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COMMUNITY DIAGNOSISCDX – PART 2
CM3 2010-2011Department of Family and Community MedicineDe La Salle Health Science CampusEstrella P. Gonzaga M.D.
epgonzaga DFCM DLSHSI 2010
CM3 Program/ Project Management Cycle
P
I/M
E P
I/M
E
PI
SITUATIONAL ANALYSIS
CDX
P
I/M
EHEALTHEDUCATION
epgonzaga DFCM DLSHSI 2010
CDx in the Program/ Project Management Cycle
CDX1. Plan - CDx Plan
Work PlanEvaluation Plan
2. Conduct3. Reporting
Lit Rev
Step 1: Situational Analysis
Step 2. Objective Setting
Step 3: Action Planning
Step 4. Plan for Evaluation
Problem Investigation
1. Plan – PI PlanWork Plan
Evaluation Plan
2. Conduct3. Reporting
epgonzaga DFCM DLSHSI 2010
1.2 & 1.3 Plan the Work Activities/ Evaluation
Who will do what and
when? Attained ?
c. Data collection tools
d. Data recording and processing
e. Data analysis
4. Describe report format
What instruments will
be used to measure
the conditions?
b. VariablesWhat will be covered?
3. Identify the Methods
a. Study Population Who will be interviewed?
1. Clarify purpose
2. Identify the objectives
Why is the survey
being done?
1.1 Planning the CDx Planning Survey
epgonzaga DFCM DLSHSI 2010
ANALYSIS
epgonzaga DFCM DLSHSI 2010
Planning the analysis
Decisions on
- Coding
- Processing
- Computer
- Manual – Hand tallying
- Hand sorting
- Statistical Analysis
- Dummy Tables (skeleton tables – row and column headings but no figures)
- Statistical Techniquesepgonzaga DFCM DLSHSI 2010
Statistical Analysis
Examine
- each variable separately
- pairs of variables
- sets of three or more variables
-
epgonzaga DFCM DLSHSI 2010
Statistical Analysis
1. Simple descriptive statistical displays and summaries
- Examine the frequency distribution of all variables
- Summarize e.g. means, %/ rates
* Seek patterns and inconsistencies
2. Relationships between variables
- cross tabulations (Contingency table)
- diagrams e.g. pie, bar, line
epgonzaga DFCM DLSHSI 2010
HEALTH
STATUS
Popn Social Econ Envr Health Sector
Knowledge/
Perception
STRUCTURE OF DATA CATEGORIES
GENERAL DESCRIPTION
epgonzaga DFCM DLSHSI 2010
Community Diagnosis Survey Plan 1
DATA CATEGORY(Variables)
DATACOLLECTIONSource/ Tool
DATA ANALYSIS REPORT
GeneralDescription
Records ReviewKey informant interview
Content analysis Report FormatSec 4.1
HEALTH DETERMINANTS
InterviewQuestionnaire
DescriptiveStatistics
Population Sec I- A, #2-5 Frequency Distribution Sec 4.2.1
Sec 4.2.1
Health Status Sec II-A #1,7Sec III-A, B
Frequency Distribution Sec 4.2.2
Sec 4.2.2
epgonzaga DFCM DLSHSI 2010
DATA CATEGORY VARIABLES
General Description GeographyClimateTemperatureRoad condition/ How reachedHouseholds – numberHouses spatial arrangementSource of LivelihoodMeans of transportationHealth Resources/ FacilitiesInfrastructure/ Educational/ Sports FacilitiesHistory of BarangayBarangay Council Members
Population AgeSexCivil StatusDependency RatioSex RatioNatural Growth RateVital Indices
DETAILS
epgonzaga DFCM DLSHSI 2010
Source: NOH 2005-2010 epgonzaga DFCM DLSHSI 2010
Source: Field Statistics Health Information Service
15 – 49 (34)61%
Less than 15(14)
35%
65 over4%
50.4% M
49.6% F
EST.79,503,675.
epgonzaga DFCM DLSHSI 2010
Community Diagnosis Survey Plan 2
DATA CATEGORY DATA COLLECTIONSource/ Tool
DATA ANALYSIS
REPORT
Social InterviewQuestionnaireSec I- A # 6-11Sec I-C,D
Frequency Distribution Sec 4.2.3
Sec 4.2.3
Economic Sec 1-B Sec 4.2.4 Sec 4.2.4
Environment Sec I- E Sec 4.2.5 Sec 4.2.5
Health Sector
a. HumanResource
Sec II-A #1,2Sec II-C,#9Sec II-D,#2,7Sec III-A,#6,7,9Sec III-B,#6,7
Sec 4.2.6.1 Sec 4.2.6.1
epgonzaga DFCM DLSHSI 2010
DATACATEGORY
Variables
Social Number and Type of FamilyHousehold sizeHousehold Head CharacteristicsYears of residence in communityPlace of OriginPlace of Last ResidenceReligionEducational AttainmentMembership in community organization x type x nameDwelling Unit – type of housing material, house ownership, lot ownership, electricity, cooking facility
DETAILS
epgonzaga DFCM DLSHSI 2010
DATACATEGORY
Variables
Economic Number of Source of IncomeType of Main Occupation by genderType of other source of income by genderTotal monthly incomeby main and other source Income bracketMean, median, mode
Environment Type of water source by distancePractice of boiling waterType of excreta disposalType of garbage disposalType of drainage system
DETAILS
epgonzaga DFCM DLSHSI 2010
DATA CATEGORY Variables
Health Sector
Human Resource Attendant at birth x PlacePrenatal consult x AOGSource of FP KnowledgeSource of information on FP methodPersons first consulted for illness by Place of consultationEffectiveness of treatment by consulted personCause of death by person consultedReason for non-medical attendance
DETAILS
epgonzaga DFCM DLSHSI 2010
Community Diagnosis Survey Plan 3
DATA CATEGORY DATACOLLECTIONSource/ Tool
DATA ANALYSIS REPORT
Knowledge of Primary Health Care
Sec IV Content Analysis Sec 4.2.7
Sec 4.2.7
Perceived Community Health Problems/ Causes/ Solutions
Sec V Content analysis withFrequency DistributionSec 4.2.8
Sec 4.2.8
Perceived Medical Problems/ Causes/ Solutions
Sec VI Content Analysis with Frequency DistributionSec 4.2.9
Sec 4.2.9
epgonzaga DFCM DLSHSI 2010
DATA CATEGORIES VARIABLES
PHC concepts Knowledge Preventable Diseases, Protein role, Signs of
Normal Pregnancy, Newborn bath and cord care
Breastfeeding / Bottle feeding effect on infant
Health, Immunizable diseases, Covered Child
With fever, Family planning, herbal medicine
Safety, Tuberculosis sign, wound cleaning,
Burning of garbage, Drugs in Hypertension,
Fruits sugar and diabetes
Perceived community Health Health problems, corresponding causes
Problems, Solutions Corresponding solutions
Perceived Medical Problems Medical problems, corresponding causes
Solutions Corresponding solutions
DETAILS
epgonzaga DFCM DLSHSI 2010
Summary forms
Frequency distribution: one variable, two or more
* Check appropriate Denominators
Quantitative
measures of central tendency
measures of dispersion
Qualitative
rates
ratios epgonzaga DFCM DLSHSI 2010
Rates
e.g. Prevalence
Numerator : No. of HH
of HH Members
reporting sick with fever during a six month period
Denominator: Total number of HHof total Population
Factor: 10, 100, 1,000, 10,000, 100,000
epgonzaga DFCM DLSHSI 2010
Analysis of problems: 2 of the 5 Q Sec 4.3 (Q1) What is the state of
health of the community?
Statement on the overall health condition of the community based on
Findings on the 4 life events:-- births -- 0-6 nutritional status-- morbidity-- mortality
epgonzaga DFCM DLSHSI 2010
HEALTH: Vital Events
BIRTH
NUTRITIONAL STATUS
ILLNESS/ DISEASE
DEATH
epgonzaga DFCM DLSHSI 2010
Sec 4.3 : Health status of the community
Health Events Status
Births
Nutrition, 0-6 y.o.
Morbidity
Mortality
epgonzaga DFCM DLSHSI 2010
DATA CATEGORY Variables
Health Status 1 year Mortality – RatesCause by Age by SexHouseholds with Deaths
•6 months Morbidity –Prevalence Rates•Cause by Age by Sex•Households with Sick
•Nutritional Status 0 -71 months•Weight by Age by Sex• Height by Age by Sex
epgonzaga DFCM DLSHSI 2010
Data Processing/ Organization
Causes of Morbidity Cases Prevalence
Fever 15 8.77
Cough 6 3.51
Tonsillitis 4 2.34
Colds 2 1.17
Flu 2 1.17
Dengue 1 0.58
Allergy 1 0.58
Acute
Gastroenteritis
1 0.58
Table 2.2.3 Frequency and prevalence rates of the causes of Morbidity from December 1, 2005 to May 31, 2006 in Bgy. X
epgonzaga DFCM DLSHSI 2010
Sec 4.4 Q2: “What are the factors responsible for the health condition of the community?
Identification of factors known to affect the particular health condition
Assumption: knowledgeable of event process
logical sequence of conditions (factors) that lead to undesirable event
Presentation types
1. Tabular (Cdx use)
2. Graphical e.g Problem tree (Problem
investigation use)
epgonzaga DFCM DLSHSI 2010
PREGNANCY0 – 9 mos
DELIVERY
24 HOURS
POSTPARTUM
0 – 6 WEEKS
Family Planning
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Total Fertility Rate: Average number of births that woman would have at the end of her reproductive life
Source: National Objectives for Health
Compared to Itself1999:
NCR 2.13East Visayas 4.73
Urban 3Rural 4.7
Mother’s Educationwithout 5.01
Elem 5.0HS 3.6
College 2.9
epgonzaga DFCM DLSHSI 2010
Source: NOH 2005-2010 p. 207
epgonzaga DFCM DLSHSI 2010
epgonzaga DFCM DLSHSI 2010
Sec 4.4: Factors affecting the health status of the community
HEALTH STATUS CORRELATES
Pop SOCIAL ECONO ENV H SERVCS KAP
BIRTH
ILLNESS
NUTRITION
DEATH
epgonzaga DFCM DLSHSI 2010
HS CORRELATES
P S E Env HHR/HHF K PHC Percept
BirthHigh
CBR
%W
MRA
EducAttain
Mother
HH incom
e
Attendanceat birth by
place
% #3 %HH report
ing problems/
cause
% FP knowledge
No.8 FP
% FP use
% PrenatalConsult
epgonzaga DFCM DLSHSI 2010
Data Processing/ Organization
Facility Consulted (simple illness) Freq %
Private hospital/clinic 16 47.1
Government Hospital 0 0
Rural Health center 6 17.6
Community Health Worker 0 0
Self – medication 11 32.4
Others: none 1 2.9
Total 34 100
Table 2.1.1 Frequency and percentage distribution ofhouseholds by type of facility usually consulted
for simple illness in Bgy. X.2005
epgonzaga DFCM DLSHSI 2010
Data Processing/ Organization
Facility Consulted Simple Illness Serious
Private hospital/clinic 47.1 73.5
Government Hospital 0 11.8
Rural Health center 17.6 5.9
Community Health Worker 0 2.9
Self – medication 32.4 0
Others: none 2.9 5.9
Total 100 100.0
Table 2.1.1 Frequency and percentage distribution of householdsBy type of facility usually consulted for simple illness in Bgy. X.
2005
epgonzaga DFCM DLSHSI 2010
Table 6.1 Frequency distribution of perceived
community health problems in Bgy X. 2005
Community Health Problem Frequency %
Garbage 12 35.3
Frequent colds/ cough of children
12 35.3
Mosquitoes 6 17.6
Piggery 5 14.7
Air pollution 4 11.8
Tall grasses 3 8.8
Far from health center 1 2.9
Total HH: 34 Total HH with no answer 10epgonzaga DFCM DLSHSI 2010
PROBLEM Freq/ % CAUSES Freq / % SOLUTION Freq/ %
Diarrhea 10 / 50 Parentsneglect
20/ 100 Teach
Dirtywater
DasmaWater SS
Play in flood
Scold
FLies Garbage City Hall
Rains None
Table 6.2 Frequency distribution of perceived community health problems , causes and solutions in Bgy X. 2005
epgonzaga DFCM DLSHSI 2010
Sec 4.5 Current efforts about the health situation
Summarizes
- What the community is doing about it
- What the health services is doing about it
epgonzaga DFCM DLSHSI 2010
Interpreting the Findings
1. “ Make sense of the findings”
- Identify problems
Aspects of community (variables)
in relation to a standard
Problem areas = if below the standard
- Explain causes of the problems
epgonzaga DFCM DLSHSI 2010
Interpreting the Findings
1. “ Make sense of the findings”
2. ‘Broader significance’ –
extent to which they may be generalized beyond study population,
- wider scientific implications,
- research questions raised or unanswered
- practical implications e.g. provision of medical care or public health action
epgonzaga DFCM DLSHSI 2010
5. Conclusion
“ Making sense of the Data collected”
4.1 Identification of problems areas
(compare collected data with standards / reference points)
epgonzaga DFCM DLSHSI 2010
Comparison with Standards /Reference points
1. Acceptable levels - Desired situations
Health goals
2. Within same area –Trends (time)
3. Within country : Municipality; Province / Region National
4. With other countries – Western Pacific
South East Asia
epgonzaga DFCM DLSHSI 2010
Sources of standards: (CM3 use)1. National Objectives for Health
1999-20042005-2010
2. National Statistical Coordination Board 3. World Health Organization
- World HeaLth Statistics 2010- Country Health Information
4. UNICEF – State of the World Children Report5. Health of Asia and the Pacific
epgonzaga DFCM DLSHSI 2010
DATA CATEGORY StandardsNational Obj for health, 1999-2005
Findings
PopulationCBR
28.4/ 1000 pop or 2.84%
Health statusNutritional Status
Morbidity TB = 1.9 / 1000Ph 0-6 = 350 / 100,000Polio = 0Measle = < 3,000NT = 1 / 1000 LBDip = <300 casesPerluri = <1,500 casesPavasit = < 50%Diarrhea = 1%HPN = <15%Cancer = 5 / 10,000
epgonzaga DFCM DLSHSI 2010
DATACategory
STANDARDS(Source/ Year)
CommX
FINDINGS
Population
CBR 23.1/1,000 pop(PHS, 2000)1
18.0/1000
20.50/1,000pop (PHS,2004)2
1. National Objectives for Health, 2005-2010
2.Western Pacific Country Health Information Profiles 2008
DIFFERENT VALUES AMONG
REFERENCES!
epgonzaga DFCM DLSHSI 2010
Western Pacific Country Health Information Profiles 2008epgonzaga DFCM DLSHSI 2010
Findings
- Comparison between the specific condition in community and the standard/ reference
With in Standard BELOWSTANDARD
Acceptable NOT ACCEPTABLE
Favorable NOT FAVORABLE
BETTER WORSE
epgonzaga DFCM DLSHSI 2010
Source: National Objectives for Health
WITHIN STANDARD
BELOW STANDARD
VALUES HIGH OR LOW HIGH OR LOW
IMPLICATION ACCEPTABLE NOT ACCEPTABLE
FAVORABLE NOT FAVORABLE
BETTER WORSE
TFR : 2.3 in 2010
epgonzaga DFCM DLSHSI 2010
epgonzaga DFCM DLSHSI 2010
Infant Mortality Rate
1998
Urban 30.9
Rural 40.2
Lowest
Metro Manila 23.7
Central Luzon 23.6
Western Visayas 26Highest
Eastern Visayas 60.8
ARMM 55.1
Caraga 53.2
Source: National Objectives for Health
epgonzaga DFCM DLSHSI 2010
Indonesia: 312 - 385
Philippines :
1970 190
1995 179.7
Malaysia 20
Thailand 10.7
Japan 7.6
Singapore 4.1
MATERNAL DEATHS/ 100,000 LIVE BIRTHS
Source: National Objectives for Healthepgonzaga DFCM DLSHSI 2010
Lowest
Metro Manila
Southern Tagalog
Highest
ARMM
Northern Mindanao
Maternal Deaths: less 1% of total deaths
Source: National Objectives for Healthepgonzaga DFCM DLSHSI 2010
Sec 5.1 : Problem ID
Information Bgy X Standard Findings
Population
Health status
Social
Economic
Environm
Health sector
Health services
Knowledge PHC/ Perceptions
epgonzaga DFCM DLSHSI 2010
Sec 5.2 Problem Prioritization
WHO criteria for prioritization:
1. Magnitude of the problem
2. Vulnerability to technology
3. Social concern
4. Existing health policy
epgonzaga DFCM DLSHSI 2010
Magnitude
Severity level of disease or condition
Extent of People affected
- Prevalence
- Incidence
(projected number of new cases)
- Case fatality rate (projected no. of
deaths)
- Worsening trend
epgonzaga DFCM DLSHSI 2010
Vulnerability to technology
1. Existence of effective technology
2. Feasibility of implementation of technology
3. Geographical application of technology
4. Multiplicity of effects of technology
epgonzaga DFCM DLSHSI 2010
Social concern
Value attached by community to the Disease/ Condition
- Explicitly expressed as a problem
- % of HH reporting
Check the perceived causes and solutions for the identified problem (correct knowledge/ LOGICAL SEQUENCE)
epgonzaga DFCM DLSHSI 2010
Existing health policy
1. Presence of an existing policy
2. Relevance of existing health policy to the identified health problem
epgonzaga DFCM DLSHSI 2010
Prioritization process
Scoring system
1. Prepare a scale (0 to 3; 1-5 )
May have different scales depending on nature of problem
Describe each point in scale –
ensure exclusivity
2. Rate each problem
epgonzaga DFCM DLSHSI 2010
Sec 5.2.1 WHO criteria for prioritization
Points M V SC HP
0 0- 24 % No vaccine < 25
HH report
None
1 25-34% Vaccine for health
workers
25 - 49
HH
1-3 years
2 35- 50% Vaccine free for
young and old
50 – 74%HH
4-6 years
epgonzaga DFCM DLSHSI 2010
Sec 5.2.2 : Problem prioritization (Application of criteria)
Prob
-lems
Magnit
-ude
Vulnera-bility to tech
Social concern
Existing health policy
Total score
CBR 1 3 1 3 8
Diarrhea (0-5 years)
3 3 3 3 12
epgonzaga DFCM DLSHSI 2010
Sec 5.2.3 List of 3 priority problems
PROBLEMS BASIS
1.Diarrhea among 0-5 years
Highest score 12
2. High Birth Rate 2nd highest 8
3. High Below Normal WT 3rd highest 6
From the table of Sec 5.2.2, list the three
priority problems with the highest total
scoresepgonzaga DFCM DLSHSI 2010
Activity Results Persons DateTime
Resources
Accomplishments/ Deviations
Reasons for deviation
Sec 6. WORK PLAN
epgonzaga DFCM DLSHSI 2010
7. Prepare Report
1. Review the prescribed report format
2. Prepare the draft
3. Get comments (team and preceptor)
4. Finalize the report
epgonzaga DFCM DLSHSI 2010
Report Format
INTRODUCTION (rationale of project)
I. Situational Analysis
A. Community Diagnosis
B. Problem Investigation
II. Project Plan
III. Project Implementation
IV. Project Evaluation
epgonzaga DFCM DLSHSI 2010
Report Format
I. Situational Analysis
A. Community Diagnosis
1. Rationale (Purpose)
2. Objectives
(SMART – RESULTS)
3. Methodology
4. Results
5. Conclusion
6. Work Plan / Results
7. Evaluation Plan/ Results
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
1. Rationale
- clarifies the purpose of doing a community diagnosis
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
2. Objectives GeneralSpecific -Measurable, Attainable,
REALISTIC, TIME-BOUND
(= RESULTS)
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
3. Methodology: - descriptive vv analytical
- Population: Total, sample
- Data collection: Interview,
questionnaire, documents /
literature review
- Data processing: manual/ computer
- Data analysis:
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. Results
4.1 General description of place
( follow handout outline)
geography, climate etc
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. Results
4.2 Description of the community
- Population Characteristics
- health status
- socio-economic
- environment
- health sector
- health services
Tabular or graphical
Preceded by a statement
Highlights of table/ graph
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. Results
4.3 Description of status of each life event
- At birth
- Nutritional status
- Morbidity
- Mortality Tabular
1- 2 statements
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. 3 LIFE EVENT STATUS
At birth
Nutritional Status
Morbidity
Mortality
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. 4. Factors affecting Life Event
LIFE EVENT CORRELATES
At birth
Nutritional Status
Morbidity
Mortality
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
4. 5. Description of Current Efforts about the
Health Situation by the Community and
Health Services
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
5. Conclusion
5.1 Identified Problems (a. detailed list)
Information Standards Comm X Findings
Population
Health Status
Socio -econ
Environment
Health Sector
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
5. Conclusion
5.1 b. Table on Problems and Basis
Problems Basis
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
5. Conclusion
5.2 Problem Prioritization
- Using WHO criteria, assign points for each criterion and basis for points
- Prioritize the identified health problems using your developed point system for the WHO criteria
epgonzaga DFCM DLSHSI 2010
Sec 5.2.1 WHO criteria for prioritization
Points M V SC HP
0 20 - 25 % No tech < 10
HH report
Plenty of children
None
1 26 – 30% Available
Minimal
risk
11 – 19
HH
Existing
Less 5 years
2 31- 35% Wide use
Multiple
effect
20 – 34HH
5 - 10 years
use
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis
5. Conclusion
5.2 Problem Prioritization
Prob M V SC EP Total
P1
P2
Pn
epgonzaga DFCM DLSHSI 2010
Report FormatI. Situational Analysis
A. Community Diagnosis 5. Conclusion
5.2 Problem Prioritization
Priority Problem Basis
Problem 1
Problem 2
Problem 3
epgonzaga DFCM DLSHSI 2010
6. Monitor the activities
Use the
- CDx plan
field editing to ensure reliable and valid results
- Work plan
ensure smooth implementation of activities and provide support to team
members
(PURPOSE OF PRECEPTORIALS)
epgonzaga DFCM DLSHSI 2010
1.3 Prepare CDx Work Plan (CM3)
Activities/
subactivities
Results Person DateTime Resources
Plan survey CDx Plan
Work Plan
Evaln Plan
Team
Paper
-……..
Conduct
-Collection
CDx Report July 20/ 21
-Processing
-Analysis
Evaluate
Knowledge
Skills
Student
Leader
Peer
June 13
July 22- 30
Exams
Grading sheets
epgonzaga DFCM DLSHSI 2010
8. Evaluate the CDx
Use the evaluation plan
- attainment of objectives
- efficiency of methods
epgonzaga DFCM DLSHSI 2010
1.2. Prepare Evaluation Plan
Activities/
subactivities
Results Person Date/Time Resources
Pepare evaluation design
Objectives
Methods defined
June 1- 6 Papers
Handout
Conduct of data gathering
Activities and data gathered
June 14-16 Observation sheets
Data analysis
Responses organized / analyzed
January 30 Papers, computer
Report preparation
Oral and Written reports
Feb 1-15 Papers, computer, printing
epgonzaga DFCM DLSHSI 2010
Activity Results Persons DateTime
Resources
Accomplishments/ Deviations
Reasons for deviation
Sec 7. EVALUATION PLAN
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7. Feedback to the community
Provide community copy of the report
Present results to community
---confidentiality of data must be respected--
feedback must be population rates and not at the individual levels.
epgonzaga DFCM DLSHSI 2010
CDx in the Program/ Project Management
Cycle
Phase 1: PlanningStep1. Situational Analysis
Community Diagnosis (broad)
Problem Investigation (specific)Step 2. Objective SettingStep 3. Action PlanningStep 4. Plan for Evaluation
Phase 2: Implementation Phase 3: Evaluation
epgonzaga DFCM DLSHSI 2010
WHAT NEXT !
I. Situational Analysis
A. Community Diagnosis
31 hours work
End point: 3 priority problems
B. Problem Investigation
II. Project Plan
III. Project Implementation
IV. Project Evaluation
Dr. J. Carnate
epgonzaga DFCM DLSHSI 2010
References1. Kark, Sidney: The Practice of Community –Oriented Primary Health Care. Appleton, Century Crofts,
New York. 1981. P. 112. Ibid. p. 253. Abramson. J.H. Survey Methods in Community
Medicine. 4th edition. Churchill Livingstone. Edinburgh London Melbourne and New York 1990.
p.3154. Presentation format/ content adapted from Dr. Carmen Tolabing’s powerpoint and materials 2005-
2006
epgonzaga DFCM DLSHSI 2010