Health Needs Assessment

1
Health Needs Assessment

• Dr Christine Hine, Consultant in Public Health,
• Bristol South Gloucestershire PCTs
• Glen Monks
• NTA Regional Manager, South West

2
What is health needs assessment?

• ..a systematic method of identifying unmet health
  and healthcare needs of a population.
• ..and making changes to meet these unmet needs
• (J Wright in Oxford Handbook of
• Public Health Practice, 2001)

3

• the purpose .is to gather information required
  to bring about change beneficial to the health of
  the population.
• within finite resources.
• Health gain can be achieved by reallocating
  resources.
• (A Stevens, S Gillam.BMJ 19983161448-1452)

4
Need

• Need for health
• Need for health intervention not only is there
  need, there is also real potential to benefit
  from an intervention.

5
Evidence based policy making is about taking
decisions based on evidence and the needs and
values of the population J A Muir
Gray, programme director, UK National Screening
Committee
..decisions are based on evidence and not made
by evidence
BMJ  2004329988-989 (30 October),
6
Example Cochlear implants for profound deafness

• A local hospital wants to offer a new highly
  specialist service providing Cochlear Implants
• Should funding be found to provide this service?

7
(No Transcript)
8
(No Transcript)
9
How might this model relate to needs assessment
and treatment planning?

• How does our system perform compared to (a)
  national guidance (b) similar areas?
• Who are the corporate stakeholders and how do
  we best involve them?
• What interventions are there/could there be?
  advantages and disadvantages of each.
• What data is routinely available to us?
• What data might we need to collect?
• What resources are available? (now and in future)
  

10
(No Transcript)
11
An applied example...

• Is there a need to increase the level of needle
  exchange provision in Borchester DAAT?

12
(No Transcript)
13
Rapid appraisal

• A research method involving participation, data
  gathering and analysis to gain understanding.
• Not hypothesis testing
• Rural rapid appraisal started in 1970s, used in
  aid programmes, agriculture.
• Might involve key informant interviews, focus
  groups,meetings,observations,small surveys, data
  analysis.
• Triangulation to improve validity compares
  several info sources on the same issue

14
Rapid appraisal- principles

• Data collected is relevant and appropriate to
  purpose (quality and quantity)
• Methods adapted to local conditions
• Involves members of the relevant communities in
  defining needs and generating possible solutions

15
Rapid appraisal - strengths

• Relatively low cost
• Quick
• Ownership by local people
• Flexible
• Revealing, can gain in-depth understanding of
  complex issues
• Multi-disciplinary, and encourages broader
  perspectives.

16
Rapid appraisal - limitations

• Bias e.g. no objective sampling technique
• Limited generalisability
• Decision makers may prefer statistics!
• Preparation takes time e.g. training community
  interviewers
• May seem intrusive to communities

17
Rapid appraisal- references

• USAID Evaluation Publications, Published 1997
  2000. http//www.dec.org/usaid_eval/
• (see number 5 for common methods, their
  advantages and limitations)
• Murray SA. Experiences with rapid appraisal in
  primary care involving the public in assessing
  health needs, orientating staff and education
  medical students. BMJ 1999318440-4
  http//bmj.bmjjournals.com/cgi/content/full/318/71
  81/440