Case Scenario
Pakistan’s health indicators are among the worst in the world. For every 100,000 children born 276 mother die and 67 infants die for every 1,000 live births in Pakistan. Communicable diseases such as Tuberculosis, Hepatitis, Malaria and Dengue remain a serious concern. Polio eradication is still a challenge for health authorities. There is a dire need to think about what accounts for such statistics. What do you feel is the most pressing public health concern facing Pakistan?
Learning objectives:
At the end of this CBL the students should be able to answer the following:
- Historic development of public health
- Public health services
- Public health problems of Pakistan
- Measure to improve public health in Pakistan.
Tasks:
- Prioritize ten public health problems of Pakistan.
- Identify the public health issues of your locality.
Major Public Health Problems
1. Communicable Diseases:
- Preventable (through EPI) e.g. tetanus, measles, diphtheria, whooping cough, polio, T.B.
- Infectious (viral and bacterial) e.g. STD, hepatitis B and C.
- Parasitic e.g. malaria, hook worm, guinea worm.
2. Malnutrition:
- PEN
- Vitamin/mineral/iodine deficiency.
- Anemia.
3. Birth related problems:
Problems associated with perinatal period such as still birth, low birth weight, congenital disorders.
4. Reproductive Health Problems:
Problems of women associated with pregnancy and child birth such as eclampsia, hemorrhage etc.
5. Geriatric Problems:
Health problems related to aging
6. Accidents:
All accidents but those related to working environment.
7. Occupational Health Related Problems:
Accidents and diseases related to working environment.
8. Non-communicable Diseases:
Heart diseases, Diabetes, Cancers and other Systemic diseases.
9. Emerging Health Problems:
AIDS, drug abuse, certain types of cancer.
Leading Causes of Major Health Problems
1. Household Environment:
These include factors relating to environment of household which have negative effects on health e.g.
- Poor water supply.
- Lack of family hygiene.
- Poor food handling.
- Insanitary living conditions.
2. General Society and Physical Factors:
Factors relating to general environment outside but excluding occupational environment. These include:
- Poor garbage and excreta disposal.
- High level of air, water and soil pollution.
- Poor quality control of water supply, food market and slaughter houses.
- Industrial exhaust.
- Low level of education and illiteracy.
- Employment.
Main Causes of Avoidable Deaths in Country Are:
- T.B.
- Childhood illness.
- Micronutrient deficiency.
- Insanitary conditions.
- Poor nutritional practices.
Public Health
Public health may be defined as
“The science and art of preventing disease, prolonging life, promoting health and efficiency through organized community efforts” for the
- Sanitation of environment.
- Control of communicable diseases.
- Education in personal hygiene.
- Organization of health services for early diagnosis and medical treatment.
- Development of social machinery to ensure good living standards for every individual.
Changing Concepts in Public Health:
a) Pre-industrial Era
b) Modern Era.
- Miasma phase.
- Bacteriology phase.
- Health resources phase.
- Social engineering phase.
- Health promotion phase.
Scope of Public Health
- Accidents/violence/injuries.
- Health equity.
- Occupational health.
- Environmental health.
Strategies of Public Health
a) Assess the current health situation
- Surveys.
- Surveillance
- Morbidity and mortality reporting.
b) Identify problem.
c) Research correlates of occurrence.
d) Develop and evaluate interventions.
e) Disseminate results.
f) Influence policy to incorporate results.
Intervention Strategies
a) Immunization programs.
b) Health education.
c) Behavioral modification strategies.
d) Community intervention/mobilization.
e) Modification of environment.
- Occupational environment.
- Living environment.
f) Policy development and implication.
g) Political pressure.
