handout in health management

8/11/2019 Handout in Health Management

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COMMUNITY DIAGNOSISAccording to WHO definition, it is a quantitative and qualitative description of the health of

citizens and the factors which influence their health. It identifies problems, proposes areas for improvement and stimulates action.

What is its purpose!". Anal#ze the health status of the communit#.$. %valuate the health resources, services, and s#stems of care within the communit#.&. Assess attitudes toward communit# health services and issues.'. Identif# priorities, establish goals, and determine courses of action to improve the health

status of the communit#.(. %stablish an epidemiologic baseline for measuring improvement over time.

The Management Process


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Chapter 1

BACKGROUND AND SETTING O T!E COMMUNITY

A" !#stor#ca$ Bac%gro&n'

B" Ph(s#ca$ Descr#pt#on o) the Area

)eographic *haracteristics

+opograph#

oil *lassification

Agriculture

*limate

-ap


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Chapter II

POPU*ATION ANA*YSIS

A" Pop&$at#on S#+e an' D#str#,&t#on

B" Age an' Se- D#str#,&t#on

Age ependenc# /atio

C" am#$( S#+e


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Chapter III

ANA*YSIS O RE*ATED SOCIO ECONOMIC CONDITION

A" ECONOMIC INDICES

Agr#c&$t&ra$ pro'&cts

*rops

0ivestoc1

2arm Implements

Month$( am#$( Income

Occ&pat#on

D.e$$#ng/re$ate' In'#cators

Housing tatus

0and tatus

House /oofing

House 2looring

House *onditions


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Comm&n#cat#on

Transport

e$)are ser0#ces

Recreat#ona$ ser0#ces

C" EN2IRONMENTA* INDICES

E$ectr#c#t(

So&rce o) .ater

San#tat#on

To#$ets

aste '#sposa$

D" PO*ITICA* STRUCTURE

*oca$ go0ernment a'm#n#strat#on an' po$#t#ca$ s&,'#0#s#on

Peace an' Or'er s#t&at#on

E" CU*TURA* EATURES

Comm&n#t( ce$e,rat#ons


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Chapter I2

ANA*YSIS O T!E !EA*T! SECTOR

A" !EA*T! SER2ICES

B" !EA*T! !UMAN RESOURCES

Rat#o o) hea$th h&man reso&rces to pop&$at#on

C" !EA*T! INDICATORS

Prenata$ Care

am#$( P$ann#ng

Repro'&ct#0e Intent#on

Ch#$',#rth an' De$#0er(

Post/nata$ Chec%/&p

Breast)ee'#ng

N&tr#t#on

E-pan'e' Program on Imm&n#+at#on

De.orm#ng


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Chapter 2

T!E PROB*EM

Pro,$em I'ent#)#cat#on

Identif# 3at most4 "5 problems with #our communit#

Sitio Acasia, Barangay Tamugan, Marilog District

1. Low family income

2. Increase incidence of acute respiratory infection andacute gastroenteritis

3. Improper waste disposal

4. Lack of postnatal visits5. Increase ome deliveries

6. !ig incidence of ealt risk factors "e.#. $moking%alco ol drinking&

7. 'alnutrition

(. Low educational attainment). !ouse olds wit out toilets


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Soc#a$ Concern8 the value attached b# the communit# to the problem8 the problem affects certain age, se9 or marginalizedP "f e#pressed by the community as important, the higher the score.

E-#st#ng !ea$th Po$#c#es8 the intervention:s on a particular health condition is anchored on e9isting health policies

ProblemMagnitu

de of theProblem

Vulnerabil ity to

Change

Existing

HealthPolicies

Social

Concer n Total Rank

Low ,amily Income 5 2 5 7 1) 5Increase Incidence of

- I/-#0) 6 4 ) 2( 2

Improper aste isposal 3 ) 2 2 16 6Increase !ome eliveries 7 3 ( 4 22 4

Lack of ostnatal isits 6 1* ) 2 2( 2!ig Incidence of isk

,actors2 ( 3 6 1) 5

'alnutrition ( 5 1* ( 31 1Low 0ducational

-ttainment4 1 6 1 12 7

!ouse olds wit out

oilets

1* 7 7 1* 27 3

+o 0lectricity 1 4 1 5 11 (


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Pro,$em Tree Ana$(s#s Anal#ze the problem and determine the cause8effect relationships between the

problems; 7isualize the cause8effect relationships in a diagram; and Identif# the central or core problem


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Ana$(s#s o) Ca&ses

Can Be cted by the HealthSector

Can Be cted by !ther Sectors

Lack of nowledge +o Latrinesoor ractice egraded $oiloor !ygiene ,ailed !arvestiarr eaoor iet

"mmediate Concern Medium to #ong$term Solution % &eeds #egislation

Lack of nowledge oor ietoor ractices iarr eaoor !ygiene

O,3ect#0e Tree

8 is a visual representation of ob


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Chapter 2I

!EA*T! ACTION P*AN

T#t$e4

Pro,$em4

Rat#ona$e4

Genera$ O,3ect#0e4

A program goal 3general ob will the program:pro


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TITLE: Tamang &utrisyon Tungo sa 'alusugan(

PROBLEM: T)enty$four *of +,- children .,$/, months old arebelo) normal$lo) )eight *for age-0 )hile , are belo) normal$1ery lo) )eight2

RATIONALE: &utrition is a basic human right0 1ital for sur1i1al0gro)th and de1elo3ment2 Malnutrition is caused by a host ofinterrelated factors2

4hile re3orts indicate that there is enough food to feed thecountry0 many 5ili3inos continue to go hungry because of thelack of kno)ledge and 3oor 3ractices2

GENERAL OBJE TI!E:

ll the malnourished children in Purok casia )ill be )ell$nourished2

SPE I"I OBJE TI!ES:

.2 By the end of &o1ember ..0 ,6..0 all the mothers ofmalnourished children )ill ha1e ade7uate kno)ledge onnutrition2


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Causes of the CoreProblem

!b8ecti1e cti1ities Materials&eeded

Time 5rame PersonsRes3onsible

!b8ecti1ely Veri9able"ndicator

oorknowledge

y t e end of+ovem8er 11%2*11% all t emot ers ofmalnouris edc ildren will

aveade9uateknowledge onnutrition.

Lecture on+utrition

enueisual aids

$nacks

+ovem8er 2( 'edical:lerks! s

Lectureconducted

-ttendancere;/ ost;test

oor practices y t e end of+ovem8er2*11% all t emot ers willpractice goodnutrition t ru8ackyardgardeningand preparingand cookingnutritiousmeals.

emonstration on

ackyardgardening

enueisual aids

+ovem8er 2) 'edical:lerks

! s+$

$anitaryInspector

ep from-griculture

Lectureconducted

-ttendanceeturn demoackyardgarden

oor ygiene y t e end of+ovem8er2*11% allmalnouris ed

Lectureemo

enueisual aids

+ovem8er 3* 'edical:lerks! s

Lectureconducted

-ttendanceeturn demo

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For the exit conference and nalreport, include the number ofattendees, pre- and post testscores (mean), and other


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c ildren willpractice good

ygiene.

Act#0#t#es measurable amount of wor1 performed to convert inputs into outputs describes how 3 means3 the ob


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%*O O-I* %7A0BA+IO refers to the s#stematic anal#sis attempt to identif# measure, evaluate and compare the cost 3inputs4and benefits 3outcomes4 of two or more alternative treatments or interventions. 8 4abay, et. al

Meas&r#ng Costs an' O&tcomes+o assess whether the health resources are used optimall#, there must be a wa# to measure the costs of health interventions 3e9penses intr#ing to produce better health4, and the effects of these health interventions 3the health effects of the costs spent4 or its abilit# to produce

better health4.

Ideall#, the effects of health programs, activities, or interventions, should outweigh their costs.

2ig. &. Ideall#, outputs or outcomes of health intervention 3health effects4 should outweigh the costs of such intervention. +o be able toassess, we s ould 8e a8le to measure t e costs involved in an intervention% and compare t em wit t e e>ects of suc .

16


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Bas#c Pr#nc#p$es o) Econom#c E0a$&at#on

". ecision -a1ing

8 economic evaluations are techniques done to evaluate options which all promise to produce better health

8 allows program planners to have an ob


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2ig. '. ample %conomic %valuation 6rocess

T(pes o) Econom#c E0a$&at#on

1" Cost/E))ect#0eness Ana$(s#s

*%A compares effects and costs

TOTA* COST 6 TOTA* !EA*T! E ECT

1(


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more specificall#, it evaluates8 which possible intervention will best achieve a given ob


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Bse ollibee stores &F, G5 6&,G(5,55 6E .EG:childimmunized

7" Cost/M#n#m#+at#on Ana$(s#s

*-A a derivation of *%A focuses on the costs of different alternative programs or intervention options assumes that regardless of whichever option is ta1en, the effects or the outcomes will be identical with the assumption that the outcomes of the interventions are measurabl#

identical, the least cost option is chosen the simplest form of economic evaluation

advantages8 the measurement problem is reduced in e9amining resourceconsequence

8 anal#sis will consist of simpl# comparing costs alone, or consideringother resource consequences that are measured in monetar# terms inorder to identif# the least cost alternative or the cheapest option

disadvantages

8 inappropriate to use if $ treatments signal differences in effectiveness, or the cheaper option ma# harm the patient8 needs a strong assumption that individual health effects are the same between $ alternative treatments

another e9ample, is blood pressure monitoring

2*


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8" Cost/Ut#$#t( Ana$(s#s

*BA special form of the *%A estimates the ratio between the cost of a health8related intervention and the benefit it produces 3outcome4 outcomes are measured in terms of utilit# 3well8being4; in terms of the number of #ears lived in full health b# the beneficiaries the most well81nown measure of health utilit# is the Jualit# Ad


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8 3".F JA0K43B Q(5,5554 L 3B QE5,5554

8 3".( JA0K43B Q(5,5554 L 3B QG(,5554

Ta,$e 7" CUA )or Treatment o) Breast Cancer

#tho&t Co,a$t Treatment #th Co,a$t Treatment

%stimated survival L & #ears %stimated survival L "5 #ears

%stimated JA0K weight L 5.( %stimated JA0K L 5.F

JA0Ks L 3& 9 5.(4 L ".( JA0Ks L 3"5 9 5.F4 L F

JA0K gained from cobalt treatment L F R ".( L .( JA0Ks

*BA L 3 .(43B Q(5,5554 L B Q&$(,555

:" Cost/Bene)#t Ana$(s#s

*CA values both costs and benefits in mone# terms and compares them directl# compares the benefits of a chosen option against the costs incurred with the option evaluation criterion becomes a ratio the ratio shows how man# times the cost is earned b# its effect through the monetar# benefits of a certain option

8 a ratio of one 3"4 means that the option simpl# had the same monetar# benefits compared to the costs attached to the option

to ma1e a decision, if the program ratio is greater than one 3"4, the pro


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as the ratio becomes higher than one 3"4, the pro


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Cases Cost Tota$

",$ 5 uncomplicated cases 9 6 (55.55 6 &5,555.55

" $ meningo8encephalitis 9 6$5,555.55 6&,$'5,555.55

&GF bronchopneumonia 9 6"(,555.55 6(, G5,555.55

+otal 6E.('5,555.55

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