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

Mental Health

• Mental  Health

OCCUPATIONAL HEALTH HAZARDS

OCCUPATIONAL HEALTH HAZARDS

PREVENTION OF OCCUPATIONAL DISEASES

PREVENTION OF OCCUPATIONAL DISEASES

OCCUPATIONAL HEALTH

OCCUPATIONAL HEALTH

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.

Carriers

Definition:

       A carrier is defined as “an infected person or animal that harbours a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection for others”.

Element: The elements in a carrier state are:

(a) The presence in the body of the disease agent

(b) The absence of recognizable symptoms and signs of disease, and

(c) The shedding of the disease agent in the discharges or excretions, thus acting as a source of infection for other persons.

Classification of Carriers: Carriers may be classified as below-

A. Type

            a. Incubatory

            b. Convalescent

            c. Healthy

B. Duration

            a. Temporary

            b. Chronic

C. Portal of Exit

            a. Urinary

            b. Intestinal

            c. Respiratory

            d. Others

Modes of Communicable diseases transmission

Communicable diseases may be transmitted from the reservoir or source of infection to a susceptible individual in many different ways, depending upon the infectious agent, portal of entry and the local ecological conditions.

Direct transmission

o   Direct contact

o   Droplet in faction

o   Contact with soil

o   Inoculation into skin or mucosa

o   Tran placental (vertical)

Indirect transmission

o   Vehicle-borne

o   Vector-borne

o   Mechanical

o   Biological

o   Air-borne

o   Droplet nuclei

o   Dust

o   Fomite-borne

o   Unclean hands and fingers

Epidemic and Endemic

Epidemic (Epi=Upon; Demos = people):

            The occurrence of cases of a disease or other health related events clearly in excess of normal expectation in a particular place in a given period of time is called on epidemic.

            The usual epidemic diseases are: measles, chickenpox and cholera.

Endemic (En-in; Demos = People):

            The occurrence of a disease or infectious agent regularly in an area either throughout the year, or in particular seasons on an yearly basis without importation from outside is called endemic.

            Example: Cholera in post monsoon period in rural Bangladesh, malaria and leprosy in some parts, goitre at Rangpur and Jamalpur regions.  

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Hyperendemic and Holoendemic

Hyperendemic : 

         It expresses that the disease is constantly present at high incidence and/ or prevalence rate and effects all age groups equally.

Holoendemic : 

        It expresses a high level of infection beginning early in life and effecting most of the child population, leading to a state of equilibrium such that the adult population shows evidence of the disease much less commonly than do the children.




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Pandemic

When an epidemic disease affects a large proportion of the population and occurs over a wide geographic area such as a section of a nation, the entire nation, a continent or the world, is called pandemic.

Pandemic diseases: Influenza, acute hemorrhagic conjunctivitis, syphilis, gonorrhoea, AIDS etc.







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Zoonosis

An infection or infectious disease that usually and primarily develops in vertebrate animals and transmissible to man under natural conditions.

Zoonotic diseases: rabies, plague, bovine, tuberculosis, anthrax, brucellosis, salmonellosis, endemic typhus, hydatidosis etc.