Community Health and Primary Health Care
Community health asks you to think at population level as well as individual level. Understand primary health care principles - accessibility, equity, community participation, intersectoral collaboration, and appropriate technology - and the distinction between primary, secondary, and tertiary prevention (prevention before disease, early detection, and limiting disability).
Know the core tools of community practice: epidemiology (incidence versus prevalence, attack rate, case fatality, and interpreting an outbreak), levels of prevention applied to common conditions, communicable disease control (notification, isolation, contact tracing, immunisation, and the chain of infection), maternal and child health services (antenatal and postnatal care, growth monitoring, family planning), environmental health (safe water, sanitation, waste disposal, food hygiene), and health education (planning based on assessed needs, using appropriate channels and plain language).
Lesotho-specific context matters: mountainous terrain and seasonal access, high HIV and tuberculosis burden, and the role of village health workers in extending services. Questions may test home-based care, adherence support, stigma reduction, and referral pathways.
Traps: confusing incidence with prevalence; choosing a tertiary-prevention option when the stem describes primary prevention; recommending an intervention that ignores local feasibility; and forgetting that community assessment precedes community action. Also watch for questions that ask about the nurse's role in notification - statutory reporting is a legal duty, not optional.
Rule of thumb - assess the community as you would a client: data collection, prioritisation, planning with the community, implementation, and evaluation. Worked example: several diarrhoea cases appear in one village. Before advising treatment, investigate the water source and sanitation, because interrupting the common-source exposure prevents further cases - that is primary prevention at population level.