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Category: Community Medicine [Digital Book For MBBS]
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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

  1. Labotex (2 hour lab room based)
  2. Organisation visit (½ day field)
  3. Community Diagnosis Program (1 week field)
  4. Family Health Exercise (1 week field)
  5. Epideman (1week field)
  6. Healthman (1 week field)
  7. Occupational Health (3days industry)
  8. School Health Program (7days School)
  9. Medical Informatics (3 days workshop)
  10. 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

Name

Type

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

Name

Type

1

1

1

CDP  & FHE-CBDRC Phase I

  1. Community visit and meeting with the health coordinators, leaders and community managers
  2. Social mapping and geospatial mapping of the community
  3. Collection of socio-demographic information of the community
  4. Allocation of the family to the student
  5. Quantitative data collection
  6. Focus Group Discussion
  7. Key Informant Interview
  8. Socio-economic Status Calculation
  9. Nutrition assessment
  10. Health Education at household level
  11. Community based social drama performance
  12. Finding presentation to the community
  13. Report submission to the department

Field

Vehicle

2

1

1

Nutrition Module

  1. Nutrition value of common food items
  2. Calculation of balance diet
  3. Nutrition status assessment 

Labotex

  

3

1

1

Biostatistics Module

  1. Construction of frequency table
  2. Graphs, charts and diagrams
  3. Measures of central tendency
  4. Measures of dispersion

Labotex

  

4

1

2

FHE-CBDRC Phase II

  1. Follow up of allocated family and collection of required information
  2. Follow up DRC 
  3. Health education for common diseases
  4. Environmental health education for common environmental profile
  5. Nutrition counselling and balance diet skill demonstration
  6. Community clinic

Field

Vehicle

5

1

2

Demography Module

  1. Demography cycle
  2. Sex ratio, population density, dependency ratio, population pyramid
  3. Measures of fertility
  4. Measures of mortality
  5. 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

  1. Visit to water treatment plant and learn the process of water filtration
  2. Analysis of water quality based on WHO standard

Field

Vehicle

9

2

3

Immunisation Module

    1. National immunisation schedule
    2. AEFI (Adverse Event Following Immunisation)
  • Visit to hospital immunisation clinic

Labotex

  

10

2

3

Family Planning and SGBV Module

Family Planning and SGBV Module

    1. Common family planning device
    2. Eligible couple and target couple
    3. 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

  1. Anti-tubercular drugs
  2. Ant leprosy drug
  3. Anti-malarial
  4. Anti-filarial
  5. Piyush
  6. Deworming drug
  7. Hand washing techniques
  8. Others

Labotex

  

13

2

4

Epidemiology Study Module

    1. Calculation of common epidemiological parameters
  • Sensitivity and specificity calculation

Labotex

  

15

2

4

CB-IMNCI Module

    1. 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

  1. Follow up of allocated family and collection of required information
  2. Follow up DRC 
  3. Health education for common diseases
  4. Environmental health education for common environmental profile
  5. Nutrition counselling and balance diet skill demonstration
  6. Community clinic
  7. Community assessment of IDD

Field

Vehicle

18

3

6

Occupational Health

    1. Visit to industry to learn the occupational environment
    2. Clinical check-up of workers
    3. Worker health promotion program
  • Legislative measures of occupational health and safety appraisal

Field

Vehicle

19

3

6

Epidman

    1. Collection of information on one of the public health issues
    2. Finding presentation
  • Report submission

Field

Vehicle

20

4

7

FHE-CBDRC Phase VI

Field

Vehicle

21

4

7

Inferential Biostatistics

    1. Problems of probability and probability distribution
    2. Problems of estimation: standard error, confidence interval, alpha & beta error and sample size calculation
    3. Test of significance I
    4. Test of significance II
  • Correlation and regression

Labotex

  

22

4

7

Research Methodology, Journal Club & Medical Informatics

    1. Proposal
    2. Excel
    3. SPSS
  • End note

Workshop

  

23

4

7

School Health Program

    1. 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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