Community Health Nursing
Community Health Nursing - what the exam tests
This domain covers levels of prevention, primary health care, epidemiology, the national immunisation schedule, community maternal and child health services, family welfare and national health programmes.
Core rules
- Levels of prevention: primordial, primary (immunisation, health education), secondary (early diagnosis, screening), tertiary (rehabilitation).
- Primary health care (Alma-Ata, 1978): equitable access, community participation, appropriate technology, intersectoral coordination and a defined set of essential services.
- Incidence = new cases ÷ population at risk × 1,000 in a period; prevalence = all existing cases ÷ total population × 1,000 at a point in time.
- India's immunisation schedule: BCG, OPV-0 and hepatitis B at birth; pentavalent and OPV at 6, 10 and 14 weeks; measles-rubella at 9–12 months and 16–24 months; DPT booster at 16–24 months; TT/Td for pregnant women.
- Cold chain: most vaccines at 2–8 °C at the PHC; OPV kept frozen; check the vaccine vial monitor.
Worked example
A village of 2,000 people reports 20 new typhoid cases in a month while 200 known cases are still under treatment. Incidence = 20 ÷ 2,000 × 1,000 = 10 per 1,000 per month. Prevalence = 220 ÷ 2,000 × 1,000 = 110 per 1,000. Reasoning: incidence measures the risk of new infection and responds to water and sanitation measures; prevalence measures total burden and guides service planning.
Traps that cost marks
- Reporting prevalence when the question asks for incidence.
- Giving measles vaccine at 6 weeks instead of 9–12 months.
- Freezing pentavalent or DPT, or leaving OPV unfrozen.
- Forgetting that the family folder and eligible-couple register are core community-nurse records.