Community

COMMUNITY DIAGNOSIS / Community Assessment or Situational Analysis
Caring the community as client starts with determining its health problem:
PROCESS of community diagnosis
1.1. collects data –to identify the different factors that may directly or indirectly
influence the health of the population
1.2 analyze – seek explanations for the occurrence of health needs and problems
of the community
1.3 diagnose - chn diagnoses are derived and will become the basis for
developing and implementing chn interventions and strategies
TYPES OF COMMUNITY DIAGNOSIS
1. COMPREHENSIVE COMMUNITY DIAGNOSIS – aims to obtain a general

information about the community.
A. Demographic Variables – the analysis of the community’s demographic

characteristics should show the size, composition and geographical distribution
of the population as indicated by the following:
1. total population and geographical distribution including urban-rural index and

population density
2. age and sex composition
3. selected vital indicators such as growth rate,crude birth rate,crude death rate
and life expectancy at birth
4. patterns of migration
5. population projections
B. Socio-Economic and Cultural Variables
There are no limits as to the list of socio-economic and cultural factors that may
directly or indirectly affect the health status of the community. However we
should consider the following essential information:
1. social indicators
a. communication network – whether formal or informal channels; necessary for

disseminating health information or facilitating referral of clients to the health
care system
b. transportation system – including road networks necessary for accessibility of

the people to health care delivery system
c. educational level – which maybe indicative of poverty and may reflect on health
perception and utilization pattern of the community
d. housing conditions which may suggest health hazards

(congestion,fire,exposure to elements)
2. economic indicators
a. poverty level income
b. unemployment and underemployment rates
c. proportion of salaried and wage earners to total economically active population
d. types of industry present in the community
e. occupation common in the community
3. environmental indicators
a. physical/geographical/topographical characteristics of the community
- land areas that contribute to vector problems
- terrain characteristics that contribute to accidents or pose as geohazard zones
- land usage in industry
- climate / season
b. water supply
 % population with access to safe, adequate water supply

 Source of water supply
c. waste disposal
 % population served by daily garbage collection system

 % population with safe excreta disposal system
 Types of waste disposal and garbage disposal system
d. air,water and land pollution
 Industries within the community having health hazards associated with it

 Air and water pollution index
4. Cultural factors
a. variables that may break up the people into groups within the community such
as:
 Ethnicity
 Social class
 Language
 Religion
 Race
 Political orientation
b. cultural beliefs and practices that affect health
c. concepts about health and illness
C.Health and Illness Patterns
In analyzing the health and illness patterns, the nurse may collect primary
data about the leading causes of illness and deaths and their respective rates of
occurrence . If she has access to recent and reliable secondary data, then she
can also make use of these
1. Leading cause of mortality

2. Leading cause of morbidity
3. Leading cause of infant morality
4. Leading cause of maternal mortality
5. Leading cause of hospital admission
D. Health resources
The health resources that are available in the community is an important

element of the community diagnosis mainly because they are the essential
ingredients in the delivery of basic health services. The nurse needs to
determine manpower, institutional and material resources provided not only
by the state but those which are contributed by the private sector and other
non-government organizations.
1. manpower resources
 categories of health manpower available
 geographical distribution of health manpower
 manpower population ratio
 distribution of health manpower according to health facilities
( government, non-government, health units, private )
 distribution of health manpower according to type of organization
 quality of health manpower
 existing manpower development/policies
2. material resources
 health budget and expenditures
 sources of health funding
 categories of health institutions available in the community
 hospital bed-population ratio
 categories of health services available
E. Political/Leadership Patterns
The political and leadership patterns is a vital element in achieving the goal of
high level wellness among the people . It reflects the action potential of the
state and its people to address the health needs and problems of the
community. It also mirrors the sensitivity of the government to the people’s
struggle for better lives.
In assessing the community, the nurse describes the following:
1. power structure in the community (formal or informal )

2. attitudes of the people towards the authority
3. conditions/events/issues that cause social conflict or that leads to social
bonding or unification
4. practices/approaches that are effective in settling issues and concerns
within the community
2. PROBLEM-ORIENTED COMMUNITY DIAGNOSIS
– type of assessment that responds to a particular need.
Example:
STEPS IN CONDUCTING COMMUNITY DIAGNOSIS
1.DETERMINING THE OBJECTIVES
– the nurse decides on the depth and scope of the data she needs to gather.
2.DEFINING THE STUDY POPULATION
–the nurse identifies the population group to be included in the study.
3.DETERMINING THE DATA TO BE COLLECTED
– the objectives will guide the nurse in identifying the specific data she will
collect, and will also decide on the sources of these data.
4.COLLECTING THE DATA
– the nurse decides on the specific methods depending on the type of data to be
generated.
5.DEVELOPING THE INSTRUMENT
– instruments/tools facilitate the nurse’s data-gathering activities.
Most common instruments:
-survey questionnaire
-interview guide
-observation checklist
6.ACTUAL DATA GATHERING
– the nurse supervises the data collectors by checking the filled-up instruments
in terms of completeness, accuracy and reliability of the information collected.
7.DATA COLLATION
– the nurse is now ready to put together all the information.

8.DATA PRESENTATION
– will depend largely on the type of data obtained.(descriptive & numerical data)
9.DATA ANALYSIS
– aims to establish trends and patterns in terms of health needs and problems of
the community.
10.IDENTIFYING THE COMMUNITY HEALTH NURSING PROBLEMS
Health status problems
– increased or decreased morbidity, mortality,fertility or reduced capability for

wellness.
Health resources problems
– lack of or absence of manpower, money, materials or institutions necessary to

solve health problems.
Health-related problems
– existence of social, economic, environmental and political factors that

aggravate

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COMMUNITY DIAGNOSIS / Community Assessment or Situational Analysis

PROCESS of community diagnosis

TYPES OF COMMUNITY DIAGNOSIS

1. COMPREHENSIVE COMMUNITY DIAGNOSIS – aims to obtain a general

A. Demographic Variables – the analysis of the community’s demographic

1. total population and geographical distribution including urban-rural index and

2. age and sex composition

B. Socio-Economic and Cultural Variables

a. communication network – whether formal or informal channels; necessary for

b. transportation system – including road networks necessary for accessibility of

d. housing conditions which may suggest health hazards

a. poverty level income

b. unemployment and underemployment rates

c. proportion of salaried and wage earners to total economically active population

d. types of industry present in the community

e. occupation common in the community

a. physical/geographical/topographical characteristics of the community

- land areas that contribute to vector problems

- terrain characteristics that contribute to accidents or pose as geohazard zones

- land usage in industry

 % population with access to safe, adequate water supply

 % population served by daily garbage collection system

d. air,water and land pollution

 Industries within the community having health hazards associated with it

b. cultural beliefs and practices that affect health

c. concepts about health and illness

C.Health and Illness Patterns

1. Leading cause of mortality

The health resources that are available in the community is an important

In assessing the community, the nurse describes the following:

1. power structure in the community (formal or informal )

– type of assessment that responds to a particular need.

STEPS IN CONDUCTING COMMUNITY DIAGNOSIS

1.DETERMINING THE OBJECTIVES

2.DEFINING THE STUDY POPULATION

–the nurse identifies the population group to be included in the study.

3.DETERMINING THE DATA TO BE COLLECTED

4.COLLECTING THE DATA

5.DEVELOPING THE INSTRUMENT

– instruments/tools facilitate the nurse’s data-gathering activities.

Most common instruments:

6.ACTUAL DATA GATHERING

– the nurse is now ready to put together all the information.

10.IDENTIFYING THE COMMUNITY HEALTH NURSING PROBLEMS

Health status problems

– increased or decreased morbidity, mortality,fertility or reduced capability for

Health resources problems

– lack of or absence of manpower, money, materials or institutions necessary to

– existence of social, economic, environmental and political factors that

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