PROCESS IN COMMUNITY HEALTH ASSESSMENT

NURSING
❖ Community assessment is an essential
process for:
➢ understanding the community
➢ identifying its needs or weaknesses
and assets or strengths
▪ useful to achieve healthy
communities
❖ The data that need to be collected
depend on the objectives of community
assessment.
❖ nurses need to collect data on the three
features of a community
➢ people
➢ place
➢ social system
❖ The community health nurse typically
1. Evaluate begins a community health needs
▪ Review and assess the assessment by determining what data is
community’s health needs and already available (secondary data)
existing resources. ➢ National, regional, province, and
2. Assess municipal health data are readily
▪ Collect data about the available
community’s health, identifying
strengths, weaknesses, and TOOLS FOR ASSESSMENT
potential health issues.
3. Diagnose
▪ Analyze the gathered information 1. DEMOGRAPHY
to determine the community’s
❖ science which deals with the study of the
health problems and needs.
ff:
4. Identify the Outcome
➢ human population size
▪ Define specific, measurable goals
➢ composition
for improving the community’s
➢ distribution in space
health based on the diagnosed
issues.
5. Plan Interventions SOURCES OF DATA
▪ Develop strategies and plans to
address the identified health PRIMARY DATA
problems and achieve the desired
outcomes. ❖ original data collected for a specific
6. Implement purpose by a researcher.
▪ Put the planned interventions into ❖ Example:
action, actively working towards ➢ Data collected when there is a
improving the community’s suspected Cholera outbreak in a
health. community
 ▪ including getting water sample
from their water source and ➢ crude birth rate
interviewing people about their ➢ general fertility rate
symptoms. ➢ total fertility rate
➢ annual growth rate
SECONDARY DATA ➢ other population dynamics
❖ data already collected by other (migration)
individuals and/ or institutions for some
specific purpose. POPULATION SIZE
❖ Example: 1. Natural increase
➢ Population census, birth, and death 2. Rate of natural increase
certificates
➢ disease registries POPULATION COMPOSITION
➢ patients' medical records 1. Sex composition
➢ health insurance claims 2. Age composition
➢ health surveys, etc. 3. Age and sex composition
VITAL STATISTICS POPULATION DISTRIBUTION
❖ study of the characteristics of human 1. Urban-Rural distribution
populations. 2. Crowding index
❖ It comprises a number of important 3. Population density
events in human life
➢ Birth
2. HEALTH INDICATORS
➢ Death
➢ fetal death
➢ marriage
A. FERTILITY RATES
➢ divorce
➢ annulment 2. CRUDE BIRTH RATE (CBR)
➢ judicial separation ❖ measures how fast people are added to
➢ adoption the population through births.
➢ legitimation ❖ CBR=total number of live births for a
➢ recognition given area and time period/total
➢ Individual records population at the midpoint of the time
▪ Birth period x 1000
▪ Death
▪ marriage/ divorce 1. GENERAL FERTILITY RATE
(GFR)
POPULATION RECORDS
❖ serve as key demographic variables in ❖ the number of live births per 1,000
the analysis of population size, growth women aged 15-49 in a given year
and geographic distribution. ❖ GFR=number of registered live births in a
year/ midyear population of women 15-
POPULATION INDICATORS 49 years of age ×1000
❖ Includes population growth indicators
that can affect the age-sex structure of
the population.

B. MORBIDITY RATES
1. INCIDENCE RATE (IR)
❖ describes the occurrence of new cases of
a disease or condition in a community
over a given period relative to the size of
the population at risk for that disease or
conditions during that same period.
❖ IR=number of new cases of disease
developing from a period of time/
population at risk of developing the
disease X F
2. PREVALENCE RATE (PR)
❖ number of all cases of a specific disease
or condition in a population at a given
point in time relative to the population at
the same point in time.
❖ PR=number of existing cases in
population at a particular point in time/
population at the same specified point in
time x F
C. MORTILITY RATES
1. CRUDE DEATH RATE (CDR)
❖ represents the total or overall death rate
in a given population.
❖ CDR= number of deaths for a given area
and time period/ size of population at risk
of dying, usually taken as the estimated
population at the midpoint of the calendar
year x 1000
2. SPECIFIC DEATH RATE
❖ represents a subset of the population or
with particular classes of deaths
❖ SDR= number of deaths in a specified
group/ midyear population of the same
specified group x 1000
3. CAUSE OF DEATH RATE
❖ gives the rate of dying due to specific
causes.
❖ Cause of Death Rate= number of deaths
from a specified cause / midyear
population x 1000
4. INFANT MORTALITY RATE (IMR)
❖ number of deaths per 1,000 live births of
children under one year of age.
❖ IMR= deaths under 1 year of age/
number of live births x 1000
5. MATERNAL MORTALITY RATE
(MMR)
❖ deaths due to complications from
pregnancy or childbirth.
❖ MMR= number of deaths due to
pregnancy, delivery and puerperium /
number of live births x 1000
6. PROPORTIONATE MORTALITY
RATE (PMR)
❖ describes the proportion of deaths in a
specified population over a period of time
attributable to different causes.
❖ PMR= number of deaths from a particular
cause / total deaths x 100
7. SWAROOP’S INDEX
❖ proportion of deaths aged 50 years and
above. The higher the Swaroop's index of
a population, the greater the proportion of
the deaths who were able to reach the
age of at least 50 years, i.e., more people
grew old before they died.
❖ Swaroop's Rate=numbers of death
among those 50 yrs. and over/ total
deaths x 100
8. CASE FATALITY RATE
❖ proportion of people who die from a
specified disease among all individuals
diagnosed with the disease over a certain
period.
❖ used as a measure of disease severity
and is often used for prognosis
(predicting disease course or outcome),
 where comparatively high rates are ❖ Health Infrastructure
indicative of relatively poor outcomes. ➢ NGOs
❖ used to evaluate the effect of new ➢ Health Referral Systems
treatments, with measures decreasing as ➢ other health systems
treatments improve. ➢ hospitals
❖ The rates are not constant; they can vary ❖ Communication and Transportation
between populations and over time, ➢ Internet
depending on the interplay between the ➢ cellphone signal
causative agent of disease, the host, and ➢ public transport
the environment as well as available
treatments and quality of patient care. GATHERING OF PRIMARY DATA
❖ CFR= numbers of death from a specified ❖ Focus Group Discussion/ Community
cause/number of cases of the same Forums
disease x 100 ➢ With barangay health workers
➢ With representatives of households
COMMUNITY HEALTH NEEDS ➢ With LCEs
ASSESSMENT INITIAL MEETINGS ➢ Other stakeholders
▪ NGOS
❖ Courtesy call to Mayor with the MHO ▪ Private organizations
❖ Courtesy call to Barangay Captain with
▪ Academe working in the area
Community Coordinator and RHM to
❖ Hand Distributed Survey
discuss
❖ Initial community meeting with PROVIDER INVENTORIES
stakeholders
❖ No. health workers according to
➢ Introduction of group and purpose of
category:
meeting
➢ MD
GATHERING OF SECONDARY DATA ➢ RN
➢ RHM
❖ Demographics
➢ Dentist
➢ Population ➢ RSI
➢ MWRA, etc.
➢ others (both government RHU, BHS
❖ Health Indices and hospitals
➢ Endemic diseases
❖ Inventory of services being provided by
➢ Epidemics
health facilities
➢ Top ten leading causes of mortality / ❖ Other health providers in NGOs, private
morbidity
organizations, etc
➢ EPI
❖ Inventory of alternative health care
➢ FP indicators
providers (TBAs, Hilots)
➢ WATSAN
➢ MMR
➢ IMR, etc.
❖ DRRM
➢ Hazards
➢ DRRm Plan
➢ Committee
❖ Economics
➢ Main sources of livelihood