1 / 43

Better Understanding Our Problem: Pro blem-Orient ed Needs Assessment

Better Understanding Our Problem: Pro blem-Orient ed Needs Assessment. William M. Sappenfield , MD, MPH Professor & Chair, Dept. of Community and Family Health USF College of Public Health Training Course in MCH Epidemiology Denver Colorado. Being Effective in Public Health.

ashling
Download Presentation

Better Understanding Our Problem: Pro blem-Orient ed Needs Assessment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Better Understanding Our Problem:Problem-Oriented Needs Assessment William M. Sappenfield, MD, MPH Professor & Chair, Dept. of Community and Family Health USF College of Public Health Training Course in MCH Epidemiology Denver Colorado

  2. Being Effective in Public Health

  3. Being Effective in Public Health?

  4. Being Effective in Public Health

  5. Health Problem:Late PNC EntrySouth Carolina

  6. Needs Assessment • Underreporting of prenatal visits • Physicians not starting to 2nd trimester • Late entry into the WIC program • Problem recognition by Community • Transportation & child care barriers • Unintended pregnancy

  7. Potential Strategies • Underreporting of prenatal visits • Vital registration manual • Clerk training • Health department record transfer • Physician record transfer • Standardized prenatal care record • Physician & hospital education • Monthly reporting system • Hospital standards • Incentive awards

  8. Chosen Strategies • Underreporting of prenatal visits • Vital registration manual • Clerk training • Health department record transfer • Physician record transfer • Standardized prenatal care record • Physician & hospital education • Monthly reporting system • Hospital standards • Incentive awards

  9. Being Effective in Public Health

  10. Health Problem:Late PNC EntrySouth Carolina

  11. So Why Doesn’t It Happen? • Limited/over-committed staffing. • Limited expertise. • Lack of adequate follow-up. • Previous planning failures. • Insufficient resources for current initiatives. • Lack of political will. • Committed/focused on present activities. • Competing priorities/desires.

  12. Being Effective in Public Health

  13. Definition of Needs Assessment Systematic collection and examination of information… to make decisions to formulate a plan… for the next steps leading to public health action…

  14. Needs Assessment Qualities • Visionary • Conceptual • Systematic • Resourceful • Pragmatic • Action-oriented • Cohesive

  15. Types of Needs Assessment... • Community--Healthy Communities • Population--Title V (MCH) • Health Systems--Emergency Response • Program--Title X (Family Planning) • Health Services--Prenatal Clinic Location • Health Problem--Infant Mortality

  16. Needs Assessment Phases Part 1 • Health problem identification and measurement • Prioritization of health problems • Analysis of a particular health problem • Assess potential strategies to address targeted aspects Part 2

  17. What is a health problem? • Community perception? • Health status measure? • Risk Factor? • Health Service Deficiency? • Measurement? • Comparison?

  18. Problem Identification & Verification • Stakeholders • Partners • Reports • Available Data Purpose: Search & compile

  19. Problem Definition • Extent • Duration • Expected future course • Variation Purpose: Define, describe & validate

  20. Types of Prioritization • Group consensus • Voting • Criteria-based rating • Q sort Purpose: Build consensus/support

  21. Q-Sort Procedure: Priority Log Sheet for 25 MCH Needs

  22. Part 1:Identification & PrioritizationSelection Criteria • Magnitude of the problem • Trend • Severity/consequences • Perceived preventability • National/state goals • Agency capacity • Political/community acceptability

  23. Part 1:Identification & PrioritizationReal Selection Criteria • State or agency political will • Current program priority • Currently funded activity • Fits current staffing/resource patterns • People available to work on the issue • Important issue to the heart

  24. Matrix of MCH Problems

  25. Clear Scoring Criteria Magnitude • Low incidence/prevalence • Moderate in some subgroups • Moderate in all groups • High in some subgroups • High in all groups

  26. Part 1:Identification & PrioritizationReal Selection Criteria • Available funding • State or agency political will • Program priority • Currently funded activity • Fits current staffing/resource patterns • People available to work on the issue • Required performance measure • Important issue to the heart

  27. Needs Assessment Phases Part 1 • Health problem identification and measurement • Prioritization of health problems • Analysis of a particular health problem • Assess potential strategies to address targeted aspects Part 2

  28. Evaluation Assessment Plan Who? What? Monitor Capacity & Strategies When? Where? How? Resources? Implement Plan Do Being Effective in Public Health

  29. Bill's Steps for Problem-Oriented Needs Assessment • Theoretical Framework • Gather Readily Available Information • Frame and Choose Critical Questions • Choose and Develop Methods • Analyze and Answer Your Questions • Summarize Your Problem • Present the Results

  30. Gather… • Other Needs Assessments • Available Reports • Key Data People • Key Community People

  31. Frame & Choose Critical Questions • What Are Remaining Questions? • What is Gained By Answering the Question? Do Something Different? • Can the Question Be Answered? • What Will It Cost? • Will It Be Part of the Big Picture?

  32. Bill's Steps for Problem-Oriented Needs Assessment • Theoretical Framework • Gather Readily Available Information • Frame and Choose Critical Questions • Choose and Develop Methods • Analyze and Answer Your Questions • Summarize Your Problem • Present the Results

  33. Needs Assessment Results • Statement of the problem • Problem trends • Individual contributors to the problem • Individual strengths • Community contributors to the problem • Community strengths

  34. Being Effective in Public Health

  35. Problem Analysis Access to poison by children Provide childproof containers Ingestion of poison Reduce poison consumption Death from poison consumption Reduce child poison deaths Program Hypothesis

  36. Program Hypothesis Reduce child poison deaths Death from poison consumption Reduce poison consumption Ingestion of poison Provide childproof containers Access to poison by children Problem Analysis

  37. Program Hypothesis Goal Change in health of community Policy Change in health status of recipients Program Change in characteristics of recipients Operational Activities of the program

  38. Logic Model Framework Population Focus: Community(ies) Assumptions Inputs Activities Outputs Outcomes Theoretical assumptions about why a program works The resources needed to deliver the program Key actions of program staff and clients Products of the program Changes in the target population • Short Term • Intermediate • Long Term

  39. Being Effective in Public Health

  40. Needs Assessment Debates • Qualitative or Quantitative • Assets or Problems • Assessment or Surveillance • One Time or Ongoing • Ourselves or Contract • Science or Art • Performance or Pretty

More Related