By Mpaiko Nkeng
Community health nursing synthesis the body of knowledge from the public health sciences and professional nursing theories for the purpose of improving the health of the entire community. Community health nursing practice therefore promotes and preserves the health of the population. The community is not an easily or consistently defined entity. It is a nebulous, complex concept. Thus a community in its broadest sense will be defined as a group of people living in an environment that has the ability to meet their life goals and needs.
The entry into the community is usually made possible by the chief medical officer through the issuance of letters to community leaders for easy acceptability and accessibility. Critical to the dynamics of a community are its patterns of communication, leadership and decision making and this occurs as a result of interaction between community members and the larger society. The different components of this community include people, environment and health care delivery system and together they determine the physical, social, mental states of wellness of the people.
For the people component there is:
a. Demographics such as population distribution, mobility, density and census data;
b. Biological aspects will include health and disease status, province/state of origin, nationality, age, sex, mortality.
c. Acquired aspects are twofold, social which takes into account occupation, activities, marital status, education, religion and cultural which include position, roles value, customs, norms, taboos.
For the environmental component there is:
a. Physical aspect which include natural resources, landscape, climate, terrain, relief, boundaries and limits;
b. Biological and chemical aspects such as animal reservoirs, toxic substances, food supply, standard of food control, water source, staple food, vector control, living arrangement, sewage disposal, water supply and refuse disposal;
c. Social aspects involve industry and economics, communication, transportation, recreation/recreational facilities and religion.
For the health care delivery system component, there is:
a. The organizational aspect involving government and private sectors, systems, linkages and
b. Resources which involve health personnel, health centers, clinics and hospitals, funds, services.
Through the complete understanding of these different components, then can health promotion, disease prevention and rehabilitative measures be implemented. Promoting health of the people and their welfare can be done through health education to both individuals and families. During these education sessions, various aspects of diseases, their prevention can be given as well as ways of rehabilitation when calamity strikes.
Community health problems will then be arrived at through two ways:
a. As perceived by the community and then
b. As perceived by the community health nurse.
A community diagnosis will then be reached, which can range from one to several. Recommendations can then be made to the appropriate people concerned.
In conclusion, the community health nurse, in doing this assessment, must strive to work as a team with the community involved and he/she must be able to achieve if not all, some of the eight components of primary health care, such as immunization against infectious diseases, an adequate supply of safe water, education concerning prevailing health problems and the methods of preventing and controlling them.
By MPAIKO NKENG. (BNS)
NURSING CONSULTANT, Capetown, South Africa.
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