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Lecture notes on Public Health

Presentation · February 2020

DOI: 10.13140/RG.2.2.35702.75845

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Hamze ALI Abdillahi

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Dr.HAMZE ALI
ABDILLAHI
Basic Concepts in Public Health
 DEFINITIONS IN PUBLIC HEALTH
• the science and art of preventing disease, prolonging life, and promoting
health through organized community efforts for the sanitation of the
environment, the control of community infections, the education of the
individual in personal health, the organization of medical and nursing
services for the early diagnosis and preventive treatment of disease, the
development of the social machinery which will ensure to every individual
in the community a standard of living adequate for the maintenance of
health.
 DEFINITIONS IN PUBLIC HEALTH
• The science and art of preventing disease, prolonging life, and promoting
health through the organized efforts and informed choices of society,
organizations, public and private communities, and individuals.
 The Mission and vision of Public Health
• Vision:
• Healthy People in Healthy Communities
• Mission:
• Promote Physical and Mental Health and Prevent Disease, Injury, and
Disability.
 Goals of Public Health

1. Prevents epidemics and the spread of disease

2. Protects against environmental hazards
3. Prevents injuries
4. Promotes and encourages healthy behaviors
5. Responds to disasters and assists communities in recovery
6. Assures the quality and accessibility of health services
 core functions of public health are these:
• 1. Assessment
• 2. Policy development
• 3. Assurance
 core functions of public health
• Assessment constitutes the diagnostic function, in which a public health agency
collects, assembles, analyzes, and makes available information on the health of the
population.
• Policy development , like a doctor’s development of a treatment plan for a sick
patient, involves the use of scientific knowledge to develop a strategic approach to
improving the community’s health.
• Assurance is equivalent to the doctor’s actual treatment of the patient. Public health
has the responsibility of assuring that the services needed for the protection of
public health in the community are available and accessible to everyone.
 Essential Public Health Services
1. Monitor health status to identify community health problems
2. Diagnose and investigate health problems and health hazards in the
community
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships to identify and solve health problems
5. Develop policies and plans that support individual and community health
efforts
 Essential Public Health Services
1. Enforce laws and regulations that protect health and ensure safety
2. Link people with needed personal health services and assure the provision
of health care when otherwise unavailable
3. Assure a competent public health and personal health care workforce
4. Evaluate effectiveness, accessibility, and quality of personal and population-
based health services
5. Research for new insights and innovative solutions to health problems
 The Ten Essential Public Health Services
• Assessment
• 1. Monitor health status to identify community health problems
• 2. Diagnose and investigate health problems and health hazards in the
community.
 The Ten Essential Public Health Services
• Policy Development
• 3. Inform, educate, and empower people about health issues
• 4. Mobilize community partnerships to identify and solve health problems
• 5. Develop policies and plans that support individual and community health
efforts.
 The Ten Essential Public Health Services
• Assurance
• 6. Enforce laws and regulations that protect health and ensure safety
• 7. Link people to needed personal health services and assure the provision of
health care when otherwise unavailable
• 8. Assure a competent public health and personal healthcare workforce
• 9. Evaluate effectiveness, accessibility, and quality of personal and
population-based health services.
Selected Unique Features of Public Health
1. Basis in social justice philosophy
2. Inherently political nature
3. Dynamic, ever-expanding agenda
4. Link with government
5. Grounding in the sciences
6. Use of prevention as a prime strategy
 Summary Ten Essential Public Health Services
• 1. Monitor Health
• 2. Diagnose and Investigate
• 3. Inform, Educate, Empower
• 4. Mobilize Community Partnership
• 5. Develop Policies
• 6. Enforce Laws
• 7. Link to/Provide Care
• 8. Assure a Competent Workforce
• 9. Evaluate and 10 Research
 Focus Areas of Public Health
• 1. Access to health services
• 2. Adolescent health
• 3. Arthritis, osteoporosis, and chronic back conditions
• 4. Blood disorders and blood safety
• 5. Cancer
• 6. Chronic kidney diseases
• 7. Dementia, including Alzheimer’s disease
• 8. Diabetes
 Focus Areas of Public Health
• 9. Disability and secondary conditions
• 10. Early and middle childhood
• 11. Educational and community-based programs
• 12. Environmental health
• 13. Family planning
• 14. Food safety
• 15. Genomics
• 16. Global health
 Focus Areas of Public Health
• 17. Health communication and health information technology
• 18. Healthcare-associated infections
• 19. Hearing and other sensory or communication disorders (ear, nose,
throat—voice, speech, and language)
• 20. Heart disease and stroke
• 21. HIV
• 22. Immunization and infectious diseases
 Focus Areas of Public Health
• 23. Injury and violence prevention
• 24. Lesbian, gay, bisexual, and transgender health
• 25. Maternal, infant, and child health
• 26. Medical product safety
• 27. Mental health and mental disorders
• 28. Nutrition and weight status
• 29. Occupational safety and health
 Focus Areas of Public Health
• 30. Older adults
• 31. Oral health
• 32. Physical activity
• 33. Preparedness
• 34. Public health infrastructure
• 35. Quality of life and well-being
• 36. Respiratory diseases
• 37. Sexually transmitted diseases and Sleep health
• 38. Social determinants of health and Tobacco use
 Basic Six Services of Local Public Health
1. Vital statistics—collection and interpretation.
2. Sanitation.
3. Communicable disease control, including immunization
4. Maternal and child health (MCH)
5. Health education
6. Laboratory services to physicians.
 Nationally Notifiable Infectious Diseases
• Anthrax
• Arboviral diseases, neuroinvasive and non-neuroinvasive
• Babesiosis
• Botulism
• Brucellosis
• Chancroid
• Chlamydia trachomatis infection
• Cholera
 Nationally Notifiable Infectious Diseases
• Coccidioidomycosis
• Congenital syphilis
• Cryptosporidiosis
• Cyclosporiasis
• Dengue virus infections
 Nationally Notifiable Infectious Diseases
• Diphtheria
• Ehrlichiosis and anaplasmosis
• Giardiasis
• Gonorrhea
• Haemophilus influenzae, invasive disease
• Hansen’s disease
 Nationally Notifiable Infectious Diseases
• Legionellosis
• Leptospirosis
• Listeriosis
• Lyme disease
• Malaria
• Measles
• Meningococcal disease
• Mumps
• Novel influenza A virus infections
 Nationally Notifiable Infectious Diseases
• Pertussis
• Plague
• Poliomyelitis, paralytic
• Poliovirus infection, nonparalytic
• Psittacosis
• Q fever
• Rabies, animal
• Rabies, human
• Rubella
• Rubella, congenital syndrome
 Nationally Notifiable Infectious Diseases
• Salmonellosis
• Severe acute respiratory syndrome–associated coronavirus disease
• Shiga toxin-producing Escherichia coli
• Shigellosis
• Smallpox
• Spotted fever rickettsiosis
• Streptococcal toxic-shock syndrome
 Nationally Notifiable Infectious Diseases
• Syphilis
• Tetanus
• Toxic shock syndrome (other than streptococcal)
• Trichinellosis
• Tuberculosis
• Tularemia
• Typhoid fever
• Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus
aureus
 Nationally Notifiable Infectious Diseases
• Varicella
• Varicella deaths
• Vibriosis
• Viral hemorrhagic fever
• Yellow fever
 Maternal and Child Health/Objectives and
Targets of WHO
1. To reduce maternal morbidity and mortality due to pregnancy and child
birth
2. To reduce morbidity and mortality due to unsafe abortion.
3. To reduce perinatal and neonatal morbidity and mortality
4. To promote reproductive health awareness for young children.
5. To increase knowledge of reproductive biology and promote responsible
safe sex and prevention of sexually transmitted infections.
 Maternal and Child Health/Objectives and
Targets of WHO
1. To reduce the levels of unwanted pregnancies in all women of reproductive age.
2. To reduce the incidence and prevalence of sexually transmitted infections, in order
to reduce the transmission of HIV infection.
3. To reduce the incidence and prevalence of cervical cancer.
4. To reduce female genital mutilation and provide appropriate care for females who
have already undergone genital mutilation.
5. To reduce domestic and sexual violence and ensure proper management of the
victims.
 Maternal and Child Health/Objectives and
Targets of WHO
1) To provide primary health care services
2) To promote the use of safe water, sanitation and immunization
3) To extend integrated MCH services into the rural areas.
4) To initiate, develop and co-ordinate operational and other relevant research
in MCH.
 Major Causes of Maternal Mortality
1. Haemorrhage
2. Infection
3. Hypertensive disorders of pregnancy
4. Obstructed labour
5. Abortion
 Female Genital Mutilation
• The prevalence varies for different countries, such as
• In Somalia 100%,
• In Egypt 94%( reported in 1998)
• In Sudan 80%.
• In Uganda and Congo 5- 10%
• In Ethiopia – Among both Christians and Moslems and no region is spared.
 Types of FGM
1. Sunna is the mildest form of FGM Removal of the hood or the fold of the
skin over the clitoris or the excision of the clitoral prepuce only.
2. Excision (modified circumcision) Removing the entire clitoris part of or
inner labia minora
3. Radical circumcision or Infibulation Removal of clitoris, labia minora and
part of L. Majora.
 Risk Factors Identifiable In ANC
• Risk factors identifiable in ANC include:
• • Age under 18 or above 35
• • Primigravida
• • Previous caesarean section, vacuum, or forceps delivery
• • Previous perinatal death, stillbirth
• • Previous Post partum haemorrhage
• • Previous ante partum haemorrhage
 Risk Factors Identifiable In ANC
• More than 6 pregnancies
• • Twins
• • Hydrominos
• • Pre eclampsia
• • Diabetes, cardiac problem, renal disease etc.
 Delivery Care Service
1. Clean hands
2. Clean delivery service
3. Clean cutting of the cord.
 Causes of Perinatal Mortality
1. Low birth weight
2. Cord prolapse
3. Asphyxia
4. Birth injury
5. Congenital anomalies
6. Sepsis
7. Neonatal tetanus
 Causes of Perinatal Mortality
1. Complicated labours (prolonged, obstructed, breech, transverse).
2. Mismanagement of labour
3. Maternal age
4. Maternal anaemia
5. Maternal health problems like, renal problem, diabetes, hypertensive
disorders.
6. Maternal infections
 Causes of Perinatal Mortality
1. Parity
2. Placental insufficiency
3. Ruptured uterus
4. Mother’s utilization of health services
5. Maternal education
 Causes of low birth weight include:
1. Short stature
2. Low pre-pregnancy weight
3. Inadequate weight gain during pregnancy
4. Anemia
5. Reproductive tract infections,
6. Other infections during pregnancy
 Components of MCH Care
1. Preconceptional
2. • Antenatal or prenatal care
3. • Natal care
4. • Postnatal care
5. • Family planning.
 Components of MCH Care
1. Blood pressure checked
2. • Blood tested – Hb, blood group, Rh factor, VDRL test
3. • Urine tested – albumin, sugar
4. • Abdomen examined
5. • Breast examined
6. • Sonogram/Ultrasound done
7. • Delivery date told
8. • Delivery advice given
9. • Nutrition advice given.
 Maternal Morbidity and Mortality
• Women of reproductive age group: Women belonging to 15 to 44 + years of
age.
• Child: Male and female below 15 years of age.
• Infant: A child below the age of one year.
• Infant mortality rate (IMR): The number of infant
• deaths per 1000 live births in one year in a community or country.
 Maternal Morbidity and Mortality
• Maternal mortality: A maternal death is defined as the death of a woman
while pregnant, or within 42 days of termination of pregnancy, irrespective
of the duration and the site of pregnancy, from any cause related to or
aggravated by the pregnancy or its management but not from accidental or
incidental causes.
• Maternal mortality ratio (MMR): The number of maternal deaths per 1000
(or per 100,000) live births in the year in a community or country.
 three core functions: Public Health

1. Assessment. ■ ■ Public health agencies should collect and analyze

information about the health of the communities they serve.
2. Policy ■ ■ Development. Agencies should promote the use of sound
science and act as leaders in the development of comprehensive public
health policies.
3. Assurance. ■ ■ Agencies should assure the provision of services necessary
to meet public health goals.
 MAJOR DISCIPLINES IN PUBLIC
HEALTH
• Nutrition and Research
• Reproductive health and Demography
• Environmental Health
• Health Education and Ecology
• Epidemiology
• Health Service Management
• Biostatistics and Health Economics
 • thank you.

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