSIS) ◦ The NSO serves as the central repository of civil registries ◦ This is the official, recording and reporting system of the and the NSO Administrative and the Civil Registrar NSCB to generate health statistics. General of the Philippines. ◦ The FHSIS is an essential tool in monitoring the health ◦ Reliable civil registration and vital statistics provide status of the population at different levels. realistic basis for program planning and implementation. FHSIS Basis for: ▪ The birth and death registries are of particular ◦ Priority setting by local governments importance to the nurse, since they are sources of ◦ Planning and decision making at different levels fertility and mortality data. ◦ Monitoring & evaluating health program BIRTHS FHSIS is composed of recoding and reporting tools. Live birth is the complete expulsion/extraction from mother of ◦ Records are facility-based. a product of conception, regardless of duration of pregnancy ◦ Kept at the Barangay Health Station or at Rural Health Unit ◦ After such separation, breathes or with evidence of life or health center. (ex. beating of heart, pulsation of umbilical cord, or ◦ With day-to-day account of activities of health workers, movement of voluntary muscles, whether or not umbilical service delivered to clients are basis of data entered in the cord been cut or placenta is attached) each product of records. such birth is considered LIVEBORN. ◦ A basis of reports. Who will register the births? ◦ Reports consists of summary data that are transmitted or ◦ Facility-based births: facility administrator submitted monthly, quarterly, annually to higher level. ◦ Outside birth facility: physician, nurse, midwife or anybody ◦ From BHS → RHU or health center → Provincial → to who attended the delivery, Regional Office Health Office ◦ Default of the Hospital: either parent may also register the The FHSIS Manual of Operations (DOH-IMS, 2011) lists and birth describes the following recording tools: ◦ Aboard a vehicle, vessel, or airplane while in transit: joint ◦ INDIVIDUAL TREATMENT RECORD (ITR) responsibility of the driver, captain or pilot and the parents ▪ Is the fundamental building block of FHSIS. The record The birth of a child should be registered within 30 days from contains the date, name, address of patient, presenting the occurrence of the birth at the Local Civil Registry Office symptoms or complain of the patient on consultation of city or municipality where the birth occurred (NSO, 2010). and the diagnosis (if available), treatment and date of DEATHS treatment Death is a permanent disappearance of all evidence of life ▪ ITR is maintained at the facility. Health workers are at any time after live birth has taken place (postnatal advised not to rely on client-maintained records like the cessation of vital functions without capability of home-based mothers record. resuscitation) ◦ TARGET/CLIENT LISTS (TCLs) Presidential Decree 856. Sanitation Code ▪ Are the second building block of the FHSIS. ◦ In 1975, Office of the President necessitates death ▪ Target or Client Lists maintained in the RHU and health certificate before burial of deceased centers: Who will register the deaths? ▫ TCL for Prenatal Care ◦ Physician: The physician who last attended the deceased ▫ TCL for Postpartum Care ▫ TCL of Under1-Year Child Children Kath Venus 2 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 ▫ TCL for Family Planning ▹ Morbidity Report (M2) ▫ TCL for Sick Children Contains a list of all cases of disease by: ▫ National Tuberculosis Program TB Registrar ◦ Age ▫ National Leprosy Control Program Central ◦ Sex Registration Form ▫ QUARTERLY FORMS ▪ These service records have the following purposes: ▸ Are usually prepared by the nurse ▫ To plan and carry out patient care and service ▹ Municipality/City delivery since midwives and nurses use TCLs to There should only be one Quarterly Form for monitor target or eligible populations for particular the municipalities/cities with two or more health services. RHUs or health centers. ▫ To facilitate monitoring and supervision of service Consolidation done under the direction of delivery activities. Municipality/City Health Officer ▸ priority setting by local governments ▹ Provincial ▸ planning & decision making at different levels Quarterly forms are submitted to the (barangay, municipality, district, provincial & Provincial Health Office. national) ▸ Types of Quarterly Forms ▸ monitoring and evaluating health program ▹ Program Report (Q1) implementation contains the 3-month total of indicators ▫ To report services delivered, thus reducing the need categorized as maternal care, family to refer back to the ITRs to accomplish reporting. planning, child care, dental health and ▫ To provide a clinic-level database that can be disease control. accessed for further studies. ▹ Morbidity Report (Q2) ◦ SUMMARY TABLE is a 3 month consolidation of Morbidity ▪ This is accomplished by the Midwife. Report ▪ It is a 12-column table in which columns correspond to ▫ ANNUAL FORMS the 12 months of the year. ▸ A-BHS ▪ This record is kept at the BHS and ▹ is a report by the midwife that contains: ▪ It has two components: Demographic ▫ Health Program Accomplishment and Environmental ▫ Morbidity/Disease Natality data ▪ Summary Table is supposed to be updated on a monthly ▸ Annual Form 1 (A-1) basis. ▹ is prepared by the nurse and is the report of the ▪ The Health Program Accomplishment provides the RHU or health center. midwife with: ▹ It contains demographic and environmental ▫ Tool for assessment of accomplishments data, and data on natality and mortality for the ▫ Ready source for reports entire year. ▪ The monthly summary of morbidity gives information on: ▸ Annual Form 2 (A-2) ▫ Monthly trend of disease ▹ Prepared by the nurse, is the yearly morbidity ▫ Serves as a source for the 10 leading cases of report by age and sex. morbidity in the municipality/city ▸ Annual Form 3 (A-3) ▪ The Summary Table is also a source of data for any ▹ Also prepared by the nurse, is the yearly report survey or research. of all deaths (mortality) by age and sex. ◦ MONTHLY CONSOLIDATION TABLE (MCT) ▫ UPON OCCURRENCE ▪ Accomplished by the nurse based on the Summary ▸ E-1 Notification of Death Forms Table. ▸ E-2 Maternal Death Report ▪ It serves as: ▸ E-3 Perinatal Death Report ▫ the source document for the Quarterly Form ▫ WEEKLY ▫ the Output Table of the RHU or health center ▸ Weekly Report of Notifiable Disease ▪ REPORTING FORMS OF MCT DISEASE REGISTRY ▫ MONTHLY FORMS A listing of persons diagnosed with a specific type of disease ▸ Are regularly prepared by the midwife and in a defined population. submitted to the nurse who then uses the data to Data collected through disease registries serve as a basis for prepare the Quarterly Forms. These are: monitoring decision making and program management. ▹ Program Report (M1) The Department of Health has developed and maintained Contains indicators categorized as: registries for HIV/AIDS and chronic non communicable ◦ Maternal care disease, particularly cancer, diabetes mellitus, chronic ◦ Child care obstructive pulmonary disease and stroke. ◦ Family planning CENSUS DATA ◦ Disease control. It is a periodic governmental enumeration of the population. The midwife copies the data from the It provides for a national census of population and other Summary Table related data in the Philippines every 10 years. Kath Venus 3 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 The Philippine Statistical System provides statistical information and services to the public. The NSCB is the policy-making and coordinating body of the PSS. ◦ NSO is the PSS arm that generates general-purpose statistics: ▪ Population ▪ Employment ▪ Process ▪ Family income/expenditures. During a census, people may be assigned to a locality by de jure or de facto method ◦ DE JURE: based on the legally established place of residence of people ◦ DE FACTO: according to the actual physical location of people. The NSO conducts the national census using the de jure method. ◦ The census population consists of Filipino nationals, to include those residing in and out of the Philippines, and nationals of other countries having their usual residence in the Philippines. ◦ Demographic characteristics, household size, and data on fertility and mortality are some of the census information that the nurse can utilize for needs assessment. Census data are accessible at the NSO. METHODS TO PRESENT DATA PURPOSES Inform health teams and members Make member of community appreciate the significance of health information in their lives Solicit broader support Validate findings. PIE-CHART Show percentage distribution or show composition SCATTER PLOT OR DIAGRAM Show correlation between two variables LINE GRAPH Visual image of trends in data over time or age BAR GRAPH To compare values across different categories of data Kath Venus 4  1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Diagnosis COMMUNITY DIAGNOSIS Determining community health status is a process called ▪ Occupation common in the community community assessment. ▪ Communication network (whether formal or informal It is the process of community diagnostics channels) necessary for disseminating health Keystone in developing community health nursing process. information or facilitating referral of clients to the ◦ Community Diagnosis in nursing consist of two parts: health care systems. ▪ The nurse collects data about the community in order to ▪ Transportation systems including road networks find different factors that may directly and indirectly necessary for accessibility of the people for health care influence health of the population. delivery system ▪ Analyze and seeks explanation to the occurrence of ◦ ENVIRONMENTAL INDICATORS health needs and problem of the community. ▪ Physical/geographical/topographical characteristics of TYPES OF COMMUNITY DIAGNOSIS the community COMPREHENSIVE COMMUNITY DIAGNOSIS ▫ Land areas that contribute to vector problems ◦ General information about the community ▫ Terrain characteristics that contribute to accidents or PROBLEM-ORIENTED COMMUNITY DIAGNOSIS pose as geohazards zones ◦ Made to responds to a particular need of a target group ▫ Land usage in industry ▫ Climate/Season COMPREHENSIVE COMMUNITY DIAGNOSIS ▪ Water supply This aims to obtain the general information of the community ▫ Population with access to safe, adequate water with the intent of determining prevalent health conditions supply and risk factors (epidemiologic approach), lifestyle behaviors ▫ Source of water supply and attitudes that affects their health (behavior approach) as ▪ Waste disposal well as their socio-economic condition (socio-economic ▫ % population served by daily garbage collection approach). system ELEMENTS OF COMPREHENSIVE COMMUNITY DIAGNOSIS ▫ % population with safe excreta disposal system DEMOGRAPHIC VARIABLES: This shows the size, composition ▫ Types of waste disposal and garbage disposal system and geographical characteristics of population. Consist of: ◦ CULTURAL FACTORS ◦ Total population, geographic distribution, including urban- ▪ Variables that may break up the people into groups rural index and population density within the community such as: ◦ Age and Sex composition ▫ Ethnicity ◦ Household size ▫ Social class ◦ Selected Vital Indicators such as growth rate, crude birth ▫ Language rate, crude death rate and life expectancy at birth ▫ Religion ◦ Patterns of Migration ▫ Race ◦ Population Projections ▫ Political orientation SOCIO-ECONOMIC AND CULTURAL VARIABLES: These ▪ Cultural beliefs and practices that affect health affects health of the community directly and indirectly. ▪ Concepts about health and illness ◦ SOCIAL INDICATORS HEALTH AND ILLNESS PATTERN ▪ Educational Level: Can be indicative of poverty, can ◦ The nurse may collect primary data about leading causes also reflect in the perception in terms of health and of illness and deaths and their respective rates of utilization of pattern of the community occurrence. If he accesses to recent, reliable secondary ▪ Housing Condition: May reflect health hazards such as data, then she can also make use of these: congestion fire, exposure to elements ▪ Leading causes of mortality ▪ Social Classes or groupings ▪ Leading Causes of Morbidity ◦ ECONOMIC INDICATORS ▪ Leasing Causes of Infant and Child Mortality ▪ Poverty Level Income ▪ Leading Causes of Hospital Admissions ▪ Unemployment and Underemployment Rate ▪ Leading Causes of Clinic Consultation ▪ Proportion of Salaried and Wage earners to total ▪ Nutritional data economically active population ▪ Types of industry present in the community Kath Venus 1 1.07 – COMMUNITY DIAGNOSIS – CHNN312 HEALTH RESOURCES: This is an essential element in the COLLECTING THE DATA delivery of basic services in the community. The nurse needs ◦ Different methods may be utilized to generate health to determine manpower, institutional and material resources data. In general, we use the following methods of data provided by states and those from private sector &other collection: NGO. ▪ OBSERVATION ◦ MANPOWER RESOURCES ▫ Extracting information from subjects by observing ▪ Categories of health manpower available behaviors & environment. ▪ Geographical distribution of health manpower ▫ Ocular survey/Windshield survey ▪ Manpower-population ratio ▫ Participant Observation ▪ Distribution of health manpower according to health ▪ RECORDS REVIEW facilities (hospitals, rural health units, etc.) ▫ Written information kept in folders, files or books ▪ Distribution of health manpower according to type of ▪ INTERVIEWS organization (government, non-government, health units, ▫ Face-to-face interview private) ▫ Telephone interview ▪ Quality of health manpower ▫ Individual interview ▪ Existing manpower development/politics ▫ Group interview ◦ MATERIAL RESOURCES ▫ Key informant interview (KII) ▪ Health budget and expenditure ▫ Structured and Unstructured interview ▪ Sources of health funding ▪ FOCUS GROUP DISCUSSION/FGD ▪ Categories of health institutions available in the ▫ Set a characterisitcs of the participants in terms of: community ▸ Characteristics common to them ▪ Hospital to population ratio ▸ Characteristics that will differentiate them from ▪ Categories of health services available one another POLITICAL/LEADERSHIP PATTERN: This is a vital element in ▫ Participants are selected based on the variable being achieving the goal of high-level wellness among the people. studied It reflects the action potential of the state and its people. A qualitative research technique utilize for its value in This is to address the health needs and problems of the understanding & documenting human behaviors people. It also mirrors the SENSITIVITY of the government to ▫ A FACILITATOR, will summarize & synthesize the the people’s struggle for better lives. discussion to make certain that issues have clarified ◦ The nurse describes the following: rather than confused participants ▪ Power structures in the community (formal or informal) DEVELOPING THE INSTRUMENT ▪ Attitudes of the people toward authority ◦ Instruments or tools facilitate the nurse’s data gathering ▪ Conditions/events/issues that cause social activities. conflict/upheavals or that lead to social bonding or ◦ The most common are: unification ▪ Survey questionnaire ▪ Practices/approaches effective in setling issues and ▪ focus group discussion guide concerns within the community ▪ Key informant ▪ Interview guide PROBLEM-ORIENTED COMM. DIAGNOSIS ▪ Observation checklist This is a type of assessment that responds to a particular ◦ Survey Questionnaire Or survey instrument. need of a target group ▪ The form one uses to document the date being STEPS IN CONDUCTING COMMUNITY DIAGNOSIS collected. DETERMINING OBJECTIVES ◦ In the form of: ◦ The following questions should be answered: ▪ INTERVIEW SCHEDULE: in which the PHN reads question ▪ What is the present health condition of the people in the & record responds and a Self-completed or self- community? administered questionnaire in which respondents read ▪ Why are the people in the community in such condition? question & write down responses What specific problems are causing these conditions? ▪ FOCUS GROUP DISCUSSION GUIDE: Helps as a guide ▪ What are the roots of these problems? to facilitate the course and flow of ideas on definite ▪ What solutions will address the problems? topics or concepts among participants. DEFINING THE STUDY POPULATION ▪ KEY INFORMANT INTERVIEW GUIDE: The KII is a set of ◦ This may include the: guided question about the subject. To be effective - Be ▪ Entire population in the community or conversant, have working knowledge about subject ▪ Focused on a specific population. matter The person being interviewed is selected ▪ Sample or sub-set of target population if a complete because of his expertise or concern to the subject enumeration of the desired population is not feasible. matter DETERMINING THE DATA TO BE COLLECTED. ▪ OBSERVATION CHECKLIST: List of data that are ◦ Achieved by developing a data collection plan in which manifestation of health needs or problems objectives are used to guide the data collectors. Data categories are primary and secondary Kath Venus 2 1.07 – COMMUNITY DIAGNOSIS – CHNN312 ACTUAL DATA GATHERING ▪ EXHAUSTIVE CATEGORY. It anticipates all possible ◦ Preparation before interview are the following: answers that a respondent may give. ▪ PHN meets teams involved in data collection. ▫ Ex. Types of Infant Feeding ▪ Instruments are discussed & analyzed. It can be _______ Breastfeeding modified or simplified because of time limitation and so _______ Bottle Feeding as not to burden those limited education. Pre-testing of Condensed Milk the instrument is recommended Evaporated ▪ Data Collectors are given orientation & training on how Am to use the instruments. A role–play of data collection _______ Mixed Feeding can be performed Breastmilk and Am ▪ Teach data collectors PARTICIPATORY TOOLS & Breastmilk and Formula Milk TECHNIQUE ▪ SUMMARIZING DATA FROM FIXED RESPONSE. ▫ These are creative and innovative method that will ▫ With the aid of Flashcard in which an assigned increase participation of people in data collection number or letters will correspond to specific category ▫ These are alternative to customary household survey of choices. because it takes too long to finish. ▫ It offers CHOICES to respondent to select from & will ▫ Participatory tools are non-threatening and simplify serve as CATEGORIES for collating responses. data gathering ▫ Use of flashcard to aid respondent select answer is PARTICIPATORY TOOLS AND TECHNIQUES performed for very young respondents or respondents Informal, guided interviews session in which some questions with limited education. are predetermined. ▪ OPEN–ENDED QUESTIONS. Categories are created only Semi-Structured after data collection is over. It is constructed from Interviews A new question or lines of questioning arise during the responses in randomly selected questionnaires. interviews which is in response to answers from those interviewed. ▫ Ex. Anong dahilan at hindi kayo nag Family Planning? Response 3 Mahal Analytical This is for quick means of finding out an individual's or a Response 14 Nakakataba Games group's list of priorities or preferences Response 19 Walang pambili Short, colorful descriptions of situations encountered by Response 29 Sumasakit ulo ko pag nag-take ako Stories and PHN in the field. Portraits ng pills These also stories recounted by people ▸ Possible categories are: Financial: Responses 3, 9 Simple, schematic devices that presents information in readily understandable visual forms. These are analytical Side Effects: Responses 14, 29 Diagrams ▪ SUMMARIZING THE DATA. The next step after procedures, a means of communication between and among different people. categorizing the responses is to summarize the data. Bring people together. Outsiders can be introduced to Two (2) ways to summarize data. Workshop participate actively in reviewing, analyzing & evaluating the ▫ Manually by tallying the data information gathered. An outsider is needed for their skills ▫ By using computer and experience ▸ Tallying involves entering responses into prepared ◦ AFTER THE DATA GATHERING, the PHN checks filled-up tally sheets showing all possible responses. instruments to see its: completeness, accuracy and Gender Tally Mark Frequency (F) reliability of information collected. If there are problems in Male IIIII – IIIII- III 13 accuracy or reliability, there is a need to go back & secure appropriate information. This is the only way to maintain Female IIIII - II 7 integrity and good quality of data for community diagnosis Total Respondents 20 DATA COLLATION ▸ For tallying by computers such as using software ◦ This refers in putting the facts “together.” such as EPIINFO involves the use of a Coding such ▪ Two Data that are generated are Numeric and as a number or codes. Descriptive Data. Numerical data are counted like Variable Category Code number of children in a family or how many are using “alkantarilya” as a form of excreta disposal. Descriptive Male 1 Gender data are those that can described or that can reveal Female 2 characteristics of an observable facts like beliefs DATA PRESENTATION ▪ Plan for collation should have been developed prior to ◦ Presentation will depend on the data: data collection which is done by creating and ▪ DESCRIPTIVE DATA are presented in narrative reports, constructing categories for classification of responses Ex. Geographic data history of the community, belief either mutually exclusive and exhaustive. regarding health and illness ▪ MUTUALLY EXCLUSIVE CHOICE. The choices do not ▪ NUMERICAL DATA is presented using table or graphs overlap. Responses fall only in one category among set because it is useful in showing key information making it of choices. True for numeric and descriptive data. easier on the type of data being presented ▫ Ex. Place of Origin _____ Luzon Kath Venus 3 _____ Visayas _____ Mindanao 1.07 – COMMUNITY DIAGNOSIS – CHNN312 ▫ Types of Graph and its Data Function ▹ Among the roots of the problems, which are the ▸ LINE GRAPH: Shows trend or changes in data with easiest to address? time or age with respect to some other variables ▹ Which of the effects should not be allowed to ▸ BAR GRAPH OR PICTOGRAPH: For comparison of continue? absolute or relative counts and rates between ▹ What could possibly happen if nothing is done? categories ▹ What should be done? ▸ HISTOGRAM OR FREQUENCY POLYGRAM: Graphic IDENTIFYING THE COMMUNITY HEALTH NURSE PROBLEMS presentation of frequency distribution or ◦ Defining the community health nursing problems will help measurement the PHN and the team to decide with the people actions ▸ PROPORTIONAL OR COMPONENT BAR GRAPH OR that will effectively address and improve community’s PIE CHART: Shows breakdown of a group or total health. where the number of categories is not too many. ◦ Categories of their health problems are as follows: ▸ SCATTERED DIAGRAM: Correlation data for data ▪ HEALTH STATUS: Increased/morbidity, mortality, fertility, variables. reduced wellness capability DATA ANALYSIS ▪ HEALTH RESOURCES: lack of manpower, money, ◦ This is the MOST crucial stage in community diagnosis materials, institutions ◦ This involves the quantification, description and ▪ HEALTH-RELATED: with social, economic, environmental classification of data. & political factor ◦ Triangulation is performed. Consistency and validity of PRIORITY–SETTING. data is checked. This is necessary because there are ◦ Considering limited resources, the following criteria are multiple sources of data which were collected using used in scaling: different methods. Nature of the Classified as Health status, health resources or health ◦ Data are sorted and classified in terms of relatedness and Condition/Problem related interpreted for any presented ◦ significance or implication. Magnitude of the Refers to severity of the problem ◦ Data analysis aims to established trend, patterns in terms This is measured in terms of proportion of population Problem affected of health needs and problems of the community. ◦ To help the PHN view and analyze which are indicators of Modifiability of the The probability of reducing, controlling or eradicating health problems & which factors give rise to health Problem the problem problems, patterns in terms of human relations, time, and Preventive Potentials Probability of controlling or rerducing the effects posed space are analyze. by the problem ◦ The magnitude and extent of the problem and their Refers to the perception of the population or the Social Concern implications can be derived by comparing them with community as they are affected by the problem standard values or norms ▪ PROBLEM TREE ANALYSIS APPROACH ▫ Representative of sectors of community should be present during data analysis. ▫ An analogy that leaves and branches conditions are manifestations of the over state of the plant and cause by what it gets from the soil in terms of nourishment from the roots. ▸ Problem Tree Analysis Approach is a participatory approach. ▸ The PHN writes data in 3 x 12 inches size cartolina and post it on wall ▸ Using manila paper or board the PHN draws a big tree that details leaves, branches, trunk & roots. ▸ The PHN instructs people to look at the data written in cartolina and think which can be considered as main/central problem then posts it in trunk; cause of problem will be posted in roots; effects are posted in branches and leaves ▸ Afterwards, people are encouraged to give opinions, comments, and reactions or seek clarifications on what or how the others view the problems. ▸ Questions listed below are possible to deepen analysis of community representatives: ▹ How are the main or central issue of the problem related to one another? ▹ Which of the problems seems to be the most serious? Kath Venus 4  1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Planning Community Health Interventions COMMUNITY HEALTH PROBLEMS Community Health Problems are conditions or situations that ENVIRONMENTAL DOMAIN intervene with the community’s capability to achieve wellness. Material resources and physical surroundings both inside and These are Health Status, Resources, Health-Related Problems outside the living area, neighborhood, and broader community. SCHEMES IN STATING COMMUNITY DX Income Sanitation Residence Neighborhood/workplace safety Problem Classification Scheme ◦ Provides structure, terms, & system of cues & clues for a PSYCHOSOCIAL DOMAIN standardized assessment of individuals, families, & Patterns of behavior, emotion, communication, relationships, and communities. development. ◦ It helps practitioners collect, sort, document, classify, Communication with Role change Caretaking/ analyze, retrieve, and communicate health-related needs community resources Interpersonal parenting and strengths. Social contact relationship Sexuality NANDA (Now known as NANDA, International) Abuse Neglect Grief Spirituality Growth & NANDA International (NANDA-I) NANDA–International earlier Mental health development known as the North American Nursing Diagnosis Association (NANDA) PHYSIOLOGICAL DOMAIN Is the principal organization for defining, distribution and Functions and processes that maintain life. integration of standardized nursing diagnoses worldwide Recent versions included nursing diagnostic labels for Hearing Vision Speech and language Oral health Cognition Pain community labels Respiration Consciousness Skin Such as 2018-2020, Eleventh Edition has Standardization of Neuro-musculo-skeletal Circulation Digestion-hydration diagnostic indicator terms, i.e., defining characteristics, function Urinary function Reproductive fx related factors, risk factors, associated conditions, and at-risk Bowel function Postpartum Communicable/ Pregnancy infectious cond populations ◦ Ex. Coping: Community, Ineffective HEALTH-RELATED BEHAVIORS DOMAIN ◦ Ex. Coping: community, Readiness for Enhanced ◦ Ex. Therapeutic regimen Management, Ineffective Patterns of activity that maintain or promote wellness, promote recovery, and decrease the risk of disease ◦ Ex. Therapeutic Regimen Management, Effective (Source. NANDA Diagnoses, 2003 -2004 version) Nutrition Sleep & rest pattern SHUSTER AND GOEPPINGER PROPOSED FORMAT Physical activity Personal care Substance use Family planning In 2004, Shuster and Goeppinger proposed format of nursing Health care supervision Medication regime diagnoses for population group. Three-part statement Ex Scenario: Flu Outbreak with intention to reduce consists of: transmission ◦ Health risk or specific problem DOMAIN: PHYSIOLOGICAL ◦ Specific aggregates or community Problem: Communicable/infectious condition (high priority) ◦ Related factors: influence how the community will respond Problem Classification Scheme to the health risk or problem Modifiers: Community and Actual ▪ Proposed format: SIGNS/SYMPTOMS OF ACTUAL: ▪ Ex. Risk for Infection leading to mortality among ◦ infection pregnant women in Sitio X related to unavailability of ◦ fever skilled birth worker and community perception that ◦ positive screening/culture/laboratory results skilled birth worker is not necessary during childbirth. ◦ inadequate supplies/equipment/policies to prevent OMAHA SYSTEM transmission Clusters of signs and symptoms that describe actual ◦ does not follow infection control regimen problems are at the fourth or most specific level. ◦ inadequate immunity Using the Problem Classification Scheme with the Intervention Scheme and Problem Rating Scale for Outcomes creates a comprehensive problem solving model for practice, education, and research. Kath Venus 1 1.08 – PLANNING COMMUNITY HEALTH INTERVENTIONS – CHNN312 SHORT-TERM PLAN PLANNING ◦ Consist of one or two-year plan such as a yearly budgetary Planning is a process which involves steps that would be health plan taken in the future to attain desired end. It is performed to CATEGORY OF PLANNING BASED ON AUTHORITATIVENESS source out and allocate resources. INDICATIVE PLANNING: when it is used only as a guide but not Process of Planning in community health in order involves: binding assessing health problems & needs of community PRESCRIPTIVE PLANNING: when it is accepted and PRIORITY SETTING (WHO SPECIAL CONSIDERATION) implemented as approved by the organization, compulsory Significance of the Problem: based on the number of people in the community affected TYPES OF PLAN Level of Community Awareness members health concern STRATEGIC PLAN Ability to Reduce Risk: related to the availability of Expertise This is a long–term plan that extends about 3 to 5 years Cost of Reducing Risk: PHN considers economic, social & This is usually accomplished by managers of an organization ethical requisites & consequences of planned action. after a review their SWOT analysis (Strength, Weakness, Ability to identify the target population: intervention is a Opportunities, Threats, mission, and goals) matter of availability of data resources OPERATIONAL PLAN Availability of Resources: intervene in the reduction of risk, A short range plan that is usually less than 3 years. financial & other material resources of the community, nurse It usually deals with the routine activities of an organizations. & health agency ◦ Ex. A system of recording ITR in the FHSIS CONCEPT OF PLANNING PROGRAM PLAN Futuristic It entails a course/set of actions towards improvement of an Change-oriented identified health problem. Continuous It has a broader scope, more diverse and is bigger in Dynamic Process magnitude in comparison to a Project Plan. Flexible It consist of an organized set of activities, projects, Systemic Process processes, or services which aims for the realization of a IMPORTANCE OF PLANNING IN COMM. HEALTH PRACTICE certain objective. Basis of decision-making instead of guts: feeling, vested interest or political considerations PROGRAM PLANNING Allows utilization of available community resources: Given Program deals with the design of a strategy, for the multiple needs of people and scarce community resources achievement of a given health policy, objectives. Assist in the determination of common goals, objectives and It is a type of plan that is concerned with courses of actions strategies. for the resolution or improvement of a specific health Positive change & growth is feasible with planning problems. TYPES OF PROGRAMS APPROACHES TO PLANNING HEALTH PROGRAM FOR DIRECTION, COORDINATION AND PARTICIPATORY PLANNING FOR COMMUNITY HEALTH MANAGEMENT PRIMARY HEALTH CARE APPROACH: Emphasizes the need to ◦ This refers to program to formulate policies, programs and “work with people” as equal partners towards the goals of projects to direct. increased individual & community control, political efficacy, ◦ Coordinate and control activities and to provide improved quality of community life & social justice. informational and administrative support i.e., personnel, ◦ COMMUNITY-BASED APPROACH: empowers people finance and logistics, legal service. ◦ INTEGRATED APPROACH: considers other dimension of PROGRAM FOR HEALTH SYSTEM INFRASTRUCTURE health such as lifestyle, environment, health care system ◦ Comprises of program for planning and development of a ◦ COMPREHENSIVE APPROACH: strikes at the root of the basic health facility network, health manpower, policies problem and training, health education and public information CATEGORY OF PLANNING BASED ON SOURCE OF PLAN TECHNOLOGY PROGRAM COMPREHENSIVE PLAN: includes public and private sector ◦ Program providing functional support like infrastructure alike development, human resources development, health PARTIAL PLAN: includes other a public or a private entity only information, accounting and budgeting CATEGORY OF PLANNING BASED ON TIME SPAN OF PLAN STEPS IN PROGRAM PLANNING LONG TERM PLAN Organizing a planning group ◦ Which covers a minimum period of 8 years. ◦ 5 to 10 people but not more than 12 with specific task ◦ Such as National Health Plan or National Development Formulating goals Plan. Identification of Strategies ▪ Ex. Australia 10-year Primary Health Care Plan Determining Activities MEDIUM TERM PLAN Estimating Resources ◦ Spans in a period of 4–7 years. ◦ Include list of manpower. Material and financial resources ◦ Such as the Third Medium Term Plan (MTP III) 2018-2022 of that are needed Kenya or the Medium Term Philippine Development Plan Assessing Effects of the Program ◦ Develop an evaluation scheme Kath Venus 2 1.08 – PLANNING COMMUNITY HEALTH INTERVENTIONS – CHNN312 KEY ELEMENTS OF A PROGRAM ◦ In writing objectives, the PHN should utilize verbs with Name which identifies with a health policy objective, or specific conditions (on how well or how many) that disease/condition it is addressing describe to what degree that the people will be able to Brief Statement/report of priority disease/condition it demonstrate mastery of task. proposes to improve or program status STRATEGY AND ACTIVITY SETTING Objectives This answers “How do we get there?” Disease condition target that specifies quantified changes This defines the strategies and the activities that the nurse from existing level of recurrence and community set to achieve in order to realize the goals Activity/Service Targets which show percentage coverage of and objectives. a given eligible population It implies the identification of resources. In here, the nurse Approach which designates the course of actions to be facilitates the definite strategy or approach in health followed, such as manner of implementation, program program. tactics, field unit responsible for the delivery of services and Resources, constraints of the program are estimated. Analyze principal constraints that need to be overcome constraints and limitations. Linkages Deciding on Community Interventions Program Budget ◦ Analyze reason for health behavior Need for technical cooperation from external agencies ◦ Direct strategy to respond to the underlying cause Evaluation Indicators Implementing Community Health interventions ◦ Entire process is directed to enhanced community’s PLANNING CYCLE capabilities in dealing with health problems. PHN role is to facilitate process & not directly implement planned intervention ◦ Requires common understanding of set goal & objective ◦ Entails coordination of intervention with community & health teams as well with other sectors IMPLEMENTING COMM. HEALTH INTERVENTION Entire process is directed to enhanced community’s capabilities in dealing with health problems. PHN role is to facilitate process & not directly implement planned intervention Requires common understanding of set goal & objective Entails coordination of intervention with community & health teams as well with other sectors Evaluation Based on Donabedian’s Quality of Care ◦ STRUCTURE EVALUATION: Involves looking into the manpower and physical resources of the agency responsible for community health interventions. SITUATIONAL ANALYSIS ◦ PROCESS EVALUATION: Examining the manner by which Answers the question, “where are we now?” assessment, diagnosis, planning, implementation and Involves the process of collecting, synthesizing, analyzing and evaluation were undertaken interpreting information in a manner that provides a clear ◦ OUTCOME EVALUATION: Determining the degree of picture of the health status of the community. attainment of goals and objectives It brings out the health problem of the community. ONGOING EVALUATION OR MONITORING: Done during The nurse and the community provide explanation to the implementation to provide feedback on compliance to the problems to determine what situation needs to be changed, plan as well as on need for changes in the plan; To improve developed or maintained. process and outcome of evaluation. GOAL AND OBJECTIVE-SETTING STANDARDS OF EVALUATION This answers “where do we want to go?” The basis of good evaluation are: This a process that formulates the goal and objectives of the UTILITY health program and nursing strategies. ◦ Value of evaluation in terms of usefulness of results. Goal is the desired end Objective are more precise. Align ◦ Gives insights about strengths, weaknesses of plan and priorities among objectives. manner of its implementation. Formulating goals And Objectives ◦ Evaluation may result in policy change such as budgetary ◦ Goal is the desired outcome at the end of intervention allocations whereas objectives are short–term changes in the ◦ Basis using same community health process for other community community health concern. End-beneficiary of evaluation ◦ These two are more likely if mutually agreed upon and is community community must participated in the process. ◦ Dissemination of evaluation results allows community to ◦ Objectives is also referred to as behavioral objectives or identify barriers & allow to think of strategies to outcomes. This is because objectives describe a visible overcome/mitigate in future Kath Venus 3 behavior rather than knowledge 1.08 – PLANNING COMMUNITY HEALTH INTERVENTIONS – CHNN312 ◦ Build community experience, confidence in dealing with ◦ It consists of measurements and expressed in numbers own community concern. such as in percentages, rates and ratios, These indicators FEASIBILITY are as follow: ◦ Determine if plan for evaluation is doable or not ▪ AVAILABILITY: Shows if something exists & its availability ◦ Resources include facilities, time, expertise for conducting ▪ RELEVANCE: shows how something is appropriate evaluation ▪ ACCESSIBILITY: within reach those who need them ◦ Data gathering during evaluation should bring minimal ▪ UTILIZATION: being used for its purpose disruptions of everyday activity. ▪ COVERAGE: what proportion of those who need ◦ Entails anticipation of how the results of the evaluation will somthing actually receiving it be received by different groups & misused of data derived ▪ QUALITY: Shows standard from process ▪ EFFORT: shows hoe much is being invested to attain PROPRIETY objective ◦ Involves ethical, legal matters. Respect for worth and dignity of participants in data collection should be given due consideration. ◦ Result should be truthfully reported to give credit where it is due & show strength, weakness. Strength for further growth; weakness for remedial action if possible. ◦ For financial matters, transparency, accountability should be observed ACCURACY ◦ Validity and reliability of the results of evaluation ◦ Begins with accurate documentation while health process is ongoing. ◦ Right evaluation tool yields high reliability, validity ◦ Review of data gathered during evaluation accompanied by corrective measures when errors occurs Increases level of accuracy TWO PROCESS OF EVALUATION Two process of evaluation are observation and measurement Two approaches in evaluating program are qualitative method of evaluation determines the meaning and experience of the program for the people involved and quantitative method. Measures and score changes occurring as a result of the program THREE ASPECTS OF A PROGRAM THAT EVALUATION LOOK INTO ARE: PROCESS: measures the activities, effects of the program & quality and who it is reaching out. IMPACT: Measures the immediate effect of the program & determines if objectives were met. OUTCOME: Measures the long-term effects of the program & determines if it meets the goal of the program EVALUATION Evaluation encompasses reflecting on each previous stage to know the plan’s strengths and weaknesses (process evaluation) In evaluating, include participant’s verbal or written feedback including PHN thorough analysis. ◦ Process evaluation also known as formative evaluation, allows one to gauge both positive and negative aspects of each experience honestly and expansively and whether the desired outcomes were achieved (product evaluation) ◦ Product evaluation is summative and can comprise of end- of intervention surveys plus other tools that ensure whether objectives have been met. ◦ Summative evaluation is another term for product evaluation and looks at outcomes. The PHN uses an Indicators to measure program. ◦ Indicators are “markers: It shows progress and help to measure change. Kath Venus 4  1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Health Interventions/Organizing PARTNERSHIP AND COLLABORATION COMMUNITY ORGANIZING PARTNERSHIP Social development methodology utilizes to facilitate the is a collaborative relationship between two or more parties process of forming and sustaining self-reliant and self- based on trust, equality and mutual understanding for the determining communities achievement of a specified goal. Effecting change through community participation means: Partnerships involve risks as well as benefits, making shared changing condition within the community then people’s accountability critical. behavior, Introducing new program and policy that would COLLABORATION impact health Org. helps each other enhance their capabilities in Level of community participation: Reflects level of power an performing their tasks, as well as provisions of services. organization has, Reflects capability to tap resources in order IMPORTANCE OF PARTNERSHIP & COLLABORATION to responds to their needs. To get the people work together in order to address Range of participation can be from passive involvement in problems/concerns that affects them predetermined activities to full control of health organization Gives peoples opportunities to learn skills in group of health organization and health-related affairs to relationship, interpersonal relations, critical analysis and involvement to full range social development methodology decision-making in terms of democratic leadership. utilize to facilitate the process of forming and sustaining self- ACTIVITIES ON HOW TO GET STARTED IN PARTNERSHIP AND reliant and self-determining communities COLLABORATIVE WORK Nurse involve all stakeholders in the process of partnership CORE PRINCIPLES and collaboration with people PEOPLE-ORIENTED Working together face risk together, they must know and trust People and means are ends of development and community each other development is the process and the outcome. Determines how each org. views problems, proposes to solve PARTICIPATIVE the problem and perceived how org can solve the problem Community is the prime-mover and determinants rather than Should agree on the kind or level of relationship on better the beneficiary of health efforts. accomplishing group goal considering needs and available It is critical for success. Evident in their involvement, they are resources well-informed and aware their potentials for participation. When org. agreed on the type of relationship, formulate Decision making is in the hand of ordinary people not among ground rules to becomes basis of decision-making elite. Distinction is not made among different groups and ◦ MOST IMPORTANT POINTS ARE: different personalities ▪ Listen to what each has say DEMOCRATIC ▪ Take time to listen to people who voice out their Empower disadvantaged population. Allows people to concern recognize, analyze needs and articulate aspirations, ▪ Don’t force org. to give up identity. Decisions are from whole people/common people than the elite or leader alone. ADVOCACY Leader needs to do participative and consultive approach to The nurse as an advocate, helps empower the people to effectively process conflict within the group make decisions and carry out actions that have potential to DEVELOPMENTAL better their lives. Directed in changing underlying situation. Through ACTIVITIES INVOLVED IN ADVOCACY empowerment of marginalized people. Community gains Informing the people about the rightness of the cause insights, hones capabilities and develops. Later take leads in Thoroughly discussing with the people the nature of the wholistic improvement of community. consequence PROCESS-ORIENTED Supporting peoples right to make a choice & act on their It is a process of change. Allow community to internalize it choice and embrace the process requires time. It is dynamic with the Influencing other's opinion evolving community situation and monitoring and periodic SOCIAL MOBILIZATION review Social mobilization is the process of bringing together all societal and personal influences to raise awareness of and demand for health care, assist in the delivery of resources and services, and cultivate sustainable individual and community involvement Kath Venus 1 1.09 – IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS/COMMUNITY ORGANIZING – CHNN312 B. COMMUNITY PROFILING COMMUNITY ORGANIZING ACTION RESEARCH Contact person identifies other person who can be HISTORY depended upon to initiate community activities. These people Introduced in 1990’s in social psychology, approach that will comprise the core group. encourages recipient of benefits (family, providers, policy Core group will assist in community profiling. makers) to partake in research & work together as full Community Profile will: provides overview of; demographics, partners in community organizing. community and health-related services and facilities. Serves Later, it becomes an approach for community development, a as initial database of community. Provides basis for planning tool for community organizing participatory action research & programming of organizing of activities. Determines or COPAR appropriate approach & method of organizing specific to the A Participatory Action Research (PAR) Approach population group or sectors that will be organized. INTENTION C. ENTRY IN THE COMMUNITY Promoting transformation among participants being studied, Before actual entry in community, nurse will: be partners in entire phases of research-from design, data ◦ Determine actual information about the area in relation to collection, analysis & dissemination cultural practices, lifestyle of people ◦ Establishing rapport & integration is easier if he PARTICIPATORY ACTION RES APPROACH (PAR) understands, accept/imbibe their community life. D. INTEGRATION WITH THE PEOPLE Integration: Involves living with the people. Understanding their problem, undergoing their hardship, sharing their hopes & aspirations to help build mutual trust & cooperation. ◦ GUIDELINES IN INTEGRATION ▪ Adapt lifestyle ▪ Modest dwelling ▪ Avoid raising expectations ▪ Participate in production process ▪ Make house call/seek people ▪ Participate in some social activities ▪ Recognize role/position of local authorities II. ORGANIZATIONAL PHASE This phase consists of activities that leads to the formation of people’s organization A. SOCIAL PREPARATION Sensitization of people on the critical events of their life Share their ideas on how to manage their problem Motivating to take collective action regarding this problem ◦ PURPOSE OF SOCIAL PREPARATION: It deepens our ties with the people B. SPOTTING/DEVELOPING POTENTIAL LEADERS Characteristics of potential leaders: ◦ Not necessary highly educated, from affluent family of COMMUNITY ORGANIZING PARTICIPATORY community ACTION RESEARCH (COPAR) ◦ Important: the people identifies with him, understand & articulate the problems that beset them 3 APPROACHES OF DEVELOPMENT ◦ Advantage If: has relative wide influence-among poor & Welfare Transforms apathetic, individualistic & elite voiceless poor into a PARTICIPATORY Modernization ◦ Important Consideration: willingness to work for desired & responsive community mobilizing … Participatory/Transformatory for RESOLUTION of problem change C. CORE GROUP FORMATION PHASES OF COPAR Consist of identified potential leaders I. PREPARATORY PHASE ◦ Foundation of organization A. AREA SELECTION ◦ Diff characterisitics (youth, women, worker) Guides the nurse in selecting and prioritizing areas for ◦ Committee: Consist of 8 to 10 members who possess community health development. leadership potentials formed into a cohesive working Following questions must be answered: group ◦ Is the community in need of assistance? TASK OF CORE GROUP ◦ Do the community members feel need to work together to ◦ Democratic and collective leadership overcome specific health problems? ◦ Planning and assuming of task ◦ Are there any concerned groups & organizations the nurse ◦ Resolve conflict can work with? ◦ Critical thinking/decision-making ◦ What will the counterpart of the community in terms of community support, commitment and human resource? Kath Venus 2 1.09 – IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS/COMMUNITY ORGANIZING – CHNN312 D. SETTING UP COMMUNITY ORGANIZATION ◦ Conduct of meetings, assessment, planning, After all sectoral organization has been placed, setting-up of implementation, monitoring and evaluation of activities. community-wide organization is now ready. The organization ◦ Skills needed in this phase/master are: organizational facilitates collective action on the community problem skills, human relations development, or supervisory skills Nurse will: after organization was formed, make certain Formal leadership training skills in financial, project/program maximum participation of and control by the members in all management. its activities. Nurse will: assess specific training and practical needs of ◦ Organizational structure must be simple, facilitate leaders. Plan for continuing education program consultation & decision-making among its members IV. SUSTENANCE-MAINTENANCE PHASE ◦ Part of organizational structure will be working committees A. LEADERSHIP-FORMATION ACTIVITIES specifically created to look into different concerns of the It Is a continuous process organization and communities e.g.. health committee. Learn in actual organization activities... conduct meeting, Nurse will: assists in placing plans of health committee and planning of activities initial prospective community health workers (CHW). CHW Project/program management may be involved in the next phase. Formal leadership training (ex. financial) III. EDUCATION AND TRAINING PHASE B. INTERSECTORAL COLLABORATION Purposes are: to strengthen the organization & develop The need for resource-material, human, financial will have to capability to attend to community’s basic health health-care be sourced externally. needs. Achieved by conducting community diagnosis, training Assistance, support through collaboration with other health workers, undertaking health services & mobilization & organizations & communities leadership skills training. Nurse will: facilitate, coordinate with organizations agency, A. CONDUCTING COMMUNITY DIAGNOSIS key people This is performed to come up with the profile of the local ◦ NETWORKING health situation. Basis for health program and services to bed ▪ Relationship among org: exchanging information about deliver in community. each other's goal, objectives, services or facilities Nurse will: Assist people in developing plan & actual conduct ▪ Result: aware of worth & capabilities, how each other of community diagnosis. Asset identify, analyze, understand contribute to accomplishment of networks goals & implication of data collected objectives B. TRAINING OF COMMUNITY HEALTH WORKERS ◦ COORDINATION After presentation of the result of community diagnosis, the ▪ Orgs. modify their activities in other to provide better community now decides the roles that the community health service to target beneficiary. workers are expected to perform. ▪ Time-consuming, requires more involvement & trust on After community diagnosis presentation: the part of committed organization ◦ Decides on roles community health workers perform ◦ COOPERATION ◦ Competence & qualities they should possess ▪ Sharing of information & resources, make adjustments in ▪ Need to decides who will be trained as community respective agendas to accommodate other health workers organizations agenda Nurse will: After community health workers are named, ▪ Org shares ownership of the success & rewards, as well conduct a Training Needs Assessment (TNA) to know level of as problems & hassles that go with working together health skills and knowledge trainees possess. TNA serves as ◦ COLLABORATION basis of health skills curriculum to focus on required ▪ Level of Org. partnership in which org. help each other competencies. enhance their capabilities in performing their tasks, as ◦ TRAINING: Purpose is to develop the leaders skills, well as provisions of services. knowledge and attitude ▪ People becomes partners NOT competitors ◦ EDUCATION: Aims to heighten their awareness or ◦ COALITION OR MULTI-SECTOR COLLABORATION consciousness on existing community problems & its ▪ Org & citizens form a partnership where all parties give correlation with existing social realities priority to the good of the community; requires great C. HEALTH SERVICES PROVISION AND MOBILIZATION investment in terms of time, trust & will to make a Organization now lead in undertaking activities that will solve change. problems community is confronted with. ◦ ADVOCACY WORK (KOHNKE, 1982) Involve organization in collective work: gives opportunities to ▪ Informing people about the rightness of the cause test & strengthen collective spirit, build/enhance confidence. ▪ Thoroughly discussing with the people the nature of the Nurse will: to prevent frustration on part of people, consider consequence resources available & problem prioritization to be addressed ▪ Supporting peoples right to make a choice & act on at a given time, while strengthening collective spirit & their choice enhancing community health worker’s confidence ▪ Influencing other's opinion. D. LEADERSHIP-FORMATION ACTIVITIES C. PHASE-OUT Continuous and sustained process of community leaders To practice independence development Plans monitoring & ff-up Leaders learn engaging in actual organizational activities Community gradually shoulder greater responsibility in such as: managing health care needs. Kath Venus 3 1.09 – IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS/COMMUNITY ORGANIZING – CHNN312 Nurse gradually prepares the turn-over of work, develop plan VENN DIAGRAM of monitoring, follow-up of activity until full disengagement Visual representation of social support system and phase-out ◦ BIG CIRCLE: represents community ◦ SMALL CIRCLE INSIDE THE BIG CIRCLE: representing CRITICAL ACTIVITIES IN COPAR groups/organization in the community INTEGRATION ▪ Draw inside the most active/influential group in the Involves living with the people. Understanding their problem, community undergoing their hardship, sharing their hopes & aspirations ◦ SMALL CIRCLE OUTSIDE THE BIG CIRCLE: represents to help build mutual trust & cooperation. organization outside the community such as public or SOCIAL INVESTIGATION private (govt or private institutions). Proximity or distance Also known as community study of these circle will symbolize their degree of influence in Systematic, scientific process of collecting & analyzing data the community. to draw a clear picture of the community TENTATIVE PROGRAM PLAN BASIC QUALITIES OF A COMMUNITY ORG Community chooses one issue to work to start community Exemplary professional & moral qualities organizing Good communication & facilitation skills GROUNDWORK Ability to set good leadership Going from place to place, motivating people on a one-on- Charismatic personality: draws people to organizing work one basis to act on the issue chosen Adapts/enjoys working & living, with different types of MEETINGS people People jointly ratify what have been decided individually. Empathize with people/community he is working with Gives people collective action and confidence Believes in vision of change, development/empowerment ROLE PLAY Personal conviction consistent with values, principles being Acting out meeting that would takes place amongst people