Family and Community Health: Disease Control, Immunisation and First Aid
What this domain covers
Family and Community Health tests how health is protected at household and community level: control of communicable disease, maternal and child health, the immunisation schedule, first aid, sanitation and national health programmes.
Core concepts
- Chain of infection: agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host. Control means breaking any single link - safe water and food cut vehicle transmission, vector control addresses malaria and dengue, isolation interrupts contact, and immunisation protects the host.
- Universal Immunisation Programme schedule: BCG, OPV-0 and the Hepatitis B birth dose at birth; at 6, 10 and 14 weeks Pentavalent (DPT–HepB–Hib), OPV, Rotavirus, with fIPV at 6 and 14 weeks and PCV at 6 and 14 weeks; at 9–12 months MR-1, JE-1 and PCV booster; at 16–24 months MR-2, DPT booster-1 and OPV booster; DPT booster-2 at 5–6 years; Td at 10 and 16 years.
- Antenatal care: at least four check-ups, iron-folic acid and calcium supplementation, Td immunisation, blood pressure and haemoglobin checks, institutional delivery, and exclusive breastfeeding for six months.
- First aid: cool a burn under running water for about 20 minutes - never ice, toothpaste or oil; for a suspected fracture, immobilise the limb and never try to straighten it.
Worked example
A mother brings an 18-month-old who completed all doses up to 14 weeks and received MR-1 at 9 months. What is due now? Reasoning: the child is in the 16–24 month window, so MR-2, DPT booster-1, OPV booster and JE-2 (in endemic districts) are due, along with the next Vitamin A dose. The 14-week doses were primary doses, not boosters - mixing these up is the commonest error.
Traps
- Calling the 9-month measles dose a booster; it is the first dose.
- Confusing OPV-0 (birth) with the 6-week OPV dose.
- Recommending ghee, toothpaste or ice on a burn.