This file talks about an area of Community Medicine which is Environmental health. It focuses on community health status diagnosis. It Applies the 7 parameters that help in giving a proper community diagnosis.

1. COLLEGE OF MEDICINE AND
ALLIED HEALTH SCIENCES
DEPARTMENT OF COMMUNITY HEALTH

2. COMMUNITY DIAGNOSIS AND MOBILISATION
WHAT IS COMMUNITY
• A group of people with atleast one common characteristic
(geographic location, occupation, ethnicity, housing condition) or
interest living together within a larger society.
Operational definition
• A whole entity that functions because of the interdependence of its
parts or subsystems.
• Eight subsystems forms the community core.

3. Community Core
Community core includes
traits like history, socio-
demographic characteristics,
vital statistics,
values/beliefs/core religions.

4. The Eight Subsystems
Core
Physical
environment
Education
Safety and
transportation
Health social
services
Recreation
Economics
Communication
Politics and
government

5. Community diagnosis
Definition
• WHO definition, it is “a quantitative and qualitative description of the
health of citizens and the factors which influence their health. It
identifies problems, proposes areas for improvement and stimulates
action”.
• Community diagnosis is a comprehensive assessment of the health status
of the community in relation to its social, physical and biological
environment.

6. Types of community diagnosis
• Problem-oriented Community Diagnosis.
• Comprehensive Community Diagnosis:
more focused on obtaining general information about the community

7. Purpose of community diagnosis
• to define existing problems, determine available resources and set
priorities for planning, implementing and evaluating health action, by
and for the community

8. Objectives of Community Diagnosis
• Analyze the health status of the community.
• Evaluate available health resources, services, and
systems of care of the community.
• Assess attitudes of people toward community
health services and systems.
• Identify priorities, establish goals, and determine
courses of action to improve health status.
• Establish epidemiologic baseline for measuring
improvement over time.

9. Importance of community diagnosis
• It helps to identify the common problems or diseases prevalent
within a community
• It helps to identify the real problems of the community people which
might not have been perceived as problems
• It helps to define the available resources(human,material etc) which
could be contribute to the improvement of health.
• It helps to identify uderpriviledged people in the community who are
unable to access the available facilities due to poverty, prevailing
discriminations or other reasons.
• It helps to impart knowledge and attitudes to turnover people’s
problems towards the light of solution.

10. Relevance of community diagnosis: (SUMMARY)
• act as a data reference for the district
• provides an overall picture of the local community and the residents’
concerns
• suggest priority areas for intervention and the feasible solutions
• indicate the resource allocation and the direction of work plans
• create opportunities for intersectoral collaboration and media
involvement

11. 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”.

12. Community Health indicators
• Health indicators are the variables used for the assessment of community health.
Indicators must be valid, reliable, sensitive, specific, feasible and relevant.
• Indicators could be outcome or impact
Outcome: effectiveness of health programs in services ‘ converge e.g
% of pregnant women who received ANC
% of births attended by skilled personnel
Impact: Effectiveness of programs in improving health status.e.g
MMR/100,000 live births
Infant mortality rate/1000 live births

13. Classification of Health Indicators
• Mortality
• Morbidity
• Disability rates
• Nutritional status
• Health care delivery
• Utilization rates
• Social and mental
health
• Environmental
• Socio-economic
• Health policy
• Quality of life

14. Mortality Indicators
• Mortality Rates
The traditional measures of health status. Widely used
because it is readily availability.( death certificate)
• Crude death rates
• Infant mortality rate
• Maternal mortality rate
• Case Fatality rate

15. Morbidity Indicators
Morbidity rates
- Data on morbidity are preferable, although often difficult to
obtain
• Incidence and prevalence
• Attendance rates: out-patient clinics or health centers.
• Admission and discharge rates
• Hospital stay duration rates

16. Health Care Delivery Indicators
Reflect Provision of health care and equity
• Physician / Population ratio
• Physician / Nurse ratio
• Population / Bed ratio
• Population / Health center

17. Environmental Indicators
Environmental health Indicators- Reflect the quality of environment
• Measures of Pollution
• Proportion of people having access to safe water and sanitation
facilities

18. Process of community diagnosis
Four stages:
1. Initiation:
• set up a multi sectoral coordinating/working committee
• identify the available budget and resources
• Define the scope
2. Data collection and analysis
• Collect quantitative and qualitative data
• use surveys through self-administered questionnaires, face to face
interviews, focus groups and telephone

19. Process ……….Contd
3. Diagnosis
Diagnosis of the community is reached from conclusions drawn from
the data analysis. It should cover the following areas
health status of the community
determinants of health in the community
potential for healthy community development
4. Dissemination of results/findings
Community meeting
Press release
5.Action plan