MUKUBA UNIVERSITY

SCHOOL OF MATHEMATICS AND NATURAL SCIENCES

ENVIRONMENTAL HEALTH

NAME: MYLESS MUKENDI

STUDENT ID: 21012004

COURSE CODE: IEH 201

COURSE NAME: INTRODUCTORY ENVIRONMENTAL HEALTH

LECTURER NAME: GEDEON PHIRI

ASSIGNMENT: ONE

TASK: Community diagnosis is a comprehensive assessment of health status of the community

in relation to its social, physical and biological
environment. It shows the distribution patterns of diseases in a community
described in terms of their contributing factors.
a. In carrying out the study of community diagnosis, what kind of data
would you include concerning the characteristics of the population
b. Discuss the steps you would follow in order to collect the relevant data
in community diagnosis
c. Describe PHC (Primary Health Care) model of service delivery describing levels of primary
health care using the Community-based health care
and basic health services.
According to WHO definition, community diagnosis is “a quantitative and qualitative description
of the health of citizens and the factors which influence their health. It identifies problems,
proposes areas for improvement and stimulates action”. This process of community diagnosis
involves the Community's full participation depends on these four concepts of primary health
care: Acceptability, Accessibility, Affordability and Availability. (Omondi.A, 2020)

When carrying out community diagnosis, they are some data which has to be collected such as:

Demography including health statistics. Causes of morbidity and mortality by age and gender.
Use of group services. Nutrition, Mental health and assessment of possible cause of mental
illness. Patterns of leadership and communication within the community. State of the
environment including water, Community's Knowledge, Epidemiological details of endemic
diseases of the community population. (Omondi.A, 2020)

Well, apart from all these data one can also include some data on the characteristics of
population. Which may include: (Mahur.M, 2021)

Population size: the total number of organisms of a specific species present in a specific
geographical area at s specify time represents population size.

Population density: the number of individuals of a species per unit are of volume represents the
population density.

Birth rate or Nasality rate: it is generally expressed as number of births per 1000 individuals of
a population per year.

Mortality rate: it is generally expressed as number of deaths per 1000 individuals of a

population per year.

Dispersal: due to movements of majority of individuals at one time or other time during their
life cycle changes the population size and density of a given area from time to time. The
movement can be immigration or emigration.
In order to collect relevant data they several steps which has to be followed. However, these
steps are classified into four stages of community diagnosis namely: initiation, data collection
and analysis, diagnosis, and dissemination. The following stages are explained below. (Maurer.F;
Claudia.M, 1995)

Initiation

In order to initiate a community diagnosis project, a dedicated committee or working group

should be set up to manage and coordinate the project. The committee should involve relevant
parties such as government departments, health professionals and non-governmental
organizations.

At an early stage, it is important to identify the available budget and resources to determine the
scope of the diagnosis. Some of the common areas to be studied may include health status,
lifestyles, living conditions, socioeconomic conditions, physical and social infrastructure,
inequalities, as well as public health services and policies. Once the scope is defined, a working
schedule to conduct the community diagnosis, production and dissemination of report should be
set. (Maurer.F; Claudia.M, 1995)

Data collection and analysis

The project should collect both quantitative and qualitative data. Moreover, Population Census
and statistical data e.g. population size, sex and age structure, medical services, public health,
social services, education, housing, public security and transportation, etc. can provide
background of the district. As for the community data, it can be collected by conducting surveys
through self-administered questionnaires, face to face interviews, focus groups and telephone
interviews. (Maurer.F; Claudia.M, 1995)

In order to ensure reliability of the findings, an experienced Organization such as an academic

institute can be employed for conducting the study. The sampling method should be carefully
designed and the sample size should be large enough to provide sufficient data to draw reliable
conclusions. Therefore, study results derived can truly review the local community.

Collected data can then be analyzed and interpreted by experts. Here are some practical tips on
data analysis and presentation:
- Statistical information is best presented as rates or ratios for comparison.

- Trends and projections are useful for monitoring changes over a time period for future
planning.

- Local district data can be compared with other districts or the whole population.

- Graphical presentation is preferred for easy understanding Basic Principles of Healthy Cities:
Community Diagnosis.

Diagnosis

Diagnosis of the community is reached from conclusions drawn from the data analysis. It should
preferably comprise three areas:

- Health status of the community

- Determinants of health in the community

- Potential for healthy city development

Dissemination

The production of the community diagnosis report is not an end in itself, efforts should be put
into communication to ensure that targeted actions are taken. The target audience for the
community diagnosis includes policy-makers, health professionals and the general public in the
community.

The report can be disseminated through the following channels:

- Presentations at meetings of the health boards and committees, or forums organized for
voluntary organizations, local community groups and the general public.

- Press release

- Thematic events (such as health fairs and other health promotion programme).
According to the Alma-Ata international conference (Alma.A, 1978) defines primary health care
as an essential health care made universally accessible to individuals and acceptable to them,
through their full participation and at a cost the community and country can afford. There
basically three levels of primary health care, however another one was introduced recently and it
will be discussed in this paper.

Primary care level

Primary health care is the first and foremost link between the people and national health system,
where majority of their health problems are dealt with and resolved. (Wood.C, 2008)

It is provided by the primary health centers, their sub-centers, multipurpose health workers,
village health guides and primary care providers. These primary care providers may include;
Doctors, nurse practitioners, and physical assistants. People seek primary care for the following:

 Illness: people see their primary care doctor when they notice a new symptom or when
they come down with a cold or flu.
 Injury: they may also seek primary care for a broken bone, a sore muscle, a skin rash or
any other acute medical problem.
 Referral: also, primary care is typically responsible for coordinating your care among
specialists and other levels of care.

Secondary care level

Secondary care is when primary care provider refers you to a specialist. Secondary care means
the doctor has transferred to someone who has more specific expertise in whatever health issue
you are experiencing. It includes district hospitals and community health centers which also
serve as the first referral level. Examples of specialists may include: (Wood.C, 2008)

 Cardiologists focus on the heart and blood.

 Endocrinologist focus on hormone system, diseases like diabetes and thyroid disease.
 Oncologists specialize in treating cancers.

Tertiary care level

It has specific facilities and highly specialized health workers provided by the regional or central
level institution. At this level, you can find procedures such as: (Wood.C, 2008)

 Severe burn treatments

 Complex treatments
 Neurosurgeries
 Dialysis
 Coronary artery bypass surgery
 Plastic surgeries

Quaternary level (Maurer.F; Claudia.M, 1995)

Quaternary care is considered an extension of tertiary care. However, it is even more specialized
and highly unusual. Because it is so specific, not every hospital or medical center offers
quaternary care. Some may only provide quaternary care for particular medical conditions or
systems of the body.

The types of quaternary care include:

 Experimental medicine and procedures

 Uncommon and specialized surgeries
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