Community Diagnosis/Community Situation Analysis

Table of Contents

Community Diagnosis

Community diagnosis refers to the process of collecting quantitative and qualitative data about a community to understand the health status of individuals, families, and the community as a whole.

It involves identifying and quantifying health problems, assessing their causes and correlates, and determining the population groups at risk or in need of healthcare interventions.

Community diagnosis can be described as a comprehensive assessment of the community’s health in relation to its social, political, economic, physical, and biological environment.

The collected information should cover a range of health-related factors such as sanitation, nutrition, immunization, and vital statistics including birth and death rates. Additionally, community diagnosis may include other development issues related to the community’s well-being.

The process of community diagnosis involves gathering data from various sources within the community, including household heads, health units, local authorities, women’s clubs, youth clubs, and extension workers, among others. This data collection aims to provide a holistic understanding of the community’s health needs, challenges, and resources. This follows Community Assessment.

Objectives of Community Diagnosis

Analyze health status: Community diagnosis aims to assess the health status of individuals, families, and the community as a whole. It involves collecting and analyzing data on mortality rates, morbidity rates, prevalence of diseases, and other health indicators to understand the current health situation.
Evaluate health resources, services, and systems of care: Community diagnosis involves assessing the availability, accessibility, and quality of health resources, services, and systems within the community. This evaluation helps identify gaps, strengths, and weaknesses in the healthcare infrastructure.
Assess attitudes toward community health services and issues: Community diagnosis seeks to understand the attitudes, perceptions, and beliefs of community members regarding health services and health-related issues. This assessment helps in designing interventions that are culturally appropriate and acceptable to the community.
Identify priorities, establish goals, and determine courses of action to improve health status: Based on the analysis of health status, resources, and community attitudes, community diagnosis helps in identifying priority areas for intervention. It helps establish goals and develop strategies to improve the health status of the community.
Establish an epidemiologic baseline for measuring improvement over time: Community diagnosis provides a baseline for measuring changes and improvements in health status over time. It helps in monitoring and evaluating the effectiveness of interventions and programs implemented to address the identified health issues.

Goals of Community Diagnosis

Analyze the health status of the community: Community diagnosis aims to assess the overall health status of the community, including the prevalence of diseases, health behaviors, and the determinants of health. It provides a comprehensive understanding of the health issues and needs of the community.
Evaluate the health resources and systems of care within the community: Community diagnosis involves evaluating the availability, accessibility, and quality of health resources, services, and systems in the community. This assessment helps identify strengths, weaknesses, and gaps in healthcare delivery.
Assess attitudes towards community health services: Community diagnosis aims to understand the attitudes, perceptions, and beliefs of community members towards health services and healthcare providers. This assessment helps in identifying barriers to accessing and utilizing healthcare and enables the development of strategies to address them.
Increase levels of awareness about prevailing negative factors: Community diagnosis helps raise awareness about the existing negative factors that contribute to poor health outcomes in the community. By identifying and highlighting these factors, community members, healthcare providers, and policymakers can work together to address them and promote positive health behaviors.

Goals: The goals mentioned (analyzing the health status, evaluating health resources and systems of care, assessing attitudes towards community health services, increasing levels of awareness about negative factors) represent the overall intentions and purposes of community diagnosis. They provide a broad framework for the process and guide the overall direction of the assessment.

Objectives: The objectives listed (analyzing health status, evaluating health resources, assessing attitudes towards community health services, increasing levels of awareness about prevailing negative factors) are more specific and measurable targets that contribute to achieving the broader goals. They outline the specific actions and outcomes that need to be accomplished during the community diagnosis process.

In summary, goals represent the broader purpose or direction, while objectives are specific, measurable targets that contribute to achieving the goals.

Content of community diagnosis (sample)

Demographic Information: Who lives in the community?

Number of households/families
Number of adults, including male-to-female ratio
Number of children, including male-to-female ratio

Geographical Location: Where do they live?

Identification of the specific locations of houses within the community

Socioeconomic Status: How do they live?

Source of income for community members
Source of food supply
Income distribution within the community

Community Problems: What problems do they have?

Identification of general problems faced by the community, including security concerns
Health-related problems prevalent in the community

Community Resources: What resources do they have?

Industrial or agricultural facilities available within the community
Schools and educational institutions
Markets and business centers
Health facilities, including clinics or hospitals
Water supply sources and quality
Sanitary facilities, such as toilets and waste management systems
Road network and transportation infrastructure
Access to information sources like radio or newspapers

Process / stages of carrying out community diagnosis

Initiation
Data collection and Analysis
Diagnosis
Dissemination
Prioritization
Action Plan

1. Initiation phase

Define or identify the area of study from which the data is to be gathered for community diagnosis (i.e. location, population size, sex and age structure, climate condition, ethnicity, economic status, education, standards of living, occupation, religion, infrastructure, e.t.c).
At an early stage, it is important to identify the available resources needed to determine the scope of the diagnosis.
In order to initiate a community Diagnosis, a dedicated committee or working group should be networked to manage and coordinate the project.
The committee should involve relevant parties such as government departments, health professionals and non – governmental –organizations
Some of the common areas to be studied may include health status, lifestyles, living conditions, socioeconomic conditions, physical and social infrastructure, inequalities, as well as public health services and policies, medical services, public health issues, education, housing, public security and transportation
Once the scope is defined, a working schedule to conduct the community diagnosis, production and dissemination of reports should be set.

2. Data collection with analysis

Data collection refers to gathering data about the health problems present in the community.
Design the relevant tools to be used in data collection.
Prepare for data collection using selected methods e.g. these can be the questionnaires, interview guide or observational checklists, focus group discussions.
The following sources of data can be used:

Discussion with community members about their main health problems
Reviewing records of the health services utilized by the community
Undertaking a community surveyor a small-scale project
Observing the risks to health present in the community.

5. Data analysis: Data analysis refers to categorizing the whole of the data you collected into groups so as to make meaning out of it. For instance you can assess the magnitude of a disease by calculating its prevalence and its incidence from the numbers of cases you recorded and the number of people in the population in your community.
6. Collected data can then be analyzed and interpreted by experts, Here are some practical tips on data analysis and presentation:

Statistical information is best presented as rates or ratios for comparison
Trends and projections are useful for monitoring changes over a time period for future planning
Graphical presentation is preferred for easy understanding

3. Diagnosis

Diagnosis of the community is reached from conclusions drawn from the data analysis. It should preferably comprise three areas:

Health status of the community
Determinants of health in the community
Potential for healthy community development

4. Dissemination

The production of the community diagnosis report is not an end in itself; efforts should be put into communication to ensure that targeted actions are taken.
The target audience for the community diagnosis includes policy-makers, health professionals and the general public in the community.
The report can be disseminated through the following channels: presentations at meetings of the health boards and committees, or forums organized for voluntary organizations, local community groups and the general public through press releases or meetings.
It is important to realize that Community Diagnosis is not a one-off project, but is part of a dynamic process leading to health promotion in the community.
Target audience for report can be determined to;-

Policy makers
Press release
Health professionals
presentation
Meetings of health boards
General public committees

5. Prioritizing health problems

As a health professional working in a community affected by several health problems at the same time it is difficult to address all the problems at once. Therefore, you should give priority to the most important ones first.
Health problems which have a high magnitude and severity, which can be easily solved, and are major concerns of the community and the government, are given the highest priority.
After prioritizing which disease (or diseases) you will give most urgent attention to, the next step is to develop an action plan.

6. Action plan (work plan)

An action plan sets out the ways in which you will implement the interventions required to prevent and control the disease or solve a problem.
It contains a list of the objectives and corresponding interventions to be carried out, and specifies the responsible bodies who will be involved.
It also identifies the time and any equipment needed to implement the interventions.

Summary of Steps to consider when carrying out community diagnosis

Plan for the resources required for the activity
Decide the scope I areas to be studied
Design the relevant tools to be used in data collection
Conduct surveys to obtain quantitative and qualitative data
Collect and analyze the data
Form a community diagnosis and disseminate the report via different channels
Establish and prioritize areas for improvement
Set work plans for implementation and indicators for evaluation

Importance of community diagnosis

Helps to identify community needs and problems
It provides data as a prerequisite for planning, implementation and evaluation of successful community based health and development programmes.
Helps to decide strategies for community involvement
It gives an opportunity for the community to learn about itself i.e. the community becomes conscious of its existing problems and finds solutions.
Helps to match project organizations and services to community needs.
Helps to understand about the social, cultural and environmental characteristics of the community.
To create opportunities for Intersectoral collaboration and media involvement
It helps to obtain up-to-date information about the community quality is necessary for effective planning, Monitoring with evaluation for development.
It helps to improve community level of awareness about the prevailing factors that affect their health and general development.
It helps the community to prioritize their problems before implementation.
It fosters community participation.

Roles of a Nurse in Community Diagnosis

Data Collection: Nurses play a crucial role in collecting relevant data about the health status of individuals, families, and communities. They gather information through interviews, surveys, and observations.
Assessment: Nurses assess the health needs and concerns of individuals and the community as a whole. They identify risk factors, social determinants of health, and existing health problems through comprehensive assessments.
Collaboration: Nurses collaborate with other healthcare professionals, community leaders, and stakeholders to gather diverse perspectives and insights. They work as part of a multidisciplinary team to ensure comprehensive data collection and analysis.
Health Education: Nurses educate community members about the importance of community diagnosis, encourage participation, and explain the relevance of data collection in improving health outcomes.
Data Analysis: Nurses contribute to the analysis of collected data by interpreting and summarizing the findings. They assist in identifying patterns, trends, and health priorities to inform the community diagnosis process.
Planning and Implementation: Nurses collaborate with the healthcare team to develop action plans based on the community diagnosis. They help in setting goals, defining interventions, and implementing strategies to address identified health needs.
Advocacy: Nurses advocate for the community’s health needs and concerns based on the findings of the community diagnosis. They raise awareness about key issues and work towards ensuring equitable access to healthcare services.
Evaluation: Nurses participate in the evaluation of interventions and programs implemented based on the community diagnosis. They assess the effectiveness of the strategies and make recommendations for improvement.
Health Promotion: Nurses engage in health promotion activities within the community, empowering individuals and groups to make informed decisions about their health. They support community members in adopting healthy behaviors and lifestyles.
Collaborative Partnerships: Nurses collaborate with community organizations, government agencies, and non-governmental organizations to leverage resources and strengthen community health initiatives based on the findings of the community diagnosis.

Related Question

4. (a) Define the term community diagnosis.

Community diagnosis is defined as a comprehensive assessment of the state of the entire community in relation to its social, political, economic, physical and biological environment.

(b) Outline any 5 objectives of community diagnosis.

To analyze the health status of the community.
To evaluate health resources, services, and systems of care in the community.
To assess the attitudes towards community health services and issues.
To identify priorities, establish goals, and determine courses of action to improve health status.
To establish epidemiologic baseline for measuring improvement over time.

Initiation phase:

Planning for the resources required for the activity
Defining or identifying the area of study from which the data is to be gathered for community diagnosis (i.e. location, population size, sex and age structure, climate condition,. ethnicity, economic status, education, standards of living, occupation, religion
Once the scope is defined, a working schedule to conduct the community diagnosis, production and dissemination of report should be set.
Some of the common areas to be studied may include health status, lifestyles, living conditions, socioeconomic conditions, physical and social infrastructure, inequalities, as well as public health services and policies, medical services, public health issues, education, housing, public security and transportation

Data collection with analysis

Data collection refers to gathering data about the health problems present in the community.
Design the relevant tools to be used in data collection.
Prepare for data collection using selected methods e.g. these can be the questionnaires, interview guide or observational checklists, focus group discussions.
The following sources of data can be used:
Discussion with community members about their main health problems
Reviewing records of the health services utilized by the community
Undertaking a community surveyor a small-scale project
Observing the risks to health present in the community.
Data analysis: Data analysis refers to categorizing the whole of the data you collected into groups so as to make meaning out of it. For instance you can assess the magnitude of a disease by calculating its prevalence and its incidence from the numbers of cases you recorded and the number of people in the population in your community.

3. Diagnosis:

Diagnosis of the community is reached from conclusions drawn from the data analysis. It should preferably comprise three areas:

Health status of the community
Determinants of health in the community
Potential for healthy community development

4. Dissemination

The production of the community diagnosis report is not an end in itself; efforts should be put into communication to ensure that targeted actions are taken.
The target audience for the community diagnosis includes policy-makers, health professionals and the general public in the community.
The report can be disseminated through the following channels: presentations at meetings of the health boards and committees, or forums organized for voluntary organizations, local community groups and the general public through press releases or meetings.
It is important to realize that Community Diagnosis is not a one-off project, but is part of a dynamic process leading to health promotion in the community.
Target audience for report can be determined to;-

Policy makers
Press release
Health professionals
presentation
Meetings of health boards
General public committees

5. Prioritizing health problems

Health problems which have a high magnitude and severity, which can easily be solved, and are major concerns of the community and the government, are given the highest priority.
After prioritizing which disease (or diseases) you will give urgent attention to, the next step is to develop an action plan.

6. Action plan (work plan)

An action plan sets out the ways in which you will implement the interventions required to prevent and control the disease or solve a problem.
It contains a list of the objectives and corresponding interventions to be carried out, and specifies the responsible bodies who will be involved.
It also identifies the time and any equipment needed to implement the interventions.

Lets use a scenario to understand the steps/process.

Initiation Phase:

The health committee in Goma village, Mukono District, Uganda, notices an increase in waterborne diseases and a lack of proper sanitation facilities after Community Assessment. They decide to conduct a community diagnosis to address these issues.

Planning:

The committee plans the resources needed, including volunteers, survey tools, and educational materials. They define the area of study, considering factors like population size, age structure, economic status, and sanitation practices.

Data Collection with Analysis:

Volunteers design questionnaires and conduct interviews and focus group discussions with community members. They also review health service records and observe sanitation practices. The collected data is analyzed to identify the prevalence of waterborne diseases and sanitation challenges.

Diagnosis:

Based on data analysis, the community diagnosis reveals a high prevalence of waterborne diseases due to poor sanitation and inadequate access to clean water. Determinants of health problems include a lack of awareness, limited resources, and insufficient sanitation infrastructure. The potential for healthy community development is hindered by these issues.

Dissemination:

The community diagnosis report is disseminated through presentations at health board meetings, press releases, and community meetings. The target audience includes policymakers, health professionals, and the general public. The report emphasizes the urgent need for interventions to improve sanitation and access to clean water.

Prioritizing Health Problems:

Waterborne diseases are prioritized due to their high magnitude, severity, and impact on the community. The committee identifies diarrhea and cholera as the most urgent health problems.

Action Plan (Work Plan):

a. The committee develops an action plan focusing on improving sanitation practices and providing access to clean water sources.

b. Objectives include raising awareness, building sanitation facilities, and collaborating with local authorities.

c. Responsibilities, timelines, and required resources are clearly outlined in the action plan.

(d) Outline any 10 importance of community diagnosis.

Helps to identify community needs and problems
It provides data as a prerequisite for planning, implementation and evaluation of successful community based health and development programmes.
Helps to decide strategies for community involvement
It gives an opportunity for the community to learn about itself i.e. the community becomes conscious of its existing problems and finds solutions.
Helps to match project organizations and services to community needs.
Helps to understand about the social, cultural and environmental characteristics of the community.
To create opportunities for Intersectoral collaboration and media involvement
It helps to obtain up-to-date information about the community quality is necessary for effective planning, Monitoring with evaluation for development.
It helps to improve community level of awareness about the prevailing factors that affect their health and general development.
It helps the community to prioritize their problems before implementation.
It fosters community participation.