Dr. O. Maduka

08033298096

Public health has been defined as ‘the science and art of preventing disease, prolonging life and promoting physical health and efficiency through organised community efforts for the sanitation of the environment, the control of community infections, the education of the individual on the principles of personal hygiene, the organization of medical and nursing services for the early detection and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health’ – Winslow.

Community Medicine is the specialty which deals with population and tries to measure the health needs of the population – both sick and well. It also plans and administers services to meet these needs and carry out research and teaching in this field.

The Department of Preventive and Social Medicine in the University of Port Harcourt and the Department of Community Medicine in the University of Port Harcourt Teaching Hospital are two jointly managed departments that are well established for teaching, research and service institution that had been involved in the in the training of Community Health officers, nursing, post-basic nursing, undergraduate, graduate students, and residency training.

The Department of Preventive and Social Medicine in the University of Port Harcourt is a broad-based service, teaching and research organisation with well-motivated and committed human resources that strive to understand why some people are healthy and some are not, how to prevent illness and injury, how people’s health can be improved through working with communities, how political systems and health organisations affect health, and other issues relating to the health of populations. Our perspective to health is holistic and we appreciate the role different actors play in protecting, improving and maintaining population health. We have been involved in public health training, public health research and public health actions since the inception of the University of Port Harcourt.

The department has a public health laboratory with the basic equipment required for routing public health investigations.

Students in the department also make use of the laboratory of the department’s health centre, and those of the departments of Chemical Pathology, Haematology and Microbiology. The facilities in these laboratories received a big lift through the Federal Government’s Vamped programme, and a public-private partnership with a Canadian firm. It is worth mentioning that the department of Microbiology now has a virology laboratory, and a dedicated facility for the culture of tuberculosis bacilli.

The department has a museum that has in stock assorted samples of environmental sanitation equipment, mounted specimens of some vectors of public health significance, and models depicting various aspects of the specialty. The museum also has a photo gallery consisting of pictures of public health significance.

The department has a library that stocks relevant public health textbooks and journals, both in hardcopy and in electronic form. The library also has internet access and also has access to HINARI. Residents in training also have access to the medical library of the University of Port Harcourt.

The department has dedicated computers for data processing that provides for the training of residents in various computer statistical packages. The facility is manned by the Epidemiology and Biostatistics unit of the department and has been useful for data entry and analysis for several studies carried out in and outside the department.

Clinical facilities within the department for residency training

The department has the following clinical practice areas and facilities for the training of resident doctors:

The DOTS clinic was established following the rising incidence of TB/ HIV co-infection; and is funded by the German Leprosy Relief Association (GLRA) through the Rivers State TB/ Leprosy Control Programme.  The management of the patients in the DOTS clinic is the direct responsibility of the department, but the laboratory backup is provided by the microbiology department of the hospital. With the setting up of a culture facility for tuberculosis bacilli in the microbiology department, the management of tuberculosis in the department is to include an isolation ward for the management of multi-drug resistant tuberculosis. This will provide a good training for resident doctors in the management of severe communicable disease.

This is one of the clinics under the control of the epidemiology and disease control unit of the department. It sees both self-referred patients, and those referred from other clinics in and outside the teaching hospital. Its activity is boosted by a well-equipped side laboratory, and the arrangements put in place for contact tracing.

This clinic is run in conjunction with the departments of Internal Medicine and Haematology of the teaching hospital. The clinic is for the management of HIV/AIDS patients with drugs and testing kits provided by the Federal Government and healthcare partners like Institute of Human Virology of Nigeria (IHVN) and Family Health International (FHI).

This clinic provides NPI immunization services to children and women of child-bearing age, and immune-prophylaxis to individuals according to identified risks. The clinic also undertakes growth monitoring, health education, and nutritional counselling (provided in conjunction with the Dietetics department of the hospital). Plans are underway to broaden the range of preventive medical services provided in the clinic.

This is located in Aluu – a semi-urban community located about 5km from the present site of the teaching hospital. It is solely managed by the department and designed to provide training in rural community health.

The health centre currently provides the following services:

• Out-patient services

• Well Child Clinic

• Pharmacy

• Laboratory services

• Ante-natal Clinic

• Maternity services

• Family planning clinic

The health centre also provides free Voluntary Confidential Counselling and Testing and has a PMTCT (Prevention of Mother to Child Transmission of HIV/AIDS) programme established in partnership with two international NGOs – Africare and IFESH. These programmes have been a good training opportunity for the residents.

Since the department assumed responsibility for the management of the health centre in the 1980s, it has made great effort in ensuring that the catchment communities make inputs into the running of the health centre. However, the zeal with which this was pursued at the inception of health centre was not sustained due to the establishment of other health centres in the area, dwindling funding, and the rapid influx of students and staff of the University of Port Harcourt into the communities.

The need for another health facility to provide training in rural community health was felt following the rapid urbanization of the Aluu community, and the very short distance between the Aluu health centre, and the permanent site of the teaching hospital. As part of the minimum standard, ‘every medical school must adopt at least one local government area or, better still, its population base, and supervise and coordinate its primary health service facilities, using such facilities as physical basis for the schools’. K-Dere – a rural Ogoni community, located about 50km from the teaching hospital was chosen as the site of the new facility because:

• The community has been successfully used by the department for the rural posting of medical students.

• Members of the community demonstrated support for the project by donating the community-owned health centre, and securing the support of key stakeholders in the health centre (the local government council, and Shell Petroleum Development Company);

• An agreement with the local government council and the primary health care board to cede the control of the health centre to the department is not yet concluded.

The K-Dere facility is still in its development stage, with the K-Dere community, the University of Port Harcourt, the teaching hospital, the Rivers State Government, the Local Government Council, and the Shell Petroleum Development Company as development partners. The fully developed K-Dere health centre will provide ample training opportunities for the training of not only resident doctors and medical students, but also for Community Health Officers and other categories of health workers.

This unit is saddled with the responsibility of maintaining the sanitation of the environment of the teaching hospital. It is however under the control of the occupational/ environmental health unit of the department. It is therefore an avenue for the practical training of the residents in various aspects of environmental health.

Although most of the activities of the environmental health unit are now carried out by contractors, it remains the responsibility of the department to provide technical support and ensure the proper execution of the contracts. The occupational/ environmental health unit of the department regularly surveys the hospital to identify environmental health problems, and then proffer solutions for the consideration of the hospital’s management.

This centre is a 34-bed facility that admits persons with drug resistant tuberculosis and provides them with care and treatment using second line anti-TB drugs. It is supported by the Institute of Human Virology of Nigeria (IHVN) and is managed by a Consultant in the department with senior resident doctors assigned to the Program Manager.

Our training approaches involves competency based training and self-directed learning.

“Competency-based learning or competency-based education and training is an approach to teaching and learning more often used in learning concrete skills than abstract learning. It differs from other non-related approaches in that the unit of learning is extremely fine grained” . Competency based trainings are designed to allow the trainee demonstrate their ability to do something. The focus is on what the trainee is able to achieve in the workplace independently or in a team after completing the training and the emphasis is on the ability of the learner to do what he or she had been trained to do. The unit of progression in a traditional educational system is time and it is teacher centered. In CBT, the unit of progression is mastery of a particular knowledge and skills and is learner or participants’ centered. The Department believes that CBT should be used as opposed to the ‘medieval’ concept of time-based learning. Therefore, residents on training can only be signed in for the various levels of examination under any of the Colleges when they show demonstrable skills and competencies in what they have been trained to do. A competent public health physician is one that is able to perform a clinical or public health skill to a satisfactory standard. Two important terms need to be understood in CBT:

• Skills – A task or group of tasks performed to a specific level of competency or proficiency which often use motor functions and typically require the manipulation of instrument and equipment (e.g. undertaking Incision and Drainage). Some skills such as health promotion and counselling however, are knowledge and attitude based.

• Competency – A skill performed to a specific standard under specified conditions

Essential elements of CBT system include:

• Competence to be achieved are carefully identified, verified and made public in advance.

• Criteria to be used in assessing achievement and conditions under which achievement will be assessed are explicitly stated and made public in advance.

• The instructional programme provides for the individual development and evaluation of each of the competencies specified

• Assessment of competencies takes the participant’s knowledge and attitudes into account but requires actual performance of the competency as the primary source of evidence

• Participants progress through the instructional program at their own rate by demonstrating the attainment of the specified competences.

Advantages of CBT

Clearly, CBT is focused on the success of each trainee. Benefits of CBT include:

• Trainee achieve competencies required in the performance of their jobs

• Trainee build confidence as they succeed in mastering specific competencies

• Trainee could receive a transcript of the list of the competencies they have achieved

• Training time is used efficiently and effectively as the trainer is only a facilitator of learning as opposed to provider of information

• More training time is devoted to working with participants individually or in small group as opposed to presenting lectures.

• More training time is devoted to evaluating each trainee’s ability to perform essential job skills

Despite the numerous advantages of CBT, we would guide against certain pitfalls that can be seen as limitation of the CBT system. Some of these limitations we would guide against include:

• The tendency to “teach as we were taught” where the CBT trainer quickly revert to the roles of traditional teacher. We would ensure that regular training and follow-up assistance are provided for the trainer

• If little or no attention is given to identification of the essential job skills, then the resulting training is likely to be ineffective. This is because, a CBT is only as effective as the process used to identify the competences.

The implications of using CBT in our training centre is that:

• Our organisation must be committed to providing adequate resources and training materials.

• Audio-visual materials need to be provided and should directly be related to the written materials

• All training activities must have clear objectives and learning outcomes

• Continuous interactions among trainees and between the trainees and the departmental trainer must take place

• Trainees must be prepared and motivated for CBT as this approach is different from their past educational and training experiences

The major objective of the community medicine course is to provide medical graduates with the necessary skills and background to make them well-grounded doctors so that they can make an impact in a demanding workplace and in the community.

These skills include:

Technical Skills

 – Detailed technical knowledge of community medicine and healthcare

 – Understanding of the applications of this knowledge in solving health problems in the society at large

–  Technical, interpersonal and organizational competence in health

Generic Skills

– Acquire skills to become a highly effective manager and leaders

– Ability to work independently and in a team within an organisation

– Presentation skills and experience

– Social skill in dealing successfully with every individual in the work place and in the community

The intended learning outcomes on successful completion of the various trainings in Community Medicine are: –

(a) know the concept of disciplinary Community Medicine and its relevance in

Nigeria health care system;

(b) make community diagnosis;

(c) Describe the major ecological and social factors affecting human health.

(d) carry out epidemiological studies to identify prevalent health problems

in the community and determine the effective means of solving them;

(e) know how to plan, organize and evaluate appropriate health programmes;

(f) seek and mobilize resources for health care management;

(g) develop the spirit of team work among the members of the health team;

(h) Exhibit the highest principle of medical ethics in the promotion of health.

(i) Prevent and control major communicable diseases in the community and institutions.

(j) Describe the principles of dietetics and nutrition for all age and community.

(k) Describe the major public health laws that are applied by health authorities in the community

(l) Carry out a research project in any area of Community medicine.

In addition, the Primary Health Care training aims at enabling the doctor to possess the knowledge, attitude, and skills to: –

(a) Diagnose the health problem of a community;

(b) Develop a primary Health Care Plan for the defined community

(c) Deliver the component services of Primary Health Care

(d) Provide essential curative care for common conditions at the level   of Primary Health Care Clinic in a defined community

(e) Provide immunisation services to a defined community

(f) Provide maternal health services and family planning to a defined                                      community

(g) Provide health education to individual and the community

(h) Identify and provide solutions to the problems of environmental sanitation;

(I) Describe the epidemiology of local endemic diseases and provide      appropriate preventive and curative services for a defined community

(j) Manage, monitor and evaluate the implementation of Primary Health Care        services for a community

(k) Implement appropriate training programmes for health personnel and       members of the community for delivery of Primary Health Care Services.

 TRAINING METHODS

(a) Didactic lectures

(b) Tutorials and Discussions

(c) Group activities

(d) Seminars

(e) Field visits to places of public health importance including health-related institutions and industries

(f) Clinical practice e.g. Clinics for Endemic Diseases, Sexually Transmitted Diseases, Staff Clinics and general medical practice at the primary health centres

(g) Community-based field training – Health surveys involving households, under-fives, primary school, and secondary school in both rural and urban communities; outbreak investigation (simulation)

(h) Research project

(i) Practical – both public health related and computer training

(j) Self-directed learning.

INTRODUCTION TO HEALTH CARE/HISTORY OF MEDICINE/DENTISTRY (PSM 301, 1 credit unit)

This course will teach the history of medicine in antiquity, through the middle ages down to the scientific era as well as the history of medicine in Nigeria. Broad areas to be covered include – History of Medicine (Paleo medicine, Primitive medicine, Ethnomedicine, Alexandria and Rome (300 Be), Medieval medicine (500 to I500 AD), Renaissance medicine (15th to 16th Century AD), History of Medicine in Nigeria); History of medicine in Nigeria; Health system – traditional and modern health systems; Formal and lay health care in Nigeria; Alternative medicine; Health professional groups; The Health Team; Definition and Sub- Specialties in Community Medicine; The Role of the Community Health Physician; The Doctor’s Role in the society; Behavioural & Non-Behavioural Factors in Health and Disease; History of Dentistry – global and the Nigerian context.

MEDICAL SOCIOLOGY (PSM 302, 1 credit unit)

This course will teach the relevance and contributions of Sociology to Medicine and explore the concept of illness behaviour and types of patient-doctor relationships. Students will also learn about hospital organizations and use of health services in Nigeria. Broad course outlines will include – Introduction to Medical Sociology; Definition of Health, Disease, Sickness, Illness; Socialisation; Role Differentiation; Beliefs, Values, Norms, Superstitions, Taboos etc; Human Organisations and Systems: Family Systems, Marriage Types and Stability; Type of Societies, Social Classification; Culture and Health – Beneficial, Harmful and Neutral Practices; Religion and Health; Socio-Economic Status and Health; Educational Status and Health; Traditional and Modern Health Systems in Nigeria; Recreation, Sleep; Behavioural concepts in Public Health; Change processes; Health Behaviour and Illness Behaviour; Working Population, Unemployment, Retirement, Ageing; Dependency; Social Security. Adverse effects of Social Deviance; Alcoholism; Drug Abuse; Smoking; Domestic violence e.g. battered wife syndrome, rape; The health of underprivileged in the Society.

HUMAN ECOLOGY (PSM 305, 1 credit)

This course will teach Components of the Environment – Biological, Physical and Social; Ecological Concepts; Man’s Interaction with the Environment: Adaptation Process, Balance and Change; Socioeconomic Activities and the Human Environment – Deforestation, Irrigation, Dams, Industrialisation, etc; Environment and health; Geography and health; Urbanization and health; Globalization and Health; Trade and Health.

DESCRIPTIVE MEDICAL STATISTICS (PSM 306, 2 credit units)

This course will teach descriptive statistics as tools for research and practice in the field of medicine. It will equip prospective students with basic skills in quantitative reasoning and application necessary for medical research. Broad outlines include – Introduction to statistics; Uses of statistics; Types of data, types of variables, Types of distribution; Sources of Data, Tools for Data Collection; Scales of Measurement; Diagrammatic Presentation of Data – Histograms, Pie charts, Bar Charts, Graphs, Pictogram etc.; Numerical Presentation of Statistical Data – Measures of Central Tendency and Location; Measures of Dispersion; Tabular presentation – simple and cross table etc; Population, Samples and Sampling Techniques

BIOETHICS (PSM 303, 1 credit unit)

This course is to acquaint the students with the broad bioethics and ethical knowledge necessary for medical practice and research. It will introduce the students to the basic ethical principles and the key issues in medical ethics. Tracing the history of biomedical ethics to current ethical issues in medical practice and research. Broad outlines covered include – History and Evolution of Medical Ethics; International Code of Medical Ethics (Hippocratic, Physician oaths, Helsinki declaration); Introduction to law & ethics; Duties of Doctors – relationship to fellow colleagues, teachers, and members of the health care team and society; The Medical and Dental Council of Nigeria; Professional Negligence/Responsibility/Confidentiality/Misconduct/appearance in court; The Doctor and the Law: Judicial, Coroner’s Court

DEMOGRAPHY (PSM 404, 1 credit)

This course will teach Demography – Definition, Uses; Population Composition – Age, Sex, Occupation, Ethnicity etc; Population Dynamics (Fertility, Mortality, Migration, Population Structure, Growth and Projection); Sources of Population Data; Sources of Health and Vital Statistics; Cancer Registration; Demographic Transition; Malthusian Theory of Population; Census – National and Local; World Population and Policy; the National Population Policy; Interaction between Medical Action, Population, Health and Population Growth; Measurements of Health and Disease; Different Rates and their Uses; Standardisation of Vital Rates.

ENVIRONMENTAL HEALTH (PSM 405, 4 credit units)

This course will teach the impact of the environment on human health. Explain the concept Agent-Host –Environment Model. It will emphasize those aspects of human health including quality of life that are determined by physical, chemical, biological, social and psychological factors in the environment. Broad areas covered will include: Introduction to Environmental Health; Environmental Sanitation and its Components; Water and Health, Sources of Water; Uses of Water; Examination of Water, Purification of Water, Water Supply; WHO Water Programmes; Food Hygiene; Safe Guarding of Food; Housing and Health; Disposal of Wastes – Sewage and Refuse, Disposal of the Dead; Control of Vectors, Other Pests and Animal Reservoirs of Infection; Insecticides of Public Health Importance ; Air Hygiene and Prevention of Atmospheric Pollution, climate change; Legislation and Environmental Health – Public Health Laws; The Petroleum Industry and the Niger Delta; The Ozone Layer; Green House Gases; Disaster Management; Refugees; Environmental Toxicology; Environmental Impact Assessment; Environment and health; Geography and health; Urbanization and health; the Eco-system and biodiversity.

NUTRITION & DIETETICS (PSM 414, 1 credit unit)

This course will teach Nutrition and Health; Classification of Food; Nutritional Values of Common Nigerian Foodstuffs; Culture and Nutrition; Beliefs and Taboos; Infection and Nutrition; Breastfeeding; Weaning Practices; Food Policy; The National Breast-Feeding Policy; Food Hygiene and Toxicology; Nutrition Education. Others are –

• Applied Dietetics I – Diet in the Aetiology and Management of Diseases (Kwashiorkor,

oMarasmus, Vitamin Deficiencies, Mineral Deficiencies, Obesity, Hypervitaminoses, etc)

• Applied Dietetics II – Diet in the Aetiology and Management of Diseases (Diabetes,

oEssential Hypertension, Coronary Heart Disease, Liver Failure, Goitre, Myxoedema, Cretinism, Dental Caries, Anaemia)

• Assessment of the Nutritional Status of a Community

PRINCIPLES OF EPIDEMIOLOGY (PSM 407, 1 credit unit)

This course will teach: Definition; History of epidemiology; Distribution and Determinants of Diseases: Biological, Behavioural, Social, etc; Epidemiological approach; Infective Agents: Reservoir of Infection; Transmission of Communicable Diseases; Host Factors; Epidemiologic triad; Natural history of disease, spectrum of diseases; Risk Factors in the Epidemiology of Communicable and Non-Communicable Diseases; Epidemiological Methods: Epidemiological Tools – Rates (Crude and Specific), Ratios, Percentages, etc; Epidemiological Methods: Epidemiological Studies; Disease Surveillance and Notification; Screening and Screening Tests; Uses of Epidemiology; Principles of Disease Control; Levels of Prevention; Epidemiological Transition.

Computer Appreciation (PSM 427, 1 credit unit)

This course would cover introduction to the use of computers in health; Systems, Programmes and software; Statistical Packages for Data Entry and Data Analyses.

INFERENTIAL MEDICAL STATISTICS (PSM 635, 1 credit unit)

This course seeks to ensure that students are familiar with the basic principles of Inferential Statistics. It covers topics like The Standard Normal Curve, Probability Distributions, The Sampling Distribution and Central Limit Theorem, Standard Error, Confidence Intervals, Hypothesis Testing and Tests of Significance e.g. Z-Test, t-Test, Chi-Square Test, etc.

FAMILY/REPRODUCTIVE HEALTH (PSM 614, 2 credit units)

This course will teach Introduction to Family Health; Concept, Components and Objectives; Measurements in Family Health; Health Problems and Health Needs of Mothers and Children; Determinants of Health of Mothers and Children; Family Health Practice; Maternal Health Care Services, Infant Welfare Clinic; Organisation and Evaluation of Family Health Programmes; Immunisation Programmes; Population Dynamics and Family Planning; The “At Risk” Concept in MCH; Safe Motherhood Initiative; Integrated Management of Childhood Illnesses (IMCI); School Health – Aims and Objectives; The School Health Programme

SOCIAL AND REHABILITATIVE MEDICINE (PSM 601, 1 credit unit)

This course will teach Introduction to Social Medicine; Health assessments; Social Deviance; Alcoholism; Drug Abuse; Smoking; Domestic violence e.g. battered wife syndrome, rape; The underprivileged in the Society; Disability, Handicap, Impairment; Classification and Causes of Handicaps; Problems of the Aged; Social Welfare Services in Nigeria and Other Countries; Care of the Handicapped; Orphanage; Old Peoples Home; Remand Homes; Prisons; Care of the terminally ill and hospice care; Voluntary Agencies in health and social services. Forms of Illness behaviour; Patient-Doctor Relationships in health care; Patient Care Management. Emergency preparedness and Federal, State and Local Government Levels

OCCUPATIONAL HEALTH (PSM 613, 1 credit unit)

this course would cover Introduction to Occupational Health, Aims and Objectives; Occupational Health, Hazards and their Control; The Environment of Working Places; Occupational Health Services; Fate of Inhaled Aerosol; Pneumoconiosis; Hazards of Radiation; Hazards of Various Occupations – Petroleum, Butchers, Bottling, Executives, Agriculture; Occupational Cancers; Environmental & Biological Monitoring; Industrial Medical Examination; Industrial Health Notification, Industrial Notifiable Diseases; Industrial Legislation – Factory Act, Workman’s Compensation Act; Industrial Rehabilitation; National and International Health Regulations Relating to Occupational Health

EPIDEMIOLOGY AND DISEASE CONTROL (PSM 604, 3 credit units)

This course will teach: Principles of Disease Control and Prevention

Epidemiology and control of communicable diseases

•Epidemiology and Control of Communicable Diseases According to their Routes of Transmission

• Epidemiology and Control of Viral Infections (Poliomyelitis, HIV/AIDS, Viral Hepatitis A-G,

oYellow Fever, Chickenpox, Lassa fever, Ebola, Exotic Diseases, Rabies, Measles, Rubella, Mumps, Viral RTIs,)

•Epidemiology and Control of Bacterial Infections (Tb, Leprosy, Enteric Fevers, Bacillary dysentery, Cholera, Bacterial Food Poisoning, Tetanus, Bacterial Pneumonia, Meningococcal Infections, Rheumatic Fever, Pertussis, Diphtheria, Plague, Anthrax, Chlamydial Infections)

•Epidemiology and Control of Protozoal Infections (Malaria, Amoebiasis, Giardiasis, Trichomoniasis, Trypanosomiasis,

• Epidemiology and Control of Fungal Infections (Superficial Fungal Infections, Candidiasis,

•Epidemiology and Control of Helminthic Infestations (Ascariasis, Trichuriasis, Enterobiasis, Visceral Larva Migrans, Cutaneous Larva Migrans, Dracontiasis, Taeniasis, Hydatid Disease, Fascioliasis, Hookworm, Schistosomiasis, Strogyloidiasis, Bancroftian and Malayian Filariasis, Loaiasis, Onchocerciasis,)

•Epidemiology and Control of Arthropod Infestations (Scabies, Lice, Ticks, Mites)

•Epidemiology and Control of Special Groups of Communicable Diseases – STIs, Zoonoses, Diarrhoeal Diseases, Emerging and Re-Emerging Infectious Diseases, Hospital Infections

•Control Programmes for Communicable Diseases in Nigeria

Epidemiology and control of non-communicable diseases

•Epidemiology and Control of Genetic and Congenital Diseases – Sickle Cell Disease, Down’s syndrome

• Epidemiology and Control of Juvenile Delinquency

•Accidents – RTA and Home Accidents

•Epidemiology and Control of Asthma and Peptic Ulcer

• Epidemiology and Control of Diabetes (DM, DI), Hypertension, Sickle Cell Disease,

oCoronary Heart Disease, G6PD Deficiency, Ca Breast, Ca Cervix, Ca Prostate

•Control Programmes for Non-communicable Diseases in Nigeria

HEALTH EDUCATION AND PROMOTION (PSM 612, 1 credit unit)

this course would cover areas such as: Health Education – Principles, Methods and Strategies; Principles of learning and behavioural change; Assessment of learning needs (individual, community); Designing educational materials; Evaluation of health education programme; Health Education in the Control of Communicable and Non-Communicable Diseases; Health promotion

RESEARCH METHODS (PSM 622, 2 credit units)

Research methods refer to the practices and techniques use to collect, process, and analyse data. The topics taught include Planning a research, Ethical issues in research, Study design in medicine and public health research, problem identification and objective setting, formulation of hypothesis, Literature search / literature review, approaches to study materials and method, data analysis, Presentation of results, and report writing.

These course would cover areas such as: Planning a Research; Ethical Issues in Research; Study Designs in Medicine and Public Health; Choice of Topic; Introduction (Problem Definition, Objectives); Formulation of hypothesis; Testing of hypothesis; Literature Search/Literature Review; Materials & Methods (Sample Size Determination/Calculation, Instrument for data collection,  Data Collection/Management); Presentation of Results (Data Presentation, Analysis etc); Discussion, Conclusion and Recommendations; Referencing; Project Write-Up

PRIMARY HEALTH CARE (PSM 621, 1 credit unit)

this course would cover areas such as: Definition, History and Elements of Primary Health Care (PHC); Strategies for the Implementation of PHC; Basic Health Services Scheme and PHC Institutions; The Medical Officer of Health; Vaccines, Types; the Cold Chain; The National Programme on Immunisation; Mass Immunisation Programmes; The Bamako Initiative. Other areas include:

•Referral System in Health Care Delivery

oPrinciples of Primary Health Care

Equitable Distribution

Integration of Services

Appropriate Technology

Community Participation

Inter-sectoral Collaboration

oCommunity Diagnosis

The Structure and Functioning of Communities

Methods in Practical Epidemiology

The Conduct of Demographic and Morbidity Surveys in a Defined Community

Methods of Informal Data Collection

Health Care Alternatives at the Community Level

oHealth Management in PHC

•Identifying and Describing the Health Needs and Problems of a Defined Community

•Establishing Health Priorities for A Defined Community

•Setting Goals, Objectives and Targets for PHC Services for a Defined Community

•Formulating A PHC Plan

•Drawing Up A PHC Budget; Budgeting and Accounts

•Organisational Structure of PHC

•Integration of Services for PHC

•Management of Staff, Transport, Drugs, Equipment and Supplies in PHC

• Basic Operations Analysis Techniques for Monitoring PHC Staff and Service Performance

oWork Sampling

oPatient Follow-Up

oTask Analysis

oTreatment Audit

•Assessment of PHC Service Coverage with Particular Reference to Availability,

•Accessibility and Acceptability

•Effectiveness, Efficiency and Equity in PHC Service Delivery

oMaternal Health and Family Planning

•Organising Antenatal Care for Maximum Coverage of the Community

•Health Education

•Identification of Learning Needs

•Planning Health Education for Individual Groups and Communities

•The Principles of Communication

•Selection and Production of Appropriate Audio-visual Aids

•Environmental Sanitation

•Identification of an Appropriate Water Supply for a Defined Community

•Identification of an Appropriate Method of Sanitation for a Defined Community

•Promoting Self-Help Projects at the Community Level

•Locally Endemic Diseases

•The Epidemiology of Locally Endemic Diseases

• Appropriate Management and Prevention of Locally Endemic Diseases at the PHC Level

oEssential Drugs

•The Essential Drugs Approach

•The Essential Drugs List for PHC in Nigeria

•Estimating the Essential Drug Needs of a Defined Community

• Administering an Essential Drugs Policy in PHC Services for a Defined Community

• Evaluation of PHC

• Research in PHC

•PHC Reforms

HEALTH MANAGEMENT (PSM 618, 3 credit units)

the training in health management would cover areas such as: Concepts, Principles and Functions of Management; Health Services Management – Definition, History, Elements; Principles, Scope and Nature of Health Services (Levels of Health Care); Organisation of Health Services in Nigeria (Federal, State and LGAs); Comparative Analysis of Health Care Systems in Different Countries; Planning of Health Services (Cybernetic Cycle); Evaluation of Health Services; Management of Human, Material and Financial Resources; Management of hospitals and other health organization; National Health Policy; Health quality improvement; The Health Team; Principles of Health Economics – Basic and applied; Health care financing; Public private partnership in health; Health Management Information system; Leadership training; Competency based learning.

INTERNATIONAL HEALTH (PSM 616, 1 credit unit)

The course in international health will cover areas such as: Health and international health: concepts, history and standing theories; Globalisation and health; International Health Organisations/Agencies, e.g. WHO, UNICEF, UNFPA, FHI etc; Port Health; International Notification of Diseases; International Health Regulations; Travel medicine; Health in the Millennium Development Goals; Health systems: comparison and performance; Trade and health; the global health workforce:  crisis, future and challenges

Rural Posting (PSM 624, 20 credit units)

Rural posting is the common term used for the periodic field visit and experience-based learning required to complete the stipulated curriculum in medical education for undergraduate studies in Nigeria. The objective being to expose students to typical rural settings and to develop in them the skill, attitude and motivation to work and live in such environments, to assess the health of the people, to promote their health and to organize relevant programs to alleviate the people’s health problems. The rural posting in Preventive and Social Medicine requires that at the end of the 2 months period, medical students should be able to carry out community diagnosis (i.e. identify causes of ill health in the community, social and economic problems), initiate measures for the prevention of health disorders and communicable diseases, apply patient management techniques, undertake research on tropical health issues, and lead a health team.

Laboratory Practice (PSM 626, 1 credit unit)

Computer Appreciation (PSM 627, 1 credit unit)

This course would cover introduction to the use of computers in health; Systems, Programmes and software; Statistical Packages for Data Entry and Data Analyses.

Seminar (PSM 628, 1 credit unit)