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Community diagnosis is vital in health planning, evaluation and needs assessment, several types of indicators are valid to be used for community diagnosis including Socio-economic, demographics, health system, and living arrangements.
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Understanding the definition of Community, its’ subsystems, Community diagnosis and its indications.
To understand the methods involved in community diagnosis.
To list the essential characteristics of health indicators.
To realize the value of different health indicators in community service and development.
Develop the ability and skill to identify, and prioritize health problems within the community using the specific set of indicators
A cluster of people with at least one common characteristic (geography, occupation, race, ethnicity, housing condition……)
A group of people with a common characteristic or interest living together within a larger society .
A whole entity that functions because of the interdependence of its parts or subsystems.
Includes Eight subsystems plus the community core.
Community core includes traits like history, socio-demographic characteristics, vital statistics, values/beliefs/core religions.
Core
Physical
environment
Education
Safety and
transportation
Health social
services
Recreation
Economics
Communication
Politics and
government
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.
Examining the aggregate of health and social statistics in addition to the knowledge of the local situation, aiming at determining the health needs of a given community.
Analyze the health status.Evaluate the health resources, services, and systems of care.
Assess attitudes toward community health services and issues.
Identify priorities, establish goals, and determine courses of action to improve health status.
Establish epidemiologic baseline for measuring improvement over time.
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”.
DemographicEnvironmentalSocioeconomic Health resources and services
Health policiesStudy of target groups.
Health Indicators Variables used for the
assessment of community health.
Valid: Measure what they are supposed to measure.
Reliable and objective: the same if measured by different people in similar circumstances
Sensitive: to changes in the situation concerned,
Specific: reflect changes only in the situation concerned
Feasible: Have the ability to obtain data needed
Relevant: Contribute to theunderstanding of the phenomenon of interest.
Mortality Morbidity Disability rates Nutritional status Health care
delivery Utilization rates
Social and mental health
Environmental Socio-economic Health policy Quality of life
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
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
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
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: Anemia, Hypothyroidism, Night blindness
Health Care Delivery Indicators
Health Care Delivery Indicators
- Reflect the Equity / Provision of health care
Physician / Population ratio
Physician / Nurse ratio
Population / Bed ratio Population / Health
center
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. “immunization coverage”.
Proportion of pregnant women who receive ante-natal care.
Hospital-Beds occupancy rate.
Hospital-Beds turn-over ratio
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.
Environmental Indicators
Environmental health Indicators
- Reflect the quality of environment
Measures of Pollution Proportion of people
having access to safe water and sanitation facilities
Vectors density
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
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
Others
Other health indicators
Indicators of quality of life.
Basic needs indicators.
Health for all indicators.
Problem identification Priorities setting
Identification of contributory factors
1- Health system2- Demographics 3- Socio-economic 4- Living environment - % rural population
- Gross domestic product/per-capita /year- % poor - Literacy rate (%) ≥15 years- % unemployment ≥15 years- % under 5 years - % <15 years- Family size - Age dependency %
Problem identification Priorities setting
Identification of contributory factors
1- Health system2- Demographics 3- Socio-economic 4- Living environment
- Population density: individuals/KM2- House H Access to piped water (U/R and total)% - House H access to sanitation (U/R and total) %
- Health units/100,000- Physicians / 10000- Nurses / 10000
Problem identification Priorities setting
Identification of contributory factors
1- Health system2- Demographics 3- Socio-economic 4- Living environment
Outcome indicators: effectiveness of health programs in converge with services% pregnant received ANC% births by skilled persons % children ever breastfed% infants 12-23 months fully immunized % contraceptive prevalence
Impact indicators: effectiveness of programs in improving health status. Crude birth rate/100,000Crude death rate/100,000Annual growth rate/100,000Life expectancy at birthInfant mortality rate/1000 LB<5 mortality rate/1000 LBMMR/100,000 LBDisability /1000<5 underweight
Indicators Governorate/region/district
Total national burden
Crude birth rate/100,000
Crude death rate/ 100,000
Annual growth rate /100
Life expectancy at birth
Infant mortality rate /1000 LB
Under 5 mortality rate/1000 LB
MMR ratio/100,000 LB
Prevalence of disability /1000
% underweight in under 5
Indicators Governorate/
region/district
Total national burden
% pregnant ANC
% birth assisted by skilled
% ever breastfed
% infants 12-23 months fully immunized
%Contraceptive prevalence
Health units/100,000
Physician /10000
Nurses /10000
Indicators Governorate/
region/district
Total national burden
% rural to urban population
GPD /capita/ year
% poor
Literacy rate *%
Unemployment rate *%
Under 5 to total population
Under 15 %
Average family size
Age dependency ratio
Thank You
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