1. Dr. Rasha Salama PhD Community Medicine Suez Canal University Egypt
Community Diagnosis
Dr. Rasha Salama
PhD Community Medicine
Suez Canal University
Egypt

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. 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.

4. Community Core
1. Community core: history, socio-demographic characteristics, vital statistics, values/beliefs/religions.core

5. Eight Subsystems 2. Eight subsystems: Physical environment Education
Safety and transportation
Politics and government
Health and social services
Communication
Economics
recreation

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, and 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 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.

9. How is the community diagnosed?

10. 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”.

11. 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.

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
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

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 rates
Specific death rates: age/disease
Expectation of life
Infant mortality rate
Maternal mortality rate
Proportionate mortality ratio
Case Fatality rate

17. Morbidity Indicators Morbidity rates Incidence and prevalence
- 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

18. 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

19. 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

20. Health Care Delivery Indicators
- Reflect the Equity / Provision of health care
Doctor / Population ratio
Doctor / Nurse ratio
Population / Bed ratio
Population / 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 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

22. 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.

23. 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

24. 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

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.

27. Thank You