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