NCM 113 (Community Health Nursing 2)
LEARNING MODULE PART 3
Prepared by: Melissa D. Sarmiento, MSN
I. Working with Groups Toward Community Development
A. Stages of Group Development
Groups naturally evolve through predictable stages. Understanding these helps a nurse or facilitator guide
the group effectively.
1. Forming
This is the beginning stage where members are polite and cautious.
Individuals are focused on getting to know each other, understanding the purpose, and figuring out their
place in the group.
Roles and expectations are unclear.
The leader must provide orientation and set a positive tone.
2. Storming
Members start expressing opinions more openly.
Conflicts may arise related to leadership, responsibilities, or differences in ideas.
Group members test boundaries, challenge authority, and may form subgroups.
This is a critical stage that requires conflict management and guidance.
3. Norming
The group begins to establish cohesion and trust.
Members agree on group norms, rules, and standards of behavior.
Communication becomes more open and respectful.
Roles become clearer, and teamwork begins to strengthen.
4. Performing
The group reaches optimal functioning.
Members are now focused on working efficiently toward shared goals.
Collaboration is strong, and tasks are performed with minimal conflict.
This is the most productive stage.
5. Adjourning
The group’s work is completed.
Members prepare to close or dissolve the group.
May involve celebration, evaluation, and recognition.
Emotional responses may include pride or sadness as relationships end.
B. Interventions to Facilitate Group Growth
These interventions help the group move smoothly through development stages.
1. Orientation, Structure, Direction
Provide clear instructions, processes, and flow.
Establish the purpose, timelines, and expectations.
2. Clarifying Goals, Roles, Expectations, and Procedures
Ensures everyone knows:
o What the group aims to achieve
o Who is responsible for specific tasks
o How decisions and discussions will be managed
3. Process, Negotiation, Conflict Resolution
Encourage members to voice concerns.
Provide mediation and facilitate problem-solving sessions.
Prevent conflicts from escalating.
4. Encouraging Open Communication & Mediation
Promote trust by allowing people to speak freely.
The facilitator models respectful dialogue.
5. Awareness of Effects of Behaviour
Help members reflect on how their actions affect others.
Encourage self-awareness, accountability, and constructive feedback.
6. Application of New Learning
Give members opportunities to practice skills (e.g., decision-making, leadership).
Evaluate outcomes and improve group processes.
C. Collaboration and Partnership
Collaboration involves working with LGUs, NGOs, private sectors, and community groups to achieve
shared health goals.
Key Benefits
Resource-sharing → manpower, funding, supplies.
Ownership and participation → ensures the community accepts and supports the program.
Sustainability → partnerships maintain programs even after initial interventions end.
II. Information Technology and Community Health
A. What is e-Health?
e-Health is the use of digital technologies for health services and information management. Examples
include:
Electronic Medical Records (EMR)
Telehealth/telemedicine
Mobile health apps
Digital reporting systems, such as FHSIS
It improves the efficiency and accuracy of healthcare delivery.
B. Power of Data
Good data leads to better decisions.
Benefits
Real-time decision-making for outbreaks or emergencies.
Improved accuracy which reduces errors.
Better policy formulation.
Allows surveillance and trend analysis to detect patterns in diseases.
C. e-Health Situation in the Philippines
Increasing use of EMRs in hospitals, rural health units (RHUs), and barangay health stations.
Telemedicine is expanding, especially after the COVID-19 pandemic.
Challenges:
o Poor internet access in rural areas
o Low digital literacy
o Systems that don’t integrate well
D. Using e-Health in Communities
Practical e-health applications include:
Teleconsultation for geographically isolated areas.
SMS reminders for immunization schedules and follow-ups.
Online health education via social media, webinars, or group chats.
FHSIS for accurate monitoring and reporting.
E. Role of the Community Health Nurse in e-Health
The CHN should:
Encode accurate digital data for surveillance and reporting.
Use EMRs and telehealth tools effectively.
Teach communities about safe digital practices.
Ensure data privacy, confidentiality, and ethical use of technology.
III. Current Trends in Public Health
1. Rise of Non-Communicable Diseases (NCDs)
Hypertension, diabetes, cancers due to lifestyle changes.
2. Mental Health Prioritization
Growing awareness and integration into primary care.
3. Climate Change Impacts
Increased dengue, heat-related illnesses, disasters.
4. Strengthening Disaster Preparedness
DRRM-based health planning.
5. Universal Health Care (UHC) Implementation
Aims for equitable, accessible, and quality healthcare.
6. Telehealth Expansion
Remote consultations and digital monitoring systems.
IV. Role of the Community Health Nurse
The CHN is essential in delivering primary health care.
Key Roles
Frontline provider of promotive, preventive, and curative services.
Implements DOH programs (e.g., NTP, EPI, NCD programs).
Acts as health educator, advocate, leader, and coordinator.
Conducts community profiling, assessment, and planning to support UHC.
V. Health Care Delivery in the Filipino Context
A. Filipino Culture
Kapwa – shared identity and empathy
Strong family ties
Respect for elders (“po” and “opo”)
Bayanihan – community cooperation
These influence health-seeking behavior and community mobilization.
B. Customs and Traditions
Hilot and herbal medicine as common first aid.
Fiestas that affect scheduling of health activities.
Religious practices (e.g., visiting faith healers).
C. Filipino Values, Traits, and Beliefs
Positive Traits
Resilience
Hospitality
Pakikisama (smooth interpersonal relations)
Generosity
Challenges
Hiya – shyness or fear of shame; prevents asking for help
Fatalism (bahala na) – affects health decisions
Late consultation – tendency to delay seeking medical care
VI. Positive Qualities of Community Health Nurses
A. Personal Attributes
Empathy
Respect
Cultural sensitivity
Integrity
B. Professional Competencies
Competent in health assessment
Program planning and management
Health education and communication
e-Health and data management
Leadership, teamwork, and advocacy
VII. Health-Related Entrepreneurial Activities
A. Community-Based Projects
These promote livelihood while improving community health.
Community gardens for nutrition
Herbal medicine production and packaging
Waste management (recycling, composting)
Nutrition programs (e.g., feeding, micronutrient products)
B. Wellness Clinics
Entrepreneurial opportunities for nurses include:
Screening services (BP, blood sugar)
Counseling and lifestyle coaching
Maternal and child health support
Fitness, weight management, and wellness programs
UNIVERSAL HEALTH CARE (UHC)
is a health system goal where all people receive the health services they need—without suffering
financial hardship. It ensures that every individual, regardless of income, location, or social status, has
access to quality, affordable health services.
1. Key Principles of Universal Health Care
a. Equity in Access
Everyone should be able to use health services when they need them.
No one should be left behind due to poverty, geography, or discrimination.
b. Quality of Services
UHC is not just about access—it requires safe, effective, and people-centered care.
c. Financial Risk Protection
People should not go bankrupt because of illness.
UHC prevents catastrophic health expenditures, especially for poor families.
2. Essential Components of UHC
a. Health Service Coverage
Includes:
Health promotion
Disease prevention
Treatment and care
Rehabilitation
Palliative care
b. Health Workforce
A well-trained, adequately staffed workforce is essential.
This includes doctors, nurses, midwives, CHWs, and specialists.
c. Health Financing System
Countries use different methods:
Government taxation
Mandatory health insurance
Social health insurance (e.g., PhilHealth in the Philippines)
Subsidies for the poor
d. Medicines and Technology
Affordable, high-quality essential medicines and diagnostics must be available.
e. Leadership and Governance
Strong policies, transparency, and accountability to ensure efficient health systems.
3. Benefits of Universal Health Care
a. Improved Health Outcomes
Early detection and continuous access to care reduce disease and mortality.
b. Reduced Inequality
Marginalized groups—rural communities, the poor, elderly—gain fair access.
c. Economic Protection
Prevents families from falling into poverty due to high medical bills.
d. Stronger Community Health
When people can access preventive care, the entire population becomes healthier.
4. Challenges in Achieving UHC
Limited health workforce
Geographical barriers
Insufficient health financing
Overcrowded facilities
Weak referral systems
High out-of-pocket payments
Countries must continuously strengthen their health systems to overcome these barriers.
5. UHC in the Philippine Context
Under the Universal Health Care Act (RA 11223):
All Filipinos are automatically covered by PhilHealth.
Emphasis on primary care and healthcare provider networks (HCPNs).
Local government units (LGUs) play a major role in service delivery.
The goal: Accessible, affordable, and quality health services for all Filipinos.
Universal Health Care is essential for building a fair and healthy society.
It is not just a health goal—it is a right, a social investment, and a pathway to national development.
Achieving UHC requires collaboration among government, health workers, communities, and stakeholders
to ensure that no one is left behind in healthcare.