The authors have declared that no competing interests exist.
Reporting of suspected or confirmed communicable diseases is paramount. Although physicians have primary responsibility for reporting, school nurses, laboratory directors, infection control practitioners, daycare center directors, health care facilities, state institutions and any other individuals providing health care services are also required to report communicable disease. Therefore, community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the national health regulations and other communicable diseases of public health importance, including emerging or re-emerging infections.
Todescribe relevant medical needs of townspeople so that treatment plans can be developed accordingly.
The Study was a cross-sectional with qualitative approach. In-depth interviews and focus group interviews was used as research technique. Data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically.
Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only.
The patient waiting time, dental services in health centers, and the way of dissemination new health information, mutual health insurance and insufficient human resources are the major concerns of townspeople that they wish improvement.
Community health needs assessment should not be confused with clinical needs assessments, which are routinely performed during an initial visit to a medical care provider. Community health needs assessment produces information that is relevant to groups and is not focused on the medical needs of individuals so that treatment plans can be developed accordingly. Furthermore, community health needs assessment should not be confused with assessment of disease prevention services. Since health is not seen merely as the absence of disease, community health needs assessment, therefore, focuses on general wellbeing. Of course, in many cases, disease prevention and promotion of general health overlap
Definitions of community needs health assessment widely vary. While some definitions focus on data collection and analysis, others highlight the use of assessment data to develop objectives and action plans for health improvement
Community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases. Urban people find it more difficult than rural communities to address threats to public health security effectively because they lack the necessary resources
Respondents were asked what they consider to be important when thinking about the level or quality of health of a community and its residents. This question intentionally lacked specific reference to the local community, encouraging respondents to think more broadly and possibly in more «ideal» terms
The Study was a cross-sectional with qualitative approach. To have the details of the situation under study and understand the reality to be interpreted, this research adopted an ontological and epistemological philosophy with subjectivism and interpretivism approach. In-depth interviews (individual interviews) and focus group interviews was used as research technique. In-depth interviews was especially used to create an affinity between the researcher and research participant. For data analysis, data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically. The study enrolled 8 nurse head of health center, 8 community health officers at health center level, 8 medical doctors and 8 nurses from 4 public hospital, 36 representative of community health workers (CHWs) from 36 health centers, 10 people living in Kigali city, 8 medical doctors and 8 nurses from 3 private clinics. The study was conducted in 3 districts of Kigali city. The study participants were selected randomly. The focus group discussion was used for health providers and community health workers. The in-depth interviews was used for people where researchers reached them house to house. Health providers and community health workers were invited to meet with researchers at the place nearer with their working place. Each focus group discussion was composed with 8 persons. Before conducting interview, researchers explained the objective of the study and accepted to be enrolled in the study by consent.
During the interview, the representative of health centers said they do not have sufficient health care providers comparing with their daily clients, this is justified by the waiting time of clients. Another need is a regular payment of invoices by health insurances. The head of health centers explained in the following way:
During the interview, community health officerssaid they community have a problem of unwanted pregnancies in youth may be due to lack information about reproductive health service offered at health facilities. Another community need is to license private clinics to receive clients of a public mutual health insurance because patient are overloaded at public health facilities whereas private clinics have no more clients. The community also need that new health service information could be posted in public places like bars, pubs, coffee shops and coffee houses rather than to pass in media and post at public institutions only.
The community health officers explained in the following way:
During the interview, community health workers had a quite similar view of community needsas their representative at health centers level (community health officers). They said that it is difficult to call a meeting and be attended on satisfactory level. People are busy in searching their daily family needs. In this case community health workers who are supposed to create awareness of new information of health services became obliged to go house to house and most time they find none because the home are closed. They suggest to use media and posts of everywhere. The community health workers explained in the following way:
During the interview, people living in Kigali said that dental therapy is a service that is needed to be added to the services offered at health center and staffs should be increased because a patient spend much time at public health centers waiting the service. They desire public mutual health insurance to work with private clinics and pharmacies.
The people explained in the following way:
During the interview, medical doctor working in public hospital said that the patients wait the service much time and most of the time they get angry with the service. The Doctors explained in the following way:
During the interview, Nurses working in public hospital said the similar to the doctors working together, they human resources intervention is required to satisfy the service needed by patients in public health facilities. The nurses explained in the following way:
During the interview, medical doctor working in private hospital said that they have an obstacle of not working with mutual health insurance of ordinary people, they work with private insurers only and the civil servants health insurance. The Doctors explained in the following way:
During the interview, nurses working in private hospital said that public mutual health insurance should be flexible to let their client choose where they want health services like done by other insurer. The nurses explained in the following way:
It is evident from this study, that although urban residents are generally satisfied with health services within the urban health service, gaps do exist. Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only.