Gem 201 Flashcards
What is a community?
Why is community health so important?
A community can be described as a group of people who share some or all of the following: geographic boundaries; a sense of membership;
Culture and language;
common norms, interests, or valucs; and common health risks or conditions (IOM, 1995; Jewkes and Murcott, 1996;
Ruderman, 2000; Ricketts, 2001).
Community health is important because:
Health is a “fundamental resource to the individual, the community and to society* (Kickbusch, 1989: 13).
• When people are healthy, they are better able to work, leam, build a good life, and contribute to society.
State the four constituents of a community
Individual health is influenced by what things?
State six characteristics of a healthy community
Constituents:
Individuals
Families
Organizations
Associations
Organizations are usually more formal, with clear structures, rules, and goals (e.g., to deliver services, make profit, or solve a problem).
• Associations are more about membership and unity over a common interest, often voluntary and for advocacy, networking, or professional development.
Term Meaning Example
Organization: A structured group of people working together to achieve specific goals. A hospital, school, NGO, company, ministry
Association :A group of people who come together based on shared interests or purpose. Medical Association, Teachers’ Association
About the individual:
From the 15th century and earlier, and also today within the fields of statistics and metaphysics, individual meant indivisible, typically describing any numerically singular thing. but sometimes meaning a person,
• From the 17th century on, individual indicates separateness that’s seeks unique personal identity
• Even though the individuals make up the family and society, the need of the individual varies with the need of the family and society
• The individual health is influenced by a number of factors that are within that person age, sex, knowledge, behavior and lifestyle etc.) and outside that person (Family practices, love and care, socialization, environmental halth, family economy etc.)
Characteristics of a healthy community
What is a healthy community?
• Leadership
• Public health and social infrastructure and policies on health
• Essential public health services
• values Communication and collaborations
•considers and addresses the determinants of health
• Individuals make informed positive choices
These characteristics are the key pillars of a healthy community because they ensure overall well-being by addressing health at multiple levels:
1. Leadership → Guides decision-making, sets policies, and drives health initiatives and assesses community resources and needs
2. Public Health & Social Infrastructure → Provides essential services like hospitals, sanitation, and policies that promote health.
3. Essential Public Health Services → Ensures disease prevention, health promotion, and emergency preparedness.
4. Values, Communication & Collaboration → Strengthens trust, encourages teamwork, and promotes collective action for health improvement.
5. Determinants of Health → Recognizes that health is influenced by social, economic, and environmental factors such as income, education and environment.
6. Informed Choices → Empowers individuals to take responsibility for their health through education and access to resources.
Together, these aspects create an environment where people can thrive physically, mentally, and socially, making them essential characteristics of a healthy community.
State three features of the community
use them to define what a community is
Location:
• This means a specific geographical location.
• The health of the community is affected by the location, including the placement of the service, the geographical features
• Population:
diverse people who live with in the boundary of the community.
• Social system
Various entities (conomic, educational, cultural etc.) that interact to form a relational system
It looks like you were trying to explain the key features of a community, but the wording might have made it unclear. Here’s a clearer way to structure what you meant:
Features of a Community
1. Location → A community exists in a specific geographical area. The health of the community depends on factors like service availability, environmental conditions, and infrastructure.
2. Population → The people who live within the community’s boundaries. They may be diverse in terms of age, culture, and socioeconomic status.
3. Social System → The different institutions and interactions (e.g., economy, education, healthcare, culture) that help the community function as a connected system.
Definition of Community
You can define a community based on:
• Geographical boundaries (e.g., a town, neighborhood, or country).
• Shared interests or identity (e.g., religious groups, professional groups).
• Social connections (e.g., online communities, cultural groups).
You were likely trying to emphasize that a community is defined by its location, people, and systems, and that these factors shape its overall well-being. Let me know if you want it reworded further!
What is the human development index?
State the three human development index (HDI) indicators and dimensions and dimensions indexes
Dimensions:
Long and healthy life
Knowledge
A decent standard of living
Respective indicators:
Life expectancy at birth
Expected years of schooling and mean years of schooling
GNI per capita income(PPP$)
Respective dimensions indexes:
Life expectancy index
Education index
GNI index
Human Development Index (HDI)
The HDI is a measure used by the United Nations Development Programme (UNDP) to assess and compare human development across countries. It considers three key dimensions:
1. Health – Measured by life expectancy at birth (how long people are expected to live).
2. Education – Measured by mean years of schooling (average years of education received) and expected years of schooling (how many years a child entering school is expected to complete).
3. Standard of Living – Measured by Gross National Income (GNI) per capita (average income per person).
The HDI gives a score between 0 and 1, where:
• Closer to 1 → High human development
• Closer to 0 → Low human development
Ghana’s HDI score of 0.613 indicates medium human development. In the African context, Ghana ranks 14th, with countries like Seychelles (0.802), Mauritius (0.796), and Algeria (0.746) leading the continent in HDI rankings. 
It’s important to note that while the HDI provides a snapshot of a country’s development, it doesn’t capture all aspects of human well-being, such as inequality, poverty, and security. For a more comprehensive understanding, other indices like the Inequality-adjusted Human Development Index (IHDI) and the Gender Development Index (GDI) can be considered.
Think of it like this:
• Dimensions are the big ideas or categories you want to measure.
• Example: If you’re measuring health, dimensions could be “nutrition,” “fitness,” and “mental well-being.”
• Indicators are the specific things you look at to measure those dimensions.
• Example: For “nutrition,” an indicator could be “daily fruit and vegetable intake.”
• Indexes are scores that summarize multiple indicators into one number.
• Example: A “Health Index” might combine scores from nutrition, fitness, and mental well-being to give an overall health score.
GNI is gross National income
What are the 8 WHO identified health priorities
WHO identified health priorities
• Inadequate health education
• Inadequate food supply and poor nutrition
• Unsafe water and inadequate basic sanitation
• Inadequate maternal and child health
• Inadequate family planning
• Incomplete immunizations
• Uncontrolled endemic diseases
• Scarcity of essential drugs
How can you learn about a community
• Learn custom and language
• Study reports on the area
• Observe how people live
• Ask about the community
• Listen to people talk
• Visit families and places
• Join local celebrations
One of the constituents of the community is family.
State the factors that affect the health of the family
What is community influence?
State the three things that influence the community
In human context, a family(Latin is familia) is a group of people affiliated by consanguinity, affinity or co residence. In a human context, a family refers to a group of people connected by:
1. Consanguinity → Blood relations (e.g., parents, children, siblings).
2. Affinity → Relationships through marriage or legal bonds (e.g., spouses, in-laws).
3. Co-residence → People living together as a household, even if not related by blood or marriage (e.g., adopted children, long-term caregivers).
The word “familia” comes from Latin and originally referred to a household, including relatives and even servants. Over time, the concept of family has evolved to include nuclear families, extended families, and even chosen families based on emotional bonds.
In most societies it is the principal institution for the socialization of children.
• Even though families make up the communities, the need of the family and that of the communities varies in many aspects.
• The health of the family is affected by many factors that are within the family (family practices, gene and heredity, family income, intrafamily relationship etc.) and
outside the family (environmental sanitation of the surrounding. social relations, socio cultural practices, availability of health services, natural disasters, availability of market, educational facilities etc.j.
Community influence:
Social
Economic
Environmental and physical risks
Community Influence refers to how a community impacts the lives of its members in different ways:
1. Social Influence → The community shapes values, behaviors, and relationships through culture, traditions, and social networks (e.g., education, support systems, crime rates).
2. Economic Influence → Economic conditions affect job opportunities, income levels, and access to resources like healthcare and education. A wealthy community offers more opportunities, while a poor one may struggle with unemployment and low wages.
3. Environmental & Physical Risks → The physical environment affects health and safety. Risks include pollution, poor sanitation, natural disasters, and lack of infrastructure (e.g., unsafe water, air pollution, or flood-prone areas).
These factors together determine the well-being and development of a community.
Note: 80% of the worlds population resided in developing country where people suffer and die from preventable and easily treatable illnesses.
o For improvement to occur, the problem and their causes must be identified and appropriate solutions formulated
and implementeu
0 Community assessment involves identifying problems at the community level which adversely affect health:
What are community health practices
State the elements of community health practice and explain how they relate
Part of larger public health efforts that focuses on health and well-being of the community as a whole.
Basic clements
• health promotion
• Prevention of health prolems
• Treatment of disorders
• rehabilitation
Evaluation
Research
Determinants of health
Elements of Community Health Practice & Their Relationship
1. Health Promotion → Encourages healthy behaviors and lifestyles (e.g., education on nutrition, exercise, and hygiene).
• Related to: Prevention of health problems, determinants of health.
2. Prevention of Health Problems → Focuses on reducing disease risks through primary (vaccination), secondary (screening), and tertiary (disease management) prevention.
• Related to: Health promotion, treatment, rehabilitation.
3. Treatment of Disorders → Provides medical care to manage illnesses and improve health outcomes.
• Related to: Prevention (to stop complications), rehabilitation (for recovery).
4. Rehabilitation → Helps individuals recover and regain function after illness or injury (e.g., physiotherapy, counseling).
• Related to: Treatment, evaluation.
5. Evaluation → Assesses the effectiveness of health programs and interventions to improve future efforts.
• Related to: Research, determinants of health.
6. Research → Studies health trends, risk factors, and interventions to improve community health.
• Related to: Evaluation, prevention, treatment.
7. Determinants of Health → The factors that influence health, including social, economic, environmental, and genetic factors.
• Related to: Every other element, as they all aim to address or improve these determinants.
All these elements work together to improve and sustain community health, from preventing diseases to treating, rehabilitating, and evaluating health strategies.
State seven aims of community health diagnosis
Aims
• Describe the socio-cconomic characteristics of the community
• Describe the health status of the population in the community
• Determine factors that contribute to health status
• Identify assets and resources that can be mobilized
• Conduct micro health projects following need prioritization
• Develop comprehensive community health profile and
• develop an epidemiological baseline for follow up.
State the five Components of community health diagnosis
Components of community health diagnosis
• A description of the demographics of the population
• Sociocultural and behavioral aspects of the community
• A general description of health problems by different strata of the population
• Availability of heaith resources in the community and the
patter of delivery and utilization
• Non-health resources and their role in future improvement
Explain community health assessment or diagnosis as a process
Explain it as a product
Community health diagnosis
• Community health assessment/diagnosis is both a process and a product.
As a process:
• Gathering and interpreting information
• Prioritizing needs and developing strategies
• Conducting and evaluating the MHP
Preparing the further strategies
• As a product:
• Community diagnosis report: A Community Assessment Report is the final product of a community health assessment. It summarizes health needs, resources, and recommendations for action. The report is data-driven, structured, action-oriented, and used by stakeholders to guide policies and health programs. It helps drive evidence based decision making to improve community health
• Further/future intervention plan
Conducting and Evaluating the MHP (Maternal Health Program) as Part of Community Health Assessment
Community Health Assessment (CHA) is a process used to identify health needs, develop interventions, and measure their impact. One key aspect is conducting and evaluating the Maternal Health Program (MHP) to ensure maternal and child well-being.
1. Conducting the MHP → This involves implementing programs that support maternal health, such as:
• Prenatal and postnatal care services.
• Nutrition and vaccination programs for mothers and infants.
• Education on safe pregnancy and childbirth.
2. Evaluating the MHP → After implementation, the program is assessed to determine:
• Effectiveness in improving maternal and child health outcomes.
• Accessibility and quality of services.
• Challenges and areas for improvement.
How This Fits into the Community Health Assessment Process
• Identifies maternal health issues (e.g., high maternal mortality rates, poor prenatal care).
• Develops targeted interventions (e.g., training midwives, improving healthcare access).
• Measures program success through data collection, surveys, and health indicators.
• Improves future programs based on findings from the evaluation.
This process helps ensure that maternal health programs are effective, sustainable, and responsive to community needs.
State the steps in community health diagnosis
Steps in community health diagnosis
• Developing the operational definition of the community
•Collecting background information of various communities
• Selecting a target community
• developing tools and techniques
• Entry to the community and Rapport Building
• information collection
• Data entry, processing and analysis
•Need identification
• Community Presentation
• prioritizing needs with community people
• Conducting Micro-Health Project
• final community presentation and departure from the community
Follow up
Steps in Community Health Diagnosis
1. Developing the Operational Definition of the Community → Clearly define the community by location, population, or social structure.
2. Collecting Background Information → Gather existing data on demographics, health status, and resources.
3. Selecting a Target Community → Choose the specific community for assessment based on needs and feasibility.
4. Developing Tools & Techniques → Create surveys, interviews, and observational checklists for data collection.
5. Entry & Rapport Building → Gain community trust through meetings and discussions.
6. Information Collection → Conduct surveys, interviews, and focus groups to gather primary data.
7. Data Entry, Processing & Analysis → Organize and analyze collected data to identify trends and health issues.
8. Need Identification → Determine priority health needs based on data.
9. Community Presentation → Share findings with the community for validation.
10. Prioritizing Needs → Work with the community to rank health concerns based on severity and impact.
11. Conducting a Micro-Health Project → Implement a small-scale intervention to address a key health issue.
12. Final Community Presentation & Departure → Present project outcomes and handover responsibilities to the community.
13. Follow-up → Monitor progress and provide support to ensure sustainability.
Each step ensures an inclusive, data-driven approach to improving community health.
Explain the differences between clinical diagnosis and community diagnosis
Community diagnosis:
Community
• Focus is on Community
• Survey team goes to the community
• take individual as well as houschold information in details (socio economic, cultural,
environmental, behavioral)
• Socio economics, behavioral, educational and environmental interventions (c.g. micro-health project)
• Researchers (might) go to the community to measure the effect of interventions
clinical
• Focus is on
Individual/ patient
• Patient decides to consult
doctor
• Take symptoms, history, as well as laboratory details
• Usually drug treatment and
advice afterwards
• Patient comes for follow up
What is community health diagnosis
State five purposes of community health diagnosis
A means of examining aggregate and social statistics in addition to the knowledge of the local situation, in order to determine the health needs of the community”
Or This means analyzing broad health data (like disease rates and life expectancy of a group) alongside social factors (like income and living conditions) to understand what a community needs to improve its health.
• The purpose of community health diagnosis is to:
Analyze the health status of the community
• Evaluate the health resources, services, and systems of care
within the communities
• Assess attitudes toward community health services and issues
•identify priorities, establish goals, and determine courses of action to improve the health status of the community
• Establish an epidemiologic baseline for measuring improvement over time.
State the four main models of community health diagnosis
Models of community health diagnosis
• There are a number of models that serve as the conceptual frameworks for community health diagnosis
• The common models that are widely used are
• Community-as-partner model
• Ecological mode!
• Health behavior model
• Heaith belief model
Each model provides a framework to make sense of the data collected during community health diagnosis. So these models help you use the data to identify the problems in the community and their probable causes and what the community needs to stay healthy.
Here’s how they help:
1. Community-as-Partner Model → If data shows high malnutrition rates, this model helps analyze whether it’s due to economic issues (poverty), lack of education, or poor healthcare access.
2. Ecological Model → If pollution levels are high and many people have respiratory diseases, this model looks at how the environment (factories, poor waste disposal) is affecting health.
3. Health Behavior Model → If data shows high obesity rates, this model helps find out whether it’s because of unhealthy eating habits, lack of exercise, or poor awareness of nutrition.
4. Health Belief Model → If vaccination rates are low, this model helps understand whether people are avoiding vaccines due to fear, mistrust, or cultural beliefs.
So, these models help interpret health data by focusing on different aspects of a community’s health problems.
The Community-as-Partner Model looks at how different factors in a community interact to affect health.
For example, if many children in a community are malnourished, this model helps identify the causes. It examines:
• Economic factors → Are families too poor to afford nutritious food?
• Education → Do parents understand what a balanced diet is?
• Healthcare access → Are there enough clinics or nutrition programs?
This model helps figure out which of these factors (or a combination) is the real issue so that the right solution can be applied.
This model aligns with the earlier definition of community health diagnosis because it emphasizes analyzing broad health data and social factors with the community, rather than for them. It recognizes that effective health solutions come from understanding local needs directly from the people affected. Instead of just relying on statistics, this approach integrates community input to identify health problems and create sustainable solutions.
Which model of community health diagnosis focuses on the community as target of the needs assessment and says the community is considered capable of determining its own needs ?
Community-Partner Model of community health diagnosis
• It was first termed as “community as client” model
• The model focuses on the community as target of and partner in needs assessment
• The community is considered capable of determining its own needs
• External people only have to empower the community people to make them able to identify their own health
issues and develop their strategies
• Model focuses on establishing a partnership between service providers and the community to accurately assess, plan, implement, and evaluate any health services
Which model of community health diagnosis says that Health and wellness are affected by multiple levels of environmental influences that occur at individual, interpersonal, organizational, community and public policy levels?
This model is assessed in two ways or aspects, state them.
Ecological Model
• Health and wellness are affected by multiple levels of environmental influences that occur at individual, interpersonal, organizational, community and public policy levels
The assessment is done of two aspects:
• Influence of environment on health and wellness behavior
• Influence of these behaviors on the environment
The Ecological Model of Community Health Diagnosis looks at how the environment and human behavior affect each other in two ways:
1. How the Environment Affects Health Behaviors
• The physical environment (e.g., air pollution, access to clean water) can make people sick or influence their health choices.
• The social and economic environment (e.g., poverty, education, cultural beliefs) can shape behaviors like diet, exercise, and seeking medical care.
2. How Health Behaviors Affect the Environment
• The way people live and behave can impact their surroundings.
• For example, littering and improper waste disposal can cause pollution, and smoking in public places can harm others’ health.
Why Is This Important?
By understanding these interactions, health programs can target both environmental factors and behavior changes to improve community health effectively.
This approach helps identify root causes of health issues and guides interventions for sustainable health improvements.
Which model of community health diagnosis says that “Consumers use of health services is determined by their perception of threats to health and benefits of using services, plus triggers that cause them to seck services”
Health behaviour Model
• The underlying principle of this model is:
• “Consumers use of health services is determined by their perception of threats to health and benefits of using services, plus triggers that cause them to seck services or what makes them do what they do
• This model is useful in predicting existing health services, examine health knowledge, psychomotor capacities and self management skills
Health Behavior Model
This model explains how people decide whether to use health services. The key idea is that people seek healthcare based on their perception of risk and the benefits of taking action.
1. Perceived Threat to Health → If a person believes they are at risk of illness (e.g., feeling symptoms or knowing a disease is common), they are more likely to seek healthcare.
2. Perceived Benefits of Seeking Care → If they believe treatment will be effective and accessible, they are more likely to use health services.
3. Triggers (Cues to Action) → Events like illness, health campaigns, or recommendations from others can push someone to seek care.
Why Is This Important?
This model helps in predicting healthcare usage, understanding health knowledge, and improving self-management skills to encourage better health decisions.
Usefulness of the Health Behavior Model
This model is useful because it helps predict and improve how people use health services by identifying what influences their decisions.
1. Predicting Health Service Use → It helps health workers understand why some people seek care while others don’t. For example, if people don’t feel at risk, they may ignore check-ups.
2. Improving Health Education → It helps assess health knowledge and identify gaps. If people don’t understand a disease, they may not take preventive actions like vaccination or screenings.
3. Enhancing Self-Management → The model helps in designing interventions that improve how people manage their health, such as teaching patients how to control diabetes or hypertension.
Why It Matters
By understanding what motivates or discourages people from seeking healthcare, policies and programs can be designed to increase health service use and improve community health.
Psychomotor Capacities in the Health Behavior Model
Psychomotor capacities refer to a person’s physical ability to perform health-related tasks. The model considers this because even if someone understands their health risk and wants to seek care, they must also have the skills to take action.
Usefulness in Health Services:
1. Self-Management Skills → People with chronic diseases (e.g., diabetes) need motor skills to check their blood sugar or administer insulin properly.
2. Treatment Adherence → If a person lacks the ability to follow treatments (e.g., elderly patients struggling to take medication correctly), interventions should provide support or training.
3. Health Education Design → Programs should not only provide knowledge but also teach practical skills (e.g., proper handwashing, CPR, or using medical devices).
Why It Matters
Even if people understand health risks and benefits, they must also have the physical ability and skills to act on them. This ensures that health services and education are accessible and effective for all.
Which model of community health diagnosis Focuses on consumer’s belief on efficacy of health behaviors and practices, and their relationship to the use of health services
Health belief model
• Focus is on consumer’s belief on efficacy of health behaviors and practices, and their relationship to the use of health services or mindsets they have that will affect the way they do what they do
• Often used to explain and predict primary health behaviors for the prevention of illness, disease and other health conditions
• Useful in guiding the development of programs that provide incentives for consumers to use health services
Health Belief Model (HBM)
This model focuses on how a person’s beliefs about health behaviors influence their decisions to use health services.
1. Belief in Effectiveness → People are more likely to adopt health behaviors if they believe they will prevent illness (e.g., getting vaccinated to avoid disease).
2. Predicting Preventive Behaviors → Helps explain why people do or don’t engage in prevention (e.g., screenings, vaccinations, healthy eating).
3. Guiding Health Programs → Useful for designing programs that motivate people by addressing their concerns and providing incentives (e.g., free screenings or health campaigns).
Why It Matters → It helps in shaping public health policies and interventions to encourage better health choices.
What is community entry procedures?
Process of establishing contact with leadership structure in a community
Community entry is a Process of initiating, nurturing and sustaining a desirable relationship with the purpose of securing and sustaining the
community’s interest in all aspects of a programme
Involves recognizing the community, its leadership and people and adopting the most appropriate process in meeting, interacting and working with them
• Involves principles and techniques of community mobilisation and participation.
What are the preparations before entering a community (you can go over Dr Taylor’s slides on community entry)
State six interest groups and personalities in the community
who can serve as contact persons
Preparations before entry into a community
1. form a reconnaissance team which is a team which
Spy
2. read about the community (read annual report from the DHMT, District Assembly or special report, disease durance report, news papers health journals)
3. collect informal information about the community (this is done through interview with individuals, through focus groups discussion, through mapping, contact opinion leaders, through house to house census)
4. transect walk and observation
Interest groups and personalities in the community
who can serve as contact persons
• Prominent head of families
• Heads of schools/teachers
• Religious leaders/catechists
• District assembly members
• Unity committee members
• Yout’ leaders
• Women group leaders
• The water and sanitation committee
• Disease surveillance volunteers
• Health workers
HOW DO WE INITIATE COMMUNITY ENTRY
HOW DO WE INITIATE COMMUNITY ENTRY
• Start off with a transparent community selection process and share results
• Map community priorities and identify community leaders through community assessments
• Hold preliminary meetings with community leaders and enlist their support to mobilize community participation
• Hold community assembly meetings to elect local representation to coordinate program activities
• Allow communities to prioritize and select quir a impact projects to solidify support and galvanize local participation
PCD is a framework. What does it include
It includes the improvement of people lives in terms of:
• economic,
• social,
• political,
• environmental,
• spiritual/personal and
• cultural aspects
P means participation
C means community development or so
What is participation in the PCD framework
Paul (1987) also refers participation as the shift and a self-transformational process and learning by practice.
According to Oakely (1991) the term participation refers to:
harnessing the existing physical, economic and social resources of rural people in order to attain the objectives of community development programs and projects.
Refers to the involvement of the community in the decision making process of implementation of development projects (Maser, 1997).
