Special need group ELDERLY
Part one: Defining needs and needs assessment
What is a needs assessment?
A needs assessment is a systematic process that provides information about social needs or issues in a place or population group and determines which issues should be prioritised for action. The term ‘social issue’ as used here is intended to be deliberately broad and essentially denotes an identified problem in a place or population. Social issues, or ‘needs’, can include health-related topics such as the increased prevalence of poor mental health in a population or high smoking rates, or issues such as low levels of literacy or child development. In this context, a social need or social issue is something that can be addressed by service providers (or community members in a community development initiative), so a needs assessment gathers information about the issue that can then inform service provision or policy development.
A needs assessment in this context moves beyond individual assessment and explores the needs of a community. Community is frequently defined in terms of a geographical area but a needs assessment could also explore the needs of a specific population group; for example, the needs of single-parent families. A needs assessment in a geographical area may also have a focus on priority population groups; for example, Aboriginal and Torres Strait Islander people.
Needs assessment is most often undertaken in order to allocate or redistribute resources and design programs, policies and services. However, needs assessment can also be considered as a form of evaluation, or as a component of program evaluation, because it involves collecting information in order to make an evaluative judgement about what needs exist in a community, what needs should be prioritised and how a particular policy, service, program or suite of activities will address those needs. A needs assessment can also provide baseline data that can be used in an evaluation.
Importantly, a needs assessment is best undertaken as a systematic process (Altschuld& Kumar, 2005; Rossi, Lipsey, & Freeman, 2004):
- Decisions are made about the scope of the needs assessment.
- There is a plan to collect information.
- Data are collected and analysed.
- These data are used to determine priorities and make decisions about resource allocation, program design and service delivery.
In practice, needs assessments are often done informally. For example, a number of clients might present with similar issues that are not met by current services, a gap in service delivery may be observed, or a new client group becomes known, and something is designed to address these issues. Without a systematic process of needs assessment that includes multiple forms of evidence, this ad hoc method of meeting client need can eventually result in a fragmented service system that may not be making the most effective use of scarce resources. There may also be client or community needs that are less visible and so not being met. Undertaking a systematic needs assessment is a transparent and defensible way of ensuring that resources are being used in the most effective way possible.
Why and when should you do a needs assessment?
It is critical that services, policies and programs are as relevant and effective as possible. Without planning, services and programs are likely to be reactive and fragmented, and not working strategically or with a prevention focus (Baum, 2008). In the absence of a planned and systematic approach, the allocation of resources is subject to political pressures, personal preferences, ‘what has always been done’ and the intuition of staff (Owen, 2006). While practitioners, policy makers and agency leaders are often skilled and knowledgeable, practice wisdom is only one form of evidence and everyone may have their own biases based on their personal experience. Someone who works in child protection and sees many cases of child abuse and neglect, for example, may consider this the most important issue in a community. In contrast, someone who works in the mental health field may consider mental health the most important community issue (Rossi et al., 2004). A systematic needs assessment ensures that programs, policies and services are cohesive, equitable and informed by multiple forms of evidence, making them truly responsive to community need. Figure 1 shows the three forms of evidence that are understood as making up an evidence-informed approach: lived experience, practice expertise and research evidence. A robust and systematic needs assessment should include each of these three types of evidence.
Figure 1: Evidence-informed approach
Source: Hunter &Carlow, 2018
There are a range of benefits to conducting a needs assessment:
- A needs assessment contributes to the quality and effectiveness of programs, policies and services through ensuring that they are relevant, practical, credible and appropriate (Sleezer, Fuss-Eft, & Gupta, 2014).
- A needs assessment is an important component in an evidence-informed approach because the understanding of community needs provides an evidence-based foundation for a program, policy or service (Hawtin& Percy-Smith, 2007).
- A needs assessment can facilitate more prevention and early intervention work through services, policies and programs being less reactive (Baum, 2008).
- A needs assessment ensures that services and programs are based on accurate and systematically collected information (Sleezer et al., 2014).
- The process of the needs assessment can build relationships among stakeholders and build support for action (Sleezer et al., 2014).
- A needs assessment can support evaluation – through developing an understanding of community needs an evaluation can then measure whether these needs were met (Rossi et al., 2004).
- When community members are supported to define their own needs through a needs assessment process, this can contribute to citizen empowerment (Ife, 2002).
A needs assessment is generally used to plan new work; for example, to determine what should be delivered in a geographic region or with a particular population group. However, needs change over time (Reviere, 1996). It is necessary that programs, policies and services remain flexible and adaptable. A needs assessment can therefore also assess whether current programs or services are still adequate and relevant. If demand for a program or service has diminished or increased, or the characteristics of people accessing a program or service have changed, this could be an indication that needs in the area have changed. Even where demand stays consistent, there may be new needs that are not being addressed by the current suite of programs and services. A needs assessment can ensure that the current program, policy or service is correctly targeted and addressing the most important needs of the community.
A needs assessment implies there is a gap or discrepancy between the current conditions – ‘what is’ – and the ideal conditions – ‘what should be’ (Sleezer et al., 2014). This gap – the difference between the current condition and the ideal condition – is the ‘need’ (Owen, 2006). However, needs are relative and what is necessary depends on your vantage point (Royse, Staton-Tindall, Badger, & Webster, 2009). As Ife (2016) observes, any identification of need contains an ‘implicit notion of what constitutes an acceptable minimum standard of personal or community wellbeing’ (p. 68). Different people have different opinions about these minimum standards, and ‘what should be’; therefore, a needs assessment is a subjective and value-driven process (Ife, 2002). While using population-level data can provide a more objective assessment of issues in a community, decisions about what data are used and how can have an impact on the needs that are identified and prioritised, and determining the ‘acceptable minimum standard’ of wellbeing and what constitutes a need often remains unavoidably value-driven and subjective.
In social services, most needs are value-driven and there can be differences of opinion about the ideal condition (Altschuld& Kumar, 2005). When compared with health, for example, needs assessment in social services is complex. In health, the ‘acceptable minimum standard’ is often more clearly defined and easier to measure; for example, there is a weight range within which newborn babies are considered healthy. If a newborn infant weighs under this range then it is considered underweight and steps are taken to bring the infant up to the healthy weight range. However, a concept such as ‘family functioning’ is more subjective and harder to define and agree on.
The challenges of identifying and understanding needs have been recognised by theorists and evaluators who have developed different ways to conceptualise needs (e.g. Bradshaw, 1972; Davidson, 2005). One of the most enduring conceptualisations of needs was described by Bradshaw (1972), who identifies four types of need
|Need||Definition||Example||Strengths and limitations|
|Normative need||Normative need is measurable against accepted standards, research or expert opinion (Bradshaw, 1972).||There is an accepted range for the healthy birthweight of babies. If there is a large number of babies in a community born outside of this range, this is an area of need for a community.||A normative definition of need isn’t absolute, and needs can change over time as a result of gaining new knowledge or shifting social expectations (Bradshaw, 1972).|
|Felt need||Felt need is what people feel that they need and is often equated with want.||Community members identify a need for more peer support with parenting.||Felt need is particularly important in community development initiatives or in projects with a high degree of community engagement. Felt need is subjective, and is limited by the perceptions of the individual; people may not wish to be seen as ‘needy’ or lacking, or they may have limited knowledge of what is available and attainable (Bradshaw, 1972).|
|Expressed need||Expressed needs are those that people have acted on. Bradshaw (1972) refers to expressed need as ‘need turned into action’ (p.3).||There is a long waiting list for financial counselling and many clients are asking for advice with debt.||Expressed need generally paints a limited picture of need because not everyone will act on their needs.|
|Comparative need||Comparative need examines the data on a population and compares them with data about service availability and service access to determine need (Bradshaw, 1972).||Data on the numbers of people with a disability are compared with data on the number of disability services. Data between different regions may also be compared. This strategy is often combined with risk profiling; e.g. the characteristics of families deemed at risk of child abuse and neglect may be defined, and then data collected on the numbers of families who meet these characteristics who are not being reached by services.||The presence of services, even where they are being accessed, does not mean that needs are being met.|
Needs and power: Who conceptualises and assesses need?
Underlying definitions and conceptualisations of need are questions about power, voice and visibility. Who is making decisions, and who has a ‘seat at the table’? There is no right or wrong way to conceptualise need, and each or all of these definitions of need may be relevant to different projects. As outlined above, defining and assessing needs is value-laden and subjective. It is important to consider who is involved in a needs assessment, and how they are involved, as the inclusion or exclusion of different voices may result in the identification and prioritisation of different needs.
The way need is conceptualised will also have implications for the type and method of data collection. What is important is that when undertaking a needs assessment, you give some thought to how needs will be defined and measured and who will be involved, and that this is agreed on by all stakeholders. Each approach to needs assessment, and each way of defining and measuring need has strengths and limitations. Making a conscious and transparent decision about who will be involved, and how need will be determined in your needs assessment, and documenting these decisions, are important steps to ensure rigor and transparency and the ability to justify your findings.
Part two: How to do a needs assessment
There are many possible ways to conduct a needs assessment, and the type of needs assessment undertaken should be appropriate for the scale of policy or service provision that it is designed to inform. For example, a large-scale service reform or strategy may require an extensive and well-resourced needs assessment whereas planning for a single program might only require a rapid needs assessment completed with minimal resources.
Part two of this resource describes one way to approach a needs assessment. This step-by-step process can be followed or adapted to undertake a systematic needs assessment. This process has been developed based on a synthesis of the research and practice literature and draws from common practice in the social services and public health sectors. Drawing on Altschuld and White (2010) and Rabinowitz (2017), the steps of a needs assessment are laid out in the image below.
A needs assessment is a systematic and transparent process that identifies and prioritises needs in a community in order to inform programs, policies and services aimed at addressing those needs. A needs assessment can be undertaken to plan new work and to better understand the context for existing work. Determining needs is a subjective process as different people are likely to have different views on what is required for community wellbeing. Using multiple forms of evidence and ensuring that community members, subject matter experts, and holders of practice wisdom are all involved in the needs assessment process will ensure that a full range of issues are identified. Conducting regular needs assessments ensures that programs and services are effective and reflect the best use of resources. Policy, strategy and interventions that have been informed by a needs assessment will be better targeted, planned rather than reactive, and aligned with community need, agency and regional priorities and resources.
Needs assessment is a systematic and reproducible process of determining and prioritising needs in a community for the purpose of taking action. There are many benefits associated with undertaking a needs assessment, including building more relevant and effective programs and services and enabling a more systematic and transparent distribution of resources.
Needs assessments can be small or large, and the scope and methods of a needs assessment depends on the purpose and the available resources. It is important to develop a plan and have clear criteria for assessing needs before data are collected. While this resource has presented a set of steps that can be followed, in practice a needs assessment may not always be a structured, linear process as presented here; the process is likely to be more iterative and flexible to reflect the complexities of working on the ground (Royse & Badger, 2015).