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Comunity Medicine

Comunity Medicine

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Published by api-3831375
a guide to second proff
a guide to second proff

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Published by: api-3831375 on Oct 18, 2008
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03/18/2014

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Question 1
Briefly describe new philosophy of health. Write determinants of health

New philosophy of health
1. Health is a fundamental human right
2. Health is the essence of productive life, and not the result of ever increasing expenditure of medical care
3. Health is intersectoral
4. Health is an integral part of development
5. Health is central to the concept of quality of life
6. Health involves, state and international responsibilities
7. Health and its maintenance is a major social investment
8. Health is a world wide social goal

DETERMINANTS OF HEALTH
The factors which influence health lie both within the individual and externally in the society in which he or
she lives are collectively known as determinants of health
1. Heredity

a). physical and mental traits are determined by an individuals genes
b). disease of genetic origin
e.g.: mental retardation, hemophilia

2. Environment
a) Internal(tissue & organ)
b) External (macro environment)

Those things which man is exposes to after conception
\u2022
Physical \u2013 water, housing
\u2022
Biological-man, animal, microorganism
\u2022
Psychosocial-stress , family
3. Life style
\u2022
the way people live
\u2022
cultural pattern
\u2022
personal habits - harmful life style-smoking
Healthy life style-exercise
4. socio-economic condition

a) Economic status
Determines purchasing power, standard of living, quality of life family size & pattern of disease and deviant
behavior in the community

b) Education (especially female education)
Illiteracy
poverty
poor health
c) Occupation
Employment
promotes health
Unemployment ill health
5. Health and family welfare services
\u2022
Immunization
\u2022
Safe water supply
\u2022
MCH service
6. Other factors
Health related factors e.g. agriculture, Education, social welfare
Question 2.
Describe levels of health care, write features of ideal health care delivery system

Levels of health care
Health care services are normally organized at three levels , each level supported by a higher level
to which the patient can be referred

1. Primary health care
First level of contact between the individual and the health system. Essential health care is
provided.
E.g.: thana health complex and their union sub centers

2. Secondary health care
More complex problems are dealt with, care comprises essentially of curative services. Eg: district
hospitals
First referral level of health systems

3. Tertiary healthcare
Super specialist care provided by regional or central level institutions
Eg: medical college hospitals
Referral support for primary and secretary levels

Features of an ideal health care delivery system
1. Appropriateness: whether the service is needed at all in relation to essential human needs at all in

relation to essential human needs, priorities and policies
2. Comprehensiveness: optimum mix of preventive curative and promotional service
3. Adequacy: if the service is proportionate to the requirement
4. Availability: ratio between administrative unit and the health facility

E.g.: doctor population ratio

5. Accessibility: Geograpghic ac
6. Affordability: Cost of health care should be within the individual and the state.
7. Feasibility \u2013 Operational efficiency of certain procedures, logistic support, man power

Question 3
Define screening. write comparison between screening test and diagnostic test
Definition of screening
The search for unrecognized disease or defect by means of rapidity applied tests, examinations or

other procedures in apparently health individuals
Eg:pap smear for cervical cancer
Chest x-ray for TB

Comparison between screening test and diagnostic test
Screening test
Diagnostic test
1. Done on apparently health
1.Done on those with indications or sick
2. Applied to groups
2.applied to single patients, disease consider
3. Based on one criterion
3.based on evaluation of a number of symptoms,
signs, and laboratory findings
4. Less accurate
4.less accurate
5. Less expensive
5.more expensive
6. Not a basis for treatment
6.used for basis for treatment
7. The initiative comes from the investigator
or agency providing care
7.the initiative comes from a patient with a com-
plaint

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