COMMUNITY MEDICINE SOLVED PAST QUESTIONS

(BY MARYAM MALIK – RAWALPINDI MEDICAL

COLLEGE)

HEALTH CARE SYSTEM IN PAK

Major bulk of Pak population lives in villages, but
major budget share is for urban.name the disparity
indicated,
Name other principles of prim health care
Disparity= social injustice (lack of equitable
distribution of heath care facilities)
OTHER PRINCIPLES:
1. Community participation
2. Inter-sectorial coordination
3. Appropriate technology
4. Accessibility
5. Affordability
6. Acceptability (last 3 are given in naveed alam not
Park)

Difference between medical care & health care?

• Medical Care: Personal Services provided by
Physicians
• Health Care: Services provided to individuals and
communities by health care professionals for the
purpose of
– Promoting
 – Maintaining
– Monitoring and
– Restoring Health

Components of PHC
1. Health education
2. Food supply and proper
nutrition
3. Safe water and sanitation
4. Maternal and child health care
5. . Immunization against infectious diseases
6. Prevention and control of Endemic diseases
7. Common diseases and injuries treatment
8. Essential drugs provision

Constraints to PHC in Pakistan.

Obstacles to implementation of PHC Strategy

• Misinterpretation of the PHC concept.
• Misconception that PHC is second rate health
care for the poor.
• Resistance to change
• Lack of political will.
• Centralized planning and management
infrastructure
What are the advantages of PHC?
 PHC is more convenient and effective.
 People are more satisfied with health services.
 The workload in tertiary care hospitals is
decreased
 staff job satisfaction improved
What are the Methods to enable parents themselves to
halve the rate of child deaths and save the lives of up
to 20,000 children each day?
• Growth monitoring
• Oral rehydration
• Breast feeding
• Immunization
• Family Education
• Family Spacing
• Food supplements
(GOBI-FFF)
Principles of PHC/ what are the reasons for choosing
PHC for health improvement of people of Pakistan?
• Community participation in planning and
implementation of health programs is the
fundamental principle. (Financial and
Manpower-wise involvement. Let the people
promote their own health)
• Equitable distribution (Health Services must be
shared by all people, Be accessible to all people,
Equity not equality)
• Appropriate technology(According to need, not
demand)
• Intersect oral coordination (Housing,
Agriculture, Food & Nutrition. cooperation of
sanitary engineers, department of agriculture,
animal husbandry)
Representatives of 134 govts, UNO, NGO’s attended a
conference held at Alma-Atta in 1978 to develop an
approach to improve health of people all over the
world.
Which conference it was?
What are the main principles of this approach to make
it more appropriate for improvement of health of the
people?
Health for all by year 2000 (HFA)
DEFININTION (WHO) : attainment of a level of health
that will enable every individual to live socially &
economically a productive life i.e. he can work
productively and can participate actively in social life
in the community in which he lives.
• Community participation in planning and
implementation of health programs is the
fundamental principle. (Financial and
Manpower-wise involvement. Let the people
promote their own health)
• Equitable distribution (Health Services must be
shared by all people, Be accessible to all people,
Equity not equality)
• Appropriate technology(According to need, not
demand)
 • Inter-sectoral coordination (Housing,
Agriculture, Food & Nutrition. cooperation of
sanitary engineers, department of agriculture,
animal husbandry)

Enlist MDGs, which 3 are related to health?

1.To eradicate extreme poverty & hunger
2.To achieve universal primary education
3.To promote gender equality and empower women
4.To reduce child mortality
5.To improve maternal health
6.To combat HIV/AIDS, malaria, and other diseases
7.To ensure environmental sustainability
8.To develop a global partnership for development
4, 5 & 6 ARE RELATED TO HEALTH.
What is FLCF?
It stands for first level care facilities
DEFINITION: these are health institutions where first
contact between patient and professional health care
provider takes place.
Includes
 BHU
 RHC
 DISPENSARIES,MCH CENTRES
 Sub-health centers, OPDs of hospitals

Services provided at RHC

1. MCH & family planning
2. EPI services
3. School health services
4. Diarrheal disease control
5. Health education
6. Sanitation
7. CDC,ARI & other programs
8. Improvement of nutritional status
9. National program of FP & PHC
10. Training for local dai’s
11. Sputum microscopy
12. DOTS
Services provided at BHU.
 1. MCH & family planning
2. EPI services
3. Diarrheal disease control
4. Health education
5. Malaria control
6. Sanitation
7. CDC,ARI & other programs
8. Improvement of nutritional status
9. Outreach service to pregnant mothers
through traditional birth attendants (TBA’s)
& lady health workers (LHW’s)

Compare BHU & RHC.

S/NO PARAMETER BHU RHC
1 AREA 24-40 km 240-
(radius) 400km
2 POPULATION 5000-10,000 50,000-
100,000
3 Referral for For LHW, For BHU
LHV
4 Staff All Not All present
 SMO present
 WMO
 Hakeem
 Dentist
5 Facilities
 Beds 1-2 beds 20-25 bed
  Ambulance No Present
 Lab No Present
 X-rays No Present
 OT No Present
6 SURGERY No surgery Minor
allowed surgery
allowed
7 Admission No present
8 Medico legal No present
services
9 Linked to 5-10 BHU RHC is
linked to RHC linked to
THQ

Reasons of failure of provision of adequate services by

prim health care units
 Population explosion
 Political environment
 Lack of community participation
 Lack of awareness
 Deficiency in allocation of funds
 Deficiency in medical education
 Health man power deficiency
 Doctors reluctant to go to rural areas
 Lack of efficient & effective referral health care
system
 Lack of appropriate technology
 Lack of coordination
Public health engineer dept. wants to make latrines in
a village but have no funds; villagers offer them
funds.....which principle of PHC is operate in above
scenario
Community participation
Draw the Hierarchical structure of health system in
Pakistan Public health sector

Tertiary
Hospitals

District head
quarters
Hospital

Tehsil head quarters

& civil
Hospitals

Rural health centers

Basic health units

Lady health workers

The community s