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1.Faculty of MedicineIntroduction to Community Medicine(31505201)ByHatim JaberMD MPH JBCM PhD18-09-2016
2. معلومات وقواعد عامة • • • • • • • التعريف االلتزام والوقت ساعات العمل في المكتب الحضور والغياب االمتحانات منسق المجموعة المراجع والكتب
3.Presentation outlineIntroduction to course 31505201Time12:10 to 12:20Medicine and Health12:20 to 12:30Public Health and Medical Care12:30 to 12:40Community Medicine and Clinical Care12:40 to 12:50
5.Community Medicine ااالسهلااالممتنع
6.Introduction to course31505201• Course Title : Introduction to Community Medicine• Credit Hours: 3 Credit Hours• Calendar Description : 15 weeks/ First Semester 2nd year (2016/2017)• Teaching Approaches : 3 Lectures per week for 15weeks(including twoDepartment)field visits to Public Health
7.Introduction to course 31505201 (cont…)• General Objective: Founding the basisnecessary for the understanding andappreciation of Community Medicine as theumbrella that address the spectrum of publichealth problems.
8.Introduction to course 31505201(cont…)••••••••••••••••Specific Objectives: by the end of the course, a student shall be able to :List the names and roles of the different public health disciplines under the community medicineumbrella .Name nutrient categories according to their physiologic roles, and outline the ecology of malnutritionwith differentiation characterization of the various types and classes of nutritional disorders.Identify nutrition-risk groups by application of proper criteria and suggest ideas for the prevention andcontrol of nutrition-related diseases.List the scientific reasons that justify the launching of public campaigns that target at the promotion ofbreast feeding practice for infantsDefine primary health care strategy and it’s contents.List steps of planning health education talk to individual persons and to groups.Describe epidemiology and the special features of environmental and occupational epidemiology.Describe diseases that are related to water , food and air pollution and their Control.Specify the uses of epidemiology .Differentiate between various epidemiological methods.Define epidemic and endemic occurrence of diseases.Enumerate steps in the investigation and control of disease .List levels of prevention and differentiate between population strategy and high risk strategy used indisease preventionDescribe criteria used in disease screeningDescribe study design focusing on experimental randomized trials.
9.Introduction to course 31505201(cont…)• Method of Instruction : Lectures and field visits3 ‘one full hour’ Lectures per week (Sun, Tue, Thu) 12:0013:00 and two field visits• Evaluation and Grading : three written exams (MCQ)• First Exam - assessment 25%• Second Exam- assessment 25%• Final Examination 50%• Field Visits ????????????????
10.Introduction to course 31505201(cont…) Course Content•Week 1 Unit 1: Introduction to Health and Community Health•Week 2 Unit 2 Nutrition and Nutrition Assessment and Diet•Week 3: Unit 2 (cont.) Nutrition and Nutrition Assessment and Diet•Week 4 Unit 2 (con..): Infant and Breast Milk Characteristics•Week 5 Unit 3: Public Health/Environmental HealthField visit to environmental health department – mostly in Saturday•Week 6Unit 4: Epidemiology In course assessment I•Week 7Unit 4 (cont…): Epidemiology•Week 7Unit 5: Primary Health care•Week 8Unit 6:Demography, Data and Biostatics•Week 9Unit 7: Public Health Surveillance•Week 10 Unit 8:Study design•Week 11 Unit 9: Prevention and Control of Diseases In course assessment II•Week 12 Unit 10: Health Education and Communication• Field visit to environmental health department – mostly in Saturday•Week 13 Unit 11:Screening•Week 14 Unit 12:Health Administration and healthcare management•Week 15 Unit 13:Health Research•Week 16Final assessment (Exams.)
11.Next• 31505204 Epidemiology andBiostatistics (3 H)• 31505291 Public Health (3 H)• 31505391 Health Economic(2 H)
12.What is health?Nutritious foods help usstay healthy.Regular exercise helpskeep us strong andhealthy.Doctors, hospitals &medicines help us gethealthy if we’re sick.
13.Definition: ‘Health …’• ‘…is a state of complete physical, mentaland social well-being and not merely theabsence of disease or infirmity’(WHO,1948)• ‘Health is only possible where resources areavailable to meet human needs and wherethe living and working environment isprotected from life-threatening and healththreatening pollutants, pathogens andphysical hazards’(Who, 1992)
14.Defining Health:The WHO Definition• Health is the state of complete physical,mental and social well-being and not onlythe absence of disease or infirmity (illness).Ecological definition:• “Health is a state of optimal physical, mentaland social adaptation to one’s environment.”
15.Concept of HealthAlong the continuous change of the world, newconcepts of health emerge based on newpatterns of thought.1. Biomedical concept2. Ecological Concept3. Psychosocial concept4. Holistic concept
16.Concepts of Health1. Biomedical : “ health is the absence of disease”- (Germtheory of disease).2. Ecological Concept: Health is an Dynamic Equilibriumbetween Man and his Environment. Imbalance results inDisease.3. Psychosocial concept: Psychological, Social, Cultural ,Economic, Political factors are included in defining andmeasuring health.4. Holistic concept: Include all the factors of the other concepts inaddition to all human activities such education, communication,agriculture, industry, housing , recreation etc.
17.• Have you noticed that when you have beenthrough an illness You become irritable? Lose your temper much faster than in yourhealthy days.Why?
18.You lack in physical energy &gets frustrated can’t do things that youwant to do. Hence you get angry,shout, and screamPHYSICAL, SOCIAL AND MENTAL HEALTH ARE INTER RELATED
19.The Health Triangle• Health is the measure ofour body’s efficiency andover-all well-being.• The health triangle is ameasure of the differentaspects of health.• The health triangleconsists of: Physical,Social, and Mental Health.
20.Physical , Mental & Social Health• Physical health deals with thebody’s ability to function.• Mental heath deals with how wethink, feel and cope with dailylife.• Social Health deals with the wayreact with people within ourenvironment.
21.Signs of Good Healthwhat are signs of good Physical health—no disease Social heath Mental health
22.Signs of Good HealthB. Social heathA person with good socialhealth –• gets along well withpeople around• has pleasant manners• helps others• fulfills responsibilitytowards othersC. Mental healthMental health implies • control on emotions• sensitive to the needsof others• confidence in one’sown abilities• freedom fromunnecessary tensions,anxieties and worries
23.New philosophy of Health••••••Health is a Fundamental rightHealth is the essence of Productive lifeHealth is IntersectorialHealth is Integral part of DevelopmentHealth is central to Quality of LifeHealth Involves Individuals, Families, CommunitiesLocal, National and International responsibilities• Health and its maintenance is a Social Investment• Health is Worldwide Social Goal.
25.EconomicalsystemSocialjusticeResourcesNationalpoliciesWorkenvironmentEducationenvironmentDifferentcultureshosingenvironmentSocietysupportSocialchangesCongenital andpsychological factors HealthservicesLife styleFacilitiesHealthEntertainmentSocialpoliciesIncomeservicesMedia and communicationEffect levels on health25
26.Population Perspective of RelationsAll populationsHuman populationCommunity, nationFamilyIndividual
27.Community MedicineTimePublic Health and Medical Care12:30 to 12:40Community Medicine and Clinical Care12:40 to 12:50
28. Confusion about DEFINITION , SCOPE , &CONTENTS OF:Public HealthPreventive medicinePreventive and social medicineCommunity medicineChronologically these terms present the:WORLD PICTURE OF EVOLUTION OF THEDISCIPLINE
29.• Scope of this specialty is quite wide rangesfrom:planning & provision of public health services,to the delivery of primary health carethrough out the life cycle of human beings(i.e. from child hood to old age).It demands not only study of generalmedicine covering all the organ systems ofhuman body but also the awareness of thecivic, social , legal & economic organizationof the communities.
30.Therefore community specialist has to:acquire vast knowledge & range of skills,have basic understandings & skills todeliver general medicine care & possessin depth knowledge of communicableand non communicabledisease ,principles of social & behaviorsciences.
31.Public health• The WHO has defined it as “The science and art of preventingdisease, prolonging life, and promoting health throughorganized community efforts”• Public health is a combination of scientific disciplines (e.g.,epidemiology, biostatistics, laboratory science, social science,demography) and skills and strategies (e.g., epidemiologicalinvestigations, planning and management, intervention,evaluation) that are directed to the maintenance andimprovement of the health of people.• Public health is both a body of knowledge and also means toapply that knowledge
32.Preventive medicine• Preventive medicine developed as a branch ofmedicine distinct from public health, based onetiology.• It scored several successes in the prevention ofcommunicable diseases based on immunization. Asconcepts of the etiology of disease changed throughtime, so too have the techniques and activities ofPM.• The concept of PM has broadened to include healthpromotion, treatment, and prevention of disability.
33.Social medicine• “The study of man as a social being in his totalenvironment”. It concerned with all the factors affecting thedistribution of health and disease in population.Social medicine reflect the strong relationship betweenmedicine and social science.• The laboratory to practice social medicine is the wholecommunity, the tools for diagnosing community ills areepidemiology and biostatistics; and social therapy doesn’tconsist in administration of drugs but social and politicalaction for better conditions of life.
34.Definition of community• A true community in the sociological sense (sharedcommunity sentiment, social institutions)• A defined neighborhood• Workers/students in a defined company/school• Persons registered as potential users of a group practice/health center• Users of a defined service or repeated users of theservice
35.Community medicine• This term is a newcomer. It is oftenconsidered synonymous with preventiveand social medicine, public health, andcommunity health. All these share commonground, i.e. prevention of disease andpromotion of health• CM provides comprehensive health servicesranging from preventive, promotive,curative, to rehabilitative services.
36.Community Medicine•••••••Providing medical services in the communityUnderstanding community resourcesHealth promotion and disease preventionOccupational healthKnowledge of communitiesCare of populationsCommunity participation in health care activities
37.4 Dimensions of Community Medicine• Paying attention to socio-cultural aspects of patientcare• Coordinating a community’s health resources in thecare of patients• Identifying and intervening in a community’s healthproblem• Assimilating into a community and participating inits organizations
38.Community Medicine• WHO defined community medicine as a system ofdelivery of comprehensive health care to the people byhealth team to improve the health of the communitythrough the promotive, preventive and curative healthservices.Health care on epidemiologicbasis includes:1. Promotive2. Preventive3. CurativeHealth care on health caresystem management basisincludes:1. Primary (PHC)2. Secondary3. Tertiary
39.Community Medicine and InternalMedicine (family medicine)CommunityMedicineInternal
40.Community health componentsEpidemiologyRegistrationSurveillanceBiostatisticsDATAHealth care systemHealth caremanagement
41.MODERN MEDICINE• CURATIVE MEDICINE – Removal Of Disease.• PREVENTIVE MEDICINE/COMMUNITYMEDICINE – Prevention of disease .• SOCIAL MEDICINE – Study of man as socialbeing in his total environment .• FAMILY MEDICINE - Family oriented medicineor health care centered on the family as unit .
42.PREVENTIVE MEDICINE:• It is the science and art of Preventing disease Prolonging life and Promoting health through efficiency groups ofindividuals and individuals within these groups,• THROUGH INTERCEPTION OF DISEASE PROCESSES• Customarily applied to “healthy” individuals• Actions affect large numbers or population
43.Cont.• Modern Preventive Medicine:The science and art of healthpromotion, disability limitationand rehabilitation
44.Edge of community medicine specialistsover physicians from other disciplinesIn addition to the knowledge of basic and clinical sciences and skillscommon to all physicians , distinctive aspects of preventive medicineinclude knowledge of and competence in: Epidemiology & biostatistics Administration (including planning, organization,management, financing & evaluation of health programs) Environment & occupational health. Application of the social & behavioral factors in health. Application of primary , secondary & tertiary preventivemeasures.
45.What do community medicine specialistsdo?• Assess the health needs of the population byidentifying appropriate information orgenerating new information that recognizesthe interactions of biological, behavioral, social& environmental factors that affect health .• Recognize the strengths and weakness invarious measurements of health &characteristics of society & understand theprinciples of the statistical methods required tosummarize & analyze the information.
46.Cont.• Set priorities and develop programs to meetthe health needs of the population.• Implement programs taking in to account thesocioeconomic, educational, occupati