Community health has been defined as the science and art of preventing disease, prolonging life and promoting health, through organized efforts and informed choices of society and organization in a defined community.
In many institutions the Department of Community Health is variously referred to as Preventive Medicine, Social and Preventive Medicine, Community Health and Nutrition, Community Health and Epidemiology or Public Health. We prefer the terminology “Community Health” because it is more encompassing thus reflecting the concept of health and disease pattern in the Community, unlike the individual pattern orientation emphasized in other specialties.
The Department of Community Health, University of Benin was established in 1973 as one of the Clinical Departments of the School of Medicine, with Staff compliment consisting of Head of Department (a clinician), research fellows, Sociologist and Nutritionist. Since then the Department has expanded and continues to combine teaching, research, community outreaches and training programs within set out Departmental objectives for undergraduate and post graduate training in addition to rendering Consultancy services, which the Department continues to uphold a high standard for and deliver effectively.
The Community Health Department addresses factors that maintain health (e.g. Nutrition), the identification and description of health related events and conditions in terms of frequency of occurrence, distribution, determinants and deterrents within a defined community (epidemiology) and ways of controlling them through well-articulated intervention such as treatment, health education, etc.
The Department is organized in such a way that it embraces the following sub-specialties such as: Medical Statistics, Public Health Nutrition, Health Education and Community Mobilization, Family Health/Reproductive Health, International Health, Environmental Health, Occupational Health, Health Management, Epidemiology of communicable and non-communicable disease, Social and Rehabilitative Medicine. The undergraduate courses are taught from 200 level through to 600 level at the end of which students sit for the Part IV MB:BS Examinations;
At the end of the undergraduate programme in Community Health, the student should have acquired knowledge, attitude and required skills to carry out the following:-
- Describe the principles of health care delivery for a community and articulate the concept of community health practice.
- Apply the principles of medicine to the maintenance of the health of the community.
- Describe the major ecological and social factors affecting human health.
- Plan, organize and implement health interventions e.g immunization programmes, health education etc.
- Prevention and control major communicable diseases in the community or in institutions.
- Use of epidemiological, demographic and medical statistical methods in the assessment and reporting of health problems in a community.
- Advise on environmental health including water supply and waste disposal.
- To acquire knowledge and skill in public health policy planning and administration, and play a leadership role in its performance.
- To health educate the public on common health problems.
- Describe the principles of dietetics and nutrition for all age and communities.
- Describe the major public health laws that are applied by the health authorities in the community.
- Advice on personal health maintenance and prevention of disease at all levels in a community.
- To strengthen medical learning and education through evidence based interest in research.
- To be conversant with medical ethics guiding medical research and practice.
- To carry out a one year research project in any area of Medicine.
This is itemized as follows and covers the following areas:
- Definition, concepts and history of community health in Africa and in the world.
- Human ecology and factors affecting health.
- Family structure and factors affecting health.
- Health statistics
- Principles of epidemiology
- Environmental health
- Introduction to community health
- Epidemiology and control of communicable and non-communicable diseases including practical exercises, entomological and parasitological laboratory work
- Principles of public health administration, management and planning
- Family health services; maternal, infant and under-five children, adolescent health, school health, occupational and geriatric health services.
- Epidemiology and control of chronic diseases, tuberculosis, leprosy, National Control Programmes.
- Social security, effect of social and economic changes on health
- Public Health Nutrition
- Health Education
Community Health Courses (with Course credit), Postings and Examination
The following courses are offered by the Department:
- Demography and Medical Statistics (COH 212) are taught during the 1st Semester of the 2nd medical year. The Course carries 2 credit units.
- Medical Sociology, Social/Rehabilitative Medicine and Environmental Health (COH 222)is taught during the 2nd semester of the 2nd medical year. The course carries 2 credit units.
- Family Health/School Health/Public Health Nutrition and Health Education (COH 322) is taught during the second semester of the 3rd medical year and carries 2 credit units.
- Epidemiology (COH 412) carries 6 credit units and is taught in the 1st semester of the 4th medical year.
- Occupational Health (COH 422) carries 3 credit units and is taught in the 2nd semester of the 4th medical year.
- Management of Health Services, International Health, Primary Health Care, Research Methodology and Medical Ethics (COH 512). Lectures are given during the 1st semester of the 5th medical year. It carries 3 credit units.
- Urban Posting / One year project (COH 522). This course carries 6 credit Urban postings is carried out during the 2nd semester in the 5th medical year
- Rural Posting, Completion of One year project, Revision and Part IV MB; BS Examination (COH 612). This course is carried out during the 1st semester of the 6th medical year. It carries 6 credit units.
- of the 6th medical year. It carries 6 credit units.
|First Semester (Credit Units)||Second Semester (Credit Units)||Total Credit Units|
|MED 200 Level||COH 212 (2 Credit Units) – Demography and Medical Statistics||COH 222 (2 Credit Units) – Medical Sociology, Environmental Health, Social/ Rehabilitative Medicine||4|
|MED 300 Level||COH 322 (2 Credit Units) -Family Health – School Health -Public Health Nutrition -Health Education||2|
|MED 400 Level||COH 412 (6 Credit Units) – Epidemiology of communicable & non communicable disease||COH 422 (3 Credit Units) Occupational Health||9|
|MED 500 Level||COH 512 (3 Credits Units) – Management of Health Services, International Health, Primary Health Care, Research Methodology and Medical Ethics||COH 522 (6 Credit Units) – Urban (Junior) Posting and One year Project||9|
|MED 600 Level||COH 612 (6 Credit Units)- Rural (Senior) Posting, Completion of One year Project Part IV MB.BS Examination||6|
|Total Credit Units||17||13||30|
The above courses carry a total credit load of 30 credit units. These courses begin from 200 to 600 level. The urban and rural postings last for 8 weeks respectively. These posting lay emphasis on clinical, laboratory public health practice as well as rural medical practice. At the end of each semester, there is an end of semester examination and credit points are earned by each student.
End of semester and posting examinations form the continuous assessment of the students’ progress, which is 30 percent of the total marks for the Final MBBS examinations in Community Health. The final examination is taken in 1st semester of the 6th medical year and there is a repeat examination 3 months after.
Details of specific courses are given below:
Course COH 212: Demography and Medical Statistics (2 Credit Units)
200 Level First Semester:
Introduction to Community Health and Specialties in Community Health.
Demography: Definitions, uses, population composition by age, sex, occupation, ethnicity, etc and population size.
Population dynamics: fertility, mortality, migration, population growth and projection.
Demographic transition, World population policies: Malthusian theory of population, National population policy
Census: National and Local
Introduction to statistics: Type of data, sources of data and uses of statistics. Health and vital statistics: sources. International classification of diseases, Uses of statistics in Medicine
Community diagnosis: Morbidity surveys, Tools for data collection.
Measures of Health and Disease: Crude and specific rates
Patterns of distribution:Gaussian curve and other distributions
Types of variables, Presentation of statistical data:Tables, histograms, pie and bar chart, graphs, scatter gram
Measures of central tendency and dispersion
Population samples and sampling techniques, table of random numbers
Contingency tables – Tests of significance: P value, Chi-square test, Z- Test, Students t test, Confidence intervals etc
Routine and immediate notification of disease: Cancer registration
Course COH 222: Medical Sociology, Social and Rehabilitative Medicine/Environmental Health (2 Credit Units).
200 Level First Semester:
Introduction to Medical Sociology: Definitions of Health, Diseases, Sickness and illness.
Culture and Health, Traditional practices, taboos etc
Family systems, marriage types and stability
Socio-economic status and Health (Type of societies, social class, educational status, occupation, etc)
Recreation, sleep, religion and health;
Educational status and Health.
Family Systems, Role Differentiation,
Ageing and health, Dependency/working populations, unemployment, retirement and social security.
Beliefs, Values and Societal Norms, Superstitions, Religions and Health,
Social deviancy: Alcoholism, smoking, Drug/substance abuse
Social Services: Orphanages. Care of the elderly, remand homes, prisons.
Introduction to Environmental Health, classification of the environment, environmental sanitation.
Public Health Law,
Housing and Health – ventilation, floor space, etc.
Waste disposal, disposal of the dead, control of vectors and reservoirs of Infection.
Water sanitation – WHO water programmes, disinfection
Air hygiene and control of atmospheric pollution
Course COH322: Family Health, School Health, Public Health Nutrition and Health Education (2 Credit Units).
300 Level Second Semester:
Introduction to family health: Maternal and Child health care services. Family planning and family planning methods: National population policy.
Health need of a child: Infant welfare clinic.
Nutrition and Health, National breast feeding policy
Care of handicapped children.
The “at risk concepts in maternal and child health”
National programme on immunization; National immunization schedule
Safe motherhood initiative
Integrated management of childhood illness
Classification of food/food values: beliefs and taboos, etc
Infant feeding and weaning practices
Assessment of nutritional status in the community,
Epidemiology and control of nutrition related disease – Kwashiorkor, marasmus
Vitamin related disease – Trace elements/minerals and diseases e.g. goitre, myxoedema, cretinism, dental caries
Diet in the aetiology and management of disease e.g. diabetes, liver failure cardiovascular diseases.
Epidemiology and control of obesity and anaemia
School Health Programme – Aims and Objectives, School Health Environment, School Health Education, Care of handicapped Children
Health Education: Principles, Methods and Strategies.
Health Education in the control of communicable and non-communicable disease;
Course COH 412: Epidemiology of Communicable and Non-Communicable Diseases (6 Credit Units).
400 Level First Semester:
Definition of Epidemiology – Principles and Methods – Uses
Principles and Prevention – Isolation, quarantine, surveillance
Control of Communicable and Non-communicable diseases
Epidemiology and control of helminticinfection (Nematode, Cestodes, Trematodes
Epidemiology and control of Tuberculosis and leprosy
Epidemiology and control of Schistosomiasis
Epidemiology and control of sexually transmitted infections including HIV/AIDS
Epidemiology and control of arthropod born disease – e.g. yellow fever, Dengue fever exotic disease
Epidemiology and control of Tyrpansosomiasis
Epidemiology and control of Malaria
Epidemiology and control of Zoonotic disease e.g. rabies, anthrax, brucellosis
Epidemiology and control of diarrhoeal diseases.
Epidemiology and control of cholera, Typhoid, paratyhoid, bacillary and Amoebic dysentery
Epidemiology and control of airborne infection e.g. measles, mumps, chickenpox
Epidemiology and control of filarial infections e.g. Loasis, Onchocerciasis, Wuchereria bancrofti
Epidemiology and control of nosocomial infection
Epidemiology and control of genetic and congenital diseases e.g sickle cell disease, albinism, mongolism, spina bifida
Epidemiology and control of accidents RTA and home accidents
Epidemiology and control of Disaster- Natural disasters, chemical spills etc
Epidemiology and control of substance abuse- Hard drugs, smoking and alcoholism
Epidemiology and control of juvenile delinquency
Epidemiology and control of asthma and peptic ulcer disease
Epidemiology and control of malignant diseases lung, breast, cervix, leukemia, hepatoma
Epidemiology and control of Cerebrospinal meningitis
Course COH 422: Occupational Health (3 Credit Units).
400 Level Second Semester.
Principles of occupational health; Introduction, history and definitions of occupational and industrial health;
Organization of occupational health services aims and objective. Occupational hazards: pneumoconiosis,
Problems of agricultural workers, problems of workers in industries, Industrial legislation: Factory’s act, workman compensation acts etc.
Safety/Prevention and control: Specific control measures,
Environmental and biological monitoring, industrial medical examination, health education in industry,
Course COH 512:Management of Health Services, International Health, Primary Health Care, Research Methodology and Medical Ethics (2 Credit Units).
500 Level Second Semester
Principles, scope and nature of health Services, Level of health care
National Health Policy
Organization of Health Services: Federal, State and LGAs in Nigeria
History and Principles of Primary Health Care
Strategies for the Implementation of Primary Health Care
The Health Team
PHC institutions – Medical Officer of Health
The Bamako Initiative
Health Services Management – Definition – History – Elements, levels of health services management
Planning of Health Services (Cybermetic cycle)
Staffing, leadership styles, control of health services
Management of resources
Budgeting in health services management
Organizing and evaluation of health services
Current national control programmes
Project Writing 1 – Choice of Topic – Introduction/Literature Review
– Aims and Objectives
International health/Port health
International Health Organization/International Health Agencies e.g. WHO, UNICEF, ILO etc.
Project Writing II – Material and Methods – Questionnaire Design
Project Writing III – Presentation of Results – Discussion, conclusion and recommendation– Referencing
Referral System in Health Care delivery
Introduction to Medical Ethics: Foundation theories in ethics, Regulation of medical and dental practices in Nigeria.
General principles of Ethics of ethics of medical and dental practices in Nigeria, Misconduct, Negligence, etc.
Course COH 522: Urban (Junior) posting and One year project (6 Credit Units).
500 Level Second Semester.
Urban Postings (8 weeks intensive course): Concept of Community diagnosis to help assess and quantify the magnitude of health problems, factors that contribute to these health problems, for appropriate community prescription and treatment.
Specific steps for community diagnosis and treatment, the principle for community survey, analysis, write up and presentations are taught with practical field experiences.
It also entails field visits to places of public health importance across sub-specialties of Community Health with report writing and presentations. Guest Lectures from Public Health Departments and Agencies
Executive summary of findings is sent to the Executive Chairman of the Local Government Area of survey and other relevant stakeholders.
At the end of the urban posting the students (individually or in groups) would have undertaken the following activities;
- Submit type written group reports on local demographic survey of a census enumeration are (CEA) in Benin City.
- Visit places of public health importance in Edo State and submit individual type written reports on all the visits, observations made during the visits are compared with the ideal, with recommendations made to address the Gaps identified. The visits will also be presented to the whole department by the sub-groups that conducted the visits.
- Conduct a school health survey in a primary school and secondary school in the CEA. The aims of the survey should include:
- Evaluation of the general health status of the children
- Inspection of the school facilities for meals, water supply, sanitation, play, class rooms, etc.
- Determine their concepts of health and disease and their attitude to illness.
- Design and give health talk to pupil based on findings.
- Conduct survey of interest for each sub group.
- Data Management using SPSS and Epi info statistical soft wares
- End of posting presentation to department
- Carry out end of posting examination.
Submit the urban posting reports with the completed survey materials to the supervising lecturer on the last day of posting.
Course COH 612: Rural (Senior) Posting, Completion of One year Project (6 Credit Units)Part IV MB.BSExamination.
600 Level First Semester.
Rural (Senior) Posting (8 weeks intensive course).
Rural posting (8 weeks)
The rural posting is focused on a defined community and identifying their health related events and problems and proffering appropriate interventions to solving them. It lays emphasis on principles and implementation of PHC in a defined Rural Community in Edo State. It entails the following;
- Community Entry: Identifying relevant stakeholders and soliciting their cooperation and participation in identifying their health needs and finding solutions to them.
- Community diagnosis:
- Methods in practical Epidemiology
- Methods of formal and informal data collection
- Availability of health and social services
- Utilization of health and social services
- Identifying and prioritization of health needs (felt and real needs)
- Implementation of health programme following resource mobilization with appropriate community mobilization and participation in addition to formulation and drawing up budget for a Primary Health care plan.
- Evaluation of health programmme
- Client response
- Changes in morbidity and mortality patterns.
- Emphasis is given to all components of Primary Health Care
- Conduct similar surveys carried out in urban posting such as conduct of demographic characteristics and health seeking behaviour surveys in a defined community
- Data Management using SPSS and Epi info statistical soft wares
- Comparative assessment of urban and rural survey findings
- Departmental presentation of surveys by sub-group
- General revision on all courses taught in community health
- Submission of posting reports and other relevant documentation fortheposting.
Specific steps for community Diagnosis
- History taking for the community diagnosis
- Assessment of community health problems
- Prevalence study of disease problems
- Incidence study of disease problems
- KAP studies on prevailing health conditions / programmes
- Assessment of environmental health status in communities, etc
Specific steps for community Intervention
- Assessment of health problems
- Assessment of available resources
- Needs assessment
- Organization of health care delivery
- Monitoring and evaluation of progress on intervention implementation.
The students are expected to submit a report at the end of the posting.
Course objectives for Urban and Rural posting
At the end of posting course the student should possess the knowledge, attitude and skill to:
- Diagnose the health problems of a defined community
- Develop a primary health care plan for the defined community
- Deliver the components services of primary health care
- Provide essential curative care for common conditions at the primary health care center in a defined community
- Assess the nutritional status, manage nutritional problems and teach sound nutritional practice at the level of primary health clinic and defined community.
- Provide immunization services to a defined community
- Provide maternal health services, including family planning ,at primary health clinic level and in a defined community
- Give health education to individuals, groups and communities
- Identify and propose solutions to health related problems in a defined community
- Describe the epidemiology of locally endemic diseases and provide appropriate preventive and curative services at the level of primary health care centre and a defined community
- Identify and plan for the provision of essential drugs required for primary health care services for a defined community.
- Manage, monitor and evaluate the implementation of primary health services for a defined community.
- Implement appropriate training programme for health personnel and members of the community for the delivering of primary health care services.
Assessment and Conduct of Examination
It is the responsibility of the student to ensure that:-
- He/She attends all lectures, which must be certified and signed by the respective lecturers.
- All clinical activities are carried out by (the student and signed by the Supervisors).
- He/She attains a minimum of seventy percent(70%) of all the activities at the urban and rural postings in order to qualify to sit for the MB:BS part IV Examinations in Community Health.
Students are also required to carry out one project under lecturer supervision on any topic in Medicine. Topics must be approved by Lecturers at the beginning of the First Semester of 500 Level and completed during the Second Semester.
Quarto size bound project duly certified by project Supervisor, in the departmental colour of NAVY BLUE, must be submitted before the CLOSING DATE; given by the department. This is a mandatory requirement for the award of the MB; BS degree.