Week 11: Leadership in Community Types of Community Diagnosis

Development
1. Comprehensive Community Diagnosis -
Community Development focused on obtaining general information about
the community.
- "Community Development is a process designed
2. Problem-oriented Community Diagnosis –
to create conditions of economic and social
deals with problems that are readily seen and
progress for the whole community with its
should be acted upon immediately.
active participation and fullest possible reliance
a. For example, if there’s an epidemic in the
upon the community's initiative."
community, what you should make is a
problem-oriented diagnosis. After all, it
would be quite unwise to use a
The Community as a Client comprehensive community diagnosis
- Community – is a cluster of people with at least when people are already dying and
one common characteristic (geographic location, suffering.
occupation, ethnicity, housing condition……)
- A group of people with a common characteristic
or interest living together within a larger society Phases of Community Diagnosis
Assessment planning models and frameworks
identify 10 Steps in the Community Health
Community Core Assessment development process. They are:
Community core:
• Establishing the assessment team.
• History • Identifying and securing resources.
• socio-demographic characteristics • Identifying and engaging community partners.
• vital statistics • Collecting, Analyzing, and Presenting Data.
• values/beliefs/religions • Setting Health Priorities.
• Clarifying the Issue.
• Setting Goals and Measuring Progress.
Community Diagnosis • Choosing the Strategy.
• Developing the Community Health Assessment
- generally refers to the identification and
document.
quantification of health problems in a community
• Managing and sustaining the process.
in terms of mortality and morbidity rates and
ratios, Identification of their correlates for the
purpose of defining those at risk or those in need
of health care. Goal: Analyze the Health Status of the
Community
• Evaluate the health resources, services, and
The Community Diagnosis Process systems of care within the community
- “A means of examining aggregate and social • Assess attitudes toward community health
statistics in addition to the knowledge of the local services and issues
situation, in order to determine the health needs • Identify priorities, establish goals, and determine
of the community” courses of action to improve the health status of
the community
• Establish an epidemiologic baseline for
measuring improvement over time.
Components of Community Diagnosis To set your priorities, you must consider these
things:
Eight subsystems:
1. Nature of the condition or problem presented.
• Physical environment. 2. Magnitude of the Problem.
• Education. 3. Modifiability of the Problem.
• Safety and transportation. 4. Preventive Potential.
• Politics and government. 5. Social Concern
• Health and social services.
• Communication.
• Economics. Select community health priorities
• recreation.
Priorities can be selected as part of an established
process informed by contributing partners, including
community stakeholders, health departments, social
Definition
service agencies, policy makers and hospital
• Health problems – a disease or medical ailment leadership. Action steps to be considered are:
or an environmental condition that poses the risk
• Select a prioritization committee – Members
of disease or medical ailment.
can be from hospitals, community stakeholder
o Example:
organizations and other
▪ Blood. Hematological diseases,
organizations/institutions with specialized
anemia, clotting (including
knowledge or constituents.
thromboses and venous
• Discuss the data – Present the qualitative and
embolisms) and normal
quantitative data to the prioritization committee.
development and function of
Make sure that the data are presented in a format
platelets and erythrocytes.
that is accessible for the individuals on the
▪ Cancer and neoplasms.
committee. Foster an environment for open
▪ Cardiovascular.
dialogue to discuss the identified health needs
▪ Congenital disorders.
thoroughly.
▪ Ear problems
▪ Eye problems • Review community assets – Reflect back on
▪ Infection. your asset map to identify what resources exist in
▪ Inflammatory and immune your community to address the need. Take stock
system. of what resources (staffing, in-kind, financial,
etc.) in your hospital could potentially be
leveraged to address that need.
Three Types of Community Nursing Problems: • Select priorities – Decide which approach you
want to use to determine priority needs.
1. Health Status Problems — problems that are
directly related to the community’s health (e.g.,
too many breeding grounds for vectors, Strategies in People Participation
epidemics, malnourishment).
2. Health Resources Problems — problems that 1. Create a Welcoming Space.
concern a community’s health resources (e.g., 2. Choose Your First Project Wisely.
understaffing in the barangay health center, lack 3. Include a Healthy Mix of Heavy and Light Issues.
of hospitals, lack of health transportation). 4. Create a Fun Video to Maximize Public
3. Health-related problems — problems that Involvement.
indirectly influence health (e.g., lack of funding 5. Promote Public Participation with Social Media.
from the government, indifference of the people)
6. Provide Printed Materials and Swag in as Many of preventable cancer, prevent and manage its
Touchpoints as Possible. recurrence, and provide access to quality
7. Take Advantage of Current Digital City healthcare for its treatment.
Communications to Encourage Public • Chronic-Kidney Disease Prevention and
Engagement Control – this program aims to reinforce
8. Write Questions That Result in the Data You strategies for the prevention and control of CKDs
Need. such as lifestyle-related disease prevention,
9. Remain Engaged with the Community in facilitation of early detection and evaluation, and
Between Projects proper disease management for people with
10. Employ Specific, Targeted Advertising CKDs.
• Climate Change – Through its NDC, however,
the Philippines still committed 75 percent GHG
DOH has programs for mental health, nutrition, emission reduction and avoidance nationwide by
the addressing of specific diseases, immunization 2030 in the agriculture, waste, industry,
or vaccination, baby care, and a lot more. transport, and energy sectors. Of such target, the
government said 2.71 percent will be
Here is a full list of the DOH Programs in the
implemented mainly through domestic resources.
Philippines:
• Dengue Prevention and Control Program –
• Adolescent Health and Development Program IMS-dengue is a management model aimed at
– focuses on improving the health of young strengthening national programs and thereby
people, ages 10-19, and providing educational reducing the morbidity, mortality, and social and
and skill building workshops and programs that economic burden generated by dengue outbreaks
help them navigate safely through adolescence and epidemics.
and into adulthood. • Dental Health Program – It aims to further
• Aedes-Borne Viral Diseases Prevention and improve oral hygiene knowledge and practices to
Control Program – this program, aims to reduce the incidence of dental caries among
expand and integrate the existing program to learners through effective dental health service
include the prevention and control interventions delivery and the preventive track of effectively
for various aedes-borne viral diseases such as controlling risk behaviors related to diet,
dengue, zika, and chikungunya, and other hygiene, nutrition, smoking, and substance abuse
diseases with similar vectors. in promoting good oral health and oral disease
• Belly Gud for Health – is a six months challenge prevention.
designed by the DOH where Executives and staff • Early Childhood Care Development Program
undergo nutrition and physical activity, – Early Childhood Care and Development
counseling, healthy diet, aerobic and isometric (ECCD) System refers to the full range of health,
exercises and stress management activities aimed nutrition, early education and social services
towards optimum wellbeing. programs that provide for the basic holistic needs
• Blood Donation Program – Republic Act No. of young children from birth to age six, to
7719, also known as the National Blood Services promote their optimum growth and development.
Act of 1994, promotes voluntary blood donation • Emerging and Re-emerging Infectious
to provide sufficient supply of safe blood and to Diseases Program –is a network of 10 state
regulate blood banks. This act aims to inculcate health departments using public health practice to
public awareness that blood donation is a address emerging infections. Each site is a
humanitarian act. collaboration between health departments,
• Cancer Control Program – It serves as the academic institutions, and other key public health
framework for all cancer-related activities of the stakeholders.
government that aims to decrease the incidence • Environmental Health Program – connects us
to the world around us, teaching us about both
natural and built environments. EE raises agency effort to control Leprosy in the country
awareness of issues impacting the environment with private and public partnership in achieving
upon which we all depend, as well as actions we its goals to lessen the burden of the disease and
can take to improve and sustain it. its mission to have a leprosy-free country.
• Expanded Program on Immunization – The • Malaria Control and Elimination Program –
Expanded Program on Immunization (EPI) was The goal of most current National Malaria
established in 1976 to ensure that infants/children Control Programs and most malaria activities is
and mothers have access to routinely to reduce the number of malaria-related cases and
recommended infant/childhood vaccines. Six deaths. To reduce malaria transmission to a level
vaccine-preventable diseases were initially where it is no longer a public health problem is
included in the EPI: tuberculosis, poliomyelitis, the goal of what is called malaria “control.”
diphtheria, tetanus, pertussis and measles. • Mental Health Program – a treatment,
• Filariasis Elimination Program – this program prevention, rehabilitation, or educational service
aims to eliminate Filariasis as a public health offered by a community mental health center or
problem through a comprehensive approach and other entity for the purpose of maintaining or
universal access to quality health services that improving the mental health of an individual or
combat the disease such as mass treatment community.
programs integrated with parasitic control • Micronutrient Supplementation Program – is
programs and elimination campaigns. the provision of pharmaceutically prepared
• Food and Waterborne Diseases Prevention vitamins & minerals for treatment or prevention
and Control Program – In 1997, the of specific micronutrient deficiency
Department of Health (DOH) issued AO No. 29- • National Family Planning Program – the
A s. 1997 “Creation of the Food and Waterborne National Family Planning Program aims to
Diseases Prevention and Control Program” ensure every Filipino has a universal access to
which defines the roles and responsibilities of correct information, medically safe, legal, non-
different agencies to ensure prevention and abortifacient, effective, and culturally acceptable
control of Food and Waterborne Diseases. modern family planning (FP) methods.
• Healthy and Productive Ageing Program – • National Leprosy Control Program – is a
This program primarily aims to promote quality multi-agency effort to control Leprosy in the
life among older persons and contribute to nation country with private and public partnership in
building through providing equitable access to achieving its goals to lessen the burden of the
quality healthcare. disease and its mission to have a leprosy-free
• Infant and Young Child Feeding Program – country.
IYCF program is considered a key area in • National Safe Motherhood Program – The
improving nutrition status and promoting healthy National Safe Motherhood Program primarily
growth and development of children. Its sole goal focuses on the health and welfare of women
is to reduce child mortality and morbidity throughout their pregnancy. It also includes the
through optimal feeding of infants and young adolescent pregnant and meeting the unmet needs
children. for family planning contraceptives of women into
• Integrated Management of Childhood Illness its priority agenda until 2030.
Program – is an integrated approach that focuses • Newborn Hearing Screening Program – The
on the health and well-being of the child. IMCI newborn hearing screening test helps identify
aims to reduce preventable mortality, minimize babies who have permanent hearing loss as early
illness and disability, and promote healthy as possible. This means parents can get the
growth and development of children under five support and advice they need right from the start.
years of age. • Newborn Screening Program – Newborn
• Leprosy Control Program – The National screening are tests done on your baby before your
Leprosy Control Program (NLCP) is a multi-
baby leaves the hospital. These screening tests and other eye conditions, eye screenings, and
check for serious conditions in your baby. The treatment services necessary to prevent
tests will look for certain genetic and metabolic blindness. Our goal is to prevent blindness
conditions, hearing loss, and specific heart through early diagnosis and treatment.
problems. • Rabies Prevention and Control Program –
• Occupational Health Program – The NRPCP is a multi-agency effort to control and
Occupational Health Program primarily aims to eliminate rabies in the country lead by the
prevent and control occupational diseases, work- Department of Agriculture (DA) and Department
related diseases, and injuries among workers in of Health (DOH), Department of Interior and
all occupations. Local Government (DILG), Department of
• Oral Health Program –The Oral Health Education (DepEd) in coordination with other
Program promotes oral health activities designed Government Organizations (GOs), Non-
to encourage good oral health practices and Governmental
increase awareness of the importance of oral • Safe Motherhood Program – The Safe
health and preventive care. Motherhood Initiative focuses on the four leading
• Persons with Disabilities – The term persons causes of maternal death: maternal sepsis,
with disabilities is used to apply to all persons obstetric hemorrhage (severe bleeding), venous
with disabilities including those who have long- thromboembolism (blood clots), and severe
term physical, mental, intellectual or sensory hypertension in pregnancy (high blood pressure).
impairments which, in interaction with various • Unang Yakap (Essential Newborn Care:
attitudinal and environmental barriers, hinders Protocol for New Life) – Essential newborn care
their full and effective participation in society on includes Immediate care at birth (delayed cord
an equal basis with others. clamping, thorough drying, assessment of
• Philippine Cancer Control Program – The breathing, skin-to-skin contact, early initiation of
Philippine Cancer Control Program, begun in breastfeeding) Thermal care. Resuscitation when
1988, is an integrated approach utilizing primary, needed. Support for breast milk feeding.
secondary and tertiary prevention in different • Water Safety Program – A Water Safety Plan
regions of the country at both hospital and (WSP) is defined by the World Health
community levels. Six leading cancers (lung, Organization (WHO) as “a comprehensive risk
breast, liver, cervix, oral cavity, colon and assessment and risk management approach that
rectum) are discussed encompasses all steps in water supply from
• Philippine Medical Travel and Wellness catchment to consumer”1 to ensure safe
Tourism Program – Wellness journeys in the drinking-water.
Philippines provide a unique blend of Filipino • Medical care – Medical Program means a
modalities, deeply rooted in rich healing Welfare Program that provides group health
traditions, and programs focused on maintaining benefits that are subject to the Patient Protection
physical health, set in a welcoming and nurturing and Affordable Care Act.
environment like nowhere else in the world. • Environmental sanitation – is the promotion of
• Philippine Organ Donation and Transplant hygiene and the prevention of disease and other
Program –The Philippines "Organ Donation Act consequences of ill-health, relating to
of 1991" updates the "1949 Act to legalize environmental factors.
permissions to use human organs". Under the • Communicable disease control –The objective
new legislation, each individual can donate all or of communicable disease control is ultimately to
any part of his body by way of legacy or will. stop transmission of the causative agent, so that
• Prevention of Blindness Program – The no new individuals will get infected and be at risk
Prevention of Blindness Program (POB) is a of developing disease.
statewide program created in 1915 that provides
free public education services about blindness
The Nursing Components of the Abovementioned Mission:
DOH Programs
The mission of the DOH, in partnership with the
• Health Care System – is an organized plan of people to ensure equity, quality and access to health
health services (Miller-Keane, 1987) care:
• Health Care Delivery – rendering health care
• by making services available
services to the people (Williams-Tungpalan,
• by arousing community awareness
1981).
• by mobilizing resources
• Health Care Delivery System – the network of
health facilities and personnel which carries out • by promoting the means to better health
the task of rendering health care to the people.
• Philippine Health Care System – is a complex
set of organizations interacting to provide an Levels of Health Care Facilities
array of health services (Dizon, 1977). 1. Primary Level of Health Care Facilities
- are the rural health units, their sub-centers, chest
clinics, malaria eradication units, and
Concepts and Principles of Networking and schistosomiasis control units operated by the
Linkage Building DOH; puericulture centers operated by League of
Puericulture Centers; tuberculosis clinics and
Components of the Health Delivery System
hospitals of the Philippine Tuberculosis Society;
The Department of Health Mandate: private clinics, clinics operated by the Philippine
Medical Association; clinics operated by large
The Department of Health shall be responsible
industrial firms for their employees; community
for the following: formulation and development of
hospitals and health centers operated by the
national health policies, guidelines, standards and
Philippine Medicare Care Commission and other
manual of operations for health services and
health facilities operated by voluntary religious
programs; issuance of rules and regulations, licenses
and civic groups (Williams-Tungpalan, 1981).
and accreditations; promulgation of national health
standards, goals, priorities and indicators;
2. Secondary Level of Health Care Facilities
development of special health programs and projects
- are the smaller, non-departmentalized hospitals
and advocacy for legislation on health policies and
including emergency and regional hospitals.
programs. The primary function of the Department
- Services offered to patients with symptomatic
of Health is the promotion, protection, preservation
stages of disease, which require moderately
or restoration of the health of the people through the
specialized knowledge and technical resources
provision and delivery of health services and through
for adequate treatment.
the regulation and encouragement of providers of
health goods and services (E.O. No. 119, Sec. 3).
3. Tertiary Level of Health Care Facilities
- are the highly technological and sophisticated
services offered by medical centers and large
Vision: hospitals. These are the specialized national
Health as a right. Health for All Filipinos by the hospitals.
year 2000 and Health in the Hands of the People by - Services rendered at this level are for clients
the year 2020. afflicted with diseases which seriously threaten
their health and which require highly technical
and specialized knowledge, facilities and
personnel to treat effectively (Williams-
Tungpalan, 1981)
Factors on the Various Categories of Health Two-Way Referral System (Niace, et. al. 8th
Workers among Countries and Communities edition 1995)
1. Available Health Manpower Resources A two-way referral system need to be
2. Local Health Needs and Problems established between each level of health facility e.g.,
3. Political and Financial Feasibility barangay health workers refer cases to the rural
health team, who in turn refer more serious cases to
either the district hospital, then to the provincial,
Three Levels of Primary Health Care Workers regional or the whole health care system.

A. Village or Grassroot Health Workers

• First contacts of the community and initial links Multisectoral Approach to Health
of health care.
• Provide simple curative and preventive health 1. Intersectoral Linkages
care measures promoting healthy environment. - Primary Health Care forms an integral part of the
• Participate in activities geared towards the health system and the over-all social and
improvement of the socio-economic level of the economic development of the community. As
community like food production program. such, it is necessary to unify health efforts within
• Community health worker, volunteers or the health organization itself and with other
traditional birth attendants. sectors concerned. It implies the integration of
health plans with the plan for the total community
B. Intermediate Level Health Workers development.
• Represent the first source of professional health Sectors most closely related to health include
care those concerned with:
• Attends to health problems beyond the
competence of village workers a. Agricultural
• Provide support to front-line health workers in b. Education
terms of supervision, training, supplies, and c. Public works
services. d. Local governments
• Medical practitioners, nurses and midwives. e. Social Welfare
f. Population Control
C. First Line Hospital Personnel
2. Intrasectoral Linkages
• Provide back up health services for cases that
- In the health sector, the acceptance of primary
require hospitalization
health care necessitates the restructuring of the
• Establish close contact with intermediate level
health system to broaden health coverage and
health workers or village health workers.
make health service available to all. There is now
• Physicians with specialty, nurses, dentist,
a widely accepted pyramidal organization that
pharmacists, other health professionals.
provides levels of services starting with primary
health and progressing to specialty care. Primary
health care is the hub of the health system.
Pyramidal Health Structure Evaluation of programs and services
Recording and reporting system of the following:
• Vital Statistics
• Notifiable Disease
• Services Provided to Family and Community

The National Health Plan (Niace, et. al 8th edition

1995)
- The National Health Plan is the blueprint which
is followed by the Department of Health. It
defines the country’s health problems, policy
thrusts, strategies and targets.
Policy Thrusts and Strategies
There are policy thrusts and strategies which are
commonly important. These are:
1. Information, education, and communication
programs will be implemented to raise the
awareness of the public, including policy makers,
program planners and decision makers;
2. An update of the legislative agenda for health,
nutrition and family planning (HNFP), and
stronger advocacy for pending HNFP –related
legislations will be pursued;
3. Integration of efforts in the health, nutrition and
family planning sector to maximize resources in
the delivery of services through the establishment
of coordinative mechanisms at both the national
and local levels;
4. Partnership between the public and the private
sectors will be strengthen and institutionalized to
effectively utilize and monitor private resources
for the sector;
5. Enhancement of the status and role of women as
program beneficiaries and program implementers
will be pursued to enable them to substantially
participate in the development process.