Community Diagnosis Flashcards
Family definition
Intergenerational social group organized and governed by social norms regarding descent and affinity, reproduction, nurturant socialization
What are assumption made about the family concept
Dominance of men
Head ensure welfare of members
Fathers and mothers have joint responsibility for childrens maintenance
Parents support children
When children are economically able they support parents
Family members reside in same household
Type of families
Extended Multigenerational Nuclear Single parents with children Reconstituted
Basic features of families
Intimate
Interdépendant
Stable over time
Identity
Anthropology view of family
Source and carrier of culture
Social psychology view of family
Small groups with task to master
Clinical psychology view of family
Environment within which normal or abnormal behavior begins
Why is family important in healthcare
Disease genetics Health promotion Disease and injury prevention Chronic disease management Health surveillance
Types of relation in families
Blood
Marriage
Adoption
Affiliation
Main way of formation of Families
Marriage
Types of marriage in African society
Légal marriage Civil Religious Customary Combinations
What is consensual union
Cohabitation
Visiting union
Persons do not live together but marital relationship with children
Cause of family dissolution
Divorce
Seperation
Widowhood
Variations of family structure
Single parent family Blended family Grandparents headed family Foster care family Adoptive family Unmarried couple as parent
What are some issues that bring community together to solve them
Public goods ( security,Infrastructure , Roads , Schools)
Amenities (water, electricity, services, healthcare )
Environmental issues ( noise, sanitation ) Social problems, unemployment , streetism
Types of membres of the community
Local community individuals Opinion leaders Organized groups Religious organizations Businesses NGOs Government
What is a community
People living together in some social organization and cohesion
Members kno each other, have interpersonal relationships and communicate
Characteristics of community
Location
Identification ( norms, values, )
Is a community completely homogeneous
No can differ in religion, politics, ideological affiliations
What is a healthy community
Members come together to improve community conditions health and well-being
Déterminants of healthy community
Income
Water
Sanitation
Social relationship
Characteristics of healthy community
Safe clean physical environment
Basic need met
Social harmony and involvement of all
Good knowled of structures in community and how they function
Participation in solving community problems
Accès to varied experiences , interactions, communication
Primary healthcare services available, accessible and affordable
Upheld cultural and social values
Diverse local economy
Sustainable and available community resources
Community stakeholders definition
Individuals, groups, organizations, affected by issues affecting coMmunity and benefit from programmes institued for community
Why are community leaders important stakeholders
Have power to influence decisions in community
Type of community leaders
Tribal leader
Political leader
Religious leader
Social institution definition
Organized body in which members participate and pool resources to promote collective wellbeing of group members
Légal Rules , norms and valued upheld by members
Community mobilization definition
Process of bringing together as many stakeholder as possible to raise awareness and demand programme , assist in delivery of resources and services and strengthen community participation for sustainability and self reliance
Community mobilization steps
Bring people together
Raise people awareness
Assist in delivery of resources
Facilitate and strengthen community participation
Advantages of community mobilization
Power to influence Sharing of resources Effective problem solving from different skills, experiences, background Accountability and transparency Barriers or obstacles reduced Motivation to bring change Awareness
Structured of community important in decision making
Political
Traditional
Religious
National level of political structure
Ministry of local government
Regional level of political structure of community
Regional coordination council
District level of political structure of community
District assembly
district chief executive
Community level of political structure of community
Assembly
Unit committee head
Traditional structure of community
Chiefs , elders
Traditional council members
Religious structure of community
Churches, mosque
Etc
Key components of community mobilization
Thé Community Community participation Community ownership Sustainability Dialogue of knowledge
Even with medical research And good education of the population there’s still low adherence to good health, why
Because of people believe system and values which affect health
Definition of culture by Robert Redfield
Peoples congressional understanding manifest in acts and artifacts
Components of culture
Environment behaviors the way things are done values attitudes fundamental assumption’s beliefs
Is culture objective or subjective
Subjective
What concept was created to avoid poor health outcomes due to proximate cultural factors
Cultural
What is cultural competence
Awareness and understanding of the culture of people and the appropriate use of these understanding in professional setting
How can clinicians demonstrate cultural competence
Incorporate patients and caregivers perception of health status and expectation of outcomes of healthcare delivery into management and communication
Reconcile this is perspective of the biomedical framework and that of the patients
Incorporate patient values into healthcare decisions
What are some question that clinicians can ask in cultural competency
What is the cause of this condition
what do you think this health problem is
is it serious
how do you think the course of this problem will be
what effect do you believe this condition will have on your organs
how do you think it will affect your life ,relationships ,and finances
how do you harbor any fears about this condition
what is your greatest fear about this treatment
Should orthodox medicine still consider cultural system as primitive an obstacle to science and evidence-based medicine
No
How does increasing wealth improve health
Improved health infrastructure, technology
improved nutrition
improved public health systems like sanitation ,hygiene , waste management etc.
increased lifespan
Increased trial survival
Why is it important for community to participate in health decision
Make them more convinced about health development processes and make them more involved in the processes
Make those programmer cost effective more sustainable more effective
What is a communicable disease
This is transmit it directly from one person to another by actual contacts
What is a non-communicable disease
This is in a person with absence of infectious agents
What is an endemic disease
Disease that is present at relatively low level or with habitual presence in a given geographic area
What is an epidemic
This is that is in excess of cases in the community from what is normally expected
Can both communicable and noncommunicable disease be endemic and become epidemic
Yes
What is the beings model in risk factor of disease
Biological behavioral factors environmental factors immunological factors nutritional factors genetic factors services social sexual factors
Direct route of transmission
Human to human through water or food
Autoinfection person to person
Intermediate host to route of transmission
Snails
Copepods
animals tapeworm
What is a vector host
Insect which act as an agent of this is dissemination or inoculation or both of a parasite which causes disease
What is a definitive host
Host in which adults and sexually mature forms of parasite found
What is a Intermediate host
Who sandwich on the immature forms of parasites or sounds
Type of vector transmission
Biological transmission
mechanical transmission
What is biological transmission
Essential part of life cycle of parasites take place in body of the vector
What is mechanical transmission
No essential part of life cycle take place in the body of the Victor
What is Infectivity
Proportion of exposed persons who become infected
What is pathogenicity
Population of exposed persons would who develop clinical diseases
What is virulence
Proportion of persons with clinical disease will become severely I’ll or die
Formula number of newly infected person
Forces infection x number of susceptible
Force of infection formula
Number of infectious individuals x transmission rates
Prevalance compared to incidence in endemic disease
Prevalence equal to incidence
Routes of entry of parasites in host
Alimentary tract respiratory tract penetrate skin penetrate mucous membrane bites of bloodsucking insect
How do parasite exit a host to another
Natural secretioN
biting insect
direct contact with skin or mucous membrane
contaminated food or drink
survival adaptation likes spore or cysts
What is the natural history of disease
The way disease progresses in absence of medical or public health intervention
Difference between symptoms and signs
Symptom is manifestation of disease seen by patient himself
sign is manifestation of disease that physician perceives
What is a sub clinical disease
Not clinically apparent
should not become disease
very slight reaction
What is preclinical disease
Not clinically apparent but destined to become clinical disease
What is an abortive disease
Reaction between host and parasites not sufficient in intensity and duration so cannot be diagnosed clinically
What is a persistence disease
Person feels to sheds of the infection in persist for years
What is disease carrier
Harbors and disseminate causative organism
Two types of carrier
Incubating carrier
convalescent carrier
What is the latent period in disease
Time interval from initial infection to start of infectiousness
What is th. Incubation period
Time interval from initial infection until onset of clinical disease
Period of communicability
Period in which individual is infectious
Three stages of disease
P pre-disease stage
latent stage
symptomatic stage
Pre-disease stage
Before pathologic process begins
Latent stage
No clinical symptoms but disease process started
no active multiplication of agent
Parasite in inactive state
Symptomatic stage
Evident this is manifestation
What is primary prevention
Prevent disease process from starting
What is secondary prevention
Prevent progression to symptomatic disease
What is tertiary prevention
Slow arrest or reverse progressive disease to complications or death
What are the three classes of clinical severity of infection
Class a -> Inapparent infection frequent class B -> Clinical disease frequent ,few deaths class c -> infections usually fatal
What is immunity
Process by which body mounts defense against invading germs
ability of human body to tolerate presence of material indigenous to the body And to eliminate foreign material
Two type of immunity
Active or passive
Type of active immunity
Natural ( Previous infection)
Acquired - artificial vaccines etc
Type of passive immunity
Natural (Trans placental antibody transfer , milk breasts)
artificial ( Antibody injection)
What is immune tolerance
State of unresponsiveness to specific antigen to which person is normally responsive
Suppressed immune rxns
Causes of immune tolerance
Prior contact with antigen in fetus or a newborn
Prior contact with antigen in high or low doses
exposure to radiation chemotherapy drugs or agent that impaired immune system
heritable disease of immune system
Acquired disease of immune system like HIV
What is herd immunity
State of accumulation of immunity in a population where the causative agent has greater difficulty in finding a non-immune or susceptible host
Reasons why herd immunity declines after epidemic
New births
deaths of immunes
Immigration of non immunes
immigration of immunes
What are the different step in controlling diseases
Eliminate the reservoir either human or in animals
interrupt the transmission
Reduce the susceptibility through vaccination and chemoprophylaxis
Create a supportive environment
Input public health laws
enhance community mobilization and participation
What is the strategies and disease control (steps)
identification of disease
Interruption of transmission
prevention of recurrence (safe water supply, food safety ,injection safety blood ,safety vector control ,immunization ,chemoprophylaxis )
notification
analysis
report writing
surveillance
Measure of impact of disease
Morbidity
mortality
disability
Disease that have strong epidemic potential
Cholera
meningitis
measles
Peripheral and Primary level of disease control
Generalists who manage all disease
data surveillance
Clinical care with case management and mass drug administration
Prevention services with community mobilization ,immunization, injection safety ,advocacy ,vector control
Disease control at the district level
Training ,management of supplies and equipment
technical support
Data collection and analysis from primary level
Investigate follow up outbreaks
feedback information to primary level
Disease control at the national or central level
Coordination National prevention and control activities centralized teams technical guidance financial resources Analyze data from district level sets priorities and standard Report to who as required
What is a community
Cluster of people with at least one characteristic in common
What are some features of a community
Physical environment education safety transportation politics and government health social services communications economics recreation
4 determinants of health 4Hs
Hereditary
Habitat
Habits
Health services
What are other determinants of health
DemoGraphic environmental socioeconomic factors Health sources and services reproductive and child health policies indicators variables to assess health of community
What are important information demographic of a community
Population of the community age sex distribution religious group predominant marital status educational level occupation ethnicity migration
Important factors in the environment of the community
Sanitation facilities ( drainage ,solid waste disposal, liquid waste disposal, pest rodent control ,food hygiene )
water facilities (water sources ,clean water ,storage ,supply ,cost ,safe usage )
housing type and condition ( ventilation ,overcrowding ,type of floor of ceiling ,mosquito netting ,measures of pollution ,vector density)
Factor in disease pattern important in community diagnosis
Most common causes of illness , death most frequently diagnosed disease special health problems usual health problems number of health facilities number Health personal sources of finances for health programs
Socioeconomic factors in community diagnosis
Socioeconomic factors level of unemployment rate of population increase literacy rates female housing conditions suicide and homicide rates Road traffic accidents alcohol and drug abuse
Maternal and Child health factors in community diagnosis
For children under five Age at first pregnancy number of children and birth spacing pregnancy and birth complications Antenatal and post natal attendance breast-feeding and complementary feeding practices immunization vitamin a supplementation family planning practices nutritional indicators
What is community diagnosis
Comprehensive assessment of health status of the community in relation to eat social physical and biological environment
How is community diagnosis a process
Helps in gathering and interpreting information
prioritizing needs
developing strategies
conducting and evaluating health programs
How is community diagnoses a product
Produces a report
further and future intervention
What are the goals of community diagnosis
Analyze health status of community
evaluate health resources, systems and services
Assess attitudes towards community health services
identify priorities
establish goals
determien course of action to improve health status
What is our community diagnosis
Household survey
What is a household survey
Process of collecting and analyzing data to understand general situation of individuals in the household or all households
What are the steps in community diagnosis
Exploration interaction with community leaders objectives planning a survey planning the survey and questionnaire training interviewers Pretesting samples for survey executing a survey analysis of the results writing reports feedback to the community initial Health action after community diagnosis analysis and interpretation of results
Method of observation used
Non-participatory
Two sources of data collection
Primary sources
secondary sources
Type of primary sources of data
Record analysis
Observation
structured interviews
Type of records to analyze for data collection
Any flaws ?
Clinical records
disease registries
notification registries
May not be complete ,may not be standardized , may be inaccurate
What is a questionnaire
Set of questions to be asked from respondent in an interview with appropriate instructions indicating which answers are to be asked and in what order
What are the advantages of using a questionnaire
Enable data collection from respondents
give structure to interview
provide standard means for writing down answers
helps in processing data collected faster
How can you tell that the objectives of a researcg are good
Because they are smart specific measurable achievable realistic time bound
What type of research was done in community diagnosis
Descriptive cross-sectional survey
Health definition
Complete physical mental and social well being rather than solely absence of disease
Education definition
Giving information, teaching, learning, schooling tutoring, instruction, edification
Health education definition
Part of health care concerned with promoting healthy behavior
Enable people to understand their behavior and how it can affect health
Identify practices that cause, cure or prevent a health problem
Health education goals
Promote development and proper use of health services
Promote immunization
Resolve problems that prevent people from making healthy choices
Prepare individuals to assume responsibility for protecting their own life and not when they are sick
Push communities to carry activities that maximize health
What type of disease prevention is health education
Primary prevention
But can help support other forms of prevention
Health education in which settings
Clinic Outpatient Ward Antenatal clinic Postnatal clinic Child welfare clinic School clinic School nurse talk Church health talks Work place Health talks Patient groups Parents groups
Goal of communication in health education
Promote improvements in health by modifying human, social, and political factor that influence risky health behavior
4 component of health education communication \
Message (advice, nonverbal, pictures, appeals )
Channels ( tv, radio, newspaper, leaflets…)
Receiver (Education , visual literary , media habits, culture)
Source (credibility , age, sex, culture, language )
Stage 1 of health education communication
Reach intended audience
Stage 2 of health education communication
Attract audiences attention through appeals techniques
What are some appeal techniques to use when communicating about health education
Fear by emphasis of serious outcomes,
Humor
Logic and facts
Emotion through images
Types of appeals
One sided message - Advatanges of taking action
Two sided message - benefits and disadvantages of taking action
Positive appeal - do something
Negative appeal - dont do something
Stage 3 health education communication
Understanding of the message which depends on the visual and the pictorial perception of the message
Stage 4 of health education communication
Promotion of change by acceptance of this change by audience
Stage 5 of health education communication
Change in behavior
What is reason why people will change attitude and belief about health after education but not their behavior
If during health education communication the emphasis was only the dangers and not on how to help change
Stage 6 health education communication
Improvement of health based on accuracy and evidence of information given
Healthy education methods
Interpersonal method
Face to face
Mass media (radio, tv, newspaper, social media )
Techniques used in face to face health education
Spoken work
Non verbal communication with visual, models, pictures, written words
Techniques used in radio for health education
Spoken word
Techniques used in tv for health education
Spoken word
Visual format
Nvc
Written word
Techniques used in newspaper for health education
Written words
Visual
Pictures
Printed Material used in health education
Leaflets Posters Displays Books Models Flip chart Newsletter Magazine News paper article Advertisement
Multimedia used in health education
Slide shows Presentation Video DVDs CDs Radio Tv
Health education tools
Talks Presentation Counseling Drama Role play Puppetry Simulation Skills training Demonstrations Celebrities Slogans Song Case studies Stories Games Debates Quiz shows Question and answer sessions
What is readability of written materials
Short words Short sentences Short paragraphs Large clear font Welll spaced text Subheadings
How to calculate readability
Random large paragraph
Count number of words in first 2 sentences
Count number of words more than 5 letters
Divide number of words with more than 5 letters by number of words in first 2 sentences
Multiply result by sum of both prompts above
Ranges of readability
8 or less is easy to understand
Near 15 means moderate understanding
Near 30 means complicate to understand
Communication at the individual and family level
One to one
counseling
patient education
home visit
Communication methods at the district level and community level
Group teaching
community participation
exhibitions
demonstrations
Communication method at the national level
Mass media
social mobilization
Advantages of face-to-face communication
Different approaches available good for low literacy rate communities opportunity for questions from community targeting of population Fast adaptation to locals fast behavioral change
Disadvantages of face-to-face communication
Slow spread of information
require some privacy
Costly due to high human resources
Need training of workers
distortion of messages if not reinforced
Small group and participatory learning advantages
People think for themselves share experience learn from other problem-solving skill development good for people with limited education eliminate loneliness in issues active participant
Disadvantages of participatory methods in communication
More involving More planning preparation time consuming required skills and limited by obstacles group dynamics
Role play communication advantages
Try several options and possibilities People more sympathetic Communication and counseling skills Practice an event Safe environment
What is the Rogers communication theory
That’s even the mass media is important in providing good background information for change face-to-face communication is still required to induce health behavior change
Diagnostic test
Presence or absence of a disease when subject shows signs and symptoms
Screening test
Identifies asymptomatic individuals who may have disease
Examples of screening test
Pap smear Fasting blood sugar Blood pressure Mammography PSA test Ocular pressure Fasting blood cholesterol
Validity of test
Ability to differentiate between people suffering from disease and those not suffering
Sensitivity of test
Ability Detect those who have disease
Specificity of test
Ability to detect those who do not have the disease
Sensitivity formula
True positive / true positive + false negative
Specificity formula
True negatives / false positive + true negative
Positive predictive value
Proportion of patients who test positive who actually have disase
Negative predictive value
Proportion of patient who test negative who are actually negative
PPV formula
True positive / true positive + false positive
NPV Formula
True negative / true negative + false negative
Who has more impact on preductiv values , specificity or sensitivity
Specificity
