Community assessment :
ANA’s American Nursing Association definition of community health nursing
highlights the following important points:
1. The goal of professional practice is the promotion and preservation of the
health of populations
2.
The nature of practice is comprehensive, general, continual and not episodic
3. The knowledge base comes from nursing and public health
4.
The different levels of clientele— individuals, families and groups
5.
The practitioner's recognition of the primacy of the population as a whole.
Community health nursing is a specialized field of nursing practice. Its basic
knowledge and skills are anchored on nursing theories and important
concepts from the science of public health such as:
1.
Emphasis on the importance of the "greatest good for the greatest
number"
2.
Assessing health needs, planning, implementing and evaluating the impact
of health services on population groups
3.
Priority of .health-promotive and disease-preventive strategies over curative
interventions
4.
Tools for measuring and analyzing community health problems
5.
Application of principles of management and organization in the delivery of
health services to the community.
Basic Concepts and Principles of CHN:
1.
The FAMILY is the unit of care, the community is the patient and there are
four levels of clientele in CHN
2.
The goal of improving community health is realized through multidisciplinary
effort
3.
The community health nurse works WITH and not FOR the individual patient,
family, group or community. The latter are active partners, not passive
recipients of care
4.
The practice of CHN is affected by changes in society in general and by
developments in the health field in particular
5.
CHN is part of the community health system which in turn is part of the
larger human services system
Roles of the nurse in caring for communities and population groups:
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Clinician – health care provider, taking care of the sick people at home or in
the RHU
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Health Educator – aim is towards health promotion and illness prevention
through dissemination of correct information; educating people
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Facilitator – establishes multi-sectoral linkages by referral system
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Supervisor – monitors and supervises the performance of midwives
Other specific responsibilities of a Nurse [spelled by the implementing rules and
regulations of R.A. 7164 (Phil. Nursing Act of 1991)]

Supervision and care of women during pregnancy, labor, and puerperium
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Performance of internal examination and delivery of babies
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Suturing lacerations in the absence of the physician
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Provision of first aid measures and emergency care
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Recommending herbal and symptomatic meds.
In the care of the families:
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provision of primary health care services
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developmental/utilization of family nursing care plan in the provision of care
In the care of the communities:
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Community organizing mobilization, community development, and people
empowerment
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Case finding and epidemiological investigation
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Program planning, implementation, and evaluation
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Influencing executive and legislative individuals or bodies concerning health and
development.
Community Assessment
A community assessment is a valuable strategy for obtaining a clear picture of your
community. It will help you identify local assets as well as problem areas. It can also
serve as the starting point for developing a shared vision and strategies for change
within the community.
A comprehensive community assessment will help you identify:
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How to build your organization to address specific problems.
Community assets that encourage competence, confidence, connection,
character, and compassion for and among young people.
Risks that youth and families face and the resources and strengths your
community has to address them.
Organizations or coalitions in your community that include schools, faith
institutions, policy makers, employers, government agencies, community
members, families, and other key players.
To conduct a quality community assessment:
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Recruit committed stakeholders to identify issues, conduct research, and report
results.
Involve youth in planning, implementation, and results roll-out. They have
first-hand knowledge about what's going on among their peers, and about who
and which entities should be engaged in the assessment.
Integrate your community's cultural beliefs and practices into the assessment.
Look at strengths and resources, including positive youth development
programs and activities, in addition to risk and protective factors.
Community assessments are not conducted overnight. Leave yourself time to recruit
your partners, complete preliminary research, set up your design, conduct the
assessment, evaluate the results, craft responses, and report your findings.
Six Steps to Conducting a Community Assessment
Here are six easy-to-follow steps for conducting a community assessment:
+ Step 1: Establish the What, Where, and Who
+ Step 2: Learn More About the What, Where, and Who
+ Step 3: Identify Resources in the Community
+ Step 4: Analyze and Learn From Data
+ Step 5: Develop an Action Plan
+ Step 6: Share What is Learned
Narrow down the key questions you want answered.
When defining the scope of the community assessment to be performed, it is
important to narrow down the key questions you want the assessment to answer. Here
are some examples of key questions:
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What are the basic demographics of my community? (Consider income levels,
races/ethnicities, number of youth.)
Who are the faith-based and community organizations serving people in my
community? What services are they providing and to whom?
What services are local public agencies providing, and to whom? (Include law
enforcement, probation, courts, schools, workforce development.)
What organizations are funded by foundations and government agencies to
address the community issue?
What do local residents see as the primary needs for this community?
What are the various intervention strategies being used in my community to
address the issues? Are these practices demonstrating any clear outcomes?
Who are the leaders in my community? What key players in local government
are concerned with the issues we want to address?
What local volunteer groups serve the community?
Who are the people in my community who care about the issue?
What community organizations focus on the issue? Are they delivering
services in a meaningful way?
Are there partnering opportunities with other nonprofits or faith-based and
community organizations?
What are the gaps in service to people in the community? What would a
complete system look like?
Are community members ready for a change in the issue we are trying to
address?
Functions of community assessment :
The fundamental purpose of public health is defined by three core functions:
assessment, policy development and assurance. Community health assessments
(CHAs) provide information for problem and asset identification and policy
formulation, implementation, and evaluation. CHAs also help measure how well a
public health system is fulfilling its assurance function.
A CHA should be part of an ongoing broader community health improvement
process. A community health improvement process uses CHA data to identify priority
issues, develop and implement strategies for action, and establish accountability to
ensure measurable health improvement, which are often outlined in the form of a
community health improvement plan (CHIP). A community health improvement
process looks outside of the performance of an individual organization serving a
specific segment of a community to the way in which the activities of many
organizations contribute to community health improvement. The Public Health
Accreditation Board’s (PHAB’s) voluntary, national public health department
accreditation program is designed to document the capacity of a public health
department to deliver the three core functions of public health and the Ten Essential
Public Health Services. PHAB requires completion of a CHA and a CHIP as two of
three prerequisites to accreditation program application.
Principles of community assessment :
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Self assessment – staff should recognise the importance of assessing your
activities, and should be committed to learning from their activities with
communities
Community involvement – communities should determine the priorities of
capacity building activity, and how progress towards these is measured and
evaluated
Continuous assessment – assessing impact is not a one-off activity. It needs
to be built into your activities, and the lessons learned fed back into your
future plans.
Data sources for community heath assessment
1. Health Status Reports
2. Births, Deaths, Infant Deaths, and Fetal Deaths
3. Census Data and Population Estimates
4. Health Insurance Coverage
5. Morbidity
Types of community needs assessment :
Community needs assessment I:
This type of needs assessment seeks to evaluate the strengths and weaknesses within a
community and create or improve services based on the identified weaknesses.
Organizing this type of needs assessment is primarily structured around how to best
obtain information, opinions, and input from the community and then what to do with
that information.
Community needs assessment II :
This type of needs assessment is constructed around a known problem or potential
problem facing the community for example, disaster preparedness, how to address an
increase in violent crime etc.
Community needs assessment III:
This final type of needs assessment is based within an organization which either
serves the community at large, is currently addressing a need within the community,
or is dedicated to an under-served population within the community. This type of
needs assessment centers around improving the efficiency or effectiveness of such
organizations.