Community Diagnosis

Dr. Rasha Salama PhD Community Medicine Suez Canal University Egypt

Definition of a ³Community´ 

cluster of people with at least one common characteristic (geographic location, occupation, ethnicity, housing condition««)  A group of people with a common characteristic or interest living together within a larger society

Eight subsystems plus the community core are identified. .Community  A community is a whole entity that functions because of the interdependence of its parts or subsystems.

values/beliefs/religions.core .Community Core 1. vital statistics. socio-demographic sociocharacteristics. Community core: history.

Eight Subsystems 2. Eight subsystems: ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Physical environment Education Safety and transportation Politics and government Health and social services Communication Economics recreation .

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. .

in order to determine the health needs of the community´ .The Community Diagnosis Process  ³A means of examining aggregate and social statistics in addition to the knowledge of the local situation.

and systems of care within the community Assess attitudes toward community health services and issues Identify priorities. .Goal  The mission of community diagnosis is to:      Analyze the health status of the community Evaluate the health resources. and determine courses of action to improve the health status of the community Establish an epidemiologic baseline for measuring improvement over time. establish goals. services.

How is the community diagnosed? .

opportunities.Community Analysis  Community analysis is the process of examining data to define needs strengths. The product of analysis is the ³community profile´. readiness. . and resources. barriers.

.Community Analysis (cont.)  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.

 Community is diagnosed using: Health Indicators .

.Indicators of health are variables used for the assessment of community health.

needed. b. should be valid. they should reflect changes only in the specific.e. situation concerned. i.Characteristics of Indicators:  a. and.. should be relevant.e.e. i. i. they should contribute to the relevant. understanding of the phenomenon of interest. they should have the ability to obtain data feasible.. should be specific... should be reliable and objective. they should actually measure what they are valid..e.      . should be feasible. d.e. the situation concerned. i.e. i. supposed to measure. e. f. the answers should be the same if measured by different people in similar circumstances. i.. they should be sensitive to changes in sensitive. should be sensitive. c.

Classification of health Indicators       Mortality indicators Morbidity indicators Disability rates Nutritional status indicators Health care delivery indicators Utilization rates       Indicators of social and mental health Environmental indicators SocioSocio-economic indicators Health policy indicators Indicators of quality of life Other indicators .

Mortality Indicators  - Mortality Rates The traditional measures of health status.( 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 .( death certificate is a legal availability. Widely used because of their ready availability.

  Incidence and prevalence Notification rates Attendance rates: outoutpatient clinics or health centers.Morbidity Indicators  Morbidity rates    . Admission and discharge rates Hospital stay duration rates .Data on morbidity are preferable. although often difficult to obtain.

Disability Indicators  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  .

It is an indicator of positive health    Anthropometrics measurements Height of children at school entry Prevalence of low birth weight Clinical surveys: Anaemia.Nutritional Indicators  Nutritional Status Indicators  . Hypothyroidism. Nightblindness .

Reflect the Equity / Provision of health care Doctor / Population ratio  Doctor / Nurse ratio  Population / Bed ratio  Population / per health center  .Health Care Delivery Indicators  Health Care Delivery Indicators .

Extent of use of health services . i.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.immunization coverage.  Hospital-Beds occupancy Hospitalrate.  Proportion of pregnant women who receive ANC.e.  Hospital-Beds turn-over ratio Hospitalturn .Utilization Indicators  Health care utilization Rates ..

Indirect measures are commonly used Suicide & Homicide rates  Road traffic accidents  Alcohol and drug abuse.  .Valid positive indicators does not often exist .Social/Mental Health Indicators  Indicators of Social and Mental Health .

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  .

.Is not a direct measure of health status. No.For interpretation of health care indicators.females Family size Housing condition e.g.SocioSocio-economic Indicators  SocioSocio-economic Indicators .       Rate of population increase Per capita GNP Level of unemployment Literacy rates . of persons per room .

Proportion of GNP spent on health services.  Proportion of total health resources devoted to primary health care  .  Proportion of GNP spent on health related activities.Health Policy Indicators  Health Policy Indicators .Allocation of adequate resources.

Other Indicators  Other health indicators Indicators of quality of life.  Basic needs indicators.  .  Health for all indicators.

Thank You .