Introduction to Community Medicine.pptx

Community Medicine

1. Introduction to Community Medicine DR. Rahul Netragaonkar Professor Dept of Community Medicine ZMCH Dahod

2. Lecture content: Introduction History Of Community Medicine Basic definition Aims objective Preventive medicine Public health International organization

3. Defnition ▶ Branch of medicine which deals with the preventive, promotive, and curative health services through organized community efforts.

4. Community ▶ A group of p e ople w h o hav e common characters. Can be defined by location, race, ethnicity, age, occupation, interest in particula r problemg r s or outcomes or common bonds .

5. Community Medicine or Public Health? Term use interchangeably UK----Community Medicine US----Public Health

6. What is Public Health ? ▶ Public Health is the science and art of preventing disease, prolonging life, and promoting health through organized efforts of society (WHO 1988) ▶

7. Public Health Approach Public Health Model Medical Model

8. Growth of Community Medicine Chronologically – over time from pre-historic Primiti v e A n c i e n t C ivili z a t ion s Dark Ages Muslim/Arab Industrial / Modern

9. 4 1 : PRIM I T IV E M EDI C I N E The concept of disease in which ancient man believed =>Supernatural theory of disease Primitive man attributed disease and in fact all human sufferings to: wrath of gods invasion of body by ‘evil spirits’ and malevolent influence of stars & planets

10. Evolution of Public Health … 2 : Anc i en t 2 -A : Indi a n / Indu s V alle y civilisa t io n Ar c heo l og i ca l e v i den c e fr o m Mohenjo - da r o an d Harappa – the chief cities of Indian civilizationof about 2500 to 1500 BC– suggest an elaborate sys te m of pub li c s anitation ; ea r l y denti s t r y La w s of Man u – c od e of pe r s ona l h y gien e Early Indians set fractures, performed ampu t a ti on s , e xc i s e d t umo r , r epa ir e d he r n i a s an d e xc e l e d i n c ata r ac t e x tr a c t i o n 6

11. Evolution of Public Health … 2 -B : E g y p t i a n civilisa t io n (33 B C o n w ar d ) E g y p ti an s po s t u l a t e d th a t di s ea s e w a s due t o ab s o r p ti o n fr o m t h e i n t e s ti n e of ha rmf u l s ub s ta n ce s w h i c h ga v e r i s e to put r efa c tio n o f b l oo d an d fo r matio n of pu s D iseases were treated with cathartics, enema , bloo d - lettin g an d a wi d e r ang e of drugs 7

12. Evolution of Public Health … 2 - C : G ree k civilisa t io n ( c 46 - 13 6 B C – gol d e n period) Early leader in Greek medicine was Aesculapius(c 1200 BC) – a demigod Aesculapius bore two daughters: H y gi e a - wors h ipped as go d d e s s o f h e alth (preventive medicine) Panacea- worshipped as goddess of medicine (curative medicine) - the goddess of Universal remedy 8 R o d o f Asce l p i u s

13. Greek contribution to health Hi p p o cr a te s ( 46 0-37 B C ) – th e ‘F a t he r of medicine R e j e c t e d supern a t ur a l t heo r y of d i seas e – i nt r odu c e d sci e nt i f i c m etho d ( w h y & ho w ) Initiated application ofclinical methods in medicine Described that diseases had a natural cause: A irs , W ate r s an d Pl a c e s – f i r s t k no w n systematic attempt to present causal relationship between environmental factors an d d is e a s e – hu m o r a l sys t e m 9

14. Evolution of Public Health … 2-D: Roman civilisation (100 BC – 300AD) Ro m ans borro w e d the i r me d ic i ne mainly from Greeks By the 1 st century the centre of civilization shifted to Rome They had a keen sense of sanitation – 11

15. Maintenance of health by control of diet and hygiene G a le n (1 30 -20 5 A D ) - D i se a s e i s d u e t o p r e d i s p o s i n g , exciting and environmental factors (Epidemiological triad) – his teachings remained u n q ue s ti on e d f o r 1 4 ye ar s 12 Roman contribution to health …

16. 13 3 : M i dd l e Ag e s ( 500 - 150 AD ) With the fall of the Roman empire, the medical schools established in Roman times also disappeared The practice of medicine reverted back to primitive medicine dominated by superstition and dogma It was regarded as immoral to see one's body; consequently, people seldom bathed D i ss e ct i o n o f th e huma n b o d y wa s prohi b it e d – consequently there was no progress of medicine This period is therefore called the "Dark Ages of Medicine“

17. 4: Arab/Musl i m contr i but i on E ar l y 7 t h c entur y – c o ll e c t i n g an d tran sl at i n g th e m ed ic a l k no wl ed g e of th e Gree ks , P e rsi a n s , and Indians S alj uq s ( T ugh r il , A li p A rs alan ) e s tab lis he d ho s p i ta l s . T h e s ta f f c ompr i s e d ph ysici an , s urgeon s an d attendants served and nursed sick Many physicians, Arabs as well as non-Arabs, contributed to themedicine: – Physicians like Al-Razi, or Razes (841 – 926 AD), and Ibn-Sina, known as Avicenna (980 – 1037 AD) were p i onee r s i n t h e med i ca l f i e l d s 15

18. Muslim contribution to health … The Muslim physicians, following Galen’s tradition’ highlighted six ‘non-naturals’ c o m po s in g h y gien e A i r (o r env i ron m en t ) F oo d & drin k S leepin g an d w ak i n g M ove m en t & res t R e t en ti o n & evacua t io n M enta l e m o ti on s – “passion s of th e sou l ”

19. In 1948 the world health organization produce a constitution. All over the world health policy maker, financiers, health provider and consumers are aware of the need to reform the health care system. Informed opinion and active cooperation on the part of the public are the most importance in the improvement of the health of the people. Clinical medicine has its focus on care of the diseased patient Community medicine is concerned largely with improving the health status of the community.

20. There is also a growing realisation that preventive health technology has a greater role for a healthy life than clinically based technology. In order to meet these requirements, the future physicians should be, what boelen calls a “ five star doctor” that is; Leader Care provider Communicator Decision maker Manager

21. Community medicin e: A technical decision group of WHO defined community medicine as “ a system of delivery of comprehensive health care of the people by a health team in order to improve the health of the community” Also community medicine is defined as “ the art and science of application of technical knowledge and skills to the delivery of health care to a given community, designed in collaboration with related professionals as well as human and social science on the one hand, and the community on the other hand.

22. To reduce unnecessary morbidity and premature mortality in the whole population Explore greatest potential for health improvement.

23. “Improve health status of a community” Information required: Population data Health problems Disease pattern Availability of health services Action plan: Community health program

24. Preventive medicine, an academic discipline, and a medical speciality, with its own certifying board, is defined as; “The science and art of preventing disease, prolonging life and promoting physical and mental health and efficacy.

25. Public health defined as; “the science and art of preventing disease, prolonged life, and promoting physical and mental health and efficacy through organized community efforts for, The sensation of the environment The organization of medical services for the early diagnosis prompt treatment and prevention of disease The development of the social machinery while will ensure to every individual in the community a standard of living adequate for the maintenance of health.

26. Municipal corporations or municipalities Cantonment boards Railway and industrial organization Social security councils and institutions Voluntary agencies like, tuberculosis and public health association Medical association Governmental hospitals and health department.

27. “ social medicine is the study of man in his total environment , physical , biological, and socioeconomic.” It is concerned not only with curative medicine, but also with health promotion and prevention.

28. Community based education is defined as “ a system of education which carried out outside the teaching hospitals and inn the community whose

29. Vertical program: A single program of health service for community. For example expanded program of immunization. The staff of this service is concerned only with the immunization project.

30. World health organization ( WHO) year of existence ( 1948) United nation children fund ( UNICEF) year of existence ( 1946) United nation fund for population activities ( UNFPA)

31. Thank You…