History and development of Community Health Nursing

1. History and development of Community Health Nursing
Guided by: Mr. Ramakant Gaikwad
Presented by : Mr. Ajay Magar
Presented on: 09/02/11

2.  “Health is Not mainly an issue of doctors,
social services and hospitals. Health is an
issue of social Justice.
 There is no time to lose. We have the goal
of “Health for all by 2000 AD”. This is the
call of the world health organization. and
India has taken up the challenge.
 Formerly, Health care has been for those
living near enough to a hospital or a doctor
in times of need and for those who could
spend money for medicines and treatment.

3.  The great majority of people stayed in the village
when sick and even today many suffer and die
without proper help.
 Attempts have been made to meet the health
needs of the people of India by means of primary
health center and the training of Auxiliary Nurse
Midwives to go out from these centre’s to the
homes of the people.
 The number of ANMS trained was never sufficient
and more than half of them after training went to
work in hospitals. In fact, their training was given
mainly in the hospitals environment, with title
experience and understanding of health needs of
people, families and communities in rural areas.

4.  Community health nursing is one of the
professions/disciplines which operates within the
realms/domain of community health and helps in
meeting health and nursing needs of the
community.
 It plays a very important and challenging role in
promoting and protecting health of people. Unlike
other specialties of nursing, community health
nursing lays major emphasis on primary level
prevention and focuses on the entire community.
 Before further discussion let us see the definition of
Community Health Nursing

5.  “Community Health Nursing is a synthesis of
Nursing practice and public health practice applied
in promoting and preserving the health of
populations. The nature of this practice is general
and comprehensive. It is not limited to a particular
age or diagnostic group. It is continuing not
episodic. The dominant responsibility to the
population as a whole. Therefore nursing directed
to individuals, family or group contributes to the
health of total population. Health promotion,
health maintenance, health education, co-
ordination and continuity of care are utilized in a
holistic approach to the management of the health
care of individual, family, group and community.”

6.  Pre-vedic Period:
 The medical system that are truly Indian origin
and development are the Ayurveda and Siddha
system. Ayurveda dy definition implies “
Knowledge of Life”. Its origin is traced far back
to the Vedic times, about 5000BC. During this
period, medical history was associated with
mythological figures, sages and seers.
 Dhanvantari the Hindu god of Medicine is said to
have been born as a result of the churning of
ocean during a tug war between gods and
demons. According to some authorities medical
knowledge in the Atharvaveda gradually
developed into the science.

7.  The experience and concern in health
development and public health care dates
back to this Vedic period. In the Indus Vally
Civilization (3000 BC) itself, one funds
evidence of well- developed environmental
sanitation programmes such as arrangements
of good water supply, underground
drainages, Public baths in cities etc.

8.  In ancient India, the celebrated authorities
in Ayurveda medicine were Atreya, Charaka,
Sustra and Vagbhatt. Atreya (about 800 BC)
is acknowledged as the firdt great Indian
Physician and Teacher. Charaka a famous
Ayuirvedic Medicine, Sustra a father of Indian
Surgery. From this early writings other
authers wrote books. From these writings we
learn that surgery had advanced to a high
level, also that doctors and the attendants
(Nurse) must be the people of high
character, Hospital were large and well
equipped.

9.  Medical education was introduced in the ancient
Universitiesof Taxila and Nalanda.
 During Budha period hospital system was developed for
men and women and for animals.
 This was exapanded during king Ashoka, Moghal Period
(1000 AD) Unani Medicine which (Arabic system) was
introudced through Greek medicine which has become a
part of Indian medicine. Nursing and medicine are closely
linked together.
 Nursing was regarded on the “Science of Care” and
medicine as the “Science of Cure”. As the science of cure,
medicine is concerned with the diagnosis and treatment of
illness.
 As the scienceof care, nursing is concerned with the care
of people who are ill. The care and cure functions are
complimentary ; both are necessary and important aspects
of health care for the people.

10.  King Ashoka (272 BC-236 BC) a convert
Buddhism, brought about period of prosperity.
 Monasteries were built, houses for travelers
were provided and hospitals for both men and
women and animals were founded.
 Prevention of disease became a matter of first
importance and hygiene practices were adopted.
Cleanliness of the body was religious duty.
 Doctors and midwives were to be trustworthy
and skill full. They must wear clean cloth and
keep their nails cut short. Operations were
precede by religious ceremonies and prayers.
The nurses were usually men or old women.

11.  Women of India were favoured though
restricted to activities in the home. No doubt
they cared for the sick members in the
family.
 By 1 AD superstition and magic had been
somewhat replaced by more up to date
practice. But , medicine remained in the
hands of priest-physician who refused to
touch blood or pathological tissues.
Dissection was forbidden. This together with
religious restrictions probably helped to
bring about decline in medicine and nursing
professions.

12.  During this period diagnosis was made on empirical
basis and also the given treatment was according to
symptoms. So this era was called symptom oriented
oriented era. The health education was provided by
lectures on authoritarian instruction.

13.  This period witnessed the invention of
microscope, thermometer, BP apparatus and
other tools for detection and measurement
of diseases. Laboratory investigations were
carried out to make This period was called as
bacteria- oriented or disease oriented era.

14.  This is an era which witnessed her individual
centered or patient centered approach for
taking care of the health and illness of the
people. Clinical instructions abd bed side
teaching started in the field of medical
education education. The development of
clinical techniques was initiated in medical
science and technology.

15.  In this period prevention oriented approach
started. It was initiated by our ancient Indians at
the time of Indus Valley Civilisation.
 it is being called era of Community centered
approach, in which diagnosis and treatment at
community level emerged, clinical public health
instructions, community- side teachings were
included in the field of medical education.
 Studies releted to community development,
community measurement and criteria planning
techniques also started
 Integration of social sciences, and public health
sciences in this era took place.

16.  In this period the involvement of the
community leaders and members of the
community in planning and implementation
of the health programmes was practiced at
this stage.
 The national level health planning was
established by political authorities of
particular country by involving national and
international health agencies to provide
health for all.
 The people-centered approach has been
emphasized in this era.

17.  Community health has now entered an era of
individual responsibilities and community
participation.
 The traditional role of medical persons has been
shifted from diagnosis and treatment of
individual illness to treatment of all health
hazards of community.
 Community diagnosis is based on collection and
interpretation of relevant data related to
distribution of population according to age, sex,
educational status, marital status, religion,
caste, birthrate, death rate, prevalence of
disease etc.

18.  Definition of Community Health
development:
 “Community health nursing development is
defined as a nursing intervention that aims
at assisting members of a community to
identify a community's health concerns,
mobilize resources, and implement
solutions.”
Mosby's Medical Dictionary, 8th edition. ©
2009, Elsevier.

19.  Development in the broader sense is not only
the improvement or progress in the
community health resources but individual
progress in the professional aspect of as
community health nurse.

20. Sr.No Year Events
1 1918 The preparation of Nursing workers for public health work
started in Delhi, Lady Reading Health School
2 1930 At Calcutta All India Institute of Hygiene and Public Health was
started
3 1931 A Maternal and Child Welfare Bureau was established by the
Indian Red Cross Society.
4 1939 Indian Tuberculosis Association was started
5 1943 Health Survey and Development Committee was appointed by
GOI under the Chairmanship of Sir Joseph Bhore.

21. Sr.No Year Events
6 1918 The preparation of Nursing workers for public health work
started in Delhi, Lady Reading Health School
7 1930 At Calcutta All India Institute of Hygiene and Public Health
was started
8 1931 A Maternal and Child Welfare Bureau was established by the
Indian Red Cross Society.
9 1939 Indian Tuberculosis Association was started
10 1943 Health Survey and Development Committee was appointed
by GOI under the Chairmanship of Sir Joseph Bhore.

22. 11 1952 Community Development Programme was launched on 2nd
October for overall development of rural areas. Central
Council of Health constituted.
12 1954 National water supply and sanitation scheme was inaugurated.
National Leprosy Control Programme was started.
Food Adulteration Act was passed.
13 1955 National Filaria Control Programme started
14 1958 National Malaria Control Programme was changed to Eradication
Programme
15 1959 Mudaliar Committee was appointed to review the progress made
in health sector

23. 16 1961 Mudaliar Committee report was published
17 1962 Central Family Planning Institute was established
18 1971 MTP Act was passed, In 1972 came in force.
19 1973 Multipurpose Health Workers Scheme was introduced by Kartar Singh
committee report
20 1975 India declared as FREE from Smallpox
21 1977 Rural Health Scheme was introduced

24. 22 1978 The slogan “Health for All by 2000 AD came in force at Alma Atta
declaration in USSR underlined the primary health care approach.
23 1982 GOI framed National Health Policy. School Health Services started at trial
bases
24 1985 Universal Immunization Programme was launched on 19th
November
Indira Gandi’s Birthday.
25 1992 CSSM programme was launched on 20th
August
26 1995 Pulse Polio Immunization Programme launched in December and January.
26 1996 RCH in place of CSSM with slight modification,launched in 1997
27
28
2000
2002
GOI announced National Population Policy
GOI announces Nationational AIDS Prevention controlpolicy

25. 29 2003 Launching of ART
centres at
MetroCentres,e.g.
Sasoon
30 2004 NTCP Inclucated DOTS
31 2007 Revision of National
Population
32 2008 , revised in 2009 Swine Flu awareness
Programme and control
Programme

26.  1. Administration.
 2. Communication.
 3. Nursing.
 4. Teaching.
 5. Research.

27.  India has unique history of community health
nursing and it has changed a lot throughout
history .

28.  Queries?
 Suggestions?
 Additions?

29. Thanks

30. Books
 Park K, Parks Textbook of Preventive and Social Medicine, 20th
Edition, Banarasidas Bhanot, Jabalpur, 2010, Page No.1-
11,644-648.
 Kamalam.S, Essentials in Community Health Nursing Practice,
First Edition, 2008,Jaypee Brothers, New Delhi, Page No. 3-
10, 12-15.
 Basavanthappa.B.T, Community Health Nursing,First
Edition,Jaypee Brothers, Mumbai, 2008, Page No. 10-12.
 Marsije.L.M, A new textbook for nurses in India, CMAI, B.I.
Publication, Chennai,1997, Volume I, Page No. 3- 68.
Journals
 e Journal of Community Medicine, http://www.ijcm.org.in/
Websites and Links
 http://www.peopletree.co.in/infoemployer.htm.
 http://en.wikipedia.org/wiki/Nursing_in_India#mw-head