Health status assessment establishes whether health problems exist in a population, characterizes the problems, and identifies avoidable mortality and morbidity. It supports health needs assessment by describing disease patterns and comparing populations. Health needs assessment systematically identifies unmet health and healthcare needs and makes changes to meet them. It incorporates professionally and community-assessed needs and determines the most appropriate and cost-effective interventions through a defined process of establishing health problems, assessing status, reviewing services, determining stakeholder wants, and implementing recommendations with expected health gains. Both are ongoing processes that provide snapshots to continuously review, update, and evaluate community health.

1. Assessing Health Status & Health
Needs

2. What is Health Status Assessment?
• A health status assessment of a population establishes
whether particular health problems exist in a given
population, characterizes the problems and identifies
the potential for avoidable mortality and morbidity.
• It can be used to support health needs assessment, for
example, describe patterns of disease in a population
and compare it other populations.
• It can also be used in policy making, aiding planning
(e.g. resource allocation and target setting), evaluation
and to identify areas for further research.

3. Reasons
• To conduct health needs assessment
• To audit equitable distribution of resources
• To assist in conducting review of existing
policy
• To enable setting of targets for achievement
• To evaluate existing/proposed health
service/intervention and for research purpose
as well

4. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

5. Steps in Health Status Assessment
1.Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

6. 1. Clearly define the purpose
• The starting point of the health
assessment, defining the purpose, is very
important. Many a times, a tendency to have
an extensive unfocused list of objectives as
well as the temptation to examine interesting
but irrelevant issues may arise. These must be
resisted.

7. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

8. 2. Define the Population
• Defining the population to be assessed is extremely
important.
• Population size, structure and the period of
observation can have major effects on the numbers of
cases of disease or disability observed.
• The data is therefore usually expressed as proportions
(e.g. the number of children aged under five per
thousand population at a particular point of time) or
rates (the number of new cases of tuberculosis per
thousand population per year).

9. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

10. 3. Define the aspects of health to be considered
• Health can have a variety of meanings which
can range from the lofty definition of World
Health Organization having physical,
emotional and social dimensions.
• In practice a more restrictive definition
should be used which can be easily measured,
for example a particular group of diseases or
certain summary measures of population
health.

11. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

12. 4. Review the available data
• Comprehensive population health
assessments are based on a wide range of
data of different types.
- Local data – health service providers at local level
- National Data- Census
- International Data- WHO

13. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5.Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

14. 5. Select Data Carefully
• At first sight there may seem to be so many data
available that assessing health should not be much of a
challenge.
• Finagle’s law
The information you have is not what you
want; the information you want is not what you need;
the information you need is not what you can get; the
information you can get costs more than you want to
pay.
• When the data source proposed to be used has been
identified the following aspects of the data should be
considered before utilizing it :

15. • Validity of data for assessment-
-data must be relevant to the issue
-data items should have been defined
-data should be relevant to the defined population
• Technical quality of data-
-data should have been properly recorded according to
the specified definitions
-complete in all aspects
-be free from classification or selection biases
-appropriate for the assessment planned

16. • Quality of the analytic methods
The data should be adjusted for the population structure,
e.g. age, sex, social group or ethnic composition and the
numbers should be big enough to allow a statistically
adequate and precise estimate of the aspects being
considered

17. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

18. 6. Analyze & Interpret Data
• In progressing from data to information, the purpose of the assessment
will determine the nature of the analyses chosen.
• The results of the health assessment need to be communicated to the
concerned people with the following usual aspects:
Comparison of findings on health aspects of the
population
 Describing the relative heath of groups of the
population (based on defined areas or social groups)
and identifying inequalities.
 Comparing the health trends over time
Describing the impact of health problems in terms of
people’s experience of health problems.

19. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

20. 7. Carry out a local study, If Necessary
• The health aspect planned to be assessed can be
sufficiently important and the available local data
so limited that a case may exist for conducting a
fresh data collection.
• Conduct of special survey is however usually
constrained by the cost involved.
• At the local level, a special survey or longitudinal
study should only be carried out if time is
available and the value of the data likely to be
provided justifies the cost.

21. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

22. 8. Consider the use of comparators
• Assessing the health of a population may be
undertaken to assess what is the actual extent
of a health problem and also to determine
how it compares with previous years, other
areas and other social groupings.
• For example in examining the need for
initiatives to reduce smoking, all that may be
required is the number of deaths and extent
of ill health associated with smoking locally.

23. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

24. 9. Address issues of confidentiality & disclosure
• Assessing the health status of a population, especially at a
small area level, increases the risk of inappropriate and
unnecessary disclosure of personal data.
• For example, the assessment of the HIV positive status of
commercial sex workers in a particular area. Social and other
discrimination besides loss of clients may result from the
publication of the survey results.
• Informed consent of the participating subjects is an essential
pre-requisite to their inclusion in the assessment process.

25. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

26. 10. Communicate results effectively
• The result needs to be communicated to a general audience.
• Key points about health status analyses to consider in a written or oral
communication are :
Think through its purpose.
 Don’t leave it to the reader to relevant points from a mass of
data-quote specific data to make a point.
 Ensure confidentiality for participants in survey and ensure
this is made clear to everyone.
 Don’t be too sophisticated-many people in the target
audience will not have that much background knowledge of
the issue.

27. Steps in Health Status Assessment
1. Define the purpose
2. Define the population
3. Define the aspects of health to be considered
4. Review the available data
5. Select data carefully
6. Analyze and interpret data
7. Carry out local study, If Necessary
8. Consider the use of comparators
9. Address issues of confidentiality & disclosure
10. Communicate results effectively
11. Evaluate health status assessment

28. 11. Evaluate Health Status Assessment
• Those who are engaged in public health need
to emphasize the importance of assessment to
others.
• It is important that our work is assessed using
correct tools such as audit.

29. Now Let’s move on to
ASSESSING HEALTH NEEDS

30. What is health needs assessment?
• a systematic method of identifying the unmet health
and health-care needs of a population and making
changes to meet these unmet needs.
• Doctors- assessing the health needs of individual
patients by professional training and clinical
experiences- a systematic approach
• Such systematic approach has often been missing in
assessing the health needs of local population
• Case studies have revealed the importance of
conducting scientific “health needs assessment” before
planning appropriate interventions in society.

31. Need
• Need, implies the capacity to benefit from an
intervention.
• ‘To speak of a need is to imply a goal, a
measurable deficiency from the goal and a
means of achieving the goal. ’
• Health needs assessment is not the same as
population health status assessment.
• It incorporates the concept of a capacity to
benefit from an intervention.

32. • Two broad categories
 Normative or professionally assessed needs
the needs which the expert health care providers think
should be addressed
 Felt Needs
the needs which the community feels to be important.

33. Approaches to Needs Assessment
• Epidemiological based approach
• Comparison of the levels of service receipt
between different populations.
• Determining the demands and wishes of
professionals, patients, politicians and other
interested parties

34. Assessing of health needs provides the
opportunity for :
• Assessing the population’s health status in terms
of the patterns of disease or disorders in the local
population and the differences from district,
regional, or national disease patterns.
• Learning more about the needs and priorities of
patients and the local population.
• Highlighting areas of unmet needs and working
towards meeting these needs.
• Influencing government policy, inter-sector
collaboration, as well as research and
development priorities.

35. Steps for Health Needs Assessment
1. Identify the health problem to be addressed in
the defined population.
2. Carry out a health status assessment -for the
population, covering the relevant areas of ill-
health and/or potential health to determine
what is the size and nature of the problem.
3. Identify the existing services and interventions
being delivered, including, where relevant, the
service targeting, quality, effectiveness and
efficiency.

36. 4. Identify the interventions by determining what
patients, professionals and other stakeholders
want.
5. Identify interventions by reviewing the scientific
knowledge and determine the most appropriate
and cost effective solutions.
6. Determine the resource implications. It may
require to choose between competing ways of
meeting needs (competing interventions) and
decide on competing priorities – resources are
always limited.

37. 7. Enunciate the recommendations and the plan
for implementation.
8. Determine whether assessing need is likely to
lead to appropriate change by identifying
expected health gains.

38. Needs Assessment Requires Careful
Preparation
• The process of needs assessment involves
identifying the right issues,
By defining objectives as clear, simple and focused as
possible.
• using the right technical methods
• and managing the process effectively.
 Good leadership
 effective communication

39. Identify the Health Problem or Issue
• health problem should be clearly identified
• many sources for identification
 the results of a population health status assessment
 input from patients or stakeholders
media reports
scientific and professional literature
government priority setting
 reports of public health professional bodies

40. Dimension of the Problem
• be desirable to be able to estimate the likely number of
beneficiaries of the planned interventions
• the assessment process should be able to establish the
following :
– How many people in the studied population are likely to be
suffering from the target condition or conditions ?
– What their socio-demographic and other characteristics are?
– To what extent they are already receiving appropriate
interventions.

41. Availability of Services
• several sources of data on healthcare in locality
• Hospital Data provides information on-
 OPD attendance,
 Hospital Admission,
 patient characteristics to some extent
 length of stay

42. Determining the most Appropriate and Cost-Effective
Interventions
• Essential part of a health needs assessment is the
review of the clinical effectiveness and cost-
effectiveness of interventions that can address the
identified health needs.
• Evidence about the effectiveness of health
interventions can be found in databases of good-
quality systematic reviews such as the Cochrane
Library, or peer reviewed publications.
*The Cochrane Library is a collection of
high-quality, independent evidence to inform
healthcare decision-making.

43. Resource Implications
• Determining how resources are currently being spent
(programme budgeting)
• Defining options for change by suggesting alternatives :
(a) identify potential services which require more
resources
(b) identify services which could be provided
at the same level of effectiveness but at
reduced cost.
(c) identify services which are less cost-
effective than those identified.
• Assessing the costs and benefits of the principal options.

44. Implementation of Recommendations
• Building agreement to a practical
implementation plan for meeting the unmet
needs is an essential part of needs
assessment.

45. Summary
• Assessing health status of a community is a challenging
process required
– to conduct a health needs assessment
– to enable setting of targets for achievement
• methodology varies depending on objective
• Needs implies the capacity to benefit from an intervention.
a. Felt Needs- what people consider they
need
b. expressed needs- needs expressed by
action
c. and normative needs- what health professionals
define as need

46. • Health Needs Assessment is a systematic method
of identifying the unmet health and health care
needs of a population and making changes to
meet these unmet needs.
• Health needs are not static and therefore any
assessment will only provide snapshot of current
needs of population concerned.
• Thus health need assessment is a continuous
process which is to be reviewed, updated and
evaluate concurrently.

47. Reference
"Assessing Health Status and Health
Needs." Text Book of Public Heath and
Community Medicine. Ed. Rajvir Bhalwar. First
ed. N.p.: Department of Community Medicine,
2009. 354-59. Print.

48. Thanks for you attention!
Any Questions?????
No ??????
Superb!!!!
Hope you slept comfortably!