Moderator- Dr. Ramesh pawar Presented by- Dr. Raviraj
kamble
Community diagnosis Moderator- Dr. Ramesh pawar Presented by- Dr.
Raviraj kamble Framework- Introduction Why do it? Importance of
community diagnosis
Types of Health Information Needed for PlanningHealth Care
Framework for Community Diagnosis Steps in Conduct of Community
Diagnosis Limitations of Community Diagnosis Introduction-
Community-
A group of people with a common characteristic or interest living
together within alarger society comprises a community. Communities
can be defined by location, race, ethnicity, age, work site,
interest inparticular problems or situation in life, health
concern, or common bonds. (Glasgow et al. 1997; VanEenwyk 1997; Han
et al.1999) Introduction- Community diagnosis-
a quantitative and qualitative description of the health of
citizens and thefactors which influence their health. It identifies
problems, proposes areas forimprovement and stimulates action. In
some contexts- methods to develop a consensus about the
prioritising health problems anddeveloping strategies Similar
terms- social diagnosis, epidemiological diagnosis, behavioural
diagnosis, educationaland administrative diagnosis and community
analysis/community diagnosis. Introduction- Community Diagnosis is
a process-
Describes the state of health of local people Enables the
identification of the major risk factors and causes of ill health
Enables the identification of the actions needed to address these.
Introduction- Community Analysis: Profiling-
Community analysis is the process of examining data to define needs
strengths, barriers,opportunities, readiness, and resources. The
product of analysis is the communityprofile. Profiling- The
collection of relevant information that will inform about the state
of health andhealth needs of the population and Analysis of this
information to identify the major health issues. Objectives- To
estimate the magnitude of the health problems and the determinants
To analyse trends and changing paradigms of these problems and
determinants To determine whether the needs of the target
population are being met. Community Diagnosis process-
Where is the community now? Where does it want to be? How will it
get there? Why do it? Ensure that scarce resources are allocate
with max health benefit Plan and deliver the most effective care to
those in greatest need Apply the principles of equity and social
justice in practice Work collaboratively with the community and
plan interventions Importance of Community Diagnosis
It helps to find the common problems or diseases, which may be
easily preventable inthe community. It is a tool to disclose the
hidden problems that are not visible but affect community To access
the group of underprivileged people It helps to find the real
problems of the community people which might not haveperceived by
them as problems. It helps to impart knowledge and attitudes to
turnover peoples problems towards thelight of solution. Types of
Health Information Needed for Planning Health Care
Health situations and needs Availability of resources to deal with
those needs The accessibility and utilization of existing health
resources Impact on health outcomes Consequences of health care
financing on politics, economy and society as well as onthe welfare
of the entire population Framework for Community Diagnosis
Defining the community- Define the target community location, race,
ethnicity, age, work site, interest in particular problems or
situation in life, health concern, or common bonds. Health
indicators- Community Diagnosis is done using a tool called "Health
Indicators" Pre-requisite for the development of an effective
information system Valid, reliable, sensitive, specific, feasible
and relevant 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 Framework for Community
Diagnosis
Sources of information and the methods that can be used for
communitydiagnosis- Routine reporting from health facilities
Surveillance active and passive and sentinel surveillance Screening
of the community Surveys Vital registration of events Trend
analysis- To assess the changes in the health situation of a
community , burden of illness,prevalence of risk factors and many
other factors. Framework for Community Diagnosis
Characteristics of community diagnosis- Ability to address
important community problems which are amenable to
practicalcontrol. Ability to identify most of the targeted health
events. Adequacy in reflecting changes in distribution of events
over time, place and person. Having a clearly defined population,
data collection, data flow, analysis,interpretation and feedback.
Orientation towards appropriate action. Being participatory,
uncomplicated, sensitive, timely and inexpensive. Steps in Conduct
of Community Diagnosis
Step 1 - Establishing a Community Diagnosis Team- Motivated
individuals Advocates for a broad range of community members and
Represent appropriately the concerns of various populations Step 2
- Analyzing the existing Health Data- Compare the communitys health
statistics with those of the district, state or nationalfigures
Step 3 - Collecting Community Data- Community Health and Opinion
Survey Questionnaire, conducting Focus GroupDiscussions with
community members and obtaining data from the Health Resources
Inventory Steps in Conduct of Community Diagnosis
Step 3 - Collecting Community Data- immunization rates 1.
Characteristics of the population health behaviours, e.g. smoking,
health service use. Geography Numbers 3. Local factors affecting
health (strengthsand weaknesses) Age distribution Gender
distribution Work and employment Ethnicity and religion Poverty and
income Population trends Environment Language and literacy Social
cohesion/social support Destabilising factors 2. Health status of
the population Resources, formal and informal Measures of health,
for example: mortality 4. The health concerns and priorities of
thelocal community morbidity communicable diseases low birth
weights 5. Local and national priorities breast feeding rates
uptake of preventive services Steps in Conduct of Community
Diagnosis
Step 4 - Combining existing Health Statistics With Community Data-
Compare your population with a larger group Compare current
information with that collected in previous years to identify
trendsover time Identify significant gaps in the information
Compare and contrast different types of information e.g.
statistics, client andprofessional views, surveys and
questionnaires; and Look for positive features as well as problems;
even the most disadvantagedcommunities have strengths that can form
the building blocks for change. Steps in Conduct of Community
Diagnosis
Step 5 - Choosing Health Priorities- How many people are affected?
What is this information telling you about equity? What is the
impact on peoples lives? Are there appropriate and effective
interventions? Are the services adequate? Does the health need
identified coincide with known priorities and strategies? Is the
expertise and training available? Steps in Conduct of Community
Diagnosis
Step 6 - Developing the Community Health Action Plan- Being
creative Involving the community Collaboration Health promotion-
the process of enabling people to increase control over and to
improve their health (WHO1985). Health promotion covers- creating
healthy public policies building supportive environments
strengthening community action developing personal skills
reorganizing health services addressing inequalities. Prevention
Steps in Conduct of Community Diagnosis
Step 7 - Measuring Environmental and Policy Changes- Monitor and
record the changes that are taking place and evaluate successes and
failures Where we are now (baseline measures) Where we are going
(aim and objectives) How to get there (action plan) How we will
know we have arrived (evaluation/outcome measures) Step 8 -
Creating the Community Diagnosis Document- Share the assessment
results and plans with the entire community and other
interestedstakeholders Limitations of Community Diagnosis
The effects of health problems of individuals on their relatives
cannot be assessed sosimply The community will need to be consulted
regarding their perceptions of values to assessthe correctness of
community diagnosis THANK-YOU