phas 307 i
TRANSCRIPT
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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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COMMUNITY DIAGNOSIS IN
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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COMMUNITY DIAGNOSIS IN
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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COMMUNITY DIAGNOSIS IN
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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COMMUNITY DIAGNOSIS IN
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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COMMUNITY DIAGNOSIS IN
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?