community diagnosis. definition of a “community” a cluster of people with at least one common...
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COMMUNITY DIAGNOSIS
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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 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,
Identification of their correlates for the purpose of defining those at risk or those in need of health care.
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Goal
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.
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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 Study of target groups.
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Community is diagnosed using:
Health Indicators
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Indicators of health are 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 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 theunderstanding of the phenomenon of interest.
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Classification of health Indicators Demographic and
Fertility 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
Indicators of quality of life
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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-patient
clinics 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 specified
period. 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 1st year 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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Thank You