Brief note on Community Health in India

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Community health is defined more broadly and encompasses the entire gamut of community-organized efforts for maintaining, protecting and improving the health of the people. It involves motivation of the individual and groups to change the pattern of behavior. In addition, it also seeks to plan medical care to achieve optimal health of the members of community as a whole. Previously, the subject of community health was covered in Hygiene, Public Health or Preventive and Social Medicine.

In community health, instead of studying individuals as a patients, it is essential to understand that:

i. The patient represents the community.

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ii. Diagnosis of disease in the community, (referred to as community diagnosis) is essential.

iii. Planning treatment for the community is the objective.

For example, a single case of a cholera patient detected in a village is a danger signal. It shows that the disease is present in the community, there may be many cases of it and unless checked its spread will grip the whole village. So the appropriate measures for treatment and control of the disease are planned in advance. Since it is a water-borne disease, water sources— river, wells or underground water are examined for infection and accordingly treated. In addition, necessary treatment for the affected people and precautions such as vaccination for vulnerable people is also done. Community diagnosis may require relevant data such as given below. These are collected and interpreted.

i. Age and sex distribution in the population under study and its distribution in social groups—in the community.

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ii. Crude birth rate, infant mortality rate, maternal mortality rate, child death rate, prenatal mortality rate and neonatal post-neonatal death rate, etc.

iii. Incidence and prevalence of certain diseases in the area.

Besides investigating health problems, it is also essential to find out the various social and economic factors in the area influencing the above data. This helps in identifying the basic health needs and health problems faced by the community. After studying all the problems, the priorities are established and community action is planned. This involves a health service system which plans for improvement of water supplies, immunization, health education, control of specific diseases and it requires health legislations. Such health services are planned at individual level, family level and at the level of community. It is also essential that health care must be planned in such a way that it could be easily utilized by all and encourage people to participate. Another positive feature of community action is that it brings co­ordination between voluntary organizations and government agencies engaged in overcoming similar problems.

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