The Community Health

Nursing Process

Assessment of Community
Health Needs

Ajpelongco RN, MN
CSAB – Nursing Program
 An Introduction

• Community – “Primary client” of

the CHNurse
• 2 important reasons WHY?
1. It has a direct influence on the
health of the individual, families and
the sub-populations
2. It is at this level that most health
service provision occurs
Community Health Nurses will
also deal with these
community characteristics in
planning and developing
specific programs and in
ensuring the delivery of
effective health services
• CHNurses - COMMUNITY
ASSESSMENT as part of public
health function
• Nursing students-
COMMUNITY ASSESSMENT as
a compulsory requirement of
the Nursing curriculum
• CHNurses and Nursing students
-assess the data;analyze and
interpret the data and diagnose
the health status of the
community
• The data from the eight
subsystems are useless and
meaningless – they have
to be useful to the people
• They must be used in the
Nursing Process for the
benefit of the community
• Best persons to assess the
community’s health condition and
status are the CHNurses and
Nursing students who interact with
them and observe their social
environment
• The Nurses’ assessment & diagnosis
serve as the basis of rural health unit
or health office for community
health planning because they provide
information on the community
health concerns, needs and priorities
• All these information
obtained from the
community are very
useful in community
nursing in particular and
community health
development in general.
• The are very useful in improving
the health status of the
community through strategic and
operational planning in
community health.
• Thus, Community Health
assessment is a fundamental tool
of CHNurses
 Assessment

• Process of collecting, organizing,

processing, and analyzing data or
information obtained from the client
and other sources
Community Health Assessment
• A process by which community
members gain an understanding
of the health, concerns, and
health care systems of the
community by identifying,
collecting, analyzing, and
disseminating information on
community assets, strengths,
resources and needs
Community Diagnosis
• Diagnosis – process of
identification of the client’s
needs and problems based on
the analysis of data and or
information gathered
“they are just the same”
• Community Assessment
• Community Diagnosis
• Situational Analysis
Components of Community Health
Needs Assessment
• Health status – health condition,
health illness pattern and trend (causes
of morbidity/mortality); health
knowledge, attitudes, practice
• Health resources – RHU, BHS,
hospitals & specialty clinics, equipment
& facilities; manpower resources,
financial resources)
• Health action potential – health
implementation and services
Types of Community
Assessment/Diagnosis
• Comprehensive Diagnosis –
aims to obtain a general
information about the
community
• Problem-Oriented or
Focused Diagnosis – specific
problem in the community
Elements of Comprehensive
Diagnosis:
• A. Demographic Variables – size,
composition and geographical
distribution of the population
1. total population
2. Age and sex composition
3. Selected vital indicators – growth
rate, life expectancy at birth, crude
birth rate, crude death rate
 4. Patterns of migration
5. Population Projection

B. Socio-Economic & Cultural Variables

1. Social Indicators:
* Communication Network –
disseminate health info
* Transportation System –
accessibility of people to HCDS
 * Educational Level –
indicative of poverty &
may reflect on health
perception
* Housing Conditions – which
may suggest health
hazards
2. Economic Indicators –
* Poverty level income
* Unemployment & underemployment
* Monthly income vs. monthly expenses
* types of industry present
* occupation common in the community
3. Environmental Indicators
a) Physical/geographical/topographical
characteristics of the community

 land areas
 terrain characteristics
 land usage in industry
 climate/season
 b) Water Supply –
 Sources of water
 % population w/ access to
safe & adequate water supply
c) Waste disposal-
 % of population served by
daily garbage collection
system
 % population with safe
excreta disposal system
 types of waste disposal &
garbage disposal system
 d) Air, Water, and Land Pollution

4. Cultural Factors
 Variables that may break up people
into groups in the community–
social class, language, religion, race,
political orientation
 Cultural beliefs and practices that
affect health
 Concepts about health and illness
C. Health and Illness Patterns
 Leading cause of mortality
 Leading cause of morbidity
 Leading cause of infant
mortality
 Leading cause of maternal
mortality
 Leading cause of hospital
admission
D. Health Resources –
 essential ingredients in the
delivery of basic health services
 Manpower Resources & Material
Resources
E. Political/Leadership Patterns
reflects action potential of the
government to address the health
needs & problems of the
community
Process of Community Diagnosis:
• Collecting
• Organizing
• Synthesizing
• Analyzing
• Interpreting
Steps in Conducting Community
Diagnosis:
1. DETERMINING OBJECTIVES
Nurse decides on the depth and
scope of the data she needs to
gather
2. DEFINING THE STUDY
POPULATION
Nurse identifies the population
group to be included in the study
3. DETERMINING THE DATA TO BE
COLLECTED
Objectives will guide the nurse in
identifying the specific data she will
gather
she decides on the sources of these
data
4. COLLECTING THE DATA
different methods:
Records Review- from health &
nonhealth agencies
Surveys & Observations
Interviews
Participant Observation – nurse
actively participate in the life of the
community “immersion”
5. DEVELOPING THE INSTRUMENT
Or TOOLS to facilitate the
nurse’s data gathering activities
Most common instruments:
• Survey Questionnaire
• Interview Guide
• Observation Checklist
6. ACTUAL DATA GATHERING
7. DATA COLLATION
2 types of data:
Numerical data which can be
counted
Descriptive data which can be
described
8. DATA PRESENTATION
Narrative reports or presented
into table or graphs
9. DATA ANALYSIS
• for comparison of obtained
data with standard values
• nurse view the significance
of the problems and their
implication on the health
status of the community
10. IDENTIFYING THE COMMUNITY
HEALTH NURSING PROBLEMS
Community health problems – are
conditions or situations that
intervene with the community’s
capability to achieve wellness.
Categories of CHNsg. Problems:
1. Health status problems
― increased or decreased morbidity,
mortality, fertility
― reduced capability for wellness
2. Health resource problems
― Lack of or absence of manpower, money,
materials or institutions necessary to solve
health problems
3. Health-related problems
― social, economic, environmental and
political factors that aggravate the illness
producing situations in the community
11. PRIORITY SETTING
Criteria:
a) Nature of Condition/problem
presented
Classification:
• Health status
• Health resources
• Health- related problems
b) Magnitude of the problem – severity of
the problem that can be measured in
terms of the proportion of the
population affected by the problem
c) Modifiability of the Problem –
probability of reducing, controlling or
eradicating the problem
d) Preventive Potential – probability of
controlling, reducing the effects posed
by the problem
e) Social Concern – perception of the
population/community as they are
affected by the problem and their
readiness to act on the problem
 Criteria Weight
Nature of the problem 1
health status 3
health resources 2
health-related 1
Magnitude of the problem 3
75% - 100% affected 4
50% - 74% affected 3
25% - 49% affected 2
<25 % affected 1
Modifiability of the problem 4
High 3
Moderate 2
Low 1
Not modifiable 0
Preventive potential 1
High 3
Moderate 2
Low 1
Social Concern 1
urgent community concern; expressed 2
readiness
recognized as a problem but not needing 1
urgent attention 0
Not a community concern
 16.. Evaluating Process of
Action Community Diagnosis

15. Action 1. Exposure/Immersion

14.Planning action & 2. Establish working

Health Program Relationship w/ com.
(HPP) leaders

13. Feedback to relevant

3. Specifying what can
Groups & work w/
Be investigated & where
Them on implications/
(objectives)
options

4. Planning the data collection

12. Preparation of Methods & tools
Report (survey &
Questionnaires)

5. Training interviewers
11.Analysis of data & 6. Pretesting
Determining implications 7. Reworking data
collection./instruments
8. Determining
9. Data Collection &
Sampling
10. collation
procedures
H. Example
HEALTH PROBLEM High incidence and prevalence of intestinal
parasitism among children
GOAL To reduce the incidence and prevalence of
intestinal parasitism among children of Sitio
Camachile
OBJECTIVES 75% of children below 6 years old will test
negative for parasites after one year
80 percent of households will have access
to safe waste disposal system within six
months
80% of households will have access to safe
and adequate water supply within six
months