6)Community Diagnosis 2011

8/13/2019 6)Community Diagnosis 2011

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Community Diagnosis


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POKOK BAHASAN

1. The concept of communitydiagnosis

2. Objectives of communitydiagnosis

3. Methods of community

health diagnosis


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THE CONCEPT OF COMMUNITYDIAGNOSIS


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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


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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.


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Community Core

1. Community core: history, socio-demographic

characteristics, vital statistics,

values/beliefs/religions core


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Eight Subsystems

2. Eight subsystems:

Physical environment

Education

Safety and transportation Politics and government

Health and social services

Communication

Economics

recreation


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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 andevaluating health action, by and for the

community.


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The Community Diagnosis Process

Community diagnosis generally refers to theidentification and quantification of health problems ina community as a whole in terms of mortality andmorbidity rates and ratios, and identification of their

correlates for the purpose of defining those at risk orthose in need of health care.

A means of examining aggregate and social statistics in

addition to the knowledge of the local situation, inorder to determine the health needs of thecommunity


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OBJECTIVES OF COMMUNITYDIAGNOSIS


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Goal

The mission of community diagnosis is to:

Analyze the health status of the community

Evaluate the health resources, services, andsystems of care within the community

Assess attitudes toward community healthservices and issues

Identify priorities, establish goals, and determinecourses of action to improve the health status of

the community Establish an epidemiologic baseline for measuring

improvement over time.


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Importance of Community Diagnosis

It helps to find the common problems or diseases, which aretroublesome to the people and are easily preventable in thecommunity.

Community diagnosis can be a pioneer step for betterment of ruralcommunity health.

It is a tool to disclose the hidden problems that are not visible tothe community people but are being affected by them.

It helps to access the group of underprivileged people who areunable to use the available facilities due to poverty, prevailingdiscriminations or other reasons.

It helps to find the real problems of the community people whichmight not have perceived by them as problems.

It helps to impart knowledge and attitudes to turnover peoplesproblems towards the light of solution.


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How is the community

diagnosed?


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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.


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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.


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Community is diagnosed using:

Health Indicators


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Indicators of healthare variables used for

the assessment of community health.


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

supposed to measure;

b. should be reliableand objective, i.e., the answers should be the same ifmeasured by different people in similar circumstances;

c. should be sensitive, i.e., they should be sensitive to changes in thesituation concerned,

d. should be specific, i.e., they should reflect changes only in the situationconcerned,

e. should be feasible, i.e., they should have the ability to obtain dataneeded, and;

f. should be relevant, i.e., they should contribute to the understandingof the phenomenon of interest.


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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


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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


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Morbidity Indicators

Morbidity rates- Data on morbidity are preferable,

although often difficult to obtain.

Incidence and prevalence

Notification rates

Attendance rates: out-patientclinics or health centers.

Admission and discharge rates

Hospital stay duration rates


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Disability Indicators

Disability rates No. of days of restricted activity

Bed disability days

Work/School loss days within a specifiedperiod.

Expectation of life free of disability


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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


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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


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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 1styear

of life.

i.e..immunization coverage. Proportion of pregnant women

who receive ANC.

Hospital-Beds occupancy rate.

Hospital-Beds turn-over ratio


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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.


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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


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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


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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


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Other Indicators

Other health

indicators

Indicators of quality of life.

Basic needs indicators.

Health for all indicators.


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METHODS OF COMMUNITYHEALTH DIAGNOSIS


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Methods of community health diagnosis

Community health situation

Problem identification

Priority setting Health problem analysis

Priority setting for problem solving

projects


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Thank You

6)Community Diagnosis 2011

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