|Subject Code and Title||PUBH6007 Program Design, Implementation and Evaluation|
|Assessment||1 – Needs Assessment|
|Length||1500 words (+‐10%)|
|Learning Outcomes||Understand the principles of needs assessment, different types of community needs and analysis leading to prioritisation of health needs|
This assignment is on Needs Assessment in public health, and you have 2 options (choose one) for submission (it is an individual assignment in report structure).
Option 1: Choose a setting such as a community, health service (e.g. hospital, primary health care service) or neighbourhood you know well in Australia ( Examples (not limited to) are:
STEP 1: A discussion of how you would assess different types of needs (normative, expressed, comparative, felt, etc.) and how you would prioritise the findings, justifying your choices.
For this purpose, you would either know of/be in the situation in reality first. Then, you would have to undertake rigorous literature review to understand different types of needs assessment and consider alternative views to justify the choices for this context.
STEP 2: Any potential challenges for your needs assessment and how you would address them. This could be relating to policy, contextual issues or others.
STEP 3: A SWOT analysis, where you identify the Strengths, Weaknesses Opportunities and Threats of your organisation or program.
STEP 4: A determination of program priorities, based upon your needs assessment
In your needs assessment, you may determine multiple programs priorities – justify why you would choose the priorities you have identified. Are there any population groups that would benefit best from your program? Mention these, justify.
Let us take a GP practice in a specific growing suburb in Melbourne as a context. The waiting list seem to be increasing as many patients are approaching the GP and there are no other practices close by. It could also be that much of the population is working, and they need after hours service. If you are part of this situation (working in the practice or living in the suburb) – you would have an idea as to what type of need had risen. From that point, think about what type of needs assessment is required (via comparing few types of needs assessment from literature review), and justify your choice. Then, we are looking at potential challenges to really confirm this need, through the needs assessment.
Subsequently, look at the SWOT analysis. There may be many GPs in the practice (Strength), but, the hours may not suit the working population in the suburb (weakness). The threat may be that due to non‐suitable opening hours or waiting list, the population may begin to move to another closer suburb (where there are more GPs open late) which then (threatens) the practice. And the (opportunity) is there for this GP practice to open for more hours or have shift based GPs for different hours, keeping the practice open later. This is a simple SWOT and there may be many more.
In this situation, you would be looking at a program design that allows the GPs to open later hours or shifts, which cater to the mainly working population, young families in the new suburb/neighbourhood. You may prioritise working women, kids or mainly working men as population groups that would best benefit.
Please refer to the latest report on Australia's health (see https://www.aihw.gov.au/ reports/australias-health/australias-health-2018/contents/table-of-contents).
Then amongst all the causes mentioned for ill-health in the report for the latest year, choose any one cause for ill-health. Some of the causes mentioned for ill-health are like chronic conditions, cancer, chronic heart disease, diabetes and arthritis and musculoskeletal conditions. Please note that you need to choose any one cause of ill-health for your assessment.
Imagine you have been asked to conduct a needs assessment for this ill-health cause. Describe how you would go about a needs assessment:
For example: Assuming that you have chosen ‘Cancer Control’.
First, it is best that you break it down into the types of cancers that seem to be prevalent, looking at the incidence of these across Australia (statistics as of 2017), (do remember that you do not go into details of the health problem as such, as this is not the task. It is simply statistics to support this task) and review what services are already being provided across Australia in all the States and Territories as well as Federal initiatives. Your literature review needs to be highly comprehensive and up‐to‐date till end of 2017. Then, based on this decide on how a needs analysis can be undertaken nationally. Do remember to justify different approaches (literature review), before arriving at your final version.
Specifically, In this example:
Step 1: What is the best needs analysis approach for ‘cancer control service?’ Can this be national or state level – and why (justify via literature).
Step 2: What are the challenges that you will face in undertaking the needs analysis? Look at policy, inter‐disciplinary and generic levels.
Step 3: SWOT – From literature that exists until 2017. This can include what is being done (for example, screening), weakness (do not cover all population), threats (many people resist undertaking scanning), opportunity (making screening mandatory).
Step 4: Program priorities–identify priorities for a potential program based on the above that can be provided at grass root level via state/local councils.
(Keep in mind that designing a program as such is not the primary objective ‐ you are only outlining it at this stage)
ASSIGNMENT ON NEEDS ASSESSMENT
Diabetes has been the fastest growing chronic disease in Australia at present and includes almost 119,000 and 1.3 million patients of Diabetes type 1 and type 2 respectively in national level. Since 2000, the prevalence of the disease has grown in alarming rate including the Australian youths as well as aged people. This report presents a brief Needs Assessment analysis for controlling Diabetes in the state along with adoption of the specific stepwise approaches of needs analysis, discussion of the possible challenges that might be present and developing programme priority for succeeding the effort. Moreover, this assessment includes SWOT analysis of the services already been provided in Australia for controlling Diabetes.
For controlling rapid spread of diabetes A and B in Australia, a combination of Epidemiological and Corporate approach might be applied for generating better outcome. The Epidemiological approach would involve accessing information on risk factors encountered, its impacts and relations of these factors to demand of services. The Corporate Approach will involve assessment of major health and healthcare issues in Diabetes from professional perspectives (O’Reilly et al., 2016). Therefore, as the part of conducting this mixed approach, application of following methods would be made.
Application of the mixed approach of needs analysis would be conducted in national level considering the extent of spread of Diabetes throughout the nation, where according to figures (2020), 1.8 million people presently is living with Diabetes, out of which with 1.3 million received proper diagnosis. Almost 500,000 cases of undiagnosed diabetes 2 have been reported during 2018-2018 along with 119,000 patients with type 1 Diabetes in Australia. As mentioned by Australian Institute of Health and Welfare (2019), during 2016-2017, over 1 million cases of hospitalisation of Diabetic patients were registered in national level with 6% of Australian adults aged 18 and over. According to the facts provided by Speight et al., (2016), since 2001, prevalence of Diabetes among the Australian adults (18 and above) had doubled from 3.3% to almost over 6% at present. The rate of spread of the disease and death from the disease has been almost similar in major cities, remote places and various socioeconomic groups present in Australia. As per figures (2020), during 2016-2017, standardised rate of death from Diabetes in the country was 16.2 deaths pot of every 100,000 people.
Therefore, conduction of the Needs Analysis Approach in national level is necessary considering ever-growing number of cases of Diabetes and deaths from it and no restriction within any particular states would suffice.
Figure 1: Prevalence of Diabetes among males and Females in Australia
(Source: Australian Institute of Health and Welfare, 2019)
In case of performing the need analysis for controlling Diabetes in national level, lack of proper awareness of people and associated knowledge might be a significant challenge with this regard. As stated by Glasson et al., (2016), lower level of self-efficacy among people might be a great disadvantage in conduction of such necessary needs analysis approaches in national level. Lack of community awareness in different regions and cities in Australia might pose significant issue in this connection leading to practical challenge in implementation of the methods like self-efficacy scale, Questionnaire on Diabetes Knowledge and Hopkins Scale Checklist-25. Apart from this level of stigma among people, living with diabetes might affect the success possibility of the needs analysis approach in various disciplinary and generic levels of operations.
Figure 2: Diabetes among persons aged 18 and over in various Places in Australia
(Source: Australian Institute of Health and Welfare, 2019)
While implementing the methods of Questionnaire and self-efficacy scale, lack of diabetes education and recent updates on acuteness of the diseases in the country might resist the effort of gathering valuable information on range of needs of heath prevention by general people. This might affect the different inter-disciplinary as well as generic levels of the needs assessment task. Therefore, according to Boothet al., (2016), the areas of gathering lived experience and the best current evidences might be disturbed due to all these reasons. Apart from this, effective compliance of the overall needs analysis process to the Needs Assessment Guide, provided by the Department of Health of Australian Government might be a significant challenge in this case. As per the Government regulations for assessment of needs in healthcare, fulfilling the steps recommended by the PHN (Primary Health Networks) Commissioning Framework is necessary (Booth et al., 2016). Application of the Mixed Approach therefore, needs proper addressing the community needs while acquiring the facts and information on needs felt by the Diabetic patients for appropriate medical intervention and monitoring. Moreover, the Needs Analysis Approach has to fulfil the terms and conditions of ‘Commissioning’, as per Australian legislature, for denoting the proactive and strategic roles of the overall approach.
Figure 3: The PHN Guidelines for Needs Assessment in Healthcare
(Source: Booth et al., 2016)
Therefore, from overall perspective, conduction of the mixed approach of Needs Analysis might face the above mentioned challenges due to the necessity of meeting the issues of self-efficacy lacks, lacks in interest of the professionals and legal policy oriented complexities fo the assessment of needs.
This SWOT analysis will help in understanding the overall areas of steps taken for identifying the risks of Diabetes and controlling.
Considering the above needs of applying Need Analysis Approach for Diabetes controlling and the key possible challenges areas and opportunities for further programmes, the following programme priorities have been developed here for turning the overall effort more effective.
Firstly, as part of the priority, special screening plans are to be developed based on the needs of accessing information on different levels of healthcare intervention needs for reducing the risks of Diabetes 1 and Diabetes 2 in the community. Plans would be developed for accessing the Normative, Felt, Expressed and Comparative needs of people with this regard. Programmes are to be arranged for inclusion of the all the priority groups within mandatory screening, including the age group of 17-25. Considering over 600,000 undiagnosed diabetes cases in Australia, presently, appropriate and timely medical intervention on this particular group is necessary as part of the priority programme (Scott et al., 2016). Specific attention would be provided for ensuring the impacts of pre-existing and gestational Diabetes on the pregnant. Moreover, the task of making screening of Diabetes compulsory throughput Australia by legal obligations will be the priority here. As stated by Australian Institute of Health and Welfare (2019), planning and implementation of specific guidelines for developing overall research and information capacity on Diabetes associated factors is necessary part of priority planning. Hence, the priority programme would include this particular aim also.
With regard to making effective plans and strategies of the Priority Programme, this would be necessary to ask for effective collaboration from all the stakeholders in the government level as well as the Australian health sector levels, which is necessary for effective execution of the plans suggested by the priority programme.
The overall discussion makes this clear that Diabetes has become a great concern for all stages of healthcare and disease prevention in Australia and presently, the state of spread of the disease has reached alarming stage in national level. Therefore, application of the Mixed Approach of Needs Analysis is necessary for conducting at the national level considering impact of Diabetes on almost all the communities living there. The necessary steps and plans discussed under the programme priority are essential to be implemented at national level for gaining higher control over all types and categories of Diabetes.