how to conduct a community assessment for health projects

2014 ROTARY INTERNATIONAL CONVENTIONJUNE 2, 2014

CONDUCTING

A COMMUNITY ASSESSMENT

FOR HEALTH PROJECTS


1. Opening Remarks – By Moderator

- Marion Bunch, Rotarians For Family Health & AIDS Prevention, Founder & CEO

2. Remarks by Panel Speakers

- Renee Saunders, Centers for Disease Control, Senior Public Health Advisor

- Emmanuel A. Lufadeju, CEO Lufarmco LLC

3. Question & Answer (large group)

4. Closing Remarks – By Moderator

AGENDA

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Rotarians Should Have a Clear Understanding and Strategy For:

1. Explanation of community assessment process and importance of community buy-in when planning a project

2. Ensuring their project planning incorporates specific community assessment /community buy-in data or reports.

3. Be able to identify club, district, cooperating organization or Ministry of Health resources that will produce reliable community assessment baseline information.

4. Acquire as needed in report format this baseline information from identified cooperating organizations or Ministry of Health. Include this reported information in all project development materials, be they programs or grants.

OUTCOME OF SESSION

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KEY CONCEPTS AND PRINCIPLES OF A

COMMUNITY HEALTH NEEDS ASSESSMENT

By: Renee Saunders, Senior Public Health AdvisorCDC/Division of Global HIV/AIDS

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• Community health needs assessment is a process that:– describes the state of health of local people– enables the identification of the major risk

factors and causes of ill health; and– enables the identification of the actions

needed to address these.It is not a one-off activity, but a developmental process that is added to and amended over time. It is not an end in itself but a way of using information to plan health care and public health programs in the future.

What is a community health needs assessment?


Needs assessment enable you to:• Plan and deliver the most effective care to those

in greatest need;• Find out about and address inequalities in

health;• Identify gaps in local provision;• Ensure that scarce resources are allocated

where they can give maximum health benefit; and

• Work collaboratively with the community, other professionals and agencies to determine which health issues cause greatest concern and plan interventios to address these issues.

Why do it?


• Profiling the population: data collection and analysis

• Deciding on priorities for action• Planning public health and health

care programs to address the priority issues

• Implementing the planned activities• Evaluation of health outcomes

Steps of a community health needs assessment:


• Key questions to ask:– What are the key characteristics of the

population?– What is the health status of the people?– What local factors are affecting their health

and what impact do they have (good or bad)?– What services are currently being provided?– What do local people see as their health

needs?– What are the national and local priorities for

health?

Profiling the population


Quantitative:– Population, demographic and socioeconomic data– Previous assessments– Health indicators that address determinants of health

that promote quality of life, healthy behaviors, and healthy development across all life stages

Qualitative:– Observations through field work– Key informant interviews– Focus groups– Community asset mapping

Data collection


• Compare your population with a larger group to ascertain whether a health issue or disease rate is higher or lower than expected;

• Compare current information with that collected in previous years to identify trends over time;

• Identify significant gaps in the information;• Compare and contrast different types of

information;• Look for positive features as well as problems;

even the most disadvantaged communities have strengths that can form the building blocks for change

• Summarize and make a list of the health issues you identify

Data analysis


• Setting priorities:– How many people are affected?– Are there disadvantaged groups with high

needs for care?– Are some people less able to access services?– Are those whose needs are greatest receiving

the services they need?– What is the impact on people’s lives?– Are there appropriate and effective

interventions?– Does the health need identified coincide with

known priorities and strategies?– Is the expertise and training available?

What to do with the information?


• The measure of a good assessment process will be the success or failure of the actions taken to improve health:– Think broadly and creatively about potential solutions

to the issues you are tackling.– A community health needs assessment belongs to the

local community and those who work in it.– Work needs to be planned with others, agreeing who

the key people are and deciding together what needs to be done and by when.

– Include health promotion activities in plan

Planning and implementation


• Monitor and record changes that are taking place

• Evaluate successes and failures• Aim for small, achievable, measurable

goals• Share and celebrate you successes with

others• Where plans are not having the desired

effect, consider them again and consult with others to develop changes

Measuring success


A MATERNAL & CHILDHEALTH PROGRAM IN NIGERIA:

A Model Project

By: PDG Prof. Emmanuel Adedolapo LufadejuRotarian Action Group for Population & Development

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Steps to Organize a Community

Service Project Based on the pilot

project “child spacing and family

health program” in Nigeria

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PROJECT INITIATION

• Find out unmet real needs by conducting

a community Needs Assessment

• Conduct baseline survey of the area or

a Rapid Rural Appraisal

• Conduct situation analysis of health facilities/staff

production of map of local government area with

health post, local gynecological health clinics,

NGOs and traditional healers

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PROJECT INITIATION

• Integrate women in development clubs, associations

and health committees

• Embark on mobilization and reorientation of existing

health, and health related staff of all categories

Information, education and communication

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• Local religious leaders, traditional rulers, and chiefs,

District heads, Village and Wards heads.

• Local and State government administrators, health departments of local governments

• Town criers, health committees and influential

opinion leaders /NGOs • Teaching and specialist hospitals, State hospitals

and Local government health clinics.

ESTABLISH COMMUNITY PARTICIPATION THROUGH

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• Public Awareness Campaign and Advocacy

• Training and capacity building of Health Workers

• Counseling and Contraceptive Distribution

• Equipment procurement

and Maintenance

• Quality Assurance

PROJECT IMPLEMENTATION: APPLY THE FIVE PILLARS

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• Institute good record keeping and train recorders

• Keep accurate client records books and provide

clients with personal record

• Provide monthly return forms

PROJECT SUPERVISION

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• Ensure adequate supply of all available

materials recommended for program

• Arrange regular visits to project hospitals

and local government clinics by Rotarians

and Rotary leaders

• Service providers with other officers in

charge of health clinics

PROJECT SUPERVISION

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• Radio, TV, use of traditional rulers and celebrities

in advertising

• Drama groups

• Audio and Video cassettes

• Poster, Stickers, handbills, Bill Boards and pamphlets

• Mouth-to-mouth information by trained staff, especially TBAs

• Drama Groups

• Meetings of Village and district heads

• Town criers

INFORMATION, EDUCATION & COMMUNICATION THROUGH:

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• The principle of quality assurance in a hospital is based on three

major parameters:

1. QUALITY OF INFRASTRUCTURE comprises the condition of the hospital

building, water supply, power supply, hygienic conditions, number

and qualification of staff, and available equipment.

2. QUALITY OF PROCESS is majorly dependent on adequate structure and

also the qualification and professional capacity of the staff, their experience

and performance.

3. QUALITY OF OUTCOME is the effect and impact of necessary intervention

which will lead to a quantum reduction in maternal and infant morbidity and

mortality and consequent improvement.

• All three parameters are interdependent and connected

PROJECT ACHIEVMENTS, IMPACT AND LESSONS LEARNED

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Key Quality Indicators for Maternal Mortality Ratio (MMR)

- Reduced from 1715/100,000 (2008)

- 670/100,000 (2012)

Fetal Mortality Rate (FMR)

- 6 to 16 % (2008 to 2012 in Kaduna

- 5 to 18 % (2008 to 2013 in Kano)

Compare these results with FCT Abuja and Ondo States

- 2 to 5% for same period

ACHIEVEMENTS CONTINUED

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• Number of mothers receiving prenatal care:

- 307,184 women 2008-2013

• Number of maternal and child

health professionals trained:

- 200 in average 2008-2013

ACHIEVEMENTS CONTINUED

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• All four regions record various levels

of decrease as follows;

1. Kano (0.95 in 2008 -to- 0.36 in 2013),

2. Kaduna (0.76 in 2008 -to- 0.21 in 2013)

3. Abuja (0.06 in 2008 -to- 0.06 in 2013)

4. Ondo (0.18 in 1st qtr 2013 -to-

0.07 in 4th qtr 2013)

REPORT OF DECREASED MATERNAL MORTALITY RATES:

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• 20 Facilities are Benefiting. (5 in each Region)

1. Kano

2. Kaduna

3. Abuja

4. Ondo

NUMBER OF BENEFITING HEALTH FACILITIES:

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how to conduct a community assessment for health projects

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