2 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
3 CommunityA community is a whole entity that functions because of the interdependence of its parts or subsystems. Eight subsystems plus the community core are identified.
4 Community Core1. Community core: history, socio-demographic characteristics, vital statistics, values/beliefs/religions.core
5 Eight Subsystems 2. Eight subsystems: Physical environment Education Safety and transportationPolitics and governmentHealth and social servicesCommunicationEconomicsRecreation
6 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,Identification of their correlates for the purpose of defining those at risk or those in need of health care.
7 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”
8 Goal Analyze the health status of the community Evaluate the health resources, services, and systems of care within the communityAssess attitudes toward community health services and issuesIdentify priorities, establish goals, and determine courses of action to improve the health status of the communityEstablish an epidemiologic baseline for measuring improvement over time.
10 Community AnalysisCommunity analysis is the process of examining data to define needs strengths, barriers, opportunities, readiness, and resources.The product of analysis is the “community profile”.
11 Community Analysis (cont.) To analyze assessment data is helpful to categorize the data. This may be done as following:DemographicEnvironmentalSocioeconomicHealth resources and servicesStudy of target groups.
12 Community is diagnosed using: Health Indicators
13 Indicators of health are variables used for the assessment of community health.
14 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.
15 Classification of health Indicators Demographic and Fertility indicatorsMortality indicatorsMorbidity indicatorsDisability ratesNutritional status indicatorsHealth care delivery indicatorsUtilization ratesIndicators of social and mental healthEnvironmental indicatorsSocio-economic indicatorsIndicators of quality of life
16 Mortality Indicators Mortality Rates Crude death 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 ratesSpecific death rates: age/diseaseExpectation of lifeInfant mortality rateMaternal mortality rateProportionate mortality ratioCase Fatality rate
17 Morbidity Indicators Morbidity rates Incidence and prevalence - Data on morbidity are preferable, although often difficult to obtain.Incidence and prevalenceNotification ratesAttendance rates: out-patient clinics or health centers.Admission and discharge ratesHospital stay duration rates
18 Disability Indicators Disability ratesNo. of days of restricted activityBed disability daysWork/School loss days within a specified period.Expectation of life free of disability
19 Nutritional Indicators Nutritional Status Indicators- It is an indicator of positive healthAnthropometrics measurementsHeight of children at school entryPrevalence of low birth weightClinical surveys: Anaemia, Hypothyroidism, Nightblindness
20 Health Care Delivery Indicators - Reflect the Equity / Provision of health careDoctor / Population ratioDoctor / Nurse ratioPopulation / Bed ratioPopulation / per health center
21 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 periodProportion 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
22 Social/Mental Health Indicators Indicators of Social and Mental Health- Valid positive indicators does not often exist- Indirect measures are commonly usedSuicide & Homicide ratesRoad traffic accidentsAlcohol and drug abuse.
23 Environmental Indicators Environmental health Indicators- Reflect the quality of environmentMeasures of PollutionThe proportion of people having access to safe water and sanitation facilitiesVectors density
24 Socio-economic Indicators - Is not a direct measure of health status.- For interpretation of health care indicators.Rate of population increasePer capita GNPLevel of unemploymentLiteracy rates - femalesFamily sizeHousing condition e.g. No. of persons per room
25 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
26 Other Indicators Other health indicators Indicators of quality of life.Basic needs indicators.Health for all indicators.