BCom 1st Year Community Health Concept Notes Study Material

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BCom 1st Year Community Health Concept Notes Study Material

Introduction

Community health is a major field of study within the medical and clinical sciences which focuses on the:

• Maintenance

• Protection and

• Improvement of the health status of population groups and communities.

People residing in a particular region share similar kinds of health risks and social and economic conditions. Community health is a medical practice which focuses on people’s well-being in a particular geographical area. This essential public health sector covers programs to help neighbourhood members in protecting and improving their health, reduce the transmission of infectious diseases, and plan for natural disasters.

For example, a community may be exposed to pollutants from a nearby factory or waste dumping site or groundwater contaminants. Public wellness programs expand access to preventive health services, include people in decision-making on treatment, and seek reduced hospital costs. (BCom 1st Year Community Health Concept Notes Study Material)

Definition

The WHO defines community health as: environmental, social, and economic resources to sustain emotional and physical well-being among people in ways that advance their aspirations and satisfy their needs in their unique environment. Community health is concerned with the overall factors that influence a population’s physical and mental health.

The World Health Organization has defined health as a state of complete physical, mental, and social well-being (World Health Organization 1980). However, the meanings and perceptions of health, illness and health-seeking behaviour are not the same across cultures.

A community health worker (CHW) is a frontline worker dedicated to providing quality health care to their local community.

These individuals who make up a community live in a somewhat localized area under the same general regulations, norms, values, and organizations.

Community health services cover an extensive and diverse range of activities. Services are delivered in a wide range of settings including in people’s own homes as well as in community clinics, community centres and schools. Community services play a key role in keeping people well, treating and managing acute illness and long-term conditions and supporting people to live independently in their own homes. (BCom 1st Year Community Health Concept Notes Study Material)

Health promotion may be defined as any combination of educational and social efforts designed to help people take greater control of and improve their health. Health protection and health services differ from health promotion in the nature or timing of the actions taken. Health protection and services include the implementing of laws, rules, or policies approved in a community because of health promotion or legislation. (BCom 1st Year Community Health Concept Notes Study Material)

An example of health protection would be a law to restrict the sale of handguns, while an example of health services would be a policy offering free flu shots for the elderly by a local health department.

Importance of Community Health

Large population residing in rural areas does not have access to proper care and treatments in the hour of their need. Elderly people, pregnant women, newborn children and persons with chronic illness residing in a distant location from a hospital are always at high risk. Community health system is a big hope here.

Addressing disparities in access to health care

Rural and small cities where per capita income is less, unavailability of hospitals and shortage of doctors occur and healthcare inequalities may be extremely pronounced. Such populations are at high risk of exposure to extreme poverty, drug abuse, and several other risks to human health and life. If a regional health system that takes into account the particular features of the community is set in order to meet unmet needs, the general level of service of the community can be dramatically increased.

Factors that Affect Community and Population Health

1. Physical factors-geography (parasitic diseases), environment (availability of natural resources), community size (overcrowding), and industrial development (pollution).

2. Social and cultural factors—beliefs, traditions, and prejudices (smoking in public places, availability of ethnic foods, racial disparities), economy (employee health care benefits), politics (government participation), religion (beliefs about medical treatment), social norms (drinking on a college campus), and socioeconomic status (number of people below poverty level).

3. Community organization-available health agencies (local health department, voluntary health agencies), and the ability to solve problems (lobby city council).

4. Individual behaviour-personal behaviour (health-enhancing behaviours like exercising, getting immunized, and recycling wastes.

COMMUNITY AND POPULATION HEALTH THROUGH THE LIFE SPAN

In community health practice, it is common to study populations by age group and by circumstance because of the health problems that are common to each group. These groupings include mothers, infants (less than one year old); children (ages 1-14); adolescents and young adults (ages 15-24); adults (ages 2564); and older adults or seniors (65 years and older).

Three Tools of Community Health Practice.

Much of the work of community health revolves around three basic tools:

• Epidemiology,

• Community organizing, and

• Health education

Roles of Community Health Workers

A community health worker (CHW) is a member of a community who is chosen by community members or organizations to provide basic health an medical care within their community, and is capable of providing preventive, promotional and rehabilitation care to that community. Other terms for this type of health care provider include lay health worker, village health worker, community health aide, community health promoter and health advisor. (BCom 1st Year Community Health Concept Notes Study Material)

The roles and activities of community health workers (CHWs) are tailored to meet the unique needs of the communities they serve. A CHW’s role depends on factor such as their education, training, lived experience and experience working with specific populations. CHWs may perform the following roles:

• Create connections between vulnerable populations and healthcare providers
• Help patients navigate healthcare and social service systems
• Manage care and care transitions for vulnerable populations
• Reduce social isolation among patients.
• Determine eligibility and enrol individuals in health insurance plans.
• Ensure cultural competence among healthcare providers serving vulnerable populations.
• Educate healthcare providers and stakeholders about community health needs.
• Provide culturally appropriate health education on topics related to chronic disease prevention, physical activity, and nutrition.
• Advocate for underserved individuals or communities to receive services and resources to address health needs.
• Collect data and relay information to stakeholders to inform programs and policies.
• Provide informal counselling, health screening, and referrals.
• Build community capacity to address health issues.
• Address social determinants of health.

COMMUNITY HEALTH AND ITS ORGANISATION

Community Health-Some communities have well-trained and skilled workers. Those health workers often work at health posts or centers, but not all. When health services are needed at the community level, women are the first to contact the traditional delivery assistant or midwife or community health worker. Community health workers should be trained.

By working closely with the people of the community, they can share those local traditions and customs that can help prevent and treat common health problems before they become more serious.

Primary Health Center- Primary Health Center (PHC) is made for a population of 20,000-30,000.

• A PHC must be able to provide all these services and health information so that everyone can make better decisions about their health.
• Vaccinations that can prevent many diseases, including tetanus, measles, diphtheria, whooping cough, polio, TB, and other diseases should be readily available.
• Care during pregnancy (prenatal care) that helps a woman address problems early in pregnancy that affect her and her unborn baby, before they become serious. Family planning services should be provided that save lives by helping women choose how many children to have and when.
• Early diagnosis and treatment of malaria and TB.
• Management and prevention of diseases of the reproductive system and sexually transmitted diseases, treatment of minor diseases, timely referral services, environmental sanitation, including purification of drinking water sources.
• Training of health guides, health workers, health assistants and midwives.

Sub-Health Centers-These are health posts located at the village level. A sub-centre serves about 5000 people. In hilly, tribal and desert areas, the population they serve is 3000. Normally 5-6 sub-centres will be associated with at least one PHC.

Community Health Centers-Community health centers are generally, located in large towns. Along with providing the services provided by the prima health centres, they also have 30 beds for the treatment of the people. There are more doctors and trained nurses than in primary health centers, and the also provide special services for women and children.

However, there is possibility of overcrowding and doctors and nurses not knowing their patients properly. There are also laboratories equipped with special equipment that can conduct tests to find out the reason for the illness.

Main Problems of Health Facility-The following problems are prominent in health care facilities:

1. Growing gap between infrastructure and manpower

2. Infrastructure not functioning at full capacity

3. Weak referral services

4. Large gap in availability and supply of health services between states and districts, specially poorest and needy.

5. Non-availability of these facilities in the districts.

6. Lack of coordination in various sectors providing health care.

7. Rise in health care prices, widening gaps and discrepancies between national capacity and available resources in the event of a budget failure.

8. Raising public awareness and expectations about health care.

9. Not able to stop the sale of spurious drugs and adulteration in food items.

Measures to Increase the Effectiveness of Health-

1. To arrange reliable and continuous training for persons with vocational skills or enhancement of manpower.

2. To arrange health management information system.

3. To enhance the skills of all categories of health workers through continuous learning.

4. Improving operational efficiency by promoting research in health services.

5. To create positive awareness of health care in the community through health education.

6. Promoting the research of essential medicines for health and providing medicines at affordable rates

7. Preventing the factors that reduce the standard of health such as drinking, smoking, cannabis, ganja, prostitution, etc. and trying to explain about the ill effects. (BCom 1st Year Community Health Concept Notes Study Material)

8. To actively cooperate in the implementation of various health programs and services.

9. To try to prevent adulteration of food items and sale of spurious drugs with the help of law.

Dimension of Health- Just as there is plurality in definitions and ideologies, similarly there are different dimensions of health. The different dimensions of health are:

1. Physical

2. Mental

3. Social

4. Emotional

5. Occupational

6. Environmental

7. Cultural

8. Economic

9. Philosophical

10. Spiritual

11. Nutritional or Dietary

12. Inhibitory

13. Remedial

14. Educational

Physical Dimensions- Physical health is a major component of overall health. It means the complete functioning of all the external and internal organs of the body, that is, every cell and organ of the body should continue to function at its best capacity in perfect harmony and should remain healthy. Physically healthy person’s skin is clean, eyes and hair are shiny, breath is pleasant and has a good appetite. When a man is unwell or ill, he does not feel hungry.

The person starts seeing different symptoms like dizziness, nausea, sleeplessness, sadness etc., due to which he starts to remain angry, sad, frustrated, irritable etc. (BCom 1st Year Community Health Concept Notes Study Material)

Mental Dimension-Mental health is an important component of overall health. Mental health is a state of co-existence between the individual and his surroundings, the balance between himself and other individuals, and between one’s own realities, the environment and other individuals. Mental illness can invite all kinds of diseases. A mentally healthy person should be free from internal conflicts, have high self-esteem, be self-controlled and able to face problems, knowing one’s own abilities, limitations, etc.

The mental aspect of health is the key to achieving complete and optimal health in various dimensions. A mentally healthy person remains calm, content, and always happy. There is no conflict within himself. He remains the same inside and out, never curses himself and neither overestimates nor underestimates his worth, so he is completely satisfied with himself.

Social Dimensions-Human is a social animal, if a person is oppressed by the society, then it affects the mental health of that person. Social background is directly related to health. Social dimensions of health include social status, efficiency, functioning and a sense of self as a member of the larger community. In social dimensions, the superiority of married life and human environment is essential, which is related to the social structure of the individual.

Business and Economic Dimensions-Finance and business are essential components of human life. Job satisfaction plays an important role in physical and mental health. Economic mismanagement can destroy the health of the individual, family and community.

Health Indicators and their Kinds—There are many factors that determine health. Many of these factors are such that the physical structure of a particular person depends on his/her environment which are called direct factors, whereas indirect factors determine the level of health on the basis of social values and economic values. The indicators on the basis of which health can be assessed are called health indicators. Changes can be measured by these.

Therefore, they can also be called vector quantities. Health indicators are reliable, valid, sensitive and health is a multidimensional concept. (BCom 1st Year Community Health Concept Notes Study Material)

Therefore, various indicators have to be used to determine health. Prevailing health indicators can be divided into two categories.

Direct or specific indicators-Those indicators of health, which are by related to medical science and health services. The main ones are:

1. Mortality Indicator

2. Morbidity Indicator

3. Disability Rate

4. Health Service

5. Community Indicator

6. Health Policy Indicator

Indirect or General Indicator- It is an indirect way of indicating the health of the individual and the community. The main ones are.

1. Social and Mental Health Indicators

2. Socio-economic Indicators

3. Nutrition Level Indicators

4. Consumption Rate Indicators

5. Environmental Indicators

6. Life Quality Indicators

7. Emotional and Occupational Indicators

8. Cultural and Educational Indicators

9. Inhibitory and Environmental Indicators

10. Individual Indicators