Recognition of the needs of people seeking to improve their health. Professional and personal skills to meet these needs: competence in promoting health, communication, mutual collaboration and respect, empathy, responsiveness, sensitivity, Commitment and adherence to quality, evidence-based and ethical practice.

1. PUBLIC HEALTH IN
OCCUPATIONAL THERAPY
(OT 201)
Lecturer: Sir OAK

2. LECTURE FIVE
 Identifying health promotion needs and priorities
Learning objective:
At the end of this topic, students should be able to:
• explain the concept of needs
• identify and assess health needs of a population
• mention factors to consider in setting health promotion priorities of
a population

3. CONCEPT OF NEED
• A need is something that is necessary for an organism to live a
healthy life.
• Needs are distinguished from wants. In the case of a need, a
deficiency causes a clear adverse outcome. Eg. a dysfunction
or death.
• In other words, a need is something required for a safe, stable
and healthy life (e.g. air, water, food, land, shelter) while a want
is a desire, wish or aspiration.
• It is useful to think of need in terms of:

4. Concept of need cont…
the kinds of health problems which people experience or are at
risk from;
the requirements for a particular kind of health promotion
response;
the relationship between health problems and the health
promotion responses available.
• There are four (4) types of needs according to Bradshaw’s
(1972), namely: Normative need, Felt need, Expressed need
and Comparative need

5. Normative Need
• Defined by experts or professionals according to their own
standards; falling short of those standards means that there is a
need.
• It is based on the judgements of professional experts. Eg.
recreational style, coping style, consuming style, working style,
etc.
• Some normative needs are prescribed by law, such as food
hygiene regulations.
• NN has two problems:
Expert opinion may vary over what is acceptable standard.
The value and standards of the expert may differ from that of the client.

6. Felt Need
• Felt need is the need that people feel; it is what they want.
• This may be limited by one’s awareness and knowledge about
what could be available.
• For example, people will not feel the need to know their blood
cholesterol level if they have never heard that such a thing is
possible or know about the potential risk of high blood
cholesterol levels to health.

7. Expressed Need
• Expressed need is what people say they need.
• Felt needs are normally turned into an expressed request or
demand.
• Not all felt need is turned into expressed need or demand due
to lack of opportunity, motivation or assertiveness.
• Expressed needs may conflict with normative needs. Eg. a
patient may express a need for a private professional
counselling but the resources may not be available for this type
of health promoting service

8. Comparative Need
• This is present when two groups with similar characteristics do not
receive a similar services or products.
• When a client within a group doesn’t receive health education like
other members in the group, that client is said to have
comparative need.
• CN is assessed via methods that compare the health status of
population groups or individuals and the health services that are
available to those population groups or individuals.
• Unless there is an objective standard that can be applied, there is
no basis for comparisons to be made

9. Identifying Health Promotion Needs
• There are three key areas it is useful to think about first when
identifying people’s needs:
the scope and boundaries of your job;
the balance between being reactive and proactive in your work;
 the extent to which you are putting your clients first.

10. The Scope
• Occupational Therapists working with individual patients already
have clearly identified task of educating patients in causes of
functional deficits.
• But they have to think carefully about how they can make their
service as person centred and user friendly as possible.
• OTs need to be clear about which health promotion activities
are within their remit to undertake and which are not.
• For example, an OT may be asked to undertake sex education
with young people in schools, but is this within the boundaries
of her job?

11. Reactive or Proactive
• Being reactive means responding or reacting to the needs and
demands that other people make.
• Pressure from vested interest groups and the media may
introduce bias into how needs are perceived, and produce
pressure to react.
• Being proactive means taking the initiative and deciding on the
area of work to be done.
• Using a client-directed approach means being reactive to
consumers’ expressed needs, whereas using a medical or
behaviour change approach probably means being proactive.

12. Putting Users’ Needs First
• People have the right to participate in making decisions about
their health and should be enabled to do so.
• The needs, wants and expectations of individuals, families and
communities should be respected by health promoters and
influence priority setting and the delivery of health promotion
services.
• For example, users may want an OT service to be open on
Saturdays to improve access but providers are unable to supply
this service because of difficulties in getting staff to work at
weekends

13. Putting Users’ Needs First cont…
• The core values that would be embedded in people-centred
health promotion are:
empowerment
participation
the central role of the individuals, family and community in any
process of health development
equity and nondiscrimination.

14. Assessing Health Needs
• Health needs assessment is a systematic method for reviewing
the health issues facing a population, leading to agreed
priorities and resource allocation that will improve health and
reduce inequalities.
• It involves the collection and analysis of information that relates
to the needs of affected populations and that will help determine
gaps between an agreed standard and the current situation.

15. Benefits of Health Needs Assessment
Benefits from undertaking HNAs can include:
strengthened community involvement in decision making
improved team and partnership working
professional development of skills and experience
improved communication with other agencies and the public
better use of resources.

16. The five steps of health needs assessment
Step 1: Getting started
Step 2: Identifying health priorities
Step 3: Assessing a health priority for action
Step 4: Planning for change
Step 5: Moving on/review

17. Step 1: Getting started
• What population?
• What are you trying to achieve?
• Who needs to be involved?
• What resources are required?
• What are the risks?

18. Step 2: Identifying health priorities
• Population profiling
• Gathering data
• Perceptions of needs
• Identifying and assessing health conditions and determinant factors

19. Step 3: Assessing a health priority for action
• Choose health conditions and determinant factors with the most
significant size and severity impact.
• Determine effective and acceptable interventions and actions

20. Step 4: Planning for change
• Clarify aims of intervention
• Action planning
• Monitoring and evaluation strategy
• Risk-management strategy

21. Step 5: Moving on/review
• Learning from the project
• Measuring impact
• Choosing the next priority

22. Setting Health Promotion Priorities
• Health promotion requires policy makers across all government
departments to make health a central line of government policy.
• Health implications must be factored into all the decisions they
take, and prioritize policies that prevent people from becoming ill
and protect them from injuries.
• Priority setting is the process of making decisions about how best
to allocate limited resources to improve population health.
• Priority setting relies on the use of diverse sources of data as well
as stakeholder input to prioritize the most appropriate programs
and interventions and inform resource allocation

24. Setting Health Promotion Priorities Cont…
In conclusion, to set priorities, you must:
• analyse ‘real-life’ practices
• recognise the wide range of criteria which will affect decisions
• remember there are always constrains on time, resources and
energy.

25. Thank you