Community Health
Community Health
Community Health in the WACP Primary tests population-level reasoning: primary health care (PHC), epidemiological measures, programme indicators, and outbreak investigation. Questions often present a district scenario and ask for the correct denominator, indicator, or programme action.
Core rules and concepts
- PHC principles: equity, community participation, intersectoral collaboration, appropriate technology, and prevention.
- Incidence = new cases / population at risk over a period. Prevalence = all cases / total population at a point.
- Attack rate = new cases / population at risk during an outbreak.
- Case fatality rate (CFR) = deaths / confirmed cases.
- Under-5 mortality rate uses live births as the denominator, not total population.
- Vaccine cold chain: +2 to +8 °C; discard a vaccine vial when the inner square is darker than the outer circle.
- DHS and MICS are standard sources for coverage and mortality indicators.
Worked example
A village of 400 residents has 120 cases of acute gastroenteritis over two weeks and 3 deaths. Attack rate = 120/400 = 30%. CFR = 3/120 = 2.5%. If 12 cases were among 80 children under five, the under-five attack rate is 12/80 = 15%. The correct answer names the denominator explicitly. Using 400 for CFR (0.75%) is wrong because the denominator is cases, not residents.
Traps
- Mixing incidence and prevalence in chronic disease questions.
- Using total population instead of population at risk.
- Confusing infant mortality (deaths under 1 year per 1,000 live births) with under-5 mortality.
- Ignoring person-time when follow-up is unequal.