Community Medicine Curriculum FOR MBBS at Kathmandu University

 

Compiled By:

Dr. Surya B. Parajuli

Kathmandu University-Birat Medical College & Teaching Hospital

Budhiganga Rural Municipality-2, Tankisinuwari, Morang, Nepal

www.suryaparajuli.com.np

 

SEMESTER I

1. Human and Medicine

• Medicine in antiquity (Primitive Medicine, Indian Medicine, Chinese Medicine, Egyptian Medicine, Greek Medicine, Roman Medicine)
• Dawn of scientific medicine
• Modern medicine
• Medical revolution
• Socio-cultural aspects of health in Nepal
• Eugenics
• Alternative medicine
• Medical ethics

2. Concept of Health and Disease

• Definition of health and well-being
• Dimension and determinants of health
• Epidemiological triad
• Theories of disease causation
• Natural history of disease
• Risk factor concept
• Concept of control of disease
• Levels of prevention
• Modes of intervention
• Primary health care
• Goals/targets set to achieve "Health for All"
• Critical review of HFA 2000
• Revitalizing primary health care
• MDGs in the context of Nepal

3. Nutrition-I

• Protein-energy malnutrition
• Iron deficiency
• Vitamin A deficiency
• Determinants of nutritional status of individual/ community
• Nutritional sources and requirements
• Balanced diet
• Nutritional deficiency disorders e.g. PEM, Iron deficiency, Vitamin A deficiency
• Nutritional problems in Nepal
• Nutritional status assessment in a community

4. Nutrition-II

• Iodine deficiency disorders (IDD)
• Magnitude of the problem in Nepal
• Community assessment of IDD
• Zinc deficiency
• Salt fortification

 

5. Environment Health-I

• Environment: physical environment inside and outside the home
• Water: safe water, potable water, purification of water at the household and community levels
• Waste disposal- necessity of waste disposal
• General principles of waste disposal
• Excreta disposal – necessity of excreta disposal
• General principles of excreta disposal
• Family environment and principles of good housing

6. Biostatistics-I

• Need of biostatistics in medicine
• Statistical method
• Frequency distribution
• Measure of central tendency
• Proportions
• Presentation of statistical data
• Tables: simple and frequency distribution tables
• Charts and diagram: bar, histogram, frequency polygon, line diagram, pie-chart, pictogram

 

SEMESTER II

7. Epidemiology-I

• Definition of epidemiology
• Uses of epidemiology in hospital, community and health planning
• Basic measure in epidemiology e.g. rate, ratio and proportion
• Mortality: concepts of crude, specific and standard prevalence of disease
• Significance of time place and person distribution in epidemiology
• Sources of epidemiological data

8. Information Education Communication (IEC)

• Health educational methods including A-V aids for individual, group & mass
• Significance, advantages and disadvantage of the methods
• Planning a health education program
• Information, education and communication strategies
• Evaluation of health education activities

9. Environmental Health-II

• Air pollution source, effects, control , greenhouse effect, ozone layer
• Energy conservation: alternate source of energy
• Noise pollution: sources, effect and control
• Ventilation
• Lighting
• Radiation hazards
• Hospital waste management
• Urban health
• Global warming
• Meteorology of medical relevance

 Entomology

• Mosquito, Housefly, Lice, Ticks, Fleas, Sand-fly, Reduviid bugs
• Rodents and their control

10. Demography

• Importance of demography
• Demography cycle
• World population trend: regional difference, birth and death rate
• Growth Rate
• Transmigration
• Demographic trends of the country: age and sex composition, age pyramids
• Sex ratio, density of population, family size, urbanization, literacy, life expectancy
• Fertility- determinants of fertility: biological and behavioral determinants
• Fertility related statistics
• Effect on population of changes in birth, death and growth rates
• Vital statistics and method of collection: census, registration of vital events
• Hospital records, population surveys

 

SEMESTER III

11. Sociology

• Types of family
• Function of family
• Role of family in health and disease
• Culture factors influencing health and disease
• Social organization and community participation
• Measurement of the socio-economic status of a family and its importance in health and disease

12. Community Diagnosis Orientation (Collect demographic date and study)

• The Community environment
• Family environment
• Family support system
• Water collection/storage
• Refuse/waste disposal
• Customs/beliefs during pregnancy, lactation, postpartum
• Customs/practices towards elderly/ disabled
• Illness behavior
• Food practices/customs/ beliefs
• Beliefs about family size/ son (male) preference
• Child rearing practices
• Acute morbidity in the family
• Follow up a pregnant woman, neonate, under five year child to record growth and development
• Diet pattern of a pregnant, lactating and post-partum woman
• Follow up an adolescent
• Follow up elderly/disabled persons
• Follow up eligible couples and provide family planning advice

13. Family Medicine

• Identify and diagnose illness in the family
• Follow up and study response(s) of the individual /family/community to the specific illness
• Identify and diagnose and manage illness in the family as a family physician to acquire familiarity with the common illness such as:
• Acute respiratory infections
• Rubella
• Mumps
• Diptheria
• Pertusis
• Chickenpox
• Pneumonia
• Tuberculosis
• Measles
• Diarrhea
• Fever
• HIV and AIDS
• Bronchial asthma
• COPD

 

SEMESTER IV

14. Epidemiology-II

• Epidemiology studies; descriptive, analytical and experimental
• Basic concepts about transmission of infectious agents
• Principles of control about communicable disease
• Principles of control of non-communicable disease
• Investigation and control of an epidemic
• Epidemiological principles underlying screening
• Distinction between screening and diagnostic test
• Calculate: sensitivity, specificity, positive predictive value etc. for screening test
• Collect and interpret clinical, psycho-social information from patient/ family to understand natural history of a disease

15. Behavioral science

• Factors affecting behavior attitude
• Attitudes, nature, development
• Cognitive development
• Puberty and adolescence
• Behavior problem
• Sexual behavior
• Normal and abnormal behaviors
• Implications of behavior in illness
• Methods to change attitude behavior
• Measurement of attitudes
• Questionnaire/pre-testing and validation of a questionnaire/ interview schedule
• The need for counseling in various situations (e.g. HIV/AIDS affected person)
• Proper approach and attitude of counselor
• Communication skills required of a counselor

16. Community based integrated management of childhood illness (CBIMNCI)

• Introduction to CB IMNCI and orientation to the global problem
• Importance of CB IMNCI in family medicine

 

SEMESTER VI

17. Communicable Diseases

• Respiratory diseases (TB, Influenza, SARS)
• Vector borne diseases (Malaria, Filaria, Dengue, Leismaniasis )
• Intestinal infection (Acute Diarrheal Diseases, Viral Hepatitis , Typhoid fever, Cholera)
• Zoonosis (Rabies, Japanese Encephalitis, Chikungunya, Yellow Fever, Plague, Leptospirosis)
• Surface infections (STDs, HIV/AIDS, Leprosy)
• Emerging and re-emerging diseases
• Hospital acquired infections

18. National Plans for Communicable Diseases

• Malaria
• STD / AIDS
• Pulmonary tuberculosis
• Leprosy
• Kala-azar
• Vaccine preventable diseases (VPDs) included in the Expanded Program of Immunization: cold chain and surveillance of VPDs
• Diarrhoeal diseases

19. Occupational Health

• Working environment: health hazards of industrial and agricultural workers
• Common occupational diseases
• Industrial toxic substances, health hazards & international safety limits
• Principles of control of occupational diseases
• Legal aspects

20. Mental Health

• Problem of mental health
• Assessment of mental health
• Causes of mental ill health
• Types of mental illness
• Mental development in children
• Mental retardation
• Conversion reaction
• Schizophrenia
• Depression
• Alcoholism & drug abuse/addiction
• Suicide a deliberate self-harm
• Problem of sexuality & gender disorders
• Prevention of mental ill health
• Mental health services in Nepal
• Epilepsy

21. Non-communicable Diseases

• Epidemiology of non-communicable diseases
• Nutritional disorders
• Rheumatic heart diseases
• Coronary heart diseases
• Hypertension
• Cancers
• Blindness
• Diabetes
• Obesity
• Accidents

22. National Plans for Non-communicable Diseases

• National plan on non-communicable diseases
• Program for control of Iodine Deficiency Disorders, Blindness control programs
• Program for control of other Nutritional Disorders e.g. nutritional anemia, Night Blindness etc.
• Impairment / Disability / Handicap: Definitions and concepts
• Assessment of Impairment / Disability / Handicap: e.g. Post-Polio residual paralysis
• Programs for rehabilitation at the individual and community levels
• Community based rehabilitation

 

SEMESTER - VII

23. Reproductive Health

• Maternal and child health
• Safe motherhood
• Magnitude of the problem
• Maternal morbidity and mortality
• Under 5 year child morbidity and mortality
• Breast feeding and weaning
• Family planning methods

24. National Health programs for specific age group

• School health program
• Problems for the elderly
• Social organizations to assist the elderly

25. EPI – Info

• How to design a computer compatible questionnaire in “EPED”
• How to “ENTER” data in the questionnaire
• Simple forms of “CHECK” programs while entering data e.g. range checks, legal values etc
• “ANALYSIS” of data set
• Cleaning of data set
• Frequencies and other tables
• Graphical output
• Cross-tabulations

26. Health Planning and Management

• Primary health care
• Management of health resources
• Planning and organization of health services in Nepal
• Health team at district hospital, health post etc.
• Voluntary agencies in health care
• Evaluation of a health program: epidemiology and management principles
• Need of health economics.
• Concepts of cost benefit and cost effectiveness

27. Health delivery system in Nepal

• Evolution of health services
• Organization of health delivery system in Nepal from center (MoH) to Sub Health Post functions of different category health personnel

28. Inferential Statistics

• Probability
• Normal distribution, Poison distribution, Binomial distribution
• Estimation of standard error
• Confidence interval
• Tests of significance
• Concepts of alpha and beta error
• Bias and random error
• Sample size calculation
• Sampling
• Correlation and regression

29. Disaster Management

• Definitions of Calamity, Disaster- natural and man-made
• Concepts of Hazard and Vulnerability
• Disaster Cycle
• Planning for Disaster management
• Disaster management committee: constituents, line of command etc.
• Relief measures: when and what to ask for?
• Concept of Triage
• Practical play in a disaster situation
• Simulated exercise on patient triage

30. International Health

• Need of International Health Organization
• Structure and functions of WHO
• Other UN agencies and their role in Health care
• Bilateral Health Agencies
• Non-government International Health Agencies

31. Research Methodology

• Introduction
• Types of research: Descriptive/Experimental/Non-experimental
• Systematic Review and Meta-analysis
• Writing a research Proposal/Conduct Research Project/ Writing a research report