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Community development specialists in nursing for developing countries.

Nurses in traditional roles cannot always meet the challenge of providing health care in developing communities even though community health care is similar to that of care in developed countries (Mahler, 1984). Kupina (1995) identified components of community health including “physical aspects, safety, social norms, interpersonal processes, economic factors, and cohesion of the community” (p. 188). However, developed communities emphasize individual access to health care especially for vulnerable groups (Keane & Richmond, 1993). In developing countries, such as Pakistan, people are struggling to meet basic safety and security needs amid poor sanitary conditions, malnutrition, overcrowding, and scarce primary health care (Wagner & Menke, 1992). Massive migration of populations from rural to urban areas, overwhelming poverty and crime that threatens the very existence of some neighborhoods, high incidence of tuberculosis, drug dependency, AIDS, homelessness, and high infant and maternal mortality rates are major problems (Mason et al., 1992). In cities such as Karachi, Pakistan, rural to urban migration has resulted in the establishment of numerous squatter settlements called “katchi abadis” that lack sanitation, safe drinking water, and public health services. Even if such services were provided, high illiteracy rates and a strong sense of powerlessness, especially among women, adds further challenges for health providers.