Pancyprian Health Education cheat sheet

Ottawa Charter (1986) five action areas: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services.

Three health promotion strategies per Ottawa Charter: advocate, enable, mediate.

Health belief model constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy.

Transtheoretical model stages: precontemplation, contemplation, preparation, action, maintenance (termination optional); relapse is a return to earlier stage, not a separate stage.

Socio-ecological model levels: intrapersonal, interpersonal, organisational/community, and public policy - interventions at multiple levels are more sustainable.

PRECEDE-PROCEED: PRECEDE diagnoses social, epidemiological, behavioural, environmental, educational/ecological, and administrative/policy factors; PROCEED covers implementation and evaluation.

Social cognitive theory: reciprocal determinism, observational learning, self-efficacy, outcome expectations; self-efficacy is the strongest single predictor of behaviour change.

Precede terms: predisposing factors (knowledge, attitudes), enabling factors (skills, resources, access), reinforcing factors (family, peers, providers).

Education vs promotion: health education is a planned learning activity; health promotion adds policy, environmental, and community-level action.

Normal adult resting values: heart rate 60-100/min, respiratory rate 12-20/min, blood pressure <120/80 mmHg, SpO2 95-100%, temperature 36.5-37.5 °C.

Cardiac output = heart rate × stroke volume; mean arterial pressure ≈ diastolic + 1/3 (systolic − diastolic).

Nephron order: glomerulus → proximal tubule → loop of Henle → distal tubule → collecting duct; ~180 L filtered daily, ~1.5 L excreted.

Gas exchange occurs in alveoli by diffusion; surfactant from type II pneumocytes reduces surface tension and prevents alveolar collapse.

Insulin from pancreatic beta cells lowers blood glucose; glucagon from alpha cells raises it; HbA1c reflects average glycaemia over ~2-3 months.

Inflammation cardinal signs: redness, heat, swelling, pain, loss of function (rubor, calor, tumor, dolor, functio laesa).

Atherosclerosis: endothelial injury → LDL accumulation and oxidation → macrophage foam cells → fatty streak → fibrous plaque → thrombosis or rupture.

Shock types: hypovolaemic, cardiogenic, distributive (septic, anaphylactic, neurogenic), obstructive; all end in inadequate tissue perfusion.

Incidence = new cases / population at risk per time period; prevalence = all existing cases / total population at a point or period.

Relationship: prevalence ≈ incidence × average disease duration (for stable conditions).

Relative risk = incidence in exposed / incidence in unexposed (cohort studies); odds ratio approximates RR when disease is rare (<10%).

Attributable risk (risk difference) = incidence exposed − incidence unexposed; population attributable fraction = Pe(RR−1) / [1 + Pe(RR−1)].

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive predictive value depends on prevalence: PPV = sensitivity×prevalence / [sensitivity×prevalence + (1−specificity)×(1−prevalence)].

Study designs: cross-sectional (prevalence, no temporality), case-control (rare diseases, OR), cohort (incidence, RR), RCT (causality, allocation concealment).

Bias types: selection, information/measurement, confounding, recall, lead-time, healthy worker effect.

Screening criteria (Wilson-Jungner): important condition, accepted treatment, detectable latent stage, suitable test, cost-effective, agreed policy on whom to treat.

Confidence interval interpretation: 95% CI means 95% of similarly constructed intervals contain the true parameter; a CI excluding the null indicates statistical significance at α=0.05.

Core public health functions: assessment (monitor health), policy development, assurance (ensure services); often summarised as assessment, policy, assurance plus equity.

Health system building blocks (WHO): service delivery, health workforce, health information, medical products/vaccines/technologies, financing, leadership/governance.

Universal health coverage has three dimensions: population covered, services covered, and proportion of costs covered.

Beveridge model: tax-funded, government-provided; Bismarck model: social insurance funded by employer/employee contributions; private insurance model is market-based.

Health in All Policies: systematic consideration of health implications across sectors; requires intersectoral governance and health impact assessment.

Equity vs equality: equity allocates resources according to need; horizontal equity = equal treatment for equal need, vertical equity = unequal treatment for unequal need.

Health system performance measures: access, quality, efficiency, responsiveness, financial protection (out-of-pocket share, catastrophic spending >10-25% of household consumption).

Chain of infection: infectious agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host; break any link to prevent transmission.

Modes of transmission: contact (direct/indirect), droplet (>5 µm, <1-2 m), airborne (<5 µm, long-range), vector-borne, vehicle-borne, vertical.

Basic reproduction number R0 = average secondary cases per index case in a fully susceptible population; effective Rt = R0 × susceptible fraction; herd immunity threshold = 1 − 1/R0.

Surveillance types: passive (routine reporting), active (health workers seek cases), sentinel (selected sites), syndromic (based on symptom syndromes).

Outbreak investigation steps: verify diagnosis, confirm outbreak, define case, describe by time/place/person, generate hypothesis, test hypothesis, control, communicate.

Vaccine types: live attenuated (MMR, varicella, BCG) - avoid in severe immunosuppression and pregnancy; inactivated, toxoid (tetanus, diphtheria), subunit/conjugate, mRNA.

Cold chain: most vaccines stored at +2 to +8 °C; avoid freezing adjuvanted vaccines; monitor with temperature logs and vaccine vial monitors.

Notifiable disease reporting enables early detection; case definitions specify clinical, laboratory, and epidemiological criteria.

WHO NCD four main groups: cardiovascular disease, cancer, diabetes, chronic respiratory disease; four shared risk factors: tobacco, unhealthy diet, physical inactivity, harmful alcohol use.

BMI = weight (kg) / height (m)²; categories: underweight <18.5, normal 18.5-24.9, overweight 25-29.9, obese ≥30.

Waist circumference thresholds (WHO): increased risk at ≥94 cm men and ≥80 cm women; substantially increased at ≥102 cm men and ≥88 cm women.

WHO adult activity recommendation: 150-300 min moderate or 75-150 min vigorous activity weekly plus muscle-strengthening ≥2 days/week.

Salt intake target <5 g/day (≈2 g sodium); free sugars <10% of energy, ideally <5%; saturated fat <10% of energy.

Metabolic syndrome: any three of central obesity, raised triglycerides, low HDL, raised blood pressure, raised fasting glucose.

Diabetes diagnostic thresholds: fasting glucose ≥7.0 mmol/L, 2-h OGTT ≥11.1 mmol/L, HbA1c ≥6.5%.

Cancer prevention: ~30-50% of cancers are preventable; tobacco is the single largest modifiable risk factor.

Hierarchy of controls: elimination, substitution, engineering controls, administrative controls, personal protective equipment (least effective, last resort).

Exposure assessment elements: route (inhalation, dermal, ingestion), dose, duration, frequency, and latency between exposure and disease.

Air quality: PM2.5 penetrates alveoli and enters the bloodstream; no safe threshold is established; WHO 2021 guideline annual PM2.5 = 5 µg/m³.

Water safety: chlorination residual, turbidity, and microbiological indicators (E. coli, coliforms) signal faecal contamination; multiple-barrier approach from catchment to consumer.

Occupational exposure limits: TLV-TWA (8-hour time-weighted average), STEL (15-minute short-term), ceiling limit (never exceed).

Noise-induced hearing loss: risk rises above 85 dB(A) over 8 hours; 3 dB exchange rate halves permissible exposure time.

Environmental health risk assessment four steps: hazard identification, dose-response assessment, exposure assessment, risk characterisation.

Heat stress prevented by hydration, acclimatisation, work-rest cycles, and monitoring (WBGT index).

Antenatal care: WHO recommends at least 8 contacts; first contact before 12 weeks; screen for anaemia, hypertension, diabetes, infections, and psychosocial risk.

Danger signs in pregnancy: bleeding, severe headache with visual disturbance, severe abdominal pain, reduced fetal movements, fever, convulsions, rupture of membranes.

Exclusive breastfeeding for 6 months, complementary feeding from 6 months with continued breastfeeding to 2 years or beyond.

Growth monitoring: weight-for-age, length/height-for-age, weight-for-length/BMI, and head circumference; stunting = low height-for-age, wasting = low weight-for-height.

Childhood immunisation schedule principles: start early, complete series, catch-up for missed doses; measles requires 2 doses for adequate immunity.

Adolescent health: leading causes of mortality are road injury, violence, and self-harm; mental health, substance use, sexual health, and nutrition are key domains.

Kangaroo mother care: skin-to-skin contact, exclusive breastfeeding, and early discharge reduce neonatal mortality in low-birth-weight infants.

Maternal mortality ratio = maternal deaths per 100,000 live births; most causes (haemorrhage, eclampsia, sepsis) are preventable.

IASC MHPSS intervention pyramid: basic services and security → community and family supports → focused, non-specialised supports → specialised services.

Do no harm: avoid debriefing individuals immediately after trauma; Psychological First Aid (Look, Listen, Link) is preferred in the acute phase.

Depression screening: PHQ-9 (9 items, score 0-27; ≥10 suggests moderate depression); GAD-7 for anxiety.

Suicide risk assessment: ask directly about ideation, plan, intent, means, and previous attempts; means restriction is a key prevention measure.

Stigma reduction strategies: education, contact with affected people, and structural/legal reforms; person-first language reduces discrimination.

Mental health gap: globally most people with mental disorders receive no treatment; task-shifting to trained non-specialist workers improves access.

Common mental disorders: depression and anxiety are the most prevalent; depression is a leading cause of years lived with disability worldwide.

Protective factors: social support, secure attachment, problem-solving skills, economic security; adverse childhood experiences increase lifetime risk.

Health literacy is the ability to access, understand, appraise, and apply health information (Nutbeam: functional, interactive, critical levels).

Risk communication principles (WHO): build trust, announce early, be transparent, acknowledge uncertainty, coordinate with stakeholders.

Infodemic management: monitor misinformation, verify and fact-check, promote accurate content, engage communities, and address information voids.

Plain-language writing: short sentences, active voice, common words, clear headings, and a reading level appropriate for the audience.

Teach-back method: ask the person to explain the information in their own words to confirm understanding.

Community engagement ladder: inform, consult, involve, collaborate, empower (Arnstein); higher rungs give communities real decision-making power.

Digital divide dimensions: access (devices/connectivity), skills (digital literacy), and use (meaningful benefit); all three must be addressed.

Message framing: gain-framed messages work better for prevention behaviours; loss-framed messages can work better for detection behaviours.

Placeholder bullet one: this section is not used because domain 1 already covers this title; retained only if numbering requires an eleventh section.

Ottawa Charter action areas restated for cross-reference: healthy public policy, supportive environments, community action, personal skills, reorienting services.

Behaviour change technique taxonomy: feedback, self-monitoring, goal setting, action planning, social support, and rewards are evidence-based techniques.

Diffusion of innovations: adopters are innovators, early adopters, early majority, late majority, laggards; perceived relative advantage drives uptake.

Motivational interviewing: person-centred, non-judgemental, emphasises collaboration, evocation, and autonomy; OARS skills = open questions, affirmations, reflections, summaries.

Precede-proceed evaluation: process, impact, and outcome evaluation; process evaluation checks fidelity and reach, outcome evaluation checks health and quality of life.

Planning models select a theory based on the target behaviour, population, and setting - no single model fits all interventions.

Health needs assessment approaches: epidemiological (population data), comparative (benchmarking against similar areas), and corporate (stakeholder priorities).

Standardisation: direct standardisation applies study rates to a standard population; indirect standardisation compares observed with expected events (SMR = observed/expected × 100).

Statistical tests: chi-square for categorical comparisons, t-test for two means, ANOVA for ≥3 means, and non-parametric alternatives when assumptions fail.

P-value interpretation: probability of obtaining the observed result (or more extreme) if the null hypothesis is true; it is not the probability that the null is true.

Screening test trade-offs: lowering the cut-off increases sensitivity and false positives; raising it increases specificity and false negatives.

Sample size depends on effect size, variability, power (usually 80%), significance level (α=0.05), and expected dropout.

Causality (Bradford Hill): strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment, analogy; temporality is essential.

Data sources for needs assessment: vital registration, hospital discharge, survey data, GP records, and community consultation.

Health policy cycle: agenda setting, formulation, adoption, implementation, monitoring and evaluation.

Stakeholder analysis maps interest and influence to plan engagement and manage opposition.

Health financing functions: revenue collection, pooling, and purchasing; strategic purchasing links payment to quality and outcomes.

Primary health care (Alma-Ata 1978, Astana 2018) emphasises first-contact, comprehensive, continuous, coordinated, and community-oriented care.

Health impact assessment: screening, scoping, appraisal, reporting, and monitoring; used to predict health effects of policies outside the health sector.

Workforce planning: supply = stock of workers + inflows (graduates, migrants) − outflows (retirement, attrition, emigration).

Decentralisation can improve responsiveness but risks inequity without national standards and financing safeguards.

Antimicrobial resistance drivers: unnecessary prescribing, incomplete courses, agricultural use, and poor infection control; stewardship programmes slow resistance.

Hand hygiene (WHO five moments): before patient contact, before aseptic task, after body fluid exposure, after patient contact, after contact with patient surroundings.

Isolation precautions: standard for all patients; contact for MRSA/C. difficile; droplet for influenza/pertussis; airborne for TB/measles with negative-pressure rooms and N95 respirators.

Immunisation schedule principles: inactivated vaccines can be given in pregnancy; live vaccines are contraindicated; minimum intervals must be respected.

Cold chain management: monitor temperature continuously, record twice daily, and follow the shake test for freeze-sensitive vaccines.

Contact tracing: identify contacts, classify exposure risk, quarantine or provide post-exposure prophylaxis, and monitor for symptoms for the maximum incubation period.

Vaccine hesitancy (WHO 3Cs): confidence, complacency, convenience; address with trusted messengers and dialogue, not coercion.

Tobacco cessation: brief advice (5 As: ask, advise, assess, assist, arrange) plus pharmacotherapy (nicotine replacement, varenicline, bupropion) and behavioural support.

Alcohol risk: no safe level is established for cancer risk; standard drink ≈10 g ethanol; harmful use increases risk of liver disease, cancer, and injury.

Dietary fibre target ≥25-30 g/day; fruit and vegetables ≥400 g/day (5 portions).

Physical activity reduces risk of cardiovascular disease, type 2 diabetes, and several cancers; sedentary time is an independent risk factor.

Cardiovascular risk assessment uses multivariable tools (e.g., SCORE, Framingham) combining age, sex, smoking, blood pressure, cholesterol, and diabetes.

Cancer screening: cervical (HPV test or cytology), breast (mammography), colorectal (faecal test or colonoscopy); screening intervals depend on national programmes.

Obesity management: lifestyle first, then pharmacotherapy, then bariatric surgery for selected severe cases; even 5-10% weight loss improves metabolic outcomes.

Occupational disease categories: pneumoconioses (silicosis, asbestosis), occupational asthma, dermatitis, hearing loss, musculoskeletal disorders, and occupational cancers.

Asbestos exposure causes mesothelioma, lung cancer, and asbestosis; latency is typically 20-40 years.

Lead exposure: affects the nervous system, kidneys, and blood; no safe blood lead level in children is known.

Indoor air pollutants: radon, carbon monoxide, tobacco smoke, mould, and volatile organic compounds; ventilation is a key control.

Climate and health: heatwaves increase cardiovascular and respiratory mortality; vector ranges shift with warming.

Waste management: segregation at source, safe collection, and sanitary landfill or controlled incineration reduce environmental and health risks.

Occupational health surveillance: pre-placement, periodic, and exit medical examinations; record exposure history for compensation claims.

Postpartum care: check mother and newborn within 24 hours, at day 3, and at weeks 1-2 and 6; screen for postpartum depression and haemorrhage.

Newborn care: delayed cord clamping, immediate skin-to-skin contact, vitamin K prophylaxis, and birth-dose hepatitis B vaccine where indicated.

Child development milestones: social smile ~6 weeks, sitting without support ~6-8 months, walking ~12-15 months, two-word phrases ~18-24 months.

Adolescent friendly health services: confidentiality, respectful staff, convenient hours, and youth involvement in service design.

School health programmes: vision and hearing screening, immunisation checks, nutrition, oral health, and mental health support.

Family planning: counselling on effectiveness, side effects, and dual protection; long-acting reversible contraception has the highest effectiveness.

Stillbirth and neonatal mortality reduction: skilled birth attendance, emergency obstetric care, and early breastfeeding support.

Mental health continuum: flourishing to languishing; prevention includes universal, selective, and indicated interventions.

Psychological First Aid principles: safety, calming, connectedness, self-efficacy, and hope.

Substance use screening: AUDIT for alcohol (score ≥8 indicates hazardous use) and ASSIST for other substances.

Dementia: progressive cognitive decline; protective factors include physical activity, cognitive engagement, social connection, and vascular risk control.

Psychosis early intervention: reduce duration of untreated psychosis, provide family psychoeducation, and offer supported employment.

Mental health legislation protects rights: informed consent, least restrictive care, confidentiality, and access to review of detention.

Workplace mental health: psychosocial risk assessment, workload management, anti-bullying policies, and access to support services.

Audience segmentation: group by demographics, risk, literacy, and behaviour to tailor messages and channels.

Channel selection: mass media for awareness, interpersonal channels for persuasion, and digital channels for reach and interactivity.

Message testing: pre-test with representative users using focus groups or surveys; post-test to measure recall and behaviour change.

Digital health literacy domains: operational, information, and strategic skills; assess with tools such as eHEALS.

Social listening: monitor online conversation to detect misinformation and emerging concerns early.

Community engagement methods: community advisory boards, participatory rural appraisal, and co-design of interventions.

Evaluation of communication campaigns: reach, recall, comprehension, attitude change, intention, and behaviour; use both process and outcome indicators.

Accessibility: provide plain language, translations, captions, and multiple formats to reach people with disabilities and low literacy.

Health system resilience: absorb, adapt, and transform in response to shocks; requires surge capacity, information systems, and workforce flexibility.

One Health: integrated approach to human, animal, and environmental health for zoonoses and antimicrobial resistance.

International Health Regulations (2005): core surveillance and response capacities; states must notify WHO of events that may constitute a public health emergency of international concern.

Health equity monitoring: stratify indicators by socioeconomic status, geography, sex, and disability to detect gaps.

Quality improvement methods: Plan-Do-Study-Act cycles, clinical audits, and root cause analysis.

Health workforce retention: rural incentives, career pathways, continuing education, and safe working conditions.

Public health emergency preparedness: risk assessment, planning, stockpiles, drills, and risk communication.

Descriptive epidemiology: person (age, sex, occupation), place (geography, setting), and time (seasonality, trend, clustering).

Epidemic curves: point source (single peak within one incubation period), propagated (successive peaks), and continuous common source (plateau).

Age-standardised rates allow comparison between populations with different age structures.

Measures of association: risk ratio, rate ratio, odds ratio, and attributable fraction; interpret with confidence intervals.

Regression: linear for continuous outcomes, logistic for binary outcomes (reports odds ratios), Poisson for counts.

Missing data: complete-case analysis can bias results; multiple imputation is preferred when data are missing at random.

Health needs assessment output: prioritised needs, gaps in services, and recommendations linked to commissioning decisions.

Settings-based approach: health promoting schools, hospitals, workplaces, and cities embed health into everyday settings.

Salutogenesis (Antonovsky): sense of coherence - comprehensibility, manageability, meaningfulness - supports health.

Empowerment models emphasise community assets and participation over deficit-based approaches.

Behaviour change wheel (COM-B): capability, opportunity, and motivation determine behaviour; interventions target each component.

Nudge theory: small changes to choice architecture influence behaviour without removing options.

Health education planning: assess needs, set objectives (SMART), choose methods, implement, and evaluate.

Ethical principles in health promotion: autonomy, beneficence, non-maleficence, justice, and avoiding victim-blaming.

Immune response: innate (fast, non-specific: barriers, phagocytes, inflammation) and adaptive (specific: B cells, T cells, memory).

Vaccination induces adaptive immunity and immunological memory without causing disease.

Endocrine feedback: negative feedback maintains hormone levels; positive feedback amplifies (e.g., oxytocin in labour).

Renal regulation: kidneys control fluid, electrolyte, and acid-base balance; they secrete erythropoietin and activate vitamin D.

Respiratory control: medulla responds mainly to CO2/pH; oxygen drive becomes important in chronic CO2 retention.

Wound healing phases: haemostasis, inflammation, proliferation, remodelling; diabetes and poor perfusion impair healing.

Pathophysiology of fever: pyrogens raise the hypothalamic set point; antipyretics lower it.

Tuberculosis: airborne transmission; latent TB infection has no symptoms and is not infectious; active TB requires multidrug treatment.

HIV transmission routes: sexual, blood, and mother-to-child; post-exposure prophylaxis within 72 hours reduces risk.

Hepatitis B and C: bloodborne; hepatitis B is vaccine-preventable; hepatitis C is curable with direct-acting antivirals.

Malaria prevention: vector control (insecticide-treated nets, indoor residual spraying), chemoprophylaxis for travellers, and prompt diagnosis with rapid tests.

Sexually transmitted infections: partner notification and condom use reduce transmission; many are asymptomatic.

Outbreak communication: provide timely, consistent information and counter rumours to maintain trust.

Surveillance indicators: completeness, timeliness, sensitivity, and positive predictive value of alerts.

Vulnerable groups: children, pregnant women, older people, and those with chronic disease are more susceptible to environmental hazards.

Chemical safety: read safety data sheets, use appropriate ventilation, and dispose of hazardous waste correctly.

Radiation: ionising radiation damages DNA; ALARA principle (as low as reasonably achievable) guides protection.

Vector control: eliminate standing water, use larvicides and adulticides responsibly, and promote personal protection.

Food safety: five keys - keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, and use safe water and raw materials.

Occupational injury prevention: risk assessment, training, machine guarding, and safety culture.

Environmental impact assessment includes health considerations to prevent harm from development projects.

Preconception care: folic acid supplementation before conception reduces neural tube defects.

Antenatal screening: ultrasound, blood tests, and infection screening; offer genetic counselling when indicated.

Labour care: monitor maternal and fetal wellbeing, use the partograph to detect prolonged labour, and provide respectful maternity care.

Newborn resuscitation: dry, stimulate, assess breathing; positive pressure ventilation if not breathing.

Child nutrition: iron-rich foods from 6 months; vitamin A supplementation where deficiency is common.

Adolescent mental health: screen for depression, anxiety, and self-harm; provide confidential support.

Immunisation catch-up schedules ensure children who missed doses are protected.

Health communication campaigns: define objectives, segment the audience, select channels, pre-test messages, and evaluate.

Crisis communication: be first, be right, be credible; provide actionable guidance and update regularly.

Misinformation response: correct with truth, not repetition of the myth, and explain the manipulation technique.

Digital tools: telehealth, mHealth apps, and patient portals improve access but require usability and privacy safeguards.

Community health workers bridge health systems and communities; training and supervision are essential.

Participatory approaches: involve community members in identifying problems, designing solutions, and evaluating results.

Communication ethics: accuracy, privacy, consent, and avoiding stigmatising language.

Trauma-informed care: recognise trauma, ensure safety, avoid re-traumatisation, and support choice and control.

Depression management: psychological therapies (CBT, interpersonal therapy) and/or antidepressants; combine for moderate-severe cases.

Anxiety management: CBT, relaxation training, and gradual exposure; avoid benzodiazepines long term.

Substance use treatment: brief interventions, motivational interviewing, detoxification, and relapse prevention.

Psychosocial support in emergencies: restore services, reunite families, and provide safe spaces.

Mental health promotion: anti-stigma campaigns, school-based programmes, and workplace policies.

Recovery model: focus on hope, identity, meaning, and personal goals rather than symptom elimination alone.

Hypertension: most cases are asymptomatic; diagnosis requires repeated measurements; lifestyle changes plus medication reduce cardiovascular risk.

Diabetes prevention: weight loss of 5-7% and moderate activity reduce progression from prediabetes.

Dyslipidaemia: statins reduce cardiovascular events; monitor liver and muscle symptoms.

Obesity prevention: supportive environments, food labelling, marketing restrictions, and urban design that encourages activity.

Nutrition labelling: front-of-pack labels help consumers compare products; interpret with caution for portion sizes.

Tobacco control: price increases, smoke-free policies, advertising bans, and cessation support are most effective together.

Alcohol policy: pricing, availability restrictions, and marketing controls reduce harm.

Health information systems: collect, analyse, and use data for decision-making; data quality depends on completeness, accuracy, and timeliness.

Electronic health records improve continuity but require interoperability standards and privacy protection.

Universal health coverage monitoring: service coverage index and catastrophic health spending indicators.

Health policy analysis triangle: context, content, and process; actors and institutions shape implementation.

Priority setting: use burden of disease, cost-effectiveness, equity, and political feasibility.

Public health law: powers for isolation, quarantine, and mandatory reporting must be lawful, necessary, and proportionate.

Partnerships: multisectoral collaboration with education, agriculture, and urban planning improves health outcomes.

Random error reduces precision; increasing sample size reduces random error.

Systematic error (bias) reduces validity; cannot be fixed by increasing sample size.

Confounding: a third variable associated with both exposure and outcome; control by design (randomisation, restriction, matching) or analysis (stratification, multivariable regression).

Effect modification: the effect of exposure differs across strata; report stratum-specific estimates.

Survival analysis: Kaplan-Meier curves estimate survival; log-rank test compares groups.

Meta-analysis: combines study results; assess heterogeneity (I²) and publication bias (funnel plot).

Health needs assessment should triangulate quantitative and qualitative data to capture unmet needs.

Behaviour change maintenance: self-regulation, habit formation, and environmental support sustain long-term change.

Relapse prevention: identify high-risk situations, develop coping strategies, and use lapse management.

Peer education: credible peers influence norms and behaviour; requires training and supervision.

Social marketing: uses commercial marketing principles - product, price, place, promotion - to promote health behaviours.

Advocacy: influencing policy and decision-makers to support health; coalition building and evidence-based messaging.

Health education methods: lectures, discussions, demonstrations, role-play, and digital media; match method to objective.

Evaluation designs: before-after, controlled, and randomised; use appropriate indicators and avoid overinterpreting weak designs.