CHN 1

COMMUNITY ASSESSMENT

MARISSA S. FERNANDEZ, RN,MAN

• Community assessment is the process of identifying the strengths, assets,
needs and challenges of a specified community. ...
• A community assessment is usually performed early in the development of a
coalition to better understand the community and decide how the coalition
might best address its concerns.

• Community Assessment:
• - Status
• - Structure
• - Process
• Types of Community Assessment:
• 1. Community Diagnosis
• A process by which the nurse collects data about the community in order to
identify factors which may influence the deaths and illnesses of the
population, to formulate a community health nursing diagnosis and develop
and implement community health nursing interventions and strategies.
• 2 Types:
• a. Comprehensive community diagnosis
• - aims to obtain general information about the community
• b. Problem-oriented community diagnosis
• - types of assessment responds to a particular needs.
• Steps:
• 1. Preparatory Phase • 2. Implementation Phase
• site selection • - data collection
• preparation of the community • - data organization/collation
• statement of the objectives
• - data presentation
• determine the data to be collected
• - data analysis
• identify methods and instruments for
data collection • - identification of health problems
• finalize sampling design and methods
• make a timetable
• 3. Evaluation Phase:
• Biostatistics
• A. DEMOGRAPHY – study of population size, composition and spatial distribution as
affected by births, deaths and migration.
• B. Sources: Census – complete enumeration of the population
• 2 Ways of Assigning People
• a. De Jure – People were assigned to the place where assigned to the place they
usually live regardless of where they are at the time of census.
• b. De Facto – People were assigned to the place where they are physically present
at are at the time of census regardless, of their usual place of residence.
• Components:
• 1. Population size
• 2. Population composition
• Age Distribution
• Sex Ratio
• Population Pyramid
• Median age – age below which 50% of the population falls and above which 50% of the
population falls. The lower the median age, the younger the population (high fertility, high death
rates).
• Age – Dependency Ratio – used as an index of age-induced economic drain on human resources
• Other characteristics:
• occupational groups
• economic groups
• educational attainment
• ethnic group
• 3. Population Distribution
• Urban-Rural – shows the proportion of people living in urban
compared to the rural areas
• Crowding Index – indicates the ease by which a communicable
disease can be transmitted from 1 host to another susceptible
host.
• Vital Statistics:
• The application of statistical measures to vital events (births, deaths and common
illnesses) that is utilized to gauge the levels of health, illness and health services of a
community.
• Types of Vital Statistics:
1. Fertility Rate
• 1. Crude Birth Rate
• Total # of livebirths in a given calendar year X 1000
Estimated population as of July 1 of the same given year
• 2. General Fertility Rate
• Total # of livebirths in a given calendar year X 1000
Total number of reproductive age
• 2. Mortality Rate
1. Crude Death Rate
• _Total # of death in a given calendar year_ X 1000
Estimated population as of July 1 of the same calendar year
• 2. Infant Mortality Rate
• Total # of death below 1 yr in a given calendar year X 1000
Estimated population as of July 1 of the same calendar year
• 3. Maternal Mortality Rate
Total # of death among all maternal cases in a given calendar year X
1000
Estimated population as of July 1 of the same calendar year
• 3. Morbidity Rate:
• 1. Prevalence Rate
Total # of new & old cases in a given calendar year X 100
Estimated population as of July 1 of the same calendar year
• 2. Incidence Rate
• Total # of new cases in a given calendar year_ X 100
Estimated population as of July 1 of the same calendar year
• 3. Attack Rate
• Total # of person who are exposed to the disease X 100
Estimated population as of July 1 of the same calendar year
• Epidemiology:
• the study of distribution of disease or physiologic condition among human population
s and the factors affecting such distribution
• the study of the occurrence and distribution of health conditions such as disease,
death, deformities or disabilities on human populations
• 1. Patterns of disease occurrence
• a. Epidemic
• A situation when there is a high incidence of new cases of a specific disease in excess
of the expected.
• when the proportion of the susceptible are high compared to the proportion of the
immunes
• b. Epidemic potential
• an area becomes vulnerable to a disease upsurge due to causal factors such as
climatic changes, ecologic changes, or socio-economic changes
• c. Endemic
• habitual presence of a disease in a given geographic location accounting for
the low number of both immunes and susceptibles. E.g. Malaria is a disease
endemic at Palawan.
• The causative factor of the disease is constantly available or present to the
area.
• d. Sporadic
• disease occurs every now and then affecting only a small number of people
relative to the total population
• intermittent
• e. Pandemic
• global occurrence of a disease
• Steps in Epidemiological Investigation:
• 1. Establish fact of presence of epidemic
• 2. Establish time and space relationship of the disease
• 3. Relate to characteristics of the group in the community
• 4. Correlate all data obtained
• 2. Role of the Nurse
• 1. Case Finding
• 2. Health Teaching
• 3. Counseling
• 4. Follow up visit
• Functions of a Health Worker:
• 1. Community Health Service Provider
• a. Carries out health services contributing to the promotion of health,
prevention of illness, early treatment of illness and rehabilitation.
• b. appraises health needs and hazards (existing or potential)
• 2. Facilitator
• a. helps plan a comprehensive health program with the people
• b. continuing guidance and supervisory assistance
• 3. Health Counselor:
• Provides health counseling including emotional support to individuals, family, group
and community
• 4. Co-researcher:
• a. Provides the community with stimulation necessary for a wider or more complex
study or problems.
• b. Enforce community to do prompt and intelligent reporting of epidemiologic
investigation of disease.
• c. Suggest areas hat need research (by creating dissatisfaction)
• d. Participate in planning for the study in formulating procedures
• e. Assist in the collection of data
• f. Helps interpret findings collectively
• g. Act on the result of the research
• 5. Member of a Team
• - In operating within the team, one must be willing to listen as well as to contribute, to
teach as well as to learn, to lead as well as to follow, to share as well as to work under
it
• - Helps make multiple services which the family receives in the course of health care,
coordinated, continuous and comprehensive as possible
• - Consults with and refers to appropriate personnel for any other community services
• 6. Health Educator
• Health education is an accepted activity at all levels of public works. A health educator
is the one who improves the health of the people by employing various methods of
scientific procedures to stimulate, arouse and guide people to healthful ways of living.
She takes into consideration these aspects of health education:
• Information – provision of knowledge
• Education – change in knowledge, attitude and skills
• Communication – exchange of information
• Components of a community assessment:
• A community assessment involves
• (1) an evaluation of the current situation in a community,
• (2) a judgment of what the preferred or desired situation in that
community would be, and
• (3) a comparison of the actual and desired situation for the purpose of
prioritizing concerns.
• Key Principles of Community Assessment:
• 1. Residents are the best experts on the community in which they live.
• 2. All residents have skills, abilities and talents that they can contribute to the community.
• 3. A strong community is built upon the talents and resources of its members.
• The Purpose of a Community Assessment:
• A community assessment can be useful in mobilizing a community to action as it identifies and
matches the skills of community members with the resources of organizations. A community
assessment can also be used to do the following:
• 1. Create a coalition action plan
• 2. Establish objectives for a program or intervention
• 3. Select the strategies to use in a program or intervention
• 4. Establish a baseline for evaluating progress in the community
• 5. Identify new ideas, strategies, partners and resources that can be used in working toward
a common goal
• Conducting a Community Assessment:
• The process of conducting a community assessment can be divided into three
phases: pre-assessment, assessment and post-assessment. Questions to
consider during the pre-assessment phase include the following:
• - What is going to be assessed?
• - What is already known?
• - What data will need to be collected?
• - How and by whom will data be collected?
• - How and by whom will data be analyzed?
• Steps on community assessment:
• 1. Determine the purpose and scope of the assessment.
• = Decide whether the assessment will focus on a specific population within the
community versus the community at large.
• = Decide which health topics to prioritize, limiting the scope of the assessment to
what can reasonably be accomplished.
• 2. Define the goals and objectives of the assessment.
• 3. Select data collection methods to use.
• = Find out whether the desired information exists or if a new data collection effort
is needed.
• = Common methods for new data collection include surveys, interviews, focus groups
and observation.
• 4. Select or design the necessary instruments and procedures for data collection.
• = Look for valid and reliable instruments that have been tested in similar
communities with similar populations. It is much easier and less costly to adapt an
existing instrument than to create one from scratch.
• 5. Pilot test the instruments and procedures.
• 6. Prepare a timeline and budget.
• 7. Collect the data.
• 8. Analyze the data.
• 9. Prepare and disseminate a report of the findings.
• 10. Evaluate the assessment's merit and worth.
• = Consider what worked well, what problems were encountered and what could
have been done better.
• Tips for Effectively Reporting a Community Assessment:
• 1. Prepare multiple reports using a variety of media.
• 2. Include an executive summary.
• 3. Keep a logical sequence in mind, using language that is easily understandable.
• 4. Highlight the information that community members perceive as most important.
• 5. Explain why the needs assessment was completed, what is now known that was not
known before and how the new information will help address discrepancies in the
community.
• 6. Acknowledge limitations and alternative explanations for the findings.
• 7. Keep the information relevant, practical, credible and understandable.