The dynamic atmosphere of community health-care reform challenges health professionals and community allies to participate actively in developing a culturally appropriate and comprehensive community health-care delivery system. In most developing countries, the community health-care system represents at least five layers of care that respond to the comprehensive healthcare demands of its people. The five layers include:
- individual self-care,
- family care,
- care and support among neighbors and groups in the community,
- care and support given by health-care providers and healers, and
- welfare and support provided by community allies such as the local administrative government; community organizations such as community health funds, community funds, and cremation fund; social welfare office; etc.
Through assessing all layers of care, key actors in community health care can be identified. These key actors work to their capacity in a community health-care team, according to their roles and functions. The key actor could be an able contributor to the learning of students.
All community health services and care activities carried out respond to the needs, health problems and health risks, cultural way of living, resources, and preferences of the community. In a health-care system in transition, where currently the quality of service is emphasized, community health nursing represents a profession that responds to all categories of demands of the people.
The roles and responsibilities of the community health nurse thus vary and differ according to the context of the health-care delivery system. The dynamic, complex and emerging environment of health care presents complex healthcare demands of the community that require different capabilities in today’s community health nurses and health-care professionals.
Community health nursing is a population-focused, community-oriented approach aimed at health promotion of an entire population, and prevention of disease, disability and premature death in a population. Unique to community health nursing is the opportunity for nurses to learn and develop partnership skills with all stakeholders and key actors in their communities. The experience of community health nurses heightens communication and leadership skills and allows for creativity in solving community health problems.
In cooperation with other disciplines, community nurses are expected to have greater professional autonomy to provide ethical and legal nursing care services in different community settings, such as schools, homes and health centres. Although the number of roles and responsibilities of community health nurses are many, these are far fewer than what the community expects them to fulfill.