LibGuides: Community Medicine (MBBS): Course Outline

Course Outline

COMMUNITY MEDICINE

CONTENTS OF CURRICULUM

1. Concept of Health & Disease Introduction to Qualitative research methodology.

Concept of health, Definition of health (Dimensions, physical, mental, social and spiritual). Spectrum of health, Determinants of health. Responsibility for health. Indicators of health.

Concept of disease. Concept of causation (all theories including ecological triad, (agent, host & environmental factors). Spectrum of disease. Iceberg phenomenon. Natural history of disease. Levels of prevention. Disease elimination and eradication. Disease surveillance.

2. Introduction to Public Health and Health Systems in Pakistan

Background and Concepts: Definitions and concepts in Public Health. Development of Public Health in Pakistan. Economics and Health. Health Policy and planning in Pakistan. “Health for all”, background, concepts and progress. “Primary Health Care”: Concepts and progress. The National Disease Control programmes; policies, strategies and operations.

Health System in Pakistan: The role of Federal and Provincial Governments in Health Care. The District Health System, in the context of devolution. The Physician as a manager: Functions of manager, management of material, human and financial resources. Leadership and motivation.

Partners in Health: The public and private sector. Non-governmental Organizations and International Agencies. Resources for health. Community Mobilization.

3. Epidemiology and disease control

General Epidemiology and Research methodology.

Background and concepts, uses, Basic measurements in epidemiology (morbidity, Mortality, disability and fatality). Epidemiological methods (descriptive, analytic and experimental). Epidemiological transition. Association and causation. Investigation of an outbreak or an epidemic. Screening for disease. Community diagnosis. Research and survey methodology.

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Introduction to Qualitative research methodology.

Prevention and control of Infectious diseases:

Definitions to differentiate between

• Infection, contamination, pollution, infestation

• Infectious disease, communicable disease, contagious disease

• Host, Immune and susceptible persons

• Sporadic, Endemic, Epidemic, Pandemic

• Epizootic, Exotic, Zoonosis

• Contact, fomites, Carriers, Insect Vectors, Reservoir of infection

• Incubation period, Infective period, Generation time

• Cross infection, Nosocomial infection, Opportunistic infections, Iatrogenic (Physician induced) disorders

• Surveillance control, Eradication, Elimination

Dynamics of infections disease Transmission:

Reservoir and source of infection, Escape of organism, Mode of transmission, Entry into the body, Susceptible host, Immunity (different types of immunity and immunization)

Control of infection:

Controlling the reservoir-notification, early diagnosis treatment, isolation, quarantine, disinfections.

Interruption of transmission.

The susceptible host (active & passive immunization, Combined. Chemoprophylaxis, Non-specific measures).

Health advice to travellers.

National case management guide lines.

i. Epidemiology, control and prevention of infectious diseases of Public Health importance.

2. Diseases transmitted through Faeco-oral route.

3. Arthropod borne diseases.

4. Diseases of animals conveyed to man.

5. Diseases due to direct contact.

ii Epidemiology, control and prevention of non-infectious diseases of Public Health importance.

1. Hypertension.

2. Coronary heart disease.

ii Epidemiology, control and prevention of non-infectious diseases of Public Health importance.

1. Hypertension.

2. Coronary heart disease

3. Cancers.

4. Injuries.

5. Diabetes mellitus.

6. Obesity.

7. Acute Rheumatic fever and heart disease.

4. Biostatistics

A. Concepts and uses

B. Data and its types

C. Rates, ratios and proportions

D. Crude, specific and standardized rates.

E. Collection and registration of vital events in Pakistan

F. Sources of health related statistics

G. Measures of central tendency, (Mean, Median, Mode),

H. Measures of dispersion (Range, Standard deviation, Standard error)

I. Normal curve,

J. Methods of data presentation (tables, graphs & diagrams)

K. Interpretation of data (t-test and Chi-square test)

L. Sampling and its various techniques.

M. Health Management Information System

5. Demography and Population dynamics

A. Concept, demographic principles and demographic processes

B. Census, definition, methodology, types

C. Determinants of fertility, mortality

D. Population Pyramid, and its interpretation

E. Demographic Transition, Demographic Trap and its public health importance

F. Demographic and social implication of high population growth

G. Social Mobilization

H. Urbanization

6. Food and Nutrition

A. Concepts (Nutrition, Nutrient, Food, Diet). Food groups and their functions. Role of fibre in diet. Balanced Diet

B. Malnutrition at all stages of life its types causes and prevention. Common nutritional problems of public health importance and their prevention and control

C. Dietary requirements of normal human being at different stages of life

D. Food hygiene, Pasteurization, fortification, additives & adulteration and preservation

E. Food Poisoning

F. Assessment of nutritional status of a Community
7. Reproductive and Child Health
A. Safe motherhood, and its components. (Ante-natal, Post-natal, Family Planning & Emergency Obstetric Care)
B. Maternal mortality, causes and prevention
C. Infant care: Growth and development. Breast feeding, common causes of morbidity and mortality, their prevention and control
D. Child Care: Health promotion strategies. Common ailments, home accidents, child mortality prevention. Strategic approaches of Integrated Management of Childhood Illness (IMCI)
E. Adolescent health
F. Reproductive tract infections: guidelines for management of STD’s
8. Health of school age children
A. Role of teachers and role of doctor in maintenance of health
B. Procedures for determining health status of school age children
C. Common health problems of school children
9. Environmental Health Sciences
A. Air: Composition of air. Causes of Air pollution. Purification of Air. Diseases caused by impurities in air and their prevention
B. Water: Sources of Water. Daily water requirement. Water pollution its causes and prevention. Purification of Water. Water quality Standards. Diseases due to polluted water
C. Waste disposal: Contents, hazards and safety measures for solid and liquid; Domestic, Industrial and Hospital waste
D. Climate: Climate and weather. Global environmental concerns (Green house effect, depletion of ozone layer, Acid rains). Effect of extremes of temperature, humidity, atmospheric pressure on human health and their prevention
E. Radiation: Sources, types, causes, hazards and prevention
F. Healthful housing. Urban and rural slums. Refugee camps and hostels
G. Noise: Definition, causes, acceptance level, hazards and control

10. Occupational Health
A. Concepts, of occupational health, occupational medicine and occupational hygiene. Ergonomics and its importance
B. Occupational hazards. Principles of control
C. General principles of occupational disease prevention
D. Organization of occupational health services
E. Health Insurance and Social Security Schemes
11. Arthropods and their public health importance
A. Common arthropod borne diseases
B. Control of arthropods of medical importance
C. Insecticides and their public health importance

12. Prevention and control of Parasitic diseases of public health importance
13. Snake Bites: Personal protection and management
14. Mental Health
A. Concept. Common mental health problems, their causes, prevention and control
B. Juvenile delinquency
15. Behavioural Sciences and lifestyle
A. Concept, attitudes, health and illness behaviour
B. Drug abuse, addiction and smoking
C. Child abuse and child labour
D. Role of physical exercise in health and disease
16. Information, Education and Communication (IEC)
A. Concept. Aims and objectives
B. Approaches used in public health
C. Contents, principles and stages of health education
D. Communication methods, barriers and Skills in health education
E. Planning, organizing and evaluating a health education programme
F. Social Marketing

17. Disaster
Definition, Classification, (Natural disasters like earthquake, floods. Epidemic of communicable diseases, Man Made Disasters. Accidents, Thermo nuclear warfare, causes and prevention).
Magnitude and effects of disaster and Public Health consequences.
Disaster: preparedness and management.
18. Medical Ethics:
A. Background Concepts and components
B. National recommended guidelines
C. Code of Medical Ethics

PRACTICAL AND COMMUNITY BASED TRAINING
I. Student should have practical experience in questionnaire development, data collection, compilation, presentation, analysis and report writing
II. Field visits
a) Visit to BHU and RHC
b) Visit to an NGO
c) Visit to a primary school to asses the nutritional status of school children
d) Visit to MCH/Reproductive Health Centre to observe the organization, and function of the centre and to demonstrate counselling skills in one of the following
• Nutritional counselling for children, pregnant and lactating women
• Antenatal Care
• Family planning services
• Immunization, others
e) Visit to a hospital to see the hospital waste disposal
f) Visit to an industry
g) Visit to a physical/mental/social rehabilitation centre
III. Skills development lab
a. Water purification at domestic level
b. Contraceptives
c. Vaccination including the cold chain
d. Oral Rehydration solution