Community Diagnosis

POKOK BAHASAN
1. 2. 3. The concept of community diagnosis Objectives of community diagnosis Methods of community health diagnosis

THE CONCEPT OF COMMUNITY DIAGNOSIS

Definition of a Community
A cluster of people with at least one common characteristic (geographic location, occupation, ethnicity, housing condition) A group of people with a common characteristic or interest living together within a larger society

Community
A community is a whole entity that functions because of the interdependence of its parts or subsystems. Eight subsystems plus the community core are identified.

Community Core
1. Community core: history, socio-demographic characteristics, vital statistics, values/beliefs/religions core

Eight Subsystems
2. Eight subsystems:
Physical environment Education Safety and transportation Politics and government Health and social services Communication Economics recreation

Definition of Community Diagnosis

Community diagnosis is a comprehensive assessment of health status of the community in relation to its social, physical and biological environment. The purpose of community diagnosis is to define existing problems, determine available resources and set priorities for planning, implementing and evaluating health action, by and for the community.

The Community Diagnosis Process

Community diagnosis generally refers to the identification and quantification of health problems in a community as a whole in terms of mortality and morbidity rates and ratios, and identification of their correlates for the purpose of defining those at risk or those in need of health care. A means of examining aggregate and social statistics in addition to the knowledge of the local situation, in order to determine the health needs of the community

OBJECTIVES OF COMMUNITY DIAGNOSIS

Goal
The mission of community diagnosis is to: Analyze the health status of the community Evaluate the health resources, services, and systems of care within the community Assess attitudes toward community health services and issues Identify priorities, establish goals, and determine courses of action to improve the health status of the community Establish an epidemiologic baseline for measuring improvement over time.

Importance of Community Diagnosis

It helps to find the common problems or diseases, which are troublesome to the people and are easily preventable in the community. Community diagnosis can be a pioneer step for betterment of rural community health. It is a tool to disclose the hidden problems that are not visible to the community people but are being affected by them. It helps to access the group of underprivileged people who are unable to use the available facilities due to poverty, prevailing discriminations or other reasons. It helps to find the real problems of the community people which might not have perceived by them as problems. It helps to impart knowledge and attitudes to turnover peoples problems towards the light of solution.

 How is the community diagnosed?

Community Analysis
Community analysis is the process of examining data to define needs strengths, barriers, opportunities, readiness, and resources. The product of analysis is the community profile.

Community Analysis (cont.)

To analyze assessment data is helpful to categorize the data. This may be done as following:
Demographic Environmental Socioeconomic Health resources and services Health policies Study of target groups.

 Community is diagnosed using:

Health Indicators

Indicators of health are variables used for

the assessment of community health.

Characteristics of Indicators:
a. should be valid, i.e., they should actually measure what they are supposed to measure;

b. should be reliable and objective, i.e., the answers should be the same if measured by different people in similar circumstances; c. should be sensitive, i.e., they should be sensitive to changes in the situation concerned, d. should be specific, i.e., they should reflect changes only in the situation concerned,
e. should be feasible, i.e., they should have the ability to obtain data needed, and; f. should be relevant, i.e., they should contribute to the of the phenomenon of interest. understanding

Classification of health Indicators

Mortality indicators Morbidity indicators Disability rates Nutritional status indicators Health care delivery indicators Utilization rates Indicators of social and mental health Environmental indicators Socio-economic indicators Health policy indicators Indicators of quality of life Other indicators

Mortality Indicators

Mortality Rates
The traditional measures of health status. Widely used because of their ready availability.( death certificate is a legal requirement in many countries)

Crude death rates Specific death rates: age/disease Expectation of life Infant mortality rate Maternal mortality rate Proportionate mortality ratio Case Fatality rate

Morbidity Indicators

Morbidity rates

- Data on morbidity are preferable, although often difficult to obtain.

Incidence and prevalence Notification rates Attendance rates: out-patient clinics or health centers. Admission and discharge rates Hospital stay duration rates

Disability Indicators

Disability rates

No. of days of restricted activity Bed disability days Work/School loss days within a specified period. Expectation of life free of disability

Nutritional Indicators

Nutritional Status Indicators

- It is an indicator of positive health

Anthropometrics measurements Height of children at school entry Prevalence of low birth weight Clinical surveys: Anaemia, Hypothyroidism, Nightblindness

Health Care Delivery Indicators

Health Care Delivery Indicators

- Reflect the Equity / Provision of health care

Doctor / Population ratio Doctor / Nurse ratio Population / Bed ratio Population / per health center

Utilization Indicators

Health care utilization Rates

- Extent of use of health services

- Proportion of people in need of service who actually receive it in a given period

Proportion of infants who are fully immunized in the 1st year of life. i.e..immunization coverage. Proportion of pregnant women who receive ANC. Hospital-Beds occupancy rate. Hospital-Beds turn-over ratio

Social/Mental Health Indicators

Indicators of Social and Mental Health

- Valid positive indicators does not often exist - Indirect measures are commonly used

Suicide & Homicide rates Road traffic accidents Alcohol and drug abuse.

Environmental Indicators

Environmental health Indicators

- Reflect the quality of environment

Measures of Pollution The proportion of people having access to safe water and sanitation facilities Vectors density

Socio-economic Indicators

Socio-economic Indicators
- Is not a direct measure of health status. - For interpretation of health care indicators.

Rate of population increase Per capita GNP Level of unemployment Literacy rates - females Family size Housing condition e.g. No. of persons per room

Health Policy Indicators

Health Policy Indicators

- Allocation of adequate resources.

Proportion of GNP spent on health services. Proportion of GNP spent on health related activities. Proportion of total health resources devoted to primary health care

Other Indicators

Other health indicators

Indicators of quality of life. Basic needs indicators. Health for all indicators.

METHODS OF COMMUNITY HEALTH DIAGNOSIS

Methods of community health diagnosis

Community health situation Problem identification Priority setting Health problem analysis Priority setting for problem solving projects

Thank You