Assessing community needs and assets is essential to building a healthier city or community. A situation assessment helps inform the group planning and action to follow.
Key Questions to Consider
- What information will be used to help assess the situation and choose priority health and development goal(s) for the city or community? Who has access to this information, and how can we obtain it?
- What issues and concerns are important to people in the city or community?
- What groups are most affected by these issues, where, how, and to what extent?
- What methods will be used to gather and analyze information about the situation (e.g., surveys; review trends in key indicators; analyze environmental and social factors influencing outcomes)?
- What personal, environmental, and social factors affect these issues?
- What assessment information will be used to justify the choice of priority goals, including marked differences in outcomes for particular groups?
- What resources and assets of institutions in different sectors can be engaged to address these issues? How will the initiative be financed?
- How do we assure mechanisms for participation so that diverse voices can be heard in the assessment?
Some Recommended Actions
- Gather information about the situation related to health, well-being, and equity. Including:
- Monitor levels of population/local-level outcomes related to health and well-being (e.g., incidence of diseases, injuries, deaths; education levels; percentage of people with/without access to clean water, sanitation, housing)
- Monitor inequities (i.e., marked differences in outcomes for particular groups, in particular places)
- Gather information on community concerns (e.g., issues of high importance, low satisfaction)
- Gather additional quantitative data (e.g., surveys, observation, small area analysis)
- Gather additional qualitative data (e.g., interviews, listening sessions, focus groups)
- State evidence that will be used to justify the choice of the priority goal(s), including:
- Municipality/Community-level indicators showing the size of the problem (e.g., rate of communicable diseases, infant deaths)
- How frequently the problem (or related behavior) occurs (e.g., number of particular diseases, injuries or deaths in the past 30 days)
- Marked differences in outcomes related to particular groups or places (e.g., by income/poverty level, gender, race/ethnicity, and/or where people live)
- Identify social determinants that produce marked differences in outcomes (inequities) for particular groups including:
- Differential exposures and opportunities (e.g., to stress, support networks)
- Differential vulnerabilities and capabilities (e.g., education)
- Differential consequences and access (e.g., access to quality health services, discrimination)
- Analyze the costs, burden, and benefits of achieving progress on priority goal(s) for the overall population and for different sub-groups, with particular attention to those living in vulnerable conditions
- Describe what relevant resources and assets (e.g., financial, people, institutions, civil society groups) are available in participating sectors, and how intersectoral action can use those resources to address the priority goal(s).
- Establish mechanisms for participation so that diverse voices—including those responsible and those most affected—can participate in gathering and using information in the assessment.
Examples of Assessment
Assessing and Responding to Community Needs through Faces, Voices, and Places (FVP)
BOCA DE MAO, DOMINICAN REPUBLIC
How can program actions be developed based on the needs identified by the community? The Faces, Voices and Places (FVP) initiative, carried out in the Boca de Mao region of the Dominican Republic, demonstrated how assessment can guide action. The purpose of this initiative was to reduce inequality and strengthen citizenship through shared responsibilities and community participation.
Program activities in FVP were developed based on the needs and priorities identified by the community; namely, sanitation, hygiene, food production, and basic living conditions. This effort was coordinated by the Local Council for Sustainable Human Development (LCSHD). In addition to the health sector, the LCSHD included representatives from community and neighborhood associations, the municipal authorities, the agricultural and education sectors, PAHO/WHO, and the Institute of Nutrition of Central America and Panama (INCAP).
The community was encouraged to participate in open council meetings, advocacy efforts, health fairs, and food fairs. This initiative showcased the level of coordination between a strong community organization, and a holistic and coordinated response from various government sectors.
- Pan American Health Organization. Health in All Policies: Summary of experiences from the Americas. The 8th Global Conference on Health Promotion; 2013 Jun 10-14; Helsinki (Finland). Washington, DC: PAHO; 2013
- Pan American Health Organization (PAHO). Health in All Policies in the Americas: Human Sustainable Development in Boca de Mao [Internet]; 2016. Available from:http://saludentodaslaspoliticas.org/en/experiencia-amp.php?id=21
Assessing and Responding to Women’s Health Issues through STAR Health Services
LA PAZ, BOLIVIA
Assessments revealed the troubling health situation of women in La Paz, Bolivia. Data showed high incidence of cancer, maternal mortality, sexual and reproductive health issues, HIV/AIDS, and domestic and intra-family violence. Assessments also pointed to key determining factors including low level of education, lack of political participation, and limited employment opportunities. Women showed significantly less access to health care, and minimal participation in the promotion and care of their own health, largely associated with discrimination.
The STAR Health Services Initiative, focusing on health inequities related to gender, was initiated in response to the health situation of women in La Paz. It was developed and implemented from 2004 to 2006 through direct intervention by the health department in La Paz. The initiative aimed to improve health conditions by strengthening the management of services, especially those pertaining to “quality with focus on gender” and the development of processes that empower women in their community to enhance their access to health care.
Evaluation showed the main achievements of this initiative were: incorporation of gender considerations into health services, greater responsiveness to the specific health needs of women, improvement in service teams and the quality of patient care and treatment, monitoring of user satisfaction, enhanced health coverage, and development of a community education program that raises awareness for women’s health care rights.
- Pan American Health Organization (PAHO).Star Health Services. Washington, D.C: PAHO; 2009. Available from: http://www1.paho.org/hq/dmdocuments/2011/2009-BP-Bolivia-Star-Health-Services.pdf
Some Resources to Help You Assess
Tools from the Community Tool Box
- Toolkit: Assessing Community Needs and Resources
- Toolkit: Analyzing Problems and Goals
- Chapter 3: Assessing Community Needs and Resources
- Troubleshooting Guide: We need to understand the community or situation better
- Troubleshooting Guide: We don’t understand the problem or goal
Resources from the World Health Organization/Pan American Health Organization
- Urban Heart: Urban Health Equity Assessment and Response Tool: User Manual
- Rapid Assessment and Action Planning Process (RAAPP)
- Support Tool to Assess Health Information Systems and Develop and Strengthen Health Information Strategies
- Early detection, assessment and response to acute public health events