NAME: OLA MIRACLE EUNICE

MATRIC NUMBER:229464
COURSE CODE: NSG 311
COURSE TITLE: COMMUNITY HEALTH NURSING
LECTURER IN CHARGE: MRS OLUSEYE
ASSIGNMENT 1
1.Holistic Health Model
The Holistic Health Model is a comprehensive approach to health and wellness that considers the
physical, emotional, mental, and spiritual aspects of an individual. It emphasizes the
interconnectedness of these aspects and seeks to understand how they influence one another.
Components of Holistic Health Model
1.Physical Health: Focuses on the body's physiological systems and functions.
2.Emotional Health: Examines emotions, feelings, and relationships.
3.Mental Health: Explores thoughts, beliefs, and cognitive processes.
4. Spiritual Health: Considers meaning, purpose, and connection to something greater.
5. Environmental Health: Recognizes the impact of external factors like nature, culture, and
society.
6. Social Health: Emphasizes relationships, community, and social connections.
Principles:
1. Interconnectedness: All aspects are connected the and influence one another.
2. Whole-person approach: Considers the individual as a whole, rather than focusing on a
specific aspect.
3. Balance and harmony: Seeks equilibrium among all aspects.
4. Self-awareness and self-care: Encourages personal growth and self-responsibility.
5. Prevention and wellness: Focuses on preventing illness and promoting wellness.
6. Integration and collaboration: Combines conventional and complementary therapies.
Benefits:
1. Comprehensive understanding: Provides a complete picture of an individual's health.
2. Personalized approach: Tailors health strategies to individual needs.
3. Empowerment: Encourages self-awareness, self-care, and personal growth.
4. Holistic healing: Addresses root causes, rather than just symptoms.
5. Increased well-being: Promotes overall wellness and resilience.

●
 Holistic Health Model Diagram
Application to Community Health Nursing: How can a community health nurse use the
Holistic Health Model to develop a comprehensive health program for a refugee community?
Answer:
A community health nurse can use the Holistic Health Model to develop a comprehensive health
program for a refugee community by considering the physical, emotional, mental, spiritual,
environmental, and social aspects of health.
1. Physical Health: Provide access to healthcare services, health screenings, and education on
healthy habits, nutrition, and disease prevention.
2. Emotional Health: Offer counseling services, support groups, and stress management
techniques to address trauma, anxiety, and depression.
3. Mental Health: Provide mental health assessments, therapy, and referrals to specialized
services for conditions like PTSD(Post Traumatic Stress Disorder).
4. Spiritual Health: Respect and support the community's spiritual beliefs and practices, and
connect them with spiritual leaders or resources.
5. Environmental Health: Address living conditions, sanitation, and access to clean water,
food, and air.
6. Social Health: Foster social connections, community engagement, and cultural preservation
through community events, support groups, and cultural activities.
By considering the interconnectedness of these aspects, the community health nurse can:
1.Develop a comprehensive program addressing the unique needs of the refugee community.
2.Empower individuals and families to take control of their health.
3.Foster a sense of community and social suppor.t
4.Address health disparities and improve health outcomes.
5. Provide culturally sensitive and compassionate care.
This holistic approach enables the community health nurse to provide comprehensive, person-
centered care that honors the complexity and individuality of each community member.

2.High Level Wellness Model

Understanding Wellness
Wellness is a holistic state of well-being that encompasses physical, mental, emotional, social,
spiritual, and environmental dimensions. It's more than just the absence of disease; it's a
conscious effort to live a life that promotes optimal health and happiness.
The concept was originally developed with a view to improving the life and well-being of
university and college students. The guiding philosophy was the pursuit of high-level wellness,
first defined by Halbert Dunn (1959) as, “an integrated method of functioning which is oriented
toward maximizing the potential of which the individual is capable.”
The High-Level Wellness model was introduced by Dunn in 1959 and was pioneering in its time.
Dunn’s model was followed by another highly influential model, proposed by Hettler in the
1970s.
The High-Level Wellness model was introduced by Dunn in 1959 and was pioneering in its time.
Dunn’s model was followed by another highly influential model, proposed by Hettler in the
1970s.
The dimensions of wellness
Bill Hettler recognized the following six dimensions of wellness comprising a hexagonal model:
Intellectual, physical, emotional, social, spiritual, and occupational dimensions of wellness.
According to Hettler (1980) these dimensions of wellness embrace the following attributes and
activities:
1.Intellectual Wellness :measures the degree to which a person engages with creative and
stimulating activities; an intellectually well person makes the best use of available resources to
expand upon their knowledge and skills.
2.Physical Wellness :measures the degree to which a person looks after their cardiovascular
health and is mindful of following a healthy diet.
3.Emotional Wellness:an awareness and acceptance of one’s own feelings; the degree of
positivity and enthusiasm about life .
4.Spiritual Wellness :the commitment to seeking meaning and purpose in human existence; a
deep awareness of the depth and expanse of life and an appreciation of the natural forces in
existence in the universe.
5. Occupational Wellness:a measure of work satisfaction and the amount of enrichment
interconnected with this
6.Social Wellness: the degree to which an individual contributes to his or her community; this
parameter emphasizes interconnectedness with others and with the natural world.
A recognized seventh dimension of wellness is that of environmental wellness. This parameter
involves recognizing the interconnections between the environment, community and self. The
‘environment’ can encompass a person’s daily surroundings such as home, university or college,
work and neighborhood.

● Dimensions of Wellness diagram

Application to Community Health Nursing
How can a community health nurse use the High-Level Wellness Model to develop a
comprehensive wellness program for a low-income housing community?
Answer:
A community health nurse can use the High-Level Wellness Model to develop a comprehensive
wellness program for a low-income housing community by addressing all six dimensions of
wellness:
1.Physical Wellness:
 - Conduct health screenings and provide education on healthy habits, nutrition, and exercise.
- Collaborate with local organizations to offer fitness classes and access to healthy food
options.
2. Emotional Wellness:
- Establish support groups for residents dealing with stress, anxiety, or depression.
- Provide counseling services and connect residents with mental health resources.
3. Intellectual Wellness:
- Offer educational workshops on health literacy, disease management, and wellness
strategies.
- Partner with local libraries to provide access to health-related resources and information.
4. Social Wellness:
- Organize community events and activities promoting social connections and relationships.
- Establish a volunteer program to foster community engagement and social support.
5. Spiritual Wellness:
- Provide access to spiritual resources and support groups for residents.
- Collaborate with local faith-based organizations to offer spiritual services and counseling.
6. Occupational Wellness:
- Offer job training and employment resources to support residents' occupational goals.
- Partner with local businesses to provide job opportunities and career advancement.
By addressing all six dimensions of wellness, the community health nurse can help residents
achieve optimal wellness and improve their overall quality of life. The program can be tailored to
meet the specific needs of the community, and partnerships with local organizations can help
leverage resources and expertise.

3.Optimum Level of Functioning

The optimum level of functioning refers to the highest possible level of physical, emotional,
mental, and social well-being that an individual can achieve. It encompasses various aspects,
including:
1. Physical functioning: Performing daily activities with ease and independence.
2. Emotional functioning: Managing emotions, coping with stress, and maintaining healthy
relationships.
3. Mental functioning: Thinking clearly, making informed decisions, and solving problems
effectively.
4. Social functioning: Participating in activities, maintaining social connections, and
contributing to the community.
5. Spiritual functioning: Having a sense of purpose, meaning, and connection to something
greater.
Characteristics of optimum level of functioning
1. Balance and harmony among all aspects of life.
2. Ability to adapt to change and challenges.
3. Resilience and coping skills.
4. Self-awareness and self-acceptance.
5. Positive relationships and social connections.
6. Purpose and meaning in life.
7. Physical and mental well-being.
8. Continuous learning and personal growth.
How Optimum level of functioning is applied in Community Health Nursing
In Community Health Nursing, the optimum level of functioning is applied by:
1. Conducting comprehensive assessments to identify individuals' or communities' strengths,
needs, and goals.
2. Developing personalized plans to promote health, wellness, and functioning.
3. Implementing evidence-based interventions to address physical, emotional, mental, and social
needs.
4. Empowering individuals and communities to take control of their health through education,
support, and resources.
5. Facilitating access to community resources, services, and partnerships.
6. Fostering community engagement, social connections, and collective action.
7. Monitoring progress, evaluating outcomes, and adapting plans accordingly.
4. Importance of frameworks to theory and nursing practice.
What are frameworks?
Frameworks are set of interrelated concepts that represents an image of a phenomenal.
Frameworks are essential to theory and nursing practice as they:
1. Organize and structure knowledge, making it easier to understand and apply.
2. Guide practice, ensuring consistency and high-quality care.
3. Facilitate communication among healthcare professionals, promoting collaboration.
4. Support education and research, providing a foundation for teaching and investigation.
5. Enhance critical thinking and problem-solving, encouraging analysis and creativity.
6. Promote evidence-based practice, connecting theory to research and practice.
7. Foster continuity and consistency, ensuring coherence across settings and populations.
8. Enable evaluation and quality improvement, providing a basis for assessment and refinement.

In nursing practice, frameworks:

1. Inform assessment and diagnosis
2. Guide care planning and implementation
3.Support patient education and empowerment
4. Facilitate collaboration and coordination
5. Enhance patient outcomes and satisfaction
6. Promote professional development and accountability
By using frameworks, nurses can ensure that their practice is grounded in theory, evidence, and
best practices, ultimately leading to better patient care and outcomes.

5. General System Theory

General System Theory (GST) is a theoretical framework that explains how systems work and
interact. Developed by Ludwig von Bertalanffy in the 1940s, GST aims to provide a unified
approach to understanding complex systems across various disciplines.
Concepts of General System Theory
1. System: A set of interrelated components that function together to achieve a common goal.
2. Holism: Understanding the system as a whole, rather than focusing on individual parts.
3. Interdependence: Components interact and influence each other.
4. Homeostasis: Systems maintain stability and balance through self-regulation.
5. Adaptation: Systems adjust to changes in the environment.
6. Feedback loops: Information flows back into the system to maintain balance or promote
change.
Application of General System Theory to Nursing practice
1. Patient as a system: View patients as complex systems with physical, emotional, and social
components that interact and influence each other.
2. Holistic care: Address the whole person, not just the disease or symptoms, considering the
interdependence of physical, emotional, and social factors.
3. Family and community: Recognize the impact of family and community on patient well-
being, addressing social support and environmental factors.
4. Healthcare team: Collaborate with interdisciplinary teams, acknowledging the
interdependence of healthcare professionals.
5. Homeostasis and adaptation: Support patients' self-regulation and adaptation to changes,
promoting resilience and coping.
6. Feedback loops: Use patient feedback to adjust care plans and improve outcomes.
7. Systematic assessment: Conduct comprehensive assessments considering physical,
emotional, social, and environmental factors.
8. Care planning: Develop individualized plans addressing the complex needs of patients.
9. Evaluation: Continuously evaluate patient outcomes and adjust care plans accordingly.
10. Quality improvement: Apply GST to identify areas for improvement in healthcare systems
and processes.

6. Contemporary Health Care Delivery System

The Contemporary Health Care Delivery System is a complex network of organizations,
services, and professionals working together to provide healthcare to individuals and
populations. Characteristics include:

1.Integration: Coordination and collaboration among healthcare providers, settings, and

services.
2. Patient-centeredness: Focus on individualized care, patient engagement, and empowerment.
3. Value-based care: Emphasis on quality, outcomes, and cost-effectiveness.
4. Digital health: Leveraging technology, data analytics, and telehealth to enhance care.
5. Interprofessional collaboration: Team-based care involving diverse healthcare professionals.
6. Population health management: Focus on preventive care, health promotion, and disease
management for defined populations.
7. Accountable care: Healthcare providers held accountable for quality, costs, and patient
outcomes.
8. Cultural competence: Care tailored to diverse patient needs, values, and preferences.
9. Community engagement: Partnerships with community organizations, social services, and
public health agencies.
10. Continuous quality improvement: Ongoing evaluation and enhancement of healthcare
services.
Aims
- High-quality, patient-centered care
- Improved health outcomes
- Enhanced patient experience
- Increased efficiency and effectiveness
- Better population health management
- Reduced healthcare costs

7. Current status of Health Care System

The current status of the healthcare system in Nigeria is challenging, with limited access to
quality healthcare services, especially for vulnerable populations . Here are some key aspects of
the current healthcare system:
1.Limited coverage: The National Health Insurance Scheme (NHIS) covers less than 10% of the
population, leaving many without access to affordable healthcare .
2.Poor quality of care: The quality of healthcare services is a significant concern, with many
primary healthcare facilities in poor condition due to inadequate funding .
3.Out-of-pocket payments: Many individuals and households face high out-of-pocket payments
for healthcare services, leading to financial hardship .
4.Vulnerable populations: Children, pregnant women, people living with disabilities, and the
elderly are among the most vulnerable populations, often facing significant barriers in accessing
healthcare services .
5.Health outcomes: Nigeria faces significant health challenges, including high maternal and
child mortality rates, with 814 deaths per 100,000 live births and 100-150 deaths per 1,000 live
births, respectively .

Efforts are being made to address these challenges, including the expansion of the NHIS, the
implementation of universal health coverage schemes, and investments in healthcare
infrastructure .

ASSIGNMENT 2.
"As a community health nurse, posted to a newly established community health based
facility to help tackle severe diarrhea and dehydration among under 5 children, despite
series of health education provided by health workers. Most of the mothers that attend are
young (age 18-25yrs) most of them have no prior education, only few have primary
education. The older women and mother in laws are major source of health related
information. Write out your plan of intervention using health belief model as underlying
framework for care. Your goal is to reduce cases of diarrhea and dehydration."
Answer
Health Belief Model is a social psychological health behavioral change model. It predicts and
explains health behavior particularly in regard to uptake of health services.
Here's a plan of intervention using the Health Belief Model (HBM) as the underlying framework:
Goal: Reduce cases of diarrhea and dehydration among under-5 children in the community.
Target population:Young mothers (18-25 years) with limited education, and older
women/mother-in-laws who influence health decisions.
HBM Components:
1. Perceived Susceptibility:
- Educate mothers on the severity of diarrhea and dehydration, and their susceptibility to these
conditions.
- Use visual aids and simple language to explain the risks.
2. Perceived Severity:
- Share stories of children who have suffered from diarrhea and dehydration, highlighting the
potential consequences (e.g., hospitalization, death).
- Emphasize the importance of prompt treatment.
3. Perceived Benefits:
- Explain the benefits of proper hydration, sanitation, and hygiene practices in preventing
diarrhea and dehydration.
- Highlight the advantages of seeking early medical attention.
4. Perceived Barriers:
- Identify and address barriers to seeking medical care, such as cost, distance, or lack of
knowledge.
- Offer solutions, like free or low-cost treatment, transportation assistance, or health education.
5. Cues to Action:
- Provide reminders and prompts for mothers to take action, such as:
- Demonstrating proper handwashing techniques
- Showing how to prepare oral rehydration solution (ORS)
- Scheduling regular health checks
6. Self-Efficacy:
- Encourage mothers to take ownership of their children's health by:
- Teaching them how to identify early signs of diarrhea and dehydration
- Empowering them to make informed decisions about seeking medical care
Intervention Strategies:
1. Health Education Sessions:
- Conduct regular sessions for young mothers, using simple language and visual aids.
- Involve older women/mother-in-laws as co-facilitators to build credibility.
2. Demonstration and Practice:
- Show mothers how to prepare ORS, and have them practice.
- Demonstrate proper handwashing techniques, and have them practice.
3. Home Visits:
- Conduct home visits to:
- Monitor children's health
- Provide personalized guidance
- Encourage mothers to seek medical care when needed
4. Community Outreach:
- Organize community events to raise awareness about diarrhea and dehydration prevention.
- Engage with local leaders and influencers to promote the importance of proper hygiene and
sanitation practices.
5. Collaboration with Local Health Workers:
- Work with local health workers to:
- Provide medical care and treatment
- Offer health education and support
Evaluation:
1. Monitor the number of cases of diarrhea and dehydration among under-5 children.
2. Conduct regular surveys to assess mothers' knowledge, attitudes, and practices related to
diarrhea and dehydration prevention.
3. Evaluate the effectiveness of the intervention strategies and make adjustments as needed.

ASSIGNMENT 3
"As a community health nurse, posted to a newly established community health based
facility to help tackle severe diarrhea and dehydration among under 5 children, despite
series of health education provided by health workers. Most of the mothers that attend are
young (age 18-25yrs) most of them have no prior education, only few have primary
education. The older women and mother in laws are major source of health related
information. Write out your plan of intervention using health belief model as underlying
framework for care. Your goal is to reduce cases of diarrhea and dehydration."
Complete the nursing process of the case scenario above:

Assessment data:the local high school has had a 50% increase in the number of teen
pregnancies in the past year, causing high school graduation rates to decrease due to pregnant
students dropping out of high school.
 Community diagnosis: increased need for additional birth control and resources for prevention
of pregnancy due to lack of current resources, as evidenced by 50% increase in teen pregnancies
in the last year and a decrease in graduation rates (WISCONSIN Technical College System)"
Objective: To reduce the rate of teen pregnancies and increase in graduation rate in the local
high school by 20% within 3 years of intervention.
Outcome: There will be a 20% decrease in the rate of teen pregnancies and increase graduation
rate in the local high school within 3 years.
Action plan
1. To create education and aware6 by collaborating with high schools to integrate comprehensive
reproductive health education into the curriculum.
2. To collaborating with local social services to provide resources for parenting students such as
childcare resources.
3. To advocate for flexible scheduling and academic accommodation to support continued
education.
4. To develop a data collection plan to monitor teen pregnancies rates, graduation rates and
program effectiveness.
Implementation of Intervention
1. Collaborating with school administrators and teachers to incorporate sex education into the
curriculum.
2. Offer parenting classes in schools and community centers.
3. Partnership with local high schools to advocate for flexible scheduling and academic
accommodation to support continued education.
4. Monitoring teen pregnancies rates, graduation rates and program effectiveness within time of
intervention.
Evaluation of action plan
1. 60% of students reported increased access to resources and support within 26months of
intervention.
2. There was decreased in teen pregnancies by 15% within 3years of intervention .
3. There was 20% increase in graduation rates among teens within 3 years of intervention.

ASSIGNMENT 4
National/ International policies on population growth
Population Policies
Population policies are different laws or regulations that governments enact in order to
accomplish demographic changes, like reducing or raising birth rates, reducing mortality,
increasing immigration, or implementing other related objectives. Sometimes, they even try to
change the composition of that population.

International Policies
1.United Nations: The UN plays a crucial role in promoting sustainable development and
population policies. It has established various programs and initiatives, such as the International
Conference on Population and Development (ICPD), which outlined a global agenda for
reproductive health and rights.
2.World Health Organization (WHO): The WHO provides technical assistance and guidance
to countries in implementing population policies, focusing on reproductive health, family
planning, and maternal and child health.
3.International Planned Parenthood Federation (IPPF): As a global reproductive health and
rights organization, the IPPF works to ensure that individuals, especially women and girls, have
access to comprehensive sexual and reproductive health services.
National Policies
The specific policies adopted by individual countries vary widely depending on their
demographic trends, cultural values, and economic circumstances. However, some common
approaches include:

1.Family Planning Programs: These programs provide access to contraception, reproductive

health education, and family planning services to help individuals make informed decisions
about their family size.
2.Education and Empowerment of Women: Investing in education and empowering women
can lead to lower fertility rates, as educated women often have greater control over their
reproductive choices.
3.Economic Development: Promoting economic development and improving living standards
can also influence population growth, as people may have fewer children as their economic
situation improves.
4.Social Security and Pension Systems: Some countries have implemented social security and
pension systems to encourage smaller family sizes, as individuals may feel more secure in their
old age without having many children to support them.
Examples of National Policies
1.China's One-Child Policy: From the late 1979 to 2016, China implemented a strict one-child
policy to control population growth. While effective in reducing population growth, it faced
criticism for human rights violations and unintended consequences.
2.India's Family Planning Programs(2000): India has had a long-standing family planning
program, with a focus on providing contraception and reproductive health education.
3.Sub-Saharan Africa: Many countries in Sub-Saharan Africa have implemented family
planning programs and promoted women's empowerment to address high fertility rates.
4. Nigeria's National policy(2004):seeks to reduce population growth rate and achieve
sustainable development.

ASSIGNMENT 5
Implications of population growth on Ecology/Environment
The implications of population growth on ecology and the environment are numerous and far-
reaching. Some of the most significant effects include:
1.Resource depletion: Increased demand for resources like water, food, and energy, leading to
scarcity and depletion.
2.Habitat destruction: Expansion of urban areas, agriculture, and infrastructure, resulting in
loss of natural habitats and biodiversity.
3.Pollution: Increased industrial and agricultural activities, leading to air, water, and soil
pollution.
4.Climate change: Growing energy demands and consumption patterns contribute to greenhouse
gas emissions, accelerating climate change.
5. Loss of ecosystem services: Degradation of ecosystems, leading to loss of essential services
like pollination, pest control, and nutrient cycling.
6. Water scarcity: Increased demand for freshwater, leading to scarcity and competition for this
limited resource.
7. Food security: Pressure on agricultural systems, potentially leading to food insecurity and
malnutrition.
8. Waste management: Increased waste generation, challenging waste management
infrastructure and leading to environmental pollution.
9. Urbanization: Unplanned urban growth, resulting in environmental degradation, social
inequality, and health issues.
10. Biodiversity loss: Habitat destruction, pollution, and climate change contribute to loss of
species and ecosystem disruption.

ASSIGNMENT 6
Effects of Age and gender on population growth.
Age and gender significantly impact population growth:
Age
1. Fertility rates: Women's fertility peaks between 20-24 years, while men's fertility declines
with age.
2. Dependency ratio: Populations with high proportions of children (0-14) and elderly (65+)
rely on working-age individuals (15-64) for support.
3. Population momentum: Large youth populations can lead to rapid growth, while aging
populations can lead to decline.

Gender
1.Sex ratio at birth: Biased sex ratios (e.g., more boys than girls) can impact population growth
and structure.
2. Female education and empowerment: Educated women tend to have fewer children,
contributing to slower population growth.
3.Maternal mortality: High maternal mortality rates can reduce population growth and increase
dependency ratios.
4.Gender-based violence and discrimination: Can impact fertility rates, population growth,
and overall well-being.
Interplay between age and gender:
1. Young population: High proportions of young people (especially females) can lead to rapid
growth.
2. Aging population: Low fertility rates and aging populations can lead to decline.
3.Gender-age pyramid: Visual representation of population structure by age and gender,
helping to understand demographic trends.
Understanding these factors is crucial for:
1. Population projections.
2. Policy development (e.g., education, healthcare, economic empowerment).
3. Resource allocation.
4. Addressing demographic challenges (e.g., aging, youth bulge).