Vlctlmlz'atton Blaming the victim for are. 1s Impoverished people outside lndf Vldual control leading to limited access to services Disadvanta ged status Being 11'1 the rnlnorlt'( Hn,lts Indigenous groups; women the partrcipatlon of this people in health planning Source: Sta11hopt! and l!ancastu, 1992 The nurse develops and implements the plan of care in the conte. x-t of the above causes or sources of vulnerabil ities of her caseloaa. In addressing the specific need for health care treatment, the nurse focuses on care coordinat ion with other members of the health team depending on the actual or potential health and medical problem s of the caseload. [f several members of the health team will be involved, care coordination calls for a mechani sm for systematic follow-up or monitoring of the progress of c Uents under the caseload. Referral an<l follow-up to va1;ous community resources will be an integral part of cure coordination and allow the clients to access health services. In this regard, the nurse will be responsible for identifying resources that are available for the clients. Collaboration with other sectors or disciplin es in ca. re provision addresses the issues of vulnerability. As health advocates, nurses are ex-peeled to advance the interest of her clients for better health conditions by lobbying for healthy policies and delivery of quality health service. Although much· of the work to be done by the nurse as n caseload manager involves tl1e external environmen t, it is equally important to put emphasis on developing the competency of the clients in self-care and to facilitate behavior change. This can be carried out as group intervention wbe:re clients under the nurses caseload come together to learn specific skills related to their health care. The nurse can take this opportun ity for clients to cultivate and foster a supportive system among them. CONCLUSION Working with aggregates of people for sustaine d participation in health development work requires empowerment processes and competencies. The nursing interventions described in this chapter are a. imed at developi ng these competenc ies....,,;th the communit-y. The Primary Health Care Approach serves as the context of these interventions while community competence is seen as the ultimate goal of all these interventions. Health promotion as an approach is important mainly because it encompass es health education. Health education mainly focuses on individual behavior al change but health promotion believes that behavioral changes can be speeded \tp with environmental changei;; and reorientation of health care system. Jndividual behavioral changes coupled ·w:ith community organizing and mobilization facilitates Ll1c empowerment process. Bul nurses need lo ensure that the initial efforts will be sustainable. Sustainab ility is guaranteed through capability-buildi ng activities and proper supervisio n of l1calth workers who are ex7Jecte<l to monitor the different health activities in the com. munjty. From time to time, the commu1tity \vill need to lobby for support from other people in their effort to address their health concerns. Issues of vulnerabi lity limit certain groups of people to access health services. For this reason, the nurse must teach them how the process of advocacy, partnership and collaborat ion work to improve their health status. 243 