In my view, we should try to understand the epidemiology of the disease targetted for control like Rho and Herd Immunity indices for the disease.
https://www.slideshare.net/singh_br1762/r0-value-herd-immunity
next is formulating objectives of the programme and involvement of health care workers to execute the programme
An important step is to perform a standard community health assessment to understand the community's health status, health resource needs related to the disease (e.g. which other community partners are providing screening, testing, surveillance, and treatment). Using the results of the community health assessment, creating a health improvement plan and incorporating the plan into the strategic plan of the organization are some important best practices.
Dear Singh
Good question that is not always understood by many policy makers and planners.
This is not a work of one person at all. Rather it is a team work.
The first step is a thorough situational analysis and environmental examination to gather information about:
.a. Population size, age and sex composition
b. epidemiological analysis of morbidity and mortality. Define the types of problems, extent, severity, causes and impact on the community as a whole.
c. identify financial, manpower, legal, ethical and other constraints.
d. Identify complaints and expectations of the population.
e. Available health care facilities (for training and services delivery).
The second step is to decide on priorities. To decide on which problem to prevent first, when we have limited resources and we face more than one problem. The usual criteria used in this context are
- Extent of the problem.
- Severity of the problem.
- Manageability of the problem.
- Community concern about the problem.
The third step is to state clearly the short-term and long-term objectives or goals to be achieved. These are the desirable end results of an action. They are the guide to action and the yard stick to measure work after it is done. It is preferable that objectives are phrased in quantitative and measurable terms and made logical and feasible within available resources.
The fourth step is to explore and formulate alternative strategies to be adopted: their feasibility, operational choice and the likely outcome and cost of each alternative is carefully studied.What methods are available to prevent a particular disease?
The fifth step. Once these alternative strategies are fully explored, an operational plan or programming is selected. The allocation of resources, authority, time - tabling and monitoring system is decided upon.
The sixth step. The selected programme or plan is then implemented and the collection of monitoring data is initiated. At this phase, the effects of the programme on clients and on adjacent systems such as the housing and educational systems are also evaluated. Any deviation from the planned activities is sorted out and corrective measures are undertaken. Implementation requires effective organization and adequate resources.
The seventh step. The last step in the planning process is evaluation, which might be applied at three stages of the planning process:
a. Prior to plan implementation: evaluation of the plan itself. Is it going to work and achieve the stated objectives?
b. During implementation (monitoring). Day to day follow up of activities. Is the plan achieving the stated objectives?
c. At the end of the implementation: Final evaluation. Has the plan achieved the stated objectives?
For evaluation purposes of disease prevention one might suggest indicators of success like herd immunity, reduction in incidence, severity or mortality due to the targeted disease (s).
Thank you, Dr. Habib, I may be using your tenets in my lectures with your kind permission.
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