PHAS 307 I

8/7/2019 PHAS 307 I

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COMMUNITY HEALTH

DIAGNOSIS

PHAS 307

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COURSE OUTLINE

� As discussed.

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Concept of Community Diagnosis

� Individual diagnosis:- attempts to know the

health status of an individual within the

community.

� Some information need to be gathered about

the individual.

- The specif ic disease process, its stage of

evolution and prognosis, whether treatment

has been given and its eff ects.

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CONCEPTOFCOMMUNITY DIAGNOSIS

CONTD

- The nutritional status of the individual.

- The level of development of the patient.

- Are there any physiological states.- The immunological background of the patient.

- The state of emotional, mental and social

adjustment.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

- The socio-economic and environmentalsituation in which the individual lives.

- The state of knowledge of the individual (or parent).

To get this information, several steps are taken:

- History taking, including details of the

evolution of the condition and itsmanagement to date.

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CONCEPTOFCOMMUNITY DIAGNOSIS

CONTD

- Physical examination

- Special investigations and perhaps f urther

questioning.- Making a diff erential diagnosis, specif ic

diagnosis and tentative prognosis.

- Startin

g treat

men

t.- Surveillance and reappraisal of the patient

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

- Alter the diagnosis if new signs and symptoms

appear or no response to treatment

- Reassess the results.- Follow up if necessary.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

� Family diagnosis:- aims at obtaining some measure of

understanding of the reasons for various levels of

health in the f amily.

� Family diagnosis also includes an assessment of the

eff ectiveness of a programme of care.

� In f amily diagnosis, the process is more complicated

�

It involves the initial diagnosis of individual f amilymembers.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

� There should be a process of comparing and

contrasting the individual diagnosis.

�

There sh

ould be a c

onside

rati

on of

theinterplay of health and disease within the

f amily milieu with its particular environmental

and behavioural f actors.

� Formulation of a programme of care is

needed.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

� Community diagnosis:- involves the collection,analysis and dissemination of data about thecommunity.

� The data should cover health matters, use of health services and their eff ectiveness,sociological and cultural information andenvironmental data.

� This gives a broad view of the community to be diagnosed.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

� The diagnostic tools are surveys and validated

indicators or screening tests of pathology

within the community.

� Statistical and epidemiological methods are

involved in the planning and analysis of these

surveys or diagnostic investigations.

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CONCEPT OFCOMMUNITY

DIAGNOSISCONTD

- Nutrition, diet and warning pattern, and thegrowth of preschool and school children.

- The pattern of leadership and communication within the society.

- Mental health together with an assessment of the common causes of stress.

- Environment, esp. water, housing and vectorsof disease.

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CONCEPT OF COMMUNITY

DIAGNOSIS CONTD

- Knowledge, attitudes and practices of the

population with respect to health related

activities.

- The detailed epidemiology of any endemic

condition.

- The services and resources available for

development, such as agriculture, veterinary

and social services.

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CONCEPT OF COMMUNITY DIAGNOSIS

CONTD

- The degree of involvement of people in their

own healthcare, including the use of

traditional healers.

- The reasons for f ailure of health programmes

in the past and the diff iculties likely to be

encountered.

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CONCEPT OF COMMUNITY

DIAGNOSIS CONTD

� Community self diagnosis:- this is the process

in which communities are helped to look at

themselves and to come out with an

assessment of their own problems and

priorities, and of the causative f actors which

need tackling.

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COMMUNITY DIAGNOSIS IN

PRACTICE

� The Process:- involves initial exploration andinteraction with the community, planning thesurvey in detail, pre-testing the methods,

executing the survey and analysing of theresults.

� It also involves f eeding these conclusions backto the community and health workers to initiate health service planning and activities.

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PRACTICE CONTD

� Exploration:

� Ideally, health surveys in a community will

take place af ter

arequest by eithe

rthe

community itself or the people involved in

providing health services.

� Once a community has accepted a survey, it

will expect some benef it from its co-

operation.

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COMMUNITY DIAGNOSIS IN PRACTICE

CONTD

� Work through the hierarchy of authorities.

� Highest governmental and medical people in charge

of the administrative area should be approached.

� Discuss the objectives of the survey, any possiblef uture actions and obtain permission to work in the

community.

� Any other government and medical personnel in the

community must also be approached.

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PRACTICE CONTD

� The community leaders may be the last to be

approached, but extremely important to the

success of the survey.

� They must clearly understand what, how,

when and why things will happen, and their

assistance in implementing the survey must

be sought.

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PRACTICE CONTD

� The opinions of the problems in the

community and what might be done about

them should be sought from community

members through informal interviews.

� As much background data as possible be

gathered about the community, such as,

population size, demographic variables,

climate conditions, maps,etc.

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PRACTICE CONT

� Planning a survey:- this encompasses themost important part of the entire process

of community diagnosis.

�For a successf ul survey planning process,the following questions must be

answered.

�

Why is the survey being done? -Objectives

� Where will it take place? Decide with

com.peo

� Who should do the surve ? U & Com.

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PRACTICE CONTD

� Who is to be interviewed?

� When is the survey to take place?

�What will be covered in the survey?

� Why are certain variables included and others

not?

�What will be the instrument for measuring thecommunitys health status?

PHAS 307 I

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