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Concepts in Public He Alth: A Case Study of Protein Energy Malnutrition (PEM)
Concepts in Public He Alth: A Case Study of Protein Energy Malnutrition (PEM)
Ò Belongs to Scheduled
caste
Ò Has four daughters, out of which 2 are under five yrs age
É Female gender
É Rural area
É Illiterate mother
Underweight
mother
Fre quent
Low birth
pre gnancies U
we ight
Large family R
B
s ize
Pove rty A
N
Concurrent I
illness of s iblings Z
Inadequate Poor living A
e nergy intake condition T
Poor pe rs onal I
hygiene O
N
Re current Wrong
infections bre astfeeding Illiteracy
practices
Proximate causes
Non-functional Incomplete Distant causes
Anganwadice ntre Immunization Indirect causes
WAS MALNUTRITION PREVENTABLE?
Yes
Non-functional
Anganwadice ntre
Underweight
mother
Fre quent
Low birth Large family
pre gnancies
we ight s ize
Pove rty
OUTSIDE THE HEALTH
Poor living SYSTEM
condition
Illiteracy
Urbanization
CONCEPTS OF DISEASE CAUSATION
Ò Traditional Bio-medical concept
É Disease caused due to the presence of causative agents
É Basis in Germ theory of disease
Ò Socio- Epidemiological Concept
É Causative agents alone may/may not be sufficient for disease occurrence
É Social factors important in the disease causation & progression
Ò Politico- Developmental Concept
É Comprehensive approach, puts health in the context of politico-
developmental situations
É Effects of government policies & outfalls of development on disease
occurrence,
É Stems from the multi-factorial causation of disease
12
Traditional Bio-Medical Concept
Inadequate
energy intake
Recurrent
Low birth
Malnutrition in ARI/GI tract
weight children infections
Decrease immunity
13
Socio- Epidemiological Concept
Poverty & Illiteracy Large family size/
no contraception use
Inadequate Wrong
energy intake Breast
Under- feeding
weight
practices
mother
Recurrent
Low birth
Malnutrition in ARI/GI
children tract
weight
infections Incomp-
lete
No access Immuni-
to govt. Worm
zation
health infestation
facility
Poor environmental
Poor personal hygiene conditions
14
Politico- Developmental Concept
Uncontrolled Urbanization
18
19
BHORE COMMITTEE
“The physician of tomorrow will be
Ò naturally be concerned with the promotion of the new e ra of social
me dicine
Ò scientist and social worker
Ò re ady to cooperate in te am work
Ò in close touch with the pe ople he se rves
Ò a frie nd and le ader
Ò directs all his e fforts towards the prevention of dise ase and
Ò be comes a the rapist whe re prevention has broken down
Ò the social physician
Ò Protecting the pe ople, and Guiding the m to a he althier and happier life”.
BHORE COMMITTEE REPORT(1 9 4 6 ) He alth Survey & De ve lopme nt Committe e , Govt .of India
20
CRITICAL APPRAISAL
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