Health Administration in Bangladesh

 Definitions: Health administration is a branch of Public administration which deals with matters relating to promotion of health, preventive services, medical care and rehabilitation, development of health manpower and medical education and training.

Aspects of Public Health Administration:

  1. Organizational Structure

  2. Health manpower development

  3. Health planning and management

  

Functions of public health administration:

   The efforts of public health administration are directed towards raising the level of health of community by –

    1. Planning

    2. Organizing staffing

    3. Directing

    4. Coordinating

    5. Budgeting

    6. Reporting

Determinants of Health

   Some of the major determinations of health are as follows:

   
1. Genetic

  
 2. Environment

(a) Internal environment

(b) External or macro environment

•         Physical environment that has bearing on health

•         Biological environment that has bearing on health

•         Psycho – social environments

(c) Microenvironment (personal environment)

3. Lifestyle (ways of living)

 4. Socio – economic and political conditions

 5. Health and family welfare services:

      (i) Immunization of children

     (ii) Provision of safe water supply

     (iii) Maternal and child health care

     (iv) Other essential health related programs

Indicator of Health:

     1. Mortality indicators:

           (i) Crude death rate

          (ii) Expectation of life

          (iii) Infant mortality rate

          (iv) Child mortality rate

          (v) Under – five mortality rate

          (vi) Maternal mortality rate

          (vii) Disease – specific mortality rate

          (viii) Proportional mortality rate

2. Morbidity indicator

       (i) Incidence and prevalence rate

       (ii) Notification rate

       (iii) Attendance rate of out – patient departments, health centers etc.

       (iv) Admission, readiness and discharge rates in health service institutions

        (v) Duration of stay in hospital

        (vi) Spells of sickness or absence from work or school.

 

3. Disability rates

      (i) Number of days of restricted activity.

      (ii) Bed disability days

      (iii) Work loss days (or school loss days) within a specified period

      (iv) Limitation of mobility

      (v)  Limitation of activity

      (vi) Expectation of life free of disability

4. Nutritional status indicators

5. Health care delivery indicators:

     (i)  Doctor – population ratio

     (ii) Doctor - Nurse Ratio

     (iii) Population – bed ratio

     (iv) Population per health center/ sub center

     (v) Population per traditional birth attendant

 6. Health care utilization rate

7. Quality of life indicators:

     (i) Infant mortality rate

     (ii) Life expectancy at age one

     (iii) Literacy rate



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Immunity

Definitions:

    
Immunity is the relative ability of the body to resist almost all types of organism or toxins that tend to damage the tissues and organs.

  
 Immunity is also defined as the ability of the body to recognize, destroy and eliminate the antigenic material foreign to its own. It is normally a defensive mechanism of the body.

    
Antigen: An antigen is a substance which when introduced into the system is capable of including an immune response leading to the formation of antibody with which it reacts specifically.

     
Antibody: An antibody is a modified globulin (immunoglobulin) produced in response to an antigen with which it reacts specifically.

     
Immunization: It is a technique by which immunizing agents are introduced into the body for the production of antibody to prevent diseases.

  

    
Toxin: It is the product of bacterial metabolism and is toxic, i.e., inhibitory or lethal to the cells of the host.

   Toxin may be –

    (i) endotoxin

    (ii) exotoxin

  
 Toxoid: It is a derivative of the toxin which is devoid of toxigenicity but still possessing the antigenicity.

   Toxic are used for the purpose of immunization.

   Examples: Tetanus toxoids, diptheria toxoids.

Classification of immunity:

• Innate or nonspecific

Genetic

Mechanical

Humoral

Cellular

• Acquired or specific

a. Active

1. Natural
2. Artificial

b.Passive

1. Natural
2. Artificial

Different types of inquest

Different types of inquest

An inquiry or investigation into the cause of un-natural death or sudden or suspicious deaths. 

 

Example-

• suicide, homicide and infanticide
• sudden death, the cause of whose unknown

Different types of inquest:

    3-types.-

• The police inquest
• The magistrates inquest and
• The coroner’s inquest

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Immunity

Immunity

Immunity is the relative ability of the body to resist almost all types of organism or toxins that tend to damage the tissues and organs.

   

Immunity is also defined as the ability of the body to recognize, destroy and eliminate the antigenic material foreign to its own. It is normally a defensive mechanism of the body.

   

Antigen: An antigen is a substance which when introduced into the system is capable of including an immune response leading to the formation of antibody with which it reacts specifically.

    

Antibody: An antibody is a modified globulin (immunoglobulin) produced in response to an antigen with which it reacts specifically.

    

Immunization: It is a technique by which immunizing agents are introduced into the body for the production of antibody to prevent diseases.

  

Toxin: It is the product of bacterial metabolism and is toxic, i.e., inhibitory or lethal to the cells of the host.

Toxin may be –

    (i) endotoxin

    (ii) exotoxin

   

Toxoid: It is a derivative of the toxin which is devoid of toxigenicity but still possessing the antigenicity.Toxic are used for the purpose of immunization.

   Examples: Tetanus toxoids, diptheria toxoids

Classification of immunity:

• Innate or nonspecific

1. Genetic
2. Mechanical
3. Humoral
4. Cellular

• Acquired or specific

a.Active

1. Natural
2. Artificial

b.Passive

1. Natural
2. Artificial

Cold chain:

Definition: Cold chain is a system of storage and transport of vaccine at low temperature maintaining their potency from the manufacturer to the actual vaccination site.

Usefulness: Cold chain is necessary because vaccine failure may occur due to failure to store and transport under strict temperature controls.

Expanded Programme on Immunization (EPI) / universal child immunization

1. Introduction

Ø  In May 1974, the WHO officially launched a global immunization programme, known as ‘Expanded Programme on Immunization’ (EPI) to protect all children of the world against six vaccine preventable diseases, namely – diphtheria, whooping cough, tetanus, polio, tuberculosis and measles by he year 2000.

Ø  In Bangladesh, EPI was formally launched on 7^th April 1979. The following Table shows the achievements and targets of EPI under 1 year in Bangladesh.

2.   National EPI Policies
3.    1. To immunize all children under one year of age throughout the country.
4.    2. To immunize all women of child bearing age including the pregnant women throughout the country.
5.    3. To extend service delivery point up to the community to cover all target population.
6.    4. To involve community level health and family planning workers as vaccination.

Table 14.13. National EPI Vaccination Schedule:

Name of the vaccine	Quantity for each dose	Interval between doses	Number of doses	Time of starting	Time of complementation
BCG	0.05ml		1	After birth	1 year
DPT	0.05ml	4 weeks	3	6 weeks	1year
HBV	0.05ml	4 weeks	3	6 weeks
OPV	0.05ml	4 weeks	4	6 weeks	1 year
Measles	0.05ml		1	After 270 days	1 year

• Vaccination should be completed within 1 year of age.
• The vaccine given before the interval between doses is uncountable and that dose of vaccine is valueless.
• Doses of OPV are 4. The 4^th dose should be with measles vaccine.
• There is no maximum limit of days between intervals of doses. If there is delay in coming to take the scheduled dose of vaccine, the vaccination should be completed according to vaccination schedule.  

Disinfection and disinfectants

• Disinfection is the killing of infectious agents outside the body by direct exposure to disinfectants.
• Disinfectants or germicide is a substance which destroys harmful microbes (not usually spores) present on the surface of inanimate objects.
• Sterilization is the process of destroying all living organism – pathogenic and non – pathogenic including their spores.
• Antiseptic is a substance which destroys or inhibits the growth of potentially infectious microorganisms.
• Disinfestations is the process of destroying small animals particularly arthropods or rodents.

Classification of disinfectants:

• Natural

1. Fresh air
2. Sunlight

• Physical

1. Heart
2. Radiation

• Chemical

1. Solid
2. Liquid
3. Gaseous

OCCUPATIONAL HEALTH HAZARDS

OCCUPATIONAL HEALTH HAZARDS

PREVENTION OF OCCUPATIONAL DISEASES

PREVENTION OF OCCUPATIONAL DISEASES

OCCUPATIONAL HEALTH

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DEMOGRAPHY

Demography

Definition:

            Demography is the scientific study of human population.

Focus of Demography :

   Demography focuses its attention on three readily observable human phenomena :

(i) Changes in population ‘size’ (growth or decline).

(ii) The ‘composition’ of the population and

(iii) the ‘distribution’ of population in space.

Demographic Cycle (transition)

 The history of world population since 1950 suggests that there is a demographic cycle of 5 stages through which a nation passes :

(I) First stage - high stationary.

(ii) Second stage - early expanding .

(iii) Third stage - late expanding.

(iv) Fourth stage - law stationary.

(v) Fifth stage- declining.

Population Explosion :

“Population explosion” means a rate more than a very rapid growth of population.

 There is no definite bench mark, it must be in relation to the resources of a particular country. Opinion varies, some say it begins when growth crosses 2%, others say it is when the growth reaches the rate of 2.5%.

Population Pyramid :

            The age of people of Bangladesh is typical of developing countries, with a broad base and a tapering top, age group. This also indicates a rapid population growth in future.