Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries.
BACKGROUND
We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland


METHODS
We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation.


RESULTS
The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services.


CONCLUSIONS
We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process.
Smith
Susan M
SM
Department of Public Health and Primary Care, University of Dublin, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital Dublin, Incorporating The National Children's Hospital, Tallaght, Dublin, Ireland. susmith@tcd.ie
Long
Jean
J
Deady
Jillian
J
O'Keeffe
Frances
F
Handy
Deirdre
D
O'Dowd
Tom
T
D019352:Censuses; D016000:Cluster Analysis; D018672:Community Health Planning / Q000379:methods*; D019049:Developed Countries; D003906:Developing Countries; D006306:Health Surveys; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D015233:Models, Statistical; D020380:Needs Assessment / Q000592:standards*; D017062:Small-Area Analysis; D014504:Urban Health / Q000706:statistics & numerical data*; D035862:Vulnerable Populations