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community medicine An Introduction

By Dr Mahmood Ur Rahman Professor of Community Med. community medicine An Introduction. Community Medicine. The field concerned with the study of health and disease in the defined community or group.

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community medicine An Introduction

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  1. By Dr Mahmood Ur Rahman Professor of Community Med communitymedicineAn Introduction

  2. 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.

  3. GOALS OF MODERN MEDICINE • Focus shift from treatment of sick • Prevention of Diseases • Promotion of health • Quality of life improvement for individuals & groups

  4. Five Star Doctor Leader Manager Care Provider Communicator Decision Maker

  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 – ASEQs/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 – BSEQs/SAQs (09 Marks each) Q–6 MCH and family planning / demography Q–7 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: 135 Marks Internal Assessment: 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 • 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 Non-infectious Diseases of Public Health Importance • Hypertension • Coronary heart disease • Cancers • Injuries • Diabetes Mellitus • Obesity • Acute Rheumatic fever • Ischaemic heart diseases

  21. Biostatistics • 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 • 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 • 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 • 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 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 • 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: • Questionnaire development • Data collection • Compilation • Presentation • Analysis • Report writing

  36. Field Visits • 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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