Subject- Community Health Nursing- I (Theory)
Theory: 120 hours
This course is designed to provide students with basic knowledge in community health nursing regarding the concept of health and spectrum of health, primary health care, communication, nutrition, epidemiology, health statistics and indicators, community diagnosis, environmental health and sanitation, family planning, national immunization program, occupational health hazards, and pollution hazards. This course focuses on the primary health care approach in providing care to individuals, families, and community people.
At the end of the course the learners will be able to:
- Interpret fundamental concepts of health and spectrum of health and illness.
- Identify social determinants of health
- Discuss level of prevention and intervention
- Identify the roles and functions of the community/public health nurse
- List the elements and basic principles of primary health care
- Describe communication skills effectively in providing primary healthcare to the individual client, family and group.
- Explain the scope of nursing outside the hospital.
- Illustrate population problem and the need for Family Planning (FP) in Nepal.
- Describe the function of nutrition in health promotion and disease prevention of the individual, family and community.
- Discuss the use of epidemiological approach to solve health problems in community.
- Explain the national immunization programme of Nepal.
- Explain different types of environmental health and sanitation.
- Explain the safety measures for the prevention of occupational health hazards.
- Explain community health diagnosis.
- Describe the ways in attaining optimum health of the individual, family and community.
- Define the various indicators used in community/public health
Unit 1: Introduction to Health (8 hrs)
1.1 Concept of health and disease- 1hrs
1.2 Dimension of health- 1hrs
1.3 Social determinants of health (WHO 2011)- 2 hrs
1.4 Public and community health- 1 hrs
1.5 Level of prevention- 1 hrs
1.6 Level of intervention- 1 hrs
1.7 Major roles and functions of the nurse in community/public health- 1 hrs
Unit 2: Primary Health Care (6 hrs)
2.1 Definition of primary health care- 0.5 hrs
2.2 Elements of primary health care- 0.5 hrs
2.3 Basic principles of primary health care- 1 hr
2.4 Major challenges of PHC in the context of Nepal- 2 hrs
2.5 Role of the nurse in primary health care- 1 hr
2.6 Primary Health Care Revitalization in Nepal- 1 hr
Unit 3: Nursing Practice in the community (2 hrs)
3.1 Scope of nursing outside the hospital- 1 hr
3.2 Role of community/public health nurse outside the hospital- 1 hrs
Unit 4: Communications (8 hrs)
4.1 Definition, aims, and importance of communication- 0.5 hrs
4.2 Elements of communication- 0.5 hrs
4.3 Types of communication and counseling- 1 hr
4.4 Barriers of effective communication- 1 hr
4.5 Keys to overcoming barriers of communication- 1 hr
4.6 Importance of interpersonal relationships with- 1 hr
4.7 Interviewing in the community- 1 hr
Unit 5: Introduction to Epidemiology (10 hrs)
5.1 Definition of epidemiology- 1 hr
5.2 Epidemiological- 4 hrs
5.3 Concept of disease- 1 hr
5.4 Modes of disease transmission- 1 hr
5.5 Epidemiological approach to solve community health problems- 1 hr
5.6 Steps of investigation of epidemic diseases- 2 hrs
Unit 6: Health indicators and statistics (8 hrs)
6.1 Definition of various health indicators- 4 hrs
6.2 Use of vital and health statistics- 2 hrs
6.3 Sources of vital and health statistics- 2 hrs
Unit 7: Community Health Diagnosis 10 hrs
7.1 Definition aims and purpose of community diagnosis- 1 hr
7.2 Steps of the community health diagnosis process- 1 hr
7.3 Components of community health diagnosis- 1 hr
7.4 Difference between community and clinical diagnosis- 1 hr
7.5 Data Collection- 4 hrs
Unit 8: Nutrition (10 hrs)
8.1 Digestive system (Review from Basic science)- 0.5 hrs
8.2 Definition of nutrition- 0.5 hrs
8.3 Relationship between nutrition and health- 1 hr
8.4 Main function of food- 1 hr
8.5 Nutrients- 1 hr
8.6 Meaning of balanced diet- 1 hr
8.7 Home garden- 1 hr
8.8 Food security- Policy of Government of Nepal- 1 hr
8.9 Milk pasteurization- 1 hr
8.10 Food adulteration- 1 hr
8.11 National Nutrition program- 1 hr
Unit 9: Health Education (8 hrs)
9.1 Concept of health education- 1 hr
9.2 Methods of health education: Introduction, purposes, advantages, disadvantages, and process- 1 hr
9.3 Media of health education- 2 hrs
9.4 Use of methods and media for health education- 2 hrs
9.5 Evaluation of health education- 2 hrs
Unit 10: Family Planning (10 hrs)
10.1 Definition family planning- 0.5 hrs
10.2 Health aspects of family planning- 1 hr
10.3 Population problems and need for family planning in Nepal- 2 hrs
10.4 Use of “ABHIBADAN” for family planning counseling- 0.5 hrs
10.5 Approach for FP counseling- 0.5 hrs
10.6 Temporary modern contraceptive methods: Introduction, advantages, disadvantages, action, side effect, management, and referral- 1 hr
10.7 Permanent contraceptive methods/voluntary surgical sterilization- 1 hr
10.8 Emergency Contraception- 0.5 hrs
10.9 Post abortion contraception- 0.5 hrs
10.10 Contraception for adolescents and women above 35 Years- 0.5 hrs
10.11 Client assessment- 1 hr
10.12 Role of nurse in family planning clinic- 2 hrs
Unit 11: Immunization (6 hrs)
11.1 Immunity (Review from basic science related to health)- 2 hrs
11.2 National Immunization Programme (NIP)- 2 hrs
11.3 Health teaching for mothers/parents and pregnant women- 2 hrs
Unit 12: Environmental Health and Sanitation (16 hrs)
12.1 Environmental sanitation and its components- 1 hr
12.2 Refuge- 1 hr
12.3 Transmission of fecal-borne diseases through- 1 hr
12.4 Sewage- 1 hr
12.5 Health Care Waste Management- 9 hrs
12.6 WASH- 1 hr
12.7 Rodents- 2 hrs
Unit 13: Water (6 hrs)
13.1 Define safe and wholesome water- 1 hr
13.2 Uses of water- 1 hr
13.3 Daily requirement of water for a person- 1 hr
13.4 Sources of water and its impurities- 1 hr
13.5 Water-borne diseases- 1 hr
13.6 Purification of water- 1 hr
Unit 14: Housing 8 hrs
14.1Criteria for healthful housing 1 hrs
14.2 Housing needs for human being 2 hrs
14.3 Standards of housing 2 hrs
14.4 Effects of poor housing on health 2 hrs
14.5 Standard of living and Quality of life 1 hrs
Unit 15: Occupational Health (2 hrs)
- Occupational health hazards
- Safety measures in the work place
- The safety measures regarding occupational health in the work place
Unit 16: Pollution Hazards (2 hrs)
- Types of pollution hazards on health
Subject- Community Health Nursing- I (Practical)
Total hours: 210 (6 weeks)
This course helps the students to work in different community fields and institutions. It provides opportunities to apply the concepts of primary health care while identifying the health problems of individuals, families, and communities.
The students will be divided into two groups: one group will be in the hospital setting and another group in the community. During their training period, each student will conduct a small community survey and provide comprehensive care to at least two families. The total community field experience period is of 6 weeks, which will include visits to local institutions, families and applying the epidemiological approach to solve the identified problem. One community-level health action will be conducted in a selected community. Weekly small group seminars will be held to discuss the problems faced during the field practice.
By the end of the course, students will be able to:
- Identify the different places, besides hospitals where nursing care is provided.
- Use the theoretical knowledge of primary health care in the community setting.
- Identify the problems of clients in home situation.
- Identify the problem and needs of community through community diagnosis.
- Use the nursing process in dealing with individuals, families and the community in order to solve their health problems.
- Plan and conduct community level health action to the groups of people by using the epidemiological approaches.
- Use appropriate communication skills while helping clients in the community
- Utilize the local resources in solving the problem in the community.
- Advise the preservation of the nutrient values in the foodstuffs for the sake ofgood health.
- Refer clients to appropriate places according to their needs.
- Explain the gender status in the community/health facilities and provide gender friendly services to maintain the quality of care.
- visit to different home
Social determinants of Health and Nursing in the community
- Visit to different local institutions
- Industrial nursing (Brick, iron, textile, cement)
- Institution for the disabled, Rehabilitation center, Geriatric center, S.O.S. Center,
- Milk pasteurization center, Water plant of Municipalities and Hospitals
- Maintain log book
- Identification of GBV cases and refers to appropriate centers
- Providing gender friendly services
- Providing health education/actions for the family/community based on the identified needs with gender sensitive approach
- Select two families with problems
- Make home visits
- Collect information about family
- Maintain inter-personal relationship
Primary health care
- Observation of home environment
- Sanitation, water supply, nutrition
- Disposal of waste material, latrine
- Assessing the health need of children and referring to the appropriate center, if necessary
- Helping families become more self-reliant regarding health by teaching them
Vital and health statistics
- Source of vital and health statistics
- Census, registration, notification, records, health survey
- Analysis of data for statistical representation and recommendation for improvement
- Recommendation for improvement
Environmental health and sanitation
- Assessing water supply, garbage, sewage disposal
- Excreta disposal
- Methods of Improving Environment
- Rat poisons or rodenticides
- Improving sanitation
- Controlling of vermin (Rodents)
- Utilization of local resources such as
- Nutrition-food stuffs
- Home equipment-supply
- Manpower: parents/family members/others
Community health diagnosis and Micro Health Project
- Community diagnosis
- Select 5 families for a community survey in a defined area.
- Collect the data by using the prescribed survey format.
- Analyze data for statistical presentation.
- Carrying out health action by
- Setting objectives, planning and implementing
- Date, time, place, client, subject matter, AV Aids and physical set up, etc.
- Community-level health action of one selected problem in a community setting
Recording and report
- Write daily log book, observation visit reports and submit final survey report
Recommended References and Books for PCL Nursing 1st Year Syllabus- Community Health Nursing I
- WHO (2013). Determinants of Health, Retrieved from http:
- WHO (2008). Social Determinants of Health, Retrived from Ternopil State Medical University (2003). Roles and functions of the community health nurse, Institute of Nursing, Department of Clinical Immunology, Allergology and General Patient Care.
- Mamata Manandhar, Community Health Nursing –I, kshav Publication, Kathmandu
Primary Health Care
- WHO/UNICEF (1978). Primary HealthCare: Health for All (series # 1), Geneva.
- Reproductive Health, National and International Perspectives.