Lecture 15: Community based health approach Flashcards
3 common characteristics of community
Location/geographical proximity (most important)
Common ties
Social interactions
Function of community Includes
Group identity
Social interactions
organization
Elements of community that encourage change are
common goals of people
local beliefs
Factors impacting a sense of community
religion, safety, SES, frequent relocation, suspicion of other groups
changing demographics (issues impaction older populations)
communication
Community development
to create conditions of economic and social progress for the whole community
making programs sustainable
maximize local strengths and abilities
Civil society
an number of different organizations partnering to better develop of fight global poverty
is both a participatory and empowering form of development
International stake holders should think about
how much people rely on community based services vs government based services
how much an effect they will have once they leave (taking away from local doctors or nurses)
First health care discipline for assessment, treatment and services was
nursing
they would live and work within the community
Some of the earliest public health initiatives include
immunization of children, hygiene
Community based health services
public sector is failing and private sector is growing
distance and lack of funding are major barriers for public sectors
Ideal characteristics for community based services
specific, sensitive inexpensive and non-invasive ways to diagnose
safe, effective drugs that have long shelf life and easily administered
equipment that is easily transported
Community –oriented programs
programs that don’t start in the community, external body says who should be targeted
Community- initiated programs
community develops and initiates the main goal
Community programs should foster (3)
community ownership, participation, and empowerment
Community health workers
women from the community who are exceptional re trained to provide forms of health care for people in rural community
Characteristics of a community health worker
looked up too by community
good communication skills
health/ literate
Steps to make health workers
- Recruit: in poorest and rural vilages
- Train: as frontline health professionals
- Equip:
- Manage: supervised by nurse mentor
- Payment:
Product development: Push
Direct finicaing
Facilitate clinical trials
Tax creditors for R&D
Focused on making interventions
Product development : pull
Increase uptake of vaccines Transferable patents Co-payments Market assurances After interventions are created
Community health worker : Kenya
Looked at rural mothers and infants in Bangladesh, India and Pakistan
Trained community workers to look for infant signs of severe illness within the first week of life and refer them to health facilities if needed
Training programs included recognizing signs and symptoms and which should be assessed
Written pre and post-test along with clinical evaluation
Reduced the neonatal mortality rates by 30-61%
Community mobilization
Process of bring people together to raise awareness and demand for development programs to help with delivery of resources and to achieve project sustainability and self-reliance
Community Profile
Community demographic (age, sex, religion, income)
community social and health services (which services exist, which services are lacking, things to consider before implementing a program)
methods to develop profile of community (what is the nature of the community problem, what is the best approach, how many people will this program effect, how to make observations without people knowing)
Health/social service profile
Learning about the individual or group level issues/needs
Population: can be broad or specific
Condition: concerned with what falls under a certain condition
Context: context of services. Ex. community shelter
Needs
Is a gap between real and ideal conditions
4 types of needs
Normative Needs: defined by experts (oncologist identifying cancer)
Expressed needs: vocalised by people or observing how people use services
Comparative needs: needs may be similar in another area with similar characteristic (SES or demographics)
Felt needs: voiced by community members, include wants, wishes and desires
Needs assessment
Phase 1: determine the needs of the population by looking at already done research or professionals at the community level
Phase 2: figure out the specific needs from the perspective of the target population
Methods to assess needs
Interviews, focus groups, semi-formal interviews
Program Evaluation
System that evaluates the effectiveness of the program ability to meet desired outcomes
What has the program done to date and how did you evaluate it
Methods for evaluation : needs assessments, efficacy, impact, individual satisfaction ect
Outcome Evaluation
Focus on the results of the program or services
What difference did the program make and how did you address the peoples needs
Formative Evaluation
Interval reports assessing how the program is doing
How it is responding to goals and how services can be revised
Summative Evaluation
Occur at the end of the program
Logic model
Displays sequence of action and describes what the program is and what the program will do
Shows how interventions are linked to results
Inputs, outputs, outcomes, assumptions, external factors
5 aspects of the logic model
Input: resources that went into program
Outputs: activities, services, events that reached the people
Outcomes: results or changes from the program/group/systems
Assumptions: your underlying beliefs about the program, the people and the project
External Factors: outside factors that Interact with or influence the program ex. differences in religion
