HISTORICAL DEVELOPMENT

OF PUBLIC HEALTH NURSING

T. POULEENA
PRINCIPAL
SIMS COLLEGE OF
URSING
EVOLUTION OF PUBLIC HEALTH
GLOBALLY:
 The history of public health is derived
from many historical ideas, trial and error,
the development of basic sciences,
technology, and epidemiology
 Early explanations for the occurrence of

disease focused on superstition, myths,

and religion. Primitive peoples believed in
natural spirits that were sometimes
mischievous or vengeful
HISTORICAL DEVELOPMENT OF
COMMUNITY HEALTH NURSING
The modern concept of community
health and welfare is one which has
taken many centuries to evolve. All
ancient civilization particularly Egypt,
India and China developed their own
specific team of medicine.
Egypt appeared to have been the first
and the best in the field that had a
fully developed medical system by
3000BC.
 China appeared around 450 BC.
 Indian system of medicine around

200BC
 “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.
 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.
 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

 DEFINITION OF COMMUNITY HEALTH
NURSING BY ANAIN 1980
 “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, coordination and continuity of care
are utilized in a holistic approach to the management of
the health care of individual, family, group and
community.”
HISTORY AND DEVELOPMENT OF
COMMUNITY HEALTH NURSING IN INDIA
 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.
 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.
 Inancient 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 authors 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.
II. POST VEDIC PERIOD – (600 BC- 600 AD)
 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 science of 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.
 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.
 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.
III. EMPIRICAL HEALTH ERA (1800- 1850)
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.
IV. BASIC SCIENCE ERA 91850 -1900)
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.
V.CLINICAL SCIENCE ERA (1950 – 1975)
 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.
VI. PUBLIC HEALTH SCIENCE ERA (1950 -1975)
 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.

 VII.POLITICAL HEALTH SCIENCE ERA
(1975 – 2000AD)CONT…
 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 people-centered approach has been

emphasized in this era.

 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.
NURSING IN INDIA
 Definitionof 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.
DEVELOPMET OF CHN
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.
HERE ARE IMPORTANT CHRONOLOGICAL
DEVELOPMENT EVENTS ABOUT COMMUITY
HEALTH NURSING IN THE INNDIA.
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.
S.NO. YEAR EVENT

9 1939 Indian Tuberculosis Association was starte

10 1943 Health Survey and Development Committee was appointed by

GOI under the Chairmanship of Sir Joseph Bhore.

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
SR. YEA EVENT
NO. R
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
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.
SR. YEAR EVENT
NO.
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

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.
SR. YEAR EVENT
NO.
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
27 1996 RCH in place of CSSM with slight
modification,launched in 1997
SR. YEAR EVENT
NO.
2002
29 GOI announces Nationational AIDS
Prevention controlpolicy
30 2003 Launching of ART centres at
MetroCentres,e.g. Sasoon
31 2004 NTCP Inclucated DOTS

32 2007 Revision of National Population

33 2008 , Swine Flu awareness Programme and control

revised Programme
in
2009
THANK YOU
BIBLIOGRAPHY
 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.