Community Health Nursing
What this domain tests
Community health nursing in NORCET covers epidemiology, levels of prevention, national health programmes, immunisation, maternal and child health, and health indicators in Indian settings. Expect data interpretation and programme-priority questions.
Core rules
- Levels of prevention: primordial (risk-factor reduction), primary (immunisation, health promotion), secondary (screening, early treatment), tertiary (rehabilitation).
- Incidence = new cases ÷ population at risk × 1,000 over a period. Prevalence = all existing cases ÷ total population × 1,000 at a point or period.
- Cold chain: OPV is stored frozen; most other vaccines at 2–8°C; use vaccine vial monitors; avoid freezing freeze-sensitive vaccines such as hepatitis B, DPT and TT.
- India's Universal Immunisation Programme: BCG, OPV-0 and hepatitis B birth dose; pentavalent, OPV and rotavirus at 6, 10 and 14 weeks; PCV and fIPV according to the current UIP schedule; MR1 and JE1 at 9–12 months; DPT and OPV boosters and MR2 at 16–24 months.
- Primary health care: equitable access, community participation, inter-sectoral coordination and appropriate technology.
- Indicators: infant mortality rate, maternal mortality ratio, total fertility rate and sex ratio.
Worked example
A district has 200,000 people. In one year, 400 new hypertension cases are diagnosed; 1,600 people already have hypertension. Incidence = 400 ÷ 200,000 × 1,000 = 2 per 1,000 per year. Point prevalence at year-end = (400 + 1,600) ÷ 200,000 × 1,000 = 10 per 1,000. New cases are already counted once.
Traps
Using total population instead of population at risk for incidence; calling screening 'primary prevention'; freezing DPT or hepatitis B; mixing vaccine doses and routes; and confusing IMR with MMR.