The document discusses community diagnosis, defining it as a comprehensive assessment of a community's health status in relation to its social, physical, and biological environment. It outlines the objectives, types, and steps in conducting a community diagnosis. The types include familiarization, problem-oriented, community subsystem, and comprehensive assessments. Steps involve initiation, data collection/analysis, diagnosis, and dissemination. Key aspects of data collection are health indicators covering mortality, morbidity, disabilities, nutrition, healthcare access, and socioeconomic factors. The goal of community diagnosis is to understand community health needs and priorities to improve health.
2. Definitions
Objectives of community diagnosis
Types of community diagnosis
Steps in community diagnosis
Importance of community diagnosis
Sample of community diagnosis tool
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3. A community is a cluster of people
with at least one common
characteristic (geographic location,
occupation, ethnicity, housing
condition etc)
A community is a group of people
with a common characteristic or
interest living together within a
larger society
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4. 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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5. Community needs assessment is the
process of determining the real or
perceived needs of a defined
community.
The type of assessment depends on
variables such as the needs that
exist, the goals to be achieved, and
the resources available for carrying
out the study.
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6. 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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7. Community diagnosis process is
“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”
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8. According to WHO definition,
Community diagnosis is “a
quantitative and qualitative
description of the health of citizens
and the factors which influence their
health. It identifies problems,
proposes areas for improvement and
stimulates action”.
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9. 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.
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10. Community assessment or diagnosis
is the process by which systematically
information obtained to understand
the community, in which one plans to
work or serve.
The term community assessment also
known as community profile or
community study (situational
analysis).
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11. A community diagnosis is a
comprehensive assessment of
health status of the community in
relation to its social, physical and
biological environment
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12. ◦ To analyze the health status of the
community
◦ To evaluate the health resources,
services, and systems of care within
the community
◦ To assess attitudes toward community
health services and issues
◦ To identify priorities, establish goals,
and determine courses of action to
improve the health status of the
community
◦ To establish an epidemiologic baseline
for measuring improvement over time.
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13. To define the existing problems, determine
available resources and set priorities for
planning, implementing and evaluating
health action, by and for the community.
To help in the identification and
quantification of health problems in a
community.
To act as 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 community.
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14. 1. Familiarization or windshield
Familiarization assessment involves
studying data already available on a
community, and gathering a certain
amount of firsthand data, to gain a
working knowledge of the community.
Such an approach, sometimes called
“windshield survey” is used by new
staff members in community health
agencies.
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15. 2. Problem-oriented assessment
A second type of community
assessment, problem-oriented
assessment, begins with a single
problem and assesses the
community in terms of that
problem.
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16. The problem-oriented assessment is
commonly used when familiarization
is not sufficient and a comprehensive
assessment is too expensive.
This type of assessment is
responsive to a particular need. The
data collected will be useful in any
kind of planning for a community
response to the problem.
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17. 3. Community subsystem assessment
In Community subsystem assessment,
the community health researcher
focuses on a single dimension of
community life. e.g. religion,
perception of health etc.
For example, the researcher might
decide to survey the religious
organizations to discover their roles in
the community.
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18. Community subsystem
assessment can be a useful way
for a team to conduct a more
thorough community assessment.
If five members of a health
agency divide up the ten systems
in the community and each
person does an assessment of
two systems, they could then
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19. 4.Comprehensive assessment
Comprehensive assessment seeks to
discover all relevant community health
information. A survey compiles all the
demographic information on the
population, such as its size, density,
and composition
It starts with a review of existing
studies and all the data presently
available on the community.
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20. Key informants are interviewed in
every major system education, health,
religious, economic, and others.
Then, more detailed surveys and
intensive interviews are performed to
yield information on organizations
and the various roles in each
organization.
The study is an expensive, time
consuming process; it is rarely used.
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21. A comprehensive assessment
describes not only the systems of
a community but also how power
is distributed throughout the
system, how decisions are made,
and how change occurs (Plescia,
Koontx, & Laourent, 2001;
Williams & Yanoshik, 2001).
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22. 5. Community Assets Assessment
The final form of assessment
presented here is assets
assessment, which focuses on the
strengths and capacities of a
community rather than its
problems.
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23. The previously mentioned methods are needs
oriented and deficit based – in other words, they
are "pathology" models, in which the assessment
is performed in response to needs, barriers,
weaknesses, problems, or scarcity in the
community.
This may result in a fragmented approach to
solutions for the community's problems rather
than an approach focused on the community's
possibilities, strengths, and assets.
This approach requires that the assessor look for
the positive, or see the glass as "half full".
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24. Define the background of the community
Analyze the health status of the community
Analyze the health care system/health
resources
Analyze the community’s social assistance
system
Conduct the community diagnosis
Evaluate the methodology used
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25. Demographic data (population of community
age,
sex).
Vital rates (birth, death, crude death rate,
maternal mortality rate etc.).
Survey data (health matters, kind of facilities
they have and how they utilize them).
Sociological(cultural information from the
community- taboos, customs, lifestyles and
patterns of living, festivals).
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26. Survey
Focus group discussion
Meetings
Interviews
Descriptive epidemiology studies- examines
the amount and distribution of disease or
health condition in a population by a person
(who is affected), place (where does the
condition occurred?) time (when did the cases
occurred?)
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27. It helps to find the common problems or diseases
It brings solutions and sets priorities in the
community
It is a tool to disclose the hidden problems that are
not visible to the community people
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 people’s problems towards the right
solution
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28. ◦Making a general diagnosis of the
community
◦Promoting community health
◦Fostering community participation
◦Promoting research
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29. Identify the target population and the
key leaders
Apply the ethics procedure
Have all necessary requirements
available
Have a topic guide at hand
Use local language
Involve the community and its leaders
throughout the process
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30. Questionnaire (topic guide)
Trained human resource
Community mobilization, awareness and
acceptability
Transport and other facilities; community,
leaders, key informers, cultural beliefs
Time
Pens/pencils/paper
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31. Community is diagnosed using:
Health indicators
◦ Indicators of health are variables used for the
assessment of community health.
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32. 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
understanding of the phenomenon of interest.
33. 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
34. Mortality indicators
- 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
35. 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
36. 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
37. 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
38. 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
39. 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
40. 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.
41. 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
42. 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
43. 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
44. Other Indicators
Other health
indicators
Indicators of
quality of life.
Basic needs
indicators.
Health for all
indicators.
45. Initiation; working group design a plan including
resources required e.g human, financial,
transport, scope of diagnosis
Data collection and analysis; look at variables
such as age, sex religion population size,
Diagnosis; health status of the community ,
determinants of health and,
Dissemination; report the findings to the
stakeholders, community.
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