introduction Community Health this important course Every one who interesting public Health upgrade Quality of environmental issue, As we know Every years Graduated thousand of student graduated First degree specially science

1. BMLB
Dr-Abdikadir Daahir Jaama (geesdiir)

2. Introduction to community health

3. introduction
 Community health is a part of health care that is
concerned with the health of the whole population
and the prevention of disease.
 It involves establishing the health status of the
community, planning and management of community
level services that enhance health and wellbeing.
 This includes promotive, preventive, curative as well as
rehabilitative services.

4.  As a discipline, community health focuses on
populations and how specific social determinants of
health and disease influence wellbeing.
 The emphasis is usually on how well the community
can be mobilized and empowered to improve on the
conditions within their homes, their behavior, socio
cultural interactions, as well as effectiveness in the use
of resources to achieve the best possible level of
wellness

5.  It has been realized that focusing on disease
prevention, health promotion and effectiveness
rehabilitation has far reaching positive effects, both in
terms of health and socio-economic development of
the community

6. Natural history of disease
 The natural history of disease is the process through
which a disease or illness goes from its beginning till
the affected person either recovers, becomes disabled
or dies.
 The health of a person is usually discussed In terms of
disease.
 Most people make a full recovery from a disease, but
some suffer damage to their bodies and may be left
with permanent disability.
 If a disease is very severe, if may lead to death.

7.  At first, the person is well and healthy .ideally this is
the way we should continue throughout life along the
pathway of health.
 But then, sometimes, something begins to go wrong a
disease process, for example infection with
tuberculosis, starts in the body.

8.  In the early stages ,although the disease process has
started ,the affected person will be unaware that
anything is wrong that is to say ,the disease is sub-
clinical or pre-symptomatic, if, in this case the
tubercle bacilli are in the lungs ,it will probably be
several months before they begin to produce
symptoms.
 some diseases may remain sub-clinical and heal
before they have produced any symptoms infectious
diseases such as cholera, hepatitis and enterovirus
infections are particularly up to do this

9.  When the symptoms of a disease start and the affected
person becomes sick, we say the disease is clinical.
 Even when the symptoms of a disease (e.g. fever,
cough or diarrhea ) first begin , many people ignore
them and hope they will go away.
 if the symptoms persist , some people try to treat
themselves , buy something from a pharmacy or
consult a traditional healer.
 Seeking help from the nearest clinic or hospital may be
delayed because the sick person lives too far away.
 Or feels too ill to travel ,or perhaps thinks the health
services will not do any good .there are many reasons
why people often wait a long time before going for
help.

10.  The clinical stage of illness is a best known stage as most
outpatients and inpatients are clinically ill.
 People come every day to dispensaries , health centers and
hospitals complaining of various clinical symptoms and
are diagnosed and treated.
 if the disease is severe and not properly treated ,the patient
may die. Even if one recovers, they may have a disability.
 such as a damaged lung from pulmonary tuberculosis a
paralyzed arm from polio, or an amputated leg from a
severe injury.
 however most of those who are treated will recover fully
 By the time a person has symptoms, the disease is often
already well advanced

13. Factors influencing an individual’s
health
 Some people, families or communities seem become
sick and even die faster than others; the children are
frequently sick with diarrhea or malnutrition or the
young people often with tuberculosis or anemia.
 Observations about health and disease patterns in a
community and what can be done about them lead to
the practice of community or public health

14. Conti……
 Various factors are believed to influence an
individual’s health and wellbeing.
 these include:
 the social,
 cultural and economic factors,
 environmental factors, genetics factors perception of
disease, health facility factors as well as personal
factors among.

15. Factors influencing the health of
the community
 To help individuals some basic information is needed
about their state of health that is what stage the
disease or diseases may have reached.
 This information is collected through history taking
and physical examination and laboratory investigation
then a diagnosis is made
 Knowing what help is available; a plan is made for
what to do for the patient that is the management of
the illnesses and rehabilitation.
 There should then be follow up to confirm whether or
not the treatment has worked.

16.  The same process is appropriate for a disease of the
community first; some basic information about the
whole community is needed.
 Then a community diagnosis is made – what are the
main things that are wrong and as far as possible the
reasons for them.
 From here, a community health program is planned
and finally follow up is required to evaluate the
program to see if it has made the community healthier

18.  The process of community diagnosis usually highlights the
factors influencing the health of a community, both
positively and negatively.
 The process should also highlight the available resources,
including manpower, materials, money and time for
combating the factors that influence health negatively.
 The factors that are thought to influence the health of the
community differ from one community to another.
 They include nutrition, sanitation, water environment,
transport, and communication network, leadership,
housing and social structures among others.

19. The value of community health
 It is not possible or even helpful to try to separate what
is preventive from what is curative medicine or what is
individual or community health.
 When a mother brings a child with diarrhea, the
health worker will provide advice on how to make the
child better and how to prevent the illness from
reoccurring.
 Treating individuals with pulmonary tuberculosis
helps to prevent others in the community from getting
the disease

21. Methods of prevention
 There are three methods:
 Primary prevention
 Secondary prevention
 Tertiary prevention

22. Primary prevention:
 The objectives here are to promote health, prevent
exposure, and prevent disease.
 Health promotion: This consists of general non-
specific interventions that enhance health and the
body’s ability to resist disease, such as measures aimed
at the improvement of socio-economic status through
the provision of adequately paid jobs, education and
vocational training, affordable and adequate housing,
clothing, and food, old-age pension benefits; emotional
and social support, relief of stress, etc.
 In-short it is any intervention that promotes a healthier
and happier life.

23.  Prevention of exposure:- This includes actions
such as the provision of safe and adequate water, proper
excreta disposal, vector control, safe environment at home
(e.g., proper storage of insecticides and medicines, out of
children’s reach), at school and at work (e.g., proper
ventilation, monitoring of harmful substances in
factories), and on the streets (e.g., driver licensing laws).

24.  Prevention of disease:-This occurs during the
latency period between exposure and the
biological onset of disease. An example for this is
immunization.
 Immunization against an infectious organism does not
prevent it from invading the immunized host, but
prevents it from establishing an infection.

25.  Active immunization means exposing the host to a
specific antigen against which it will manufacture its own
protective antibodies after an interval of about three weeks
(during which the immunized person remains susceptible
to the disease).
 Passive immunization means providing the host with
the antibodies necessary to fight against disease.
 Both forms of immunization act after exposure. However,
for active immunization to be protective, the timing of its
administration must be at least three weeks prior to
exposure,

26.  Breastfeeding is an example of an intervention that
acts at all three levels of primary prevention:
 Health promotion: by providing optimal nutrition for
a young child, either as the sole diet up to four months
of age, or as a supplement in later months.
 Prevention of exposure: by reducing exposure of the
child to contaminated milk.
 Prevention of disease after exposure: by the
provision of anti-infective factors, including antibodies,
white blood cells, and others.

27. b. Secondary prevention
 After the biological onset of disease, but before
permanent damage sets in, we speak of secondary
prevention.
 The objective here is to stop or slow the progression of
disease so as to prevent or limit permanent damage,
through the early detection and treatment of disease.
 e.g. breast cancer (prevention of the invasive stage of the
disease),
 trachoma (prevention of blindness), and
 Syphilis (prevention of tertiary or congenital syphilis)

28. C. Tertiary prevention
 After permanent damage has set in, the objective of tertiary
prevention is to limit the impact of that damage. The
impact can be physical, psychological, social (social stigma
or avoidance by others), and financial.
 Rehabilitation refers to the retraining of remaining
functions for maximum effectiveness, and should be seen
in a very broad sense, not simply limited to the physical
aspect. Thus the provision of special disability pensions
would be a form of tertiary prevention.