WHAT DO I SEE?

WHAT DO I SEE?
WHAT DO I SEE?
WHAT DO I SEE?
 PRIMARY HEALTH CARE 2

THE COMMUNITY
WELLA GRACE A. GO, RN, RM
THE COMMUNITY

 The word “community” is

derived from the Latin
communitas meaning
fellowship, which in turn, is
derived from communis
meaning common
THE COMMUNITY

 the prefix “com” signifies

(with/together/in
conjunction/joint)
 while “munis” derived from “munire”
means (to fortify, strengthen, or
defend)
 AKA strength in numbers
COMMUNITY DEFINED

 a social group of people

interacting with each other,
determined by geographic
boundaries, living together
to attain certain and common
goals and sharing the same
interest
COMMUNITY DEFINED

 functions within a particular

socio-cultural context
 there is varying physical
environment so as their
behaviour and coping
COMMUNITY COMPONENTS
 People
 Fundamental or essential
component
 Community refers to group of
people
 Environment
 Both living and non-living
 Interactions happen between
animal, soil, plant, water etc.
 Reside in a definite territory
COMMUNITY COMPONENTS
 Economy
 Since community are made up
of people who seek means of
survival and ultimately interact
with their physical and social
environment, there must be
some form of daily
transactions, thus making
community good for business
COMMUNITY COMPONENTS
 Health
 As defined is the level of functional and
metabolic efficiency of an individual
 Ability of communities to adapt and self-manage
when facing physical, social, mental and
psychological changes in the environment
 Quality of life

 General well-being of individuals and societies

with both negative and positive features of life
 Observes life satisfaction whether in health,
education, religion, family etc.
COMMUNITY COMPONENTS
 Culture
 As defined is the social behaviour and
norms found in human societies and
communities
a) Material culture (technology,
architecture, art)
b) Immaterial culture (politics, social
institution, philosophy, literature)
 They have something in common like
norms, religion, values and identity
COMMUNITY COMPONENTS
A. Membership
 Feelings of belonging and identification

B. Influence
 Individuals influence community and vice

versa
C. Fulfillment
 Physical and psychological needs are met

D. Connection
 Connect positive effects of membership to

community
GENERAL CHARACTERISTICS OF A COMMUNITY
 defined by its geographic
boundaries within certain
identifiable characteristics
 made up of institutions
organized into a social system
 there is a common interest
that bind members together
GENERAL CHARACTERISTICS OF A COMMUNITY

 has an area with fluid

boundaries where problems
can be solved
 has population aggregate
concept
 regarded as an organism with
its own stages of development
where maturity varies – fast or
COMMUNITY CLASSIFICATION
 RURAL
 URBAN

 SUBURBAN
DESCRIBE ME...
COMMUNITY CLASSIFICATION
1. RURAL COMMUNITY
 aka open lands, village
 mostly less dense and more
spacious
 places found in the provincial areas
 people earn a living by agriculture
COMMUNITY CLASSIFICATION
 people have intimate relationships
 has close contact with nature
since most of their daily activities
revolve around the natural
environment
 transportation (tractors, jeepney,
tricycle, horses)
DESCRIBE ME...
COMMUNITY CLASSIFICATION
2. URBAN COMMUNITY
 aka the city

 non-agricultural type of community

 community is dense and mostly

populating the whole community

 source of income from industrial

products and technology, business

(e.g. Makati CBD)
COMMUNITY CLASSIFICATION

 people are physically crowded

but socially distant (nigh-
dwellers not neighbours)
 relations are not intimate but
rather impersonal
 transportation (trains, buses,
PUVs, cars)
DESCRIBE ME...
COMMUNITY CLASSIFICATION
3. SUBURBAN
 aka the capitals
 lower population density than

inner city neighbourhoods

 defined as any area in the

metropolitan outside the

central city
COMMUNITY CLASSIFICATION
 separate residential communities
within commuting distance of a city
 capital of provinces where there is
a mix of agricultural and industry -
technology is utilized only to
increase productivity of agriculture,
industry
DIFFERENCE BETWEEN URBAN AND RURAL:

 Physical environment
 Population size and
density
 Economy
 Culture
DIFFERENCE BETWEEN URBAN AND RURAL

 Political dynamics
 Availability and adequacy of
social services
 Accessibility of health
resources
ELEMENTS OF A HEALTHY COMMUNITY
 Healthy, stable and affordable
housing
 Complete neighbourhood and
communities
 High-quality education system
 Thriving and inclusive economy
 Healthy food access
ELEMENTS OF A HEALTHY COMMUNITY
 Active transportation options
 Safe and diverse public places,
parks, open space
 Sense of belongingness and safety
 Clean environment
 Public services and infrastructures
for all people
CHARACTERISTICS OF A HEALTHY COMMUNITY
 The members are aware of their
own health and biologic status.
 Members give credit to the
governing authority.
 The natural and biological
resources are open for everybody
but the consumption is controlled
to help in preserving this
resources.
CHARACTERISTICS OF A HEALTHY COMMUNITY

 Has a strong and reliable

governing body.
 The people work together to
attain independence.
 Environmental and physiologic
needs are sustained by the
community and families.
CHARACTERISTICS OF A HEALTHY COMMUNITY
 Parents and guardians serve as role
models for the children.
 The people are concerned with their
health status.
 Health needs are accessible and
affordable to the public and free for
the indigent.
 Everyone is working to attain health
citizenry.
FACTORS AFFECTING COMMUNITY HEALTH
 FACTORS AFFECTING COMMUNITY HEALTH
 Income and social status –
higher income and social status are
linked to better health. The greater
the gap between the richest and
the poorest people, the greater the
differences in health.
 Education – low education levels
are linked with poor health, more
stress and lower self- confidence
FACTORS AFFECTING COMMUNITY HEALTH
 Physical environment – safe water
and clean air, healthy workplaces,
safe houses, communities and roads
all contribute to good health
 Employment and working
conditions – people in employment
are healthier, particularly those who
have more control over their working
conditions
FACTORS AFFECTING COMMUNITY HEALTH
 Social support networks – greater
support from families, friends, and
communities is linked to better health.
 Culture – customs and traditions, and
the beliefs of the family and community
all affect health
 Genetics – inheritance plays a part in
determining lifespan, healthiness and the
likelihood of developing certain illnesses
FACTORS AFFECTING COMMUNITY HEALTH
 Personal behaviour and coping skills –
balanced eating, keeping active, smoking,
drinking, and how we deal with life’s stresses
and challenges all affect health
 Health services – access and use of
services that prevent and treat disease
influence health
 Gender – men and women suffer from
different types of diseases at different ages
COMMON HEALTH ISSUES IN THE COMMUNITY

 POLLUTION
 IMPROPER SEWAGE AND HUMAN
EXCRETA DISPOSAL
 IMPROPER GARBAGE AND REFUSE
DISPOSAL
 FOOD SANITATION
 CONTROL OF RODENTS AND INSECTS
COMMON HEALTH ISSUES IN THE COMMUNITY
 POLLUTION

 Air pollution (burned gasoline, car engines, power plants)

 Water pollution (sewage, oil leakage, detergents)
COMMON HEALTH ISSUES IN THE COMMUNITY

Water supply:
A. Level I (Point Source)
 Protected well-developed spring with an
outlet but without distribution system,
rural areas applied
 Serves 15 to 25 households

 Located not more than 250 meters from

the farthest source
 Generally yield from 40 to 140L/min
COMMON HEALTH ISSUES IN THE COMMUNITY

B. Level II (Communal Faucet System or

Stand Posts)
 System composed of source reservoir, a piped
distribution network and communal faucet,
rural areas applied
 Located not more than 25 meters from the
farthest house
 Delivers 40-80L/capital/day to an average of
100 households, with one faucet per 4-6
households
COMMON HEALTH ISSUES IN THE COMMUNITY

C. Level III (Water works System or

Individual house connections)
 System with a source, a reservoir, a
piped distributor network and
household taps
 Suited for densely populated areas
 Requires minimum treatment for
disinfection
COMMON HEALTH ISSUES IN THE COMMUNITY
 IMPROPER SEWAGE AND HUMAN
EXCRETA DISPOSAL
Types of Excreta Disposal:
A. Water Sealed Latrine or Pour
Flush
 consist of a simple bowl made of
concrete or durable material
COMMON HEALTH ISSUES IN THE COMMUNITY
B. Septic Tank
 With water carriage where water under
pressure is necessary to transport the
waste materials to final disposal
site
COMMON HEALTH ISSUES IN THE COMMUNITY

C. Balot System or Wrap and Throw

 Utilizes materials such as old
newspapers or plastic bags to collect
human waste usually fecal matter
before it is disposed
COMMON HEALTH ISSUES IN THE COMMUNITY

 IMPROPER GARBAGE AND REFUSE

DISPOSAL
Ways of Disposal:
A. Burning – involves open burning in the
ground or garbage can
B. Burying – garbage deposited in pits covered
with soil
C. Dumping – a method of disposing garbage in
actual low areas then covered with sand or
soil
COMMON HEALTH ISSUES IN THE COMMUNITY
 FOOD SANITATION
 Microbiological hazards

 Pesticide residues

 Misuse of food additives

 Chemical contaminants including biological

toxins
 Adulteration

 CONTROL OF RODENTS AND INSECTS

 dengue fever, leptospirosis etc.
HEALTH WORKERS IN
COMMUNITY SETTING
COMMUNITY HEALTH WORKERS DEFINED
 A frontline public health worker who
is a trusted member of and/or has
an unusually close understanding of
the community served; this trusting
relationship enables the CHW to
serve as a liaison/link/intermediary
between health/social services and
the community to facilitate access
to services and improve the quality
and cultural competence of service
CONT’D...
 CHWs come from the communities

they serve, building trust and vital

relationships; this crucial
relationship significantly lowers
health disparities because CHWs
provide access to services, improve
the quality and cultural competence
of care, create an effective system
of disease management and
increase the health knowledge and
CONT’D...
QUALITIES OF A COMMUNITY HEALTH WORKER
A. OPEN
 Accepts need for joint planning and
decision relative to health care in a
particular situation, not resistant to
change
B. TACTFUL
 One who presides over an assembly,
meeting or discussion in a subtle
manner, does not embarrass but
gives constructive criticisms
CONT’D...
C. COORDINATOR
 Brings into consonance or harmony
the community’s health care
activity
D. OBJECTIVE
 Unbiased and fair in decision-
making
E. GOOD LISTENER
 Always available for the participant
CONT’D...
F. EFFICIENT
 Knowledgeable about everything
relevant to his/her practice, has the
necessary skills expected of him
G. FLEXIBLE
 Able to cope with different
situations
H. CRITICAL – THINKER
 Decides on what has been
FUNCTIONS OF A COMMUNITY HEALTH WORKER
1. Community health service provider
 Carries out health services contributing
to the promotion of health, prevention
of illness, early treatment of illness and
rehabilitation
 Appraises health needs and hazards
( existing or potential)
2. Facilitator
 Helps plan a comprehensive health
program with the people
 Continuing guidance and supervisory
CONT’D...
3. Health counselor
 Giving appropriate advice and
broadening the client’s insight about a
problem so that appropriate decisions
are made which can lead to positive
resolution of the problem
 Provides health counseling including
emotional support to individuals,
family, group and community.
CONT’D...
4. Co-Researcher
 Provides the community with stimulation
necessary for a wider or more complex
study of problems.
 Enforce community to do prompt and
intelligent reporting of epidemiologic
investigation of diseases
 Suggest areas that need
research ( by creating dissatisfaction)
 Participate in planning for the study and in
formulating procedures
CONT’D...
 Assist in the collection of data.
 Help interpret findings collectively
 Act on the result of the research
 Plan and conduct of nursing and
related studies that contribute to the
improvement of nursing and health
services, either alone or
independently, or in collaboration of
other members of the health
and intersectoral teams
CONT’D...
5. Member of a team
 In operating within the team, one must
be willing to listen as well as to
contribute, to teach as well as to learn,
to lead as well as to follow, to share
authority as well as to work under it
 Helps make multiple services which the
family receives in the course of health
care, coordinated and comprehensive as
possible
 Consults with and refers to appropriate
CONT’D...
6. Health Educator
 Health education is an accepted activity at
all levels of public work. A health educator
is the one who improves the health of the
people by employing various methods or
scientific procedures to stimulate, arouse
and guide people to healthful ways of living.
She takes into consideration these aspects
of health education namely:
a. Information- provision of knowledge

b. Education- change in knowledge, attitude

and skills
DUTIES AND TASKS OF A HEALTH EDUCATOR
Health educators typically do the following:
 Assess the needs of the people they serve

 Develop programs and events to teach people about

health topics
 Create and distribute health-related posters,

pamphlets, and other educational materials

 Evaluate the effectiveness of programs and materials

 Help people find health services or information

 Supervise staff who implement health education

programs
 Collect and analyze data to learn about their

audience and improve programs

 Advocate for improved health resources and policies
CONFLICTS IN THE COMMUNITY
TYPES OF CONFLICT

A. Task Conflict
• Related to work assignments
• Disputes about how to divide up
resources
• Differences of opinions on policies
and procedures
• Managing expectations at work
CONT’D...
B. Relationship Conflict
• occurs between two or more
individuals who are in opposition to
one another
• Sources of conflict:

a. Personal differences

b. Information deficiency

c. Role incompatibility

d. Environmental stress
CONT’D...

C. Value Conflict
• arise from fundamental differences
in identities and values, which can
include differences in politics,
religion, ethics, norms, and other
deeply held beliefs
HOW TO RESOLVE CONFLICT
 Avoiding
 Ignore or withdraw from the conflict
 Competing

 Used by people who go into a conflict

planning to win
 Assertive and not cooperative
 Accommodating

 Strategy where one party gives in to the

wishes or demands of another
 They’re being cooperative but not assertive
 CONT’D...
 Collaborating
 method used when people are both assertive and
cooperative. A group may learn to allow each
participant to make a contribution with the
possibility of co-creating a shared solution that
everyone can support.
 Compromising
 The concept is that everyone gives up a little bit of
what they want, and no one gets everything they
want
 Partially assertive and cooperative
 Perceived as being fair, even if no one is particularly
happy with the final outcome.