Public Health Flashcards
Risk
Likelihood that a harmful event may take place
Hazard
Environmental stressors with capacity to do harm
5 categories of hazards
- physical
- chemical
- biological
- ergonomic
- psychosocial
Hierarchy of control
- eliminate
- substitute
- engineer controls
- administrative controls
- personal protective equipment
Why needle stick injuries often occur
- stress
- overwork
- careless attitudes
Explain universal precautions
Treat all body fluids as if they are infectious
4 levels of TB prevention for health workers
- facility level (surveillance)
- administrative (triage, cough etiquette)
- environmental (ventilation)
- personal protective equipment (respirators)
Possible obstacles to health care for refugees
- fear of arrest
- not speaking language
- fear of discrimination
- rejection by staff
- lack of local knowledge
- lack of resources
- depression/PTSD
- not treated with dignity
- cultural alienation
Refugees rights from the bill of rights
- no one may suffer discrimination on grounds of birth
- everyone has right to access to health care services
- right to environment that is not harmful to health
- children’s right to basic health services
Patient’s rights charter rights
- access to health care
- choice of health services
- confidentiality and privacy
- informed consent
- continuity of care
- healthy and safe environment
- participation in decision making
- knowledge of health insurance/ medical aid scheme
- treated by a named health professional
- refusal of treatment
- a second opinion
- complaints about health services
Medical practitioner’s responsibilities to refugees
- provide assistance and info in how to lodge a complaint
- facilitate registration as a legal refugee
- act as intermediary between refugee and human rights commission
- have a positive attitude
- do a thorough clinical evaluation
- orient towards NGOs for psychosocial services
United Nations definition of a refugee
Includes all asylum seekers feeling prosecution, including those who have not been afforded refugee status by another country
Expectations a patient can have according to the PRC
- receiving timely emergency care
- treatment and rehab made known and understood
- provision of special needs
- palliative care that is affordable and effective
- positive disposition displayed by health care workers
- health info given in language understood by patient
10 priorities in emergencies
- initial assessment
- water and sanitation
- food and nutrition programmes
- shelter and site planning
- measles immunizations
- curative activities
- control of other communicable diseases and epidemics
- surveillance system
- human resources and training
Objectives of initial assessment
- assess magnitude of emergency
- assess health priorities in terms of
- basic needs
- main killers
- outbreaks with high CFR
Definition of sentinel surveillance
A sentinel surveillance network facilitates the collection of data outside the scope of routine health data
- constitutes selected healthcare centres/workers who submit data toast centralized point
- eg SASPREN
Advantages of sentinel surveillance
- likely to be more complete
- provides more accurate info that is better quality
- generally less costly to run
Limitations of sentinel surveillance
- might not be representative of total population
- denominator not always known (difficult to calculate rates)
- could be underestimation of numerator (not all diseased visit sentinel sites)
What a doctor using sentinel surveillance needs to do
- confirm diagnosis
- communicate info to patient
- obtain consent to forward info to SASPREN
Purposes of health surveillance
- estimate magnitude of health prob
- identify risk groups
- establish long term trends
- detect epidemics
- document effect of interventions
- facilitate health system planning
- resource allocation
- provide info describing the natural history of a disease
- monitor changes in infectious agents
- setting research priorities
- morbidity and mortality reporting
Problems assoc with routine surveillance programs
- inconsistent diagnoses
- overcounting
- under reporting
- under reporting certain groups
- incomplete details
- inefficient admin systems
- delayed action with data
- no feedback to health care providers
- quality of data often poor
Definition of surveillance
Continued watchfulness over the distribution, trends and incidence of disease and risk factors through the systemic collection, collation and analysis of relevant data
What makes a disease notifiable
- epidemic prone (cholera)
- new/emerging disease
- environmental/zoonoses (rabies)
- preventable (measles)
- control programme priority (TB)
Why blinding is important
- to minimize bias in selection of groups
- in equal treatment of the trial
- in measurement of the outcomes
