LECTURE 4-COMMUNITY DIAGNOSIS.pptx

community diagnosis

1. COMMUNITY DIAGNOSIS AND PHARMACEUTICAL NEED ASSESSMENT AYO NELSON CLINICAL INSTRUCTOR LIRA INSTTITUTE OF HEALTH AND MANAGEMENT SCIENCES EMAIL: [email protected]

2. INTRODUCTION Definitions 1. Community A community is a group of people living within a specified geographic area, with a common characteristic/interest(s). Community members usually know and interact with each other. Most definitions of community must include the three dimensions of people, place and function.

3. INTRODUCTION 2. 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 identification of associated factors for the purpose of defining those at risk or those in need of health care. 3. Clinical Diagnosis - refers to the study of a patient by a trained physician (medical Dr or Clinician) to identify presence or absence of disease.

4. INTRODUCTION Community diagnosis usually highlight the factors influencing the health of the community both positively and negatively It should be able to highlight available resources including man power, materials and time for combating the health problem In community diagnosis for example may realize that children are suffering from viral infection then actions are taken to solve it Community diagnosis will point where health system should put main effort and resources, community diagnosis highlight local priorities In summary, it identifies problems, proposes areas for improvement and stimulates actions

5. Types of information necessary for community diagnosis What is the commonest disease seen in the patients? What is the distribution of comment disease in the area? What disease has been epidemic in the area? What disease are community concerned about? What are the most important local health problem?

6. OBJECTIVES OF COMMUNITY DIAGNOSIS IN HEALTH CARE Analyze health status Evaluate health resources, services and system of care Assess attitudes toward community health services and issues Identify priorities, establish goals and determine courses of action to improve health status Establish epidemiologic baseline for measuring over time

7. IMPORTANCE OF COMMUNITY DIAGNOSIS It helps to find the common problems or disease which are troublesome to the people and are easily preventable in the community It is a tool to disclose hidden problems that are not visible to community health It helps to identify the group of people at risk of the health problem in the community It help to access group of underprivileged people who are unable to use the available facility due to poverty, prevailing discrimination or other reasons It ensures that decisions are made based on solid information and knowledge Helps to impart knowledge and attitudes to turn over people problems toward the light of solution

8. Importance …. Provides overall picture of the local community health problem Suggest priority areas for intervention and feasible solutions Indicate the resource allocation and direction of work plan Create opportunity for Intersectoral collaboration Form basis of setting indicators for health care practice evaluation Provide data that act as reference for the district

9. PROCESS OF COMMUNITY DIAGNOSIS How to conduct community diagnosis? The process of community diagnosis involves four stages: 1 . Initiation 2 . Data collection and analysis 3 . Diagnosis 4 . Dissemination

10. 1. Initiation In order to initiate a community diagnosis project, a dedicated committee or working group should be set up to manage and coordinate the project. The committee should involve relevant parties such as government departments, health professionals and non-governmental organizations. At an early stage, it is important to identify the available budget and resources to determine the scope of the diagnosis. Some of the common areas to be studied may include health status, lifestyles , socioeconomic conditions, physical and social infrastructure, inequalities, as well as public health services and policies. Once the scope is defined, a working schedule to conduct the community diagnosis, production and dissemination of report should be set.

11. 2. Data collection and analysis The project should collect both quantitative and qualitative data . Population Census and statistical data e.g. population size, sex and age structure, medical services, social services, education, housing, public etc . can provide background of the district. As for the community data, it can be collected by conducting surveys through self-administered questionnaires, face to face interviews, focus groups and telephone interviews. In order to ensure reliability of the findings, an experienced organization such as an academic institute can be employed for conducting the study. The sampling method should be carefully designed and the sample size should be large enough to provide sufficient data to draw reliable conclusions. Therefore, study results derived can truly review the local community. Collected data can then be analyzed and interpreted by experts

12. Practical tips on data analysis and presentation: Statistical information is best presented as rates or ratios for comparison Trends and projections are useful for monitoring changes over a time period for future planning Local district data can be compared with other districts or the whole population Graphical presentation is preferred for easy understanding

13. 3. Diagnosis Diagnosis of the community is reached from conclusions drawn from the data analysis. It should preferably comprise three areas: Health status of the community Determinants of health in the community Potential for healthy living

14. 4. Dissemination The production of the community diagnosis report is not an end in itself, efforts should be put into communication to ensure that targeted actions are taken. The target audience for the community diagnosis includes policy-makers, health professionals and the general public in the community. The report can be disseminated through the following channels: - Presentations at meetings of the health boards and committees, or forums organized for voluntary organizations, local community groups and the general public Press release Thematic events (such as health fairs and other health promotion programme)

15. Difficulties experienced in community diagnosis Community may be concerned about other problem than being concerned with the real health problem Health workers may tend to be taken away by what community wants than concentrating on the main problem Rushing into conclusion before understanding and commitment and the program and the program may be unsuccessful.

16. Summary It is important to realize that Community Diagnosis is not an one-off project, but is part of a dynamic process leading to health promotion in the community. Therefore community diagnosis should be conducted at regular intervals to allow the Health Care Programs be continuously improved.

17. Health indicators Community Diagnosis is done using a tool called "Health Indicators" which are the variables used for the assessment of community health. Indicators must be: valid, reliable, sensitive, specific, feasible and relevant.

18. Health indicators can be classified as 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

19. How county can evaluate their PHC system Access to services Continuity of services Coordination of delivery Comprehensivess of the health system Financing to the primary health care

20. Assignment Question 1 During community assessment, it was found that majority of home state lack pit latrines, had buses around homes, most of children under 1 years are malnourished and were not immunized according to immunization schedule, most of the homes could only afford one meal a day What is community assessment? Explain steps considered while carrying out community assessment Formulate three actual and potential diagnosis for above community assessment Explain how you would manage the above health problem basing on your diagnosis

21. Assignment 2. Discuss gender roles of women and men in your community in relation to health 3. Outline 10 ways in which culture can affect health of the community 4. What factors would you consider while choosing community/village health workers 5. What is community diagnosis 6. Describe how you would diagnose a community problem 7. Classify and give all the examples of health indicators used in community diagnosis