•Department of Community Department of Community MedicineMedicine

UHS ExamUHS Exam• THEORYTHEORY::• SEQs:SEQs: == 7070• MCQ:MCQ: == 6565• Internal Assessment:Internal Assessment: == 1515

•Total:Total: 150150

VIVA/PRACTICALVIVA/PRACTICAL::• OSPE:OSPE: == 10×410×4 == 40 40

MarksMarks• Research activityResearch activity == 1010• House Hold ServeyHouse Hold Servey == 0505• Field VisitsField Visits == 0505• Press CuttingPress Cutting == 0505• Internal AssessmentInternal Assessment == 1515• Internal Internal == 3535• ExternalExternal == 3535• Total:Total: ________________

150150

HEALTHHEALTH

A state of complete A state of complete physical, mental and physical, mental and

social well being and not social well being and not merely the absence of merely the absence of

disease or infirmity and disease or infirmity and ability to lead a socially ability to lead a socially

and economically and economically productive life.productive life.

PUBLIC HEALTHPUBLIC HEALTHThe Science and art of preventing The Science and art of preventing

disease, prolonging life and disease, prolonging life and promoting physical and mental promoting physical and mental health and efficiency through health and efficiency through

organized community efforts for organized community efforts for the sanitation of the environment, the sanitation of the environment,

control of communicable control of communicable infections, education of the infections, education of the

individuals and the organization individuals and the organization of medical and nursing services of medical and nursing services for the maintenance of health.for the maintenance of health.

PREVENTIVE MEDICINEPREVENTIVE MEDICINEIt is a branch of medicine which It is a branch of medicine which deals with healthy people. deals with healthy people. It is the science and art ofIt is the science and art of

Promotion of physical and Promotion of physical and mental mental health, health,

Prevention of diseases,Prevention of diseases, Disability limitation andDisability limitation and Prolonging life and efficiency.Prolonging life and efficiency.

SUCCESSES OF SUCCESSES OF PREVENTIVE MEDICINEPREVENTIVE MEDICINE

• Bacterial Vaccines Bacterial Vaccines and anti seraand anti sera

• Antiviral vaccinesAntiviral vaccines• Synthetic InsecticidesSynthetic Insecticides• Nutritional Deficiency Nutritional Deficiency

DiseasesDiseases• ChemoprophylaxisChemoprophylaxis• Mass drug treatmentMass drug treatment• Screening of Diseases Screening of Diseases

& risk factors& risk factors

• Prevention of chronic Prevention of chronic & Degenerative & Degenerative diseasesdiseases

• Hereditary DiseasesHereditary Diseases• Geriatric ProblemsGeriatric Problems• Disease EradicationDisease Eradication

• Population explosionPopulation explosion• Education of peopleEducation of people• Anticipatory MedicineAnticipatory Medicine

It is an art and science of It is an art and science of application of technical knowledge application of technical knowledge and skills to the delivery of health and skills to the delivery of health

care to a given community designed care to a given community designed in collaboration with related in collaboration with related

professions as well as human and professions as well as human and social sciences on the one hand and social sciences on the one hand and

the community on the other.the community on the other.

COMMUNITY MEDICINE

DETERMINANTS OF DETERMINANTS OF HEALTHHEALTH

• Health is multifactorialHealth is multifactorial• In the individual – Genetic In the individual – Genetic make upmake up• In the environmentIn the environment• Health promoting Health promoting deleterious effectdeleterious effect

BIOLOGICAL BIOLOGICAL DETERMINANTSDETERMINANTS

• Physical & mental traits – genes Physical & mental traits – genes • Genetic make up is uniqueGenetic make up is unique• Genetic Diseases – chromosomal Genetic Diseases – chromosomal

abnormalitiesabnormalities- Errors of Metabolism - Errors of Metabolism - Mental Retardation- Mental Retardation- Diabetes & CVD.- Diabetes & CVD.

Health:Health: a state which is based upon the a state which is based upon the absence from genetic constitutional absence from genetic constitutional serious defects and presence of normal serious defects and presence of normal chromosomal characterization to express chromosomal characterization to express potential of his genetic make up.potential of his genetic make up.

Behavioural and Socio-cultural Behavioural and Socio-cultural ConditionsConditions

Life style the way people live Life style the way people live Social values, attitudes & activities Social values, attitudes & activities Personal habitsPersonal habits Behaviours – promoting healthBehaviours – promoting health Adverse effects on health Adverse effects on health Association between health & life styleAssociation between health & life style Health problems Health problems

DevelopedDeveloped- - CHD CHD - Lack of sanitation- Lack of sanitation- - ObesityObesity - Poor nutrition- Poor nutrition- Lung cancers - Lung cancers - Personal hygiene- Personal hygiene

- Addiction- Addiction - Human habits - Human habits

- Physical activity- Physical activity- Smoking & Addiction- Smoking & Addiction

Environmental DeterminantsEnvironmental Determinants

- Internal- Internal

- External - External - Physical - Physical

- Biological- Biological

- Psychosocial - Psychosocial

- - Direct impact on health - Direct impact on health - favourablefavourable

- Unfavourable - Unfavourable

- Protection & Promotion of family - Protection & Promotion of family and and environmental healthenvironmental health

Socio-economic Socio-economic ConditionsConditions

• S.E developmentS.E development• Per capita Income, GNPPer capita Income, GNP• EducationEducation• NutritionNutrition• Employment/OccupationEmployment/Occupation• HousingHousing• Political SystemPolitical System

Health ServicesHealth Services• Personal & family servicesPersonal & family services• Community servicesCommunity services

ForFor- Treatment of diseases- Treatment of diseases- Prevention of diseases- Prevention of diseases- Promotion of health- Promotion of health- Improve health status of people- Improve health status of people- Decrease- Decrease

– – MorbidityMorbidity _ Mortality_ Mortality

• ServicesServices- Social periphery- Social periphery- Equitable distribution- Equitable distribution- Accessible to all- Accessible to all- Affordable cost- Affordable cost- Socially acceptable- Socially acceptable

Aging of the Aging of the populationpopulation

•In world more than one In world more than one billion in 2020billion in 2020

•Two third in developing Two third in developing countriescountries

•Increase in chronic diseases Increase in chronic diseases •Increase in disabilitiesIncrease in disabilities

GenderGender• Increased conc. Of women’s issueIncreased conc. Of women’s issue• Action on women’s health forAction on women’s health for

- Nutrition- Nutrition

- Reproductive health- Reproductive health

- Health consequences of violence- Health consequences of violence

- Life style & related conditions- Life style & related conditions

- Ageing- Ageing

- Occupational environment- Occupational environment

HEALTH FOR ALLHEALTH FOR ALL

• The main social target of govt. The main social target of govt. and WHO is “attainment by all and WHO is “attainment by all citizens of the world by the year citizens of the world by the year 2000 a level of health that will 2000 a level of health that will permit them to lead socially and permit them to lead socially and economically productive life.economically productive life.

It was social goal for all It was social goal for all GovernmentsGovernments

Health IndicatorsHealth Indicators Measure Health status of a Measure Health status of a

Community/countryCommunity/countryComparison of health status between Comparison of health status between

two communities/Countries.two communities/Countries. Assessment of health care needs Assessment of health care needs Allocation of scare resourcesAllocation of scare resources Monitoring & Evaluation of health Monitoring & Evaluation of health

services, activities & programmes.services, activities & programmes. The extent to which the objectives & The extent to which the objectives &

targets are being attained.targets are being attained.

Mortality IndicatorsMortality Indicators

• Crude death rateCrude death rate• Expectation of lifeExpectation of life• Infant mortality rateInfant mortality rate• Child mortality rateChild mortality rate• Under -5 Mortality rateUnder -5 Mortality rate• Maternal mortality rateMaternal mortality rate• Disease specific mortality rateDisease specific mortality rate• Proportional mortality rateProportional mortality rate