8/3/2019 PHC Community Diagnosis

1/27

Community Diagnosis

8/3/2019 PHC Community Diagnosis

2/27

Definition of a Community

A cluster of people with at least onecommon characteristic (geographiclocation, occupation, ethnicity, housingcondition)

A group of people with a commoncharacteristic or interest living together

within a larger society

8/3/2019 PHC Community Diagnosis

3/27

Community

A community is a whole entity thatfunctions because of the interdependenceof its parts or subsystems. Eight

subsystems plus the community core areidentified.

8/3/2019 PHC Community Diagnosis

4/27

Community Core

1. Community core: history, socio-demographiccharacteristics, vital statistics,values/beliefs/religions.core

8/3/2019 PHC Community Diagnosis

5/27

Eight Subsystems

2. Eight subsystems:

Physical environment

Education

Safety and transportation Politics and government

Health and social services

Communication

Economics

recreation

8/3/2019 PHC Community Diagnosis

6/27

Definition of Community Diagnosis

Community diagnosis generally refers tothe identification and quantification ofhealth problems in a community as a

whole in terms of mortality and morbidityrates and ratios, and identification of theircorrelates for the purpose of defining

those at risk or those in need of healthcare.

8/3/2019 PHC Community Diagnosis

7/27

The Community Diagnosis Process

A means of examining aggregate and

social statistics in addition to theknowledge of the local situation, in order to

determine the health needs of thecommunity

8/3/2019 PHC Community Diagnosis

8/27

Goal

The mission of community diagnosis is to:

Analyze the health status of the community Evaluate the health resources, services, and systems

of care within the community Assess attitudes toward community health services

and issues Identify priorities, establish goals, and determine

courses of action to improve the health status of thecommunity

Establish an epidemiologic baseline for measuringimprovement over time.

8/3/2019 PHC Community Diagnosis

9/27

How is the community

diagnosed?

8/3/2019 PHC Community Diagnosis

10/27

Community Analysis

Community analysis is the process ofexamining data to define needs strengths,barriers, opportunities, readiness, and

resources. The product of analysis is thecommunity profile.

8/3/2019 PHC Community Diagnosis

11/27

Community Analysis (cont.)

To analyze assessment data is helpful tocategorize the data. This may be done asfollowing:

Demographic

Environmental

Socioeconomic

Health resources and services

Health policies

Study of target groups.

8/3/2019 PHC Community Diagnosis

12/27

Community is diagnosed using:

Health Indicators

8/3/2019 PHC Community Diagnosis

13/27

Indicators of health are variables used

for the assessment of community health.

8/3/2019 PHC Community Diagnosis

14/27

Characteristics of Indicators: a. should be valid, i.e., they should actually measure what they are

supposed to measure;

b. should be reliableand objective, i.e., the answers should be thesame 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 thesituation concerned,

e. should be feasible, i.e., they should have the ability to obtain dataneeded, and;

f. should be relevant, i.e., they should contribute to theunderstanding of the phenomenon of interest.

8/3/2019 PHC Community Diagnosis

15/27

Classification of health Indicators

Mortality indicators

Morbidity indicators

Disability rates

Nutritional statusindicators

Health care deliveryindicators

Utilization rates

Indicators of social andmental health

Environmental indicators

Socio-economicindicators

Health policy indicators

Indicators of quality of life

Other indicators

8/3/2019 PHC Community Diagnosis

16/27

Mortality Indicators

Mortality Rates- 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

8/3/2019 PHC Community Diagnosis

17/27

Morbidity Indicators

Morbidity rates- Data on morbidity are preferable,

although often difficult to obtain.

Incidence and prevalence

Notification rates

Attendance rates: out-patientclinics or health centers.

Admission and discharge rates

Hospital stay duration rates

8/3/2019 PHC Community Diagnosis

18/27

Disability Indicators

Disability rates No. of days of restricted activity

Bed disability days

Work/School loss days within a specifiedperiod.

Expectation of life free of disability

8/3/2019 PHC Community Diagnosis

19/27

Nutritional Indicators

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

8/3/2019 PHC Community Diagnosis

20/27

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

8/3/2019 PHC Community Diagnosis

21/27

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

8/3/2019 PHC Community Diagnosis

22/27

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.

8/3/2019 PHC Community Diagnosis

23/27

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

8/3/2019 PHC Community Diagnosis

24/27

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

8/3/2019 PHC Community Diagnosis

25/27

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

8/3/2019 PHC Community Diagnosis

26/27

Other Indicators

Other healthindicators

Indicators of quality of life.

Basic needs indicators.

Health for all indicators.

8/3/2019 PHC Community Diagnosis

27/27

Thank You