Population-Based Interventions Paper

COMMUNITY NEEDS ASSESSMENT REPORT 2

COMMUNITY NEEDS ASSESSMENT REPORT 2

Community Needs Assessment Report.

PHN- 652 Population-Based Interventions

Grand Canyon University

May 5, 2021.

Community Needs Assessment Report

The research targeted communities living in rural areas because we felt that they were disadvantaged in benefiting from national resource allocation. Government, public and private institutions essentially place their concern in cities and towns, not considering the needs of those living in rural areas; that is why many institutions, social amenities, and significant projects are in urban areas but inadequate facilities in the interior. These people have to travel to towns which at some considerations are very far from finding government services and medical attention. In America, about 19.3% of the population, which constitutes 60 million people, reside in rural areas occupying 97% of America, where most of them are farmers and small business owners (Duncan, (2018)). For years rural people were left out of development, technology, and service provision, and it is time for their needs to be considered equal to other Americans. Having 60 million people is a large number of people; hence, it will be better to cater for their needs using essential facilities such as hospitals and schools, which are at their disposal. Population-Based Interventions Paper

We started the intervention by exploring the rural areas and collecting data about social amenities’ allocation based on the local needs. Questionnaires were used, including direct interviews with rural residents, as well as observations to collect data and to arrive at our conclusion. The data collected showed us that there are no modern hospitals in rural areas, however, they have dispensaries, which is also located far apart, with one dispensary per five miles squared. It is unfortunate that these rural people are uninformed about health insurance coverage, which makes it difficult for them to raise medical bills. We also discovered that the dispensaries had neither machines nor qualified doctors that can treat complicated diseases but catered for minor illnesses and first aid. Patients had to look for hospitals in neighboring towns that are well-equipped and can treat their conditions. There are some other interior places that were suffering the lack of water, they have to travel far in search of clean water for drinking and food preparation as there are no piped water in the residential areas. Inadequate or poor transportation structures are also a hinderance in most these remote areas due to the poor and untied roads, which makes the site inaccessible, especially during the rainy season. Population-Based Interventions Paper

There is a need to upgrade rural dispensaries by equipping them with necessary machinery and equipment and providing more doctors. Upgrading hospitals in rural areas will reduce the rate at which patients are referred to urban hospitals, reducing the cost incurred looking for health care. Also, the mortality rate will decrease as patients will be receiving immediate health care, unlike now, patients die before they can get to cities where health facilities are. Supply of water is another necessity urgently required. There is a need to dig boreholes and put necessary structures to supply water at homes of locals to make life simple for them. Availing piped water will eliminate the challenging task of fetching water, especially for those who find water at far distances during drought seasons. Population-Based Interventions Paper

Rural people need to be educated about medical insurance covers and be encouraged to register with insurance companies (Tegeler, 2020). Many people have failed to get medical attention due to the lack of funds to pay medical bills. Others must sell assets like houses or land to raise funds leaving their families struggling with poverty. Government should intervene in the rural areas by constructing all-weather roads or upgrading rural roads. Many interior places are categorized with poor transport structures and ore out of reach, especially during rainy seasons. Upgrading roads will make it easier for locals to get services as they will travel at ease to where the services are. Also, equipping dispensaries with drugs and health necessities will be guaranteed compared to current situations where facilities do not reach some dispensaries on time due to poor transport.

Government censuses will be reliable sources of secondary data required to identify needy places further and plan for the need. Therefore, we will be collecting data from government institutions regarding population distribution, resources allocated and identifying the gap that requires fulfillment. Through the internet, detailed information about different areas will be obtained at ease and much lower cost(Johnston (2017)). We shall also include our target group in the data collection process through direct interviews. Population-Based Interventions Paper

Through the intervention, we realized that the community in rural areas needs reliable medical facilities. The current dispensaries are overcrowded, and most times, they are out of required drugs making patients get back at home unattended, leading to an increased mortality rate (Iademarco, 2017). Indeed, one dispensary per three-kilometer square is a stretch of resources, and more dispensaries need construction to reduce the congestion in the current dispensaries. There are also no machines to test or cater to complicated diseases like cancer and other chronic disorders; therefore, many people do not get tests to make the conditions worse when the situation worsens and is hard to treat.

Poor transport structures are significant determinants to the inadequate provision of health services in rural areas (Menachemi, 2017). Many roads are seasonal, and not leveled making it hard for ambulances to carry patients in the regions considering that some areas are hilly. During the rainy season, the condition is even worse because drugs and other necessary equipment for attending patients do not arrive at dispensaries. Making the situation more painful is when the expectant mothers deliver children at the homes without a medical officer around only because there were no means to carry the woman to maternity. The lack of educated people in the villages has also contributed to the poor situation as there are no people to push for development. When people get education in rural areas, they move to urban areas where they believe job opportunities leave villagers without the intellect to air their grievances. Population-Based Interventions Paper

To solve the need to improve health care quality in rural areas, we will use the health ministry to borrow money from money lending organizations. We will also include the well-wishers and non-government organizations to raise funds. Since all cannot be done at once, equipping already existing dispensaries and ensuring enough medicine supply will be the first action. When the situation in current dispensaries is solved, the idea of constructing more dispensaries will follow. There will be the formation of a board of management to develop strategies to follow and oversee the implementation of the intervention. Locals will be enlightened about health insurance covers and the need to take the insurance cover. Medical insurance companies will be encouraged to send representatives in rural areas to enlighten people about insurance companies and encourage them to take covers. Population-Based Interventions Paper

References

Johnston (2017). Secondary data analysis: A method of which the time has come. Qualitative and quantitative methods in libraries, 3(3), 619-626.

Macarena C. Garcia, Mark Faul, Greta Massetti, Cheryll C. Thomas, Yuling Hong, Ursula E. Bauer, & Michael F. Iademarco. (2017). Reducing potentially excess deaths from the five leading causes of death in the rural united states. MMWR. Surveillance Summaries, 66(2), 1-7. doi:10.15585/mmwr.ss6602a1

Strowd, R. E., Strauss, L., Graham, R., Dodenhoff, K., Schreiber, A., Thomson, S., . . . Tegeler, C. (2020). Rapid implementation of outpatient teleneurology in rural Appalachia: Barriers and disparities. Neurology. Clinical Practice, , 10. doi:10.1212/CPJ.0000000000000906

Ulrich-Schad, J. D., & Duncan, C. M. (2018). People and places left behind: Work, culture and politics in the rural united states. The Journal of Peasant Studies, 45(1), 59-79. doi:10.1080/03066150.2017.1410702

Vest, J. R., Grannis, S. J., Haut, D. P., Halverson, P. K., & Menachemi, N. (2017). Using structured and unstructured data to identify patients’ need for services that address the social determinants of health. International Journal of Medical Informatics (Shannon, Ireland), 107, 101-106. doi:10.1016/j.ijmedinf.2017.09.008

Marian Alli

PHN- 652 Population-Based Interventions Module 4 IP.docx

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  Marian Alli PHN- 652 Population-Based Interventions Module 4 IP.docx Summary Submission Ide: 208a29a3-25e7-44d8-8ead-bdc417a68f42   1280 Words   73% SIMILARITY SCORE        1   CITATION ITEMS        9   GRAMMAR ISSUES        0   FEEDBACK COMMENTS Internet Source   0% Institution   73% COMMUNITY NEEDS ASSESSMENT REPORT1 Community Needs Assessment Report. PHN- 652 Population-Based Interventions Marian Alli Grand Canyon University May 5, 2021. COMMUNITY NEEDS ASSESSMENT REPORT2 Community Needs Assessment Report The research targeted communities living in rural areas because we felt that they were disadvantaged in benefiting from national resource allocation. Government, public and private institutions essentially place their concern in cities and towns, not considering the needs of those living in rural areas; that is why many institutions, social amenities, and significant projects are in urban areas but inadequate facilities in the interior. These people have to travel to towns which at some considerations are very far from finding government services and medical attention. In America, about 19.3% of the population, which constitutes 60 million people, reside in rural areas occupying 97% of America, where most of them are farmers and small business owners (Duncan, (2018)). For years rural people have been left behind in terms of development, technology, and service provision, and it is time for their needs to be considered equal to other Americans. 60 million is A very massive number of people; therefore, it is necessary to cater to their needs by taking essential facilities like hospitals and schools at their reach Our intervention started by exploring rural areas and collecting data about social amenities allocation according to the needs of the locals. We used questionnaires, direct interviews with rural people, and observation to collect data to draw our conclusion. Data collected showed no modern hospitals in rural areas but only dispensaries located far apart, about one dispensary per three kilometers squared. Rural people are uninformed about health insurance covers, making it difficult for them to raise medical bills. The dispensaries had no machines or qualified doctors to treat complicated diseases but catered for minor illnesses and first aid. Patients look for hospitals in towns that are equipped and could treat the condition. Some interior places suffered a lack of water, and they traveled far in search of clean water for consumption as there is no piped water in the areas of residence. Poor transport structures are also a disaster in COMMUNITY NEEDS ASSESSMENT REPORT3 most remote areas due to on upgraded roads, making the site inaccessible, especially during the rainy season. There is a need to upgrade rural dispensaries by equipping them with necessary machinery and equipment and providing more doctors. Upgrading hospitals in rural areas will reduce the rate at which patients are referred to urban hospitals, reducing the cost incurred looking for health care. Also, the mortality rate will decrease as patients will be receiving immediate health care, unlike currently, patients die before they can get to cities where health facilities are. Supply of water is another necessity urgently required. There is a need to dig boreholes and put necessary structures to supply water at homes of locals to make life simple for them. Availing piped water will eliminate the challenging task of fetching water, especially for those who find water at far distances during drought seasons. Rural people need to be educated about medical insurance covers and be encouraged to register with insurance companies (Tegeler, 2020). Many people have failed to get medical attention due to the lack of funds to pay medical bills. Others must sell assets like houses or land to raise funds leaving their families struggling with poverty. Government should intervene in the rural areas by constructing all- weather roads or upgrading rural roads. Many interior places are categorized with poor transport structures and ore out of reach, especially during rainy seasons. Upgrading roads will make it easier for locals to get services as they will travel at ease to where the services are. Also, equipping dispensaries with drugs and health necessities will be guaranteed compared to current situations where facilities do not reach some dispensaries on time due to poor transport. Government censuses will be reliable sources of secondary data required to identify needy places further and plan for the need. Therefore, we will be collecting data from government institutions regarding population distribution, resources allocated and identifying the COMMUNITY NEEDS ASSESSMENT REPORT4 gap that requires fulfillment. Through the internet, detailed information about different areas will be obtained at ease and much lower cost(Johnston (2017)). We shall also include our target group in the data collection process through direct interviews. Through the intervention, we realized that the community in rural areas needs reliable medical facilities. The current dispensaries are overcrowded, and most times, they are out of required drugs making patients get back at home unattended, leading to an increased mortality rate (Iademarco, 2017). Indeed, one dispensary per three-kilometer square is a stretch of resources, and more dispensaries need construction to reduce the congestion in the current dispensaries. There are also no machines to test or cater to complicated diseases like cancer and other chronic disorders; therefore, many people do not get tests to make the conditions worse when the situation worsens and is hard to treat. Poor transport structures are significant determinants to the inadequate provision of health services in rural areas (Menachemi, 2017). Many roads are seasonal, and unleveled making it hard for ambulances to carry patients in the regions considering that some areas are hilly. During the rainy season, the condition is even worse because drugs and other necessary equipment for attending patients do not arrive at dispensaries. Making the situation more painful is when the expectant mothers deliver children at the homes without a medical officer around only because there were no means to carry the woman to maternity. The lack of educated people in the villages has also contributed to the poor situation as there are no people to push for development. When people get education in rural areas, they move to urban areas where they believe job opportunities leave villagers without the intellect to air their grievances. To solve the need to improve health care quality in rural areas, we will use the health ministry to borrow money from money lending organizations. We will also include the well- COMMUNITY NEEDS ASSESSMENT REPORT5 wishers and non-government organizations to raise funds. Since all cannot be done at once, equipping already existing dispensaries and ensuring a sufficient medicine supply will be the first action. When the situation in current dispensaries is solved, the idea of constructing more dispensaries will follow. There will be the formation of a board of management to develop strategies to follow and oversee the implementation of the intervention. Locals will be enlightened about health insurance covers and the need to take the insurance cover. Medical insurance companies will be encouraged to send representatives in rural areas to enlighten people about insurance companies and encourage them to take covers COMMUNITY NEEDS ASSESSMENT REPORT6 References Johnston (2017). Secondary data analysis: A method of which the time has come. Qualitative and quantitative methods in libraries, 3(3), 619-626. Macarena C. Garcia, Mark Faul, Greta Massetti, Cheryll C. Thomas, Yuling Hong, Ursula E. Bauer, & Michael F. Iademarco. (2017). Reducing potentially excess deaths from the five leading causes of death in the rural united states. MMWR. Surveillance Summaries, 66(2), 1- 7. doi:10.15585/mmwr.ss6602a1 Strowd, R. E., Strauss, L., Graham, R., Dodenhoff, K., Schreiber, A., Thomson, S., . . . Tegeler, C. (2020). Rapid implementation of outpatient teleneurology in rural Appalachia: Barriers and disparities. Neurology. Clinical Practice, , 10. doi:10.1212/CPJ.0000000000000906 Ulrich-Schad, J. D., & Duncan, C. M. (2018). People and places left behind: Work, culture and politics in the rural united states. The Journal of Peasant Studies, 45(1), 59-79. doi:10.1080/03066150.2017.1410702 Vest, J. R., Grannis, S. J., Haut, D. P., Halverson, P. K., & Menachemi, N. (2017). Using structured and unstructured data to identify patients’ need for services that address the social determinants of health. International Journal of Medical Informatics (Shannon, Ireland), 107, 101-106. doi:10.1016/j.ijmedinf.2017.09.008 COMMUNITY NEEDS ASSESSMENT REPORT7

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