• GOAL:

The broad goal of the teaching of undergraduate students in Preventive & Social Medicine (Community Medicine) is to prepare them to function as community and first level physicians in accordance with the institutional goals, and to prepare them as teachers of PSM and Epidemiologists and public health consultants.

• OBJECTIVES :

(a) KNOWLEDGE :

At the end of the course, the student shall be able to :

1. Describe the health care delivery system including rehabilitation of the disabled in the country.
2. Describe the National Health Programmes with particular emphasis on maternal and child health programs, family welfare planning and population control.
3. List epidemiological methods and describe their application to communicable and non-communicable diseases in the community or hospital situation.
4. Apply bio-statistical methods and techniques.
5. Outline the demographic pattern of the country and appreciate the roles of the individual, family, community and socio-cultural factors including urbanization on health and disease.
6. Describe the health information systems.
7. Enunciate the principles and components of primary health care and the national health policies to achieve the goal of Health for All.
8. Identify the social environmental and occupational hazards and their control.
9. Describe the importance of water and sanitation in human health.
10. To understand the principles of Health Economics, Health Administration, Health Education in relation to community.
11. Explain the principles of sociology including demography and population dynamics.

(b)SKILLS :

At the end of the course, the student should be able to:

1. Use epidemiology as a scientific tool to make rational decisions relevant to community and individual patient intervention.
2. Collect, analyze, interpret and present simple community and hospital based data.
3. Diagnose and manage common health problems and emergencies at the individual, family and community levels keeping in mind the existing health care resources and in the context of the prevailing socio-cultural beliefs.
4. Diagnose and manage maternal and child health problems and advise a couple and the community on the family welfare planning methods available in the context of the national priorities.
5. Diagnose and manage common nutritional problems at the individual and community level.
6. Acquire managerial skills of a health professional manager.
7. Plan, Implement and evaluate a health education programme with skill to use simple audio-visual aids.
8. Interact with other members of the health care team and participate in the organization of health care services and implementation of national health programmes.
9. Conduct a survey and employ its findings as measure towards arriving at a community diagnosis or to judge efficacy of a programme.

1.Introduction to Humanities and Community Medicine : History of Medicine, Definition of Health, Concept of Health, Spectrum of Health, Determinants of Health, Indicators of Health.

2.Demography & Population Dynamics : Definition, Collection of Demographic Data, Populations Census, Records of Vital Statistics, Demographic Cycle, Demographic Trends in India, Definitions of Vital Events, Collection of Vital Statistics Data, Compilation, Tabulation and Presentation.

3.Health Economics : Introduction, Natural Economical resources of the Country, Economic Levels, Health Planning and Budgeting.

4.Social Science & Health :

(a)Medical Sociology : Concept and principles of Sociology, Social Sciences, Social Classification, Social Factors related to Health and Diseases, Social Organizations, Urban and rural Societies, Family Types, Functions and Role of Family in Health and Disease, Society and Culture, its Functions, Role of Culture in Health and Disease, Hospital Sociology.

(b)Behavioral Sciences : Community behavior and Ecology, Interaction of Human being to Human Environment, Social Psychology, Impact of Psychology on Health. Impact of Urbanization of Health and Disease, Medico-Social problems.

5.Hospital Management: Principles of practice of medicine including visit to the hospital for familiarization with elementary nursing practice, practices of sterilization, injection and dressing techniques, necessity for record keeping, art of communication with patients including history taking medico-social work and immunization against disease and health check-up.

6.Health Care Delivery System: Health care delivery system at Central, State, District and Local levels. Rural Health Services, Health Care of Community, Primary Health Care Comprehensive Health Care, Basic Health Care, Health Care Delivery, Health Status and Health Problems of India and Gujarat.

Field Visit to Health Establishment:

Following health establishment have been considered for field visits in these establishments Health Intervention Programme are Operative. Total 15 visits will be planned. Each visit will cover two hours of demonstrations, participation etc.

1. Urban Health centre
2. Family Visit in the community
3. Anganwadi Centre
4. Immunization clinic
5. Malaria Clinic (NMEP)
6. Curative and preventive General Practice Clinic
7. Family Welfare Planning and training Centre
8. Post Partum Unit
9. District TB Clinic
10. STD Clinic
11. Medical Record Section of Hospital
12. Hospital setup – Visit to learn autoclaving, sterilization, incineration, organization etc.

1.Environment Health

• Air and ventilation : Atmospheric air - its composition, effects of of vitiated air, overcrowding. Indices of thermal comfort, Natural and Artificial Ventilation. Air pollution, Air borne diseases, disinfection of air, Air conditioning, measurements of air temperature. Humidity and velocity. Indices of heat stress, effect of health on health.
• Lighting : Requirement, Sources, Measurements, Normal Standards, and Health effects of poor lighting.
• Noise : Sources, Properties, Measurements effects on human health, Noise control.
• Radiation : Sources, Type of radiation, Measurement, Effect on health, radiation protection and control.
• Housing in relation to health : Criteria for health housing , house standards over crowding, housing and health
• Disposal of Wastes: Collection, removal, Disposal of refuse, Night soil and sewage, Sanitary barrier, Fecal borne diseases various methods of disposal of dead.
• Village Sanitation : Housing, Provision of safe water supply, sanitary disposal of refuse and excreta, Village latrines, Manure pit.
• Sanitation of Camp and Fair : Site, Water supply, Control of food establishments, Disposal of refuse and excreta, Control of communicable diseases.

2.Nutrition and Health : Importance of safe milk and other food stuffs. Adulteration, Preservation food poisoning, food and milk borne disease. Role of nutrition in various diseases. Dietetics – nutritional surveys. National Nutritional Programmes.

3.Genetics and Health : Principles, Heredity chromosomal disorders and abnormalities, Population genetics, General Epidemiology and Control of genetic disorders, Genetic counseling.

4.General Epidemiology : Definition , Epidemiology methods, uses of Epidemiology, Screening of the disease, Epidemic investigation, infectious disease epidemiology, Disease transmission, Nature of reservoir of infection, immunity, immunoprophylaxis, National Immunization Programmes, Non –communicable epidemiology, Disease control and prevention, Health advise to travelers, Hospital acquired infection, Notification, Isolation, Quarantine, Surveillance, Disinfection and sterilization.

5.Systematic Epidemiology :

• Communicable diseases : Problem, Epidemiology, Prevention, Control and national Control and eradication programmes of Common Communicable disease such As small-pox, Chickenpox, Measles, Rubella, Mumps, Influenza, Diphtheria, Whooping Cough, Meningococcal meningitis, Viral hepatitis, Cholera, Enteric fever, Tuberculosis, Acute Respiratory Infections, Poliomyelitis, Food poisoning, Acute Respiratory Infections, Poliomyelitis, Food poisoning, Amoebiasis, Bacillary dysentery, Diarrheal diseases, Helminthes infestations, Guinea worm, Yellow fever, Dengue fever, KFD, Japanese encephalitis, Leptospirosis, Rabies, Trachoma, Tetanus, Leprosy, STD, AIDS, Yaws etc.
• Non- Communicable Diseases: Problem, Epidemiology, Prevention, Control and National Control Programmes of Common non- communicable diseases such as Cancer, Cardio- Vascular diseases, Rheumatic fever and heart disease, Hypertension, Diabetes, Obesity, Blindness, Accidents etc.

6.Occupational Health: Occupation environment, Interaction of Physical, Chemical, Biological, Mechanical and Social agents with man, Occupational hazards and diseases of importance and their prevention and control such as Pneumoconiosis, Lead poisoning, Occupational Cancers, Occupational dermatitis, Radiation hazards, Hazards of Agricultural workers, Accidents in Industry, Industrial Toxicology, Sickness Absenteeism, Health Problems and General measures of prevention and control of industrial problems, prevention and control of occupational diseases, Indian Factory Act and ESIS Act, Industrial Social Security.

7.Maternal and Child Health and Family Planning : Maternal and infant mortality and morbidity in the country, Causes and schemes for its prevention. Measures for promotion of maternal and child welfare. Prevention of pre-natal, Neonatal and infant deaths, Care of the pre-school child. Various National, State and Voluntary agencies for child and maternal protection, Socio- economic and educational aspects of the problem.

8. School Health: School premises and environmental sanitation, Periodic medical inspections. Early detection of aliments, Defects and their treatment. Correction of deformities, Mid-day meal programmes, Care of the backward Child, Health education.

9. Family Planning: Medico-Social and Health aspects of Family Planning, Contraceptives, National Family Welfare Programme, Post Partum Programme, Medical Termination of Pregnancy Act.

10. Geriatrics & Health: Problems of Aging, Health Status of aged persons, Measures to solve problems of aged persons

11.Mental Health: Mental Deficiency, Care and Control of Mental Health, Child Guidance Clinics, Drug dependence and its control

12.Health Education: Principles of Health Education, Health and personal Habits, Various Methods for dissemination of the knowledge.

13. Public Health Administration: Health planning, Health Management, Health Planning in India, Bhore Committee, Mudaliar Committee, Other Health Committee reports for Health Planning in India, Five Year Health Plans, Health for all by 2000 AD, Health Status and Health Problems of India & Gujarat. Resources like Health Manpower, Money, and Material etc. to improve Health Status of People, Hospitals, Health Insurance, and Governmental& Non- Governmental Health Agencies. National Health Programs of India, ROME, ICDS etc. International Health Organizations like WHO, UNICEF, FAO, ILO, CARE and others.

Field Visit/ Practicals/ Clinics/ Tutorials/ Demonstrations/ Community Posting/ etc : Following subjects will be covered through teaching methods using field visits, practical, Clinics, Tutorials, Demonstrations, Community Posting, Workshops, etc. Students will be posted for 4 weeks each during third, fourth and sixth semesters (Total posting period will be 12 weeks). If required additional periods of two hours each will be arranged depending upon subjects and suitable community hour exposure.

1.Training in Hospital :

• Hospital visit will be arranged to demonstrate following:
• Nursing including bed making.
• Techniques of disinfection and dressing.
• Management of hospital including Clean Linen.
• Bedside manners and Medical ethics.
• Art of communication, history taking, winning the confidence of the patient.
• Keeping- completeness and reliability.
• Patient’s psychology understanding the patient’s perception of his problem.
• Medico- Social Work.
• Principles of health education- Doctor’s Role.

2.Field Visits : Field Visits will be arranged to learn the following:

• Factors determining health and disease including environment influences.
• Applied Sociology – importance of community Participation.
• Limited resources – Necessity of maximization of utilization.
• Effect of nutrition on Health & Disease.
• Acute infectious diseases and other local endemic diseases, for example, trachoma, goiter, filariasis etc.
• Tuberculosis
• Preventive aspect of psychological medicine and psychiatry.
• Preventive aspects of Leprosy.
• V. D. Control.
• Preventive aspects of dietetics and Nutrition information on all National Health Organization.

• The need for Family Panning.
• Organization of Family Planning Services.
• Health Education in relation to family Planning.
• Nutrition.
• Psychological needs of the mother, the child and the family.
• Demography and vital statistics.

3.Health Information and Basic Medical statistics: Sources and presentation of data, Sampling, Measures of Central Tendency, Variability, Probability, Normal Distribution and Normal Curve, Sampling Variability and Significance, Demography and Vital Statistics, Life table etc.

4.Environment Health:

• Role of environment in health and disease.Components of environmental health and their impact on health and disease.
• Sources, Collection, Storage and Distribution of water impurities and their relation to health, Purification, importance of safe water supply. Collection and forwarding of sample of water, analysis of water, standards of purity, public swimming bath sanitation. National Water Sanitation Programme. Water Borne Diseases.
• Medical Entomology:

Life history, role in disease transmission and control of common vectors of medical importance such as mosquitoes, housefly, sand fly, tsetse fly, rat flea , bedbugs, ticks, mites, Cyclops etc.

• Rodent:

Role in disease transmission, habitat and control of common rodents of medical importance.

• Insecticides:
• Classification, resistance and toxicity.
• Demonstrations on insects, micro-organisms, parasites, insecticides, rodenticides, instrument, food stuffs, immunological substances etc.

5. Epidemiological Exercises and Statistical Exercises: Students will be trained for epidemiological and statistical exercises, field visit demonstrations etc.

6.Family health and Clinico-Social Study.

7.National Health Programmes and Epidemic Situations. 8.Visit to an Industry and Class room demonstrations on occupational health relevant to state.

9.Project Work: Candidate would be assigned a project to learn epidemiology and management on specific of Health and Disease subjects in community medicine. A report on it will be prepared and evaluate at the level of University examination.