Community diagnosis is vital in health planning, evaluation and needs assessment, several types of indicators are valid to be used for community diagnosis including Socio-economic, demographics, health system, and living arrangements.

1. Professor Tarek Tawfik Amin
Public Health, Cairo University
amin55@myway.com

2.  Understanding the definition of Community, its’
subsystems, Community diagnosis and its indications.
 To understand the methods involved in community
diagnosis.
 To list the essential characteristics of health indicators.
 To realize the value of different health indicators in
community service and development.
 Develop the ability and skill to identify, and prioritize
health problems within the community using the
specific set of indicators

3.  A cluster of people with at least one common
characteristic (geography, occupation, race,
ethnicity, housing condition……)
 A group of people with a common characteristic
or interest living together within a larger society
.

4.  A whole entity that functions because of
the interdependence of its parts or
subsystems.
 Includes Eight subsystems plus the
community core.

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

6. Core
Physical
environme
nt
Education
Safety and
transportat
ion
Health
social
services
Recreation
Economics
Communicati
on
Politics
and
governme
nt

7. Identification and quantification of
health problems in a community as a
whole in terms of mortality and
morbidity rates and ratios, and
identification of their correlates for the
purpose of defining those at risk or those
in need of health care.

8. Examining the aggregate of health and
social statistics in addition to the
knowledge of the local situation,
aiming at determining the health
needs of a given community.

9. Analyze the health status.
Evaluate the health resources, services, and
systems of care.
Assess attitudes toward community health
services and issues.
Identify priorities, establish goals, and
determine courses of action to improve health
status.
Establish epidemiologic baseline for measuring
improvement over time.

10. 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”.

11. Demographic
Environmental
Socioeconomic
Health resources and services
Health policies
Study of target groups.

12. Health Indicators
Variables used for the assessment of
community health.

13.  Valid: Measure what they are supposed to
measure.
 Reliable and objective: the same if measured
by different people in similar circumstances
 Sensitive: to changes in the situation
concerned,
 Specific: reflect changes only in the situation
concerned
 Feasible: Have the ability to obtain data needed
 Relevant: Contribute to theunderstanding of
the phenomenon of interest.

14.  Mortality
 Morbidity
 Disability rates
 Nutritional status
 Health care delivery
 Utilization rates
 Social and mental
health
 Environmental
 Socio-economic
 Health policy
 Quality of life

15. Mortality Indicators
 Mortality Rates
- The traditional measures of health status.
- Widely used because of their ready availability.( death certificate is a legal
requirement in many countries)
 Crude death rates
 Specific death rates: age/disease
 Expectation of life
 Infant mortality rate
 Maternal mortality rate
 Proportionate mortality ratio
 Case Fatality rate

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

17. Disability Indicators
 Disability rates
 No. of days of restricted activity
 Bed disability days
 Work/School loss days within a
specified period.
 Expectation of life free of disability

18. Nutritional Indicators
 Nutritional Status
Indicators
- It is an indicator of positive health
 Anthropometrics measurements
 Height of children at school entry
 Prevalence of low birth weight
 Clinical surveys: Anemia,
Hypothyroidism, Night blindness

19. Health Care Delivery Indicators
 Health Care Delivery
Indicators
- Reflect the Equity / Provision of health care Physician / Population ratio
 Physician / Nurse ratio
 Population / Bed ratio
 Population / Health center

20. Utilization Indicators
 Health care utilization
Rates
- Extent of use of health services
- Proportion of people in need of service
who actually receive it in a given
period
 Proportion of infants who are
fully immunized in the 1st year
of life. “immunization
coverage”.
 Proportion of pregnant women
who receive ante-natal care.
 Hospital-Beds occupancy rate.
 Hospital-Beds turn-over ratio

21. Social/Mental Health Indicators
 Indicators of Social
and Mental Health
- Valid positive indicators does not
often exist
- Indirect measures are commonly used
 Suicide & Homicide rates
 Road traffic accidents
 Alcohol and drug
abuse.

22. Environmental Indicators
 Environmental health
Indicators
- Reflect the quality of environment
 Measures of Pollution
 Proportion of people having
access to safe water and
sanitation facilities
 Vectors density

23. Socio-economic Indicators
 Socio-economic
Indicators
- Is not a direct measure of health
status.
- For interpretation of health care
indicators.
 Rate of population increase
 Per capita GNP
 Level of unemployment
 Literacy rates - females
 Family size
 Housing condition e.g. No. of
persons per room

24. Health Policy Indicators
 Health Policy
Indicators
- Allocation of adequate resources.
 Proportion of GNP spent on
health services.
 Proportion of GNP spent on
health related activities.
 Proportion of total health
resources devoted to primary
health care

25. Others
 Other health indicators
 Indicators of quality of life.
 Basic needs indicators.
 Health for all indicators.

26.  Problem identification
 Priorities setting
 Identification of contributory
factors
1- Health system
2- Demographics
3- Socio-economic
- % rural population 4- Living environment
- Gross domestic product/per-capita /year
- % poor
- Literacy rate (%) ≥15 years
- % unemployment ≥15 years
- % under 5 years
- % <15 years
- Family size
- Age dependency %

27.  Problem identification
 Priorities setting
 Identification of contributory
factors
1- Health system
2- Demographics
3- Socio-economic
4- Living environment
- Population density:
individuals/KM2
- House H Access to piped water
(U/R and total)%
- House H access to sanitation
(U/R and total) %
- Health units/100,000
- Physicians / 10000
- Nurses / 10000

28.  Problem identification
 Priorities setting
 Identification of contributory
factors
1- Health system
2- Demographics
3- Socio-economic
4- Living environment
Outcome indicators: effectiveness of
health programs in converge with services
% pregnant received ANC
% births by skilled persons
% children ever breastfed
% infants 12-23 months fully
immunized
% contraceptive prevalence
Impact indicators: effectiveness of programs
in improving health status.
Crude birth rate/100,000
Crude death rate/100,000
Annual growth rate/100,000
Life expectancy at birth
Infant mortality rate/1000 LB
<5 mortality rate/1000 LB
MMR/100,000 LB
Disability /1000
<5 underweight

29. Indicators Governorate/regi
on/
district
Total
national
burden
Crude birth rate/100,000
Crude death rate/ 100,000
Annual growth rate /100
Life expectancy at birth
Infant mortality rate /1000 LB
Under 5 mortality rate/1000 LB
MMR ratio/100,000 LB
Prevalence of disability /1000
% underweight in under 5

30. Indicators Governora
te/region/
district
Total national
burden
% pregnant ANC
% birth assisted by skilled
% ever breastfed
% infants 12-23 months fully immunized
%Contraceptive prevalence
Health units/100,000
Physician /10000
Nurses /10000

31. Indicators Governorate
/region/
district
Total
national
burden
% rural to urban population
GPD /capita/ year
% poor
Literacy rate *%
Unemployment rate *%
Under 5 to total population
Under 15 %
Average family size
Age dependency ratio

33. Thank You