Lesson 4: Community Study

INTRODUCTION
Communities are unique in nature, it is therefore very important that after health workers gain access they study and adopt various strategies in dealing with various communities.

DEFINTION
This is the study or survey carried out on a community to gather data about the people the community health nurse is going to work with.


 * REASON
 * This will enable the community to know those in the community.
 * It will help her to schedule her work effectively to cover the entire community.
 * It will help her to know her demarcation and catchments area Definition: this is a survey of an area to gather information or date about the people the community health nursing is going to write with
 * This information will enable her to know the people betters, identify their health needs and help her work effectively
 * It will help her plan her work.
 * It will help her schedule her work effectively.

these include children under 5 years. Pregnant and lactating women Those with serious, chronic illnesses such as TB, leprosy and AIDS The physically and mentally disabled, the elderly Any group, family or individual who is socially out cast or very poor.
 * Purpose:
 * To discover the main health needs of the community. Accurate, baseline information on the community is obtained before solutions are put in place. Resurveying after a period of time, say 3 to 5 years later so that estimation of progress can be a curtained.
 * To discover those individuals and families with the greatest health needs:
 * To build relationships, create trust
 * To teach and sensitise (create awareness) about how problem identified could be solved
 * Information enables the health worker to work effectively
 * It will help the health worker to plan his work
 * It will help the health worker to schedule her work effectively to cover her target population.

TYPES OF SURVEYS

 * Comprehensive surveys: ever home is visited and questions are asked concerning al family members. The main advantage is that all individual at risk can be discovered and comprehension care given. The main disadvantage is that all is time consuming.
 * Sample surveys: some, but not all houses are visited. E.g. Every 5th or 10th house can be visited. Sample survey is used if numbers in the project are very large.
 * Mixed surveys: here we may visit each house to record certain important information such as the weight or upper arm circumference of children but only some houses to record other details such as socio economic data.
 * Pilot surveys: small scale surveys carried out at the start of a project either to estimate the needs of the people, an approximate census or to pre-test a surveying technique.


 * Who should do the survey?
 * Project and community members should work together.
 * The project member.
 * The Community Health Worker (community health worker).
 * A health committee member.


 * When the survey should be done:
 * When the community is ready for it. make sure the community understand the reason for the survey and is ready to participate.
 * When the project has enough resources. Team members who have been trained in surveying forms or folders must be available.
 * At a time of day and a time of year when most people are at home and not too busy with other activist such as harvesting.


 * What we need to do
 * Prepare materials
 * Decide what information needs to be gathered. This information should be useful, easily gathered.
 * Study and adapt existing survey forms.
 * Collect the materials needed e.g. questioner.


 * Train the survey team.
 * Train them and how to relate to the community to be friendly, tactful etc.
 * Obtaining Information,should be skilful in questioning and recording.


 * Carry out the survey
 * arrange the day in advance inform the people and co-ordinate with community partners.
 * work in pairs.
 * do the survey; observation, questioning and recording use guidelines for community study format.



DATA COLLECTED DURING COMMUNITY STUDY

 * location of the community
 * history of the community
 * population
 * climate
 * soil
 * Vegetation and crops (nutrition)
 * Environmental sanitation
 * Markets
 * Housing
 * Occupation
 * Social organisation and way of life
 * Political organisation
 * Basic amenities
 * Transportation, health facilities
 * Health problems
 * Groups and organisation

DATA
To work effectively in a community it is important to find our about the history of the community, how it came into existence and the extent of development and growth.
 * History of the community
 * REASONS
 * 1) This will help the community to know the background of the people
 * 2) It helps her to plan ahead so that she is not over taken by events
 * 3) It will also help to know if they are nay conflicts in the community, the various sections (factors) so that she can relate tactfully with the people.

The community should know the name of the community, where it is situated, its neighbouring communities or surrounding as well as the boundaries. Number of houses .she should also know if there are rivers, mountains and valleys, where they take their source of water. This will enable the community health nursing to know those in the community. It will help her to schedule her work effectively to cover the entire community. It will help her to know her demarcate and catchments area.
 * LOCATION

Find out the number of market in the community and their condition. find out whether the markets are clean or unclean and also the item being sold. Whether they are sold in the sun or under shades. Find out whether it is accessible to do community members or not. do they have to travel long distance. Find out about the condition of drinking and doping bars.
 * MARKET

Culture is a way of life of a group of people. They are influenced by an acceptable way of living. this is governed by norms, taboos and beliefs which may affect the propel attitudes towards health. eg causes of disease may be attributed to gods. It is therefore important for the community health nurse to study the culture so that she can commend on the good ones and tactfully discourage the harmful ones.
 * CULTURE

Find out the type of religious groups the number or churches. Find out about their traditional beliefs, traditional doctors, priest priestess etc. This will help the nurse in her counselling e.g. some beliefs prevent them from eating certain foods.It will also help her to reach out to all
 * RELIGION


 * The Size Of The Community: how large or small and location notes. I.e. boundaries, landmarks.


 * Population: identify the various age groups children 0-5, WIFA, numbers of males, females teens, aged etc. helps the proper learning.

Find out the normal daily routine of the people their working pattern, their leisure times farming or fishing days, market days etc. find out the head of the family, the type of family and the size of family. Find out about their responsibilities e.g. head knowing heir free times will help your to plan your activities e.g. communal labour.
 * SOCIAL ORGANISATION (FAMILY LIFE)

Find out who are the traditional leaders, political leaders, influential people or opinion leaders etc. The community health nurse should contact the above groups for information.(because thy know). They can also help the community to carry out her word e.g. establish clinics, communal labour.
 * POLITICAL ORGANISATION OT RULING AUTHORITY

The community health nurse should find out est. following facilities and amenities. Numbers of schools, churches, shops, markets, cultural group etc. the chiefs palace and how it is opened to visitors and when. The number of police stations, banks, post office how these facilities serve the people, how the community patronage.
 * FACILITIES/AMENITIES

It is important to know the means of transpose in the community, the type of vehicles available and their condition. Know the condition of roads and whether they are accessible, passable throughout the year. Find about other transport like railway, river transport. Find out if there are radios, televisions, telephone or express service and how they sand their message. Find out the language commonly spoken in the community. These will help the community health nurse know how to get to the people and mode of communicate.
 * TRANSPORT AND COMMUNICATION

Find out about exiting hospital (government private ) maternity homes, spiritualist, herbalist, TBA. Druggists and health personnel in the community.These will help her know the standard of health care that the people receive. She will have to supervise the TBA, herbalist.
 * HEALTH AMENITIES

She must identify the main health problems as states by the people and also as states by the health facility. She must find out their needs, what they think causes disease and the common disease in the community.
 * HEALTH OF THE COMMUNITY

Find out the interest of the community regarding to education which will reflect on the level of education.Find out the number of schools and colleges their attitude found learning. The higher the level of education the easier it will become for the community health nurse to carry out her health educational programmes.
 * EDUCATIONAL STATUS

Find out the type of food eaten in the community. This will help the community health nurse in her nutritional counselling. Find out whether the food are form this local market, garden farm etc. Find out if the children are neat fed and the duration. Find out about the method of cooking in relation to find nutrients destruction Find out about alcohol consumption.
 * NUTRITION

Data should be collected on the number of voluntary groups like the Red Cross, Women Groups, Church Groups, Youth Groups, 31st December women etc. Find out about government department that can be of assistance to health service e.g. Agriculture Extension Officer, Community Development, Social Welfare etc.
 * GROUPS AND ORGANISAITONS

Data should be collected on developmental projects and the effect they have in the lives of the people; Find out about planned projects whether it will be beneficial to the community Find out about standing problem that data or hinder development. At the end of the community study report is written a map is drawn and kept in a file. Can be used for reference purposes can be uses for continuity of care. Recommendation to the immediate supervision for action.
 * CHANGES ALREADY TAKING PLACE



Reading Assignment
Read on Community Needs Assessment

Tests/Quizzes

 * What is community study
 * List four reasons for studying a community

Reference

 * MOH/GHS (2002 ) Community Mobilisation and Participation Training Manual; Community-Based Health Planning and Services.


 * JHPIEGO(2003) CHPS Learning Package For Community Schools Trainer’s/Preceptors’ Manual ; 1. Community Health Nursing.}}

Jaquansah 18:32, 1 March 2007 (CET)