Lesson Notes By Weeks and Term v3 - Senior Secondary 1
Community Health Services
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Community Health Services
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Subject: Health Education
Class: Senior Secondary 1
Term: 3rd Term
Week: 2
Theme: Community Health
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define Community Health identify Community Health Services and providers state examples of Community efforts in Health promotion
on balanced diets, food preparation, and infant feeding practices. Nigerian
Example: Education on complementary feeding for infants given to new mothers.
Family Planning: Providing information and services for birth spacing and responsible parenthood. Nigerian
Example: Counseling on various contraceptive methods at PHC centres.
Hygiene Promotion: Encouraging personal hygiene practices like handwashing, bathing, and oral hygiene. Nigerian
Example: Handwashing campaigns in schools during cholera outbreaks.
D. Rehabilitative Health Services: These services help individuals recover from illness, injury, or disability, restoring them to their fullest possible physical, mental, social, and vocational potential.
Physiotherapy: Helping patients regain movement and function after injuries or surgeries.
Occupational Therapy: Assisting individuals with disabilities to perform daily activities. Nigerian
Example: Post-stroke rehabilitation exercises at a specialist facility (though less common at basic community health centres, awareness of its importance is crucial). 2.
3. Community Health Service Providers These are the professionals and individuals who deliver community health services.
Formal Providers: Doctors (Medical Officers): Diagnose and treat diseases, perform minor surgeries, supervise other health workers. Often stationed at higher-level PHCs or general hospitals.
Nurses: Provide patient care, administer medications, assist doctors, offer health education, manage clinics. Community Health Extension Workers (CHEWs) and Junior Community Health Extension Workers (JCHEWs): Backbone of primary healthcare in rural Nigeria. They provide basic diagnosis and treatment, maternal and child health services, immunisation, health education, and community mobilisation.
Midwives: Specialise in maternal and child health, conduct deliveries, provide antenatal and postnatal care.
Pharmacists/Pharmacy Technicians: Dispense medications, provide drug information and counselling.
Laboratory Technicians: Perform basic diagnostic tests (e.g., malaria parasite test, urine analysis).
Environmental Health Officers (EHOs): Inspect food premises, monitor water quality, ensure proper waste disposal, enforce sanitation laws.
Nutritionists/Dietitians: Provide expert advice on diet and nutrition. Informal/Traditional Providers (often integrated or regulated): Traditional Birth Attendants (TBAs): Assist women during childbirth, particularly in remote areas. Efforts are often made to train them in safe practices and to refer complicated cases.
Traditional Healers/Herbalists: Use traditional remedies and practices to treat illnesses. Nigerian Context
Note: While informal providers play a significant role, particularly in rural settings, it is important to understand the formal system's preference for evidence-based medicine and the efforts to regulate or train traditional practitioners for safer outcomes. 2.
4. Community Efforts in Health Promotion These are instances where community members, groups, or leaders actively participate in or initiate activities to improve their health.
A. Community Clean-up Exercises (Environmental Sanitation Days): Organised regular clean-up of streets, markets, drainage systems, and public spaces to prevent diseases like cholera, typhoid, and malaria by controlling vectors and improving hygiene. Nigerian
Example: "Environmental Sanitation Day" observed monthly or periodically in many states where citizens are mandated to clean their surroundings.
B. Formation of Health Advocacy Groups: Local associations (e.g., market women associations, youth groups, religious organisations) that advocate for better health services, raise awareness on health issues, or promote healthy practices among their members. Nigerian
Example: A market women's association campaigning for improved toilet facilities in their market or educating members on exclusive breastfeeding.
C. Fundraising and Donation for Health Facilities: Communities coming together to raise funds or donate materials to build, renovate, or equip local health centres, purchase ambulances, or provide essential medicines. Nigerian
Example: A village development union raising money to buy a generator for their community health post or stock its pharmacy.
D. Voluntary Blood Donation Drives: Organised events within a community to encourage members to donate blood, ensuring a supply for emergencies and patients in need at local hospitals. Nigerian
Example: A youth association partnering with a local hospital to host a blood donation drive.
E. Communal Provision and Maintenance of Water and Sanitation Facilities: Collective efforts to sink boreholes, dig wells, build public latrines, or maintain existing water and sanitation infrastructure. Nigerian
Example: A community contributing labour and resources to repair a broken community borehole or building public toilets near a market. *
F. Engagement with Health Campaigns and Programs: Active participation in government or NGO-led health campaigns, such as immunisation days, deworming exercises, This section provides in-depth explanations of the core concepts related to Community Health Services. 2.
1. Definition of Community Health Community Health refers to the overall health and well-being of a group of people living within a specific geographical area, often sharing common interests, characteristics, or social norms. It is distinct from individual health in that it focuses on the collective rather than the singular. Community health involves organised efforts by the community itself, as well as governmental and non-governmental organisations, to prevent disease, promote health, and prolong life among its residents.
Key aspects of Community Health: Collective Responsibility: It implies that health is not solely an individual's concern but a shared responsibility of all members and institutions within a community.
Preventive Focus: A significant aspect is preventing diseases and promoting healthy lifestyles rather than just treating illnesses after they occur.
Environmental and Social Determinants: Community health considers broader factors like sanitation, access to clean water, food security, education, housing, and social networks, all of which influence the health status of the population.
Organised Efforts: It involves planned activities, programs, and policies implemented at the community level. Nigerian Context
Example: A community-wide campaign for childhood immunisation against polio and measles, organised by the Primary Health Care (PHC) centre with community leaders' support, is a direct application of community health principles. It aims to protect all eligible children in that community, not just a few individuals. 2.
2. Community Health Services and Providers Community Health Services are the various health-related activities, programs, and facilities provided to improve, maintain, and protect the health of a population within a defined community. These services are often delivered at the primary health care level and are accessible to the public. They can be broadly categorised as follows:
A. Preventive Health Services: These services aim to prevent the occurrence of diseases and health problems.
Immunisation: Vaccination against infectious diseases like polio, measles, tetanus, diphtheria, whooping cough, tuberculosis, and Hepatitis
B. Nigerian
Example: Routine immunisation for infants at Primary Health Care (PHC) centres.
Health Education and Awareness: Providing information and education on healthy behaviours, disease prevention, nutrition, hygiene, and family planning. Nigerian
Example: Workshops for market women on food safety, school health talks on malaria prevention.
Environmental Sanitation: Promoting and implementing practices for clean surroundings, safe water supply, proper waste disposal, and vector control (e.g., mosquitoes, rats). Nigerian
Example: Monthly environmental sanitation exercises, inspection of boreholes and public toilets by Environmental Health Officers.
Antenatal and Postnatal Care: Services for pregnant women and new mothers, including check-ups, nutrition advice, and infant care. Nigerian
Example: Regular visits by pregnant women to PHC centres for check-ups and delivery.
B. Curative Health Services: These services focus on the diagnosis and treatment of existing illnesses and injuries.
Treatment of Common Illnesses: Providing diagnosis and medication for prevalent diseases like malaria, typhoid, respiratory infections, and minor injuries. Nigerian
Example: Consulting a Community Health Extension Worker (CHEW) at a local health post for malaria treatment.
First Aid: Providing immediate care for injuries or sudden illnesses before professional medical help arrives. Nigerian
Example: Basic first aid kits available in schools or community centres.
Referral Services: Directing patients to higher levels of care (e.g., secondary or tertiary hospitals) when their condition requires specialised treatment. Nigerian
Example: A CHEW referring a complicated pregnancy case to a general hospital.
C. Promotive Health Services: These services aim to foster general health and well-being, enhancing people's capacity to take control over and improve their health.
Nutrition Education: Advising on balanced diets, food preparation, and infant feeding practices. Nigerian
Example: Education on complementary feeding for infants given to new mothers.
Family Planning: Providing information and services for birth spacing and responsible parenthood. Nigerian
Example: Counseling on various contraceptive methods at PHC centres.
Hygiene Promotion: Encouraging personal hygiene practices like handwashing, bathing, and oral hygiene. Nigerian
Example: Handwashing campaigns in schools during cholera outbreaks.
D. Rehabilitative Health Services: These services help individuals recover from illness, injury, or disability, restoring them to their fullest possible physical, mental, at local hospitals. Nigerian
Example: A youth association partnering with a local hospital to host a blood donation drive.
E. Communal Provision and Maintenance of Water and Sanitation Facilities: Collective efforts to sink boreholes, dig wells, build public latrines, or maintain existing water and sanitation infrastructure. Nigerian
Example: A community contributing labour and resources to repair a broken community borehole or building public toilets near a market.
F. Engagement with Health Campaigns and Programs: Active participation in government or NGO-led health campaigns, such as immunisation days, deworming exercises, or HIV/AIDS awareness programs. Nigerian
Example: Community leaders mobilising parents to bring their children for immunisation during National Immunisation Days.
G. Setting Up Community Watch/Security Groups: While not directly health services, these groups indirectly promote health by ensuring peace and security, which are prerequisites for people to access health services and live healthily. Nigerian
Example:* A local vigilante group reducing crime, thereby reducing injuries from violence and allowing health workers to operate safely. Introduction (10 minutes)
Teacher Activity: Begin by posing a relatable scenario: "Imagine a situation where there's a sudden outbreak of cholera in our community due to contaminated water. What do you think should be done, and who should do it?" Facilitate a brief class discussion, guiding students to think beyond individual action towards collective responsibility.
Student Activity: Students share their thoughts and ideas on how to address the hypothetical cholera outbreak, brainstorming immediate and long-term solutions, and identifying potential helpers.
Activity 1: Defining Community Health (15 minutes)
Teacher Activity: Based on the introductory discussion, lead students to formulate a working definition of "health" at an individual level. Then, introduce the concept of "community" and guide them to combine these ideas to define "Community Health." Present the formal definition, emphasising collective well-being, prevention, and organised efforts.
Use a local example: "How does having a functional community borehole contribute to the health of everyone in the village, not just one person?" Student Activity: Students brainstorm definitions of individual health. They then work in pairs to discuss and propose a definition for "Community Health." Selected pairs share their definitions, which are then refined with teacher guidance.
Activity 2: Identifying Community Health Services and Providers (25 minutes)
Teacher Activity: Divide the class into small groups (4-5 students). Instruct each group to list different types of health services they have seen or heard about in their own communities (e.g., PHC, immunisation, traditional healers). Alongside each service, they should identify who provides it (e.g., doctor, nurse, CHEW, TBA, EHO). Circulate among groups, providing clarification and prompting. After group discussions, facilitate a whole-class sharing session. Systematically introduce and explain the categories of Community Health Services (Preventive, Curative, Promotive, Rehabilitative) and elaborate on the formal and informal providers, using Nigerian examples.
Student Activity: In groups, students brainstorm and list community health services and their providers. Groups present their findings, leading to a comprehensive list on the board. Students ask questions for clarification.
Activity 3: Exploring Community Efforts in Health Promotion (15 minutes)
Teacher Activity: Present a scenario: "In a certain community in Nigeria, malaria is a major problem. What actions could the community members themselves take to reduce malaria cases, beyond just going to the clinic when sick?" Encourage brainstorming, then introduce and elaborate on various community efforts in health promotion (clean-up drives, advocacy groups, fundraising, etc.), linking them back to student suggestions and providing more Nigerian examples.
Student Activity: Students discuss the malaria scenario in small groups, suggesting community-level actions. They share their ideas, which are then connected to the formal categories of community efforts.
Conclusion (5 minutes)
Teacher Activity: Summarise the key points covered: definition of Community Health, types of services, providers, and community efforts. Emphasise the importance of active community participation in health.
Student Activity: Students ask any lingering questions and briefly recap one key learning point from the lesson.
Participation in Local Health Initiatives: Students can apply their knowledge by actively participating in existing community health programs within their local government areas. For instance, during a community sanitation day, students can understand why they are clearing drainage systems (preventing malaria, cholera), who coordinates it (Environmental Health Officers, community leaders), and how their collective effort impacts the entire community's health. This fosters civic responsibility and hands-on understanding.
Advocacy for Health Improvements: Equipped with an understanding of community health services and needs, students can identify health-related challenges in their immediate school environment or local community (e.g., inadequate waste disposal in the market, lack of clean water in a neighbouring village). They can then use their knowledge to advocate for solutions, perhaps by forming a school health club to raise awareness, writing letters to local authorities, or even initiating small-scale projects (e.g., a school-led clean-up drive or a handwashing campaign).
Career Awareness and Future Pathways: This topic provides a practical understanding of the diverse career opportunities within the health sector, particularly at the community level in Nigeria. Students learn about the roles of CHEWs, EHOs, nurses, and doctors working in primary health care settings. This can inspire them to consider professions that directly contribute to public health and community well-being, influencing their academic choices and future career aspirations.