SOCIAL - HYGIENIC PROBLEMS OF PUBLIC HEALTH AND PUBLIC HEALTH SYSTEM IN COUNTRIES AROUND THE WORLD

The methodical booklet

For students III-VI courses Faculty of Medicine Specialties "Medicine ", "Pharmacy", "Dentistry"

Moscow Published by Russian Peoples Friendship University 2007

It is authorized RPS of the Academic council of Russian Peoples Friendship University

Authors: D.I. Kicha, I.V. Kalmykova, T.V.Lyapunova Social - hygienic problems of populations health and public health system of the countries around the world: The research paper on hygiene, public health and public health system / Authors: D.I. Kicha, I.V. Kalmykova. T.V. Lyapunova- M.: Publishing house RPFU, 2007. 15.

Taking into account of the integrated approach of teaching hygiene, public health and public health system in the faculty, the research paper has complex character but can probably be separated by the given method. For students from III-VI course in the faculty of medicine, specialties "Medicine", "Pharmacy", "Dentistry", must carry out the course work within the framework of the curriculum.

Done in the Department of hygiene, public health and public health system. Authors group, 2007 Publishing house Russian Peoples Friendship University, 2007

Dear students, By carrying out the given research paper, it will help you, students, in addition of the curriculum to get acquainted with conditions of life of the population of the country, medical are system, medico-social problems of populations health, to determine once view in solving the problems of health and public health system, in more exact choice of the future specialization of your profession. We wish you health and success on the work of your country and your people. Yours faithfully, Teachers of Department

ONTENTS 1. Preface. 2. Plan for general hygiene .

3. Plan for public health and public health system .. 4. rules .
5. ENCLOSURE

PREFACE This methodical booklet is the main guideline intended for students working on their research paper about general hygiene, public health and public health system. The research paper is prepared all through the 4 semesters. The research paper is written in accordance with the general medical educational program in which every student is asked to write about his/her country of origin. The purpose of this research paper is to assess, analyze and review statistical data obtained from the WHO, UNICEF and other international organizations or from other sources that the student may have access to. Students working on their research paper should consult various statistical handbooks and publications from their country of origin or any international relevant publication. The sources of information are available at libraries, embassies, governmental agencies of the country under question, senior students of the same country and any other relevant sources. The purpose of the research paper is to help the student develop skills of independent work, critical analysis, draw critical conclusion and consolidate these various data into a written from. Tasks required for the research paper: 1. Apply methods of independent analysis of statistical data about hygiene and public health system of the respective country of origin; 2. Study peculiarities of data about the health conditions of the populations of the country in question as well as comparing these data with other countries; 3. Research the main social-hygiene problems that the student encountered in his country of origin. 4. Analysis of the public health, public health system of the country. 5. Development of planning skills of different activities where the student would make a conclusion and provide suggestions in order to improve the public health system of his/her country of origin. Upon the first lectures of General hygiene and then on public health and public health system along with the laboratory works, the students will be informed about writing the research paper. Consultations are available with the teaching staff, special programs and questionnaires along with this booklet will also be provided to the student.

During the process of writing the research paper, the student is encouraged to consult with the teaching staff, professors and the chief of department. Students are required constantly refer to literature that is available at the department of hygiene, RPFUs library, Moscow libraries and any other source of information. Students in accordance with this present booklet must complete their research paper and hand it to their teacher two weeks prior to completion of the hygiene course. They will be also required to defend their work at the department of hygiene. 3rd 4th year students while studying the General Hygiene course, will be required to complete the tasks of the I IInd and bibliography chapters of the research paper. 4th- 5th year students while studying the public health and public health system course, will be required to complete the tasks of the IIIth XIIth chapters of the research paper.

SOCIAL - HYGIENIC PROBLEMS OF PUBLIC HEALTH AND PUBLIC HEALTH SYSTEM IN COUNTRIES AROUND THE WORLD

I. GENERAL SOCIAL-ECONOMIC DEVELOPMENT OF THE COUNTRY * Administrative foundation * Climate-geographic particularities * General economical growth, types of productivity (industrial and agricultural) * Working conditions of the population * Urbanization * Social-economic characteristics of residential life in a given region II.THE SOCIAL-HYGIENIC PROBLEMS OF THE COUNTRY Characteristics of nutrition General characteristics of a populations health in alignment with its nutritional habits (for example: nutrition and infantile mortality in a specific country, diseases and physical growth). Specific diseases due to nutritional insufficiency and invalidity (for example: blindness due to exophthalmia from Vit.A deficiency). Causes of mortality due to nutritional/vitamin insufficiency, hunger affecting a few groups of the population. Widespread Protein-energy insufficiency (PEI). Indicate the clinical signs of the severe forms of PEI. Provide statistical findings of the number of hospitalized children affected with PEI, and their mortality rate as well as the widespread PEI of your own country. Provide the mortality rate of children 1-4 years old suffered from diarrhea and parasitic diseases, with nutritional insufficiency being the causative factor. Illustrate these findings in a table under the following heading: Demonstration of nutrition related child mortality from ages 1-4. Birth body weight and nutritional habits in different groups in country s population. Childs physical growth at different ages. Regime of normal nutrition recommended by WHO. Average calorie regime of adults of the country being studied in comparison to other countries. What is the main food staple by the population of that country. Provide statistic findings (table).

Consumption of animal and vegetal protein (meat, fish, milk, vegetables). Widespread alimentary anemia in that country in comparison with other countries. Widespread avitaminosis, vit.A insufficiency(exophthalmia), vit.D insufficiency (Rickets and osteomyelitis), vit.B insufficiency (beri-beri) etc. Widespread nutritional intoxication/infection due to the absence of the food quality control measures and ready-made foods (for example : salmonelosis etc..) and food poisoning from non-bacterial origins (biotoxins, fish, plants etc..). Living (Habitations) condition The data of specialists and committees of the UN about problem of living in developing countries. Describe the residential problems in your country (economically related, population growth, urban migration, growth of slums etc.). Provide the annual population growth due to urban migration in the capital of your country. Give the particularities of the living conditions in the rural areas (constructions, construction materials, inhabited area, usage of the premises, number of family members in a single house, sanitary level, general living conditions, prevention against insects and animals). Social-hygienic characteristics of the living conditions in the country, and the percentage of the population living in poverty. Electricity provided inhabited areas, level of indicators in comparison with the data of the country and others. Central water supply and canalisation in the inhabited areas. Relations between inhabitants and sanitary-hygienic characteristics as far as diseases, their spread (tuberculosis, rheumatism, intestinal infections etc.), structural reasons of mortality, physical growth, indicators of the conditions of different healthy groups within the population. Water supply and canalization in an inhabited area The spread of diseases due to poor water supply and sanitary conditions. What percentage of the countrys population has uninfected clean drinking water? Compare the data with those of other countries and the regime of the WHO. What programs are available in your country that helps improving the water supply and sanitary conditions according to the international law in drinking water and sanitary? Have there been any changes last years? Effectiveness of the WHO in the management and realization of the plans. Analyze the model concept direct and indirect effect of water supply and sanitary conditions on health. Analyze the sanitary-hygienic problems that occur in the country in connection with urbanization and industrialization. Scope levels of the countrys population with the adequate sanitary conditions (compare it with the regions under WHO). Efforts of the country to improve sanitary conditions and remove trash (canalization and backyard systems). What national plans are working and becoming reality in your country? Methods of sanitation in inhabited area (collection, removal, recycling and utilization of waste) in cities and rural areas. Sanitary laws in relation to the

environment, protecting borders and solving general hygienic nutritional problems, living conditions, water supply and cleaning of the inhabited areas. Working conditions. Hygienic characteristics of the basic types of production, level of the working population, professional hazards and diseases, their prophylaxis, organisation of the industry. III. CHARACTERTIC OF THE POPULATIONS HEALTH IN THE COUNTRY. Demographic indicators. 1. Population statistics (quantity, density, gender, age factor, formation and other information of social-economic structure of the population) 2. Population dynamics (mechanical movements of the population, birth, mortality, children mortality, infant mortality, natural population movement, natural growth, average life expectancy) Types of mechanical population movement. Internal and external migration (level, reasons). Problems brain drain to the developed countries, social-political aspects. Child mortality from the age of 1 year old (structure, reasons, levels, family role). Child mortality in other ages groups. Birth rate in the country; its reasons and factors. Programs of family planning. Visualize the main demographic indicators in the last 5 years, data of graphical presentations, analyses them and estimate them. Morbidity In agreement with the international classification of diseases, traumas, and death reasons (10th law, 1995) indicate the structures and levels of the main diseases and mortality of a population. The main points should be the transmission of infectious diseases, their levels, spread, analysis and the dynamic data of the last 5 years. Analysis and estimates of the most commonly found diseases among children from ages of 1-4 years and 5-14 years (structure, levels and reasons). Give the main indicators of the diseases in the last 5 years, graphical data presentation, estimation and their analysis. Estimate the levels of health and diseases in a family in different programs. Physical growth.

Physical growth of children and teenagers (main information). Perspectives of growth indicators, physical growth in relation with nutrition and lifestyle. Problems of hereditary diseases. Estimate the child physical growth, take a family genesis, write down its family tree, indicate the basic factors that will be transmitted onto the next generation and will cause family pathologies. . Disability Provide information about the commonly found disabilities in the population and in a given family. Estimate its structure, level and reasons of growth of disability in the population. IV. ORGANISATION OF THE PUBLIC HEALTH NATIONAL SERVICES Estimate the characteristics of public health: Governmental services, contractbased care insurance (mandatory and supplementary), and private care services. Service relations. Activity of these governmental sectors. The system of public health in the country. Structure of the public health ministry with provision of services (treatment, sanitary, pharmaceutical etc). Direction of the structure of public health and medical services in towns and rural areas. Give the dynamics of the last 5 years where the main characteristics of the treatment-prophylactic network, the outpatient departments and polyclinics, general, specialized and rural hospitals. Main relationship between the different types and levels of hospitals. What main establishments of PMCP do you have in your country? Give the characteristics of the most typical medical establishments, showing the first medical-sanitary help (center of public health, dispensaries, rural out-patients department, centers of protection provided to the health of the mother and the child and others). The radius of main services provided by PMCP establishments. Give the characteristics of bed provisions in the hospital to the population (number of beds per 10000 persons (in the last year) Give the estimated structure and volume of medical care to the family. V. SERVICES PROVIDED TO MOTHERHOOD AND CHILDHOOD IN THE COUNTRY. Provide the female and child ideal weight in relation with the with country s population. Ideal weight of females of childbearing age (15-49 years) and younger primigravidae (15 years and younger).

Presence of working women in the industry, ideal weight of working class women. Spread of polygamy. The basic family types. Tabulate the basic characteristics of the types of the families in the population. Schooling systems and types of schools as well as the schooling age. Main laws in the areas of services provided to mothers and children in the country. Types and forms of OMD in the towns and rural areas, organisations of its relations, particularities of its structure. Immunization given to the children. Practice and systems of family planning. What are the main establishments and services of public health are there in the programs for family planning. (Service centers provided to the health of the family, special consultations, coordinations of services, affectivity, problems faced). Give the characteristics of the working member in the area of a planned family and its functions. What is the ideal weight of a female of childbearing age who is taking contraceptives (from statically findings)? System of delivery, duration of birth, help from medical establishments and help at home with the help of medical personnel and without them. Family reproductive system. Family planning. Role played by the family in regard to the child health. VI. PUBLIC HEALTH PLANNING, FINANCIAL AND ECONONMIC PROBLEMS IN THE COUNTRY. Public health planning in the country, short and long-term plans. Main indications for planning. Public health budget, ideal public health budget in the general budget of the country. Source of medical services, prophylactic, sanitation measures. Spread of paid services. Paid services forms. Elements of medical insurance policies. Compile a table showing medical establishments in primary, secondary, tertiary medical of help and their functions. Estimate the relations between governmental, partial and insurance sectors of public health in the country. Give the estimate of the levels used by the family of partial medical care. Familys economic functions. VII. MEDICAL PERSONNEL. Describe the main following points: The learning institutes, Medical doctors training, location of the institutes and the duration of the training. The learning institutes, Nurses training and medical assistances, duration of learning. The preparation of medical staffing in your country and abroad.

 The training of family doctors and nurses. Give the characteristics of population of doctors and middle medical workers: Number of doctors per 1000 persons in the population. Number of medical nurses per 1000 persons in the population. Conditions of sanitary services given in the population: The main problems of sanitary-hygienic culture in the population in relation to the pathologies and levels of population. Sanitary-hygienic education programs (National and WHO) as well as trials performed for infectious diseases. Specialized sanitary establishments in the country, the most commonly found forms and methods Forms and methods of sanitary establishments (illustrate the material found in your country) Preparation of sanitary activity (programs, work of the medical personnel, their participation, practice and different forms of learning). Estimate the role-played by the family in prophylaxis of diseases and sanitary enlightens by the males in the family. Medical functions of family. VIII. RELATIONS BETWEEN INTERNATIONAL ORGANISATIONS AND PUBLIC HEALTH IN YOUR COUNTRY. WHO programs, their presence in different regions and in your country, if they are put into practice, problems faced and their perspectives. Provisions of different programs (programs for the eradication of malaria, probes for tuberculosis, leprosy, family planning etc) Medical personnel education and training. Constructions of medical establishments and others. Problems of health in the family and growth of family medicine abroad. IX. PUBLIC HEALTH DEVELOPMENT PERSPECTIVES. Main social-hygienic measures in reducing diseases, mortality and improvement of services to the health of the population (opening of new medical establishments; increasing the amount of patients beds; quality of doctors and medical staff; increase of finance from the governmental budget for public health and others- give concrete information). Question of public health growth in the governments documentations, constitutions and others. Improvement of family medicine in the government agenda and orders from the public health ministry.

X. ANALYSIS, CONCLUSIONS AND SUGGESTIONS. It is necessary to provide a full analysis of the given information: dates of the characteristics of demographic process and diseases in the population, estimation of the given indicators of health in the country, define the tendencies of its growth. Give your own suggestions about improving public health in the country and level of its future use and participations. XI. CONCLUSION XII. BIBLIOGRAPHY

ENCLOSURE TITLE PAGE

RUSSIAN PEOPLES FRIENDSHIP UNIVERSITY MEDICAL FACULTY Department of Social hygiene and organizational healthcare Chief of department: Prof. Dimitri Ivanovich Kicha Chief of Department Professor Dimitri Ivanovich Kicha

Research paper intended for the course of GENERAL HYGIENE, PUBLIC HEALTH AND PUBLIC HEALTH SYSTEM

Complex course work for hygiene, public health and public services

SOCIO-HYGIENIC PROBLEMS OF PUBLIC HEALTH AND PUBLIC HEALTH SYSTEM IN COUNTRIES OF THE WORLD .Sociohygienic problems in a healthy population and public health......(name of country)

Name of student: Group: Name of teacher: Submitted in dept.:

Moscow 2007 1. Structure of the research paper 5 points Title page 0,5 point, Contents 0,5 point, Preface 1 point, Conclusion and suggestion 1 point, Bibliography 1 point, The main chapters of the research paper 1 point. Shows the main problems and the aim this research work. Your own mind about problems and perspectives of development of the country 20 sources

2. Contents of the main chapters 2.1. Preface 2.2. Conclusion and suggestion 2.3. Bibliography 2.4. The main chapters
CHARACTERTIC OF THE POPULATIONS HEALTH IN THE COUNTRY ORGANISATION OF THE PUBLIC HEALTH SYSTEM MOTHER AND CHILD HEALTH CARE IN THE COUNTRY PUBLIC HEALTH PLANNING, FINANCIAL AND ECONOMIC PROBLEMS IN THE COUNTRY MEDICAL STAFF

15 point 1 point 3 point 1 point 10 points 2 points 2 point 2 point 1 point

1 point

RELATIONS BETWEEN 1 point INTERNATIONAL ORGANISATIONS AND PUBLIC HEALTH SYSTEM IN THE COUNTRY PUBLIC HEALTH 1 point DEVELOPMENT PERSPECTIVES

In common for the research paper - 20 point. Excellent 18-20 points (90% and more)

Good 15-17 points (from 75 to 90%) Satisfactory 12-14 points (from 60 to 75%) Unsatisfactory less then 12 points (less then 60%)