Community Diagnosis

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Community Diagnosis

• Dr. Rasha Salama
• PhD Community Medicine
• Suez Canal University
• Egypt

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Definition of a Community

• A 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

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Community

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

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Community Core

• 1. Community core history, socio-demographic
  characteristics, 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 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.

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The Community Diagnosis Process

• A means of examining aggregate and social
  statistics in addition to the knowledge of the
  local situation, in order to determine the health
  needs of the community

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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 the community
• Establish an epidemiologic baseline for measuring
  improvement over time.

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• How is the community diagnosed?

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Community Analysis

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

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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.

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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 reliable and objective, i.e., the
  answers should be the same 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 the situation concerned,
• e. should be feasible, i.e., they should have the
  ability to obtain data needed, and
• f. should be relevant, i.e., they should
  contribute to the understanding of the phenomenon
  of interest.

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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
• Socio-economic indicators
• 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-patient clinics 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 specified period.
• 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 health indicators

• Indicators of quality of life.
• Basic needs indicators.
• Health for all indicators.

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• Thank You