Comprehensive Health Needs Assessment: Evaluating Impacts and Reducing Inequalities

Introduction

The assessment of health needs is a measure of fundamental importance for making adequate decisions. This implies not only the health of the population of the victims and those affected. But also the sanitary conditions that exist as a consequence of the event itself. In addition to the evaluation of the establishments that offer health services. The health needs assessment process is carried out in the disaster area to determine the type and extent of the effects on affected populations' health. Damages and areas that require more urgent intervention. On the opposite, the social disparity in health relates to the various privileges and wealth linked to health that individuals have due to their social status, sex, region, or race, which is mirrored in worse health in socially collectives less favored/ Multiple scientific studies indicate that health differences are immense, which in several cases cause excess mortality and morbidity, higher than for other known risk factors for disease. Besides, these disparities almost always escalate in the areas under review as well-being in the most advantageous social groups is improving more rapidly. It may also note that scientific research shows that health inequalities can be minimized if adequate public health and social programs and initiatives are applied. Sociology, our status, and the social comparisons will contribute to our social concerns about how others see us, concerns that extend into the very roots of social life, our social reflectivity, and our propensity to see one another through one's own eyes. The intelligence obtained within the first 8 hours helps them respond to the need to minimize human suffering.

Comprehensive Health Needs Assessment

For assessing the damage's costs and the need for money for its restoration or repair, it is essential to provide data from 48 to 72 hours after the tragedy. Epidemiologists allow us to understand and prepare action strategies to advance the health profile of affected areas. In the early reaction process, however, it is most beneficial to identify immediate needs and goals for assistance to the affected population and information on the emergence of health risk factors and the evolution of the dangerous disease in the environment. Data providing the damage evaluation method information must be rapidly obtained in exceedingly unfavorable conditions and numerous information sources for analyzes inserted.

Discussion

First of all, it is necessary to understand that the succession of routines, processes, and stages commonly called the procedure or methodology to develop a pre-established task is not an inflexible and rigid scheme. However, a guide to action for research teachers, incorporating and synthesizing the previous experience to facilitate the execution of the task, never to make it difficult or impose a straitjacket on initiatives that can improve investigative work results.

In the case of identifying learning needs, this working principle is doubly valid for many reasons, among others, the lack of own experience in the country and the sector, as well as the objective reality that there are no communities, territories, or work units exactly equal to each other, but on the contrary, the peculiarities and specificities, the trajectory and individual experience of the people who investigate, the process of personal and collective development, and many other critical defining elements of the investigation that are casuistic (Muktabhant et al., 2019).

Comprehensive Health Needs Assessment

On the other hand, it is not essential to start from a homogeneous and necessarily common approach, from which the specific elements and the corresponding initiatives would be introduced. To facilitate both trends (the unity of focus and methodology within the framework of the local initiative), the general procedures from which the research should be based are set out below

It is an objective reality that at the level of each province, municipality, polyclinic, hospital, or any other unit, the training needs to be investigated are a combination of those presented. There are no pure manifest needs, totally separated from the hidden ones. Nor is it likely that organizational needs appear entirely isolated from those of a community or those of the individuals who ensure the Health System's functioning at that level. In other words, needs are intermingled, as they occur at the level of what we call Municipality for Health, where whole groups with different needs interact (Muktabhant et al., 2019).

Despite this reality, it is convenient from the methodological, investigative, and practical point of view to understand the specific procedure for each type of need to delve into each one of them and fully understand their content and specificity, a necessary condition for successfully apply the procedure to practical research (Muktabhant et al., 2019).

Comprehensive Health Needs Assessment

In each specific case, the proposed procedure for identifying learning needs for manifest and hidden needs and organizational, occupational, and individual needs will be established, and the consolidation of the investigation in each health municipality will yield a complete result from where the corresponding educational interventions will be designed (Van et al., 2006).

Some health assessment especially studied child mortality, and reduced health disparities produce outcomes. This section also covers systemic determinants of health inequalities such as multiple axes of social system discrimination, social groups, socio-economic status, gender, race, or ethnicity. Those axes define health opportunities and emphasize health inequality due to power hierarchies or access to services, where women, men, and white people of dominant social classes are present. In regards to inequality, the highest wealth and the most fortunate individuals have the most significant access to capital concerning the least power and the lowest access to the most vulnerable hazards (Muktabhant et al., 2019).

These axes of uniformity refer to the notion of segregation, or of 'unjust class, sex and racial relations that are based on social and behavioral processes, under which members of the majority party obtain rights that rely on subordinating others and defend those practices through philosophies called classism, patriarchy or bigotry of dominance or distinction. The social system defines the intermediate inequalities that, in essence, determine health inequalities. (a) material circumstances like accommodation, income, working conditions and residence (b) psychological factors such as lack of social assistance, traumatic situations (negative life situations), lack of influence, etc. (c) compartmental and biological factors such as lifestyles which damage the health system; and (d) healing facilities (c) Furthermore, paying for healthcare services will lead people in these social groups to poverty (Vyhrystyuk et al.,2017).

Comprehensive Health Needs Assessment

Regulation can increase the population's well-being standards. For eliminating the inequalities of well-being between multiple communities, the aim is to improve the least favored health status and not to reduce disparities by reducing the welfare levels of the most favored classes. Different ways of eliminating health inequalities should be employed. The three are the most famous. This approach considers that amongst the various social groups, there is a degree of well-being and illness; therefore, universal politics need to be taken into account. As mentioned, these policies defend the public from inequality, such as welfare state policy (Vyhrystyuk et al.,2017). 

According to Link and Phelan, a vulnerable population has a high-risk factor, whereas a vulnerable population is a subgroup that is more likely to be exposed to certain risks because of common social features. The build-up of risk factors represents the underlying causes associated with society's role (as supposed by the above-mentioned conceptual model). These "causes" are the dangers that contribute to others (Vyhrystyuk et al.,2017).

Population-based health improvement interventions will need to concentrate on reducing differences between multiple social classes. Interventions often do not take differences into account, making life easier for the more fortunate socio-economic classes. The social determinants of health disparities should be addressed, not just health determinants, as the determinants of health inequalities might not be the same. Interventions on public well-being to minimize health inequality need to be multi-spectral. The critical factors of vulnerability are rooted in daily life, which, as described in the preceding section on the conceptual model, are beyond the health sector (e.g., conditions of life and work). Therefore, the health sector's role is to act rather than take on the leadership role and encourage other industries to collaborate to minimize social determinants. The detrimental consequences of the measures introduced should be remembered. Thus in Latin American countries promoted by the World Bank, health-reconstruction programs often raised inequality and primarily impacted the population's most vulnerable industries. Instruments are expected to determine the degree of health inequality and the steps taken. In order to do so, differences in both relative and absolute social classes should be calculated. In relative values, inequality may decrease, but in absolute terms, increase or vice versa (Vyhrystyuk et al.,2017).

It is vital to support and enable the involvement of the most disadvantaged individuals. One critique that target audiences also have diverse perceptions, beliefs, and concerns from politicians and health advocacy staff is that disadvantaged people should not be included from crisis research to program implementation and assessment. This policy solution style reflects a fundamental shift in public health policy that means a model distinct from that built on the disease's clinical paradigm, focusing on daily issues for the population and not on the healthcare workers' problems  (Wells et al., 2017).

The techniques and procedures to be used in the investigative process for determining learning needs are very varied and dissimilar, depending on the timing, magnitude, complexity, and profile of the investigation. It is unnecessary to clarify that the least talked technique is not always the least useful, nor is it the one spoken of the most, nor is it still the most beneficial. Given epidemic situations, health disparities should be defined according to ethnicity or geographical region, in this case, and the socio-economic status or social class; it is essential to look at other axes of inequalities. Health systems must be fair, delivering public services independent of their economic ability. Health systems must be to minimize inequality; strategies must be based on a logical model. Policies may have different entry points based on the above model. Any of the policies can be found here. This section concerns policies that are generally linked to political authority, not just about political parties. This encompasses measures to increase political engagement or reinforce unions or civil societies (Wells et al., 2017).

Implications

Health assessment is not a fixed and static process. On the contrary, it is dynamic and changes with the situation generated from day to day; therefore, it must be carried out periodically using instruments that confirm the needs of the sectors most affected and specifically determine the quantitative and qualitative aspects of healthcare. These must be determined, even if the entire evaluation process has not been completed. The routine epidemiological surveillance system should institute alert and contingency mechanisms, with a list of possible diseases related to each type of disaster, establish a simple data collection program, and implement disease control programs. Disasters cause direct and indirect alterations to the health of the population: during the event, there may be injured, traumatized, or similar, that is, patients with acute and urgent illnesses. After the event, the environment's sanitary conditions and the habitat conditions can cause other diseases considered a tracer (van Bon-Martens, 2017). Tracer diseases have been established based on epidemiological studies and disaster monitoring in various countries; many of these diseases result from the environment's elements and the systems enabled for the affected population. Its solution does not depend exclusively on the health sector; Intersectoral coordination is vital in managing the situation, both in the exchange of information and in the definition of priorities. The prior information, together with the damage assessment, must indicate and identify the risk factors to which the population is subjected or exposed so that adequate control plans can be drawn up in each situation. The main factors that generally change related to the appearance of diseases or epidemic outbreaks are the following. Proportional to the degree of endemicity and the introduction of communicable diseases and the increase in morbidity from endemic diseases in local populations and more frequent diseases: acute respiratory infections, non-specific diarrhea.  The population moves to nearby places and areas located at a certain distance (van Bon-Martens, 2017).

Interventions aimed at strengthening behaviors or lifestyles must consider that these behaviors are not individual choices but are socially conditioned. Some examples would be the increase in tobacco and alcoholic beverages (effective interventions to reduce inequalities in consumption), the construction of public facilities where physical exercise can be carried out, and the control of healthy food prices (Hafsa, Maidin & Sukri Palutturi, 2019).

The government's demand for scientific evidence mobilized the scientific community. Highlight the democratic process to develop the strategy. The entire process was carried out with constant dialogue between those responsible for developing the interventions and the intervention's people. Documents were prepared, and seminars and conferences were organized to promote participation and collaboration (van Bon-Martens, 2017).

The public health function according to the comprehensive care model, a strategy that guarantees care throughout the life cycle with units equipped with the resolution capacity to promote health and quality of life through educational, preventive, curative, and rehabilitative actions, which act both on immediate health needs and the social determinants of the health of individuals and communities (van Bon-Martens, 2017).

Although it is an unfinished process, the experience of building a public health system based on primary health care confirms the importance of incorporating health as a universal right and can serve as an example to other neighboring countries with a similar situation. This type of policy places public health before a great challenge since the reduction of inequalities in health requires moving from the biomedical paradigm focused on health problems, which places the main responsibility in the health field, to one based on the social determinants of health, which requires a high political commitment that involves all government areas and the participation of citizens in prioritizing problems, diagnosing them, designing programs, implementing and evaluating them (Brownson, 2009).

Nature	Subject	Source / Method
Socio-political/ epidemiological	Community	- Health Statistics - Health programs - Polls
Administrative	Healthcare system	- Staff offer - Reference system - Audit / interconsultation - Norms and standards
Performance (performance)	Individual	- Performance evaluation - Work studies - Supervision - Audit / interconsultation - Critical incidents - Exams and tests (Brownson, 2009)

Conclusion

This paper analyzes learning needs as the core of the curricular design of postgraduate education and its consideration as a type of educational research work based on investigation-action. The different educational needs and the ways of determining them are classified. Learning needs and their system approach are studied from a conceptual viewpoint based on health situation, the working process, and professionals' deficiencies. A methodology for a comprehensive approach to this subject is assessed. In comparison, the incidence of diseases in all populations is similar to the socio-economic system, i.e., the prevalence of nearly all disorders and health issues raises as a social step down: inequity affects all of us. In the relation between health and socio-economic conditions, psycho-social factors play a central role, and the lower the level of socio-economic deprivation, the better the population. More fair cultures are less stressful and more unified. Detroit to health inequality Subordinate social status, the lack of friends, social fabric, and lack of autonomy and power are purely societal factors that affect health. Socio-economic disparities impact the whole life sphere. The consistency of the social atmosphere (which has deteriorated in those communities where wealth gaps are higher, trust and inclusion in group lives are reduced, crime and violence increased) are influenced by social and economic inequality and the population's psycho-social well-being.  On the other hand, biological and psycho-social processes have links that affect health. Most psychological health consequences may trigger chronic anxiety and tension and cause chronic physiological arousal, which increases the vulnerability to illness. 

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