HISTORY OF COMMUNITY HEALTH AND COMMUNITY HEALTH NURSING

UMA J DEAVER

Asst Professor

MM College of nursing

“The only thing new is the history you haven’t read”

President Harry S. Truman

A.INFLUENCES OF ANCIENT CULTURES ON PUBLIC HEALTH: 

PUBLIC HEALTH EGYPTIAN CIVILIZATION (ca 3000 BC) Built irrigation canal and granaries for storage of food Practice of prophylaxis by the medicine man and high priest. Emphasis on personal hygiene, cleanliness within & outside the body Sanitation measures ( removal of refuse and crude fumigation in times of epidemics)

Hebrews (c.a. 1400 BC)Founders of public hygiene Moses “father of Sanitation” Mosaic Health Code pertained to every aspect of individual, family & community hygiene, included:

a. Principles of personal hygiene (rest, sleep, hours of work, cleanliness)

 b. Environmental sanitation 1. Inspection of food 2. Methods of disposal of excreta 3. Detecting and reporting diseases 4. Practice of isolation, quarantine, fumigation

and disinfection 5. Detailed instructions on the correct way of

hand washing

Greeks (ca. 600 BC) Hippocrates – “Father

of Medicine” > exponent of the science of preventive medicine > introduced the philosophy of the interrelationship between physical and mental health ( “A healthy mind dwells in a healthy body”)

Romans (ca. 50 BC)  * Contributed to the field of

sanitation (building of Aqueducts, purification of water supply)

* Appointing of public health medical officers * Establishment of hospitals which emphasized both preventive and curative aspects of care

 B.DEVELOPMENT OF PUBLIC HEALTH NURSING AS A WORLD MOVEMENT

1. Early Christian Period (1 st century) * order of Deaconesses- organized visiting of the sick - called visiting nurses - forerunner of CHN - endeavored to practice the corporal works of mercy (feeding the hungry, caring for the sick, burying the dead) Phoebe a friend of St Paul and the first Deaconess and visiting nurse

Middle Ages (500-1500)  * Beguines of Flanders- worked as nursing sister in the hospital, but also gave care to the sick in their homes, staying with the dying and consoling the families of the bereaved.

Renaissance (1500-1700)  St Vincent De Paul- introduced modern

principles of visiting nurse and social services

* taught that indiscriminate giving was harmful

* emphasized the concept of helping people help themselves

* organized the daughters of charity primarily for the care of the sick at home

* maintained the family is the unit of the service

* recognized the importance of supervision of those who render service to the sick

Early 19 th century

Pastor Theodor Fliedner- German Lutheran pastor, went tour to raise funds when the main industry of his community failed, came back with money and ideas for a program social work.

Fredericka Munster Fliedner- a wife pastor organized women society for visiting nursing the sick poor in their homes

Couple recognized the need for preparing the training those who care for the sick , organized a hospital school of nursing in Germany ( Kaiserswerth Institute for the training of Deaconesses)

C.Development of Modern PHN 1 Characterized by clean-up measures

in the control of communicable diseases Removal of refuse Clean-up campaign

of prison and asylums Improvement of working conditions of

women and children William Rathbone father of modern

district nursing with the encouragement of Florence Nightingale, organized a training school for nurses in the Liverpool Royal Infirmary which provided training for hospital nurses, private duty nurses and district nurse.

2.Period of Scientific Control of Communicable Diseases(1890-1910) -Application of bacteriology and immunology

3 Period of health education (1910-present) - Characterized by education for prevention of diseases with active cooperation of the individual in the health action

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COMMUNITY HEALTH NURSING IN INDIA

Pre – Independence Era:  Pre – Independence Era Early History Indus

Valley Civilization(before 3,000 B.C) – planned cities with drainage, houses and

public baths built of backed bricks (Environmental Sanitation)

1400 B.C – Invasion of Aryans. Ayurveda and Siddha medicine came into existence. Manu Samhita – prescribed rules and regulations for personal health, dietetics, hygienic rituals, unity of the physical, mental and spiritual aspects of life. Sarve Jana Sukhino Bhavatu – may all men be free from diseases and may all be healthy

Post vedic period (600 B.C – 600 A.D) – medical education in University of Taxila

and Nalanda leading to the titles of Pranacharya and Pranavishara . Hospital system was introduced for men, women and animals by Rahula Sankirtyana .

650 – 1850 A.D – Muslim rulers came to India. Arabic system of medicine ( Unani ) introduced. Due to political changes the medical education and medical services became static and ancient universities and hospitals disappeared

British India 1757 – British established their rule.

Civil and military services established. 1825 – Quarantine Act was promulgated.

1859 – Royal commission was appointed. Pointed out the need for the protection of water supplies, construction of drains and prevention of epidemics . Established “Commission of Public Health”

1864 – sanitary commission was appointed in Madras, Bombay & Bengal.

  1869 – Public Health Commissioner &

Statistical Officer appointed. 1873 – Birth and Death Registration Act was

promulgated. 1880 – Vaccination Act was passed. 1881 – Indian Factories Act was passed. First

Indian census was taken. 1885 – Local Self Government Act was

passed. Local government came into existence

1888 – local bodies was directed to look for sanitation but no local public staff appointed.

.

  1896 – severe epidemic of plague occurred in

India. Plague commission was appointed. 1897- Epidemic Disease Act 1904 – plague commission report submitted.

It recommended the reorganization and expansion of public health department & establishment of laboratory facilities for production of vaccines and sera.

1909 – Central Malaria Bureau at Kausali 1911 – Indian Research Fund Association

(now called as ICMR) to promote research. 1912 – Govt. India decided to help the local

bodies. Appointed Deputy Sanitary Commissioners & Health Officers.

1918 – Lady Reading Health School, Delhi & Nutrition Research Laboratory, Coonoor was established.

1919 – First step in decentralization of health administration. Montague – Chelmsford Constitutional Reforms – transfer of public health, sanitation and vital statistics under the control of elected minister.

1920 – 21 – Municipality & Local Board Acts passed containing legal provisions for advancement of public health

1930 – All India Institute of Hygiene and Public Health, Calcutta established in aid with Rockfeller Foundation. The Child Marriage Restraint Act( Sarda Act) came into effect. (Girl – 14 yrs and Boys – 18 yrs)

1931 – Maternity and Child Welfare Bureau established under IRC.

1935 – Government of India Act (1919) revitalized. Health activities in the country grouped as federal, concurrent, provincial.

1937 – Central Advisory Board of Health was set up with Public Health Commissioner as Secretary and representatives from provinces and Indian states as members.

  1939 – Madras Public Health Act was

passed. First Rural Health training Centre was established at Singur with the aid from Rockefeller Foundation.

Tuberculosis Association of India was established.

1940 – Drugs Act was passed. 1943 – The Health Survey and

Development Committee ( Bhore committee) was appointed – to survey the existing position with regard to health conditions and health organization.

1946 – Bhore committee submitted its report. It reviewed on the following and recommended short and long term programme to attain reasonable health. Public health Medical relief Professional education. Medical research. International health.

Post independence era: 

1947 – Ministries of health established in state & center. Post of Director General of Health Services ( principal advisor to the union government on both medical & public health matters) was formed by combining the posts of Public Health Commissioner& director general of Indian Medical Service.

1948 – India joined WHO as a member state. ESI Act passed in 1948. the report of the Environmental Hygiene Committee was published.

1949 – constituent Assembly adopted the constitution of India(Article 246 covers all the health subjects). Post of registrar general of India created in the ministry of home affairs. SEARO office established in New Delhi. The Indian Research Fund Association was reconstituted as ICMR.

1950 – planning commission was set up. 1951 – First five year plan begin. BCG vaccination

programme launched. 1952 – community development block launched.

Central council of health was constituted. Primary health center was set up.

1953 – NMCP commenced. National Extension programme was started for rural development. Nation wide family programme was started. A committee was appointed to draft a Model Public Health Act.

1954 – Contributory Health Service Scheme was started at Delhi. The Central Social Welfare Board was set up. National water supply & sanitation programme was inaugurated. NLCP was started. VDRL antigen was set up in Calcutta. The prevention of Food Adulteration Act was passed.

1955 – NFCP was commenced. The central leprosy teaching and research institute established in chengelpet. A filaria training centre was established at Ernakulum. The Hindu marriage act passed. National TB sample survey commenced.

1956 – second five year plan launched. The model public health act published. The central health education bureau was established. Director, family planning appointed. Demographic training & research centre established in Bombay. The TB chemotherapy center established in Madras. The immoral traffic act was passed. Trachoma control pilot project was established. RCA project was established with aid from ford foundation.

1957 – influenza pandmeic swept the country. The demographic research centers was established in Calcutta, Delhi & Trivandrum.

1958 – NMCP converted into NMEP. Leprosy Advisory committee of the Govt. of India was constituted. The National Development Council endorsed the recommendations made by Balwantrai Mehta Committee on Panchayth Raj. The national Tb survey was completed.

1959 – Mudhaliar committee was appointed. Central expert committee was appointed under ICMR to study the problems of cholera and chicken pox in India. Rajasthan was first state to introduce panchayat raj. National TB institute was established at Bangalore. The national research laboratory at coonoor was shifted to Hyderabad.

1960 – School Health Committee was constituted. A National Nutrition Advisory Committee was constituted. Pilot projects for eradication of small pox was initiated. Vital statistics was transferred to the Registrar General of India.

1961 – third five year plan launched. The report of Mudhaliar Committee was published. The Central Bureau of Health Intelligence was established.

1962 – Central Family Planning Institute was established in Delhi. National Small Pox Eradication Programme was launched. The School Health Programme was initiated. National Goiter Control Programme was launched. The District Tuberculosis Programme was formulated.

1963 – Applied Nutrition Programme was launched. Defense Institute of Physiology and Allied Sciences was set up.

National Institute of Communicable Diseases was inaugurated.

National Trachoma Control Programme was launched. Contributory Health Service Scheme was changed into CGHS. Extended family planning programme was launched.

Chadha Committee established a norm of one basic health worker for every 1000 population. A drinkling water board was set up.

1964 – National Institute of Health Administration and Education was opened in collaboration with Ford foundation. Committee was set up under the chairmanship of Shanthilal Shah to study the question for legal abortion.

1965 –lippes loop was recommended as safe. Reinforced extended family planning was launched. BCG vaccination on a house to house basis introduced.

1966 – Mukherjee committee was set up. Minister of health was also appointed for minister of family planning. A separate department for family planning was started. The population council started International postpartum family planning programme.

1967 – Modhok committee was constituted. A small family norm committee was set up. The central council of health recommended the levy of a health cases on patient attending hospital.

1968 – small family committee’s report was submitted.A bill of registration of birth and death was passed. The govt. of India appointed medical education committee.

1969 – fourth five year plan launched. The name of the Nutrition Research Laboratory was changed into National Institute of Nutrition. Comprehensive legislation for control of river water pollution was drafted. The central births and deaths registration act was promulgated. The report of the medical education committee was submitted.

  1970 – The Drugs Order was promulgated. All

India Post Partum Family Planning Programme was started. The population council of India was formed. Chittaranjan mobile hospitals was installed. The registration of births and deaths Act came into force. The name of the Demographic Training and Research Center, Bombay was changed into International Institute for Population studies.

1971 – The family pension scheme for industrial workers came into force. MTP bill passed in parliament. An expert committee was appointed to draft legislation on air pollution.

  1972 – MTP act came into force. National service

bill passed. The National Nutrition Monitoring Bureau was set up under the ICMR.

1973 – the national programme for minimum needs was incorporated with the fifth five year plan. The government envisaged a scheme of setting 30 bedded rural hospitals one for 4 PHC. Kartar singh committee submitted its report.

1974 – fifth five year plan launched. Parliament enacted the Water Act.

1975 – India became small pox free. Govt. of India accepted NMEP. ESI Act amended. Cigarettes Regulation Act was passed in parliament. Shrivastav committee submitted its report.

1976 – Indian Factories Act amended. The prevention of food adulteration act came into force. The equal remuneration act was promulgated. New population policy announced. Central council of health proposed 3 – tier plan for medical care. National programme for prevention of blindness was formulated.

1977 – National Institute of Health and Family Planning formed. Rural health scheme was launched. Revised modified plan of malaria eradication put into operation.

1978 – child marriage restraint bill approved in parliament. EPI launched.

1979 – offices of family welfare and NMEP were merged and named as Regional Office for health and family welfare.

1980 – sixth five year plan launched. Small pox was officially declared from entire world.

1981 – census was taken. The Air Act was enacted. 1982 – new 20 point programme was announced. National health policy announced.

1983 – IMPACT India launched (National Plan of Action Against Avoidable Disablement). NLCP called as NLEP. Guinea worm eradication programme launched.

1984 – Bhopal gas tragedy occurred. Workmen’s compensation act came into force. Juvenile Justice Act came into force.

1985 – seventh five year plan launched. UIP launched. A separate department of women and child development was set up.

1986 – The Environment Act promulgated. Mental health bill was voted in parliament.

1987 – new 20 point programme was launched. ISI was renamed as Bureau of Indian Standards. Safe motherhood campaign was launched. National diabetes control programme and national AIDS control programme initiated.

1989 – blood safety programme was launched. 1990 – control of ARI programme initiated. 1991 – decadal census was conducted.

1992 – eighth five year plan was launched. CSSD was launched. The Infant Milk Substitute, Feeding Bottles and Infant Foods Act came into force.

1993 – RNTCP with DOTS introduced. National Nutrition policy formulated.

1994 – Return of plague. Panchayath Raj Act came into force.

1995 –ICDS renamed as IMCD. The Legislation on Transplantation of Human Organs was enacted. Expert Committee on Malaria submitted its report and recommended Malaria Action Plan.

1996 – PPI launched. Family planning programme made target free. Yaws eradication programme came into force.

1997 – RCH launched. Ninth five year plan launched.

1998 – 99 – NFHS II undertaken. NMEP renamed as National Anti – Malaria Programme. Phase – II of National Aids Control Programme became effective. National Policy for Older Persons announced.

2000 – govt. of India announced national population policy. Declared guinea worm free country. Signatory of UN millennium declaration. National commission on population constitute.

2001 – fist census of the century. National policy for empowerment of women launched.

2002 – National Health Policy announced. Govt. announced National AIDS Prevention and Control Policy. Tenth five year plan launched. Emergence of SARS.

2003 – parliament approves the Cigarette and Tobacco Products Act. NVBDCP approved.

2004 – Vandematarum scheme launched. Revised programme of National support to primary education launched. Low osmolality ORS introduced. National guidelines on infant and young child feeding formulated.

2005 – RCH – II launched. JSY launched. NRHM launched. IPHS for community centers formulated. National plan of Action for children formulated. India achieved leprosy elimination target.

2006 – WHO releases pediatric growth chart. Ban on child labor. RNTCP covers whole country. NFHS – II conducted. IMNCI launched.

2007 – 11 th five year plan launched. NACP –III launched. IPHS standards for PHC and sub center formulated. Maintenance and welfare of parents and senior citizens bill passed.

2008 – Non communicable diseases programme was launched.

2009 – H1N1 outbreak. New ICDS mother and child protection card came into force. 2010 – ICMR announces nutrients requirement for RDA for Indians.

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