This document outlines the 5 step process for conducting a needs assessment in public health care: 1) Getting Started, 2) Identifying Health Priorities, 3) Assessing Health Priorities, 4) Planning for Change, and 5) Moving On/Reviewing. The goals of needs assessment are to understand the health issues facing a population and agree on priorities and resource allocation to improve health and reduce inequalities. Key aspects include defining the target population, gathering data on health conditions and their impacts, selecting priorities based on impact and changeability, and developing an action plan to address priorities through acceptable and feasible interventions.

1. NEED ASSESSMENT IN
PUBLIC HEALTH CARE
Group 4 LPKPKA 2/2022

2. NICE Definition of Health Needs Assessment
“A 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 health inequalities.”

3. PURPOSE OF NEED ASSESSMENT
◦ Development of new programs:
- Can be used to validate the current target populations in need of services as well as to
identify new target populations with unmet needs.
- Help to reaffirm current need priorities and acknowledge new ones. These in turn can
be used to refine or redefine appropriate goals, objectives, and activities of programs
and agencies.
◦ Reassessment for existing programs and agencies:
- Serves as a periodic reappraisal of whether their various services and activities
continue to be needed.
- Improve the quality of policy or program decision made.

4. NEED ASSESSMENT IN PUBLIC HEALTH CARE
◦ Public health is responsible for assessing the health needs of the entire population.
This responsibility includes the publication and dissemination of the results of the
assessment for the use of all interested parties.
◦ The assessment function of public health must not only consider the needs of the
many, it must ensure that the needs of vulnerable groups are also regularly assessed
and given attention.
◦ The results may bring about marked changes. Not only can it alter perceptions
regarding the need for an activity or agency, but can also reshape a program’s
purpose, direction, organization, operations, and personnel complement.

6. STEP 1 : GETTING STARTED
• What are u trying to achieve?
• Clear aims & objectives for the project need to be
identified
• Who needs to be involved?
• What population?
• Eg: All people living in Hulu Langat
• What subpopulation group?
• Eg: Children under 5 & their families
• Reasons why this group has been chosen?
• What resources are required?
• What are the risks?
• Identify key stakeholders for HNA
• Be aware of Government Health policy
& key objectives for improving health

7. Target population
The four main population types
1. Geographic at different levels, eg regional/neighbourhood wide
2. Settings for eg schools, workplaces, prisons, clinic,hospitals
3. Shared social experience homelessness, refugee, ethnicity, culture,age, sexuality.
4. Specific health experience diseases, mental health, disabilities
Example: older people living in a deprived neighbourhood
Ensure you have:
• Clearly defined the population.
• Clarity around sub groups
• Checked they match with National/local priorities on reducing health inequalities?

8. HNA selection criteria
• HNA is worthwhile undertaking only if it results in changes that will benefit the population.
• It is essential to be realistic and honest about what you are capable of achieving.
• FOUR CRITERIA should be used in selecting issues for intervention:
1. Impact – which health conditions and determinant factors have the most impact, in terms of size and severity, on the health functioning of
the population?
2. Changeability – can the most significant health conditions and determinant factors be changed effectively by those involved in the
assessment?
3. Acceptability – what are the most acceptable changes needed to achieve the maximum impact?
4. Resource feasibility – are there adequate resources available to make the required changes?

9. STEP 2 : IDENTIFYING HEALTH PRIORITIES
• Priorities are set based on the needs of populations, government requirements, the capacity of KKM and
local public health agencies.
• Establish partnership with families, communities, stakeholders, and public health professionals to better
understand the needs of a targeted population.
• Involves a series of field activities and assembly of data to gather information about health issues
affecting the defined population.
• The information sources for any needs assessment include:
 Perceptions of the population
 Perceptions of service providers and managers
 Data on the size of the potentially important aspects of health functioning/conditions/ factors and
population characteristics
 Relevant national, local or organisational priorities.

10. STEP 2 : IDENTIFYING HEALTH PRIORITIES
• Identify the aspects of health functioning and conditions and factors that might have a significant impact on
the health of the profiled population
• Developed a profile of these issues
• Use this information to decide a limited number of overall health priorities for the population, using the first
two explicit selection criteria of HNA :
1. Impact – they have a significant impact in terms of severity and size
2. Changeability – they can be changed locally

11. COMPARE SCORES, COMMUNICATE THE FINDINGS & SHORTLIST PRIORITIES FOR ACTION
CHOOSING PRIORITIES ACCORDING TO CHANGEABILITY click for example
WHICH ONES AFFECT THE HEALTH FUNCTIONING OF MANY PEOPLE – SIZE IMPACT? click for example
WHICH ONES HAVE A SIGNIFICANT IMPACT, INTERMS OF SEVERITY ON HEALTH FUNTIONING? click for example
WHICH ONES HAVE A SIGNIFICANT IMPACT ON HEALTH FUNCTIONING? click for health triangle
WHAT ARE THE HEALTH CONDITIONS & DETERMINANT FACTORS AFFECTING THE HEALTH FUNCTIONING OF THE TARGET
POPULATION? click for example
POPULATION PROFILING

13. STEP 3 : ASSESSING A HEALTH PRIORITY
FOR ACTION
• The task is to assess each specific health priority for change.
• The needs-led approach requires being clear about the ‘what and why’ before
considering the ‘how’.

14. Why this specific
health priority is
important for the
profiled population
What changes you
can make that will
have a positive
impact on the most
significant issues
affecting the priority.
Then applying
the two final
HNA selection
criteria :
Acceptability &
Resource
feasibility

15. Target point to achieve:
Identified who should be involved in making the specific change happen
Through identifying the health conditions and determinant factors that have significant impacts on it
Identify of the boundaries of the assessment
Identified effective interventions
Defined your target population
Identified the changes required
Confirmed that the proposed changes will help reduce health inequalities.

16. REVIEW STEP 3
At this stage in the process you should:
• Be confident that the health conditions/determinant factors with the most significant impact
on health functioning for the selected health priority are being tackled
• Be sure the action is focused on reducing health inequalities for that health priority
• Have identified acceptable and cost-efficient actions to improve the selected health priority.
You will now be ready for action planning.

17. STEP 4 Planning for Change
◦ Clarifying aims of intervention
◦ Action planning
◦ Monitoring and evaluation strategy
◦ Risk management strategy
◦ Some questions to help us
◦ WHAT are we aiming to do?
◦ WHO is going to do it?
◦ WHEN is it going to be done?
◦ HOW are we going to monitor and evaluate the programme?
◦ WHAT is our implementation and dissemination plan?
◦ WHAT is our risk assessment strategy?

18. STEP 5 : MOVE ON/REVIEW
• This final stage of the HNA process involves the team in some reflective questions and the opportunity to
take stock and learn, both for individual contributors and from a team perspective. This is a vital part of
the process if HNA is to continue to be a relevant and effective tool in improving health and tackling health
inequalities in the population.
• Learn from the project:
 What went well, and why? Check achievements against the original aims and objectives of the project
 What did not go well, and why? Is any further action required?
 Identify further action to be taken. Perceived improvement in health/services following the interventions:
How effective was it?
How could it have been improved?
What were the main challenges?
What were the main barriers?

19. STEP 5 : MOVE
ON/REVIEW
• Evaluation must involve an
honest description of what
happened
• It is not meant to prove
that everything went
brilliantly
• But to celebrate successes
• Share difficulties
encountered