Sociology of Family Planning

MIRO GifNumPooLoo CEEMI

1. Myths:
i. Children are gift of God.
ii. The number of children is decided by God.
iii. Children are poor man’s wealth.
iv. Children will look after you during your dependency.
2. Increase in status of women.
3. Raise the age of marriage.
4. Old age security.
5. Compulsory Education to raise the IQ
6. Employment opportunities
7. Economic development is the best contraceptive.
8. Mass education and communication about small family benefits.
9. Incentives & Disincentives

Any 7 with brief description 7 marks.

Only enumeration of points 4 marks

Draw schematic Diagram of methods in Health Communication

PerCo-HomVi-PerLet//LeDeDiscuss- GroSyPaSe- WoRoCo//TRIN-PriDi-PoFoHeam

 IPHS: Sub-centres, Primary Health Centres & Community Health Centres
Sub-centre PHC CHC
Objectives 1.Basic general & MCH 1.Comprehencive 1. Emergency & routine care in surgery,
services medicine, ObGyn & paediatrics.
primary health care
1mark 2.Acceptable standard of quality of care
3. To make the services more responsive & sensitive to the needs of the community.
Types Type A: All services except Type A:< 20 deliveries
the delivery services.
1 mark Type B: All services including Type B: 20 or more
the delivery services. deliveries.
Beds Type B: 2-4 6 30
Manpower Type A Type B Type A Type B
ANM/HWF 1-2 2-3 1 1 1
HWM 1 1 1 1
Sweeper 1- part time 1-full time 1 1 5
Nurse-midwife - - 3 4 19
MO-MBBS - - 1 1 6+1(Dentist)+1 (AYUSH)
Pharmacist 1 1 3+1(AYUSH Pharmacist)
Lab Technician 1 1 3
HAM - - 1 1
HAF - - 1 1
ACCT/DEO 1 1 2
Multi-skilled - - 2 2
Group D worker
Consultants Surgeon-Physician-
1 each Ophthalmologist-
Obstetrician-Paediatrician-
Anaesthetist-PHM-Ayush-1
1 Each Dhobi-OPD attendant-Mali-
OT Technician-Accountant
others Chaukidar-5, Aya-5,
Wardboys-5,Reg clerk-2
Radiographer-2,Dresser-2
Ophthalmic assistant-1
Services
Common Medical-MCH-FP-MTP-IEC-School health-Adolescent health-Nutrition services-Scientific collection &
disposal of solid post-Collection & Reporting of vital events-Promotion of sanitary latrines-Testing of
water quality-National health Programmes-Appropriate and prompt referral-Record of vital vents-
Training-Prevention and control of locally endemic diseases-IDSP-Monitoring & Co-ordination
Specific -PHC & Promotion of medicinal herbs PMR-MDR-Basic lab services-Select surgical
CHC procedures
Specific -CHC - - Blood storage services
Specialist serivices-RTI/STI
Marks Distribution: Objectives-1 mark, Manpower 2 (PHC & SC), 3(CHC) Functions-3 marks Types-1mk

Enumerate Food Borne Diseases

 Food-borne Infections
 Bacterial diseases: Typhoid fever, Paratyphoid fever, Salmonellosis, Staphylococcal
intoxication, CJ.perfringens illness, Botulism, Cereus Food Poisoning, E.coli diarrhoea, Non-
cholera vibrio , V.parahaemolyticus,Streptococcal infection,Shigellosis,Brucellosis.
 Viral diseases: Hepatitis A and E, Norovirus Gastroenteritis.
 Parasites: Taeniasis, Hydatidosis, Trichinosis, Ascariasis, Amoebiasis, Oxyuriasis
1 mark each, Total 3 marks

Food-borne intoxications
1. Due to naturally occurring toxins in some foods:
a. Lathyrism (beta oxalyl amino-alanine)
b. Endemic ascites (Pyrrolizidine alkaloids).
2. Due to toxins produced by certain bacteria: a. Botulism b. Staphylococcus poisons
3. Due to toxins produced by some fungi:
a. Aflatoxin b. Ergot c. Fusarium toxins

4. Food-borne chemical poisoning:

a. Heavy metals, e.g., mercury (usually in fish), cadmium (in certain shellfish) and lead (in canned food)
b. Oils, petroleum derivatives and solvents (e.g., Trycresyn phosphate or TCP)
c. Migrant chemicals from package materials
d. Asbestos
e. Pesticide residues (DDT, BHC)
1 mark each, Total 4 mark

Triangle of Epidemiology & Advanced Triangle of Epidemiology

Head Triangle of Epidemiology Advanced Triangle of Epidemiology

Applies To Communicable Diseases Non-Communicable Diseases
The 3 angles Agent-Host-Environment Agent-Host-Environment
Agent factors Bacteria-viruses-parasites-fungi- Overnutrition-Undernutrition-Physical inactivity-
Helminths etc. Alcohol-Tobacco-chewing etc.
Host factors Age-sex-marital status-occupation- Risk groups like Pregnant women, Paediatric &
habits geriatric age groups, Occupations, Habits etc.
Environmental Contaminations of Water, milk, Contaminations of Water, milk, foods by chemical
factors foods by pathogens, insects, and toxins, Air Pollution, Poor housing etc.
overcrowding etc.
Time Incubation Period, Duration Latent Period, Duration
Applications 1.Useful for the study of communicable & non-communicable diseases
2. Offers various modes of interventions.
3. Quantification & prioritization of risk factors.
Agent 2 marks, host 2 marks, environmental factors 2 marks, Applications, Any 2. 1 mark

Diet to Prevent Cancers

1. Dietary fat
High fat intake accounts for high incidence of colonic cancer.
Fat consumption is also associated with breast cancer. 0.5 Mk

2. Dietary fibre
Risk of colon cancer is decreased by increasing the food fibres. 0.5mk

3. Micronutrients
Vit A protects against cancer lung.
Vit C protects from cancer stomach by inhibiting nitrosamines formation.
Trace elements deficiency like selenium is also implicated in the Etiology of cancers.
Food additives & contaminants
Nitrosamines cause certain cancer stomachs.
Saccharin & Cyclamate are weak bladder carcinogens.
Aflatoxin is a carcinogenic metabolite.
Coffee intake has been associated with bladder cancers and pancreatic cancers. 0.5 mk

4. Alcohol
Alcohol contributes 3% of all cancer deaths.
Heavy drinking increases the risk of liver cancer.
Beer consumption may be related to cancer rectum. 0.5 Mk

OR

5. Foods Cancer Patients should avoid 1 mark

1. Spicy Foods + Acidic Foods
2. Avoid unpasteurized milk, undercooked eggs, and cheese
3. Raw or Undercooked Meat [Colo-rectal cancers]
4. Processed Foods like Chips, Baked goods, Deli meats, Fried foods & artificial ingredients
5. Junk foods [Food items high in fat-salt-sugar.]

6. Foods Cancer Patients Should Eat 1mark

1, Vegetables
2. Healthy Carbs like grain brown rice, nuts and seeds, bran, and oats.
3Choose foods that are high in omega-3 fatty acid
4. Plant-Based Protein: like beans, peas, whole soy foods like tempeh or edamame, and lentils.
Embrace Dairy Alternatives like oat, almond, or cashew-based products.

Diet to Prevent Hypertension

1. Salt should be less than 5 grams/day, preferably less than 10 mmols/day.
[North Japanese consume highest salt (400 mmols/day).Hypertension is
highest in North Japanese. Some African tribes where salt intake is barely 60
mmols/day have no hypertension.]
2. Focus on heart-healthy foods
 Vegetables, such as spinach, broccoli, and carrots
 Fruits, such as apples, oranges, and bananas
 Fish, particularly those rich in omega-3 fatty acids
 Fat-free or low-fat dairy products, such as curd.
 Whole grains, such as brown rice and whole-grain bread
 Nuts and beans
3. Limit saturated and Transfats like Fast food, and frozen food. Saturated fats
should be less than 10% of total energy intake.
4. Eat more potassium like Bananas, spinach, and tomatoes, Fruit juices.
6. Cut back on alcohol, caffeine & smoking
7. Try the DASH eating plan: The DASH diet includes foods that are rich in potassium,
calcium and magnesium. The diet limits foods that are high in sodium, saturated fat and
added sugars.
8. Prudent Diet 2 marks

DM & Diet
1. Diabetics eat on an average of 1000 C more than a non-diabetic.
2. Diabetic patients should use moderate/Low glycaemic index foods.
3. Diabetics should have frequent small quantity meals
4. Excess alcohol damages pancreas and may be associated with type II Dm.
5. Eat fresh fruits and vegetables. They have low GI.
6. Eat whole grain and bran breads.
7. Deficiency of chromium, copper & Zinc may be associated with diabetes.
8. Malnutrition (protein deficiency) may be involved with pathogenesis of some forms of
diabetes. 2 marks

Obesity & Diet

1. Obesity is associated with over nutrition.
2. Obese people should have salads to fill the stomach.
3. Fibre rich food is healthy.
4. Obese people should learn to bear hunger, without which
weight loss is not possible.
5. It is important to regularly maintain the log book of Weight
record.
6. Mother and wives should also be counseled that ‘to be fat is
not a sign of a healthy.
7. Patient should be counseled about the hazards of obesity.
8. Follow prudent Diet. Follow Balanced diet. 2 marks

Glycemic Index
The glycaemic index (GI) is expressed as a ratio comparing the blood glucose
increase caused by a test food to that of a reference food (usually glucose) for 2
hours following ingestion.

G.I=Area under the Curve for Test Food x 100/ Area under the Curve for Reference Food

2 marks

GLYCEMIC INDEX VALUE/Example

Low GI 0 – 55 soyabean,fruit juice
Moderate GI 56 – 69 Pulses, Grains
High GI ≥ 70 Sugar, Potato, Rice

2marks

1st Internal Assessment Examination

Community Medicine
Total Duration: 2 Hours Total Marks: 50 [Section A (MCQs) +B (SAQs4+LAQ1)]
Abbreviations used are standard Community Medicine abbreviations.
SECTION B
Short answer questions (Answer any 4 out of 5) (7x4=28
Marks)
1 Sociology of family planning
2. Draw schematic diagram of methods in Health Communication
3. Indian Public Health Standards for Community health centres
4 Enumerate food borne diseases.
5. Compare the triangle of epidemiology and the advanced model of the triangle of
epidemiology.

Long answer question

(1x12=12 marks)

Diet to prevent Diabetes mellitus. 2 marks

Diet to Prevent Hypertension. 2 marks
Diet to prevent Obesity. 2 marks
Diet to Prevent to Cancers. 2 marks
Define Glycaemic Index. Classify foods on the basis of glycaemic index. 4 months