2. Comminity Diagnosis Defn-2021 3304.pptx

Community Diagnosis

1. CHS 3304: COMMUNITY DIAGNOSIS What is Community diagnosis ?

2. Definitions Community A cluster of people with at least one common characteristic (geographic location, occupation, ethnicity, housing condition……) Consists of people living together in some form of social cohesion . Its members share in varying degrees, political, economic, social and cultural … characteristics as well as interests and aspirations including health Communities vary widely in size and social economic profiles ranging from clusters of isolated homesteads to more organized villages, towns and cities [Alma-Ata Conference on Primary Health Care 1978] A group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings

3. Definitions Diagnosis A well known medical term used to define the effort made to ascertain a patient’s disease before treatment is initiated In the same way, before initiating health activities in a community a clear understanding is needed of the situation in that community ;- its health problems, needs, resources, local traditions, history … etc.

4. 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 , and identification of their correlates for the purpose of defining those at risk or those in need of health care “ A means of examining aggregate and social statistics i n addition to the knowledge of the local situation , in order to determine the health needs of the community”

5. CD therefore is; ….. A comprehensive assessment of the health state of an entire community in relation to its social, physical, and geographical environment CD is the process by which the community health stakeholders eg HMC and Health Staff, devt partners, medical students and the community itself begin to learn about the community’s health problems, needs and concerns CD is done in order to define and describe the health status of the population in a specific community and rests on epidemiological information

6. Community Diagnosis Involves comprehensive assessment (of identifying, collecting, analysing , and disseminating information) with the aim to achieve a broader understanding of many facets of community [ including social, cultural, physical, and biological status, leadership and power structure, means of communication, helping patterns and important institutions of a community] in order to identify problems and set priorities for program development ] Needs assessments can identify priority issues in a community, and asset analyses can help to further prioritize based on the current capacity of a community ; which is useful for health planning

7. Levels of community diagnosis Descriptive Level: includes a collection of epidemiological information to describe ill health, health risk factors, patterns and social factors of interest Analytical level : analyzing and understanding the community Health action programmes : develop strategy for decisions to implement different health action programmes /interventions.

8. Levels of community diagnosis 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

9. Community Diagnosis should be a community-based, community-owned, and community-directed process to; Analyzing the health status of the community Evaluate health resources, services, and systems of care within the community Assess attitudes towards community health services and issues. Identify priorities, establish goals, and determine courses of action to improve the health status of the community Establish a baseline for measuring improvement over time

10. Components / Areas to Assess…. Demography – age, sex, gender, ethnicity, religion ... Causes of morbidity and mortality Use of health services in the area especially maternal and child health c linics , private, alternative care services … Nutrition, available foods, diet and weaning patterns and the growth of preschool and school children Society; cultural and socioeconomic stratification, religious groups, traditional practices, … Pattern of leadership – local governments, cultural institutions, religious leadership … Communication networks within the community … telephones, public transport, boda-bodas … Mental health and common causes of stress

11. Components……Cont’d Environment assessment; especially water, housing and vectors of disease knowledge, attitudes and practices of the population in respect to health related activities The detailed epidemiology of any endemic conditions The services and resources available in that community………… (for development especially non-medical ones such as agriculture, veterinary and social services … ) The degree of involvement of people in their own health care including the use of traditional healers The reasons for failure of the health programmes in the past and the difficulties likely to be encountered in the future

12. Components……Cont’d Physical environment Education Safety and transportation Politics and government Health and social services Communication Economics recreation

13. Why Community Diagnosis To identify the resources available for community involvement for health development is the community itself To effectively deal with the challenges in the delivery of health services – cheap, acceptable, feasible ,,, Encourage participation - is how to make people feel that the health system is theirs, that they own it, take pride in it, and support it because it meets their needs and fits in with local traditions……So the solution = CD.. Effective use of the health services: Countries often make large investments to build up industrial and commercial base of economic development with a belief that this would trickle down and spur development among the rural poor……!

14. ……Cont Why Community Diagnosis Therefore:….a useful first step - before preparing a comprehensive plan -may be to conduct a “community diagnosis." It costs far less, can be completed in a fairly short time, and can help get a hand on the community's "hot button" issues

15. Planning for H/Services Involving the communities in identification of their problems, needs, planning health programmes , evaluating them Raises community level of awareness of their health problems and commits them to doing something about their health situation As health workers, you have certain medical skills and know about how to keep people healthy but, it is the community that know best how health interventions can be implemented/knowledge can be applied Therefore, we need to get to know/ understand the community, be trusted by the people in it, interact and work with the local people to provide the services they need

16. Planning Through collaborative efforts with stakeholders key questions about the community are raised and help I planning; What are the strengths in the community?” What health concerns do community members have?” What resources are available? what is needed in the community to address these concerns

17. Importance Community assessment is the foundation for improving and promoting the health of community members CD Helps identify factors that affect the health of a population and determine the availability of resources within the community to address these factors

18. Benefits of Community Diagnosis for the community include: Provides communities the opportunity to participate in directing the course of health services and delivery systems Involving communities in development of health strategies which are directly responsive to the community’s needs and are locally designed, implemented, and monitored Provides justification for budget improvement requests, a foundation of information for seeking grants , and a tool for use in promoting public relations Provides (at the local level), current/up to date health information

19. In health services community diagnosis involves both providers and consumers of health services , and can help inform each about the important needs, strategies, interventions … CD process allows local agencies to learn about unfamiliar health issues in the communities and foster new relationships with community members Useful in planning and advocacy: Important for For health planning and advocacy needs at the community level; community leaders, organizations, and local health departments ensure that documented community health problems are addressed

20. NOTE: Community diagnosis involves using both quantitative and qualitative data collection/research methods in a real community setting A good CD culminates in a report and suggests what it is like to live in that community, what the important health problems are , and what interventions are likely to be effective .