1. PUBLIC HEALTH
Prepared by:
SAgun PAudel
Health Assistant
Student of BPH @ LA GRANDEE International college, Simalchour
Pokhara, Nepal
Presented with:
Suraj pant
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2. Prevention & Control of Malnutrition,
STIs & Cancer........
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3. Malnutrition:
General concept:
Malnutrition is defined as a pathological state resulting from relative or
absolute deficiency or any excess of one or more essential nutrients.
It comprises four forms:
 Under nutrition: results when insufficient food is eaten over long time.
 Over nutrition: consumption of excessive quantity of food over a long
time.
 Imbalance: pathological condition resulting from a disproportion
among essential nutrients with or without the absolute deficiency of
any nutrients.
 Specific deficiency: state resulting from a relative or absolute lack of
individual nutrients.
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4. Preventive measures:
There is no simple solution to the problem of PEM. Many types of
action are necessary. The preventive measures can be described in
following ways:
Prevention at different level:
Prevention at family level:
 Encourage exclusive breast feeding of infants for first 4-5 years
completely.
 Additional nutritive supplementation introduce by age of 4-5
months,
 As much as milk, meat, eggs, or foods of biological value as family
can afford should be offered.
 Adequate immunization.
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5. P
U
B
L  Restriction of feeding in fever and diarrhea should be encouraged.
I  Maternal care and ANC & PNC visit also plays a role to minimize or
prevent malnutrition.
C
 Equal distribution of nutritive foods among male & female children.
 Minimize or keep far from maternal malnutrition & other infectious
H diseases such as malaria, TB, diarrhea etc.
E
A
L
T
H
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6. C
L
A
S
S Prevention at community level:
A
S  Promotion of health through health intervention & education in community to
S reduce the malnutrition.
I  Non formal education for pre- school age children, lactating mother and
G
pregnant women.
N
M  Nutritional education & mass communicative approaches.
E  Early detection of malnutrition and intervention.
N
T
 Vigorous promotion of family planning.
 Income generation activities.
P  Integrated child development services (ICDS).
R
E
S
E
N
T
A
T
I
O
N
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7.  Food fortifications;
 Iodination of salts.
 Supplementation of vitamin A.
 Distribution of iron-folic acid. Etc.
 Anthropometric assessment of the developing children such as:
 Height
 Weight
 Mid upper arm circumference
 Head circumference
 Weight for height etc.
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8. Prevention at national level:
 Good nutritional planning, implementation & also evaluate the success.
 Nutritional rehabilitation services.
 Nutritional intervention programs such as Distribution of iron and folic
acid tablet to pregnant mother.
 Good Nutritional supplementation strategy.
 Rural development & Stabilization of population.
 Diet and nutrition surveys should be carried out.
 Increase agricultural/ food production & appropriate fortification &
formulations.
 Nutritional surveillance to detect the cause, character & magnitude of
nutritional problems. Etc.
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9. C
L
A
S
S
Prevention at international level:
A
S
S  Food & nutrition are global problems. International
I cooperation in solving problems of malnutrition.
G
N
 Plays important role in mitigating the effect of acute
M emergencies caused by floods & droughts.
E  Multilateral coordination with organizations such as: WHO,
N
T FAO, UNICEF, WORLD BANK, UNDP etc.
P
R
E
S
E
N
T
A
T
I
O
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10. Preventive levels & interventions:
 Primordial & primary prevention:
 Health promotion:
 Measures directed to pregnant & lactating women (education, distribution,
and supplementation).
 Promotion of breast feeding.
 Development of low cost weaning foods: the child should be made to eat
more food at frequent intervals.
 Measure to improve family diet.
 Nutritional education: promotion of correct feeding practices.
 Home economics.
 Family planning & spacing of births.
 Family environments.
 Specific protection:
 The child’s diet must contain protein and energy- rich foods, milk, eggs,
fresh fruits should be given if possible.
 Immunization.
 Food fortification.
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11. Secondary prevention:
 Early diagnosis & treatment:
 Periodic surveillance.
 Early diagnosis of any lag in growth.
 Early diagnosis & treatment of infections & diarrhea.
 Development of programmes for early rehydration of children with
diarrhea.
 Development of Supplementary feeding programmes during epidemics.
 De-worming of heavily infested children.
Tertiary prevention:
 Rehabilitation:
 Nutritional rehabilitation services.
 Hospital treatment.
 Follow-up care.
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13. Sexually transmitted diseases:
General Concept:
 The sexually transmitted diseases (STD) are a group of communicable
diseases that are transmitted predominantly by sexual contact and caused
by wide range of bacteria, viruses, protozoan, and fungal agents and ecto
parasites.
 Some Examples are:
 Gonorrhea, syphilis, chancroid, genital herpes, Chlamydia trachomatis,
candidaisis etc
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14. Primary prevention:
 Health education & promotion:
 Health education is an integral part of STI control & prevention
programmes.
 To help individual alter their behavior in an effort to avoid STIs.
 Minimize disease acquisition and transmission.
 The target group may be general public, patients, priority groups,
community leaders etc.
 Personal prophylaxis:
 Information system:
- The basis of effective control programme of any communicable disease is the
existence of an information system.
- prerequisite for effective programme planning, coordinating, monitoring &
evaluation.
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15. Secondary prevention:
 (Early diagnosis & treatment)
 Case detection: it is an essential part of any control programme.
 Screening: it is the testing of apparently healthy volunteers from the
general population for the early detection of disease.
 Cluster testing.
 Case holding & treatment: every effort should be made to ensure complete
and adequate treatment.
 STI clinic & laboratory facilities: adequate laboratory facilities & trained
staff are essential for proper patient management. An ideal service is one
that is free, easily accessible to patient & available for long hours each day.
 Clinical follow up.
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16. Tertiary prevention:
 Reduce impairments, minimize disabilities & suffering.
 STI is the main cause of pelvic inflammatory disease. So we can prevent in
tertiary level.
 Stop & minimize other complications.
 Disability limitations.etc.
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17. At individual level:
Personal prophylaxis:
 Mechanical barriers e.g. condom& diaphragm can be recommended
for Personal prophylaxis against STIs.
 Promotion of safer sex behavior.
 Provision of condoms at affordable prices.
 Making the condom accessible.
 Reducing rates of partner.
Vaccinations: e.g. hepatitis B etc
The 4C’s:
 Compliance: completing all the treatment as prescribed.
 Counseling / education: about the disease & STIs.
 Contact tracing: making sure all the sexual partners are
encountered to get treatment.
 Condom: promotion & how to avoid catching STIs again.etc.
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18. :
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19. At National level:
Initial planning:
 Control programmes have to be designed to meet the unique needs
of each country & to be in line with that country’s health care
system, its resources & priorities.
Problem definition:
 Disease problem must be defined in terms of prevalence,
psychosocial consequences, and other health effects- by
geographical areas & population groups.
Prevention & Control of
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Malnutrition, STIs & Cancer........

20. P
R
E
V Establishing priorities:
E
N
TI
 Rational planning requires establishment of priorities.
O
N  Depends upon health problem considerations (magnitude,
&
consequences).
C
O  Availability of resources. Social & political commitment.
N
T
R  Priority group may also categorize e.g. age, sex, place of
O
L residence, occupation, etc.
O
F
Setting objectives:
M
A
L
 Priorities must be converted into discrete, achievable &
N
U measurable objectives.
T
RI
TI
 Broad coverage of the population is crucial for STI control.
O
N Considering strategies:
,
S
TI  Define the mixture of interventional strategies which are most
S
& appropriate.
C
A
N
C
E
R
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22. Cancer:
General concept:
 Cancer may be regarded as a group of diseases characterized by;
 Abnormal growth of cells.
 Ability to invade adjacent tissues & even distant organs.
 The eventual death of the affected patient if the tumor has progressed
beyond that stage when it can be successfully removed.
 Cancer can occur at any site or tissue of the body & May involved any type
of cells.
 Major categories are;
o Carcinomas (mouth, Esophagus , intestine, uterus etc)
o Sarcomas( fibrous tissue, fat, bones)
o Lymphomas (bone marrow, immune system).
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23. Preventive measures:
At least one-third of all cancer cases are preventable. Prevention offers
the most cost-effective long-term strategy for the control of cancer.
Cancer control consists of series of measures based on present medical
knowledge in the fields of prevention, detection, diagnosis,
treatment, aftercare & rehabilitation.
aimed at reducing significantly the number of new cases, increasing the
number of cures and reducing the invalidism due to cancer.
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24. Primary prevention:
 Control of being Physical inactivity, dietary factors, obesity and being
overweight:
 Dietary modification is important approach to cancer control. There is a
link between overweight and obesity to many types of cancer
(esophagus, colon-rectum, breast, endometrial and kidney).
 Diets high in fruits and vegetables may have a protective effect against
many cancers. Conversely, excess consumption of red and preserved
meat may be associated with an increased risk of colorectal cancer.
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25.  Healthy eating habits that prevent the development of diet-associated
cancers will also lower the risk of cardiovascular disease.
 Regular physical activity and the maintenance of a healthy body weight,
along with a healthy diet, will considerably reduce cancer risk.
 National policies and programmes should be implemented to raise
awareness and reduce exposure to cancer risk factors, and to ensure that
people are provided with the information and support they need to adopt
healthy lifestyles.
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26.  Control of Alcohol & tobacco consumption:
 Alcohol use is a risk factor for many cancer types (oral cavity, pharynx,
larynx, esophagus, liver, colon-rectum and breast).
 Risk of cancer increases with the amount of alcohol consumed &
substantially increases if the person is also a heavy smoker.
 Maintenance of personal hygiene:
Can prevent the cancers such as; cancer of cervix.
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27. C
L
A
S
S
 Prevention from infections:
A
S
S  Infectious agents are responsible for almost 22% of cancer deaths in the
I
G developing world and 6% in industrialized countries.
N
M
E  Viral hepatitis B and C cause cancer of the liver; human papilloma virus
N
T infection causes cervical cancer.
P  The bacterium Helicobacter pylori increases the risk of stomach
R
E Preventive measures include vaccination and prevention of infection and
S infestation.
E
N
T
A
T
I
O
N
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28.  Prevention from Occupational carcinogens:
 More than 40 agents, mixtures and exposure circumstances in the working
environment are carcinogenic to humans and are classified as occupational
carcinogens .
 Occupational Carcinogens are causally related to cancer of the lung,
bladder, larynx and skin, leukemia and nasopharyngeal cancer.
 Occupational cancers are concentrated among specific groups of the
working population, for whom the risk of developing a particular form of
cancer may be much higher than for the general population.
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29. Preventive approaches to Environmental pollution:
 Environmental pollution of air, water and soil with carcinogenic
chemicals cause cancer.
 Exposure to carcinogenic chemicals in the environment can occur
through drinking water or pollution of indoor and ambient air.
 Prevention from Ultraviolet (UV) radiation & other ionizing & non
ionizing Radiation.
 Cancer education: preventive health education.
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30. Secondary prevention :
 Cancer registration:
 Cancer registration provides a base for assessing the magnitude of the
problem and for planning the necessary services.
 Cancer registrations are of two types i.e. hospital-based & population
based.
 cancer screening:
 In light of the present knowledge, early detection & prompt treatment of
early cancer & precancerous conditions provide the best possible protection
against cancer for the individual & community.
 Early detection of cases:
 Early detection programme will require mobilization of all available
resources & development of a cancer infrastructure starting at the level of
primary health care, ending with complex cancer centers or institutions at
the national levels.
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31. C
L
A
S
S  Treatment:
A
 Certain form of cancers is amenable to surgical removal; while some others
S are respond favorably to radiation or chemotherapy or both.
S
I  Multi-modality approach to cancer control has become a standard practice
G
N in cancer centers.
M
E
 A largely neglected problem in cancer care is the management of cancer
N pain.
T
P
R Tertiary prevention:
E
S  Disability Limitation.
E
N  Rehabilitation.
T
A  Reduce impairments, minimize disabilities & suffering.
T
I  Prevent from invade adjacent tissues & even distant organs.etc.
O
N
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33. धनयवाद ………………
Prevention & Control of
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Malnutrition, STIs & Cancer........

34. Prevention & Control of
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Malnutrition, STIs & Cancer........