Community Assessment

• Program


  A general approach provided specific intervention and services, usually a long-term process of intervention because it must have sustenance or a sustainability factor, can result to the final goal
• Project


  A time limited or experimental effort in providing intervention and services in an organizational, a short-term process of intervention
• Service


  What is given to the community like the goods and interaction between the public health care workers and the target community
• Health Project Planning


  1. Identify the issues or health problems in the community

  2. Prioritize the issues or health problems to identify the one that the project will address

  3. Identify the risk factors and set the goal for the project

  4. Determine contributing factors and state objectives for the project

  5. Determine what strategies will be

  6. Develop the action plan for the project

  7. Sustain the project or keep the project (or some parts of it) going

  8. Evaluate the project
• Needs Assessment


  A process of collecting information that will give a good indication of the priority needs of a community, clarifying need is an essential part of deciding what issue or problem the project will address, provides an opportunity for the community to become involved in the planning from the beginning, helps with allocating resources and making decisions about where to start with health promotion work
• Classification of Needs


  • Normative Needs
  • Felt Needs
  • Expressed Needs
  • Comparative Needs
• Baseline Data


  Describe the situation or condition at the time the project or intervention starts, data collection later during the evaluation is then compared against the baseline data to see the effect of the project
• Risk Factors


  Any aspect of behavior, society or the environment that are directly linked to the health problem, lead to or directly cause the problem, some can be changed while others are not able to be modified
• Contributing Factors


  Any aspects of behavior, society, or the environment that leads to risk factors developing, enable or reinforce the risk factors, can relate to individual, financial, political, educational, environmental, etc.
• Modifiable


  People can change their food choices
• Non-modifiable


  People cannot change their genetics
• Environmental


  Direct exposure to bacteria and germs may be a risk factor for diarrhea
• Contributing factors

  • Any aspects of behavior, society, or the environment that leads to risk factors developing
  • Enable or reinforce the risk factors
  • They can relate to individual, financial, political, educational, environmental, etc.
• Goal


  • Making changes to the risk factors addressed by project
  • Indicates what the planned, longer-term outcome of the project is
  • Intended to inspire, motivate, and focus people and encourage team cooperation
• Objectives


  • State what changes the project will make to the contributing factors
  • Indicate what the impact will be on the contributing factors during the time frame of the project
  • Its about what has to change in the short term to get closer to achieving the project goal
• Strategies describe what it is that the project team will do to try and make the changes required to achieve the objectives
• Action plan


  • Includes all the specific activities, large and small, that will need to be done to implement each of these activities, when they will be completed and how they will be evaluated
  • Once the strategies of the project are determined, the project team can write the action plan
  • Also list the resources required for the project
• Resources


  • Required throughout the whole project, from needs assessment through putting strategies into action to final report writing
  • Can include human resources, financial resources, materials, equipment, venues, and dates
• Sustainability


  • Planning for sustainability means thinking of ways to keep the project (or important parts of it) going after its official end
  • It then becomes an ongoing part of community activity
  • Many factors can threaten sustainability of the project
  • Project teams need to be on the lookout for these factors and have a plan for dealing with them
  • Sustainability needs to be considered from the initial planning stages of a project
• Evaluation


  • Evaluating a project is about looking critically at what is happening in the project and making a judgment about its value, worth, or benefit
  • Evaluation is important because it can tell us how the project is going, what effect it is having, and what changes we need to make to improve it
• Human behavior


  The population of behavior exhibited by humans and influence by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion, and genetics
• Questionnaire


  • One way to find out what people think is to use a community questionnaire
  • Frequently, it may be difficult for community members devise their own questionnaires and the information collected may require sophisticated analysis
  • Because the questions must be defined before the information is collected, the information will be limited to these issues
  • Therefore, it may not be flexible enough to include other issues of importance to the community
• Participatory approaches


  • Often grouped together and referred to as participatory rural (or rapid) appraisal
  • The techniques allow the community itself to develop areas for discussion, rather than using questionnaire responses to define the topics
  • These techniques are sometimes used with questionnaires
  • Participatory approaches cover a range of techniques, including key informant, interviews, group discussions, and observations
• Key informant


  • Key informant interviews are discussed with key people within a community who have a special interest in, or responsibility for improving health
  • Includes women's leaders, youth leaders, religious leader and health workers
  • Rather than directly asking prepared questions, the interviewer can instead prepare topic guides to ensure that the principal areas of interest are covered during the course of discussions
  • The objective of each interview should be clearly defined and the community member best places to provide answers should be identified
• Focus group discussion


  • A technique that brings together groups of people to discuss a particular issue, often in an informal setting
  • The role of the group facilitator is to help the group to identify key issues related to the topic under discussion, while allowing sufficient flexibility to cover all aspects of the topic to everyone's satisfaction
  • To help foster agreement about key issues, it is better to establish a goal or objective that the whole group agrees with from the outset
  • It is important that people do not feel they are being ridiculed for their views
• Changing risky behavior


  • People who engage in risky activities do so for many reasons, some of which may relate to other problems in their life or in their society
  • This behavior can be a means of trying to cope with these problems
  • First step in changing risky behavior is to encourage people to talk about the impact that their behavior has on themselves and on their community which requires that they have access to information and support
  • Encouraging people to change risky behavior takes effort and time, and may require working with individuals, households, and the whole community
  • One approach is to form a community support group with support from counselors or other health personnel so those who engage in risky behavior can discuss the problems associating their behavior
  • It is important not to penalize people who revert to risky behavior, they should be helped to understand why they went back and encourage to change
• Detoxification


  • In some cases, the individual or community my need support from medical personnel or mental health specialists
  • Sometimes, when a person has become depended on a substance, he or she will need medical assistance to stop using the substance
• Health education


  • It is important to work with communities to develop strategies and knowledge for preventing it
  • Prevention is much better than trying to treat problems after they occur
  • The whole community should be encouraged to participate in defining the impacts and problems associated with risky behaviors, and to discuss how they can be reduced or prevented
  • It is important that children have access to information about the impact of risky behavior on their health and on the well-being of community
• Communicable diseases


  • Communicable diseases are often the leading causes of all illness in the country today
  • Most often they afflict the most vulnerable, young, and elderly
  • They have numerous economic psychological, disabling and distinguishing effects to the emergence of newly discovered diseases and the re-emergence of old ones
  • They are readily transferred from one infected person to a susceptible and uninfected person and maybe caused by microorganisms
• Types of microorganism causing infections

  • Bacteria
  • Viruses
  • Fungi
  • Parasites
• Chain of infection (IREMES)

  • Infectious agent
  • Reservoir
  • Exit
  • Mode of transmission
  • Entry
  • Susceptible host
• Etiologic agent


  • Microorganism
  • The extent to which any microorganisms is capable of producing an infectious process depends on the number of microorganism (pathogenicity)
  • The ability of the microorganisms to enter the body, the susceptibility of the host, and the ability of microorganisms to live in the host's body
• Reservoir


  • Host
  • There are many reservoirs, or source of microorganisms
  • Common sources are the other humans, the client's own microorganism, plants, animals, or the general environment
  • People are the most common source of infection for others and for themselves
• Portal of exit from reservoir


  Before an infection can establish itself in a host, the microorganism must leave the reservoir
• Method of transmission


  After the microorganisms leaves its reservoir, it requires a means of transmission to reach another person or host through a receptive portal of entry
• Portal of entry to the susceptible host


  • Before a person can become infected, microorganisms must enter the body
  • The skin is a barrier to infectious agents. However, any break in the skin can readily serve as portal of entry
  • Often, microorganisms enter the body of the host by the same route they used to leave the source
• Susceptible host


  • Any person who is at risk for infection
  • A compromised host is a person "at increased risk": an individual who for one or more reasons is most likely than others to acquire an infection
  • Impairment of the body's natural defenses and a number of other factors can affect susceptibility to infection
• Types of method of transmission

  • Direct transmission
  • Indirect transmission
• Direct transmission


  • Involves immediate and direct transfer of microorganisms from person to person through touching, biting, kissing, sexual intercourse, and droplet spread
  • Droplet spread only occurs when the source and host are within 3ft each other
  • Sneezing, coughing, spitting, singing, or talking can project droplet spray into conjunctiva or onto the mucous membranes of the eyes, nose, or mouth of the other person
• Indirect transmission


  • Vehicle Borne Transmission - any substance that serves as an intermediate means to transport and introducing infectious agent into susceptible host through a suitable portal of entry
  • Vehicle borne transmission includes fomites (inanimate objects or materials) such as handkerchiefs, toys, soiled clothes, cooking or eating utensils, and surgical instruments
  • Vector-Borne Transmission - a vector is an animal or flying or crawling insects that serves as an intermediate means of transporting the infectious agents
  • Vector-borne transmission may occur by injecting salivary gland fluid during biting or by depositing feces or other materials on the skin through the bite wound or a traumatized skin area