Community Health and Public Health Programmes
This domain tests how disease is prevented at community level, basic epidemiology terms, population norms for health facilities, and the national programmes a health worker must be able to name and explain.
Core rules
- Levels of prevention: primary - before disease occurs (immunisation, safe water, health education); secondary - early detection and prompt treatment (screening, case finding); tertiary - disability limitation and rehabilitation.
- Epidemiology terms: incidence = new cases in a period; prevalence = all existing cases at a point in time; endemic (constant presence), epidemic (unexpected rise), pandemic (global spread).
- Population norms: sub-centre 1 per 5,000 in the plains and 3,000 in hilly or tribal areas; PHC 1 per 30,000 plains and 20,000 hilly; CHC 1 per 1,20,000 plains and 80,000 hilly.
- Programmes to know: NTEP for tuberculosis (free diagnosis and DOTS, notification mandatory), NVBDCP for malaria, dengue and kala-azar, NPCDCS for diabetes, hypertension and cancer screening, NACP for HIV with ICTC services, UIP for immunisation, RMNCH+A, Ayushman Bharat with Health and Wellness Centres and PM-JAY.
- Key indicators: infant mortality rate, maternal mortality ratio, total fertility rate, sex ratio, life expectancy.
Worked example
Classify each activity. Reasoning: chlorinating wells and teaching handwashing act before any disease appears, so they are primary prevention. A nurse screening every adult over 30 for raised blood pressure is finding disease early in asymptomatic people, so it is secondary prevention. Physiotherapy for a patient with post-stroke hemiplegia limits disability, so it is tertiary prevention.
Traps that cost marks
Calling screening primary prevention; mixing incidence with prevalence; believing TB notification is optional; forgetting that JSY applies to institutional delivery; quoting plains population norms for hilly districts.