COMMUNITY DIAGNOSIS

Definition of Community Diagnosis

q 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.
 Definition of Community Diagnosis
q consists of two important parts:
a. Collection of data about the community in
order to identify the different factors that may
directly or indirectly influence the health of the
population.
b. Analyze and seek explanations for the
occurrence of health needs and problems in the
community.
Community assessment – “keystone” of
community health process
 Definition of Community Diagnosis
• The PH worker utilizes assessment data to
derive the community health diagnoses and
become the bases for developing and
implementing community health
interventions and strategies which completes
the community diagnosis.
 Ecologic Approach to
Community Diagnosis
àRecognizes the fact that the health status of
the community is a product of various
interacting elements such as population,
physical and topographical characteristics,
socio-economic and cultural factors, health
and basic social services and power structure
within the community.
à These elements will explain the health and
illness patterns in the community.
According to Freeman and Heinrich (1981), there are 3
independent, interacting and constantly changing
conditions:
1. The health status of the community,
including the population’s level of
vulnerability.
2. Community health capability or the ability of
the community to deal with its health
problems.
3. Community action potential, or the patterns
in which the community is likely to work on
its health problems.
Types of Community Diagnosis
I. Comprehensive Community Diagnosis
à Aims to obtain general information about the
community with the intent of determining not
only prevalent health conditions and risk factors
(epidemiologic approach) but also the socio-
economic condition (socio-economic approach)
and lifestyle behaviors and attitudes that have
effect on health (behavioral approach)
Elements of Comprehensive CD:
a. Demographic variables
a.1 total population and geographical
distribution and population density
a.2 age-sex composition
a.3 vital indicators
a.4 patterns of migration
a.5 population projection
b. Socio-economic and Cultural Variables
b.1 Social indicators
b.1.1 educational level
b.1.2 housing conditions
b.1.3 Social classes or groupings
b.2 Economic indicators
b.2.1 Poverty level income
b.2.2 Unemployment and
underemployment rates
b.2.3 Proportion of salaried and wage
earners
b.2.4 Types of industry present
b.2.5 Occupation common in the community
b.2.6 Communication network
b.2.7 Transportation system
b.3 Environmental indicators
b.3.1Physical/Geographical/Topographical
characteristics
b.3.2 Water supply
b.3.3 Waste disposal
b.3.4 Air, water and land pollution
b.4 Cultural factors
b.4.1 Variables that may break up the
people into groups (ethnicity,
social class, language, religion,
race, political orientation)
b.4.2 Cultural beliefs and practices
b.4.3 Concepts about health and
illness
c. Health and Illness Patterns
c.1 Leading cause of mortality
c.2 Leading cause of morbidity
c.3 Leading cause of infant and child
mortality
c.4 Leading cause of maternal mortality
c.5 Leading cause of hospital admission
c.6 Leading cause of clinic consultation
c.7 Nutritional status
d. Health Resources
1. Manpower resources
2. Material resources
e. Political and Leadership Patterns
1. Power structure in the community
2. Attitudes of the people toward authority
3. Conditions/events/issues that cause social
conflict/upheavals or that lead to social
bonding or unification
4. Practices/approaches effective in settling
issues and concerns
II. Problem-oriented Community Diagnosis
à responds to a particular need for a
target group
 COMMUNITY DIAGNOSIS: THE PROCESS
• The community is an active partner not a
passive recipient of care.
• The public health worker works WITH and not
FOR the community.
• A PHW does not operate like an external
assessor of community needs, but as the
facilitator working in a team composed of
community members and leaders.
 STEPS IN CONDUCTING COMMUNITY DIAGNOSIS

1. Determining the objectives.

àDuring the planning phase, the objectives will
serve as a guide in directing disease control
and wellness promotion in the community.
 In stating the objectives, the following
questions should be answered:
a. What is the present health condition of the
people in the community?
b. Why are the people in the community in such
condition? What specific problems are
causing these problems?
c. What are the roots of these problems?
d. What solution will address the problems?
 STEPS IN CONDUCTING COMMUNITY DIAGNOSIS

2. Defining the study population.

3. Determining the data to be collected.
à achieved by developing a data
collection plan
à data can be categorized as primary or
secondary based on the source of data
 STEPS IN CONDUCTING COMMUNITY DIAGNOSIS
4. Collecting the data.
a. Observation
à ocular survey/windshield survey
à participant observation
b. Records review
c. Interviews
àface-to-face or telephone interview, individual
or group interview, structured or unstructured
interview
 STEPS IN CONDUCTING COMMUNITY DIAGNOSIS
d. Focus group discussion
à qualitative research technique utilize for
its value in understanding and documenting
human behavior
à In the conduct of focus group discussions,
make sure to set the characteristics of the
participants in terms of:
A. those characteristics that will be common
to them
B. those characteristics that will differentiate
them from each other
5. Developing the instruments.
a. Survey questionnaires / survey instruments
b. Focus group discussion guide à facilitate the
direction and flow of exchange of ideas on specific
topics or concepts among the participants
c. Key informant interview guide à gives direction to
the person doing the interview using a set of
prepared questions on a very specific subject
d. Observation checklist à list of data that are
manifestation or indicators of health need or
problem
6. Actual data gathering.
a. semi-structured interviews
b. analytical games
c. stories and portraits
d. diagrams
e. workshop
7. Data collation
àPut together all facts and figures to generate
information about the health status of the
community
à2 types of data are generated:
a. Numerical data
b. Descriptive data
8. Data presentation
àDescriptive data are presented in narrative
reports whereas numerical data may be
presented into table or graphs
à Types of graphs:
A. Line graph: show data trend or changes
B. Bar graph / Pictograph: comparisons of
counts and rates
C. Histogram / frequency polygon: graphic
presentation of frequency
D. Scattered diagram: correlation data for
two variables
E. Pie chart: breakdown of a group
9. Data analysis àthe most critical stage;
quantification, description and classification
of data
àProblem tree analysis approach
ü causes and effects

10. Identifying the community health problems.

Categories of community health problems:
A. Health status problems
à Described in terms of increased or decreased
morbidity, mortality, fertility or reduced
capability for wellness
B. Health resources problems
à Described in terms of lack of or absence of
manpower, money, materials or institutions
necessary to solve health problems
C. Health-related problems
à described in terms of social, economic,
environmental and political factors that
aggravate the illness-inducing situations in
the community
11. Priority-setting à prioritize which problems
can be attended to considering available
resources, limitations, and constraints.

Criteria:
a.Nature of the condition/problem presented
b.Magnitude of the problem
c.Modifiability of the problem
d.Preventive potential
e.Social concern