Session 3 - Health, Patient and Community

Question 1

Define community

Answer 1

1. the mode of life adopted by a group of individuals for the purpose of harmonious coexistence for mutual benefit.
2. A group of people who live in a particular are and who have shared values, cultural patterns and social problems.

Question 2

Define community healthcare

Answer 2

Comprehensive healthcare provision by a team of people and organisations, making use of various kinds of resources available in the community.

Question 3

Define Health need

Answer 3

A gap in a person’s health state, which would benefit from an appropriate and effective care intervention.

Question 4

Name the 4 phenomena that underline health needs according to increasing level of severity.

Answer 4

1. risk of morbidity
2. risk of pain and discomfort
3. risk of disability and impairment
4. risk of mortality

Question 5

Give the 4 principles of the humanitarian approach to health needs.

Answer 5

1. humanity
2. neutrality
3. impartiality
4. independence

Question 6

Name the 4 types of health needs.

Answer 6

1. felt needs
2. expressed needs
3. normative needs
4. comparative needs

Question 7

What are felt needs?

Answer 7

What the patient wants, wishes and desires. Ultimately what the patient experiences.

Question 8

What are expressed needs?

Answer 8

vocalised needs or how people use services. Ultimately what the patient demands.

Question 9

What are normative needs?

Answer 9

needs identified by healthcare professionals

Question 10

What does comparative needs entail?

Answer 10

comparing the needs of different patients or communities.

Question 11

Identify the 9 steps of a health needs assessment within a community and how to prioritise the identified health needs.

Answer 11

1. decide what information you need
2. review existing health information
3. collect the information
4. analyse information and identify community health need
5. assess needs and possible solutions
6. select priorities amongst needs identified
7. ‘reality check’ with community members
8. integrate into regional health plan
9. plan for ongoing monitoring, assessment and evaluation

Question 12

Identify 5 major differences in perspectives of community healthcare users.

Answer 12

1. having their own different knowledges
2. having their own distinct interests and objectives
3. developing their own philosophies, values and ideas
4. establishing their own different process or way of doing things
5. employing different forms of communication

Question 13

What is community participation?

Answer 13

the process by which individuals and families assume responsibility for their own health and welfare and for those of the community to develop the capacity to contribute to their and the community’s development.

Question 14

What is the importance of community participation within the field of healthcare provision?

Answer 14

1. it creates awareness amongst stakeholders on how funds for health services are used
2. the community is involved in decision-making
3. creates transparency and increases accountability

Question 15

Explain the 8 levels of community participation and how to measure it. Focus specifically on the proposed model of Arnstein and her rungs of a ladder of citizen participation.

Answer 15

[real objective is not enable people to participate in planning programs, but to enable powerholders to educate people]
1. manipulation (non-participation)
2. therapy (non-participation)

[allows people to be heard and have a voice but no assurance of change]
3. informing (tokenism)
4. consultation (tokenism)
5. placation (tokenism)

[enter into partnership and enables people into the decision-making process]
6. partnership (citizen power)
7. delegated power (citizen power)
8 citizen control (citizen power)

Question 16

Give the 9 factors that could influence the success of community participation.

Answer 16

1. good faith on part of sponsoring group
2. authority of citizen groups must be clearly defined and resources must be available
3. citizen group must be able to create and sustain an effective organisation which they control
4. early and extensive knowledge of community history, resources and past successful or unsuccessful efforts at change
5. commitment of project sponsors to partnership
6. clearly stated role and time commitments for community volunteers and training time
7. planned recognition of citizen participation must be built into programme development and design
8. early identification and open discussion to barriers to change or lack of government funding
9. timely use of conflict resolution strategies

Question 17

List 6 community characteristics that could have an influence on community participation.

Answer 17

1. complexity of the social structures and the demographic components
2. degree of crystallization of issues and values pre-existing in the community
3. degree to which the community is striving towards social or economic goals
4. degree of social acceptability and identification of change-agent
5. degree of internal control
6. existing involvement in community life