Unit 1 Introduction Community Health 2024 PDF

CMH 2213 Mrs. Niza R.S Belvin MPH and MBChB Pre-Clinical Coordinator Texila American University Zambia Learning Objectives Accurately define the terms health, community health, population health, and public health Explain the difference between personal and community health activit...

CMH 2213 Mrs. Niza R.S Belvin MPH and MBChB Pre-Clinical Coordinator Texila American University Zambia Learning Objectives Accurately define the terms health, community health, population health, and public health Explain the difference between personal and community health activities List and discuss the factors that influence the health of a community Relate the history of community/public health, including the recent history of community and public health in the twentieth-century Provide an overview of the current health status of Africa, Kenya being an example Describe the status of efforts to improve world health and list some plans for the future What is a community? Group of people who have common characteristics, that is people with a shared location; environment and fate A defined neighborhood Workers/students in a defined company/school Persons registered as potential users of a group practice/Health Management Organization/health center. A community is a collection of people who share some important feature of their lives. Brief History of Community and Public Health Renaissance/Exploration (1500-1700) renewed interest in causes/cures of disease. Great advances in natural sciences, use of epidemiology to investigate diseases seen as environmentally caused, examined the sick to understand illnesses. 1500 B.C. More than 700 drugs were known to the Egyptians. Babylon evidence The Code of Hammurabi contained laws pertaining to physicians and health practices. Book of Leviticus provided guidelines for personal cleanliness, sanitation, disinfection of wells, isolation of disease, disposal of refuse, and the hygiene of maternity. CLASSICAL CULTURES 500 B.C. to 500 A.D. Greeks Golden age of Greece games of strength and skill for men Greeks Active in community sanitation Greeks Running water supplemented local city wells with water supplies from mountains as far as 10 miles away. Romans Improved on Greek engineering and built aqueducts and sewer systems Romans Christians built hospitals for the public as charitable organizations Cont... Evidence of community health in earliest civilizations Northern India (bathrooms, sewers) Egypt (water drainage) Crete (toilets, sewers) Sumer (prescription drugs, clay tablet) Egyptians (700 drugs) Babylon (medical, health practices) Early Bible (emphasis on hygiene, isolation of disease) Ancient Greeks (sanitation, running water physical/athletic health) Romans (aqueducts, sewer systems, Christian-built charity hospitals) Middle Ages (500-1500 AD) separation from Romans turn to spiritual health great epidemics little progress in public health. Community Health in the 21st Century World Planning Reduce the burden of excess mortality and morbidity Counter potential threats to individual health Develop effective health systems Expand the knowledge base THE CONCEPT OF COMMUNITY  It can be a society of people holding common rights and privileges  (eg, citizens of a town),  sharing common interests (e.g. a community of farmers),  living under the same laws and regulations (e.g. a prison community).  The function of any community includes  its members’ collective sense of belonging  their shared identity, values, norms, communication, and common interests and concerns.  In community health, it is useful to identify a geographic boundaries, such as city or country, to become a clear target for analysis health needs.  Available data, morbidity mortality and population density can augment assessment studies to form the basis for planning health programs  Community health broadens that focus to concentrate on families, populations, and the community at large. Cont.... Communities can influence the spread of disease, provide barriers to protect members from health hazards, organize ways to combat outbreaks of infectious disease, and promote practices that contribute to individual and collective health. Many different professionals work in community health to form a complex team inlcudes; The city planner designing The social worker The physician And other Cont... COMMUNITY HEALTH Includes both private and public efforts of individuals, groups, and organizations to promote, protect and preserve the health of those in the community. GOVERNMENTAL HEALTH AGENCIES Funded primarily by tax dollars: International e.g.WHO/PAHO, UNICEF Local e.g.Ministry of Health, Regional Health Authorities, Regional Corporations NON‐GOVERNMENTAL HEALTH AGENCIES NGOs‐Funded by private donations or membership dues e.g. T&T Cancer Society, Living Waters hospice. Private practice‐health care workers d hprovi ding a service at a cost to the patient. Cont... GOVERNMENTAL HEALTH AGENCIES Responsibility for the provision of health care services is devolved from the Ministry of Health to Regional Health Authorities (RHAs) with the passing of the Regional Health Authorities. RHAsareautonomousbodiesthatown and RHAs are autonomous bodies that own and operate health facilities in their respective Regions. Cont... MINISTRY OF HEALTH (MOH)  The Ministry of Health it is required to play a key role in:  ensuring that they are properly run, by setting policies, goals and targets for Regions based on ssessment of real health needs.  This is the main role of the Ministry of Health.  The Ministry also allocates resources to the RHAs to financetheiroperations. finance their operations.  To date, the Ministry of Health has also retained responsibility for the operations of Vertical Services and National Programs.  These span a variety of public health programs and allied health services to the population. MEMBERS OF THE COMMUNITY HEALTH TEAM County Medical Officer of Health (CMOH) Medical Officer of Health (MOH) Primary Care Physicians District Health Visitor District Nurse Nursing Assistant g Patient Care Assistant Surveillance Nurse Public Health Inspectors Community Dietitian THE DOMAIN OF COMMUNITY HEALTH Its diversity requires a multidisciplinary approach with all efforts aimed at reducing morbidity/ mortality and improving the quality of life. Meeting the health needs of mothers, infants and children and children Meeting the health needs of special populations e.g.  The elderly Community health in schools Dental health Protection of the food and water supply protection of the food and water supply Control of communicable and non communicable diseases Cont.... MATERNAL AND CHILD HEALTH Services offered: Antenatal Clinic, Postnatal Clinic Family Planning Clinic Pap Smear Clinic, Family Planning Clinic, Pap Smear Clinic, Home visiting, Immunization and Child Health Clinics. IMMUNIZATION When a child is born, a referral is given to a community Health Centre by the hospital or health care professional. A nurse at the Health Centre will visit the child and mother during the six weeks following birth, during which an appointment will be given for the parent or care giver to bring the infant in for assessment. At age six weeks, an assessment is done at the Health Centre and another appointment is made to administer the child’s first vaccines, at age two months. Children are monitored at the Health Centre up to five years of age. Cont.... CARE OF THE ELDERLY Services Offered Include: Home visits Chronic disease clinics Walk‐In clinics. CHRONIC DISEASE ASSISTANCE PROGRAMME (CDAP) Provides citizens with free prescription drugs and other pharmace utical items to combat the following health conditions: Diabetes Asthma Cardiac Diseases Arthritis Glaucoma Depression High Blood Pressure Benign Prostatic Hyperplasia (Enlarged Prostate) Epilepsy Hypercholesterolemia Parkinson’s disease Thyroid diseases Cont... SCHOOL HEALTH PROGRAMME Including Screening e.g. 1st year Primary School students (Public and Private Schools). Screening for hearing loss identifies the school age children who may have hearing problems that can interfere with their education, health development. PROTECTION OF THE FOOD AND WATER SUPPLY Responsibility of the Public Health Inspectorate. Collaboration with Local Government through Administrative division. Includes food and water sampling and testing, site visiting to ensure acceptable levels of sanitation and investigation of levels of sanitation and investigation of complaints made by the public. Cont.... DENTAL HEALTH SERVICES The Dental Services Division of the Ministry of Health provides quality oral health care (with the emphasis on prevention) to ensure the maintenance of good oral health. These services include fillings, cleaning, fluoride treatment, and dental health education. INSECT VECTOR CONTROL SERVICES There are several diseases that are transmitted by insects or other organisms that are pote ntially hazardous to the health of citizens. Some of these diseases include dengue fever, malaria and yellow fever. The Insect Vector Control Unit of the Ministry of Health monitors and controls these insect a nd organism vectors. Community health and public health share many features Both are organized community efforts aimed at the promotion, protection, and preservation of the public’s health. Historically, as a field of practice, public health has been associated primarily with the efforts of official or government entities for example, federal, state, or local tax supported health agencies that target the whole range of health issues. In contrast, private health efforts, such as those of the American Lung Association or the American Cancer Society, work toward solving selected health problems. Currently, public health practice encompasses both approaches and works collaboratively with all health agencies and efforts, public or private,that are concerned with the public’s health. Principles of Community Medicine/Health Providing medical services in the community Understanding;  community resources Health promotion and disease prevention Occupational health, Knowledge of communities Care of populations Community participation in health care activities. Paying attention to socio-cultural aspects of patient care Coordinating a community’s health resources in the care of patients Identifying and intervening in a community’s health problem Assimilating into a community and participating in its organizations. Cont... The recognized need of individuals, families and communities provides the basis for Community Health practice. Knowledge and understanding of the objectives and policies of the agency facilities goal achievement. CH considers the family as the unit of service. Its level of functioning is influenced by the degree to which it can deal with its own problems. Respect for the values, customs and beliefs of the clients contribute to the effectiveness of care to the client. CH integrated health education and counseling as vital parts of functions. Collaborative work relationships with the co-workers and members of the health team facilities accomplishments of goals. Cont... Periodic and continuing evaluation provides the means for assessing the degree to which CH goals and objectives are being attained. Continuing staff education program quality services to client and are essential to upgrade and maintain sound practices in their setting. Utilization of indigenous and existing community resources maximizing the success of the efforts of the Community Health. Active participation of the individual, family and community in planning and making decisions for their health care needs, determine, to a large extent, the success of the CH programs. Supervision of nursing services by qualified by CH personnel provides guidance and direction to the work to be done. Accurate recording and reporting serve as the basis for evaluation of the progress of planned programs and activities and as a guide for the future actions. FACTORS AFFECTING COMMUNITY HEALTH SOCIAL/CULTURAL FACTORS Beliefs, traditions, and prejudices Economy, politics, religion Socioeconomic status Social norms PHYSICAL FACTORS Industrial development Community size Environment Geography Cont.... Factors Affecting Community Health Physical factors Level of industry community size environmental quality geographic setting. Factors Affecting Community Health Economic/Social/Cultural factors economic base, political system Cultural beliefs, traditions, biases, religious traditions socio-economic status social norms. Cont... Health Care Delivery  Rising health care costs  Insured versus the uninsured  Access issues Environmental Problems  Air  Water  Damaged natural resources  Must improve our conservation of resources  Overpopulation  Environment  The circumstances or conditions that surround an organism or group of organisms Especially the external physical conditions that  affect growth and survival. The study and management of environmental conditions that affect our health and well- being. Cont..... Lifestyle Diseases Obesity Type II diabetes Heart disease Cancer Stroke Chronic lower respiratory disease Need better control of behavioral lifestyle, such as exercise, diet, and use of tobacco, alcohol, or other drugs Cont.... Communicable Diseases Infectious types of disease Drug-resistant forms New diseases such as severe acute respiratory syndrome (SARS) Bioterrorism Terrorism Possible agents Chemical Nuclear Biological  Global health Problems, issues, and concerns that transcend national boundaries May be influenced by circumstances or experiences in other countries Are best addressed by cooperative actions. COMMUNITY HEALTH vs. INDIVIDUAL HEALTH INDIVIDUAL BEHAVIORS Takes the concerted effort of many if not most to make a community voluntary program work Individual actions and decision making that affect the health of an individual or his or her immediate family Individual Actions Community mobilizes the concerted efforts of many individual members COMMUNITY ORGANIZATION How community organizes itself to mobilize resources i.e governmental & non- governmental services. Activities aimed at protecting or improving the health of a population or community Ways in which communities organize their resources i.e.Tax-supported vs. non- tax- supported services The complex social and cultural conditions that affect the individual or community. Questions 1. Which of the following best describes a community? A. A defined neighborhood B. Workers/students in a defined company/school C. Persons registered as potential users of a group practice/HMO/health center D. All of the above 2. In the context of community health, why is it important to identify a geographic boundary? E. To enforce health regulations F. To target health programs to specific populations G. To collect data on individual health H. To track the movement of diseases Questions 3. What is a key function of a community? A. Providing healthcare services B. Enforcing laws C. Fostering a sense of belonging and shared identity D. Collecting data on health needs 4. What kind of data is useful for assessing community health needs? E. Patient medical records F. Morbidity and mortality rates G. Individual health insurance plans H. Doctor appointment schedules 5. How does community health differ from individual healthcare? I. Community health focuses on prevention, while individual healthcare focuses on treatment J. Community health focuses on families and populations, while individual healthcare focuses on single patients K. Community health focuses on mental health, while individual healthcare focuses on physical health L. Community health focuses on wealthy patients, while individual healthcare focuses on low-income patients Thank you