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Community Diagnosis
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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
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Community
A community is a whole entity thatfunctions because of the interdependenceof its parts or subsystems. Eight
subsystems plus the community core areidentified.
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Community Core
1. Community core: history, socio-demographiccharacteristics, vital statistics,values/beliefs/religions.core
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Eight Subsystems
2. Eight subsystems:
Physical environment
Education
Safety and transportation Politics and government
Health and social services
Communication
Economics
recreation
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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.
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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
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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.
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How is the community
diagnosed?
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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.
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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.
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Community is diagnosed using:
Health Indicators
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Indicators of health are variables used
for the assessment of community health.
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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.
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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
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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
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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
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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
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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
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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
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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
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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.
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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
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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
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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
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Other Indicators
Other healthindicators
Indicators of quality of life.
Basic needs indicators.
Health for all indicators.
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Thank You