Community Health and Public Health
Overview
Community Health and Public Health tests how disease is measured and prevented in populations, and how national programmes reach villages - particularly through ASHA workers, sub-centres and PHCs in Assam.
Levels of prevention
- Primary: before disease - immunisation, safe water, health education, mosquito control.
- Secondary: early detection and prompt treatment - screening, DOTS for TB, blood pressure checks.
- Tertiary: disability limitation and rehabilitation - physiotherapy after stroke.
Measures and programmes
- Incidence = new cases in a period; prevalence = all existing cases at a point or period.
- IMR = infant deaths under one year per 1,000 live births; MMR = maternal deaths per 100,000 live births.
- NTEP (formerly RNTCP) provides free TB diagnosis and DOTS; NVBDCP covers malaria, dengue and kala-azar; the Universal Immunisation Programme provides free vaccines.
- Diarrhoea: ORS plus zinc for 14 days; continue feeding.
Worked example
After a flood, many children in a village develop watery diarrhoea. Reasoning: the likely source is contaminated water. The community response is to chlorinate and protect the water source, promote handwashing, set up ORS corners at the sub-centre and anganwadi, and notify the PHC. This is primary prevention plus early treatment - not mass antibiotics.
Traps that cost marks
- Mixing incidence and prevalence in a sentence.
- Using total population instead of live births as the denominator for IMR and MMR.
- Calling screening tertiary prevention.