Introduction-to-Community-Medicine

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COMMUNITY MEDICINE
AN INTRODUCTION
By
Dr Mahmood Ur Rahman
Professor of Community Med
1
Community Medicine
 The field concerned with the study of
health and disease in the defined
community or group.
 Its goal is to identify the health problems
and needs of people (community
diagnosis) and to plan, implement and
evaluate the effectiveness of health care
system.
2
GOALS OF MODERN MEDICINE
 Focus shift from treatment of sick
 Prevention of Diseases
 Promotion of health
 Quality of life improvement for individuals
& groups
3
Five Star Doctor
Leader
Manager
Care Provider
Communicator
Decision Maker
4
Knowledge regarding
Population to be served
Study of :
Demography
Patterns of Health and disease Epidemiology
Collection, compilation and
analysis of data
Biostatistics
Behavioral factors and their
effect on Health
Behavioral sciences
Control and prevention of
diseases
Preventive Medicine
The food people eat
Nutrition
Environmental factors and their Environmental Health
effects on Health
Delivery of Health Care
Health Administration and
Planning
5
EXAMINATION PATTERN
6
Assessment System (Annual)
 TERM TESTS: 02
 PRE-ANNUAL EXAM
 ANNUAL EXAM
 Viva and spotting
 PBL (Problem Based Learning)
7
Annual Examination
Marks of Written Paper
:
135
Time Allowed = 3 Hrs
(Including MCQs)
Marks of Internal Assessment
:
15
Max Marks :
150 Pass Marks :
75
 Written paper will comprise of two parts
(A & B)
 Q–1 (MCQ) (one best out of five items type from
whole course, on separate sheet (Time 30 Min) : 30
Marks
8
Part – A
SEQs/SAQs (15 Marks each)
Q–2 PBQ Whole course
Q–3 Epidemiology (Gen & Spec) + Screening of
Diseases
Q–4 Statistics
Q–5 Communicable / non communicable diseases
9
Part – B
SEQs/SAQs (09 Marks each)
Q–6
Q–7
MCH and family planning / demography
Nutrition /
Entomology / Parasitology / Health
Education/
Occupational Medicine/ Social /
Behavioral Sciences
Q–8 Water / Environmental Health
Q–9 Accidents / Disasters / Smoking / / Substance
abuse
/ School Health / Mental Health /
Geriatrics /
Housing/ Snake bite
Q–10 HMIS / Medical Ethics / PHC / International Health /
Concept of Health and disease / Planning and Management
10
Allocation of Marks
Written Paper Max Marks:
Internal Assessment:
135 Marks
15 Marks
(Based on marks obtained in Theory Papers of Term Tests and
Pre Annual exam)
Sub Total:
150 Marks
11
Oral & Practical
Max Marks:
150
Viva:
100 Marks
Spotting:
10 Marks
Project: Day Book/Visit Book/Entomology/
Research
25 Marks
Internal Assessment:
PBL/ Viva Pre Annual:
15 Marks
Sub Total:
150 Marks
Grand Total:
300 Marks
12
COURSE CONTENTS
13
The complete course of Community
Medicine is according to the laid
down Syllabus issued by PMDC
14
Core Contents
 Concepts of Health and disease
 Introduction to Public Health and Health
Systems in Pakistan
 Epidemiology , Screening and Infectious Disease
Control
 Non Communicable Diseases
 Biostatistics and HMIS
 Demography and Population Dynamics
 Food and nutrition
 Reproductive and Child Health
15
Core Contents….
 School Health Services
 Environmental health
 Occupational Health
 Parasitic Diseases – Prevention and control
 Zoonotic diseases
 Arthropods of Public Health Importance
 Mental Health
 Behavioral Sciences
 Health Education and Promotion
 Disaster Management
 Medical Ethics
16
Concept of Health and Disease
 Dimensions and Spectrum of
Health
 Determinants of Health
 Health Indicators
 Primary Healthcare Concept
17
Introduction to Public Health &
Health systems in Pakistan
 Background and concepts
 Development of Public Health in Pakistan
 Economics and Health
 Health Policy and Planning in Pakistan
 Health System in Pakistan
18
Epidemiology and Disease Control
 Background and concepts, uses
 Basic measurements in epidemiology
 Epidemiological methods, association and
causation investigation of epidemics, screening for
disease Research and survey methodology
 Definitions: infection, contact, host, carriers
19

Dynamics of infectious disease transmission
Control of infection
Epidemiology, control and prevention of
infectious diseases of public health importance
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Diseases transmitted through inhalation
Diseases transmitted through faeco-oral route
Diseases of animals conveyed to man
Diseases due to direct contact
20
Epidemiology, Control and Prevention of Noninfectious Diseases of Public Health Importance
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Hypertension
Coronary heart disease
Cancers
Injuries
Diabetes Mellitus
Obesity
Acute Rheumatic fever
Ischaemic heart diseases
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Biostatistics
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Concepts and uses
Data and its types
Rate, ratio and proportion
Crude, specific and standardized rates
Collection and registration of vital events in Pakistan
Sources of health related statistics
Measures of central tendency
(Mean, Mode, Median)
22
Demography and Population Dynamics
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Concept, Principles, Demographic processes
Census, definition, types, methodology
Determinants of fertility, mortality
Population pyramid and its interpretation
Demographic transition, demographic trap
Demographic & social implications of high
population growth
Social mobilization
Urbanization
23
Food and Nutrition
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Concepts of Nutrition
Malnutrition at all stages of life
Dietary requirements
Food hygiene, pasteurization, fortification,
adulteration and preservation
Food poisoning
Assessment of nutritional
status of Community
24
Reproductive and Child health
 Safe motherhood & its components
 Maternal mortality, causes and prevention
 Infant care, growth & development,
breast feeding, common causes of morbidity and
mortality, their prevention and control
 IMCI (Integrated Management of Childhood
Illness)
 Adolescent health
 Reproductive tract infections,
managing STDs
25
Health of School age Children
 Role of teachers and role of doctors in
maintenance of health
 Procedures for determining the health status
of school children
 Common health problems of school children
26
Environmental Health
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Air Composition, pollution, purification, diseases
caused by air impurities & their prevention
Water, Sources, daily requirement, causes of pollution,
its prevention, purification, quality
standards,
diseases
due to polluted water
Waste Disposal, Hazards and Safety Measures
Radiation sources, types, causes, hazards,
prevention
Healthful housing, urban & rural slums, Refugee camps
and hostels
Noise, causes, acceptance level,
hazards and control
27
Occupational Health
 Concepts of occupational Health and
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Medicine
Ergonomics and its Importance
Occupational Hazards
Principles of prevention and Control
Organization of Occupational Health Services
Health insurance and Social Security Schemes
28
Arthropods and Their Public Health
Importance
 Common arthropod borne diseases
 Control of arthropod of medical
importance
 Insecticides and their public health
importance
29
 Prevention and control of parasitic
diseases of public health importance
 Snake bites, personal protection and
management
30
Mental Health

Concept, common mental health
problems, causes and prevention

Juvenile delinquency
31
Behavioural Sciences and Life Style
 Concept, attitudes, health and illness
behaviour
 Drug abuse, addiction and smoking
 Child abuse and child labour
 Role of physical exercise in health and
disease
32
Information, Education and
Communication (IEC)
 Concept, aims & objectives
 Approaches used in public health
 Contents, principles & stages of health
education
 Communication methods, barriers, and skills
in health education
 Planning, organizing and evaluating a health
education programme
 Social marketing
33
Disaster
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Definition, classification
Natural Disasters like Earthquakes, Floods
Epidemic of communicable diseases
Man made disasters
Accidents, thermonuclear warfare, causes and
prevention
 Magnitude and effects of Disaster and Public
Health consequences
 Disaster preparedness and management
34
Medical Ethics
 Background concepts and components
 National recommended guidelines
 Code of Medical Ethics
35
Practical and Community Based Training
Students should have practical experience in:
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Questionnaire development
Data collection
Compilation
Presentation
Analysis
Report writing
36
Field Visits
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Visit to BHU and RHC
Visit to an NGO
Visit to a primary school to assess the nutritional
status of school children
Visit to MCH/Reproductive Health Centre to observe
the organization, function of the centre, Antenatal
care, FP services & Immunization
Visit to a hospital to see the hospital waste disposal
Visit to an industry
Visit to a physical/mental/social rehabilitation centre
37
Skills Development Lab
 Water purification at domestic level
 Contraceptives
 Vaccination including the
cold chain
 Oral Rehydration solution
38
Recommended Reading
 Park’s Text Book of Preventive and Social
Medicine by K Park
 Public Health and Community Medicine by
Ilyas and Ansari
 Lecture Notes
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