Community Health and Public Health Nursing
Community Health and Public Health Nursing examines prevention levels, epidemiology measures and knowledge of Iran's primary health care network, where the health house (خانه بهداشت) and the community health worker (بهورز) deliver first-contact care in villages, and urban health centres serve city populations.
Prevention levels
Primary prevention acts before disease (immunisation, sanitation, health education); secondary prevention detects early disease (screening, case finding); tertiary prevention limits disability (rehabilitation, chronic disease follow-up). Placing a screening test in the wrong level is a common distractor.
Epidemiology measures
Incidence counts new cases among people at risk over a period; prevalence counts all existing cases at a point in time. A long-duration disease raises prevalence without changing incidence. Attack rate is used in outbreaks and equals new cases divided by the exposed population.
Worked example
A district of 100,000 people records 50 new tuberculosis cases in one year. Reasoning: incidence rate = 50 ÷ 100,000 = 50 per 100,000 person-years. If the same district reports 300 people currently under treatment, that figure is prevalence, not incidence.
Programmes you should recognise
Tuberculosis control follows DOTS with directly observed therapy and smear follow-up. Non-communicable disease screening is delivered through the IraPEN package for hypertension, diabetes and depression risk. Certain diseases such as polio, measles and cholera require immediate notification through the national surveillance system.
Traps that cost marks
- Labelling vaccination as secondary prevention.
- Confusing incidence with prevalence in a chronic disease question.
- Forgetting that the home visit requires hand hygiene and bag technique before contact with the family.