Community Medicine Practical Manual Made Easy

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COMMUNITY MEDICINE PRACTICAL MANUAL

Birat Medical College & Teaching Hospital

Prepared By

Dr. Surya B. Parajuli

Assistant Professor, Department of Community Medicine, Birat Medical College & Teaching Hospital, Morang

The Curriculum

The new innovative curricula of medical sciences is SPICES model. Kathmandu University is following this model for medical teaching-learning activities. We are following this model here.

Types of practical

Labotex (2 hour lab room based)
Organisation visit (½ day field)
Community Diagnosis Program (1 week field)
Family Health Exercise (1 week field)
Epideman (1week field)
Healthman (1 week field)
Occupational Health (3days industry)
School Health Program (7days School)
Medical Informatics (3 days workshop)
Research methodology (4 days workshop)

Class hours

Semester I (45 hrs)+ Semester II (40 hrs)+Semester III (30 hrs)+Semester IV (30 hrs)

Sem VI & Sem VII (100 hr+3 wks field posting)

Program timeline at a glance

SN	Year	Semester	Program		Remarks
SN	Year	Semester	Name	Type	Remarks
1	1	1	CDP & FHE-CBDRC Phase I	Field	Vehicle
2	1	1	Nutrition Module	Labotex
3	1	1	Biostatistics Module	Labotex
4	1	2	FHE-CBDRC Phase II	Field	Vehicle
5	1	2	Demography Module	Labotex
6	1	2	Vectors Module	Labotex
7	2	3	FHE-CBDRC Phase III	Field	Vehicle
8	2	3	Water Treatment Plant Visit	Field	Vehicle
9	2	3	Immunisation Module	Labotex
10	2	3	Family Planning and SGBV Module	Labotex
11	2	4	FHE-CBDRC Phase IV	Field	Vehicle
12	2	4	Chemical/Medicine of Public health Importance Module	Labotex
13	2	4	Epidemiology Study Module	Labotex
15	2	4	CB-IMNCI Module	Workshop	Vehicle
16	2	4	Milk Dairy Visit	Field	Vehicle
17	3	6	FHE-CBDRC Phase V	Field	Vehicle
18	3	6	Occupational Health	Field	Vehicle
19	3	6	Epidman	Field	Vehicle
20	4	7	FHE-CBDRC Phase VI	Field	Vehicle
21	4	7	Inferential Biostatistics	Labotex
22	4	7	Research Methodology & Journal Club	Workshop
23	4	7	School Health Program	Field	Vehicle
24	4	7	Healthman	Field	Vehicle
25	5	Internship	Research Report Submission & Manuscript Submission

Index:

CDP=Community diagnosis program; FHE=Family health exercise; CB-DRC=Community based doctor run clinic; SGBV=Sexual and gender based violence;Epidman= Epidemiological Skills for health management; Healthman= Managerial skill for health management

Program Micro Activities

SN	Year	Semester	Program		Remarks
SN	Year	Semester	Name	Type	Remarks
1	1	1	CDP & FHE-CBDRC Phase I Community visit and meeting with the health coordinators, leaders and community managers Social mapping and geospatial mapping of the community Collection of socio-demographic information of the community Allocation of the family to the student Quantitative data collection Focus Group Discussion Key Informant Interview Socio-economic Status Calculation Nutrition assessment Health Education at household level Community based social drama performance Finding presentation to the community Report submission to the department	Field	Vehicle
2	1	1	Nutrition Module Nutrition value of common food items Calculation of balance diet Nutrition status assessment	Labotex
3	1	1	Biostatistics Module Construction of frequency table Graphs, charts and diagrams Measures of central tendency Measures of dispersion	Labotex
4	1	2	FHE-CBDRC Phase II Follow up of allocated family and collection of required information Follow up DRC Health education for common diseases Environmental health education for common environmental profile Nutrition counselling and balance diet skill demonstration Community clinic	Field	Vehicle
5	1	2	Demography Module Demography cycle Sex ratio, population density, dependency ratio, population pyramid Measures of fertility Measures of mortality Presentation on basic demographic pattern and vital statistics of Nepal & India	Labotex
6	1	2	Vectors Module	Labotex
7	2	3	FHE-CBDRC Phase III	Field	Vehicle
8	2	3	Water Treatment Plant Visit Visit to water treatment plant and learn the process of water filtration Analysis of water quality based on WHO standard	Field	Vehicle
9	2	3	Immunisation Module National immunisation schedule AEFI (Adverse Event Following Immunisation) Visit to hospital immunisation clinic	Labotex
10	2	3	Family Planning and SGBV Module Family Planning and SGBV Module Common family planning device Eligible couple and target couple CPR and NRR Sexual and gender based violence	Labotex
11	2	4	FHE-CBDRC Phase IV	Field	Vehicle
12	2	4	Chemical/Medicine of Public health Importance Module Anti-tubercular drugs Ant leprosy drug Anti-malarial Anti-filarial Piyush Deworming drug Hand washing techniques Others	Labotex
13	2	4	Epidemiology Study Module Calculation of common epidemiological parameters Sensitivity and specificity calculation	Labotex
15	2	4	CB-IMNCI Module Self-appraisal of knowledge and skills of CB-IMNCI Using of IMNCI module for community case management	Workshop	Vehicle
16	2	4	Milk Dairy Visit	Field	Vehicle
17	3	6	FHE-CBDRC Phase V Follow up of allocated family and collection of required information Follow up DRC Health education for common diseases Environmental health education for common environmental profile Nutrition counselling and balance diet skill demonstration Community clinic Community assessment of IDD	Field	Vehicle
18	3	6	Occupational Health Visit to industry to learn the occupational environment Clinical check-up of workers Worker health promotion program Legislative measures of occupational health and safety appraisal	Field	Vehicle
19	3	6	Epidman Collection of information on one of the public health issues Finding presentation Report submission	Field	Vehicle
20	4	7	FHE-CBDRC Phase VI	Field	Vehicle
21	4	7	Inferential Biostatistics Problems of probability and probability distribution Problems of estimation: standard error, confidence interval, alpha & beta error and sample size calculation Test of significance I Test of significance II Correlation and regression	Labotex
22	4	7	Research Methodology, Journal Club & Medical Informatics Proposal Excel SPSS End note	Workshop
23	4	7	School Health Program Health promotion of schools students, teachers and parents Health check up	Field	Vehicle
24	4	7	Healthman 1.Visit to different organisation NATA;HP-Tanki;PHC-Jhorahat; Health Coordinator Office; NGO; INGO; CBO; WHO; UNICEF;Plan-Nepal; Salt trading centre; NRH; FPAN; Immunisation camp; CBR 2. Presentation of the finding 3. Report submission	Field	Vehicle
25	5	Internship	Research Report Submission & Manuscript Submission

About each program

LOBOTEX

This is a practical session for MBBS students at Birat Medical College and Teaching Hospital. Each batch was divided into 2 groups as group A and group B. They have to spend 2 hours in the departmental lab for skill based practical work.

Community Diagnosis Program (CDP)

Department organise CDP program at 1st semester of MBBS. As an integral component of MBBS teaching in Community medicine, 1 week posting at Budhi-Ganga Rural municipality. Community diagnosis by door to door survey, meeting with village leaders, in depth interview, FGD with villagers. They have to conduct school health program and health awareness program. Multispecialty medical check-up camps and health exhibition in the community. At the end of CDP, student will present the report of community diagnosis program at the community and department. Finally they have to submit a report to the department.

Family Health Exercise (FHE)

The FHE program used to be organised just after CDP program. An important aspect of community teaching and learning activities is the concept and practice of Family Physician. Each student has to take care of 5 allotted family during their MBBS duration. They have to provide healthcare to the needy family member through CB-DRC system.

Community Based Social Awareness & Advocacy Program

After completion of first phase of FHE program, students are able to find the common public health issues of the community. They have to analyse the issues and advocate through the social awareness drama.

Community based –Doctor Run Clinic (CB-DRC)

Community based doctor run clinic is the innovative idea of heath care of surrounding communities of Birat Medical College & Teaching Hospital based on continuum of care model. The MBBS students learn to work as a family physician at BHS cohort.

Occupational Health

The occupational health program is organised in 6th semester of MBBS. This is a 3 full day program conducted in industries of Morang-Sunsari industrial corridor. Students learn the occupational health and safety issues in the industrial setting.

EPIDMAN

The EPIDMAN program is organised in 6th semester of MBBS. This is a community based epidemiological skill development program. Practice of epidemiology based research work at community setting is the major goal of this one week field program.

School Health Program

The school health program is organised in 7th semester. Students go to the school and examine the school children including their teachers. They provide the necessary health education to the school students and even teachers. During clinical evaluation if

anybody has significant clinical problem, they bring them to our teaching hospital for treatment.

HEALTHMAN

The HEALTHMAN program is organised in 7th semester of MBBS. Students learn the managerial skills for health management. They used to get practical exposure on health care delivery system of Nepal.

Health Advocacy Program

During different public health days, students have to be involved in the program. They have to coordinate with the different partners for the organisation of the program. Student use to advocate the public health issues.

Community Based Elective Posting

Students from different universities used to visit for their community based elective posting. In July 2018, 2 students from Australia visited our BHS cohort.

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