Community Diagnosis, Plan

Of Action and Program

Evaluation
Scientific Problem Solving Cycle for
Community Health Problem
Learning Objective
Identify the community health problem, risk
factor and resources
Proposed plan of action to overcome
community health problem
Proposed evaluation indicator and method for
program intervention
The Cycle
Problem
Identification
Community Dx
Intervention
Plan Of Action
Evaluation
Community Diagnosis
Explain the community diagnosis concept and aim
Explain the community diagnosis process
Determine the community diagnosis based on a
given set of data
Community diagnosis concept
The foundation for improving and promoting the
health of community member
The role: to identify the health problem and
factors that affect the health of population and
determine the availability resources within the
community to adequately address these factors
Definition of Term
Health problem and potential health problem
Health status indicator compared to national, target or
previous data
Risk factors:
Health determinant: environment, psychobiologic, behavior
and health service related to problem
Resources available:
Community capability : facility, socio-economic, education
Health service facility
Health service provider
Community Diagnosis Process
Data Collection
Data Processing
and Analysis
Problem
Identification and
Selection
Risk Factor and
Etiology Analysis
Resources
Analysis
Additional Data?
Data collection
What are our problem?
What factor contribute to these problem?
What resources are available in the community
to address these problem?
Data? Bloom Theory
Source of
Information?
Data Collection
Health Status
Health Services
Environment Lifestyle
Psychobiologic
Data Collection
Morbidity, Disability,
Mortality Data
Health Facilities,
Health Provider,
Utilization
Insurance,
smoking, sport
behavior
Pollution,
Sanitation,
Demography
Nutrition, Violence,
Immunization
Source of Information
Primary Data
Community
perception survey
Focus Group
Discussion
Community leader
interview
Secondary Data
PHC data
BKKBN
BPS
Hospital data
Provincial data
Data Processing and Analysis
Entry the data
Summarize : table and graph
Analysis:
Compare with provincial, national or target
Made a trend analysis if possible
Analysis the relationship between problem identified


Problem Identification and Selection
List of problem?
Related problem or independent problem? What is the
underlying problem?
Can we address all the problem?
Selection criterion:
Prevalence
Severity
Rate of increase
Degree of unmeet demand
Social benefit
Public concern
Political climate
Risk Factor and Resources
Identify the risk factor or possible causes of
each problem based:
Data
Brainstorming
Identify the capability of resources available:
Man
Money
Material
Community and political support
Summary of Community Diagnosis
Health Problem Statement
Tingginya angka kematian bayi dan ibu maternal ( statistik)
Tingginya prevalensi penyakit infeksi/menular (statistik kelompok
penyakit)
Risk Factor or Possible Causes
High risk pregnancy, nutrition status and other socio-culture factors
Environment quality : poor sanitation, lack of clean water

Resources Capability
Ratio of health provider and maternal cases
Ratio of health service
Community economic capability
National program
DATA ANALYSIS
COMMUNITY DIAGNOSIS
LEARNING OBJECTIVE
Explain the types and sources of community
data
Evaluate the quality of community data
Analyze the community data using descriptive
statistic
Conclude the community diagnosis based on
data
Community Diagnosis
Community Health Problem
Community Health Risk Factor
Community Resources
SOURCE OF DATA
Program dan Laporan Kegiatan Puskesmas:
KIA
KB
Gizi
P2P
Balai Pengobatan
Data Pemantauan Wilayah Desa/Kecamatan
TYPE OF DATA
GEOGRAFIS-DEMOGRAFI:
Letak geografis
Kondisi geografis
Jumlah dan komposisi penduduk
Perpindahan dan pertambahan penduduk
Densitas, Dependency Ratio
SOSIAL EKONOMI:
Kondisi pemerintahan
Pendidikan
Agama
Pekerjaan
TYPE OF DATA
INDIKATOR KESEHATAN:
Derajat Kesehatan
Upaya Kesehatan:
Fasilitas dan Sarana
Program dan Pelayanan Kesehatan
Kualitas Lingkungan


Derajat Kesehatan
Mortalitas: CBR, CDR, Specific Death Rate
Morbiditas: Angka kunjungan, 5-10 penyakit terbesar, angka
kesakitan khusus (P2P)
Upaya Kesehatan:
Cakupan program
Ratio sarana dan petugas
Lingkungan:
Sanitasi
SPAL

Data Analysis
Quality of
Data
Data Analysis
Table, Graph,
Regrouping
Interpretation
Meaning or
Impact on
health status
Example: Demografi
Diubah menjadi piramida penduduk
Diolah:
Dependency ratio
Sex ratio
Analisis arti dan potensial dampak pada
kesehatan
Example: Grouping 10 penyakit
terbanyak
ISPA
Scabies
Diare
Pegel Linu
Gastritis
Infeksi Kulit
Jamur Kulit
Alergi kulit
Disentri
Hipertensi
ISPA
TERTINGGI?
COMMUNICABLE
DISEASE?
POOR
SANITATION?
Data Analysis
DATA
List of Actual or
Potential Problem
Risk Factors
Resources
Problem
Priority
Health
Problem
high MMR
Upaya/Program
Related
Resources
Available
Lingkungan
PLAN OF ACTION
A step by step intervention action
Planning Component
Mission Statement
Problem Statement (Community Dx)
General and Specific Objective
Description of activity
Planning assumption
Strategy of approach
Target group
Time
Staff (who provide what)
Indicator for evaluation and milestone (Program Evaluation)
Planning
Health Problem
Risk Factors, Possible Causes
Resources
List of Potential Intervention
Program
Program evaluation and
selection
Set the objective and target:
Relevant with problem
Measurable outcome : what, who,
how, when and target
Organizing the Activity
Person and Job description
Procedures and Method
Target Group
Time
Resources Needed
Monitoring and
Evaluation
assuring the program implementation
and achievement
What and Why
What:
Verifying whether everything occurs in conformity
with the plans adopted, the instruction and the
principle
To find deviation, proposed corrective action
The use of both active and passive means of
ensuring that the program moves along in which it
was planned

Three basic condition
Standard of input, process and output and
outcome
Information indicating deviation
Authority to correct the problem
Supervisor main function
To help your staff to perform their jobs better
by providing
Guidance and training
Assistance with resource and logistic
Support, encouragement and advocacy for their right
Monitoring and evaluation

Description of task
Setting individual performance objective
Managing performance problems and conflicts
Having regular contact to motivate, solve problem,
provide feedback, guidance, assistance and support
Designing supervisory system
Preparing supervisory schedule
Conducting periodic performance appraisal
Supervisory session
Personal or group
Element:
Overview of progress and problem
Learning from experience
Foreseeing potential problem
Getting employee commitment
Identify support and assistance needed
Selective supervision session
Identify critical activity
Set the supervision frequency and schedule
Prepare the planning:
Core task
Current report
Potential difficult
Problem solving plan

And
Choose your supervision style
Examine your employee and working
environment

I dont to see any mistake anymore
Or
I believe that you can make it better by..
Exercise
Based on your program:
Stated the technique that you might use in three
types of control
Identify one critical activity and develop supervision
session plan.