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
▶Agroup of people who have common
characters.
• Can be defined by location, race,
ethnicity, age, occupation, interest in
particular problemgrs 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 HealthApproach
Public Health Model Medical Model

10. Growth of Community Medicine
Chronologically–overtime frompre-historic
Primitive AncientCivilizations
DarkAges Muslim/Arab
Industrial/ Modern

11. 4
1:PRIMITIVE MEDICINE
• 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

12. Evolution of Public Health …
2:Ancient
2-A:Indian / IndusV
alleycivilisation
• Archeologicalevidencefrom Mohenjo-daro and
Harappa–the chief cities of Indian civilizationof
about 2500 to 1500 BC–suggestan elaborate system
of public sanitation; earlydentistry
• Lawsof Manu –codeof personalhygiene
• EarlyIndians set fractures, performed
amputations, excisedtumor, repairedhernias and
exceled in cataractextraction
6

13. Evolution of Public Health …
2-B:Egyptiancivilisation (3300BC onward)
• Egyptianspostulated that diseasewasdue to
absorption from the intestine of harmful
substanceswhich gaverise to putrefaction
of blood and formation of pus
• Diseaseswere treated with cathartics,
enema,blood-letting and awide rangeof
drugs 7

14. Evolution of Public Health …
2-C:Greekcivilisation(c460-136BC– golden period)
• Early leader in Greek medicine was Aesculapius(c 1200 BC) – a
demigod
• Aesculapius bore two daughters:
– Hygiea - worshipped as goddess of health (preventive
medicine)
– Panacea- worshipped as goddess of medicine
(curative medicine) - the
goddess of Universal remedy
8
RodofAscelpius

15. Greek contribution to health
• Hippocrates (460-370 BC)–the ‘Fatherof medicine
• Rejectedsupernatural theory of disease– introduced
scientific method (why &how)
• Initiated application ofclinical methods in medicine
• Describedthat diseaseshadanaturalcause: Airs,Waters
and Places–first known systematic attempt to present
causal relationship between environmental factors and
disease–humoral system
9

16. Evolution of Public Health …
2-D:Romancivilisation(100BC– 300AD)
• Romans borrowed their medicine mainly from
Greeks
• By the 1st century the centre of civilization
shifted to Rome
• They had a keen sense of sanitation –
11

17. Maintenance of health by control of diet and
hygiene
Galen (130-205AD) - Disease is due to predisposing,
exciting and environmental factors
(Epidemiological triad) – his teachings remained
unquestioned for 1400years
12
Roman contribution to health …

18. 13
3: MiddleAges(500-1500AD)
• 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
• Dissection of the human body was prohibited –
consequently there was no progress of medicine
• This period is therefore called the "Dark
Ages of Medicine“

19. 4: Arab/Muslim contribution
1. Early7th century –collecting and translating the
medical knowledge of the Greeks,Persians, and
Indians
2. Saljuqs(Tughril,AlipArsalan)established hospitals. The
staff comprised physician, surgeonsand attendants
servedandnursedsick
3. Many physicians,Arabsaswell asnon-Arabs,
contributed to themedicine:
– Physicianslike Al-Razi,or Razes(841– 926AD),and Ibn-
Sina,known asAvicenna(980 – 1037AD)were pioneers
in the medicalfields
15

20. Muslim contribution to health …
• TheMuslim physicians,following Galen’s
tradition’ highlighted six ‘non-naturals’
composinghygiene
1. Air (or environment)
2. Food& drink
3. Sleepingand waking
4. Movement & rest
5. Retention & evacuation
6. Mental emotions –“passionsof thesoul”

21. ⦁ 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 ofthe community.

22. ⦁ 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;
1. Leader
2. Care provider
3. Communicator
4. Decision maker
5. Manager

23. Community medicine:
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.

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

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

26. 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.

27. 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,
a) The sensation of the environment
b) The organization of medical services for the early
diagnosis prompt treatment and prevention of disease
c) 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.

28.  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.

29. “ 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.

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

31. 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.

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