WHO definition of community medicine
A system of delivery of comprehensive healthcare
To the people by a health team
In order to improve the health of community
Define community
It is defined as a large number of people
Living together in a defined geographical area
Having common interests, goals and ways of life
Define medicine
A branch of science
Which deals with the dx , rx and maintenance of health
Define comprehensive health care
It refers to the provision of personal and impersonal health services to the community
For the
prevention of disease
cure of illness
prevent disability
and economic insecurity
and dependency
associated with illness
Personal health services egs
Directly affecting individual
School health
Occupational health
Mother and child health
Impersonal health services egs
Indirectly affecting individual
Water supply
Sanitation
Drainage
Housing
Professor Winslow's definition of Public Health
The science and art of
preventing disease,prolonging life and promoting physical and mental health and
efficiency
Through organized community efforts for :
- the sanitation of the environment
-Organizing the medical and nursing services for the early diagnosis, prompt treatment
of disease and prevention of disease
-the development of the social machinery that will ensure to every individual in the
community a standard of living adequate for the maintenance of health
What is community diagnosis?
Identification and quantification of health problems in a community in terms of mortality and
morbidity rates and ratios for the purpose of defining those who are at risk and those who are in
need of health care
What is a program (UQ)
Its types (with example)
Program is an ongoing activity which is carried out for an indefinite period of time till achievement of
objectives according to specifications
Eg ; EPI (expanded program of immunisation)
Types of program
1. Vertical program
A single program of health service for the community
In this program , staff focuses on only one activity
Eg ; EPI , AIDS control program , TB control program, leprosy control program
[Link] Program
A health service program that covers two dimensions of health ie. Personal health and community
health
Examples:
●Social Action Program I (SAP-I) (deals with primary healthcare, sanitation, primary education, water
supply , family planning)
●Social Action Program II (SAP - II)
●National program of family planning
●Benazirs program
When a vertical program is merged with another program it becomes a horizontal program
Define
Disease control
Disease elimination
Disease Eradication
Disease control
Operation aimed at reducing the incidence, duration , effects , complications and financial burden of disease
The agent is permitted to persist in the community at a level where it ceases to be a public health problem
Disease elimination
It is a regional process , involving interruption of the chain of transmission of a disease
Eg: elimination of measels or polio from a large geographical area
Disease eradication
It is a global process. It involves termination of all transmission by extermination of the infectious agent
The only disease which has been eradicated is Smallpox (eradicated in 1980)
What is natural history of a disease and its phases
(defta) = Natural history of a disease means the way disease is going to unfold itself in the absence of treatment and prevention
It has 2 phases
1. Pre pathogenesis phase
For disease to occur 3 factors are needed(called epidemiological triad)
Agent
Host
Environment
If any one is missing disease will not occur
In pre pathogenesis phase all 3 exist but they are isolated
When they start interacting we move to next phase
2. Pathogenesis phase
(IPSR)
Incubation period
Prodromal period
Specific disease period
Recovery period
What is epidemiological triad? (UQ)
Enumerate its factors?
Three factors which interact to cause disease:
Agent
Host
Environment
Agent factors
Can be living (pathogenic microbes)
Non living (chemicals )
●Biological agents (bacteria , virus etc)
●Nutrient Agent (excess or deficiency of any nutritient may cause disease
●Physical (heat , cold , pressure etc)
●Chemical (endongenous as in uremia , ketosis OR exogenous as in allergens , dusts)
●Mechanical agents (crushing , friction etc)
●Social agents (poverty , smoking etc)
Host factors Demo BLS
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Environmental factors (DIE)
What are the levels of prevention of disease and
modes of intervention ? (uq)
A disease can be prevented at 4 levels :
They are called
1. Primordial prevention
2. Primary prevention
3. Secondary prevention
4. Tertairy prevention
The modes of intervention which are used at various levels of prevention are 5 , they are
1. Health promotion
2. Specific protection
3. Early diagnosis and promt treatment
[Link] limitation
[Link]
Explanation is in other cards
Expalin the levels of prevention of disease
There are 4 levels
1. Primordial prevention UQ
It is prevention of chronic diseases (ed HTN , cancer , DM)
It is aimed at educating children to adopt healthy lifestyles so that risk factors for diseases (obesity , HTN)
[Link] prevention
It is prevention in the pre pathogenesis phase to prevent disease from occuring
It is better than secondary and tertiary prevention (because they occur in pathogenesis phase , when disease
has already occurred, and controlling it becomes mkre difficult and expensive)
It follows the concept of positive health (not only prevention of disease but promoting good health in general)
It has 2 approaches
Population (mass) strategy (aimed at whole population ) and high risk strategy (aimed at only
those people who are at high risk of a disease )
3. Secondary prevention
It is done in early pathogenesis phase
Aim is early diagnosis and prompt treatment of disease to prevent complications
More expensive and less effective than primary prevention
4. Tertiary prevention
It occurs in the late pathogenesis phase
Its aims are;
To prevent or minimiza disability due to disease
To Minimize suffering
And rehabilitation after disease (making person able to take care of himself and live a relatively
normal life after permanent disability has occured)
Basically in primordial prevention you prevt risk factors befor they occur
In primary prevention risk factors have occured now you prevent disease in those who have risk
factors
In secondary prevention disease has occureed and you try to prevent complications
In tertiary prevention you try to limit disability due to the complications and try to make the patient
accustomed to the new life
All of this is achieved by 5 modes of prevention
Note on modes of intervention
n
There are 5 modes of intervention to control diseases
E Have 1. Health promotion
Periodic Group. It involves
●Health education (most important component )
●Environmental modifications (safe wtaer , sanitary latrines etc)
●Nutritional interventions(providing nutrition to high risk groups like pregnant women , adolescents
etc)
●Periodic medical examination
●Sex education
●Genetic counselling
●Healthy lifestyle
2. Specific protection
Immunization
Specific nutrients (eg Vit C for scurvy prevention)
Chemoprophylaxis
3. Early diagnosis and promt treatment
Early diagnosis is done by Screening
Eg ; sputum tests and mass miniature radiography for TB
4. Disability limitation
Disease may lead to impairment
Impairment leads to Disability
Disability leads to handicap
Impairment: loss or abnormality of physiological , psychological or anatomical structure (eg accident
causes loss of hand)
Disability: Inability to perform function within a range that is considered normal for a human (eg loss of
hand causes loss of ability to lift objects )
Handicap : A disadvantage resulting from Impairment or Disability, that limits or prevents the fulfilment
of a lore that is normal for that person (eg loss of job as a labourer because he cannot lift bricks)
[Link] -(UQ)
Retraining the individual to reach highest functional ability is called rehabilitation
(SO-MPV)
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What is WHO
Its main objective
Enlist its functions(UQ)
WHO = WORLD HEALTH ORGANISATION
formed 7th april 1948
Headquarters in Geneva (Switzerland)
Main objective
* Attainment of highest level of health by all people
Functions : -
(NAME
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What is Unicef
Its functions
UNICEF = United Nations International Childhood Emergency Fund
Formed in December 1946
Fuctions:
one
WHEN mnemonic
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Welfare of children
Healthcare of children
Education of Children
Nutrition of Children