PRACTICAL 1 COMMUNITY

IDENTIFICATION
AND DIAGNOSIS
Structure
1.0 Objectives
1.1 Introduction
1.2 Community Identification .
1.2.1 Indications for Community Identification
1.2.2 Points to Remember
12.3 Articles/EquipmentRequired for Community Identification
1.2.4 Procedure and Guidelines
1.3 Preparing a Report on Community Profile
1.4 Let Us Sum Up

1.5- Answers to Check Your Progress

1.0 OBJECTIVES
- - - -

After going through this practical, you should be able toi

explain importance of community identification;
locate the sources of information for community iderdfication;
use the different methods for collecting data related to community
identXcation;
writelprepare a community identification report; and
prepare an action plan based on the information collected from the
community.

As a Community health nurse you hqve to practice in variety of geographical

locations. Each community, whether urban, suburban or rural has its unique
characteristic, strengths and limitations. As you gain knowledge about the
community, you can play a significant role in creating awareness among community
about improving their health status by improving the health practices of its people.
This practical will help you to learn the steps of community identification and
develop a community profile. You will learn a systematic way of gathering data
about the community assets and liabilities in terms of community health and
illnesses. You will be able to identify the relationship between the data gathered
and the health and well being of the community. You should try to identify
biological, physical socio-economic and cultural factors that have influence on the
health status of a particular community. Once you have collected the data you
should record it, you would be able to function meaningfully towards the
improvement of community health through community action.
The basis of community health action must be an accurate assessment of the state '

of the health of the community as a whole. For this reason community health
diagnos2- 9 kevstone of community health practice.
;Q
Nursing Practices in
Community Health-I 1.2 COMMUNITY IDENTIFllCATION
Community identification involves the exploration of the various aspects of the
community, related to health and welfare of the people in order to provide effective
services to the community. Not all information about the community may be
required at a time however, it will depend upon the purpose for which community
identification needs to be done. You must explore various methods and techniques
to collect maximum information.

You should prepare the performa for data collection in advance, record the
information collected and analyze systematically for a meaningful service.

The main purposes of Community identification are to:

Systematically gather health related data about a selected community,

Explore boundaries of community,

Identify health and heaith related resources in the community,

Identify community assets and liabilites,
Examine relationship between data gathered and health and well being of the
community,
Record the health conditions that are threats to specific population groups in
the community,

Identify biological, physical and social forces that have bearing on health of
the community.

1.2.1 In&%ationsfor Community Identification

The indications are to:

Develop acquaintance with the community.

Identify its resources for maximum utilization to optimize the health and
welfare of the community.
Assess health needs.
Plan, implement and evaluate health care.

Collect data for community nursing actions.

1.2.2 Points to Remember

As a community health nurse you must be prepared to know the multifacts of
community. You must be able to meet the changing needs of community, and reflect
change in your health related activities.

You must follow an ecological approach which is basic to the community health
diagnosis because science of ecology is concerned with the interaction of man and
nature of man made environment. You should take following steps to establish
community health diagnosis.
- Data collection is a pre-requisite to a realistic assessment of community and
establishment of nursing diagnosis. You need to utilize variety of zpproaches to
collect data for need assessment. Informal infw-marlon or chseivation of the
new community will provide you an over view cud guide yoc t~ r-r?\\ L.5- .h
status of a given community.
- Before doing a needs assessment or collection of data of a given community, Community Identification
you must clarify the purpose in words that seem reasonable and acceptable to and Diagnosis
respondents. T h ~ should
y be explained what information is wanted? Why it is
important? How will this information be used? These questions must be
devised in advance, i.e., in the preparation of tools for interview or
questionnaires, so that important issues are considered and time is used
usefully.
- If official permission is required it should be taken in advance so that there is
no delay or problem in the process of community identification.

Considerations of Community Health Diagnosis

While making community diagnosis you must consider following issues:

There are three interdependent, interacting and constantly changing conditions:

which include:
- The health status of the community including the vulnerability level of
population.
- Community health capability or the ability of the community to deal with
its health problems.
- Community health action potentials or the ways and direction in which
the community is likely to work on its health problems.

Communities have their own styles of response:

- Some community tend to organize for health care on a community wide
basis with plans and action designed for the city or country or state as a
whole.
- Others focus on area wise planning with considerable diversity.

1.2.3 ArticlesIEquipment Required for Community Identification

Since study of community identification involves use of various approaches, the use
of tools and equipment will depend upon the approaches being used. These tools
may include:

Observation checklist

Key information registers

Meeting place or meeting room for community leaders

Community leaders views
Interview schedule
Questionnaire
Map of geographical area
Measuring tools such as weighing scales, thermometer, blood slides, needles.

1.2.4 Procedure and Guidelines

As a community health nurse you should follow following steps to gather
information about community:

Obtain a map of conmunity

Nursing Practices in Go around the local community to gain first hand impressions of the 1:1! our 01
Community Health-I the area, housing, spacing of residences, roads, environmental concli~ion\.
business and industrial establishments, neighbourhood services. educ.arional,
recreational fdcilities, Health institutions, private and indigenous pl-i~c-r
i r ioners,
community recourses for water and sanitation, fuel and food, law ;111dorder.
~ a l c ae village walk along with health workers
Meet community leaders and influential people
Meet Mahila Mandals and other woman groups
Visit various institutions
Coordinate with other related sectors to get information
Guidelines for Cammunity Identification
Follow the following guidelines to record community information:
A) The Health Status
I) Geographical Characteristics
Name of the locality or the area
Boundaries
Important roads, streets, buildings, establishments, offices
Important landmarks
Seasons and months
Prepare a map of the area.
Total area
11) Demographic Characteristics
Total population
Total families
Average size of the families
Number and characteristics of those functioning below their
potential health level.
Population Distribution According to:
- Age
- Sex
Education
'\

- Occupation
- Income
- Caste, religion, language
\

Vital Health Events

- Birth rate
- Death rate
- Infant mortality rate
 - Morbity rate Community Identification
and Diagnosis
- Specific morbidity

Special Health Groups

- Infants
- Preschoolers
- School going children
- Antenatal mothers

Post natal and lactating mothers

- High risk antenatal mothers
- Vulnerable families/multi problem families

II I) Environmental Characteristics

Houses
- Number

- Type
- Living space per head
- Other facilities in the home environment
Bathing
Kitchen
Toilets
Electricity
Purity of air
Water supply- safelunsafe
Water and Waste Disposal
- Collection and removal of solid waste
- Collection and removal of liquid waste
- Vector control measures
- Environmental sanitation

Structural Organization for Environmental Sanitation Services

Educational Opportunities
- Schools
- Colleges
- Vocational institutions

B ) Health Capability
It is represented by the degree to which community isable to cope with its
health problems and needs.
 Resources
Economic Resources of Community
. - income.
Major occupation, average family income, Per capita
Institutional Resources
a Health and health allied agencies
a Hospital Beds
a Nursing homes and other community health facilities
a Equipmeat's used are sufficient or not
a Staff, whether qualified and supervised by senior staff or not
a Resources are available at all the times or not
a Provision for specialized or referral services
a Educational agencies
a Social welfare agencies
a Industrial and commercial agencies
a Recreational and resources
Human Resoiurces
a Formal
- Professionals- doctors, medical specialists, generalist,
-- Private practitioners, nurses, ANM's, teachers, lawyers,
Para-professional: traditional health worker and indigenous practitioners
a Informal
- Senior citizens, influential persons, women and men, persons giving care
for the families, neighbuors (Home Nursing)
Natural Resotirces
- Land, water, soil etc.

C) Health Action Potential

. Community health action potential affects health planning, as such community
will differ in its patterns of health action depending on the value that people
assign to health as compared to their other life needs and the characteristic
way of taking action. The political system by which they govern themselves
and their habits they have developed with respect to social action.

Health Knowledge, Beliefs and Practices

About Health and Disease
- Outlook on cause of disease, spread and preventation of disease
- Existing health practices related to prevention, care for some specific
illness
- Superstlitions related to food, child care and health practices
- Promotional health ~ractices.food. rest. relaxation. recreation. eames etc.
 - Attitude towards health agencies - positive or negative to community Community Identification
health programmes and community organization and Diagnosis

The decision by a prestigious leader/village priest or mayor influences the behaviour

of the group.

Community Organizations
- Voluntary welfare organizations
- Youth welfare organizations
- Women welfare organizations
- Mahila mandals
- Youthclubs
- Vikas mandals
- Occupational organizations
Trade union organizations
- Private institutes/institutions
- Vocational centers
- Labour units
- Business organizations
Statutory Bodies
- Panchyat
- CounLselors
- Executive committees

Leadership Patterns
- Informal leaders
- Influential persons
- Local trade leaders
- Teachers
- Landlords
- Fonnal leaders
- Political party leders
-- Trade union, head of associations like PresidentNice President
- Group dynamics Types of groups as per:
Religion
Caste
Occupation
- . .
 Nursing Practices In Health Problems as Felt by the Community

I
Community Health4
- Major health problems and needs
- Priority problems as felt by the people or community leaders
Channels of Communication
I
i - official
- Non-official
- Common meeting places used
- Chaupal, community centre, hall
- Important communicators;
Traditional like barber, numberdar, Teachers, retired people
- Mechanism of communications - Fairs and festival, religious meetings
and Official meetings
- Media of communications
- Radio, TV and cinema
Factors that can Help or Hinder Community Health Actions
Sources of these information
- health and health allied resources
- community people
- community leaders - formal or informal
- census records
After gaining information of the community you can find out how local
announcement are made, meetings are conducted, common meeting places and
how meetings are arranged. By getting familiar with these characteristics of the
community, you as a community health nurse can plan subsequent activities and
actions, which will help you to get actions acquainted with community you are going
to serve.

PROFILE 3 -
Report prepared about community profile should be such that all health team
members and related team members can use it. It should include all -facts and
figures of information collected. A brief report is helpful in orientation to new staff
and planning for future services.
Check Your Progress
( J ) mark the correct answer.
1) Objectives of community identification are:
a) Understand community
b) Explore community boundaries
c) Prepare community profile
d) Identify community resources
P\ A l l the ahnvp
2) Demographic data can be obtained from Community Identification
and Diagnosis
a) Census record
b) School attendance data
C) Hospital admission data

3) Which are the most important vital event rates?

a) Birth, death and illness

b) Birth, mamage and illness

c) Death, migration and illness

4) Which of the following community characteristics have impact on the

community health status?
a) Physical and geographical boundaries

b) The people
C) Political structure
d) Economic stateius

e) All of the above

Activity
- Select a community for your community health experience and for rendering
community health services.
- Prepare a guideline for community identification
- Collect data to identify the community
- Prepare a community profile report

This should include information about community in general and assessment of

health related aspects of community.

1.4 LET US SUM UP

In this practical we have learnt how to go about carrying out community
identification and use this information for rendering community health services.

1.5 ANSWERS TO CHECK YOUR PROGRESS