COMMUNITY MEDICINE

AN INTRODUCTION

By
Dr Mahmood Ur Rahman
Professor of Community Med

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 Community Medicine

 The field concerned with the study of

health and disease in the defined
community or group.
 Its goal is to identify the health problems
and needs of people (community
diagnosis) and to plan, implement and
evaluate the effectiveness of health care
system.

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GOALS OF MODERN MEDICINE

 Focus shift from treatment of sick

 Prevention of Diseases
 Promotion of health
 Quality of life improvement for individuals
& groups

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 Five Star Doctor
Leader

Manager Care Provider

Communicator
Decision Maker

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 Knowledge regarding Study of :
Population to be served Demography

Patterns of Health and disease Epidemiology

Collection, compilation and Biostatistics

analysis of data
Behavioral factors and their Behavioral sciences
effect on Health
Control and prevention of Preventive Medicine
diseases
The food people eat Nutrition

Environmental factors and their Environmental Health

effects on Health
Delivery of Health Care Health Administration and
Planning 5
EXAMINATION PATTERN

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Assessment System (Annual)
 TERM TESTS: 02
 PRE-ANNUAL EXAM
 ANNUAL EXAM
 Viva and spotting
 PBL (Problem Based Learning)

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Annual Examination

Marks of Written Paper : 135

Time Allowed = 3 Hrs (Including MCQs)
Marks of Internal Assessment : 15
Max Marks : 150 Pass Marks : 75
 Written paper will comprise of two parts
(A & B)
 Q–1 (MCQ) (one best out of five items type from
whole course, on separate sheet (Time 30 Min) : 30
Marks

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Part – A
SEQs/SAQs (15 Marks each)
Q–2 PBQ Whole course
Q–3 Epidemiology (Gen & Spec) + Screening of
Diseases
Q–4 Statistics
Q–5 Communicable / non communicable diseases

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Part – B
SEQs/SAQs (09 Marks each)
Q–6 MCH and family planning / demography
Q–7 Nutrition / Entomology / Parasitology / Health
Education/ Occupational Medicine/ Social /
Behavioral Sciences
Q–8 Water / Environmental Health
Q–9 Accidents / Disasters / Smoking / / Substance abuse
/ School Health / Mental Health / Geriatrics /
Housing/ Snake bite
Q–10 HMIS / Medical Ethics / PHC / International Health /
Concept of Health and disease / Planning and Management

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Allocation of Marks

Written Paper Max Marks: 135 Marks

Internal Assessment: 15 Marks
(Based on marks obtained in Theory Papers of Term Tests and
Pre Annual exam)

Sub Total: 150 Marks

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 Oral & Practical

Max Marks: 150

Viva: 100 Marks
Spotting: 10 Marks
Project: Day Book/Visit Book/Entomology/
Research 25 Marks
Internal Assessment:
PBL/ Viva Pre Annual: 15 Marks
Sub Total: 150 Marks
Grand Total: 300 Marks

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COURSE CONTENTS

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The complete course of Community
Medicine is according to the laid
down Syllabus issued by PMDC

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Core Contents

 Concepts of Health and disease

 Introduction to Public Health and Health
Systems in Pakistan
 Epidemiology , Screening and Infectious Disease
Control
 Non Communicable Diseases
 Biostatistics and HMIS
 Demography and Population Dynamics
 Food and nutrition
 Reproductive and Child Health
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Core Contents….
 School Health Services
 Environmental health
 Occupational Health
 Parasitic Diseases – Prevention and control
 Zoonotic diseases
 Arthropods of Public Health Importance
 Mental Health
 Behavioral Sciences
 Health Education and Promotion
 Disaster Management
 Medical Ethics 16
 Concept of Health and Disease

 Dimensions and Spectrum of

Health
 Determinants of Health
 Health Indicators
 Primary Healthcare Concept

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Introduction to Public Health &
Health systems in Pakistan

 Background and concepts

 Development of Public Health in Pakistan

 Economics and Health

 Health Policy and Planning in Pakistan

 Health System in Pakistan

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Epidemiology and Disease Control

 Background and concepts, uses

 Basic measurements in epidemiology
 Epidemiological methods, association and
causation investigation of epidemics, screening for
disease Research and survey methodology
 Definitions: infection, contact, host, carriers

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 Dynamics of infectious disease transmission
 Control of infection
 Epidemiology, control and prevention of
infectious diseases of public health importance
 Diseases transmitted through inhalation
 Diseases transmitted through faeco-oral route
 Diseases of animals conveyed to man
 Diseases due to direct contact

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Epidemiology, Control and Prevention of Non-
infectious Diseases of Public Health Importance
 Hypertension
 Coronary heart disease
 Cancers
 Injuries
 Diabetes Mellitus
 Obesity
 Acute Rheumatic fever
 Ischaemic heart diseases

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Biostatistics
 Concepts and uses
 Data and its types
 Rate, ratio and proportion
 Crude, specific and standardized rates
 Collection and registration of vital events in Pakistan
 Sources of health related statistics
 Measures of central tendency
 (Mean, Mode, Median)

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Demography and Population Dynamics

 Concept, Principles, Demographic processes

 Census, definition, types, methodology
 Determinants of fertility, mortality
 Population pyramid and its interpretation
 Demographic transition, demographic trap
 Demographic & social implications of high
population growth
 Social mobilization
 Urbanization

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Food and Nutrition

 Concepts of Nutrition
 Malnutrition at all stages of life
 Dietary requirements
 Food hygiene, pasteurization, fortification,
adulteration and preservation
 Food poisoning
 Assessment of nutritional
status of Community

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Reproductive and Child health
 Safe motherhood & its components
 Maternal mortality, causes and prevention
 Infant care, growth & development,
breast feeding, common causes of morbidity and
mortality, their prevention and control
 IMCI (Integrated Management of Childhood
Illness)
 Adolescent health
 Reproductive tract infections,
managing STDs

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Health of School age Children

 Role of teachers and role of doctors in

maintenance of health
 Procedures for determining the health status
of school children
 Common health problems of school children

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Environmental Health
 Air Composition, pollution, purification, diseases
caused by air impurities & their prevention
 Water, Sources, daily requirement, causes of pollution,
its prevention, purification, quality standards,
diseases
due to polluted water
 Waste Disposal, Hazards and Safety Measures
 Radiation sources, types, causes, hazards,
prevention
 Healthful housing, urban & rural slums, Refugee camps
and hostels
 Noise, causes, acceptance level,
hazards and control
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Occupational Health
 Concepts of occupational Health and
Medicine
 Ergonomics and its Importance
 Occupational Hazards
 Principles of prevention and Control
 Organization of Occupational Health Services
 Health insurance and Social Security Schemes

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Arthropods and Their Public Health
Importance
 Common arthropod borne diseases
 Control of arthropod of medical
importance
 Insecticides and their public health
importance

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 Prevention and control of parasitic
diseases of public health importance

 Snake bites, personal protection and

management

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Mental Health

 Concept, common mental health

problems, causes and prevention

 Juvenile delinquency

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Behavioural Sciences and Life Style

 Concept, attitudes, health and illness

behaviour
 Drug abuse, addiction and smoking
 Child abuse and child labour
 Role of physical exercise in health and
disease

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Information, Education and
Communication (IEC)
 Concept, aims & objectives
 Approaches used in public health
 Contents, principles & stages of health
education
 Communication methods, barriers, and skills
in health education
 Planning, organizing and evaluating a health
education programme
 Social marketing
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Disaster
 Definition, classification
 Natural Disasters like Earthquakes, Floods
 Epidemic of communicable diseases
 Man made disasters
 Accidents, thermonuclear warfare, causes and
prevention
 Magnitude and effects of Disaster and Public
Health consequences
 Disaster preparedness and management

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Medical Ethics

 Background concepts and components

 National recommended guidelines
 Code of Medical Ethics

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Practical and Community Based Training
Students should have practical experience in:
 Questionnaire development
 Data collection
 Compilation
 Presentation
 Analysis
 Report writing

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Field Visits
 Visit to BHU and RHC
 Visit to an NGO
 Visit to a primary school to assess the nutritional
status of school children
 Visit to MCH/Reproductive Health Centre to observe
the organization, function of the centre, Antenatal
care, FP services & Immunization
 Visit to a hospital to see the hospital waste disposal
 Visit to an industry
 Visit to a physical/mental/social rehabilitation centre

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Skills Development Lab

 Water purification at domestic level

 Contraceptives
 Vaccination including the
cold chain
 Oral Rehydration solution

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Recommended Reading
 Park’s Text Book of Preventive and Social
Medicine by K Park

 Public Health and Community Medicine by

Ilyas and Ansari
 Lecture Notes

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