families "in choosing possibilities in changing tl1c health process which is accomp lished by intersubjective participation "'ith people" (George, 2002:439 ). The art of nursing is demonstrated by nlll'ses who c,m maintain the delicate balance between c. loi. ng things for their clients and doing things with them, thus co-cre;iting a better or more me. 111ingful reality. The prnctice of community health nursing, therefore, entails active interaclion and partnership between the nurse. ind the client. Sud, parlne,-:. hip recognizes the autonomy of both parties and the potential of e;ich one in unrid1ing their relationship. Nursing is also a scie11ce, which means that community health nurses should use practice-based and evidence-based methods and tools. 'I11ey :. ilso need to engage in generating evidence to support their practice throu Rh research. Quantilative research is needed lo descrihe or quantify vari<1blcs of inter·est lo comm uni Ly health nurses or to eval 11 ate I he cff eel iveness of e:dsting; pr-icli. ces, proccd u res or intc rveu Lions. Qua Ii tut ive research can be done to understand specific human response phenomena such as client-partners' livetl experiences on poverty,1nd adaptation. The roles of CHNs are grouped by Clark (:2008; 14-22) into clie11t-01·ie11ted roles (caregiver, educator, counselor, refern1l i·esource, role model and case manager); deliverv-m·ien led Mies (coordinatm·, collaborator and li,\ison); and, pvp11/a1ion­ oriented roles (case finder, leader, change agent, community mobilizer. coc1lition builder, policy advocate, social marketer and researcher). ln rcccnl years, lhe case manager role in tbc community setting is gaining importance as an innovative strategy to provide high quality care in a· financially restricted environment. As lhe case management concepts of client independence. control, advocacy and coordination ctre already reflected in current nursing models and philosophies, nurses are considered the most appropriate professionals to fill the role of cnsc managers(Kno Umueller, 1989; Bergen, 1992). As a CHN practice optiott in many countries, commun ity-based case managem ent is discussed at length towards the end of this chapter. FRAMEWORK FOR COMMUNITY HEALTH NURSING The practice of nursing, particularly in CI-IN differs from one geographic area (country or region) to another. It is influenced by a number of factors primarily the scope of practice as "defined by the nursing Jaw, policies and standards of the Department of Health and organizations where CHNs WO("k and the health needs and problems of the people. The macro framework for CHN practice has four components: (1) the health care delivery system, with its CHN subsystem; (2) the clients (individual, family, popu Jation group and com Jnuuity); (3) health which is the goal of the health care deliveiy system (HCDS); and, (4) the economic, sociocultural, political and environmenta l factors that affect the 1-JCDS, tl1e practice of community healtl, nursing and the people's health. These constitute the conte. xt of commu. njty health nursing practice in tbe Philippines This chapter elaborates on the different components of the framework. CLIENTS OF COMMUNITY HEALTH NURSES There a. re different levels of clientele in community health nursing-the individual, family, population group and community, with the latter os the primary client. Individual 