Principles of public & community health

MBCHB 1.1, May 2022

Dr HTumusiime(MD,MPH)
 Demography
• Demography is the statistical study of populations,
especially human beings.
• encompasses the study of size, structure, and
distribution of these populations,
• and changes in them in response to birth, migration,
aging, and death
• the study of statistics such as births, deaths, income, or
the incidence of disease, which illustrate the changing
structure of human populations.
• the composition of a particular human population.
• Population growth is the increase in the number of
people living in a particular area.
•  populations can grow exponentially (over population)
• causing resource depletion rapidly that may lead to;
• specific environmental concerns such as
• global warming, deforestation and decreasing
biodiversity
• Other negative effects of population growth  include
poverty caused by low income per capita, famine and
diseases
 Measurement of health & counting of
diseases
• The first task in measuring disease in a population is
to count its occurrence. 
• Counting disease frequency can be done in several ways
• Measures of morbidity frequency characterize the
number of persons in a population who become ill
(incidence)
• or are ill at a given time (prevalence).
• Incidence refers to the occurrence of new cases
of disease or injury in a population over a specified
period of time
 incidence
• Incidence –no of new cases of a disease that occurs during a
specified period of time in a pop at risk for developing the disease.
• Is a measure of the probability of occurrence of a given disease in
a population in a specified period of time.
• Although loosely expressed as no of new cases ,its better
expressed as rate or proportion with a denominator.
• Denominator must have potential to become the numerator
• Measure of risk of contracting disease
• More useful than prevalence in regard to etiology
• Disease that takes long to cure has high prevalence but low
incidence
 Prevalence

• No of affected persons in the pop at a specific time

divided by the pop at that time.
• What proportion of the pop is affected by the disease at
that time.
• It’s a snap shot or a slice thru the pop at a point in time.
• Mix of people with different duration of disease and
there4 its not a measure of risk
• Point prevalence as described above
• Period prevalence-over a duration of time.
• Prevalence= Incidence x Duration
 Disease out break
• is a sudden increase in occurrence of disease
when case are in excess of normal expectancy in
certain geographical location
• May affect small n localized grp or thousands of
pop across wider area.
• An epidermic is more widespread than an outbreak
• It can also be a single case in new area
• If not quickly controlled an outbreak can become
an epidermic
 Steps for investigating an outbreak
• verification
• Prepare to conduct further investigations
• Construct a case definition
• Collect lab tests & get results
• Search & record more cases while managing the already
identified cases
• Describe the epidemic
• Formulate hypothesis
• Reach at a final decision
• Take control measures/intervene
• Report and disseminate findings
 Types of epidermic
• Common source point, continuous,
intermittent
• Propagated
• Mixed
 Community diagnosis
• Community -A group of people who share common interests
and experiences-(eg pple in same geog boundaries-
village,street etc or pple wiz same cultural and social
background eg religion,occupation etc
• Community Diagnosis- Comprehensive assessment of state
as an entire community in relation to its
social,political,economical,physical & biological envt.
• Purpose-it helps in identification &quantification of health
problem in community as the whole in terms of morbidity &
mortality rates and ratios.
• Identification of those at risks & in need of health care
 Community assessment
• process of gathering, analyzing and reporting
information about the needs of the community
• and the capacities or strengths that are also
currently available in the community to meet those
needs.
• Begins by convening a meeting with community
leaders, influential, political and professional people
• establishing a vision and prioritizing the issues that
require change
Steps in conducting Community DX
• Establishing the assessment team
• Identifying & secure resources
• Identifying & engaging community partners
• Collecting ,analyzing & presenting data
• Setting health priorities
• Clarify the issue
• Setting goals &presenting measuring progress
• Choosing the strategy
• Developing the community health assessment of
results,managing and sustain the process.
 Criteria for identifying a problem
• Relevance
• Duplication
• Urgency of data
• Political
• Feasibility
• Ethical acceptability
• Applicability of results
 MCH
• Programs that focus on health issues
concerning women, children and families
• Access to recommended prenatal & wellbeing
child care
• Infant and maternal mortality prevention
• New borne screening
• Immunization
• Child nutrition
• aims to support pregnant women to
experience healthy pregnancies
• Support parents of infants &young children
and their families
• Access to quality MCH care ensures both
mother n child are safe
• Specific objectives of MCH include reduction
of MMR,IMR,child hood mortality n morbidity
• Promotion of reproductive health
• Physical and psychosocial devt of the child
 Factors affecting MCH
• Age of the mother
• Social economic factors
• Income level
• Education level
• General health status of the mother
• Access to medical care