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1. Lecture Notes 1 on:
Principles of Community Health (PCH 220)
Prepared and Delivered by:
Dr. Bwijo AB
Department of Public Health/Community Medicine
For Students of BPH 2.2B

2. Principles of Community Health &
Epidemiology
A. Principles of Community Health (PCH)
B. Principles of Epidemiology

3. A. Principles of Community Health (PCH)
Course Content:
1. General Principles of Community Health
2. Demography including Determinants of Population
Growth
3. Measurements of Health and Counting of Disease
4. Diseases Prevention and Health Promotion, including the
Concept and Pillars of Primary Health Care (PHC)
5. Environmental Sanitation
6. Occupational Health
7. Communicable and Diseases and their Control

4. A. Principles of Community Health
Course Content:
8. Maternal and Child Health
9. Nutrition and Malnutrition
10. Health Policy, including the National Health Plan and
Policy and Health Care reforms
11. Public Health Legislation
12. Health of Refugees and Internally Displaced People
13. Disaster Preparedness and Response
14. Community Drug Use

5. B. Principles of Epidemiology [MCE 101(b)]
Course Content:
1. Descriptive and Analytical Epidemiology
2. Sources of Routine Data
3. Measure of Disease Frequency
4. Measures of Mortality, including Rates and Ratios
5. Association and Causation
6. Clinical Trials
7. Infections

6. Literature:
A. Principles of Community Health [MCE 101(a)]
1. Novick and GP Mays (eds); Public Health Administration:
Principles for Population-Based Management by LF Novick and
GP Mays (eds); Jones and Bartlett Publishers; 2001.
2. Turnock, Bernard. “Essentials of Public Health.” Sudbury, MA:
Jones and Bartlett Publishers, 2007.
3. Babu Sheshu, ‘Review in Community Medicine’, Paras
Publication
4. Clarke, ‘Preventive & Community Medicine’, Boston Little Brown
Company
5. There will be additional readings required. These readings will
come from a variety of sources including web-sites on the
Internet

7. Literature:
B. Principles of Epidemiology [MCE 101(b)]Novick and GP
1. Richard Dicker, Fatima Coronado, Denise Koo, Roy Gibson
Parrish; The Principles of Epidemiology in Public Health Practice,
3rd Edition
2. Gordis L. Epidemiology. 3rd Edition. W.B. Saunders Company,
2004. ISBN-13: 978-1-4160-2530-6
3. Aschengrau A and Seage G. Essentials of Epidemiology in Public
Health. 2nd Edition. Jones and Bartlett Publishers, Inc., 2008
4. 4. Morabia A. History of Epidemiologic Methods and Concepts.
Birkahuser, 2004
5. There will be additional readings required. These readings will
come from a variety of sources including web-sites on the
Internet

8. General Principles of Community Health

9. • General Principles of Community Health
Definition;
Community Health refers to “Simple Health Services” that
are delivered by people outside hospitals and clinics
Community Health Volunteers and Community Health
Workers are the main practitioners and they work with
Primary Care Providers to facilitate entry into, exit from and
utilization of the formal health system by community
members. “Initiative to help the community”
Principles;
They should meet the needs of the community

10. Principles of Community Health
• Before you explore the principles of Community Health,
first look at the definition of the word ‘Principle’.
• A Principle can be defined as: A basic belief, theory, or
rule that has a major influence on the way in which
something is done - Macmillan English Dictionary for
Advanced Learners (2002)
• Principles are the basic ideas of conduct or rules of
action. They provide the Community Health Nurse with a
clear and rational framework to guide their work

11. Principle of Community Health (Alma Ata Declaration -
WHO 1978)
• Availability of health care for all people and at a cost they
can afford
• Promotive and preventive aspects of health care
• Integration of curative and preventive services
• Active participation of individuals and communities in the
planning and provision of care
• Development of maximum potential for self-care
• Utilization of all levels and types of community manpower
• Inter-sectoral approach

12. Impact of Community Health
•Community Health is a Medical Specialty that focuses on
the Physical and Mental well-being of the people in a
specific geographical region
•Community Health impacts everything—educational
achievement, safety and crime, people’s ability to work
and be financially healthy, life expectancy, happiness and
more
• Communities that are attentive to public health can even
reduce inequality among their residents. Also helps to
reduce health gaps caused by differences in race and
ethnicity, location, social status, income and other factors
that can affect health

13. The Consequences of neglecting Community Health
•A lack of focus on Community Health can lead to a range
of complex problems that aren’t easy to correct. For
example, crime and safety issues that result from
neglected community health can quickly becoming a self-
perpetuating cycle. “Repeated exposure to crime and
violence may be linked to an increase in negative health
outcomes”. Children exposed to violence may show
increased signs of aggression starting in upper-elementary
school (Healthy People 2020)
• Chronic diseases, such as diabetes and heart disease, can
also increase if a community’s overall well-being is
suffering. An unhealthy community tends to be obese and
struggle more from chronic diseases and other health
challenges

14. The consequences of neglecting Community Health
•Chronic diseases, such as diabetes and heart disease, can
also increase if a community’s overall well-being is
suffering
• Chronic diseases like these not only reduce life
expectancy, they have a dramatic effect on the economy
•Curbing the spread of infectious disease is also a priority
of community health programs. Without them,
communities may find themselves battling outbreaks of
illnesses that put vulnerable populations like the elderly at
higher risk

15. Factors that improve Community Health
• Improving community health is a huge undertaking that
involves cooperation between public health workers, local
government, volunteers and average citizens alike—and
the end products of their work can take a lot of forms.
• Communities benefit from walking trails and bike paths,
from access to healthy food and playgrounds, from
accessible healthcare services, schools and places of
employment, as well as affordable housing

16. Factors that improve Community Health
• Individuals can step up to the plate for their
community’s health by volunteering at health fairs or
blood drives, petitioning local officials to develop more
green space and walking trails and maintaining their own
health
• The collective responsibilities that individuals have for
their communal health can lead to positive interactions
within the community as a whole

17. Medical interventions
Medical interventions that occur in communities can be classified
in three categories: each focuses on a different level and
approach toward the community or population group:
Primary Health Care. Primary health care programs aim to reduce
risk factors and increase health promotion and prevention.
Secondary Health Care. Secondary health care, also called
"hospital care," is where acute care is administered in a hospital
setting.
Tertiary Health Care. Tertiary health care refers to highly
specialized care usually involving disease or disability
management.

18. Outline of Community Health Principles
• Community Health is one of the main in Medicine
• Students are exposed to the important social and environmental
determinants of health and develop pragmatic methodological
skills in community assessment, evaluation, and research
• The Community Health curriculum empowers future physicians
to improve the health of diverse communities and reduce health
inequities.
• Students choose a path of critical community engagement.
Engage in rigorous and longitudinal community-responsive
scholarship with established community-campus partners to
assess and reduce health inequities among local underserved
communities

19. Interpretations and applications in biomedical sciences
• Community health is a medical specialty that focuses on
the physical and mental well-being of the people in a
specific geographic region
• This includes initiatives to help community members
maintain and improve their health, prevent the spread of
infectious diseases and prepare for natural disasters
• Working at the community level promotes healthy living,
helps prevent chronic diseases and brings the greatest
health benefits to the greatest number of people in need
• Community health impacts everything—educational
achievement, safety and crime, people’s ability to work
and be financially healthy, life expectancy, happiness and
more

20. Demography including Determinants of Population
Growth

21. Demography:
Refers to the systematic, statistical study and analysis of the
population
It tries to understand the dynamics, trends, and processes of
the population by focusing its attention on certain
demographic processes such as birth, migration, aging, and
death.
Demography is derived out of two words, demos meaning
people and graphic meaning to describe and thus is known
as the study or description of the population

22. Few Concepts of Demography
• Birth rate: it refers to the total number of live births in
a particular area at a given point of time per 1000
population.
• Death rate: which is the number of deaths in a
particular area at a given point in time per 1000
population.
• Fertility rate/ total fertility rate: is the number of live
births per 1000 women in the childbearing age group
(15-49 years), if they are likely to be alive in this age
group

23. At the end of the session
1. Describe Elements of demography
2. Describe populations as to:
 Size
 Composition/structure
 Distribution
3. Describe factors affecting population kinetics

24. Distribution
Composition
Size
Foci of Demography
Size

25. Size
• Population change
• Population Dynamics
• Population Kinetics
 Mortality
 Migration

26. Foci of Demography
Composition
Measurable
characteristics of people
 Sex
 Age
 Marital Status
 Education
 Occupation

27. Distribution
How are people
distributed?
 Village
 Town
 Province

28. Public Health Application:
Prevention and Control of Public Health Problems
 How large is the population affected and where
they are found
 Population growth and dispersal to predict future
developments and consequences

29. SOURCES OF DEMOGRAPHIC DATA
• Most common sources of information
 Censuses
 Sample surveys
 Registration systems
• Other sources:
 Population registers
 Voter’s registry
 School rosters

30. CENSUS
• The total process of collecting, compiling and
publishing demographic data, economic and social
data, pertaining at a specified time or times, to all
persons in a country or delimited territory
• Simultaneous recording of demographic , social and
economic data of individuals of a country on a specified
day
• Most nations once every 10 years

31. CENSUS
• Minimum list of information collected: Age, sex,
race or ethnicity
• Number of children ever born by married women
• Literacy or educational attainment
• Marital status
• Place of birth
• Occupation

33. Thank you