Public Health For All

Dengue

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Dengue and dengue hemorrhagic fever

Definition Dengue hemorrhagic fever is a severe, potentially fatal infection that occurs when someone with immunity to one type of Dengue virus is infected by a different type. It is spread by certain mosquitoes (Aedes aegypti) which bite primarily during the day.

Alternative names Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever

Over the past 3 decades there has been a dramatic global increased in the frequency of DF, DHF, & DSS and their epidemics, with a concomitant increase in disease incidence.

Dengue is a mosquito-borne infection which in recent years has become a major international public health concern. Dengue is found in tropical and sub-tropical regions around the world, predominantly in urban and semi-urban areas.

Dengue hemorrhagic fever (DHF), a potentially lethal complication, was first recognized in the 1950s during the dengue epidemics in the Philippines and Thailand, but today DHF affects most Asian countries and has become a leading cause of hospitalization and death among children in several of them.

There are four distinct, but closely related, viruses that cause dengue. Recovery from infection by one provides lifelong immunity against that serotype but confers only partial and transient protection against subsequent infection by the other three. There is good evidence that sequential infection increases the risk of more serious disease resulting in DHF.

NUTRITION

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NUTRITION

Good nutrition has a direct impact on your overall health and quality of life. When you follow a healthy diet that consists of fruits, vegetables and whole grains, you aren’t just satisfying your hunger—you’re nourishing your body too. Although it’s okay to indulge once in a while (we’ve all been there!), it’s crucial to keep track of what you eat so you can maintain a healthy lifestyle. Our bodies are built of and powered by solely what we eat and drink. Food is the source of all of the energy needed why do humans have to eat? Is it just because we get hungry? That is not all. People get energy from food. We need energy all the time, when we run, jump, sing, and even when we sleep. We create all the energy we need by eating. The structures components that make up the human body, such as muscles, organs, and bones, are also composed of the nutrients contained in food, meaning that it is. This is why eating and taking in the nutrients that provide energy and become the components of our bodily structures is essential to for sustaining human life.

IMPORTANCE OF NUTRITION

1. DECREASES THE CHANCE OF DEVELOPING VARIOUS DISEASES

Having quality eating habits can reduce your risk of developing certain diseases that could severely impact your health. Among these maladies are hypertension, diabetes and heart disease, which was the leading cause of death in the United States in 2014, according to the Centers for Disease Control and Prevention. If you want to increase your chances of staying well, it’s best to stick to a healthy diet.

2. HELPS KEEP A HEALTHY WEIGHT

Eating natural food instead of processed foods can have a positive effect on your weight. Plus, your weight also influences your overall health. For example, being overweight raises your risk of developing Type II diabetes. It can also harm your joints, limiting your mobility.

3. INCREASES ENERGY LEVELS

Have you ever eaten a bunch of junk food and experienced a sudden jolt of energy, only to feel completely exhausted a short time later? That is how your body reacts when you absorb an abundant amount of refined sugar. By avoiding such unhealthy foods and fueling your body with nutritious options instead, you’ll be able to increase your energy levels throughout the entire day, not just for an hour or so—and you won’t endure that crash-and-burn effect. You’ll be able to focus on what’s going on around you rather than on how tired you feel. So, put down that candy bar and pick up a piece of fruit that contains natural sugars!

4. IMPROVES SKIN HEALTH

Good nutrition doesn’t just affect your weight or your energy. It can also play a role in the health of your skin. According to the American Academy of Dermatology, foods that contain vitamins C and E, lycopene and other antioxidants, as well as olive oil, can help to protect your skin against sun damage.

5. BOOSTS IMMUNE SYSTEM

When you practice good nutrition, you’re consuming natural and healthy foods that can help your body. This includes improving your immune system.

Classification of food

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Classification of food

There are many ways of classifying foods

1. Classification by origin

1) Foods of animal origin

2) Foods of vegetable origin.

2. Classification by chemical composition

1) Proteins

2) Fats

3) Carbohydrates

4) Vitamins

5) Minerals.

3. Classification by predominant function

1) Body-building foods, e.g., milk, meat, poultry, fish, eggs, pulses, groundnuts, etc.

2) Energy-giving foods, e.g., cereals, sugars, roots and tubers, fats and oils.

3) Protective foods, e.g., vegetables, fruits, milk.

4. Classification by nutritive value

1) Cereals and millets

2) Pulses (legumes)

3) Vegetables

4) Nuts and oilseeds

5) Fruits

6) Animal foods

7) Fats and oils

8) Sugar

9) Condiments and spices

10) Miscellaneous foods.

Carbohydrates

• Carbohydrates are the sugars and starches found in foods.

• They are made up of carbon, hydrogen, and oxygen.

• Athletes are not the only people who need carbohydrates.

• Everyone needs them.

• There are two general types of carbohydrates: simple and complex.

The Role of Carbohydrates

· our body converts all carbohydrates to glucose.

· Glucose that is not used right away is stored as glycogen.

· When more energy is needed, our body converts the glycogen back to glucose.

· our body converts and stores the excess carbohydrates as body fat.

Fats (Lipids)

• Fats are solid at 20 deg. C; they are called "oils" if they are liquid at that temperature.

• Fats are the nutrients that contains the most concentrated form of energy. Fats are type of lipid.

• Lipids are substances that are somewhat similar to carbohydrates, but they contain less oxygen and they do not dissolve in water.

• Fats are part of many body tissues and are important as carriers of other nutrients, such as vitamins.

• Fats also carry the flavor of foods – making foods tastier, but consumption of fat should be closely monitored.

The Role of Fats

· They transport vitamins A, D, and K in the blood.

· They serve as sources of linoleic acid—an essential fatty acid that is needed for growth and healthy skin.

· They add flavor and texture to food.

· They satisfy hunger longer than other nutrients do.

Protein

• Proteins are substances found in every cell. The body needs proteins to build and repair all body tissues. Protein is an important part of blood cells. Proteins are made up of carbon, hydrogen, oxygen, and nitrogen atoms that are formed into basic units called amino acids.

• There are 20 different amino acids. Nine of them are essential, and the other eleven amino acids can be produced by the body.

The body uses proteins to:

· Build new cells and tissues.

· Replace damaged cells by making new ones.

· Make enzymes, hormones, and antibodies.

· Supply the body with energy.

Vitamins and Minerals

Vitamins are essential for:

– Building body tissues such as bones, skin, glands, nerves, and blood.

– Assisting in the metabolizing of proteins, fats, and carbohydrates so you receive energy from food.

– Promoting healing

– Preventing nutritional deficiency diseases.

Minerals are essential for:

– The formation of strong bones and teeth

– Helping to control the nervous system

– Fluid balance in tissues

– Muscle contractions

Minerals

• Minerals are simple substances found in the environment that are essential to the body’s functioning.

• Minerals are used to regulate a wide range of body processes, from bone formation to blood clotting, and they are important for the body structure.

• Most minerals are either quickly used or lost in waste products, therefore we must eat mineral-rich foods daily to replenish our supply.

• Iron is an exception –it tends to be kept and recycled by the body, except when there is a blood loss.

Malnutrition Problems in Nepal

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Major Malnutrition Problem

1. PEM (Protein Energy Malnutrition)

2. IDA (Iron Deficiency Anemia)

3. VAD ( Vitamin A Deficiency)

4. IDD (Iodine Deficiency Disorders)

1. PEM (Protein Energy Malnutrition)

•Inappropriate breastfeeding

•Inadequate complementary feeding practices

•Insufficient health services (Growth monitoring and counseling)

•Low birth weight

•Infectious diseases

•Inadequate energy intake

Consequences

•Failing to grow (underweight, stunted, and wasted)

•Reduced learning ability

•Reduced resistance and immunity against infection

•Reduced productivity in the future

Causes

•Inadequate energy intake

•Inadequate knowledge and practice of maternal feeding

•Heavy physical workload

•Lack of extra food intake during pregnancy and lactation

2. Iron Deficiency Anemia (IDA)

Causes

•Inadequate intake of iron from daily diets

•Inadequate absorption of dietary iron

•Infestations such as hookworms and malaria

•High requirements of iron particularly during growth and pregnancy

•Blood loss (menstruation, and injury)

•Vitamin A deficiency

Consequences

•Impaired human function at all stages of life

•Impaired work performances, endurance and productivity

•Increased risk of maternal morbidity and mortality

•Increased risk of sickness and death for the baby

3. Vitamin A Deficiency (VAD)

Causes

•Low intake of Vitamin A from daily diets

•Restricted Vitamin A (VA) absorption

•Worm infestation

•Increased VA requirement resulting from infectious diseases

Consequences

•Xerophthalmia (Night blindness, Bitot’s spot, corneal ulcer, Keratomalacia, xerosis)

•Increased risk of morbidity and mortality

•Increased risk of anemia

4. Iodine Deficiency Disorders (IDD)

Causes

•Lack of Iodine in food

Consequences

•Cretinism

•Goiter

•Impaired cognitive function

•Increased prenatal morbidity and mortality

•Reduced productivity.

Tuberculosis

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Tuberculosis

Definition

· Tuberculosis remains a leading cause of infectious morbidity and mortality worldwide.

· World Health Organization (WHO) called tuberculosis a "global emergency, 1993"

· About 8 million new cases of tuberculosis each year.

· Miliary tuberculosis is a systemic version of TB affecting many organ systems due to hematogenous spread.

Etiology

· Mycobacterium tuberculosis—the major etiologic agent worldwide; humans are the sole reservoir

· M. bovis—transmitted from milk of infected cows; rare since institution of pasteurization

· M. africanum—rare; only in Africa

Risk Factors

Occupational: healthcare workers—airborne transmission, infection from extrapulmonary disease such as draining an abscess, autopsies; embalmers—from body fluids generating infectious aerosols
Contact with infected person
Location of birth: Asia, Africa, Latin America
HIV infection
Residence in a long-term care facility
Immunosuppressive therapy
Tuberculosis infection: increases likelihood of developing active disease within two years
Low income, medically underserved individuals
In areas with a high incidence of TB, exogenous re-infection is a major cause of recurrence after effective treatment.

Signs and Symptoms

Asymptomatic—especially from initial infection
Mild fever, headache, chills, night sweats
Malaise, fatigue
Anorexia, weight loss
Cough—nonproductive or mucopurulent
Hemoptysis
Pleuritic chest pain
Dyspnea
Adenopathy
Children—asymptomatic and extrapulmonary manifestations are more frequent than in adults; look for signs of meningitis, adenopathy

Differential Diagnosis

Bacterial pneumonia
Other nontubercular mycobacterial infections
Lymphomas
Sarcoidosis
Lung abscess

Drug Therapies

Standard antibiotics for tuberculosis include:

Isoniazid—adults 5 mg/kg/day, children 10 to 20 mg/kg/day, 300 mg maximum for both; side effects: hepatitis (risk increased with alcohol consumption), peripheral neuropathy, rash, fever; additional drug interactions and toxicity for patients with HIV
Rifampin—adults 10 mg/kg/day, maximum 600 mg/day, children 10 to 20 mg/kg/day; side effects: gastrointestinal upset, hepatitis, orange discoloration of body fluids (and contact lenses); additional drug interactions and toxicity for patients with HIV
Pyrazinamide—15 to 30 mg/kg/day, 2 g maximum; side effects: hepatitis, hyperuricemia possibly with polyarthralgias (both reduced by concurrent rifampin administration)
Ethambutol—least potent against M. ; 15 to 25 mg/kg/day for 2 months, then reduce to 15 mg/kg/day; side effects: retrobulbar optic neuritis and color perception problems, avoid with children
Streptomycin—used least often because of toxicity; intramuscular or intravenous administration of 10 to 15 mg/kg/day, maximum 1 g/day, up to 5 times per week for adults, 20 to 40 mg/kg/day with 1 g/day maximum for children; side effects: ototoxicity (both hearing loss and vestibular dysfunction), nephrotoxicity, teratogenic
Pyridoxine (vitamin B₆) added to regimen particularly in populations at risk for vitamin deficiency (e.g., malnourished, alcoholics, elderly, pregnant and nursing mothers) or at risk for neuropathy (diabetics, HIV, chronic renal failure)

Experimental drugs:

Rifapentine—longer acting, allowing dosing twice a week
Fluoroquinolones (e.g., ciprofloxacin)—antibacterial; concentrations higher in respiratory secretions than in serum; well tolerated, but insufficient data to use as standard treatment; less effective with HIV
Rifabutin—as effective as rifampin with concurrent HIV, but reduces time to sputum conversion; 150 mg/day associated with fewest adverse effects; possible role with multidrug resistance

TUBERCULOSIS THERAPY

Based on antitubercular activity

1. Tuberculocidal agents – Isoniazid, Rifampicin, Streptomycin, pyrazinamide, capreomycin, Kanamycin, Ciprofloxacin.

2. Tuberculostatic agents – Ethambutol, ethionamide, thiacetazone, cycloserine, PAS.

First line drugs

Isoniazid (INH) – Tuberculocidal for rapidly multiplying bacilli but static for resting bacilli.

INH destroys:

a) intracellular bacilli as it penetrates into the cells, and

b) Bacilli multiplying in the walls of the cavities.

Thus it is effective against both intra and extracellular organisms.If used alone, mycobacteria develop resistance.

Mechanism of action: INH inhibits the synthesis of mycolic acids which is an important component of the mycobacterial cell wall.

Pharmacokinetics: INH is completely absorbed orally, penetrates all tissues, tubercular cavities, necrotic tissues and CSF. It is metabolised by acetylation. Metabolites are excreted in urine.

ADRs: Peripheral neuritis (due to interference with utilization and increased excretion of pyridoxine) can be avoided by giving prophylactic pyridoxine (10 – 50 mg) with INH.

Hepatitis, CNS toxicity, anorexia etc.

Rifampicin – Antibiotic obtained from Streptomyces mediterranei.

The other rifamycins are rifabutin and rifapentine.

Rifampicin is bactericidal to M.tuberculosis, M.leprae and atypical mycobacteria. Also inhibits, most Gram +ve and –ve bacteria like Staph.aureus, N.meningitidis, E.coli, Proteus, Pseudomonas and legionella.

Antitubercular action: Only drug acts on persisters; acts on both intra and extracellular organisms & is effective against TB bacilli resistant to other drugs.

MOA: Rifampicin binds to DNA dependent RNA polymerase and inhibits RNA synthesis in the bacteria.

Pharmacokinetics: has good tissue penetrability – reaches caseous material, cavities and CSF; It also appears in saliva, tears, sweat.

It is a microsomal enzyme inducer.

ADRs: Skin rashes, diarrhoea, nephritis & hepatotoxicity.

It stains the secretions including tears, saliva and sweat orange red.

Use:

1. TB and atypical mycobacterial infections.

2. Leprosy

3. Prophylaxis of H.influenza and meningococcal meningitis

4. Resistant staphylococcal infections.

5. Brucellosis – Rifampicin 600 – 900 mg+ Doxy 200 mg daily for 6 weeks.

6. To eradicate carrier state – rifampin eradicates the nasal carrier state of N.meningitidis, H.influenza and S.aureus – 600 mg BD for 2 days.

Rifubutin: similar to Rifampicin, may be used in TB pts with AIDS who are receiving antiviral drugs.

Rifapentine – analog of Rifampicin.

Pyrazinamide: Tuberculocidal,

MOA not known.

It is effective against intracellular bacilli.

ADRs: Hepatotoxicity

Hyperuricaemia – due to ↓excretion of uric acid may result in gouty arthritis.

Arthralgia, vomiting etc.

Streptomycin: Tuberculocidal, acts against extracellular organisms due to poor penetrating power.

Second line drugs

Ethambutol: Tuberculostatic, acts on fast multiplying bacilli in the cavities. Also effective against atypical mycobacteria.

It inhibits the incorporation of mycolic acids into the mycobacterial cell wall.

Optic neuritis resulting in ↓ visual acuity and inability to differentiate red from green is an important ADR which needs withdrawal of the drug. Colour vision should be monitored during treatment.

Anorexia, headache, fever, allergic reactions.

Thiacetazone: Tuberculostatic with low efficacy.

It delays the development of resistance to other drugs.

ADRs: Hepatotoxicity, dermatitis, GI side effects.

Ethionamide: Tuberculostatic, effective against both intra and extracellular organisms.

It is also effective in atypical mycobacteria.

ADRs: Anorexia, metallic taste in the mouth, hepatitis, peripheral neuritis.

Ethionamide is a secondary agent used only when primary drugs are ineffective.

Para-aminosalicylic acid (PAS): related to sulfonamides is tuberculostatic.

GI effects like nausea, anorexia & epigastric pain and diarrhoea make it poorly tolerated drug.

Rarely used.

Other second line drugs

Amikacin, kanamycin and capreomycin – They are oto and nephrotoxic and are used only in resistant cases.

Amikacin is effective against atypical mycobacteria.

Cycloserine – antibiotic that inhibits cell wall synthesis, is tuberculostatic, also effective against some gram-positive organisms.

It causes CNS toxicity including headache, tremors, psychosis and sometimes seizures. It is used only in resistant TB.

Fluoroquinolones – Ciprofloxacin, ofloxacin and sparfloxacin inhibit TB bacilli and atypical mycobacteria.

They are useful in multidrug resistant TB in combination with other drugs.

Treatment of TB

A combination of trt is given to

- delay the development of resistance

- reduce toxicity

- shorten the course of trt.

Chemotherapy is given in 2 phases –

- First phase – initial, intensive phase of 1 – 3 months duration aimed at killing as many as possible.

- Second phase – continuation phase to destroy the dormant or persisters – duration 6 – 9 months.

Short-term regimens

Directly Observed Treatment (DOT) is a strategy that is found to be effective & is recommended throughout the world.

INH + R + Z + E/S daily for 2 months

Followed by

INH + R daily for 4 months.

Role of glucocorticoids:

As steroids depress host defense mechanisms, they should be used only in conditions like TB meningitis, miliary TB, pleural effusion, renal TB.

Steroids suppress inflammatory reaction which can lead to extensive fibrosis and damage.

Rifampicin – 600 mg

INH - 300 mg

Pyrazinamide – 2000 mg

Ethambutol - 1500 mg

Streptomycin – 1 gm

Planning

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Meaning of Planning

· “Planning is deciding in advance about what to do, how to do it, when to do it, and who is to do it. It provide ends to be achieved”. - Stephen P. Robbins

· “Planning is the process by which managers define goals and take necessary steps to ensure that goals are achieved - Richard Steers

· “To some people, planning means specifying a plan of action; to others, determining the most efficient allocation of resources; still to others, identifying the future want”.- Mary Arnold

· A plan is defined as a road map, as preparation, as an arrangement. Planning defines where one wants to go, how to get there and the timetable for the journey. Complete planning sets out indicators for tracking progress and ways to measure if the trip was worth the investment. Health System Intelligence Project – 2006 Ontario

Health Planning

· Health planning “The systematic process of defining community health problems; identifying unmet needs and surveying the resources to meet them; establishing the priority goals that are realistic and feasible and projecting administrative actions to accomplish the purpose of anticipated program”. - WHO

Planning answer the Question

· Where are we now? ( assessment)

· Where do we want to go? ( priorities, goal, objectives, targets, decisions)

· How will we get there? (strategy, management)

· How will we know where we arrive? (monitoring, evaluation)

Planning

In summary “Planning is a systematic process of:

1. defining health needs;

2. prioritize the problems;

3. setting goals, objectives and strategies;

4. analyze and allocate resources;

5. prepare details plan of action and

6. setting monitoring and evaluation methods”

Why planning ? / Purpose of planning

To match limited resources with many problems

To eliminate wasteful expenditures or duplication of expenditures

To develop the best course of actions for achieving the defined objectives

The purpose of planning is to ensure that a program has the best possible likelihood of being successful defined in terms of being effective with the least possible resources (greater outcome with least resources).

Importance of planning

· Control risk and uncertainty of the project

· Allocate resources in the coordinated manner

· Establish standards of performance of monitoring and evaluation

· Provide a structured to execute the project

· Establish procedure to make correction the project work

· Achieve results in time in estimated cost and desired level of quality performance

· Improve efficiency of project operation by minimizing waste

Characteristics of planning

· Futuristic in nature

· Systematic process

· Change oriented

· Continuous and dynamic

· Goal-focused

· Efficiency

· Pervasiveness (concern in all level)

Types of Planning

Types of planning is vague. There is no any specific classification of planning, rather it is classified in different perspectives.

A. Types of planning – by duration

1. Long term planning: long term planning usually covers several years of planning, deals with subject which needs long time to meet (e.g. HR, infrastructure)

2. Medium term planning: usually 3-7 years period, more concerned achieving pre-defined goals and objectives

3. Short term planning: mostly 1-2 year period, link with government’s budget period

B. Types of planning - by level

1. Top level planning: focuses on setting directions and policies, known as health policy plan, guide and regulate health system

2. Middle level planning: deals with translation of policy in to operation, known as health sector program planning

3. Lower level planning: deals with necessary arrangement for implementation including formulation of projects, basically known as health project planning

C. Types of planning – by function

1. Strategic planning: Strategic planning involves determining the goals and gives general direction of healthcare delivery and the development of the overall framework and principles, which may require “engineering” an agreement between various stakeholders.

2. Strategic planning is a process where top-level management sets long-term organizational goals and determines where an organization is going over a period time, more -typically 3 to 5 years, although some extend their vision to 10 to 20 years.

1. Operational planning (tactical): Operational planning refers to the translation of strategic objectives into action. includes concrete sequence of activities, involving the allocation of budgets and resources, the provision of facilities, equipment and staff and the organization of services. Operational plans that are short-term and deal with the day-to-day work of their team. Short-term goals are aligned with the long-term goals and can be achieved within a month, quarter or up to one year.

Culture

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Meaning of Culture

Culture (from the Latin cultura stemming from colere, meaning "to cultivate"). When the concept first emerged in eighteenth- and nineteenth-century Europe, it connoted a process of cultivation or improvement, as in agriculture or horticulture. In the nineteenth century, it came to refer first to the betterment or refinement of the individual, especially through education, and then to the fulfillment of national aspirations or ideals. In the mid-nineteenth century, some scientists used the term "culture" to refer to a universal human capacity. For the German sociologist, George Simmel, culture referred to "the cultivation of individuals through the agency of external forms which have been objectified in the course of history".

Source. Wikipedia

Definition of culture

Culture is that complex whole which include knowledge, belief, art, morals, law customs and any other capabilities acquired by man as a member of society- Tylor

In an another definition he said; “Culture is an attribute of man, acquired by him in time, as a member of society”

Culture is sum total of human achievements materials as well as non-material, capable of transmission, sociologically i.e. by tradition and communication, vertically as well as horizontally- Maxumdar HT

Culture is the totality of the group ways of thought and action duly accepted and followed by the group of people – A F Walter Paul

Culture is socially transmitted system of idealized ways in knowledge, practice and belief along with the artifacts that knowledge and practice produce and maintain a they change in time – Green

Culture is integrated system of learned behavior patterns which are characteristics of the member o society and which are not the biological inheritance

Culture is the particular way of life of the society

Culture is genetically pre-determined: it is non instinctive

It is result of social invention and is transmitted and maintained solely through communication and learning.

In 1952, Alfred Kroeber and Clyde Kluckhohn compiled a list of 164 definitions of "culture" in Culture: A Critical Review of Concepts and Definitions.However, the word "culture" is most commonly used in three basic senses:

• Excellence of taste in the fine arts and humanities, also known as high culture

• An integrated pattern of human knowledge, belief, and behavior that depends upon the capacity for symbolic thought and social learning

• The set of shared attitudes, values, goals, and practices that characterizes an institution, organization or group

MANIFESTATIONS OF CULTURE

Cultural differences manifest themselves in different ways and differing levels of depth. Symbols represent the most superficial and values the deepest manifestations of culture, with heroes and rituals in between.

Symbols are words, gestures, pictures, or objects that carry a particular meaning which is only recognized by those who share a particular culture. New symbols easily develop, old ones disappear. Symbols from one particular group are regularly copied by others. This is why symbols represent the outermost layer of a culture.
Heroes are persons, past or present, real or fictitious, who possess characteristics that are highly prized in a culture. They also serve as models for behavior.
Rituals are collective activities, sometimes superfluous in reaching desired objectives, but are considered as socially essential. They are therefore carried out most of the times for their own sake (ways of greetings, paying respect to others, religious and social ceremonies, etc.).
The core of a culture is formed by values. They are broad tendencies for preferences of certain state of affairs to others (good-evil, right-wrong, natural-unnatural). Many values remain unconscious to those who hold them. Therefore they often cannot be discussed, nor they can be directly observed by others. Values can only be inferred from the way people act under different circumstances.
Symbols, heroes, and rituals are the tangible or visual aspects of the practices of a culture. The true cultural meaning of the practices is intangible; this is revealed only when the practices are interpreted by the insiders.

Characteristics of Culture

• Culture is an acquired quality

• Culture is social not individual heritage of man

• Culture is idealistic; it embodies the ideas and norms of a groups. It is some total of ideal patterns and norms of group of people

• Culture is total social heritage

• Culture fulfils some needs; Cultural fulfills those ethical and social needs of groups which are ends in themselves

• Culture is an integrated system

• Language is chief vehicle of culture

• Culture evolves into more complex

• Culture is changing

• Culture is adaptive

Motivation

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Motivation

• Motivation is the driving force that causes the flux from desire to will in life. For example, hunger is a motivation that elicits a desire to eat.

• Motivation is an inner drive to behave or act in a certain manner. These inner conditions such as wishes, desires and goals, activate to move in a particular direction in behavior.

Abraham Maslow’s Hierarchy of Motivation

Motivation in Health Problem Solution

• Self-actualization: Problem solving Need at top, that is to be self-actualized by the person or people.

• Esteem: Respect by others and achievement

• Love/belonging: self, family, friendship

• Safety and security of: body, health, family, life

• Physiological: breathing, water, food, sleep, excretion, etc.

Types of Motivation

1. Intrinsic (internal) motivation, and

2. Extrinsic (external) motivation

• Intrinsic motivation refers to motivation that is driven by an interest or enjoyment in the task itself, and exists within the individual rather than relying on external pressures or a desire for reward.

• Extrinsic motivation refers to the performance of an activity in order to attain an outcome, whether or not that activity is also intrinsically motivated. Extrinsic motivation comes from outside of the individual. e.g., money, reward, upgrades, promotion, etc.

• Role of Health Education and Counseling in Health

• Knowledge (+ve) and understanding of the problem and solution

• Positive attitude development

• Motives and drives towardness

• Motivational action

• Behavior improvement

• Long term impact/result as an improved behavioral culture established

Primary Health Care (PHC)

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Concept of Primary Health Care (PHC)

Primary health care (PHC)

Jointly both World Health Organization (WHO) and United Nations International Children’s Fund (UNICEF) conference was held at Alma Ata in Almaty, Kazakhstan in 1978 A.D. and endorsed (declared and signed) on the WHO concept of Health for all by the year 2000 A.D. and suggested a new approach to health care that integrates at the community level all the factors required for improving the health status of people is known as primary health care(PHC).

Nepal had signed the HFA 2000 document at Alma-Ata in 2978 A.D. and had accepted Primary health care(PHC) as being an effective method by which essential health services were to be providing the community people.

Health for all 2000 (HFA 2000)

Health For All means that health is to be brought within reach of everyone in a given country.

And by "health" is meant a personal state of well being, not just the availability of health services – a state of health that enables a person to lead a socially and economically productive life. In other worlds, as a minimum, all people in all countries should have at least such a level of health that they are capable of working productively and of participating actively in the social life of the community in which they live.

Primary health care (PHC): Alma Ata Declaration

The Alma-Ata Declaration was adopted at the International Conference on Primary Health Care (PHC), at Almaty, Kazakhstan, 6-12 September 1978 ratified by 134 WHO member states. It expressed need of urgent action by all the government, all health and development workers, and the world community to protect and promote the health of all people. It highlighted the importance of Primary Health Care(PHC). The conference highlighted that the HFA by 2000 is a goal and Primary Health Care(PHC) is a strategy or approach to achieve that goal. It reaffirmed the health, which is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.

Primary health care (PHC)

Primary health care (PHC) refers to essential health care based on scientifically sound and socially acceptable methods and technology, made universally accessible to all individuals and families in a community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self determination. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work and constitutes the first element of a continuing health care process.

Pillars/principles of Primary health care (PHC)

Equitable distribution of health care – according to this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, caste, color, urban/rural location and social class.
Community participation – in order to make the fullest use of local, national and other available resources. Community participation was considered sustainable due to its grass roots nature and emphasis on self-sufficiency, as opposed to targeted (or vertical) approaches dependent on international development assistance.
Health work force development – comprehensive healthcare relies on adequate number and distribution of trained physicians, nurses, allied health professions, community workforce and others working as a health team and supported at the local and referrals levels.
Use of appropriate technology - medical technology should be provided that is accessible, affordable, feasible and culturally acceptable to the community. Examples of appropriate technology include refrigerators for vaccine cold storage. Less appropriate could include, in many settings, body scanners or heart-lung machines, which benefit only a small minority concentrated in urban areas. They are generally not accessible to the poor, but draw a large share of resources.
Multi-sectional approach – recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self-reliance of communities. These sectors include, at least: agriculture (e.g. food security); education; communication (e.g. concerning prevailing health problems and the methods of preventing and controlling them); housing; public works (e.g. ensuring an adequate supply of safe water and basic sanitation); rural development; industry; community organizations (including Panchayats or local government etc.).

8 elements of Primary health care (PHC)

1. E- Essential Drug Supply: By providing essential drugs to those who need them, such as antibiotics to those with infections, caregivers can help prevent disease from escalating. This makes the community safer, as there is less chance for diseases to be passed along.

2. L- Local endemic Disease Control: Prevention and control of local diseases is critical to promoting primary health care in a population. Many diseases vary based on location. Taking these diseases into account and initiating measures to prevent them are key factors in efforts to reduce infection rates.

3. E- Expanded Program on Immunization: By administering global immunizations, WHO works to wipe out major infectious diseases, greatly improving overall health globally.

4. M- Maternal and Child Health Care and Family Planning: Ensuring comprehensive and adequate health care to children and to mothers, both expecting and otherwise, is another essential element of primary health care. By caring for those who are at the greatest risk of health problems, WHO helps future generations have a chance to thrive and contribute to globally. Sometimes, care for these individuals involve adequate counseling on family planning and safe sex.

5. E-Education on Health: Public education is the first, and one of the most essential, component of primary health care. By educating the public on the prevention and control of health problems, and encouraging participation, the World Health Organization works to keep disease from spreading on a personal level.

6. N-Nutrition: Nutrition is another essential component of health care. WHO works to prevent malnutrition and starvation and to prevent many diseases and afflictions.

7. T-Treatment for minor illness: Another important component of primary health care is access to appropriate medical care for the treatment of diseases and injuries. By treating disease and injury right away, caregivers can help avoid complications and the expense of later, more extensive, medical treatment.

8. S-Sanitation and safe drinking water supply: A supply of clean, safe drinking water, and basic sanitation measures regarding trash, sewage and water cleanliness can significantly improve the health of a population, reducing and even eliminating many preventable diseases.

Health for all: a public health vision

2020-06-04T10:42:00.002-07:00

Health for all: a public health vision

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services.

Health for all: a public health vision:

Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.

Health for all: a public health vision:The general wellbeing framework incorporates

General wellbeing organizations at state and neighborhood levels
Social insurance suppliers
Open security organizations
Human help and noble cause associations
Training and youth advancement associations
Entertainment and expressions related associations
Monetary and generous associations

Ecological offices and associations

Health for all: a public health vision: The Core Public Health Functions Steering Committee built up the system for the Essential Services in 1994. The board of trustees included delegates from US Public Health Service offices and other significant general wellbeing associations.

Health for all: a public health vision: Network Health Assessment and Health Improvement Planning

A people group wellbeing appraisal, otherwise called network wellbeing needs evaluation, alludes to a state, ancestral, nearby, or regional wellbeing evaluation that recognizes key wellbeing needs and issues through methodical, extensive information assortment and investigation. A people group wellbeing improvement plan is a long haul, orderly exertion to address general medical issues dependent on the consequences of network wellbeing appraisal exercises and the network wellbeing improvement process.

Health for all: a public health vision :A people group wellbeing appraisal gives associations far reaching data about the network's present wellbeing status, needs, and issues. Thusly, this data can help with building up a network wellbeing improvement plan by advocating how and where assets ought to be apportioned to best address network issues.

Health for all: a public health vision: The data and direction on these pages can help state, inborn, nearby, and regional wellbeing divisions as they create network wellbeing appraisals and wellbeing improvement plans, regardless of whether for accreditation planning, charitable medical clinic joint effort, or different reasons.

Health for all: a public health vision :The Public Health Accreditation board characterizes network wellbeing appraisal as a deliberate assessment of the wellbeing status pointers for a given populace that is utilized to distinguish key issues and resources in a network. A definitive objective of a network wellbeing evaluation is to create methodologies to address the network's wellbeing needs and recognized issues. An assortment of devices and procedures might be utilized to direct a network wellbeing evaluation; the fundamental fixings are network commitment and community oriented investment.

Health for all: a public health vision: A people group wellbeing evaluation gives associations extensive data about the network's present wellbeing status, needs, and issues. This data can help build up a network wellbeing improvement plan by defending how and where assets ought to be apportioned to best address network issues.

Health for all: a public health vision: Advantages incorporate

Improved hierarchical and network coordination and cooperation
Expanded information about general wellbeing and the interconnectedness of exercises
Fortified associations inside state and neighborhood general wellbeing frameworks
Distinguished qualities and shortcomings to address in quality improvement endeavors
Baselines on execution to use in getting ready for accreditation
Benchmarks for general wellbeing practice upgrades

Books

2020-06-04T07:38:00.004-07:00

k. park-park's textbook of preventive and social medicine 23rd Edition

Copy the Following link and paste it in browser.

https://drive.google.com/file/d/14sofiq8IA-7c2GW8PR9QWuTAQG9JdIjx/view?usp=sharing

2020-06-04T07:36:00.001-07:00

COVID-19

2020-06-04T07:22:00.007-07:00

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

COVID-19

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face.

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

To prevent infection and to slow transmission of COVID-19, do the following:

Wash your hands regularly with soap and water, or clean them with alcohol-based hand rub.
Maintain at least 1 metre distance between you and people coughing or sneezing.
Avoid touching your face.
Cover your mouth and nose when coughing or sneezing.
Stay home if you feel unwell.
Refrain from smoking and other activities that weaken the lungs.
Practice physical distancing by avoiding unnecessary travel and staying away from large groups of people.

COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.

Most common symptoms:

fever.
dry cough.
tiredness.

Less common symptoms:

aches and pains.
sore throat.
diarrhoea.
conjunctivitis.
headache.
loss of taste or smell.
a rash on skin, or discolouration of fingers or toes.

Serious symptoms:

difficulty breathing or shortness of breath.
chest pain or pressure.
loss of speech or movement.

Seek immediate medical attention if you have serious symptoms. Always call before visiting your doctor or health facility.

People with mild symptoms who are otherwise healthy should manage their symptoms at home.

On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days.

Myth busters- COVID-19

Most people who get COVID-19 recover from it

Most people who get COVID-19 have mild or moderate symptoms and can recover thanks to supportive care. If you have a cough, fever and difficulty breathing seek medical care early - call your health facility by telephone first. If you have fever and live in an area with malaria or dengue seek medical care immediately.

Drinking alcohol does not protect you against COVID-19 and can be dangerous

The harmful use of alcohol increases your risk of health problems.

Thermal scanners CANNOT detect COVID-19

Thermal scanners are effective in detecting people who have a fever (i.e. have a higher than normal body temperature). They cannot detect people who are infected with COVID-19. There are many causes of fever. Call your healthcare provider if you need assistance or seek immediate medical care if you have fever and live in an area with malaria or dengue.

There are currently no drugs licensed for the treatment or prevention of COVID-19

While several drug trials are ongoing, there is currently no proof that hydroxychloroquine or any other drug can cure or prevent COVID-19. The misuse of hydroxychloroquine can cause serious side effects and illness and even lead to death. WHO is coordinating efforts to develop and evaluate medicines to treat COVID-19.

Adding pepper to your soup or other meals DOES NOT prevent or cure COVID-19

Hot peppers in your food, though very tasty, cannot prevent or cure COVID-19. The best way to protect yourself against the new coronavirus is to keep at least 1 metre away from others and to wash your hands frequently and thoroughly. It is also beneficial for your general health to maintain a balanced diet, stay well hydrated, exercise regularly and sleep well.

COVID-19 IS NOT transmitted through houseflies

To date, there is no evidence or information to suggest that the COVID-19 virus transmitted through houseflies. The virus that cause COVID-19 spreads primarily through droplets generated when an infected person coughs, sneezes or speaks. You can also become infected by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands. To protect yourself, keep at least 1-metre distance from others and disinfect frequently-touched surfaces. Clean your hands thoroughly and often and avoid touching your eyes, mouth and nose.

Spraying and introducing bleach or another disinfectant into your body WILL NOT protect you against COVID-19 and can be dangerous

Do not under any circumstance spray or introduce bleach or any other disinfectant into your body. These substances can be poisonous if ingested and cause irritation and damage to your skin and eyes.

Bleach and disinfectant should be used carefully to disinfect surfaces only. Remember to keep chlorine (bleach) and other disinfectants out of reach of children.

Drinking methanol, ethanol or bleach DOES NOT prevent or cure COVID-19 and can be extremely dangerous

Methanol, ethanol, and bleach are poisons. Drinking them can lead to disability and death. Methanol, ethanol, and bleach are sometimes used in cleaning products to kill the virus on surfaces – however you should never drink them. They will not kill the virus in your body and they will harm your internal organs.

To protect yourself against COVID-19, disinfect objects and surfaces, especially the ones you touch regularly. You can use diluted bleach or alcohol for that. Make sure you clean your hands frequently and thoroughly and avoid touching your eyes, mouth and nose.

Exposing yourself to the sun or to temperatures higher than 25C degrees DOES NOT prevent the coronavirus disease (COVID-19)

You can catch COVID-19, no matter how sunny or hot the weather is. Countries with hot weather have reported cases of COVID-19. To protect yourself, make sure you clean your hands frequently and thoroughly and avoid touching your eyes, mouth, and nose.

You can recover from the coronavirus disease (COVID-19). Catching the new coronavirus DOES NOT mean you will have it for life.

Most of the people who catch COVID-19 can recover and eliminate the virus from their bodies. If you catch the disease, make sure you treat your symptoms. If you have cough, fever, and difficulty breathing, seek medical care early – but call your health facility by telephone first. Most patients recover thanks to supportive care.

Being able to hold your breath for 10 seconds or more without coughing or feeling discomfort DOES NOT mean you are free from the coronavirus disease (COVID-19) or any other lung disease.

The most common symptoms of COVID-19 are dry cough, tiredness and fever. Some people may develop more severe forms of the disease, such as pneumonia. The best way to confirm if you have the virus producing COVID-19 disease is with a laboratory test. You cannot confirm it with this breathing exercise, which can even be dangerous.

Drinking alcohol does not protect you against COVID-19 and can be dangerous

Frequent or excessive alcohol consumption can increase your risk of health problems.

COVID-19 virus can be transmitted in areas with hot and humid climates

The best way to protect yourself against COVID-19 is by maintaining physical distance of at least 1 metre from others and frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

Cold weather and snow CANNOT kill the new coronavirus.

There is no reason to believe that cold weather can kill the new coronavirus or other diseases. The normal human body temperature remains around 36.5°C to 37°C, regardless of the external temperature or weather. The most effective way to protect yourself against the new coronavirus is by frequently cleaning your hands with alcohol-based hand rub or washing them with soap and water.

Taking a hot bath does not prevent the new coronavirus disease

Taking a hot bath will not prevent you from catching COVID-19. Your normal body temperature remains around 36.5°C to 37°C, regardless of the temperature of your bath or shower. Actually, taking a hot bath with extremely hot water can be harmful, as it can burn you. The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

The new coronavirus CANNOT be transmitted through mosquito bites.

To date there has been no information nor evidence to suggest that the new coronavirus could be transmitted by mosquitoes. The new coronavirus is a respiratory virus which spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose. To protect yourself, clean your hands frequently with an alcohol-based hand rub or wash them with soap and water. Also, avoid close contact with anyone who is coughing and sneezing.

Are hand dryers effective in killing the new coronavirus?

No. Hand dryers are not effective in killing the 2019-nCoV. To protect yourself against the new coronavirus, you should frequently clean your hands with an alcohol-based hand rub or wash them with soap and water. Once your hands are cleaned, you should dry them thoroughly by using paper towels or a warm air dryer.

Ultra-violet (UV) lamps should not be used to disinfect hands or other areas of your skin

UV radiation can cause skin irritation and damage your eyes.

Cleaning your hands with alcohol-based hand rub or washing your hands with soap and water are the most effective ways to remove the virus.

Thermal scanners CANNOT detect COVID-19

Thermal scanners are effective in detecting people who have a fever (i.e. have a higher than normal body temperature). They cannot detect people who are infected with COVID-19.

There are many causes of fever. Call your healthcare provider if you need assistance or seek immediate medical care if you have fever and live in an area with malaria or dengue.

Do vaccines against pneumonia protect you against the new coronavirus?

No. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, do not provide protection against the new coronavirus.

The virus is so new and different that it needs its own vaccine. Researchers are trying to develop a vaccine against 2019-nCoV, and WHO is supporting their efforts.

Although these vaccines are not effective against 2019-nCoV, vaccination against respiratory illnesses is highly recommended to protect your health.

Can regularly rinsing your nose with saline help prevent infection with the new coronavirus?

No. There is no evidence that regularly rinsing the nose with saline has protected people from infection with the new coronavirus.

There is some limited evidence that regularly rinsing nose with saline can help people recover more quickly from the common cold. However, regularly rinsing the nose has not been shown to prevent respiratory infections.

Can eating garlic help prevent infection with the new coronavirus?

Garlic is a healthy food that may have some antimicrobial properties. However, there is no evidence from the current outbreak that eating garlic has protected people from the new coronavirus.

Does the new coronavirus affect older people, or are younger people also susceptible?

People of all ages can be infected by the new coronavirus (2019-nCoV). Older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.

WHO advises people of all ages to take steps to protect themselves from the virus, for example by following good hand hygiene and good respiratory hygiene.

Are antibiotics effective in preventing and treating the new coronavirus?

No, antibiotics do not work against viruses, only bacteria.

The new coronavirus (2019-nCoV) is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment.

However, if you are hospitalized for the 2019-nCoV, you may receive antibiotics because bacterial co-infection is possible.

Are there any specific medicines to prevent or treat the new coronavirus?

To date, there is no specific medicine recommended to prevent or treat the new coronavirus (2019-nCoV).

However, those infected with the virus should receive appropriate care to relieve and treat symptoms, and those with severe illness should receive optimized supportive care. Some specific treatments are under investigation, and will be tested through clinical trials. WHO is helping to accelerate research and development efforts with a range or partners.

(These all the information regrading to COVID-19 are extracted through WHO website)

Millennium Development Goals (MDGs)

2020-06-04T05:48:00.001-07:00

Millennium Development Goals (MDGs)

The United Nations Millennium Development Goals are eight goals that all 191 UN member states have agreed to try to achieve by the year 2015. The United Nations Millennium Declaration, signed in September 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women. The MDGs are derived from this Declaration, and all have specific targets and indicators.

The Eight Millennium Development Goals are:

to eradicate extreme poverty and hunger;
to achieve universal primary education;
to promote gender equality and empower women;
to reduce child mortality;
to improve maternal health;
to combat HIV/AIDS, malaria, and other diseases;
to ensure environmental sustainability; and
to develop a global partnership for development.

The MDGs are inter-dependent; all the MDG influence health, and health influences all the MDGs. For example, better health enables children to learn and adults to earn. Gender equality is essential to the achievement of better health. Reducing poverty, hunger and environmental degradation positively influences, but also depends on, better health.

Important Days of Public Health

2020-06-04T05:14:00.001-07:00

Important Days of Public Health

30th January Anti-Leprosy Day

2nd Wednesday of March No Smoking Day

8th March International Women’s Day

15th March World Disabled Day

24th March Anti-TB Day

7th April World Health Day

25th April World Malaria Day

8th May World Red Cross Day

31st May No Tobacco Day

5th June World Environment Day

14th June World Blood Donor Day

1st July Doctors Day

11th July World Population Day

28th July World Hepatitis Day

8th September World Literacy Day

28th September World Rabies Day

1st October International Day for Older Persons

1st October National Voluntary Blood Donation Day

2nd Wednesday of October World Disaster Reduction Day

9th October World Sight Day

10th October World Mental Health Day

24th October UN Day

10th November Universal Immunization Day

25th November International Day for Elimination of Violence against Women

1st December World AIDS Day

3rd December International Day of Disabled Persons

10th December Human Rights Day

Last Week of April World Immunization Week

1–7th May Anti–Malaria Week

1–30th June Anti–Malaria Month

1–8th August World Breast Feeding Week

25th August–8th September Eye Donation Fortnight

15–21st November Newborn Care Week

PUBLIC HEALTH

2020-06-04T04:56:00.003-07:00

PUBLIC HEALTH

Public health is the “science and art of preventing disease, prolonging life and promoting physical and mental health and well-being.” This definition was given by Winslow in the year 1920.

---Winslow

Public health efforts enhance the capacity of community and society to maintain and improve personal health. Public health is defined as the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.

The definition of public health is different for every person. Public health is defined as the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.
The definition of public health is different for every person.

Public health involves the application of many different disciplines:

· Biology

· Anthropology

· Public policy

· Mathematics

· Engineering

· Education

· Psychology

· Computer science

· Sociology

· Medicine

· Business

· and others

WHAT DO PUBLIC HEALTH PROFESSIONALS DO?

As a public health professional, you will be trained to perform one or more of these ten essential services:

· Monitor the health status of a community to identify potential problems

· Diagnose and investigate health problems and hazards in the community

· Inform, educate, and empower people about health issues, particularly the under served and those at risk

· Mobilize community partnerships to identify and solve health problems

· Develop policies and plans that support individual and community health efforts

· Enforce laws and regulations that protect health and ensure safety

· Link people to needed personal health services and ensure the provision of health care when otherwise unavailable

· Ensure a competent public health and personal health care workforce

· Evaluate effectiveness, accessibility, and quality of personal and population-based health services

· Research new insights and innovative solutions to health problems

Public Health Professionals focus on preventing disease and injury by promoting healthy lifestyles. They implement educational programs, develop policies, administer services, conduct research, and regulate health systems to achieve these goals.